Margaret M. Byrne, Ph.D.
Research Associate Professor of Epidemiology & Public Health
Description of Research
Dr. Byrne’s research interests focus on medical decision making in a variety of settings. Previous work included collaboration on a study of patient preferences for treatment of prostate cancer, which include preference elicitation and knowledge assessment (VA SDR 93-007), as well as on a study of racial differences in preferences for osteoarthritis treatment (AHRQ 5P01 HS10876-022000). Her career development award from NCI explored the consequences of and decisions about lung cancer screening in high risk individuals (NCI K07CA101812). As PI, she has recently completed a study describing cancer patients’ attitudes, knowledge and perceptions of participation in cancer clinical trials (Bankhead Coley Research Program Grant 07BP-01-12333), and discussions of clinical trials on the NCI Cancer Information Service (CIS) call line. Currently her funded research as PI includes work on decision making in the following areas: developing a decision aid to improve decision making about participation in cancer clinical trials in minority cancer patients (RC2 MD004784); examining decision making in lung cancer screening (R21 CA139371); and decision making about behavior during situations of Florida Red Tide (R21 ES017413). In addition, she is involved in research that explores the effectiveness and ethics of financial incentives for study participants.Highlights
- Recommendations and barriers to screening colonoscopy - A large majority of physicians believe that colonoscopy is the most sensitive and thorough method for screening for colorectal cancer, yet physicians recommend the procedure to just 51 percent of patients. Difficulty in receiving approval from insurance companies for the procedure is one major reason doctors do not recommend it more often. In a survey of insurance companies, Dr. Byrne found that approximately 50 percent of companies indicated that they would cover screening colonoscopy. HMOs were just as likely to cover screening as other plans.
- Effects of lung cancer screening - Individuals who receive an indeterminate screening result are more anxious and thus typically perceive their health to be lower following a screening. In addition, their perceived risk of having lung cancer substantially increases to levels much higher than their actual objective risk. Individuals that undergo a negative screening process reduce their perceived risk of having cancer but not to objective levels.
- Participation in cancer clinical trials - Participation in cancer clinical trials is very low in Florida. Database findings using Clinical Trials Cooperative Groups data show that less than 1% of individuals with cancer in Florida participate in CTCG trials. Data from ACOS showed higher rates (around 5%). A survey of 1100 cancer patients (prostate, breast, lung, and colorectal) found that 7.6% of those surveyed reported being in a clinical trial, and this varied significantly by race/ethnicity: Whites 11.4%, Blacks 7.1%, and Hispanics 4.5%. Willingness to participate did not vary by race (approximately 33% overall). Only 11.9% reported that they had talked with someone about participating. Although 69% stated that they had not received any information on clinical trials, only 60% stated that lack of information was a barrier. The most prevalent reported barriers to participation were concerns about insurance coverage, the doctor not being encouraging, and not wanting to feel like a guinea pig. A survey of 62 oncology health care providers in Florida found that providers were very supportive of clinical trials, and believed quality time with a research nurse or MD was the best way to improve clinical trials participation.
- Discussions of clinical trials on the NCI CIS call line - Only 6.9% of all calls to the CIS during 2006-2008 included a discussion of cancer clinical trials. Discussions were more likely to occur with callers who had colorectal, GYN, or lung cancer, who had higher education, and who were repeat callers. Discussions were significantly and substantially less likely to occur with minority callers; this was particularly true for the calls that were conducted in Spanish.
Selected Cancer-Related Publications
- Brookfield KF, Cheung MC, Yang R, Byrne MM, Koniaris LG. Will patients benefit from regionalization of gynecologic cancer care? PLoS ONE 4:e4049, 2009. Read more »
- Cheung MC, Hamilton K, Sherman R, Byrne MM, Nguyen DM, Franceschi D, Koniaris LG. Impact of Teaching Facility Status and High-Volume Centers on Outcomes for Lung Cancer Resection: An Examination of 13,469 Surgical Patients. Ann Surg Oncol 16:3-13, 2009. Read more »
- Byrne MM, Daw CN, Nelson HA, Urech TH, Pietz K, Petersen LA. Method to develop health care peer groups for quality and financial comparisons across hospitals. Health Serv Res 44:577-92, 2009. Read more »
- Gutierrez JC, Koniaris LG, Cheung MC, Byrne MM, Fischer AC, Sola JE. Cancer care in the pediatric surgical patient: A paradigm to abolish volume-outcome disparities in surgery. Surgery 145:76-85, 2009. Read more »
- Johnson ML, Petersen LA, Sundaravaradan R, Byrne MM, Hasche JC, Osemene NI, Wei II, Morgan RO. The association of medicare drug coverage with use of evidence-based medications in the Veterans Health Administration. Ann Pharmacother 43:1565-75,2009. Read more »
- Yang R, Cheung MC, Hurley J, Byrne MM, Huang Y, Zimmers TA, Koniaris LG. A comprehensive evaluation of outcomes for inflammatory breast cancer. Breast Cancer Res Treat 117:631-41,2009. Read more »
Programs
Collaborating in the Multidisciplinary Research Program(s):