“...our hypothesis asked: is it true for African American patients, if they go to high volume physicians, is their quality of care naturally improved? But we found out that's not true… Then our next series of studies looked at the continuity of care. For instance, fragmented care, when they are in and out of the insurance plans or the healthcare providers. So that may be the reason…. And both recent papers concluded that lack of continuity of care was one of the driving forces of disparity in observed outcomes for African American patients.”

“So one of the things that we have observed for the last several years of our study is that African Americans continue to receive less surgery… through our PCORI study we had focus groups and one-on-one conversation with patients, we learned that the information they are getting through their community or peers or friends or their family members is maybe biased. That's one of the reasons. This is our hypothesis… That's why they end up receiving radiation therapy compared to surgery. So to rectify that and also to help them strengthen their shared decision-making tool, we educate them to build their understanding of what their preferences are, what they want to maximize in terms of quality of life attributes.”

“And one important aspect is shared decision making through the preference assessment. Numerous decision aid tools are there, but the decision aid tools that incorporate preference assessment help patients to identify their values.”