1,720,978 research outputs found
A defense of surgical procedures regulation
No full textSince the advent of drug regulation in 1962, regulatory agencies have been in the practice of using strict standards to test the safety and efficacy of medical treatments and products. Regulatory agencies, such as the FDA, demand two full-fledged Randomized Clinical Trials demonstrating the safety and effectiveness of drugs to grant its marketing authorization. On the contrary, surgical treatments are left completely unregulated. There are several reasons explaining this difference, and all of them point to the difficulty of conducting well-designed RCTs in surgery. However, we argue that none of these arguments is decisive and that, under certain conditions, surgical RCTs can be morally justified and methodologically sound. Although ethical constraints restrict the number of testable surgical procedures, and surgical trials might not be as dependable as pharmaceutical RCTs, our analysis suggests that, in certain cases, it is possible to obtain high-quality evidence about the safety and efficacy of surgical procedures. Untested surgical treatments may prove to be ineffective and harm patients. Therefore, regulation of surgical procedures seems not only morally acceptable and able to provide reliable scientific evidence, but also desirable and justified from an ethical-political standpoint
Introduction: Foundations of Clinical Reasoning – An Epistemological Stance
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Disentangling Responsibility: Perspectives on Dementia Prevention From Stakeholders in Canada, Germany and Switzerland
No full textABSTRACT Dementia prevention has become a priority in medical research and public health. Various medical, social and environmental risk factors have been identified; however, medical studies, media discourses and health policies predominantly centre on individual‐level prevention and promote personal responsibility for maintaining cognitive health. This emphasis on individual preventive efforts faces increasing criticism for being ethically problematic, medically insufficient and reflective of a neoliberal responsibilisation of (cognitive) ageing. Our study, based on 64 semi‐structured qualitative interviews with stakeholders involved in dementia research, care and health policy from Canada, Germany and Switzerland, situates the preventive turn within contemporary ageing cultures and welfare policies. By examining the epistemic and normative arguments underlying current debates on dementia prevention, we illustrate how stakeholders justify both personal and governmental responsibilities in preventing dementia. Although managing and mitigating various risk factors throughout life is often framed as a matter of personal responsibility, many stakeholders advocate combining individual‐level prevention with population‐level efforts to address social inequalities that affect the risk of developing dementia. Drawing on the interview study, we highlight the importance of recognising the political and normative foundations and implications of dementia prevention strategies.Santé https://doi.org/10.13039/501100000156Canadian Institutes of Health Research https://doi.org/10.13039/501100000024Bundesministerium für Bildung und Forschung https://doi.org/10.13039/501100002347Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung https://doi.org/10.13039/50110000171
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Why do we need randomized controlled trials? Medical scandals and the evolution of drug regulation
Full text linkPerché abbiamo bisogno degli studi randomizzati e controllati (RCT)? Finora, le risposte a questa domanda si sono concentrate principalmente sulle loro virtù metdologiche. In breve, abbiamo bisogno degli RCT perché questi sono il modo migliore per valutare la sicurezza e l'efficacia dei farmaci. Ma questa risposta è solo parzialmente soddisfacente, non spiega infatti perché mai vogliamo testare i farmaci prima che possano essere commercializzati e perché vogliamo farlo in modo così rigoroso. In questo articolo analizzo le ragioni che hanno portato gli RCT a diventare il 'gold standard' della
ricerca clinica. Tali ragioni sono il risultato dell'interazione di preoccupazioni storiche, organizzative
e socio-politiche. Concentrandomi sulla storia della regolamentazione dei farmaci negli Stati Uniti, sostengo che i cambiamenti e le riforme sono stati attuati in risposta a grandi scandali farmaceutici, e non solo in risposta alle reali esigenze epistemiche emerse con gli sviluppi della ricerca farmaceutica. Nello specifico, mostro che gli
scandali hanno giocato un ruolo cruciale nell'innescare una serie di riforme della regolamentazione dei farmaci, e quindi nel plasmare la metodologia della ricerca clinica
contemporanea
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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