1,721,039 research outputs found
"You decide doctor". What do patient preference arms in clinical trials really mean?
No full textIt is well established that random assignment between experimental treatment and control arms is the gold standard in clinical trials to minimise differences between the groups being compared and safeguard against bias. There is, however, a fear that such random allocation may not accord with patients' preferences for the intervention or treatment, thereby compromising trial validity. It is possible that patients may resent not receiving their treatment of choice, and their negative attitude may lead to non-adherence to treatment or affect outcomes in some other way. Consequently, one option for trial designers is to include patient preference arms, whereby patients with no treatment preference are randomly allocated to experimental and control arms, while patients expressing a treatment preference are allocated to receive their preferred treatment
Patient preferences for treatment for angina: an overview of findings from three studies
No full textBackground: Access to cardiac treatments has been documented to vary with patients' age. It is unknown whether these variations reflect patients' treatment preferences. We aimed to investigate patients' preferences for cardiology treatments and develop a Patients' Preferences Questionnaire.Methods: Semi-structured interviews with primary care patients with diagnosed angina with postal follow-up. The resulting Patients' Preferences Questionnaire was tested with newly admitted inpatients with acute coronary syndrome and with patients in primary care.Results: The Patients' Preferences Questionnaire was psychometrically sound. Analyses of preference subscale scores showed that the most positive preference scores were for medication. Angioplasty scored highest at the negative end of the scale. Detailed analyses showed that older people and women were less likely to prefer coronary artery bypass surgery (CABG), reflecting its greater level of invasiveness. Older people (aged over 75 years, compared to people aged under 75 years), but not women, were also more cautious in their strength of preference for angioplasty. More positive attitudes towards CABG surgery, and more negative attitudes towards medication, were associated with greater impact of the condition on life.Conclusions: The research resulted in a psychometrically sound Patients' Preferences Questionnaire. There was some evidence to support the view that older people's weaker preferences for CABG may contribute slightly to variations in the provision of re-vascularization. There was also variation in preferences within age groups, cautioning against the assumption that all or most older people are more reluctant than younger people to undergo invasive procedures
A study of patient expectations in a Norfolk general practice
No full textOBJECTIVE: To use semi-structured interviews to ascertain patterns in patients' expectations of health care and the extent to which these expectations were met or not.
BACKGROUND: In health policy it is important to evaluate health services from varying perspectives including consumers'. One concept of emerging importance in this regard is that of patient expectations. Whether expectations are met or not have been found to be related to general patient satisfaction with treatment and treatment compliance. However, there is conceptual and methodological uncertainty and little informing empirical work regarding what is an 'expectation' and how it should be measured.
DESIGN: A qualitative study using semi-structured interviews to elicit 20 GP patients' expectations prior to their consultation. A post consultation interview gauged the extent to which these expectations had been met. SETTING AND
PARTICIPANT: Twenty patients of a GP practice in Norfolk (UK).
RESULTS: Results suggest several different expectations, concerned with the doctor-patient interaction, the specific processes of the consultation, outcomes, and issues to do with time and space.
CONCLUSIONS: This research has used an innovative exploratory approach to address the expectations of GP patients and has implications for how doctors ought to manage their consultations. These results will be used to inform the development of a quantitative expectations questionnaire so as to develop a validated measure of expectations. Such an instrument has great potential to aid in health care research and practice
Do treatment preferences for patients with angina change? An 18-month follow-up study.
No full textObjectives To assess whether preferences for patients with angina changed at 18-month follow-up using the Patient Preferences Questionnaire for Angina treatment (PPQA). Background Evidence suggests that patients want information about treatment options. Reliable measurement of patient preferences for treatment is important for empowering patients. Design Postal self-administered questionnaire survey at baseline and follow-up. The preference questionnaire comprised 18 items about the main treatments for angina: medication, angioplasty and coronary artery bypass grafting (CABG). Setting and participants Patients with diagnosed angina from seven participating general practices across England. The sample comprised 222 patients with angina who responded to both baseline and follow-up treatment preference questionnaires. Results Most patients' condition and preferences scores for treatment remained stable over 18 months. An exception was angioplasty preference scores, which indicated more negative attitudes towards this procedure over time. People aged over 75 years least preferred angioplasty. There were no associations between any changes in condition and changes in preferences. However, within-subject agreement could vary by ±5 to 7 points between baseline and follow-up, with stability apparently worst for the medication and best for surgery sub-scales, raising the question of what represents reasonable stability. Conclusion These results suggest preferences are relatively stable, even where there are changes in health, and provide further evidence of the utility (in particular, reliability) of the PPQA. However, this stability in scores did mask some movement in scale scores and in patients' first-ranked treatment choices, showing changing preferences largely from angioplasty to CABG and vice versa, indicating the complexity of preferences
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
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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