1
40
4
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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URL Address
<a href="http://doi.org/10.1046/j.1365-2753.1998.t01-1-00006.x" target="_blank" rel="noreferrer">http://doi.org/10.1046/j.1365-2753.1998.t01-1-00006.x</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
In the queue for total joint replacement: patients' perspectives on waiting times
Publisher
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Journal Of Evaluation In Clinical Practice
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Arthroplasty; Hip; Hip Prosthesis; Joint Prosthesis; Knee; Replacement; Time Management; Waiting Lists
Creator
An entity primarily responsible for making the resource
Llewellyn-Thomas HA; Arshinoff R; Bell M; Williams JI; Naylor CD; the Ontario Hip; Knee Replacement Project Team
Description
An account of the resource
We assessed patients on the waiting lists of a purposive sample of orthopaedic surgeons in Ontario, Canada, to determine patients' attitudes towards time waiting for hip or knee replacement. We focused on 148 patients who did not have a definite operative date, obtaining complete information on 124 (84%). Symptom severity was assessed with the Western Ontario/McMaster Osteoarthritis Index and a disease-specific standard gamble was used to elicit patients' overall utility for their arthritic state. Next, in a trade-off task, patients considered a hypothetical choice between a 1-month wait for a surgeon who could provide a 2% risk of post-operative mortality, or a 6-month wait for joint replacement with a 1% risk of post-operative mortality. Waiting times were then shifted systematically until the patient abandoned his/her initial choice, generating a conditional maximal acceptable wait time. Patients were divided in their attitudes, with 57% initially choosing a 6-month wait with a 1% mortality risk. The overall distribution of conditional maximum acceptable wait time scores ranged from 1 to 26 months, with a median of 7 months. Utility values were independently but weakly associated with patients' tolerance of waiting times (adjusted R-square = 0.059, P=0.004). After splitting the sample along the median into subgroups with a relatively 'low' and 'high' tolerance for waiting, the subgroup with the apparently lower tolerance for waiting reported lower utility scores (z=2.951; P=0.004) and shorter times since their surgeon first advised them of the need for surgery (z=3.014; P=0.003). These results suggest that, in the establishment and monitoring of a queue management system for quality-of-life-enhancing surgery, patients' own perceptions of their overall symptomatic burden and ability to tolerate delayed relief should be considered along with information derived from clinical judgements and pre-weighted health status instruments.
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1046/j.1365-2753.1998.t01-1-00006.x" target="_blank" rel="noreferrer">10.1046/j.1365-2753.1998.t01-1-00006.x</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1997
Arshinoff R
Arthroplasty
Backlog
Bell M
Hip
Hip Prosthesis
Joint Prosthesis
Journal Article
Journal Of Evaluation In Clinical Practice
Knee
Knee Replacement Project Team
Llewellyn-Thomas HA
Naylor CD
Replacement
the Ontario Hip
Time Management
Waiting Lists
Williams JI
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1177/0272989x9501500208" target="_blank" rel="noreferrer">http://doi.org/10.1177/0272989x9501500208</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Communicating the benefits of chronic preventive therapy: does the format of efficacy data determine patients' acceptance of treatment?
Publisher
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Medical Decision Making
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
Subject
The topic of the resource
Female; Humans; Male; Adult; Questionnaires; Aged; Middle Aged; Treatment Outcome; Patient Acceptance of Health Care; Informed Consent; Non-U.S. Gov't; Research Support; decision making; Statistical; Data Interpretation; Primary Prevention; Patient Education; Antilipemic Agents/therapeutic use; Hyperlipidemia/complications/drug therapy/psychology
Creator
An entity primarily responsible for making the resource
Hux JE; Naylor CD
Description
An account of the resource
Patients' informed acceptance of chronic medical therapy hinges on communicating the potential benefits of drugs in quantitative terms. In a hypothetical scenario of treatment initiation, the authors assessed how three different formats of the same data affected the willingness of 100 outpatients to take what were implied to be three different lipid-lowering drugs. Side-effects were declared negligible and costs insured. Subjects make a "yes-no" decision about taking such a medication, and graded the decision on a certainty scale. Advised of a relative risk reduction--"34% reduction in heart attacks"--88% of the patients assented to therapy. All other formats elicited significantly more refusals (p < 0.0001): for absolute risk difference--"1.4% fewer patients had heart attacks"--42% assented; for inverted absolute risk--"treat 71 persons for 5 years to prevent one heart attack"--only 31% accepted treatment. When the data were extrapolated to disease-free survival--"average gain of 15 weeks"--40% consented. Similar responses were obtained for descriptions of an antihypertensive drug: 89% assented to therapy when given relative risk reduction but only 46% when given absolute risk reduction. The subjects were confident in both acceptance and refusal: 93% of the decisions were rated "somewhat certain" to "completely certain." The authors conclude that patients' views of medical therapy are shaped by the formats in which potential benefits are presented. Multiple complementary formats may be most appropriate. The results imply that many patients may decline treatment if briefed on the likelihood or extent of benefit.
1995
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/0272989x9501500208" target="_blank" rel="noreferrer">10.1177/0272989x9501500208</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1995
Adult
Aged
Antilipemic Agents/therapeutic use
Backlog
Data Interpretation
Decision Making
Female
Humans
Hux JE
Hyperlipidemia/complications/drug therapy/psychology
Informed Consent
Journal Article
Male
Medical Decision Making
Middle Aged
Naylor CD
Non-U.S. Gov't
Patient Acceptance of Health Care
Patient Education
Primary Prevention
Questionnaires
Research Support
statistical
Treatment Outcome
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1200/jco.1997.15.10.3192" target="_blank" rel="noreferrer">http://doi.org/10.1200/jco.1997.15.10.3192</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Breast cancer patients' attitudes about rationing postlumpectomy radiation therapy: applicability of trade-off methods to policy-making
Publisher
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Journal Of Clinical Oncology
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Female; Humans; Adult; Canada; Aged; Middle Aged; Attitude; Patient Acceptance of Health Care; Risk Factors; Patient Satisfaction; Time Factors; Combined Modality Therapy; 80 and over; Non-U.S. Gov't; Research Support; Policy Making; Waiting Lists; Breast Neoplasms/psychology/radiotherapy/surgery; Health Care Rationing; Mastectomy; Segmental
Creator
An entity primarily responsible for making the resource
Palda VA; Llewellyn-Thomas HA; Mackenzie RG; Pritchard KI; Naylor CD
Description
An account of the resource
PURPOSE: Along with evidence, clinical policies must take patients' values into account. Particularly where evidence is limited and where assumptions of utility-maximizing behavior may not be valid, new methods such as trade-off techniques (TOTs), which allow elicitation of patients' treatment alternatives, might be useful in policy formulation. We used TOTs to assess breast cancer patients' attitudes toward two clinical policies designed to ration adjuvant postlumpectomy breast radiation therapy. METHODS: Cross-sectional interviews were performed in a tertiary cancer center. A total of 102 patients were presented with information about the side effects and benefits associated with two hypothetical decisions: (1) willingness to receive treatment elsewhere to shorten the wait for radiation therapy, and (2) foregoing radiation therapy in the face of small marginal benefits. For each scenario, a TOT was used to identify the maximal acceptable wait time (MAWT) for therapy and the benefit threshold at which the patient would forego therapy. Associations of clinical and demographic factors with these decisions were determined by regression analysis. RESULTS: Patients would be willing to wait, on average, 7 weeks before wanting to leave their city for radiation therapy, less than the 13-week delay our patients actually faced. Older patients were less willing to wait (P = .013); 46% of patients would not give up radiation therapy, even in the face of no stated benefit. Willingness to give up radiation therapy was predicted by willingness to accept delay (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.05 to 3.37) and being employed (OR, 2.61; 95% CI, 1.08 to 6.54). Patients with larger tumors were less willing to give up radiation therapy (OR, 0.57; 95% CI, 0.31 to 0.97). CONCLUSION: Even in difficult decisions such as rationing postlumpectomy breast cancer radiation therapy, TOTs can inform policy formulation by indicating the distributions of patients' preferences.
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1200/jco.1997.15.10.3192" target="_blank" rel="noreferrer">10.1200/jco.1997.15.10.3192</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1997
80 And Over
Adult
Aged
Attitude
Backlog
Breast Neoplasms/psychology/radiotherapy/surgery
Canada
Combined Modality Therapy
Female
Health Care Rationing
Humans
Journal Article
Journal Of Clinical Oncology
Llewellyn-Thomas HA
Mackenzie RG
Mastectomy
Middle Aged
Naylor CD
Non-U.S. Gov't
Palda VA
Patient Acceptance of Health Care
Patient Satisfaction
Policy Making
Pritchard KI
Research Support
Risk Factors
Segmental
Time Factors
Waiting Lists
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.7326/0003-4819-117-11-916" target="_blank" rel="noreferrer">http://doi.org/10.7326/0003-4819-117-11-916</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Measured enthusiasm: does the method of reporting trial results alter perceptions of therapeutic effectiveness?
Publisher
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Annals Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1992
Subject
The topic of the resource
Humans; Male; Adult; Attitude of Health Personnel; Questionnaires; Middle Aged; Treatment Outcome; Ontario; Outcome Assessment (Health Care); Hospitals; Risk; Teaching; Non-U.S. Gov't; Research Support; Statistical; Data Interpretation; Clinical Trials; Gemfibrozil/therapeutic use; Hyperlipidemia/complications/drug therapy/mortality; Myocardial Infarction/etiology/mortality/prevention & control
Creator
An entity primarily responsible for making the resource
Naylor CD; Chen E; Strauss B
Description
An account of the resource
OBJECTIVE: To compare clinicians' ratings of therapeutic effectiveness when different trial end points were presented as percent reductions in relative compared with absolute risk and as numbers of patients treated to avoid one adverse outcome. DESIGN: Survey, with random allocation of two questionnaires. SETTING: Toronto teaching hospitals. RESPONDENTS: Convenience sample of 100 faculty and housestaff in internal medicine and family medicine. INTERVENTION: One questionnaire presented results for three end points of the Helsinki Heart Study as separate drug trials using only absolute differences in events; the other showed the same end points as relative differences. Both questionnaires included a fourth "trial," showing person-years of treatment needed to prevent one myocardial infarction. MAIN OUTCOME MEASURE: The "trials" were each rated on an 11-point scale, from treatment "harmful" to "very effective." RESULTS: Respondents' ratings of effectiveness varied with the end point. Controlling for end point, ratings of effectiveness by the 50 participants receiving absolute event data were lower than those by 50 participants responding to relative risk reductions (P < 0.001); however, no end-point difference was more than 0.6 scale points. For a "trial" reporting that 77 persons were treated for 5 years to prevent one myocardial infarction, mean ratings were 2.3 or 1.8 scale points lower, respectively (both P < 0.001), than when the same data were shown as relative or absolute risk reductions. CONCLUSIONS: Clinicians' views of drug therapies are affected by the common use of relative risk reductions in both trial reports and advertisements, by end-point emphasis, and, above all, by underuse of summary measures that relate treatment burden to therapeutic yields in a clinically relevant manner.
1992
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.7326/0003-4819-117-11-916" target="_blank" rel="noreferrer">10.7326/0003-4819-117-11-916</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1992
Adult
Annals Of Internal Medicine
Attitude Of Health Personnel
Backlog
Chen E
Clinical Trials
Data Interpretation
Gemfibrozil/therapeutic use
Hospitals
Humans
Hyperlipidemia/complications/drug therapy/mortality
Journal Article
Male
Middle Aged
Myocardial Infarction/etiology/mortality/prevention & control
Naylor CD
Non-U.S. Gov't
Ontario
Outcome Assessment (health Care)
Questionnaires
Research Support
Risk
statistical
Strauss B
Teaching
Treatment Outcome