Abstract:
OBJECTIVE:To examine how much oncologists tell patients about the survival benefit of palliative chemotherapy during consultations at which decisions about treatment are made. DESIGN:Qualitative study in which consultations were observed and digitally recorded. SETTING:Teaching hospital and district general hospital in south west England. PARTICIPANTS:37 patients with advanced non-small cell lung cancer (n=12), pancreatic cancer (n=13), and colorectal cancer (n=12); and nine oncologists, including four consultants and five registrars. MAIN OUTCOME MEASURES:All recordings were transcribed completely, anonymised, and electronically coded with ATLAS.ti. Constant comparison was used to identify themes and patterns. The framework method of data management, in which data were charted, was used to aid transparency of interpretation. RESULTS:During the consultations, information given to patients about survival benefit included numerical data ("about four weeks"), an idea of timescales ("a few months extra"), vague references ("buy you some time"), or no mention at all. In most consultations (26/37) discussion of survival benefit was vague or non-existent. CONCLUSIONS:Most patients were not given clear information about the survival gain of palliative chemotherapy. To aid decision making and informed consent, we recommend that oncologists sensitively describe the benefits and limitations of this treatment, including survival gain.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Audrey S,Abel J,Blazeby JM,Falk S,Campbell Rdoi
10.1136/bmj.a752subject
Has Abstractpub_date
2008-07-31 00:00:00pages
a752eissn
0959-8138issn
1756-1833journal_volume
337pub_type
杂志文章,多中心研究abstract:OBJECTIVES:To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. DESIGN:Retro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f866
更新日期:2013-02-13 00:00:00
abstract:OBJECTIVE:Firstly, to assess the completeness of ascertainment in the National Congenital Anomaly System (NCAS), the basis for congenital anomaly surveillance in England and Wales, and its variation by defect, geographical area, and socioeconomic deprivation. Secondly, to assess the impact of the lack of data on pregna...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38300.665301.3A
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To determine if the macrolide clarithromycin affects mortality and cardiovascular morbidity in patients with stable coronary heart disease. DESIGN:Centrally randomised multicentre trial. All parties at all stages were blinded. Analyses were by intention to treat. SETTING:Five Copenhagen University cardiolog...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38666.653600.55
更新日期:2006-01-07 00:00:00
abstract:OBJECTIVE:To find out whether enalapril or ramipril causes the sensitivity of the cough reflex to change or symptomatic cough to develop in patients with hypertension. DESIGN:Prospective, placebo controlled, double blind, randomised crossover study. SETTING:Academic units of clinical pharmacology and medicine. PATIE...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.299.6690.13
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVES:To see whether telling peer reviewers that their signed reviews of original research papers might be posted on the BMJ's website would affect the quality of their reviews. DESIGN:Randomised controlled trial. SETTING:A large international general medical journal based in the United Kingdom. PARTICIPANTS:54...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c5729
更新日期:2010-11-16 00:00:00
abstract:OBJECTIVE:To compare the clinical effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts. DESIGN:A multicentre, open, two arm randomised controlled trial. SETTING:University podiatry school clinics, NHS podiatry clinics, and primary care in England, Scotland, and Ireland. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.d3271
更新日期:2011-06-07 00:00:00
abstract:OBJECTIVE:To confirm the findings of pilot studies that interferon alfa is an effective treatment of Europid men with chronic hepatitis B virus infection. DESIGN:Randomised controlled trial of three months treatment with interferon alfa followed by 12 months of observation. SETTING:Outpatient clinic of a tertiary ref...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.299.6700.652
更新日期:1989-09-09 00:00:00
abstract:OBJECTIVE:To compare the use and effect of a computer based information system for cancer patients that is personalised using each patient's medical record with a system providing only general information and with information provided in booklets. DESIGN:Randomised trial with three groups. Data collected at start of r...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.319.7219.1241
更新日期:1999-11-06 00:00:00
abstract:OBJECTIVE:To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN:Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING:Gothenburg, Sweden. SUBJEC...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6916.1385
更新日期:1993-11-27 00:00:00
abstract:OBJECTIVE:To examine the absolute risks or benefits on cancer associated with oral contraception, using incident data. DESIGN:Inception cohort study. SETTING:Royal College of General Practitioners' oral contraception study. PARTICIPANTS:Directly standardised data from the Royal College of General Practitioners' oral...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.39289.649410.55
更新日期:2007-09-29 00:00:00
abstract:OBJECTIVES:To assess whether and how investigators of placebo controlled randomised trials inform participants of their treatment allocation at trial closure and to assess barriers to feedback. DESIGN:Postal survey with a semistructured questionnaire. PARTICIPANTS:All investigators who published a placebo controlled ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7376.1329
更新日期:2002-12-07 00:00:00
abstract:OBJECTIVE: To compare the effectiveness of flexible sigmoidoscopy in screening for colorectal cancer by patient sex and age. DESIGN: Pooled analysis of randomised trials (the US Prostate, Lung, Colorectal and Ovarian cancer screening trial (PLCO), the Italian Screening for Colon and Rectum trial (SCORE), and the Norwe...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.i6673
更新日期:2017-01-13 00:00:00
abstract::The author is one of the medical advisers to the judge who led a government inquiry into allegations that an experimental research program at the National Women's Hospital in Auckland, New Zealand, to study the natural course of cervical carcinoma in situ had withheld conventional treatment from some patients. She ar...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6647.533
更新日期:1988-08-20 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of corticosteroid injections with physiotherapy for the treatment of painful stiff shoulder. DESIGN:Randomised trial. SETTING:40 general practices. SUBJECTS:109 patients consulting general practitioners for shoulder pain were enrolled in the trial. INTERVENTIONS:Patients were ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.317.7168.1292
更新日期:1998-11-07 00:00:00
abstract:OBJECTIVE:To determine whether inhaled salmeterol, a new long acting inhaled beta adrenergic agonist, reduces nocturnal bronchoconstriction and improves sleep quality in patients with nocturnal asthma. DESIGN:Randomised, double blind, placebo controlled crossover study. SETTING:Hospital outpatient clinics in Edinburg...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.301.6765.1365
更新日期:1990-12-15 00:00:00
abstract:OBJECTIVE:To examine the patterns of physical activity among British schoolchildren aged 11 to 16 and to assess whether the children experience the intensity and duration of physical activity that are believed to stress the cardiopulmonary system appropriately. DESIGN:Cross sectional study of a sample of children draw...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6745.203
更新日期:1990-07-28 00:00:00
abstract:OBJECTIVE:To obtain information about the computerisation of general practice in Wales, and to enable more effective planning of educational provision for doctors and other primary health care workers. DESIGN:Postal questionnaire sent to all general practices in Wales. SUBJECTS:553 general practices, of which 401 (73...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6794.93
更新日期:1991-07-13 00:00:00
abstract:OBJECTIVE:To evaluate the clinical benefit of lipid lowering drug treatment in patients with and without diabetes mellitus, for primary and secondary prevention. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Cochrane, Medline, Embase, and reference lists up to April 2004. STUDY SELECTION:Randomised, place...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38793.468449.AE
更新日期:2006-05-13 00:00:00
abstract:OBJECTIVE:To investigate whether an important football match increases stress to such an extent that it triggers acute myocardial infarction and stroke. DESIGN:Longitudinal study of mortality around 22 June 1996 (the day the Dutch football team was eliminated from the European football championship). Mortality on 22 J...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7276.1552
更新日期:2000-12-23 00:00:00
abstract::Fetomaternal haemorrhage was studied after 68 consecutive fetal intravascular transfusions performed in 20 patients with Rh isoimmunisation. alpha Fetoprotein concentration was assayed in maternal blood taken before, and immediately after each transfusion and three and 24 hours later. An increase of 50% or more in the...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6660.1379
更新日期:1988-11-26 00:00:00
abstract:OBJECTIVE:To assess the impact of a pay for performance incentive on quality of care and outcomes among UK patients with hypertension in primary care. DESIGN:Interrupted time series. SETTING:The Health Improvement Network (THIN) database, United Kingdom. PARTICIPANTS:470 725 patients with hypertension diagnosed betw...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d108
更新日期:2011-01-25 00:00:00
abstract:OBJECTIVES:To investigate the effect of Chlamydia pneumoniae infection on future development of ischaemic heart disease and mortality. DESIGN:Prospective longitudinal study. SETTING:Caerphilly, South Wales. SUBJECTS:Plasma specimens were collected during 1979-83 from 1773 men aged 45-59 years. These were tested for ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7190.1035
更新日期:1999-04-17 00:00:00
abstract::A committee of French bishops has contradicted the Vatican's condemnation of all methods of contraception by acknowledging that condom use may be necessary in order to prevent the spread of HIV and protect against AIDS. The Social Commission of the French Episcopate made this statement in a book entitled AIDS: Societ...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.312.7029.462a
更新日期:1996-02-24 00:00:00
abstract:OBJECTIVE:To investigate whether residence before and after birth near 50 Hz high voltage installations increases a child's risk of cancer and whether risk correlates with the strength of the magnetic field. DESIGN:A population based case-control study. SETTING:Denmark. SUBJECTS:1707 children under the age of 15 wit...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6909.891
更新日期:1993-10-09 00:00:00
abstract:OBJECTIVE:To investigate whether users of oral contraceptives and in [corrected] carriers of a hereditary prothrombotic condition (factor V Leiden mutation, protein C, S, or antithrombin deficiency) have an increased risk of cerebral sinus thrombosis. DESIGN:Comparison of a prospective series of cases of cerebral sinu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7131.589
更新日期:1998-02-21 00:00:00
abstract:OBJECTIVE:To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN:Cross sectional. SETTING:Denmark. SUBJECTS:323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE:Bias in dietary reporting of energy and pr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7011.986
更新日期:1995-10-14 00:00:00
abstract::In a one year prospective study within the Trent Regional Health Authority the demand for neonatal intensive care was estimated to be 1.1 cots per 1000 births. Intensive care level 1 (as defined by the British Paediatric Association and British Association for Perinatal Paediatrics) was determined by two separate tech...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6711.1305
更新日期:1989-11-25 00:00:00
abstract:OBJECTIVE:To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. DESIGN:Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7106.449
更新日期:1997-08-23 00:00:00
abstract:OBJECTIVES:To assess the performance of a panel of common single nucleotide polymorphisms (genotypes) associated with type 2 diabetes in distinguishing incident cases of future type 2 diabetes (discrimination), and to examine the effect of adding genetic information to previously validated non-genetic (phenotype based)...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b4838
更新日期:2010-01-14 00:00:00
abstract:OBJECTIVE:To describe risk factors for infantile colic. DESIGN:Questionnaire administered by health visitors. SETTING:Sheffield. SUBJECTS:Mothers of 76,747 infants born between 1 August 1975 and 31 May 1988, interviewed when the infant was 1 month old. MAIN OUTCOME MEASURES:Reporting of infantile colic and its dura...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7090.1325
更新日期:1997-05-03 00:00:00