The standard of care debate: can research in developing countries be both ethical and responsive to those countries' health needs?


:To avoid exploitation of host communities, many commentators argue that subjects must receive the best methods available worldwide. Others worry that this requirement may block important research intended to improve health care, especially in developing countries. To resolve this dilemma, we propose a framework for the conditions under which it is acceptable to provide subjects with less than the best methods. Specifically, institutional review boards should assume a default of requiring the "worldwide best" methods, meaning the best methods available anywhere in the world, in all cases.However, institutional review boards should be willing to grant exceptions to this default for research studies that satisfy the following 4 conditions: (1) scientific necessity, (2) relevance for the host community, (3) sufficient host community benefit, and (4) subject and host community non-maleficence.


Am J Public Health


Wendler D,Emanuel EJ,Lie RK




Has Abstract


2004-06-01 00:00:00














  • Exercise prescription: a clinical trial.

    abstract::To assess the effectiveness of physician prescribed exercise, health education, and patient self-monitoring, 124 firefighters were medically screened and randomly allocated to a control and two treatment groups. Physiologic and reporting methods were employed to assess adherence to regular exercise at three months and...

    journal_title:American journal of public health

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Reid EL,Morgan RW

    更新日期:1979-06-01 00:00:00

  • Immunization and the American way: 4 childhood vaccines.

    abstract::Childhood immunization constitutes one of the great success stories of American public health in the 20th century. This essay provides a historical examination of this topic through 4 particularly important examples: diphtheria, pertussis, polio, and measles. Each case study illustrates how new vaccines have posed uni...

    journal_title:American journal of public health

    pub_type: 历史文章,杂志文章


    authors: Baker JP

    更新日期:2000-02-01 00:00:00

  • What people really know about their health insurance: a comparison of information obtained from individuals and their insurers.

    abstract:OBJECTIVES:This study determined the validity of self-reported data on selected health insurance characteristics. METHODS:We obtained telephone survey data on the presence of health insurance, source of insurance, length of time insured, and type of insurance (managed care or fee-for-service) from a random sample of 3...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Nelson DE,Thompson BL,Davenport NJ,Penaloza LJ

    更新日期:2000-06-01 00:00:00

  • Physical activity and coronary heart disease in middle-aged and elderly men: the Honolulu Heart Program.

    abstract::The relationship of physical activity to the development of definite coronary heart disease was examined separately in middle-aged (45-64 years) and elderly men (65-69 years) participating in the Honolulu Heart Program. After 12 years of follow-up, results indicate that increased levels of physical activity reported a...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Donahue RP,Abbott RD,Reed DM,Yano K

    更新日期:1988-06-01 00:00:00

  • Recruitment activities and sociodemographic factors that predict attendance at a mammographic screening program.

    abstract::A random sample of 2266 women aged 50 to 69 years was used to investigate factors that predict attendance at a free Australian mammographic screening program. The most important predictor was receipt of a personal invitation letter. A letter that included an appointment time increased attendance 132-fold initially and...

    journal_title:American journal of public health

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Hurley SF,Huggins RM,Jolley DJ,Reading D

    更新日期:1994-10-01 00:00:00

  • Side effects of diphtheria-tetanus toxoid in adults.

    abstract::During a mass diphtheria-tetanus immunization campaign in November 1975, more than 220,000 doses of diphtheria-tetanus toxoid, adult type were administered to adults throughout Alaska. In Anchorage, where more than 87,000 doses were given, a survey was conducted to determine the frequency of side effects. Postcard que...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Middaugh JP

    更新日期:1979-03-01 00:00:00

  • Epidemiology of alcohol abuse in military and civilian populations.

    abstract::Results from a random sample survey of US Air Force personnel show that 4.6 per cent exhibit alcohol dependence, indicated by symptoms of withdrawal and impaired control over drinking. An additional 9.3 per cent can be identified as nondependent alcohol abusers, indicated by serious adverse effects of drinking (such a...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Polich JM

    更新日期:1981-10-01 00:00:00

  • Grab a Cup, Fill It Up! An Intervention to Promote the Convenience of Drinking Water and Increase Student Water Consumption During School Lunch.

    abstract:OBJECTIVES:We evaluated a low-cost strategy for schools to improve the convenience and appeal of drinking water. METHODS:We conducted a group-randomized, controlled trial in 10 Boston, Massachusetts, schools in April through June 2013 to test a cafeteria-based intervention. Signage promoting water and disposable cups ...

    journal_title:American journal of public health

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Kenney EL,Gortmaker SL,Carter JE,Howe MC,Reiner JF,Cradock AL

    更新日期:2015-09-01 00:00:00

  • Life-style and death patterns of the Missouri RLDS church members.

    abstract::Members of the Reorganized Church of Jesus Christ of Latter-Day Saints (RLDS) are dissuaded from the use of tobacco, alcohol, and hot drinks. A well-balanced diet is also stressed. This study compares the 1972-78 mortality experience of the Missouri RLDS with three other population groups. The findings show Missouri R...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: McEvoy L,Land G

    更新日期:1981-12-01 00:00:00

  • Health care reform and social movements in the United States.

    abstract::Because of the importance of grassroots social movements, or "change from below," in the history of US reform, the relationship between social movements and demands for universal health care is a critical one. National health reform campaigns in the 20th century were initiated and run by elites more concerned with def...

    journal_title:American journal of public health

    pub_type: 历史文章,杂志文章


    authors: Hoffman B

    更新日期:2003-01-01 00:00:00

  • Impact on Nonfirearm Deaths of Firearm Laws Affecting Firearm Deaths: A Systematic Review and Meta-Analysis.

    abstract::Background. There is debate whether policies that reduce firearm suicides or homicides are offset by increases in non-firearm-related deaths.Objectives. To assess the extent to which changes in firearm homicides and suicides following implementation of various gun laws affect nonfirearm homicides and suicides.Search M...

    journal_title:American journal of public health

    pub_type: 杂志文章,meta分析


    authors: Smart R,Schell TL,Cefalu M,Morral AR

    更新日期:2020-10-01 00:00:00

  • Factors influencing the health and wellness of urban aboriginal youths in Canada: insights of in-service professionals, care providers, and stakeholders.

    abstract::We addressed the positive and negative factors that influence the health and wellness of urban Aboriginal youths in Canada and ways of restoring, promoting, and maintaining the health and wellness of this population. Fifty-three in-service professionals, care providers, and stakeholders participated in this study in w...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Yi KJ,Landais E,Kolahdooz F,Sharma S

    更新日期:2015-05-01 00:00:00

  • Polysubstance Use Among US Women of Reproductive Age Who Use Opioids for Nonmedical Reasons.

    abstract:OBJECTIVES:To determine the prevalence and patterns of polysubstance use among US reproductive-aged women who use opioids for nonmedical purposes. METHODS:We used the National Survey of Drug Use and Health (2005-2014) data on female respondents aged 18 to 44 years reporting nonmedical opioid use in the past 30 days (u...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Jarlenski M,Barry CL,Gollust S,Graves AJ,Kennedy-Hendricks A,Kozhimannil K

    更新日期:2017-08-01 00:00:00

  • Gender differences in cigarette smoking and quitting in a cohort of young adults.

    abstract:BACKGROUND:Smoking among young women is associated with a variety of negative health outcomes. Gender specific influences on smoking, quitting and attempting to quit are hypothesized to occur and may have implications for cessation programs. METHODS:Telephone surveys were conducted in a large (n = 6,711) cohort of you...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Pirie PL,Murray DM,Luepker RV

    更新日期:1991-03-01 00:00:00

  • Fear of dying and HIV infection vs hepatitis B infection.

    abstract::Accidental exposure to the blood of hepatitis B patients produced less fear than does accidental exposure today to the human immunodeficiency virus (HIV), even though both have an approximately equal overall risk of death (approximately 1%). Subjects responding to hypothetical insect-exposure and disease-exposure scen...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Schneiderman LJ,Kaplan RM

    更新日期:1992-04-01 00:00:00

  • Occupational carpal tunnel syndrome in Washington State, 1984-1988.

    abstract:BACKGROUND:There are no published population-based studies of occupational carpal tunnel syndrome (OCTS) using a strict case definition. Most studies are either industry specific or present patient self-report of symptoms. METHODS:We conducted a population-based incidence study of OCTS using the Washington State Worke...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Franklin GM,Haug J,Heyer N,Checkoway H,Peck N

    更新日期:1991-06-01 00:00:00

  • Revisiting the effect of the Pap test on cervical cancer.

    abstract:OBJECTIVES:This report documents the effect of not having had a Papanicolaou (Pap) test on survival with uterine cervical squamous carcinoma. METHODS:Data were derived from Charity Hospital of Louisiana at New Orleans Tumor Registry reports for 1984-1987 and 1996. RESULTS:During the 5 study years, 101 of 213 women (4...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Holmquist ND

    更新日期:2000-04-01 00:00:00

  • Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study.

    abstract:OBJECTIVES:We sought to estimate the effects of recreational physical activity and back exercises on low back pain, related disability, and psychological distress among patients randomized to chiropractic or medical care in a managed care setting. METHODS:Low back pain patients (n=681) were randomized and followed for...

    journal_title:American journal of public health

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Hurwitz EL,Morgenstern H,Chiao C

    更新日期:2005-10-01 00:00:00

  • Controlled trial of Giardia lamblia: control strategies in day care centers.

    abstract:BACKGROUND:Strategies for control of Giardia lamblia in day care differ in numbers of children treated and in costs to parents and day care operators. The effectiveness of these strategies has not been systematically evaluated. METHODS:We conducted a prospective randomized controlled trial comparing three strategies f...

    journal_title:American journal of public health

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Bartlett AV,Englender SJ,Jarvis BA,Ludwig L,Carlson JF,Topping JP

    更新日期:1991-08-01 00:00:00

  • Ongoing Disparities in Prediagnosis Preexposure Prophylaxis Use Among Persons Recently Diagnosed With HIV in New York City, 2015-2017.

    abstract::Objectives. To quantify sociodemographic disparities in prediagnosis preexposure prophylaxis (PrEP) use in persons recently diagnosed with HIV in New York City and assigned for partner services.Methods. We used partner services data from November 2015 to September 2017 from persons diagnosed with HIV in the past 12 mo...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Misra K,Huang JS,Udeagu CN

    更新日期:2019-09-01 00:00:00

  • Oral health care for children in countries using dental therapists in public, school-based programs, contrasted with that of the United States, using dentists in a private practice model.

    abstract::The United States faces a significant problem with access to oral health care, particularly for children. More than 50 countries have developed an alternative dental provider, a dental therapist, practicing in public, school-based programs, to address children's access to care. This delivery model has been demonstrate...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Mathu-Muju KR,Friedman JW,Nash DA

    更新日期:2013-09-01 00:00:00

  • Symptoms of depression among blacks and whites.

    abstract:OBJECTIVES:We sought to examine relationships between sociodemographic indicators of risk and depression symptoms within the Black and White populations. METHODS:In a national probability sample, differences in sex, age, marital status, religion, social class, employment status, urbanicity, and region were evaluated a...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Jones-Webb RJ,Snowden LR

    更新日期:1993-02-01 00:00:00

  • Health care attitudes and experiences during gynecologic care among lesbians and bisexuals.

    abstract::Bisexuals (N = 424) and lesbians (N = 1,921) were surveyed regarding their sources of gynecologic care, utilization patterns, openness with physicians, and assessment of quality of care. About 40 per cent of each group believed that physician knowledge about their sexual preference would hinder the quality of medical ...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Smith EM,Johnson SR,Guenther SM

    更新日期:1985-09-01 00:00:00

  • Why did black life expectancy decline from 1984 through 1989 in the United States?

    abstract:OBJECTIVES:The objective of this study was to partition the change in US life expectancy into those major causes of death and age groups that contributed most to the decline in life expectancy for Black males and females and to the increase in life expectancy for White males and females in the period from 1984 through ...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Kochanek KD,Maurer JD,Rosenberg HM

    更新日期:1994-06-01 00:00:00

  • Underreporting of maternal deaths on death certificates and the magnitude of the problem of maternal mortality.

    abstract:OBJECTIVES:I studied the extent to which maternal deaths are underreported on death certificates. METHODS:We collected data on maternal deaths from death certificates, linkage of death certificates with birth and fetal death records, and review of medical examiner records. RESULTS:Thirty-eight percent of maternal dea...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Horon IL

    更新日期:2005-03-01 00:00:00

  • Impact of Two Adolescent Pregnancy Prevention Interventions on Risky Sexual Behavior: A Three-Arm Cluster Randomized Control Trial.

    abstract:OBJECTIVES: To test the efficacy of Reducing the Risk (RTR) and Love Notes (LN) on reducing risky sexual behavior among youths yet to experience or cause a pregnancy. METHODS: The four dependent variables were ever had sex, condom use, birth control use, and number of sexual partners at 3- and 6-month follow-up in a 3...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Barbee AP,Cunningham MR,van Zyl MA,Antle BF,Langley CN

    更新日期:2016-09-01 00:00:00

  • Role of Department of Defense Policies in Identifying Traumatic Brain Injuries Among Deployed US Service Members, 2001-2016.

    abstract:OBJECTIVES:To examine the role of Department of Defense policies in identifying theater-sustained traumatic brain injuries (TBIs). METHODS:We conducted a retrospective study of 48 172 US military service members who sustained their first lifetime TBIs between 2001 and 2016 while deployed to Afghanistan or Iraq. We use...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Agimi Y,Regasa LE,Ivins B,Malik S,Helmick K,Marion D

    更新日期:2018-05-01 00:00:00

  • Rubella in the workplace: the need for employee immunization.

    abstract::From 1983 to 1985, the New York City Department of Health investigated five workplace outbreaks of rubella. Approximately 40 per cent of the 265 cases were detected among women of child-bearing age (15-44 years). Data are reviewed from the 1983 Financial District outbreak to illustrate the continued susceptibility of ...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Goodman AK,Friedman SM,Beatrice ST,Bart SW

    更新日期:1987-06-01 00:00:00

  • Immunization status and sociodemographic characteristics: the mediating role of beliefs, attitudes, and perceived control.

    abstract:OBJECTIVES:This study examined how immunization-related beliefs, attitudes, and perceived control mediate up-to-date immunization among various sociodemographic groups. METHODS:Statewide estimates of immunization rates among children up to the age of 2 years were obtained via a multistage cluster sample. In-person int...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Prislin R,Dyer JA,Blakely CH,Johnson CD

    更新日期:1998-12-01 00:00:00

  • A measles outbreak at university medical settings involving health care providers.

    abstract::In 1985, a measles outbreak involved 14 students and non-student contacts in Michigan. Eight transmissions occurred at university medical facilities; five of these were likely airborne transmissions. Medical students and a medical resident were involved in the outbreak's propagation. Health care providers need to be i...

    journal_title:American journal of public health

    pub_type: 杂志文章


    authors: Sienko DG,Friedman C,McGee HB,Allen MJ,Simonsen WF,Wentworth BB,Shope TC,Orenstein WA

    更新日期:1987-09-01 00:00:00