Abstract:
:Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples' preconceptions. Scenarios are plausible, not probable or preferable, portraits of alternative futures. A series of four of alternative scenarios were constructed: "sobriety in sufficiency," "risk avoidance," "technology on demand," and "free market unfettered." Each scenario was drawn as a narrative, documented quantitatively wherever possible, that described the world as it might be if particular trends were to dominate development. The medical community and health policy markers may use scenarios to take a long term view in order to be prepared adequately for the future.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Leufkens H,Haaijer-Ruskamp F,Bakker A,Dukes Gdoi
10.1136/bmj.309.6962.1137subject
Has Abstractpub_date
1994-10-29 00:00:00pages
1137-40issue
6962eissn
0959-8138issn
1756-1833journal_volume
309pub_type
杂志文章abstract:OBJECTIVE:To assess the efficacy of a newly developed system for applying continuous or intermittent negative (subatmospheric) extrathoracic pressure in respiratory failure. DESIGN:Uncontrolled clinical trials in infants deteriorating or failing to improve despite standard medical treatment. SETTING:Paediatric and ne...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.299.6710.1253
更新日期:1989-11-18 00:00:00
abstract:OBJECTIVES:To develop a systematic method for both summative and formative audit of practice audits, and to use the method to review Oxfordshire practice audits and to plan improvement. DESIGN:Development of a coding system for the audit cycle subsequently used prospectively to assess audits reported to medical audit ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.303.6812.1247
更新日期:1991-11-16 00:00:00
abstract:OBJECTIVE:To investigate the association between cerebral palsy and direct evidence for perinatal exposure to neurotropic viruses. DESIGN:Population based case-control study. SETTING:Adelaide Women's and Children's Hospital Research Laboratory. PARTICIPANTS AND MAIN OUTCOME MEASURES:Newborn screening cards of 443 wh...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38668.616806.3A
更新日期:2006-01-14 00:00:00
abstract:OBJECTIVE:To estimate trends between 1972-6 and 1996 in the prevalences of asthma and hay fever in adults. DESIGN:Two epidemiological surveys 20 years apart. Identical questions were asked about asthma, hay fever, and respiratory symptoms at each survey. SETTING:Renfrew and Paisley, two towns in the west of Scotland....
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7253.88
更新日期:2000-07-08 00:00:00
abstract::The relations among parental reports of respiratory symptoms, bronchospasm measured after exercise, and the presence of visible fungal mould in the home was assessed in a population sample of 7 year old children (n = 873). Wheeze in the past year was the symptom most closely associated with reported dampness and parti...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6658.1223
更新日期:1988-11-12 00:00:00
abstract:OBJECTIVE:To evaluate the association between use of hormone replacement therapy and the risk of idiopathic venous thromboembolism. DESIGN:Population based case-control study. SETTING:Population enrolled in the General Practice Research Database, United Kingdom. SUBJECTS:A cohort of 347,253 women aged 50 to 79 witho...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7083.796
更新日期:1997-03-15 00:00:00
abstract:OBJECTIVES:To observe one general practice's attempt to reduce prescribing costs on becoming third wave fundholders through the introduction of a generic formulary applied to all new and repeat prescribing. To assess the impact on patients and prescribing patterns. DESIGN:An observational study using interviews with p...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6978.505
更新日期:1995-02-25 00:00:00
abstract:OBJECTIVES:To compare the clinical and cost effectiveness of total hip arthroplasty with resurfacing arthroplasty in patients with severe arthritis of the hip. DESIGN:Single centre, two arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation. SETTING:One large teaching hospita...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.e2147
更新日期:2012-04-19 00:00:00
abstract:OBJECTIVES:To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses. Design T...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c1594
更新日期:2010-04-20 00:00:00
abstract:OBJECTIVES:To assess incidence of and mortality from cancer in hypertensive patients taking atenolol, comparing the findings with two control populations and with hypertensive patients taking other drugs. DESIGN:Retrospective analysis of patients first seen in the Glasgow Blood Pressure Clinic between 1972 and 1990. P...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6878.609
更新日期:1993-03-06 00:00:00
abstract:OBJECTIVE:To determine whether cognitive therapy is effective in preventing the worsening of emerging psychotic symptoms experienced by help seeking young people deemed to be at risk for serious conditions such as schizophrenia. DESIGN:Multisite single blind randomised controlled trial. SETTING:Diverse services at fi...
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.e2233
更新日期:2012-04-05 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of health checks by nurses in reducing risk factors for cardiovascular disease in patients from general practice. DESIGN:Randomised controlled trial. SETTING:Five urban general practices in Bedfordshire. SUBJECTS:2136 patients receiving an initial health check in 1989-91 and sch...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-01-29 00:00:00
abstract:OBJECTIVE:To determine how length of anticoagulation and clinical presentation of venous thromboembolism influence the risk of recurrence after anticoagulant treatment is stopped and to identify the shortest length of anticoagulation that reduces the risk of recurrence to its lowest level. DESIGN:Pooled analysis of in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.d3036
更新日期:2011-05-24 00:00:00
abstract:OBJECTIVES:To elucidate current trends and geographical patterns in the sex ratio at birth and in the population aged under 20 in China and to determine the roles played by sex selective abortion and the one child policy. DESIGN:Analysis of household based cross sectional population survey done in November 2005. SETT...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b1211
更新日期:2009-04-09 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::In Oregon, Planned Parenthood and a group of physicians who perform abortions have filed a civil suit against several anti-abortion groups individuals. The suit seeks $200 million in damages and an injunction to bar the defendants from posting information on the Internet that threatens the lives and well-being of the...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.318.7178.214a
更新日期:1999-01-23 00:00:00
abstract:OBJECTIVE: To measure the association between a surgeon's degree of specialization in a specific procedure and patient mortality. DESIGN: Retrospective analysis of Medicare data. SETTING: US patients aged 66 or older enrolled in traditional fee for service Medicare. PARTICIPANTS: 25 152 US surgeons who performed one...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.i3571
更新日期:2016-07-21 00:00:00
abstract:OBJECTIVE:To investigate whether paracetamol (acetaminophen) plus ibuprofen are superior to either drug alone for increasing time without fever and the relief of fever associated discomfort in febrile children managed at home. DESIGN:Individually randomised, blinded, three arm trial. SETTING:Primary care and househol...
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.a1302
更新日期:2008-09-02 00:00:00
abstract:OBJECTIVE:To investigate the impact of patients' preferences for the treatment of atrial fibrillation, by using individualised decision analysis combining probability and utility assessments into a decision tree. DESIGN:Observational study based on interviews with patients. SETTING:Eight general practices in Avon. P...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.320.7246.1380
更新日期:2000-05-20 00:00:00
abstract:OBJECTIVE:To assess whether mini flow meters used to measure peak expiratory flow can track changes in lung function and indicate clinically important changes. DESIGN:Comparison of measurements with a spirometer and different brands of mini flow meter; the meters were allocated to subjects haphazardly. SUBJECTS:12 bo...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.308.6928.572
更新日期:1994-02-26 00:00:00
abstract:OBJECTIVE:To describe and quantify the patients and clinical activities of independent short stay hospitals. DESIGN:Retrospective survey of hospital records for sampled periods of one financial year and comparison with data from 1981 to 1986. SETTING:217 independent hospitals in England and Wales, 1992-3. MAIN OUTCO...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6945.1699
更新日期:1994-06-25 00:00:00
abstract:OBJECTIVE:To determine if the Food Standards Agency nutrient profiling system (FSAm-NPS), which grades the nutritional quality of food products and is used to derive the Nutri-Score front-of-packet label to guide consumers towards healthier food choices, is associated with mortality. DESIGN:Population based cohort stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m3173
更新日期:2020-09-16 00:00:00
abstract:OBJECTIVE:To investigate whether breast feeding is related to subsequent risk of breast cancer. DESIGN:Population based case-control study designed primarily to investigate the relation between oral contraceptives and risk of breast cancer; data obtained from questionnaires administered by interviewers, general practi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6895.17
更新日期:1993-07-03 00:00:00
abstract::Cancers of unknown primary (CUPs) are histologically confirmed, metastatic malignancies with a primary tumor site that is unidentifiable on the basis of standard evaluation and imaging studies. CUP comprises 2-5% of all diagnosed cancers worldwide and is characterized by early and aggressive metastasis. Current standa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.m4050
更新日期:2020-12-07 00:00:00
abstract:OBJECTIVE:To evaluate the association between body mass index and mortality from overall cardiovascular disease and specific subtypes of cardiovascular disease in east and south Asians. DESIGN:Pooled analyses of 20 prospective cohorts in Asia, including data from 835,082 east Asians and 289,815 south Asians. Cohorts w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f5446
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To determine whether fibrinogen and lipid concentrations are risk factors for ischaemic stroke. DESIGN:Case-control study with a population based comparison within the overall study. SETTING:Oxfordshire community stroke project and a neurology clinic. SUBJECTS:105 patients who had a transient ischaemic at...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6803.605
更新日期:1991-09-14 00:00:00
abstract:OBJECTIVES:To identify the extent of HIV infection and injecting drug use among female streetworking prostitutes in Glasgow; to estimate the size of the female streetworking prostitute population in the city; and to estimate the number of HIV positive women working as prostitutes on the streets in Glasgow. DESIGN:Obse...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6857.801
更新日期:1992-10-03 00:00:00
abstract:OBJECTIVE:To determine whether the increased iron demands of pregnancy could be met by increased absorption from dietary sources. DESIGN AND SETTING:Longitudinal prospective study in the research unit of a maternity hospital. SUBJECTS:12 normal pregnant women. INTERVENTIONS:At 12, 24, and 36 weeks' gestation (within...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6947.79
更新日期:1994-07-09 00:00:00
abstract:OBJECTIVE:To assess the effect of the timing of first postnatal home visit by community health workers on neonatal mortality. DESIGN:Analysis of prospectively collected data using time varying discrete hazard models to estimate hazard ratios for neonatal mortality according to day of first postnatal home visit. DATA ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.b2826
更新日期:2009-08-14 00:00:00
abstract:OBJECTIVES:To calculate socioeconomic and health status measures for the primary care groups in London and to examine the association between these measures and hospital admission rates. DESIGN:Cross sectional study. SETTING:66 primary care groups in London, total list size 8.0 million people. MAIN OUTCOME MEASURES:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7268.1057
更新日期:2000-10-28 00:00:00