Abstract:
:With the aim of promoting the informed choice of pregnant women, staff and pregnant women at two urban hospitals were offered leaflets summarising the best available evidence about the effectiveness of routine ultrasonography in early pregnancy. Ultrasonographers doubted the credibility of the evidence and were concerned that the leaflets would raise women's anxiety, reduce uptake of scans, disrupt hospital organisation, and reinforce media messages about the poor safety record of ultrasonography. Midwives thought that the leaflets would inform women, help them to talk about their care with health professionals, and help them to get better care. Women were shocked at some of the contents but thought that it was appropriate to include both advantages and disadvantages of routine scanning in the leaflet. This case study highlights the resistance of some health professionals to evidence based health care; underlying conflicts with the principle of professional autonomy; concern that informed choice may create anxiety; and professional and organisational barriers to allowing informed choice.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Oliver S,Rajan L,Turner H,Oakley A,Entwistle V,Watt I,Sheldon TA,Rosser Jdoi
10.1136/bmj.313.7067.1251asubject
Has Abstractpub_date
1996-11-16 00:00:00pages
1251-3issue
7067eissn
0959-8138issn
1756-1833journal_volume
313pub_type
杂志文章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::The first call for applications to the NHS research and development programme on the interface between primary and secondary care was advertised in February 1994. A total of 674 outline proposals were submitted and 54 (8%) secured funding. Projects have been commissioned in 16 of the 21 priority areas and around 6m po...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7012.1080
更新日期:1995-10-21 00:00:00
abstract:OBJECTIVE:To examine the association between obstetric epidural anaesthesia and subsequent long term problems. DESIGN:Postal questionnaire on health problems after childbirth linked to maternity case note data. SETTING:Maternity hospital in Birmingham. SUBJECTS:11701 women who delivered their most recent child durin...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6837.1279
更新日期:1992-05-16 00:00:00
abstract:OBJECTIVE:To assess adjustment practices for primary outcomes of randomized controlled trials and their impact on the results. DESIGN:Meta-epidemiologic study. DATA SOURCES:25 biomedical journals with the highest impact factor according to Journal Citation Reports 2009. STUDY SELECTION:Randomized controlled trials p...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f4313
更新日期:2013-07-12 00:00:00
abstract:OBJECTIVE:To determine the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by Clostridium difficile. DESIGN:Randomised double blind placebo controlled study. PARTICIPANTS:135 hospital patients (mean age 74) taking antibiotics. E...
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.39231.599815.55
更新日期:2007-07-14 00:00:00
abstract:OBJECTIVE:To assess the effects of social deprivation on survival after cardiac surgery and to examine the influence of potentially modifiable risk factors. DESIGN:Analysis of prospectively collected data. Prognostic models used to examine the additional effect of social deprivation on the end points. SETTING:Birming...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b902
更新日期:2009-04-02 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness and costs of a multifaceted flexible educational programme aimed at reducing antibiotic dispensing at the practice level in primary care. DESIGN:Randomised controlled trial with general practices as the unit of randomisation and analysis. Clinicians and researchers were blinded ...
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.d8173
更新日期:2012-02-02 00:00:00
abstract::Objective To analyse stage specific incidence of breast cancer in the Netherlands where women have been invited to biennial mammography screening since 1989 (ages 50-69) and 1997 (ages 70-75), and to assess changes in breast cancer mortality and quantified overdiagnosis.Design Population based study.Setting Mammograph...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j5224
更新日期:2017-12-05 00:00:00
abstract::A brief note on the status of the AIDS pandemic, from the Amsterdam VIIIth International Conference on AIDS, warns that the course of the epidemic is not being altered by prevention efforts. AIDS occurs in every country, usually spread by heterosexual contact, so that women are equally affected with men. WHO estimat...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.305.6847.209
更新日期:1992-07-25 00:00:00
abstract:OBJECTIVES:To examine the effects of physical work environment on long term sickness absence and to investigate interaction between physical and psychosocial risk factors. DESIGN AND SETTING:Prospective cohort study of long term sickness absence among employees in Denmark. PARTICIPANTS:5357 employees interviewed in 2...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38731.622975.3A
更新日期:2006-02-25 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 assess treatment related changes in quality of life up to 15 years after diagnosis of localised prostate cancer. DESIGN:Population based, prospective cohort study with follow-up over 15 years. SETTING:New South Wales, Australia. PARTICIPANTS:1642 men with localised prostate cancer, aged less than 70, an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m3503
更新日期:2020-10-07 00:00:00
abstract:OBJECTIVES:To determine clinical correlates and outcome of hypoxaemia in children admitted to hospital with an acute lower respiratory tract infection. DESIGN:Prospective cohort study. SETTING:Paediatric wards of the Royal Victoria Hospital and the hospital of the Medical Research Council's hospital in Banjul, the Ga...
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.318.7176.86
更新日期:1999-01-09 00:00:00
abstract:OBJECTIVE:To assess the association between genitourinary infections in the month before conception to the end of the first trimesterand gastroschisis. DESIGN:Case-control study with self reported infections from a computer assisted telephone interview. SETTING:National birth defects prevention study, a multisite, po...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.39567.509074.25
更新日期:2008-06-21 00:00:00
abstract:OBJECTIVES:To understand the approaches to learning of practising physicians in their workplace and to assess the relation of these approaches to their motivation for, preferred methods of, and perceived barriers to continuing medical education. DESIGN:Postal survey of 800 Ontario physicians. PARTICIPANTS:373 physici...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7374.1218
更新日期:2002-11-23 00:00:00
abstract::In July 1992 Dr Keith Mumby, a clinical ecologist, appeared before the professional conduct committee of the General Medical Council on five charges to do with his practice of clinical ecology. He was found guilty of two of the charges--touting for publicity and failing to give a patient adequate medical attention--an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6870.122
更新日期:1993-01-09 00:00:00
abstract:OBJECTIVES:To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences, and costs. DESIGN:Randomised c...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38558.393669.E0
更新日期:2005-09-03 00:00:00
abstract:OBJECTIVE:To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. DESIGN:Retrospective cohort study. SETTING:University Hospital, Helsinki, Finland. PARTICIPANTS:7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38663.459039.7C
更新日期:2005-11-19 00:00:00
abstract::Objective To estimate the incidence and prevalence of resistant hypertension among a UK population treated for hypertension from 1995 to 2015.Design Cohort study.Setting Electronic health records from the UK Clinical Practice Research Datalink in primary care.Participants 1 317 290 users of antihypertensive drugs with...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3984
更新日期:2017-09-22 00:00:00
abstract:OBJECTIVE:To study changes from 1969 to 1983 in the prognosis of patients with acute myocardial infarction treated in a coronary care unit. DESIGN:Mortality follow up of all patients with definite acute myocardial infarction. SETTING:The coronary care unit of the Royal Melbourne Hospital, a tertiary referral centre. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6704.892
更新日期:1989-10-07 00:00:00
abstract:OBJECTIVE:To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). DESIGN:Follow up study of 3 months. SETTING:Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7214.878
更新日期:1999-10-02 00:00:00
abstract:OBJECTIVE:To assess long term survival (> 5 years) and quality of life in severely ill patients referred for urgent cardiac transplantation. SETTING:Tertiary referral centres: before transplantation at the National Heart Hospital (late 1984 to end 1986); after transplantation at Harefield Hospital. SUBJECTS:Eighteen ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6870.98
更新日期:1993-01-09 00:00:00
abstract:OBJECTIVE:To assess the associations between different antidepressant treatments and the rates of suicide and attempted suicide or self harm in people with depression. DESIGN:Cohort study. SETTING:Patients registered with UK general practices contributing data to the QResearch database. PARTICIPANTS:238,963 patients...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h517
更新日期:2015-02-18 00:00:00
abstract::The International AIDS Vaccine Initiative, based in New York, US, was established in 1996 to develop a safe and affordable AIDS vaccine. It is funded by a number of large foundations and charities, the British government, and the World Bank. The Initiative's first 2 large projects, 2 research programs into a vaccine...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.317.7172.1543
更新日期:1998-12-05 00:00:00
abstract:OBJECTIVE:To assess the effect of weight loss induced by a very low energy diet on moderate and severe obstructive sleep apnoea in obese men. Design Single centre, two arm, parallel, randomised, controlled, open label trial. Blocked randomisation procedure used for treatment allocation. Setting Outpatient obesity clini...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.b4609
更新日期:2009-12-03 00:00:00
abstract::I have attempted to adopt the perspective of a patient--albeit one with a rather atypical background--to explore what I want from health research and researchers. This has left me with the impression that health researchers could serve the interests of the public more effectively in a variety of ways, and that they wo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6990.1315
更新日期:1995-05-20 00:00:00
abstract:OBJECTIVE:To develop and refine a complex intervention for diabetes support and education in minority ethnic groups, delivered through bilingual health advocates. DESIGN:Action research framework-a variety of methods used in an emergent and developmental manner, in partnership with clinicians, managers, and service us...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.330.7492.628
更新日期:2005-03-19 00:00:00
abstract:OBJECTIVE:To assess the effect of high dose inhaled corticosteroids on skin. DESIGN:Cross sectional study of patients receiving treatment for chest diseases. SETTING:Outpatient chest clinic in a teaching hospital. PATIENTS:68 Patients divided into four groups of similar age--namely, 15 receiving long term oral predn...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6739.1548
更新日期:1990-06-16 00:00:00
abstract::An increase in the incidence of cardiovascular disease has generally been observed in postmenopausal women, but there have been few studies of the association between menopausal state and atherosclerosis. In this study 294 premenopausal and 319 postmenopausal women aged 45 to 55 were examined radiographically for calc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6674.642
更新日期:1989-03-11 00:00:00
abstract:BACKGROUND:Twenty-four hour ambulatory blood pressure thresholds have been defined for the diagnosis of mild hypertension but not for its treatment or for other blood pressure thresholds used in the diagnosis of moderate to severe hypertension. We aimed to derive age and sex related ambulatory blood pressure equivalent...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c1104
更新日期:2010-04-14 00:00:00