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A unique relationship exists between physicians and philosophers — one that expands on the constructive potential of the liaison between physicians and, for example, theologians, on the one hand, or, social workers on the other. This liaison should focus in the scientific aspects of medicine, not just the ethical aspects. Philosophers can provide physicians with a perspective on both the philosophy and the history of medicine through the ages — a sense of how medicine has adapted to the social cultural and ethical needs of each period. This perspective, while emphasizing medicine asscience, should not be limited to matters of methodology, or to criteria for distinguishing science from other intellectual pursuits, but should be concerned also with the history, sociology and politics of science. Both physicians and philosophers stand to gain from a strengthening of their active liaison now as never before; but most of all, the public will be the beneficiary. 相似文献
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A cost analysis of the utilization of new expensive vascular grafts is performed, applying the methodology of decision analysis to the theoretical case of a sixty year old male patient undergoing femoropopliteal grafting for limb threatening ischemia. The problem is presented graphically as a decision tree, uncertainties are quantified in terms of probabilities and end outcomes are evaluated in monetary terms. This informations is then utilized to calculate cost values associated with alternative actions. Based on initial cumulative patency figures of the new more expensive grafts and the known performance of the older grafts, the initial high expense for the new grafts is justified economically, if the saphenous vein is not available. This analysis, apart from giving an answer to a specific clinical problem, can be viewed as a general model for cost analysis of surgical procedures. 相似文献
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An attempt was made to identify the best method of locating the egocenter by comparing the predictive validity and reliability of the four methods introduced by Fry (1950), Funaishi (1926), Howard and Templeton (1966), and Roelofs (1959). To determine predictive validity, egocenters located by these methods were used to predict the responses of 14 subjects on three visual direction tasks; the correlation between the predicted and the actual responses on each task was computed. To determine reliability, the test-retest stability and the internal consistency were estimated for each method. All of the methods were reliable, but only the Howard and Templeton method predicted the results on all three of the visual direction tasks. The high reliability and predictive validity of the Howard and Templeton method is attributed to its high precision. 相似文献
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Aucone EJ Wagner EE Raphael AJ Golden CJ Espe-Pfeifer P Dornheim L Seldon J Pospisil T Proctor-Weber Z Calabria M 《Assessment》2001,8(3):351-353
This study assesses the test-retest reliability of the revised Advanced Psychodiagnostic Interpretation (API) scoring system for the Bender Gestalt Test (BGT). The API system identifies 207 possible distortions in a BGT protocol. Test-retest reliability for 40 schizophrenic patients tested twice with a mean interval of 6.4 years (SD=3.8 years) was good, ranging from .71 to .80. Further reliability and validity studies are needed to further demonstrate the effectiveness of the system. 相似文献
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Rodrigues CS de Oliveira VZ Camargo G Osório CM de Castilhos RM Saraiva-Pereira ML Schuler-Faccini L Jardim LB 《Journal of genetic counseling》2012,21(1):101-112
Diagnostic tests are available to detect several mutations related to adult-onset, autosomal dominant, neurodegenerative diseases.
We aimed to describe our experience in a presymptomatic testing program run by the Brazilian Public Health System from 1999
to 2009. A total of 184 individuals were eligible for presymptomatic testing due to a risk for spinocerebellar ataxia (SCA)
- SCA3 (80%), Huntington’s disease (11.9%), familial amyloidotic neuropathy (4.3%), SCA1, SCA2, SCA6, or SCA7. Most were women
(70%), married (54%), and had children prior to presymptomatic testing (67%). Their mean age at entrance was 34 (SD = 11 years).
Educational level was above the average Brazilian standard. After receipt of genetic counseling, 100 individuals (54%) decided
to undergo testing; of these, 51 were carriers. Since no individual returned for post-test psychological evaluation, we conducted
a subsequent survey, unrelated to test disclosures. We contacted 57 individuals of whom 31 agreed to participate (24 had been
tested, 7 had not). Several ascertainment concerns relating to these numerous losses prevented us from generalizing our results
from this second survey. We concluded that: decision-making regarding presymptomatic testing seems to be genuinely autonomous,
since after genetic counseling half the individuals who asked for presymptomatic testing decided in favor and half decided
against it; general characteristics of Brazilians who sought presymptomatic testing were similar to many European samples
studied previously; and individuals at risk for SCA3 may be at greater risk of depression. Although no clear-cut reason emerged
for rejection of follow-up psychological sessions after presymptomatic testing, this finding suggests adjustments to our presymptomatic
testing program are necessary. 相似文献
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