| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Blease, Charlotte, et al.
(författare)
-
Artificial intelligence and the future of primary care : exploratory qualitative study of UK general practitioners' views
- 2019
-
Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 21:3
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The potential for machine learning to disrupt the medical profession is the subject of ongoing debate within biomedical informatics and related fields.Objective: This study aimed to explore general practitioners' (GPs') opinions about the potential impact of future technology on key tasks in primary care.Methods: In June 2018, we conducted a Web-based survey of 720 UK GPs' opinions about the likelihood of future technology to fully replace GPs in performing 6 key primary care tasks, and, if respondents considered replacement for a particular task likely, to estimate how soon the technological capacity might emerge. This study involved qualitative descriptive analysis of written responses ("comments") to an open-ended question in the survey.Results: Comments were classified into 3 major categories in relation to primary care: (1) limitations of future technology, (2) potential benefits of future technology, and (3) social and ethical concerns. Perceived limitations included the beliefs that communication and empathy are exclusively human competencies; many GPs also considered clinical reasoning and the ability to provide value-based care as necessitating physicians' judgments. Perceived benefits of technology included expectations about improved efficiencies, in particular with respect to the reduction of administrative burdens on physicians. Social and ethical concerns encompassed multiple, divergent themes including the need to train more doctors to overcome workforce shortfalls and misgivings about the acceptability of future technology to patients. However, some GPs believed that the failure to adopt technological innovations could incur harms to both patients and physicians.Conclusions: This study presents timely information on physicians' views about the scope of artificial intelligence (AI) in primary care. Overwhelmingly, GPs considered the potential of AI to be limited. These views differ from the predictions of biomedical informaticians. More extensive, stand-alone qualitative work would provide a more in-depth understanding of GPs' views.
|
|
| 5. |
- Blease, Charlotte, et al.
(författare)
-
Computerization and the future of primary care : a survey of general practitioners in the UK
- 2018
-
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:12
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo describe the opinions of British general practitioners regarding the potential of future technology to replace key tasks carried out in primary care.DesignCross sectional online survey.Participants1,474 registered GPs in the United Kingdom.Main outcome measuresInvestigators measured GPs’ opinions about the likelihood that future technology will be able to fully replace–not merely aid–the average GP in performing six primary care tasks; in addition, if GPs considered replacement for a particular task likely, the survey measured opinions about how many years from now this technological capacity might emerge.ResultsA total of 720 (49%) responded to the survey. Most GPs believed it unlikely that technology will ever be able to fully replace physicians when it comes to diagnosing patients (489, 68%), referring patients to other specialists (444, 61%), formulating personalized treatment plans (441, 61%), and delivering empathic care (680, 94%). GPs were not in agreement about prognostics: one in two participants (380, 53%) considered it likely that technology will be fully capable of replacing physicians in performing this task, nearly half (187, 49%) of whom believed that the technological capacity will arise in the next ten years. Against these findings, the majority of GPs (578, 80%) believed it likely that future technology will be able to fully replace humans to undertake documentation; among them 261 (79%) estimated that the technological wherewithal would emerge during the next ten years. In general, age and gender were not correlated with opinions; nor was reported burnout and job satisfaction or whether GPs worked full time or part time.ConclusionsThe majority of UK GPs in this survey were skeptical about the potential for future technology to perform most primary care tasks as well as or better than humans. However, respondents were optimistic that in the near future technology would have the capacity to fully replace GPs’ in undertaking administrative duties related to patient documentation.
|
|
| 6. |
|
|
| 7. |
- Faria, Vanda, et al.
(författare)
-
Parental Attitudes About Placebo Use in Children
- 2017
-
Ingår i: The Journal of Pediatrics. - : MOSBY-ELSEVIER. - 0022-3476 .- 1097-6833. ; 181, s. 272-278
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To assess parental attitudes regarding placebo use in pediatric randomized controlled trials and clinical care. Study design Parents with children under age 18 years living in the US completed and submitted an online survey between September and November 2014. Results Among all 1300 participants, 1000 (76.9%; 538 mothers and 462 fathers) met the study inclusion criteria. The majority of surveyed parents considered the use of placebos acceptable in some pediatric care situations (86%) and some pediatric trials (91.5%), whereas only 5.7% of parents found the use of placebos in children always unacceptable. The clinical use of placebo was considered acceptable by a majority of parents for only 7 (mostly psychological) of the 17 conditions presented. Respondents' judgment about acceptability was influenced by the doctors' opinions about the therapeutic benefits of placebo treatment, the conditions for pediatric placebo use, transparency, safety, and purity of placebos. Conclusion Most surveyed parents accepted the idea of using placebos in pediatric trials and within the clinic for some conditions without the practice of deception and with the creation of guidelines for ethical and safe use. This study suggests a need to reconsider pediatric trial design and clinical therapy in the light of generally positive parental support of appropriate placebo use.
|
|
| 8. |
- Faria, Vanda, et al.
(författare)
-
Placebos in pediatrics : A cross-sectional survey investigating physicians' perspectives
- 2023
-
Ingår i: Journal of Psychosomatic Research. - : Elsevier. - 0022-3999 .- 1879-1360. ; 172
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Placebo responses are significantly higher in children than in adults, suggesting a potential underused treatment option in pediatric care. To facilitate the clinical translation of these beneficial effects, we explored physicians' current practice, opinions, knowledge, and likelihood of recommending placebos in the future.Methods: A cross-sectional web-based survey administered by REDCap was conducted at Boston Children's Hospital between October 2021 and March 2022. Physicians (n = 1157) were invited to participate through an email containing a link to a 23-item survey designed to assess physicians' attitudes and perceptions towards the clinical use of placebo in pediatrics.Results: From 207 (18%) returned surveys, 109 (9%) were fully completed. Most respondents (79%) believed that enhancing the therapeutic components that contribute to the placebo response may be a way of improving pediatric care. However, whereas most (62%) found placebo treatments permissible, only one-third reported recommending them. In pediatrics, placebos are typically introduced as a medicine that "might help" (43%). The most common treatments recommended to enhance placebo effects are physical therapy, vitamins, and over-the-counter analgesics. Physicians most frequently recommend placebos for occasional pain, headaches, and anxiety disorders. Finally, the great majority of physicians (87%) stated they would be more likely to recommend pla-cebo treatments if there were safety and ethical guidelines for open-label placebos.Conclusions: Placebo treatments seem permissible to physicians in pediatric care, but the development of safety and ethical guidelines may be necessary before physicians systematically incorporate the benefits of the placebo effect in pediatrics.
|
|
| 9. |
- Jensen, Karin, et al.
(författare)
-
Surgeons' behaviors and beliefs regarding placebo effects in surgery
- 2021
-
Ingår i: Acta Orthopaedica. - : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 92:5, s. 507-512
-
Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — Emerging evidence from sham-controlled trials suggest that surgical treatment entails substantial non-specific treatment effects in addition to specific surgical effects. Yet, information on surgeons’ actual behaviors and beliefs regarding non-specific treatment and placebo effects is scarce. We determined surgeons’ clinical behaviors and attitudes regarding placebo effects.Methods — A national online survey was developed in collaboration with surgeons and administered via an electronic link.Results — All surgical clinics in Sweden were approached and 22% of surgeons participated (n = 105). Surgeons believed it was important for them to interact and build rapport with patients before surgery rather than perform surgery on colleagues’ patients (90%). They endorsed the importance of non-specific treatment effects in surgery generally (90%) and reported that they actively harness non-specific treat- ment effects (97%), including conveying confidence and calm (87%), building a positive interaction (75%), and making eye contact (72%). In communication regarding the likely outcomes of surgery, surgeons emphasized accurate scientific information of benefits/risks (90%) and complete honesty (63%). A majority felt that the improvement after some currently performed surgical procedures might be entirely explained by placebo effects (78%). Surgeons saw benefits with sham-controlled surgery trials, nevertheless, they were reluctant to refer patients to sham controlled trials (46%).Interpretation — Surgeons believe that their words and behaviors are important components of their professional competence. Surgeons saw the patient–physician relation- ship, transparency, and honesty as critical. Understanding the non-specific components of surgery has the potential to improve the way surgical treatment is delivered and lead to better patient outcomes.
|
|
| 10. |
- Kube, Tobias, et al.
(författare)
-
Hope in medicine : applying multidisciplinary insights
- 2019
-
Ingår i: Perspectives in biology and medicine. - : Johns Hopkins University Press. - 0031-5982 .- 1529-8795. ; 62:4, s. 591-616
-
Tidskriftsartikel (refereegranskat)abstract
- Hope is a crucial aspect of human life and has been a topic of interest in many scholarly disciplines. The medical literature, however, has with a few exceptions failed to take account of conceptions of hope across other scholarly disciplines. Before exploring what makes hope a distinctive and important phenomenon in medical contexts, this article reviews prominent views on hope from philosophy, anthropology, theology, and psychology. To synthesize these different conceptions, the authors propose an integrative approach aimed at improving the understanding of hope in medicine. The authors use a modes-of-hoping framework to explain different phenomena related to hope in medicine, such as hope in the face of a dismal prognosis, in the disclosure of diagnostic information, and in the initiation of new treatments. Based on this tentative framework, possible directions for future empirical research are discussed. Beside further qualitative research into the patients' and physicians' understanding and experiences of hope, the authors urge a quantitative examination of the impact of hope (while recognizing that a quantitative approach might not able to capture hope's many intricacies). Finally, they discuss clinical and ethical implications with respect to a balance between physicians being honest and acknowledging patients' hope
|
|
