| 1. |
- Annoni, Marco, et al.
(författare)
-
A critical (and cautiously optimistic) appraisal of moerman’s" meaning response"
- 2018
-
Ingår i: Perspectives in biology and medicine. - : Johns Hopkins University Press. - 0031-5982 .- 1529-8795. ; 61:3, s. 379-387
-
Tidskriftsartikel (refereegranskat)abstract
- In this article we propose a critical reassessment of Daniel Moerman's "meaning response." First, we reconstruct and criticize Moerman's original proposal of introducing the "meaning response" as a way of clarifying some terminological and conceptual issues in the placebo debate. Next we evaluate the criticisms that Moerman's proposal is epistemically moot since other existing and more empirically grounded models already account for all the phenomena that fall under the concept of the "meaning response." We conclude that Moerman's original proposal is inherently problematic and that, in order to be instrumentally useful in the future, the meaning response must be reconceived so that it may finally support, rather than oppose, other theoretical and empirical lines of research currently ongoing in the field of placebo studies.
|
|
| 2. |
|
|
| 3. |
- Blease, Charlotte, et al.
(författare)
-
Are ME/CFS Advocacy Organisations militant? : Patient Protest in a Medical Controversy
- 2018
-
Ingår i: Journal of Bioethical Inquiry. - : Springer Nature. - 1176-7529 .- 1872-4353. ; 15:3, s. 393-401
-
Tidskriftsartikel (refereegranskat)abstract
- Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) is a contested illness category. This paper investigates the common claim that patients with ME/CFSand by extension, ME/CFS patient organizations (POs)exhibit militant social and political tendencies. The paper opens with a history of the protracted scientific disagreement over ME/CFS. We observe that ME/CFS POs, medical doctors, and medical researchers exhibit clear differences in opinion over how to conceptualize this illness. However, we identify a common trope in the discourse over ME/CFS: the claim of militant patient activism. Scrutinizing this charge, we find no compelling evidence that the vast majority of patients with ME/CFS, or the POs representing them, have adopted any such militant political policies or behaviours. Instead, we observe key strategic similarities between ME/CFS POs in the United Kingdom and the AIDs activist organizations of the mid-1980s in the United States which sought to engage scientists using the platform of public activism and via scientific publications. Finally, we explore the contours of disagreement between POs and the medical community by drawing on the concept of epistemic injustice. We find that widespread negative stereotyping of patients and the marginalization and exclusion of patient voices by medical authorities provides a better explanation for expressions of frustration among patients with ME/CFS.
|
|
| 4. |
|
|
| 5. |
- 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.
|
|
| 6. |
|
|
| 7. |
- 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.
|
|
| 8. |
- Blease, Charlotte
(författare)
-
Consensus in placebo studies : lessons from the philosophy of science
- 2018
-
Ingår i: Perspectives in biology and medicine. - : Johns Hopkins University Press. - 0031-5982 .- 1529-8795. ; 61:3, s. 412-429
-
Tidskriftsartikel (refereegranskat)abstract
- In the relatively nascent field of placebo studies, empirical studies have burgeoned. Yet debate about how to define the terms placebo and "placebo effect" has not abated. A number of prominent scholars (drawn from medical practice, as well as philosophy, psychology, and anthropology) continue to propose and defend different conceptual models for these terms, and the perception that conceptual debate persists is often given as one justification for new definitions. Paradoxically in spite of this lively debate this article finds considerable underlying agreement about definitional matters within placebo studies. Drawing on key insights from philosophy of science, and by exploring the nature of scientific consensus and normal scientific research, this paper argues that well-developed placebo concepts form the basis for a placebo paradigm and that conceptual disagreement is overstated.
|
|
| 9. |
- Blease, Charlotte, et al.
(författare)
-
Does disclosure about the common factors affect laypersons’ opinions about how cognitive behavioral psychotherapy works?
- 2018
-
Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Written and online information about cognitive-behavioral therapy (CBT) prioritizes the role of specific techniques (e.g., cognitive restructuring) and typically omits discussion of “common factors” (e.g., the working alliance, or therapist empathy). However, according to extensive psychotherapy process research the common factors may be important mediators of client improvement.Objectives: This study aimed to assess lay opinions about the role of specific and common factors in CBT for depression. We also aimed to determine how different client disclosure processes might affect lay opinions about the relative importance of specific and common factors in CBT.Methods: We conducted a web-based experiment involving a sample of US participants who had never undergone psychotherapy. All participants were presented with similar vignettes describing an individual suffering from depression whose doctor recommends CBT. Participants were randomized to read one of six vignettes created in a 2 × 3 factorial design that crossed client gender with type of informed consent (Standard CBT Disclosure vs. Common Factors and CBT Disclosure vs. No Disclosure).Results: Disclosure type had a significant effect on participants' ratings of Common and Specific factors in psychotherapy. As compared to the CBT disclosure, participants allocated to the Common Factors disclosure rated Empathy and Positive Regard as significantly more important to treatment outcome, and rated the Specific factors of CBT as significantly less important to outcome. There were no significant differences between No Disclosure and Standard CBT Disclosure, and these participants rated Specific factors of CBT and the Working Alliance as more important components in treatment, and Empathy and Positive Regard as less important.Conclusions: The content of information disclosures influences lay opinions about the importance of specific and common factors in CBT. Further research should investigate ethically acceptable disclosures to CBT and other forms of psychotherapy, including whether disclosure practices affect treatment outcome.
|
|
| 10. |
|
|
