The involvement of professional medical writers in medical publications

In this editorial, we comment on the European Medical Writers Association (EMWA) guidelines and the accompanying Delphi study published in this issue of Current Medical Research and Opinion. These articles deal with 'ghost writing' and the role of professional writers. We propose that the interaction between professional writers and authors is defined along the following principles: Guarantee: are the authors guarantors of the article? Advice: was the professional writer 'advised' by the author(s) before, as well as after, starting the assignment? Were the overall conclusions defined by the author(s)? Transparency: the contribution of professional writers should be acknowledged (we provide a draft statement). Expertise: does the professional writer have sufficient knowledge in the relevant specific field? The initials of these headings form the word ' GATE '. Therefore, we called them the ' GATE principles '. We also discuss suggestions for the accreditation of professional writers in specific fields. Professional writers play a useful role but this has to be clearly defined so as to achieve high ethical and scientific standards.     

Lack of involvement of medical writers and the pharmaceutical industry in publications retracted for misconduct: a systematic,controlled, retrospective study

Abstract

Objectives:

The primary objective of this study was to quantify how many publications retracted because of misconduct involved declared medical writers (i.e., not ghostwriters) or declared pharmaceutical industry support. The secondary objective was to investigate factors associated with misconduct retractions.     

Community pharmacists and continuing professional development: a study of perceptions and current involvement

Few pharmacists understood and practised the principles of continuing professional development Needs were often identified through a practice situation which had made the pharmacist uncomfortable by highlighting an area they felt unfamiliar with There was little reported evaluation of learning; indeed, many pharmacists were unsure how they could do this Very few pharmacists had a personal development plan, but over half thought that one would be of value Pharmacists queried the relevance of continuing professional development and personal development plans once their career had progressed as far as they desired or believed themselves capable of and were in “maintenance” mode     

Delphi法及其在医学研究和决策中的应用

Delphi法又称专家调查法，是世界上比较流行的预测或评估某事物规律或流行趋势的调查方法之一。Delphi法，就是为了达到对某事物或研究课题的认识，利用专家的知识、经验、智能等无法量化的信息，通过邮寄问卷调查形式就某一领域问题对一组选定的不同领域的专家进行征询，让他们书写意见并寄回，经过数轮（一般两轮以上）信息交流和反馈修正，使专家意见趋于一致，最后根据专家的综合意见，对研究对象作出预测、评价。预测结果是否准确和成功取决于研究者问卷的设计、所选专家的合格程度、专家的数量及数轮征询时被征询专家的稳定性。     

Interpreting clinical trial results of patient-perceived onset of effect in asthma: methods and results of a Delphi panel

ABSTRACT

Objective: The purpose of this study was to determine if empirically observed differences in patient perception of, and satisfaction with, onset of effect between an active maintenance treatment and placebo are clinically meaningful to practicing clinicians. A secondary objective was to determine the lowest threshold for a clinically meaningful difference in terms of both between-group differences and maximum acceptable placebo effect.

Methods: Twelve community-based healthcare professionals participated in a Delphi consensus panel. Panelists were provided with blinded results of two clinical trials showing statistically significant treatment effects for treatment A (budesonide/formoterol [Symbicort^*]) over placebo in the proportion of patients who could perceive the medication working right away and the proportion of patients satisfied with this perception. Panelists were then asked to respond to a series of questions to identify a threshold for clinically important differences in patient-perceived onset of effect and satisfaction with speed of onset of effect. All expert panelists participated in two rounds of the Delphi process.

Results: Panelists were unanimous in their conclusion that the statistically significant results from the two trials were clinically meaningful. According to these practitioners, the empirical results presented to them, showing that patients could feel a maintenance inhaler therapy work right away, were meaningful to clinical decision-making, and the attribute could potentially improve patient adherence with therapy. A group consensus was reached that a minimum active treatment response for these outcomes should range from 50% to 75% and be 2–3 times larger than the placebo response, with a maximum placebo effect of 26–40%.

Conclusion: A Delphi panel study of practitioners was used to establish a meaningful range of response and a minimal important difference for interpreting results of clinical trials in which patient perception of onset of effect and satisfaction with this perception are tested. While the views of this panel may not be generalized to the entire population of practitioners in the United States, results provide insight into how a typical practitioner is likely to view clinical trial results and how the information might be used in clinical practice.     

军队医院聘用医务人员职称评聘的探讨和研究

在军队精简整编背景下,聘用人员日益成为军队医院发展的一支重要力量.本文从医院实际出发,通过对人员结构、人员需求、人员思想等状况的调查,探索了军队医院聘用医务人员职称评聘工作的做法,研究了新形势下军队医院聘用医务人员管理的新模式,对军队医院聘用人员职称评聘工作提供了有益的借鉴.     

The experience of gambling problems in British professional footballers: a preliminary qualitative study

Media reports suggest high rates of gambling amongst professional footballers but little is known about how footballers develop and then seek help for gambling problems. Here, we report the findings of in-depth, qualitative interviews with 11 British professional footballers who had, or who were, being treated for gambling problems at a residential clinic. These individuals experienced gambling as a highly salient feature of life as a professional football player in UK professional leagues. Often gambling began as part of social networks of young players, but then progressed to gambling problematically in isolation. Factors that facilitated this transition included structural aspects of professional football as an occupation (e.g. high salaries, spare time, gambling as a shared leisure pursuit) as well as the competitive and emotional challenges of the game (e.g. loss of form, injury or contract release and their effects upon mood). Seeking help was delayed by a reluctance to disclose problems to peers and club managers, but facilitated by recommendations from other players with similar experiences.     

The occurrence of leg ulcers in Auckland: results of a population-based study

AIM: To estimate the cumulative incidence rate and prevalence of leg ulcers in Auckland. METHODS: A cross-sectional study was conducted to identify all individuals who had or developed a leg ulcer in the North Auckland and Central Auckland health districts between 1997 and 1998. Cases were identified through multiple sources, including community-based and hospital-based health professionals and by self-notification. All ulcer types were investigated. RESULTS: 611 individuals with healed or current leg ulcers were identified during the study period, of whom 426 had current leg ulcers. The annual cumulative incidence rate was 32 per 100,000. The point prevalence of current leg ulcers was 39 per 100,000, with a period prevalence of 79 per 100,000 per year. Men had lower age-adjusted incidence rates than women, but a higher age-adjusted point prevalence of leg ulceration, indicating that ulcers take longer to heal in men. Annual cumulative incidence rates increased steeply with age (< 60 years = 4, 60-69 years = 62, 70-79 years = 191, 80+ years = 466 per 100,000 per year), as did point prevalence (< 60 years = 5, 60-69 years = 76, 70-79 years = 238, 80+ years = 564 per 100,000). CONCLUSIONS: These data indicate that the risk of developing leg ulcers increases dramatically with age, with individuals aged 60 years and over particularly at risk. Given New Zealand's rapidly ageing population, the number of older people with leg ulcers each year is expected to double in the next 25 years.     

The Newcastle chronic depression study: results of a treatment regime

A trial is described of new therapeutic approaches in treatment-resistant chronic depression. Phenelzine, L-tryptophan and lithium ("5HT-cocktail") was used as the major pharmacological strategy, and a regime aimed at reducing vanadium concentrations was added in the second part of the trial. Patients were randomly assigned to cognitive behaviour therapy in addition. All but 1 of the patients who ultimately entered the trial were unipolar depressives; 2 bipolar patients were withdrawn in the initial drug-free period because of the development of mixed affective states. Eleven of 20 patients showed an improvement to less than 50% of their initial scores on the Hamilton Rating Scale for Depression, and all those who improved did so in the first 6 weeks. Cognitive behaviour therapy did not seem to influence the response, but it is recognized that the short duration of therapy may be inadequate in these circumstances. It is suggested that intensive drug treatment is a necessary preliminary in management and may allow the effective use of rehabilitation aimed at the secondary handicaps of chronic depression.