M K Giacomini
Affiliation: McMaster University
- When research seems like clinical care: a qualitative study of the communication of individual cancer genetic research resultsFiona A Miller
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
BMC Med Ethics 9:4. 2008..Empirical data on these questions are limited. Available evidence suggests, on the one hand, growing support for disclosure, and on the other, the potential for significant harm...
- Guidelines as rationing tools: a qualitative analysis of psychosocial patient selection criteria for cardiac proceduresM K Giacomini
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont
CMAJ 164:634-40. 2001..The aim of this study was to investigate the terms and justifications for and the meanings of psychosocial patient characteristics used in cardiac procedure guidelines...
- Banking on it: public policy and the ethics of stem cell research and developmentMita Giacomini
Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC 3H1C, 1200 Main Street, West, Hamilton, Ont, Canada L8N 3Z5
Soc Sci Med 65:1490-500. 2007..They are therefore highly worthy of scientific pursuit. This conclusion is provisional and the framework must be reapplied as scientific knowledge, technological capacity and ethical mores evolve...
- Ethics frameworks in Canadian health policies: foundation, scaffolding, or window dressing?Mita Giacomini
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Health Policy 89:58-71. 2009..Only one third of the documents relate specific ethical elements to specific policies. In conclusion, we draw on the clinical guidelines literature to propose some features of a robust, coherent and meaningful ethics framework...
- One of these things is not like the others: the idea of precedence in health technology assessment and coverage decisionsMita Giacomini
Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main Street West, HSC 3H1C, Hamilton, Ontario L8N 3Z5, Canada
Milbank Q 83:193-223. 2005..Each stage requires distinctive decision maker roles, information, and methods...
- The policy analysis of 'values talk': lessons from Canadian health reformMita Giacomini
Centre for Health Economics and Policy Analysis, McMaster University, HSC 3H1C, Hamilton, ON, Canada L8N 3Z5
Health Policy 67:15-24. 2004..but also in substance (e.g. physical entities, goals, principles, attitudes, etc.). We review the diversity of concepts underlying 'values talk' in health policy, and discuss implications for policy analysis and future research...
- Economic considerations for health insurance coverage of emerging genetic testsMita Giacomini
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada
Community Genet 6:61-73. 2003....
- Confronting the "gray zones" of technology assessment: evaluating genetic testing services for public insurance coverage in CanadaMita Giacomini
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
Int J Technol Assess Health Care 19:301-16. 2003..The third domain addresses the need to make decisions under uncertainty and to respond to "gray" evaluations with conditional-coverage decisions. The evaluation criteria should be applied within sound decision-making processes...
- Life support decision making in critical care: Identifying and appraising the qualitative research evidenceMita Giacomini
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
Crit Care Med 37:1475-82. 2009..The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care...
- Theory-based medicine and the role of evidence: why the emperor needs new clothes, againMita Giacomini
Department of Clinical Epidemiology and Biostatistics, Centre for Health Economic and Policy Analysis, McMaster University, Hamilton, ON, Canada
Perspect Biol Med 52:234-51. 2009..Medicine-even evidence-based medicine-is theory-based at its core. EBM must cultivate greater capacity to address the crucial role of theory in both the generation and use of experimental evidence...
- What does it mean to trust a health system? A qualitative study of Canadian health care valuesJulia Abelson
Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Canada
Health Policy 91:63-70. 2009..We used a qualitative empirical study of Canadians' values toward their health system to develop more meaningful conceptualizations of trust and health systems that can inform the pursuit of more trustworthy health systems...
- Ethics in Canadian health technology assessment: a descriptive reviewDeirdre DeJean
Health Research Methodology Programme, McMaster University, Ontario, Canada
Int J Technol Assess Health Care 25:463-9. 2009..This study examines both whether and how ethical issues are incorporated into HTA...
- Bringing 'the public' into health technology assessment and coverage policy decisions: from principles to practiceJulia Abelson
Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Health Sciences Centre, Hamilton Ontario, Canada
Health Policy 82:37-50. 2007..The framework offers a menu of choices for policy makers contemplating changes to public involvement, as well as a model that can be used to characterize and analyze different approaches across jurisdictions...
- Ruling in and ruling out: implications of molecular genetic diagnoses for disease classificationFiona Alice Miller
Centre for Health Economics and Policy Analysis, McMaster University, Canada
Soc Sci Med 61:2536-45. 2005....
- Redefining disease? The nosologic implications of molecular genetic knowledgeFiona Alice Miller
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
Perspect Biol Med 49:99-114. 2006..Ironically, genetic information is likely to play a central role in producing a new, but still empirical, classification scheme...
- Understanding and changing attitudes toward withdrawal and withholding of life support in the intensive care unitDeborah Cook
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Crit Care Med 34:S317-23. 2006..Understanding these attitudes may offer valuable insights about strategies that should help improve the care for dying patients and their families...
- How qualitative research can contribute to research in the intensive care unitTasnim Sinuff
Department of Critical Care, Sunnybrook Health Sciences Centre, and Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada
J Crit Care 22:104-11. 2007..To illustrate how our understanding of social phenomena such as patient safety and behavior change has been enhanced we use recent qualitative studies in acute care medicine...
- Facilitating clinician adherence to guidelines in the intensive care unit: A multicenter, qualitative studyTasnim Sinuff
Department of Critical Care and Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Crit Care Med 35:2083-9. 2007..To determine perceived facilitators and barriers to guideline implementation and clinician adherence to guidelines in the intensive care unit (ICU)...
- Practice guidelines as multipurpose tools: a qualitative study of noninvasive ventilationTasnim Sinuff
Department of Critical Care, Sunnybrook Health Sciences Centre, Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada
Crit Care Med 35:776-82. 2007..The objective was to understand the knowledge about and attitudes toward an NIV guideline for patients with ARF and potential barriers to its use...
- Wanted: a new ethics field for health policy analysisNuala Kenny
Department of Bioethics, Dalhousie University, 5849 University Ave, Rm 315, Halifax, NS B3H 4H7
Health Care Anal 13:247-60. 2005..Third, we require new policy and ethical analytic approaches that contribute to constructive (not obstructive) policy making. Finally, we need indicators of robust, high quality ethical analysis for the purpose public policy making...
- Research use in children's mental health policy in Canada: maintaining vigilance amid ambiguityCharlotte Waddell
Mental Health Evaluation and Community Consultation Unit, Department of Psychiatry, University of British Columbia, 2250 Wesbrook Mall, Vancouver, BC, Canada V6T1W6
Soc Sci Med 61:1649-57. 2005....
- Fairness, accountability for reasonableness, and the views of priority setting decision-makersDouglas K Martin
Department of Health Policy, Management and Evaluation, and the Joint Centre for Bioethics, University of Toronto, 88 College Street, Toronto, Ont M5G 1L4, Canada
Health Policy 61:279-90. 2002..According to these decision makers, accountability for reasonableness is acceptable and applicable. Our findings also provide refinements to accountability for reasonableness...
- Contending visions in the evolution of genetic medicine: the case of cancer genetic services in Ontario, CanadaFiona Alice Miller
Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario M5T 3M6, Canada
Soc Sci Med 67:152-60. 2008..Yet questions about who will control genetic technologies are not simply turf battles between the professions: they are also inescapably questions about what the genetic technologies should and will accomplish clinically...
- Predictive genetic tests and health system costsSteve Morgan
Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC
CMAJ 168:989-91. 2003