Steven Joffe

..An alternate approach to risk-benefit assessment that is congruent with the scientific purpose of RCTs can better guide ethical evaluation of these trials, as discussed in this Perspective...

..Many research subjects believe incorrectly that the primary purpose of clinical trials is to benefit the participants rather than to improve therapy for future patients. However, few data are available about how physicians view trials...

..We sought to examine the relative influence of involvement in decisions, confidence and trust in providers, and treatment with respect and dignity on patients' evaluations of their hospital care...

..Even though ACP was more prevalent among this sample than in the general population, its use still could be enhanced, given the high risks of decisional incapacity and death that HCT patients face...

..This principle is violated if trials systematically favour either the experimental or the standard treatment...

..To study pediatricians' assessments of the quality of their ethics education, the impact of various learning methods, and their confidence in confronting ethical dilemmas arising in pediatric practice...

..Until such data are available, patients with cancer should be encouraged to enroll in clinical trials on the basis of trials' unquestioned role in improving treatment for future patients...

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..The effects of clinical-trial funding on the interpretation of trial results are poorly understood. We examined how such support affects physicians' reactions to trials with a high, medium, or low level of methodologic rigor...

..Pediatric hematopoietic cell transplantation physicians are currently best situated to use cord blood therapeutically. We sought to describe the experiences and views of these physicians regarding private cord blood banking...

..Future studies should consider sharing trial results with patients and evaluating the process and its effect on both patients and clinicians...

..Although sparse, the medical literature on this increasingly prevalent type of medical communication is also reviewed...

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..We conducted a national survey of ethicists at freestanding children's hospitals to explore the structures and processes of their ethics-consultation services and committees and to characterize their training and professional activities...

..CONCLUSION Authors who perform key roles in the conception and design, analysis, and interpretation, or reporting of oncology clinical trials are more likely than authors who do not perform such roles to have financial ties to industry...

..We assessed parents' experiences with treatment for their children with cancer and no realistic chance of cure...

..To date, only five children with both diseases have been described. The aim of the study was to describe the characteristics of children with IBD and ITP...

..With the increasing availability of new, modestly toxic, expensive drugs for patients with advanced cancer, questions of when to stop these drugs will become increasingly relevant...

..e. duty to warn). We also provide a summary of consensus points and additional discussion questions for each case...

..S., highlight how consent to research differs from consent to treatment, and explore the difficulties that arise in research involving cancer patients and certain vulnerable populations...

..Efforts to educate providers and participants about the underlying goals of clinical trials are needed...

..Previous studies have evaluated practice variation in hematopoietic cell transplantation (HCT) among transplant centers and countries. There are no studies investigating individual physician practice variation in HCT...

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..Current practice for documenting assent is derived largely from documentation of informed consent for adults as there is little guidance in federal regulations. We propose a new approach to documenting assent...

..A substantial minority wanted to be informed about the oversight system to protect against financial conflicts of interest and about researchers' financial interests. Copyright 2006 Massachusetts Medical Society...

..After clarifying the ethical significance of the therapeutic misconception with respect to the decision making of patients, we offer policy recommendations for obtaining informed consent to participation in clinical trials...

..We need an entirely new conception of clinical research ethics - one that looks to science instead of the doctor-patient relationship...

..Using data from American Society of Clinical Oncology (ASCO) Annual Meetings, we determined the frequency, type, and monetary value of researchers' financial interests...

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..These data will help shape practice and policy regarding the return of individual results from genomic research. ..

..Joffe's development as a local and national resource in research ethics for the oncology community. ..

..Finally, public trust in and support for the research enterprise itself requires rigorous attention to the identification and management of adverse events. ..

..These data will help shape practice and policy regarding the return of individual results from genomic research. ..

..The findings of this proposal will either reaffirm trust in these trials, or will stimulate the development of enhanced systems of accountability for clinical research ..