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Biomedical subjects

H R Wulff

Publications and source records attributed to H R Wulff.

At least 19 recordsLinked to original sources
PubMed1995

[Attitude of Danish patients and physicians to information on cancer. A questionnaire study].

This survey reports the attitude towards information of cancer patients as regards diagnosis and prognosis among gastroenterologists and patients (not suffering from cancer). The questions were based on a case history (a patient with colonic cancer). Most doctors informed their patients openly, and most patients expected that. Younger doctors in particular were more restrictive than patients as regards information of the spouse.

Adult↗
PubMed1995

The inherent paternalism in clinical practice.

It is sometimes suggested that the physician should offer the patient "just the facts," preferably in a "value-free manner," explain the different options, and then leave it to the patient to make the choice. This paper explores the extent to which this adviser model is realistic. The clinical decision process and the various components of clinical reasoning are discussed, and a distinction is made between the biological, empirical, empathic/hermeneutic and ethical components. The discussion is based on the ethical norms of the public health services in the Nordic countries, and the problems are illustrated by a clinical example. It is concluded that the adviser model is unrealistic. Patient information is important, but the complexity of clinical reasoning makes it impossible to separate facts and value judgments. It is claimed that there is an inherent element of paternalism in clinical decision-making and that clinical practice presupposes a mutual trust between physician and patient.

Adult↗
PubMed1993

[Clinical decisions in a philosophical perspective].

Medicine is both a scientific and a humanistic discipline. The foundation for clinical decisions has four components (two scientific and two humanistic). 1) The biological component (reasoning based on biological theory). Biological thinking is currently being revolutionised, partly through the development of systems theory. 2) The empirical component (reasoning based on experience from earlier patients), which comprises both uncontrolled and controlled experience. 3) The empathic-hermeneutic component (reasoning based on an understanding of the patient as a fellow human being). Empathy requires hermeneutic knowledge which can be acquired through personal experience and by qualitative research. 4) The ethical component which comprises both utilitarian and deontological considerations.

Clinical Competence↗
PubMed1993

What do gastroenterologists in Europe tell cancer patients?

This survey concerns the variation in attitudes among European gastroenterologists to truth telling in cases of cancer. Gastroenterologists in all parts of Europe were asked to consider a case of colonic cancer and to state what they would tell the patient and the patient's spouse. 260 replied. Gastroenterologists in northern Europe would usually reveal the diagnosis to both the patient and the patient's spouse, but some would inform only the spouse with the patient's permission. They would sometimes embellish the truth if the cancer had metastasised. Gastroenterologists in southern and eastern Europe would usually conceal the diagnosis from the patient, in many cases even when the patient asked to be told the truth. Most, however, would tell the spouse the full truth about both diagnosis and prognosis. The variation probably reflects differences in both doctors' attitudes and patients' expectations.

Attitude of Health Personnel↗
PubMed1992

Philosophy of medicine--from a medical perspective.

In this commentary on the article by Arthur L. Caplan [1] the philosophy of medicine is viewed from a medical perspective. Philosophical studies have a long tradition in medicine, especially during periods of paradigmatic unrest, and they serve the same goal as other medical activities: the prevention and treatment of disease. The medical profession needs the help of professional philosophers in much the same way as it needs the cooperation of basic scientists. Philosophy of medicine may not deserve the status of a philosophical subspecialty or field, but is so closely linked to the main trends of contemporary medical thinking that it must be regarded as an emerging (or reemerging) medical subdiscipline.

Ethics, Medical↗
PubMed1990

[Future medical research].

Medical progress requires a well-balanced research effort in a number of different fields, and this paper lists those types of research which will be needed in the future. The author analyses the foundation of clinical decisions and stresses the importance of continued biological laboratory research and controlled clinical studies. He also stresses the need for new types of research such as quality assurance, medical audit and humanistic studies (qualitative research, descriptive ethical studies and philosophical enquiries).

Decision Making↗
PubMed1988

Magic of p values.

Explore the source record for details and available documents.

Statistics as Topic↗
PubMed1988

What do dentists know about statistics?

A multiple choice test with nine statistical questions was sent to a random sample of Danish dentists to assess their knowledge of elementary statistical expressions (SD, SE, P less than 0.05, P greater than 0.05 and r). Of 250 dentists, 129 (52%) answered the questions. The test was also completed by 27 (71%) of 38 dental students immediately after the last lecture in statistics. The median number of correct answers was 2.2 among the dentists and 3.4 among the dental students. It is concluded that the statistical knowledge of most dentists, and to a lesser degree also dental students, is so limited that they cannot be expected to be critically against or to draw the right conclusions from those statistical analyses with which they are confronted. Only 35% of the dentists stated that it is very important that this problem be raised.

Attitude of Health Personnel↗
PubMed1988

Effect of omeprazole and cimetidine on prepyloric gastric ulcer: double blind comparative trial.

We conducted a six week double blind randomised study of 176 patients with prepyloric gastric ulcer to determine whether the proton pump inhibitor, omeprazole 30 mg daily would accelerate healing and pain relief, as compared with cimetidine 1 g daily. At two, four, and six weeks after entry ulcers healed in a larger percentage of patients treated with omeprazole (54, 81, and 86%) than of those treated with cimetidine (39, 73, and 78%) ('intention to treat' cohort; p less than 0.05 at two weeks). A higher proportion of patients on omeprazole became free of pain during the first week of treatment (p less than 0.05). No major clinical or biochemical side effects were noted. Omeprazole is an efficient treatment for patients with prepyloric gastric ulcers.

Adult↗
PubMed1988

Single case studies. An introduction.

The limitations of conventional group comparative therapeutic trials are discussed. They include: the heterogeneity problem (due to biological variations within the sample) and the extrapolation problem (i.e. the problem of external validity). These problems may to some extent be overcome by multiple cross-over studies in a single patients. Such studies may be useful in selected cases in daily clinical work, but could also be used for detecting treatment effects in rare diseases. Usually, it is necessary to measure the clinical effect by means of clinical scores, for which reason ranking methods must be used. The statistical significance may be judged by means of a permutation test. The risk of committing a type II error in single patient studies is usually high.

Clinical Trials as Topic↗