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Biomedical subjects

L Fallowfield

Publications and source records attributed to L Fallowfield.

45 records · Page 3Linked to original sources

Getting it taped: the 'bad news' consultation with cancer patients.

'Not being told what is wrong' is the most frequent complaint patients make (Fletcher, 1980). In cancer a lack of information greatly increases the stress and anxiety experienced. In this report, 46 patients with cancer were given audiotape recordings of their 'bad news' consultations to take home. Analysis of subsequent questionnaire data revealed that both patients and their families benefited enormously from the opportunity to hear the details of their diagnosis and treatment again.

Humans↗

Selective loss of chromatic sensitivity in demyelinating disease.

Thresholds for detecting changes in color for isoluminant stimuli and for detecting changes in luminance were measured in patients with histories of demyelinating disease and in normal controls. Thresholds for detecting changes in color were higher for patients' affected eyes, that is, ones in which symptoms had been found previously, than in their unaffected eyes, or for eyes of control subjects. Thresholds for detecting changes in luminance were raised less than those for changes in color. The pattern of loss is different than that found in subjects with congenital color blindness. The results suggest that the impairment occurs at a level in the nervous system beyond which signals from more than one class of cone receptor are combined.

Color Perception↗

Missing quality of life data in cancer clinical trials: serious problems and challenges.

Measurement of quality of life (QOL) in cancer clinical trials has increased in recent years as more groups realize the importance of such endpoints. A key problem has been missing data. Some QOL data may unavoidably be missing, as for example when patients are too ill to complete forms. Other important sources are potentially avoidable and can broadly be divided into three categories: (i) methodological factors; (ii) logistic and administrative factors; (iii) patient-related factors. Logistic and administrative factors, for example, staff oversights, have proven to be most important. Since most QOL measurements require patient self-report, it is usually not possible to rectify the failure to collect baseline data or any follow-up assessments. There is strong evidence that such data are not 'missing at random', and cannot be ignored without introducing bias. Although several approaches to the analysis of partly missing data have been described, none is entirely satisfactory. Prevention of avoidable missing data is better than attempted cure. In July 1996, an international conference on missing QOL data in cancer clinical trials reported the experience of most major groups involved. This paper will serve as an introduction to the problem and provide an estimation of its magnitude, and approaches to its prevention and solution.

Bias↗

The ideal consultation.

Poor communication skills have adverse consequences on physical, psychosocial and economic aspects of health care. The essential elements of an ideal consultation as described lead to more accurate diagnosis, greater patient satisfaction, and more rewarding consultations both professionally and personally.

Clinical Protocols↗