Genetic knowledge and moral responsibility: ambiguity at the interface of genetic research and clinical practice

2006 ◽  
Vol 69 (3) ◽  
pp. 199-203 ◽  
Author(s):  
D. Pullman ◽  
K. Hodgkinson
2005 ◽  
Vol 20 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Alexandra E. Shields ◽  
David Blumenthal ◽  
Kevin B. Weiss ◽  
Catherine B. Comstock ◽  
Douglas Currivan ◽  
...  

2007 ◽  
Vol 23 (2) ◽  
pp. 162-168 ◽  
Author(s):  
Kirsten F. L. Douma ◽  
Kim Karsenberg ◽  
Marjan J. M. Hummel ◽  
Jolien M. Bueno-de-Mesquita ◽  
Wim H. van Harten

Objectives: Technologies in health care are evolving quickly, with new findings in the area of biotechnological and genetic research being published regularly. A health technology assessment (HTA) is often used to answer the question of whether the new technology should be implemented into clinical practice. International evidence confirms that the results of HTA research sometimes have limited impact on practical implementation and on coverage decisions; the study design is commonly based on the paradigm of stability of both the technology and the environment, which is often not the case. Constructive technology assessment (CTA) was first described in the 1980s. In addition to the traditional HTA elements, this approach also takes into account the technology dynamics by emphasizing sociodynamic processes. With a CTA approach, comprehensive assessment can be combined with an intentional influence in a favorable direction to improve quality.Methods: In this study, the methodological aspects mainly concerning the diagnostic use of CTA are explained. The methodology will be illustrated using the controlled introduction of a new technology, called microarray analysis, into the clinical practice of breast cancer treatment as a case study. Attention is paid to the operationalization of the phases of development and implementation and the research methods most appropriate for CTA.Conclusions: In addition to HTA, CTA can be used as a complementary approach, especially in technologies that are introduced in an early stage of development in a controlled way.


1997 ◽  
Vol 46 (3) ◽  
pp. 139-146
Author(s):  
B. Dallapiccola ◽  
I. Torrente ◽  
R. Mingarelli ◽  
G. Novelli

AbstractThe present genome era is characterized by speedy progress and prompt transfer of results into clinical practice. This creates the need for rapid disclosure of results and renewal of laboratory's protocols. Molecular cytogenetics has provided and increased ability to identify chromosomes, correlate chromosome structure with gene location, find out cryptic aberrations, and detect specific DNA sequences. These advances have allowed the confident discovery of a number of contiguous gene syndromes. The positional cloning and positional candidate strategies have greatly expedited the search process of disease genes, and become relevant methods for genes' discovery. Understanding the molecular basis of diseases has shown an unpredicted wide genetic heterogeneity, which has splitted single disorders into many clinically similar conditions, and added complexity to the nosology of human diseases. The opposite process, allelism, where clinical diversity results from allelic mutations, has lumped together many distinct disorders, by showing that different clinical entities are not necessarily due to mutations in different genes. Dynamic mutations have provided the molecular understanding of interindividual and intrafamilial variability including anticipation, in a number of diseases. The discovery of distinct correlations between the molecular pattern and disease severity is providing a unique opportunity for using molecular results to assess the clinical outcome. Diagnostic, presymptomatic and predictive molecular testing are becoming widely used and provide enormous opportunities for improving the lot of our patients.


2014 ◽  
pp. 1-16
Author(s):  
Alessio Squassina ◽  
Mirko Manchia ◽  
Christina Mitropoulou ◽  
George P. Patrinos

2010 ◽  
Vol 11 (8) ◽  
pp. 1149-1167 ◽  
Author(s):  
Alessio Squassina ◽  
Mirko Manchia ◽  
Vangelis G Manolopoulos ◽  
Mehmet Artac ◽  
Christina Lappa-Manakou ◽  
...  

2011 ◽  
Vol 118 (1) ◽  
pp. c3-c8 ◽  
Author(s):  
Albert C.M. Ong ◽  
Olivier Devuyst

Author(s):  
Bethania López-Star ◽  
José F. Pérez-Pérez ◽  
Priscila Sánchez-Moreno ◽  
Luis A. Ochoa-Ramírez

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