scholarly journals New Frontiers and Old Challenges: How to Manage Incidental Findings When Forensic Diagnosis Goes Beyond

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 731
Author(s):  
Luciana Caenazzo ◽  
Pamela Tozzo ◽  
Kris Dierickx
Keyword(s):  
Clinical Practice ◽  
Medical Research ◽  
Cause Of Death ◽  
Incidental Findings ◽  
Descriptive Analysis ◽  
Traditional Values ◽  
Forensic Investigation ◽  
Potential Health ◽  
Forensic Assessments ◽  
Unexpected Findings

Incidental findings (IFs) are well known in medical research and clinical practice as unexpected findings having potential health or reproductive importance for an individual. IFs are discovered under different contexts but do not fall within the aim of a study, and/or are unanticipated or unintentionally revealed, and/or are not the specific focus or target of the particular research or clinical query. Today, in forensic settings, we can consider as incidental findings all the information that is neither related to the cause of death nor to the dynamic of the event or the scope of the forensic investigation. The question whether and how professionals should consider traditional values as guiding notions in the reporting of IFs in the context of forensic assessments is the focus of this article. We propose a descriptive analysis, which focuses on the forensic field, describing forensic situations in which IFs may occur, and whether and to whom they may be disclosed. Some considerations will be provided regarding forensic experts concerning their moral commitment to warn relatives about IFs.

scholarly journals After placebo: In medical research and clinical practice R.Nunn, ArjanaMedia 2015

2018 ◽  
Vol 24 (5) ◽  
pp. 1265-1267
Author(s):  
Cosima Locher ◽  
Jens Gaab ◽  
Michael Loughlin ◽  
Charlotte Blease
Keyword(s):  
Clinical Practice ◽  
Medical Research

scholarly journals Shining a Light also Casts a Shadow: Neuroimaging Incidental Findings in Neuromarketing Research

Neuroethics ◽  
2021 ◽  
Author(s):  
Owen M. Bradfield
Keyword(s):  
Public Health ◽  
Rapid Growth ◽  
Incidental Findings ◽  
Brain Research ◽  
Social Value ◽  
Financial Resources ◽  
Potential Health ◽  
Functional Brain ◽  
Public Health Systems ◽  
The Social

AbstractRapid growth in structural and functional brain research has led to increasing ethical discussion of what to do about incidental findings within the brains of healthy neuroimaging research participants that have potential health importance, but which are beyond the original aims of the study. This dilemma has been widely debated with respect to general neuroimaging research but has attracted little attention in the context of neuromarketing studies. In this paper, I argue that neuromarketing researchers owe participants the same ethical obligations as other neuroimaging researchers. The financial resources available to neuromarketing firms and the social value of neuromarketing studies should command greater attention to the elucidation and management of incidental findings. However, this needs to be balanced against finite resources available within most public health systems.

Meso-Level Racism in Medicine

Contexts ◽  
2021 ◽  
Vol 20 (3) ◽  
pp. 57-59
Author(s):  
Ashley C. Rondini
Keyword(s):  
Clinical Practice ◽  
Medical Research ◽  
Medical Care ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Structural Racism ◽  
Meso Level ◽  
Medical Tests ◽  
The U.S

This article highlights that the standardization of medical care in the U.S. relies on clinical practice guidelines (CPGs), which indicate institutionalized norms about when and under what circumstances it is appropriate to administer specific medical tests and courses of treatment. However, when CPGs in medicine derive from medical research that was informed by since-debunked ideas about race, they may also facilitate structural racism.

scholarly journals Ten Famous Composers of the Romantic Era and their Cause of Death

2021 ◽  
Author(s):  
Ernest K.J. Pauwels
Keyword(s):  
Medical Research ◽  
Cause Of Death ◽  
21St Century ◽  
Causes Of Death ◽  
Human Life ◽  
Modern Medicine ◽  
Expression Of Emotion ◽  
The World ◽  
Romantic Era ◽  
Clinically Significant

The musical composers in the Romantic Era (1800-1910) strived for compositions that expressed human life, including happiness, harmony and despair. They lived in a period in which freedom of thinking, expression of emotion and inspiration by nature predominate. During this period, intensive trading with other parts of the world brought new microorganisms along, which made infections and epidemics very common. This article serves to address the cause of death and relevant biographic data of a number of well- known Romantic composers. Primarily, this review refers to clinically significant findings using reports that were retrieved from Pubmed, Embase and Google over the 19th, 20th and 21st century till 14th June 2021. Here, this text dwells on diseases and the cause of death of ten composers, namely Mozart, Beethoven, Chopin, Schubert, Schumann, Mendelssohn, Brahms, Liszt, Mahler and Bruckner. It is evident that, in the sight of modern medicine, symptoms and forensic facts are not complete, but witnesses' reports and recent medical research have provided passable and plausible clarity. Although many questions will remain unanswered, it appears that the diseases of these composers and their causes of death have their origins in alcohol abuses, age, epidemics (like tuberculosis) and syphilis.

scholarly journals Premature Mortality in Canada

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Catherine Liang ◽  
Emmalin Buajitti ◽  
Laura Rosella
Keyword(s):  
Cause Of Death ◽  
Descriptive Analysis ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Income Quintile ◽  
Mortality Trends ◽  
Premature Deaths ◽  
Central Canada ◽  
Over Time

Introduction: Premature mortality (deaths before age 75) is a well-established metric of population health and health system performance. In Canada, underlying differences between provinces/territories present a need for stratified mortality trends. Methods: Using data from the Canadian Vital Statistics Database, a descriptive analysis of sex-specific adult premature deaths over 1992-2015 was conducted by province, census divisions (CD), socioeconomic status (SES), age, and underlying cause of death. Premature mortality rates were calculated as the number of deaths per 100,000 individuals aged 18 to 74, per 8-year era. SES was measured using the income quintile of the neighbourhood of residence. Absolute and relative inequalities were respectively summarized using slope and relative indices of inequality, produced via unadjusted linear regression of the mortality rate on income rank. Results: Premature mortality in Canada declined by 21% for males and 13% for females between 1992-1999 and 2008-2015. The greatest reductions were in Central Canada, while Newfoundland saw notable increases. CD-level improvements appeared mostly in the southern half of Canada. As of 2008-2015, Newfoundland, Nova Scotia, and Nunavut had the highest mortality rates. Low area-level income was associated with higher mortality. SES inequalities grew over time. Newfoundland’s between-quintile differences rose from 1292 to 2389 deaths per 100k males, or 1.33 to 2.12-fold, and 586 to 1586 per 100k females, or 1.24 to 1.74-fold. In 2008-2015, mortality rates of the bottom quintile in Manitoba and Saskatchewan were more than 2.5 times those of the top. Mortality increased with age, and varied regionally. Low mortality in Central Canada and BC, and high mortality in the Territories were consistent across eras and sexes. Cause of death distributions shifted with age and sex, with more external deaths in younger males. Conclusion: Improvements were seen in adult premature mortality rates over time, but were unequal across geographies. Evidence exists for growing socioeconomic disparities in mortality.

scholarly journals Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care

2020 ◽  
Vol 30 (11) ◽  
pp. 1748-1756
Author(s):  
Charles H Norell ◽  
John Butler ◽  
Rhonda Farrell ◽  
Alon Altman ◽  
James Bentley ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Clinical Practice ◽  
Health System ◽  
Cancer Treatment ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Patterns Of Care ◽  
Debulking Surgery ◽  
Potential Health ◽  
International Differences

IntroductionThe International Cancer Benchmarking Partnership demonstrated international differences in ovarian cancer survival, particularly for women aged 65–74 with advanced disease. These findings suggest differences in treatment could be contributing to survival disparities.ObjectiveTo compare clinical practice guidelines and patterns of care across seven high-income countries.MethodsA comparison of guidelines was performed and validated by a clinical working group. To explore clinical practice, a patterns of care survey was developed. A questionnaire regarding management and potential health system-related barriers to providing treatment was emailed to gynecological specialists. Guideline and survey results were crudely compared with 3-year survival by ‘distant’ stage using Spearman’s rho.ResultsTwenty-seven guidelines were compared, and 119 clinicians completed the survey. Guideline-related measures varied between countries but did not correlate with survival internationally. Guidelines were consistent for surgical recommendations of either primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery with the aim of complete cytoreduction. Reported patterns of surgical care varied internationally, including for rates of primary versus interval debulking, extensive/‘ultra-radical’ surgery, and perceived barriers to optimal cytoreduction. Comparison showed that willingness to undertake extensive surgery correlated with survival across countries (rs=0.94, p=0.017). For systemic/radiation therapies, guideline differences were more pronounced, particularly for bevacizumab and PARP (poly (ADP-ribose) polymerase) inhibitors. Reported health system-related barriers also varied internationally and included a lack of adequate hospital staffing and treatment monitoring via local and national audits.DiscussionFindings suggest international variations in ovarian cancer treatment. Characteristics relating to countries with higher stage-specific survival included higher reported rates of primary surgery; willingness to undertake extensive/ultra-radical procedures; greater access to high-cost drugs; and auditing.

scholarly journals Incidental findings during emergency sonographic examinations: a case series

CJEM ◽  
2001 ◽  
Vol 3 (02) ◽  
pp. 105-108
Author(s):  
John L. Kendal ◽  
Diku Mandavia
Keyword(s):  
Emergency Medicine ◽  
Clinical Practice ◽  
Patient Care ◽  
Incidental Findings ◽  
Training Programs ◽  
Case Series ◽  
Sonographic Examination ◽  
Emergency Ultrasonography

ABSTRACTThe teaching of ultrasonography is rapidly being incorporated into emergency medicine (EM) training programs and clinical practice. Most literature focuses on appropriate indications for the performance of emergency ultrasonography, and most EM-related courses and programs limit their teaching to standard focused indications. Generally this will suffice; however, occasionally, incidental findings, which are beyond the realm of what is taught in these programs, have influenced patient care. In this paper we discuss 7 cases in which incidental findings were discovered during an emergency sonographic examination. In each case the findings changed the patient’s disposition, diagnosis and, potentially, outcome.

scholarly journals Empirical Analysis of Current Approaches to Incidental Findings

2008 ◽  
Vol 36 (2) ◽  
pp. 249-255 ◽  
Author(s):  
Frances Lawrenz ◽  
Suzanne Sobotka
Keyword(s):  
Empirical Analysis ◽  
Incidental Findings ◽  
Scientific Literature ◽  
Human Subjects ◽  
Human Subjects Research ◽  
Potential Health ◽  
National Human ◽  
Multidisciplinary Working ◽  
Imaging Research ◽  
Object Of Study

Researchers in the health sciences regularly discover information of potential health importance unrelated to their object of study in the course of their research. However, there appears to be little guidance available on what researchers should do with this information, known in the scientific literature as incidental findings (IFs). The study described here was designed to determine the extent of guidance available to researchers from public sources. This empirical study was part of a larger two-year project funded by the National Human Genome Research Institute (NHGRI) to generate guidance on how incidental findings should be managed in human subjects research, especially genetics, genomics, and imaging research. We generated empirical analysis of publicly available guidance and consent forms to help guide a multidisciplinary Working Group of experts in their formulation of normative recommendations reported in this symposium.

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