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Biomedical subjects

A Robert Kagan

Publications and source records attributed to A Robert Kagan.

At least 19 recordsLinked to original sources
PubMed2006

The case for case reports: avoiding statistical seduction.

The management of patients with cancer teaches us the worth of logical thought, the advantage of flexibility of thinking and the thrill of occasionally doubting the experts. Asking questions and learning from the answers teaches us how to think. On the other hand, searching for the single best treatment, when no single treatment works for all patients, leads to a sort of intellectual tyranny that has numerous names: the gold standard, the community standard, best practice, and evidence-based medicine (EBM), with the implication that to take an alternative management route is substandard and unethical.

Evidence-Based Medicine↗
PubMed2005

Intensity-modulated radiotherapy for adenocarcinoma of the prostate: a point of view.

Adenocarcinoma of the prostate (CaP) is treated by surgery or irradiation, or both, with the type of treatment determined largely by local resources and referral patterns. Although the techniques employed by surgeons and radiation oncologists have improved and the morbidities associated with each have declined, for neither are they negligible. Epidemiologic data suggest that between 81% and 85% of men with CaP die of other causes, and a recent survey of untreated men arrived at a similar figure of 83%. Clinical reports, based upon postoperative tumor volume and grade, show that at least 5% of prostatectomies are unnecessary but the extent to which the other 95% benefit from this procedure is unclear. Some sense of these benefits is provided by a randomized, prospective clinical trial that compared prostatectomy with watchful waiting, and found only a 6% gain in overall survival after 8 years. These data call into question the promotion of highly complex and expensive radiation therapy equipment for the treatment of CaP when the prospects for increased life expectancies are at best small and unlikely to be distinguishable from results achieved by surgery, conventional external beam, or radioactive-seed implants.

Adenocarcinoma↗
PubMed2004

Communicating with patients.

The effective clinician realizes that more than accurate factual information is necessary for effective communication. The responsibility for this communication is the doctor's. Herein is an examination of some of the major areas of contention that, if acknowledged by the physician, can lead to better communication with the patient.

Communication↗