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Biomedical subjects

H R Wulff

Publications and source records attributed to H R Wulff.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1986

Rational diagnosis and treatment.

Clinical decisionmaking includes reasoning from prescientific or scientific theories, reasoning from uncontrolled or controlled experience, and reasoning based on empathic understanding and moral beliefs. The development of contemporary clinical thinking is discussed, and it is found that successive generations of medical practitioners have had different views of the rationality and relative importance of these modes of reasoning: that which is considered rational by one generation of doctors is sometimes denounced by the next. The author's book, Rational Diagnosis and Treatment, which is an example of clinical thinking in the 1960s and early 70s, is used to illustrate one particular view of clinical decisionmaking.

Clinical Trials as Topic↗
PubMed1984

Additional antacid does not increase the effect of cimetidine in gastric ulcer disease.

Eighty-one adult outpatients with endoscopically confirmed gastric ulceration were treated with cimetidine (1 g/day). In addition, the patients were allocated at random to either intensive antacid treatment or placebo treatment. This part of the study was double-blind. It was found that additional antacid treatment had no effect on ulcer healing and symptoms in cimetidine-treated gastric ulcer patients. The results were similar in patients with corpus ulcers and patients with prepyloric ulcers.

Adult↗
PubMed1982

Does the patient appear acutely or chronically ill? An interobserver study of global assessments of hospital patients.

The general appearance of 201 patients was assessed by a team of observers. Each patient was seen by two experienced physicians, two junior physicians and two medical students who stated whether the patients did not appear ill or whether the patient appeared acutely or chronically ill. The interobserver variation was considerable and the kappa-values ranged from around 0 to 0.75. The level of agreement did not seem to depend on the clinical experience of the observers. One experienced clinician assessed the patients differently from the others.

Acute Disease↗
PubMed1981

Ethical aspects of clinical decision-making.

The aim of the present investigation was to describe and to classify significant ethical problems encountered by the members of the staff during the daily clinical work at a hospital medical department. A set of definitions was prepared for the purpose, including the definition of a 'significant ethical problem'. During a three month period 426 inpatients and 173 outpatients were admitted. Significant ethical problems were encountered during the management of 106 in-patients (25 per cent) and 9 out-patients (5 per cent). No significant difference was found between the frequency of ethical problems in female and male patients, but a positive correlation was noted between the number of problems and the patients' age. The problem types were classified according to a problem list. The results of this investigation suggest that greater attention must be paid to discussions about ethical problems among doctors and other categories of health personnel and that, among others, medical students ought to be taught the analysis of ethical problems.

Adolescent↗
PubMed1981

How to make the best decision. Philosophical aspects of clinical decision theory.

An attempt is made to discuss some of the philosophical implications of the use of decision-analytic techniques. The probabilities of a decision analysis are subjective measures of belief, and it is concluded that clinicians base their subjective beliefs on both recorded observations and theoretical knowledge. The clinical decision maker also evaluates the consequences of his actions, and therefore clinical decision theory transcends medical science. A number of different schools of normative ethics are mentioned to illustrate the complexity of everyday decision making. The philosophical terminology is useful for the analysis of clinical problems, and it is argued that clinical decision making has both a teleological and a deontological component. The results of decision-analytic studies depend on such factors as the wealth of the country, the organization of the health service, and cultural norms.

Clinical Competence↗