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Biomedical subjects

R K Lie

Publications and source records attributed to R K Lie.

16 recordsLinked to original sources
PubMed2004

The standard of care debate: the Declaration of Helsinki versus the international consensus opinion.

The World Medical Association's revised Declaration of Helsinki endorses the view that all trial participants in every country are entitled to the worldwide best standard of care. In this paper the authors show that this requirement has been rejected by every national and international committee that has examined this issue. They argue that the consensus view now holds that it is ethically permissible, in some circumstances, to provide research participants less than the worldwide best care. Finally, the authors show that there is also consensus regarding the broad conditions under which this is acceptable.

Clinical Trials as Topic↗
PubMed2004

Research ethics and evidence based medicine.

In this paper, the author argues that the requirement to conduct randomised clinical trials to inform policy in cases where one wants to identify a cheaper alternative to known effective but expensive interventions raises an important ethical issue. This situation will eventually arise whenever there are resource constraints, and a policy decision has been made not to fund an intervention on cost effectiveness grounds. It has been thought that this is an issue only in extremely resource poor settings. This paper gives an example from the United Kingdom illustrating that this is also a problem faced by richer countries.

Control Groups↗
PubMed1998

Ethics of resource allocation in developing countries: the case of Sri Lanka.

The issues of prioritization of health care services and allocation of resources have recently received increasing attention and discussion. Several reports have been published by governments in different countries and the issues are discussed in many recent books and papers. In this paper the focus is on the problems faced by a developing country when allocation of health care resources is considered. We consider these issues under three headings and exemplify the situation in a developing country by taking Sri Lanka as an example. Firstly the evidence to formulate an ethical basis for the existing health care system in Sri Lanka is discussed, in particular the problem of defining a minimum quality of health care for the population. Secondly, we consider the issues which arise when we want to formulate the ethical basis for health sector reform. In particular, we examine current World Bank proposals. We shall argue that there are a number of important conceptual and ethical issues that have not been properly addressed in the various policy documents. Finally, we introduce our own alternative ethical framework for policy reform.

Developing Countries↗
PubMed1993

Methodological and conceptual issues in health care system comparisons: Canada, Norway, and the United States.

There is a growing interest in comparison of international health care data with the hope that such studies will enable individual systems to learn from other systems. Such comparisons, however, presuppose that there exist common criteria for evaluating health care systems. The main thesis of this paper is that these comparative studies are misleading because they employ inappropriate operationalizations of these criteria because the operationalizations are based upon mistaken global conceptualizations of the criteria in question. The essay provides a methodological critique of what has been done and sets a new agenda for future research.

Canada↗
PubMed1991

[Prioritization of health services in Oregon--what can we learn?].

The authors present the state of Oregon's recent proposal for prioritizing the health services. We suggest that the proposal involves certain problems, and suggest alternative methods of making priorities. It is also pointed out, however, that there may be certain lessons to be learned from this proposal in terms of the method used to obtain a prioritized list of health care services.

Cost-Benefit Analysis↗
PubMed1991

The angina pectoris controversy during the 1920s.

This paper examines the evidence for and against the various rival theories for the explanation of pain in angina pectoris. It is shown that the counterarguments used during the 1920s against the coronary theory had not been answered a decade later when the coronary theory was generally accepted by the research and clinical community.

Angina Pectoris↗
PubMed1984

Interns' evaluation of their preparation for general practice: a comparison between the University of Tromsø and the University of Bergen.

A total of 168 interns who have graduated from the Medical Schools of Bergen and Tromsø were asked about various aspects of the medical curriculum. In Bergen the curriculum has a traditional structure with a pre-clinical and a clinical part, but in Tromsø the pre-clinical and clinical subjects are integrated. In addition, the students in Tromsø spend long periods in municipal hospitals and in the primary health care service. We were interested in how the interns from the two universities evaluated their respective curricula and how prepared they felt for their current work. There was a response rate of 86% to the questionnaire. The results showed that the interns from Tromsø are more satisfied with their education and feel more confident in their practical skills than the interns from Bergen. They are also more motivated for future work in general practice. In our opinion the main reason for these results is the difference in curricula in the two medical schools. Other possible reasons are also discussed.

Curriculum↗
PubMed1983

Propranolol induced lipid accumulation and mitochondrial granularity in myocardial cells.

The ultrastructure of the left ventricular wall was studied in mice given intraperitoneal injections of propranolol (5 mg or 20 mg.kg-1 b.w. twice a day for 48 h with an additional dose 3 h before death), and in saline injected controls. Injections of propranolol increase the number of lipid droplets in areas of the myocardium. Fractional volume of lipid droplets in myocardial cells determined using quantitative stereological techniques, showed an increase of 280% and 544% in the group receiving the lowest and highest doses respectively. Injections of propranolol were also followed by an increased granularity of the mitochondria.

Animals↗
PubMed1981

Accumulation of myocardial lipid droplets in dexamethasone-treated mice.

Conventionally fixed and plastic-embedded myocardial tissue from mice treated with 1 mg/kg body weight dexamethasone for 48 h was examined in the electron microscope. The dexamethasone-treated mice showed a marked increase in the accumulation of lipid droplets, as compared with control animals. The percent volume of lipid droplets, calculated by morphometric analysis, showed a significant increase in the dexamethasone-treated mice. No other ultrastructural difference between dexamethasone-treated mice and controls was observed.

Animals↗