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Biomedical subjects

Thomas E Finucane

Publications and source records attributed to Thomas E Finucane.

At least 19 recordsLinked to original sources
PubMed2006

Advance care planning by or on behalf of peritoneal dialysis patients in long-term care.

BACKGROUND: Advance care planning (ACP) is recommended for dialysis patients, especially those living in long-term-care facilities. Factors influencing ACP and the effect of plans on outcome are incompletely studied. METHODS: We performed a retrospective chart review and follow-up of all peritoneal dialysis patients admitted to an academic nursing home between 1986 and 2000 and abstracted demographics, comorbidities, functional status as activities of daily living (ADL) score, documentation of ACP, and actual interventions. RESULTS: Of 109 patients, 108 had ACP; of these, patients participated in 71%. Plans to do not attempt resuscitation (DNAR) were associated with the presence of coronary disease (odds ratio, 4.24; confidence interval [CI], 1.49 to 12.02), lower ADL score (odds ratio, 1.22; CI, 1.08 to 1.38), and older age (odds ratio, 1.04; CI, 1.0007 to 1.09). Plans to do not hospitalize (DNH) were associated with ADL score only (odds ratio, 1.26; CI, 1.07 to 1.48). Patients with DNAR plans had poorer 3-, 6-, and 12-month survival (P < 0.02), but not after adjustment for age of 75 years or older, poor functional status, coronary disease, and decubiti. Plan compliance was limited. DNH plans were not associated with the likelihood of hospitalization (5 of 14 versus 42 of 93 patients) or length of stay (11.0 +/- 16.4 versus 8.0 +/- 15.1 days). Compliance with DNAR plans was determined for 81 of 108 patients. No patient with a DNAR plan had resuscitation attempted. Only 7 of 46 patients with plans to undergo resuscitation had it attempted. CONCLUSION: For these chronically ill patients, age and functional status strongly influence DNAR and DNH plans. ACP was not decisive in determining events during acute illness.

Adult↗
PubMed2004

Association of funding and findings of pharmaceutical research at a meeting of a medical professional society.

PURPOSE: To evaluate the association between funding and findings of pharmaceutical research presented at an annual meeting of a medical professional society. METHODS: We reviewed the abstracts of all papers and posters presented at the annual meeting of a medical professional society. Two independent raters classified each study of a drug (n = 48) as either positive (favoring the drug studied) or negative, and as either funded by a pharmaceutical company or not. We computed kappa and chi-squared statistics to evaluate the agreement between the raters, as well as the association between the results and the sponsorship of the study. RESULTS: Thirty studies of drugs (63%) were supported by pharmaceutical companies, all of which reported positive results. Of the 18 studies (37%) not supported by pharmaceutical companies, 67% reported positive results. The association between pharmaceutical funding and positive findings was statistically significant (P = 0.0007). CONCLUSION: At this scientific meeting, research funding from pharmaceutical companies was associated with study findings that supported the use of drugs marketed by pharmaceutical sponsors. We emphasize further study of this relation and suggest three principles--full disclosure, policies against "outcome bias," and educational opportunities--that may help manage industry-academia conflicts of interest that could otherwise jeopardize the credibility of pharmaceutical research presented at scientific meetings.

Drug Industry↗