An anecdote is an anecdote is an anecdote ... but a clinical trial is data.
Explore the source record for details and available documents.
Adult↗
SEARCH · PubMed Health
Results for “ANECDOTES”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Anecdotal obsessions? A comment on the use of anecdotes by the general media to support claims in CAM.
Explore the source record for details and available documents.
Complementary Therapies↗
Anecdotal therapies.
Traditionally, many advances in medicine have been serendipitous. Are serendipitous and anecdotal synonymous? Many of our materia medica today relate to initial probes and anecdotal reports that matured to full investigation and therapeutic indications. The recent situation regarding Skin Cap is one that highlights the downside of this scenario. Several drugs in the US continue usage largely related to anecdotal indications, and anecdotal extension of legend indications is a standard for American Dermatology. The situation with systemic drugs, such as Trental, zinc preparations, imidazoles for extended indications, lysine and melatonin, all will be discussed. Topical preparations such as skin cap, cantharone, Vioform, all also are included in this category. It is important to place this topic in perspective in regards to geographic variation and therapeutic need. Many diseases lacking specific therapy are important targets for anecdotal therapy, and this will foster continued approaches in this area. The growing standardization of medicine and pharmaceutical regulation, threatens the anecdotal approach, but it provides still an important link to the future for some forms of therapy in diseases that are difficult to treat. Traditionally, the anecdote has been the first step in the therapeutic chain. Withering discovery of the benefits of the common fox glove in dropsy, was followed by many other anecdotes arriving via folk-medicine in the New World. This approach of utilizing folk medicine has now reached new heights, with very active searches by major pharmaceutical companies throughout the third world for remedies that may have potential. Couched with this is the history of anecdotal "snake-oil" remedies, that clearly had no benefit to anyone except the huckster marketing same. The excesses in this area of unproven and false therapies, led to the gradual organization of therapeutic trials and the Food and Drug Administration in the US as we know it today. The biggest shot in the arm for enhancing FDA protocols was the thalidomide situation, an outgrowth of an ethically studied and used medication that perhaps had been released too soon, prior to sufficient trials to determine the total patient risk. As in many situations, the pendulum swings in both directions, and after thalidomide, the acceptance of new treatments required more and more rigorous studies, and studies from other countries often were not acceptable unless a small part of a larger, whole proposal. The AIDS crisis has prompted a swing back, away from such expensive and rigorous pre-marketing review, to more expedited processes for the relief of patients with this fatal disease. This has streamlined the FDA, and hopefully the swing of the pendulum will not go too far, to result in problems in the future. Anecdotal therapies and medications are the first step in many parts of the world to therapeutic trials. The most widely used aspects of anecdotal therapies, again, remains in the situation with diseases without good therapies at the present time. The so-called orphan drugs and orphan diseases, while a serious medical problem, do not present a significant volume for effective drug screening in many instances, and the FDA has developed some new approaches to circumvent this very expensive development process for patients suffering from these rare and unusual disorders. The most recent example of anecdotal therapy catching the public fancy in dermatology was the Skin-Cap Spray. This product, over the period of twelve months, got rave reviews in the lay press in the non-peer reviewed dermatologic periodicals, and amassed impressive sales figures in this period of time. It was extremely effective, and most dermatologists who used it have patients who consider it the most effective therapy in the last year. The formulation of a low concentration of zinc pyrithione seemed unusual, and this truly was an anecdotal approach, using a homeopathic dosage of a commonly used p
Anecdotes as Topic↗
Reducing the influence of anecdotal reasoning on people's health care decisions: is a picture worth a thousand statistics?
BACKGROUND: People's treatment decisions are often influenced by anecdotal rather than statistical information. This can lead to patients making decisions based on others' experiences rather than on evidence-based medicine. OBJECTIVE: . To test whether the use of a quiz or pictograph decreases people's reliance on anecdotal information. DESIGN: . Two cross-sectional survey studies using hypothetical scenarios. Participants read a scenario describing angina and indicated a preference for either bypass surgery or balloon angioplasty. The cure rate of both treatments was presented using prose, a pictograph, a quiz, or a pictograph and quiz combination. Participants read anecdotes from hypothetical patients who described the outcome of their treatment; the number of successful anecdotes was either representative or unrepresentative of the cure rates. Setting and Participants. Prospective jurors at the Philadelphia County Courthouse and travelers at the Detroit-Wayne County Metropolitan Airport. Measurements. Proportion of respondents preferring bypass over balloon angioplasty. RESULTS: . In study 1, when statistical information was presented in prose, treatment choices were influenced by anecdotes, with 41% of participants choosing bypass when the anecdotes were representative and only 20% choosing it when the anecdotes were unrepresentative (x(2) = 14.40, P < 0.001). When statistics were reinforced with the pictograph and quiz, anecdotes had no significant influence on treatment decisions (38% choosing bypass when anecdotes were representative v. 44% when unrepresentative, x(2) = 1.08, P > 0.20). In study 2, the tradeoff quiz did not reduce the impact of the anecdotes (27% v. 28% choosing bypass after receiving or not receiving the quiz, x(2) < 1, P > 0.20). However, the pictograph significantly reduced the impact of anecdotes, with 27% choosing bypass after receiving no pictograph and 40% choosing bypass after receiving a pictograph (x(2) = 6.44, P < 0.001). CONCLUSIONS: . Presenting statistical information using a pictograph can reduce the undue influence of anecdotal reasoning on treatment choices.
Adult↗
Doctors telling stories: the place of anecdote in GP registrar training.
Observational studies within a hospital setting confirm the widespread use of anecdotes in hospital-based medical education and hypothesize a number of reasons for this. Whilst anecdotes may be used effectively in teaching there can be dangers in their inappropriate use. There is no information on the level and nature of the use of anecdotes within medical education in the community. The authors undertook a questionnaire study that asked GP trainers about how they used anecdote in their GP registrar teaching. The results suggested that GP trainers use anecdotes frequently in their registrar teaching, recognize the use of anecdotes described in the literature and have little concern that anecdotes might mislead. The authors discuss how anecdotes may be used to help build registrars' illness scripts, and to develop ways of thinking and working congruent with the existing professional community.
Anecdotes as Topic↗
Unity from diversity: the evidential use of anecdotal reports of adverse drug reactions and interactions.
Anecdotal case reports contribute about one-third of the published literature on adverse drug reactions and interactions, but are regarded as providing poor-quality evidence. However, they can occasionally provide proof of cause and effect, and there are many other reasons for publishing them. Because an anecdote is a narrative, narratological paradigms from literature, art, and music can show how we can make evidential use of anecdotes. Useful paradigms are the dramatic unities (of time, place, and action), comprehensive catalogues, and pattern formations. Here I give examples of each of these types of paradigm and show how they can be used to interpret anecdotes about adverse drug reactions and interactions. The dramatic unities show how a proper classification of adverse drug reactions can be achieved, according to dose-relation, time-course, and susceptibility factors; use of this classification should improve the evidential use of anecdotal reports. A high background incidence of the effect (the medical equivalent of subplots, which violate the unity of action) makes it more difficult to detect adverse drug effects using anecdotal reports. To make best evidential use of the corpus of anecdotal reports of adverse drug reactions, comprehensiveness is important: each suspected adverse reaction should be reported in detail and reactions should be reported in sufficient numbers for proper classification and for patterns to be recognized. One form of pattern recognition, teleoanalysis of data, should, when possible, include not only randomized controlled trials and observational studies, but also case series and anecdotal reports.
Anecdotes as Topic↗
Misuse of anecdotes in primatology: lessons from citation analysis.
This study analyzes the accuracy of anecdotes cited in behavioral primatology publications. Anecdotes (n=1 cases) recounting tool use were sought in the four main primatological journals. Citations of anecdotes in the scientific literature that met three criteria were systematically coded for recognition and accuracy. The results showed that 60% of the time, authors who cited anecdotes did not explicitly acknowledge them as such. To a lesser extent, the citations exaggerated the frequency of anecdotal events or misrepresented their status. For tool use specifically, the actor was misreported more often than the tool or its target. Multiple citations were incorrect more often than single citations. Overall, it seems that citation of anecdotes is problematic and may have far-reaching implications in terms of misleading overgeneralizations. Primatologists should take care in citing singular or rare events.
Anecdotes as Topic↗
Using anecdotal information in evidence-based health care: heresy or necessity?
Anecdotes are powerful tools that humans use to make decisions. Despite their power and influence, they are sometimes misused, and sometimes undervalued. Ignoring or under-estimating the role of anecdotal information in health care decisions is likely to hinder communication among decision makers, and to retard their uptake of research evidence. Anecdotal information should not be considered as a replacement for, but as a complement to formal research evidence. If evidence-based health care is to meet its potential, the important role of anecdotes must be acknowledged, studied and utilized.
Anecdotes as Topic↗
Does qualitative synthesis of anecdotal evidence with that from scientific research help in understanding public health issues: a review of low MMR uptake.
STUDY OBJECTIVE: To explore the professional and parental factors underlying low MMR uptake by qualitative synthesis of evidence from technical and non-technical anecdotal literature. METHODS: An intensive investigation of literature covering research, press, online, E groups and grey literature was carried out using devised search strategies. Key themes were identified from both the research and anecdotal evidence, which were merged to form common themes. RESULTS: The review of technical literature identified media scare and inadequate information from health professionals as the main reasons for non-uptake of MMR. The non-technical anecdotal evidence showed that professionals' belief in parental right to choose, target payments and fear of autism were the major factors. CONCLUSIONS: Anecdotal evidence may contribute to evidence-based public health practice, especially in widely debated public health issues.
Humans↗
Patient treatment preferences in localized prostate carcinoma: The influence of emotion, misconception, and anecdote.
BACKGROUND: Multiple therapeutic options exist for localized prostate carcinoma, without conclusive evidence to guide the choice of treatment. Thus, treatment should reflect trade-offs between the probability of curing disease and the desire to avoid treatment-associated side effects. Factors that actually influence patient treatment preferences are poorly understood. METHODS: We reviewed medical records and carried out in-depth, semistructured interviews of 20 men with newly-diagnosed, clinically-localized prostate carcinoma in a Veterans Affairs Hospital following their first consultations with urologists and before treatments were initiated. Six to eight months after treatment, we carried out follow-up interviews. Interviews explored beliefs and attitudes about prostate cancer and treatment options, emotional reactions to the diagnosis, treatment preferences, information sources, and perceptions of interactions with urologists. RESULTS: Patient treatment preferences were not based on careful assessments of numerical risks for various clinical outcomes. Instead, feelings of fear and uncertainty contributed to a desire for rapid treatment, and specific preferences were profoundly influenced by misconceptions, especially about prostatectomy, and by anecdotes about the experiences of others with cancer. Few patients wanted to seek second opinions. Most patients received treatments that matched their initial preferences. Afterwards, they justified their choices in terms of the same misconceptions and anecdotal influences invoked during treatment deliberation. CONCLUSIONS: For men with localized prostate carcinoma, the treatment decision-making process would benefit from interventions that moderate feelings of fear and a desire for rapid treatment, dispel common and powerful misconceptions about prostate cancer and its therapies, and help patients avoid over-reliance on anecdotes.
Aged↗
Anecdotal notes. Effective clinical evaluation and record keeping.
Faculty use numerous techniques to evaluate student nurses' clinical performance. The development of keen observational skills is crucial to evaluating students' performance, but this is only the first step. Fair student evaluations require the faculty member to recall incidents and draw sound conclusions about clinical performance events. There are various tools to assist the nurse educator in evaluating students' clinical performance. The authors describe one such tool, the anecdotal record, used by nursing faculty for clinical record keeping and evaluation. Guidelines for anecdotal record keeping and solutions to common management issues related to anecdotal record keeping are provided.
Anecdotes as Topic↗
Galen's anecdote of the fallen sophist: on the certainty of science through anatomy.
In this paper the author recounts an anecdote presented by Galen of Pergamum (circa 130-200 A.D.) about a sophist named Pausanias, who fell from his mount and struck his back against a rock. The patient developed a subsequent loss of sensation in the fingers of his left hand with complete sparing of motor function. Numerous medications were applied to his hand but to no avail. Galen stated that he applied the same medications to the original point of dorsal tenderness, resulting in the patient's dramatic and full recovery. Galen attributed the healing to local drug action at the site of a presumed spinal root injury, at the level of C-7. Galen repeated this anecdote elsewhere to illustrate the remote effects of spinal cord and nerve injury and the importance of treating the site of pathology, rather than its somatic manifestations. Galen's observation is interpreted in light of his earlier experiments on spinal cord and nerve transections in live animals and his evolving concepts of functional and correlative neuroanatomy. This anecdote is also discussed as a striking example of the dangers of conjecture and the temptation to confuse association with causation when interpreting the effects of therapy in light of widely accepted paradigms.
Greece, Ancient↗
Can anecdotes add to an understanding of hypnosis?
This paper emphasizes the importance of anecdotes, in conjunction with experimental data and careful clinical observation,for an understanding of hypnosis. Anecdotes are presented that bear on (a) individual differences in hypnotizability, (b) the stereotypes of hypnosis, (c) the importance of careful wording in preparing experimental subjects and clinical patients for hypnosis, (d) the notion of hypnosis as involving a partial, but not complete, setting aside of critical judgment, which permits the hypnotized person to engage in fantasy and make-believe, (e) confabulation in hypnotic age regression, (f) the differentiation of hypnotic and therapeutic suggestion, (g)the nature of hypnotic suggestion, and (h) some experiences with the posthypnotic persistence of an uncanceled suggestion.
Anecdotes as Topic↗
Technology as the representative anecdote in popular discourses of health and medicine.
Using a Burkean framework (1969), this article approaches medical dramas as cultural texts to be read for dominant meanings of health and health care. Burke's representative anecdote illuminates the melding of science, technology, and healing in popular discourses of health, establishing technological intervention as the norm and marginalizing nontechnological (i.e., alternative) forms of health care. Popular entertainment reinforces this anecdote in narratives of healing as technological competence triumphing over nature.
Anecdotes as Topic↗
The Mersey Basin: an historical assessment of water quality from an anecdotal perspective.
The freshwaters of the Mersey Basin have been seriously polluted for over 200 years. Anecdotal evidence suggests that the water quality was relatively clean before the start of the Industrial Revolution. The development of the cotton and chemical industries increased the pollution load to rivers, and consequently a decline in biota supported by the water was observed. Industrial prosperity led to a rapid population increase and an increase in domestic effluent. Poor treatment of this waste meant that it was a significant pollutant. As industry intensified during the 19th century, the mix of pollutants grew more complex. Eventually, in the 1980s, the government acknowledged the problem and more effort was made to improve the water quality. Knowledge of social and economic history, as well as anecdotal evidence, has been used in this paper to extrapolate the changes in water quality that occurred.
Animals↗
Validity of anecdotal reports of suspected adverse drug reactions: the problem of false alarms.
Suspected adverse drug reactions first reported in 1963 in the "British Medical Journal," the "Lancet," the "Journal of the American Medical Association," and the "New England Journal of Medicine" were reviewed 18 years later to assess their initial validity and subsequent verification. Of 52 first reports, five were deliberate investigations into potential or predictable reactions, and in each case causality was reasonably established; the other 47 reports were essentially anecdotal. Of these 47 reports, 14 related to categories of adverse reaction where false-positive reports were unlikely: immediate reactions, local reactions, and known reactions caused by a different mode of administration or a brand previously thought or claimed to be safe. The problem of false alarms rose in the remaining types of reactions: general reactions that did not occur immediately after administration and arose for the first time with a new chemical entity. Of 33 reports of such suspected adverse reactions, validity was satisfactorily established in 14 cases on the basis of rechallenge, predictability from known pharmacology, or the unique nature of the reaction. Of the remaining 19 reports, further verification still has not been satisfactorily established in 12. Seven of these possible false alarms were haematological reactions.Although 35 of the 47 anecdotal reports were clearly correct, of the 19 reports that were not reasonably validated at the time of the report, only seven were subsequently verified. This suggests that agencies monitoring adverse drug reactions should adopt criteria for assessing the validity of first reports of suspected adverse reactions. Such criteria should include: reactions on rechallenge, a pharmacological basis for the adverse reaction, immediate acute reactions, local reactions at the site of administration, reactions with a new route of administration of a drug known to provoke such reactions by another route, and the repeated occurrence of very rare events.
Drug-Related Side Effects and Adverse Reactions↗
Turning anecdotes into data--the critical incident technique.
This article describes the critical incident technique and offers practical guidance on how the technique can be used to investigate dilemmas in medicine. It extols the particular virtue of this research method for general practice that it can be used to exploit the natural tendency of doctors to tell anecdotes. How the principles of the technique relate to significant event analysis, a form of medical audit, is also discussed.
Anecdotes as Topic↗
Distorted learning from unusual medical anecdotes.
Doctors are encouraged to look upon each patient as a learning experience ( Wyngaarden , 1979). Case-oriented learning begins in the clinical years of medical school and continues throughout the professional career of the doctor. Clinical cases, or anecdotes, have the potential of producing accurate, relevant and meaningful learning for the clinician even though they are uncontrolled in a scientific sense. However, unusual or atypical cases can also result in erroneous learning which can negatively affect patient care. The purpose of this article is to identify difficulties in this form of subjective learning which can lead to suboptimal doctor practice patterns. Six actual clinical cases are briefly described to illustrate how inaccurate learning distorted subsequent clinical problem-solving by doctors. Suggestions are then made for ameliorating this difficulty.
Anecdotes as Topic↗