The impact of consent on observational research: a comparison of outcomes from consenters and non consenters to an observational study

Background Public health benefits from research often rely on the use of data from personal medical records. When neither patient consent nor anonymisation is possible, the case for accessing such records for research purposes depends on an assessment of the probabilities of public benefit and individual harm. Methods In the late 1990s, we carried out an observational study which compared the care given to affluent and deprived women with breast cancer. Patient consent was not required at that time for review of medical records, but was obtained later in the process prior to participation in the questionnaire study. We have re-analysed our original results to compare the whole sample with those who later provided consent. Results Two important findings emerged from the re-analysis of our data which if presented initially would have resulted in insufficient and inaccurate reporting. Firstly, the reduced dataset contains no information about women presenting with locally advanced or metastatic cancer and we would have been unable to demonstrate one of our initial key findings: namely a larger number of such women in the deprived group. Secondly, our re-analysis of the consented women shows that significantly more women from deprived areas (51 v 31%, p = 0.018) received radiotherapy compared to women from more affluent areas. Previously published data from the entire sample demonstrated no difference in radiotherapy treatment between the affluent and deprived groups. Conclusion The risk benefit assessment made regarding the use of medical records without consent should include the benefits of obtaining research evidence based on 100% of the population and the possibility of inappropriate or insufficient findings if research is confined to consented populations

Acute Neurological Toxicity (NT) and Long-Term Outcomes in High-grade Glioma RTOG Trials

Background: Treatment of high-grade glioma consists of fractionated radiation therapy (RT) ± chemotherapy. The incidence/significance of neurological toxicity (NT) in this disease is not known. We evaluated the relationship between acute and chronic NT, and ultimate outcome, as well as risk factors for NT from the RTOG database. American Society of Clinical Oncology (ASCO) 46th Annual Meeting June 4-8, Chicago, IL

Notes on a scandal: the official enquiry into deviance and corruption in New Zealand police

Since 2004, the New Zealand Police Service has been engulfed by a series of scandals relating to allegations that officers have committed rape and sexual assault and conducted inappropriate sexual relations with vulnerable people. Moreover, it has been claimed that other officers engaged in corrupt practices to thwart the investigation and prosecution of criminal behaviour of police officers. In 2007, a Commission of Inquiry report established a program of reform intended to shape the future direction of the police service. This article provides an overview of these scandals, the context in which they have emerged, and the political and policing response to them. The analysis contained in the Commission report is compared with that offered by comparable investigations of police deviance and corruption in other countries. The methodological and conceptual limitations of the Commission are outlined and the prospects of the recommendations are considered

Reclaiming professional identity through postgraduate professional development: Career practitioners reclaiming their professional selves

Careers advisers in the UK have experienced significant change and upheaval within their professional practice. This research explores the role of postgraduate level professional development in contributing to professional identity. The research utilises a case study approach and adopts multiple tools to provide an in-depth examination of practitioners’ perceptions of themselves as professionals within their lived world experience. It presents a group of practitioners struggling to define themselves as professionals due to changing occupational nomenclature resulting from shifting government policy. Postgraduate professional development generated a perceived enhancement in professional identity through exposure to theory, policy and opportunities for reflection, thus contributing to more confident and empowered practitioners. Engagement with study facilitated development of confident, empowered practitioners with a strengthened sense of professional self

On predicting the outcomes of chemotherapy treatments in Breast cancer

Chemotherapy is the main treatment commonly used for treating cancer patients. However, chemotherapy usually causes side effects some of which can be severe. The effects depend on a variety of factors including the type of drugs used, dosage, length of treatment and patient characteristics. In this paper, we use a data extraction from an oncology department in Scotland with information on treatment cycles, recorded toxicity level, and various observations concerning breast cancer patients for three years. The objective of our paper is to compare several different techniques applied to the same data set to predict the toxicity outcome of the treatment. We use a Markov model, Hidden Markov model, Random Forest and Recurrent Neural Network in our comparison. Through analysis and evaluation of the performance of these techniques, we can determine which method is more suitable in different situations to assist the medical oncologist in real-time clinical practice. We discuss the context of our work more generally and further work.Postprin