33 research outputs found
Do self-reported intentions predict clinicians behaviour: a systematic review.
Background: Implementation research is the scientific study of methods to promote the systematic uptake of
clinical research findings into routine clinical practice. Several interventions have been shown to be effective in
changing health care professionals' behaviour, but heterogeneity within interventions, targeted behaviours, and
study settings make generalisation difficult. Therefore, it is necessary to identify the 'active ingredients' in
professional behaviour change strategies. Theories of human behaviour that feature an individual's "intention" to
do something as the most immediate predictor of their behaviour have proved to be useful in non-clinical
populations. As clinical practice is a form of human behaviour such theories may offer a basis for developing a
scientific rationale for the choice of intervention to use in the implementation of new practice. The aim of this
review was to explore the relationship between intention and behaviour in clinicians and how this compares to
the intention-behaviour relationship in studies of non-clinicians.
Methods: We searched: PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled
Trials, Science/Social science citation index, Current contents (social & behavioural med/clinical med), ISI
conference proceedings, and Index to Theses. The reference lists of all included papers were checked manually.
Studies were eligible for inclusion if they had: examined a clinical behaviour within a clinical context, included
measures of both intention and behaviour, measured behaviour after intention, and explored this relationship
quantitatively. All titles and abstracts retrieved by electronic searching were screened independently by two
reviewers, with disagreements resolved by discussion.
Discussion: Ten studies were found that examined the relationship between intention and clinical behaviours in
1623 health professionals. The proportion of variance in behaviour explained by intention was of a similar
magnitude to that found in the literature relating to non-health professionals. This was more consistently the case
for studies in which intention-behaviour correspondence was good and behaviour was self-reported. Though firm
conclusions are limited by a smaller literature, our findings are consistent with that of the non-health professional
literature. This review, viewed in the context of the larger populations of studies, provides encouragement for
the contention that there is a predictable relationship between the intentions of a health professional and their
subsequent behaviour. However, there remain significant methodological challenges
CCNE1 and survival of patients with tubo-ovarian high-grade serous carcinoma: An Ovarian Tumor Tissue Analysis consortium study
BACKGROUND: Cyclin E1 (CCNE1) is a potential predictive marker and therapeutic target in tubo-ovarian high-grade serous carcinoma (HGSC). Smaller studies have revealed unfavorable associations for CCNE1 amplification and CCNE1 overexpression with survival, but to date no large-scale, histotype-specific validation has been performed. The hypothesis was that high-level amplification of CCNE1 and CCNE1 overexpression, as well as a combination of the two, are linked to shorter overall survival in HGSC. METHODS: Within the Ovarian Tumor Tissue Analysis consortium, amplification status and protein level in 3029 HGSC cases and mRNA expression in 2419 samples were investigated. RESULTS: High-level amplification (>8 copies by chromogenic in situ hybridization) was found in 8.6% of HGSC and overexpression (>60% with at least 5% demonstrating strong intensity by immunohistochemistry) was found in 22.4%. CCNE1 high-level amplification and overexpression both were linked to shorter overall survival in multivariate survival analysis adjusted for age and stage, with hazard stratification by study (hazard ratio [HR], 1.26; 95% CI, 1.08-1.47, p = .034, and HR, 1.18; 95% CI, 1.05-1.32, p = .015, respectively). This was also true for cases with combined high-level amplification/overexpression (HR, 1.26; 95% CI, 1.09-1.47, p = .033). CCNE1 mRNA expression was not associated with overall survival (HR, 1.00 per 1-SD increase; 95% CI, 0.94-1.06; p = .58). CCNE1 high-level amplification is mutually exclusive with the presence of germline BRCA1/2 pathogenic variants and shows an inverse association to RB1 loss. CONCLUSION: This study provides large-scale validation that CCNE1 high-level amplification is associated with shorter survival, supporting its utility as a prognostic biomarker in HGSC
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A comparison of three methods of eliciting sensitive information from female adolescents
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Psychological distress and in vitro fertilization outcome
ObjectiveTo examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress.DesignProspective cohort study over an 18-month period.SettingFive community and academic fertility practices.Patient(s)Two hundred two women who initiated their first IVF cycle.Intervention(s)Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up.Main outcome measure(s)IVF cycle outcome and psychological distress.Result(s)In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety.Conclusion(s)IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure