The aim of this study was to investigate (potential) research participants' (a) information preferences with regard to receiving biobanks' genetic research results, and (b) attitudes towards the... Show moreThe aim of this study was to investigate (potential) research participants' (a) information preferences with regard to receiving biobanks' genetic research results, and (b) attitudes towards the duties of researchers to communicate research results. A total group of 1,678 was analyzed, consisting of a sample of the general Dutch population (N = 1,163) and patients with asthma, rhinitis, and thrombosis (N = 515) who completed a survey including six fictitious genetic research results each presented as aggregate and individual result, varied for treatability and kind of disease. Five questions assessed attitudes towards researchers' duties to communicate research results. Additionally, background characteristics were measured. A majority of the respondents wanted to receive aggregate results as well as individual results. A small majority (59%) held the view that researchers should communicate individual results with no health consequences. One third agreed with an information duty only when treatment is available. A preference for individual results and an attitude in favor of communicating results were both associated with belonging to the general Dutch population rather than being a patient, wanting to learn about own health as the reason for biobank-participation, a monitoring coping style, a general desire for health information, perceived meaningfulness of genetic information and no anticipated anxiousness. A sizable majority of respondents showed a high information preference for individual results, even when it is unclear that treatment is available. Fewer were of the opinion that researchers should make this possible. For their communication policy biobanks should take notice of (potential) participants' high information preferences and expectations. (C) 2010 Wiley-Liss, Inc. Show less
The incidence of venous thrombosis (VT) increases sharply with age: it is very rare in young individuals (< 1 per 10 000 per year) but increases to similar to 1% per year in the elderly, which... Show moreThe incidence of venous thrombosis (VT) increases sharply with age: it is very rare in young individuals (< 1 per 10 000 per year) but increases to similar to 1% per year in the elderly, which indicates that aging is one of the strongest and most prevalent risk factor for venous thrombosis. The cause of this steep age gradient is as yet, unexplained. The aim of this review was to provide an overview of studies on the effect of conventional risk factors as well as age-specific risk factors for thrombosis in the elderly. Limited data are available on risk factors for thrombosis in the elderly, i.e. all results are based on small study groups. Results indicate that, of the conventional risk factors, malignant disease, the presence of co-morbidities and the genetic risk factors factor (F)V Leiden and the prothrombin mutation seem to be associated with an increased risk of venous thrombosis. In the elderly, the population attributable risk (PAR) of malignancy is approximately 35%, for co-morbidities a PAR up to 25% is found, and the contribution of genetic risk factors to the thrombosis incidence is estimated to be 7-22%. Age-specific risk factors of thrombosis, i.e. endothelial dysfunction and frailty may be important in the explanation of the increased incidence of VT in the elderly. In conclusion, as aging is a major risk factor for thrombosis, further identification of the risk factors for thrombosis in the elderly is needed to elucidate the age gradient of the incidence of VT and to target preventive measures. Show less
P>Venous thrombosis of the upper extremity is a rare form of thrombosis, accounting for around 4% of all venous thromboses, and for which only a few risk factors are known. This case-control... Show moreP>Venous thrombosis of the upper extremity is a rare form of thrombosis, accounting for around 4% of all venous thromboses, and for which only a few risk factors are known. This case-control study investigated the effect of coagulation factors on risk of venous thrombosis of the upper extremity. Patients with venous thrombosis of the arm and partner controls were selected from the Multiple Environmental and Genetic Assessment study, a large population-based case-control study. Participants with a malignancy were excluded. Odds ratios (OR) were estimated for elevated levels of factor II, VII, VIII, IX, X, XI, von Willebrand Factor (VWF), and fibrinogen, low levels of protein C, protein S, and antithrombin, and for blood group non-O. Substantially increased risks of venous thrombosis of the upper extremity were found for patients with high levels (above 90th percentile versus below) of factor VIII (OR: 4 center dot 2, 95% confidence interval (CI): 2 center dot 2-7 center dot 9), VWF (OR: 4 center dot 0, 95% CI: 2 center dot 1-7 center dot 8), fibrinogen (OR: 2 center dot 9, 95% CI, 1 center dot 5-5 center dot 7), and for blood group non-O compared to O (OR: 2 center dot 1, 95% CI, 1 center dot 3-3 center dot 6). The other factors were not associated with an increased risk. Elevated levels of several procoagulant factors are associated with a strongly increased risk of venous thrombosis of the upper extremity. Show less
Background: Claims made in advertisements in medical journals might not always be supported by high-quality evidence, and referenced studies may have been sponsored by the pharmaceutical industry... Show moreBackground: Claims made in advertisements in medical journals might not always be supported by high-quality evidence, and referenced studies may have been sponsored by the pharmaceutical industry itself We studied to what extent randomised controlled trials (RCTs) support the claims in advertisements in leading medical journals. Methods: Consecutive unique advertisements were selected from nine different medical journals, and evaluated by 250 medical students using a standardised score form. The quality of RCTs that were referenced in these advertisements was assessed with an instrument based on the Chalmers' score. Results: 158 RCTs from 94 advertisements were used in the study. In total 55% of the RCTs had a high-quality score, 44% intermediate, and Show less
