Showing papers by "Alessandro Liberati published in 1991"
TL;DR: Comparison of patient and physician reports should not be used to validate either source of information, but the degree of patient-physician disagreement found in this research may alert physicians to potential difficulties that can arise in communicating with cancer patients.
79 citations
TL;DR: It is suggested that other than scientific factors guide many doctors in their decision making; they may help to explain why the diffusion of research results into clinical practice is often disappointingly slow.
Abstract: The influence of Italian physicians' attitudes, beliefs, and personal characteristics on medical decision making is examined in the case of surgical treatment of early breast cancer. Responses to a mail survey of 657 physicians from different specialties were analyzed comparing doctors recommending a radical procedure (9%) to those preferring a conservative procedure for younger patients only (25%), and those considering conservative surgery the treatment of choice regardless of patients' age (66%). The findings suggest that the likelihood of physicians' preferring a conservative procedure is influenced by their specialty and the extent to which they feel that a patient should have a role in the treatment decision more than by differences in the beliefs of treatment outcomes. Only preferences of the small group indicating radical surgery as the sole admissible treatment can be accounted for by ignorance or distrust of results of recent trials. These findings suggest that other than scientific factors guid...
75 citations
TL;DR: Overall, the net effect of the intervention appeared to be limited in terms of actual diffusion, attributable influence, and impact, and it was concluded that any thorough assessment of the impact of educational interventions should include a careful analysis of the strategy and process of dissemination.
Abstract: The impact of a national education program based on the dissemination of written guidelines for the treatment of breast, colorectal, and ovarian cancer was investigated in Italy. Through a survey of 770 physicians exploring their knowledge and attitudes and a review of medical records of 1,483 patie
75 citations
30 citations
TL;DR: The distribution of ER and PgR profiles was similar in relation to family history of breast cancer, reproductive events and other selected epidemiologic characteristics of the patients, and ER status and concentrations were independent of menopausal status after adjustment for age.
Abstract: A total of 1095 patients with operable breast cancer and en-rolled in a randomized clinical trial were analysed for estrogen (ER) and progesterone (PgR) receptor content of their primary tumor, and the relationships between steroid receptor status and several epidemiologic characteristics were studied. The proportion of ER+ and median ER levels increased with age: compared to women younger than 40, those aged 66 or more were approximately three times more likely to have an ER+ tumor (OR = 3.0, 95% C.I. = 1.6–5.7). This difference tended to be more marked after comparison between patients with ER > 100 fmol/mg protein and ER- within the same age groups: OR = 7.04, 95 % C.I. = 2.89–17.12. No association emerged between age and PgR. ER status and concentrations were independent of menopausal status after adjustment for age, whereas the proportion of PgR+ and PgR levels were significantly lower in postmenopausal patients of the same age. The distribution of ER and PgR profiles was similar in relation to family history of breast cancer, reproductive events and other selected epidemiologic characteristics of the patients.
8 citations
TL;DR: The worth of a minimal surveillance policy in patients with early-stage breast cancer is discussed and the argument in favor or against minimalist follow-up is based on each authors opinions and beliefs rather than on scientific evidence.
Abstract: To the Editor.— Drs Schapira and Urban 1 and Dr Wertheimer 2 discuss the worth of a minimal surveillance policy in patients with early-stage breast cancer. In both articles, the argument in favor or against minimalist follow-up is based on each authors opinions and beliefs rather than on scientific evidence; in fact, no experimental data (ie, results from randomized clinical trials) are yet available. In 1985 in Italy, the controversy over intensive vs minimal follow-up was rampant. The impossibility of reaching a consensus led to setting up a randomized clinical trial. Two cooperative groups designed a trial independently but with the explicit intent of prospectively pooling their results, comparing an intensive vs a minimalist approach (Table). Overall, 43 Italian hospitals joined the two projects. 3-5 From 1985 to 1987, the two trials accrued 1250 and 1450 patients, respectively, and the median follow-up time is now 5 and 3.5 years. Both
1 citations