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The International Committee of Medical Journal Editors (ICMJE) criteria does provide clarity on who qualifies to be an author but I have not been able to find any guidelines about the last author.
1. What is the main senior supervisor's correct position (order of authorship)?
2. Is the second position more valuable than the last one?
3. Do the first and last authors have the same value?
4. In case an author does qualify the ICJME criteria but contributes the least, would it be ideal to place the author last or as the penultimate author to the main senior author?
5. What value does being a corresponding author hold? Since its often used as an important criterion for promotions.
Many thanks
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Does Big Pharma play too big a role in directing and funding Global reasearch?
Should academics be banned from ANY interaction with Big Pharma?
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I think we've seen this problem in this pandemic, big pharma are funding and controlling journals today, and academics are turning to them because the salaries are much higher and the funding is always available.
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Is anyone aware of any organizations that one may apply to for help sponsoring distance learning education in bioethics?
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As part of the available forms of financial support for the development of education conducted remotely via the Internet, e-learning programs are being developed in some countries by government subsidies for schools and universities. On the basis of these financial subsidies, universities and schools can purchase modern IT equipment, computers, laptops, more modern IT systems, etc. enabling the effective implementation of e-learning.
Regards,
Dariusz Prokopowicz
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A need to check different aspects of Teledentistry in COVID-19 situation.
A need to discuss on the topic.
Reply or feedback on various content of the topic is welcomed.
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There are a lot of aspects to talk about regarding teledentistry. Here are some articles on the topic.
This is a good question and it should be added that teledentistry has long been existing, yet the existence of COVID-19 highlighted it. Sub-questions should or may also be added for an in-depth discussion on teledentistry.
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I have never read a systematic review or meta-analysis where a study was excluded due to not being pre-registered as is required by the Declaration of Helsinki. Is this a matter of "the ends do not justify the means" or is it not one to be concerned about?
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Pre-registering is more often required for a systematic review/meta-analysis and not a primary research study that could be in it. Yes, it is becoming more common to pre-register a study/trial now a days but if you exclude studies that are not pre-registered, you may simply just be excluding the older studies. They would be punished simply because pre-registering wasn't around when they were conducted. Thus, requiring pre-registration could impose a bias in your meta-analysis. An approach to evaluate the effect of only including pre-registered studies vs. all studies in a systematic review/meta-analysis would be to run a subgroup analysis comparing pre-registered vs. unregistered studies.
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Measles has been globally well-contained for decades, thanks to the widespread MMR vaccine, which protects children against measles, mumps, and rubella.
However, in recent years, an alarmingly increasing number of parents have decided against vaccinating their children as anti-vaccination "literature" or "culture" has proliferated online, claiming the vaccinations could create worse health issues.
With decreased vaccination coverage, those infections are coming back among children and societies, such as the recent measles outbreak in New York.
What can we do to help prevent such issues in the future?
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"What the Measles Epidemic Really Says About America
The return of a vanquished disease reflects historical amnesia, declining faith in institutions, and a troubling lack of concern for the public good.
PETER BEINART AUGUST 2019 ISSUE [The Atlantic]
...One answer is that contemporary America suffers from a dangerous lack of historical memory. Most of the parents who are today skipping or delaying their children’s combined measles, mumps, and rubella (MMR) vaccine don’t remember life with measles, much less that it used to kill more children than drowning does today. Nor do they recall how other diseases stamped out by vaccines—most prominently smallpox and polio—took lives and disfigured bodies...
Our amnesia about vaccines is part of a broader forgetting. Prior generations of Americans understood the danger of zero-sum economic nationalism, for instance, because its results remained visible in their lifetimes. ..
Declining vaccination rates not only reflect a great forgetting; they also reveal a population that suffers from overconfidence in its own amateur knowledge. In her book Calling the Shots: Why Parents Reject Vaccines, the University of Colorado at Denver’s Jennifer Reich notes that starting in the 1970s, alternative-health movements “repositioned expertise as residing within the individual.” This ethos has grown dramatically in the internet age, so much so that “in arenas as diverse as medicine, mental health, law, education, business, and food, self-help or do-it-yourself movements encourage individuals to reject expert advice or follow it selectively.” Autodidacticism can be valuable. But it’s one thing to Google a food to see whether it’s healthy. It’s quite another to dismiss decades of studies on the benefits of vaccines because you’ve watched a couple of YouTube videos. In an interview, Reich told me that some anti-vaccine activists describe themselves as “researchers,” thus equating their scouring of the internet on behalf of their families with the work of scientists who publish in peer-reviewed journals.
In many ways, the post-1960s emphasis on autonomy and personal choice has been liberating. But it can threaten public health. Considered solely in terms of the benefits to one’s own child, the case for vaccinating against measles may not be obvious. Yes, the vaccine poses little risk to healthy children, but measles isn’t necessarily that dangerous to them either. The problem is that for others in society—such as children with a compromised immune system—measles may be deadly. By vaccinating their own children, and thus ensuring that they don’t spread the disease, parents contribute to the “herd immunity” that protects the vulnerable. But this requires thinking more about the collective and less about one’s own child. And this mentality is growing rarer in an era of what Reich calls “individualist parenting,” in which well-off parents spend “immense time and energy strategizing how to keep their children healthy while often ignoring the larger, harder-to-solve questions around them.”"
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There are many predatory journals online available and also growing day by day. How to detect that the journal is predatory, As I found there is site where there is list of predatory journals but how we will come to know these sites information is correct or not?
Any other way to find out?
As there is continuous threat that somebody may waste their data in publishing in these journals.
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The best, I found with all the information, that we check with thompson reuter.
Please follow the link below for the all journal list, which are peer reviewed and indexed with Thompson reuters
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My questions are divided into two different parts:
1) There are a lot of mosquito control products int he market. I am currently working with one company dedicated to mosquito control, as everyone discusses the new sciences eg. genetic engineering or new larvicide or adulticide but I am interested in knowing the real business after the first testing is done.Kindly suggest some papers. 
2) I have been thrown into a question that what if I have been given 10 Million dollars and preliminary results from a potentially applicable model for mosquito control, so how I am going to use those 10 Million dollars, should I get convinced by the preliminary results and go for further testing or should straight away not get convinced by the results and go with other projects. 
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Hello. I think #1 depends in part on if and which federal regulatory agency would be in charge of clearing your product for use. I've seen the EPA the FDA and the USDA involved depending on the specific technology. For #2, I'm not sure if I'm reading it correctly. But to set up a control program you can work with traditional technologies or partner with someone for using a novel technology. Here is a straightforward read about setting up a traditional program: http://msdh.ms.gov/msdhsite/_static/resources/800.pdf
Hope that helps.
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If this is an issue of microorganism contamination, is it too inefficient to disinfect serum from adult sacrificed animals? Or does adult bovine serum just not work in cell culture? I am asking because I recently read that fetal blood drawal is quite cruel and ethically debated.
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As far as I know FBS has lower leves of antibodies and higher levels of growth factor than serum from adult cows, making it more suitable for fussy cells.
Also the influence of established protocols and acceptance should not be underestimated.
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How should be young practitioner guided towards the ethical issue in this regard? What are the difficulties during making a clinical decision and judgment?
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I endorse comments from Kamal in that testing must be for the benefit of the patient, not the health care professional, who should take standard precautions. In short, test when there is a reason to test, and if the patient is unable to consent, you should be able to explain to a third party why you did the test. If HIV reaches epidemic proportions, then public health measures may need to be considered, policies for which may be slightly different.
On the Indian sub-continent, guidelines for gaining consent from patients for any intervention are frequently inadequate (or not followed), with clinicians having had little or no training on how this should be done. The notion of fully informed consent is a bit of a myth, but clinicians should strive to meet the best standards possible for involving patients in decisions about their care, whether for HIV testing or anything else. The article below is recent and may help (although it doesn't directly address HIV). http://www.astrocyte.in/text.asp?2015/2/2/83/172686. Much of the literature on consent focuses on Europe and north America, but this article is specifically about India.
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Human values are needed for it we need books please inform.
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OK: Alasdair MacIntyre, After Virtue, Notre Dame: University of Notre Dame Press, 1981, 2nd edn. 1984, 3rd edn. 2007 //  Dependent Rational Animals: Why Human Beings Need the Virtues. Chicago: Open Court, 1999. // Three Rival Versions of Moral Enquiry. The Gifford Lectures. Notre Dame: University of Notre Dame Press, 1990.
 Martin Rhonheimer, La prospettiva della moral. Fondamenti dell'etica Filosofica. Armando, Roma 1994.
R. Spaemann, Basic Moral Concepts, trans. T.J. Armstrong. London: Routledge, 1990 (1982).  // 
D. Von Hildebrand, Ethics, 
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Can you also describe other documents needed like informed consent forms, conflicts of interests, research protocols, etc? Samples will be appreciated as well as any guidelines with examples (because those we use in Ukraine might be different from those accepted in EU).
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Hi Svitlana,
You may find useful information in the website "CODEX - rules and guidelines" in the section on human subjects research (and in the subsections about informed consent, biobanks, handling personal information etc).
Good luck!
Mirko
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Eric Racine, a bioethicist, notes: “Naturalism is a controversial stance [in bioethics] because it is customary to view ethics and bioethics as normative and prescriptive fields and therefore different from empirical sciences, which are descriptive and explicative. The reluctance to acknowledge naturalistic commitments, however, can impede methodological and empirical progress in bioethics” (2008, 98). Addendum to that:
"His [Seedhouse’s] belief that no distinction can be drawn between the ethical and empirical aspect of medicine is both wrong and dangerous Whether or not there is a fundamental metaphysical distinction between facts and values, in clinical practice one can and must distinguish the two dimensions…Failure to do so results in muddled thinking. Hume´s naturalistic fallacy is rife in medicine…[he] encourages the powerful body of opinion, which believes that medical ethics is just a matter of opinion…"(Toon 1995, 47).
I know Strong Naturalism, or bioethics as developed by Potter in 1970 doesn't have a good way to counteract a highly relativized medical ethic. Pragmatic Naturalism offers a slightly better model for medical ethics. But also falls short as it will marginalize weaker societal voices. “Thus, as Bellantoni notes, religious experience must, for pragmatic bioethics be at least discounted, if not fully discredited (2003).” (Tollefsen, Cherry, 2003, 541). Then finally, “[I]n the absence of something authoritative to guide moral choices, the phenomenon of moral assertion and argument becomes rather ominous. If moral assertion and argument are understood as oriented towards some standard by which it is to be measured as successful or deviant, then participants in the practice of moral assertion and argument can understand themselves in a common undertaking, aimed at resolving itself into the correct, or right answer. Where there is no such standard, by contrast, assertion and argument become more and more the mere expression of will, and the attempt to manipulate others into accepting one’s own personal dictates.” (540).
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If I understand the question - I would say, methodological naturalism (understood as exclusion of the supernatural from consideration) has done very little to relativize bioethics.  One might think that, by abandoning talk of God in bioethical work, one cannot ground universal, objective moral claims.  But secular ethics has developed a plethora of resources in an attempt do just that. Consider, for example, Rawlsian demands for publically-accessible reasons justifying (basic) laws, which exclude supernatural claims that some will reject.  Rawlsians hardly end up being relativists at the normative level (whatever their metaethical commitments) - they ground universal moral claims using the entirely natural procedure of reflective equilibrium.  And principalism, which for better or worse is dominant in practical bioethics, is also entirely naturalistic while eschewing relativism.  Secular bioethics is very interested indeed in justifying objective moral claims without appeal to God.
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In 12 years of experience with Parkinson's clients the neurological community has agreed with many of my CAM suggestions and even admitted not having thought of supplements recommended.  Effectiveness-based results seem to get credibility.
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Drs ask their patients if they are going to the Vera Lady and tell them to keep going
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Dear everybody, 
As far as I'm concerned, case report doesn't require ethical approval and/or informed consent if researchers can protect the right to anonymity and confidentiality of the patient.
I searched and found that the authors usually don't need any informed consent or/and ethical approval for publishing their article(s) (or they didn't state that information?). Nevertheless, I also found some "outside" ones, they mentioned about informed consent in their article.
This is an example: http://www.jogc.com/abstracts/full/201309_CaseReport_2.pdf (The woman whose story is told in this case report has provided written consent for its publication.).
Do I miss something? Could you please give me a big picture about this?
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You should acquire informed consent by those involved in the study, even if you believe that the anonymity and confidentiality of the patients is being ensured. Research on anonymised data sets have shown that by combining the anonymised data with other open information sources, then deanonymisation is often possible. This risk may be especially large if you talk about a rare disease. It is therefore better to be on the safe side and acquire informed consent by the patients, which they most often will accept doing.
Here is one example of a paper on deanonymising anonymised users:
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(ex. hospitals, non-hospital settings, homes, universities, etc.) What components and characteristics comprise these test beds? Are there different types of medical device test beds(ex. hardware, software, etc)? Where do these devices operate in the radio frequency? Is there a central repository of test results/data that the medical community and other stakeholders can access? What types of medical devices and innovations are being tested? How are tests and simulations being conducted in these settings? What testing standards, if any, are being applied for current wireless medical device test beds? Who are the primary users of wireless medical device test beds (researchers, doctors, innovators, entrepreneurs) and what knowledge can be gleaned from them?
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Try the following;
U.S. Army Telemediicne and Advanced Technology Center (TATRC) at url http://www.tatrc.org/www/default.html
A good central resource for private sector R&D is ECRI Institute at url https://www.ecri.org/Pages/default.aspx
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I assume that we want to conduct a small observational-retrospective human genetic study and publish it to a journal. Example subject: detected Down syndrome rate in a city from 2001 to 2010. Our laboratory already has necessary data because we have done this test for ten years and data were save automatically by the data management system.
So do we need an ethical approval, why and how to get it?
If we need one, so how do the national health statistics office conduct their job in this case, for a nation?
Thank you.
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You can check the HIPAA, but I think all patients or study participants have the right to know how their health information will be used.
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I've submitted a research article that deals with new biomarkers, and is based on samples received from cancer patients. The patients didn't give the blood for this project, however they consented to use the samples for research purposes. The journal asked me an ethical clarification, because I'm working with human material. Can anyone help me with this? If there is any document for exception of ethical clarifications please send it to me.
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The following are some suggested ethical guidelines....
1. The study should not affect adversely in any way to a race, ethnic group, social strata, community or geographical region,.  it may result in social stigma, isolation, healthcare benefits etc because of the study results 
2. All the samples must be de identified  and no personal identifiable information  be included in the study.
3.Bioethics committee of  your Institution  should approve use of samples for the study.
4. ALL SAMPLES ARE CONSIDERED EXEMPT FOR "INFORMED CONSENT"  IF USED FOR NON PROFIT BIOMEDICAL RESEARCH AIMED AT IMPROVING THE HEALTH AND WELLBEING OF THE COMMUNITY . That means you need formal approval from your agency  but you do not need individual consent forms to be signed by the patients/ subjects.
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I recently was told that there may be new regulations and I was curious if there were and what people thought of them.
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Dr. Beth A. Jerskey,
In July of 2014, the FDA revised policies on obtaining Informed Consent in Clinical Trials.  In this newly revised policy the FDA states, "Enrollment of subjects with partial impairment may require modifications to the consent form and process to enable those subjects to consent on their own behalf. When a subject's consent capacity is sufficiently impaired that the subject is unable to provide legally effective informed consent, the subject may not be enrolled unless the subject's legally authorized representative consents on the subject's behalf. "(21 CFR 50.3(l) and 50.20.)
I have attached a link to the FDA website where this policy can be accessed in review. If you refer to section V part E of this document (additional considerations) you will find the entire FDA policy pertaining to enrolling participants with an impaired capacity. I hope the information I have provided is helpful, in your research. It is my pleasure to wish you the best of luck in your future research. Look forward to reading your publications, I hope you have a wonderful weekend.
Regards,
Lars Lafferty
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Although verbal consent is approved in some research (e.g., emergency medicine), it is often not allowed by institutional review boards for standard outpatient protocols. Are there circumstance under which verbal consent, for minimal risk research studies, be allowed?
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In relation to low risk questionnaires (especially electronic questionnaires), it's possible to include a consent statement on the first page, that states that by completing the questionnaire consent is inferred.  This consent statement reiterates the information provided in the information sheet that would normally be included in the consent form (i.e. re: use of data, withdrawal, etc.). I agree with Alper, in that I too think written consent is the preferred method unless there is an extraordinary circumstance making this untenable.  The only other form of verbal consent I have encountered that would seem ethical is the recording of consent in interviews, but this too is often still backed up by written consent.
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Obviously a subject with a great deal of baggage attached to it, but try to forget that and focus purely from a scientific (genetic) point of view what defining features does it have?
My interest in this comes from the recent debate here in the UK about whether mitochondrial replacement therapy constitutes genetic modification. Opinion is divided but the Department of Health thinks it is not. They say that GM is "the germ-line modification of nuclear DNA (in the chromosomes)" - specifically excluding the mitochondrial genome.
See page 15 of this PDF file:
My own opinion is that this definition is not correct but, really, I am most interested to hear how other people (particularly the scientists on ResearchGate!) might define it.
Many thanks
Ted
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Genetic engineering, also called genetic modification, is the direct manipulation of an organism's genome using biotechnology. New DNA may be inserted in the host genome by first isolating and copying the genetic material of interest using molecular cloning methods to generate a DNA sequence. Genetic modification, or GM for short, is not the same as cloning. Although cloning techniques are used in genetic engineering, the two things should not be confused.I believe that the proposed mitochondrial donation techniques do not constitute genetic modification.
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Most of the big companies sponsor clinical trials for their product. But usually trials are directed and inclusion/exclusion criteria will look perfect when reality we can see different results.
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The way most  big companies advertize their products by highly exaggerating facts, and by making false claims,  will lead to similar conclusions about pharmaceutical  companies as well. In their scramble for more profit, one can expect all kinds of  falsehood from them. There is a need for effectively  regulating their activities so as to save the innocent public from being deceived.
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Clearing ethical issues is one of the important steps in bio-medical research/clinical research. What are the issues to be concerned while writting or publishing a case report?
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Dear @ Nageswara, Costas and Abedallah, thanks for the input.
The BMC Medical ethics for case report has not given any requirement for taking ethical clearance. But it is strongly recommended to optain written and signed informed consent from patient/ guardians for publishing the case report.
The statement of world medical association ethical manual also surprisingly didn't discussed the compulsory requirements of ethical approval for reporting a case.
Here I am attaching the links of BMC, World medical association and statement of 59th WMA General Assembly, Seoul, Republic of Korea, October 2008. What is your views on this statements?
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Entomological Studies involving mosquitoes or other arthropods of medical importance requires collection of mosquitoes (adults, larvae, pupa) from human habitation including house-holds, house campuses, agriculture/civil land properties belonging to humans as well as from government lands, forests etc. Is there any ethical issue involve that must be followed and how?
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Dear Dr.Praveen,
As far as I know, there is no ethical clearance required for collection of mosquito or mosquito larvae from human habitat. Unless or until, you are planning to set up a mosquito collecting unit or cabin inside of anyones home, there is not ethical clearance required. Though a word to the local municipality or corporation office would make things easy.
A word to local officals, is only to make things easy and to avoid susspesion.
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This is a weird question on a taboo topic.
I have been discussing some issues about data manipulation with colleagues. Some of them believe that considerable manipulation is done in statistical description of experimental data when unethical researchers want to "prove" their point with statistical analysis. This is made easier by the traditional practice of not publishing raw data behind statistical tests and data descriptions.
However asking to see the raw data is often prized as the ultimate test for veracity. My friends insist that there must be a simple tool, even in Excel, of generating random numbers that would be fit any given (plausible) description of mean +/- SD within an interval, which could be used to bypass such proof tests by giving a false superficial impression of data veracity. I particularly think that such a generated random numbers would not fit statistical tests perfectly, especially if the index values given were also manipulated. This comparison sounds like be an interesting way of using the same tool to double-check statistical data, and seems like it could be automated and even applied to random published literature as a (very controversial yet interesting) scan test.
This is an awkward idea that crossed my mind, and I got curious. I could not find any discussion on this and I find this relevant.
Maybe others here would know more about this?
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Let me rephrase what I think you are asking for. Given a parametrized probability distribution parameters, you seek to generate a data set, for which the empirical estimates of the parameters are identical to specified population parameters. That should be relatively easy for most standard distributions.
For example, if you specify a Gaussian distribution with mean and SD and seek to generate a data set with N observations, you have (N-2) degrees of freedom in your data. That is, you could generate N-2 observations by randomly drawing from the distribution and analytically determine the remaining two observations, such that the mean and SD come out as you have specified them.
Thus, it is easy to see that publishing the raw data is not good enough to ensure veracity. I think the strength in having access to raw data rather is the increased chance to understand and reproduce results and their coming about after data was collected. Generally, it is easier to judge how much voluntary or involuntary nudging went into the choices of preprocessing and methods.
The gold standard for ensuring veracity remains independent replicability.
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Ethical codes are often treated with almost religious reverence but on examination translate to not much more than a rule book. Medical ethics have been with us since Imhotep devised some in around 2600BCE and for over four and a half thousand years have guided medical practice. Are they a higher form of philosophy or just a list of do's and don'ts?
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"Have you got ethics?" Is a question I often hear about whether a research project has got appropriate governance approval. Such approval may involve seeking the opinion of a research ethics committee, but the question is not really asking wheher the ethical issues have been considered, it's asking whether the research can go ahead or whether some box has yet to be ticked. I agree with all the above who say that ethics is about nuanced, contextual consideration of the issues at stake, the complete opposite to a box ticking exercise. However, if the word ethics is used as (inappropriate) shorthand for the somewhat bureaucratic exercise of research governance approval, then confusion will result.
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I am wondering how many individuals with autism have guardianship.
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Anthony,
I agree with your answer, but I am trying to delineate the proportion of individuals who have guardians who make medical decisions (and research decisions depending on state/local laws) for them.
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Is it ethical practice in the provision of methadone to drug users not to offer abstinence programmes to them?
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The much of the literature was about heroin dependent long term addicts and clearly the two options were long term residential treatment of at least 6 months or opioid maintenance. Short term detox treatments in these populations were clearly ineffective. Now days we have a great deal of prescription opioid dependence , some with patients with chronic pain, some with anxiety , and some with clearly addiction as the primary disorder. The data is not as clear in these populations because the duration of dependence varies, but the longer the duration, the more it seems that they are like the old heroin dependent patients. Injectable naltrexone has now come on and shows some promise and is FDA approved for this. A new application of a long used approach is aversion therapy for the opioid use. It still needs to be tested in long term outcomes, but aversion for alcohol and cocaine and smoking dependencies has been very effective in certain populations. Clearly, any abstinence program has to focus on retraining the patient's stress management, anxiety response system and PTSD , and often will require other medications to address these issues. Untreated dual diagnosis also needs to be addressed and may have played a role in impacting the heroin results as well. There is no conflict between 12 step spiritual growth and opioid maintenance or the use of other modalities. Patients with Chronic pain need to be divided into those with ongoing mechanical injury, those with hx of opioid dependence independent of their injury, and those with high anxiety/PTSD prior to or as a result of their injury. The first group may or not be addicted but function better with their opioid maintenance. The second group continue to seek opioids even when the injury resolves and are more like the original opioid dependent patient. The latter includes patients with Fibromyalgia and migraine headaches. The latter group do better with a multidisciplinary program.
The risk of relapse in opioid dependence is special in that a person who had a tolerance and lost it during treatment, and relapses at the same dose level that they used to use, often dies due to loss of tolerance.
The above information should be part of informed consent which allows the patient to choose treatment options for him/herself. Because the risk of relapse to opioid dependence can be fatal this needs to also be included in any informed consent.
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More journals these days are requiring an ethics statement if a human was involved in an experiment. But are there some trivial no-risk classes of experiment for which no approval is universally accepted? Or must one really seek approval for every tiny thing?
For example if I write a paper that records and analyses pedestrian movement in streets is that ok without ethics approval? The data there can be de-identified motion vectors.
Now what about if I study the natural motions of individual people? Is that still ok if the data is de-identified?
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Good question. Taking your term experiment broadly to include observational research with no video or participation by the researcher you are exempt from IRB review. If you have any doubts, you can get what is called an expedited review by the IRB, but you will not be required to use consent forms. In my experience, journals are happy to know that you had an expedited review.
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Getting ethical approval is essential to conduct a study in any society. Thus establishing ethical committees or institutions are mandatory to approve proposals and to monitor the research activities in any societies. However, in some developing countries there are no such committees or institutions; in these cases is it possible to conduct studies without getting ethical approval?
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I've seen people taking formal approval from their head of department in cases where there was no established committee. You can then mention in the article that since there was no ethical committee, the hospital protocol dictated that approval be taken from the head of department. An even better approach may be to actually approach the head of the institution and ask them to set a committee up.
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Exparel is a medication used in surgery. It is the liposomal version of bupivacaine. The company did 3 "pivotal" trials for its approval (www.fda.gov). 2 of these were against placebo and 1 was against bupivacaine. Exparel did better than placebo, but not better than bupivacaine. The exparel versus bupivacaine study was never published. The 2 placebo trials are heavily marketed.
Exparel is $300 versus $2 for bupivacaine.
I have put together an article with above details as well as other information that shows similar outcomes with exparel and bupivacaine and just submitted to pharmacy journal. However, seems like I should do more.
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There are times in which an expensive version of a drug is effective for an individual while the less expensive one is not. I would urge caution in drawing any conclusions based on one study that is only available from the FDA. That is not to say you should not publish, only use caution.