It has been argued extensively that diagnostic services are a general good, but that it is offered in excess. So what is the problem? Is not "too much of a good thing wonderful", to paraphrase Mae West? This article explores such a possibility in the field of radiological services where it is argued that more than 40% of the examinations are excessive. The question of whether radiological exami...

BACKGROUND Creatine and minocycline were prioritized for testing in Phase II clinical trials based on a systematic evaluation of potentially disease modifying compounds for Parkinson disease (PD). OBJECTIVE To test whether creatine and minocycline alter the course of early PD relative to a predetermined futility threshold for progression of PD in a randomized, double-blind, Phase II futility ...

The central role of the virtue of compassion in the shaping of the professional character of healthcare providers is a well-emphasized fact. On the other hand, the utmost obligation of physicians is to alleviate or eliminate human suffering. Traditionally, according to the Aristotelian understanding of virtues and virtue ethics, human virtues have been associated with masculinity. In recent dec...

The problem of respecting the patients' religious-based decisions seems to play increasingly important role in medical practice. Most probably it happens because: (i) bioethical standards accentuate the principle of the respect for autonomy (the departure form medical paternalism) and (ii) the contacts between people belonging to different religious traditions are becoming more and more frequen...

Mr. X is a 52-year-old Hispanic man who was admitted to the intensive care unit (ICU) for congestive heart failure. He had mitral valve disease with repair in 1999 and underwent a heart valve replacement in February 2001. Mr. X has a history of renal disease that was diagnosed in 1999 and was treated for a gastric ulcer in 2000. He also has chronic gout. He was diagnosed with multiple myeloma i...

Contrary to the widespread concern about over-treatment at the end of life, today, patient preferences for palliative care at the end of life are frequently respected. However, ethically challenging situations in the current healthcare climate are, instead, situations in which a competent patient requests active treatment with the goal of life-prolongation while the physician suggests best supp...

Many biomarkers identified in marker discovery are shown to have inadequate performance in validation studies. This motivates the use of group sequential designs that allow early termination for futility. However, an option for early termination will lead to biased estimates for studies that reach full enrollment. We propose conditional estimators and confidence intervals that correct for this ...