The study investigated the routine introduction of a new surgical consent form containing a tissue consent section to investigate patient attitudes to the use of surplus tissue for research (after the Alder Hey inquiry) and also the differing approaches by consent takers. All surgical consent forms received in histopathology for the same 2-month period in 2 consecutive years were analysed, recording available information about the specimen, the tissue consent section and, for the second year, the consent taker. The findings showed that <5% of patients whose views were recorded disagreed with the use of their tissue for research. They also showed that the number of completed forms sent to histopathology had increased but the pattern of completion had changed very little. A wide variation between departments and also between clinicians was apparent in the levels of completion of the tissue consent section, suggesting wide variability in the quality of the consenting process. When asked, patients rarely object (<5%) but if the highest standards of consent for surgical tissue are to be achieved and the wishes of patients to donate tissue are to be effectively recorded then new resources or approaches will be needed for this process.
Several mathematical equations have been tested for their ability to fit pharmacological dose‐response curves over the range 5 to 95% of the maximal response. It has been shown that one such equation, which will be called the L‐transformation, adequately fits sets of dose‐response data obtained from a number of different tissues. The graphical application of this equation has been suggested previously by other workers but has been used only to a very limited extent. Techniques have now been developed which enable the L‐transformation to be fitted to single sets of dose‐response data, and to pairs of sets of data simultaneously. By itself the L‐transformation cannot adequately fit all dose‐response curves. However if another preliminary transformation is carried out on the measured responses then the L‐transformation can usefully be applied to dose‐response curves of widely different shapes and slopes. Various applications of these techniques are discussed. When the L‐transformation is applied to pairs of dose‐response curves obtained, for example, from a single piece of isolated tissue, it can be used to calculate potency ratios, with standard errors and fiducial limits. When combined with the occupation theory of drug action and use of the null method, the L‐transformation can be applied to suitable pairs of dose‐response curves to provide estimates of the affinity constants (with their standard errors) of drugs for their receptors. The techniques can be extended to other models of drug‐receptor interaction. Computer programs are available which greatly facilitate the application of these curve fitting methods to the types of problem outlined above.
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