Searching for Medical Certainty: Medical Chemistry to Molecular Medicine

Martensen, Robert L.

doi:10.1001/jama.1997.03550080013005

Cited by 1 publication

(2 citation statements)

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“…Therapeutic innovations reinforce the issue of medical uncertainty inherent in medicine (Fox, 1957;Gerrity, Earp, DeVellis, & Light, 1992;Parsons, 1951). One of the objectives of the development of molecular biology is to seek certainty (Martensen & Jones, 1997), but there are still gaps in the corpus of available knowledge (Fox, 2000). This is a structural problem.…”

Section: Discussionmentioning

confidence: 99%

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New oral targeted therapies for metastatic breast cancer disrupt the traditional patients’ management-A healthcare providers’ view

et al. 2016

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Although a cure still cannot be expected for metastatic breast cancer, thanks to progressive advances in treatments, life expectancy has been increasing over the past 15 years. This study aims to present the impact on the organisation of patients' management of newly released oral targeted therapies dedicated to metastatic breast cancer and the obstacles to their diffusion. Our work is based on the analysis of 40 semi-structured interviews, conducted with oncology healthcare professionals in three regions of France (2015-2016). It shows three main results. First, the prescription of an oral targeted therapy requires greater collaboration between healthcare professionals than traditional intravenous oncology drugs, which may be challenging. Second, there remain many barriers to the dissemination of oral targeted therapies. Third, taking an oral targeted therapy keeps the patient away from the hospital facility and asks for a strong therapeutic alliance. The management of oral targeted therapies is time-consuming for medical oncologists and disrupts the traditional care pathway. The multiplication of actors involved in patients' management reinforces the slowdown in the deployment and acceptance of therapeutic innovations. More players equal a higher risk of slowdown. Questioning and re-designing hospital organisation and management modalities towards this type of care are critical.

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Section: Discussionmentioning

confidence: 99%

“…This is a structural problem. One of the objectives of the development of molecular biology is to seek certainty (Martensen & Jones, 1997), but there are still gaps in the corpus of available knowledge (Fox, 2000).…”

Section: Discussionmentioning

confidence: 99%