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  1. Book ; Online ; E-Book: The power of placebos

    Howick, Jeremy

    how the science of placebos and nocebos can improve health care

    2023  

    Author's details Jeremy Howick
    Keywords Clinical trials ; Nocebos (Medicine) ; Placebos (Medicine)
    Subject code 610.724
    Language English
    Size 1 Online-Ressource (ix, 304 Seiten), Illustrationen, Diagramme
    Publisher Johns Hopkins University Press
    Publishing place Baltimore
    Publishing country United States
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    HBZ-ID HT030633496
    ISBN 978-1-4214-4639-4 ; 9781421446387 ; 1-4214-4639-1 ; 1421446383
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Book: The philosophy of evidence based medicine

    Howick, Jeremy

    2011  

    Title variant The philosophy of evidence-based medicine
    Author's details Jeremy Howick
    Keywords Evidence-Based Medicine ; Philosophy, Medical ; Evidenz-basierte Medizin ; Medizinische Ethik
    Subject Ärztliche Ethik ; Klinische Ethik ; Ärztliches Ethos ; Arzt ; Medizin ; Heilberuf ; Medizinethik ; Evidence-based medicine ; Gutachtenbasierte Medizin ; Evidenzbasierte Medizin
    Language English
    Size XIV, 229 S. : Ill., graph. Darst.
    Publisher Wiley-Blackwell BMJ Books
    Publishing place Chichester u.a.
    Publishing country Great Britain
    Document type Book
    HBZ-ID HT016785731
    ISBN 978-1-4051-9667-3 ; 1-4051-9667-X
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2011 A 1540 order for loan Magazin

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  3. Article ; Online: Unethical informed consent caused by overlooking poorly measured nocebo effects.

    Howick, Jeremy

    Journal of medical ethics

    2020  Volume 47, Issue 9, Page(s) 590–594

    Abstract: Unlike its friendly cousin the placebo effect, the nocebo effect (the effect of expecting a negative outcome) has been almost ignored. Epistemic and ethical confusions related to its existence have gone all but unnoticed. Contrary to what is often ... ...

    Abstract Unlike its friendly cousin the placebo effect, the nocebo effect (the effect of expecting a negative outcome) has been almost ignored. Epistemic and ethical confusions related to its existence have gone all but unnoticed. Contrary to what is often asserted, adverse events following from taking placebo interventions are not necessarily nocebo effects; they could have arisen due to natural history. Meanwhile, ethical informed consent (in clinical trials and clinical practice) has centred almost exclusively on the need to inform patients about intervention risks with patients to preserve their autonomy. Researchers have failed to consider the harm caused by the way in which the information is conveyed. In this paper, I argue that the magnitude of nocebo effects must be measured using control groups consisting of untreated patients. And, because the nocebo effect can produce harm, the principle of non-maleficence must be taken into account alongside autonomy when obtaining (ethical) informed consent and communicating intervention risks with patients.
    MeSH term(s) Humans ; Informed Consent ; Morals ; Nocebo Effect ; Placebo Effect
    Language English
    Publishing date 2020-02-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 194927-5
    ISSN 1473-4257 ; 0306-6800
    ISSN (online) 1473-4257
    ISSN 0306-6800
    DOI 10.1136/medethics-2019-105903
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1163: Show issues Location:
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  4. Article ; Online: Teaching an empathy-focused approach to difficult consultations: a pilot session and co-production evaluation workshop.

    Ward, Andy / Howick, Jeremy

    Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors

    2023  Volume 34, Issue 4, Page(s) 228–232

    Abstract: Background: Patients who are annoyed, upset, angry or uncooperative may be categorised as having behavioural problems, shifting the blame from healthcare providers to patients. This can exacerbate the problem. Adopting an empathic approach to such ... ...

    Abstract Background: Patients who are annoyed, upset, angry or uncooperative may be categorised as having behavioural problems, shifting the blame from healthcare providers to patients. This can exacerbate the problem. Adopting an empathic approach to such consultations can reduce anger and frustration and improve patient care.
    Approach: A pilot teaching session was introduced to the second year of the medical degree at Leicester Medical School with the aim of preparing students to deal with difficult consultations and helping them to understand the impact of empathy in such situations. The teaching involved the use of prior reading, videos and simulated patients acting the role of angry and frustrated patients. It was delivered to groups of 8 students by a team of 20 GP tutors. Approximately 300 second year medical students took part in the session.
    Evaluation: Ninety per cent of students felt they had a better understanding of how an empathic approach could help in difficult consultations. Most GP tutors also felt better prepared to deal with difficult consultations because of teaching the session. Following the initial evaluation, a co-production workshop was convened comprising of tutors, students and patient representatives to review the teaching materials and evaluation. Potential improvements to the session were identified.
    Conclusion: We were able to deliver a successful pilot session that improved students' understanding of the skills needed and had a positive impact on GP tutors involved in the session. A subsequent co-production workshop identified key strategies to improve the session for future years.
    MeSH term(s) Humans ; Empathy ; Students, Medical ; Referral and Consultation ; Education, Medical, Undergraduate ; Teaching
    Language English
    Publishing date 2023-08-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2074818-8
    ISSN 1475-990X ; 1473-9879
    ISSN (online) 1475-990X
    ISSN 1473-9879
    DOI 10.1080/14739879.2023.2241037
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: On the ethical requirement to inform patients about potential treatment benefits.

    Howick, Jeremy / Doshi, Peter

    BMJ (Clinical research ed.)

    2023  Volume 381, Page(s) 1233

    MeSH term(s) Humans ; Disclosure
    Language English
    Publishing date 2023-06-05
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.p1233
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Exploring the Asymmetrical Relationship Between the Power of Finance Bias and Evidence.

    Howick, Jeremy

    Perspectives in biology and medicine

    2019  Volume 62, Issue 1, Page(s) 159–187

    Abstract: Financial conflicts of interest can influence the design, conduct, and dissemination of medical trials. In attempting to resist "finance bias," critics and proponents of evidence-based medicine (EBM) and its precursors have largely focused on trying to ... ...

    Abstract Financial conflicts of interest can influence the design, conduct, and dissemination of medical trials. In attempting to resist "finance bias," critics and proponents of evidence-based medicine (EBM) and its precursors have largely focused on trying to improve evidence. These efforts have led to successes ranging from the 1962 Kefauver-Harris amendments to the US Federal Drug and Cosmetic Act of 1938 to recent recommendations that all trials be published. However, there are two problems with the strategy of trying to improve evidence as a buffer against finance bias. First, without political teeth, rules of evidence can be ignored with relative impunity. This is because, as sociologist Bent Flyvbjerg has pointed out, there is an asymmetry between power (of finance bias) and rationality (evidence), tending towards victory of power in an open confrontation. Second, by improving the way evidence is produced, the process has become more expensive, and thus more susceptible to influence by finance bias. Unless they address the powers behind finance bias directly, critics and proponents may be doomed to lose the war against finance bias, even if they win some battles. For EBM to be effective, the power of finance bias influencing the production and dissemination of evidence needs to be addressed as a priority. This is starting to happen, with initiatives such as the AllTrials campaign, which identifies and exposes unpublished trials. On the other hand, there are reasons to be less optimistic, as Cochrane, the most trusted source of evidence, has become more susceptible to stronger influences from industry.
    MeSH term(s) Anti-Arrhythmia Agents/adverse effects ; Clinical Trials as Topic/economics ; Drug Industry/economics ; Evidence-Based Medicine/economics ; Humans ; Oseltamivir/adverse effects ; Public Opinion ; Thalidomide/adverse effects
    Chemical Substances Anti-Arrhythmia Agents ; Oseltamivir (20O93L6F9H) ; Thalidomide (4Z8R6ORS6L)
    Language English
    Publishing date 2019-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80373-x
    ISSN 1529-8795 ; 0031-5982
    ISSN (online) 1529-8795
    ISSN 0031-5982
    DOI 10.1353/pbm.2019.0009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Why include humanities in medical studies: comment.

    Howick, Jeremy

    Internal and emergency medicine

    2019  Volume 15, Issue 3, Page(s) 527–528

    MeSH term(s) Education, Medical ; Humanities ; Humans
    Language English
    Publishing date 2019-10-09
    Publishing country Italy
    Document type Letter ; Comment
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-019-02198-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6673: Show issues Location:
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  8. Article ; Online: Beyond empathy training for practitioners: Cultivating empathic healthcare systems and leadership.

    Howick, Jeremy / de Zulueta, Paquita / Gray, Muir

    Journal of evaluation in clinical practice

    2024  

    Abstract: Empathic care benefits patients and practitioners, and empathy training for practitioners can enhance empathy. However, practitioners do not operate in a vacuum. For empathy to thrive, healthcare consultations must be situated in a nurturing milieu, ... ...

    Abstract Empathic care benefits patients and practitioners, and empathy training for practitioners can enhance empathy. However, practitioners do not operate in a vacuum. For empathy to thrive, healthcare consultations must be situated in a nurturing milieu, guided by empathic, compassionate leaders. Empathy will be suppressed, or even reversed if practitioners are burned out and working in an unpleasant, under-resourced environment with increasingly poorly served and dissatisfied patients. Efforts to enhance empathy must therefore go beyond training practitioners to address system-level factors that foster empathy. These include patient education, cultivating empathic leadership, customer service training for reception staff, valuing cleaning and all ancillary staff, creating healing spaces, and using appropriate, efficiency saving technology to reduce the administrative burden on healthcare practitioners. We divide these elements into environmental factors, organisational factors, job factors, and individual characteristics.
    Language English
    Publishing date 2024-03-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1327355-3
    ISSN 1365-2753 ; 1356-1294
    ISSN (online) 1365-2753
    ISSN 1356-1294
    DOI 10.1111/jep.13970
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: On the need for empathy in the acute hospital setting.

    Slavin, Daniel / Winter, Rachel / Ward, Andy / Howick, Jeremy

    British journal of hospital medicine (London, England : 2005)

    2023  Volume 84, Issue 10, Page(s) 1–3

    Abstract: This article reviews the need for empathy, and what happens in its absence in an acute hospital setting, using the example of a homeless man in an emergency department. Three simple but meaningful changes that all healthcare practitioners can make are ... ...

    Abstract This article reviews the need for empathy, and what happens in its absence in an acute hospital setting, using the example of a homeless man in an emergency department. Three simple but meaningful changes that all healthcare practitioners can make are recommended to promote empathy.
    MeSH term(s) Humans ; Male ; Delivery of Health Care ; Emergency Service, Hospital ; Empathy ; Hospitals
    Language English
    Publishing date 2023-09-29
    Publishing country England
    Document type Editorial
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2023.0210
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Towards an empathic hidden curriculum in medical school: A roadmap.

    Howick, Jeremy / Slavin, Daniel / Carr, Sue / Miall, Fiona / Ohri, Chandra / Ennion, Steve / Gay, Simon

    Journal of evaluation in clinical practice

    2024  

    Abstract: The "hidden curriculum" in medical school includes a stressful work environment, un-empathic role models, and prioritisation of biomedical knowledge. It can provoke anxiety and cause medical students to adapt by becoming cynical, distanced and less ... ...

    Abstract The "hidden curriculum" in medical school includes a stressful work environment, un-empathic role models, and prioritisation of biomedical knowledge. It can provoke anxiety and cause medical students to adapt by becoming cynical, distanced and less empathic. Lower empathy, in turn, has been shown to harm patients as well as practitioners. Fortunately, evidence-based interventions can counteract the empathy dampening effects of the hidden curriculum. These include early exposure to real patients, providing students with real-world experiences, training role models, assessing empathy training, increasing the focus on the biopsychosocial model of disease, and enhanced wellbeing education. Here, we provide an overview of these interventions. Taken together, they can bring about an "empathic hidden curriculum" which can reverse the decline in medical student empathy.
    Language English
    Publishing date 2024-02-08
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1327355-3
    ISSN 1365-2753 ; 1356-1294
    ISSN (online) 1365-2753
    ISSN 1356-1294
    DOI 10.1111/jep.13966
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