Benefits of flu vax outweigh risks
A LARGE meta-analysis published in The Lancet shows that pandemic (H1N1) 2009 influenza A monovalent inactivated vaccines were associated with a small increased risk of Guillain-Barré syndrome, equivalent to about 1.6 excess cases per million people vaccinated. Data were obtained from six adverse event monitoring systems and included about 23 million vaccinated people. The authors of the study said the increased risk found was consistent across individual surveillance systems, for expanded case definitions, in people who received or did not receive a concurrent seasonal influenza vaccine or had influenza-like symptoms, across various time windows, and in different age categories. “The consistency of secondary analyses supports the robustness of the primary finding”, they wrote. “In view of the morbidity and mortality caused by 2009 H1N1 influenza and the effectiveness of the vaccine, clinicians, policy makers, and those eligible for vaccination should be assured that the benefits of inactivated pandemic vaccines greatly outweigh the risks.”

Conflicting evidence on HRT and breast cancer
ECOLOGICAL evidence supporting the hypothesis that the incidence of breast cancer declines as soon as hormone replacement therapy (HRT) is stopped does not adequately satisfy the principles of time order, bias, confounding, strength of association, dose–duration response, internal consistency or external consistency, so “biological plausibility cannot be assessed”, according to the authors of a study published in the Journal of Family Planning and Reproductive Health Care. The authors wrote that the claim HRT was an established cause of breast cancer was based on three studies. After publication of one study in particular in 2002, the use of HRT rapidly declined. A correspondingly rapid decline in the incidence of breast cancer had been reported, and attributed to the drop in the use of HRT. “The evidence, however, is conflicting”, the authors wrote. An accompanying commentary said the original studies were based on HRT as one entity. “If there is a risk, the risk is small, and the benefits of HRT can be life altering; it is vital that we keep this in perspective”, the author wrote.

Elderly survive inhospital cardiac arrest
A LARGE prospective US study, published in the New England Journal of Medicine, has found that among elderly survivors of inhospital cardiac arrest, 58.5% were alive at 1 year. The authors also found that 34.4% of patients had not been readmitted to hospital. They had linked data from a national registry of inpatient cardiac arrests with Medicare files and identified 6972 adults who were 65 years of age or older, who had been discharged after surviving an inhospital cardiac arrest between 2000 and 2008. The risk-adjusted rate of 1-year survival was lower among older patients than younger patients, and among men than women. The differences in survival and readmission rates persisted at 2 years, the authors wrote. “At 3 years, the rate of survival among survivors of in-hospital cardiac arrest was similar to that of patients who had been hospitalized with heart failure and were discharged alive”, they wrote. Survival and readmission rates differed according to the demographic characteristics of the patients and neurological status at discharge.

Neuroenhancement “not justifiable”
THE prescription of neuroenhancements for healthy patients is inadvisable because of numerous social, developmental and professional integrity issues, according to the authors of an ethics position paper published in Neurology. The authors wrote that there had been an increase in the use of prescription medication to augment cognitive or affective function (neuroenhancement) in healthy adult and paediatric populations. In children and adolescents, this appeared to be increasing in parallel to increasing rates of attention deficit disorder diagnoses and stimulant medication prescriptions. They wrote that their paper was “not an attempt to determine public policy recommendations, provide medical–legal interpretation, or define societal norms related to the permissibility of neuroenhancement in general”. However, they wrote that particularly in the case of children “we conclude at the present time that neuroenhancement in legally and developmentally nonautonomous children and adolescents is not justifiable”.

Citizen research needs ethical standards
FAILURE to adequately address the ethical standards of participant-led research (PLR) and generate consensus on best practice could pose a threat of harm to participants and undermine the credibility of the research, according to a policy forum article published in PLOS Medicine. The authors wrote that the proliferation of online social networks and increasing access to digital technologies had allowed more individuals to become involved directly in research. They said that although PLR was potentially a boon to research, it did pose a number of challenges. The article focused on whether adequate ethical oversight of PLR should involve standard ethics review. “PLR holds out the alluring prospect of citizen engagement in the co-production of knowledge with the scientific community”, they wrote. However, a failure to address ethical issues could eventually provoke a backlash of overregulation “that deprives us of its potential benefits”.

‘Likes’ reveal personal attributes
RESEARCHERS have found that a wide variety of people’s personal attributes, ranging from sexual orientation to intelligence, can be automatically and accurately inferred using their Facebook “Likes”. The research, published in the Proceedings of the National Academy of Sciences, also found similarity between Facebook Likes and other kinds of digital records, such as browsing histories, search queries or purchase histories, which suggested that the potential to reveal users’ attributes was unlikely to be limited to Likes. The study was based on a sample of 58 466 US volunteers, found through Facebook, and looked at their Likes (170 per person on average), psychometric test scores and survey information. The authors wrote that the wide variety of attributes predicted in the study indicated that with appropriate training data, it might be possible to reveal other attributes. “Predicting users’ individual attributes and preferences can be used to improve numerous products and services”, they wrote. “Moreover, inference based on observations of digitally recorded behavior may open new doors for research in human psychology.”

Posted 18 March 2012

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