Artificial heart: the beat goes on
Article Abstract:
In spite of the high costs and lack of success of research efforts to develop an artificial heart, interest by the government in funding such research remains at a high level. A panel at the Institute of Medicine (IOM) has concluded that research on the subject should be promoted, but also that the costs would be greater and the benefits lower than for any medical procedure in current use. The demand for artificial hearts is expected to rise, raising questions about how patients can pay for these expensive devices. If the devices are developed using public funds, access for all patients must be guaranteed. However, the gain in the number of quality-adjusted life years (QALYs), the measure of life extension used by the panel, makes the heart a bad deal. It would cost approximately $105,000 per QALY, a poorer bargain than heart transplantation or other methods of treating some forms of heart disease. The prediction that an artificial heart will add 4.4 years to the life of an average user, by the year 2010, is doubted by many experts. Some question the ethical aspects of devoting so much resources to a technology that will benefit few people. The panel set up guidelines to address some of these issues, including the recommendation that certain current research projects be continued and intensified. These include work on the left ventricular assist device (LVAD), which is essentially half of an implanted heart, as well as contracts with four research teams to develop other devices. Claude Lenfant, director of the National Heart, Lung, and Blood Institute and the person who initially requested help from the IOM in deciding research priorities, supports the panel's conclusions but hopes other developments in cardiology, such as molecular biology and gene therapy, will not be neglected. In 1988, Lenfant cancelled contracts for research on the artificial heart, but continued funding the LVAD program. However, this action was overruled by the Senate. All groups concerned have decided to continue investigating the possible risks and benefits of the artificial heart, thereby postponing firm decisions about the broader ethical and economic issues surrounding the subject. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Science
Subject: Science and technology
ISSN: 0036-8075
Year: 1991
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A clash over standards for scientific records
Article Abstract:
Differences of opinion exist between Public Health Service (PHS) officials and academic researchers regarding how scientific data should be stored. The PHS maintains that it needs to be able to produce substantiating material if a published report is challenged, while many scientists object to such intervention. A recent meeting in Washington, D.C., called by the Office of Scientific Integrity Review of the U.S. Public Health Service, allowed both sides to address the issue. Researchers suggested that problems, if any, come about as a result of actions taken by the PHS, which has converted an accounting requirement (that research data be kept on hand for three years after a final expense report) into a matter of intellectual integrity. The Office of Scientific Integrity Review monitors compliance of grantee institutions with good research practices. The Office also has an investigative function if allegations of poor adherence to standards are made. This 'fraud squad' is kept busy: 74 cases are now under investigation, and 50 more are being monitored for other agencies. The PHS urged university administrators to become involved in quality control of research on the local level, to make its surveillance unnecessary. The academic response was that such an approach would be 'wasteful', while acknowledging that attention to standards is important. A legal viewpoint held that federal grant recipients do not have exclusive rights to their data; sharing is required, and a point made by the PHS is that data should be retained in a form that can be interpreted by other scientists in the field. A consensus was reached on some issues: that problems are best handled by peer groups, professional societies, or journal editors; that sharing data is different from mandatory compilation of archives; and that universities should share data-maintenance functions with individual scientists. The PHS expressed consternation at the end of the meeting over the scientists' sentiment that there is 'no problem'. Whether federal rules are forthcoming is not yet known. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Science
Subject: Science and technology
ISSN: 0036-8075
Year: 1990
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Critics say Laskers omitted NO pioneer
Article Abstract:
Prominent medical researchers have protested two omissions from the 1996 Albert Lasker Basic Medical Research Award, which honored Robert Furchgott and Fred Murad for advances in the understanding of the role of NO in health and disease. They say key discoveries were made by Moncada and Lou Ignarro.
Publication Name: Science
Subject: Science and technology
ISSN: 0036-8075
Year: 1996
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