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Browsing Artikler, rapporter og annet (klinisk medisin) by Title
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Børresen-Dale, Anne-Lise; Dumeaux, Vanessa; Frantzen, Jan-Ole; Kristensen, Vessela N.; Kumle, Merethe; Lund, Eiliv (Journal article; Tidsskriftartikkel; Peer reviewed, 13-Feb-2008)[+][-]
Abstract: Introduction: The introduction of high-throughput technologies, also called -omics technologies, into epidemiology has raised the need for high-quality observational studies to reduce several sources of error and bias. Methods: The Norwegian Women and Cancer (NOWAC) postgenome cohort study consists of approximately 50,000 women born between 1943 and 1957 who gave blood samples between 2003 and 2006 and filled out a two-page questionnaire. Blood was collected in such a way that RNA is preserved and can be used for gene expression analyses. The women are part of the NOWAC study consisting of 172,471 women 30 to 70 years of age at recruitment from 1991 to 2006 who answered one to three questionnaires on diet, medication use, and lifestyle. In collaboration with the Norwegian Breast Cancer Group, every NOWAC participant born between 1943 and 1957 who is admitted to a collaborating hospital for a diagnostic biopsy or for surgery of breast cancer will be asked to donate a tumor biopsy and two blood samples. In parallel, at least three controls are approached for each breast cancer case in order to obtain blood samples from at least two controls per case. The controls are drawn at random from NOWAC matched by time of follow-up and age. In addition, 400 normal breast tissues as well as blood samples will be collected among healthy women participating at the Norwegian Mammography Screening program at the Breast Imaging Center at the University Hospital of North-Norway, Tromsø. Results: The NOWAC postgenome cohort offers a unique opportunity (a) to study blood-derived gene expression profiles as a diagnostic test for breast cancer in a nested case-control design with adjustment for confounding factors related to different exposures, (b) to improve the reliability and accuracy of this approach by adjusting for an individual's genotype (for example, variants in genes coding for hormone and drug-metabolizing and detoxifying enzymes), (c) to study gene expression profiles from peripheral blood as surrogate tissue to biomonitor defined exposure (for example, hormone) and its association with disease risk (that is, breast cancer), and (d) to study gene variants (single nucleotide polymorphisms and copy number variations) and environmental exposure (endogenous and exogenous hormones) and their influence on the incidence of different molecular subtypes of breast cancer. Conclusion: The NOWAC postgenome cohort combining a valid epidemiological approach with richness of biological samples should make an important contribution to the study of the etiology and system biology of breast cancer. URI: http://hdl.handle.net/10037/1423 File(s) in this item: 1
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Nieder, Carsten; Marienhagen, Kirsten; Dalhaug, Astrid; Norum, Jan (Journal article; Tidsskriftartikkel; Peer reviewed, 16-Jul-2008)[+][-]
Abstract: Newly developed systemic treatment regimens might lead to improved survival also in the subgroup of breast cancer patients that harbour brain metastases. In order to examine this hypothesis, a matched pairs analysis was performed that involved one group of patients, which were treated after these new drugs were introduced, and one group of patients, which were treated approximately 10 years earlier. The two groups were well balanced for the known prognostic factors age, KPS, extracranial disease status, and recursive partitioning analysis class, as well as for the extent of brain treatment. The results show that the use of systemic chemotherapy has increased over time, both before and after the diagnosis of brain metastases. However, such treatment was performed nearly exclusively in those patients with brain metastases that belonged to the prognostically more favourable groups. Survival after whole-brain radiotherapy has remained unchanged in patients without further active treatment. It has improved in prognostically better patients and especially patients that received active treatment, where the 1-year survival rates have almost doubled. As these patient groups were small, confirmation of the results in other series should be attempted. Nevertheless, the present results are compatible with the hypothesis that improved systemic therapy might contribute to prolonged survival in patients with brain metastases from breast cancer. URI: http://hdl.handle.net/10037/1702 File(s) in this item: 1
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Sexton, Randall Harold; Stabbursvik, Ellen Anne Buljo (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
Description: The accepted version of this article is part of Randall H. Sexton's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2450 URI: http://hdl.handle.net/10037/3017 File(s) in this item: 1
article.pdf (215.5Kb) -
Kummervold, Per Egil; Wynn, Rolf (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: The aim of this study was to summarize and analyse findings from four prior studies on the use of the Internet as a source of health information in five European countries (Norway, Denmark, Germany, Greece, and Portugal). A cross-study comparison of data was performed. All the studies included fit with a trend of a sharp and continuous growth in the use of the Internet for health information access in the major part of the last decade. Importantly, the Internet has become an important mass media source of health information in northern Europe. While the use of the Internet for health information is somewhat less common in the south European countries, its use is also clearly increasing there. We discuss the advantages of cross-study comparisons of data and methodological challenges. As the use of the Internet for health information is likely to peak in some countries in the near future, new population surveys on health information access should focus more on the details of information that is accessed and which sites that are most used and trusted. URI: http://hdl.handle.net/10037/4856 File(s) in this item: 1
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Brækkan, Sigrid Kufaas; Mathiesen, Ellisiv B.; Njølstad, Inger; Wilsgaard, Tom; Hansen, John-Bjarne (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
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Hald, Erin Mathiesen; Brækkan, Sigrid Kufaas; Mathiesen, Ellisiv B.; Njølstad, Inger; Wilsgaard, Tom; Brox, Jan; Hansen, John-Bjarne (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: High-sensitivity C-reactive protein is associated with risk of arterial cardiovascular disease but conflicting results have been reported on its role in venous thromboembolic disease. The objective of our study was to investigate the association between high-sensitivity C-reactive protein levels and risk of future venous thromboembolism in a prospective cohort recruited from a general population. High-sensitivity C-reactive protein was measured in serum samples from 6,426 men and women, aged 25-84 years, recruited from the Tromsø Study in the period 1994-1995. Incident venous thromboembolism events (n=209) were registered during a median of 12.5 years of follow up. Cox’s proportional hazards regression models were used to estimate age- and genderand multivariable-adjusted hazard ratios with 95% confidence intervals for total venous thromboembolism, and for provoked and unprovoked venous thromboembolism by increasing levels of high-sensitivity C-reactive protein. There was no increased risk of venous thromboembolism per 1 standard deviation increase in high-sensitivity C-reactive protein (hazard ratio 1.08; 95% confidence interval 0.95-1.23) or across quartiles of high-sensitivity C-reactive protein (P for trend 0.6) in analyses adjusted for age and gender. Further adjustment for body mass index, smoking and diabetes did not alter the risk estimates. Moreover, high-sensitivity C-reactive protein was not associated with venous thromboembolism in either gender specific analysis or in separate analyses of provoked and unprovoked venous thromboembolism events. In this prospective study, serum levels of high-sensitivity C-reactive protein were not associated with future development of venous thromboembolism. Our findings do not suggest a causal role for C-reactive protein in the pathogenesis of venous thromboembolism. URI: http://hdl.handle.net/10037/3855 File(s) in this item: 1
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Berntson, L.; Nordal, Ellen Berit; Damgård, M.; Andersson-Gäre, B.; Herlin, T.; Nielsen, S.; Rygg, M.; Zak, M.; Fasth, A. (Conference object; Konferansebidrag, 15-Sep-2008)[+][-]
Description: Poster presentatiopn at 15th Paediatric Rheumatology European Society (PreS) Congress London, UK. 14–17 September 2008 URI: http://hdl.handle.net/10037/2357 File(s) in this item: 1
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Dybwik, Knut; Nielsen, Erik Waage; Brinchmann, Berit Støre (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Home mechanical ventilation probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting. The aim of this study was both to explore the challenges experienced by health care professionals in community health care services when caring for patients dependent on home mechanical ventilation, continual care and highly advanced technology, and their proposed solutions to these challenges. Using qualitative research methods, a grounded theory influenced approach was used to explore the respondents' experiences and proposed solutions. A total of 34 multidisciplinary respondents from five different communities in Norway were recruited for five focus groups. The core category in our findings was what health care professionals in community health care services experience as "between a rock and a hard place," when working with hospitals, family members, and patients. We further identified four subcategories, "to be a guest in the patient's home," "to be accepted or not," "who decides," and "how much can we take." The main background for these challenges seems to stem from patients living and receiving care in their private homes, which often leads to conflicts with family members. These challenges can have a negative effect on both the community health caregivers' work environment and the community health service's provision of professional care. This study has identified that care of individuals with complex needs and dependent on home mechanical ventilation presents a wide range of immense challenges for community health care services. The results of this study point towards a need to define the roles of family caregivers and health care professionals and also to find solutions to improve their collaboration. The need to improve the work environment for caregivers directly involved in home-care also exists. The study also shows the need for more dialogue concerning eligibility requirements, rights, and limitations of patients in the provision and use of ventilatory support in private homes. Description: This article is part of Knut Dybwik's doctoral thesis available in Munin at http://hdl.handle.net/10037/3692 URI: http://hdl.handle.net/10037/4065 File(s) in this item: 1
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Meum, Torbjørg; Wynn, Rolf (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
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Mark, Eckhard; Jacobsen, Olaf; Kjerstad, Astrid Kristine; Næsheim, Torvind; Busund, Rolf; Bahar, Ramez; Jensen, Jon Kjetil; Skorpen, Per Kristian; Bjertnaes, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: A 41-year-old man suffered hypothermic cardiac arrest after water immersion and was transported to our university hospital by ambulance helicopter for rewarming on cardiopulmonary bypass. He resumed spontaneous cardiac activity 6 h 52 min after cardiac arrest and recovered completely. URI: http://hdl.handle.net/10037/4941 File(s) in this item: 1
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Melsom, Toralf; Mathisen, Ulla Dorte; Ingebretsen, Ole C; Jenssen, Trond Geir; Njølstad, Inger; Solbu, Marit Dahl; Toft, Ingrid; Eriksen, Bjørn Odvar (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Increased glomerular filtration rate (GFR), also called hyperfiltration, is a proposed mechanism for renal injury in diabetes. The causes of hyperfiltration in individuals without diabetes are largely unknown, including the possible role of borderline hyperglycemia. We assessed whether impaired fasting glucose (IFG; 5.6–6.9 mmol/L), elevated HbA1c, or hyperinsulinemia are associated with hyperfiltration in the general middle-aged population. A total of 1,560 individuals, aged 50–62 years without diabetes, were included in the Renal Iohexol Clearance Survey in Tromsø 6 (RENIS-T6). GFR was measured as single-sample plasma iohexol clearance. Hyperfiltration was defined as GFR >90th percentile, adjusted for sex, age, weight, height, and use of renin-angiotensin system inhibitors. Participants with IFG had a multivariable-adjusted odds ratio of 1.56 (95% CI 1.07–2.25) for hyperfiltration compared with individuals with normal fasting glucose. Odds ratios (95% CI) of hyperfiltration calculated for a 1-unit increase in fasting plasma glucose (FPG) and HbA1c, after multivariable-adjustment, were 1.97 (1.36–2.85) and 2.23 (1.30–3.86). There was no association between fasting insulin levels and hyperfiltration. A nonlinear association between FPG and GFR was observed (df = 3, P < 0.0001). GFR increased with higher glucose levels, with a steeper slope beginning at FPG ≥5.4 mmol/L. Borderline hyperglycemia was associated with hyperfiltration, whereas hyperinsulinemia was not. Longitudinal studies are needed to investigate whether the hyperfiltration associated with IFG is a risk factor for renal injury in the general population. URI: http://hdl.handle.net/10037/4113 File(s) in this item: 1
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Romner, Bertil; Heskestad, Ben; Baardsen, Roald; Ingebrigtsen, Tor; Helseth, Eirik; Waterloo, Knut (Journal article; Tidsskriftartikkel; Peer reviewed, 20-Feb-2009)[+][-]
Abstract: Background: In three previous Norwegian studies conducted between 1974 and 1993, the annual incidence rates of hospital admitted head injuries were 236, 200 and 169 per 100,000 population. The aim of this study was to describe the incidence of head injury in the Stavanger region and to compare it with previous Norwegian studies.
Methods: All head injured patients referred to Stavanger University Hospital during a one-year period (2003) were registered in a partly prospective and partly retrospective study. The catchment area for the hospital is strictly defined to a local population of 283,317 inhabitants (2003).
Results: The annual incidence rate was 207/100,000 population for hospital referred head injury and 157/100,000 population for hospital admitted head injury. High age- and sex specific incidence rates were observed among the oldest, and the highest rate (882/100,000) among men above 90 years. More than 50% of the injuries were caused by falls.
Conclusion: Comparison with previous Norwegian studies indicates decreasing annual incidence rates for hospital admitted head injury during the last 30 years.URI: http://hdl.handle.net/10037/2194 File(s) in this item: 1
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Laine, Katariina; Skjeldestad, Finn Egil; Sandvik, Leiv; Staff, Anne Cathrine (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Objective To compare the incidence of obstetric anal sphincter injuries (OASIS) in two time periods, before and after implementing a training programme for improved perineal support aimed at reducing the incidence of obstetric anal sphincter injuries. The secondary aim was to study incidence of obstetric anal sphincter injuries in subgroups defined by risk factors for OASIS. Design Population-based cohort study. Setting University hospital setting in Oslo, Norway. Participants Two cohorts of all delivering women in the largest hospital in Norway during two time periods (2003–2005 and 2008–2010) were studied. After excluding caesarean sections and preterm deliveries (< week 32), the study population consisted of 31 709 deliveries, among which 907 women were identified with obstetric anal sphincter injury. Primary and secondary outcome measures Incidence of OASIS in two time periods. Maternal, obstetrical and foetal risk factors for OASIS were collected from the hospital obstetric database. Univariate analyses and multivariate logistic regression analyses, presenting adjusted ODs for OASIS, were performed. Results The OASIS incidence was significantly reduced by 50%, from 4% (591/14787) in the first time period to 1.9% (316/16 922) in the second. This reduction could not be explained by changes in population characteristics or OASIS risk factors during the study years. The reduction of incidence of OASIS between the two study periods was consistent across subgroups of women; regardless of parity, delivery method and infant birth weight. Conclusions A marked reduction in the incidence of OASIS was observed in all studied subgroups of women after implementing the training programme for perineal protection. Further, this reduction could not be explained by the differences in patient characteristics across the study period. These findings indicate that the training programme with improved perineal protection markedly reduced the risk of OASIS. URI: http://hdl.handle.net/10037/4938 File(s) in this item: 1
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Smetkin, Alexey Anatolievich; Kuzkov, Vsevolod; Suborov, Evgeny; Bjertnaes, Lars J.; Kirov, Mikhail (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: In acute respiratory distress syndrome (ARDS) the recruitment maneuver (RM) is used to reexpand atelectatic areas of the lungs aiming to improve arterial oxygenation. The goal of our paper was to evaluate the response to RM, as assessed by measurements of extravascular lung water index (EVLWI) in ARDS patients. Materials and Methods. Seventeen adult ARDS patients were enrolled into a prospective study. Patients received protective ventilation. The RM was performed by applying a continuous positive airway pressure of 40 cm H2O for 40sec. The efficacy of the RM was assessed 5 min later. Patients were identified as responders if PaO2/FiO2 increased by >20% above the baseline. EVLWI was assessed by transpulmonary thermodilution before the RM, and patients were divided into groups of low EVLWI (<10 mL/kg) and high EVLWI (≥10 mL/kg). EVLWI was increased in 12 patients. Following RM, PaO2/FiO2 increased by 33 (4–65) % in the patients with low EVLWI, whereas those in the high EVLWI group experienced a change by only −1((−13)–(+5)) % (P = 0.035). Conclusion. In ARDS, the response to a recruitment maneuver might be related to the severity of pulmonary edema. In patients with incresed EVLWI, the recruitment maneuver is less effective. URI: http://hdl.handle.net/10037/4927 File(s) in this item: 1
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Eilertsen, Gro Østli; Van Ghelue, Marijke; Nossent, Johannes C (Journal article; Tidsskriftartikkel, 2011)[+][-]
Abstract: Objectives. To determine whether increased levels of B-cell activating factor (BAFF) in patients with SLE are due to disease activity or genetic variations in the promoter region of the BAFF gene and BAFF gene expression. Methods. The case-control study included 101 SLE patients and 111 healthy controls. Five single nucleotide polymorphisms (SNPs) in the BAFF promoter region were investigated by melting point analysis: c.-2841 (T > C), c.-2704 (T > C), c.-2701 (A > T), c.-871 (C > T) and c.-514 (A > G). BAFF mRNA levels were determined by real-time PCR (BAFF-RQ) and serum BAFF (s-BAFF) levels were measured by ELISA. Independent predictors that might be correlated with increased s-BAFF in SLE patients were analysed by multivariate regression methods. Results. Although s-BAFF levels were increased in SLE patients (1.73 vs 0.98 ng/μl, P < 0.001), no specific BAFF genotype was found to associate with SLE. The different genotypes defined by the investigated SNPs were identified both in SLE patients and healthy controls with similar frequencies. No association was found between BAFF genotype and BAFF-RQ. s-BAFF was independent of other factors, correlated with CRP (β = 0.40, P < 0.001) and physician's visual analogue score (R = 0.21, P = 0.046) and inversely with haemoglobin (β = -0.32, P < 0.001) and IgA (β = -0.33, P = 0.001). Conclusions. Increased s-BAFF levels in SLE patients are associated with the acute-phase responses, CRP and haemoglobin, but probably not dependent on BAFF genotype or expression. This indicates that s-BAFF production occurs at sites of inflammation. Description: This article is part of Gro Østli Eilertsen's doctoral thesis. Available in Munin at http://hdl.handle.net/10037/3594 URI: http://hdl.handle.net/10037/3837 File(s) in this item: 1
article.pdf (212.7Kb) -
Conley, LN; Mortensen, Kim Erlend; Nygård, Ingvild; Sørensen, Peter; Mortensen, Elin; Bendixen, C; Revhaug, Arthur (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
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Conley, Lene N.; Mortensen, Kim Erlend; Nygaard, Ingvild; Sorenesen, Peter; Mortensen, Elin; Bendixen, Christian; Revhaug, Arthur (Journal article; Tidsskriftartikkel; Peer reviewed, 20-Jan-2010)[+][-]
Abstract: Background: Hemodynamic changes in the liver remnant following partial hepatectomy (PHx) have been suggested to be a primary stimulus in triggering liver regeneration. We hypothesized that it is the increased sinusoidal flow per se and hence the shear-stress stimulus on the endothelial surface within the liver remnant which is the main stimulus to regeneration. In order to test this hypothesis we wanted to increase the sinusoidal flow without performing a concomitant liver resection. Accordingly, we constructed an aorto-portal shunt to the left portal vein branch creating a standardized four-fold increase in flow to segments II, III and IV. The impact of this manipulation was studied in both an acute model (6 animals, 9 hours) using a global porcine cDNA microarray chip and in a chronic model observing weight and histological changes (7 animals, 3 weeks).
Results: Gene expression profiling from the shunted segments does not suggest that increased sinusoidal flow per se results in activation of genes promoting mitosis. Hyperperfusion over three weeks results in the whole liver gaining a supranormal weight of 3.9% of the total body weight (versus the normal 2.5%). Contrary to our hypothesis, the weight gain was observed on the non-shunted side without an increase in sinusoidal flow.
Conclusions: An isolated increase in sinusoidal flow does not have the same genetic, microscopic or macroscopic impact on the liver as that seen in the liver remnant after partial hepatectomy, indicating that increased sinusoidal flow may not be a sufficient stimulus in itself for the initiation of liver regeneration.Description: This article is part of Kim Erlend Mortensen's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2893 URI: http://hdl.handle.net/10037/2895 File(s) in this item: 1
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Dønnem, Tom; Lønvik, Kenneth; Eklo, Katrine; Berg, Thomas; Sørbye, Sveinung Wergeland; Al-Shibli, Khalid Ibrahim; Al-Saad, Samer; Andersen, Sigve; Stenvold, Helge; Bremnes, Roy M.; Busund, Lill-Tove (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Angiogenesis is pivotal in tumor development. Vascular endothelial growth factor-A (VEGF-A) is considered one of the most important angiogenic factors, but lately several microRNAs (miRs) have been associated with vascular development. miR-126 has been related to tumor angiogenesis and in the regulation of VEGF-A. The authors aimed to investigate the prognostic impact of miR-126 and its co-expression with VEGF-A in nonsmall cell lung cancer (NSCLC) patients. Tumor tissue samples from 335 resected stage I to IIIA NSCLC patients were obtained and tissue microarrays (TMAs) were constructed with 4 cores from each tumor specimen. VEGF-A expression was evaluated by immunohistochemistry, and in situ hybridization was used to evaluate the expression of miR-126. In the total material, miR-126 was a significant negative prognostic factor in both univariate (P = .005) and multivariate analyses (hazard ratio [HR] 1.8, 95% confidence interval [CI] 1.2-2.8, P = .01). Stratified by histology, miR-126 was only significant in squamous cell carcinomas (univariate: P < .001; multivariate: HR 3.1, CI 95% 1.7-5.6, P<.001). Stratified by lymph node status, miR-126 was significant only in the lymph node-positive subgroup (univariate: P<.001; multivariate: HR 4.1, CI 95% 2.0-8.4, P < .001). High miR-126 expression correlated significantly with high VEGF-A expression (P = .037). The co-expression of miR-126 and VEGF-A had a significant prognostic impact (P = .002), with 5-year survival rates of 68%, 51%, and 42% for low/low (n = 150), mixed combinations (n = 129), and high/high (n = 35) expression, respectively. miR-126 is a strong and independent negative prognostic factor in NSCLC, and its prognostic impact appears related primarily to histology and nodal status. Cancer 2011. © 2011 American Cancer Society. URI: http://hdl.handle.net/10037/4072 File(s) in this item: 1
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Hermansen, Stig eggen; Kalstad, Trine; How, Ole-Jakob; Myrmel, truls (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: Systemic inflammation and elevated circulating levels of the endogenous nitric oxide inhibitor asymmetrical dimethylarginine (ADMA) have been associated with increased risk in cardiogenic shock (CS). In this prospective study, we assessed, over 4 consecutive days, the changes and possible associations between vascular function, markers of inflammation, and circulating ADMA levels in patients with CS (n = 12) and postcardiotomy heart failure (n = 12, PC-HF). Vasodilator function was measured as a reactive hyperemia index (RH-index) using a finger plethysmograph. Blood samples were analyzed for plasma ADMA, interleukine-6, interleukine-8, intracellular adhesion molecule-1, and vascular adhesion molecule-1. Baseline RH-index was significantly attenuated compared with healthy controls (2.28) for both CS and PC-HF (1.35 and 1.45, respectively, P = 0.001). Although vasodilator function improved in PC-HF patients, it remained attenuated in CS. Inflammatory markers were markedly elevated followed by a significant fall during the observation period in both groups. ADMA levels increased significantly during the observation period for PC-HF, whereas no pattern of change was observed for CS. No association was found between the longitudinal changes in RH-index, markers of inflammation, or ADMA in CS. However, an improved RH-index was associated with decreasing inflammatory markers in PC-HF. ADMA correlated to arterial lactate levels and the degree of organ dysfunction in CS. In conclusion, CS and PC-HF were characterized by a marked inflammatory activation accompanied by an attenuated vasodilator function. ADMA was related to organ dysfunction and degree of hypoperfusion during CS but showed no correlations to inflammation or hampered vasodilator function. The pathogenic significance of these responses needs clarification URI: http://hdl.handle.net/10037/4112 File(s) in this item: 1
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Santana, Silvina; Lausen, Berthold; Bujnowska-Fedak, M; Chronaki, C; Prokosch, H.-U.; Wynn, Rolf (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: The knowledge about the relationship between health-related activities on the Internet (i.e. informed citizens) and individuals’ control over their own experiences of health or illness (i.e. empowered citizens) is valuable but scarce. In this paper, we investigate the correlation between four ways of using the Internet for information on health or illness and citizens attitudes and behaviours toward health professionals and health systems and establish the profile of empowered eHealth citizens in Europe. Data was collected during April and May 2007 (N = 7022), through computer-assisted telephone interviews (CATI). Respondents from Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal participated in the survey. The profiles were generated using logistic regressions and are based on: a) socio-demographic and health information, b) the level of use of health-related online services, c) the level of use of the Internet to get health information to decide whether to consult a health professional, prepare for a medical appointment and assess its outcome, and d) the impact of online health information on citizens’ attitudes and behavior towards health professionals and health systems. Citizens using the Internet to decide whether to consult a health professional or to get a second opinion are likely to be frequent visitors of health sites, active participants of online health forums and recurrent buyers of medicines and other health related products online, while only infrequent epatients, visiting doctors they have never met face-to-face. Participation in online health communities seems to be related with more inquisitive and autonomous patients. The profiles of empowered eHealth citizens in Europe are situational and country dependent. The number of Europeans using the Internet to get health information to help them deal with a consultation is raising and having access to online health information seems to be associated with growing number of inquisitive and self-reliant patients. Doctors are increasingly likely to experience consultations with knowledgeable and empowered patients, who will challenge them in various ways. URI: http://hdl.handle.net/10037/3862 File(s) in this item: 1
article.pdf (300.0Kb)
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