Embryo disposal practices in IVF clinics in the United States.

Background: The moral status of the human embryo is particularly controversial in the United States, where one debate has centered on embryos created in excess at in vitro fertilization (IVF) clinics. Little has been known about the disposal of these embryos.

Methods: We mailed anonymous, self-administered questionnaires to directors of 341 American IVF clinics.

Comparing the standard rating scale and the magnifier scale for assessing risk perceptions.

Objective: A new risk perception rating scale ("magnifier scale") was recently developed to reduce elevated perceptions of low-probability health events, but little is known about its performance. The authors tested whether the magnifier scale lowers risk perceptions for low-probability (in 0%-1% magnifying glass section of scale) but not high-probability (>1%) events compared to a standard rating scale (SRS).

Method: In studies 1 (n = 463) and 2 (n = 105), undergraduates completed a survey assessing risk perceptions of high- and low-probability events in a randomized 2 x 2 design: in study 1 using the magnifier scale or SRS, numeric risk information provided or not, and in study 2 using the magnifier scale or SRS, high- or low-probability event.

Patients' resistance to risk information in genetic counseling for BRCA1/2.

Background: Risk information from health care providers is relevant to and used in nearly all medical decisions. Patients often misunderstand their risks, yet little is known about the risk perception that patients derive from risk communications with health care providers. This study examines patients' risk perceptions following communication with health care providers during genetic counseling about the risks of breast cancer and BRCA1/2 mutations.

Screening practices and beliefs of assisted reproductive technology programs.

Objective: To explore assisted reproductive technology (ART) programs' beliefs about and practices for screening program candidates for the use of ART services.

Design: An anonymous, self-administered, mailed questionnaire.

Setting: U.

Accounting for apparent "reverse" racial disparities in Department of Veterans Affairs (VA)-based medical care: influence of out-of-VA care.

Conclusions regarding racial differences in care following a newly elevated prostate-specific antigen (PSA) test at the Department of Veterans Affairs (VA) may differ depending on whether follow-up care outside the VA is considered. Consecutive Philadelphia, Pa, VA patients with newly elevated PSA tests (n = 183) were interviewed 1 year after baseline. Among exclusive VA users, Blacks had higher rates of urology referrals and prostate biopsies compared with Whites.

Intended message versus message received in hypothetical physician risk communications: exploring the gap.

We examined the risk perception that is derived from hypothetical physician risk communications. Subjects (n= 217) completed a questionnaire on the Web for $3. Subjects were presented with four hypothetical cancer risk scenarios that included a physician risk communication in one of three risk communication formats: verbal only, verbal plus numeric probability as a percent, and verbal plus numeric probability as a fraction.

The effect of numerical statements of risk on trust and comfort with hypothetical physician risk communication.

Objective: To contribute to the debate about whether numeric statements of risk ought to be included in risk communications.

Design: Subjects (n = 115) completed a questionnaire involving a physician risk communication and 4 scenarios, each of which described a patient with symptoms and signs potentially suggestive of cancer. Each scenario was presented in 3 risk communication versions (a verbal version and 2 numeric versions) in a within-subject 4 x 3 design.

Differential willingness to undergo smallpox vaccination among African-American and white individuals.

Objective: To examine potential disparities in willingness to be vaccinated against smallpox among different U.S. racial/ethnic groups.

The role of physicians' recommendations in medical treatment decisions.

Background: A shift away from the medical paternalism of the past has occurred, and today, the law and ethics advocate that physicians share decision-making responsibility with their patients. It is unclear, however, what the appropriate role of physicians' recommendations ought to be in this new shared decision-making paradigm. One way to approach this question is to assess the influence of physicians' recommendations.