RESUMEN
We analyse data on patient adherence to prescribed regimens and surrogate markers of clinical outcome for 168 human immunodeficiency virus infected patients treated with antiretroviral therapy. Data on patient adherence consisted of dose-timing measurements collected for an average of 12 months per patient via electronic monitoring of bottle opening events. We first discuss how such data can be presented to highlight suboptimal adherence patterns and between-patient differences, before introducing two novel methods by which such data can be statistically modelled. Correlations between adherence and subsequent measures of viral load and CD4+T-cell counts are then evaluated. We show that summary measures of short-term adherence, which incorporate pharmacokinetic and pharmacodynamic data on the monitored regimen, predict suboptimal trends in viral load and CD4+T-cell counts better than measures based on adherence data alone.
Asunto(s)
Terapia Antirretroviral Altamente Activa/estadística & datos numéricos , Recuento de Linfocito CD4/estadística & datos numéricos , Infecciones por VIH/epidemiología , Infecciones por VIH/terapia , Evaluación de Resultado en la Atención de Salud/métodos , Cooperación del Paciente/estadística & datos numéricos , Medición de Riesgo/métodos , Simulación por Computador , Interpretación Estadística de Datos , Infecciones por VIH/inmunología , Humanos , Modelos Biológicos , Reproducibilidad de los Resultados , Factores de Riesgo , Sensibilidad y Especificidad , Estadística como Asunto , Resultado del Tratamiento , Estados Unidos/epidemiologíaRESUMEN
The purpose of this article is to convey some understanding of Orthodox Jewish thought on organ donation and transplantation. This perspective is particularly important as practitioners become more culturally diverse and medical care becomes more globalized. The Jewish ethical position, found in the Compendium on Medical Ethics: Jewish Moral, Ethical and Religious Principles in Medical Practice, is described. Points of view for determining death in Jewish law as well as some halakic (Jewish law) issues for the donor and recipient are also indicated.