ABSTRACT
The majority of women diagnosed with breast cancer will experience some form of drug-related toxicity and subsequent impairments in Health-related Quality of Life (HRQoL). Despite this, HRQoL is assessed inconsistently and there is no validated method to integrate HRQoL data into the assessment of therapeutic agents. This proof of concept study utilizes data from the neoadjuvant I-SPY 2 clinical trial to describe the development of the Quality of Life Index (QoLI) measure. The QoLI represents a single composite score that incorporates validated longitudinal measures of clinical efficacy and QoL and one that permits a more comprehensive, direct comparison of individual therapeutic agents. Preliminary data suggest the QoLI is able to distinguish between agents based on their efficacy and toxicity; with further validation, the QoLI has the potential to provide more patient-centered evaluations in clinical trials and help guide treatment decision making in breast cancer and other oncologic diseases.
ABSTRACT
Are we witnessing a moral panic or a moral evaluation in the responses to the new reproductive technologies? Locating women in reproductive technology is a particularly powerful way into a discussion of values and consequences, intended or unintended. Twelve areas are isolated for discussion beginning with issues of definition and location: What is reproductive and genetic engineering? and How does human reproduction fit into bio-technological developments generally? Next issues are raised about how the new developments are being shaped ideologically and how they are being promoted by the state. A series of legal issues affecting women, men, children, embryos and fetuses follow. The focus then shifts to the way women are ideologically constructed: Why is there an assumption that woman = mother, and mother = heterosexual married or stable cohabiting woman?--and socially controlled: Why assume technological change in human reproductive processes means the basic subordination of women to men will not alter? The usefulness of the new technologies in relieving involuntary childlessness is then queried which leads on to a questioning of whether these developments are qualitatively different from other technologies used in human reproduction. Futuristic concerns such as the importance of the male pregnancy and the social consequences of fully medicalising human reproduction are raised. The last area to be considered is protest by women and suggested alternative approaches to increase the social visibility and recognition of the needs and interest of women in the current and potential use of the new medical and scientific developments.