The 1995 pill scare revisited: anatomy of a non-epidemic

Spitzer, Walter O.

doi:10.1093/humrep/12.11.2347

Cited by 43 publications

(27 citation statements)

References 49 publications

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“…However, the impact of our observations for 'pill thrombosis' was also questioned (Balasch, 1997;Schramm & Heinemann, 1997;Spitzer, 1997;Winkler, 1998). Amongst other things it was argued that the APC resistance test developed in our laboratory has not yet been clinically validated (Balasch, 1997;Spitzer, 1997;Winkler, 1998) and that the different effects of OC in our APC resistance test might have been affected by the selection of patients or may be due to an ex-vivo effect (Schramm & Heinemann, 1997).…”

mentioning

confidence: 90%

Acquired APC resistance and oral contraceptives: differences between two functional tests

Curvers¹,

Thomassen²,

Nicolaes³

et al. 1999

Br J Haematol

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Summary.Resistance to activated protein C (APC) is often associated with a mutation in factor V (factor V Leiden ). Individuals without factor V Leiden who exhibit a response in functional APC-resistance tests similar to that of carriers of factor V Leiden are considered to be acquired APC resistant. This phenomenon is particularly observed in women using oral contraceptives (OC).In the present study we compared the response to APC in plasma from normal individuals, carriers of factor V Leiden and women who use OC using functional tests that either quantify the effect of APC on the endogenous thrombin potential (ETP) or on the activated partial thromboplastin time (aPTT).Both tests discriminated equally well between individuals with and without factor V Leiden who were not using OC. In contrast to the aPTT-based test, the ETP-based assay yielded significant differences in sensitivity to APC between non-OC users and OC users and between users of second and third generation OC. Since there was no correlation between APCsensitivity determined with both assays in non-carriers of factor V Leiden and in women who use OC and a poor correlation in carriers of factor V Leiden , we propose that other plasma components differentially modulate the response to APC in the aPTT-and ETP-based APC-resistance tests and that OC change the level of plasma protein(s) that modulate the effect of APC on thrombin formation initiated via the extrinsic coagulation pathway.

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mentioning

confidence: 90%

Acquired APC resistance and oral contraceptives: differences between two functional tests

Curvers¹,

Thomassen²,

Nicolaes³

et al. 1999

Br J Haematol

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“…6 Some events had attracted considerable attention, suggesting that what constitutes a 'health scare' emerges from common understandings and concerns that cluster around specific events. By numbers of publications, the top three in this sample were an advisory about 'third generation' oral contraceptives in the UK in 1995 (see eg Balasch, 1997;Spitzer, 1997Spitzer, , 1999, bovine spongiform encephalopathy (BSE) / prion diseases and HIV/AIDS. To a significant degree this result must be regarded as an artifact of the search strategy, dependent on the genre and structure of the academic discussion on these subjects; other topics (eg, MMR vaccine and autism) have almost certainly engendered at least as many publications.…”

Section: The Samplementioning

confidence: 99%

“…In several cases experts misjudges the appropriate timing for the public release of information. Examples include the 1995 oral contraceptives scare in Britain, concerns about hormone replacement therapy 12 from the Million Women study, and the link between acrylamide and cancer (Lofstedt, 2003;Panay, 2004;Spitzer, 1997Spitzer, , 1999Williams, Kelly, Carvalho, and Feely, 1998)). Some writers argued that exhaustive scientific debate should be required before political and public judgments are formed (Benagiano and Primiero, 1999), but others pointed out that experts may feel caught between accusations of cover-up or collusion if they do not publicise information, and accusations of scare-mongering if they do (Shickle, 2000).…”

Section: Experts and Evidencementioning

confidence: 99%

“…Describing risk in relative rather than absolute terms was frequently a problem in health scares related to pharmaceutical products (Baum, 2000;Hunter and Leyden, 1995;Lilford and Braunholtz, 1996;Skouby, 1998;Spitzer, 1997). Failure to relate incidence rates to longer epidemiological patterns amplified concern (Calnan et al, 1976;Chiazze, Silverman, and Levin, 1976;Stuart, 1996).…”

Section: Experts and Evidencementioning

confidence: 99%

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Health scares: Professional priorities

Hooker

2010

Health (London)

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Currently, many health scholars are concerned about health scares. But what do they mean by the term 'health scare' -are health scares an identifiable phenomenon, and how do we currently understand their causation and consequences? By collecting and analyzing published articles about events considered to be health scares, this paper maps the current views of scholars on their characteristics and causes. Results show that health scares are generally understood as events characterized by fears of catastrophic consequences but little actual mortality. However, the social and economic impacts of these events have often been severe. This survey shows that health scares can be usefully sorted into 6 categories, each with identifiable internal dynamics, suggesting different communications strategies to achieve resolution in each category. Using the social amplification of risk framework, the conditions under which risk signals were amplified were traced in general terms among major stakeholders. Simple causes for health scare events could not be identified, though some triggers did emerge. Importantly, public ignorance of real risk, media scaremongering, and political inaction could be dismissed as primary explanations, though they were sometimes factors in scare events. Implications for risk communication and for future research on risk and public health are discussed. Keywords:Health scare, Social amplification of risk, Expert, Media, Risk controversyIn the age of SARS and 'mad cow' (BSE -bovine spongiform encephalitis) disease, many health professionals in both government and academe worry about what they refer to as 'health scares'. Exactly what these are is, however, unclear. Are they small risks falsely judged as large, as were fluoride additives to water -or alternatively a form of 'health panic' (Moynihan, Heath, and Henry, 2002;Rail and Beausoleil, 2003) or moral panic (Ungar, 2001, McRobbie andThornton, 1995)? The colloquialism seems often to be an umbrella term for a raft of different concerns: sometimes of governments meeting public demands to spend vast sums on protections against negligible risks, and yet at other times of government failure to commit 2 sufficient resources to protect against others risks; of panicky public reactions to media beatups, and yet also of public ignorance of highly damaging risks; of the failure to identify and control the pandemic of influenza feared to be coming, and simultaneously that planning for it will end up costing more than we wish it to in terms of lost revenue, or public mistrust or complacency, or the shunning of particular cultural groups. In particular there are concerns about the enormous political and economic costs of certain scare situations, so disproportionate do they seem when compared to the actual mortality attributable to, for example, SARS or anthrax or 'new variant' Creuzfeld-Jakob disease (nvCJD) (Skinner, 2004).The first aim of this paper is to use the extant literature to work out what scholars mean by the term 'health scare'. Because ther...

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“…This, together with a reduction of the risk of venous thromboembolism (VTE) with increasing duration of use, formed the basis for one of the most important distorting factors in the initial three studies (Kaper, 1996;Rosenberg et al, 1996). New epidemiological studies and a 1120 re-analysis of one of the 1995 studies have taken the increased knowledge on this and other distorting factors on board in order to make more appropriate adjustments for these confounders (Spitzer, 1997).…”

Section: Rfkapermentioning

confidence: 99%