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  • (2008) Cowan, Ruth; Meiser, Bettina; Giles, Graham; Lindeman, Geoffrey; Gaff, Clara
    Journal Article
    Purpose: Genetic testing for hereditary cancer facilitates medical management and improves health outcomes. Genetic testing is not currently available for prostate cancer, but trials are underway to investigate if antiandrogens and selenium have a preventive role for at-risk individuals. To inform future genetic counseling, we sought to understand the pre-existing beliefs and behaviors of men with a family history of prostate cancer and explore their intention to adopt possible preventive behaviors in response to test results. Methods: A survey was completed by 280 men (response: 59%). Results: The belief that diet influenced prostate cancer risk was held by 73% of participants, whereas 37% believed in medication/natural therapies. Thirty-nine percent reported at least one change to their diet, alcohol consumption, smoking, exercise patterns, vitamin/mineral/supplement intake and/or medication/natural therapy in response to their family history. The men expressed interest in genetic testing with 92% `definitely` or `probably` interested. Definite interest was associated with number of affected relatives and prostate cancer-related anxiety. A positive genetic test would motivate 93% of men to make at least one behavioral change. Conclusions: Participants commonly believed behavioral factors influenced prostate cancer risk and reported that they would alter their behavior to reduce risk after (hypothetical) genetic testing.

  • (2008) Large, M.; Nielssen, O.
    Journal Article
    Psychiatrists and psychologists acting as expert witnesses in court cases are often accused of bias or error. We examined the level of agreement and factors influencing agreement between expert reports admitted into evidence during adversarial civil proceedings. The inter-rater reliability of the psychiatric diagnosis was examined in 51 pairs of civil medicolegal reports written by experts engaged by the same side and 97 pairs of experts engaged by opposite sides. Reports written by experts engaged by the same adversarial side had good agreement about the presence of a mental disorder ({kappa} = .74) but had only fair agreement about the specific psychiatric diagnosis (average {kappa} = .31). Reports written by experts engaged by opposing adversarial sides had poor agreement about the presence of any mental disorder and also the specific psychiatric diagnosis. Experts were more likely to agree about the presence of a mental disorder if the plaintiff was involved in a fatal accident. The agreement of treating doctors and experts was similar to that of pairs of experts.