Environmental, behavioural but also genetic factors are thought to play a role in the aetiology of childhood constipation. We provide an overview of genetic PD98059 clinical trial studies performed in constipation. Until now, linkage studies, association studies and direct gene sequencing have failed to identify mutations in specific genes associated with constipation. We show that along with functional constipation, there are numerous clinical syndromes associated with childhood constipation. These syndromic forms of constipation

appear to be the result of mutations in genes affecting all aspects of the normal physiology of human defecation. We stress that syndromic causes of childhood constipation should be considered in the evaluation of a constipated child. (C) 2010 Elsevier Ltd. All rights reserved.”
“Background: Evidence-based medicine, the Institute of Medicine (IOM) and the German Institute for Quality and Efficiency in Health Care (IQWiG), support the inclusion of patients’ preferences in health care decisions. In fact there are not many trials which include an assessment of patient’s preferences. The aim of this study is to demonstrate that preferences of physicians and of patients can be assessed

and that this information may be helpful for medical decision making.

Method: One of the established methods for assessment Fosbretabulin solubility dmso of preferences is the conjoint analysis. Conjoint analysis, in combination with a computer assisted telephone interview (CATI), was used to collect data from 827 diabetes patients and 60 physicians, which describe the preferences expressed as levels of four factors in the management and outcome of the disease. The first factor described the main treatment effect (reduction of elevated Hb(A1c), improved well-being, absence of side effects, and no limitations of daily life). The second factor described the effect on the body weight (gain, no change, PF-00299804 reduction). The third factor analyzed the mode of application (linked to meals or flexible application). The fourth factor addressed the type of product (original brand

or generic product). Utility values were scaled and normalized in a way that the sum of utility points across all levels is equal to the number of attributes (factors) times 100.

Results: The preference weights confirm that the reduction of body weight is at least as important for patients especially obese patients – and physicians as the reduction of an elevated Hb(A1c). Original products were preferred by patients while general practitioners preferred generic products.

Conclusion: Using the example of diabetes, the difference between patients’ and physicians’ preferences can be assessed. The use of a conjoint analysis in combination with CATI seems to be an effective approach for generation of data which are needed for policy and medical decision making in health care.