A Lesson in Futility

Medical futility: a futile concept?

A lesson in sigmoidoscopy.

"watershed effect," finding 10 to 15 years ofproblems all in 2 years due to an enhanced technology, or the common effect of increased findings that happens with many new screening or casefinding programs. In any event, as a direct result of screening sigmoidoscopies, three patients have had their cancers diagnosed at an earlier time than would have otherwise happened. Most importantly, four to ...

Tackling medical futility in Texas.

n engl j med 357;1 www.nejm.org july 5, 2007 was an 18-month-old boy who had Leigh’s disease, a progressive and fatal neurometabolic disorder. He had been on life support in the intensive care unit for 5 months. The hospital had invoked the Texas Advance Directives Act, which authorized it to withdraw life support if an ethics committee had determined that further life support was medically ina...

Futility stopping in clinical trials

Early stopping due to futility, also referred to as a go/nogo decision, during interim analysis has become an important feature of clinical trial designs. Current methods for futility stopping in literature are mostly based on conditional power or predictive power in conjunction with the theory of stochastic curtailment or group sequential design. They have certain drawbacks that have been note...

Futility in neurosurgery: a patient-centered approach.

The concept of futility has been a source of discussion for many years. Even though it is tempting to propose that an action or clinical intervention should be deemed futile if it does not achieve the goals of that action, further clarification is needed in terms of the nature of the likely outcomes of an intervention and the probabilities of various outcomes being achieved. The outcome, in an ...