But in Jefferson's stunning opening paragraph of the Declaration of Independence, he blew away thousands of years of assumptions about government -- the divine right of kings, citizens owing obedience to whatever government they lived under, adherence to tradition, rule by aristocracy.
This last concept (which can be subsumed under adherence) is central to the experimental validity of studies in which psychological treatments are being compared.
Interestingly, we found that, although statins can be very effective in reducing cholesterol, the vast majority of the efficiency loss comes from over-adherence, as opposed to under-adherence, even though less than half of patients eventually adhered in the long run.
Currently, however, many public and private interventions focus on bluntly addressing under-adherence.
The valuable growth of personalized medicine that will result should not only reduce the amount of under-adherence but the amount of over-adherence as well.
In particular, we found that the ex-post efficiency loss from over-adherence is over 80% larger than that from under-adherence.
This approach is not based on science and assumes that that under-adherence is the sole problem, but over-adherence to ineffective treatments is equally harmful to patients – and potentially more costly for the health system.
MD-DC were cultured in bags under adherence-free conditions (Lifecell, Baxter) for 5 days in serum-free AIMV medium (Gibco-BRL) supplemented with 1000 UI/ml of rhGM-CSF (R&D Systems) and 200 UI/ml of rhIL-4 (Schering Plough).
On the other hand, some patients who are adherent to the treatment may not use the electronic monitors appropriately (e.g., pocket dosing, weekly organizers, etc)., resulting in potential under-estimation of adherence.
RF is defined as the number of times more likely that target success is attained under perfect adherence compared to imperfect adherence; or when comparing two drugs under a standard setting of imperfect adherence.
A forgiveness criterion, relative forgiveness, is defined as the number of times more likely that a target is successfully attained under perfect adherence compared to imperfect adherence; or when comparing two drugs under a standard setting of imperfect adherence.
