Neil A Holtzman
Biographic Data
| ID | 351760 |
|---|---|
| NAME | Neil A Holtzman |
| GIVEN NAMES | Neil A |
| FAMILY NAME | Holtzman |
| SIGNATURE | HOLTZMAN N A |
| AFFILIATIONS | Johns Hopkins University |
| VERIFIED | No |
| TOTAL WORKS | 23 |
| TOTAL CITATIONS | 45 |
| AUTHOR COUNT | 23 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1974 |
| LATEST PUBLICATION YEAR | 2021 |
| H-INDEX | 4 |
Invited commentary: The Covid-19 pandemic in the United States
Despite being the wealthiest and one of the most technologically advanced countries in the world, the United States has the greatest number of Covid-19 cases and deaths. What accounts for this failure? The dismantling of the country's public health infrastructure has crippled contact tracing and exacerbated inequality as a disproportionate number of poor people and people of color have fallen ill with Covid-19. Inadequate regulation of the privat…
Public Health and the Risk Factor: A History of an Uneven Medical Revolution (review)
Reviewed by: Public Health and the Risk Factor: A History of an Uneven Medical Revolution Neil A. Holtzman William G. Rothstein . Public Health and the Risk Factor: A History of an Uneven Medical Revolution. Rochester Studies in Medical History. Rochester, N.Y.: University of Rochester Press, 2003. xiii + 466 pp. Tables. $95.00; £70.00 (1-58046-127-1). Risk factors can be reduced or removed by interventions in populations, individuals, or both. I…
Assessing Mass Media Reporting of Disease-Related Genetic Discoveries: Development of an Instrument and Initial Findings
Objective: To develop an instrument to assess the content and balance of media stories about genetic discoveries relevant to human diseases and assess its ability to detect variability. Methods: Consumer focus groups to help develop the instrument, and surveys of scientists and journalists to evaluate the items. Ratings by at least two readers assessed reliability. Variability was measured by comparing scores of 47 stories emanating from two disc…
Houseofficers’ reactions to media coverage about the sequencing of the human genome
Genetics and social class
Objective: To assess claims that genes are a major determinant of social class. Design: Using genetic epidemiological principles, five claims on the role of genes in determining social class are examined: (1) traits that run in families are usually inherited; (2) complex traits can be explained by alleles at a single gene locus; (3) complex traits are transmitted intact from one generation to the next; (4) natural selection explains social advant…
Eugenics and Genetic Testing
The ArgumentPressures to lower health-care costs remain an important stimulus to eugenic approaches. Prenatal diagnosis followed by abortion of affected fetuses has replaced sterilization as the major eugenic technique. Voluntary acceptance has replaced coercion, but subtle pressures undermine personal autonomy. The failure of the old eugenics to accurately predict who will have affected offspring virtually disappears when prenatal diagnosis is u…
"Decoding" Informed Consent Insights from Women regarding Breast Cancer Susceptibility Testing
Cancer susceptibility testing is likely to become routine in medical practice, despite many limitations and unanswered questions. These uncertainties greatly complicate the process of informed consent, creating an excellent opportunity to reconsider exactly how it should be conducted. Research with women's reactions to the availability of genetic susceptibility testing for breast cancer dramatically underscores that informed consent ought to be h…
Genetic screening and public health
editorial
A Qualitative Assessment of Primary Care Physicians' Perceptions about the Ethical and Social Implications of Offering Genetic Testing
Due to the increasing likelihood that new genetic tests will be incorporated into primary care, we investigated the preparedness of primary care physicians to offer such tests. As a follow-up to a national survey of physicians' knowledge and attitudes regarding genetics, we conducted five focus groups with a total of 39 survey respondents from 5 specialties and 4 states. Semi-structured questions were used to generate and guide discussion about p…
Improving response rates through incentive and follow-up: The effect on a survey of physicians' knowledge of genetics
OBJECTIVES. This study assessed efforts to increase response rates to a mailed physician survey and examined whether, as a result, nonresponse bias was reduced. METHODS. Randomly selected physicians and geneticists were mailed a questionnaire concerning genetics knowledge and attitudes. In the final but not the pilot survey, a $25 incentive and intensive follow-up were used to increase the response rate. RESULTS. The response rate from physicians…
Measuring Physicians?? Tolerance for Ambiguity and its Relationship to Their Reported Practices Regarding Genetic Testing
Despite uncertainties in medicine, attempts to study physicians' tolerance for uncertainty have been few, and limited by the measurement instruments available. This paper describes development of a modified tolerance for ambiguity (TFA) scale, and correlates it with several physician characteristics and reported behaviors. Eighteen TFA items were included in a national survey of physicians' knowledge and attitudes about genetic testing. Sixty-fiv…
Maternal cigarette smoking and oral clefts: A population-based study
Analyses of 1984 data from the Maryland Birth Defects Reporting and Information System indicate that mothers of infants with oral clefts (cleft lip with or without cleft palate; and cleft palate) smoked more during pregnancy than mothers of infants with other defects (odds ratio OR of 2.56 and 2.39, respectively). There was a dose-response relation between the daily amount smoked and the risk of clefting. Adjustment for available confounding vari…
Prenatal screening and pregnant women's attitudes toward the abortion of defective fetuses
We studied the attitudes of 490 pregnant women toward the abortion of defective fetuses. Three hundred of these women were participating in a prenatal screening program for neural tube defects. Although theoretical accounts of the effects of behavior on attitude would suggest that participation in a screening program would affect abortion attitudes, evidence in support of such an association was weak. The overwhelming majority of women, regardles…
III Health and Use of Medical Care; Community-Based Assessment of Morbidity in Children
The purpose of this study was to assess the relationship between morbidity and ambulatory care utilization in a randomly selected sample of children with stable patterns of use of services in a prepaid multispecialty group practice. The unique features of the approach were a focus on long-term relationships (over 8 years) and on assessment of health status by a combination of parent reports, child reports, teacher reports, and physical examinatio…
Assessment of risk by pregnant women: Implications for genetic counseling and education
One of the central elements of genetic counseling is the transmission of quantitative information concerning risk of defects in an unborn child from counselor to client. In order to investigate this subject, we studied the understanding of numeric and nonnumeric descriptions of genetic risk by 190 pregnant women. Specifically, three risk issues were explored: (1) whether women were able to interpret numeric risks as percentages; (2) whether shift…
What participants understand about a maternal serum alpha-fetoprotein screening program
We investigated the knowledge of pregnant women participating in a maternal serum alphafetoprotein (MSAFP) screening program for the detection of neural tube defects (NTDs) in the fetus. Women participating in the screening program scored higher on two knowledge tests than a comparison group of pregnant women who were not offered screening. However, there were substantial gaps in the knowledge base of women in the program, as measured by one of t…
Education, consent, and counseling in sickle cell screening programs: Report of a survey
In 1980, we surveyed screening facilities to determine the extent of sickle cell screening and to assess compliance with Maryland regulations. Approximately 52,000 persons were screened per year in Maryland by local health departments, hospitals, primary care centers, correctional facilities, and units dedicated entirely to screening. Thirteen thousand persons were screened without informed consent. Many facilities were deficient in providing edu…
Pregnant women's attitudes toward the abortion of defective fetuses
A survey to evaluate parental consent as public policy for neonatal screening
Most states currently have laws which result in compulsory neonatal screening practices, despite a widespread consensus that participation in genetic services and programs should be voluntary. In 1976, Maryland adopted a regulation designed to respect parents' rights to refuse neonatal screening by imposing a parental consent requirement. The results of a study designed to evaluate the effects of this regulation are reviewed here. Many health car…
Parental rights, child welfare, and public health: The case of PKU screening
The right of parents to refuse consent for phenylketonuria (PKU) screening is discussed in terms of moral justifications. The authors take the position that the primary function of a parental consent requirement is to protect children's welfare. In the case of PKU screening, the intervention poses minimal risk of harm while refusal of screening poses a significant risk to the child. Therefore, the principle of preventing harm overrides the parent…
Aboard the Lifeboat Debate
Cystathionine in the brains of tree shrews and other mammals
Neonatal screening for phenylketonuria. IV. Factors influencing the occurrence of false positives
Neonatal screening for phenylketonuria. IV. Factors influencing the occurrence of false positives. Affiliation N A Holtzman, A G Meek, and E D MellitsCopyRight https://doi.org/10.2105/AJPH.64.8.755 Published Online: October 07, 2011
Improving response rates through incentive and follow-up: The effect on a survey of physicians' knowledge of genetics
OBJECTIVES. This study assessed efforts to increase response rates to a mailed physician survey and examined whether, as a result, nonresponse bias was reduced. METHODS. Randomly selected physicians and geneticists were mailed a questionnaire concerning genetics knowledge and attitudes. In the final but not the pilot survey, a $25 incentive and intensive follow-up were used to increase the response rate. RESULTS. The response rate from physicians…
Genetics and social class
Objective: To assess claims that genes are a major determinant of social class. Design: Using genetic epidemiological principles, five claims on the role of genes in determining social class are examined: (1) traits that run in families are usually inherited; (2) complex traits can be explained by alleles at a single gene locus; (3) complex traits are transmitted intact from one generation to the next; (4) natural selection explains social advant…
What participants understand about a maternal serum alpha-fetoprotein screening program
We investigated the knowledge of pregnant women participating in a maternal serum alphafetoprotein (MSAFP) screening program for the detection of neural tube defects (NTDs) in the fetus. Women participating in the screening program scored higher on two knowledge tests than a comparison group of pregnant women who were not offered screening. However, there were substantial gaps in the knowledge base of women in the program, as measured by one of t…
Assessing Mass Media Reporting of Disease-Related Genetic Discoveries: Development of an Instrument and Initial Findings
Objective: To develop an instrument to assess the content and balance of media stories about genetic discoveries relevant to human diseases and assess its ability to detect variability. Methods: Consumer focus groups to help develop the instrument, and surveys of scientists and journalists to evaluate the items. Ratings by at least two readers assessed reliability. Variability was measured by comparing scores of 47 stories emanating from two disc…
Prenatal screening and pregnant women's attitudes toward the abortion of defective fetuses
We studied the attitudes of 490 pregnant women toward the abortion of defective fetuses. Three hundred of these women were participating in a prenatal screening program for neural tube defects. Although theoretical accounts of the effects of behavior on attitude would suggest that participation in a screening program would affect abortion attitudes, evidence in support of such an association was weak. The overwhelming majority of women, regardles…
Parental rights, child welfare, and public health: The case of PKU screening
The right of parents to refuse consent for phenylketonuria (PKU) screening is discussed in terms of moral justifications. The authors take the position that the primary function of a parental consent requirement is to protect children's welfare. In the case of PKU screening, the intervention poses minimal risk of harm while refusal of screening poses a significant risk to the child. Therefore, the principle of preventing harm overrides the parent…
A survey to evaluate parental consent as public policy for neonatal screening
Most states currently have laws which result in compulsory neonatal screening practices, despite a widespread consensus that participation in genetic services and programs should be voluntary. In 1976, Maryland adopted a regulation designed to respect parents' rights to refuse neonatal screening by imposing a parental consent requirement. The results of a study designed to evaluate the effects of this regulation are reviewed here. Many health car…
Houseofficers’ reactions to media coverage about the sequencing of the human genome
Eugenics and Genetic Testing
The ArgumentPressures to lower health-care costs remain an important stimulus to eugenic approaches. Prenatal diagnosis followed by abortion of affected fetuses has replaced sterilization as the major eugenic technique. Voluntary acceptance has replaced coercion, but subtle pressures undermine personal autonomy. The failure of the old eugenics to accurately predict who will have affected offspring virtually disappears when prenatal diagnosis is u…
A Qualitative Assessment of Primary Care Physicians' Perceptions about the Ethical and Social Implications of Offering Genetic Testing
Due to the increasing likelihood that new genetic tests will be incorporated into primary care, we investigated the preparedness of primary care physicians to offer such tests. As a follow-up to a national survey of physicians' knowledge and attitudes regarding genetics, we conducted five focus groups with a total of 39 survey respondents from 5 specialties and 4 states. Semi-structured questions were used to generate and guide discussion about p…
Maternal cigarette smoking and oral clefts: A population-based study
Analyses of 1984 data from the Maryland Birth Defects Reporting and Information System indicate that mothers of infants with oral clefts (cleft lip with or without cleft palate; and cleft palate) smoked more during pregnancy than mothers of infants with other defects (odds ratio OR of 2.56 and 2.39, respectively). There was a dose-response relation between the daily amount smoked and the risk of clefting. Adjustment for available confounding vari…
Pregnant women's attitudes toward the abortion of defective fetuses
Assessment of risk by pregnant women: Implications for genetic counseling and education
One of the central elements of genetic counseling is the transmission of quantitative information concerning risk of defects in an unborn child from counselor to client. In order to investigate this subject, we studied the understanding of numeric and nonnumeric descriptions of genetic risk by 190 pregnant women. Specifically, three risk issues were explored: (1) whether women were able to interpret numeric risks as percentages; (2) whether shift…
Education, consent, and counseling in sickle cell screening programs: Report of a survey
In 1980, we surveyed screening facilities to determine the extent of sickle cell screening and to assess compliance with Maryland regulations. Approximately 52,000 persons were screened per year in Maryland by local health departments, hospitals, primary care centers, correctional facilities, and units dedicated entirely to screening. Thirteen thousand persons were screened without informed consent. Many facilities were deficient in providing edu…
Neonatal screening for phenylketonuria. IV. Factors influencing the occurrence of false positives
Neonatal screening for phenylketonuria. IV. Factors influencing the occurrence of false positives. Affiliation N A Holtzman, A G Meek, and E D MellitsCopyRight https://doi.org/10.2105/AJPH.64.8.755 Published Online: October 07, 2011
Cystathionine in the brains of tree shrews and other mammals
Neonatal screening for phenylketonuria. IV. Factors influencing the occurrence of false positives
Neonatal screening for phenylketonuria. IV. Factors influencing the occurrence of false positives. Affiliation N A Holtzman, A G Meek, and E D MellitsCopyRight https://doi.org/10.2105/AJPH.64.8.755 Published Online: October 07, 2011
Aboard the Lifeboat Debate
A survey to evaluate parental consent as public policy for neonatal screening
Most states currently have laws which result in compulsory neonatal screening practices, despite a widespread consensus that participation in genetic services and programs should be voluntary. In 1976, Maryland adopted a regulation designed to respect parents' rights to refuse neonatal screening by imposing a parental consent requirement. The results of a study designed to evaluate the effects of this regulation are reviewed here. Many health car…
Parental rights, child welfare, and public health: The case of PKU screening
The right of parents to refuse consent for phenylketonuria (PKU) screening is discussed in terms of moral justifications. The authors take the position that the primary function of a parental consent requirement is to protect children's welfare. In the case of PKU screening, the intervention poses minimal risk of harm while refusal of screening poses a significant risk to the child. Therefore, the principle of preventing harm overrides the parent…
Pregnant women's attitudes toward the abortion of defective fetuses
Education, consent, and counseling in sickle cell screening programs: Report of a survey
In 1980, we surveyed screening facilities to determine the extent of sickle cell screening and to assess compliance with Maryland regulations. Approximately 52,000 persons were screened per year in Maryland by local health departments, hospitals, primary care centers, correctional facilities, and units dedicated entirely to screening. Thirteen thousand persons were screened without informed consent. Many facilities were deficient in providing edu…
What participants understand about a maternal serum alpha-fetoprotein screening program
We investigated the knowledge of pregnant women participating in a maternal serum alphafetoprotein (MSAFP) screening program for the detection of neural tube defects (NTDs) in the fetus. Women participating in the screening program scored higher on two knowledge tests than a comparison group of pregnant women who were not offered screening. However, there were substantial gaps in the knowledge base of women in the program, as measured by one of t…
III Health and Use of Medical Care; Community-Based Assessment of Morbidity in Children
The purpose of this study was to assess the relationship between morbidity and ambulatory care utilization in a randomly selected sample of children with stable patterns of use of services in a prepaid multispecialty group practice. The unique features of the approach were a focus on long-term relationships (over 8 years) and on assessment of health status by a combination of parent reports, child reports, teacher reports, and physical examinatio…
Assessment of risk by pregnant women: Implications for genetic counseling and education
One of the central elements of genetic counseling is the transmission of quantitative information concerning risk of defects in an unborn child from counselor to client. In order to investigate this subject, we studied the understanding of numeric and nonnumeric descriptions of genetic risk by 190 pregnant women. Specifically, three risk issues were explored: (1) whether women were able to interpret numeric risks as percentages; (2) whether shift…
Maternal cigarette smoking and oral clefts: A population-based study
Analyses of 1984 data from the Maryland Birth Defects Reporting and Information System indicate that mothers of infants with oral clefts (cleft lip with or without cleft palate; and cleft palate) smoked more during pregnancy than mothers of infants with other defects (odds ratio OR of 2.56 and 2.39, respectively). There was a dose-response relation between the daily amount smoked and the risk of clefting. Adjustment for available confounding vari…
Prenatal screening and pregnant women's attitudes toward the abortion of defective fetuses
We studied the attitudes of 490 pregnant women toward the abortion of defective fetuses. Three hundred of these women were participating in a prenatal screening program for neural tube defects. Although theoretical accounts of the effects of behavior on attitude would suggest that participation in a screening program would affect abortion attitudes, evidence in support of such an association was weak. The overwhelming majority of women, regardles…
Improving response rates through incentive and follow-up: The effect on a survey of physicians' knowledge of genetics
OBJECTIVES. This study assessed efforts to increase response rates to a mailed physician survey and examined whether, as a result, nonresponse bias was reduced. METHODS. Randomly selected physicians and geneticists were mailed a questionnaire concerning genetics knowledge and attitudes. In the final but not the pilot survey, a $25 incentive and intensive follow-up were used to increase the response rate. RESULTS. The response rate from physicians…
Measuring Physicians?? Tolerance for Ambiguity and its Relationship to Their Reported Practices Regarding Genetic Testing
Despite uncertainties in medicine, attempts to study physicians' tolerance for uncertainty have been few, and limited by the measurement instruments available. This paper describes development of a modified tolerance for ambiguity (TFA) scale, and correlates it with several physician characteristics and reported behaviors. Eighteen TFA items were included in a national survey of physicians' knowledge and attitudes about genetic testing. Sixty-fiv…
A Qualitative Assessment of Primary Care Physicians' Perceptions about the Ethical and Social Implications of Offering Genetic Testing
Due to the increasing likelihood that new genetic tests will be incorporated into primary care, we investigated the preparedness of primary care physicians to offer such tests. As a follow-up to a national survey of physicians' knowledge and attitudes regarding genetics, we conducted five focus groups with a total of 39 survey respondents from 5 specialties and 4 states. Semi-structured questions were used to generate and guide discussion about p…
"Decoding" Informed Consent Insights from Women regarding Breast Cancer Susceptibility Testing
Cancer susceptibility testing is likely to become routine in medical practice, despite many limitations and unanswered questions. These uncertainties greatly complicate the process of informed consent, creating an excellent opportunity to reconsider exactly how it should be conducted. Research with women's reactions to the availability of genetic susceptibility testing for breast cancer dramatically underscores that informed consent ought to be h…
Genetic screening and public health
editorial
Eugenics and Genetic Testing
The ArgumentPressures to lower health-care costs remain an important stimulus to eugenic approaches. Prenatal diagnosis followed by abortion of affected fetuses has replaced sterilization as the major eugenic technique. Voluntary acceptance has replaced coercion, but subtle pressures undermine personal autonomy. The failure of the old eugenics to accurately predict who will have affected offspring virtually disappears when prenatal diagnosis is u…
Genetics and social class
Objective: To assess claims that genes are a major determinant of social class. Design: Using genetic epidemiological principles, five claims on the role of genes in determining social class are examined: (1) traits that run in families are usually inherited; (2) complex traits can be explained by alleles at a single gene locus; (3) complex traits are transmitted intact from one generation to the next; (4) natural selection explains social advant…
Assessing Mass Media Reporting of Disease-Related Genetic Discoveries: Development of an Instrument and Initial Findings
Objective: To develop an instrument to assess the content and balance of media stories about genetic discoveries relevant to human diseases and assess its ability to detect variability. Methods: Consumer focus groups to help develop the instrument, and surveys of scientists and journalists to evaluate the items. Ratings by at least two readers assessed reliability. Variability was measured by comparing scores of 47 stories emanating from two disc…
Houseofficers’ reactions to media coverage about the sequencing of the human genome
Public Health and the Risk Factor: A History of an Uneven Medical Revolution (review)
Reviewed by: Public Health and the Risk Factor: A History of an Uneven Medical Revolution Neil A. Holtzman William G. Rothstein . Public Health and the Risk Factor: A History of an Uneven Medical Revolution. Rochester Studies in Medical History. Rochester, N.Y.: University of Rochester Press, 2003. xiii + 466 pp. Tables. $95.00; £70.00 (1-58046-127-1). Risk factors can be reduced or removed by interventions in populations, individuals, or both. I…
Invited commentary: The Covid-19 pandemic in the United States
Despite being the wealthiest and one of the most technologically advanced countries in the world, the United States has the greatest number of Covid-19 cases and deaths. What accounts for this failure? The dismantling of the country's public health infrastructure has crippled contact tracing and exacerbated inequality as a disproportionate number of poor people and people of color have fallen ill with Covid-19. Inadequate regulation of the privat…
Medicine (21 works) · Family medicine (13 works) · Psychology (12 works) · BRCA gene mutations in cancer (9 works) · Political science (8 works) · Environmental health (7 works) · Psychiatry (7 works) · Public health (7 works) · Nursing (6 works) · Biology (5 works)