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Record 4
from database: MEDLINE
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- Title
- Clinical and statistical prediction: a
retrospective and would-be integrative
perspective.
- Author
- Holt RR
- Address
-
- Source
- J Pers Assess, 1986 Fal, 50:3, 376-86
- Abstract
- One of the early participants in the
clinical-statistical controversy describes
his effort to mediate the dispute and to
direct attention to the underlying issues,
to most of which the box scores were
irrelevant. A previously undiscussed
undercurrent of the controversy is the
conflict between different metaphysical
world views, the history of which for the
past few hundred years is quickly
sketched. The mechanist metaphysics of
behaviorism, which has long been dominant
in American mainstream psychology, favors
objective and statistical approaches and
discourages interest in judgement, an
issue that nevertheless refuses to go
away. Systems philosophy is proposed as an
integrative alternative.
- Language of Publication
- English
- Unique Identifier
- 87112056
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- MeSH Heading (Major)
- Psychology, Clinical|*/HI; Statistics|*
- MeSH Heading
- Behaviorism|HI; History of Medicine,
19th Cent.; History of Medicine, 20th
Cent.; Human; Metaphysics; Philosophy|HI;
Support, U.S. Gov't, P.H.S.; United States
- Publication Type
- HISTORICAL ARTICLE; JOURNAL ARTICLE
- ISSN
- 0022-3891
- Country of Publication
- UNITED STATES
Record 6
from database: MEDLINE
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- Title
- Quantitative methods in research on
complementary and alternative medicine. A
methodological manifesto. NIH Office of
Alternative Medicine.
- Author
- Levin JS; Glass TA; Kushi LH; Schuck JR;
Steele L; Jonas WB
- Address
- National Institute for Healthcare
Research, Rockville, MD, USA.
- Source
- Med Care, 1997 Nov, 35:11, 1079-94
- Abstract
- OBJECTIVES: This article summarizes the
deliberations of the Quantitative Methods
Working Group convened by the National
Institutes of Health (NIH) in support of
the NIH Office of Alternative Medicine.
METHODS: The working group was charged
with identifying methods of study design
and data analysis that can be applied to
empirical research on complementary and
alternative medicine. This charge was
broad and inclusive and addressed the
evaluation of alternative therapies, the
investigation of the basic science of
complementary medical systems, studies of
health promotion and disease prevention,
and health services research. RESULTS: The
working group produced a
"methodological manifesto," a
summary list of seven recommended
methodological guidelines for research on
alternative medicine. These
recommendations emphasize the robustness
of existing research methods and analytic
procedures despite the substantive
unconventionality of alternative medicine.
CONCLUSIONS: Contrary to the assertions of
many researchers and alternative
practitioners, established methodologies (eg,
experimental trials, observational
epidemiology, social survey research) and
data-analytic procedures (eg, analysis of
variance, logistic regression,
multivariate modeling techniques) are
quite satisfactory for addressing the
majority of study questions related to
alternative medicine, from clinical
research on therapeutic efficacy to basic
science research on mechanisms of
pathogenesis and recovery.
- Language of Publication
- English
- Unique Identifier
- 98033683
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- MeSH Heading (Major)
- Alternative Medicine|*/MT/SN; Health
Services Research|*MT; Research
Design|*/ST
- MeSH Heading
- Clinical Trials; Evidence-Based
Medicine; Human; National Institutes of
Health (U.S.); Outcome Assessment (Health
Care)|MT; Statistics; Support, U.S. Gov't,
P.H.S.; United States
- Publication Type
- CONSENSUS DEVELOPMENT CONFERENCE;
GUIDELINE; JOURNAL ARTICLE; PRACTICE
GUIDELINE; REVIEW
- ISSN
- 0025-7079
- Country of Publication
- UNITED STATES
Record 3
from database: MEDLINE
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- Title
- Association between use of
unconventional therapies and conventional
medical services.
- Author
- Druss BG; Rosenheck RA
- Address
- Department of Psychiatry, Yale
University, West Haven, Conn, USA.
benjamin.druss@yale.edu
- Source
- JAMA, 1999 Aug, 282:7, 651-6
- Abstract
- CONTEXT: The terms
alternative and complementary medicine
suggest 2 contradictory possibilities.
Whether individuals use unconventional
therapies as a substitute for or as an
"add on" to conventional medical
treatments is uncertain. OBJECTIVE: To
determine the association between use of
unconventional therapies and conventional
medical care in a national sample. DESIGN,
SETTING, AND PARTICIPANTS: The 1996
Medical Expenditure Panel Survey was
distributed to a probability sample of the
noninstitutionalized civilian US
population. Of 24676 individuals
responding (77.7% response rate), 16068
adults 18 years or older were included in
the analysis. MAIN OUTCOME MEASURES:
Visits to practitioners for unconventional
therapies and conventional medical
services, including number of inpatient,
outpatient, and emergency department
visits and use of 8 types of preventive
medical services (blood pressure,
cholesterol level, physical examination,
influenza vaccination, prostate
examination, breast examination,
mammography, and Papanicolaou test).
RESULTS: During 1996, an estimated 6.5% of
the US population had visits for both
unconventional therapies and conventional
medical care; 1.8% used only
unconventional services; 59.5% used only
conventional care; and 32.2% used neither.
Compared with those with only conventional
visits, those who used both types of care
had significantly more outpatient
physician visits (7.9 vs 5.4; P<.001),
and used more of all types of preventive
services except mammography. These groups
did not differ significantly in inpatient
care, prescription drug use, or number of
emergency department visits. Individuals
in the top quartile of number of physician
visits were more than twice as likely as
those in the bottom quartile to have used
unconventional therapies in the past year
(14.5% vs 6.4%; P<.001). The
association between unconventional
treatments and physician visits remained
after adjusting for potential confounders
and across different types of
unconventional treatment. CONCLUSIONS: In
this sample, use of unconventional
therapies was substantially lower than has
been reported in previous national
surveys, but was associated with increased
use of physician services. From a health
services perspective, practitioner-based
unconventional therapies appear to serve
more as a complement than an alternative
to conventional medicine.
- Language of Publication
- English
- Unique Identifier
- 99445306
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- MeSH Heading (Major)
- Alternative Medicine|*UT
- MeSH Heading
- Adult; Female; Health Status; Health
Surveys; Human; Male; Middle Age;
Multivariate Analysis; Population
Surveillance; Preventive Medicine|TD;
Regression Analysis; Statistics,
Nonparametric; Support, U.S. Gov't,
P.H.S.; United States|EP
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0098-7484
- Country of Publication
- UNITED STATES
Record 4
from database: MEDLINE
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- Title
- Use of alternative health care
practitioners by Canadians.
- Author
- Millar WJ
- Address
- Health Statistics Division, Statistics
Canada, Ottawa. millway@statcan.ca
- Source
- Can J Public Health, 1997 May, 88:3,
154-8
- Abstract
- This study focuses on
the use of alternative health care
practitioners by Canadians aged 15 and
over using data from the 1994-95 National
Population Health Survey. A total of
17,626 respondents were selected.
Consultation with an alternative health
care provider or with a chiropractor was
deemed to be an indicator of the use of
alternative health care. In 1994-95, an
estimated 15% of Canadians aged 15 and
over (3.3 million people) used some form
of alternative health care in the year
preceding the survey. Use of alternative
health care was most prevalent among
women, persons aged 45-64 and among higher
income groups. The use of alternative
health care was associated with the number
of diagnosed chronic illnesses. Among
persons free of chronic diseases, 9%
consulted alternative health care
providers compared with 26% of those with
three or more chronic conditions. Since
the population is aging, the proportion
with multiple chronic illness will also
increase, with consequent demand for
services from alternative health
practitioners. The inclusion of any
alternative practitioner services under
existing health care plans could result in
higher health care costs.
- Language of Publication
- English
- Unique Identifier
- 97407008
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- MeSH Heading (Major)
- Alternative Medicine|*UT
- MeSH Heading
- Adolescence; Adult; Aged; Canada;
Chronic Disease; Demography; Female;
Health Surveys; Human; Male; Middle Age;
Sex Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0008-4263
- Country of Publication
- CANADA
Record 5
from database: MEDLINE
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- Title
- Statistics and medical experimentation.
- Author
- Meier P
- Address
-
- Source
- Biometrics, 1975 Jun, 31:2, 511-29
- Abstract
- Starting from a review of four major
experimental areas in medicine (Polio,
Coronary Surgery, Diabetes, Breast
Cancer), some of the special statistical
problems arising in the design and
analysis of clinical experiments are
reviewed, and the limitations of current
formulations are emphasized. Particular
attention is given to the ethical dilemma
and an alternative formulation of the
inference/decision problem is proposed.
- Language of Publication
- English
- Unique Identifier
- 76019334
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- MeSH Heading (Major)
- Research Design|*; Statistics|*
- MeSH Heading
- Aged; Breast Neoplasms|SU; Clinical
Trials; Coronary Artery Bypass; Diabetes
Mellitus|DT; Ethics, Medical; Female;
Follow-Up Studies; Human; Insulin|TU;
Male; Middle Age; Placebos; Poliomyelitis;
Poliovirus Vaccine; Thyroid Neoplasms|PC;
Thyroxine|TU; Tolbutamide|TU
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE
- ISSN
- 0006-341X
- Country of Publication
- UNITED STATES
Record 6
from database: MEDLINE
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- Title
- Statistical approaches to
pharmacodynamic modeling: motivations,
methods, and misperceptions.
- Author
- Mick R; Ratain MJ
- Address
- Department of Medicine, University of
Chicago, Pritzker School of Medicine, IL
60637.
- Source
- Cancer Chemother Pharmacol, 1993, 33:1,
1-9
- Abstract
- We have attempted to outline the
fundamental statistical aspects of
pharmacodynamic modeling. Unexpected yet
substantial variability in effect in a
group of similarly treated patients is the
key motivation for pharmacodynamic
investigations. Pharmacokinetic and/or
pharmacodynamic factors may influence this
variability. Residual variability in
effect that persists after accounting for
drug exposure indicates that further
statistical modeling with pharmacodynamic
factors is warranted. Factors that
significantly predict interpatient
variability in effect may then be employed
to individualize the drug dose. In this
paper we have emphasized the need to
understand the properties of the effect
measure and explanatory variables in terms
of scale, distribution, and statistical
relationship. The assumptions that
underlie many types of statistical models
have been discussed. The role of residual
analysis has been stressed as a useful
method to verify assumptions. We have
described transformations and alternative
regression methods that are employed when
these assumptions are found to be in
violation. Sequential selection procedures
for the construction of multivariate
models have been presented. The importance
of assessing model performance has been
underscored, most notably in terms of bias
and precision. In summary, pharmacodynamic
analyses are now commonly performed and
reported in the oncologic literature. The
content and format of these analyses has
been variable. The goals of such analyses
are to identify and describe
pharmacodynamic relationships and, in many
cases, to propose a statistical model.
However, the appropriateness and
performance of the proposed model are
often difficult to judge. Table 1 displays
suggestions (in a checklist format) for
structuring the presentation of
pharmacodynamic analyses, which reflect
the topics reviewed in this paper.
- Language of Publication
- English
- Unique Identifier
- 94094399
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- MeSH Heading (Major)
- Models, Statistical|*; Pharmacology,
Clinical|*
- MeSH Heading
- Data Interpretation, Statistical; Human;
Motivation; Multivariate Analysis;
Regression Analysis; Statistics|MT;
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0344-5704
- Country of Publication
- GERMANY
Record 7
from database: MEDLINE
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- Title
- The development of a method for
assessing the quality of life of cancer
patients.
- Author
- Selby PJ; Chapman JA; Etazadi Amoli J;
Dalley D; Boyd NF
- Address
-
- Source
- Br J Cancer, 1984 Jul, 50:1, 13-22
- Abstract
- Although the need for a method of
measuring the quality of life of patients
undergoing therapy for cancer has been
widely recognised, no adequately evaluated
or feasible method has been established.
We describe a method in which 31 items
were assessed by patient self report using
linear analogue scales. Eighteen items
inquiring about general health problems
were derived from the Sickness Impact
Profile, an established method of
assessing the effect of health upon
behaviour and function. Thirteen items
inquiring about major problems associated
with breast cancer were derived from
clinical experience and the opinions of
patients with this disease. Each item of
the measurement method (instrument) has
been evaluated for content, feasibility,
reliability and validity by methods that
are widely used in psychometry but less
familiar in medicine. It appeared easy to
use, acceptable and reliable in these
assessment. Validity was evaluated
indirectly since no standard measurements
of quality of life exist for comparison.
Most items appeared valid when compared to
alternative measurement methods including
the Sickness Impact Profile and evaluation
by a physician in a structured interview.
The correlations between items in the
instrument were analysed by factor
analysis and seemed to fit with the
clinical features of breast cancer. The
method distinguished between clinically
distinct groups of patients and detected
changes with time. The study illustrates
the possible approaches to the scientific
evaluation of methods for measuring
subjective features of patients lives.
This method appears suitable for some
purposes to measure quality of life in
breast cancer and is intended to be
flexible enough to be modified for other
diseases. However, further evaluation,
development and refinement will be needed
before routine clinical application can be
recommended.
- Language of Publication
- English
- Unique Identifier
- 84257390
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- MeSH Heading (Major)
- Breast Neoplasms|CO/*PX/TH; Quality of
Life|*
- MeSH Heading
- Attitude to Health; Female; Human;
Methods; Middle Age; Regression Analysis;
Self Assessment (Psychology); Statistics;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0007-0920
- Country of Publication
- ENGLAND
Record 8
from database: MEDLINE
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- Title
- Relative risk estimation from vital
statistical data: validation, a pitfall
and an alternative method.
- Author
- Silcocks PB; Murphy M
- Address
- Department of Clinical Epidemiology
& Social Medicine, St. George's
Hospital Medical School, London.
- Source
- J Epidemiol Community Health, 1987 Mar,
41:1, 59-62
- Abstract
- A previously described method of
obtaining an estimate of relative risk
from routinely available data was applied
to data on cigarette consumption and lung
cancer mortality to test its validity.
Some shortcomings of the method were noted
and an alternative approach using weighted
logistic regression gave results closer to
those predicted on the basis of other
studies, without the disadvantages of the
original technique.
- Language of Publication
- English
- Unique Identifier
- 88034838
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- MeSH Heading (Major)
- Risk|*; Vital Statistics|*
- MeSH Heading
- Female; Human; Lung Neoplasms|ET; Male;
Methods; Mortality; Smoking|AE
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0143-005X
- Country of Publication
- ENGLAND
Record 9
from database: MEDLINE
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- Title
- Long QT syndrome. New
electrocardiographic characteristics [see
comments]
- Author
- Benhorin J; Merri M; Alberti M; Locati
E; Moss AJ; Hall WJ; Cui L
- Address
- Department of Medicine, University of
Rochester School of Medicine and
Dentistry, New York.
- Source
- Circulation, 1990 Aug, 82:2, 521-7
- Abstract
- The long QT syndrome is
electrocardiographically characterized by
a prolonged QT interval and by several
other, more subtle, ST-T-U wave
abnormalities, most of which have not been
quantified. To determine the possible
usefulness of several new
electrocardiographic characteristics in
identifying patients with known long QT
syndrome, logistic regression models were
applied to a data base of seven new,
relatively independent,
electrocardiographic repolarization
variables. These were measured on
digitized 12-lead electrocardiograms of
315 normal subjects and 37 patients with
the long QT syndrome (members of
well-identified long QT syndrome families,
QTc greater than 0.44 second, 27%
symptomatic), who ranged in age from 17 to
60 years. Electrocardiographic variables
that independently differentiated (p less
than 0.001) patients with long QT syndrome
from normal subjects included quantitative
measures of repolarization: early
duration, rate, T wave symmetry, late
phenomena, and heterogeneity. All selected
repolarization variables except the early
duration variable were essentially
independent of the QTc (r2 less than
0.15), and all contributed significantly
to the identification of patients with
long QT syndrome. A classification model
of five electrocardiographic predictor
variables resulted in an estimated
sensitivity (95% confidence interval) of
92.6% (81.6-100%) and an estimated
specificity (95% confidence interval) of
95.8% (93.6-98.1%). This model performed
significantly better than an alternative
classification model that was based on the
early duration variable as a single
predictor variable. The symptomatic status
of patients with long QT syndrome could
not be predicted by any combination of the
electrocardiographic variables in the
investigated model.
- Language of Publication
- English
- Unique Identifier
- 90322575
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- MeSH Heading (Major)
- Arrhythmia|*DI; Electrocardiography|*;
Long QT Syndrome|*DI
- MeSH Heading
- Adolescence; Adult; Comparative Study;
Diagnosis, Computer-Assisted; Forecasting;
Human; Middle Age; Models, Theoretical;
Reference Values; Statistics; Support,
Non-U.S. Gov't; Support, U.S. Gov't,
P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0009-7322
- Country of Publication
- UNITED STATES
Record 10
from database: MEDLINE
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- Title
- Health services use among the elderly
under alternative health service delivery
systems.
- Author
- Thomas C; Kelman HR
- Address
- Department of Epidemiology and Social
Medicine, Montefiore Medical Center,
Bronx, NY.
- Source
- J Community Health, 1990 Apr, 15:2,
77-92
- Abstract
- This article compares patterns of health
care utilization for hospitalizations and
ambulatory care in a sample of 1855 urban,
elderly, community residents who report
obtaining their health care from one of
four types of arrangements: a
fee-for-service (FFS) physician, a
hospital-based health maintenance
organization, a network model HMO, or a
preferred provider organization (PPO).
Utilization rates reported by respondents
at six month intervals over three years
were adjusted for health and socioeconomic
characteristics of enrollees. PPO plan
members consistently have mean and total
lengths of hospital stay one-third to
one-half those of the others. Although
rates of use of particular categories of
ambulatory care vary across systems of
care, total ambulatory care rates are
highest for network model HMO plan
members. Specific features of alternative
delivery systems, rather than general
model types, may have an impact on
utilization rates and the costs of care.
- Language of Publication
- English
- Unique Identifier
- 90285342
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- MeSH Heading (Major)
- Health Maintenance Organizations|*UT;
Health Services for the Aged|*UT; Managed
Care Programs|*UT; Preferred Provider
Organizations|*UT; Private Practice|*UT
- MeSH Heading
- Aged; Comparative Study; Fees, Medical;
Female; Hospitalization; Human; Male; New
York City; Statistics; Support, U.S.
Gov't, P.H.S.; Urban Population
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0094-5145
- Country of Publication
- UNITED STATES
Record 11
from database: MEDLINE
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- Title
- Gender and ethnic differences in
alternative and conventional arthritis
remedy use among community-dwelling rural
adults with arthritis.
- Author
- Arcury TA; Bernard SL; Jordan JM; Cook
HL
- Address
- Center for Urban and Regional Studies,
University of North Carolina at Chapel
Hill 27599-3410, USA.
- Source
- Arthritis Care Res, 1996 Oct, 9:5,
384-90
- Abstract
- OBJECTIVE: To examine the frequency of,
and the ethnic and gender differences in,
the use of arthritis remedies among rural
adults. METHODS: Interviews were conducted
with 219 adults from a nonmetropolitan
North Carolina county. Participants
reported whether they ever used and still
used 19 remedies. Participants were
evaluated for the actual presence of
arthritis and functional capacity.
Analysis included descriptive statistics
and multivariate logistic regression.
RESULTS: Participants used a variety of
alternative and conventional remedies,
with prayer (92%) being most widely used.
Prescription medicine was used by 60%.
Differences in remedy use included
European-Americans making greater use of
conventional remedies and
African-Americans making greater use of
some alternative remedies. Those with
greater functional disability have used
alternative remedies, but they still used
prescription medicine. CONCLUSIONS: Rural
individuals use a variety of remedies,
with differences by gender, ethnicity, and
functional capacity. Future research must
examine the role of gender, culture,
residence, and disease severity in
arthritis remedy use decisions.
- Language of Publication
- English
- Unique Identifier
- 97151995
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- MeSH Heading (Major)
- Alternative Medicine|*; Arthritis|*PC;
Blacks|*; Self Care|*MT; Whites|*
- MeSH Heading
- Adult; Aged; Aged, 80 and over; Female;
Human; Male; Middle Age; North Carolina;
Questionnaires; Rural Health; Sex Factors;
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0893-7524
- Country of Publication
- UNITED STATES
Record 12
from database: MEDLINE
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- Title
- How the manner of presentation of data
influences older patients in determining
their treatment preferences.
- Author
- Mazur DJ; Merz JF
- Address
- Department of Veterans Affairs Medical
Center, Oregon Health Sciences University,
Portland.
- Source
- J Am Geriatr Soc, 1993 Mar, 41:3, 223-8
- Abstract
- OBJECTIVE: To assess how the manner of
presentation of graphic data to older
patients influences their treatment
preferences. DESIGN: Cross-sectional
structured interviews with patients.
SETTING: A university-based Department of
Veterans Affairs Medical Center. PATIENTS:
One hundred sixty-six consecutive patients
(mean age = 64.8 years, range of ages
29-82) seen in a Department of Veterans
Affairs general medicine clinic.
MEASUREMENTS: Five pairs of 5-year
survival curves were presented to
patients. Each pair was composed of two
survival curves for alternative
unidentified treatments for an
unidentified medical condition. Curve A
(LT = better long-term, worse short-term
survival) was fixed throughout all curve
pairs. Curve B (ST = better short-term,
worse long-term survival) changed in each
curve pair, showing incrementally better
chances of short-term survival across the
five curve pairs. Patients were randomly
assigned to view the curve pairs in
forward (increasing short-term survival)
or backward (decreasing short-term
survival) order. RESULTS: Order is a
significant predictor of patients' initial
preferences for the short-term survival
curve (P = 0.0004) as well as their
willingness to shift preferences during
presentation of the five curve pairs.
Patients > or = 65 were more likely to
initially choose the ST curve in forward
order presentation than patients < 65.
More educated patients generally were less
likely to prefer the ST curve under both
elicitation orders. CONCLUSIONS: The data
indicate that the method of eliciting
patients' preferences strongly influenced
their expressed preferences, and that
these preferences may have predictable
relationships with demographic
characteristics such as age.
- Language of Publication
- English
- Unique Identifier
- 93179656
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- MeSH Heading (Major)
- Aged|*PX; Communication|*; Patient
Participation|*
- MeSH Heading
- Adult; Aged, 80 and over;
Cross-Sectional Studies; Data Display;
Decision Making; Educational Status;
Hospitals, Veterans; Human; Life
Expectancy; Middle Age; Oregon;
Statistics; Support, U.S. Gov't,
Non-P.H.S.; Survival Rate
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0002-8614
- Country of Publication
- UNITED STATES
Record 13
from database: MEDLINE
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- Title
- Voices of leadership in a community
under stress: personal observations by
officials on an epidemiologic mistake.
- Author
- Guidotti TL; Abercrombie S
- Address
- Department of Health Services
Administration and Community Medicine,
University of Alberta Faculty of Medicine,
Edmonton, Canada.
- Source
- J Public Health Med, 1994 Dec, 16:4,
381-8
- Abstract
- We studied the responses of leaders in a
suburban community in western Canada near
Edmonton, Alberta, that was affected by a
false allegation of increased cancer risk.
In 1986, a cancer agency responded to
community concerns by conducting a study
of cancer incidence (1979-1983) and
reported elevations on the order of 25 per
cent over expected for most sites.
Reanalysis of these data several months
later revealed an error in the population
figure used to calculate the rates.
Correction brought the rates into line
with Alberta as a whole and comparable to
those for other communities surrounding
Edmonton. We interviewed elected and
appointed public officials in one affected
community as well as non-official
community leaders and realtors to
determine their subjective impression
regarding the effect of the incident on
their communities and to rule out
alternative explanations for the drop in
housing prices in association with the
incident we have reported elsewhere. Their
narrative responses were particularly
interesting and articulate, and are quoted
at length. Their collective perceptions
appear to confirm the impression of a
profound impact on the community,
reflected in housing prices, and attribute
at least part of the impact to the
disclosure that a high official in the
community was afflicted by cancer. Most
felt that there remained a great deal of
latent concern in the community and at
least some felt that a subsequent public
issue involving transmission line
rights-of-way near the community
reactivated this latent concern.
- Language of Publication
- English
- Unique Identifier
- 95186195
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- MeSH Heading (Major)
- Leadership|*; Neoplasms|*EP; Public
Relations|*; Statistics|*
- MeSH Heading
- Adult; Alberta|EP; Commerce; Costs and
Cost Analysis; Housing|EC; Human;
Incidence; Risk; Stress, Psychological;
Support, Non-U.S. Gov't; Urban Population
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0957-4832
- Country of Publication
- ENGLAND
Record 14
from database: MEDLINE
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- Title
- Accuracy of clinical diagnoses in a
teaching hospital: a review of 997
autopsies.
- Author
- Kajiwara JK; Zucoloto S; Manço AR;
Muccillo G; Barbieri MA
- Address
- Department of Morphology, Faculty of
Medicine, University of SÃao Paulo,
RibeirÃao Preto, Brazil.
- Source
- J Intern Med, 1993 Aug, 234:2, 181-7
- Abstract
- OBJECTIVES. To analyse the concordance
between clinical and autopsy diagnoses.
DESIGN. Nine-hundred-and-ninety-seven
autopsies were studied comparing the
diagnoses of the autopsy requests with
those of the death certificates and
autopsy reports. The cases were grouped
according to the 17 categories of diseases
of the International Classification of
Diseases (ICD) and the concordance was
analysed with the kappa (kappa)
coefficient of concordance. SETTING. The
Hospital da Clínicas da Faculdade de
Medicina de Ribeirão Preto da
Universidade de São Paulo (HCFMRPUSP),
Ribeirão Preto, SP, Brazil. SUBJECTS. The
patients autopsied at HCFMRPUSP during the
period between 1978 and 1980. MAIN OUTCOME
MEASURES. kappa statistics offer an
alternative approach to measuring the
concordance between clinical and autopsy
diagnoses. RESULTS. The kappa-value
obtained was equal to 0.601 with a
variance of 1.545 x 10(-4) when comparing
the clinical diagnoses and the autopsy
diagnoses, and equal to 0.661 with a
variance of 1.531 x 10(-4) comparing the
clinical diagnoses with those obtained
after the gross examination. These values
are significant at the level of 5%, i.e.
there is an overall statistical
concordance between clinical and autopsy
diagnoses although the value is not
absolute (kappa = 1.00). CONCLUSIONS. If
autopsies are heeded without bias, they
will continue to give important feedback
concerning medical diagnosis.
- Language of Publication
- English
- Unique Identifier
- 93340604
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- MeSH Heading (Major)
- Autopsy|*; Diagnostic Errors|*;
Hospitals, Teaching|*ST
- MeSH Heading
- Brazil; Human; Retrospective Studies;
Statistics
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0954-6820
- Country of Publication
- ENGLAND
Record 15
from database: MEDLINE
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- Title
- Vital fluorescence to assess in vitro
and in vivo the antibacterial effects of
amalgams.
- Author
- Netuschil L; Brecx M; Vohrer KG; Riethe
P
- Address
- Department of Conservative Dentistry,
School of Dental Medicine, University of TÂubingen,
FRG.
- Source
- Acta Stomatol Belg, 1996 Sep, 93:3,
129-34
- Abstract
- The aim of the present study was to
establish an alternative methodology for
testing the antibacterial effects of
different amalgams. The vitality of mutans
streptococci grown in vitro on various
amalgam surfaces was monitored with a
vital fluorescence staining technique
using fluorescein diacetate and ethidium
bromide. The in vivo effect of
amalgam-non-gamma 2 fillings on the
vitality of dental plaque was assessed
with the same method and compared with
samples originating from enamel. The
median in vitro vitality of mutans
streptococci was estimated as 70% on
glass, 50% on Amalcapnon-gamma 2 and
Sybraloy, 20% on Amalcap F and 10% on Neo-Silbrin.
In vivo plaque vitality on enamel varied
from 60 to 70%. In contrast, plaque
sampled from non-gamma 2-amalgam surfaces
revealed significant reductions in
vitality with a minimum value of 25% of
one day old supragingival plaque. The
vital fluorescence technique was shown as
an easy and quick method to assess the
bactericidal effect against biofilm
bacteria of dental materials in vitro as
well as in vivo.
- Language of Publication
- English
- Unique Identifier
- 98148723
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- MeSH Heading (Major)
- Anti-Infective Agents|*PD; Dental
Amalgam|*PD
- MeSH Heading
- Biofilms|DE/GD; Chi-Square Distribution;
Comparative Study; Dental Plaque|MI;
Human; In Vitro; Male; Microscopy,
Fluorescence|MT; Pilot Projects;
Statistics, Nonparametric; Streptococcus
mutans|DE/GD
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0001-7000
- Country of Publication
- BELGIUM
Record 16
from database: MEDLINE
Return
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- Title
- Reviewer bias against the
unconventional? A randomized double-blind
study of peer review.
- Author
- Ernst E; Resch KL
- Address
- University of Exeter, Department of
Complementary Medicine, UK.
- Source
- Complement Ther Med, 1999 Mar, 7:1,
19-23
- Abstract
- OBJECTIVE: To test the hypothesis that
there is a reviewer bias against
publication of a test of an unconventional
drug. DESIGN: Randomized, controlled,
double-blind study of peer review.
PARTICIPANTS: Convenience sample of 291
medical doctors from a wide variety of
specialties drawn from a list of
conference participants. METHODS:
Reviewers were randomly assigned to
receive one of two versions of a
manuscript. Version M related to an
in-vitro experiment on a mainstream drug (Metoprolol).
The otherwise identical version V used a
highly unconventional drug (beef spleen
cell extract) for the same experiment.
Reviewers were asked to complete a
standardised evaluation sheet including
visual analogue scales (VASs) on a set of
predefined quality criteria. All
participants were debriefed after
completion of the study. RESULTS: The
response rate was 61%. There were no
significant differences in VAS ratings
between the two versions of the
manuscript. Ratings covered the entire
range of the VASs. CONCLUSION: In the
present setting, there was no evidence for
a reviewer-bias against testing an
unconventional drug. The low inter-rater
reliability, however, suggested inadequate
validity of peer review.
- Language of Publication
- English
- Unique Identifier
- 99289918
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- MeSH Heading (Major)
- Alternative Medicine|*; Peer Review,
Research|*; Tissue Extracts|*TU
- MeSH Heading
- Animal; Bias (Epidemiology); Cattle;
Comparative Study; Double-Blind Method;
Human; Observer Variation; Reproducibility
of Results; Statistics, Nonparametric
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0965-2299
- Country of Publication
- SCOTLAND
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