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Biomedical subjects

A Kazanjian

Publications and source records attributed to A Kazanjian.

6 recordsLinked to original sources
PubMed1997

Anticoagulation in chronic nonvalvular atrial fibrillation: a critical appraisal and meta-analysis.

OBJECTIVE: To assess the outcomes associated with warfarin treatment of patients with chronic nonvalvular atrial fibrillation (CNVAF) for prevention of primary stroke. DATA SOURCES: MEDLINE was searched for literature published from 1987 to August 1996. Search terms used were 'atrial fibrillation' and 'anticoagulants'. STUDY SELECTION: Five published randomized controlled trials concerning primary stroke prevention. DATA EXTRACTION: Data were pooled across trials to estimate the magnitude of the effect for each of nine reported end-points. The annual probability of occurrence of each outcome was calculated, including standard errors and Mantel-Haenszel significance tests with 95% CIs. DATA SYNTHESIS: In view of the lack of blinded assessment and documented low inter-rater reliability of soft neurological end-points, the analysis was limited to the relatively objective end-points of major strokes, fatal strokes, major bleeding and fatal bleeding. Warfarin did not reduce the incidence of fatal strokes to a statistically significant extent, nor was incidence of fatal bleeding increased significantly. Warfarin reduced the absolute annual incidence of major strokes in patients with CNVAF by 0.89%, while at the same time it increased the absolute annual risk of major bleeding incidents by 1.8%. Though small, these differences were statistically significant. CONCLUSIONS: On balance, the margin between expected benefit and harm for warfarin prophylaxis in patients with CNVAF is uncomfortably thin. These results and conclusions differ from those of a previously published meta-analysis of these same studies.

Anticoagulants↗
PubMed1993

Defusing technology. Technology diffusion in British Columbia.

In order to explore the diffusion of the selected technologies in one Canadian province (British Columbia), two administrative data sets were analyzed. The data included over 40 million payment records for each fiscal year on medical services provided to British Columbia residents (2,968,769 in 1988) and information on physical facilities, services, and personnel from 138 hospitals in the province. Three specific time periods were examined in each data set, starting with 1979-80 and ending with the most current data available at the time. The detailed retrospective analysis of laboratory and imaging technologies provides historical data in three areas of interest: (a) patterns of diffusion and volume of utilization, (b) institutional profile, and (c) provider profile. The framework for the analysis focused, where possible, on the examination of determinants of diffusion that may be amenable to policy influence.

British Columbia↗
PubMed1989

A profile of academic physicians in British Columbia.

To determine the extent of involvement of British Columbia's physician community in the operation of the province's only medical school, the authors sent questionnaires to all physicians who had any affiliation with the University of British Columbia (UBC). About 20 percent of the province's physicians were involved in some capacity with the UBC Faculty of Medicine, which accepts about 120 students into the first year annually. Most faculty held "clinical" appointments, meaning that they pursued largely non-academic careers. Full-time academic appointees worked more than 20 percent more hours annually than did their "clinical" counterparts, and average hours for men exceeded those for women. As many as two-thirds of the full-time faculty were also engaged in sufficient clinical practice activity to be classified as full-time practicing physicians by a definition adopted by a provincial Joint Medical Manpower Committee.

Adult↗
PubMed1986

Modeling the supply of nurse labor. Life-cycle activity patterns of registered nurses in one Canadian delivery system.

Using 1980 membership data made available by the provincial nurses' association, a simple, age-specific projection model was developed that comprised two submodels: a Markovian one to monitor yearly movements from one membership state to another and a linear submodel for the infusion of new members. The model assumes that the likelihood of moving to any membership state depends only on the nurse's current age and membership state. A comparison of actual/projected data for 1981-1984 indicates a fairly high level of accuracy, despite the oscillatory pattern of the nurse labor market in the Province of British Columbia since 1982. The details of the projections of labor force over time show a particular age cohort's characteristic behavior and delineate the effect of childbearing and aging on the supply of nurses. As well as projecting future manpower, the age-specific transition matrices were used to estimate the professional life expectancy of registered nurses. This information includes the average number of continuous years of practice for each age, as well as the average total number of years of practice until being deleted from the system at the age of 75. The forecasting capability developed from this work attempts to address two questions central to manpower planning: how many nurses will there be in the province in the next 5 years? and what is the time-frame involved in nurses' life-cycle activity patterns?

Age Factors↗