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Biomedical subjects

A O Berg

Publications and source records attributed to A O Berg.

At least 55 records · Page 3Linked to original sources
PubMed1981

Case-control diagnosis and Bayesian inference in common viral infections.

The predictive values of symptoms and signs for given diseases are often unknown. The fact that a high proportion of individuals with a certain disease may have a specific group of symptoms (the case-control approach) does not necessarily mean that the specific group of symptoms will allow one reliably to diagnose the disease. This study, utilizing a population based data set for common acute infections, shows that descriptions of common viral illnesses found in medical textbooks that associate illnesses with symptoms do not allow one to predict reliably isolation of the supposed causal organism. Positive predictive value of groups of symptoms for specific viral infections did not exceed 11 percent in this study. However, the data closely fitted the Bayesian statistical model often proposed for such decision making by physicians.

Adolescent↗
PubMed1980

Targeting symptoms for self-care health education: a multivariate analysis of physician contacts.

The purpose of this study was to identify common acute symptoms that were significantly related to the decision to seek medical care. Data were from the Seattle Virus Watch, a 4-year study of 149 young families designed to monitor viral infection, regardless of medical care contact. Illness diaries were maintained by the families and checked for accuracy every 2 weeks during home visits by study personnel. Age sex, family unit, medical contact, duration and presence or absence of 80 symptoms in 17 categories were recorded for each illness. In 11,583 person-months of observation, 3,929 illness records were compiled. Using physician contact as the dependent variable and the illness information as independent variables, a series of discriminant analyses were performed on a 50% random sample of illnesses. Success of each analysis was tested on the remainder of the illnesses. Fever and ear symptoms were significant predictors in all age groups and cough was significant in four of five age groups. These symptoms are suggested as logical choices for health education programs in self-care of acute illnesses.

Adult↗
PubMed1979

Potential effect of self-care algorithms on the number of physician visits.

To assess the potential effect of self-care algorithms on the number of physician visits, actual visits from the Seattle Virus Watch were compared retrospectively with those recommended by clinical algorithms for common illnesses from the book, Take Care of Yourself, by Vickery and Fries. From a total of 3929 illnesses, records indicating the presence of the index symptom for eight algorithms were identified, determining whether the criteria for seeing a physician were met and whether a physician visit was recorded. The number of visits observed was compared to the number of visits recommended by the algorithms. Strict adherence would have increased the number of visits over that observed for five, remained the same for two, and decreased for one of the algorithms. These results indicate that adherence to some commonly promulgated self-care algorithms may increase rather than decrease the number of physician visits.

Activities of Daily Living↗
PubMed1979

Some non-random views of statistical significance.

Although research in family medicine is growing rapidly, few family physicians have had experience or training in statistical methods. Statistical significance and P values are often misunderstood and frequently misapplied. "Significance" is arbitrary; the actual P value is of greater interest than a significant/not significant statement; P values do not measure the strength of an association; statistical significance is not equivalent to "actual" significance; P values are largely dependent on sample size; and data "dredging" is guaranteed to yield spurious results. Competent statistical consultation, careful study planning, and recognition of statistical pitfalls are important to anyone who does research, and knowledge of these areas is useful as well to anyone reading the medical literature.

Family Practice↗
PubMed1979

Does continuing medical education improve the quality of medical care? A look at the evidence.

Although continuing education has a long tradition within the medical profession, mandated continuing medical education is of very recent origin. The conceptual framework used to justify continuing medical education is that it exposes physicians to new knowledge, changes physician behavior, and favorably alters patient outcomes. Considerable evidence exists that physician knowledge can be increased, and that behavior can be changed, but there is very little to show an effect on patient outcomes. The effectiveness of continuing medical education is further clouded by such issues as consumerism, licensure politics, and professional standards review organization legislation. Family physicians should have a role in determining the outcome of the continuing medical education debate, as participants, as policy-setters, and as informed critics.

Behavior↗
PubMed1977

Placebos: a brief review for family physicians.

Placebos are as old as the practice of medicine and for thousands of years represented nearly the totality of medical therapeutics. Positive and negative placebo effects occur in about 35 percent and 10 percent of individuals, respectively. Without exception, all medical therapeutics may be assumed to have significant placebo components. Factors contributing to the success of placebos are many, but include the expectations of physician and patient, the doctor-patient relationship, and societal norms. Ethical issues regarding the use of placebos are not clear-cut but, in general, the use of placebos is contraindicated except as an adjunct to specific therapy, or as a research tool with informed consent.

Ethics, Medical↗
PubMedDate not supplied

Dimensions of evidence.

Explore the source record for details and available documents.

Clinical Trials as Topic↗
PubMedDate not supplied

Variations among family physicians' management strategies for lower urinary tract infection in women: a report from the Washington Family Physicians Collaborative Research Network.

BACKGROUND AND METHODS: This study surveyed a random sample of Washington State family physicians regarding their attitudes toward and usual practices in providing care to women with lower urinary tract infection. RESULTS: Based on a 70 percent response rate, wide variations in diagnostic testing, treatment, and follow-up strategies were identified. For example, a patient vignette presenting an uncomplicated infection prompted 82 separate management strategies among the 137 replies. Attitude questions also showed wide variations in spite of stated physician confidence and comfort in evaluating and managing urinary tract infection. Associated estimated costs ranged from negligible to more than $250 per case. CONCLUSIONS: These findings demonstrate significant physician variability in managing women's lower urinary tract infections.

Family Practice↗
PubMedDate not supplied

Misconduct in science: does family medicine have a problem?

Through several recent and widely publicized cases, misconduct in science has caught the public's attention and reached the agenda of Congress. After a brief historical overview, this article presents a number of cases from family medicine raising issues of duplicate publication, plagiarism, inappropriate authorship, citation errors, inappropriate attribution, and data manipulation and fabrication. Misconduct policies from national organizations are noted, and specific recommendations are made that would limit growth of misconduct in the family medicine research community.

Authorship↗
PubMedDate not supplied

Development of sexually transmitted diseases treatment guidelines, 1993. New methods, recommendations, and research priorities. STD Treatment Guidelines Project Team and Consultants.

To develop the 1993 Sexually Transmitted Diseases Treatment Guidelines, experts from the Centers for Disease Control and Prevention reviewed the literature on sexually transmitted disease treatment, assembled tables of evidence, and listed key questions on therapeutic outcome: microbiologic cure, alleviation of symptoms, and prevention of sequelae and transmission. At a meeting with external experts, evidence was systematically assessed and guidelines developed. Quality of evidence for microbiologic cure was generally good for gonorrhea and chlamydia, poor for syphilis, and fair for most other diseases. Evidence on preventing sequelae and transmission was limited. The Guidelines include new recommendations for single-dose oral therapy of gonorrhea (cefixime, ciprofloxacin, and ofloxacin), chlamydia (azithromycin), and chancroid (azithromycin); outpatient therapy of pelvic inflammatory disease (ofloxacin and either clindamycin or metronidazole); and patient-applied therapy of genital warts (podofilox). Syphilis therapy did not change substantially. Several global issues that emerged during the development of the World Health Organization Recommendations for the Management of Sexually Transmitted Diseases also are discussed. This evidence-based approach clarified important treatment issues and the rationale for recommendations, and identified research priorities.

Anti-Infective Agents↗