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Biomedical subjects

A R Nelson

Publications and source records attributed to A R Nelson.

16 recordsLinked to original sources
PubMed1987

Abdominal tuberculosis.

The recent literature on abdominal tuberculosis is comprehensively reviewed, and seven cases of abdominal tuberculosis are reported, including four belonging to three generations of the same family. Possible explanations for this familial incidence are discussed. Abdominal tuberculosis is not so rare; 135 cases have recently been reported from the United States and Canada. This review dissipates four common misconceptions: abdominal tuberculosis is rare, tuberculosis is a stigmata of the poor, abdominal tuberculosis is always associated with active pulmonary tuberculosis, and chronic abdominal pathology is synonymous with regional enteritis. Since the description of regional enteritis, more and more cases of chronic intestinal pathology have been labeled "regional enteritis." The fact that intestinal tuberculosis is rather uncommon should not automatically lead to the diagnosis of regional enteritis. The possibility that many cases of so-called regional enteritis may, in fact, be a stage or a variant of abdominal tuberculosis, is worth considering. Abdominal tuberculosis is not a relic of the past. It remains a real challenge to the diagnostic acumen and therapeutic skills of both the internist and the surgeon.

Abdomen↗
PubMed1976

Orphan data and the unclosed loop: a dilemma in PSRO and medical audit.

The experience of the Utah Professional Review Organization in conducting medical audit as a PSRO prototype, and later a PSRO, suggests that usage of diagnosis-oriented process audits, using criteria similar to those supplied by the American Medical Association, will result in accumulation of vast amounts of unusable data. Even studies based on outcome data may fail to change physician behavior substantially because of communication difficulties between the PSRO or hospital conducting the evaluation and the physicians subject to the audit. UPRO's experience suggests that medical audit can be made more effective if it employs a special study format that looks at a particular element of care, selected for its importance to patient welfare and potential for improvement. The study should be based on criteria solidly validated by clinical research, and should involve a direct and personal interaction between the review body and the physician being reviewed.

Education, Medical, Continuing↗
PubMed1975

Relation between quality assessment and utilization review in a functioning PSRO.

The Utah State Medical Association, through its peer-review foundation, the Utah Professional Review Organization, has implemented an integrated system of utilization reveiw and quality assessment linked to a program of continuing education. Nurse co-ordinators, employed by the Organization, screen all hospitalized patients covered by Titles XVIII, XIX and V as well as by subscribing private insurers. Approximately 10 per cent of hospitalized patients do not meet peer-generated criteria for admission review or length of stay and are screened out for peer review, The nurse co-ordinators collect data for retrospective quality assessment, identifying targets for continuing medical education. Preliminary data support the cost effectiveness of such a review program. Continuing qualtiy audit will test the effectiveness of education programs.

Education, Medical, Continuing↗