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Biomedical subjects

A S Floyd

Publications and source records attributed to A S Floyd.

8 recordsLinked to original sources
PubMed2001

Diagnosis, self-help, and maintenance care as key constructs in treatment research for "alcohol use disorders" (AUD).

OBJECTIVE: This study examines a sample of alcohol user treatment outcome studies to determine the amount of attention given to three areas of concern and cost-effectiveness in treatment research: patient diagnosis, use of self-help groups (e.g., Alcoholics Anonymous [AA]), and use of maintenance care services (also known as a "aftercare"). METHOD: A preliminary sample of 40 studies was coded for the degree of specific information provided to each of the three areas of interest. RESULTS: Eight studies in the sample did not mention the diagnostic criteria used to determine patient addiction, 18 did not mention use, referral, or recommendation of AA, and 20 did not mention use, referral, or recommendation of maintenance care services. CONCLUSIONS: As cost-effective additions to primary treatment, AA and maintenance care services deserve greater attention in the treatment of "substance abuse disorders." Researchers should also pay greater attention to patient diagnosis as an integral part of patient care. Finally, journal editors should institute minimum requirements for published reports ensuring that sufficient information on patient care is provided.

Alcoholism↗
PubMed1999

Program closure and change among VA substance abuse treatment programs.

OBJECTIVE: The population of Veterans Affairs (VA) substance abuse treatment programs in 1990 and 1994 was examined to determine which factors-program legitimacy or cost-accounted for program closure and change. Legitimacy is a concept in institutional theory that organizations tend to take on a form appropriate to the environment. METHODS: The study had two competing hypotheses. The first was that if external pressures push programs to produce high-quality and efficient treatment, then those that are initially closer to the legitimate form should be less likely to close later, and among surviving programs they should be less likely to experience change. The second hypothesis was that cost is the primary factor in program closure and change. The study used data from administrative surveys of all VA programs (273 in 1990 and 389 in 1994). Program legitimacy variables measured whether programs offered the prevalent type of treatment, such as 12-step groups or behavioral treatment, and had the prevalent type of staff. RESULTS: Program costs did not explain closure or change. For inpatient programs, the risk of closure increased in facilities with more than one substance abuse treatment program. The risk of closure increased for outpatient programs offering the prevalent type of treatment, contrary to what was predicted by the legitimacy hypothesis. Inpatient programs that offered the prevalent treatment were less likely to change the type of treatment offered. CONCLUSIONS: Patterns of change differed over time for inpatient and outpatient programs. Legitimacy factors, rather than cost, seem to play a role in program closure and change, although the picture is clearer for inpatient programs than for outpatient programs.

Health Facility Closure↗
PubMed1999

Substance abuse treatment cost offsets vary with gender, age, and abstinence likelihood.

The cost-offset effect has been promoted as a way for substance abuse treatment to pay for itself by generating reductions in health care utilization in other areas. Clients (n = 5,434) that were abstinent for 24 months following substance abuse treatment had lower posttreatment utilization than clients that had relapsed. An examination of cost offsets revealed a complex interplay between gender, age, and type of utilization (medical versus psychiatric). Cost offsets were especially pronounced for women over 40 years old.

Adolescent↗
PubMed1989

Atlantoaxial instability and neurologic indicators in rheumatoid arthritis.

Atlantoaxial subluxation in rheumatoid arthritis is characterized by pain, disability, and occasionally death. Surgical fusion of the offending vertebrae is the appropriate surgical remedy, but it is a procedure with a high failure and complication rate. Because cord compression and myelopathy are the main complications of this condition, it would be logical to use evidence of early neurologic deficit as an indicator for surgery. A group of 250 patients with rheumatoid arthritis were investigated to evaluate the neurologic status with respect to the degree of instability in the proximal cervical spine. Neurologic isolated signs such as hyperreflexia could not be correlated with the onset of cervical myelopathy or quadraparesis or to the radiographically measured degree of atlantoaxial instability. These signs should not be used as an indication for surgery. The positive indications are intractable pain, cervical myelopathy, and severe atlantoaxial instability.

Adult↗
PubMedDate not supplied

Alcoholism treatment outcome studies, 1980-1992: methodological characteristics and quality.

We examine the methodological characteristics and provision of study information in 339 alcoholism treatment outcome studies reported between 1980 and 1992. We consider factors in four methodological domains: sampling and description of patients, specification of treatments, outcome variable assessment and follow-up, and treatment effect estimates; we also consider the methodological quality of the studies. Although methodological quality has improved over time, there remains room for improvement. Of special concern is the low statistical power of many studies. Multiple treatment group studies had an average .54 probability of detecting a treatment effect of medium size.

Adult↗
PubMedDate not supplied

Alcoholism treatment outcome studies, 1980-1992: the nature of the research.

We reviewed 339 alcoholism treatment outcome studies reported between 1980 and 1992. After comparing single and multiple treatment group studies, we focus on multiple-group studies, examining and comparing principal investigator and study characteristics, patient characteristics, treatment modalities and characteristics, and follow-up points and outcome variables in published and unpublished studies. This article provides an overview of the nature of the alcoholism treatment outcome research reported in the English language over the 13-year review period.

Adult↗