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Biomedical subjects

C J Mankin

Publications and source records attributed to C J Mankin.

4 recordsLinked to original sources
PubMed1996

The hazards of the biopsy, revisited. Members of the Musculoskeletal Tumor Society.

In 1982, members of the Musculoskeletal Tumor Society, representing sixteen centers for the treatment of bone and soft-tissue cancer, compiled data regarding the hazards associated with 329 biopsies of primary malignant musculoskeletal sarcomas. The investigation showed troubling rates of error in diagnosis and technique, which resulted in complications and also adversely affected the care of the patients. These data were quite different when the biopsy had been carried out in a treatment center rather than in a referring institution. On the basis of these observations, the Society made a series of recommendations about the technical aspects of the biopsy and stated that, whenever possible, the procedure should be done in a treatment center rather than in a referring institution. In 1992, the Musculoskeletal Tumor Society decided to perform a similar study to determine whether the rates of complications, errors, and deleterious effects related to biopsy had changed. Twenty-five surgeons from twenty-one institutions submitted the cases of 597 patients. The results were essentially the same as those in the earlier study. The rate of diagnostic error for the total series (in which cases from referring institutions and treatment centers were combined) was 17.8 percent. There was no significant difference in the rate of patients for whom a problem with the biopsy forced the surgeon to carry out a different and often more complex operation or to use adjunctive irradiation or chemotherapy (19.3 percent in the current study, compared with 18 percent in the previous one). There was also no significant differences in the percentage of patients who had a change in the outcome, such as the need for a more complex resection that resulted in disability, loss of function, local recurrence, or death, attributable to problems related to the biopsy (10.1 percent in the current study, compared with 8.5 percent in the 1982 study). Eighteen patients in the current study had an unnecessary amputation as a result of the biopsy, compared with fifteen in the previous study. Errors, complications, and changes in the course and outcome were two to twelve times greater (p < 0.001) when the biopsy was done in a referring institution instead of in a treatment center.

Biopsy↗
PubMed1995

Practical library research: a tool for effective library management.

Librarians are being urged to conduct research as one of their professional responsibilities. Many librarians, however, avoid research, because they believe it is beyond their capabilities or resources. This paper discusses the importance of conducting applied research-research directed toward solving practical problems. The paper describes how one library conducted practical research projects, including use studies and surveys, over an eighteen-year period. These projects produced objective data that were used by the library to make management decisions that benefited both the library and its parent institution. This paper encourages other librarians to conduct practical research projects and to share the results with their colleagues through publication in the professional literature.

Data Collection↗
PubMed1980

A simple objective method for determining a dynamic journal collection.

In order to determine the content of a journal collection responsive to both user needs and space and dollar constraints, quantitative measures of the use of a 647-title collection have been related to space and cost requirements to develop objective criteria for a dynamic collection for the Treadwell Library at the Massachusetts General Hospital, a large medical research center. Data were collected for one calendar year (1977) and stored with the elements for each title's profile in a computerized file. To account for the effect of the bulk of the journal runs on the number of uses, raw use data have been adjusted using linear shelf space required for each title to produce a factor called density of use. Titles have been ranked by raw use and by density of use with space and cost requirements for each. Data have also been analyzed for five special categories of use. Given automated means of collecting and storing data, use measures should be collected continuously. Using raw use frequency ranking to relate use to space and costs seems sensible since a decision point cutoff can be chosen in terms of the potential interlibrary loans generated. But it places new titles at risk while protecting titles with long, little used runs. Basing decisions on density of use frequency ranking seems to produce a larger yield of titles with fewer potential interlibrary loans and to identify titles with overlong runs which may be pruned or converted to microform. The method developed is simple and practical. Its design will be improved to apply to data collected in 1980 for a continuous study of journal use. The problem addressed is essentially one of inventory control. Viewed as such it makes good financial sense to measure use as part of the routine operation of the library to provide information for effective management decisions.

Humans↗