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Biomedical subjects

E Mumford

Publications and source records attributed to E Mumford.

At least 19 recordsLinked to original sources
PubMed1988

Meta-analysis of the effects of educational and psychosocial interventions on management of diabetes mellitus.

A meta-analysis of the literature of controlled studies of educational and psychosocial interventions in the treatment of diabetes mellitus yielded 93 studies of 7451 patients testing the effects of eight intervention types: (1) didactic education, (2) enhanced education, (3) diet instruction, (4) exercise instruction, (5) self-monitoring instruction, (6) social learning/behavior modification, (7) counseling, and (8) relaxation training. An overall mean effect size (ES) of +0.51 +/- 0.11 was found moderate but significant (P less than 0.05) improvements for all intervention subjects. Physical outcome and knowledge gain were most affected, followed by psychological status and compliance. Diet instruction and social learning interventions showed the strongest (ES = +0.68 +/- 0.58 and ES = +0.57 +/- 0.42, respectively) and relaxation training the weakest (ES = +0.30 +/- 0.74) effects. Associations between study and sample characteristics and mean ES values were explored with type of setting and methodological weaknesses such as single group design and non-random assignment achieving statistical significance. Neither intervention type, number of visits, sex, age, nor type of diabetes were significantly correlated with mean ES values. Implications of these findings for clinical treatment and future research are discussed.

Diabetes Mellitus↗
PubMed1987

Assessing consumer benefit. Cost offset as an incidental effect of psychotherapy.

In addition to improved quality of care, evidence of cost benefits associated with the provision of consultation-liaison services may be used to justify the expenses of such programs. Reductions in use of medical services following mental health treatments are not inevitable, however. Advocates of C-L should be aware of the circumstances under which cost benefits are likely to be found and focus assessments appropriately.

Cost-Benefit Analysis↗
PubMed1987

Ratings of videotaped simulated patient interviews and four other methods of evaluating a psychiatry clerkship.

Ratings of videotaped interviews with simulated patients were compared with four other measures commonly used to evaluate medical students during their psychiatry clerkship. Intercorrelations among self-reported attitude change, written examination grade, and student rating of satisfaction with the clerkship suggest that each measures different processes. Low but significant correlations between preceptor ratings of interaction skills and data-gathering skills and process and content scores based on an end-of-course videotaped interview suggest that preceptor ratings and the videotaped interview method evaluated the same skills. The authors conclude that preceptor evaluations supplemented by objective ratings of videotaped interviews show promise for evaluating the development of interviewing skills.

Attitude↗
PubMed1984

A new look at evidence about reduced cost of medical utilization following mental health treatment.

Meta-analysis of 58 controlled studies and analysis of the claims files for the Blue Cross and Blue Shield Federal Employees Plan for 1974-1978 provide mutually supporting evidence of the cost-offset effects of outpatient mental health treatment. These two complementary resources provide a powerful tool for investigating the nature of associations between mental health services and subsequent reductions in the use of other medical services. The authors found that the reductions in use of medical services are associated with inpatient rather than with outpatient utilization and tend to be larger for persons over 55 years of age.

Adolescent↗
PubMed1983

Mental health treatment and medical care utilization in a fee-for-service system: outpatient mental health treatment following the onset of a chronic disease.

Charges for medical services of persons covered by the Blue Cross/Blue Shield Federal Employees Program from 1974 through 1978 who were first diagnosed as having one of four chronic diseases in 1975 and within one year began mental health treatment (MHT) were compared with persons who also were first diagnosed as having one of these diseases in 1975 but had no subsequent MHT. In the third year following the diagnosis, those having seven to 20 MHT visits had medical charges $309 lower and those having over 21 MHT visits had medical charges $284 lower than the comparison group. The savings in medical charges over three years of the group having seven to 20 MHT visits were a function of lower use of inpatient services and roughly equaled the cost of 20 MHT visits. Outpatient mental health treatment can be included in a fee-for-service medical care system to improve the quality and appropriateness of care and, if not extensive, may also serve to lower medical care costs.

Adolescent↗
PubMed1982

The effect of psychological intervention on recovery from surgery and heart attacks: an analysis of the literature.

A quantitative review of 34 controlled studies demonstrates that, on the average, surgical or coronary patients who are provided information or emotional support to help them master the medical crisis do better than patients who receive only ordinary care. A review of 13 studies that used hospital days post-surgery or post-heart attack as outcome indicators showed that on the average psychological intervention reduced hospitalization approximately two days below the control group's average of 9.92 days. Most of the interventions were modest and, in most studies, were not matched in any way to the needs of particular patients or their coping styles. Beyond the intrinsic value of offering humane and considerate care, the evidence is that psychological care can be cost-effective.

Adult↗
PubMed1978

The bent twig: psychiatry and medical education.

The authors note that an increase in psychiatry's involvement in the selection and education of medical school students, which historically has been limited and problematic, would benefit both the discipline and the profession in general. There is evidence indicating the need to pay attention to personal attributes in medical education, particularly in light of the incidence of problems in physicians (e.g., addiction, alcoholism, and suicide) that fall within psychiatry's area of expertise. Active participation by psychiatry in medical education might also help combat the cynicism that seems to develop during training and might contribute to consideration of ethical issues and to the fostering of emotional maturity.

Education, Medical↗