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Biomedical subjects

F C McCaslin

Publications and source records attributed to F C McCaslin.

6 recordsLinked to original sources
PubMed1989

Substituting diagnostic services. New tests only partly replace older ones.

Hospitals' patterns of ancillary service use were examined to determine whether new technologies replace older, more outmoded technologies, and to explore the factors associated with adoption of newer services and abandonment of older services. Annual inpatient use of five pairs of ancillary services was measured for 1978 through 1980 at 63 hospitals in five regions. The diagnostic test pairs consisted of one well-established diagnostic test and one newer service that could largely substitute for the older one and included (1) oral cholecystogram and gallbladder ultrasound; (2) brain scan and computed tomographic head scan; (3) skull roentgenogram and brain scan; (4) bone survey and bone scan; and (5) blood type/cross and type/screen. Use of gallbladder ultrasound increased significantly after its adoption, with small decreases in the use of oral cholecystogram, its paired test. For the other newer tests examined, increased use was not accompanied by significantly decreased use of the paired older service. The strongest predictors of change in patterns of test use were hospital size, number of residencies, occupancy, urban location, and the proportion of specialists on staff. We conclude that diffusion of new diagnostic services occurs gradually and often without concomitant decrease in older, outmoded services; new services generally seem to complement rather than substitute for older ones. Larger hospitals with a greater teaching commitment make a faster transition to the use of new technologies and the abandonment of older ones.

Diagnostic Services↗
PubMed1978

Drug use and employment patterns before and during treatment.

This paper was initiated to study the effect of outcome measures as they relate to indication of treatment success. Results have shown that after the third month in treatment, drug use decreases very little. Time in treatment in significantly related to urin-analysis results during the first 3 months; that is, those clients who were to remain in treatment for longer periods were those whose average opiate use during the first 3 months were lowest. We also found that no relationship exists between pretreatment opiate use and opiate use during any evaluation time period. Analysis of employment change rate for a 1-year's period indicate that those employed at intake remain employed and those unemployed remain so. Change in opiate use during any evaluation period had no influence whatsoever on employment.

Amphetamines↗
PubMed1978

A critique of project evaluations.

In recent years an increased stress has been placed on the evaluation of mental health, education, and welfare service programs. The majority of studies readily available to most evaluators represent local project evaluations which usually contain diverse references to different aspects of the evaluative process. For evaluative results to be even minimally useful to other projects, however, certain requirements must be met. These are: (1) internal validity, (2) external validity, (3) specification of the population and treatment being implemented, and (4) standardization of indicators of treatment impact. To determine the extent to which published project impact evaluations meet these criteria, a study was undertaken to "evaluate the evaluations" themselves within heroin addiction treatment programs. Six high-yield journals and 100 random sources were systematically searched for reports of evaluations which provided measures of success in terms of the consumer. Articles were analyzed in regard to our four prerequisites for cross-project comparisons regarding process variables, impact variables, and methodologies. It became clear, however, that our original objectives in evaluating either the usefulness of published project evaluations or testing any specific impact hypotheses were not achievable due to the state of evaluative measurement and reporting practices at this time. The major problems we eoncountered in our inability to complete a necessary and potentially fruitful comparative assessment of project evaluations are discussed in detail with recommendations for future work.

Heroin Dependence↗
PubMed1976

The impact of methadone and drug-free treatment on criminal behavior.

The present study was initiated to evaluate the effect of methadone versus drug-free treatment on a series of criminal involvement measures. A 50% random sample of the 776 clients who had registered with the Central Intake Unit over a one year period was selected for intensive study. Data were collected through examination of intake and treatment files for pre- and post-admission time periods. Arrest, conviction and incarceration rates as well as correctional status were measured and compared across pre-treatment, intake and three month post-intake periods. The arrest rate for the total sample decreased radically from 92.8% upon entering treatment to 8% after three months in treatment. The subsequent rates at 6, 9 and 12 months decreased in a fairly consistent manner. This trend was similar in the methadone, drug-free, and methadone/drug-free groups for either arrests, convictions or incarceration rates with time in treatment. The relationship between arrests and employment and drug use was also examined. No association was found between use of opiates as measured by urinalysis results and frequency of arrest. Similarly, arrest rates showed no significant association with employment rates during the first nine months of treatment, although the comparison at twelve months was significant with only 16.7% of those employed clients being arrested.

Adult↗