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Biomedical subjects

J Luck

Publications and source records attributed to J Luck.

29 records · Page 2Linked to original sources
PubMed1995

Giant bone island of femur. Case report, literature review, and its distinction from low grade osteosarcoma.

A 42-year old male with the largest reported giant bone island (10.5 cm in length) is presented. Due to its ominous size, association with some degree of pain and increased uptake on radionuclide bone scan, a biopsy was considered necessary definitively to rule out a slow-growing osteosarcoma or blastic metastasis. Documentation of growth in adult patients of conventional and giant bone islands, coupled with evidence of increased radionuclide uptake, makes the clinicoradiological distinction between bone islands and blastic malignancies difficult. Guidelines for biopsy versus serial radiographic follow-up of such lesions are addressed.

Adult↗
PubMed1994

A comparative study of the elastic properties of continuous tear curvilinear capsulorhexis versus capsulorhexis produced by radiofrequency endodiathermy.

Capsulorhexis using radio-frequency endodiathermy may confer some advantages over continuous tear curvilinear capsulorhexis (CTCC) in certain clinical situations. It is unclear whether a capsulorhexis produced in this fashion has the clinically advantageous elasticity and resistance to tearing that a CTCC has been demonstrated to have. To investigate this, a test of capsular elasticity was carried out on pairs of eyes obtained from an eye bank, 42 eyes of 21 patients in total, using modified digital vernier calipers. One eye of each pair had a CTCC, the other a diathermy capsulorhexis (DC). The elasticity of the capsule in both groups was expressed by comparing the circumference of the capsulotomy at rest with its circumference at rupture. The mean capsular elasticity of the CTCC group was significantly greater than that of the DC group (p << 0.001). The capsular edge in both groups was examined using scanning electron microscopy, and the difference in morphology appears to be the source of the difference in elasticity.

Adolescent↗
PubMed1992

Dependence of ocular protrusion, asymmetry of protrusion and lateral interobital width on age.

Ocular protrusion and lateral interorbital width were measured in 462 patients; 187 females and 275 males ranging in age from 9 to 92 years. The object of this study was to determine if ocular protrusion, asymmetry of protrusion and lateral interorbital width was dependent upon age. There was a significant reduction in ocular protrusion and lateral interorbital width with increasing age in both females and males. There was a strong correlation between ocular protrusion and lateral interorbital width. Asymmetry of ocular protrusion did not develop with age. These findings may help in the longitudinal assessment of patients.

Adolescent↗
PubMed1992

Comparison of electrocardiogram interpretations by family physicians, a computer, and a cardiology service.

BACKGROUND: Some family physicians may be under pressure to relinquish the interpretation of outpatient electrocardiograms to cardiologists. The purpose of this study was to determine whether the quality of electrocardiogram (ECG) interpretations by family physicians justifies this pressure, and whether an immediately available computerized ECG interpretation program could serve as an appropriate backup for the family physician. METHODS: Family practice faculty and residents at a university-based residency program provided written interpretations of 301 ECGs ordered over an 11-month period. Their ECG findings were compared with those from a computerized interpretation program and the readings of the cardiology service. All interpretations were then compared with those of a fellowship-trained electrocardiographer, whose readings served as the reference standard. RESULTS: Discrepancy was found between the family physician and the electrocardiographer on 33% of those items that had any potential clinical significance. The computer interpretation and the cardiologist's interpretation agreed with that of the electrocardiographer on 63% and 71% of these discrepancies, respectively (not statistically different). CONCLUSIONS: Family physicians reached a level of agreement with the reference standard in ECG interpretation that was comparable to previously published reports for expert interrater agreement. In this study, however, the quality of ECG readings by family physicians was further improved by expert review. The quality of computer-assisted ECG interpretation was comparable to that of review provided by a cardiology service. Furthermore, computerized interpretation may be clinically more useful because it is immediately available.

Aged↗
PubMedDate not supplied

An automated scoring algorithm for computerized clinical vignettes: evaluating physician performance against explicit quality criteria.

OBJECTIVE: To evaluate the accuracy of an automated algorithm for scoring physicians' responses to open-ended clinical vignettes against explicit, evidence-based quality criteria. METHODS: One hundred sixteen physicians completed a total of 915 computerized clinical vignettes at 4 sites. Each vignette simulated an outpatient primary care visit for one of 8 different clinical cases. The automated algorithm scored disease-specific quality criterion as done or not done by recognizing the presence or absence of predefined patterns in the physician's text response to the vignette. Scores generated by the automated algorithm for each criterion were compared to scores generated by trained human abstractors. Vignette responses were divided into development and test sets. Percentage agreement between automated and manual scores was computed separately for the development and test sets. Sensitivity and specificity were calculated. Costs of automated and manual scoring were compared. RESULTS: Accuracy of the algorithm exceeds 90% for both the development and test sets, and is high for care items that were deemed either necessary or unnecessary, across diverse clinical cases, and for all domains of the outpatient clinical encounter. The sensitivity of the automated scoring algorithm is 89.0%, and specificity is 93.5%. Automated scoring is approximately 84% less expensive than manual scoring. CONCLUSION: Automated scoring of computerized vignettes appears feasible and accurate. Computerized vignettes incorporating accurate automated scoring offer the promise of a highly standardized but relatively inexpensive measurement tool for a wide range of quality assessments within and across health systems.

Algorithms↗