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M D Low

Publications and source records attributed to M D Low.

At least 19 recordsLinked to original sources
PubMed1999

Assessing the cost of a cardiology residency program with a cost construction model.

BACKGROUND: Although the total costs of graduate medical education are difficult to quantify, this information is of great importance in planning over the next decade. METHODS AND RESULTS: A cost construction model was used to quantify the costs of teaching faculty, cardiology fellows' salaries and benefits, overhead (physical plant, equipment, and support staff), and other costs associated with the cardiology residency program at the University of Texas-Houston during the 1996 to 1997 academic year. Surveys of cardiology faculty and fellows, checked by the program director, were conducted to determine the time spent in teaching activities; access to institutional and departmental financial records was obtained to quantify associated costs. The model was then developed and examined for a range of assumptions concerning cardiology fellows' productivity, replacement costs, and the cost allocation of activities jointly producing clinical care and education. The instructional cost of training (cost of didactic, direct clinical supervision, preparation for teaching, and teaching-related administration, plus the support of the teaching program) was estimated at $73,939 per cardiology fellow per year. This cost was less than the estimated replacement value of the teaching and clinical services provided by cardiology fellows, $100,937 per cardiology fellow per year. Sensitivity analysis, with different assumptions on cardiology fellows' productivity and replacement costs, varied the cost estimates but generally represented the cardiology residency program as an asset. CONCLUSIONS: Cost construction models can be used as a tool to estimate variations in resource requirements resulting from changes in curriculum or educators' costs. In this residency, the value of the teaching and clinical services provided by cardiology fellows exceeded the cost of the resources used in the educational program.

Cardiology↗
PubMed1999

A cost construction model to assess the cost of a family practice residency program.

BACKGROUND AND OBJECTIVES: This study uses a cost construction approach to evaluate the cost of training family practice residents in a university-based residency program. The approach calculates the cost of the educational program from a global institutional perspective, including all monetary and nonmonetary costs, independently of how they are financed. METHODS: Cost construction analysis is used to compute the instructional cost, which includes the cost of faculty and resident time directly related to teaching and the support of the teaching program. The value of the clinical care and supervision provided by the family practice residents is assessed as a replacement cost. Sensitivity analysis examines a range of assumptions concerning residents' productivity, replacement costs, and the cost allocation of activities that jointly produce clinical care and education. RESULTS: For a junior resident, the instructional cost is $94,835 per year, and the replacement cost is $65,052 per year. The value of the teaching and clinical services provided by senior residents, $124,247 per year, exceeds the cost of the resources used to educate them, $98,364 per year. CONCLUSIONS: The cost construction model can be used as a tool to allocate resources, negotiate for funding, and estimate variations in cost due to changes in curriculum and in the health care environment.

Costs and Cost Analysis↗
PubMed1997

Using a cost-construction model to assess the cost of educating undergraduate medical students at the University of Texas--Houston Medical School.

PURPOSE: To assess the cost of educating undergraduate medical students at the University of Texas-Houston Medical School (UT-Houston) in 1994-95 through the use of a cost-construction model developed elsewhere and adapted for UT-Houston. METHOD: The cost-construction model identified the cost of the entire program as well as instructional costs (the cost of activities related to direct-contact teaching), educational costs (instructional costs plus the costs of general supervision), and milieu costs (educational costs plus the costs of research). The model predicted these costs based on student contact hours, student enrollment, full-time-equivalent (FTE) faculty and residents required, professional-activity profiles, faculty and resident salaries, and supporting resource costs. Sensitivity analysis was used to explore the effects of such factors as institutional overhead, joint products, volunteer faculty, residents, and varying assumptions about the percentage of time the faculty dedicated to direct-contact teaching. RESULTS: The four-year undergraduate medical program at UT-Houston had a total cost of $82,692,280. For an average class of 200 students, the annual per-student instructional, educational, and milieu component costs were $43,993, $57,370, and $90,660, respectively. The program required 201 FTE faculty members and 258 FTE residents. Sensitivity analysis revealed the financial effects of the various factors, some of which increased costs and some of which decreased costs. CONCLUSION: Although the cost-construction model is conceptually straightforward, there are several inherent complexities and aspects open to debate that must be understood in its application: for example, assumptions regarding faculty time; assumptions regarding the allocation of faculty time to various activities; the definition of those activities; the difficulty of separating costs; the difficulty of accurately defining total educational costs; and so on. However, this study provides a starting point for identifying the distinct costs associated with an undergraduate medical school program and should encourage further discussion and research.

Costs and Cost Analysis↗
PubMed1988

MRI in the diagnosis of MS: a prospective study with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT.

We compared the diagnostic capabilities of MRI to CT, evoked potentials (EP), and CSF oligoclonal banding analysis in a prospective evaluation of 200 patients with suspected multiple sclerosis (MS). MRI was the best method for demonstrating dissemination in space. An abnormal appropriate EP in monosymptomatic disease was usually supported by MRI and CSF analysis as being predictive of MS as a clinical diagnosis. A normal appropriate EP study was not satisfactory because MRI and CSF analysis often did not support a diagnosis of non-MS. When there is agreement between three of these paraclinical studies, the diagnosis of MS is probably unequivocal. For use in research studies, laboratory-supported definite MS (LSDMS) could be diagnosed in 85 patients of the total 200 (42.5%), in 19/38 (50%) of optic neuritis (ON) patients, and in 24/52 (46%) of chronic progressive myelopathy (CPM) patients. MRI was 100% successful in identifying patients who qualified for LSDMS in the ON and CPM groups. In a short follow-up (less than 1 year), 19/200 (10%) went on to develop clinically definite MS (CDMS), and MRI predicted that diagnosis in 18/19 (95%). Only long-term follow-up will show how well these studies and the category of LSDMS predict the development of CDMS. The clinical diagnosis of MS (CDMS), even though only 95% accurate, must remain the gold standard.

Adolescent↗
PubMed1987

Cognitive and task-related EEG correlates of arithmetic performance in adolescents.

Cognitive and neurophysiological correlates of arithmetic calculation, concepts, and applications were examined in 41 adolescents, ages 12-15 years. Psychological and task-related EEG measures which correctly distinguished children who scored low vs. high (using a median split) in each arithmetic subarea were interpreted as indicative of processes involved. Calculation was related to visual-motor sequencing, spatial visualization, theta activity measured during visual-perceptual and verbal tasks at right- and left-hemisphere locations, and right-hemisphere alpha activity measured during a verbal task. Performance on arithmetic word problems was related to spatial visualization and perception, vocabulary, and right-hemisphere alpha activity measured during a verbal task. Results suggest a complex interplay of spatial and sequential operations in arithmetic performance, consistent with processing model concepts of lateralized brain function.

Achievement↗
PubMed1982

Cerebral evoked potentials: a historical review of the marseilles contributions and a preliminary report on a study of the effects of various stimulus parameters on the P90 component of the pattern visual evoked potential.

A preliminary report is given of a study in 10 normal subjects comparing the laterality of the P90 component of the PVEP as elicited by pattern reversal and pattern appearance stimuli delivered monocularly and binocularly in the central and peripheral portions of one-life field. P90 was shown often to appear maximally over the hemisphere ipsilateral to the stimulus field with pattern reversal stimuli in central targets viewed monocularly. Pattern appearance, peripheral targets and binocular stimulation provoked less consistently lateralized and sometimes differently configured responses. It is concluded that while all combinations provoked responses consistent with a dipole generator model similar to that proposed by Blumhardt et al. (1978), these different modes of stimulation cannot be considered to be equivalent.

Cerebral Cortex↗
PubMed1981

A comparison of visual, brainstem auditory, and somatosensory evoked potentials in multiple sclerosis.

Multimodality evoked potentials testing including PVEPs, SEPs and BAEPs was done in 112 patients who were known or suspected to have multiple sclerosis. The incidence of abnormal evoked potential findings in each of these systems was considered in patients in the different diagnostic categories of M.S. Results were also evaluated with respect to the presence of abnormal clinical visual, somatosensory, or brainstem signs. The PVEP was found to be the most frequently abnormal in even patients without clinical involvement in the visual system (45% of patients with definite, probable, or possible M.S.), the SEP was less frequently abnormal in the absence of clinical signs (35% in patients with M.S.), and the BAEP showed the lowest frequency of abnormalities in patients without brainstem signs (14% in patients with M.S.). Combining the three types of evoked potentials significantly increased the percentage of M.S. patients having abnormal findings, compared to any of these tests alone, with 97% of "definite" M.S. patients, 86% of "probable" M.S. patients and 63% of "possible" M.S. patients having at least one of these EP tests abnormal.

Adult↗
PubMed1980

Lipomas of the corpus callosum and epilepsy.

An analysis of four cases of lipomas of the corpus callosum with epilepsy, and a review of the literature, have led to the following conclusions: (1) Epilepsy as an almost constant feature is often severe, nearly always partial, and begins before the age of 15. (2) Pathophysiology of the seizures appears to be essentially an interhemispheric disconnection (rather than the classic theory that seizures depend upon an infiltration of the cingulate gyri by fibrous tissue growing out from the capsule of the lipoma). This disconnection is responsible for a facilitatory and disinhibitory action that favors the appearance of seizures caused by an epileptogenic lesion (the effects of which remain subthreshold in the presence of an intact corpus callosum playing its normal inhibitory role). This hypothesis is clearly applicable in explaining the epilepsies--in every way comparable--that are observed in agenesis of the corpus callosum and in Marchiafava-Bignami disease.

Adolescent↗
PubMed1979

Automatic classification of electroencephalograms: Kullback-Leibler nearest neighbor rules.

A prototypic problem in screening of electroencephalograms in the automatic classification of stationary electroencephalogram time series is treated here by the Kullback-Leibler nearest neighbor rule approach. In that problem, the category or state of an individual is classified by comparison of his or her electroencephalogram with those taken from other individuals in the alternative categories. The Kullback-Leibler nearest neighbor classification rules yield a statistically reliable estimate of the smallest possible probability of electroencephalogram misclassification with a relatively small number of labeled sample electroencephalograms. The automatic classification of anesthesia levels L1 and L3, respectively the anesthesia levels insufficient and sufficient for deep surgery, is treated by machine computation on the electroencephalogram alone.

Anesthetics↗
PubMed1979

Antiepileptic properties of clobazam, a 1-5 benzodiazepine, in man.

Clobazam is a benzodiazepine with special molecular structure (its nitrogen radicals are in positions 1 and 5, rather than 1 and 4 as in all other antiepileptic benzodiazepines), and it is rapidly effective--in a matter of hours or within a few days--against all varieties of epileptic seizures in 52% of subjects treated with it. Its effects are relatively mild. Unfortunately, its outstanding antiepileptic properties are exhausted after only a few weeks in one-third of all cases. The authors discuss the potential significance of this phenomenon, and stress the urgent need for intensive study of the basic mechanism governing exhaustion of the antiepileptic properties of the benzodiazepines in general and clobazam in particular.

Adolescent↗
PubMed1977

Head injuries in children: a prospective five year follow-up.

A five year follow-up study was conducted with two groups of head-injuried children. 131 younger than 9 years old at time of injury and 100 older than 9 years. The four aspects studied were neuropsychological function, neurological status, EEG status, and school progress. There was an extended recovery process over time, as well as evidence of a differential rate of recovery for the four aspects measured.

Adolescent↗