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Biomedical subjects

M E Drolette

Publications and source records attributed to M E Drolette.

9 recordsLinked to original sources
PubMed1983

A national study of fluoride mouthrinse adoption: implications for school health personnel.

The ongoing adoption of school-based fluoride mouthrinse programs in the U.S. has provided the opportunity to study the issues surrounding the adoption and implementation of a health technology by public schools. Findings from a National Study on the Diffusion of Preventive Health Measures to Schools have been selected for analysis with regard to the role of school health personnel in the adoption and delivery of the service. A more visible role for school health personnel as on-site health experts is discussed, as well as the potential ways for increasing their involvement through facilitating initial program adoption, relaying accurate and up-to-date implementation information to decision-makers, developing a constituency for long-term program support and ensuring program accuracy through monitoring and continuing education.

Diffusion of Innovation↗
PubMed1980

Policy research related to the diffusion of medical technologies.

There has been a growing interest among policy-makers in improving the transfer of preventive health technologies from research in the laboratory to application in the field. The dissemination of disease prevention technologies depends on understanding the dynamics of local acceptance and long-term commitment to such technologies by institutions, many of which do not have health as their primary responsibility. This paper describes selected national programs concerned with technology transfer and discusses a study of the adoption and implementation of one preventive health innovation---fluoride rinse procedures---as it is diffusing to public schools. Policy implications inherent in research regarding the diffusion and implementation of medical technologies are examined in terms of their relevance to those interested in assessing the school as a feasible site for delivering preventive health services and to those concerned with achieving the successful transfer of a technology from the laboratory to the field.

Communication↗
PubMed1978

Estimating exposure-specific disease rates from case-control studies using Bayes' theorem.

The methods used for selecting subjects yield three types of case-control studies: 1) incident cases are compared to non-cases chosen to be representative of the exposure distribution among the person-years which produced the cases. In this type of study the exposure-odds ratio equals the incidence density ratio; 2) incident cases are compared to residual non-cases at the end of the risk period (exposure-odds ratio = cumulative incidence-odds ratio); 3) prevalent cases are compared to non-cases (exposure-odds ratio = prevalence odds ratio). In study type 1 the equivalence of odds ratio to rate ratio requires no "rare disease assumption;" this permits estimation of exposure-specific illness rates when the overall rate is known. In study types 2 and 3 the exposure-odds ratio equals the corresponding rate ratios only when exposure-specific rates are low. Nonetheless, exposure-specific rates can be calculated without making any rare disease assumption using Bayes' theorem and information on the overall disease rate. A method for obtaining approximate confidence limits around the exposure-specific rates is presented.

Biometry↗
PubMed1977

A retrospective study of physical activity and coronary deaths.

For a series of 568 married white men aged 30-70 years who died from coronary heart diseases, (CHD), and a matched sample of living neighbourhood controls, information was collected on a large number of variables, including physical activity, (PA), classified according to the Health Insurance Plan Study criteria. Increased leisure PA was associated with a decreased risk of coronary death (p less than .001) but there was no association between job activity and coronary deaths. Step-up multiple regression, based on within-pair differences, was used to control for the possible confounding effects of all variables studied. Even when these variables were controlled for there was still a significant association between increased leisure PA and decreased risk of death due to CHD (P less than .001). These data are consistent with the hypothesis that increased leisure PA can contribute to the prevention of death from CHD.

Adult↗
PubMed1976

Coffee drinking and death due to coronary heart disease.

For a series of 649 patients who died of coronary heart disease within 24 hours of onset of symptoms, and an equal number of neighborhood controls, information was obtained on a large number of variables, including coffee consumption. An analysis using multivariate risk scores to control for all available variables yields a maximum likelihood estimate of the risk ratio associated with coffee drinking of 1.1 (95 per cent two-sided confidence limits, 0.8 to 1.6). The estimate of the risk ratio depends somewhat on the number and nature of variables controlled for in the analysis. Overall, our findings, limited to low-risk and middle-risk patients, suggest that the risk, if any, of death from coronary heart disease associated with coffee drinking is small.

Adult↗
PubMed1975

The effect of incomplete follow-up.

By generating sampling distributions for each of three commonly used estimators for qz, the conditional probability of death in an interval, it is shown that the inclusion of subjects due for withdrawal introduces bias in all three, especially the "actuarial estimator" (Berkson and Gage [1950]). The bias is shown to depend on the proportion due for withdrawal and on the level of qz. Some practical suggestions are made for dealing with the bias.

Breast Neoplasms↗