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Biomedical subjects

M W McClatchey

Publications and source records attributed to M W McClatchey.

4 recordsLinked to original sources
PubMed1993

Proactive screening mammography counseling within the Cancer Information Service: results from a randomized trial.

In 1987, the Division of Cancer Prevention and Control, National Cancer Institute (NCI), funded a randomized trial of a proactive counseling protocol to promote screening mammography among age-eligible female callers to the Cancer Information Service (CIS). This protocol included interactive counseling by CIS counselors to help callers overcome barriers to screening mammography; this counseling was an extension of usual service and was combined with a 2-week follow-up mailout to reinforce the brief (6-minute) proactive telephone-counseling protocol. The screening-mammography counseling intervention was tested in two regional CIS offices using a randomized two-group design. Callers were randomly assigned to the intervention or control group based on the week of their call to the CIS (n = 1831 eligible female callers). Self-reported adherence to NCI screening-mammography guidelines was assessed from telephone interviews conducted at 12 months' follow-up (87% response rate). Among all CIS callers enrolled in this study, self-reported adherence to screening-mammography guidelines at 12 months' follow-up was 63.5%. The most frequently cited barriers to screening mammography reported by CIS callers were inconvenience/being too busy (52%), cost (36%), lack of physician referral (34%), no symptoms (34%), and fear of radiation (29%). A significant intervention effect on adherence behavior was found but only in one of the two test sites and only among CIS callers reporting total family income of $30,000 or more (odds ratio = 1.38, P = .04). The vast majority (90%) of CIS callers (both intervention and control subjects) endorsed the concept of proactive counseling by the CIS. The implications of these findings for the CIS and future research are discussed.

Adult↗
PubMed1992

The usefulness of matched pair randomization for medical practice-based research.

To be feasible, study designs for most intervention research in primary care settings must limit the number of participating physicians, without sacrificing the statistical power required to test the research hypotheses. A model was developed to examine sample size and statistical power requirements when using the physicians' practice as the unit of analysis. Randomized designs using either matched or unmatched samples of practices were compared under varying conditions. When baseline variability is small or the number of practice pairs is large, matching at best marginally increases power. However, in the typical case when baseline variability is large or the number of practice pairs is small, matching substantially increases the power to find intervention effects with a smaller sample. Thus, matching prior to randomization could improve the design of many intervention studies in primary care settings.

Humans↗
PubMed1988

Beyond sensitivity, specificity and statistical independence.

Sensitivity and specificity have clear definitions when there is a single test for one disease, and the test is either positive or negative. This paper presents a unified approach for obtaining posterior probabilities (predictive values) when there are more than two test outcomes and/or more than one disease state. In these cases, sensitivity and specificity do not have clear definitions. Three examples from the literature demonstrate how this approach simplifies the presentation of Bayesian revision of prior probabilities. Use of proper care in data collection for the purpose of estimating conditional probabilities can avoid assumptions of statistical independence.

Decision Support Techniques↗