Biomedical subjects

Matthew C Holtman

Publications and source records attributed to Matthew C Holtman.

3 recordsLinked to original sources

PubMed2006

Disciplinary careers of drug-impaired physicians.

Alcohol and drug abuse are among the leading reasons for disciplinary action against physicians by state licensing authorities in the United States. I use event history models to describe the longitudinal patterns in disciplinary actions taken against physicians' licenses by state medical boards in the United States, 1990-2000. Adverse licensure action episodes that included discipline for drug or alcohol abuse were more likely to be followed by license restoration than episodes that did not. However, those restorations were also more likely to be followed by subsequent disciplinary action than episodes that did not include discipline for drug abuse. Furthermore, disciplinary licensure actions for drug abuse were the category most likely to be followed by a subsequent action for the same reason over the longer term (4-11 years). The increased risk of repeat disciplinary action associated with drug abuse may result in part from intensive surveillance of physicians who complete impaired physician programs, through mechanisms that include urine screening. However, it is also likely that the chronic nature of addiction leads to continued risk of relapse even among physicians receiving appropriate treatment.

Databases as Topic↗

PubMed2006

A multilevel analysis of the relationships between selected examinee characteristics and United States Medical Licensing Examination Step 2 Clinical Knowledge performance: revisiting old findings and asking new questions.

BACKGROUND: This study examines: (1) the relationships between examinee characteristics and United States Medical Licensing Examination Step 2 Clinical Knowledge (CK) performance; (2) the effect of gender and examination timing (time per item) on the relationship between Steps 1 and 2 CK; and (3) the effect of school characteristics on the relationships between examinee characteristics and Step 2 CK performance. METHOD: A series of hierarchical linear models (examinees-nested-in-schools) predicting Step 2 CK scores was fit to the data set. The sample included 54,487 examinees from 114 U.S. Liaison Committee on Medical Education-accredited medical schools. RESULTS: Consistent with past examinee-level research, women generally outperformed men on Step 2 CK, and examinees who received more time per item generally outperformed examinees who received less time per item. Step 1 score was generally more strongly associated with Step 2 CK performance for men and for examinees who received less time per item. School-level characteristics (size, average Step 1 performance) influenced the relationship between Steps 1 and 2 CK. CONCLUSION: Both examinee-level and school-level characteristics are important for understanding Step 2 CK performance.

Female↗

PubMed2005

Analysis of count data using poisson regression.

Nurses and other health researchers are often concerned with infrequently occurring, repeatable, health-related events such as number of hospitalizations, pregnancies, or visits to a health care provider. Reports on the occurrence of such discrete events take the form of non-negative integer or count data. Because the counts of infrequently occurring events tend to be non-normally distributed and highly positively skewed, the use of ordinary least squares (OLS) regression with non-transformed data has several shortcomings. Techniques such as Poisson regression and negative binomial regression may provide more appropriate alternatives for analyzing these data. The purpose of this article is to compare and contrast the use of these three methods for the analysis of infrequently occurring count data. The strengths, limitations, and special considerations of each approach are discussed. Data from the National Longitudinal Survey of Adolescent Health (AddHealth) are used for illustrative purposes.

Adolescent↗