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Biomedical subjects

R Gunderman

Publications and source records attributed to R Gunderman.

9 recordsLinked to original sources
PubMed2000

Radiology reporting in an academic children's hospital: what referring physicians think.

Transcribed reports are the radiologist's most conspicuous and enduring product, yet relatively little investigation of report quality has been undertaken by radiologists. This paper reports the results of a survey of 266 referring physicians in an academic children's hospital regarding their needs and assessments of the quality of radiology reporting. The results outline the range and relative importance of report features from referring physicians' points of view, provide specific suggestions for how to improve reporting performance, and generally indicate that reporting should receive more attention in training and practice than it currently does.

Academic Medical Centers↗
PubMed1998

The ends of outcomes assessment.

Outcomes assessment holds great promise to improve the quality and efficiency of health care. By subjecting practices to rigorous and systematic analysis, we should be in a position to make judgments about what does and does not work in clinical practice. However, the outcomes of outcomes assessment themselves should be approached with the same critical eye. Among the many sorts of criteria by which to evaluate outcomes assessment are several key parameters: foremost among them are cognitive outcomes, ethical outcomes, and economic outcomes. Only when these outcomes are thoroughly explored and taken into account will the fullest potential of outcomes assessment be realized.

Efficiency, Organizational↗
PubMed1998

Scintigraphic screening prior to visceral arteriography in acute lower gastrointestinal bleeding.

UNLABELLED: We evaluated the effect on the diagnostic yield of visceral arteriography in patients with acute gastrointestinal bleeding of a protocol requiring a positive 99mTc-red blood cell scintiscan before the performance of arteriography (scintigraphic screening). METHODS: A retrospective review was conducted of 249 scintiscans and 271 arteriograms obtained over 99 mo, with scintigraphic screening implemented during the final 18 mo. RESULTS: Before the implementation of scintigraphic screening, arteriograms detected bleeding at a rate of 22%. After its implementation, 53% of the arteriograms detected bleeding. This represented a statistically significant increase (0.53 versus 0.22, p = 0.015). CONCLUSION: Scintigraphic screening appears to increase by a factor of 2.4 the diagnostic yield of arteriography by screening out patients who are not actively bleeding at the time of the examination, thus sparing them the risks and costs of a nondiagnostic invasive study.

Acute Disease↗
PubMed1978

Kleine-Levin syndrome associated with fire setting.

Kleine-Levin syndrome is characterized by periodic hypersomnia associated with megaphagia and striking behavioral and psychiatric symptoms; it occurs primarily in adolescent boys. We treated a 17-year-old boy who had typical recurring somnolent episodes. His bizarre behavior included fire setting and stealing, both of which may have represented compulsions. His EEG during a sleepy episode was diffusely abnormal with generalized slowing of background activity; as he awoke and improved clinically, his EEG returned to normal. Between episodes, his EEG was normal. The relationship between Kleine-Levin syndrome and other sleep disorders is discussed. The neurochemistry and neurocircuitry that may provide the requisite substrate for this complex and fascinating neuropsychiatric disorder are briefly reviewed.

Adolescent↗