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Biomedical subjects

W C Taylor

Publications and source records attributed to W C Taylor.

17 recordsLinked to original sources
PubMed1992

Absolutely relative: how research results are summarized can affect treatment decisions.

PURPOSE: To determine whether alternative methods of presenting a contrast between the same two quantities in descriptions of research results could lead to different treatment decisions by physicians. SUBJECTS AND METHODS: We conducted a survey of practicing physicians and of faculty and fellows in training programs in clinical epidemiology and social science research methods. Each questionnaire presented results from a published study of either hypertension or hypercholesterolemia in two different ways: once as the relative change in the outcome rate and once as the absolute change in the outcome rate. We asked respondents to read each summary and indicate how the information contained in the summary would influence decisions about treatment. RESULTS: Of the 235 physicians who completed the questionnaire, 108 (46%) gave different responses to the same results presented in different ways. Of these, 97 (89.8%) indicated a stronger inclination to treat patients after reading of the relative change in the outcome rate (p less than 0.0001). CONCLUSION: The manner of presentation of results can influence physicians' judgments about the treatment of patients.

Abstracting and Indexing↗
PubMed1979

A preliminary investigation of three types of multiple choice questions.

The present study reports the results of an evaluation of three types of multiple choice questions--the five choice completion, and assertion-reason. Fifty-four questions, eighteen of each type and measuring the candidate on the same scientific principle and classified as either factual or comprehension, were developed and included in the General Surgery certifying examination of the Royal College of Physicians and Surgeons of Canada. In addition to using descriptive statistics, the multitrait-multimethod technique was used to investigate whether the item types measured different aspects of examinee capabilities. Results indicated that performance on the five choice completion and the multiple completion type questions was roughly the same, whereas performance on the assertion-reason type was lower. The results of the multitrait-multimethod validation revealed that the three item types were unable to discriminate between the two traits of factual and comprehension.

Canada↗
PubMed1978

Multiple, heterogeneous actin genes in Dictyostelium.

We have used an actin gene-containing restriction fragment of plasmid M6 (Kindle and Firtel, 1978) to select a second actin gene-containing plasmid which we have named pDd actin 2. This plasmid has been shown to contain two actin genes separated by 350 bp of nonactin DNA. When heteroduplexes are formed between any two of the three actin genes present in chimeric plasmids, the region of homology is 1100 +/- 100 bp. This is close to the minimum length required to code for actin protein. The 1100 bp region of intergene homology corresponds to the 1100 bp homology observed between M6 and the two actin cDNA plasmids pcDd actin B1 and pcDd actin A1 (Bender et al., 1978). We have no evidence for additional sequences common to either the 3' or 5' ends of the 1100 +/- 100 bp region of intergene homology. Thermal denaturation experiments show that different pairs of actin genes are diverged from each other by as much as 6--8%. There are two size classes of mRNA complementary to the three actin genes. These have lenghts of 1.25 and 1.35 kb as determined on methyl mercuric hydroxide-containing agarose gels. The possible linkage of these three actin genes to other actin genes is discussed.

Actins↗
PubMed1978

Collusion of information on computerized patient management examinations.

In a computer presented examination the ratio of examinees to computer terminals is generally large. This implies that a computer presented test might span an entire day or several days with different groups of examinees taking the examination at different times. In such a situation, examinees who take the examination later on have the opportunity to gather information from their colleagues who took the examination earlier. This report investigates whether information exchanged between groups of examinees taking a computer presented patient management problem test improves the performance of late takers versus early takers. Results indicate that there is no exchange of information between groups of candidates.

Alberta↗
PubMed1976

The use of computerized patient management problems in a certifying examination.

The 1974 paediatric certification process of the Royal College of Physicians and Surgeons of Canada included four CPMPs, in addition to the conventional MCQs and orals. The CPMP's were successfully administered to 160 candidates in eight cities across Canada on the same day. The examination was judged by the candidates to be a better test of clinical skill than MCQs. The CPMP examination did not penalize French-speaking candidates, was economically feasible, and a good security risk. Correlations between MCQ, orals and CPMPs, indicated that each examination measured some aspects of paediatric competence not tested by the others.

Canada↗
PubMed1976

Paediatric candidates' attitudes to computerized patient management problems in a certifying examination.

In September 1974 candidates who had taken a computerized patient managment problem examination (CPMP), as part of the certification process in paediatrics required by the Royal College of Physicians and Surgeons of Canada, completed a questionnaire designed to elicit their reactions to CPMPs. The results indicated that respondents were favourable to CPMPs, that there was little distraction caused by the equipment, logic or semantics of the problems, and that CPMPs were an acceptable examination technique. It was recommended that, in the future, CPMP examinees be allowed practice time to familiarize themselves with the equipment, that pre-examination instructions should be clarified, and that problems judged inadequate by candidates be revised.

Attitude of Health Personnel↗
PubMed1975

Computerization of a patient management problems examination to prevent 'retracing'.

During 1973, a 10-patient, linear PMP examination was administered in both written and computerized form to 104 candidates for certification by the American Board of Pediatrics and to 122 individuals in their first month of graduate training in paediatrics. Both groups made significantly more errors of omission (failure to select appropriate actions) and fewer correct diagnoses on the computerized version of the test than on the written version. These results suggest that examinees 'retrace' (use clues from problems near the end of the case to make additional correct decisions on earlier problems) when the test is presented in written form and that computerization prevents this phenomenon. Additional analyses indicated that the reliability of the PMP examination was essentially the same for the written and computerized versions, that both forms distinguished about equally well between first-year residents and candidates, and that both forms had about the same magnitude of correlation with the American Board of Pediatrics oral examination. Finally, correlation between both PMP forms and the American Board of Pediatrics multiple-choice examination suggested that the PMP, in either mode of presentation, measures characteristics that are not tapped by the multiple-choice test. Thus, computerization of the PMP provides a means for controlling a variable (retracing) which may be considered extraneous to the desired measurement, but it does not appear to alter the reliability of the test or to modify its relations with other measures.

Computers↗
PubMedDate not supplied

A computer-based outpatient medical record for a teaching hospital.

We developed a computer-based outpatient medical record system to facilitate direct physician interaction with the clinical computing system at the Beth Israel Hospital in Boston. During the 2 years since the medical record system was installed, 20 staff physicians, 5 fellows, 64 residents, and 11 nurse practitioners have entered 15,121 active problems and 1996 inactive problems for 3524 patients, as well as 12,651 active medications and 1894 discontinued medications for 3430 patients. Another 20,321 items were entered on health-promotion and disease-prevention screening sheets, and with the help of automatic updating by the computer, an additional 21,897 entries on screening sheets were made for 8686 patients. Clinicians wrote 10.9 +/- 12.8 (mean +/- SD) words per problem when they were working at the computer, as compared with 4.3 +/- 2.5 words per problem when they were writing in the paper medical record. We conclude that physicians will readily enter data directly into a computing system when they are given appropriate tools, and that they consider the computer-based problem list to be a valuable improvement over its paper counterpart. Use of a computer-based medical record system has obvious benefits for data management and patient care.

Ambulatory Care Information Systems↗