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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 253 records · Page 14Linked to original sources
PubMed1992

Oral contraceptives and cancer of the cervix uteri. A meta-analysis.

AIM AND OBJECTIVE: Because the findings of epidemiologic studies of the relationship between oral contraceptive use and cervical cancer have not been consistent, we reanalyzed the relationship. DESIGN: Meta-analysis of studies published to date. SETTING AND SUBJECTS: Papers were located by searching the MEDLINE data base, supplemented by a hand search of all the references in the articles recovered. MEASUREMENTS: Studies were graded as to quality. Two meta-analyses were performed: one including all the studies gathered and one including methodologically acceptable studies only. The method of Woolf was used to combine relative risks. Heterogeneity of the effect was assessed. MAIN RESULTS: Fifty-one published studies were collected: 21 case-control, 18 cross-sectional, and 12 cohort designs. Twenty-one of these were considered as methodologically acceptable, but only 18 could be pooled. The main results observed were: relative risks was 1.52 (1.3-1.8) for dysplasia, 1.52 (1.3-1.8) for carcinoma in situ, and 1.21 (1.1-1.4) for invasive cancer. A significant linear dose-response effect was observed in dysplasia, carcinoma in situ, and invasive cervical cancer. Heterogeneity of the effect was present in some of the former estimates. CONCLUSIONS: Oral contraceptive use may be a risk factor for all stages of the natural history of cervical cancer, which may imply an initiator effect. Limitations to this research are discussed.

Carcinoma in Situ↗
PubMed1991

Use of primary health care in Spili, Crete, and in Dalby, Sweden.

A computerized medical record system was introduced in Greek primary health care (PHC) in the village of Spili in Crete. The present study was carried out to study similarities and differences in the pattern of PHC use in Dalby Health Centre, Sweden (DHC), and Spili Health Centre, Greece (SHC). In both Dalby and Spili more than half the population contacted their respective health centre during 1989. Patients contacted DHC more often than SHC, 3.33 vs 2.30 times. Relatively more females than males used the health services in Dalby (64% vs 50%) but not in Spili (57% vs 55%). More visits were made by appointment at DHC than SHC (36.0% vs 12.6%). There were great similarities in the two areas in the ten most common diagnoses, analysed in four age-groups. In both areas, acute upper respiratory infections dominated in the youngest age-groups, and hypertension and diabetes in those aged 45 years and above.

Adolescent↗
PubMed1992

Medical records in litigation: the Dalkon Shield story.

The Dalkon Shield was manufactured by A.H. Robins Inc. in the early and mid seventies, before it was withdrawn from sale because of the influx of lawsuits against the manufacturers. The case has become the largest tort case in history, with approximately 200,000 claimants worldwide and will not be wound up for years to come. Slater and Gordon is an Australian firm of solicitors with offices in three states. They have the largest Dalkon Shield practice in the world and represent almost 3,000 claimants. One of their most difficult tasks in preparing the cases is the gathering of medical evidence to substantiate claimants' assertions. This entails collecting relevant medical records from across the country and around the world going back almost twenty years for almost 2,000 women. The project has magnified the importance of accurate and complete documentation, kept intact and made accessible. The influence of medical record administrators is highlighted.

Australia↗
PubMed1994

The Informatics Institute: why do we need it?

Why should physician executives care about medical informatics? For that matter, what is medical informatics anyway? Broadly defined, medical informatics is the study of the collection, storage, retrieval, and analysis of data and information in health care to support clinical and administrative decision making. Informatics is important because, in the past 10 years, powerful computer, software, and information technologies have been developed to enable health care organizations to automate some of the work of decision making, for improved quality of care and cost control, and for successful managed care contracting. This new emphasis on informatics in health care was the impetus for the founding by ACPE earlier this year of The Informatics Institute, which will be involved in educational and research activities in the growing area of medical informatics. In this new column in Physician Executive, Dr. Marshall Ruffin, President and CEO of the Institute, will discuss the role of medical informatics in health care delivery and financing and its relation to physician executives.

Academies and Institutes↗
PubMed1986

Microcomputer surveillance as an aid to rational antibiotic therapy for urinary tract infection (UTI) in general practice.

We report our experience with an inexpensive microcomputer system for the storage and retrieval of susceptibility data on urinary isolates for general practitioners and doctors working in the University of Sheffield Student Health Service. Together with the results from a simple questionnaire into their prescribing habits, we believe that help can be given, enabling practitioners to achieve rational prescribing of antibiotics in their treatment of urinary tract infection.

Anti-Bacterial Agents↗
PubMed2003

Implementing technological safeguards to ensure patient privacy.

Computers play an increasingly important role in the storage and retrieval of patient data. Internet attack incidents are growing at the astronomical rate of 64 percent a year, and some estimates state that employees are responsible for more than 80 percent of all security breaches. The information security regulations of the Health Insurance Portability and Accountability Act provide an impetus for health care providers to implement processes that ensure the safety and confidentiality of patient information.

Computer Security↗
PubMed1991

Microcomputer applications for primary health care in developing countries.

This article explores some ways in which computer technology can be harnessed to strengthen primary health care planning and management, make more efficient use of scare health resources, and maximize the beneficial impact on health of local, district, and national health systems in both developing and developed countries.

Cost-Benefit Analysis↗
PubMedDate not supplied

Use of reported immunisation performance data in monitoring UIP.

Health information system is not well developed in most parts of the country. We propose to use locally available data on immunization performance so as to make them more informative and useful for implementing and supervisory personnel. Reclassification of data according to estimated number of eligibles, monthly performance and age of children immunized can given impressions about coverage, sustainability of services and their quality. Similarly, area and institution-wise data can be used to identify places needing more attention. Active use of available data will help in improvement of vaccine coverage and control of target diseases.

Data Interpretation, Statistical↗
PubMedDate not supplied

An analysis of death ascertainment and follow-up through statistics Canada's Mortality Data Base system.

The Canadian Mortality Data Base (MDB) was utilized in mortality follow-up of 17,446 refinery and petrochemical workers throughout Canada. The performance of the system in detecting 757 previously known deaths was evaluated. Of the deaths submitted, 93.1% (90% confidence interval (CI) 91.5-94.5) were detected, including 97.6% (90% CI 96.5-98.4) of deaths which occurred in Canada. Detection was generally unaffected by age, year of death (1964-1973), and the presence of middle initial or the remainder of first name. Slightly lower ascertainment was found for deaths occurring in Quebec (94.5%) and Newfoundland (93.3%). This could be due to several factors, including fewer MDB records with complete identifier information for these provinces, or lower accuracy of linking fields for records supplied to the Agency. Few links were made to employees presumed to be alive, indicating 99.8% specificity for these records.

Aged↗
PubMed1985

Developments toward clinical support systems. Beyond accounts receivable.

The role of computers in primary care is disappointing when contrasted with their ubiquity elsewhere. This article surveys unique applications that have made inroads toward successful adaptation of automation to the storage and retrieval of medical data and to clinical decision support. The author's DUCHESS system is described as an effort to overcome the impediments that have restricted application of informatics to ambulatory care.

Artificial Intelligence↗
PubMed1967

Advances in multiphasic screening and testing.

The multiphasic testing center of the future will probably be used both for periodic screening tests and for referrals by practicing physicians. Recent widespread interest of several branches of the Federal Government in multiphasic screening stems from the possibility that, through its use, the enormous cost of chronic illness to the country may be reduced.Recent advances in automation and the storage, retrieval, and analysis of data by computers make it economically feasible to obtain much more information about the patient's health than ever before. New instrument developments include both screening and diagnostic analysis of electrocardiograms by computers, analysis of heart sounds by computer, and a wide variety of other physiological and biochemical instruments. To allow for the inclusion and evaluation of these new procedures, a number of multiphasic testing centers will be needed which can do both research and routine testing. Close cooperation between the medical profession, the public health services and industry will be needed to best serve both the public and the medical profession.

Humans↗
PubMed1980

To answer questions. A review of an autopsy service.

Autopsies are important in the quality control of medical practice, in research, and in teaching. We have attempted to realize more of the service, teaching, and research potential from doing autopsies. The key of all efforts is the involvement of the senior staff. This involvement should be made possible by supporting such a person by a qualified team that consists of the mortuary service, pathologist's assistants, and highly trained and qualified residents. Such a staff person can direct his or her attention toward improving communication with clinicians, answering open questions in-depth, encouraging collaborative clinicopathological projects, developing new approaches to the performance of autopsies, such as the immediate autopsy, and using special laboratory modalities, such as electron microscopy and immunofluorescence. Computer storage of autopsy data and retrieval for special studies seem to make autopsy data available and usable. It is most important that autopsies be performed, that they be done well, and that their findings be carefully evaluated using all available scientific tools and, finally, that the results are adequately communicated.

Autopsy↗