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PubMed2005

Comparison of clinical skills of 3rd-year students who completed structured clinical skills program with 6th-year students who acquired clinical skills in unsystematic way.

BACKGROUND: The timing and methods of teaching clinical skills are some of the main concerns of medical education. PURPOSE: The aim of this study was to compare clinical skills of the 3rd and 6th-year students who acquired clinical skills training within different years and methods. METHODS: Randomly chosen students were observed and evaluated in the form of "did it-didn't do it" over the checklists composed of parameters of communication, history taking, and physical examination. The results were evaluated on the SPSS 10.0 for Windows program and Pearson chi-square test was used in the statistical analyses. RESULTS: Third-year students who had clinical skills training in early years and structured methods had better results for most of the parameters (p < .05). CONCLUSIONS: The clinical skills training given through a structured program that is widespread in the early years of medical school makes a great contribution to the development of students' clinical skills.

Clinical Competence↗
PubMed1994

[History of professionalization of modern clinical pharmacist (3). The birth of clinical medicine and clinical pharmacy].

At the end of eighteenth century and the beginning of the nineteenth century clinical medical and clinical pharmaceutical teaching was organized according to the reformation of the medical system in French Republic. Michel Foucault said in the book "Naissance de la clinique." -- "To all appearance, it was simply reviving, as the only possible way of salvation, the clinical trandition that had been developed in the 18-century. But it was fundamental experience, because, unlike the 18-century clinic, it is not a question of an encounter, after the event, of a previously formed experience and an ignorance to be dissipated. It is a question, in the absence of any previous structure, of a domain in which truth teaches itself, and, in exactly the same way, offers itself to the gaze of both the experienced observer and the naïve apprentice; for both, there is only one language: the hospital, in which the series of patients examined is itself a school."--(M. Foucault, 1963) Clinical pharmaceutical teaching started in the central pharmacy and in the hospital pharmacies in Paris with the rule of 4. ventose in year X. This was the birth of Clinical Pharmacy Practice as a new fundamental experience in France.

Clinical Medicine↗
PubMed1985

Definition of clinical pharmacy as a specialty in clinical practice. Committee on Clinical Pharmacy as a Specialty. American Pharmacy Association.

Specialty credentialing has been discussed extensively and debated within pharmacy for more than ten years. Within the profession, there now appears to be a consensus on the need for and appropriateness of acknowledging professional practice areas as unique, defined entities. However, there remain substantive differences on how the definition of specialty practice should be constructed. One approach is to identify practice areas by functional activity (e.g., nuclear pharmacy, drug information) and/or therapeutic focus (e.g., psychopharmacy, clinical pharmacokinetics). A second approach is to define clinical pharmacy as a specialty practice that would, at least initially, coalesce clinical practitioners with the common denominator of an active role in the therapeutic decision-making process. The following document was developed by the Committee on Clinical Pharmacy as a Specialty (CCPS). The CCPS is independent of any formal organizational affiliations. It will serve as the preface to a petition that will be submitted to the Board of Pharmaceutical Specialties requesting recognition of clinical pharmacy as a specialty. The intention of the committee is to resolve the question of specialty status for clinical pharmacy through the Board of Pharmaceutical Specialties' review process. It is then hoped that pharmacy can move forward on the important issue of specialty credentialing.

Certification↗
PubMed1980

International Federation of Clinical Chemistry scientific committee expert panel on pH and blood gases (EPpH) and International Union of Pure and Applied Chemistry division of clinical chemistry commission on quantities and units in clinical chemistry (CQUCC). Document stage 2, draft 1 (1979-10-10) with a view to a recommendation. Physico-chemical quantities and units in clinical chemistry with special emphasis on activities and activity coefficients.

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Chemical Phenomena↗
PubMed1979

International Union of Pure and Applied Chemistry and International Federation of Clinical Chemistry: IUPAC Section on Clinical Chemistry, Commission on Quantities and Units in Clinical Chemistry and IFCC Committee on Standards, Expert Panel on Quantities and Units. Provisional recommendation (1978) on quantities and units in clinical chemistry: optical spectroscopy. Part 1. Theoretical outline and general quantities.

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Chemical Phenomena↗
PubMed1980

International Federation of Clinical Chemistry, Scientific Committee Expert Panel on pH and blood gases (EPpH) and International Union of Pure and Applied Chemistry Division of Clinical Chemistry Commission on Quantities and Units in Clinical Chemistry (CQUCC). IFCC Document stage 2, Draft 1; 1979-10-10 with a view to a Recommendation. Physico-chemical quantities and units in clinical chemistry with special emphasis on activities and activity coefficients.

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Blood Gas Analysis↗
PubMed2004

Do clinical grant payment practices in phase 3 clinical trials influence subsequent clinical investigator prescribing behavior?

The advancement of science requires the cooperation of clinical investigators. Recent discourse, which attempts to relate pharmaceutical company grant payments to clinical investigators to subsequent preferential prescribing behavior, erodes the physician/patient relationship and may lead to an inadequate number of investigators. This study was designed to determine why the level of grant payments to Phase 3 clinical investigators differs for comparable levels of work and whether these differences are related to subsequent prescribing behavior of either the study drug or other drugs from the same sponsoring company. From a database of 100,000 investigator contracts, 2,108 U.S. physicians participating in Phase 3 trials at 2,897 clinical sites for new drugs launched in 1999-2000 were randomly selected in 10 outpatient indications. The relative grant amounts (RGAs) paid to the investigators were compared with their subsequent prescribing of the study drug and other sponsor company drugs for a period of six months after study drug introduction. The RGA is the payment percentile represented by the absolute cost per patient grant paid to any specific investigator compared with other similar studies, including such considerations as the number of patient visits, the number and types of medical procedures performed, the investigator's geographic location, and whether the study was conducted at the investigator's office or hospital. Linear regression correlations were calculated between study, investigator, and drug characteristics with the RGA, and the correlation between the RGA and subsequent prescribing behavior of the study drug and other drugs from the sponsor company at three and six months after study drug product launch. Five variables were statistically significantly related to the RGA received by an investigator: compound therapeutic novelty, the number of similar studies being conducted at same time, investigator clinical research experience, and the inverse of drug class prescription volume. Most significantly, investigators' post-study prescribing behavior was not related to RGA. Drug development and market forces explain the RGA, but RGA is not related to subsequent sponsor or study drug prescribing.

Adult↗
PubMed2001

Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials.

OBJECTIVES: To comprehensively evaluate clinical predictors of spontaneous acute urinary retention (AUR) across pooled data of placebo-treated patients from clinical trials conducted in men with lower urinary tract symptoms and clinically diagnosed benign prostatic hyperplasia. METHODS: Data from the placebo-treatment groups of several prospective, randomized clinical trials conducted in the United States (n = 3040), Scandinavia, Canada, and worldwide (n = 2295) were combined in the analyses. More than 110 variables were considered individually and in combination as predictors of AUR using logistic regression analysis and classification and regression tree methods with a split-sample approach to cross-validation. RESULTS: The different methods of analysis identified consistent potential predictors of episodes of AUR. When prostate volume was included in the analyses, it was selected as the initial variable discriminating men with and without subsequent AUR. Omitting prostate volume because of its availability in only a subset of men, a logistic model including serum prostate-specific antigen (PSA), urinating more than every 2 hours, symptom problem index, maximum urinary flow rate, and hesitancy of urination had good predictive properties (area under the receiver-operating characteristic curve [AUC] = 0.742 +/- 0.047), as did a model with PSA (AUC = 0.716 +/- 0.045). A classification and regression decision tree with the same variables predicted AUR (AUC = 0.74, sensitivity = 72%, specificity = 67%) as well as did a tree with PSA alone (AUC = 0.70, sensitivity = 75%, specificity = 64%). CONCLUSIONS: Prostate volume and serum PSA are strong predictors of AUR in placebo-treated men with lower urinary tract symptoms and clinically diagnosed benign prostatic hyperplasia who were screened for prostate cancer. From more than 110 variables, logistic models and decision trees with PSA alone were comparable to expanded models that included PSA, urinary frequency and hesitancy, flow rate parameters, and symptom problem index, and to a scoring algorithm.

Algorithms↗
PubMed2000

Comparison of young clinical investigators' accuracy and reproducibility when measuring pulmonary and skin surface nodules using a circumferential measurement versus a standard caliper measurement: American Association for Cancer Research/American Society of Clinical Oncology Clinical Trials Workshop.

PURPOSE: The clinical investigator must understand that errors in measuring tumors can greatly affect such clinical-trial end points as tumor response. We performed a prospective, controlled study of tumor measurements that compared circumferential measurements made with a loop planimeter with linear measurements made with a standard caliper. METHODS: Using a cross-over design, 76 clinical oncology fellows/junior oncology faculty members attending a Methods in Clinical Cancer Research Workshop sponsored by the American Association for Cancer Research and the American Society of Clinical Oncology measured five pulmonary nodule phantoms that ranged in size from 1.76 to 13.21 cm(2) and five surface nodule phantoms with sizes ranging from 2.3 to 12.9 cm(2). To perform these measurements, they used both a loop planimeter and a caliper. Forty-two and 40 participants repeated measurements 3 days later on pulmonary and surface nodules. Accuracy, reproducibility, and time efficiency were evaluated. RESULTS: The linear caliper measurements overestimated pulmonary nodule and surface nodule size by a median of 37% and 23%, respectively. Circumferential loop planimeter measurements overestimated pulmonary nodule size and surface nodule size by a median of 8% and 17%, respectively. Interobserver reproducibility for the planimeter was greater than that for the caliper, as evidenced by thinner measurement interquartile ranges. Furthermore, intraobserver reproducibility was higher for the planimeter, with its variability being only 31.4% and 25.5% as large as that of the caliper when measuring the pulmonary and surface nodules, respectively. CONCLUSION: Circumferential measurements provide better accuracy, reproducibility, and speed in measuring both pulmonary and surface nodules than do perpendicular diameters.

Adult↗
PubMed2002

Clinical evaluation of cervical dentin sensitivity (CDS) in patients attending general dental clinics (GDC) and periodontal specialty clinics (PSC).

AIM: The objective of this study was to compare the prevalence, severity and distribution of CDS in patients attending general dental clinics (GDC) and periodontal specialty clinics (PSC) and to correlate them to possible causal factors. MATERIAL AND METHODS: 2 groups of patients aged 20-60 years recruited from GDC (144) and PSC (151) were evaluated for CDS by means of a questionnaire and intraoral clinical examinations. Furthermore, gingival recession and plaque scores were recorded at the same visit. RESULTS: The results showed that patients referred to PSC had a significantly higher prevalence of CDS (60.3%) than those examined at GDC (42.4%) (p<0.001). Also, mean plaque scores of PSC patients (1.87 +/- 0.88) was found to be significantly higher than that of GDC (1.44 +/- 0.7) (p<0.01). The occurrence and extent of gingival recession associated with hypersensitive teeth was significantly higher in PSC than GDC patients (p<0.01), with a 5% incidence of severe recession (5 mm) in PSC only. The association of periodontal disease and periodontal treatment to the high prevalence of CDS and gingival recession in PSC patients would suggest their role in predisposition to hypersensitivity. The distribution of CDS in tooth types revealed that upper molars and lower anteriors of PSC patients were mainly affected, and followed by, to a lesser extent, lower right canine and right first molars of GDC patients. CONCLUSION: The prevalence of CDS among our periodontal patients appears somewhat lower than that reported in periodontal specialty clinics of earlier studies but still higher than those reported in other dental populations. This indicates that periodontal disease and its treatments may increase the occurrence of hypersensitivity.

Adult↗