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PubMedDate not supplied

Predicting carcinogenicity with short-term tests: biological models and operational approaches.

This paper illustrates the basic biological models that have had an influence on the development and deployment of short-term assays for carcinogens. A tentative description of such a conceptual framework is provided with the use of methods for the quantitative analysis of information. This picture is contrasted with the results of a series of statistical mathematical analyses carried out on real genotoxicity data bases. The resulting evidence indicates that the biological models derived from basic laboratory research are not adequate or sufficient to interpret the operational performances of short-term assays. Obviously these models are of great importance, but, this observed discrepancy suggests the need for articulated approaches, with particular emphasis on analytical tools able to interpret the complexity of these systems. In particular, the multivariate data analysis methods are indicated as suitable for the description of large and complex bodies of data, and the identification of typologies and regularities. A number of applications of such methods are also presented. The conclusion is that biological models and operational approaches have to interact on the same level. The operational approach should indicate whether the conceptual framework of the experimenter is adequate to describe the experimental situation and possibly point to new relationships and trends, as well as to practical solutions.

Animals↗
PubMed1991

Composing user models through logic analysis.

The evaluation of tutorial strategies, interface designs, and courseware content is an area of active research in the medical education community. Many of the evaluation techniques that have been developed (e.g., program instrumentation), commonly produce data that are difficult to decipher or to interpret effectively. We have explored the use of decision tables to automatically simplify and categorize data for the composition of user models--descriptions of student's learning styles and preferences. An approach to user modeling that is based on decision tables has numerous advantages compared with traditional manual techniques or methods that rely on rule-based expert systems or neural networks. Decision tables provide a mechanism whereby overwhelming quantities of data can be condensed into an easily interpreted and manipulated form. Compared with conventional rule-based expert systems, decision tables are more amenable to modification. Unlike classification systems based on neural networks, the entries in decision tables are readily available for inspection and manipulation. Decision tables, descriptions of observations of behavior, also provide automatic checks for ambiguity in the tracking data.

Decision Making↗
PubMed2002

Priming panic interpretations in children of patients with panic disorder.

Cognitive and psycho-physiological models of panic disorder stress the role of interpretation bias in the maintenance of the disorder. Several studies have reported results consistent with this hypothesis, but it is still unclear whether this bias precedes panic disorder or is a consequence of it. In the present study, we compared the interpretations of ambiguous scenarios of children of individuals with panic disorder, children of individuals with animal phobia, and children of healthy controls. Children were presented with three types of scenarios each including one of the following descriptions: panic-relevant physical sensations, animal-relevant stimuli, and panic-irrelevant physical sensations (i.e., cold symptoms). To test, if children's interpretation bias is affected by priming, we compared their responses to the scenarios before and after watching a panic, a spider phobic, and a cold model. The results revealed that (a) children of panic disordered parents but not of parents with animal phobia and of healthy controls showed a significant increase in anxious interpretations after priming; and (b) this significant increase emerged only after priming through presentation of a panic-relevant model and not after priming through presentation of a phobia-relevant or cold-relevant model. Because the children of panic disordered parents did not have panics themselves, their increase in panic interpretations can be viewed as a vulnerability factor. Longitudinal studies should clarify the role of interpretation style in the etiology of panic disorder.

Adult↗
PubMedDate not supplied

Development of an objective structured clinical examination (OSCE) for physical medicine and rehabilitation residents.

Clinical competency is poorly measured by knowledge-based written examinations. A five-station, four-interstation objective structured clinical examination (OSCE) has been developed in consultation with the National Board of Medical Examiners as a pilot study to standardize assessment methods that serve to evaluate the clinical competency of senior physical medicine and rehabilitation residents. Various stations demonstrating musculoskeletal and neurologic conditions commonly encountered in physiatric practice were included, incorporating the use of standardized patients into the OSCE format. This is a descriptive study of individual stations-evaluated history-taking, physical examination, and communication skills, whereas the interstations measured the residents' ability to write therapy and prosthetic/orthotic prescriptions, as well as interpret x-ray and electrodiagnostic data. The OSCE program development including case background, principal tasks, time allotment, evaluation objectives, performance criteria, therapeutic plan, standardized patients case descriptions, and assessment checklists as well as the training procedure is discussed. Additionally, cost analysis and scheduling issues are reviewed. This information should aid other training programs or consortiums in developing similar clinical evaluation tools.

Clinical Competence↗
PubMed1991

Can meta-analyses be trusted?

The enthusiasm for meta-analyses (or overviews) expressed by their proponents is not always shared by the broader medical community. To encourage constructive debate, we adopt a critical perspective on the conduct and interpretation of meta-analysis. We focus particularly on some of the statistical issues, especially heterogeneity between studies, and also on the extrapolation of meta-analysis findings to clinical practice. We conclude that meta-analysis is not an exact statistical science that provides definitive simple answers to complex clinical problems. It is more appropriately viewed as a valuable objective descriptive technique, which often furnishes clear qualitative conclusions about broad treatment policies, but whose quantitative results have to be interpreted cautiously.

Bias↗
PubMedDate not supplied

Guidelines for interpreting retinal photographs and coding findings in the Submacular Surgery Trials (SST): SST report no. 8.

PURPOSE: To describe the guidelines followed by the Submacular Surgery Trials (SST) Research Group in the interpretation of color fundus photographs and fluorescein angiograms of subfoveal choroidal neovascular lesions evaluated in the SST and to assist ophthalmologists in applying the results of the SST. METHODS: Stereoscopic color fundus photographs and fluorescein angiograms of the study eye and nonstudy eye of 1,015 patients with subfoveal choroidal neovascular lesions secondary to age-related macular degeneration, ocular histoplasmosis syndrome, or idiopathic choroidal neovascularization (CNV) were obtained and graded by certified SST fundus photograph readers at the baseline examination in three randomized clinical trials comparing surgery with observation. Adherence to the inclusion and exclusion criteria and ocular features that might affect visual outcome were documented. Stereoscopic color fundus photography and fluorescein angiography were repeated 1 month after randomization for patients assigned to surgery to provide documentation that surgery was performed and to assess compliance with the surgery protocol. Photographs and fluorescein angiograms of both the study eye and the fellow eye in all patients then were obtained 3 months, 6 months, and 12 months after randomization and then annually up to 48 months. The kappa statistic was used to evaluate interobserver reliability of photograph gradings. RESULTS: Lesion components at baseline included classic CNV, occult CNV, and features contiguous to CNV, including blood, fibrous tissue, hypofluorescence not corresponding to blood, serous detachment of the retinal pigment epithelium, and prior areas of laser photocoagulation. At follow-up, fluorescein leakage from CNV was assessed peripheral to or within the area of the retinal pigment epithelium abnormality after surgery. The lesion at follow-up could include any of the features identified at baseline as well as retinal pigment epithelium abnormalities, such as mottling of the retinal pigment epithelium with a subtle transition to normal retinal pigment epithelium or a very sharply demarcated, markedly hypopigmented area that was easily distinguished from the surrounding retinal pigment epithelium. kappa statistics for interobserver reliability ranged from good (0.47) to excellent (1.00) for features graded at baseline and follow-up. CONCLUSIONS: Although some of the definitions essential to the interpretation of the SST are similar to those used in the Macular Photocoagulation Study and randomized clinical trials of photodynamic therapy with verteporfin, this guideline provides new information regarding lesion components at baseline as well as standardized descriptions of lesions after submacular surgery. These descriptions from the SST assist in understanding what lesions were studied, when additional treatment was considered after surgery, and how anatomical results should be interpreted.

Aged↗
PubMed2001

Ligand-field analysis of an Er(III) complex with a heptadentate tripodal N4O3 ligand.

Polarized absorption and emission spectra of trigonal single crystals of an Er(III) complex coordinated to a heptadentate tripodal ligand are reported at temperatures between 8 and 298 K. The assigned energy levels below the onset of ligand absorption (< 25 000 cm(-1)) are fitted to a parametrized electronic Hamiltonian. The C(3) site symmetry of the Er(III) ion requires eight parameters for a full description of the ligand field within a one-electron operator description. This compound shows unusually large splittings of the multiplets, and the fitted parameters imply that this heptadentate ligand imparts the largest ligand field reported for an Er(III) complex. The ligand field was also interpreted within the angular overlap model (AOM). We derive the AOM matrix to include both sigma and anisotropic pi bonding and show that a useful description of the C(3) ligand field can be made using only five parameters. The success of the AOM description is encouraging for applications on isomorphous complexes within the lanthanide series and in describing the ligand field of low-symmetry complexes with less parameters than in the usual spherical harmonic expansion.

Journal Article↗
PubMed1984

Description of analytical problems arising from elevated serum solids.

There has always been a problem with the collection of data and interpretation of the results obtained from any biological fluid in which the solids content was increased to a great extent. Of these solids, the triglycerides of the lipids may cause a plasma (serum) to vary in appearance from opalescent to milky. This condition of the specimen and the concomitant turbidity upon its addition to reagents creates the well-documented optical aberrations of spectrophotometric measurements. In addition, the lipids, in conjunction with the proteins, can act as diluents when they are elevated, thereby decreasing what might be termed the residual true plasma volume. Thus the water content of an aliquot sampled for a particular analytical procedure is diminished, and by that means a situation is created in which a short sample is drawn. This dilution effect by the solids results in a lowering of the assay values obtained for the measured constituents of such a serum sample. An associated phenomenon of high concentrations of solids, especially proteins, is the increase in viscosity of a specimen, a condition that also causes an error of short sampling when certain peristaltic pumping devices are used. This review considers several aspects of problems encountered when dealing with a number of circumstances that are critical to the measurement of analytes in severely hyperlipemic and/or hyperproteinemic specimens. These include the problems of short sampling; the potential amelioration of the problem by corrective mathematics, extraction of the lipids, or ultracentrifugation of the true plasma from the lipids; the important need to include most analytes into our considerations; the difference in reference base values for the calculation of concentrations of lipids of serum versus other analytes; the concept of the use of ratios when the reference base values differ, numerator analyte from denominator analyte; and the problems of using serum blanks when necessary corrective action for the solids volume is neglected. Thus, in the final analysis, problems with underestimated volumes of samples used for many spectrophotometric determinations are considered here along with the other difficulties encountered when the need to measure analytes in serums with extremely high solids content presents.

Blood Chemical Analysis↗
PubMed1989

Epidemiological criteria for evidence of beneficial or adverse effects of elevated dosages of vitamins.

Criteria for epidemiological evidence of effects of elevated dosages of vitamins are basically the same as those for the evidence of effects of other exposures. Given the unambiguous classifications of both exposure and cases, they comprise strength, significance, specificity, and consistency of the statistical association, plausible time relationship as well as dose-effect relationship and consistency with other evidence. Today, the term epidemiological evidence usually refers to field experience, often to "observational," i.e., non-experimental, evidence. An extreme example for this are the so-called "ecological studies," which are frequently criticized because of their potential for exaggerated interpretations, though they can be very helpful in constructing and supporting hypotheses. For very rare and long-term effects the description and evaluation of individual cases are often combined with attempts of quantification, by relating them to the estimated exposure of the source population. This is subject to numerous sources of errors. If it is difficult to confirm the existence of rare and late effects, as the collection and interpretation of data on the prevention of such effects often present almost insurmountable methodological challenges. However, with correct interpretation and by keeping the quantitative perspective in mind, epidemiological evidence can be extremely helpful in the assessment of the overall importance, i.e., the public health significance, of such effects.

Epidemiologic Methods↗
PubMed1989

[Scientific articles in Ugeskrift for Laeger during a 25-year period. Analysis and interpretation of research results].

During a period of 25 years from 1959 to 1984, no essential alteration in the employment of descriptive statistics was observed in the original articles in the Ugeskrift whereas analytical statistics was employed to an increasing extent. In all of these volumes, defective, incorrect or less suitable employment of statistics could be demonstrated. Common problems were: analyses of materials in which some patients participated once while others participated on several occasions; debatable analyses of data on ranking scales; employment of 2-group tests on several groups; insufficient analysis of cross-over trials; lack of confidence intervals, and circular reasoning.

Denmark↗
PubMed1988

Description and recording physical signs in suspected child sexual abuse.

The identification of child sexual abuse may depend on the accurate interpretation of abnormal physical signs. Therefore, it is necessary to have a consistent vocabulary and a full and accurate record of the findings (Report of the Inquiry into Child Abuse in Cleveland 1987). Our suggestions are intended to promote the development of a standard acceptable to all concerned with these problems.

Child↗
PubMed1985

Studies on the release of drugs from O/W emulsion ointments using the mathematical interpretations. Part 2: Influence of the ointment composition.

The empirical function Q = t/(A + Bt) has been applied to the quantitative description of the release process of salicylic acid from the emulsion ointment as influenced by its composition. The results as compared with those obtained by the use of Higuchi's "exponential" equation confirm the usefulness of the proposed equation, especially for thin ointment layers. It has been shown that there is a satisfactory correlation between the values of parameters 1/A, 1/B and thickness of the ointment layer and its composition. In this manner it is possible to predict the time course of the release process under other conditions.

Chemistry, Pharmaceutical↗
PubMedDate not supplied

Current interpretations of the osseointegrated response: clinical significance.

The so-called concept of osseointegration demands both histomorphometric as well as clinical descriptions and definitions. The understanding of both of these aspects is still evolving and impacts significantly on the ongoing clinical determinants of success. This paper reviews some of the current clinical concerns regarding the clinical evaluation of osseointegrated implants.

Alveolar Bone Loss↗
PubMed1996

MEME-II supports the cooperative management of terminology.

Health care enterprises need enterprise-wide terminologies to compare, reuse and repurpose health care descriptions. But once they are created, these terminologies need to be maintained and enhanced to sustain their utility and that of the descriptions encoded with them. MEME II (Metathesaurus Enhancement and Maintenance Environment, Version II) supports the required activities and enables enterprises to leverage their investment in terminology and descriptions by permitting remote-extra-enterprise-enhancements to terminology to be incorporated locally, and local-intra-enterprise-enhancements to be shared remotely. MEME II represents all changes to terminologies as data, or "actions," that can be interpreted by an "action engine." These actions, or messages, represent semantic "units of work" that can be interpreted by other copies of MEME II. The exchange of update messages increases the likelihood that the comparability of terminology-based health care descriptions can be sustained.

Information Systems↗
PubMedDate not supplied

[Interpretation of the notion "dysplasia/ intraepitelial neoplasia" in the international classification of tumors].

The review of international classification of tumors of digestive tract is presented: that of Padua (1998), Wien (1998, 2002), WHO (2000). Principal definitions are considered, the content of terms "dysplastic" and "neoplasia" is analysed. The attempt to systematize the description of morphological picture of neoplasia (adenoma/dysplasia) of low and high degree and difference of uncertain neoplastic (dysplasia) from true neoplastic changes. Principles of clinical interpretation of biopsies are presented.

Adenoma↗
PubMed1992

An apparently incongruous exposure-response relationship resulting from the use of job description to assess magnetic field exposure.

Empirical data are presented to support the observation that nondifferential misclassification of subjects classified according to an ordinal scale can result in an artifactual nonmonotonic exposure-response curve. This phenomenon can be interpreted erroneously as an indication that an observed relationship is not causal. The occupational exposure of 40 subjects to extremely low-frequency magnetic fields was estimated on the basis of their job description while their "true" exposure was determined by direct dosimetry. A "true" risk was assumed to exist, and estimates of risk that could be obtained through hypothetical case-referent or cohort studies were calculated.

Case-Control Studies↗