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The Social Security Administration's 10-percent sample file of OASDI beneficiaries.

This is another in a series of technical articles describing Social Security Administration sample files and statistical systems. The focus of this article is the 10-percent sample file that provides program and demographic information on Social Security beneficiaries under the Old-Age, Survivors, and Disability Insurance program. The article explains the contents and availability of the 10-percent sample and presents several statistical tabulations as examples of the wide variety of data that can be developed from the file.

Female

Medical malpractice claims filed by Medicaid and non-Medicaid recipients in Maryland.

Several databases available in Maryland are used to investigate whether Medicaid recipients are more likely than other persons to engage in medical malpractice litigation. All malpractice claims filed during 1985 and 1986 (N = 1037) were updated for outcomes through 1989 and described with regard to the payer status of claimants. The proportion of claims filed by persons enrolled in Medicaid before and/or during the alleged malpractice incident was lower than the proportion of state residents enrolled in Medicaid. In addition, the proportion of obstetric claims filed by Medicaid recipients was identical to their proportion of hospital discharges for obstetric services during the period in which the incidents occurred.

Attitude to Health

[How and when to create a pediatric file for authorization to market a new drug. A proposal of the SNIP clinical group (National Syndicate of Pharmaceutical Industry)].

In order to recommend the pediatric use of a new drug, the registration file should include several types of studies. Existing data on toxicological and pharmacological studies in animal and human have to be thoroughly examined. In addition, the splitting potential of single doses to be adapted to the child should be studied, according to the galenic formula. In all cases, the clinical file should have one pharmacokinetic study on acute intake of one or several doses in the specific age bracket. When the efficacy of a drug has been demonstrated in adults for the same disease, and if the results are extrapolated to children, the file should include one or several open studies designs in order to assess the tolerability. On the contrary, for example when the disease is different in or specific for children, one or several double blind randomized studies against reference treatment are necessary. All those studies should show the therapeutical value of the drug, and should allow precise recommendations for the dosages, depending on the body weight and/or the body surface compatible with the galenic formula.

Child

[Centralization of all medical laboratory data by laser disk filing system].

In recent years, the medical laboratory system is being widely applied. We describe the medical laboratory system of our Saga Medical School Hospital, including the electrocardiogram (ECG) and electroencephalogram (EEG) laser disk data filing systems. The main computer system of FUJITSU M-730/4 (main memory of host computer 13 MB) handles a large amount of data, in the fields of chemistry, hematology, serology, microbiology, blood banking and histology laboratory. All 17 chemistry and hematology automatic analyzers are linked through communication lines to the main computer. The important tasks of this system are data processing, storing of information in the database, data reporting and quality control statistics. This laboratory system is also connected to the total hospital information system of FUJITSU M-760, main memory 48 MB. For pattern recognition, ECG and EEG laser disk data filing systems have been constructed. The main purpose of these filing systems is mass storage of analog data signals in laser disk, computer assisted analysis and data communication. ECG and EEG analog data are converted into digital form by the analog-to-digital converter, and then transmitted over hospital telephone lines to the central computer system for analysis. The computer assisted statements are then sent back to the ECG terminals at the nurse station. As necessary, after the physician reads over the ECG, statements are printed in the final reports. These optical reporting systems are also linked to the total hospital information system. One of the main tasks in the laboratory is the control of the seemingly endless paper work.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Laboratory Information Systems

Differences in reported car weight between fatality and registration data files.

Two national-level data sources are commonly used together to estimate and compare fatality rates by car weight. The weight of each car in a fatal crash is available on the automated files of the National Highway Traffic Safety Administration's Fatal Accident Reporting System; weight is derived by interpreting the Vehicle Identification Number of each car using a computer algorithm developed and maintained by R. L. Polk & Co. Counts of cars in use, by weight, are available on R. L. Polk & Co.'s National Vehicle Population Profile files; weights are coded from information in state vehicle registration files. However, it appears that there are systematic differences in car weight coding that complicate the use of these two sources together for calculating fatality rates (fatalities per registered car). Overall, the registration data appear to describe a car (of a particular make, model, and model year) as about one hundred pounds heavier than that car is described in the fatality data. The effect is to bias the comparison of fatalities per registered vehicle against lighter cars. Failure to consider this difference can lead to very misleading results. For example, the uncorrected data produce an estimate that the number of occupant fatalities per registered minicompact car (those under 1,950 pounds) was five times the rate in the largest cars (those weighing at least 3,950 pounds). Correcting for differences in car weight reporting produces estimates that the fatality rate in minicompact cars was twice that in the largest cars. Differences by car weight remain, but they are much less than would be concluded from the biased comparison.

Accident Prevention

[Study on obturating efficiency of Gutta-percha point as a root canal filler. Difference in results among combinational usages of hand reamers and files].

The last treatment step followings extirpation of pulp from an infected root canal is root canal filling. Before root canal filling is done, however, the canal must be enlarged enough and the infected dentin and debris removed thoroughly from the canal. Furthermore, re-infection from the apical foramen at the apex of the root canal should be prevented. In this study, we examined the root apex sealing ability of gutta-percha points applied by the lateral condensation method and the vertical condensation method, as well as the difference in root canal sealing ability of gutta-percha points when either a hand reamer or file or their combination was used for root canal enlargement. Extracted human upper incisors were used for root canal enlargement. The condition of the root canal wall after enlargement was observed by scanning electron microscope. The fitness between the wall and gutta-percha was determined by observation of replicas filled with gutta-percha. Furthermore, to assess the degree of apex sealing after root canal filling, we immersed the extracted teeth in Indian ink for 1 day, 3 days, 1 week, 2 weeks, or 4 weeks (Indian ink permeation test). The results obtained were as follows: 1. Reamer and K-file could smooth the root canal wall more than H-file by the scratch-up method. And also the instruments used by the rotation method formed a sure apical seat, which resulted in film apex filling. 2. By the observation of gutta-percha point-filled replicas we noted a border line between the apical seat and apical foramen when the lateral condensation method was used, whereas the line was not observed with the vertical condensation method. 3. Between the 2 filling methods there was no difference in the ink permeation by Indian ink permeation test, but high sealing ability was observed in the root canal in which a sure apical seat had been formed.

Gutta-Percha

Instrumentation of the curved root canal using filing or reaming technique--a clinical study of technical complications.

The technical results of two different techniques for instrumentation of root canals were evaluated. The study comprised 520 roots with various degree of curvature treated by supervised dental students using either a reaming of a filing technique. The results indicated that treatment complications were mainly associated with severely curved (greater than or equal to 35 degrees) canals (15-20% of the molars). Instrument breakage and lateral deviation from original canal curvature were more frequent with the reaming technique whereas overfilling and root perforation dominated with the filing technique. Loss in working length occurred with both techniques. It is suggested that the frequency of complications during instrumentation of curved canals might be diminished if files are used for the enlargement of the canal and reamers are used for the final shaping of the apical part.

Adult

Computer simulation of single-file transport.

A stochastic model of single-file transport was developed as the Markov process in continuous time technique. The model was constructed using an EC-1060 computer. Unidirectional fluxes were investigated and populations of channels were correlated with flux fluctuations. The profiles of channel populations were shown to have nonlinear shapes even with the transport of nonelectrolyte (the classical diffusion approach gives linear profiles). The relationship between the paired correlation function F(AB) and the concentration of transported particles was examined. The F(AB) profile was shown to become flattened (or exponential for asymmetrical cases) at high concentrations. The concentration dependence jA/jA0 ratio were analyzed, where jA is a single-file unidirectional flux, jA0 is unidirectional flux for the case of free diffusion. An interesting "stack" phenomenon was observed for abnormal time correlations of single-file fluxes.

Biological Transport

The conversion of claims files to an episode data base: a tool for management and research.

The construction of an episode-of-care file based on utilization data from the insurance claims system of Blue Cross and Blue Shield of North Carolina was undertaken for its subscribers and Medicare beneficiaries, a data base that includes 60% of the hospital days in North Carolina. The conversion was accomplished without interfering with the integrity of the accounting system, and the resulting file provides essential data for management decisions and epidemiological research. Among the uses to which the information in the file can be put are the promotion of ambulatory surgery, the redesign of group insurance benefits by employers, and the support of statewide health planning programs.

Ambulatory Surgical Procedures

[Repair of cranial defects with regenerating bone during transplantation of gamma-irradiated bone filings].

The authors studied in dog experiments the possibility of repairing cranial defects with allografts of bone filings obtained under unsterile conditions, frozen at -70 degrees C, and sterilized by gamma-irradiation in a dose of 3.5 mrad. It was found that though gamma-irradiation reduced the osteogenic inducing property of the bone filings allografts, they nevertheless were capable of inducing bone regeneration in the region of the bone defect. Frozen and gamma-irradiated bone filings can be recommended for cranioplasty.

Adolescent

Microfiling and automatic filing of radiographs.

When advantage is taken of the newest qualities of microfilms and copy films and when using their special developers and developing machines, it seems today that the microfilming of radiographs on 35 mm film is successful. Equipment in the price range of 67 000 DM is available. It includes automated filming and developing, but slipping microfilms onto the punch card jackets is semi-automatic. The advantage of the equipment is its low price, its small size compared to the Delcomat system, and thus its smaller filing space need. Also, the automation of filing is possible with this system. The system seems to be quite suitable for at least creating and maintenance of teaching files.

Finland

A filing system for transparencies.

A system has been developed to facilitate filing of 2 inches X 2 inches Kodachrome slides. This is coordinated with a diagnostic and therapeutic index that allows for easy retrieval. Compact metal filing cabinets are used, eliminating the need for subsequent rearrangement of slides. The system also provides a method for recall of patients. Preoperative photographs are maintained in plastic folders and checked periodically until the postoperative photographs have been taken.

Filing

The ophthalmologist's office: planning and practice. Patient records and filing systems.

Suggestions and examples of the components of patient charts have been offered for the most efficient office system and for the greatest protection of the ophthalmologist against malpractice charges. Emphasis has been placed on the alphabetical system of filing, the need for well-designed filing cabinets, and measures to reduce the incidence of misplacing and losing patient charts.

Filing

A patient and family number assignment and chart filing system for family physicians.

The Department of Family Medicine and Practice at the University of Wisconsin-Madison has devised and implemented an alpha-numeric system of identifying patient records together with a system of chart filing based on a variation of terminal digit filing. The system provides each patient with a unique identification number. This permanently assigned number is used as part of the medical record (chart) information, as the basis for assigning an account number, as the basis for determining the storage location of the chart in the record room, and as the basis for a family identification number. The number defines the patient's sex and position within the family, and its permanency ensures a capability for conducting both short- and long-term ambulatory care research in the family context.

Color

Students evaluate MEDFILE, a preprinted medical literature filing system.

Medical professionals are highly dependent on personal libraries and reprint files as their sources for current information. A large population of practising doctors have poorly organized medical literature data bases in their professional environment. To expedite the development of a personal library data base by medical students, we created MEDFILE, a preprinted, cross-indexed file folder system for organizing the medical literature. This paper reports the results of two surveys performed in connection with the distribution of the MEDFILE system. One hundred per cent of the students who used MEDFILE found the system to be beneficial. Ninety-seven per cent felt their ability to find their personal literature improved by using MEDFILE, and 65% felt MEDFILE improved their clinical preparation. Of all surveyed recipients of the system, 96.8% felt MEDFILE would be useful in their future studies.

Attitude of Health Personnel

Microcomputers in surgery: a data file and analysis program.

A microcomputer based patient data file and analysis system is both feasible and useful. One such system is described in this paper. The advantages and disadvantages of the system are discussed. It may be used in many patient-related specialties and will enable practitioners not only to file their data but more importantly to analyse it so that they can improve their performance and cost-effectiveness. It is the author's belief that few realize the potential of the microcomputer in clinical practice and many are put off computing and computerized recording and data analysis because of the size and the difficulties that most experience with larger minicomputer-based facilities.

Colonoscopy

Indexing and filing of pathological illustrations.

An inexpensive feature card retrieval system has been combined with the Systematised Nomenclature of Pathology (SNOP) to provide simple but efficient means of indexing and filing 2 in. x 2 in. transparencies within a department of pathology. Using this system 2400 transparencies and the associated index cards can be conveniently stored in one drawer of a standard filing cabinet.

Abstracting and Indexing