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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 109 records · Page 6Linked to original sources
PubMed1987

Clinician decisions and computers.

The clinician's decisions are subject to numerous distorting influences. Computer decision aids can help avoid these distortions by placing the clinician's limited personal experience into broader perspective through comparison with a larger repository of clinically relevant information; by making explicit the assumptions implied by his or her decisions; and by alerting the clinician whenever the decisions made do not appear consistent with these assumptions, with the available information or with the conventional rules of logic. Practical standards of performance with respect to the development, validation and clinical application of these decision aids are still in evolution, however, and a variety of ethical and legal issues have yet to be addressed. Despite the promise of computer decision aids, it remains to be seen whether their diffusion into medical practice will improve the quality and cost of health care.

Algorithms↗
PubMed2003

A primer for statistical analysis of clinical trials.

Randomized controlled trials have become the cornerstone of current practice evidence-based medicine. In this article, we present concise descriptions of fundamental statistical concepts and methods frequently used in the analysis of randomized trials. These include descriptive statistics, statistical inferences, techniques for the comparison of means or proportions from two samples, correlation, and regression analysis methods. The uses of these methods are illustrated with a number of practical examples, and the pitfalls of these topics are also briefly discussed. Lastly, some frequently used statistical terms and their meanings are also provided. By the end of the article, the reader should have sufficient knowledge to appreciate the statistical aspects of most clinical trial reports.

Evidence-Based Medicine↗
PubMed2002

Euthanasia in palliative care journals.

With the growth of palliative care services, interest in moral issues also seems to be growing. The controversial issue of euthanasia significantly provokes moral reflection on the care for dying patients. This article presents an analysis of the moral issue of euthanasia as it is discussed by the palliative care community in the professional journals of palliative care. Initially, the analysis will focus on describing the characteristics of the publications about euthanasia and the attitudes expressed in the articles towards this practice. Second, attention will be paid to the description of the uses of the term euthanasia in the various articles and also how frequently such uses occur. Third, the various arguments in support for or against a place for euthanasia in palliative care will be discussed.

Attitude of Health Personnel↗
PubMed1999

Twelve-month outcome of patients with DSM-III-R schizoaffective disorder: comparisons to matched patients with bipolar disorder.

Schizoaffective disorder is a relatively common illness with an uncertain relationship with bipolar disorder. The publication of DSM-III-R in 1987 operationalized the diagnosis of schizoaffective disorder, separating it from psychotic bipolar disorder by the presence of persistent psychosis in the absence of affective symptoms. Since that time, there have been few prospective outcome studies comparing schizoaffective and bipolar disorders. The authors recruited 27 hospitalized patients with schizoaffective disorder and compared their 12-month outcome to 27 sex-, age-, socioeconomic status- and race-matched hospitalized bipolar patients. The schizoaffective patients were significantly less likely to achieve syndromic recovery than the bipolar patients, although neither group achieved high rates of symptomatic or functional recovery. As expected, the schizoaffective patients were more likely to exhibit persistent psychosis, with or without affective symptoms, throughout the follow-up interval. These data provide clinical support of the predictive value of the DSM-III-R criteria for schizoaffective disorder in a naturalistic outcome setting.

Adolescent↗
PubMedDate not supplied

Recognizing the phenomenon of readiness: concept analysis and case study.

The concept of a phenomenon known as readiness will be analyzed. Using the Wilsonian method, the concept is broken down into a practical definition that allows nurses to assess this phenomenon in clinical practice. Nurses in AIDS care work with a patient population whose optimal health is often dependent on the ability to incorporate major lifestyle changes into their daily lives. Nursing interventions that assist patients to incorporate change must be presented to patients at a time when the patient's ability to succeed is optimal. The ability to recognize readiness in patients is essential for nurses providing AIDS care. This article discusses the concept of readiness, which may be necessary before behavior modification can occur. The phenomenon of readiness has application for various changes in behaviors, including adherence to primary prevention strategies.

Decision Making↗
PubMed2004

Effectiveness of an educational program in reducing the incidence of wrong-site tooth extraction.

OBJECTIVES: The aim of the study was to investigate the effectiveness of an educational program on the reduction of the incidence of wrong-site tooth extraction at the outpatient department of a university hospital in Taiwan. STUDY DESIGN: Data collected from cases of wrong-site tooth extraction during 1996 to 1998 were used to develop a specific educational intervention that was implemented from 1999 to 2001. The annual incidence of erroneous extraction was compared between the preintervention and intervention periods. The factors contributing to wrong tooth extraction were also analyzed. RESULTS: The annual incidence rates of erroneous extraction from 1996 to 1998 were 0.026%, 0.025%, and 0.046%, respectively. During the intervention period from 1999 to 2001, wrong-site tooth extraction did not occur at the department. There was a significant difference in the incidence of erroneous extraction between the preintervention and intervention periods (P<.01). Cognitive failure was the most frequent form of active failure responsible for wrong-site tooth extraction, whereas communication and training were found to be major latent factors contributing to these errors. CONCLUSIONS: Our results suggest the effectiveness of an educational program comprising case-based materials, information feedback, and clinical guidelines in reducing the incidence of wrong-site tooth extraction.

Adolescent↗
PubMed2002

Perioperative hemodilution.

Acute normovolemic hemodilution (ANH) entails the removal of blood from a patient either immediately before or shortly after induction of anesthesia and the simultaneous replacement with cell-free fluid, preferably synthetic colloids with a predictable volume effect (6% dextran 60/70, 6% hydroxyethyl starch 200,000 and 130.000, respectively). Hemodilution is part of the concept for avoiding or limiting the use of allogeneic blood and should be considered for patients undergoing elective surgery free of contraindications and presenting with an initial hemoglobin concentration > or = 12 g/dl and an anticipated blood loss of > or = 1500 ml. The efficacy of ANH, judged by the necessity to transfuse homologous blood, depends on the preoperative (initial) hematocrit, the target hematocrit (to which hemodilution is performed), and the preset intra- and postoperative transfusion trigger. In the past data from clinical trials have shown that in healthy subjects a target hematocrit of 20-25% (7.0-8.0 g/dl hemoglobin concentration) is feasible and safe for the patient. The lower the target hemoglobin concentration, the more extensive monitoring is required: intraoperative target hemoglobin concentrations of 5.0 g/dl and less have been tolerated by young surgical patients without adverse effects. The safety as well as efficacy of acute normovolemic hemodilution in terms of reducing homologous blood transfusion requirements have been demonstrated in various clinical studies. ANH therefore is regarded an integral part of programs aimed at reducing the need for homologous blood, and can thus be successfully combined with preoperative autologous blood deposition, intraoperative blood salvage and carefully adjusted surgical techniques.

Contraindications↗