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PubMed1999

[Interpretation of pair diagnosis with the Giessen test. An algorithm and a computer program to determine types].

An algorithm is given in order to quantify the similarity of a couple's test profile in the Giessen-Test as concerns that 16 typical test profiles discovered by Brähler and Brähler (1993). The German Giessen-Test is a personality-inventory based on psychoanalysis. The Euklidian distance was chosen as a measuring unit. The identification of that typical test profile to which any couple belongs succeeds very easily, a task which is otherwise only possible with difficulty. However, any allocation is merely for reasons of description, not based on statistical decisions. As a special service, the respective computer programme is placed at everyone's disposal.

Algorithms↗
PubMed1995

Defining quality of perioperative care by statistical process control of adverse outcomes.

BACKGROUND: Through peer review, we separated the contributions of system error and human (anesthesiologist) error to adverse perioperative outcomes. In addition, we monitored the quality of our perioperative care by statistically defining a predictable rate of adverse outcome dependent on the system in which practice occurs and respondent to any special causes for variation. METHODS: Traditional methods of identifying human errors using peer review were expanded to allow identification of system errors in cases involving one or more of the anesthesia clinical indicators recommended in 1992 by the Joint Commission on Accreditation of Healthcare Organizations. Outcome data also were subjected to statistical process control analysis, an industrial method that uses control charts to monitor product quality and variation. RESULTS: Of 13,389 anesthetics, 110 involved one or more clinical indicators of the Joint Commission on Accreditation of Healthcare Organizations. Peer review revealed that 6 of 110 cases involved two separate errors. Of these 116 errors, 9 (7.8%) were human errors and 107 (92.2%) were system errors. Attribute control charts demonstrated all indicators, excepting one (fulminant pulmonary edema), to be in statistical control. CONCLUSIONS: The major determinant of our patient care quality is the system through which services are delivered and not the individual anesthesia care provider. Outcome of anesthesia services and perioperative care is in statistical control and therefore stable. A stable system has a measurable, communicable capability that allows description and prediction of the quality of care we provide on a monthly basis.

Aftercare↗
PubMed2005

On geodetic distance computations in spatial modeling.

Statisticians analyzing spatial data often need to detect and model associations based upon distances on the Earth's surface. Accurate computation of distances are sought for exploratory and interpretation purposes, as well as for developing numerically stable estimation algorithms. When the data come from locations on the spherical Earth, application of Euclidean or planar metrics for computing distances is not straightforward. Yet, planar metrics are desirable because of their easier interpretability, easy availability in software packages, and well-established theoretical properties. While distance computations are indispensable in spatial modeling, their importance and impact upon statistical estimation and prediction have gone largely unaddressed. This article explores the different options in using planar metrics and investigates their impact upon spatial modeling.

Algorithms↗
PubMed2005

Consumers' goals in psychiatric rehabilitation and their concordance with existing services.

The objective of this study was to describe the rehabilitation goals of 165 consumers with serious mental illness who were living in the community and to assess the level of concordance between the consumers' perceived importance of their goals and the services they received to help them meet those goals. A structured interview was used to facilitate the expression of rehabilitation goals by consumers in the psychiatric rehabilitation program of a hospital in Montreal, Canada. The most frequently mentioned rehabilitation goals pertained to improving consumers' financial situation, physical health, cognitive capacities, and symptoms. Among these goals, the level of concordance was highest for services addressing symptoms and lowest for religious or spiritual goals.

Adult↗
PubMed2001

Telemedicine: cost-effective management of high-risk pregnancy.

PURPOSE: To evaluate the cost-effectiveness of telemedicine services in patients diagnosed with preterm labor (PTL). DESIGN: Women hospitalized with a diagnosis of PTL during a 3-year study period were identified within a health maintenance organization. INCLUSION CRITERIA: singleton gestation, stabilized after tocolysis and discharged from the hospital, and participation in the HMO's preterm-birth prevention program. After a PTL diagnosis, telemedicine services (home uterine activity monitoring with daily telephonic nursing contact) were authorized by the payer. The decision to prescribe telemedicine services was made by each patient's individual physician. Two groups of patients were identified: those who received telemedicine services (telemedicine group), and those who received standard care without the adjunctive outpatient service (control group). METHODS: Descriptive and statistical methods were used to compare maternal demographics, pregnancy outcome, antepartum hospitalization, delivery, nursery, and outpatient services. PRINCIPAL FINDINGS: One hundred women were identified: 60 in the telemedicine group and 40 in the control group. Gestational age at diagnosis of PTL was similar at 29.4 +/- 3.8 weeks, telemedicine group vs. 28.0 +/- 7.4 weeks, control group (P = 0.252). The telemedicine group had a significantly later mean gestational age at delivery (38.2 +/- 1.4 vs. 35.3 +/- 3.8), higher mean birth weight (3224 +/- 588 vs. 2554 +/- 911), fewer mean total nursery days (2.4 +/- 1.8 vs. 14.9 +/- 26.4), and less frequent admission to the neonatal intensive care unit (6.7 percent vs. 40 percent) than the control group (all P < 0.005). The total mean cost per pregnancy was $7,225 for the telemedicine group and $21,684 for the control group. This represented average savings of $14,459 per pregnancy using telemedicine services. CONCLUSION: Following an episode of PTL, use of telemedicine services can be a cost-effective tool to improve pregnancy outcome.

Adult↗
PubMed1986

Service consciousness and service knowledge among older Americans.

This article explores statistical relationships between socioeconomic characteristics of elderly persons in a large region of California and their consciousness and knowledge of services available to them. Regression and probit estimation are used to analyze survey data. Service knowledge is a prerequisite to utilization or informal referrals and general consciousness of services increases the probability that older persons will search for services to meet their needs. Education, age, sex, rurality, and minority status are found to be associated with service consciousness and knowledge, although a number of other characteristics have significant associations for at most a few services.

Aged↗
PubMedDate not supplied

Vital signs for your cardiovascular services.

Current trends and "best practice" operating statistics can be vital to the success of today's cardiovascular programs. The findings from a recently published survey entitled, "Trends in Cardiovascular Programs: A National Benchmarking Study", provide the administrator with immediate and current knowledge of best ways to manage cardiovascular services to succeed in a competitive market. Study results provide some interesting and valuable information regarding non-invasive cardiology, cardiac catheterization, and peripheral vascular angiography program administration and provide insight into issues of cost, quality, and cardiovascular program concerns, interests and needs.

Angiography↗
PubMed1977

[Statistical methods in medicine: in instruction, consultancy and research (author's transl)].

This survey covers the use of statistical methods in three areas of medicine: (1) the obligatory instruction of students in statistics, (2) the statistical consulting of clinicians and their candidates for a doctor's degree and (3) the modification and creation of statistical methods by the statisticians in the departments of medical statistics and documentation. Moreover some factors are discussed that reduce the effectiveness of statistical consulting, may it be service, advisory work or collaboration. Other sections of this paper cover the calamity of utilization and evaluation of old clinical records, the avoidance of fallacies and of errors committed by the inappropriate and incorrect application of statistical methods in medicine. Supplementary questions are given as a "first help" in tackling problems in medicine.

Education, Medical, Graduate↗
PubMed1993

Are reminder stickers effective in reducing immunization dropout rates in Addis Ababa, Ethiopia?

A field trial to assess the effectiveness of a reminder sticker in reducing immunization dropout rates was conducted in two districts of Addis Ababa between 14 October 1991 and 31 January 1992. A total of 703 children were entered into the study. The study population was randomly divided into intervention and control groups. The intervention group received a reminder sticker and the control group did not. All other services were identical. A baseline interview documented the socio-demographic and maternal characteristics potentially related to immunization services utilization and revealed no statistically significant differences between the two groups. The dropout rates were 7.3 and 13.3% in the intervention and control groups respectively. This difference is clinically and statistically (P < 0.01) significant. Therefore, it is concluded that the reminder sticker is effective in reducing immunization dropout rates. Further investigations under operational conditions are recommended prior to the routine introduction of stickers into the immunization services.

Costs and Cost Analysis↗