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At least 163 records · Page 9Linked to original sources
PubMed1992

The Jepson Lecture 1991. Clinical databases and surgical research.

Modern science is preoccupied with basic mechanisms at the level of the gene, molecule, atom and fundamental particle. This preoccupation has affected attitudes to medical science. Paradoxically, politicians and Departments of Health are largely concerned with clinical epiphenomena--outcomes, interventions, effectiveness, efficiency--that are often disregarded by medical scientists and viewed without favour by granting bodies. In the surgical sciences, there is renewed interest in clinical research. The small computer and the readily available database with its compatible statistical package have added a new dimension to clinical research. Database design and analysis are as much a part of the surgical investigator's skills as are laboratory techniques. There are simple rules that govern database design. The database should be simple and flexible, but provide an adequate patient profile. Entry should be standardized by precise inclusion criteria and precise definitions. Data input should be numerical whenever possible. The database program should convert simply to a comprehensive statistical program. The clinical database is useful for both observational and investigational studies. Case series, case control studies and cohort studies can all be developed from well maintained databases. In the Department of Surgery at Westmead Hospital, databases have been maintained for 10 years. The hepatobiliary and pancreatic group of databases have led to 34 publications. The liver tumour database has produced 12 studies and nearly 20 papers. The process of development of one study is outlined in detail. The chance observation of an excess incidence of gallstones in patients having regular ultrasound examinations after major abdominal surgery has been confirmed in a case control study.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Protocols↗
PubMed1990

Ageism in undergraduate psychology texts.

A sample of 139 texts written over the past 40 years was analyzed for evidence of ageism (i.e., lack of attention to the psychology of later life and stereotyping of older adults). More recent texts cover the topic more comprehensively than in the past, but this coverage is limited in depth. Although textbook authors appear to be trying to communicate a positive message about aging and older persons, their efforts are compromised by ambivalence in the form of contradictory statements about the nature of the aging process. There is an unfortunate condensation of sources in recent texts, which draw heavily from a small cluster of authorities. Implications of these findings for the larger textbook enterprise are discussed.

Aging↗
PubMed2005

Text detective: a rule-based system for gene annotation in biomedical texts.

BACKGROUND: The identification of mentions of gene or gene products in biomedical texts is a critical step in the development of text mining applications in biosciences. The complexity and ambiguity of gene nomenclature makes this a very difficult task. METHODS: Here we present a novel approach based on a combination of carefully designed rules and several lexicons of biological concepts, implemented in the Text Detective system. Text Detective is able to normalize the results of gene mentions found by offering the appropriate database reference. RESULTS: In BioCreAtIvE evaluation, Text Detective achieved results of 84% precision, 71% recall for task 1A, and 79% precision, 71% recall for mouse genes in task 1B.

Biomedical Research↗
PubMed1984

Evaluation of the TALON Cooperative Acquisitions Program for monographs.

The TALON Cooperative Acquisitions Program for monographs (TALON/CAP) was implemented in 1979 by eleven resource libraries in the South Central Regional Medical Library Program. Each participating library acquired books from selected publishers within a profile covering subject and format. The program was evaluated by comparing interlibrary loan requests, surveying participants, and analyzing cataloging records. The results were that ten of the eleven libraries significantly increased their coverage of assigned publishers, and that academic medical libraries are not all buying the same books, even from major medical publishers. The fifty-six publishers in the program accounted for 60% to 83% of the titles with 1977-80 imprints held by participating libraries. The computer-generated collection analysis reports provide a baseline for future collection management studies.

Books↗
PubMed1993

Implementing the findings of Effective Care in Pregnancy and Childbirth in the United Kingdom.

Effective Care in Pregnancy and Childbirth (ECPC) is a comprehensive analysis of evidence. The findings are only now beginning to influence practice in the United Kingdom several years after its publication. This article assesses the extent to which policy makers and practitioners are prepared to use evidence and proposes ways to implement the ECPC findings. Such efforts would require leadership from the U.K. Department of Health and the commitment of the leaders of professional and consumer bodies to promote perhaps 10 or 12 key findings rather than try to push forward the whole program at once. A coordinated approach would then be needed to influence managers, professionals, and service users, first through informing them of the findings, and then by devising specific approaches, such as the use of opinion leaders, for each group. Finally, changes in practice should be monitored.

Health Education↗
PubMed1992

Epidemiology and biostatistics content in baccalaureate education for community health nursing.

Community health nursing leaders recommend including epidemiology and biostatistics in baccalaureate curricula but do not define essential content. Topic coverage and emphasis vary across schools; students differ in academic achievement and in readiness for an epidemiologic approach to nursing. A review of textbooks showed wide variance in topic presentation. A survey of baccalaureate community health nursing faculty in a southeastern state uncovered a core of epidemiology course work comparable to that in graduate programs. Biostatistical content was sparse, and participatory learning strategies were seldom noted. Definition of essential introductory epidemiology and biostatistics content and greater linkage between knowledge and application is necessary to show their congruence with community health nursing practice, and enable differentiation between the level and scope of learning appropriate for undergraduate and graduate education.

Biometry↗
PubMed1998

Finding and applying evidence during clinical rounds: the "evidence cart".

CONTEXT: Physicians need easy access to evidence for clinical decisions while they care for patients but, to our knowledge, no investigators have assessed use of evidence during rounds with house staff. OBJECTIVE: To determine if it was feasible to find and apply evidence during clinical rounds, using an "evidence cart" that contains multiple sources of evidence and the means for projecting and printing them. DESIGN: Descriptive feasibility study of use of evidence during 1 month (April 1997) and anonymous questionnaire (May 1997). SETTING: General medicine inpatient service. PATIENTS: Medical students, house staff, fellows, and attending consultant. INTERVENTION: Evidence cart that included 2 secondary sources developed by the department (critically appraised topics [CATs] and Redbook), Best Evidence, JAMA Rational Clinical Examination series, the Cochrane Library, MEDLINE, a physical examination textbook, a radiology anatomy textbook, and a Simulscope, which allows several people to listen simultaneously to the same signs on physical examination. MAIN OUTCOME MEASURES: Number of times sources were used, type of sources searched and success of searches, time needed to search, and whether the search affected patient care. RESULTS: The evidence cart was used 98 times, but could not be taken on bedside rounds because of its bulk; hard copies of several sources were taken instead. When the evidence cart was used during team rounds and student rounds, some sources could be accessed quickly enough (10.2-25.4 seconds) to be practical on our service. Of 98 searches, 79 (81%) sought evidence that could affect diagnostic and/or treatment decisions. Seventy-one (90%) of 79 searches regarding patient management were successful, and when assessed from the perspective of the most junior team members responsible for each patient's evaluation and management, 37 (52%) of the 71 successful searches confirmed their current or tentative diagnostic or treatment plans, 18 (25%) led to a new diagnostic skill, an additional test, or a new management decision, and 16 (23%) corrected a previous clinical skill, diagnostic test, or treatment. When the cart was removed, the perceived need for evidence rose sharply, but a search for it was carried out only 12% of the time (5 searches performed out of the 41 times evidence was needed). CONCLUSIONS: Making evidence quickly available to clinicians on a busy medical inpatient service using an evidence cart increased the extent to which evidence was sought and incorporated into patient care decisions.

Evidence-Based Medicine↗
PubMed1987

Faculty evaluations of texts used to teach pharmacy financial management.

The objectives of this survey were to determine which texts were used to teach financial management to pharmacy students, to gather instructors' evaluations of the texts, and to determine which financial management topics were most often covered in pharmacy courses. Data for the study were collected via a mail questionnaire survey sent to a selected pharmacy administration faculty member at each school of pharmacy in the United States and Puerto Rico. A 90 percent response rate was achieved. The results indicated that the most frequently used texts were Effective Pharmacy Management and Principles and Methods of Pharmacy Management. Evaluations of these texts indicated that instructors who used them were, for the most part, satisfied with them. Major points of dissatisfaction were the number and types of problems included. Pharmacy courses covered a wide range of financial management and managerial accounting topics. Bookkeeping topics were much less likely to be covered. None of the available pharmacy texts covered all topics which are usually taught in courses of pharmacy financial management.

Books↗
PubMed2005

A new impact assessment method to evaluate knowledge resources.

RATIONALE: Methods to systematically measure the impact of knowledge resources on health professionals would enhance evaluation of these resources in the real world. OBJECTIVE: To propose a new impact assessment method. BACKGROUND: We demonstrated the feasibility of combining a 4-level scale with Computerized Ecological Momentary Assessment (CEMA) for efficiently measuring the impact of a knowledge resource. METHOD: We critically reviewed the world literature regarding the impact of clinical information-retrieval technology on trainees and doctors, and retained 26 papers for qualitative content analysis. FINDINGS: Of those, 21 use a nominal scale (yes/no), none systematically measures the impact of searches for information outside of a laboratory setting, and none uses an ordinal scale. The literature supports the proposed levels of impact, and suggests a fifth level. CONCLUSION: A new impact assessment method is proposed, which combines a 5-level revised scale and CEMA.

Databases as Topic↗