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PubMed1993

Predictors of home radon testing and implications for testing promotion programs.

Four data sets (total N = 3,329) are examined to identify the predictors of home radon testing. The data, interpreted in terms of a stage model of radon testing behavior, reveal that the variables predicting transitions between stages change as people move from one stage to the next. Thinking about radon testing (vs. never having even considered testing) is best predicted by general radon knowledge and by knowing other people who are concerned or have tested. Once contemplating testing, the decision to test is most closely related to the perceived likelihood of a home radon problem. Finally, there are few differences between people who say they have decided to test and those who have already tested. Instead situational factors--including difficulties in locating and choosing among test kits--appear to constitute the final barrier to testing. The ways in which these findings might assist the design of radon outreach programs are discussed, and specific outreach recommendations are advanced.

Cost-Benefit Analysis↗
PubMedDate not supplied

Diagnostic efficiency of home pregnancy test kits. A meta-analysis.

OBJECTIVE: To assess the diagnostic efficiency of home pregnancy test (HPT) kits. DATA SOURCES: A literature search of English-language studies was performed with MEDLINE and a review of bibliographies. STUDY SELECTION: Studies were included if HPT kits were compared with a criterion standard (laboratory testing), if they used appropriate controls, and if data were available to determine sensitivity and specificity. DATA EXTRACTION: Two investigators independently extracted data, and disagreement was resolved by consensus. Sensitivity, specificity, and an effectiveness score (a measure of the discriminatory power of the test, with higher scores implying greater effectiveness) were calculated. DATA SYNTHESIS: Five studies evaluating 16 HPT kits met the inclusion criteria. The range of sensitivities for HPT kits was 0.52 to 1.0. In studies where urine samples obtained by the investigators were tested by volunteers, sensitivity was 0.91 (95% confidence interval [CI], 0.84-0.96). However, the sensitivity was less in studies where subjects were actual patients who performed the test on their own urine samples (sensitivity, 0.75 [95% CI, 0.64-0.85]). The test effectiveness score was 2.75 (95% CI, 2.3-3.2) for studies where subjects were volunteers but deteriorated to 0.82 (95% CI, 0.4-1.2) for studies with actual patients. CONCLUSIONS: The diagnostic efficiency of HPT kits is greatly affected by characteristics of the users. Despite the popularity of these kits, the relatively low effectiveness scores of these kits when used by actual patients are of concern. We suggest that manufacturers of HPT kits publish results of trials in actual patients before marketing them to the general public.

Female↗
PubMed1993

A new approach to the interpretation of Canadian Home Fitness Test scores.

A modification of the Astrand (1960) nomogram procedure was applied to Canadian Home Fitness Test data obtained on 13,258 subjects, ages 15 to 69 years, during the 1981 Canada Fitness Survey. Norms were developed to allow an empirical five-level categorization of aerobic fitness, based on the attained rate of stepping and the recovery pulse count 5 to 15 s following exercise. Because of uncertainties regarding the net mechanical efficiency of stepping and the selective recruitment of fit older subjects, the apparent rate of aerobic fitness decrease with aging was no more than half of that seen in laboratory measurements, and the sex differential at any given age (about 25%) was larger than expected. The new approach thus does not claim a high level of accuracy for the predicted peak MET values. Nevertheless, it has an inherent advantage over the equation of Jetté et al. (1976) in that it takes more direct account of variations in pulse count when categorizing fitness. Moreover, there is no artificial ceiling that limits scores for very fit subjects. Tests are now needed to assess the accuracy of the proposed fitness categorizations relative to laboratory determinations of maximal oxygen intake.

Adolescent↗
PubMed1986

Self-prediction of ovulation using a urinary luteinizing hormone test.

An accurate home test for prediction of ovulation can be useful in the treatment of infertility. An enzyme immunoassay for luteinizing hormone determination was compared with other ovulation-monitoring methods. The accuracy and convenience of this method suggest that such a test merits consideration for many infertility applications.

Body Temperature↗
PubMed1998

Quantitative study of Stewart-Holmes test.

Stewart-Homes test (SHT) is an ordinary neurological test performed for the diagnosis for cerebellar disease. We developed a quantitative method based on SHT carried out on the upper limb. Nineteen cerebellar patients and fifteen volunteer healthy subjects were tested. During the test, acceleration of forearm and two associated surface EMGs over biceps and triceps brachialis were recorded and analyzed. (1) Acceleration curve showed an oscillating pattern with flexion and extension over the elbow in both groups, but in cerebellar patient group, the acceleration oscillation wave was more pronounced and latencies of peak acceleration were significantly longer. (2) Correspondingly, the EMGs timing parameters were also different between the two groups: in patient group, ceasing isometric biceps contraction was delayed; rebound EMGs bursts over both biceps and triceps were prolonged. (3) Modelization of the oscillation of acceleration curve with dampened oscillation model showed that in patient group the oscillating amplitude attenuated much more slowly than in control group. A standard curve was established for detecting the acceleration profile abnormalities of SHT in cerebellar patients.

Adult↗
PubMedDate not supplied

[Value of additional qualifying tests for home oxygen therapy in patients with chronic obstructive diseases and moderate hypoxemia].

A value of pulmonary artery catheterization, exercise test and blood oxygenation at sleep was assessed. Such tests are considered as the additional possibility for classifying the patients with chronic obstructive disease, with moderate hypoxia, to the treatment with oxygen at home. Hemodynamic tests have shown pulmonary hypertension in 73% of patients. Clinical evaluation of the cor pulmonale seemed satisfactory. A decrease in arterial blood oxygenation during exercise below 88%, being a border value classifying to the treatment with oxygen at home, was found in 82% of patients. Marked decrease in blood oxygenation at sleep has been characteristic feature of all patients. Exercise test and oximetry at night may also valuable for classifying the patients to the treatment with oxygen under home conditions.

Aged↗
PubMed1990

Effects of seizures on learning, memory, and behavior in the genetically epilepsy-prone rat.

To determine whether frequent seizures can cause deficits in learning and behavior, immature genetically epilepsy-prone rats (GEPRs) were subjected to 66 audiogenic stimulations (Group 1). GEPR littermates were handled and placed in the sound chamber but were not stimulated (Group 2). Group 3 comprised genetically epilepsy-resistant rats (GERRs) who received audiogenic stimulations but had no seizures. After 3 weeks of stimulations the rats were tested for learning, memory, and behavior using the T-maze, water maze, open field activity test, home cage intruder test, and handling test. When compared with the control GEPRs and GERRs, Group 1 rats reached criteria less frequently in the T-maze, required longer times to find the platform in the water maze, and were less active in the open field activity test, less aggressive in the home cage intruder test, and more irritable and aggressive in the handling test. This study demonstrates that frequent, brief seizures in immature animals result in significant detrimental changes in learning, memory, activity level, and behavior.

Acoustic Stimulation↗
PubMed2002

The regulation of home diagnostic tests for genetic disorders: can the FDA deny a premarket application on the basis of the device's social impacts?

This article discusses the Food and Drug Administration (FDA) authority to regulate home use diagnostics for genetic disorders based on the social effects of the devices in the premarket approval process (PMA). It begins with a discussion of the potential social impacts of home use genetic diagnostics, focusing particularly on the psychological effects of the devices. The article then discusses the FDA's past experience in regulating home use diagnostics for HIV and for drugs of abuse testing under its PMA authority. In approving PMA applications for home tests for HIV and drugs of abuse, the FDA has considered various social effects of the devices and tailored its approval to these considerations. However, the agency did not deny approval because of social considerations. The author argues that the FDA's past experience in approving PMA applications indicates both a willingness to consider social considerations in the PMA process and that the agency may deny a PMA application based on social considerations in appropriate circumstances. The author also argues that the FDA may deny application if the social impacts and other health risks of the device greatly outweigh the therapeutic benefits of the device. For example, in applications involving late onset genetic disorders for which no therapeutic options currently exist, the social risks of the device may be found to outweigh the benefits to health and therefore the FDA may deny a PMA application in these situations.

Device Approval↗
PubMed1979

A comparison between predicted VO2 max from the Astrand procedure and the Canadian Home Fitness Test.

The purpose of this study was to compare the predicted maximal oxygen concumption derived from the Canadian Home Fitness Test (CHFT) and the Astrand ergometer test to the observed VO2 max determined from a progressive multi-stage treadmill test. Sixty-four sedentary subjects (35 males and 29 females) ranging in age from 20 to 54 years participated in the study. The mean VO2 max measured on the treadmill for males and females was 34.6 +/- 6.0 ml/kg/min while the Astrand procedure predicted a mean VO2max of 29.6 +/- 6.5 ml/kg/min and the CHFT predicted a mean VO2 max of 34.8 +/- 5.0 ml/kg/min. Statistical analysis revealed a significant under-prediction (P less than 0.001) of the VO2 predicted by the Astrand test to the VO2 max derived from the treadmill test while there were no differences between the treadmill VO2max and that predicted by the CHFT. When the male and female values were analyzed separately, the same results were seen in the males. For the females, however, there were no significant differences among predicted and observed values. It concluded that the CHFT provided an adequate prediction of cardio-respiratory fitness as well as, if not superior to, the Astrand procedure.

Adult↗
PubMedDate not supplied

Behavioral effects of kainic acid administration on the immature brain.

Prepubescent male rats with an amygdaloid electrode in place were administered kainic acid (KA) intraperitoneally (i.p.) while controls received phosphate-buffered saline (PBS). All KA-treated animals developed status epilepticus with bilateral forelimb clonus and ictal discharges on the EEG. The rats were then tested as adults for learning, memory, emotionality, social interaction, and activity level using the T maze, water maze, handling test, home cage intruder test, and open field test. KA-treated rats learned at a slower rate in the water maze and T maze than the controls. In addition, KA-treated rats had evidence of impaired memory during spatial bias testing in the water maze. In the home cage intruder test, KA-treated animals were more submissive and less aggressive than control animals. Finally, KA-treated animals were significantly more active than control animals in the open field test. This study demonstrates that KA administration to the immature brain, in a convulsant dose, results in permanent changes in behavior, learning, and memory.

Age Factors↗
PubMed2004

Accuracy of home pregnancy tests at the time of missed menses.

OBJECTIVE: The purpose of this study was to investigate the validity of home pregnancy tests (HPTs) around the time of the missed menses. STUDY DESIGN: Levels of human chorionic gonadotropin (hCG) were determined in urine around the time of the missed menses, and 5th and 95th centiles were calculated. In a blind study evaluating 18 brands of HPTs, each was tested six times with five concentrations of hCG, 0 to 100 mIU/mL. Sensitivity was defined as the concentration at which six of six brands gave positive results, at the suggested reading time or at an extended time. RESULTS: It was estimated that a sensitivity of 12.5 mIU/mL was needed to detect 95% of pregnancies at the time of missing menses. Only 1 of 18 HPTs had this sensitivity. If faintly discernible results considered, 2 of 18 brands gave false-positive or invalid results. Clear positive results were given by only 44% of the brands at 100 mIU/mL hCG. If one accepted faintly discernible and extended reading times, all brands responded at 100 mIU/mL. A test with 100 mIU/mL sensitivity would detect approximately 16% of pregnancies at the time of missed menses. CONCLUSION: The utility of HPTs is questioned. Clinicians need to be aware of the limitations of current HPT brands.

Chorionic Gonadotropin↗
PubMed2005

Estimation of blood glucose levels by people with diabetes: a cross-sectional study.

BACKGROUND: Recommendations suggest that all patients with diabetes who use insulin should home test their blood glucose. Recommendations for those not using insulin remain contradictory. These recommendations are in part based upon the assumption that people with diabetes cannot make an accurate estimate. AIM: To explore whether people with diabetes can accurately estimate their blood glucose levels and to assess which factors explain variability in these estimates. DESIGN: A cross-sectional design. SETTING: One general practice in Oxfordshire, UK. PARTICIPANTS: One hundred and fifteen consecutive patients with diabetes attending a diabetic clinic were invited to estimate their blood glucose level prior to having it routinely measured. RESULTS: One hundred and four patients made estimates. Of these, 45 (43.3%) underestimated their blood glucose, 18 (17.3%) overestimated, and 41 (39.4%) made guesses that fell into the range defined as accurate. Of those not using insulin (n = 85), 37 (43.5%) underestimated their blood glucose, 12 (14%) overestimated and 36 (42.3%) were accurate. Accuracy in the non-insulin users was associated with home testing, lower blood glucose levels, coming to the clinic in a fasting state, and reporting no symptoms when they felt that their blood glucose level was high. Overestimation was associated with having co-occurring illnesses and experiencing no symptoms when their blood glucose was low. CONCLUSION: The majority of patients with diabetes in this study could not accurately estimate their blood glucose levels indicating that home testing may be a necessary part of diabetes self care. Home testing may also function as a form of biofeedback to facilitate an improved ability to estimate blood glucose levels.

Adult↗
PubMed1998

Do elderly people score better on cognitive tests at home?

OBJECTIVE: To determine whether Mini-Mental State Examination (MMSE) scores of elderly family medicine patients are different when the test is administered at home rather than at the clinic. DESIGN: Cross-sectional comparison study. SETTING: University family practice unit in an urban area. PARTICIPANTS: A convenience sample of family practice clinic patients 70 years or older were referred to the study in the sequence seen at the clinic. Of 171 patients approached in person or by telephone, 77 agreed to participate. METHOD: The MMSE was administered at home and at the clinic on the same day for all subjects. Testing site order was randomized across patients. MAIN FINDINGS: Of the 77 patients who agreed to be subjects, only 13 (16.9%) had low MMSE scores (< or = 24). Five (41.7%) of these had normal scores (> 24) at home, but low scores in the clinic. Subjects had significantly higher scores on MMSEs administered at home (P < .01) on the same day. CONCLUSIONS: Previous research has shown patients achieve higher MMSE scores at home; this study demonstrated it in a representative family medicine population. Primary care physicians should be cautious about classifying elderly patients as possibly cognitively impaired based on clinic testing alone. Testing at home could avoid many unnecessary referrals to specialist services for further assessment and diagnostic tests that use up precious health care resources.

Aged↗
PubMed1982

Demonstration of a training response by the Canadian home fitness test.

The relative merits of the Astrand nomogram and the CHFT formula for prediction of maximum oxygen intake (VO2max) have been tested in 35 men and women during performance of the advanced version of the Canadian Home Fitness Test in a laboratory setting. Prior to training, systematic errors relative to direct treadmill measurements of maximum oxygen intake were Astrand-10.1% (male) and-1.4% (female), and CHFT 5.6% (male), and 2.2% (female), the error of the Astrand procedure being statistically significant for the men. Training was effected by a walk/jog prescription or rope-skipping and calisthenics. Following training, data analysis indicated that the CHFT prediction formula distinguished quite well between the behaviour of experimental and control subjects. The Astrand procedure showed a greater increment in VO2(max) than the CHFT formula for the experimental subjects (significantly so in the women), but it also predicted a large and spurious change in many of the controls, so that in the men responses did not differ between trained and control subjects. Further comparisons suggested that the CHFT procedure gave a closer approximation to direct treadmill estimates of training response than did the Astrand nomogram.

Adult↗
PubMed2000

Utility of near patient testing and home care analysis using a portable critical care analyser.

OBJECTIVE: This study was conducted in order to determine the usefulness of the application of home patient care using a portable critical care analyser (OPTI-C) after the precision of the OPTI-C was examined. METHODOLOGY: The OPTI-C, which measures sodium (Na+) and potassium (K+) as well as pH, PCO2 and PO2 in whole blood, was used. In order to confirm the linearity of the OPTI-C, analysis using reference materials was performed (n=81). Correlation testing with whole blood samples from patients was also performed using other analysers in the laboratory (n=108). Home patient testing was performed with 15 patients. RESULTS: The slope linearity and correlation coefficients were as follows: pH, 1.0174+/-0.0091, 0.99972; PCO2, 0.9681+/-0.0094, 0.99967; PO2, 0.9844+/-0.0085, 0.99974; NaST, 0.9788+/-0.0115, 0.99911 and KST 0.9964+/-0.0128, 0.99893. The equivalent results from other analysers showed pH, 1.071+/-0.009, 0.9963; PCO2 0.985+/-0.016, 0.9870; PO2 0.989+/-0.007, 0.9976; Na+, 1.075+/-0.278, 0.9662 and K+ 1.120+/-0.020, 0.9842. The correlation coefficients and P values were as follows: pH, 0.9790, P>0.1; PCO2, 0.9990, P>0.1; PO2, 0.9980, P>0.1; Na+, 0.9438, P>0.05, and K+, 0.9174, P>0.1. CONCLUSION: The use of portable critical care analysers for near patient testing for home-care patients is recommended in order to increase the efficiency of visits as well as to improve the quality of patient care.

Adult↗
PubMed1997

The use of a simple home flow test as a quality indicator for male patients treated for lower urinary tract symptoms suggestive of bladder outlet obstruction.

OBJECTIVE: To evaluate the performance of a simple home flow test (HFT) in the examination and follow-up of patients suffering from lower urinary tract symptoms suggestive of bladder outlet obstruction. METHODS: One hundred seventy-two patients who were treated with either transurethral resection of the prostate or transurethral microwave therapy were included. Symptom evaluation, HFT and uroflowmetry were done before and 3 months following treatment. The patients' opinions about the need for further therapy and the effect of therapy were categorised at the follow-up. RESULTS: The HFT correlated strongly with the maximum flow rate (Qmax) both before and after therapy and it was better correlated to the symptoms of the patients and to the subjective effect of therapy compared to the Qmax. CONCLUSION: HFT is a cost-saving diagnostic technique for the classification of urinary flow and should be useful as a quality indicator in large-scale health care management programs.

Follow-Up Studies↗
PubMed1989

[Urine glucose testing in children with diabetes mellitus--obsolete as a daily control measure?].

Sixty-four children with type 1 diabetes (33 girls and 31 boys with a mean age of 11 1/4 years) were studied in order to ascertain whether urine sugar measurements performed by the patients or their parents can provide adequate monitoring of treatment. The results of two home-testing methods for urine glucose were compared with subsequent glucose dehydrogenase assays in the laboratory. Over the range from 0 to 5 g/dl the results of home testing disagreed with the laboratory checks by an average of one concentration grade, and displayed wide scatter. Only in the concentration range of 0.5 g/dl were there differences between the nonspecific reduction test (Clinitest) and the specific enzymatic assay. Glucose concentrations in urine specimens passed at 7 am, 12 noon and 6 pm (home testing) were compared with blood glucose concentrations checked at the same times. Correlation was not very close (correlation coefficients between 0.3 and 0.64). Correlation between pooled urine collections and 24 hour blood sugar profiles was equally poor (0.5-0.6). The author concludes that urine sugar testing is unsatisfactory for home monitoring of children with diabetes and the results are inadequate for diagnostic or therapeutic purposes.

Child↗