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Biomedical subjects

A Ciampi

Publications and source records attributed to A Ciampi.

60 records · Page 4Linked to original sources

Medical conditions and the risk of motor vehicle crashes in men.

OBJECTIVE: To determine whether men aged 45 to 70 years with any medical condition are at an increased risk of involvement as drivers in police-reported motor vehicle crashes. DESIGN: Case-control study. SETTING: Province-wide population-based sampling. PARTICIPANTS: A total of 2504 drivers randomly selected from those involved as a driver in a motor vehicle crash (cases) and 2520 men not involved in a crash (controls) during a 6-month period. DATA COLLECTION: The Societé de l'assurance automobile du Quebec (SAAQ) computerized files provided data on crashes, age, and medical conditions. A mailed questionnaire elicited information on usual mileage and driving conditions. RESULTS: Data from the SAAQ files were obtained for all 5024 drivers. The overall response rate to the mailed survey was 35.5% with no statistically significant differences in the distribution of characteristics between respondents and nonrespondents. There was no increase in crude (odds ratio, 0.99; 95% confidence interval, 0.85-1.17) or age-adjusted risk of crashes for men with a medical condition in the entire sample of subjects (N = 5024). Among respondents to the mailed questionnaire only, men with a medical condition showed no increased crude risk of crashes (odds ratio, 0.99; 95% confidence interval, 0.76-1.27); no difference was observed after adjustment for age, mileage driven, driver behaviors, and sociodemographic characteristics (odds ratio, 0.91; 95% confidence interval, 0.64-1.31). CONCLUSIONS: Unlike previous studies, the risk estimate was derived from a population-based sample of drivers and adjusted for age, mileage driven, driver behaviors, and sociodemographic characteristics in multivariate analyses. The adjusted estimates failed to show an increased risk of motor vehicle crashes for drivers with a medical condition.

Accidents, Traffic↗

Regression analysis of censored survival data with the generalized F family--an alternative to the proportional hazards model.

We show that the generalized F family is a useful tool for regression analysis with censored survival data. We discuss maximum likelihood estimation and give asymptotic procedures for calculating confidence intervals, tests of significance for the parameters, life expectancy, quantiles and survival rates. Survival data on 704 ovarian carcinoma patients serve to demonstrate the utility of the model.

Adult↗

RECPAM: a computer program for recursive partition and amalgamation for censored survival data and other situations frequently occurring in biostatistics. I. Methods and program features.

The methodology of recursive partition and amalgamation in biostatistics is presented and a FORTRAN program for its implementation, RECPAM, is described. RECPAM can be used to obtain classifications of patients according to several criteria commonly occurring in clinical biostatistics: an example is prognostic classification based on survival data. Classes are defined by simple statements, expressed in clinical terms, about predictor variables (e.g. prognostic factors). Special features of RECPAM are: the possibility of implementing a variety of classification criteria, the integration of recursive partition and amalgamation, and the availability of several strategies for constructing classification trees. A simple example to illustrate input and output features is given. The scope and flexibility of RECPAM will be illustrated in greater detail in a subsequent paper.

Algorithms↗

Benign and malignant breast disease: the relationship between women's health status and health values.

The study purpose was to determine whether differences in the weights assigned to various dimensions of health by 90 women in three subgroups (benign breast disease, breast cancer receiving chemotherapy, and breast cancer receiving other therapies) were associated with differences in self-reported health status in these dimensions. Two methods, one direct and the other indirect, were used to elicit values for mobility, depression, and social support. Two different scales also provided self-reports of health status in each of these dimensions. These measures, in conjunction with sociodemographic variables, were used to test for status-value relationships. No statistically significant association between health values and health status was observed. The absence of any detectable association may have been a result of methodologic difficulties in assessing broadly defined dimensions of health. A possible solution would be to use "individualized" dimensions that are uniquely important to the individual, and to take into account such factors as possible influences of past health status and values, and possible gaps between expected health status and health status actually experienced.

Activities of Daily Living↗

Postpartum weight loss and infant feeding.

BACKGROUND: Women are often advised that lactation accelerates loss of the excess weight gained during pregnancy, but the evidence underlying this advice is sparse and conflicting. To help fill this gap, we assessed differences in the rate of postpartum weight loss in the first 9 months postpartum according to method of infant feeding. METHODS: Two hundred thirty-six women attending two public health clinics in Montreal were weighed in one to four routine infant immunization visits up to the 9th postpartum month. After each weighing, we administered a telephone questionnaire assessing the method of infant feeding (predominantly breast-feeding, mixed-feeding, or predominantly bottle-feeding) and potential confounders. Data were analyzed using unbalanced multivariate repeated measures linear regression. RESULTS: Infant feeding was not associated with statistically significant differences in the rate of weight loss. Gestational weight gain, postpartum smoking, and maternal birthplace were important predictors of postpartum weight change. CONCLUSION: Although our results cannot exclude an effect of more exclusive or more prolonged breast-feeding, breast-feeding as commonly practiced does not appear to influence the rate of postpartum weight loss. This information should be useful in counseling new or prospective mothers and in avoiding unrealistic expectations.

Adult↗