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B Crawford

Publications and source records attributed to B Crawford.

46 records · Page 3Linked to original sources
PubMedDate not supplied

Data collection methods in prospective economic evaluations: how accurate are the results?

OBJECTIVES: Often in economic evaluations a division is made between those studies that have a high level of accuracy versus those that are easily generalized. This interstudy dichotomy is often translated into prospective, randomized controlled trials with high internal validity and observational and modeling studies with a high level of external validity. This article challenges this conventional view and examines intrastudy effects on validity. METHOD: A review and summary of the literature was conducted in order to assess the impact that data collection strategies will have on internal validity. Two scenario models were created in order to gain a preliminary understanding of the magnitude of the problem. RESULTS: Data collection strategies have an impact on the level of internal validity found in an economic evaluation. Comparisons of studies that are prospective in nature is misleading as data collection strategy can lead to different resource and cost estimates even when all other relevant factors are similar. It is possible to shift and improve the level of validity by combining different collection methods. CONCLUSIONS: Instead of viewing internal and external validity as polar opposites, validity should be considered in terms of a continuum within a particular study. The use of proxies to collect resource utilization estimates, the reliance on patient self-reported data, and the method of collecting this type of data all impact the validity of study results. National guidelines for the economic evaluation of agents and devices should consider this issue in more depth, and existing evidence rankings should be adapted to be more appropriate to pharmacoeconomic studies.

Journal Article↗
PubMedDate not supplied

Unique aspects of caring for dying children and their families.

Pediatric hospice has become an important service for children and their families in the past decade. In this article we present unique aspects of StarShine, the hospice of Children's Hospital Medical Center in Cincinnati, Ohio. Length-of-service data demonstrate the need to find innovative ways of encouraging earlier referral to hospice. Several specialized aspects of care, such as long-term bereavement, pet visitation and social services for the family are presented. The initiation of a novel in-home pain management program is described. StarShine has not followed an adult hospice model, and as such, we discuss those unique aspects of dying pediatric patients and suggest specific solutions and interventions designed for children.

Child↗
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Teaching because we care.

Explore the source record for details and available documents.

Hospital Bed Capacity, 100 to 299↗
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The development of the baboon prostate: ultrasound methodology, modelling, and natural history.

In order to evaluate the potential of ultrasound for serial, nontraumatic estimation of prostate size in the hamadryas baboon (Papio hamadryas), we adapted the technique of planimetric ultrasound to study a captive-bred colony of 30 male baboons (median age 8.4 years, range 3.3-17 years) including 4 long-term castrates. Most (19) were studied on another two occasions (at 33-and 43-day intervals) to estimate reproducibility of the prostate size (dimensions, volume) measurement. Prostatic dimensions were measured with a B-mode sector ultrasound using a 7.5-MHz transrectal transducer by planimetry at 2.5-mm steps from base to apex as well as the maximum three dimensions of the prostate. The planimetric volume estimate was reproducible (intraclass coefficient 0.81) with coefficient of variation (CV) of 24.3% for all, and 16.0% for mature, baboons. The prostate dimensions were also reproducible (CVs 7.9-13.4%). Prostate volume estimates based on the general ellipsoidal model were reasonably reproducible (19.9% for all, 12.9% for mature) but were biased in relationship to the planimetric volume (0.57 +/- 0.19, P = 0.004). Using the independent estimates of prostate volume and dimensions, we developed an empirical power-function model of prostate shape based on the generalized ellipsoidal model that was robust and unbiased (-0.07 +/- 0.15, P = 0.64) with respect to the planimetric volume. This model provides a simpler and accurate formula for prostate volume based on its three maximal dimensional measurements. The natural history of prostate growth in the hamadryas baboon was illustrated by sigmoidal correlations with age (ED50 = 6.0 years, plateau ED95 = 8.3 years), body weight (ED50 = 14.6 kg, ED96 = 16.1 kg), and testis volume (ED50 = 7.8 ml, ED95 = 18.4 ml). Between-animal variability among mature baboons was greater for prostate weight (27%) than body weight (10%), raising the possibility that a subgroup of these baboons may develop spontaneous age-related prostatic hyperplasia. These findings suggest that ultrasonic evaluation of prostate size in the hamadryas baboon may constitute a suitable model for spontaneous benign prostatic hyperplasia and for experimental studies of prostate growth, development, and hormonal regulation.

Animals↗