Dispersion models provide a flexible class of non-normal distributions with many potential applications in biostatistics, accommodating a wide range of continuous, discrete and mixed data. Starting with Liang and Zeger's generalized estimating equation method, we review some recent applications of dispersion models in longitudinal data analysis, including state space models based on the Tweedie class of exponential dispersion models. In medical applications the latent process of a state space model may often be interpreted as an unobserved potential morbidity process, which is modelled as a function of time varying covariates. By allowing a multivariate response vector of 'symptoms', the model integrates several response variables of mixed types into a single model. For growth curve models, the latent process reflects the 'true' growth.

Air Pollutants↗

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Utstein registration used as a tool in organisational development.

OBJECTIVE: To evaluate the results of out-of-hospital CPR in a county after seven independent local EMS organisations were merged into one, and to evaluate the use of Utstein registration as a tool in the reorganisation process. MATERIALS AND METHODS: All out-of-hospital cardiac arrests in Ostfold county in which the EMS system was responded to in 1997 were registered according to the Utstein template. The results were reported back to the EMS personnel and presented to the media. RESULTS: Of 163 cardiac arrests of cardiac origin where CPR was attempted, 59% received bystander CPR. 13% were discharged from hospital alive (9.1/100 000 inhabitants), 32% of those with VF/VT. At discharge 18 of 22 patients functioned normally with cerebral performance category 1 and Overall performance category 1. The media had previously been very critical of the decision to centralise the emergency services. There was large media coverage when the results were presented, and criticism virtually disappeared. The registration and presentation appeared to create a feeling of unity among the EMS personnel. CONCLUSIONS: The Utstein registration functioned well as a tool both internally and externally in an EMS reorganisation process.

Cardiopulmonary Resuscitation↗

PubMedDate not supplied

A pharmacoeconomic evaluation of amlodipine usage in patients undergoing PTCA in the US using results from the Coronary Angioplasty Amlodipine Restenosis Study (CAPARES).

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Amlodipine↗