Search PubMed⌕ Search

Biomedical subjects

C B Mueller

Publications and source records attributed to C B Mueller.

At least 37 records · Page 2Linked to original sources
PubMed1982

Measuring surgical decision-making with hypothetical cases.

Hypothetical clinical cases were used to investigate surgical decision-making in relation to surgical rates across Ontario. Six procedures were studied (cholecystectomy, colectomy, inguinal herniorrhaphy, hysterectomy, cesarean section and tonsillectomy-adenoidectomy), and substantial differences of opinion regarding the choice of surgical or nonsurgical treatment were recorded. The decision to operate, however, was not made more frequently in Ontario counties with high operative rates, and none of the demographic variables studied were correlated with the decision to operate. Other variables that might have affected operative rates were not taken into account. There were also differences of opinion in referral decisions, but generally internists and pediatricians were less likely to refer the hypothetical cases to surgeons than were family physicians.

Cesarean Section↗
PubMed1981

Breast cancer.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMed1981

Use of hypothetical cases to investigate indications for surgery.

Hypothetical case histories were used to investigate judgements to operate or to refer. Six procedures (cholecystectomy, colectomy, inguinal herniorrhaphy, tonsillectomy, cesarean section and hysterectomy) were selected and four cases were developed for each procedure. Control cases were those on which surgeons agreed and test cases were those on which there was disagreement regarding surgical or nonsurgical treatment. The case histories were mailed to 131 surgeons and referring physicians in one Ontario county. Among the 98 respondents 75% indicated that the cases were typical of problems seen in practice. This paper reviews the case histories and results for cholecystectomy and hysterectomy. Two of the cholecystectomy cases were controls with 83% of the surgeons opting for nonsurgical treatment in one and 94% opting for surgery in the other. For hysterectomy there was one control case with 90% agreement among gynecologists to operate; in the three test cases from 25% to 75% of the gynecologists favoured surgery. The combined results of all test cases indicated that younger surgeons were less likely to select operation than older surgeons. No consistent sociodemographic associations with the referral decision could be determined for referring physicians, possibly owing to the small sample size.

Adult↗
PubMed1979

Topical neomycin.

Explore the source record for details and available documents.

Administration, Topical↗
PubMed1978

Some effects of health insurance in Canada--from private enterprise toward public accountability.

Ten years after the introduction of national medical insurance in Canada, it is possible to view the effect of a comprehensive health-insurance program on the relations among physicians, society and government. With costs of health care paid from the public rather than the private purse, provincial efforts to control the cost of hospital and physician services are increasing, and various methods for cost containment are now visible. Since the budget for these expenses is publicly debated it competes for support against other publicly funded programs. The federal/provincial insurance system is evolving as an instrument of reform in the organization of health services and has led to the introduction of legislation that is changing the health-delivery system. A gradual shift in power between various health agencies, physicians, professional organizations and government is occurring.

Canada↗
PubMed1978

Arousal, personality, and assortative mating in marriage: generalizability and cross-cultural factors.

The significant assortative mating for the sensation-seeking motive in (married) American students reported by Farley and Davis was significantly cross validated on American (N = 160) and German (N = 160) samples randomly selected from two comparable cities in the Federal German Republic and the United States. A control condition of age-matched unmarried pairs was included. Spouses were found to have 19% and 29% of sensation-seeking variance in common in the American and German samples, respectively. The later figure is exceptionally high for the literature on assortative mating (exceeding or approximating some of the relationships found for intellectual measures). No significant variance was in common for the unmarried pairs. When a simple and easily measured construct with such wide implications as the sensation-seeking motive can be shown to be so significantly involved in marital partner similarity, then its consequences for successful and unsuccessful marriage should be pursued with vigor. Such a program in research and therapy is recommended and a theoretical model suggested.

Adolescent↗
PubMed1978

Breast cancer in 3,558 women: age as a significant determinant in the rate of dying and causes of death.

The forces of mortality created by cancer of the breast have been examined utilizing data collected during the past 19 years by the Syracuse, N. Y., Upstate Medical Center Cancer Registry on 3,558 women. Except for 15 lost to follow-up, all have been contacted annually through 1974 or until death. Time and cause were recorded for all deaths. In April, 1975, 1,883 remain alive and in the registry and 1,660 women have died. Using life-table analyses and considering deaths due only to breast cancer, mortality rates were calculated for three age groups--21 to 50 years, 51 to 70 years, and 71 to 100 years. Breast cancer expresses its lethality most vigorously in the oldest group. The half-death time (50% mortality rate) for the youngest group was 13 years, for the middle group 8 years, and for the oldest group 5 years. The rate of dying was a function of both age and stage at diagnosis. At 16 to 18 years after diagnosis, deaths due to breast cancer begin to disappear. Eighty-eight percent of the women who died following a diagnosis of cancer of the breast have died of their breast cancer. Age as well as stage at diagnosis are significant determinants on the length of survival and cause of death.

Adult↗
PubMed1978

Bilateral carcinoma of the breast: frequency and mortality.

Of 3558 women with cancer of the breast, 129 were found to have bilateral primary cancers. In approximately one quarter (33) of these women the two cancers developed synchronously; in the remainder (96) the second cancer developed metachronously, more than 6 months after the appearance of the first primary tumour. In two thirds (64) of the women in the latter group the second cancer made its appearance within 4 years after the first was detected. The 15-year survival curve for the 129 patients shows a 50% mortality at approximately 10 years, slightly better than that for the total group of 3558. At the time of our study (April 1975) 70 were alive and 59 were dead; 53 died as a result of their breast cancer and 6 from other causes. Only 3 of the 48 women in whom the first cancer developed before the age of 70 years died of causes other than breast cancer, giving a mortality due to breast cancer of 90%. The clinical stage, the recorded histopathology, the type of operation and the duration of time at risk after the first diagnosis did not differ significantly between those who lived and those who died. The authors conclude that age, stage or type of growth, operative therapy or time at risk do not determine the time of death or alter the 90% certainty that death will be due to carcinoma of the breast.

Adult↗