Biomedical subjects

C Ohmann

Publications and source records attributed to C Ohmann.

130 records · Page 8Linked to original sources

PubMedDate not supplied

Prognostic scores and design of clinical studies.

Randomized controlled clinical trials are the preferred scientific method and remain the vital bridge between basic science and improvements in health care according to general agreement. However, discussion has revealed various critical issues in the field of intraabdominal infection. Many of these critical points can be dealt with by prognostic scoring systems. In this paper the application areas for scores in clinical trials on intraabdominal infections are presented. These areas cover: assessment of severity of disease, definition of inclusion/exclusion criteria, analysis of comparability, adjustment for noncomparability, definition of end points and comparison of observed versus predicted outcome. The use of scoring systems in defining treatment policies is still experimental.

APACHE↗

PubMedDate not supplied

Upper gastrointestinal tract bleeding: assessing the diagnostic contributions of the history and clinical findings.

Various strategies can be used in the diagnosis of upper gastrointestinal tract bleeding. This study investigates the relevance of anamnestic and clinical findings for the diagnosis of the bleeding source. The authors introduced a computer-aided diagnostic system using Bayes' theorem and compared it with clinicians' predictions using anamnestic and clinical findings only. There was no difference in the overall accuracy rates, but a difference was observed in the diagnostic behaviors of the two "systems." In addition, the discriminatory ability of the computer-aided system, the sharpness of the predictions obtained, and the reliability of the posterior probabilities were analyzed. It is concluded that the clinician and the computer-aided system are not able to discriminate well between the disease categories. Derived classification matrices and probability-based measures show the reasons for the inadequacy of diagnostic information obtainable from the clinical history and physical findings.

Bayes Theorem↗

PubMedDate not supplied

A web-based data collection system for clinical studies using Java.

Data collection in multi-centre controlled clinical trials is a major problem. We describe a web-based documentation system for data collection via the Internet we have developed in Java. It keeps both the platform independent program (a Java applet) and the database on a single server to which the participating centres have access at any time. It is based on a three-tier model where client requests are handled and monitored by an application server (a Java application). We show the advantages such a system has over the HTML/CGI combination which is often used for database access, as well as possible extensions, e.g. connection to a data dictionary. Finally, we discuss the security problems which arise by the use of the Internet for data collection.

Data Collection↗

PubMedDate not supplied

Prognostic indices in peritonitis.

In this review an update concerning the prognostic factors and scoring systems in peritonitis is given. The course of the disease is influenced by the physiological reserve of the patient, the acute severity and the type of the disease, the success of the operation and subsequent management and complications. The Acute Physiology and Chronic Health Evaluation Score (APACHE II) may be used with pre-operative data for the assessment of the severity of the disease or with postoperative data for monitoring. The Mannheim Peritonitis Index (MPI) and the Peritonitis Index Altona are based on pre- and intraoperative data and are also used for severity assessment. Treatment selection with respect to re-operation is supported by the Prognostic Peritonitis Model and the Abdominal Re-operation Predictive Index, covering data from the pre-, intra- and postoperative period. Adequate evaluation data are available for APACHE II and MPI, showing that these instruments are useful for risk assessment, definition of inclusion/exclusion criteria and analysis of comparability in clinical trials. Evaluation of treatment policies and quality assurance can best be performed with APACHE II, monitoring with APACHE II and Multiple Organ Failure scores. Support of individual patient care is still experimental.

APACHE↗