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Biomedical subjects

D A Revicki

Publications and source records attributed to D A Revicki.

At least 109 records · Page 6Linked to original sources
PubMed1986

Relationship between body mass indices and measures of body adiposity.

We examined the relationship between various body mass indices (BMIs), skinfold measures, and laboratory measures of body fat in 474 males aged 20-70 years. Evaluations included height, weight, skinfold thickness, and hydrostatic measurements of adiposity. The weight-height ratio (W/H), Quetelet index (W/H2), Khosla-Lowe index (W/H3), and Benn index (W/HP) were calculated. The correlations among the various BMIs were high, ranging from 0.91 to 0.99, and all were strongly correlated with weight (rs = 0.81 - 0.98), while only W/H2 (r = -.03) and W/HP (r = -.01) were not correlated with height. The W/H2 and W/HP had the strongest correlation with hydrostatic and skinfold measurements, although all the BMIs were significantly correlated with these measurements. Results suggest that the Benn index and the Quetelet index are equally valid estimates of body fat in respect to their relationship with hydrostatic measures.

Adipose Tissue↗
PubMed1986

Diagnosis clusters adapted for ICD-9-CM and ICHPPC-2.

An ad hoc committee of the North American Primary Care Research Group (NAPCRG) was appointed to adapt the diagnosis clusters instrument for use with the International Classification of Diseases (ICD-9-CM) and the International Classification of Health Problems in Primary Care (ICHPPC-2). This article describes the development and testing of the final roster of 110 diagnosis clusters for family physicians. Almost 90 percent of all diagnoses recorded by family physicians in a variety of settings were included in the clusters. The diagnosis clusters can be used in the analysis of large databases and facilitate comparisons between different providers and practices.

Ambulatory Care↗
PubMed1986

Comparison of residency-trained and nonresidency-trained family physicians in North Carolina.

The objective of the present study was to compare the content and medical practice activities of residency-trained (RT) to nonresidency-trained (NRT) family physicians in North Carolina. Interviews and patient ambulatory encounter information were collected from 41 RT physicians and 44 NRT physicians. Significant differences between physicians were found in practice location, number of patient encounters per week, patient age distributions, and rank orders of the ten most frequent diagnosis clusters. The RT physicians tend to work longer hours and see fewer patients, and they are more likely to perform obstetric and pediatric services. Both groups treat a broad range of the patient population, with RT serving more pediatric patients and NRT seeing more geriatric patients.

Family Practice↗
PubMed1985

Occupational stress, social support, and depression.

A model of occupational stress, social support, locus of control, and depression among family physicians was developed. Two hundred and ten family physicians were administered measures of occupational stress, social support, locus of control, and depression. The hypothesized model was evaluated using structural equation models (LISREL). Results indicate that occupational stress exerts a direct effect on depression. This relationship is moderated directly by family social and emotional support and indirectly by the influence of locus of control on family social support. Support from peers was not significantly related to depression. Findings suggest that individuals with a strong sense of personal control also possess beneficial support systems in the presence of stressful situations.

Age Factors↗
PubMed1985

Physician suicide in North Carolina.

Previous research suggests that physicians are two to three times as prone to suicide than the general population. Review of North Carolina death certificates from 1978 to 1982 showed that the physician suicide rate is not substantially different from that of the white male population aged 25 years or older. Old age, divorce, and death of a spouse are associated with the highest suicide rates among physicians. Firearms and drugs are the most common suicidal methods. Depression, substance abuse, and retirement are significantly associated with suicide risk. Physicians need to recognize the existence of increased suicide risk with age and retirement.

Adult↗
PubMed1985

Professional stress among family physicians.

Professional stress syndrome was investigated among residents, academic physicians, and community physicians in family practice. A survey including measures of physician stress, depression, locus of control, family and peer support, and medical practice characteristics was completed by 294 physicians. Univariate analysis of variance procedures were used for all statistical tests. Results revealed a significant positive correlation among perceived stress in medical practice, depression, and external locus of control. Decreased levels of stress were associated with higher scores on indices of family and physician-peer support. Differences in stress patterns between residents, faculty, and community physicians emerged on several critical variables. Residents felt professional duties interfered with family life to a greater extent than did faculty or practitioner colleagues. Community physicians report higher levels of family support, less idealism, and greater sense of personal control. The stress and coping model proposed illustrates how environmental, as well as internal, factors are affected by stress and serve as moderators of the stress response.

Adult↗
PubMed1984

The dependability of medical encounter diagnostic information.

The dependability of medical billing diagnostic information was evaluated using a rating scale developed by Studney and Hakstian. Generalizability theory offers a comprehensive and flexible framework for analyzing problems associated with measures derived from multiple raters. The medical record and billing system diagnostic information from 45 patient encounters were rated according to similarity and value by three physician judges on two occasions. Data were analyzed using a three-way ANOVA design with levels of judges (3), occasions (2), and encounters (45). Examination of variance components and associated generalizability indicated that the judges and occasions factors or the interaction with occasions and other factors contributed little variance. The greatest proportion of variance was attributable to interindividual differences among the encounters and the interaction of judges and encounters. This investigation illustrates the application of a relatively new approach to practical measurement problems, generalizability theory.

Abstracting and Indexing↗
PubMed1984

Use of orally administered diazepam in the reduction of dental anxiety.

A double-blind randomized clinical trial of the effectiveness of orally administered diazepam in reducing dental anxiety was conducted. Forty-one subjects were assigned to a diazepam or placebo group and tested, using the Dental Fear Survey and State-Trait Anxiety Inventory. Diazepam was effective in reducing anxiety scores but not dental fear scores.

Administration, Oral↗
PubMed1983

Professional stress and the practicing family physician.

To investigate the physician stress syndrome among practicing family physicians, we mailed a questionnaire regarding stress, depression, locus of control, social and peer support, and medical practice characteristics to a sample of practicing family physicians. The response rate was 64%. Significant positive correlations were found between perceived stress in medical practice, depression, and external locus of control. Family physicians who reported increased levels of stress also had greater depression and an increased tendency to blame external agents in their environment for personal stress. Decreased levels of perceived stress tended to be associated with higher scores on indices of family and physician-peer support. Family practitioners reported high levels of family and peer support.

Depression↗
PubMed1983

Self-monitoring of blood pressure: a pilot study.

The purpose of this study was to evaluate the applicability of the sensory detection method (SDM) in patient self-monitoring of blood pressure. The SDM involves the use of a blood pressure cuff alone and represents an easy, simple blood pressure recording method. In a sample of 116 ambulatory patients visiting the Eastern Carolina Family Practice Center, only 59 percent of the patients were able to measure their systolic blood pressure, and 54 percent were able to measure diastolic blood pressure. Of those patients who could sense their blood pressure, no significant mean systolic difference between SDM and indirect method (IDM) was detected. Mean diastolic measurements were significantly different. The correlations between IDM and SDM systolic blood pressures and diastolic blood pressures suggested a moderate relationship. Further analysis suggested that education was positively related to ability to accurately measure blood pressure using SDM. No relationship was detected between obesity, age, sex, or ethnicity and ability to measure blood pressure.

Adolescent↗
PubMedDate not supplied

Health-related quality-of-life assessment and planning for the pharmaceutical industry.

Health-related quality of life (HRQL) represents a patient-centered approach to assessing functional status and well-being that integrates the impact of both medical treatment and disease. The pharmaceutical industry is increasingly incorporating HRQL measures into the drug development process as part of a comprehensive outcomes evaluation. HRQL measures can be used to distinguish the effects of competing treatments, demonstrate trade-offs between survival and functional status and well-being, and provide comprehensive information on the effects of treatment on patient outcomes. Two main approaches have been used to measure HRQL: psychometric-based instruments and preference-based instruments. Each approach has advantages and disadvantages for the evaluation of pharmaceuticals, and no one approach can be recommended for all studies. The selection of HRQL measures for clinical trials requires attention to the appropriateness, psychometric characteristics, and practicality of the available instruments. The comprehensive evaluation of pharmaceutical treatments requires measures of HRQL as well as safety and clinical efficacy.

Clinical Trials as Topic↗
PubMedDate not supplied

Recommendations for evaluating the validity of quality of life claims for labeling and promotion.

The pharmaceutical industry, the medical device industry, and national regulatory agencies such as the United States Food and Drug Administration (FDA) are faced with a number of difficult issues related to the development and evaluation of health-related quality of life (HRQL) claims for product labeling and promotion. This paper outlines some of the unique challenges of HRQL research and makes recommendations for assuring that claims are based on the results of rigorous studies designed and conducted according to accepted scientific principles and practices. Standards of evidence for HRQL are discussed in terms of research design and methodology, instrumentation, statistical analysis, and interpretation. Examples are provided to highlight important points. The paper concludes with a brief discussion of future trends in HRQL outcomes evaluation.

Journal Article↗
PubMedDate not supplied

Health-related quality of life outcomes of omeprazole versus ranitidine in poorly responsive symptomatic gastroesophageal reflux disease.

OBJECTIVE: This study evaluated changes in health-related quality of life (HRQL) outcomes of once-daily omeprazole compared with ranitidine for the short-term treatment of patients with poorly responsive symptomatic gastroesophageal reflux disease (GERD). METHODS: A double-blind, randomized clinical trial, compared omeprazole versus ranitidine for the treatment of poorly responsive GERD. Eligible patients had a history of predominant heartburn symptoms with symptomatic heartburn after 6 weeks of ranitidine treatment. Patients were randomized to omeprazole 20 mg once daily (n = 156) or ranitidine 150 mg twice daily (n = 161) and followed for 8 weeks. Assessments were completed at baseline and after 8 weeks with physician-rated symptoms: Gastrointestinal Symptom Rating Scale (GSRS); Psychological General Well-Being (PGWB) Index; Sleep Scale; Impact on Daily Activities Scale, and Overall Treatment Effect. Primary HRQL endpoints were the GSRS reflux scale and PGWB total score. RESULTS: No differences between the 2 treatment groups were observed in baseline demographic, clinical or HRQL measures. After 8 weeks, omeprazole-treated patients had greater improvement in GSRS reflux scale scores (p<0.0001) and PGWB total scores (p = 0. 019) compared with ranitidine-treated patients. Significant between group differences favoring omeprazole were also observed in GSRS total scores (p<0.0001), abdominal pain scale scores (p = 0.003), and indigestion scale scores (p = 0.003), Impact on Daily Activities (p = 0.001), PGWB positive well-being (p = 0.015), anxiety (p = 0. 030), and general health scale scores (p = 0.010). Patient ratings of overall treatment effect demonstrated the significantly (p<0. 0001) greater benefits of omeprazole (mean = 5.26) compared with ranitidine treatment (mean = 3.83). CONCLUSIONS: Omeprazole treatment significantly reduced persistent reflux-related symptoms and normalized psychological well-being compared with ranitidine in poorly responsive symptomatic patients with GERD.

Adult↗
PubMedDate not supplied

Telephone versus in-person clinical and health status assessment interviews in patients with bipolar disorder.

We evaluated the correspondence between in-person- and telephone interview-derived data on affective symptoms, health-related quality of life, disability days, and medication compliance in patients with bipolar disorder. Twenty-eight outpatients with DSM-III-R-documented bipolar disorder were randomly assigned to an initial in-person or telephone interview. An average of 4.0 days later, they were reassessed by the other interview method. Results indicate good to excellent agreement between telephone and in-person interviews on measures of mania (intraclass correlation coefficient (ICC) = 0.92) and depression symptoms (ICC = 0.90), suicide risk (kappa = 0.80), and alcohol use (kappa = 0.61), scores on the Medical Outcomes Study 36-item Short-Form Health Survey (ICCs = 0.66-0.92), and medication compliance (ICCs = 0.50-0.66). Measures of bed disability days (ICC = 0.34) and restricted activity days (ICC = 0.66) showed less agreement. Telephone interviews are feasible and reliable for collecting data on psychiatric and other health-related outcomes in bipolar disorder patients.

Adult↗