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Biomedical subjects

D A Rund

Publications and source records attributed to D A Rund.

27 records · Page 2Linked to original sources

Methodology reporting in three acute care journals: replication and reliability.

As the sciences of emergency medicine and acute care medicine develop, it becomes imperative for researchers in these fields to accurately and completely report the methodology of their investigations. It is only through complete reporting that other investigators can critically examine, replicate, or expand on the results of an investigation. The purpose of our study was to compare the completeness of methodology reporting in three acute care journals, Annals of Emergency Medicine, Critical Care Medicine, and Journal of Trauma. Thirty-eight criteria characteristics necessary for the replication of a clinical trial were identified and grouped into ten categories. The categories were experimental design, recruitment and exclusion of subjects, selection of study sample, subject allocation, therapeutic regimen, blindness, outcome criteria, analysis of confounders, withdrawal of subjects, and statistical analysis. All prospective, interventional, controlled trials appearing in these journals from January 1980 to June 1983 were identified. A total of 45 trials were found. Each trial was read independently by two reviewers to determine whether each of the 38 criteria was clearly reported, not clearly reported, or not applicable. Disagreements were resolved by a third reader (adjudicator). The results are reported as the mean proportion of items clearly reported +/- standard deviation: Annals of Emergency Medicine (n = 16), 0.39 +/- 0.10; Journal of Trauma (n = 18), 0.33 +/- 0.14; and Critical Care Medicine (n = 11), 0.32 +/- 0.09. A one-way analysis of variance found no statistically significant difference between journals with respect to these proportions (P = .25).(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Trials as Topic↗

Reporting methodology protocols in three acute care journals.

Our study compared the reporting of methodology protocol details in three acute care journals, Annals of Emergency Medicine, Critical Care Medicine, and Journal of Trauma. Eleven criteria previously reported for evaluation of clinical trials in the medical literature were used. These were eligibility criteria, admission before allocation, random allocation, method of randomization, patients' blindness to treatment, blind assessment of outcome, treatment complications, loss to follow-up, statistical methods, statistical analysis, and power. All prospective, interventional, controlled trials appearing in the journals from January 1980 to June 1983 were identified. A total of 45 trials was found. Each study was read independently by two reviewers to determine whether each of the 11 criteria was reported clearly, reported unclearly, or not applicable. Disagreements were resolved by a third reader (adjudicator). The results are reported as the mean proportion of items clearly reported plus or minus the standard deviation: Annals of Emergency Medicine (n = 16), 0.40 +/- 0.18; Journal of Trauma (n = 18), 0.41 +/- 0.24; Critical Care Medicine (n = 11), 0.35 +/- 0.18. A one-way analysis of variance found no statistically significant difference between journals with respect to these proportions (P = .75). The study reveals that these journals, as judged by these criteria, do not report enough methodologic information to allow assessment of bias-reducing techniques and statistical methodology.

Analysis of Variance↗

Attitudes of the emergency physician toward and diagnostic evaluation of suicide attempters.

The negative attitudes of emergency medical personnel toward suicide attempters are well documented in recent studies. Part of the reason for such negative attitudes may involve the emergency medical professional's lack of knowledge about the variety of psychiatric conditions present in the patient who attempts suicide. Information about such conditions and the emotional reactions certain personalities generate might alter these attitudes. Questioning the patient about the feelings and thoughts experienced during the attempt often provides some of the most helpful data about the patient's psychiatric condition, treatment needs, and prognosis. Proper guidelines and education for the emergency physician should help improve the early management of the suicide attempters.

Allied Health Personnel↗

Alcohol use and psychiatric illness in emergency patients.

Screening for alcoholism and associated psychiatric disorders using preselected research criteria demonstrated an overall prevalence of alcoholism of 20% in 200 emergency department patients. The nighttime prevalence of alcoholism was 29%, while the daytime prevalence was 11%. The psychiatric disorders most frequently associated with alcoholism were primary affective disorder (depression) and antisocial personality. The alcoholics had chief complaints relating to trauma in 63% of the cases, vague neuropsychiatric complaints in 23% of the cases, and complaints directly related to alcohol in 8% of the cases. Screening for alcoholism and associated psychiatric illnesses is important in determining an overall treatment strategy for emergency patients.

Alcohol Drinking↗

Psychiatric illness in a general urban emergency room: daytime versus nighttime population.

Two hundred adults presenting to the emergency room of an urban general hospital were interviewed by a standardized technique to evaluate the existence of a current or previous psychiatric illness. Half of the subjects presented between 8:00 a.m. and 4:00 p.m. (daytime group), and 100 presented between 12:00 a.m. and 8:00 a.m. (nighttime group). In the nighttime population 65% were judged to have current or past psychiatric illnesses. In the daytime population only 36% had current or past psychiatric illnesses. The differences between the 2 populations was highly significant. Fewer than 10% of the 200 patients presented with neuropsychiatric symptoms in their chief complaints.

Adolescent↗