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Biomedical subjects

D Meldrum

Publications and source records attributed to D Meldrum.

9 recordsLinked to original sources
PubMed1989

Confirmation of interrater reliability of the Marley Differential Diagnostic Scoring System for the Bender-Gestalt Test.

The Bender-Gestalt test has been one of the most popular clinical instruments for the past four decades. Much controversy has surrounded the use of this test as a screening instrument for organicity (brain dysfunction). Marley's Differential Diagnostic Scoring System was recently developed to improve the validity of the test for detecting organicity. The original standardization of the system reported very high interrater reliability. To provide an independent assessment of interscorer reliability, three raters were trained in the system and separately rated 40 protocols. Kappa coefficients for the three raters ranged from .94 to .98. Substantial interscorer reliability was obtained, Mdn = 92.5% for specific scores with three scores attaining 100% agreement, although some values were lower. These results suggest that there is a strong empirical basis for the scoring system and encourage further refinement of the scoring system to reflect central nervous system dysfunction.

Adolescent↗
PubMed1980

Outcome of pregnancies complicated by early vaginal bleeding.

Obstetrical and neonatal data were analysed for pregnancy outcome in 259 deliveries complicated by first or second trimester vaginal bleeding. There was a high incidence of low birth weight, low gestational age, perinatal death, asphyxia, breech delivery, placental infarcts and small-for-dates term infants. Fetal anomalies were slightly though not significantly increased. Combined suboptimal pregnancy outcome occurred in 29.7 per cent of these deliveries compared to 15.2 per cent of 25 118 concurrent deliveries without reported early pregnancy bleeding (p less than 0.0001). The combined risk remained approximately doubled even for primigravidae and for women without prior illness or pregnancy complications. The highest combined risk, 61.5 per cent, was for women with at least two prior abortions, premature births or perinatal deaths and no prior term births. These findings suggest that early gestational vaginal bleeding is one predictor of suboptimal pregnancy outcome.

Female↗
PubMed1976

Suboptimal pregnancy outcome among women with prior abortions and premature births.

Data from 25,958 consecutive UCLA deliveries were analyzed to determine the effect of prior abortions and premature births on current pregnancy outcome. Perinatal death rate, combining stillbirths and neonatal deaths, increased more than threefold among women with at least one prior premature in birth and at least one prior abortion and approached 18 per cent of current deliveries when there were three or more prior premature births. Abnormal live births, defined as infants with either birth weight under 2,501 grams, gestational age less than 37 weeks, or congenital anomalies, significantly increased as the number of prior abortions and premature births increased, each in a range of 0 through 3 or more. For example, among women with at least three prior premature births, there were greater than 50 per cent abnormal live births. The risk was mostly that of low birth weight and low gestational age, although there was a slight increase in congenital anomalies. The risk was reduced considerably when there were previous term births and was influenced variably by race, clinic classification, maternal illness, and prior pregnancy complications. This empirical data on pregnancy outcome should be useful in reproductive counseling among women with pregnancy losses and premature births.

Abortion, Spontaneous↗