Biomedical subjects
D Neuhauser
Publications and source records attributed to D Neuhauser.
Hartree-Fock calculations of atoms and molecular chains in strong magnetic fields.
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Ongoing patient randomization: an innovation in medical care research.
Hospitals often have rotational assignment of patients to one of several similar provider care teams. The research potential of these arrangements has gone unnoticed. By changing to random assignment of patients and physicians to provider care teams (firms) this kind of organization can be used for sequential, randomized clinical trials which are ethical and efficient. The paper describes such arrangements at three different hospitals: Cleveland Metropolitan General Hospital, Brooke Army Medical Center, and University Hospitals of Cleveland. Associated methodologic issues are discussed. This is a new, more widely applicable method for medical care research.
DRGs and elective surgery. What's best for the provider? What's best for the patient?
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Health services research, 1984.
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Closer links between health administration programs and medical schools.
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Money and Medicare: where do we go from here?
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Viewpoint: away with boring meetings.
Here are some new active power tactics for surviving boring meetings. Coping with meetings should be viewed as one of life's exciting and challenging games.
Ethics in hospital and health administration.
Until recently, hospital and health administrators had no formal code of ethics, despite growing ethical dilemmas within the field. This essay defines those ethical issues as set forth in the 1941 Joint ACHA-American Hospital Association Committee's code of ethics. The present ACHA Ethics Committee is also described.
Prophylactic cholecystectomy or expectant management for silent gallstones. A decision analysis to assess survival.
Decision analysis was done to compare the consequences of prophylactic cholecystectomy with expectant management for silent gallstone disease. Probability values were derived from a study of the natural history of silent gallstone disease, published cholecystectomy mortality rates, and life tables. The two strategies were compared by calculating cumulative numbers of person-years lost for hypothetical cohorts of men and women. Prophylactic cholecystectomy slightly decreases survival. A 30-year-old man choosing prophylactic cholecystectomy instead of expectant management would lose, on average, 4 days of life; a 50-year-old man would lose 18 days. Consideration of monetary costs and discounting further disfavors prophylactic cholecystectomy. Sensitivity analysis shows that differences between the two strategies remain small over a broad range of probability values, both for men and women.
A message to physicians.
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DRGs in Jersey.
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Improving the knowledge base for health systems management: the strategy at Case Western Reserve University.
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Does cost information availability reduce physician test usage? A randomized clinical trial with unexpected findings.
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New drug evaluation: cimetidine.
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Improving physician compliance with preventive medicine guidelines.
Similar general medical outpatient clinics with randomly assigned patients were used to evaluate the effectiveness of a program that was to increase house staff compliance with preventive medicine guidelines. Two clinics were designated experimental and two served as controls. In the experimental clinics, age-specific checklists of all recommended preventive procedures (drawn from the Canadian Task Force report on The Periodic Health Examination and American Cancer Society guidelines) were appended to each patient's chart. In addition, house officers were presented with a series of weekly seminars dealing with issues in screening, as well as the specific recommendations included in the checklist. House officers in all four clinics were tested for their knowledge and attitudes toward the preventive program before and after the intervention. Counts of immunizations and mammograms performed and the total populations eligible for these procedures were determined for all four clinics. As predicted, test scores as well as mammography and immunization rates increased significantly (from 2-40 per cent) in the intervention clinics as compared with controls. We conclude that this intervention was clearly effective in the short run. However, follow-up studies will be necessary to determine whether the desired long-term effect has been achieved.