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Biomedical subjects

F B Quinn

Publications and source records attributed to F B Quinn.

33 records · Page 2Linked to original sources

Statistical techniques reported in pathology journals during 1983-1985. Implications for pathology educators.

The increasingly scientific basis of medicine challenges pathology educators to incorporate quantitative skills into a very compressed curriculum. One strategy is to focus training on the statistical techniques pathologists will most commonly encounter in their literature. We identified the reporting of statistical techniques in nearly 5200 original articles published during 1983-1985 in 16 journals important to pathology. Our results suggest that a reader familiar with 12 fundamental statistical concepts can evaluate knowledgeably over 95% of the quantitative findings reported in these journals. With the exception of survival analysis and pharmacologic modeling, these techniques are typically encountered in many introductory statistical texts. In numerous articles, failure to identify the statistical methodology used made it impossible to identify the analytic procedures used and, hence, judge the scientific validity of results.

Curriculum↗

Acoustic neurinoma diagnostic model evaluation using decision support systems.

Three acoustic neurinoma (hereafter called acoustic neuroma) diagnostic models (Jenkins, Le Liever, Kaseff) were implemented as rule-based decision support systems and evaluated from the perspective of sensitivity, specificity, and US dollar cost, using a data base of 95 case histories suggestive of acoustic neuroma. The specificities of the models were equivalent (.97). The Jenkins model had the highest sensitivity (.96) and the highest average cost ($1470.99). The sensitivities and average costs of the Le Liever and Kaseff models were comparable (.84 vs. .82, and $1092.38 vs $1114.17, respectively). We observed that omitting brain-stem evoked response and electronystagmography testing from the Le Liever model subjected four (4.2%) more patients without acoustic neuroma to air contrast computed tomography, increased sensitivity to .89, and decreased the average cost to $774.75, without affecting specificity. We discuss the reasons for the slightly improved sensitivity and the impact of decision support systems on the clinician.

Decision Making↗

Management of invasive frontoethmoidal sinus mucoceles.

Invasive frontoethmoidal sinus mucoceles extending into the anterior cranial fossa or orbits are difficult to manage and can lead to lethal complications. In the past four years, nine cases of frontoethmoidal mucoceles were treated at the University of Texas Medical Branch, Galveston. Five cases were complicated by anterior cranial fossa invasion, orbital invasion, or both. The choice of surgical procedures used to manage these cases depended on mucocele extent and location, which were best determined by computed tomography. Two cases required craniotomy, one of which required an inferior-based pericranial flap for reconstruction of the floor of the anterior cranial fossa. Two cases were managed by osteoplastic flap and fat obliteration procedures. Intranasal drainage was the procedure used in one case that had extensive orbital involvement. Surgical complications included an intracranial abscess in one patient and a cerebrospinal fluid leak in a second patient.

Adult↗

Tumor responsiveness of squamous cell carcinoma to cisplatin.

The addition of chemotherapy to planned multiple modality treatment of patients with advanced head and neck squamous cell carcinomas may improve survival rates, but individual tumor response is unpredictable. An assay for determining tumor responsiveness to specific chemotherapeutic agents would facilitate treatment selection. This study used the subrenal capsule (SRC) assay to test responsiveness of squamous cell carcinoma to cisplatin. Tumor xenografts obtained from ten patients were implanted beneath the renal capsules of control and treatment mice. Tumor responsiveness was determined by using the paired Student's t-test to compare base-line and post-treatment measurements in the cisplatin-treated mice. Results indicated six of ten tumors were sensitive to cisplatin. In conclusion, tumor sensitivity to cisplatin and other drugs may be predictable with the SRC assay, but to be clinically useful, studies will be necessary to correlate assay results with responses observed in patients.

Animals↗

Impact of preceptor counseling on medical resident prescription writing.

A collaborative study was conducted by pharmacists and the clinical preceptor of the otolaryngology outpatient clinic of the University of Texas Medical Branch (UTMB). This study focused on decreasing the percent of legal or procedural errors made by resident physicians. During the study period all prescriptions written by house staff were reviewed by a pharmacist for compliance to previously established criteria. Noncompliant prescriptions were photocopied by the pharmacist and recorded for review by the resident's clinical preceptor. After an 8-week period of baseline data collection, residents were counseled privately by the clinical preceptor and critique on their ability to write a legally and procedurally correct prescription. The residents were made aware of their major deficiencies to enable them to correct the problems. During an unannounced 4-week period, beginning 5 months after preceptor consultation, resident prescription writing was again audited. The result, an overall decrease of 78.5% in noncompliant prescriptions, illustrates that establishing lines of communication between pharmacists and physicians can demonstrably improve health care services. If this change in the quality of prescription writing could be achieved in all of the institution's ambulatory care clinics, an annual conservation of at least $57,000 in pharmacist salaries would be realized.

Drug Prescriptions↗

Rhinoscleroma.

Explore the source record for details and available documents.

Adult↗

An information system for head and neck tumors: optimal use of abstracting and retrieval resources.

This report describes a symbiotic interaction between a hospital tumor registry and the physicians in a medical school department of otolaryngology. The tumor registry is responsible for collecting central registry data, entering both central registry and department-specific data, performing routine data maintenance functions, and tracking the patients over time. The departmental physicians collect site-specific data and, after entry into a computer-based data base management system, can access the information without intermediaries and at their convenience. The result is a comprehensive information resource for head and neck cancer. The development of a medical subspecialty information system, as a satellite to the central registry mechanism, is noteworthy in its low cost, frequent physician use, better patient tracking, improved patient care, and increased clinical relevance of registry activities. A subtle but pervasive benefit is the increased sense of mission experienced by all concerned.

Abstracting and Indexing↗

Dissemination of computer skills among physicians: the infectious process model.

While the potential utility of computer technology to medicine is often acknowledged, little is known as to the best methods to actually teach physicians about computers. The current variability in physician computer fluency implies there is no accepted minimum required level of computer skills for physicians. Special techniques are needed to instill these skills in the physician and measure their effects within the medical profession. This hypothesis is suggested following the development of a specialized course for the new physician. In a population of physicians where medical computing usage was considered nonexistent, intense interest developed the following exposure to a role model having strong credentials in both medicine and computer science. This produced an atmosphere where there was a perceived benefit in being knowledgeable about the medical computer usage. The subsequent increase in computer systems use was the result of the availability of resources and development of computer skills that could be exchanged among the students and faculty. This growth in computer use is described using the parameters of an infectious process model. While other approaches may also be useful, the infectious process model permits the growth of medical computer usage to be quantitatively described, evaluates specific determinants of use patterns, and allows the future growth of computer utilization in medicine to be predicted.

Computers↗

Olfactory neuroblastoma. Cytodiagnostic features in a case with ultrastructural and immunohistochemical correlation.

In a case of olfactory neuroblastoma, originally misdiagnosed as an undifferentiated carcinoma, cytologic examination of material scraped from the superior nasal vault revealed tumor cells suggestive of neuroblastoma. The most significant cytodiagnostic feature was the presence of a fibrillary cytoplasm with ill-defined borders. Also noteworthy were the smudged hyperchromatic nuclei and structures resembling rosettes or pseudorosettes. The diagnosis was confirmed by electron microscopy, which revealed the presence of dense-core neurosecretory granules, clear vesicles, neurotubules and neurofilaments, and by immunohistochemistry, which showed positive staining for neuron-specific enolase but negative staining for keratin and glial fibrillary acidic protein. Since olfactory neuroblastoma has a relatively good prognosis and aggressive surgical resection may be curative, it is important that this tumor be distinguished from other small cell malignancies arising in the nasal cavity. The present case shows that the diagnosis can be made by the cytologic examination of scrapings from the tumor.

Aged↗