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H Sandvik

Publications and source records attributed to H Sandvik.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Group sequential experiments. Short introduction and review].

Group sequential experiments are terminated when an interim statistical test turns out to be "significant", or when maximum study size is attained. To ensure a stipulated total level of significance the interim tests have to be performed at a stricter level of significance determined by the maximum number of interim tests. As for fixed size studies, it is possible to determine a study size leading to a stipulated power. This study size depends on expected effect of intervention, number of interim tests and level of significance. Tables and computer simulation programs have been developed to facilitate the design of such plans. If the intervention turns out to be about as effective as expected, a saving in study size of about 30% can be expected in the long run, relative to studies of fixed size. If the intervention is much more effective than expected, larger savings can be achieved.

Clinical Trials as Topic↗
PubMed1996

[From barber-surgeons' guild to medical association. A 400th anniversary].

The barber-surgeons' guild in Bergen was founded on 17 January 1597. For nearly 250 years this was the only "medical association" in Norway. The guild disappeared with the death of its latest master, Christian Wilhelm Wisbech (1740-1822). However, only nine years later his son, Christian Wisbech (1801-69), founded the Medical Association in Bergen. The barber-surgeons were craftsmen who got their education by apprenticeship. They were the medical practitioners of their times. Their empirical knowledge was more in touch with real life than was the medicine taught by the professors. This paper describes the barber-surgeons' education and work, including their conflicts with other craftsmen and doctors. During the 18th century the barber-surgeons' education was improved, and eventually was given full academic status.

Barber Surgeons↗
PubMed1996

[Conservative experimental groups in clinical comparative trials. Tables providing the minimum number of patients].

To calculate the minimum size of sample required for clinical trials it is first necessary to decide the expected difference between the groups, and then the acceptable risk of wrongly declaring a significant result (alpha) or wrongly declaring a non-significant result (beta). Once these three parameters are set, simple tables can show the necessary sample sizes. Such tables are presented for classical comparative studies, survival studies, and group sequential plans. Sequential plans often entail large savings in sample size compared with fixed group plans.

Biometry↗
PubMed1995

[Routines for infection testing and vaccination against hepatitis B among applicants for asylum. A questionnaire study among health personnel responsible for reception of asylum applicants].

The authors performed a questionnaire survey to investigate the current routines for screening applicants for asylum for hepatitis B virus, HIV and intestinal parasites, and for vaccination against hepatitis B. The response rate was 82% (n = 80). Of the respondents, 58% were physicians, 23% public health nurses and 18% nurses. Without regard to country of origin of the applicant 71% of the health personnel usually offer an HIV-test and 77% an HBsAg-test. Few differentiated their testing routines according to country of origin. Many agreed that an HIV-test (49%) and an HBsAg-test (65%) ought to be made compulsory. 26% usually offer vaccination against hepatitis B, while 54% do so if the person concerned is an infant. Routine screening for intestinal parasites was reported by 27% of the health personnel, but more than half (54%) take only one sample from each patient. Health control of applicants for asylum provides a good opportunity to give information about the transmission of hepatitis B and HIV, preventive measures, and testing.

Adult↗
PubMed1995

Diagnostic classification of female urinary incontinence: an epidemiological survey corrected for validity.

Diagnostic questions about stress and urge incontinence were validated against a final diagnosis made by a gynecologist after urodynamic evaluation. Thereafter, an epidemiological survey was performed, using similar questions, and correcting the answers for lack of validity. Included were 250 incontinent women at the out-patient clinic and 535 women who reported incontinence in the epidemiological survey. The sensitivity for stress incontinence was 0.66 (95% confidence interval +/- 0.08), specificity 0.88 (+/- 0.06). The corresponding values for urge incontinence were 0.56 (+/- 0.15) and 0.96 (+/- 0.03), and for mixed incontinence 0.84 (+/- 0.10) and 0.66 (+/- 0.07). Using these indices of validity as corrective measures for the diagnostic distribution reported in the epidemiological survey, the percentage of stress incontinence increased from 51 to 77%, while mixed incontinence was reduced from 39 to 11%. Pure urge incontinence increased from 10 to 12%. Mixed incontinence will be overreported in epidemiological surveys. Correction for validity indicates that a larger majority than hitherto reported may have pure stress incontinence.

Adult↗
PubMed1995

Female urinary incontinence--consultation behaviour and patient experiences: an epidemiological survey in a Norwegian community.

The objective was to study explanatory factors for help-seeking among incontinent women, and what was the outcome of the treatment. A questionnaire was mailed to all 2366 women aged 20 or over in the rural community of Rissa, Norway. Women confirming incontinence gave information about duration, precipitating factors, frequency, amount of leakage, and impact. Questions about doctor consultation or planned consultation, treatment and results were included. Women with incontinence which had resolved without treatment were also recorded. A total of 77% answered the questionnaire. Twenty per cent of women with incontinence (n = 535) had consulted a doctor, 18% had planned to consult. Increasing age and duration, and urge/mixed type of incontinence were determinative factors for doctor consultation, while increasing severity and impact were determinative for planned consultation. Drugs, exercises, pads, and electrostimulation were all important treatment options: 21% were cured, 40% much better after treatment. Of all the women, 8% reported that they had been incontinent in the past, and only 18% of these had consulted a doctor.

Adult↗
PubMed1995

The epidemiology of pad consumption among community-dwelling incontinent women.

The aim of the study was to explore the use of incontinence pads among community-dwelling women in a well-defined area of western Norway (total female population 122,516). In Norway incontinence aids are prescribed by doctors and paid for by the national insurance. Data were collected at local insurance offices and through interviews with an age-stratified (20-89 years) random sample of incontinent women. Identified were 2,991 pad users (1-year period prevalence 2.4%). Prevalence rose sharply with advancing age, reaching a maximum of 30.1% in the 90+ age group. Median number of pads used per day was 1.8. Middle-aged women used fewer and smaller pads than the rest. When compared with the number of pads actually delivered, the incontinent women tended to overestimate their consumption.

Adult↗
PubMed1995

General practitioners' management of female urinary incontinence. Medical records do not reflect patients' recall.

OBJECTIVES: To investigate the prevailing management of female urinary incontinence by Norwegian general practitioners (GPs), and to compare information given by the patients with information in their medical records. DESIGN: Incontinent women who had received reimbursement for incontinence aids or drugs were identified by the local Insurance Offices, and a random sample was interviewed about what examinations and treatments they had received. Similar information was later collected from their GPs. SETTING: The Bergen area, Norway. SUBJECTS: Forty-eight GPs and 82 patients. MAIN OUTCOME MEASURES: Actions taken according to the patients and their medical records. Kappa statistics were used to evaluate the strength of agreement. RESULTS: The GPs had done a gynaecological examination in 54%, a leakage provocation test in 12%, and a urinalysis in 73% of the patients. Thirty-two per cent of the women had been instructed in pelvic floor exercises and 13% in bladder training. The GPs had prescribed oestrogens for 48% of the older women (> 59 years), anticholinergics for 29% of those with urge or mixed incontinence. Overall Kappa between the two data sources was 0.37. CONCLUSION: GPs' incontinence management can be improved, especially regarding gynaecological examination, pelvic floor exercises, and the prescription of oestrogens. Retrospective chart data or patient interviews are unreliable data sources.

Adult↗
PubMed1995

Criterion validity of responses to patient vignettes: an analysis based on management of female urinary incontinence.

BACKGROUND AND OBJECTIVES: Patient vignettes are often used for investigating the performance of physicians. The purpose of this study was to assess the criterion validity of vignettes. METHODS: A random sample of incontinent women were interviewed, and vignettes depicting their cases were later presented to their own physicians. Questionnaires sent to the physicians included open questions about what drug treatment the doctor would give and a checklist (cueing items) for indicating other possible actions. Analysis compared actions taken with vignette patients and actual actions taken with the real patients. RESULTS: Thirty-two general practitioners and 32 patients were included in the study. When cueing items were provided, the physicians claimed more actions with vignettes than were actually performed. Mean difference was 1.9 actions per case (95% confidence interval 1.3 to 2.4). No such difference was found for the open question. When cues were provided, the likelihood ratio for reporting a vignette action in comparison with actually performing the action with a similar real patient was 2.8 (2.2 to 3.5), and Kappa .39. When no cues were provided, the likelihood ratio was 5.1 (2.6 to 10), and Kappa .45. Total number of actions with vignettes and real patients correlated significantly (r = .65, P < .001). CONCLUSIONS: Responses to vignettes with cueing items overestimate real performance. The agreement may be better when no cues are offered. The method may have acceptable validity for group comparisons.

Adult↗
PubMed1994

[Does garlic protect against vampires? An experimental study].

Vampires are feared everywhere, but the Balkan region has been especially haunted. Garlic has been regarded as an effective prophylactic against vampires. We wanted to explore this alleged effect experimentally. Owing to the lack of vampires, we used leeches instead. In strictly standardized research surroundings, the leeches were to attach themselves to either a hand smeared with garlic or to a clean hand. The garlic-smeared hand was preferred in two out of three cases (95% confidence interval 50.4% to 80.4%). When they preferred the garlic the leeches used only 14.9 seconds to attach themselves, compared with 44.9 seconds when going to the non-garlic hand (p < 0.05). The traditional belief that garlic has prophylactic properties is probably wrong. The reverse may in fact be true. This study indicates that garlic possibly attracts vampires. Therefore to avoid a Balkan-like development in Norway, restrictions on the use of garlic should be considered.

Animals↗
PubMed1994

[Roboratio or relaxatio? Clinical theory and practice in the 19th century].

The first Norwegian medical school was founded in 1814. Niels Berner Sørenssen (1774-1857), one of three professors, was responsible for teaching pathology and therapy, and for clinical education. Together with his student and successor, Andreas Christian Conradi (1809-68), he made his mark on Norwegian physicians for a period of 50 years. A few years ago a small handwritten book by a medical student, dated 1828, turned up in a second-hand market. This book, which contains notes from Professor Sørenssen's lectures on therapy, demonstrates that his teaching was heavily influenced by the speculative theories of John Brown (1735-88). Similar influence is traceable in the annual reports from Norwegian physicians during the second half of the 19th century. Sørenssen urged his students to thoroughly investigate the medical history and make a detailed clinical examination, and his attitude to therapy was careful, almost reluctant. This personal clinical attitude was probably more important than the theoretical foundation upon which he based his lectures.

Curriculum↗
PubMed1993

[Obstetric care in Ytre Nordhordland 1858-87. A comparison with national statistics].

In Ytre Nordhordland, a rural district of western Norway, the number of stillbirths and maternal deaths was 50-60% above the national average. Local unskilled midwives assisted with deliveries, but were of little use in the event of complications. The first educated midwife was appointed in 1860, the second in 1874. In this study, multiple regression analyses were undertaken to examine how educated midwives and obstetric operations influenced maternal mortality and the number of stillbirths during the 30-year period 1858-87. The explained variation was 42% for stillbirths, but only 6% for maternal mortality. While the number of skilled midwives was associated with fewer stillbirths, the opposite was found for obstetric operations, probably because obstetric operations were reserved for the most extreme cases. It is concluded that the local doctors' struggle for appointment of educated midwives was of greater importance than their obstetric skills.

Female↗
PubMed1993

["Wise Men confound the World!". A district physician's struggle against superstition and sorcery in the 19th century].

When Michael Krohn (1822-97) was appointed district physician in Ytre Nordhordland in 1855 he had to fight hard against local witchcraft. Health education became his main strategy. He gave a series of lectures to the local Board of Health and also invited the schoolteachers to the meetings. The prejudiced local politicians neglected the school system and actively opposed the propositions he put forward. Nevertheless, a generation later the witches had disappeared. Health education can take some credit for this result, but probably the most important factor was simple trust.

Health Education↗
PubMed1993

[The last victims of smallpox in Ytre Nordhordland. Experiences of a local physician].

Smallpox caused devastating epidemics in Bergen and surrounding areas down to the early 19th century. A few attempts at variolisation were performed after 1765, and vaccination started in Bergen during a new wave of smallpox in 1803. The more distant rural parish of Manger did not start vaccination until 1829, and was heavily struck by the 1803 epidemic. That year, 208 died out of a total population of 3500. In 1859 Manger again experienced a serious smallpox epidemic. The local doctor ordered mass vaccination, but the peasants were uncooperative, and the campaign was even sabotaged by the assistant vaccinator. Eventually, 27 people died of smallpox that year, the last persons ever to die of smallpox in Manger.

Disease Outbreaks↗