Search PubMed⌕ Search

Biomedical subjects

J I Balla

Publications and source records attributed to J I Balla.

At least 37 records · Page 2Linked to original sources
PubMed1985

A decision analytic approach to the role of visual evoked response and cerebrospinal fluid abnormalities in the management of singular spinal sclerosis.

With the use of Bayesian decision analytic techniques we assess the role of visual evoked response (VER) and cerebrospinal fluid (CSF) examinations in the investigation of patients with suspected singular spinal sclerosis. An abnormal VER increases the probability of multiple sclerosis by 50%. An associated CSF abnormality does not affect this probability. In a setting of a negative VER, CSF abnormalities increase the probability of multiple sclerosis by 27%. On currently available data, VER should therefore be the primary investigation in patients with suspected singular spinal sclerosis. If the result is abnormal myelography may be omitted. CSF examinations are only useful if VER facilities are not available.

Bayes Theorem↗
PubMed1984

An analysis of the decision-making process in the management of malignant gliomas.

The decision to offer surgery or deep X-ray therapy to patients diagnosed as having malignant gliomas on CT scans is often problematical. Decision-tree analysis is used to make the underlying assumptions explicit in either strategy. Using biopsy and CT data obtained from our own experience, and survival figures from the literature, we are able to demonstrate that the decision is to a large extent related to value judgement. Specifically this relates to the assessment of the utility of long-term survival versus the immediate mortality and morbidity of biopsy in addition to possible difficulties in accepting long-term uncertainty of diagnosis if a biopsy is not performed.

Biopsy↗
PubMed1983

Application of decision analysis to management of cerebral arteriovenous malformation.

Consideration of cerebral arteriovenous malformation (AVM) illustrates how decision analysis may be used to evaluate systematically two treatment options--surgery before bleeding occurs or conservative management. The analysis balances risk of immediate surgical mortality and morbidity against the delayed risks inherent in conservative management. Because the condition is rare and local experience therefore scant, probability estimates have to be obtained from the literature. From these probability estimates and from estimates of attractiveness of various outcomes (made in this study by a clinician) a quantitative assessment of the risks and benefits of surgical versus medical management can be calculated. The finding is that conservative treatment is preferable to surgery in patients who present with an AVM before bleeding occurs, even when the probability estimates used are those obtained under conditions more favourable to surgery. The decision also remains unchanged when different attractiveness values are assigned to possible outcomes.

Adult↗
PubMed1983

Diagnostic cues in gastroenterology.

Twenty seven gastroenterologists (15 physicians and 12 surgeons) were studied to capture their policy in the usage and weighting of cues in making a diagnosis. This was a relatively small sample and on account of possible sampling bias only tentative generalisations will be made. Five case vignettes, each consisting of four to eight cues, were used. Subjects were asked to give their percentage likelihood estimates of various diagnostic possibilities after each cue. This gave an indication of their perception of the significance of various cues in relationship to each diagnosis. There were marked variations in cue weighting by these experts, and in particular, most individuals were far off the mean regarding the weighting of certain clinical features, thus displaying idiosyncratic behaviour in these instances. As may be expected, there were differences in disease prevalence estimates between physicians and surgeons. Early information had an overwhelming effect on the final diagnosis. In most cases the expert relied on a few critical cues rather than on a pattern to make a diagnosis. In view of the strong influences of early diagnostic formulations, these findings confirm the need for doctors to learn to use and collect accurate factual information on prevalence rates and on the most significant critical cues for various disease processes. The study highlights some of the problems faced by novices in learning from experts who may teach them contradictory information about what are the most significant factors in coming to a diagnosis.

Adult↗
PubMed1982

The late whiplash syndrome: a study of an illness in Australia and Singapore.

A condition commonly seen after motor vehicle accidents, the Late Whiplash Syndrome, which is defined as a collection of symptoms and disabilities seen more than six months after a neck injury occurring in a motor vehicle accident, is examined in a series of 300 cases. The author suggests that the development of the Late Whiplash Syndrome, some of whose characteristics are viewed as illness and some as illness behavior, depends on social variables. The differential distribution in Western countries and in Singapore is related to sanctions against entry into the sick role associated with this type of injury which are present in countries such as Singapore. Conversely, motor vehicle injury is legitimized in Western Countries such as Australia as an historical overview shows. The author's model of the Late Whiplash Syndrome lends itself to generalizations about the development of social illness in different cultures.

Accidents, Traffic↗
PubMed1980

The late whiplash syndrome.

A condition commonly seen after motor vehicle accidents is studied. This is the "late whiplash" syndrome, which is defined as a collection of symptoms and disabilities seen more than six months after a neck injury occurring in a motor vehicle accident. A series of 300 cases is examined. With the use of factor analysis the syndrome is defined as consisting of headache, neckache, neck stiffness, and depression, as well as anxiety, all of which are strongly correlated with each other. There is, on the other hand, a poor correlation with physical or radiological abnormalities. The condition is common in women, especially in the 21 to 40 years' distribution. It is shown that social variables may be relevant n the production of the syndrome.

Accidents, Traffic↗
PubMed1969

Facial myokymia.

Explore the source record for details and available documents.

Adult↗