Biomedical subjects

J K Tobacman

Publications and source records attributed to J K Tobacman.

22 records · Page 2Linked to original sources

PubMed1982

Intra-abdominal carcinomatosis after prophylactic oophorectomy in ovarian-cancer-prone families.

Prophylactic oophorectomy was performed in 28 female members of 16 families at high risk of ovarian carcinoma. 3 of these women subsequently developed disseminated intra-abdominal malignancy; there was uncertainty about the primary site despite extensive investigation. These tumours were indistinguishable histopathologically from ovarian carcinoma. It would seem that in cancer-prone families the susceptible tissue is not limited to the ovary, but includes other derivatives of the coelomic epithelium, from which primary peritoneal neoplasms may arise.

Abdominal Neoplasms↗

PubMedDate not supplied

Variation in physician opinion about scheduling of return visits for common ambulatory care conditions.

OBJECTIVE: To determine whether there is consensus about intervals between visits for adult general medicine patients with common ambulatory care conditions. DESIGN: Survey of practicing physicians and residents. SETTING: Ambulatory care at a hospital clinic, a group practice, and a physician office. PARTICIPANTS: 153 physicians, including residents, fellows, and staff from The University of Iowa Hospitals and Clinics, internists and family practitioners from three Iowa towns, and internists from Atlantic City, New Jersey. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: There was wide variation in responses, with greater consensus for more acute conditions than for chronic conditions or preventive care. CONCLUSIONS: 1) Wide variation exists in proposed intervals between visits for care of patients with common ambulatory conditions. 2) Variation occurs within the same geographic area and is unassociated with year of graduation from medical school, year in training, or academic appointment 3) Further study is needed to assess the significance of this variation.

Adult↗

PubMedDate not supplied

Comparison of appropriateness ratings for cataract surgery between convened and mail-only multidisciplinary panels.

BACKGROUND: In this article, the authors determine the reproducibility of appropriateness ratings for cataract surgery between a multidisciplinary physician panel that convened and a multidisciplinary physician panel that completed ratings by mail. METHODS: Eighteen panelists, who constituted 2 distinct multidisciplinary panels, rated 2894 clinical scenarios as an appropriate, inappropriate, or uncertain indication to perform cataract surgery. Each panel's summary score for each scenario was calculated. Weighted kappa values were determined to assess the level of agreement between the ratings of the 2 panels. RESULTS: The panels had a substantial level of agreement overall, with a weighted kappa statistic of 0.64. There was agreement on about 68% of the scenarios, and serious disagreement, in which one panel rated an indication appropriate and the other rated it inappropriate, occurred in only 1% of the ratings. CONCLUSION: There was substantial agreement about the ratings by the 2 panels. The panel that convened rated fewer scenarios uncertain and more appropriate, suggesting the impact of group dynamics and face-to-face discussion on resolution of uncertainty.

Cataract Extraction↗

PubMedDate not supplied

Assessment of comorbidity: a review.

Eleven clinical comorbidity indices are reviewed with attention to the development of improved assessment of comorbid conditions. Elements that are critical to the indices are reviewed, including their applicability, their inclusiveness, their validation, their correlations with outcomes of interest, their inclusion of functional assessment, their inclusion of severity assessment, and their simplicity. Improved assessment of comorbidity will enable better understanding of the processes and outcomes of medical care.

Acute Disease↗