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Biomedical subjects

K Finch

Publications and source records attributed to K Finch.

10 recordsLinked to original sources
PubMed2000

Comparison of an automated thrombolytic predictive instrument to both diagnostic software and an expert cardiologist for diagnosis of an ST elevation acute myocardial infarction.

Because the electrocardiograms (ECGs) of patients with symptoms suggesting an acute thrombotic coronary occlusion are typically read by physicians relatively inexperienced in this skill, it is important to develop automated decision support. A Thrombolytic Predictive Instrument (TPI) is now available along with the standard diagnostic software in a commercially available electrocardiograph. This study evaluates the performance of the predictive software in comparison to both an expert cardiologist and standard diagnostic software. True sensitivity and specificity cannot be determined because acute coronary angiography was not performed. The specificities determined by this study were excellent (98% and 99%), and the sensitivities were very good (72% and 78%). These results that the TPI will be only rarely applied to patients who do not indeed have an acute coronary thrombosis. However, the reasons for even this small number of presumably falsely TPI positive patients should be determined and analyzed. It is unlikely that alterations of the thresholds for TPI activation will significantly improve on this very good level of sensitivity, without prohibitively decreasing specificity.

Clinical Competence↗
PubMed1997

Effectiveness and economic impact of antidepressant medications: a review.

This article reviews the existing literature on the pharmacoeconomics and effectiveness of antidepressant medications. Although selective serotonin reuptake inhibitors (SSRIs) have not proved to be more efficacious than the older tricyclics, and their prescription costs are significantly higher, they provide superior effectiveness; ie, patients are less likely to discontinue taking them or switch antidepressants. Pharmacoeconomic studies consistently demonstrate a relationship between this superior effectiveness and reductions in overall treatment costs, often through decreased utilization of medical and hospital services. The most conservative study found a cost offset that more than negated the extra cost of drugs, although the cost savings were not statistically significant. Other studies found statistically significant lowering of utilization costs by using SSRIs rather than tricyclics. Studies comparing SSRIs with each other present conflicting findings, although fluoxetine appears to have an edge over sertraline and paroxetine with regards to effectiveness and pharmacoeconomics. More studies employing a prospective outcome design and naturalistic study setting need to be conducted with SSRIs and other new antidepressants.

Antidepressive Agents, Second-Generation↗
PubMed1993

Introduction of universal precautions in a psychiatric hospital--The Riverview Hospital experience.

Despite a large and rapidly growing body of knowledge concerning the human immunodeficiency virus and treatment of the acquired immune deficiency syndrome (AIDS) cases in general hospital settings, there is a dearth of information about the care of those psychiatric patients who might be at high risk for exposure to the virus and, hence, at high risk for contracting the illness. This article deals with the approach taken by a large Canadian psychiatric hospital in educating staff and clients about AIDS, and to the development of a comprehensive Universal Precautions system to supplement existing infection control protocols.

Hospitals, Psychiatric↗