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Biomedical subjects

K N Williams

Publications and source records attributed to K N Williams.

35 records · Page 2Linked to original sources
PubMed1978

Auditory temporal resolution: effects of sensation level.

Experienced Ss identified (2IFC) the signal complex that contained a gap. When the complexes were of the same frequency, gap detection remained constant over the durations employed (up to 300 msec). When duration of the signal was 10 msec no changes in gap threshold occurred over the range of frequency disparities between signals (up to 120 Hz at F0 = 1 kHz). However, as signal duration increased (beyond 10 msec) there was an increase in gap threshold with increased frequency disparity. The degradation in gap threshold was greater for longer-duration events. Gap threshold was shown to decrease as a function of increase in intensity of the signals.

Acoustic Stimulation↗
PubMed1976

Signal onset and task variables in auditory evoked potentials.

Two auditory evoked potential studies were run to determine the effects of stimulus rise times on amplitude of N1-P2 onset and offset potentials. Onset potentials were reduced with increased onset durations. No consistent relationship was found in N1-P2 offset potentials as a function of stimulus rise time. The effects of listening tasks and stimulus duration were also examined.

Acoustic Stimulation↗
PubMed1976

Effect of medical care review on the use of injections: a study of the New Mexico Experimental Medical Care Review Organization.

Evaluation of peer review activities in the New Mexico Medicaid program (1971 to 1973) showed that it can affect aspects of quality, that is, the appropriateness of the use of injections as judged by medical criteria. Use of injections, nearly 50% of which were antibiotics, declined by more than 60%, from 41 to 16 per 100 ambulatory visits. Still, at the end of the study, 40% of the injections given were considered medically unnecessary. Analyses showed that [1] groups used injections more appropriately; [2] for solo physicians, being board-certified, being a doctor of medicine, and being a pediatrician were all associated with more proper use of injections; [3] 6% of the physicians gave 40% of the medically unnecessary injections, but even their behavior changed dramatically for the better as a result of the peer review system.

Age Factors↗
PubMed1976

Quality assurance today and tomorrow: forecast for the future.

We review here the definition, history, and current findings of quality assessment. Difficulties with quality assessment center principally on methods problems, including using the medical record as a source of information, using process versus outcome criteria, and ignoring decision analysis methods in establishing quality criteria. One overriding issue is placing a value on health and, by extension, on quality assurance and assessment efforts; another is the degree to which improvements in the quality of care can be achieved through changes in physician practices. Several sets of recommendations address these topics. With the assumption that such recommendations could be acted on in a transition period, a hypothetical quality assurance system is described for the 1980s and beyond. This system is based on preservation of the fee-for-service system, adoption of a national health insurance plan, and minimal federal involvement in quality of care decisions at the regional level.

Delivery of Health Care↗
PubMed1975

Quality of health care for the disadvantaged.

Literature review points out that: (a) differentials in health status between the disadvantaged and the nondisadvantaged persist, often to a large degree; (b) differentials in the overall amount of care received are less striking now than heretofore, but standardization by level of need demonstrates measurable discrepancies in health services provided to the disadvantaged compared with the nondisadvantaged; (c) the quality of health care for the disadvantaged is not strikingly poorer than care for the nondisadvantaged, but, in view of demonstrable shortcomings in the quality of health care in general, this is not viewed as a positive statement; and (d) attempts to improve quality of care for the disadvantaged have not had the hoped-for impact. Four new avenues are suggested for possible further research; increased patient responsibility, increased consumer knowledge, financial accountability, and quality assurance activities. Because of the likelihood of only marginal changes in health status, rigorous evaluation of any experimental program is emphasized. During the last decade, many attempts have been made by private and governmental bodies to improve the health of the American people. In general, these efforts have focused on improving the health of members of disadvantaged groups and have included such diverse activities as building OEO health centers, developing maternal and infant care programs, and financing care for the elderly. During the last few years, a different movement, concerned with assuring high quality care for all people, has produced efforts such as quality assurance activities in health maintenance organizations, the Professional Standards Review Organization program, and the medical care evaluation program of the Joint Commission on the Accreditation of Hospitals. Consideration of these two issues, i.e., improving the health of disadvantaged groups and improving the quality of care for all people, has led to two policy-relevant questions: "Can the health of disadvantaged groups be substantially improved by assuring that a high level quality of care is delivered to them?" and "Can the quality of care delivered to disadvantaged groups be improved?" The purpose of this paper is to review some available data pertinent to both these issues and to suggest some ideas for future research.

Adolescent↗
PubMed1975

A computer program for the analysis of parallel-line bioassays of clotting factors.

An interactive computer program for the analysis of clotting factor assays is described. The program provides potency estimates against a standard, and will compare the observed and expected responses of a treated patient. Tests for validity of curve fitting are provided, with a number of optional transforms. If asked, the program will provide the user with a list of valid commands at any given step, and will identify certain errors in input.

Blood Coagulation Factors↗
PubMed1975

Foreign medical graduates and their impact on the quality of medical care in the United States.

The literature on the level of quality of care delivered by foreign medical graduates (FMGs) has been reviewed in order to derive policy recommendations concerning their use in the United States. This review revealed a paucity in information on direct measures of the level of quality of care provided by FMGs. Differences between U.S. medical graduates (USMGs) and FMGs, especially with regard to the less than fully licensed FMGs and those FMGs at the start of graduate training, were found on examining proxy measures of quality, such as achievement of standard professional credentials or the quality of clinical training. Given this lack of evidence as to differences in performance between FMGs and USMGs, it is difficult to formulate recommendations, but four are advanced. These include (1) acknowledgment of the crucial significance of their heterogeneity, especially in regard to the quality of care provided, (2) assurance of the principle that peer-review activities are administered even-handedly to FMGs and USMGs alike, (3) improvement of the medical care capabilities of the less able provider, and (4) performance of quality of care studies, in both hospital and office practice settings, which compare FMGs with USMGs, not to ideal standards.

Achievement↗