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Biomedical subjects

K Stavem

Publications and source records attributed to K Stavem.

At least 37 records · Page 2Linked to original sources
PubMed2000

Acupuncture in intractable epilepsy: lack of effect on health-related quality of life.

The objective of this study was to assess the effect on health-related quality of life of acupuncture and sham acupuncture as adjunctive treatment in intractable epilepsy. We performed a randomized controlled trail with two parallel treatment arms at The National Center for Epilepsy in Norway, a comprehensive epilepsy center. Thirty-four patients with long-standing drug resistant epilepsy completed the study. The intervention consisted of 20 acupuncture treatments (bilateral needling of three acupoints plus one or two individually chosen points) or sham acupuncture (bilateral needling with smaller needles of three points outside the traditional meridians) over 8 weeks. The main outcome measures were changes in mean health-related quality of life scores for the two groups after 8 weeks, using the 89-item Quality of Life in Epilepsy (QOLIE-89) questionnaire. We found no difference between the acupuncture and sham acupuncture groups in score changes in any dimension of the QOLIE-89 questionnaire, despite testing a large number of dimensions. We also found no change in QOLIE-89 scores between baseline and 8 weeks in either groups. In conclusion, we could not demonstrate a significant effect of traditional acupuncture or sham acupuncture on the health-related quality of life of patients with intractable epilepsy.

Acupuncture Therapy↗
PubMed2000

Tympanic or rectal temperature measurement? A cost-minimization analysis.

In a cost-minimization study, we compared tympanic and rectal body temperature measurement in inpatients in a department of internal medicine. At all measurement volumes in a sensitivity analysis, tympanic temperature measurement had markedly lower average cost than rectal measurement, indicating a large savings potential if the former technique is used.

Body Temperature↗
PubMed2000

Health status of people with epilepsy compared with a general reference population.

PURPOSE: To study the impact of epilepsy in a representative sample of people with epilepsy and compare with a normal reference population. METHODS: We collected clinical and demographic data and information on health status by using the Short Form 36 (SF-36) questionnaire in two populations: (a) 397 patients with confirmed epilepsy attending a county hospital during a 7-year period, and (b) 1,663 patients from a random sample representative of the entire national population. RESULTS: The respondents with epilepsy had well-regulated disease and showed the characteristics of a community sample: 70% had had no seizures during the last year, and 80% used antiepileptic drugs (AEDs). On six of eight SF-36 scales, patients with epilepsy had lower scores than the normal reference population, and they were less likely to be married, employed, or a full-time student. Seizure-free patients with epilepsy had scores close to those of the normal reference population, with higher scores on the social functioning and mental health scales and lower on the role--emotional scale. There were no differences in health status scores between seizure-free patients using and not using AEDs. CONCLUSIONS: Our results confirm that patients with well-regulated epilepsy have a health status at the level of a general reference population.

Adaptation, Psychological↗
PubMed2000

Reliability and validity of a Norwegian version of the quality of life in epilepsy inventory (QOLIE-89).

PURPOSE: To develop a Norwegian version of the Quality of Life in Epilepsy Inventory (QOLIE-89) and to confirm its psychometric properties. METHODS: The QOLIE-89 was adapted to Norwegian language through a translation-backtranslation procedure. The assessment included 397 patients with epilepsy. We assessed internal consistency and test-retest reliabilities. Construct validity was assessed by correlating scales with items of the 15D health status questionnaire, and discriminant validity was assessed by comparing scores for known groups. RESULTS: The internal consistency reliability (Cronbach's alpha, 0.76-0.92) and test-retest reliability (intraclass correlation coefficient, 0.67-0.96) for the individual domains were acceptable. Spearman's rank correlations between QOLIE-89 domain scores and corresponding 15D single-item scores were high (p, 0.47-0.76), and generally higher than the associations between noncorresponding items. Most QOLIE-89 items discriminated well between patients according to seizure status, psychiatric comorbidity, and working status; less well after antiepileptic drug use and neurologic comorbidity. CONCLUSIONS: In this cross-sectional survey, the Norwegian version of the QOLIE-89 was reliable and showed properties supporting construct validity, at a level comparable with the original U.S. version.

Adaptation, Psychological↗
PubMed2000

Health-related quality of life in lung transplant candidates and recipients.

BACKGROUND: Studies on the health-related quality of life in lung transplantation have used general questionnaires, although lung-specific instruments might be more sensitive to small differences. OBJECTIVES: To compare the health-related quality of life of lung transplant recipients with lung transplant candidates, using lung-specific and general instruments, and to assess the reliability and validity of these questionnaires. METHODS: The study is a cross-sectional postal survey of 31 lung transplant recipients and 15 candidates, using the following outcome measures: St. George's Respiratory Questionnaire (SGRQ), a lung-specific health status instrument; the Short Form 36 (SF-36), a general measure, and the Hospital Anxiety and Depression scale (HAD). RESULTS: The SGRQ showed a significantly better score (p < 0.05) for transplant recipients in the impacts and activity dimensions and the total score than for candidates. SF-36 scores showed a similar improvement in all subscales of the SF-36 except bodily pain. Cronbach's alpha for all dimensions of the SGRQ, SF-36, and HAD were 0.77-0.95. CONCLUSIONS: Patients surviving lung transplantations can expect a considerable improvement in most dimensions of health-related quality of life. This finding was consistent using both lung-specific and general measures. The reliability of the questionnaires was acceptable. The associations between scales support the validity of the questionnaires in this setting.

Adult↗
PubMed1999

Performance of a short lung-specific health status measure in outpatients with chronic obstructive pulmonary disease.

The objective of this study was to assess the performance of a lung-specific health status measure in patients with chronic obstructive pulmonary disease (COPD). We used the Respiratory Quality of Life Questionnaire (RQLQ), a modification of an Australian questionnaire intended for asthma patients and adapted in this study to fit patients with COPD also. For comparison we chose the general health profile measure Short Form 36 (SF-36). We assessed the five RQLQ scales and eight SF-36 scales for reliability, validity and responsiveness in 59 outpatients attending a Norwegian hospital for COPD. Statistical analysis included internal consistency, test-retest reliability and convergent validity between the two questionnaires. Responsiveness was assessed in patients reporting global change in health status over 1 year. All scales of the RQLQ showed good internal consistency (Cronbach's a = 0.85-0.94) and test-retest reliability (intraclass correlation coefficient = 0.86-0.94), as did the SF-36 scales (a = 0.66-0.90) and intraclass correlation coefficient = 0.60-0.86). Pearson correlations between scales with similar items ranged from 0.54 to 0.76, supporting the construct validity of both questionnaires. The RQLQ had responsive scales, showing significant changes in the expected direction over 1 year. We conclude that the RQLQ showed an acceptable reliability, construct validity and responsiveness in COPD patients, encouraging further use of this questionnaire.

Ambulatory Care↗
PubMed1999

Reliability, validity and responsiveness of two multiattribute utility measures in patients with chronic obstructive pulmonary disease.

The objective of the study was to evaluate the reliability, validity and responsiveness of two generic multiattribute methods for measuring utility for health states: a 15-dimensional (15D) and a five-dimensional method (EuroQol and EQ-TTO). A self-administered questionnaire with both measures was used in 59 outpatients with chronic obstructive pulmonary disease and the findings compared with standard gamble (SG) and time trade-off (TTO) utilities, spirometry and arterial blood gases. Quality of life scores were smallest for EQ-TTO (median 0.73) and highest for SG and TTO (median 0.91 and 0.95 respectively), while 15D gave intermediate values (median 0.80). The test-retest reliability over 14 days was: 15D (p = 0.90) and EQ-TTO (p = 0.73), using Spearman's rank correlation. 15D was better than EQ-TTO at discriminating between groups of patients after reported global rating of change over 12 months (P = 0.004 versus P = 0.09), indicating that 15D was more responsive. The 15D instrument has many attractive properties when compared to the EQ-TTO method, including a better reliability and responsiveness. Validity depends on validation method. The findings in this study indicate that the different utility measures measure different aspects of health-related quality of life (HRQoL). Caution should be taken when choosing utility instruments in cost-utility studies, as this can strongly influence the results.

Activities of Daily Living↗
PubMed1999

Willingness to pay: a feasible method for assessing treatment benefits in epilepsy?

Contingent valuation using willingness to pay (WTP) is one of the methods available for assessing the value of a new technology or treatment for a disease in monetary terms. Experience with this method is lacking in epilepsy. The objectives of this study were to assess the acceptability of the WTP method in epilepsy, the level of the responses, and to investigate its validity by comparison with other non-monetary preference measures. Among 397 patients with epilepsy responding to a comprehensive questionnaire, 82 were randomly selected for an interview. They were asked about their WTP for an imaginary new technology which could permanently cure their epilepsy. Fifty-nine patients participated and 57 completed the interview (32 women; mean age 44 years), the majority with well-controlled epilepsy. The patients indicated a median WTP of Norwegian Kroner (NOK) 150,000 (USD 20,000; GBP 11,800), interquartile range NOK 50,000-350,000 (USD 6, 667-46, 667; GBP 3,937-27,559) for this cure. Non-response was low, indicating high acceptability of this method. There was little association between WTP and other preference measures; the Spearman rank correlation coefficient was -0.09 and -0.12 with time trade-off and standard gamble respectively, questioning the validity of this method.

Adolescent↗
PubMed1999

Predictors for recurrence of epileptic seizures in a general epilepsy population.

The aim of our study was to identify predictors for recurrence of epileptic seizures in a large county hospital population. We identified 956 patients (18-67 years) with ICD 9 code 345 as primary diagnosis, seen at the Central Hospital of Akershus over 7 years (1987-1994). The diagnosis of epilepsy was confirmed for 696 of the patients. These were divided into two groups: (1) no seizures during the previous year (n = 485) and (2) seizures during the previous year (n = 184). To identify predictors for recurrence of seizures, we used neurologic deficit, number of AEDs used, CT-scan findings, EEG findings, aetiology, gender, age below and above 50 years and comorbidity as independent variables in a logistic regression model. In a univariate analysis, the strongest predictors for recurrence of seizures were: age above 50 years (OR = 5.2;P < 0.0001), known aetiology (OR = 1.4;P = 0.04) and use of two or more AEDs (OR = 5. 7;P < 0.0001). In the multivariate analysis age, more than 50 years (OR = 1.7;P = 0.0216) and use of two or more AEDs (OR = 5.6;P < 0.0001) were the only predictors for recurrence of epileptic seizures.

Adolescent↗
PubMed1999

Health status, dyspnea, lung function and exercise capacity in patients with chronic obstructive pulmonary disease.

SETTING: A secondary hospital outside Oslo. OBJECTIVE: To assess relationships between health status and measures of dyspnea, lung function and exercise capacity in patients with chronic obstructive pulmonary disease (COPD), to identify dimensions where lung-specific instruments associate and discriminate better than general measures. DESIGN: We assessed health status in 59 out-patients with COPD, using the following instruments: Short Form 36 (SF-36)-a general health status measure, Respiratory Quality of Life Questionnaire (RQLQ)-a lung-specific measure, the Karnofsky performance scale, and a rating scale. All patients rated their dyspnea and had spirometry and exercise capacity measured. RESULTS: Mean (SD) patient age was 57.3 (9.7) years, FEV1 47% (15%) of predicted, 6 minute walk distance 503 m (122 m). Dyspnea was the strongest predictor for health status. Both SF-36 and RQLQ had dimensions associating well with dyspnea and exercise capacity. The associations with FEV1 ranged from none to moderate. CONCLUSION: All RQLQ scales had a moderate to substantial association with indices of dyspnea and exercise capacity, while the SF-36 associated well only in dimensions related to physical health. The general measure has a broader scope and complements the lung-specific measure. These findings support the construct validity of both the SF-36 and the RQLQ, and justify using a general measure to supplement a lung-specific measure.

Adolescent↗
PubMed1998

Quality of life in epilepsy: comparison of four preference measures.

Several specific and general measures are available for the assessment of overall health related quality of life in epilepsy. Few of the commonly used measures provide utility weights for use in cost-utility analyses. This study compares four methods for measuring utility weights: time trade-off (TTO), standard gamble (SG), 15D, end the EuroQol visual analog scale. All patients aged 18-67 years with a diagnosis of epilepsy, who had been admitted to or attended the outpatient clinic at a large county hospital 1987-1994, received a comprehensive questionnaire. From 397 respondents, 82 patients were randomly selected. Most of the 57 patients completing the study generally had well-controlled epilepsy, but were still on anti-epileptic medication. Mean age was 44 years. Fourty-one percent were male and 59% female. The resulting utility weights differed considerably between the measures, both with regard to central tendency and dispersion. Median utility scores: EuroQol visual analog scale 0.75, 15D 0.90, TTO 0.98, SG 0.99. There was a good association between the EuroQol rating scale and the 15D, and a moderate association between SG and TTO. These preference instruments measure different aspects of health-related quality of life and thus yield different results. Caution should be taken when interpreting cost-utility studies, as results will depend on the choice of utility instrument.

Adult↗
PubMed1997

[Anaphylactic reaction to N-acetylcysteine after poisoning with paracetamol].

Paracetamol is among the most common substances consumed in self-poisoning attempts. The recommended treatment is intravenous N-acetylcysteine. Adverse reactions to this treatment are relatively common, but are rarely serious. The article reports and discusses a patient who had an anaphylactoid reaction to N-acetylcysteine after an overdose of paracetamol. This reaction was most probably an acute toxic effect of N-acetylcysteine, and not a result of an immunologic hypersensitivity reaction. Reducing the infusion rate of the initial loading dose might reduce the risk of adverse reactions. Recent guidelines recommend giving the loading dose over 60 minutes, instead of 15 minutes.

Acetaminophen↗
PubMed1997

Accuracy of infrared ear thermometry in adult patients.

OBJECTIVE: To assess (1) the agreement between infrared ear thermometry and core reference temperature (in the pulmonary artery). (2) the agreement between measurements in the right and left ears, and (3) the screening validity of infrared tympanic thermometry in detecting rectal fever. DESIGN: Temperatures were measured in both ears with an infrared thermometer, in one group of patients by simultaneous measurements with thermistors inserted in the pulmonary artery, esophagus, and rectum, and in the other group with a rectal glass-mercury thermometer. SETTING: An intensive care unit and a department of internal medicine in a secondary care hospital. PATIENTS AND PARTICIPANTS: Two samples: 16 adult patients admitted to the intensive care unit and 103 consecutive patients admitted to the department of medicine. MEASUREMENTS: The major outcome measures were (a) the agreement between infrared ear thermometry and thermistor pulmonary artery temperature and (b) the sensitivity and specificity for detecting fever, using rectal measurement as reference. RESULTS: Both rectal and esophageal thermistor measurements showed better agreement with the pulmonary artery reference temperature than single ear tympanic thermometry. The sensitivity and specificity of ear thermometry for detecting fever (> or = 38.0 degrees C rectal reference) were 0.58 and 0.94, respectively. Double ear thermometry had a sensitivity of 0.61 and a specificity of 0.95, when using the mean value. CONCLUSIONS: Both rectal and esophageal thermistor measurements showed better agreement with pulmonary artery temperature than single ear themometry. Using the mean of two ear measurements improves the agreement and screening validity for detecting fever by rectal temperature. If temperature measurements are critical, esophageal measurements achieve excellent agreement with pulmonary artery temperatures.

Adolescent↗
PubMed1996

[Pneumoscrotum after air leak from tension pneumothorax].

Pneumoscrotum is a rare condition which may accompany retroperitoneal ruptures of air-filled gastrointestinal organs, endoscopic and surgical procedures and widespread subcutaneous emphysema. A case of pneumoscrotum as a complication to treatment of tension pneumothorax is reported, and the literature is reviewed.

Drainage↗
PubMed1995

[The EDP systems for internal hospital cost accounting].

Computer systems for hospital cost accounting are in widespread use in foreign hospitals. In Norway, few hospitals have adopted such systems. Two products are currently being developed in Norway: KosPa (a system for calculating DRG costs) and Nirvana (a system intended for presentation of costs, rather than for overhead allocations and cost calculations). Both of these systems will have rather limited uses. If an organization needs a more comprehensive system with a wider selection of features, there are no Norwegian alternatives. It should be possible to implement a foreign system without too much trouble.

Accounting↗
PubMed1995

[Relating costs to activities in hospitals. Use of internal cost accounting].

During the last few years hospital cost accounting has become widespread in many countries, in parallel with increasing cost pressure, greater competition and new financing schemes. Cost accounting has been used in the manufacturing industry for many years. Costs can be related to activities and production, e.g. by the costing of procedures, episodes of care and other internally defined cost objectives. Norwegian hospitals have lagged behind in the adoption of cost accounting. They ought to act quickly if they want to be prepared for possible changes in health care financing. The benefits can be considerable to a hospital operating in a rapidly changing health care environment.

Accounting↗
PubMed1994

[Rhabdomyolysis in carnitine palmitoyltransferase deficiency].

A 45 year old man had had recurrent rhabdomyolytic episodes from the age of 16 following prolonged exercise or infection. During one episode he developed respiratory and renal failure, but recovered completely. Biochemical investigation of muscle biopsy showed deficiency of carnitine palmityl transferase (CPT), an enzyme involved in the beta-oxidation of fat metabolism.

Acute Kidney Injury↗