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Biomedical subjects

M F Collen

Publications and source records attributed to M F Collen.

At least 19 recordsLinked to original sources
PubMed2002

Vicissitudes of preventive medicine and a new challenge.

OBJECTIVES: Significant changes in mortality patterns are part of the changing population demographics. This paper explores their implications for health evaluation and screening programs. METHODS: A review of selected age-adjusted mortality rates from the National Vital Statistics Reports of the USA was undertaken and their change over the last five decades analyzed. RESULTS: The review shows a continued decline in mortality rates from leading causes of death, such as heart disease, cancer, stroke, pneumonia and influenza, and a sharp rise in the death rates from Alzheimer's disease. Available means for detection of Alzeimer's disease are summarized. CONCLUSION: Given the emerging possibilities for the treatment and prevention of the progression of Alzheimer's disease, tests for early detection of Alzheimer's should be included in health screening examinations.

Adult↗
PubMed2000

Historical evolution of preventive medical informatics in the USA.

A major reorganization of healthcare services is occurring in the United States. It has evolved from the solo- and group-practice models of the 1940s with fee-for-service and insurer-indemnification financing that used paper-based information systems to support preventive medical services. In the 1990s there emerged nation-wide, managed-care plans employing enhanced computer-based information systems with online preventive medical practice guidelines and Internet-supported home-care telemedicine. It is helpful to review how this major reengineering of medicine has come about.

Forecasting↗
PubMed1992

A historical review of the Kaiser Permanente Medical Care Program.

The Kaiser Permanente Medical Care Program evolved from a series of major construction projects in the 1930s and from the World War II shipyards in the early 1940s. In the late 1940s, it became a community-based medical care program, and later in the 1970s, the prototype Health Maintenance Organization (HMO). Over the past five decades, Kaiser Permanente has developed its basic principles of prepaid, group practice for comprehensive-care services where physicians control their medical practice in a partnership of responsibility for the Health Plan, the Hospitals, and the Medical Groups. All of this is carried out with autonomy of its 13 regions in the United States.

California↗
PubMed1991

A brief historical overview of hospital information system (HIS) evolution in the United States.

This paper describes the evolution of hospital information systems (HIS) in the United States of America from 1950 to the present and defines HIS within the context of a medical information system. After a concise review of HIS administrative functions, the paper focuses on HIS clinical functions, including the following: computer-based patient records; data entry and retrieval; text processing; data and system protection; networks; clinical subsystems (nursing and medical subspecialties); clinical decision support and quality assurance; and research databases. The paper surveys early examples of HIS and makes projections for HIS in the 1990s.

Hospital Information Systems↗
PubMed1990

Clinical research databases--a historical review.

The increasing importance of computer-stored databases for clinical research prompted a historical review of their evolution over the past three decades. The special problems associated with the computer processing of clinical research data were reviewed, and the various types of clinical research registers and databases were described.

Databases, Factual↗
PubMed1988

Sigmoidoscopy and mortality from colorectal cancer: the Kaiser Permanente Multiphasic Evaluation Study.

The Kaiser Permanente Multiphasic Evaluation Study is often cited as evidence from a randomized trial that screening sigmoidoscopy reduces mortality from colorectal cancer. To examine the role of sigmoidoscopy in this reduction, we reviewed the 110 incident cases of colorectal cancer occurring among the 10,713 subjects from randomization in 1964 through 1982. Tumor stage at diagnosis, location, mode of discovery, and current mortality status were determined for each. We also reanalyzed chart review data for the years 1965 through 1974 to assess the difference in exposure to sigmoidoscopy between groups. Study group subjects, who were urged to have annual multiphasic health checkups (MHC), had both a lower cumulative incidence (4.3 vs 6.7 cases per 1000 persons) and a better stage distribution (86 vs 54% Stage B or better) than nonurged control subjects for colorectal cancers arising within reach of the sigmoidoscope. The lowered incidence accounted for two-thirds of the total difference in mortality. No appreciable difference in removal of colorectal polyps was seen between groups. Only a slight excess in exposure to sigmoidoscopy was seen in the study group (30 vs 25% of subjects examined at least once between 1965 and 1974), which was unlikely to account for more than a small fraction of the study group's decrease in mortality. Although the Multiphasic Evaluation Study did find a significantly lower mortality from colorectal cancer in the study group, it did not achieve a substantial difference in exposure to sigmoidoscopy. Its results are therefore inconclusive with respect to sigmoidoscopy and should not be used as evidence either for or against sigmoidoscopic screening.

Adult↗
PubMed1986

Multiphasic Health Checkup Evaluation: a 16-year follow-up.

The Multiphasic Health Checkup Evaluation Study, a long-term clinical trial, has been completed. A study group of 5156 men and women age 35-54 at entry was urged to have annual multiphasic health checkups (MHCs) for 16 years. A control group of 5557 comparable subjects was not so urged but was followed up in a comparable fashion. The mean and median number of MHCs per person were 6.8 and 6, respectively, in the study group and 2.8 and 1, respectively, in the control group. During 16 years the study group experienced a 30% reduction (p less than 0.05) in deaths from pre-specified "potentially postponable" causes, largely associated with lower death rates from colorectal cancer and hypertension. This reduction was most pronounced in the early years of the study. The two groups did not differ to a statistically significant degree in mortality from all other causes (84% of total mortality) or in total mortality. There was no difference in self-reported disability in the overall groups. In the setting of our prepaid health care plan where MHCs were already available on a voluntary basis, a program of urging middle-aged persons to undergo regular MHCs brought about a substantial reduction in mortality from preselected diseases.

Adult↗
PubMed1986

Origins of medical informatics.

Medical informatics is a new knowledge domain of computer and information science, engineering and technology in all fields of health and medicine, including research, education and practice. Medical informatics has evolved over the past 30 years as medicine learned to exploit the extraordinary capabilities of the electronic digital computer to better meet its complex information needs. The first articles on this subject appeared in the 1950s, the number of publications rapidly increased in the 1960s and medical informatics was identified as a new specialty in the 1970s.

History, 20th Century↗
PubMed1985

Full-text medical literature retrieval by computer. A pilot test.

A pilot test of a full-text, medical literature retrieval service demonstrated its capabilities for on-line search and retrieval of references, abstracts, and/or full-text journal articles. During a three-month test period, more than 500 health care professionals conducted 9,377 searches using computer terminals located in seven different health care sites. Searches were initiated for purposes of patient care, medical education, research, or for browsing. The majority of responders to a questionnaire given during the test period said they would continue to use the service during the pilot test, and only about 1% reported the search process difficult to use or not "user-friendly." It is predictable that with a comprehensive data base, full-text medical literature retrieval can be very useful for medical practice, medical education, and research.

Consumer Behavior↗
PubMed1984

The cost-effectiveness of health checkups--an illustrative study.

An economic analysis of personal health maintenance is complicated by the great variability in the health care process, the large amount of missing data and the great range in analytic results. Accordingly, this study should be considered more illustrative than conclusive. Data are available on middle-aged adults that periodic health checkups can be effective in significantly lowering mortality from potentially postponable disease. Using these data, a net-cost analysis has been attempted for periodic health checkups. The findings suggest that their costs and effects on health depend on how they are provided, how often and to whom. Yet, periodic health checkups can reduce lost earnings capability of examinees and can be cost-effective by using efficient health examination methods. If policy decision makers require health checkups for the lowest income people to be cost-effective, then these checkups probably will continue to be limited to case finding by physicians as an expense already included in current medical practice.

Adult↗