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Biomedical subjects

M P Becker

Publications and source records attributed to M P Becker.

23 records · Page 2Linked to original sources

Nursing care requirements of patients with DNR orders in intensive care units.

The purpose of this study was to examine the differences in demographic characteristics and nursing care requirements of patients with and patients without DNR (do not resuscitate) orders in intensive care. The sample consisted of 62 patients with and 62 without DNR orders from the intensive care units of three community hospitals. Data were collected until patients recovered and were transferred from the unit or until death occurred. Data were analyzed by chi-square tests for homogeneity, t tests, and analysis of covariance. Patients with DNR orders were white (p = 0.015), older (p = 0.03), more likely to reside in nursing homes (p = 0.04), had longer intensive care stays (p = 0.0005), were more likely to be admitted from another nursing unit (p less than 0.001), and had higher mortality rates (p less than 0.001). In intensive care settings, patients with DNR orders received more nursing care than patients who did not have DNR orders.

Adult↗

Preliminary development of two predictive models for DNR patients in intensive care.

The purpose of this study was to identify which variables are the best predictors of a do-not-resuscitate (DNR) classification and develop a model to predict the nursing care required by DNR patients in the ICU. Data collected on DNR and non-DNR patients included nursing care requirements, severity of illness, resource allocation and sociodemographic characteristics. One model identified the best predictors of a DNR classification in intensive care as the origin of admission and the severity of illness score on the day of admission to intensive care. The second model identified the best predictors of nursing care requirements for DNR patients in intensive care as the number of days spent in intensive care prior to the DNR order, the average daily resource allocation points after the DNR order, and the severity of illness score on the day the DNR order was designated.

Aged↗

Using association models to analyse agreement data: two examples.

Two examples demonstrate how one can use association models to analyse agreement data. The first example concerns intra-rater variability in the classification of sputum cytology slides, and the second deals with variability associated with the reporting of passive smoking histories. The paper emphasizes models in which one estimates category scores from the data, that is models that are not in the log-linear family of models. Such models have use in assessment of category distinguishability and provide insights not easily obtained with log-linear models.

Case-Control Studies↗

A multiple imputation strategy for incomplete longitudinal data.

Longitudinal studies are commonly used to study processes of change. Because data are collected over time, missing data are pervasive in longitudinal studies, and complete ascertainment of all variables is rare. In this paper a new imputation strategy for completing longitudinal data sets is proposed. The proposed methodology makes use of shrinkage estimators for pooling information across geographic entities, and of model averaging for pooling predictions across different statistical models. Bayes factors are used to compute weights (probabilities) for a set of models considered to be reasonable for at least some of the units for which imputations must be produced, imputations are produced by draws from the predictive distributions of the missing data, and multiple imputations are used to better reflect selected sources of uncertainty in the imputation process. The imputation strategy is developed within the context of an application to completing incomplete longitudinal variables in the so-called Area Resource File. The proposed procedure is compared with several other imputation procedures in terms of inferences derived with the imputations, and the proposed methodology is demonstrated to provide valid estimates of model parameters when the completed data are analysed. Extensions to other missing data problems in longitudinal studies are straightforward so long as the missing data mechanism can be assumed to be ignorable.

Bayes Theorem↗

Severity of illness and resource allocation in DNR patients in ICU.

This study examined the differences in severity of illness and resource allocation between patients with do-not-resuscitate (DNR) orders and non-DNR patients in intensive care units. Severely ill intensive care patients with DNR orders continued receiving aggressive medical care following cardiac or respiratory arrest. The continued use of advanced therapies for DNR patients raises important questions about the use of costly intensive care resources.

Adult↗