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Biomedical subjects

N Goodman

Publications and source records attributed to N Goodman.

36 records · Page 2Linked to original sources
PubMed1985

Reproducibility of multiple-observer scoring of radiologic abnormalities in the hands and wrists of patients with rheumatoid arthritis.

Forty-one coded radiographic films from 16 patients with rheumatoid arthritis were read by 13 observers, using 4 different methods for scoring abnormalities. Although absolute scores differed widely among individual observers, correlation coefficients were greater than 0.850 for approximately 2 of 3 comparisons. When films were ranked, using the median rank of all readers, 72% of individual ranks were within 10% of the median ranks. Among serial films on individual patients, 92% of comparisons between early and late films were interpreted as demonstrating progression of abnormalities when mean standardized scores showed an increase in scores of 15 units or greater. Films with lesser changes were interpreted inconsistently. This study shows good general agreement among readers in scoring radiologic abnormalities of hands and wrists, when applied to a film set showing a broad spectrum of severity, and defines the sensitivity of radiologic detection of disease progression.

Adult↗
PubMed1985

How many joints in the hands and wrists should be included in a score of radiologic abnormalities used to assess rheumatoid arthritis?

Numerous methods for reading abnormalities of rheumatoid arthritis in hand and wrist radiographs have been proposed over the past several decades. There are many differences among these methods, one of the more striking of which is the variation in the number of joints that are scored. In this study, we tested the number of joints that need to be read in order to represent abnormalities accurately and reproducibly, using the scores of multiple observers. Thirteen rheumatologists and radiologists each read a set of 41 hand and wrist films from patients with rheumatoid arthritis. Ten of 13 readers scored 27 joints in each hand and wrist; the other 3 readers scored fewer areas. Fourteen combinations of joints were selected based on the frequency of involvement and the technical adequacy of routine films in assessing a given area. After testing these 14 different combinations, 1 scheme, which included 17 areas read for erosions and 18 areas read for joint space narrowing, was tested further. The correlation coefficients for 10 intraobserver scores derived from this modified scheme compared with the original scores were between 0.981 and 0.997. Seventy-one of 78 interobserver comparisons were better using the new scheme than using the original scheme. These data indicate that the simplified scheme, using a combination of 17 joints to score erosions and 18 to score joint space narrowing, more accurately reflects the extent of abnormalities perceived by a panel of experts than does the original scheme. This abbreviated number of joints shortens the amount of time required to read a set of films and simplifies the scoring of films, since a number of areas that are difficult to read are eliminated from radiographic assessment.

Arthritis, Rheumatoid↗
PubMed1978

Illicit drug use and consumption of alcohol, tobacco, and over-the-counter medicine among adolescents.

Over 9,000 junior and senior high school students in 79 schools in 10 cities completed an anonymous questionnaire concerning use of and attitudes toward licit and illicit drugs. Single and multivariate analyses indicated strong and statistically significant relationships between the consumption of alcohol, tobacco, and over-the-counter medicines and experience with illicit drugs. Also, the user of illicit drugs is also a relatively frequent user of licit drugs--alcohol, tobacco, and over-the-counter medications. The user is more likely than the nondrug user to be a "trier," if not a consistent consumer, of a variety of different substances. The patterns of relationships held across cities, types of schools, and age levels, and distinguished between those ever using illicit drugs vs never using them, present vs former users, and single vs polydrug users. Various alternative explanations are discussed.

Adolescent↗
PubMedDate not supplied

Pleural effusion: a rare manifestation of acute pulmonary blastomycosis.

A 47-year-old woman presented with cough, pleuritic chest pain and fever of three weeks duration. Although the patient lived in an area where blastomycosis is endemic, this diagnosis was not initially considered owing to the presence of consolidation and a large pleural effusion on the initial chest roentgenogram. Cultures of sputa, bronchial washings and pleural fluid documented the presence of pleuropulmonary infection with Blastomyces dermatitidis. Therapy with amphotericin B was associated with rapid clinical, roentgenographic and bacteriologic resolution of both pleural and parenchymal lung disease.

Acute Disease↗