Search PubMed⌕ Search

Biomedical subjects

P G Goldschmidt

Publications and source records attributed to P G Goldschmidt.

12 recordsLinked to original sources
PubMed1999

Hand function following single ray amputation.

We retrospectively studied primary and reconstructive single ray resection at 16 to 150 months after surgery (median, 41 months) in 25 patients (18 males) whose average age was 28 years. Cases were reviewed 16 to 154 months after surgery (median, 41 months). The injuries involved 14 dominant and 11 nondominant hands. Twelve patients had primary ray resection (< or =2 weeks after injury) and 13 had secondary/reconstructive amputation of 18 border and 7 central digits. Examinations and functional testing by Minnesota rate of manipulation and timed grooved pegboard tests were done and x-rays were reviewed. The majority of patients were subjectively satisfied with the appearance and function of the hand. Patients lost an average of 13 weeks of work (range, 2-24 weeks); those with primary resection were out of work 9 weeks (range, 2-17 weeks) and patients who had secondary resection lost a total of 16 weeks of work (range, 7-24 weeks). Twenty-one of the 25 patients returned to their preinjury occupation. Evaluation of nonwork plus settled workers' compensation cases versus nonsettled compensation/litigation cases showed that there were statistically significant differences in grip strength, key pinch, oppositional pinch, and Minnesota rate of manipulation test results. Primary ray removal limits the total costs associated with injury and disability; unsettled compensation/litigation issues produce statistically disparate and otherwise physically inexplicable differences.

Adolescent↗
PubMed1986

Health Services Research and Development: the Veterans Administration Program.

Health expenditures are rising inexorably; health status shows relatively little gain; technological possibilities are outstripping our ability or willingness to provide a commensurate level of resources. Clinical and administrative managers face increasingly difficult choices among alternative interventions in attempting to resolve these problems. If health services research is to succeed as a tool for assisting these decisions, clinicians, administrators, and researchers must view it as an integral part of management. This paper describes this concept of health services research and its implementation by the VA HSR&D Service, results from 1981 to date, and future directions. Four programs implement the Service's system to make relevant, valid information accessible to VA staff who can use it to improve veterans' health care: Investigator-Initiated Research (IIR) Program; HSR&D Field Program, which implements the Service's mission in various local areas VA-wide; Special Projects Program, responsive to system-wide issues, including technology assessment and transfer; and Resources Program, the Service's own management system. The Service's impact on improving veterans health care is already apparent. However, the true value of the HSR&D system will become apparent only in the 1990s, after the capacity for conducting health services research has been built and integrated fully with clinical and administrative practice. The VA, the nation's largest health care system, has a unique opportunity to demonstrate how health services research can improve health care.

Aged↗
PubMed1986

Information synthesis: a practical guide.

Information synthesis is one of the most valuable contributions a scientist can make. This paper offers guidance in preparing information synthesis and a means of assessing their adequacy. Preparing an information synthesis requires four steps: defining the topic and relevant information about that topic, the purpose of the synthesis, and the target audience; systematically gathering this relevant information; assessing the validity of such information; and presenting validated information in a way useful to the target audience. This paper presents guidelines and criteria for each step, and some helpful hints for authors in preparing an information synthesis.

Documentation↗
PubMedDate not supplied

Severity of illness: red herring or horse of different color? Part 2.

In this continuation of his article, the author defines severity and acuity of illness and discusses approaches to the measurement of the two factors. He provides some background on severity of illness measures that are in current use and prepares for a discussion of the uses of these measures.

Death↗
PubMedDate not supplied

Severity of illness. Red herring or horse of different color? Part 1.

This article, the first in a three-part series, describes the theoretical underpinnings of the production of health and the measurement of health care effectiveness and provider performance. It defines severity of illness, discusses the proposed uses of severity scores, and provides criteria for validating severity measurement systems. The present use of severity scores to adjust outcomes simply assumes their validity, an obvious and inherent flaw. They do not and cannot measure the quality of care. Costs are determined by the provider's response to, and the preferences of, the patient. Use of severity scores either to adjust outcomes or to determine payment for care denies the legitimacy of patients' preferences.

Diagnosis↗
PubMedDate not supplied

Severity of illness: red herring or horse of different color? Part 3.

In this final article in a three-part series, the author discusses the various issues that surround the use of severity-of-illness measures. Particular attention is paid to the use of such measures to assess the performance of providers in the area of quality.

Evaluation Studies as Topic↗