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Biomedical subjects

Roger S Mazze

Publications and source records attributed to Roger S Mazze.

5 recordsLinked to original sources
PubMed2006

Physician pay-for-performance. Implementation and research issues.

Recent research underscores the gaps that exist between evidence-based medical practices and the care that many patients actually receive. Recognizing this, large purchasers are experimenting with new reimbursement arrangements called pay-for-performance (P4P) that tie a portion of payments for physician services to measures of quality. Agency theory, from the discipline of economics, provides a perspective on the challenges P4P is likely to encounter. The focus of most P4P initiatives on medical group performance raises additional questions about its potential effectiveness as a catalyst for change.

Employee Performance Appraisal↗
PubMed2004

Undetected, uncontrolled blood pressure in type 2 diabetes: self-monitored blood pressure profiles.

OBJECTIVES: To construct a novel and clinically relevant means of representing self-monitored blood pressure (SMBP). METHODS: Patients treated to an office blood pressure (BP) < 130/80 mmHg measured their BP at home for 14 days using an Omron IC semi-automatic portable monitor with memory. SMBP data were transferred from the monitor to a computer to produce graphic profiles (SMBPp) that depict the hourly variation in BP throughout a "typical" or modal day. RESULTS: Office BP and SMBP data from 66 subjects with type 2 diabetes and hypertension (HTN), who completed a previous study of intensified management, were analyzed based on European Society of Hypertension-European Society of Cardiology (ESH-ESC) classifications. Patients were classified as Optimal (6), Normal (12), High Normal (15), Isolated systolic HTN (29) and Grades 1, 2 or 3 HTN (4). SMBP disagreed in 32 cases, placing 29 patients in higher risk categories. Analysis by SMBPp of the 33 patients originally classified as Optimal, Normal or High Normal showed that on average 50 +/- 31% of their systolic SMBP values exceeded ESH-ESC thresholds for HTN (135 mmHg). It also revealed that 74 +/- 21% of their SMBP values exceeded the treatment goal (< 25 mmHg) for high-risk patients with type 2 diabetes. CONCLUSIONS: SMBPp allowed for a definitive measurement of the dynamic daily BP changes. It produced compelling evidence of persistent patterns of BP fluctuations among patients with normal office BP whose uncontrolled HTN would have remained undetected.

Adult↗
PubMed2002

Measuring and managing hyperglycemia in pregnancy: from glycosuria to continuous blood glucose monitoring.

The need to accurately detect and monitor hyperglycemia in pregnancy is becoming more apparent as the incidence of pregestational and gestational diabetes is increasing, especially among adolescents. The risk of adverse perinatal outcome is markedly worsened when pregnancy is complicated by elevated blood glucose. The appropriate management of both pregestational and gestational diabetes as it relates to blood glucose targets is clear. In the past 5 years, a number of studies have concluded that tight glycemic control throughout pregnancy significantly reduces both fetal and maternal risk. These studies have proposed blood glucose targets between 70 to 120 mg/dL. They have concluded that blood glucose levels should be the basis of moving rapidly to more effective treatments. The key to this approach is the adoption of blood glucose monitoring as an integral part of the treatment regimen. To assure sufficient data on which clinical decisions are made, the type of device, frequency of monitoring, and interpretation of results need to be carefully considered.

Blood Glucose↗