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Biomedical subjects

S C Farrow

Publications and source records attributed to S C Farrow.

At least 37 records · Page 2Linked to original sources
PubMed1986

Monitoring performance in the NHS. The district neural tube defect screening service.

A small medical school team has developed a six item system (SIS) for monitoring the neural tube defect (NTD) screening service. SIS is discussed in relation to possible alternative monitoring systems and the advantages which led to its implementation are described. In July 1982 the system was introduced in three districts in South Wales and the first year's results are presented. These permit the local provision, written policies and clinical and management responsibility of the service to be examined and deficiencies in the relevant information systems to be identified. Of particular concern is the discovery that districts have no way of knowing the number of terminations for NTD, and thus their current NTD incidence. In view of these findings, it would seem advisable for all districts providing NTD screening to monitor their service. SIS provides a simple, cheap and effective monitoring system which could be easily implemented throughout England and Wales.

Diagnostic Tests, Routine↗
PubMed1986

Risk targetting: an approach to cost-containment.

The need for rationing in an insurance-based system of health care is inescapable. The best way to tackle the mismatch between demand and supply is, however, not clear. Of the four general strategies described, increasing the risk of disease in a population is shown to be the most effective way of reducing the outcome cost of a service. This may enable health care systems to provide services which would otherwise be unaffordable. This paper develops a technique for assessing risk using Lorenz curves which could be used by health service managers and clinicians. The paper uses cervical cytology screening to illustrate how variables can be selected in such a way as to maximise the number of potential beneficiaries while minimising the number of people to whom the service is offered.

Cost Control↗
PubMed1985

Epidemiology for medical students: a controlled trial of three teaching methods.

Medical students taking a course in epidemiology for clinical practice were taught by either lectures, small group seminars or self-learning packages. Examination performances were no different for the three groups, but self-perceived mastery of learning objectives, and satisfaction with the course were higher for students who received self-learning packages. Sixty per cent of self instruction students found the teaching method was successful compared with 37% of the seminar students and only 19% who received lectures. A combination of self-instructional package and seminar would seem to hold most promise for a workable and effective course.

Education, Medical, Undergraduate↗
PubMed1984

Epidemiology for medical students: a course relevant to clinical practice.

A new course was designed to make epidemiology clinically relevant to medical undergraduates. The objectives were that students should (1) know the epidemiology of common diseases, (2) understand epidemiological concepts useful in diagnosis and treatment, and (3) be able to critically assess published medical evidence. Results of a written examination showed that objectives 1 and 2 had been 'easily' achieved by 80% and 68% of students respectively. Student opinion of the course, assessed by an anonymous questionnaire, showed that the majority of students considered the course to be an important part of medical education. Before the course 19% felt 'reasonably able' or 'very able' to achieve nine specific objectives related to epidemiological concepts in diagnosis and treatment. By the end of the course this had risen to 78%.

Education, Medical, Undergraduate↗
PubMed1984

Epidemiology in anaesthesia: a method for predicting hospital mortality.

Data on 13 043 operations were abstracted from 108 878 anaesthetic records in the Cardiff Anaesthetic Record System. Nine groups of surgical operations with high mortality in hospital were identified. These records were analysed using a logistic regression model to determine the probability of death in hospital. Variables included in the model were age, sex, elective or emergency operation and five intercurrent diseases. The significance of individual variables was assessed: age was the most important single variable in six of the nine operation groups. The model was used to calculate the risk of death in hospital for individuals with specific characteristics. With further development, this technique might be used by clinicians at other centres to predict the outcome for patients under their care.

Age Factors↗
PubMed1982

Epidemiology in anaesthesia. III: Mortality risk in patients with coexisting physical disease.

The Cardiff Anaesthetic Record System has been used to examine the hospital mortality rates and relative risks for patients having anaesthesia who have certain preoperative conditions coexisting with their disease requiring surgery. Each preoperative condition was associated with a higher mortality rate than occurred in patients with no preoperative condition (for example ischaemic heart disease 7%, diabetes 5.7%, no preoperative condition 0.5%). Mortality was greater for emergency than for elective operations. In contrast to an increasing mortality by age, the relative mortality risk decreased, suggesting that in older age groups coexisting disease may be less important than other risk factors in determining mortality.

Adolescent↗
PubMed1976

Geriatric admissions in East London 1962-72.

Geriatric admissions over the period 1962-72 in East London were studied. Patients, for the most part, presented combinations of physical, mental and social disability. 6286 admissions of 3988 patients were analysed with regard to length of stay, outcome, number of repeat admissions, age and sex. Numbers were large enough for trends to be clear. For example, 550 admissions were of persons over 90. The largest group were aged 75-84. The likelihood of death in hospital increased with age while the percentage of discharges home fell. With age there was a gradual increase in the percentage of those in hospital 28 days or less. Eight per cent of males and 10 per cent of females remained in hospital over one year. Seventy per cent of patients were admitted to hospital once only, while fewer than 2 per cent were admitted more than five times. A sample of new patients admitted from one borough in 1968, was traced in hospital and after discharge. The 50 per cent survival time for men was 6.5 months and for women 12.9 months.

Age Factors↗
PubMed1976

Pre-registration house appointments: a computer aided allocation scheme.

The number of pre-registration house posts allocated by the London Hospital rapidly increased in 1973. This made solution by hand of the allocation problem time consuming and complex. The Operational Research Unit was approahced and a computer aided scheme was designed which was subsequently adopted. Various alternative allocation methods are discussed and examples given. The results of the first five allocations are presented. The percentage of applicants obtaining one of their first three choices varied from 61 to 70%. Of consultants who expressed a choice, the percentage obtaining one of their first three choices was in the range of 72-94%. The allocation scheme has two principal advantages over methods used elsewhere. It is extremely flexible, allowing various weights to be given to either applicant or consultant. It also produces a complete solution which is optimal in terms of the numerical criteria specified. Details of the assignment algorithm are given in the Appendix.

Computers↗
PubMed1974

Effects of age, sex, and polycystic disease on progressive bone disease of renal failure.

A study of 150 patients undergoing haemodialysis has shown that age had a striking effect on the radiological presentation of renal bone disease, erosions being common in the young and uncommon in older patients and vascular calcification showing opposite trends to this. Men aged 20 to 59 years had a greater tendency to develop erosions than did women in this age range. Examination of a group of 53 patients over a period of five years showed that the half time for the development of vascular calcification was 4.6 years, erosions 26.7 years, and fractures 6.9 years. Nine out of 16 polycystic patients matched for age and sex with 50 controls did not develop erosions and had consistently less vascular calcification than the controls when examined over a six-year period.

Adolescent↗