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Biomedical subjects

W Hager

Publications and source records attributed to W Hager.

At least 19 recordsLinked to original sources
PubMed2000

[When does a study of different therapies allow comparisons of their relative efficacy?].

UNLABELLED: Psychotherapy research is a form of evaluation research. Among many others, two types of evaluation can be distinguished: "comparative" and "non-comparative" evaluation studies. This differentiation, though its consequences are often neglected, is fundamental, since a study designed to answer a question concerning the non-comparative or "isolated" efficacy of a therapy cannot simultaneously serve to answer the question concerning the relative efficacy of two or more therapies aiming at the same goals or objectives--and vice versa. In this article, a small part of psychotherapy research, the 22 studies which have already been used by Grawe et al. (1994) in their comparisons of behaviour therapies and short-term psychodynamic therapies, is reanalyzed with respect to the two types of evaluation and to some consequences of this differentiation. RESULTS: On the whole, it is not possible to draw conclusions about the comparative efficacy of behaviour therapies and short-term psychodynamic therapies with regard to their specific goals, even if only some consequences of the distinction between two types of evaluation are taken into account. Among other reasons, this is due to the fact that the studies have not consequently been planned and executed as comparative evaluations. Only amelioration of the 22 studies can be regarded--with certain restrictions--as comparative outcome studies with respect to amelioration of certain symptoms. A further analysis of these studies shows that there is no evidence of a "highly significant" superiority of behaviour therapies over short-term psychodynamic therapies.

Cognitive Behavioral Therapy↗
PubMed1998

[Psychotherapy research--how it should (not) be done. An expert reanalysis of comparative studies by Grawe et al. (1994)].

22 psychotherapy outcome studies used in the Bernese meta-analysis by Grawe, Donati and Bernauer (1994) for a treatment comparison between behavioural and psychoanalytic-psychodynamic treatment concepts were reanalysed by 12 expert psychotherapy researchers independent of each other. Three clinical criteria served as basic criteria for the assessment of the methodological quality of the 22 comparative studies: treatment dosage, therapists' competence or expertise, and an adequate realisation of the intended treatment concept. The expert ratings were then compared with an evaluation of an assessment of a research team from the University of Ulm and with the one from the Bernese research team. Contrary to the Bernese meta-analysis, both the experts and the Ulm research group conclude that only 5 or 8 of the 22 studies, respectively, could be accepted for a relatively fair comparison between the treatments under study. Out of the 5/8 studies, none could be considered fully suitable for a treatment comparison, at the most only moderately suitable. These remaining 5 or 8 studies, respectively, do not prove superiority of one treatment over the other. Hence, the "Dodo Bird Verdict" stands up under scrutiny.

Behavior Therapy↗
PubMed1995

[Is the M. Frostig perceptual training effective or not? On evaluation of the program for promoting visual perception in the German speaking areas].

Whereas the question concerning the efficacy of the Frostig program for the development of visual perception has been discussed controversely among American scientists, most German authors speak positively about the training. In this article, eight studies applying German versions of the Frostig training are shortly presented and their results summarized to find a statement about the effects of the German version of the Frostig program. The comparison of the eight studies turned out to be difficult, because the authors trained children with different handicaps. Moreover, the material was composed differently and the children were trained for different time periods. The interpretation of the positive results in the eight studies turned out more difficult because of unprecise presentation and of methodic shortcomings. The most severe shortcoming in most studies concerned the use of either no or of inappropriate control groups. Overall, the Frostig program seems to lead to improvements in different areas of performance when compared to normal school or preschool lessons. But it seems questionable if the Frostig material itself or the social interaction between trainer and child is responsible for the effects. Besides, the impact of the Frostig training on different performances may be a hint that the training not only affects visual perception, and that improved attention may be responsible for some of the effects.

Attention↗
PubMed1995

[Inductive reasoning and intelligence test performance--analysis of the manner of the effect of 2 thought training methods for children].

For his training programs of inductive reasoning Klauer postulates a transfer effect to inductive thinking as well as to (performance in tests of) intelligence. As evidence for these claims, however, he uses the same data. That means the same tests are used to prove enhancement of inductive thinking and to prove transfer to performance in tests of intelligence. Moreover, Klauer's claim to train inductive thinking is criticized since better performances in at least some of the tests he administers can result due to enhancements in the area of visual perception. Finally, we ask what kind of effects the programs result in: Are they mere coaching effects or do the programs result in better performance due to enhanced competencies? The empirical evidence suggest that positive effects on inductive thinking do not last as long as perceptual competencies that are necessarily fostered when visual material is presented to children.

Adolescent↗
PubMed1993

[Test strategies in evaluation of quantitative psychological hypotheses: the example of total learning time in learning of texts].

In most textbooks on statistics and experimental design, the analysis of trend hypotheses is incomplete or at least not satisfactory from an hypothesis testing point of view. Quantitative psychological hypotheses usually predict that a particular trend component will be significant, while all other trends are expected to be absent. Only a conjunction of these two results, however, eventually confirms the psychological hypothesis. This fact is not addressed in popular textbooks, and so this article deals with some statistical testing strategies that can be used to examine functional psychological hypotheses via trend tests. Under some circumstances, however, the strategies discussed may fail when several psychological hypotheses are examined simultaneously. This failure can be avoided by adding a further test to the strategies which allows a comparison of predicted and actual correlations. The different strategies for testing trend hypotheses are then applied to the simultaneous examination of two simple quantitative psychological hypotheses which address the role of total presentation time and its pacing in text learning ("total-time hypothesis"). Although Bredenkamp (1975) has convincingly argued on a theoretical basis that the form most often encountered in the literature must be false, this variant has been discussed most often in various fields of psychology. Therefore, two experiments were planned and performed in which this well-known variant of the hypothesis is compared with a modification claiming a less steep linear function than the classical variant. The article shows how the necessary tests can be planned to prevent the cumulation of error probabilities from being too large. The experiments in which N = 180 and N = 216 students have to learn and recall until they have mastered a short prose passage, demonstrated convincingly that the classical form of the total-time hypothesis does not hold, whereas the modification can be regarded as confirmed.

Adult↗
PubMed1992

Memory monitoring and memory performance: linked closely or loosely?

An experimental test of the metamemory hypothesis claiming a substantive positive relationship between memory monitoring and memory performance is provided. Forty-eight university students learned a set of abstract nouns. They were either instructed to make use of monitoring activities (experimental group), simply to learn the words (control-1) or to use non-metacognitive learning strategies (control-2). Prior to recall, the subjects had to predict the number of items they expected to remember. The experimental predictions were derived on two levels. First, prediction accuracy should be best for the experimental group. This is a necessary prerequisite for a valid test of the second prediction, namely that memory performance, too, should be best for the experimental group. Whereas the first prediction was confirmed, the second, vital for the metamemory hypothesis, was not. Thus, this hypothesis did not stand up to an experimental test, but would have been confirmed if tested by the correlation between prediction accuracy and memory performance.

Adult↗
PubMed1990

[Influence of surgical intervention on the course of patients with rheumatic mitral valvular defects].

A retrospective study of 798 patients from Essen University Medical Hospital during the period 1960-1987 with operation performed due to valvular heart disease was undertaken. Among them were 324 suffering from mitral stenosis, 12 from mitral regurgitation, 462 from mixed mitral valvular diseases. The surgical treatment consisted of commissurotomy in 611 patients, and prosthetic valve replacement in 187 patients. Follow-up studies showed: Before and after operation, occurrence of embolism was 16.5 vs 8.7%; status of class of cardiac function (NYHA) from group with commissurotomy was 3.1 vs 2.0; NYHA classification in group of prosthetic replacement was 3.1 vs 1.9; 10 years survival rate after commissurotomy was 95.2%; after valve replacement it was 80.2%; early letality rate after operation (at or within 2 months after operation) depended on 1) the type of operation: commissurotomy 2.8%, valve replacement 10.2%; 2) the state of cardiac function: in class IV it was 12.9%, in class III 4.6%; 3) the number of operations: in only operation it was 4.8%, in reoperations 19.5%. Thus the following fact will lead to false judgement: though the area is the same, the regurgitant volume may vary with the brightness of coloration. Furthermore the left auricle will be enlarged consequently following the increase of regurgitant volume, also causing misinterpretation. It is of practical importance to consider some other factors in quantifying the regurgitant volume.

Adult↗
PubMed1990

[Successful treatment of flecainide (Tambocor) poisoning--effect of hemodialysis/hemoperfusion?].

After suicidal ingestion of 3 g flecainide a 34-year-old woman showed somnolence, cerebral convulsion, disturbances of atrioventricular and intraventricular conduction and ventricular asystole. The maximum flecainide plasma level was 4900 ng/ml; this level is extremely high and exceeds the maximum therapeutic level by five times. After initial cardiopulmonary resuscitation and stabilization by intensive care treatment we performed a combined hemodialysis/hemoperfusion therapy (with activated charcoal). This procedure led to a rapid decrease of flecainide plasma levels and simultaneous improvement of ECG-alterations. The initial decrease in flecainide plasma levels during extracorporeal elimination occurred much quicker (4.5-8.5 h plasma halflife) than the spontaneous decrease rate of flecainide in humans (12-20 h plasma half-life). We conclude that, perhaps, hemodialysis/hemoperfusion therapy is an efficient method for decreasing toxic plasma levels of flecainide and for improvement of the clinical course of this intoxication.

Adult↗
PubMed1986

[Arteriosclerotic aneurysms of the right coronary artery in a 56-year-old female].

We report the case of a 56-year-old woman with a saccular aneurysm of the right coronary artery, which was resected. Aneurysmatic coronary artery disease mostly has an arteriosclerotic origin and occurs in patients with coronary artery disease with a frequency of 0.3-4.9%. In the affected patients myocardial infarction is more frequent, but their 5-year survival rate is not diminished. The therapy of choice is, as indicated, aortocoronary bypass grafting.

Aneurysm↗