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Biomedical subjects

William P Coleman

Publications and source records attributed to William P Coleman.

13 recordsLinked to original sources
PubMed2006

A quality rating scale for aesthetic surgical procedures.

BACKGROUND: Cosmetic dermatologic procedures offer the promise of visible aesthetic enhancement with minimal risk. While in recent years the number of available procedures has proliferated, there are few objective methods for evaluating the relative quality of these procedures for particular indications or specific patients. OBJECTIVE: (A) To develop a simple, easy-to-use numerical rating scale to assess the quality of cosmetic surgical procedures on a range of parameters pertaining to clinical efficacy and patient satisfaction; (B) to statistically validate the discriminative value of this rating scale. METHODS: (A) Patient and physician interviews were performed to elicit a list of factors that may collectively characterize the clinical efficacy and patient tolerability of cosmetic dermatologic procedures. A 0-100 point rating scale was developed based on these factors, with the face-validity of this scale checked by a group of patients and physicians; (B) Statistical analysis of the questionnaire was performed by asking 15 expert cosmetic dermatologic surgeons to use it to rate 23 common cosmetic dermatologic procedures, and analyzing the results. RESULTS: (A) An easy-to-use scale was constructed to assess the quality of cosmetic dermatologic procedures by rating the associated cost, risk, time (procedure and recovery), discomfort, results, and longevity of benefit. A "physician adjustment factor" was used to further increase the relevance of this 0-100 point scale for specific patients; (B) Repeated-measures analysis of variations (ANOVAs) performed on the data from the survey of experts demonstrated that this scale can be used to discriminate between common dermatologic procedures. The differences in mean subscores and total scores among procedures grouped by anatomic site and target lesion-type were significant at the level of P < .05. LIMITATIONS: Patient preferences exogenous to the rating scale may increase or decrease the suitability of specific procedures. CONCLUSIONS: Common cosmetic dermatologic procedures are of uniformly high quality, as per expert ratings on a systematic measure. This quality rating scale appears statistically valid and robust, given that expert raters assigned similar ratings to the same procedures but mean ratings were different across procedures. In the future, this quality rating scale can be used to assess novel interventions, and to help dermatologic surgeons faced with patient concern to optimally select among alternative procedures for a given indication.

Botulinum Toxins, Type A↗
PubMed2006

Lexicon of areas amenable to liposuction.

BACKGROUND: Areas amenable to liposuction are identified by a variety of terms. Both common and professional language is used. OBJECTIVE: This manuscript identifies colloquial terms for these body areas and suggests a standardized nomenclature. RESULTS: Physicians need to be aware of the lay terms so they can communicate with their patients. The careful use of a standardized vocabulary provides precision and accuracy.

Humans↗
PubMed2005

Prognostic value of pinprick preservation in motor complete, sensory incomplete spinal cord injury.

OBJECTIVE: To assess sacral and lower-extremity pinprick preservation as prognostic indicators for ambulation in motor complete, sensory incomplete spinal cord injury (SCI). DESIGN: Retrospective analysis. SETTING: Twenty-eight tertiary care centers in the United States and Canada. PARTICIPANTS: Subjects (N=131; mean age, 31.6y) with motor complete, sensory incomplete SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Ambulation at 26 and 52 weeks postinjury (modified Benzel scale). RESULTS: A higher percentage of subjects with sacral pinprick preservation at baseline were ambulating at 26 (39.4% vs 28.3%) and 52 weeks (53.6% vs 41.5%). This finding did not reach statistical significance. The presence of sacral pinprick preservation at 4 weeks postinjury was significant for predicting ambulation at 52 weeks postinjury (36.0% vs 4.4%, P =.011) and approached significance at 26 weeks (15.2% vs 0.0%, P =.056). Significant differences in ambulation rates were also observed between subjects, based on the presence of baseline lower-extremity pinprick preservation (>/=50% of lower-extremity L2-S1 dermatomes) at both 26 (50.0% vs 28.8%, P =.048) and 52 weeks (66.7% vs 40.3%, P =.023) after injury. CONCLUSIONS: Baseline lower-extremity pinprick preservation and sacral pinprick preservation at 4 weeks postinjury are associated with an improved prognosis for ambulation.

Adult↗
PubMed2005

Seroma formation following abdominal liposuction.

BACKGROUND: Liposuction of the abdominal region is a common procedure performed in the United States. A variety of complications can occur when performing this procedure. OBJECTIVE: To present a case of a patient with a seroma as a complication of abdominal liposuction and its management. RESULTS: The patient had a recurring seroma of the right lower quadrant of the abdomen that necessitated ultrasound-guided drainage. CONCLUSION: This case provided a valuable lesson. Clinicians should be conscious of the potential for this complication to occur. They must select patients appropriately to limit the risk of adverse events.

Abdominal Wall↗
PubMed2004

Tumescent liposuction report performance measurement initiative: national survey results.

BACKGROUND: This study was created by the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement to measure clinical performance and improvement opportunities for physicians and ambulatory health-care organizations. Data were collected prospectively between February 2001 and August 2002. Thirty-nine study centers participated, and 688 patients who had tumescent liposuction were surveyed and followed for 6 months. OBJECTIVE: The objective was to determine patient satisfaction with tumescent liposuction and examine current liposuction practice and the safety of tumescent liposuction in a representative cohort of patients. METHODS: The Accreditation Association for Ambulatory Health Care Institute for Quality Improvement collected prospective data from February 2001 to August 2002 from 68 organizations registered for this study. Ultimately 39 organizations submitted 688 useable cases performed totally with local anesthesia, "tumescent technique." RESULTS: The overall clinical complication rate found in the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement study was 0.7% (5 of 702). There was a minor complication rate of 0.57%. The major complication rate was 0.14% with one patient requiring hospitalization. Seventy-five percent of the patients reported no discomfort during their procedures. Of the 59% of patients who responded to a 6-month postoperative survey, 91% were positive about their decision to have liposuction (rating of 4 or 5 on a scale of 1-5) and 84% had high levels (4 or 5 on a scale of 1-5) of overall satisfaction with the procedure. CONCLUSIONS: Our findings are consistent with others in that tumescent liposuction is a safe procedure with a low complication rate and high patient satisfaction.

Adolescent↗
PubMed2002

Spinal cord injury.

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Clinical Trials as Topic↗
PubMed2002

Liposuction.

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Humans↗
PubMedDate not supplied

Injury severity as primary predictor of outcome in acute spinal cord injury: retrospective results from a large multicenter clinical trial.

BACKGROUND CONTEXT: The prognostic value of injury severity and of anatomical region in acute spinal cord injury is strong, making it hard to evaluate other indicators or assess improvement without considering them. PURPOSE: This study documents issues and suggests a practical way to stratify. STUDY DESIGN/SETTING: Retrospective analysis of data prospectively collected for the multicenter trial of GM-1. PATIENT SAMPLE: A total of 760 patients were recruited at 28 centers in North America. Injuries were rostral to T10 and left at least one leg with an American Spinal Injury Association (ASIA) motor score less than 15 of 25. Patients were assessed at baseline using the ASIA Impairment Scale (AIS): Grade A, Grade B, and Grades C and D (combined). They were divided by injury region: cervical or thoracic. OUTCOME MEASURES: The endpoint was marked recovery (MR), defined as improvement of at least two grades from AIS at baseline to Modified Benzel Scale at Week 26. Other endpoints were changes in ASIA Motor, in light touch, and in pin prick scores. METHODS: Data were verified onsite by a central team of monitors, the database was checked and standard statistical techniques were applied. RESULTS: Recruitment was uneven. In 760 patients, 579 injuries were cervical, and 482 were complete. There were few incomplete thoracic injuries. The cervical group had more MR than the thoracic group (37.2% vs 15.9%, p< .0001). AIS Groups C and D had (p< .0001) more MR (84.0%) than Group B (46.6%), which recovered more than Group A (12.8%). The cervical group had an advantage in MR because it had more patients with AIS B, and still more AIS C and D. Within AIS Group A, the cervical subgroup had (p< .02) higher MR (15.5%) than the thoracic one (7.0%), but MR was nearly equal in the B and CD groups. This suggested a new stratification variable, "injury region/severity," to distinguish cervical (n=332, MR=15.5%) and thoracic (n=150, MR=7.0%) injuries within AIS A, but not in AIS B (n=131, MR=46.6%) or AIS CD (n=147, MR=84.1%). This variable is a significant predictor of MR (p< .0001). CONCLUSIONS: AIS severity was the strongest predictor. Anatomical region was also strong but confounded with the severity effect, because the cervicals had fewer complete injuries, and because the cervical complete group did better than thoracic complete. The injury region/severity variable keeps the strong prognostic value of using both region and severity, but is simpler and more statistically economical.

Acute Disease↗