PubMed · 1539863
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S Mantha. 1992. Statistical tests and small samples.. https://doi.org/10.1097/00000542-199203000-00025
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An investigation was undertaken to assess the reliability of radiographic diagnosis of abnormalities of orthodontic significance in the anterior region of the maxilla from intraoral and dental panoramic tomograph (DPT) views. DPT films of 200 patients were scrutinised by two observers on two separate occasions, who also examined intraoral radiographs of the same patients. Sixty-three of these patients were selected because they had previously been diagnosed as presenting with a defined abnormality of orthodontic relevance, such as supernumerary teeth, absent incisors, etc. The remaining cases had been assessed as depicting normal radiographic appearances. Each radiograph was allocated a unique, randomly selected code number as the only means of identification. It was not possible for the observers to match the DPT to the corresponding intraoral films, and this information was only available to the principal investigator (JWF). Both observers were asked to record the presence or otherwise of any abnormalities at each observation of each radiograph, and to record their findings. The overall level of diagnostic accuracy and reproducibility was fairly high, and in general terms the DPT views were as reliable as the intraoral films with regard to the detection of abnormalities; however, there were significant differences between the observers. It was concluded that in many instances supplementary intraoral films would not contribute any additional information compared to the DPT and that selection criteria should be defined for the former.
In a consecutive series of 123 men (aged 55 +/- 8 years) with a recent first acute myocardial infarction (AMI), 24-hour ambulatory ST-segment monitoring was performed early after discharge (day 11 +/- 5), 6 months (day 185 +/- 6) and 1 year (day 368 +/- 8) after AMI. No difference in the prevalence of transient myocardial ischemia was found between the 3 recordings (17, 17 and 20%), and most ischemic episodes were silent (98, 100 and 97%). In the early postinfarction period, a peak of ischemic activity was demonstrated between 6 P.M. and midnight (40 of 93 episodes [43%]). Over time, the maximal occurrence of ischemia gradually advanced toward the morning hours with a peak activity between 6 A.M. and noon at 1-year follow-up (32 of 73 episodes [44%]). Significantly more patients (16 of 21 [76%]) had ischemia from 6 P.M. to midnight at discharge compared with the findings 1 year later (9 of 23 patients [39%]) (p < 0.03). An opposite trend was found regarding patients who exhibited ischemic episodes in the hours from 6 A.M. to noon: 10 of 21 patients (48%) early after discharge versus 17 of 23 patients (74%) at 1-year follow-up (p = not significant). Results from the 6-month recording displayed characteristics between the findings from discharge and 1-year ambulatory monitoring. The pathophysiologic processes underlying the observations from this study are unknown. The change in circadian periodicity could not be explained from differences in heart rate variation patterns or medical antianginal treatment among the 3 recordings.(ABSTRACT TRUNCATED AT 250 WORDS)
OBJECTIVE: Study of the degree of completeness of slips sent to forward patients from primary medical care to emergency units of the corresponding general hospital. DESIGN: This is a statistical descriptive and inferential study. SITE. The study was carried out in the general hospital allocated to Zaragoza Health Area III. PATIENTS: Included in the study are all patients sent by primary medical care for evaluation by the urgency unit in the internal medicine section. MAIN MEASUREMENTS AND RESULTS: 415 urgent treatment slips were analysed, evaluating the completion rate and the degree of correctness in relation to their source as either rural or urban. With regards the degree of completion (clinical history, antecedents, examination) and correct functioning at the visit to family doctor stage, there are highly significant differences between those sent from all other such centres (p less than 0.01). Only in the case of 8 slips were physical examinations completed for the presenting ailment: 7 came from urban health centres and 1 from rural health centres. Diagnostic impressions and observations were absent from 62.2% of the slips. CONCLUSIONS: While overall there is no difference between those sent from rural and urban centres, there were differences when those sent from urban health centres were compared with those sent by all other health centres.