PubMed · 15652101
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Catherine Mathews, Nicol Coetzee, Merrick Zwarenstein, Sally Guttmacher. 2004. Partner notification.. https://pubmed.ncbi.nlm.nih.gov/15652101/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
For survival data regression, the Cox proportional hazards model is the most popular model, but in certain situations the Cox model is inappropriate. Various authors have proposed the proportional odds model as an alternative. Yang and Prentice recently presented a number of easily implemented estimators for the proportional odds model. Here we show how to extend the methods of Yang and Prentice to a family of survival models that includes the proportional hazards model and proportional odds model as special cases. The model is defined in terms of a Box-Cox transformation of the survival function, indexed by a transformation parameter rho. This model has been discussed by other authors, and is related to the Harrington-Fleming G(rho) family of tests and to frailty models. We discuss inference for the case where rho is known and the case where rho must be estimated. We present a simulation study of a pseudo-likelihood estimator and a martingale residual estimator. We find that the methods perform reasonably. We apply our model to a real data set.
OBJECTIVES: To compare clinical practice relating to testing for, and management of, genital Chlamydia trachomatis infection in the Lothian and Grampian regions of Scotland as part of an evaluation of a Government-funded health demonstration project in Lothian, Healthy Respect. STUDY DESIGN: Clinical audit against standards developed from a national clinical guideline. METHODS: Clinical practice relating to testing for, and management of, genital C. trachomatis infection was assessed against standards for good quality care developed from a national clinical guideline (Scottish Intercollegiate Guidelines Network Guideline 42). Audit methods comprised: postal survey of primary care clinicians; review of referral letters from primary to secondary care; and review of primary and secondary care patient case records. Findings from Lothian and Grampian were compared. RESULTS: Questionnaires were returned by 167 primary care clinicians in Lothian and 96 in Grampian. Clinicians in Lothian and Grampian gave similar responses relating to: testing of symptomatic patients (87 vs 88%); offer of testing for asymptomatic young patients (55 vs 55%); choice of antichlamydial agent (47 vs 42% azithromycin as first line); and follow-up strategies (50 vs 51% offer follow-up in primary care). Clinicians in Lothian were significantly more likely to participate in partner notification work (57 vs 44%; P=0.04) and to agree with statements reflecting 'perceived self-efficacy' in chlamydia-related care (57 vs 48%; P=0.006). Referral letters from primary to secondary care were reviewed for 31 women with genital symptoms in Lothian and 28 in Grampian. More women in Lothian were tested for chlamydia prior to referral (65 vs 39%; difference not significant). Review of primary care records for consultations in young people (145 in Lothian; 203 in Grampian) showed a higher level of chlamydia testing in Grampian (Lothian, 14%; Grampian, 34%; P<0.0001). However, review of secondary care records (n=39) showed a much higher level of testing in Lothian (Lothian, 75%; Grampian, 9%; P<0.0001). Review of secondary care records relating to proven chlamydia-positive women (n=159) suggested better care in Lothian in relation to ensuring antibiotic treatment (Lothian, 91%; Grampian, 74%; P=0.004), and use of the preferred antibiotic, azithromycin (Lothian, 78%; Grampian, 37%; P<0.0001). However, documented referral to a health adviser appeared to be better in Grampian (Lothian, 32%; Grampian, 48%; P=0.048). CONCLUSIONS: During the period of activity of the Healthy Respect demonstration project, few differences were detected between clinicians in Lothian and Grampian with regard to chlamydia-related practice. In both regions, clinicians appeared to be very aware of the need to test for chlamydia in patients with relevant symptoms, but were less likely to offer opportunistic testing to young patients without specific symptoms. These findings suggest that Healthy Respect in Lothian has had little impact on clinicians. However, these findings must be considered within the context of a broader evaluation, and it is noteworthy that the few significant differences that were detected tended to suggest better practice in Lothian.
Chlamydia trachomatis infection is the most commonly reported sexually transmitted disease (STD) in the United States. An estimated 2.8 million infections occur annually. In 2002, a total of 834,555 cases in the United States, including 10,914 cases in Massachusetts, were reported through the National Notifiable Disease Surveillance System (NNDSS). Chlamydial infection is most often reported in females, particularly those aged 15-24 years, reflecting a higher level of screening in females but also important risk factors. Although the majority of infections are asymptomatic, complications are potentially severe in women and include pelvic inflammatory disease, which can lead to tubal pregnancy, infertility, and chronic pelvic pain. Chlamydial infection during pregnancy can cause illness in the infant (e.g., conjunctivitis and pneumonia). Infection in men can manifest as urethritis and epididymitis. Timely, documented diagnosis and treatment of chlamydial infection are critical to prevent both complications and transmission. Since 1996, a progressive increase has occurred in the number of reported cases of chlamydial infection in Massachusetts, in part because of an increase in screening and use of more sensitive tests. This report summarizes an evaluation of chlamydial-infection reporting in Massachusetts during January-June 2003. The results underscore the need for improvement in both completeness and timeliness of reporting chlamydial infection in Massachusetts.