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At least 181 records · Page 10Linked to original sources
PubMed1984

Effect of a medical care evaluation program on physician knowledge and performance.

A model program designed to increase the educational value of medical care evaluation committee meetings was studied to determine its effect on the knowledge and clinical performance of participating physicians. The members of hospital committees in which the program was successfully implemented showed a statistically significant gain in knowledge of the topics discussed by their committees. In addition, several members made substantial changes in their patient care practices. These changes resulted not so much from the acquisition of new medical information as from a rethinking of patient management strategies, stimulated by peer discussion during committee meetings. A structure that encourages such discussions can be incorporated in other types of patient-care-oriented committee activities as well.

Clinical Competence↗
PubMed1991

The genetic toxicity database of the National Toxicology Program: evaluation of the relationships between genetic toxicity and carcinogenicity.

The database of the U.S. National Toxicology Program has been developed over approximately two decades, principally focused on substances evaluated for carcinogenicity in rodent bioassays. These assays generally provide data on the relative toxicity and carcinogenicity of chemicals based upon discrete subchronic (13 week) and chronic (104 week) exposures. A major value of these data are that the assay protocols, rodent strains, and technical methodologies have been generally consistent, thus permitting comparisons between assays and chemicals. The genotoxicity data for many of the same chemicals have been developed also using standardized biological systems and protocols. Data for assays including mutagenicity in Salmonella and mouse lymphoma cells, chromosomal aberrations, and sister chromatid exchange in Chinese hamster ovary cells, transformation of Balb/c 3T3 cells, and in vivo cytogenetic effects in rodents have been compiled for many chemicals. The results of all of these assays provide a substantial database for evaluating chemical effects and for defining the complex relationships between mutagenicity and carcinogenicity.

Animals↗
PubMed1976

Methadone treatment: program evaluation and dose response relationships.

Data from a heterogeneous group of 155 clients in a Methadone Treatment Program were analyzed for (A) number of possible methadone administrations since S joined the program, (B) actual number of methadone administrations received, (C) spottiness (A-B), and (D) presence of illicit drugs in urine analysis reports. Data were evaluated for three separate time spans which corresponded with three programmatic changes. Results indicate that initially high blockading doses of methadone are effective in reducing illicit drug use, but as length of time in program increases, the efficacy of low doses of methadone in reducing illicit drug use increases. At least one programmatic change, a more stringent selection procedure, was demonstrated to be highly successful in reducing illicit drug use.

Adolescent↗
PubMed1992

An image analysis and statistical evaluation program for the assessment of tumour cell invasion in vitro.

Tumour cell invasion is a complex process, which is essential for the formation of metastasis and is therefore of critical clinical importance. For detailed investigations of the invasive process, quantifiable in vitro models of invasion are necessary. In this study we describe an image analysis procedure and a statistical program which facilitate an objective analysis of experiments carried out using the embryonic chick heart invasion model of Mareel. Tumour multicellular spheroids are confronted with embryonic chick heart fragments in culture and are sampled after different time intervals for up to 7 days. Immunohistological sections are then evaluated by an image analysis procedure which provides 9 parameters indicating invasion, proliferation and destruction taking place in the confrontation cultures. The data obtained by image analysis are further evaluated by a statistical program which describes the change with time of each parameter by means of linear regression analysis. Thus the data obtained at various time intervals serve as the source data for a single statistic, namely the slope of the regression line. Confidence intervals and statistical differences between various experiments can be calculated. In order to make the procedure more comprehensible in biological terms, the program provides a full text interpretation of the experimental results. The image analysis procedure in conjunction with statistical evaluation and text interpretation provides a comprehensive tool for the quantitative assessment of experimental invasion in vitro.

Animals↗
PubMed1990

Serving people who are dually diagnosed: a program evaluation.

The progress of a group of clients during their first year in a special program for persons who are both mentally retarded and psychiatrically impaired was described. The clients increased their level of independence and decreased their frequency of problem behaviors. However, they still faced significant obstacles to further growth, particularly the need to develop residential alternatives and community supports. The salience of these same issues for all individuals with dual diagnoses was discussed.

Activities of Daily Living↗
PubMed1979

Formulating therapeutic objectives as a prelude to program evaluation.

The author emphasizes the need for more precise formulation of goals for mental health treatment programs. He describes the Veterans Administration's five-year effort at goal formulation using ideas borrowed from operations research and education. With goals from various VA programs as examples, he illustrates how goal statements can be written with more specificity. He also describes how matching rating-scale items can be developed to measure the degree to which each goal is being met.

Evaluation Studies as Topic↗
PubMed1979

Community support programs: program evaluation and public policy.

The plight of chronic psychiatric patients in the community has led to a major federal effort to resolve fragmented and disorganized care. The Community Support Programs (CSPs) recently funded by NIMH offer the promise of reducing these difficulties by creating comprehensive human service systems at the local and state levels. However, the author points out that these demonstration projects should be evaluated lest they continue to operate on the basis of rhetoric rather than fact. He presents an evaluation framework whereby indexes pertinent to each program goal of the CSPs can be measured and the resulting data used for public policy purposes.

Community Mental Health Services↗
PubMed1984

The impact of a psychosocial support program on survival with breast cancer: the importance of selection bias in program evaluation.

A retrospective follow-up study was conducted to assess the impact of a psychosocial support program on survival with breast cancer. One-hundred and two nonparticipants were individually matched to 34 participants on several prognostic factors, and both groups were followed from date of cancer diagnosis (1971-1980) until December, 1981. Preliminary findings suggest a strong beneficial effect of the program on survival, which is statistically significant. However, this observed effect is due largely to a selection bias caused by the failure to match on the duration of the lag period between cancer diagnosis and program entry. Correcting for this bias in the analysis results in a small, nonsignificant program effect. We are not able to rule out a possible effect, however, because of the relative lack of statistical power and because of a modest, though nonsignificant benefit observed for women who entered the program shortly after diagnosis. Furthermore, the program might have other beneficial effects on the quality of life.

Adult↗
PubMed1983

Who volunteers for a breast self-examination program? Evaluating the bases for self-selection.

Interest in a free breast self-examination (BSE) teaching program offered to a patient population (n = 1590) was assessed, and a follow-up survey of refusers undertaken to determine difference between participants and refusers. Fifty-one percent of the known, eligible women patients expressed interest in the program and 24% ultimately had the teaching. Participants differed from refusers most notably in terms of less previous experience with BSE, more family history of cancer, a longer relationship with their physicians, and different health beliefs. They state more confidence in the effectiveness of breast cancer detection and treatment, less fear and embarrassment, and more personal and physician responsibility for health outcomes, as measured by the Health Locus of Control Scales. Self-selection thus seems rationally based on the kind of program and the needs of the women. Such self-selection can be cost-effective in delivering health education to the people most in need of it and most likely to benefit from it.

Adolescent↗
PubMed1988

Undergraduate allied health leadership development: a program evaluation and follow-up study.

The present study reports the 15-year experience of an undergraduate program in preparing allied health professionals for educational leadership positions. Seventy-three professionals completed the BS degree as of August 1986. A substantial percentage of the graduates were attracted to faculty positions in institutions of higher education; 34% had achieved positions of department chair or the equivalent. Over 50% had completed some form of graduate study. The diversified settings and job titles reported indicate that the curriculum possesses validity for a variety of health care educational and administrative positions. Overall, this undergraduate program appears to contribute to the development of leadership personnel in allied health, particularly for those professions that provide entry-level health credentials at the level of associate degree or the equivalent.

Allied Health Personnel↗
PubMed1986

Program evaluation of physical medicine and rehabilitation departments using self-report Barthel.

The Barthel Index measures performance of personal care (feeding, dressing, hygiene) and mobility (transferring, walking/wheeling) activities. Since its inception, several revisions of this index have increased its accuracy in measuring functional ability of patients during medical rehabilitation. However, this activities of daily living (ADL) scale is rarely used to determine the abilities of individuals after discharge, leaving assessment of functional outcome incomplete. In this study this index has been converted to a self-report format, which can be completed easily by the patient or family member both during the rehabilitation stay and after discharge. The reliability of the self-report version is examined, by comparing the assessments of patients to those made by the health professionals. A sample of persons at an inpatient rehabilitation facility, who could both read and write, completed the self-report during the week before discharge. Results comparing the assessment of professionals and patients showed a statistically significant difference with p less than 0.001. This paper will suggest reasons for the difference and explore the possibility of using this self-report version as a means to evaluate both the short-and long-term outcomes of rehabilitation programs.

Activities of Daily Living↗