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PubMed1991

Italian register for retinoblastoma. Pros and cons of a retrospective statistical study.

In an attempt to verify some of the current conflicting results concerning the impact of relevant prognostic factors in the retinoblastoma therapy, the authors took into consideration, for statistical analysis, the series of 459 cases included in the Italian Registry for retrospective study of retinoblastoma. Although this series appears large enough, problems related to the continuously changing approaches to the disease and the consequent lack of standardization often make it difficult to draw significant conclusions. Hence, while historical (retrospective) analysis often allows the manipulation of a great number of data, particularly in the case of relatively rare diseases, prospective randomized controlled trials are strongly recommended to standardize definitely the relevant prognostic criteria. These and other problems related to retrospective analysis are discussed in detail.

Evaluation Studies as Topic↗
PubMed1996

Systemic gadolinium toxicity in patients with renal insufficiency and renal failure: retrospective analysis of an initial experience.

OBJECTIVE: To study the possible deleterious systemic effects of gadolinium in patients with impaired renal function. DESIGN: We retrospectively analyzed the routine laboratory data and clinical course of patients who had undergone a gadolinium-enhanced magnetic resonance imaging (MRI) examination of the brain and spine and had evidence of impaired glomerular filtration. MATERIAL AND METHODS: Between October 1988 and October 1992, 15,830 patients underwent gadolinium-enhanced MRI at our institution, 151 of whom had a serum creatinine value of more than 2 mg/dL. The clinical records of these 151 patients were thoroughly examined for the period from 3 days before to 30 days after the gadolinium-enhanced MRI examination. All data were analyzed in an attempt to detect any adverse events that could be related to free gadolinium as a result of dissociation from the chelating agent due to prolonged elimination times (that is, increased serum creatinine concentrations). In addition, we calculated the 90-day mortality rate for both the study group and a matched control population of 80 patients who had undergone MRI of the brain and spine before gadolinium was available. RESULTS: The overall incidence of adverse events in the study group was 3.6%. No event was severe or life threatening--nausea and rash occurred in two patients each, and seizure and headache occurred in one patient each. These findings were not significantly different from those in previous studies performed in populations with normal elimination times. Moreover, no significant difference was noted in the 90-day mortality rate (14.6% of the study group) in comparison with that in the control group (13.8%). CONCLUSION: On the basis of this initial retrospective analysis, we were unable to detect any clinical deleterious effects of administration of gadolinium for MRI examination in patients with impaired renal function. Further investigation with prospective studies is needed to confirm these initial retrospective findings.

Adult↗
PubMed1992

The past is the past--or is it? The use of retrospective accounts as indicators of past strategy.

This study challenges the common assumption that retrospective accounts of business strategy are reliable and valid. Chief executives reported their firms' current strategies, and two years later, they reported their firms' strategies of two years earlier. Of these retrospective accounts, 58 percent did not agree with the previous and validated reports of past strategy. Retrospective errors appear to occur systematically and may be attributable to faulty memory or to attempts to cast past behaviors in a positive light.

Chief Executive Officers, Hospital↗
PubMed1999

[Update of the morbidity of radical retropubic prostatectomy: retrospective analysis of 100 consecutive operations during the period 1996-1997].

OBJECTIVE: To retrospectively evaluate the morbidity of radical prostatectomy, with the exception of sexual complications, based on a recent single-centre series. MATERIAL AND METHOD: From January 1996 to January 1998, the morbidity of 100 consecutive patients undergoing radical retropubic prostatectomy was compared to the morbidity of the first 150 patients operated by the same technique in our department for the period 1983-1993. The perioperative morbidity was studied retrospectively on case files, while continence was evaluated in the last 50 patients by a self-administered questionnaire. Sexual complications could not be evaluated objectively for methodological reasons and were not addressed in this study. RESULTS: The single operative complication was a rectal injury (1%). The transfusion rate was 31%. The early complication rate was 23% with a major complication rate of 5% (four thromboembolic complications and one gastrointestinal haemorrhage). The most frequent minor complications (18%) were wound abscess (5%). The reoperation rate was 3%. The mean duration of vesical catheterization was 7 days (range: 4-30) and the mean hospital stay was 8 days (range: 5-30). With a mean follow-up of 14 months, 73% of patients are perfectly continent, with no incontinence pads, while 15% of the patients required incontinence pads "as a precaution". Incontinence required implantation of an artificial sphincter in 2 patients (2%). Only one patient developed stenosis of the anastomosis requiring internal urethrotomy. The reduction of morbidity in these 100 recently operated patients compared to the first 150 operated patients concerned the transfusion rate (31% versus 65%), the reoperation rate (3% versus 8%) and the minor complication rate (18% versus 32%). The reduction of operative morbidity partly explains the reduction of mean duration of vesical catheterization (7 days versus 15 days), and hospital stay (8 days versus 18 days); the anastomotic stenosis rate was also decreased from 17.3% to 1%. CONCLUSION: This study confirms the reduction of overall morbidity of retropubic radical prostatectomy. This improvement is probably multifactorial: increased operative experience and better postoperative management. These retrospective data must be taken into account in the diagnostic and therapeutic decisions concerning localized prostate cancer.

Aged↗
PubMed2000

[Follow-up of opioid addicts treated with high-dose buprenorphine in a health care network. National retrospective study. Experience of French general physicians].

AIMS: This study was designed to examine the profile of drug-dependent outpatients treated by general practitioners working in a health care network and to evaluate the impact of treatment with high-dose buprenorphine on their medical and social status. METHODS: A retrospective study was undertaken by 71 general practitioners, selected at random from physicians in four health care networks. Data for the period between June and December 1997 concerning the initial prescription, the first stabilization prescription and the most recent prescription, was collected retrospectively. RESULTS: Among the outpatients included in this study, high-dose buprenorphine treatment resulted in a clear reduction in the use of heroin (69.9%) and benzodiazepine (57.1%). It also reduced associated risks of infection and social vulnerability. CONCLUSION: This retrospective study seems to show that care by general practitioners proceeds satisfactorily. The majority of opiate-dependent outpatients were compliant with treatment and successfully reintegrated into society. This method of treatment will be effective if specialised training is given to the general practitioners within the framework of a health care network.

Adult↗
PubMed2001

Explaining retrospective reports of symptoms in patients undergoing chemotherapy: anxiety, initial symptom experience, and posttreatment symptoms.

This study evaluated different perspectives on the relationship of trait anxiety to symptom report. Baseline trait anxiety was related to (a) initial symptoms reported 2 days after beginning chemotherapy, (b) posttreatment symptoms reported 2 days after cessation of medication, and (c) retrospective reports of initial symptoms (made concurrently with posttreatment reports). Associations were significant for vague psychophysiological symptoms but not for concrete visible symptoms. Path models indicated that the relationship of anxiety to retrospective report of vague symptoms was due to both enhanced encoding and facilitated recall of symptoms. Further analyses revealed, however, that this relationship reflects symptoms stability rather than anxiety-related differences in attention. Anxious and nonanxious patients appear to be equally accurate in their retrospective report of symptoms.

Adult↗
PubMed2001

Surgical treatment for pathological long bone fracture in patients with multiple myeloma: a retrospective analysis of 22 cases.

BACKGROUND: The purpose of this study was to retrospectively review the cases of pathologic long bone fractures caused by multiple myeloma treated in our hospital, to analyze the surgical method, complications, radiation therapy, survival time, and influence on quality of life. METHODS: In a retrospective study, 22 patients with the pathological long bone fractures due to multiple myeloma who were surgically treated between 1987 and 1997 were analyzed. All patients received open reduction and internal fixation either with plates or intra-medullary nailing. Cement augmentations were performed in the majority of cases (91%). A detailed retrospective analysis was done to correlate the surgical methods, radiation therapy, functional results, and complications post-surgically. RESULTS: The most common site of fracture was the femur. The mean postoperative survival time was around 19 months. Post-operative pain relief was satisfactory, and only two patients required narcotics. No major complications were observed. However the union rate was only 30%, which might have been due to the inhibitory effect of radiation therapy on bone healing, or insufficient osteogentic ability of the myeloma-involved bone. CONCLUSION: Satisfactory pain relief and low implant failure rate was achieved and no definite evidence of tumor dissemination was found in this study. The authors suggest that open reduction and internal fixation with cement augmentation is a favorable treatment option for those patients suitable for surgery. However, postoperative radiation therapy may be associated with a low rate of union.

Aged↗
PubMed2002

Prospective and retrospective research: considerations and questions.

We have outlined some of the reasons why retrospective research is generally considered inferior to prospective research and have explained some of the rationale for this view. Despite the problems, there are ethical and practical reasons for conducting retrospective research. Indeed, we have argued that there are times when retrospective research may produce more valid data. We hope that these ideas will contribute to ongoing discussions about oncology research designs.

Nursing Research↗
PubMed1988

The life history calendar: a technique for collecting retrospective data.

"This paper details the authors' selection, design, and use of a life history calendar (LHC) to collect retrospective life course data. A sample of nine hundred [U.S.] 23-year-olds, originally interviewed in 1980, were asked about the incidence and timing of various life events in the nine years since their 15th birthday.... The following aspects of the LHC are described: (a) the concept, uses, and advantages of the LHC, (b) the time units and domains used, (c) the mode of recording the responses and the decisions and problems involved, (d) interviewer training, and (e) coding. The following results attest to the accuracy of the LHC retrospective data: (a) only four of the calendars had missing data in any month; (b) the data obtained in 1980 about current work, school attendance, marriage, and children showed a remarkable correspondence to the retrospective 1985 LHC reports of these events; (c) the interviewers were positive about the LHC's ability to increase respondent recall."

Americas↗
PubMed2002

Stability of retrospective reports in depression: traumatic events, past depressive episodes, and parental psychopathology.

Research findings based on the retrospective reports of depressed individuals have long been held suspect because of possible negative reporting biases associated with depression. In the present study we assess the stability of retrospective reports of past traumatic events, past depressive episodes, parental depression, and parental substance abuse in a sample of 234 adults whose depression status changed over two assessments conducted one year apart. Depression status was found to affect reporting of number of past depressive episodes and past traumatic events, but not reporting of parental psychopathology. Implications of these findings are discussed for research that relies on the retrospective self-reports of depressed participants.

Adolescent↗
PubMed1992

Accurate diagnosis of acute appendicitis: a retrospective and prospective analysis of 686 patients.

OBJECTIVE: To formulate a score system that would make the preoperative diagnosis of acute appendicitis more accurate. DESIGN: Retrospective then prospective study. SETTING: City University Hospital. SUBJECTS: 536 patients who had their appendixes removed between 1981 and 1986 (retrospective study), and 150 consecutive patients admitted with a presumptive diagnosis of appendicitis between 1987 and 1988 (prospective study). MAIN OUTCOME MEASURES: Correlation between the histological diagnosis of appendicitis and variables representing history, clinical examination, and laboratory investigations. RESULTS: The rate of histologically proven negative appendicectomies in the retrospective series was 40% and in the prospective series 33%. The variables that were thought to be predictive were: male sex, white cell count of greater than 11 x 10(9)/l, history of less than 24 hours with no previous complaints, rebound tenderness, shift of pain from the epigastrium, and localised guarding, but all criteria had low specificities and sensitivities when applied prospectively, and combining the scores did not improve them. CONCLUSION: The accurate diagnosis of appendicitis depends largely on the experience of the surgeon and is not improved by the application of a score system that includes the above variables.

Acute Disease↗
PubMed2003

Advantages of retrospective ECG-gating in cardio-thoracic imaging with 16-row multislice computed tomography.

PURPOSE: To test the added information of a retrospective ECG-gating to the 16-row Multislice Computed Tomography (MSCT) scan of intrathoracic vessels. MATERIALS AND METHODS: Ninety-six patients (61 males, aged 59 +/- 20 years) underwent MSCT with a 16-row scanner (Sensation 16, Siemens, Germany) for the study of the thoracic vessels. In group 1 (66 patients) a retrospectively ECG-gated protocol was applied; in the control-group 2 (30 patients) a conventional MSCT protocol for thoracic imaging was applied. Images were scored regarding 1) presence or absence of artifacts determined by breath-hold, beam hardening and mis-triggering; 2) visualization (optimal, mild and poor) of great intrathoracic vessels (aorta, pulmonary arteries and veins); 3) visualization (presence or absence) of proximal, mid and distal coronary arteries (left main--LM, left anterior descending--LAD, circumflex--CX, and right coronary artery--RCA). RESULTS: Ascending aorta showed motion artifacts in 7 (24%) cases in group 2 and 2 (4%) in group 1. In group 1, proximal LAD, CX, and RCA were assessable in 89%, 91%, and 89%, respectively. Left main coronary artery was assessable in 61 (92%) and 18 (60%) cases for group 1 and 2, respectively. CONCLUSIONS: The retrospectively ECG-gated 16-row MSCT provides information regarding ascending aorta and coronary arteries not available in the conventional scan.

Adult↗
PubMedDate not supplied

Sinus floor augmentation with bovine hydroxyapatite mixed with fibrin glue and later placement of nonsubmerged implants: a retrospective study in 50 patients.

PURPOSE: The aim of the present study was to evaluate retrospectively both the results of using a mixture of bovine hydroxyapatite (BHA) and fibrin glue as the only grafting material in the floor of the maxillary sinus and the outcome of nonsubmerged implants placed later. MATERIALS AND METHODS: A total of 50 consecutive patients (71 maxillary sinuses) were augmented with a mixture of BHA and fibrin glue. The grafts were allowed to heal for a mean of 8 months prior to implant placement. A total of 218 solid titanium screw-type implants were placed in a nonsubmerged fashion and allowed to heal for a mean of 10 weeks before loading (range, 10 days to 10 months). The outcome of the placed dental implants was evaluated retrospectively. RESULTS: Twelve implants were lost, giving a cumulative survival rate of 94.5% after a mean loading time of 20 months (range, 6 to 42 months). DISCUSSION: This study shows that augmentation of the maxillary sinus with a BHA/fibrin glue mixture and later placement of nonsubmerged implants with short healing times preceding functional loading can be a predictable concept. However, the use of autogenous bone and placement of submerged implants in the grafts with long healing times is routine in many clinics. This article discusses the evidence on which this protocol is based. CONCLUSION: The short-term results from this retrospective clinical study indicated that BHA/fibrin glue can be used as a grafting material without autogenous bone in the maxillary sinus to produce a high survival rate for later placement of nonsubmerged implants.

Adult↗
PubMedDate not supplied

[Drug-cholinesterase-inhibitors persistence patterns in treated patients with dementia of Alzheimer type: retrospective comparative analysis of donepezil, rivastigmine and galantamine].

INTRODUCTION AND OBJECTIVE: Long term duration of treatment of the dementia of Alzheimer type, the most frequent type of dementia in our environment, is associated with delay in patient functional and cognitive impairment. The aim of the study was to determine retrospectively the persistence of treatment with donepezil, rivastigmine and galantamine in patients with dementia of the Alzheimer type in a population setting. PATIENTS AND METHODS: Retrospective study performed in Primary Care Health Centres. The study included patients who were treated between January, 2000 and September, 2003. Kaplan-Meier survival analysis was applied to assess pattern of treatment persistence. RESULTS: A total of 95 patients (78.8% female), with a mean age of 77.6 years (SD: 6.2) were included; 39 donepezil, 35 rivastigmine, and 21 galantamine, with a mean MMSE score of 10.3 +/- 7.8, 9.7 +/- 8.4 and 13.6 +/- 7.1, respectively (p = 0.256). Mean treatment duration was donepezil: 80.3 (SD: 7.7) weeks, rivastigmine: 52.4 (SD: 5.3) weeks and galantamine: 49.8 (SE: 4.0) weeks, p < or = 0.01. Median persistence of treatment was 129.3 weeks for donepezil, 59.1 for rivastigmine and 45.0 for galantamine, p < or = 0.001 in both cases. At week 52, 62% of donepezil-treated patients maintained the initial therapy, compared with 40% rivastigmine-treated and 33% galantamine-treated, p < 0.05. CONCLUSION: This retrospective study found that patients with dementia of the Alzheimer type treated with donepezil showed more persistence of treatment compared which those who received rivastigmine or galantamine.

Aged↗
PubMed2004

[Prostate cancer diagnosed before 55: a retrospective study from the Rare Cancer Network].

This retrospective study on a large number of cases offers a vision of the modalities of care in prostate cancer diagnosed before the age of 55, according to different policies, aiming to propose other directions for 2005. Between January 1974 and December 2001, 365 patients had a pathological diagnosis of prostate cancer occurring before the age of 55. These patients were referred to the departments of radiation therapy affiliated to the Rare Cancer Network. A questionnaire was filled in retrospectively to allow further analysis of medical and surgical data. The treatments were those recommended at the time of analysis and progressed according to new accepted standards. Clinical and pathological features of the patients were as follows: 36% of the tumours were Gleason > 7 scored, 56% of the patients had a T3-T4 and 31 had metastases at the time of diagnosis. As far as treatment was concerned, 4 groups were considered: 83 patients had a radical prostatectomy, 155 received radiation therapy with a curative intent, 87 were treated by hormonal manipulation, and the remaining 40 patients received palliative care. The free of disease survival rate at 10 years was 38% for patients without immediate metastases, only 1% of patients with metastases were alive. The multivariate analysis demonstrated the significant impact of radiotherapy on both local and distant failure rates and of T stage on distant failure rate. Survival was affected by nodal involvement and local failure. A separate analysis of two periods of time (1974-1989 and 1990-2001) did not show any differences in terms of treatment results. This retrospective study suggests that age is not a negative prognostic factor as far as adequate curative treatments are carried out. Therapeutic modalities having considerably evolved in prostate cancer, a further analysis with a longer follow up may allow the evaluation of these treatments on rates of failures and survival. Screening for prostate cancer in family histories is likely to increase the number of cases diagnosed before 55. Therefore, a complete information on morbidity associated to the different means of treatment would lead to a better acceptance of late side effects.

Adult↗
PubMed2005

[Retrospective analysis of health variables in a Reykjavík nursing home 1983-2002 (corrected)].

BACKGROUND: A municipal nursing home with 68 beds in Reykjavík, opened in mid-year 1982. OBJECTIVES: To analyse changes in demographic, health and outcome variables over 20 years. DESIGN: Retrospective analyses of data from medical records of all diseased persons with cross-sectional comparison of five four-year intervals. SETTING: Droplaugarstadir Nursing Home in Reykjavík. The nursing home is supervised by fully qualified nurses and provides maintenance rehabilitation. Medical services are delivered from a specialist geriatric hospital department. RESIDENTS: All residents who died 1983 to 2002 [corrected]. MEASUREMENTS: Demographic data, type of dwelling before admission, Nursing Home Pre-admission Assessment Score (NAPA), mobility- and cognitive score, drug usage and a list of medical diagnoses. All recorded health events during stay, falls and fractures, medical and specialist consultations. Advance directives, as recorded and end-of-life treatment, place of death, clinical diagnosis of cause of death and length of stay. RESULTS: The total number of medical records read numbered 385, including 279 females and 106 males. The mean age on admission was 85 (+/- 7) years. During the first 4 years the majority of residents came from their own private homes or residential settings but in the last four years, 60% were admitted directly from a hospital ward. The mortality rate was 17% per year in the first period and the majority died in a hospital. This ratio took a sharp turn as the mortality rate increased to 40%, and in the last period only 2 of 97 deaths took place in a hospital. Admission mobility- and cognitive scores showed increased disability with time. The most common diagnosis on admission was dementia (56%), ischemic heart disease (46%), fractures (35%) and strokes (27%). Parkinsonism and maturity onset diabetes had a low prevalence rate of 6%. A mean NHPA of 57 (+/- 17) points confirmed a high dependency selection. The mean number of drugs per patient was 5.3 (+/- 3), including 1.1 (+/- 1) for psychoactive drugs and sedatives. The most common health events during residents? stay were urinary and respiratory infections, heart failure, cardiac- and cerebral events and pulmonary disorders. Hip fractures occurred in 45 residents (12%) and other types of fractures in 47 during their stay in the nursing home. The number of medical visits and specialist referrals increased with time. Palliative care was the most common form of treatment at end of life. Pneumonia was most commonly recorded cause of death in medical notes. The yearly mortality rate was 29% and the mean length of stay was 3 (+/- 2,9) years for the whole period. LIMITATIONS: Retrospective analyses have many inherent drawbacks and the information in medical records tend to be scanty. Analyses of disabilities, as described in the medical record, can only be descriptive and health events are likely to be underreported. Statistical methods have a less meaningful role for interpretation as only diseased persons were included and survivors excluded. However, the length of time, uniform medical care and turnover rate of residents generate useful information on the patterns of the nursing home service during a time of considerable change. CONCLUSIONS: This retrospective analysis indicates increasing frailty in nursing home patients admitted over a period of 20 years. With time the residents are more often admitted directly from a hospital rather than from an individual dwelling. Most deaths took place in the nursing home and were preceded with informal or formal palliative care directives, which was a significant change over time. The data indicates growing efficiency in the nursing home selection processes due to the NHPA and improvements in holistic geriatric care. This development is in keeping with the Icelandic health care policy for elderly people to stay longer in their own home with access to a nursing home placement when needed.

Aged↗
PubMed1991

Reliability of retrospective assessments of sexual HIV risk behavior: a comparison of biweekly, three-month, and twelve-month self-reports.

A review of 30 AIDS behavioral research studies revealed that almost half employed retrospective sexual activity assessment periods of 12 months or longer. The present study examined the correspondence between retrospective reports of sexual activity for 3 overlapping time-frames (past 2 weeks, past 3 months, and past 12 months) for 61 gay men. Adjusted for equivalent 12-month intervals, the reported mean frequencies of sexual practices were considerably higher for shorter recall periods than for longer recall periods, a discrepancy greater than would be expected by normal activity fluctuation. The study also found that behavior reported across shorter retrospective time-frames was more consistent, while reliability for frequently occurring and unsafe sexual activities decreased as the recall period lengthened. Studies utilizing recall periods of 12 months or more may produce data of questionable reliability.

Adult↗
PubMed1990

Impacted lower third molars and periodontal health. An epidemiological, methodological, retrospective and prospective clinical, study.

The main objective of this series of investigations was to study periodontal health of the adjacent second molars (M2) in cases of impacted lower third molars (M3) and after impacted lower third molar surgery. An epidemiological study, comprising 693 dentate individuals, was undertaken in order to obtain the prevalence, impaction and positional relationship of third molars in a normal Swedish population. The prevalence of all third molars in individuals aged 20 years was 77.0%. One in four of the vertically positioned third molars, three in four of the mesioangular, nine in ten of the distoangular and all those horizontally placed were impacted to some extent. 68.5% of the impacted third molars were in close proximity to the root of the adjacent second molars. In order to evaluate the precision and accuracy of the radiographic assessment of intrabony defects (IBD), i.e. the distance between the cemento-enamel junction and the bottom of the pocket to firm osseous contact, on the distal surface of M2, a methodological study was performed on 25 subjects. Using conventional free hand technique, intraoral radiographs were taken in the deepest part of IBD with and without a probe as indicator. Comparing the two sets of radiographs, the deviation was 1 mm or less in 87.9% of the cases. The radiopaque marker enhanced the accuracy of assessment of IBD to 96.7%. The effects of impacted lower third molar surgery on periodontal tissues of the M2 area were investigated in a retrospective clinical study comprising 215 subjects. The results two years postoperatively showed a higher prevalence of plaque, gingivitis and periodontal pockets on the distal surface of M2 than on other surfaces of the two molars adjacent to the extraction site. IBD greater than or equal to 4 mm were registered in 32.1% of the cases. The long term effects on periodontal tissues after impacted lower third molar surgery was investigated in a comparative retrospective study, two and four years postoperatively, comprising 51 cases. The improvement concerning postoperative IBD, between the two examinations, was mainly seen in individuals less than or equal to 25 years of age. No case in this age group increased in depth, while 29.6% of postoperative IBD deteriorated in individuals greater than or equal to 26 years. A multiple regression analysis was used to identify some predictors of postoperative IBD, and the material consisted of the 215 cases from the retrospective study.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗