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PubMed1997

Self-rating Barthel index compatible with the original Barthel index and the Functional Independence Measure motor score.

To confirm concurrent validity of the final revision of the self-rating Barthel index (SB) and its test-retest reliability, we investigated 171 stroke outpatients without severe aphasia or dementia who were seen by a doctor on predetermined days at eight different hospitals. For 41 patients, the differences in scores among the original Barthel index (BI) and Granger's BI and SB were examined by the Friedman two-way analysis of variance and Wilcoxon matched-pairs signed-ranks test, and the difference in scores between Functional Independence Measure motor score (FIM-MS) and three-level scale FIM-MS was determined by the Wilcoxon's matched-pairs signed-ranks test. Concurrent validity of the SB was confirmed by Spearman's correlation coefficients with the original BI and FIM-MS, and internal consistency of the five measuring instruments was examined. For all 171 patients test-retest reliability of the SB was examined with the Spearman's correlation coefficient for total scores and kappa coefficients for each ADL item. Regression analysis was performed to determine what factors were related with test-retest reliability. Total scores of the SB and Granger's BI and the three-level scale FIM-MS were significantly higher than those of the original BI and FIM-MS, respectively. Correlation coefficients of the SB with the original BI and FIM-MS were 0.994 and 0.904, respectively, and its alpha-coefficient was 0.842. Test-retest reliability of the total score was 0.835 by the correlation coefficient, and kappa coefficients of 1 and 12 ADL items were fair and good, respectively. Regression analysis revealed that self-rating by a patient with a high SB total score is more accurate. Therefore, the SB has good concurrent validity and is well-related with the original BI and FIM, and its test-retest reliability is sufficiently high for practical use.

Activities of Daily Living↗
PubMed1991

Journals indexed by the AHA Resource Center for Hospital Literature Index and HEALTH database.

The American Hospital Association (AHA) Resource Center indexes journals for the Health Planning and Administration (HEALTH) database and Hospital Literature Index (HLI). These journals, designated special list health journals, are selected to provide access to a wide and balanced coverage of hospital and health care administration and health policy literature. This article provides background information on HEALTH and HLI and describes special list health journals in detail (including historical information, information sources, and broad subject divisions). It also discusses AHA policies relating to journal and article selection and current subject distribution of special list health journals.

Abstracting and Indexing↗
PubMed1999

Comparison of the Dougados Functional Index and the Bath Ankylosing Spondylitis Functional Index. A literature review.

The preliminary core set for endpoints in ankylosing spondylitis (AS) clinical trials includes physical function. The objective of this review was to compare properties and performance of the 2 most widely used measures of functional capacity in AS: the Dougados Functional Index (DFI) and the Bath Ankylosing Spondylitis Functional Index (BASFI). A MEDLINE search was performed covering the years 1988 through April 1998. AS studies were identified and selected if they included the DFI and/or the BASFI. Additional studies were identified by scrutinizing the references cited in the retrieved articles and by correspondence with the authors of the 2 questionnaires. The instruments were examined with respect to development, truth, discrimination, and feasibility. We identified 27 articles dealing with the instruments. Both are valid and reliable measures of functional capacity in AS. While the DFI was sensitive to change in one disease controlling (DC-ART) and in 4 symptom modifying antirheumatic drug (SMARD) clinical trials, the BASFI is not sufficiently tested in these settings. The only direct comparison of both indices in a physical therapy setting confirmed 4 other studies that suggested a better discriminative capacity of the BASFI in physical therapy clinical trials. Two likely reasons for the lack of responsiveness of the DFI in these settings are the distribution of baseline scores showing a tendency towards normal values and the less sensitive scoring system. Discriminative capacity of the BASFI was found to be superior in patients with mild functional disability. It remains to be seen whether the BASFI performs as well as or better than the DFI in SMARD and DC-ART clinical trials.

Activities of Daily Living↗
PubMed2000

[Index Copernicus: The Central and Eastern European Journals Ranking System. Why indexing needed in the region?] .

Index Copernicus is ranking system set up by members of the medical community in the Region. There were created five groups of parameters like scientific, editorial and technical quality, circulation and frequency-market stability, which allow for the generation of such a ranking system. The Authors of the Ranking System are aware of the deficiencies of parametrical analysis of science, however they believe the numbers at least set up clear, objective and just rules for all. Index Copernicus could be said the primary objectives of the system for which it has been created for.

Abstracting and Indexing↗
PubMed1989

Topographical analysis of proliferation ([3H]thymidine labelling index and mitotic index) as compared with tumour growth and tumour weight in xenotransplanted melanoma. Changes due to local and systemic application of azelaic acid.

Xenotransplanted human melanoma was investigated by measuring the increase in tumour volume and in final tumour weight (macroscopical parameters) and histomorphological parameters of cell proliferation: Mitotic index (MI) and autoradiographic [3H]thymidine labelling index (LI). A total of 87 tumours, derived from a human melanoma metastasis and a primary nodular melanoma respectively, were analysed by these methods in two series. Topical treatment of the tumours with azelaic acid cream resulted in a statistically significant reduction in the increase in tumour volume and, in the first series, in a clear decrease in final tumour weight and in the MI, as compared with controls. The LI was decreased only in the superficial region of the tumours, i.e. at the site of treatment. Subtumoral injection of azelaic acid (disodium salt solution) was the second route of local therapy. It was followed by a significant reduction in the increase in tumour volume, of final tumour weight (first series) and in the MI. The average LI was clearly smaller than in the controls, especially at the tumour base, which was the site of injection (local effect). Systemic (intravenous) injection of azelaic acid (same concentration of the disodium salt solution) had no negative effect on the increase in tumour volume or final tumour weight, but was followed by a clear reduction of the MI. The average LI of this group was significantly smaller than in the controls as well. This effect was most impressive in the perivascular regions of large and small vessels, which fact can be interpreted as a sort of local effect via the blood stream after systemic application of azelaic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

A comparative study of signal versus aggregate methods of outcome measurement based on the WOMAC Osteoarthritis Index. Western Ontario and McMaster Universities Osteoarthritis Index.

OBJECTIVE: To compare signal versus aggregate measurement strategies using the VA3.0S version of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis (OA) Index. METHODS: Seventy patients with OA of the knee were asked to identify a signal item for each of the 3 dimensions of the WOMAC OA Index at baseline and termination of a 12-week, double blind, randomized, controlled trial. RESULTS: The signal method detected statistically significant alterations in health status at relatively small sample sizes and with a relative efficiency close to or at unity. In addition to a low prevalence of deterioration in nonsignal items, we observed some inconsistency in signal selection. CONCLUSION: Signal methods of measurement may provide an alternative approach to outcome measurement provided issues of nonsignal deterioration and the consistency of signal selection can be addressed.

Aged↗
PubMedDate not supplied

Mitotic activity index, volume corrected mitotic index and human papilloma-virus suggestive morphology are not prognostic factors in carcinoma of the oesophagus.

Radiation treatment, endoscopic dilatations and laser treatment offer an alternative to surgery as palliation in oesophageal cancer, and therefore it is essential to assess the prognostic factors preoperatively in order to select the treatment individually. Mitotic activity index (MAI), volume corrected mitotic index (M/V-index) and histologic evidence for human papillomavirus (HPV) involvement together with other prognostic factors were studied in 61 patients with oesophageal squamous cell carcinomas. No patient was lost from follow-up and 18% of patients were alive at the end of follow-up. Evidence for HPV involvement was found in 11 (18%) of 61 patients, which was significantly (p < 0.001) less than in a previous series of Chinese patients. Histological grade (p = 0.025), lymph node status (p = 0.002), presence of distant metastasis (p = 0.004), surgical resection (p = 0.03) and nuclear pleomorphism (p = 0.04) were significant independent prognostic factors in univariate analysis. In multivariate analysis, the length of the tumour (p = 0.0002) as well as its histological grade (p = 0.0001) significantly predicted the patient survival. Surgical resection was almost included into the model (p = 0.11). On the other hand, MAI, M/V-index or HPV histology did not reach statistical significance as prognostic factors.

Aged↗
PubMed1993

[The Gastrointestinal Quality of Life Index. A clinical index for measuring patient status in gastroenterologic surgery].

Since the measurement of quality of life is a relevant endpoint of patient assessment, an international team of methodologists and surgeons have developed a new system-specific index. In different phases, items were collected, tested, rejected or retained and finally verified by international experts. The instrument was also validated against other generic measures, it was compared to 150 normals, tested for reproducibility with 50 stable patients and for responsiveness with 159 patients undergoing laparoscopic cholecystectomy. The product is a bilingual (German and English) questionnaire containing 36 items. Although further testing is in order, we conclude that the Gastrointestinal Quality-of-Life Index is ready to be used in clinical practice and research.

Activities of Daily Living↗
PubMed1995

Citation analysis of faculty publication: beyond Science Citation Index and Social Science Citation Index.

When evaluated for promotion or tenure, faculty members are increasingly judged more on the quality than on the quantity of their scholarly publications. As a result, they want help from librarians in locating all citations to their published works for documentation in their curriculum vitae. Citation analysis using Science Citation Index and Social Science Citation Index provides a logical starting point in measuring quality, but the limitations of these sources leave a void in coverage of citations to an author's work. This article discusses alternative and additional methods of locating citations to published works.

Abstracting and Indexing↗
PubMed1997

Thymidine labeling index in colorectal carcinoma: relation to clinicopathological parameters and to mitotic index.

Two cell-kinetic parameters, the thymidine labeling index (T-LI) and the mitotic index (MI) were determined for a prospective series of 74 primary colorectal cancers. Dukes' stages were used to define the extent of the tumor: 10 tumors were classified as Dukes' A, 36 as Dukes' B, and 22 as Dukes' C. Of these tumors, 14 were well-differentiated, 44 moderately differentiated, and 15 poorly differentiated adenocarcinomas. The H3dT-LI values obtained varied widely, from 2.5 to 38.9% (median value: 16.8%). The MI shows a range of from 0 to 13.2% with a median value of 3.2%. The T-LI values were independent of the sex and age of the patients and of the histological grading and Dukes' stage. Conversely, the MI was related to histological grading. This study indicates that the T-LI, whose application has reached the gold standard, still represents an independent parameter and the most sensible, objective, and specific complementary method for the analysis of the S phase.

Adult↗
PubMed1997

Reliability testing of the dermatology index of disease severity (DIDS). An index for staging the severity of cutaneous inflammatory disease.

OBJECTIVES: To describe a new severity of illness index for inflammatory skin disease called the Dermatology Index of Disease Severity (DIDS), and to show its preliminary use and reliability in staging disease in patients with psoriasis and dermatitis. DESIGN: Interobserver rating study using the DIDS with as many as 10 observers independently rating the same patient at a single point in time. SETTING: Ambulatory care clinics at an academic medical center with patients from various socioeconomic backgrounds. PATIENTS: Thirty-four patients with psoriasis and 15 patients with dermatitis were included in the study. MAIN OUTCOME MEASURES: The severity of illness for each patient was rated as 1 of 5 stages: 0, no evidence of clinical disease; I, limited disease; II, mild disease; III, moderate disease; and IV, severe disease. The degree of interobserver concordance was measured by the Cohen kappa statistic. RESULTS: All 5 stages were represented in the study of patients with psoriasis. The overall kappa statistic was 0.76, which is defined as substantial interobserver concordance. The use of the instrument in dermatitis showed good consensus in staging, where the kappa statistic was 0.41. CONCLUSION: We introduce an easy and efficient instrument for staging the severity of illness in inflammatory cutaneous diseases. The reliability of the DIDS is demonstrated in patients with psoriasis and in patients with dermatitis.

Adult↗
PubMed1997

S-phase fraction, 5-bromo-2'-deoxy-uridine labelling index, duration of S-phase, potential doubling time, and DNA index in benign and malignant brain tumors.

Seventy-one histologically malignant brain tumors, 52 histologically benign brain tumors, and 14 cerebral metastases were characterized according to DNA content and proliferative capacity. DNA ploidy, DNA index (DI), S-phase fraction (SPF), 5-bromo-2'-deoxy-uridine (BrdUrd) labelling index (LI), duration of S-phase (Ts), and potential doubling time (Tpot) were assessed by flow cytometry (FCM). In histologically benign tumors, a high percentage of DNA diploid tumors and a low proliferative capacity in DNA diploid tumors were found. Histologically malignant tumors and cerebral metastases were both found to be characterized by a low percentage of DNA diploid tumors and a high proliferative capacity in DNA diploid tumors. The proliferative capacity of DNA aneuploid benign tumors and that of DNA aneuploid malignant tumors, however, appeared not to differ significantly. The number of DNA aneuploid tumors was small. Duration of S-phase was short (range 3.9-4.7 hr) and appeared not to differ between the three groups. From this, the observed differences in Tpot values should be accredited mainly to differences in LI. High-grade as well as low-grade gliomas both appeared to be characterized by malignant (FCM) features, i.e., 1) a high percentage DNA aneuploidy, 2) a high mean DI (for DI > 1), and 3) a high proliferative capacity.

Aneuploidy↗
PubMed1995

DNA ploidy of ovarian granulosa cell tumors. Lack of correlation between DNA index or proliferative index and outcome in 40 patients.

BACKGROUND: Most cases of granulosa cell tumor of the ovary are characterized by relatively good outcome; however, some tumors behave aggressively, and some tend to recur many years after the initial diagnosis. Because DNA ploidy has been shown to predict biologic behavior better than conventional prognostic variables in many types of genitourinary tumors, the DNA ploidy of granulosa cell tumors was studied to determine if this test correlates with recurrence or survival. METHODS: Paraffin embedded tissue blocks were available from the primary ovarian tumors of 40 patients. DNA ploidy, percent S-phase fraction, and proliferative index were determined for each sample and were compared with patient outcome. RESULTS: Of the 40 tumors, 33 were DNA diploid, 5 were DNA near diploid/aneuploid, and 2 were aneuploid. The Kaplan-Meier estimate of the probability of tumors not recurring within 5 years postoperatively was 0.907 (95% confidence interval: 0.811, 1.00). CONCLUSIONS: There is insufficient evidence to claim that the DNA pattern is associated with morphology, stage of disease at diagnosis, or tumor size or that either survival or progression free survival differs with respect to any of the conventional prognostic factors considered. However, progression free survival tends to be shorter for those whose maximal tumor dimension was at least 10 cm (borderline significance, P = 0.0597), and survival time tends to be shorter for those with a high proliferative index (P = 0.0008).

Adolescent↗
PubMed1986

A computer evaluation of the ratio of the diastolic pressure-time index to the time-tension index from three arterial sites in dogs.

The ratio of the area under the diastolic portion of the arterial pulse pressure trace (diastolic pressure-time index; DPTI) to the area under the systolic component of the arterial pulse pressure trace (time-tension index; TTI) has been used to predict the relationship of myocardial blood supply to oxygen demand. Since introduction of the DPTI-to-TTI ratio as a measurement of this relationship, the accepted critical DPTI:TTI value below which subendocardial ischemia may occur has decreased by almost 50%. This lower critical value has come about as more clinical experience has been gained, particularly in patients with an arterial catheter in the arm. To investigate a potential cause for this decrease, we studied a canine model by pulse transduction from the central aorta (the site traditionally used for these ratio determinations), as well as the femoral artery and the median forepaw artery. Following inotropic and ventricular loading interventions, the changes in the DPTI:TTI, calculated by a special-purpose computer, were exaggerated by approximately 25% in the peripheral arterial measurements. The peripheral arterial sites had consistently higher systolic waveforms and consistently lower, broader diastolic waveforms than those for the central aortic site. This type of configurational change is probably a major cause of the differences among ratios from the three sites in our study, and it helps to explain why the value of the critical ratio has been a subject of controversy.

Animals↗
PubMed2000

[The Neuro-Mental Index. An addition to the Barthel Index for detection of impairments in basic psychological-mental diemsnions in neurorehabilitation].

The Barthel Index (BI) is the most commonly used scale for assessing impairment of activities of daily living (ADL). For a global view of patients' abilities and the care needed in everyday neurorehabilitation practice, additional information about basic psychological and cognitive functions is essential. We therefore designed a new disability scale comprised of assessments of consciousness, approachability, orientation, memory, behaviour, emotions, communication, problem solving, perception, and behaviour at night. The scale shows exactly the same inner structure as the BI, with ten items and a score of up to 20 in steps from 0-100% (or 0-20 points). By a careful weighing of the items, the final score of the neuromental index (NMI) should create a clearer picture of both the disabilities and the needed resources. A second aim was to cover a broad range of patients including those in coma and coma remission states and those with only slight neuropsychological or behavioural symptoms. The NMI was examined with a group of 179 neurorehabilitation inpatients and proved to be highly valid, reliable, and practicable. It was designed to enable a global assessment of disability as well as the care resources needed, even in patients with different disability levels in ADL and psychological and cognitive functions.

Activities of Daily Living↗
PubMed2000

New low-index liquid refractive index standard: SRM 1922.

A new standard for the calibration of refractometers has been developed. Standard Reference Material (SRM) 1922 is a mineral oil with a refractive index nD = 1.46945 at 20 degrees C, which is within the range of the Brix scale (% sucrose). The change in refractive index with temperature (dn/dT) has been characterized for the range 15 degrees C to 35 degrees C to allow for calibrations within that range of temperatures. The refractive indices were measured at 5 wavelengths in the visible spectrum by using the method of minimum deviation with a +/- 2-3 x 10(-5) uncertainty at 20 degrees C. The values of nD and dnD/dT were determined by fits of a two-term Cauchy function to the values at the measured wavelengths with a +/- 6 x 10(-5) uncertainty in nD at 20 degrees C.

Calibration↗