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At least 379 records · Page 21Linked to original sources
PubMed1994

Randomised controlled trial of routine cervical examinations in pregnancy. European Community Collaborative Study Group on Prenatal Screening.

Preterm delivery is strongly associated with neonatal mortality and morbidity. In some European countries, cervical examinations are used routinely during pregnancy to identify women at risk of preterm delivery. We sought to evaluate the efficacy and secondary effects of these routine cervical examinations. We did a randomised controlled trial in seven European countries, comparing two policies--namely, an attempt to do a cervical examination at every prenatal visit (2803 women) and avoidance of cervical examination if possible (2799). The median number of cervical examinations was 6 in the experimental group and 1 in the controls. There were 6.7% preterm (< 37 weeks) deliveries in the experimental group and 6.4% in the control group (risk ratio 1.05 [95% confidence interval 0.85-1.29]; non-significant). The low birthweight rate was 6.6% in the experimental group and 7.7% in the controls (non-significant). Premature rupture of membranes was not significantly more frequent in the experimental group (27.1% vs 26.5%). Our findings do not support the routine use of cervical examinations during pregnancy.

Adult↗
PubMed1992

Cost containment and new priorities in the European community.

This article reports on the author's survey of the cost-control measures for health care in 12 European countries during the period from 1983 to 1990. Among these countries the greatest convergence was in the use of the budget as a system of control, reinforced by manpower controls. Budgets were constructed to restrict hospital costs and payments to doctors practicing outside of hospitals. Another strategy was cost sharing for purchase of drugs and, in some cases, for dentistry. Most countries took steps to control expensive medical equipment; others, to restrict entry to medical schools. The European experience demonstrates the technical feasibility of the government's controlling health care costs by regulating supply rather than demand. The key to Europe's success in the use of monopsony power, whereby one purchaser dominates the market. The author contends that regulation works in Europe and questions whether the United States can exert similar control over its coalition of insurers and providers in order to rein in its health care expenses.

Ambulatory Care↗
PubMed1995

[Classification criteria for Sjögren's syndrome--sensitivity and specificity of criteria of the Japanese Ministry of Health and Welfare (1977) and criteria of European community (1993)].

In patients with primary Sjögren's syndrome sensitivity of Japanese criteria was 82.0% and specificity was 82.7%: sensitivity of European criteria was 73.3%, and specificity was 88.9%. In patients with secondary Sjögren's syndrome sensitivity of Japanese criteria was 74.5% and specificity was 85.7%: sensitivity of European criteria was 70.2%, and specificity was 89.3%. False-negative patients with decreased sensitivity of both criteria mostly showed a positive labial salivary gland biopsy without ovart dry mouth and dry eye symptoms. False-positive patients with decreasing specificity of both criteria were those who had only keratoconcunctivitis sicca without a positive labial salivary gland biopsy.

Europe↗