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At least 415 records · Page 23Linked to original sources
PubMed1994

Coronary artery revascularization before abdominal aortic aneurysm surgery: a decision analytic approach.

Decision analysis is a method for quantitatively comparing the risks and benefits of diagnostic and therapeutic procedures, and for determining the influence of variation in a priori probabilities assigned to different outcomes. Therefore, we have constructed a decision tree to determine outcome probabilities between performing abdominal aortic surgery alone or to perform preoperative testing which may lead to coronary revascularization before noncardiac surgery. Sensitivity analyses were performed in which the assigned probabilities, obtained from the literature, were varied within a reported range to determine its influence on the optimal decision pathway. The optimal decision whether to perform preoperative testing and coronary revascularization prior to abdominal aortic reconstruction is dependent on both the mortality associated with coronary revascularization and the mortality of the surgical procedure performed without preoperative interventions. Within the range of mortality reported in the literature, strategies of either selective preoperative testing or no preoperative testing can be justified.

Algorithms↗
PubMed1988

Treatment of intact familial intracranial aneurysms: a decision-analytical approach.

Clinical decision analysis is applied to the treatment decisions for four patients with unruptured familial aneurysms. The surgical treatment was uneventful in all patients except one with mild mixed aphasia and facial weakness postoperatively; these deficits disappeared in less than 2 years. In the decision analysis, discounted Quality Adjusted Life Years are used as an outcome measure. Probability estimates are extracted from the literature when available. It is concluded that the decision to treat the aneurysm neurosurgically in three of the four patients was correct. In two of these three patients, the decision cannot be altered by plausible changes in estimated data. For the third patient, only the combination of a low probability of rupture, a high surgical mortality and morbidity, and high discount favors conservative treatment. In the fourth patient, a toss-up situation exists. More knowledge of the probability of rupture, the probability of the development of other aneurysms, and the results of operation on intact intracranial aneurysms would have made the analysis more accurate. Clinical research should address these issues.

Adult↗
PubMed1981

Analytical approaches to the study of the disposition of myelotoxic agents.

A correlation of myelotoxic effect with concentration or a foreign compound of its metabolite at the site of action may provide useful insights into the mechanism of toxic action and/or its amelioration. This correlation requires sensitive and specific assay methods. This communication describes useful methods for the study of benzene disposition in rodents. The assays are sensitive, specific, and rapid. They rely on gas chromatography-mass spectrometry and on high performance liquid chromatography. These methods have allowed measurement of catechol, phenol, and hydroquinone in samples of rodent bone marrow following inhalation exposure to benzene. Their application to the study of benzene metabolism in rat bone marrow in situ is also described.

Adipose Tissue↗
PubMed1996

MMPI Profiles of Female Candidates for Obesity Surgery: A Cluster Analytic Approach.

BACKGROUND: Early attempts to characterize personality in obese persons led to the conclusion that the severely obese are not homogeneous on personality measures. More recently, cluster analysis procedures have been applied to identify meaningful personality subtypes in populations of persons with severe obesity; some progress has been made in this effort, but researchers have indicated the need for replication in other settings. METHODS: In the present study, the Minnesota Multiphasic Personality Inventory (MMPI) was administered to 163 female candidates for intestinal bypass surgery. RESULTS: Eight clusters were identified. Of the MMPI profiles, 71% were in one of four normal limit clusters. The remainder were distributed across four clusters, all beyond normal limits. CONCLUSIONS: Present and previous results appear to converge on representative personality subtypes in severe obesity. Identification of such meaningful subgroups of candidates for obesity surgery may enhance the prediction of surgery outcomes, and yield a better understanding of personality in severely obese women.

Journal Article↗
PubMed1990

Placement of cast restorations over direct pulp capping procedures: a decision analytic approach.

A review of the literature shows a significant amount of controversy regarding the success of pulp capping procedures, with the average clinically evaluated pulp capping success being 81%, and 75% when evaluated histologically. This study evaluated the costs and benefits of a pulp cap versus endodontic therapy for a tooth that is to receive a cast restoration, and determined what level of success is needed for pulp capping to be the preferred treatment.

Adult↗
PubMed1990

Practice valuation: an analytical approach.

Purchasing a dental practice is difficult. To help make this decision process more manageable, practitioners, practice management consultants, and practice appraisers often use standard valuation methodologies. Although useful, many of these models are simplistic, arbitrary, and dependent on criteria that are often susceptible to substantial subjectivity. Therefore, practice valuation results are often disputed. The capitalization of income method removes much of the subjectivity often associated with practice valuation and provides a more reliable assessment of the value of a practice.

Accounting↗
PubMed2000

Team mental models: techniques, methods, and analytic approaches.

Effective team functioning requires the existence of a shared or team mental model among members of a team. However, the best method for measuring team mental models is unclear. Methods reported vary in terms of how mental model content is elicited and analyzed or represented. We review the strengths and weaknesses of vatrious methods that have been used to elicit, represent, and analyze individual and team mental models and provide recommendations for method selection and development. We describe the nature of mental models and review techniques that have been used to elicit and represent them. We focus on a case study on selecting a method to examine team mental models in industry. The processes involved in the selection and development of an appropriate method for eliciting, representing, and analyzing team mental models are described. The criteria for method selection were (a) applicability to the problem under investigation; (b) practical considerations - suitability for collecting data from the targeted research sample; and (c) theoretical rationale - the assumption that associative networks in memory are a basis for the development of mental models. We provide an evaluation of the method matched to the research problem and make recommendations for future research. The practical applications of this research include the provision of a technique for analyzing team mental models in organizations, the development of methods and processes for eliciting a mental model from research participants in their normal work environment, and a survey of available methodologies for mental model research.

Group Processes↗
PubMed1992

Defining patterns of drinking in adolescence: a cluster analytic approach.

Most empirical approaches to defining patterns of adolescent alcohol consumption focus on frequency of drunkenness. In an attempt to define patterns of drinking in a more comprehensive way, the present study used measures of social context in addition to frequency and quantity of alcohol use. Subjects' scores on frequency, quantity and five social context variables were cluster analyzed separately for males and females. Results yielded four socially appropriate drinking patterns and three problem drinking patterns (two for males and one for females). Socially appropriate patterns for both sexes were light drinkers, light party drinkers, family drinkers and dating drinkers. Problem drinking patterns included school drinkers and solitary/stranger drinkers for males, and solitary/school drinkers for females. These groups of subjects showed significant differences on reasons for drinking and on drinking consequences even after differences due to frequency and quantity were statistically controlled. Effects of drinking primarily attributable to frequency and quantity appeared to be limited to differences concerning the physiological effects of alcohol.

Adolescent↗
PubMed2005

Diagnosis of zinc phosphide poisoning in chickens using a new analytical approach.

Approximately 200 chickens were found dead after the flooring of a slat-and-litter house was breached. No clinical signs of illness were observed in the surviving birds. During necropsy, rolled oats were found in the chickens' crops and gizzards, and the contents had a petroleum-like odor. Histopathologic examination revealed severe pulmonary edema and congestion of the chickens' lungs, hearts, livers, and kidneys. Based on the history and necropsy findings, zinc phosphide exposure was suspected. Diagnosis of zinc phosphide poisoning has previously been based on history of exposure, identification of the bait material in the gastrointestinal tract, and chemical detection of phosphine gas. However, currently available diagnostic methods are nonconfirmatory, and may produce false positive results. The objective of this case report was to determine whether the sudden death described in these chickens was caused by the ingestion of zinc phosphide, by developing a sensitive and highly specific gas chromatography/mass spectrometry (GC/MS) methodology for analysis of the gastrointestinal samples submitted to the laboratory. It was also found that the determination of zinc concentrations in liver or kidney tissue or stomach contents is not a reliable indicator of zinc phosphide poisoning.

Animals↗
PubMed2005

A functional analytic approach to computer-interactive mathematics.

Following a pretest, 11 participants who were naive with regard to various algebraic and trigonometric transformations received an introductory lecture regarding the fundamentals of the rectangular coordinate system. Following the lecture, they took part in a computer-interactive matching-to-sample procedure in which they received training on particular formula-to-formula and formula-to-graph relations as these formulas pertain to reflections and vertical and horizontal shifts. In training A-B, standard formulas served as samples and factored formulas served as comparisons. In training B-C, factored formulas served as samples and graphs served as comparisons. Subsequently, the program assessed for mutually entailed B-A and C-B relations as well as combinatorially entailed C-A and A-C relations. After all participants demonstrated mutual entailment and combinatorial entailment, we employed a test of novel relations to assess 40 different and complex variations of the original training formulas and their respective graphs. Six of 10 participants who completed training demonstrated perfect or near-perfect performance in identifying novel formula-to-graph relations. Three of the 4 participants who made more than three incorrect responses during the assessment of novel relations showed some commonality among their error patterns. Derived transfer of stimulus control using mathematical relations is discussed.

Adolescent↗
PubMed1978

A factor analytic approach to an effective lung function screening protocol.

Interrelationships among simple indices of pulmonary function derived from flow-volume curves and single-breath nitrogen tests were investigated by performing a factor analysis on data obtained from a generally healthy office working population (n = 388). Smoking was regarded as the major contribution to pulmonary dysfunction. Delta nitrogen was largely independent of all other measures, while flow-volume measures, including flow rates at high and low lung volumes, were highly intercorrelated but largely independent of closing volume and closing capacity. Delta nitrogen was most affected by smoking in both sexes. Scores derived from flow-volume measurements and from closing-volume measurements were significantly different, on the average, between male smokers and male nonsmokers. The methods and results presented prove to be useful in the design of protocols for effective pulmonary testing of large populations.

Adult↗
PubMed1997

Routine prenatal screening for congenital heart disease: what can be expected? A decision-analytic approach.

OBJECTIVES: This study assessed the potential impact of fetal ultrasound screening on the number of newborns affected by cardiac anomalies. METHODS: A decision model was developed that included the prevalence and history of congenital heart disease, characteristics of ultrasound, risk of abortion, and attitude toward pregnancy termination. Probabilities were obtained with a literature survey; sensitivity analysis showed their influence on expected outcomes. RESULTS: Presently, screening programs may prevent the birth of approximately 1300 severely affected newborns per million second-trimester pregnancies. However, over 2000 terminations of pregnancy would be required, 750 of which would have ended in intrauterine death or spontaneous abortion. Further, 9900 false-positive screening results would occur, requiring referral. Only the sensitivity of routine screening and attitude toward termination of pregnancy appeared to influence the yield substantially. CONCLUSIONS: The impact of routine screening for congenital heart disease appeared relatively small. Further data may be required to fully assess the utility of prenatal screening.

Abortion, Spontaneous↗
PubMed2004

Analytical approach to the discoloration of edible laver "nori" in the Ariake Sea.

To understand the cause of discoloration of the sea laver "nori," which is found in the Ariake Sea, the concentrations of pigments and elements in the normal and discolored laver samples were determined. In the discolored samples, a decrease in all of the pigments, chlorophyll a and carotenoids, and proteinous pigments, phycobiliproteins, was clearly observed. This was accompanied by a decrease in the content of Fe, Zn, Mn, Cu, and P. Good correlations between these elements and chlorophyll a, as well as between these elements and phycobiliproteins, were confirmed, indicating that, in addition to the deficiency of nitrogen and phosphorus, the deficiency of trace elements (Fe, Zn, Mn, and Cu), which are specifically required for photosynthesis, could be a reason for the discoloration of nori. The cause of elemental deficiency is also discussed.

Journal Article↗
PubMed1998

Evaluation of the potential clinical and economic effects of bodyweight stabilisation with acarbose in patients with type 2 diabetes mellitus. A decision-analytical approach.

Bodyweight is an acknowledged independent risk factor for coronary heart disease (CHD). The present model analysis was undertaken to investigate the clinical and economic impact of bodyweight gain in patients with type 2 (non-insulin-dependent) diabetes mellitus and its effects on the development of CHD. Based on a retrospective re-evaluation of data from the Diabetes Intervention Study (DIS), patients with type 2 diabetes mellitus and stable bodyweight (group A) had a significantly lower rate of combined CHD events (30.3%) than patients showing a bodyweight gain (group B; 38.2%) over 10 years. Prevention of bodyweight gain, therefore, appears to be a meaningful strategy in the management of diabetes mellitus. In addition to this clinical advantage, prevention of CHD will also result in economic savings associated with avoided treatment of coronary events. Based on the clinical outcomes from the DIS, the calculated per-patient net savings for a patient with type 2 diabetes mellitus and stable bodyweight amounted to 1085 deutschmarks (DM) when compared with a patient experiencing a bodyweight increase. In a further step, the above situation was projected to current type 2 diabetes mellitus practice. Oral first-line treatment of type 2 diabetes mellitus is usually initiated with glibenclamide (glyburide), which is known to increase bodyweight (reflecting group B). The novel alpha-glucosidase inhibitor acarbose, in contrast, appears to be as effective as glibenclamide, but has the advantage of being bodyweight-neutral (reflecting group A). From the clinical viewpoint, acarbose can thus be considered an alternative to glibenclamide. From the viewpoint of drug costs, monotherapy with acarbose is 4 times as expensive as glibenclamide in Germany, resulting in per-patient incremental costs of DM3527 for acarbose over 10 years. Balanced against the potential 10-year cost saving of DM1085 resulting from the potential of acarbose to prevent CHD, around one-third of the incremental cost of acarbose may be recouped by this single effect. However, further possible benefits of acarbose, including the avoidance of hypoglycaemia and the deferral of costly insulin therapy, may improve the economic value of this novel antidiabetic agent. Given the indirect approach of this evaluation and its many limitations, the above findings need critical appraisal, and comparative trials are urgently required to substantiate our preliminary results.

Acarbose↗
PubMed1979

Carpal injuries: analytic approach and case exercises.

Radiographic wrist relationships are reviewed emphasizing the posteroanterior view, and analyzing the three normal arcs, principles of parallelism, and overlapping articular surfaces. Use of these concepts, which are not stressed in the literature, enables the radiographic interpreter to easily arrive at a definitive diagnosis and to detect and interpret subtle and complex abnormalities. Case material is included to emphasize major different diagnostic points.

Carpal Bones↗