The Cancer Therapy Evaluation Program of the National Cancer Institute.
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Clinical Trials as Topic↗
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Results for “Program Evaluation”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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The National Pork Producers Council Maternal Line National Genetic Evaluation Program: a comparison of six maternal genetic lines for female productivity measures over four parities.
Litter (n = 8,424) and female performance records were collected in two breed-to-wean production units in order to evaluate genetic line differences for sow longevity and maternal performance over four parities. Lines evaluated were American Diamond Genetics, Danbred North America, Dekalb-Monsanto DK44, Dekalb-Monsanto GPK347, Newsham Hybrids, and National Swine Registry. Females within a line were derived from a minimum of 65 sires, 197 dams (three dams per sire), and a maximum of three daughters per dam, except in the GPK347, which were produced using semen from 12 Nebraska Index boars mated with Dekalb-Monsanto Line 34 females. All lines expressed 100% maternal heterosis. Mixed model statistical procedures were used with fixed effects including genetic line, parity, production unit, and two-way interactions. Random effects included a contemporary week of production and female for repeated records. Lactation length (average 15 d) was included as a linear covariate where appropriate. In total, 3,599 females entered as early-weaned pigs, 3,283 entered the breeding herd, 2,592 farrowed at least a single litter, and 1,656 and completed four parities. Line (P < 0.001) and parity (P < 0.001) effects were observed for virtually all traits measured. Ranges of genetic line differences averaged across parities were 1.76 pigs for total born, 1.45 pigs born alive, and 0.31 stillborn pigs per litter. Ranges of line differences in total and live litter weight were 1.4 and 1.3 kg, respectively. Ranges among lines, within Parities 1 through 4, for litter size at weaning were 0.56, 1.08, 0.91, and 0.64 pigs per litter, respectively. Line differences for weight (33.8 kg) and backfat depth (6.4 mm) at farrowing, lactation feed intake (8.7 kg), weight loss (5.0 kg), and backfat loss (0.87 mm) were observed. Extended wean-to-estrus interval was related to variation in weight, feed intake, and backfat loss in all lines except the GPK347. The GPK347 females farrowed and weaned the largest number of pigs, ate less feed in lactation, and lost more backfat and weight during lactation, yet they had the largest litters and the shortest wean-to-estrus intervals. Line x parity interactions existed for many traits due to small rank changes, but in general, the high- and low-ranked lines did not change. Genetic line differences in reproductive efficiency through four parities exist and must be recognized when choosing a female line.
Adipose Tissue↗
On-site office emergency self-evaluation program. Are you prepared to handle an emergency?
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California↗
ICWU cancer control education and evaluation program: research design and needs assessment.
The International Chemical Workers Union is implementing a 3-year nationwide field experiment in cancer prevention education. The educational program includes three stages: generalized cancer control education, education tailored to each local union, and an interactive monitoring system designed to provide ongoing communication and reinforcement for desired cancer control behaviors among local unions and their members. These alternative educational approaches will be systematically evaluated using a randomized factorial study design involving more than 120 local unions. The need for such a program is demonstrated by the results of a needs assessment survey of 690 union members. Respondents expressed strong concern regarding possible carcinogen exposures at the work site, combined with generally low ratings of co-worker knowledge of and adherence to appropriate cancer control behaviors. Engineering controls and personal protective equipment were reported to be inadequate in many work sites.
Attitude to Health↗
ADA evaluation programs: a proud history of service to the profession and the public.
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American Dental Association↗
Signs, symptoms, and ill-defined conditions in Persian Gulf War veterans: findings from the Comprehensive Clinical Evaluation Program.
OBJECTIVE: The purpose of this study was to analyze the type and frequency of signs, symptoms, and ill-defined conditions (SSID; International Classification of Diseases-9th Revision, Clinical Modification (ICD-9-CM) codes 780-799) identified by physicians evaluating Persian Gulf War veterans; to determine the influence of the extent of evaluation on the type and frequency of SSID diagnoses; and to search for evidence for a new illness, or illness related to wartime exposures, in veterans with ill-defined conditions. METHOD: Comprehensive examinations were provided for 21,579 consecutive Persian Gulf War veterans with symptoms or health concerns after the war. Data recorded on all individuals includes demographics, self-reported exposures, symptoms, and physician-assigned ICD-9-CM primary and secondary diagnoses. A detailed psychosocial history, including a multidisciplinary discussion, was incorporated for a subset of participants. RESULTS: SSID conditions were primary diagnoses for 17.2% of veterans, and either primary or secondary diagnoses for 41.8%. Although some SSIDs were objective conditions (eg, sleep apnea), most were simply symptoms. More comprehensive evaluation, especially the multidisciplinary discussion of findings, decreased the frequency of symptoms as diagnoses and increased the number of DSM-IV psychiatric diagnoses. Ill-defined conditions were not associated with particular self-reported exposures or demographic variables. CONCLUSIONS: Ill-defined conditions identified by physicians in Gulf War veterans are most often symptoms. More definitive, often psychological, diagnoses can be made by increasing the intensity of the evaluation and by multidisciplinary input. Evidence for a new or unique illness related to wartime exposures did not emerge from this analysis.
Adult↗
[Evidence-based treatment and education programs--evaluation of complex interventions].
Patient education and treatment programmes are complex interventions that require a multiphased stepwise evaluation. The continuum of increasing evidence of effectiveness of structured treatment and teaching programmes for diabetes and hypertension as implemented in Germany is presented, and the indispensable components of the program and the conditions of their effective implementation are described.
Education, Medical↗
From the Centers for Disease Control and Prevention. Performance evaluation programs for determining HIV-1 viral loads, testing for HIV p24 antigen, and identifying Mycobacterium tuberculosis using nucleic acid amplification tests.
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Clinical Laboratory Techniques↗
A model drug usage evaluation program.
Following the ten step process discussed above should bring a program into compliance with the guidelines of JCAHO. However, each facility is unique and should design its own DUE program. Since quality assurance is a dynamic process, each facility must keep abreast of frequent changes. With sufficient time and resources devoted to DUE activities, DUE programs can produce beneficial findings and impact positively on the quality and appropriateness of patient care.
Drug Utilization↗
Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA).
BACKGROUND: Program budgeting and marginal analysis (PBMA) is a framework for setting priorities in health care, used internationally over the last 25 years in Britain, Australia and New Zealand. However, the framework has undergone limited evaluation, and insight into how such evaluation should even take place is not found in the literature. METHODS: Seven PBMA case studies were conducted in three Canadian health regions to examine the feasibility of applying the PBMA framework. Structured follow-up surveys with the users of the framework were carried out following the priority setting exercises. RESULTS: The PBMA framework was feasibly implemented in three regionalized contexts and was generally viewed favorably by managers and clinicians who participated in the case studies. Numerous methodological lessons were learned and it was found that successful implementation hinges on organizational context. An empirically derived model describing PBMA is outlined and put forth as an evaluation framework for future exercises. CONCLUSIONS: Comparisons to the health care management literature indicate that the derived PBMA model is a novel addition to this broader literature. Overall, managers in health organizations internationally would be well-served to consider PBMA to aid regional decision-making processes, but should do so with explicit consideration of the context in which such activity is to occur.
Alberta↗
Environment and treatment: methodological notes on program evaluation and institutional culture.
This paper discusses the evaluation of a small regional children's rehabilitation centre. Several data sets were obtained including patient records and physical examinations of and interviews with Centre graduates. Originally, the project sought to describe the Centre's growth and determine successful programs. Design changes led to an examination of the relationship between institutional culture and the subsequent lifestyles of the graduates. The data strongly suggested that the institution's value orientation, which stressed successful accomplishment of daily living activities, life skills, had an impact upon an 'isolate lifestyle' apparent in the graduates. Standard statistical analysis are not able to support these conclusions. The methodological problems which lead to weaknesses in evaluation designs are discussed. It was concluded that researchers lack the methodological tools which would permit them to 'go beyond' simply reporting demographics, attitudes and opinions and making inferences into testing the relationships between institutional practices and subsequent behaviours.
Adolescent↗
Determinants of satisfaction with an automated alcohol evaluation program.
High rates of untreated mental illness cause serious health problems in the United States and worldwide. The use of computer-administered therapy has the potential to increase access to mental health care for certain patient populations. An online version of an alcohol check-up was developed that guided subjects through a series of standardized questionnaires, and provided them with feedback designed to enhance their appreciation of the negative aspects of their alcohol use. Ratings of the helpfulness of the questionnaires were evaluated in order to determine the characteristics of individuals who would potentially benefit from an automated substance abuse intervention, and to learn which aspects of an automated program would be most useful. Over a period of 25 months, 1,455 individuals participated in the study, 83% of whom had an Alcohol Use Disorders Identification Test (AUDIT) score indicative of problem drinking. Subjects with alcohol problems found the on-line program more useful than other subjects. The questionnaire which compared subjects' alcohol use to national norms, provided the most helpful and also the most unexpected information. Alcohol abusers with high levels of ambivalence about their drinking and other measures of motivation for change found the program more helpful than those with lower motivation. Automated therapy made available to the general public via the Internet can be accessed by large numbers of individuals. The interaction can be useful to patients with significant levels of substance abuse.
Adult↗
A court-mandated workshop for adolescent children of divorcing parents: a program evaluation.
This article provides a description and an empirical evaluation of a predivorce workshop established by the Family Court of Allen County, Indiana, for adolescent children (N = 48) of divorcing parents. Highlighted are the concerns of the adolescents, the approaches taken by the workshop staff, and the impact of the program on the participants. Viewpoints on the clinical, ethical, and legal issues involved in "required" predivorce counseling for adolescents are presented. The preventive nature of the program, its means of transforming initial resentment toward the workshop experience into positive feelings, and the implications for future practice and research are also discussed.
Adaptation, Psychological↗
The National Toxicology Program evaluation of genetically altered mice as predictive models for identifying carcinogens.
National Institute of Environmental Health Sciences researchers are exploring the utility of genetically altered mice to study mechanisms of carcinogenesis. Two of these mouse models, the Tg.AC (carrier of an activated mouse H-ras oncogene) and the p53+/- (heterozygous for the wild-type tumor suppressor gene Trp53), have genetic alterations that appear to hasten their expression of chemically induced tumors. These 2 models have been proposed as a basis for new strategies for identifying chemical carcinogens and for assessing risk. The National Toxicology Program (NTP) is conducting a series of studies with these 2 genetically altered strains to further examine their strengths and weaknesses for identification of documented rodent and human carcinogens. In this first evaluation, candidates for study were drawn from the NTP historical database of 2-yr rodent carcinogenicity studies and the open literature (primarily for drugs). Results with this first set of 11 chemicals tested in genetically altered mice, compared with previous findings in the traditional 2-yr rodent assays and literature on human tumor findings, appear to support the premise advanced by Tennant et al that these models have the potential to serve as more rapid and less expensive test systems to identify carcinogens.
Animals↗
Archival data in program evaluation and policy analysis.
Evaluators have typically avoided using existing data sets, choosing instead to collect their own information to maintain control over both the content and quality of the data. As demands on action researchers increase without provision for additional resources, primary data collection may become a luxury and the use of archival data may increase. Though archival data has practical and methodological advantages, there are limitations associated with the utilization of such information. The general problems with secondary data sources include the accuracy, acceptability and accessibility of the information. Following a discussion of these general problems, an example from the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) reimbursement data set is presented to illustrate specific difficulties with using archival data for evaluation research. Strategies are then presented for minimizing these difficulties, including determining the feasibility of utilization of such data sources, methods for assessing their accuracy and factors to consider in the data acquisition process.
Archives↗
Analysis of outcome variables of a token economy system in a state psychiatric hospital: a program evaluation.
This study describes the outcome of a token economy treatment applied to 2 distinct patient populations on the same unit of a state psychiatric hospital: individuals with a dual diagnosis of mental retardation and a DSM-IV Axis I diagnosis of either (a) a severe behavior disorder (BD) or (b) a serious and persistent psychiatric disorder (PD). Results showed that patients in the PD group were more likely to complete the treatment (17/20) than those in the BD group (17/31) who were more likely to be terminated from the program (14/31). Individuals who did not complete the program were distinguished early, within the first 3 weeks of treatment. These noncompleters received significantly more fines and earned significantly fewer tokens than those who completed the program. At an average of 2.7 years post-discharge, there was no difference in the proportion of PD (12/16) and BD completers (9/11) and BD noncompleters (3/7) remaining in the community. These data show that diverse populations of patients can be treated within the same token economy program, thereby improving cost effectiveness. Future research should be directed toward characterizing those patients (e.g., BD) less likely to succeed when they enter treatment, and determining if modifications in the program can improve that outcome.
Adolescent↗
Determination of antibody affinity by ELISA with a non-linear regression program. Evaluation of linearized approximations.
ELISA experiments based on competition between immobilized and soluble antibody for soluble antigen, and on the formation of a ternary complex of immobilized antibody, antigen and soluble antibody were used by Hoylaerts et al. (J. Immunol. Methods 126 (1990) 253-261) for the determination of dissociation constants. The dissociation constant was taken from linearized plots according to a theory that required several approximations. The effect of these approximations on the resulting dissociation constants has been investigated using two computer programs, CBEIA-C and CBEIA-S. Since most approximations that have to be made for linearization can be avoided by non-linear regression, the programs provide a more reliable basis for calculation of the dissociation constant. Experiments measuring formation of a ternary complex were found to be unsuitable for affinity determination.
Animals↗
The U.S. National Toxicology Program evaluation of transgenic mice as predictive models for identifying carcinogens.
National Institute of Environmental Health Sciences researchers have invested considerable effort in exploring the utility of transgenic mice to detect carcinogens and study mechanisms of carcinogenesis. Work has assessed several mouse models genetically altered to enhance their expression of chemically induced tumors. Results with the p53def (hemizygous for the tumor-suppressor gene) and the Tg.AC (carrier of an activated H-ras oncogene) mice have been used as a basis for a proposed new strategy for identifying chemical carcinogens and assessing risk. The U.S. National Toxicology Program is conducting a series of studies with these two transgenic strains to further examine their strengths and weaknesses for identification of documented rodent and human carcinogens and to explore their ability to provide information concerning the effective dosimetry for target organ mutation.
Animals↗