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[Experience in the use of Smith's ECG evaluation program].

After the experiences with the use of the programme of Pipberger concerning the automatised ECG-analysis in clinic, outpatient department and factory public health, which were made at the Medical Academy Erfurt during the last years, at this time comparative examinations with the ECG-analysis programme of Smith were performed. The intake of data (3 orthogonal leads) is done by means of a data establishing unit developed by us. For the analog-digital-changing, the pretreatment of data and the transmission of the ECG-data on the digital magnet tape a process-calculator TPA-i is used. The analysis is performed by the computer Robotron 21. The evaluation of the results shows that, when a great number of patients is examined, normal curves are correctly estimated at 100%. The recognition rate of pathological curves has with 79.5% about the same size as the visual judgment. The deficiencies of the diagnostic programme of Smith must be essentially found in the relatively high proportion of falsely negative findings, the insufficient differentiation of the changes of the chamber variation, in the sometimes incorrect formation, why the classification of the curves in individual groups was performed. On account of the certain centage of falsely negative ones the programme is well recognition of normal findings and the tolerable pernotion of the diagnosis and the sometimes lacking insuited for screening examinations.

Diagnosis, Computer-Assisted↗

In vivo antitumor evaluation of antibiotics. Selected results from the Drug Evaluation Program of the National Cancer Institute, U.S.A.

A summary is given of the in vivo screening results for selected antitumor antibiotics in various stages of the National Cancer Institute drug development program. In addition a brief description of general screening practices of the program is given. After long-term usage of leukemia L1210 as a primary screen, a new screening panel is being initiated with P388 leukemia as a prescreening system. Illustrative data on anguidine, actinomycin D, macromomycin, aclacinomycin, and other fermentation products are shown.

Animals↗

Early detection of kidney disease in community settings: the Kidney Early Evaluation Program (KEEP).

BACKGROUND: Early identification of persons at risk for kidney disease provides an opportunity to prevent or delay its progression and decrease morbidity and mortality. Our hypothesis was that implementation of a targeted screening program in communities with high-risk populations would detect previously unidentified persons with or at high risk for chronic kidney disease (CKD) with a prevalence that exceeds that predicted for CKD in the general population. METHODS: Persons with hypertension or diabetes or a first-order relative with hypertension, diabetes, or kidney disease were screened for kidney disease risk factors. Blood pressure, blood glucose level, serum creatinine level, hemoglobin level, microalbuminuria, hematuria, pyuria, body mass index, and estimated glomerular filtration rate (EGFR) were evaluated. RESULTS: Six thousand seventy-one eligible persons were screened from August 2000 through December 2001: of these persons, 68% were women, 43% were African American, 36% were white, 10% were Hispanic, and 5% were Native American. Most reported high-school education or more (84%) and health insurance coverage (86%). Twenty-seven percent met the screening definitions for diabetes; 64%, for hypertension; 29%, for microalbuminuria; 8%, for anemia; 18%, for hematuria; 13%, for pyuria; 5%, for elevated serum creatinine level; 16%, for reduced EGFR; and 44%, for obesity. Among participants without a reported history of specified conditions, screening identified 82 participants (2%) with diabetes, 1,014 participants (35%) with hypertension, 277 participants (5%) with elevated serum creatinine levels, 839 participants (14%) with reduced EGFRs, and 1,712 participants (29%) with microalbuminuria. Thirty-five percent of participants with a history of diabetes had elevated serum glucose levels at screening (> or =180 mg/dL [10 mmol/L]), and 64% with a history of hypertension did not have blood pressure controlled to less than 140/90 mm Hg. Only 18% of participants with a history of diabetes and 31% with a reduced EGFR had blood pressure controlled to less than 130/80 mm Hg and less than 135/85 mm Hg, respectively. CONCLUSION: Targeted screening is effective in identifying persons with previously unidentified or poorly controlled kidney disease risk factors, as well as persons with a moderately decreased EGFR.

Adolescent↗

A program evaluation of classroom data collection with bar codes.

A technology incorporating bar code symbols and hand-held optical scanners was evaluated for its utility for routine data collection in a special education classroom. A different bar code symbol was created for each Individualized Educational Plan objective, each type of response occurrence, and each student in the first author's classroom. These symbols were organized by activity and printed as data sheets. The teacher and paraprofessionals scanned relevant codes with scanners when the students emitted targeted behaviors. The codes, dates, and approximate times of the scans were retained in the scanner's electronic memory until they could be transferred by communication software to a computer file. The data from the computer file were organized weekly into a printed report of student performance using a program written with commercially available database software. Advantages, disadvantages, and costs of using the system are discussed.

Child↗

An adverse drug reaction reporting system as an integral part of a drug-usage evaluation program.

The Adverse Drug Reaction program at CSMC identifies patients whose charts have been encoded with an ICD-9 code of E930 through E949, inclusively. Incidences per drug or drug category have permitted the Department of Pharmacy, acting through the Pharmacy and Therapeutics Committee, to review patient charts, identify trends and risk factors, and subsequently develop usage criteria for DUE studies. It is hoped that these activities will result in an improvement in usage of these drugs and a reduction in adverse drug reactions to them.

Digoxin↗

Development of a toxicity evaluation program for dental materials and products. II. Screening for systemic toxicity.

A series of systemic toxicity tests for various types of compounds are presented with illustrative data and discussed in regard to their relevance as potential screening tests for dental compounds and products. In developing and marketing a new dental material, it is important not only to ensure safety for the patient but also for the dentist, dental assistant, and laboratory worker who routinely handles and uses the product. Data are presented on a number of commercially available dental products as well as various chemical entities, which were tested by one or more of the methods described.

Acetaldehyde↗

The ACHS Care Evaluation Program: a decade of achievement. Australian Council on Healthcare Standards.

In 1989 the Australian Council on Healthcare Standards (ACHS) embarked on a programme to develop acute health care clinical indicators in conjunction with the Australian medical colleges. Through a carefully structured stepwise process this collaboration established a 'World first' in 1993 with the introduction of the first set of indicators into the ACHS Accreditation programme. The programme remains unique in the formal involvement of providers in the development process and in the scope of the clinical areas covered in acute health care. From the year 2000 there will be 18 sets (and over 200 indicators) from which health care organisations (HCOs) can choose to monitor the major services they provide. There remains no compulsion to address a specific number of indicators. The growth of the programme has been considerable with more than half of the nations' acute HCOs reporting their clinical indicator data (twice yearly) and it provides a reflection of the care given for the majority of patient separations in acute care. This reporting process allows HCOs to receive feedback on the aggregate results together with comparative peer group information for each indicator they address. In addition to numerous publications in peer reviewed journals an annual aggregate report, 'the Measurement of Care in Australian Hospitals' is published. It reports both qualitative and quantitative data on all indicator sets for the preceding year. Validity of the indicators is strengthened each year with a review process and reliability and reproducibility of the data can now be demonstrated. The clinical response to the indicators has been overwhelming and there is now documented evidence of numerous actions taken by HCOs to improve both the processes and the outcomes of patient care. The nation wide database can be expected to reflect trends in care over the next few years. The process of indicator refinement, however, will continue and it is likely that a reduction in the total number of indicators will occur with a core group of the more 'robust' indicators remaining. Further directions in indicator development are likely to be in the area of multidisciplinary care and in the assessment of longer-term outcomes. In addition to measures of the quality of care, hopefully, in time, health care providers will also take part in the establishment of measures of the appropriateness of that care.

Accreditation↗

Formative program evaluation and milieu therapy with alcohol abusers.

Evaluated presumably therapeutic components within a therapeutic community in terms of perceived helpfulness by patients and staff of an alcohol treatment unit. Eighteen male patients and 18 staff members participated. A nonparametric statistic was used as an index of treatment philosophy articulation or degree of value-sharing. A core of activities valued congruently by patients and staff was identified.

Adult↗

The EORTC Melanoma Group exchange program: evaluation of a multicenter monoclonal antibody study.

In the framework of the European Organisation for Research and Treatment of Cancer (EORTC), the Immunology and Pathology Subgroups of the Malignant Melanoma Cooperative Group undertook a large multicenter monoclonal antibody (MAb) study. Fourteen laboratories from 7 European countries tested a panel of 23 MAbs for immunohistological staining reactivity for malignant and non-malignant lesions involving the melanocytic lineage. A standardized immunoperoxidase procedure was used and the results were evaluated using a standard protocol and data evaluation form developed in collaboration with the EORTC Data Center. According to this analysis, the antibodies in the panel could be classified into 3 main groups. The first group of MAbs includes those antibodies which stained the majority (greater than 80%) of all primary tumors, irrespective of their Breslow thickness and the majority of metastatic lesions. In addition, these MAbs stained a high percentage of cells within a given lesion. Several antibodies of Group I were likewise reactive with the majority of naevoblasts and with normal melanocytes. The second group of MAbs included antibodies reacting only with a limited number of primary melanomas and metastatic lesions. Antibodies of Group II reacted only weakly, if at all, with normal melanocytes or naevocytes. The percentage of cells within a malignant lesion stained by these MAbs was always rather low. The MAb group III detected surface structures whose expression appeared to be related to tumor progression; they did not react or reacted only weakly with naevi, and they all reacted with a small number of early primary melanomas (less than 0.75 mm). The number of lesions stained increased with increasing Breslow thickness. Our study suggests that the application of a panel of well defined MAbs might be of diagnostic and prognostic value in evaluating malignant melanoma.

Antibodies, Monoclonal↗

Cancer-specific worry interference in women attending a breast and ovarian cancer risk evaluation program: impact on emotional distress and health functioning.

Intrusive thoughts about cancer, often identified as 'cancer-specific worries' or 'cancer-specific distress', have been postulated to be associated with dysfunction in women at increased risk of developing breast or ovarian cancer. The current study discusses the development and validation of a measure designed to assess women's perceptions of the interference such worries create in their daily functioning. Analyses revealed that approximately two-thirds of a high-risk breast cancer clinic sample perceived worries about breast cancer as interfering with their functioning across a variety of life domains. Multiple regression analyses indicated that worry interference scores predicted Profile of Mood States (POMS) Anxiety and Confusion, and Short Form-36 (SF-36) Role-Emotional and Mental Health scores after the effects of other variables such as frequency of worry about breast cancer, and having a family history of cancer had been considered. Women who perceived their worries as interfering with their functioning reported higher levels of anxiety and confusion, and diminished mental health and role functioning. The results add to the expanding area of anxiety/distress in at-risk populations by providing (1) a direct measure of the perceived interference associated with breast cancer-specific thoughts, (2) a validation of the measure via its associations with standard measures of emotional distress and health functioning, and (3) evidence of the measure's incremental predictive value in explaining distress and quality of life, after consideration of background variables, such as having a family history of cancer.

Activities of Daily Living↗