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Clinical data evaluation and the PL health control information system.

In a health control service environment, that is, a periodic, membership AMHTS type of comprehensive health check-up system, where clinical data evaluation especially an evaluation in terms of subject-specific normal ranges, is most important, the medical information system is required to handle: (1) Various network types files; (2) real-time immediacy; (3) an asserted reliability to meet personal health control purposes. As in other computer applications already successfully used, an indexed direct assess method (IDAM) developed is our solution. It allows us to provide multiple indices for the file network, instead of inverted files, a unique index-to-record relationship, preventing any unrecoverable chaining destruction and, thereby, provides any network type access a stable access time. Furthermore, for research purposes, a data integrity for on-line access and batch access was attained as well as a retrieval language system with a multiple key retrieval function.

Diagnosis, Computer-Assisted↗

Mutagen sensitivity, smoking habits and enzyme induction in healthy middle-aged men.

Unscheduled DNA synthesis (UDS) (excision-repair) of N-acetoxy-2-acetylaminofluorene (NA-AAF) damage to the DNA of human lymphocytes and levels of 3H-labeled NA-AAF bound to the DNA (carcinogen binding) of lymphocytes after 18 hr of culturing were measured in a consecutive subsample of healthy middle-aged males attending a multiphasic health screening program at the Department of Preventive Medicine in Malmö during 3 weeks in November-December 1981, and compared relative to their smoking habits, body weight, serum cholesterol, and gamma-glutamyltransferase levels as well as aryl hydrocarbon hydroxylase inducibility. This study group numbered 66 males and was uniform in sex, age, and investigation time. No case of significant arterial hypertension was present. The UDS and carcinogen binding results showed no correlation with the other factors measured, with the exception of smoking which was strongly (P less than 0.01) associated with increasing levels of both the UDS and carcinogen binding values. It is concluded that under ordinary circumstances smoking may represent the most important exogenous factor which may modulate risk to cardiovascular disease and cancer by influencing individual mutagen sensitivity.

Acetoxyacetylaminofluorene↗

Decision-making in clinical practice: application of predictors, indicators and indices to the medical history obtained by a self-administered questionnaire.

A theoretical description of predictors, indicators, and health indices was presented in an earlier paper (Hall and Sebag, 1974). The application of predictors, indicators and health indices--including dynamic health indices--to anamnestic data obtained by a self-administered questionnaire is presented herein. Predictors and indicators showed a varying degree of 'decision-making significance' in the 122 questions examined. The health index distinguished between diagnosed individuals and those receiving no diagnosis(es). The dynamic health index was found to reflect changes in the health status of an individual over a period of time.

Decision Making↗

Multiphasic Health Checkup Evaluation: a 16-year follow-up.

The Multiphasic Health Checkup Evaluation Study, a long-term clinical trial, has been completed. A study group of 5156 men and women age 35-54 at entry was urged to have annual multiphasic health checkups (MHCs) for 16 years. A control group of 5557 comparable subjects was not so urged but was followed up in a comparable fashion. The mean and median number of MHCs per person were 6.8 and 6, respectively, in the study group and 2.8 and 1, respectively, in the control group. During 16 years the study group experienced a 30% reduction (p less than 0.05) in deaths from pre-specified "potentially postponable" causes, largely associated with lower death rates from colorectal cancer and hypertension. This reduction was most pronounced in the early years of the study. The two groups did not differ to a statistically significant degree in mortality from all other causes (84% of total mortality) or in total mortality. There was no difference in self-reported disability in the overall groups. In the setting of our prepaid health care plan where MHCs were already available on a voluntary basis, a program of urging middle-aged persons to undergo regular MHCs brought about a substantial reduction in mortality from preselected diseases.

Adult↗