SEARCH · Search PubMed

Results for “Data Sources”

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.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources

PubMed1978

Assessing technical performance at diverse ambulatory care sites.

The purpose of the large study reported here was to develop and test methods for assessing the quality of health care that would be broadly applicable to diverse ambulatory care organizations for periodic comparative review. Methodological features included the use of an age-sex stratified random sampling scheme, dependence on medical records as the source of data, a fixed study period year, use of Kessner's tracer methodology (including not only acute and chronic diseases but also screening and immunization rates as indicators), and a fixed tracer matrix at all test sites. This combination of methods proved more efficacious in estimating certain parameters for the total patient populations at each site (including utilization patterns, screening, and immunization rates) and the process of care for acute conditions than it did in examining the process of care for the selected chronic condition. It was found that the actual process of care at all three sites for the three acute conditions (streptococcal pharyngitis, urinary tract infection, and iron deficiency anemia) often differed from the expected process in terms of both diagnostic procedures and treatment. For hypertension, the chronic disease tracer, medical records were frequently a deficient data source from which to draw conclusions about the adequacy of treatment. Several aspects of the study methodology were found to be detrimental to between-site comparisons of the process of care for chronic disease management. The use of an age-sex stratified random sampling scheme resulted in the identification of too few cases of hypertension at some sites for analytic purposes, thereby necessitating supplementary sampling by diagnosis. The use of a fixed study period year resulted in an arbitrary starting point in the course of the disease. Furthermore, in light of the diverse sociodemographic characteristics of the patient populations, the use of a fixed matrix of tracer conditions for all test sites is questionable. The discussion centers on these and other problems encountered in attempting to compare technical performance within diverse ambulatory care organizations and provides some guidelines as to the utility of alternative methods for assessing the quality of health care.

Adolescent↗

PubMed1981

[Accidents related to physical education in school: epidemiologic and preventive approach].

Generally speaking, this category of accidents seems to cause mostly relatively mild injuries. It could explain, at least in part, why there are so few papers on this topic in the medical literature except for clinical reports usually based on hospitalized cases. The main results of a study of the 9261 physical education accidents registered within five years in primary and secondary schools in Basle and Geneva are used to illustrate their epidemiological characteristics, as well as the localization and the severity of the injuries. The sources of data are the files of the accident insurance companies. Initial operational definitions, data sources, measurement of exposure to risk and the (largely criticized) notion of individual accident proneness are constraints and conditions of a pertinent epidemiological approach which have to be carefully taken into consideration. This approach should be combined with the clinical and the ergonomical approaches in order to get the best possible pictures of the causes, mechanisms and consequences not only of accidents in general but especially of those occurring in physical activities in childhood and adolescence. Some considerations on prevention are briefly outlined here. They intend to take into account the risk factors related to the tasks, the circumstances and especially to the student himself taken as an individual involved in a growth and development dynamics.

Adolescent↗

PubMed2002

Service penetration by persons with severe mental illness: how should it be measured?

As performance indicators and outcomes measures become essential parts of doing business, providers of mental health services are developing and using a number of access measures. One that is being used with increasing frequency is service penetration. However, the lack of standard methods for calculating and reporting service penetration has made the comparison of penetration rates cross studies difficult. This article discusses the conceptualization and operationalization of service penetration. In addition, it presents an exploratory study of service penetration using data from the same persons using very different data sources; these data were collected during an evaluation of a Medicaid managed care system in Florida. The article offers recommendations for the use and reporting of service penetration rates.

Case Management↗

PubMed1994

Measuring resource use in economic evaluations: determining the social costs of mental illness.

Concern over costs associated with mental disorders has led to an increase in the number of economic evaluations of treatment interventions; unfortunately, methods for measuring resource use have not kept pace with this concern. Although it is well-known that a significant proportion of the costs associated with mental illness are for resources other than treatment, program evaluators and researchers often count only treatment costs in cost-effectiveness comparisons. Further, existing methods for measuring resource use are plagued by faulty assumptions about resource use, poor validity and reliability, and difficulties quantifying resource use. The authors discuss these problems and suggest five ways of improving measurement of nontreatment resources: clarifying assumptions, using multiple data sources, flexible data collection strategies, methods for improving the accuracy of recall, and an episodic approach to measurement.

Cost of Illness↗

PubMed2004

Population-based health indexes: a systematic review.

This paper presents a systematic review the literature pertaining to the development and use of population-based health indexes with regard to reason for development of the index, geographical level of aggregation, inclusion of health indicators, weighting, sources of data and validation. Any type of population-based health index that incorporated at least two health indicators was considered for inclusion in the review. Studies from the UK, Europe and North America were considered. Seventeen individual studies and one review describing a population-based health index are described. The health indexes were designed for a wide variety of purposes. Levels of geographical aggregation ranged from ward to national level. There was considerable variation between these studies regarding the indicators chosen for inclusion in the health indexes as well as the methods used to combine them. Fourteen of the 18 included studies reported information on weighting of the indicators. None of the studies gave justification for the method of weighting chosen. Indicators were on the whole obtained from routine data sources. Only four of the indexes addressed the problem of validity. A population-based health index is potentially a very useful tool for monitoring the health of a community. More research is needed to determine which health indicators should be used in the formation of such an index and the most appropriate method to combine them.

Adolescent↗

PubMed2005

Challenges and strategies in developing nursing research capacity: a review of the literature.

OBJECTIVES: This paper reports the findings of a critical overview of the development of nursing research capacity in academic departments. It examines the major barriers to developing research capacity, the capacity building strategies adopted (or proposed) within the literature, and considers the wider context within which such endeavours take place. DESIGN: The literature review forms part of a longitudinal project utilising case study methodology. A key word search was used to locate relevant journal articles for the period 1999-2004, derived from the project's research question and an earlier literature review. A number of manual 'shelf searches' were conducted. DATA SOURCES: Bibliographic data were retrieved from The Cumulative Index of Nursing and Allied Health literature, The Social Science Citation Index, and Medline. REVIEW METHODS: Approximately 150 articles were retrieved, of which 47 were included in the study. Given the paucity of work in this area papers were not excluded on the grounds of methodological weakness. Major themes were identified in each paper and an analytical framework was developed. RESULTS: Two main challenges affecting research capacity development were identified-material constraints and organisational contexts, and the changing roles and expectations of nurse educators. The importance of developing an overall strategic approach, clearly communicated, and accompanied by effective leadership was a point of common agreement. Debate existed on how research support should be managed, particularly the merits of inclusivity and the reconcilement of individual and organisational needs. Specific capacity strategies identified in the literature were the creation of infrastructures, the fostering of research cultures and environments, and the facilitation of training and collaboration. CONCLUSIONS: The literature offers many examples of capacity building strategies. However, more empirical studies are needed to understand the situated process of implementing and evaluating capacity building in individual academic departments, and how this process differs between geographical settings.

Education, Nursing, Continuing↗

PubMed2005

Avoiding pitfalls in assembling an equipment failure rate database for risk assessments.

As companies move progressively toward quantifying the risks of releases of hazardous materials, there becomes a greater need for developing the data necessary to populate the risk analysis. Sophisticated mathematical models have been developed to predict the consequences of a hazardous material release. But the effort devoted to the frequency side of the "risk equation" has been very disorganized by comparison, with inconsistent or non-existent definitions of "failure", mixing of incompatible data, application of data from one industry to a completely different industry, and a host of other problems. Nonetheless, through judicious assembly and analysis of a variety of data sources, a useful failure rate database can be developed. Many seminal sources of data are described, with an emphasis on loss of containment failure rates. Pitfalls in interpreting failure rate data are also illustrated.

Chemical Industry↗

PubMed2006

The trajectory of biomarkers in symptom management for older adults with cancer.

OBJECTIVES: To provide an overview of the trajectory of select biomarkers and their potential usefulness in symptom management in the older individual with cancer. DATA SOURCES: Empirical data and literature review. CONCLUSION: Biomarkers offer significant opportunities to understand the biological impact of cancer and its treatment on older adults whose response is likely different from their younger counterparts. Large well-designed multi-site clinical trials with adequate numbers and power are necessary to create evidenced-based practice changes. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to understand the science and implications of biomarkers to develop interventions in response to the mechanisms of symptoms experienced by older adults with cancer.

Adrenal Cortex↗

PubMed2005

Epidemiology and prevention of tobacco use in Tunisia: a review.

INTRODUCTION: This paper describes trends in tobacco sales and smoking prevalence in the Tunisian population, it estimates the consequences of smoking on mortality of this population and discusses anti-tobacco actions: educational actions, legislative measures, and price increases. DATA SOURCES: Sales data were collected from the Tunisia tobacco monopoly, smoking prevalence data from surveys conducted by several institutes, and numbers of deaths by causes have been estimated from WHO for 1998 year. RESULTS: Tobacco sales increased from 4.96 g per adult per day in 1981 to 6.3 g in 1993, then decreased widely. The proportion of smokers was 30% in 1996, 55% among men versus 5.6% among women. Among 17 to 24 years old young adults, the proportion of smokers was 29.2% in 1994 (50% among men versus 3.9% among women). Mortality attributable to tobacco in Tunisia has been estimated to 6430 deaths in 1997 (5580 among men versus 850 among women). These deaths represent 22% of total male deaths and 4% of female ones. Anti tobacco measures have been reinforced by the enactment of anti tobacco law. CONCLUSION: Proportion of young smokers remaining high, it is expected that the consequences of tobacco addiction in Tunisia in term of mortality will be even heavier in the next two decades if efficient anti tobacco actions are not implemented.

Age Distribution↗

PubMed2003

The medical management of ectopic pregnancy: a meta-analysis comparing "single dose" and "multidose" regimens.

OBJECTIVE: Medical management of an unruptured ectopic pregnancy with intramuscular methotrexate is common and cost-effective. Two treatment protocols, the "single dose" and the "multidose," have been advocated and independently reported in the medical literature. This analysis systematically compares the success and prevalence of side effects of these two regimens. DATA SOURCES: Published data on women with an ectopic pregnancy medically managed were identified using a MEDLINE search from 1966 to 2001 using key words and review of the references of each manuscript. METHODS OF STUDY SELECTION: Studies were selected based on dosing regimen, number of subjects, and study quality. Data regarding outcome, number of doses administered, side effects, and baseline characteristics were extracted. Data were summarized, and the associations of failed management and the presence of side effects with treatment protocol were calculated. Baseline serum chorionic gonadotropin values and the presence of embryonic fetal actively were controlled for with multivariable logistic regression. TABULATION, INTEGRATION, AND RESULTS: The overall success rate for women treated with methotrexate for an ectopic pregnancy was 89% (1181 of 1327). The single dose was much more commonly used. The use of single dose was associated with a significantly greater chance of failed medical management than the use of the multidose in both crude (odds ratio [OR] 1.71; 1.04, 2.82) and adjusted analyses (OR 4.74; 1.77, 12.62). The single-dose regimen was associated with fewer side effects (OR 0.44; 0.31, 0.63). Women who experienced side effects were more likely to have successful treatment regardless of regimen. CONCLUSION: The multidose regimen is more effective than the single-dose regimen.

Abortifacient Agents, Nonsteroidal↗

PubMed1999

Spinal pain syndromes: nociceptive, neuropathic, and psychologic mechanisms.

BACKGROUND: Pain continues to be the main symptom reported by patients. Frequently, clinicians incorrectly diagnose patients and resulting treatments are ineffective, which may promote the development of chronic pain. This situation may arise as a result of a lack of clarity in the literature regarding pain syndromes. OBJECTIVE: To discuss the differences between nociceptive, neuropathic, and psychologic induction of pain and provide important clinical correlates to aid in diagnosis and treatment. DATA SOURCES: The data were accumulated over a period of years by reviewing contemporary articles and books and subsequently retrieving relevant papers. Articles also were selected from MEDLINE searches and from manual library searches. DATA SYNTHESIS: Nociceptive pain syndromes are responsible for the majority of pain complaints in clinical practice. Care must be taken to avoid the common mistake of the diagnosis of neuropathic pain, which can lead to inappropriate treatments. CONCLUSION: Although the treatment of neuropathic pain is difficult, sufficient evidence in the literature demonstrates that the treatment of nociceptive pain should be multimodal and involve spinal manipulation, muscle lengthening/stretching, trigger point therapy, rehabilitation exercises, electrical modalities, a variety of nutritional factors, and mental/emotional support.

Acute Disease↗

PubMed2000

Tolerance and hematopoietic stem cell transplantation 50 years after Burnet's theory.

OBJECTIVE: In 1949, the original formulation of Burnet's theory on the mechanisms responsible for the capacity of the immune system to discriminate between foreign antigens (i.e., the "non-self") and the cells of its own body (i.e., the "self") was published. Since then, further refinements and reconsiderations of the basic concepts underlying the achievement of a state of tolerance toward a certain antigen have been reported. Here, we attempt to analyze critically new clinical and experimental strategies aimed at inducing alloantigen-specific unresponsiveness. DATA SOURCES: The data discussed in this review are drawn from articles and abstracts published in journals covered by the Science Citation Index and Medline. STATE OF THE ART: Induction of tolerance toward alloantigens still remains one of the most elusive goals of clinical immunology. Until now, nonspecific immunosuppressive drugs have been used to successfully perform both solid organ and hematopoietic stem cell transplantation. However, using this approach, patients given an allograft are exposed to the threat of infections, tumors, and other side effects. Moreover, in solid organ transplant recipients, permanent tolerance toward the graft's alloantigens is never achieved. Recently, considerable progress has been made in expanding our knowledge of transplant tolerance. The traditional model of central tolerance, derived from Burnet's concept, has been complemented by knowledge of mechanisms of peripheral tolerance. CONCLUSIONS: New experimental and therapeutic trials based on the blockade of costimulatory molecules, as well as on generation and infusion of either regulatory or nonimmunogenic cells, have been recently proposed for inducing alloantigen-specific tolerance.The achievements obtained in understanding the mechanisms of unresponsiveness toward non-self antigens are fundamental prerequisites for successful allogeneic transplants, and they could open a new exciting era of specific, immunosuppressive therapies.

Animals↗

PubMed2003

Therapeutic modalities for cow's milk allergy.

OBJECTIVE: To discuss current therapeutic modalities for cow's milk allergy and its prevention. DATA SOURCES AND STUDY SELECTION: The sources of data include original clinical studies carried out at Ste. Justine Hospital, as well as a systematic search of the published English and French language scientific literature restricted to human subjects using computerized searches (National Public Library of Medicine, Cochrane Database Systems Review) from 1997 to 2002. Search terms for article retrieval included food allergy, milk allergy, therapy, and prevention. CONCLUSIONS: The therapy of food allergies depends upon an accurate diagnosis, which remains a challenge in non--IgE-mediated cases. Dietary exclusion remains the mainstay of therapy, with medications reserved for exceptional patients. Preliminary evidence suggests that pancreatic enzyme supplementation may be of benefit for cases with multiple food allergies and severe eczema. Hydrolysate formula use is currently recommended for dietary allergy prevention in infants at an increased risk when maternal milk is insufficient or unavailable. The use of partially hydrolyzed formulas to prevent allergic disorders, including atopic dermatitis, is supported by clinical studies, but cannot be used in the already sensitized, milk-allergic child. Probiotics show enormous potential in preventing food allergic disorders as well.

Animals↗

PubMed2002

Monoclonal anti-IgE antibody: a novel therapy for allergic airways disease.

LEARNING OBJECTIVES: To familiarize the practitioner with a novel (monoclonal anti-immunoglobulin [Ig]E antibody) form of therapy for allergic airways disease. To understand the relevance of IgE as a therapeutic target. To appreciate the concepts behind the design of the molecule. To learn how anti-IgE was used in clinical trials. To anticipate the likely effects (efficacy and safety) in clinical use in patients with allergic asthma and with allergic rhinitis. To characterize the types of patients who might benefit from this therapy. DATA SOURCES: Published data for preclinical and clinical studies. RESULTS: Omalizumab is a nonimmunogenic, nonanaphylactogenic monoclonal anti-IgE antibody. In clinical use, omalizumab reduces levels of serum-free IgE. Given subcutaneously in patients with moderate-severe allergic asthma, omalizumab reduced exacerbations compared with placebo, and at the same time it allowed inhaled corticosteroids to be reduced or withdrawn. In patients with allergic rhinitis, omalizumab reduced the severity of symptoms and rescue antihistamine usage versus placebo. In both settings, quality of life was improved with active treatment relative to placebo. The drug seems safe and well tolerated. CONCLUSION: As the first clinical anti-IgE agent, omalizumab is an interesting new addition to the currently available therapies for allergic airways disease. The benefits demonstrated underline the importance of IgE in these conditions. The use of anti-IgE in other IgE-mediated allergic diseases warrants further research.

Anti-Allergic Agents↗

PubMedDate not supplied

Role of the pharmacist in childhood immunizations.

OBJECTIVE: Fewer than half of the 2-year-old children in the United States are fully immunized. This article reviews the literature on barriers to immunization in children and examines how pharmacists can promote childhood immunizations by acting as an educational resource and providing increased access to vaccines. DATA SOURCES: Published data were collected from the literature. Anecdotal data were collected from unstructured interviews with parents and health care professionals at two childhood immunization clinics in Des Moines, Iowa. DATA SYNTHESIS: Data from the literature were compared with data informally collected in the clinics. Both the literature and interviews indicated a variety of structural and personal barriers that may prevent parents from having children vaccinated. CONCLUSION: By collecting and documenting adequate vaccination histories, pharmacists can be a resource for parents and health care professionals who are unsure of a child's immunization status. Pharmacists may wish to establish immunization clinics in their pharmacies as a method to increase access to vaccines.

Adolescent↗

PubMed2005

Implant supported fixed partial dentures survival rate high, but biological and technical complications common.

DATA SOURCES: PubMed (1966-April 2004) provided the primary data source along with the bibliographies from identified articles and reviews. Manual search of eight relevant journals (published 2001-2003) provided a further source of data. STUDY SELECTION: As there were no randomised controlled trials comparing implant therapy with conventional reconstructive dentistry, English language prospective and retrospective cohort studies were selected if; they had a mean follow-up of >/=5 years; included patients who were clinically examined at follow-up; reported details on suprastructures and described at least one-third of reconstructions as fixed partial dentures (FPDs). DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened articles for inclusion. Disagreements were resolved by discussion and agreement determined by kappa. Data were extracted on the survival proportions of the reconstructions and on biological and technical complications. Biological complications included disturbances in the function of the implant characterized by a biological process affecting the supporting tissues. Technical complications denoted mechanical damage of implants, implant components, or the suprastructures. The number of events for all categories was identified and the corresponding total exposure time of the reconstruction calculated. Failure and complication rates were calculated by dividing the number of events by the total exposure time. RESULTS: Twenty-one studies of implant supported FPDs, reporting on 16 patient cohorts were included. Of the studies, 16 were prospective and five retrospective. A total of 1336 FPDs supported by 3578 oral implants were involved. Meta-analyses gave an estimated implant survival of 95.4% (95% CI 93.9-96.5) after 5 years and 92.8% (95% CI 90-94.8) after 10 years. Implant failure rate was 48% lower (P=0.006) in the more recent studies. The estimated survival for the FPDs was 95% (95% CI 92.2-96.8) after 5 years and 86.7% (95% CI 82.8-89.8) after 10 years. Four studies provided information on the number of patients free from complications - after 5 years 61.3% (95% CI 55.3-66.8) had suffered no minor or major complications. A random effects Poisson model revealed the rate of biological complications for patients treated with implant supported FPDs to be 8.6% (95% CI 5.1-14.1) after 5 years. For technical complications the cumulative 5 year complication rate varied from 0.4% for implant fracture to 13.2% for veneer fracture. CONCLUSIONS: Although survival rate for implant supported FPDs is high, biological and technical complications are relatively common.

Comment↗

PubMed2005

Ten-year survival rate for cantilevered fixed partial dentures.

DATA SOURCES: PubMed (1966-April 2004) provided the primary data source along with the bibliographies from identified articles and reviews. A manual search of two relevant journals (Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, International Journal of Oral & Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics, Journal of Clinical Periodontology, Journal of Periodontology and Journal of Prosthetic Dentistry published; published 2001-2003) provided a further source of data. STUDY SELECTION: Because there were no randomised controlled trials (RCT) that compared fixed partial dentures (FPD) with and without cantilever extensions, other studies were selected if they met the following criteria: were published in the English language; were prospective and retrospective cohort studies; had a mean follow-up of >5 years; included patients who were clinically examined at follow-up; and reported details on suprastructures and described at least one-third of reconstructions as FPD. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened articles for inclusion. Disagreements were resolved by discussion and agreement determined by kappa. Two reviewers extracted data on the survival and success of the reconstructions and on biological and technical complications. Failure and complication rates were calculated by dividing the number of events by the total exposure time. RESULTS: Three prospective and 10 retrospective cohort studies incorporating 700 patients and 816 FPD were included. The mean number of cantilever extensions ranged from 1.1 to 6.0. Meta-analyses gave an estimated survival, after 10 years, of 81.8% [95% confidence interval (CI), 78.2-84.9] and a proportion success of 63% (95% CI, 54.7-70.2). Considering biological complications using Poisson model analyses, the estimated rate of FPD lost because of caries after 10 years was 3.1% (95%CI, 1.0-8.8) and that for loss of vitality was 32.6% (95% CI, 13.9-64.9). The rate of FPD lost because of periodontitis was 1% (95% CI, 0.3-3.0). Cumulative 10-year complication rates were: 2.9% (95% CI, 1.7-5.0) for fracture of abutment tooth; 2.4% (95% CI, 0.6-9.8) for rate of loss as a result of abutment fracture; 16.1% (95% CI, 8.8-28.4) for loss of retention; and 5.9% (95% CI, 3.3-10.4) for material complications. CONCLUSIONS: Success and survival rates for cantilever FPD are poorer than those for conventional FPD and this is accompanied by frequent biological and technical complications.

Comment↗

PubMed2003

Using cost-effectiveness analysis to compare Hospital at Home and in-patient interventions. Part 1.

An economic analysis was conducted as an integral part of a comparison of the effectiveness and suitability of Hospital at Home (HaH) and in-patient interventions. The sample comprised of 109 adult primary total joint replacement patients and 21 of their coresident informal carers. The paper is presented in two parts. Part 1 includes the background and rationale for the study and the findings from the comparison of the effectiveness of the two interventions using multiple data collection sources. Data were collected using questionnaires, audit and semi-structured interviews. Hospital at Home was found to be significantly more effective in terms of patient satisfaction and reduced joint stiffness and as least as effective as in-patient care in relation to levels of joint pain, joint disability and incidence of postoperative complications. In addition informal carers reported 107 positive comments compared with 36 negative comments related to HaH care and all except one of the 21 carers would choose HaH again in preference to in-patient care.

Aged↗