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Seasonal changes in affective state measured prospectively and retrospectively.

BACKGROUND: The study was designed to investigate whether seasonal mood and behavioural changes are detectable prospectively in a non-clinical population in the way they have been reported in retrospective studies. The specificity of any seasonal fluctuation in affective state was also investigated by measuring anxiety as well as depression. METHOD: To measure seasonal fluctuations in affect and behaviour prospectively, 25 women were interviewed every month for one year using four scales (depression, anxiety, stress, and behavioural change). Retrospective accounts of mood and behaviour at the end of the year were collected with the Seasonal Pattern and Assessment Questionnaire (SPAQ). RESULTS: Seasonal depression peaked in winter as did atypical behaviour when measured either prospectively or retrospectively, but the difference between winter and summer was much more pronounced in the retrospective data. No seasonal effect was found for anxiety or psychosocial stressors. CONCLUSIONS: The results obtained by retrospective techniques have limited reliability. In the future, more prospective studies with unbiased, standardised instruments are recommended to measure seasonal variations in affect and behaviour.

Adult↗

The accuracy and completeness of data collected by prospective and retrospective methods.

OBJECTIVES: To describe and test a model that compares the accuracy of data gathered prospectively versus retrospectively among adult emergency department patients admitted with chest pain. METHODS: The authors developed a model of information flow from subject to medical record to the clinical study case report form, based on a literature review. To test this model, a bidirectional (prospective and retrospective) study was conducted, enrolling all eligible adult patients who were admitted with a chief complaint of chest pain. The authors interviewed patients in the emergency department to determine their chest pain history and established a prospective database; this was considered the criterion standard. Then, patient medical records were reviewed to determine the accuracy and completeness of the information available through a retrospective medical record review. RESULTS: The model described applies the concepts of reliability and validity to information passed on by the study subject, the clinician, and the medical record abstractor. This study was comprised of 104 subjects, of which 63% were men and the median age was 63 years. Subjects were uncertain of responses for 0-8% of questions and responded differently upon reinterview for subsets of questions 0-30% of the time. The sensitivity of the medical record for risk factors for coronary artery disease was 0.77 to 0.93. Among the 88 subjects (85%) who indicated that their chest pain was substernal or left chest, the medical record described this location in 44%. Timing of the chest pain was the most difficult item to accurately capture from the medical record. CONCLUSIONS: Information obtained retrospectively from the abstraction of medical records is measurably less accurate than information obtained prospectively from research subjects. For certain items, more than half of the information is not available. This loss of information is related to the data types included in the study and by the assumptions that a researcher performing a retrospective study makes about implied versus explicitly stated responses. A model of information flow that incorporates the concepts of reliability and validity can be used to measure some of the loss of information that occurs at each step along the way from subject to clinician to medical record abstractor.

Adult↗

Hypothalamo-hypophysial dysfunction after traumatic brain injury in children and adolescents: a preliminary retrospective and prospective study.

With two study protocols, one retrospective and the other prospective, we evaluated hypothalamo-hypophysial dysfunction (HHD) in paediatric patients treated for traumatic brain injury (TBI) in the neurosurgical or intensive care department at our hospital. The retrospective group comprised 22 patients who had experienced TBI 0.7-7.25 years before the study. The prospective group included 30 patients assessed at TBI (T0), 26 of 30 after 6 months (T6), and 20 of 26 after 12 months (T12). Auxological and hormonal basal parameters of hypothalamo-hypophysial function were evaluated at recall in the retrospective group, and at T0, T6 and T12 in the prospective group. Basal data and standard dynamic tests in selected patients revealed one with precocious puberty, one with total anterior hypopituitarism, one with central hypogonadism, and one with growth hormone (GH) deficiency in the retrospective group; three patients with cerebral salt-wasting syndrome, one with diabetes insipidus and seven with low T3 syndrome at T0 (all transient), one with hypocorticism at T6 confirmed at T12, and one with GH deficiency at T12 in the prospective group. The results of our study show that post-TBI HHD in our paediatric cohort is not uncommon. Of the 48 patients who underwent a complete evaluation (22 retrospective study patients and 26 prospective study patients evaluated at T6) five (10.4%) developed HHD 6 months or more after TBI. HHD was newly diagnosed in one previously normal patient from the prospective group at 12 months after TBI. GH deficiency was the most frequent disorder in our paediatric cohort.

Adolescent↗

Concurrent and retrospective reports of alcohol consumption across 30, 90 and 366 days: interactive voice response compared with the timeline follow back.

OBJECTIVE: To compare near-concurrent and retrospective reports of alcohol consumption and to determine whether a simple adjustment function could be applied to the retrospective reports to correct any distortions in reporting. METHOD: Reports of daily alcohol consumption collected via an Interactive Voice Response (IVR) system were aggregated over 30, 90 and 366 days and compared with the corresponding retrospective reports gathered with the Timeline Follow Back (TLFB). Comparisons of the IVR and TLFB reports for five consumption variables were made for each time period for 33 men. RESULTS: Significant differences between reporting methods were found for four of the five variables tested. On average, the TLFB yielded an underestimate of alcohol consumption compared to the IVR. This underestimate associated with TLFB reports was not dependent on the length of the recall period. Regression analyses indicated that the relationship between the two modalities of reporting was dependent on the quantity of drinks reported, thus precluding the application of a simple, linear metric to the TLFB data to model near real-time daily data obtained through the IVR more accurately. CONCLUSIONS: The retrospective TLFB consistently and significantly underestimated alcohol consumption compared to the aggregated daily reports. This underestimate, however, was stable across the three reporting periods. With one exception, no simple linear function could be applied to the retrospective TLFB consumption reports to more accurately reflect the IVR data gathered daily. Evidence presented here also suggests that underreporting on the TLFB is not simply a matter of consciously attempting to conceal consumption.

Adult↗

Retrospective validation of a surveillance system for unexplained illness and death: New Haven County, Connecticut.

OBJECTIVES: This study investigated retrospective validation of a prospective surveillance system for unexplained illness and death due to possibly infectious causes. METHODS: A computerized search of hospital discharge data identified patients with potential unexplained illness and death due to possibly infectious causes. Medical records for such patients were reviewed for satisfaction of study criteria. Cases identified retrospectively were combined with prospectively identified cases to form a reference population against which sensitivity could be measured. RESULTS: Retrospective validation was 41% sensitive, whereas prospective surveillance was 73% sensitive. The annual incidence of unexplained illness and death due to possibly infectious causes during 1995 and 1996 in the study county was conservatively estimated to range from 2.7 to 6.2 per 100,000 residents aged 1 to 49 years. CONCLUSIONS: Active prospective surveillance for unexplained illness and death due to possibly infectious causes is more sensitive than retrospective surveillance conducted through a published list of indicator codes. However, retrospective surveillance can be a feasible and much less labor-intensive alternative to active prospective surveillance when the latter is not possible or desired.

Adolescent↗

Accuracy of detection of colorectal neoplasia using an immunochemical occult blood test in symptomatic referred patients: comparison of retrospective and prospective studies.

OBJECTIVE: In this study the sensitivity and specificity of immunochemical tests for colorectal neoplasia were evaluated in retrospective and prospective studies. METHODS: Four types of fecal blood tests--a chemical test (Hemoccult II) and three different immunochemical tests including a test which detects hemoglobin and transferrin- were performed in the retrospective study. In the prospective study the test for hemoglobin and transferrin was used for all patients that underwent total colonoscopy. PATIENTS: One hundred seven patients with colorectal neoplasia, 57 with gastroduodenal bleeding, and 62 with normal digestive tracts were examined retrospectively. One thousand two hundred and ninety-eight nonspecifically symptomatic patients whose endoscopic examination was negative for hemorrhagic lesions in the upper digestive tract were examined prospectively. RESULTS: In the retrospective study, sensitivities for the detection of colorectal cancers and adenomas with diameters > or =10 mm using the tests which detect hemoglobin and transferrin were 98% and 89%, respectively. These were the highest sensitivity among the four tests. The specificity of this test was 97%, which was higher than that of the Hemoccult II test. In the prospective study, the sensitivities of the tests for hemoglobin and transferrin for the detection of colorectal cancers and adenomas with diameters > or =10 mm were 79% and 33%, respectively. The specificity was 95%. CONCLUSIONS: The test for hemoglobin and transferrin showed the highest sensitivity and specificity for colorectal neoplasia in the retrospective study. The sensitivity and specificity of this test were not so high in the prospective study, but they may be clinically applicable in the evaluation of patients with various nonspecific symptoms.

Adenoma↗

Retrospective studies and chart reviews.

A retrospective study uses existing data that have been recorded for reasons other than research. A retrospective case series is the description of a group of cases with a new or unusual disease or treatment. With a case-control study, cases with and without the condition of interest are identified, and the degree of exposure to a possible risk factor is then retrospectively compared between the 2 groups. With a matched case-control study, control subjects are selected such that they resemble (match) the cases with regards to certain characteristics (eg, age, comorbidity, severity of disease). Retrospective study designs are generally considered inferior to prospective study designs. Therefore, a retrospective study design should never be used when a prospective design is feasible.

Case-Control Studies↗

Smoking and alcohol drinking during pregnancy. The reliability of retrospective maternal self-reported information.

BACKGROUND: The reliability of retrospective maternal self-reported information regarding smoking and alcohol drinking during pregnancy seemed necessary to be checked. METHODS: Two groups of congenital abnormalities were selected for the study from the population based Hungarian Congenital Abnormality Registry. The prevalence of smoking and drinking during the study pregnancy was measured in the mothers of 81 cases affected with isolated orofacial cleft and 537 cases with congenital limb deficiencies, and in their matched control pairs without any defect by maternal self-reported retrospective information through a mailed structured questionnaire. In the second step the latter data were checked by an independent personal interview of fathers and other family members at the home visit or in our department using the same structured questionnaire. RESULTS: The family consensus indicated the low reliability of retrospective maternal self-reported information concerning smoking in the mothers of cases but not in mothers of controls. However, the comparison of retrospective maternal self-reported data and information of close relatives indicated a reported bias concerning the drinking of alcohol beverages during pregnancy in both controls and cases. CONCLUSIONS: Since retrospective maternal self-reported data had low reliability, therefore, data of smoking and alcohol drinking were not collected for the data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996.

Alcohol Drinking↗

Are retrospective peer-review transfusion monitoring systems effective in reducing red blood cell utilization?

OBJECTIVE: This research used a study-control group design and examined data collected from five hospitals to evaluate the effectiveness of retrospective peer-review systems on reducing utilization of red blood cells (RBCs). DESIGN: The effects of retrospective peer-review systems were studied in three parts: (1) trends of RBC utilization were compared by the slopes of linear regression lines that assessed the effect of time on RBC utilization among four study hospitals and one control hospital, (2) diagnosis-specific RBC utilization was compared between the control hospital and one matched study hospital, and (3) the effect of the retrospective review system of one study hospital was assessed by linear regression using data accumulated 1 year before and 2 years after implementation of the program. RESULTS: Three study hospitals showed no significant changes in RBC utilization during the 10-month study period. One study hospital and the control hospital demonstrated trends of reduced RBC use with negative slopes of regression lines; however, there was no difference in the degree of the two slopes, and the diagnosis-specific RBC utilization was not lower at the study hospital than at the control hospital. Furthermore, implementation of the retrospective peer-review system at one study hospital demonstrated no effect on RBC utilization. CONCLUSIONS: We conclude that the retrospective peer-review systems implemented at these four hospitals had no effect on reducing red blood cell utilization.

Erythrocyte Transfusion↗

Comparison between prospective and retrospective triggering for mouse cardiac MRI.

High-resolution magnetic resonance imaging (MRI) has evolved into one of the major non-invasive tools to study the healthy and diseased mouse heart. This study presents a Cartesian CINE MRI protocol based on a fast low-angle shot sequence with a navigator echo to generate cardiac triggering and respiratory gating signals retrospectively, making the use of ECG leads and respiratory motion sensors obsolete. MRI of the in vivo mouse heart using this sequence resulted in CINE images with no detectable cardiac and respiratory motion artefacts. The retrospective method allows for steady-state imaging of the mouse heart, which is essential for quantitative contrast-enhanced MRI studies. A comparison was made between prospective and retrospective methods in terms of the signal-to-noise ratio and the contrast-to-noise ratio between blood and myocardial wall, as well as global cardiac functional indices: end-diastolic volume, end-systolic volume, stroke volume and ejection fraction. The retrospective method resulted in almost constant left-ventricle wall signal intensity throughout the cardiac cycle, at the expense of a decrease in the signal-to-noise ratio and the contrast-to-noise ratio between blood and myocardial wall as compared with the prospective method. Prospective and retrospective sequences yielded comparable global cardiac functional indices. The largest mean relative difference found was 8% for the end-systolic volume.

Algorithms↗

Comparison between retrospective gating and ECG triggering in magnetic resonance velocity mapping.

ECG-triggered cinematographic studies of the cardiovascular system are hampered by several technical restrictions such as the inability to image end-diastole, ghosting, varying signal intensity, and phase contributions from eddy currents. Retrospective gating may solve these problems, but involves signal manipulation such as interpolating raw data from a time window. In this study, the performance of the two gating strategies was compared in quantitative MR velocity mapping on the abdominal aorta in eight healthy volunteers and on a pulsatile flow phantom. The results were compared to a one-dimensional velocity mapping technique and Doppler ultrasound. Finally, the consequence of decreasing the time window in the raw data interpolation used for retrospective gating was also examined. With retrospective gating, a low-pass filtering was seen, causing significantly prolonged duration and decreased amplitude of flow pulses. However, by reducing the time window retrospectively gated flow measurements were in good agreement with those that are ECG triggered. When fulfilling the demand of a narrow time window for interpolation, retrospective gating offers several advantages in MR velocity mapping.

Algorithms↗

Use of concurrent and retrospective verbal protocols to investigate workers' thoughts during a manual-handling task.

A manual handling task (an order picking task in a distribution warehouse) was investigated using concurrent verbal protocols and retrospective verbal protocols (applied at three different times after completion of the task). The study aimed to collect workers' thoughts during the task and to determine what workers are comfortable with reporting. Video recordings of the task were used as a means of investigating the accuracy of the information which was reported. The concurrent and retrospective verbal protocol methods were compared and it was found that concurrent reports could be used to collect a range of task related thoughts, although they only contained a proportion of the workers' thoughts during the task. Additional information could be obtained from retrospective reports, although these appeared to be vulnerable to bias and re-ordering of reported information. The retrospective reports produced whilst watching a video recording of the task were particularly vulnerable to bias from retrospective reasoning or the rationalisation of thoughts. Only one specific reference to posture or handling technique was made by any of the workers in their reports. There were also few references to load characteristics. Workers frequently reported aspects of the task that were easier to verbalise, such as the counting or labelling of items. It is not known whether the workers were only aware of these limited details of their tasks or whether they were only able to report limited details of the tasks because of factors affecting verbal reporting. This was an exploratory study which has collected valuable information from a small sample of experienced workers in relation to a common task from industry, but further study is needed to investigate the effects of factors such as load weight, load position and task duration on awareness and reporting of thoughts.

Adult↗

Ultrahigh frame rate retrospective ultrasound microimaging and blood flow visualization in mice in vivo.

To overcome frame rate limitations in high-frequency ultrasound microimaging, new data acquisition techniques have been implemented for 2-D (B-scan) and color flow visualization. These techniques, referred to as retrospective B-scan imaging (RBI) and retrospective color flow imaging (RCFI) are based on the use of the electrocardiogram (ECG) to trigger signal acquisitions. B-scan and color flow images are reconstructed by retrospectively assembling the processed data on a line-by-line basis. Retrospective techniques are used to produce the first in vivo B-scan and color flow images of mouse carotid arteries at frame rates up to 10,000 fps. Retrospective B-scan images of mouse heart were also produced at frame rates of 1000 fps using a version of RBI implemented on a commercial imaging system (Vevo660, VisualSonics, Toronto, ON, Canada). This technology enables detailed in vivo biomechanical studies of dynamic tissues such as the myocardium of the mouse heart with high temporal resolution.

Animals↗

Retrospective and prospective coding of information: dissociation of parietal cortex and hippocampal formation.

Animals with sham operations, hippocampal formation, or small and large parietal cortex lesions were trained in a task that required memory for short or long lists of items (spatial locations). More specifically, on any one trial, a rat is presented with 2, 4, 6, 8, or 10 items (spatial locations) on a 12-arm radial maze followed 15 min later by a win-shift test that required the animal to choose between a place previously visited and a novel place. Sham-operated animals showed an increase in errors as a function of set size (2 to 8 items) followed by a decrease in errors with a set size of 10 items, suggesting the use of both retrospective and prospective memory codes. In contrast, animals with hippocampal formation lesions made errors for all set sizes, reflecting an inability to use a retrospective and prospective memory code. The failure to use a prospective code is probably a function of the inability to use a retrospective code (i.e., the animal needs to remember first what has occurred before it can determine what information lies ahead). Animals with small or large parietal cortex lesions made most of their errors for the longest list length, reflecting an inability to shift from a retrospective to prospective memory code. This dissociation between the hippocampal formation and parietal cortex might reflect mediation of different memory operations. The hippocampal formation might mediate new incoming information (data-based memory processing) and thus accentuate the importance of a retrospective memory code. The parietal cortex might mediate existing knowledge (expectancy-based memory processing) and thus facilitate the utilization of a prospective memory code.

Animals↗

Prospective and retrospective memory in normal ageing and dementia: a questionnaire study.

Frequency of prospective memory and retrospective memory failures was rated on a 16-item questionnaire by 862 volunteers, from five groups: patients with Alzheimer Disease (rated by carers), carers of Alzheimer Disease patients, elderly, young, and a group of married couples. Reported memory failures were highest for Alzheimer Disease patients, and lowest for carers, with elderly and young controls in between. More prospective memory than retrospective memory failures were reported in all groups, although the difference was small for Alzheimer Disease patients who were rated near ceiling for both. Prospective memory failures of Alzheimer Disease patients were reported as more frustrating for carers than retrospective memory failures; prospective memory and retrospective memory failures frustrated Alzheimer Disease patients equally. Data from the couples indicated that there were no biases resulting from rating on behalf of someone else. These results suggest that: (1) normal ageing has no greater effect on self-reported retrospective memory than prospective memory failures, (2) the relatively small number of memory failures reported by carers may result from comparing themselves with the Alzheimer Disease patients in their care, and (3) prospective memory failures have a greater impact on the lives of the carers and are therefore more likely to be reported as early indicants of the disease.

Adolescent↗

What's the use of faculty development? Program evaluation using retrospective self-assessments and independent performance ratings.

BACKGROUND: The assessment of the effectiveness of faculty development programs is increasingly important in medical schools and academic medical centers but is difficult to accomplish. PURPOSE: We investigated the usefulness of retrospective self-assessments by program participants in combination with independent ratings of teaching performance by their trainees. METHODS: We used a single sample, prepost intervention design using multiple measures. Our assessment instruments were based on our institution's accepted teaching competencies. We measured participants' self-assessments of their teaching competencies before the program and their retrospective self-assessed improvements in these competencies after the program. We also used independent ratings of the participants' teaching competencies before and after their involvement in the program, as rated by their own trainees (fellows, residents, and medical students). Selected teaching competencies comprised the intended learning outcomes of the faculty development program. RESULTS: Participants' preprogram self-assessments showed that the program was appropriately matched to several topics identified as needy, but also included topics that participants did not identify as needs. The retrospective self-assessments showed improvements in teaching skills that previously were identified as needs, as well as those in which participants originally felt quite competent. The independent ratings by trainees showed overall positive improvements (some significantly). The retrospective self-assessed improvements correlated positively with the independent ratings by their trainees (p < .01). CONCLUSIONS: This evaluation strategy showed that the faculty development program improved the teaching competencies of the participants. Both the program participants' retrospective self-assessments and the independent ratings by their trainees showed postprogram improvements and were positively intercorrelated. The use of these multiple measures is a viable approach to evaluate the impact of a faculty development program. Potentially either approach could be used, but in combination, they provide a feasible, valid, and reliable evaluation.

Education, Medical↗

Measuring strategy production during associative learning: the relative utility of concurrent versus retrospective reports.

Strategy production during associative learning can be measured by self-reports made either concurrently with study or retrospectively. Both kinds of report presumably have strengths and weaknesses, yet a systematic comparison has not been conducted. Younger and older adults studied paired associates and reported strategy production using one or both kinds of report. Participants either received or did not receive descriptions of mediational strategies prior to study. Retrospective reports were not completely consistent with concurrent reports, suggesting that the validity of retrospective reports is somewhat diminished by forgetting. Making concurrent reports did not affect subsequent retrospective reports, but describing strategies affected reported strategy production for both age groups and paired-associate recall for older adults. A production deficiency constrained older adults' performance when they did not receive strategy descriptions prior to study. Discussion focuses on the relative utility of concurrent and retrospective reports of strategy production.

Adolescent↗

Prospective and retrospective duration judgments: an executive-control perspective.

Most theorists propose that when a person is aware that a duration judgment must be made (prospective paradigm), experienced duration depends on attention to temporal information, which competes with attention to nontemporal information. When a person is not aware that a duration judgment must be made until later (retrospective paradigm), remembered duration depends on incidental memory for temporal information. In the present article we describe two experiments in which durations involved with high-level, executive-control functions were judged either prospectively or retrospectively. In one experiment, the executive function involved resolving syntactic ambiguity in reading. In another experiment, it involved controlling the switching between tasks. In both experiments, there was a unique cost to the operation of control high-level, executive functions which was manifested by prospective reproductions shortening a finding that supports an attentional model of prospective timing. In addition, activation of executive functions produced contextual changes that were encoded in memory and resulted in longer retrospective reproductions, a finding that supports a contextual-change model of retrospective timing. Thus, different cognitive processes underlie prospective and retrospective timing. Recent findings obtained by some brain researchers also support these conclusions.

Animals↗