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[Quality of data provided by VESKA medical statistics: the case of the fractured proximal femur].

Within the framework of a retrospective study of the incidence of hip fractures in the canton of Vaud (Switzerland), all cases of hip fracture occurring among the resident population in 1986 and treated in the hospitals of the canton were identified from among five different information sources. Relevant data were then extracted from the medical records. At least two sources of information were used to identify cases in each hospital, among them the statistics of the Swiss Hospital Association (VESKA). These statistics were available for 9 of the 18 hospitals in the canton that participated in the study. The number of cases identified from the VESKA statistics was compared to the total number of cases for each hospital. For the 9 hospitals the number of cases in the VESKA statistics was 407, whereas, after having excluded diagnoses that were actually "status after fracture" and double entries, the total for these hospitals was 392, that is 4% less than the VESKA statistics indicate. It is concluded that the VESKA statistics provide a good approximation of the actual number of cases treated in these hospitals, with a tendency to overestimate this number. In order to use these statistics for calculating incidence figures, however, it is imperative that a greater proportion of all hospitals (50% presently in the canton, 35% nationwide) participate in these statistics.

Data Interpretation, Statistical↗

Multivariate probit analysis: a neglected procedure in medical statistics.

The multivariate probit model is designed to regress a vector of correlated quantal variables on a mixture of continuous and discrete predictors. Various applications can be found in the biological, economical and psychosociological literature, but the method is not yet widely used in medical applications. We reintroduce this model thereby showing its usefulness in medical problems. Software for this model is, however, not widely available. We have written a PC program to select predictors and estimate parameters in the multivariate probit framework. The performance and characteristics of the program are briefly illustrated.

Mathematical Computing↗

[A study of utilization review in hospitals--focusing on medical statistics].

It is a matter of course that health care is an important issue closely related to the daily life of residents. In this situation, university hospitals, although their main aim is research and education, also play a significant role as core hospitals in various regions of the community. By reviewing hospital utilization, extended to facilities in a given area, we first analyzed the medical service area and the length of stay in the hospital affiliated to the University of Occupational and Environmental Health, on the basis of discharge various directions of facility planning based on future bed using control, including addition of beds, and also attempted to evaluate the actual state of annual facility management with the aid of computer.

Catchment Area, Health↗

The design of simulation studies in medical statistics.

Simulation studies use computer intensive procedures to assess the performance of a variety of statistical methods in relation to a known truth. Such evaluation cannot be achieved with studies of real data alone. Designing high-quality simulations that reflect the complex situations seen in practice, such as in prognostic factors studies, is not a simple process. Unfortunately, very few published simulation studies provide sufficient details to allow readers to understand fully all the processes required to design a simulation study. When planning a simulation study, it is recommended that a detailed protocol be produced, giving full details of how the study will be performed, analysed and reported. This paper details the important considerations necessary when designing any simulation study, including defining specific objectives of the study, determining the procedures for generating the data sets and the number of simulations to perform. A checklist highlighting the important considerations when designing a simulation study is provided. A small review of the literature identifies the current practices within published simulation studies.

Biomedical Research↗

Medical statistics of battlefield casualties.

War surgery presents conditions and problems that are radically different from those of peacetime surgery. Categorization of the injured may be necessary (triage), while a short or erratic supply of drugs, materials and personnel may exist. In this study, the hospital mortality following military action was 6.4 per cent. In the group of patients with combined thoracoabdominal injuries mortality was high. However, the inflow of this type of patient was relatively low. In 50 per cent of the cases, ketamine/benzodiazepine anaesthesia without intubation and artificial ventilation was sufficient, with the result that the use of oxygen and nitrous oxide was minimized.

Adolescent↗

A geographic regression model for medical statistics.

A method for modeling geographic processes using census-type data is introduced in an analysis of male and female lung cancer mortality rates. The study area comprises the counties in those states which abut the Gulf of Mexico and the southeast Atlantic Coast of the United States. A spatially autoregressive model is used to estimate the strength of the univariate relationship between both the male and female lung cancer mortality rates in a country and in the respective lung cancer rates in the first to fifth order adjacent counties. The results show that male lung cancer exhibits spatial autocorrelation while female lung cancer does not, and that the female data exhibit a spatial trend while the male data do not. These findings suggest that factors which vary at the regional scale play a greater role in the etiology of female lung cancer and that factors that vary at the neighborhood scale play a greater role in the etiology of male lung cancer.

Female↗

Medical statistics in obstetrics and gynaecology.

Statistics are involved in many aspects of obstetrics and gynaecology: measurement and diagnosis, randomized trials, epidemiology, basic biological research, and the compilation of national data. Obstetrics and gynaecology has stimulated advances in statistics, particularly in the construction of centile charts and the development of meta-analysis. This account draws largely on the author's own experience of research in obstetrics and gynaecology.

Epidemiology↗