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Getting the most out of advertising and promotion.

Until recently, believing in the effectiveness of advertising and promotion was largely a matter of faith. Despite all the data collected by marketing departments, none measured what was really important: the incremental sales of a product over and above those that would happen without the advertising and promotion. Thanks to a qualitatively new kind of marketing data, that situation is changing. "Single source" data correlate information on actual consumer purchases (available from universal-product-code scanners used in supermarkets and drug-stores) with information on the corresponding television advertising those consumers receive or on the promotion events they see. This allows managers to measure the incremental impact of advertising and promotion and to improve marketing productivity. To take advantage of the new single-source data, however, managers have to throw out much of the conventional wisdom about advertising and promotion that has grown up over the years. They must learn how to evaluate marketing differently by continually examining the appropriate balance between advertising and promotion. They must also train their sales force to do a different and extremely important job: to demonstrate to retailers the consumer pull of the company's advertising and promotion programs, as well as the effect of these programs on retailer profitability.

Advertising↗

Regarding the sources of data analyzed with quantitative structure-skin permeability relationship methods (commentary on 'Investigation of the mechanism of flux across human skin in vitro by quantitative structure-permeability relationships').

We investigated the sources of data used in recently published predictive models of skin permeability. It was found that skin permeability coefficients for 63 compounds are poorly documented. We hypothesized that these coefficients were calculated using the simple two variable, three parameter 'Potts and Guy' regression equation and hence were not derived from experimental measurements. We therefore examined the distribution of residuals of these reported coefficients compared with the Potts and Guy predictions. The residuals cannot be described by a normal distribution. A substantial (51%) number of residuals equaled 0.00. Further analysis demonstrated that 89% (56 out of 63) of the skin permeability coefficients can be explained as being calculated by the Potts and Guy equation using different documented octanol-water partition coefficients, and/or transcription errors. The results strongly suggest that these 63 skin permeability coefficients are calculated and not experimentally determined-a conclusion subsequently confirmed by one of the developers of the data set. Continued use of these data would lead to biased model selection, underestimation of experimental variability, and overestimation of model predictive ability.

Linear Models↗

Sleep-wake disturbances in people with cancer part II: evaluating the evidence for clinical decision making.

PURPOSE/OBJECTIVES: To evaluate the quality of evidence on sleep-wake disturbances in people with cancer as a basis for clinical decision making and to discuss implications of the evidence for oncology clinicians, educators, and researchers. DATA SOURCES: Published, peer-reviewed articles. DATA SYNTHESIS: Members of the 2001 Oncology Nursing Society (ONS) Advanced Practice Nurse Retreat Evidence-Based Practice Sleep Working Group selected and evaluated data sources using criteria and processes outlined by ONS. CONCLUSIONS: The development of nursing science related to sleep-wake disturbances among people with cancer and the application of research findings to clinical decision making are limited by the quantity and quality of published evidence. IMPLICATIONS FOR NURSING: Clinicians are challenged to develop a plan of care that includes the assessment of sleep-wake disturbances and interventions to address them. Nurse educators are challenged to include sleep-wake content and skills to evaluate empirical data and interventions for sleep-wake disturbances in degree and continuing education curricula. Nurse researchers are challenged to specify consistent conceptual and operational definitions of key variables in sleep-wake models, use measurement instruments with evidence of reliability and validity, and design clinical trials to test interventions for sleep-wake disturbances among people with cancer.

Adult↗

The treatment of depression: prescribing patterns of antidepressants in primary care in the UK.

BACKGROUND: Consensus has been achieved about how depression should be treated in primary care, and guidelines have been issued by the Royal Colleges of General Practitioners and Psychiatrists, and by the British Association for Psychopharmacology. One of the principal recommendations is to prescribe antidepressant medicine at effective doses. This study was established to investigate how current prescribing practices in primary care compared with these guidelines. METHOD: Information on prescribing of antidepressant medicines was obtained using three independent data sources: Prescribing Analysis and Cost (PACT) data; medical notes; and a large, computerised patient record database. RESULTS: Data were obtained on populations in excess of 1.5 million people, and over 80,000 prescriptions were reviewed. All three data sources showed very similar patterns of prescribing, in particular that as many as 88% of prescriptions for older tricyclic antidepressants are prescribed by GPs at doses below those recommended by the consensus guidelines. Newer antidepressants-lofepramine and the SSRIs-are prescribed comparatively well. CONCLUSIONS: Prescribing of antidepressants by GPs is not in line with the consensus recommendations on dosage. This may have major educational implications for GPs. A pragmatic approach to improve prescribing in the short term may be to advocate the use of lofepramine or the SSRIs as first line treatment for depression. This study validates the use of PACT data as a useful audit tool in this area of clinical practice.

Antidepressive Agents↗

Injuries in the military: a review and commentary focused on prevention.

BACKGROUND: In November 1996, the Armed Forces Epidemiological Board (AFEB) Injury Prevention and Control Work Group issued a report that cited injuries as the leading cause of morbidity and mortality among military service members. This article reviews the types and categories of military morbidity and mortality data examined by the AFEB work group and the companion Department of Defense (DoD) Injury Surveillance and Prevention Work Group. This article further uses the injury data reviewed to illustrate the role of surveillance and research in injury prevention. The review provides the context for discussion of the implications of the AFEB work group's findings for the prevention of injuries in the military. METHODS: The AFEB work group consisted of 11 civilian injury epidemiologists, health professionals and scientists from academia, and other non-DoD government agencies, plus six military liaison officers. Injury data from medical databases were provided to the civilian experts on the AFEB work group by the all-military DoD Injury Surveillance and Prevention Work Group. The AFEB work group assessed the value of each database to the process of prevention and made recommendations for improvement and use of each data source. RESULTS: Both work groups found that injuries were the single leading cause of deaths, disabilities, hospitalizations, outpatient visits, and manpower losses among military service members. They also identified numerous data sources useful for determining the causes and risk factors for injuries. Those data sources indicate that training injuries, sports, falls, and motor vehicle crashes are among the most important causes of morbidity for military personnel. CONCLUSIONS: While the work group recommends ways to prevent injuries, they felt the top priority for injury prevention must be the formation of a comprehensive medical surveillance system. Data from this surveillance system must be used routinely to prioritize and monitor injury and disease prevention and research programs. The success of injury prevention will depend not just on use of surveillance but also partnerships among the medical, surveillance, and safety agencies of the military services as well as the military commanders, other decision makers, and service members whose direct actions can prevent injuries and disease.

Adult↗

Finding incident breast cancer cases through US claims data and a state cancer registry.

OBJECTIVE: With the increasing availability of automated health-care data, new methods are available to screen large populations for the presence of cancer diagnoses. However, it is crucial to evaluate how completely incident cancer cases can be ascertained using these data sources. METHODS: We used capture-recapture techniques to estimate the total number of incident breast cancer cases occurring within one state during a 3-year period. We then compared the ascertainment of these cases by the following two data sources: claims for breast cancer surgery recorded in Medicaid and Medicare data vs a cancer registry in the same state. RESULTS: Medicaid-Medicare breast cancer surgery claims identified 68% of the total estimated number of incident breast cancer cases while cancer registry data identified 78%. Case ascertainment improved markedly to 91% when both registry and Medicare-Medicaid data sources were used together. The sensitivity of ascertainment was lower for Medicaid-Medicare data among those aged under 65 and non-white; ascertainment was lower for the registry among women who were aged under 65, poor, and non-white. CONCLUSIONS: Combining health insurance claims data with a population-based cancer registry improved the identification of incident cases of breast cancer, and may be particularly useful among demographic groups found to be at highest risk of under-ascertainment such as younger women, the poor, and racial minorities.

Adult↗

Integration of multi-source gene interaction networks and omics data with graph attention networks to identify novel disease genes.

MOTIVATION: The pathogenesis of diseases is closely associated with genes, and the discovery of disease genes holds significant importance for understanding disease mechanisms and designing targeted therapeutics. However, biological validation of all genes for diseases is expensive and challenging. RESULTS: In this study, we propose DGP-AMIO, a computational method based on graph attention networks, to rank all unknown genes and identify potential novel disease genes by integrating multi-omics and gene interaction networks from multiple data sources. DGP-AMIO outperforms other methods significantly on 20 disease datasets, with an average AUROC and AUPR exceeding 0.9. The superior performance of DGP-AMIO is attributed to the integration of multiomics and gene interaction networks from multiple databases, as well as triGAT, a proposed GAT-based method that enables precise identification of disease genes in directed gene networks. Enrichment analysis conducted on the top 100 genes predicted by DGP-AMIO and literature research revealed that a majority of enriched GO terms, KEGG pathways and top genes were associated with diseases supported by relevant studies. We believe that our method can serve as an effective tool for identifying disease genes and guiding subsequent experimental validation efforts. AVAILABILITY AND IMPLEMENTATION: DGP-AMIO is publicly available at https://github.com/yangkaiyuan1027/DGP-AMIO.

Gene Regulatory Networks↗

Cancers of the oral cavity and pharynx in the United States: an epidemiologic overview.

OBJECTIVES: This paper reviews and summarizes recent epidemiologic data on the incidence, mortality, and survival of cancers of the oral cavity and pharynx. It identifies gaps in the science base, discusses emerging trends, and points out opportunities through which the epidemiology of these cancers can be understood better. METHODS: Primary data sources were SEER incidence and survival data from 1973-92 and NCHS mortality data from the same period. RESULTS: In general, the incidence, mortality, and survival rates for oral and pharyngeal cancers are well documented by existing national data; however, gaps in coverage still exist with respect to geographic, racial, and ethnic information. Overall, trends in the occurrence of these cancer types since 1973 have revealed modest improvements in incidence, more substantial improvements in mortality, and little change in survival. However, these trends varied by race, sex, and anatomic subsites. CONCLUSIONS: Demographic changes will greatly influence the epidemiology of oral and pharyngeal cancer in coming decades. For older Americans, these cancer types are likely to remain a serious and perhaps increasing problem. Understanding of these cancers can be furthered by continued analysis of existing databases and the creation of new data sources for the future.

Adolescent↗

Conceptual framework of health indicators: the IDA model.

This paper presents a flexible conceptual framework for pub-lic health indicator databases. The model is a multidimensional-hierarchical representation of statistical data describing health and health influencing factors. The main characteristics of the IDA model are the strong discrimination of concepts (categories of entities enumerated in statistical systems) and dimensions (aspects that divide categories). Top level concepts of known data sources (WHO HFA database, OECD Health Data and ECHI) have been compared and a generalized structure had been created which can represent easily and consistently all the top level concepts of the known data sources. The model has been implemented in a prototype system, which demonstrates the feasibility of the approach.

Databases as Topic↗

Uncompensated hospital care payment and access for the uninsured: evidence from New Jersey.

OBJECTIVE: We assess the impacts of New Jersey's payment for hospital uncompensated care on access for the uninsured. DATA SOURCES: Uncompensated care charges and other data were obtained from audited reports maintained by the New Jersey State Department of Health. Other data sources include the AHA Annual Survey and the Bureau of Labor Statistics. The sample includes 80 of 88 acute care hospitals in the state for 1979 to 1987. STUDY DESIGN: This study used a pre- and postdesign to assess the impacts of the introduction of uncompensated care payment. Both descriptive and multivariate analyses were used. Key variables include hospital ownership and teaching characteristics; the labor force composition; and the level of government funding for public health insurance. PRINCIPAL FINDINGS: The overall level of uncompensated hospital care increased markedly in New Jersey during the period 1979 through 1987. However, this trend can be attributed to variables other than the new payment system, including increased demand for uncompensated care. The program did result in a more even distribution of uncompensated care across hospitals. The financial condition of hospitals providing the largest share of this care also improved, ensuring continued access. CONCLUSIONS: Funding of uncompensated care via hospital payment regulation did not increase its overall provision. However, improved access was achieved as opportunities for the uninsured to receive care were made more widely available.

Financial Management, Hospital↗

Apolipoprotein E and dementia in Parkinson disease: a meta-analysis.

OBJECTIVE: To understand the relationship of apolipoprotein E (APOE) polymorphism to dementia in Parkinson disease (PD) because the APOE epsilon4 allele is linked to Alzheimer disease. DATA SOURCE: We reviewed MEDLINE, BIOSIS Previews, and ISI Web of Science from January 1, 1966, to May 7, 2004, supplemented by citation analysis from retrieved articles. STUDY SELECTION: Case-control studies using clinical or pathologic criteria for PD and dementia, and with complete APOE genotype frequencies data. DATA EXTRACTION: We compared estimated prevalence odds ratios for dementia in PD in relation to each allele. We also looked for evidence of heterogeneity and publication bias and performed a stratified analysis on several study characteristics. DATA SYNTHESIS: Data analyses suggest publication bias and heterogeneity of source data for the epsilon4 allele (homogeneity P = .2; Begg and Mazumdar, P = .06; and Egger et al, P = .1). The estimated odds ratios for development of dementia in PD are 1.6 for epsilon4 (95% confidence interval, 1.0-2.5); 1.3 for epsilon2 (95% confidence interval, 0.73-2.4); and 0.54 for epsilon3 (95% confidence interval, 0.18-1.6). The odds ratio estimates for epsilon4 were higher for studies published in 1996 or later (2.3 vs 1.0) and for studies conducted outside North American sites (2.4 vs 1.2). CONCLUSIONS: The APOE epsilon4 allele appears to be associated with a higher prevalence of dementia in PD. Publication bias and heterogeneous source data may, however, confound this conclusion. Confirmatory studies that use standardized and validated diagnostic criteria for dementia in PD are needed.

Apolipoproteins E↗

Prevalence of HIV infection in the United States, 1984 to 1992.

OBJECTIVE: To estimate the number of persons infected with the human immunodeficiency virus (HIV) living in the United States and the change in HIV infection prevalence since 1984. DESIGN: We estimated HIV prevalence from 3 data sources. We estimated past HIV infection rates from a statistical procedure based on national acquired immunodeficiency syndrome (AIDS) case surveillance data and estimates of the time from HIV infection to AIDS diagnosis. We also analyzed HIV prevalence data from 2 national surveys, a survey of childbearing woman and a household survey of current health status. We used other data sources to adjust these survey estimates to include groups not covered in the surveys. RESULTS: Approximately 0.3% of US residents (650,000-900,000 persons) were infected with HIV in 1992. Approximately 0.6% of men (including adolescent boys > or = 13 years of age) were infected, including approximately 2% of non-Hispanic black men and 1% of Hispanic men. Approximately 0.1% of women (including adolescent girls > or = 13 years of age) were infected, including approximately 0.6% of non-Hispanic black women. Approximately half of all infected persons were men who had sex with men, and one fourth were injecting drug users. The prevalence of HIV infection increased from 1984 to 1992, with a greater relative increase among women than men. CONCLUSIONS: The 3 different data sources and methods are consistent in estimating that 650,000 to 900,000 persons were infected with HIV in the United States in 1992. Among adolescents and adults of both sexes, the proportion infected was substantially higher among non-Hispanic blacks and Hispanics than among non-Hispanic whites. HIV-related illness will be a major clinical and public health problem in the United States for years to come.

Adolescent↗

Integrating health-related data from various sources: combining surveys, records and routine data.

The paper discusses the necessity of combining data from various sources in order to enhance their usefulness for a variety of applications. As future data use can hardly be forseen in advance, major data sets in health services should fulfill several formal requirements in order to make them suitable for future linkage. These formal requirements are that there be references to defined populations, to specific persons, to defined time periods, to specific places or regions. It would be necessary for terms, definition and classification schemes to agree between data sets which are to be linked and be in wide use. Three facets of data linkage are discussed specifically namely linking data at one level of aggregation, linking different data components, and combining data sets from different sources at several levels of aggregation. Three examples are provided, describing linkages of data from various sources for epidemiological studies and a study in health services research. They show that at this point in descriptive epidemiological studies linkage on the basis of regions is of great importance. This implies that it would be desirable for large scale data collection activities in health services to provide for a uniform representation of the geographic areas. Such uniformity would greatly enhance the linkage potential of data sets and thus their usefulness for small area and regional analyses.

Adult↗

[Can the sub-notification of drug adverse effects by capture/recapture method be evaluated?].

The incidence of adverse effects of a drug can be evaluated from the relationship between adverse effects reported to the drug company and to French drug surveillance centres and the number of patients exposed to the drug. Many adverse effects are never reported and this under-reporting is variable. The capture/recapture method can be used in drug surveillance to evaluate the importance of under-reporting for an adverse effect of a drug. This method, based upon the intersection of two different data sources with the aim of identifying the number of common cases, can estimate the number of unreported cases if at least two independent data sources are available. Scrupulous identification of each case and of common cases and study of the independence of the two systems are essential for this method. The application of the capture/recapture method to spontaneous reporting permits the estimation of the total number of cases and the completeness of registration of the two data sources (the drug company and the French drug surveillance centres). This application of the capture/recapture method needs to be validated by comparing the results to the results of prospective studies whenever possible.

Adverse Drug Reaction Reporting Systems↗

Evaluation of syndromic surveillance systems--design of an epidemic simulation model.

INTRODUCTION: The paucity of outbreak data from biologic terrorism and emerging infectious diseases limits the evaluation of syndromic surveillance systems. Evaluation using naturally occurring outbreaks of proxy disease (e.g., influenza) is one alternative but does not allow for rigorous evaluation. Another approach is to inject simulated outbreaks into real background data, but existing simulation models generally do not account for such factors as spatial mobility and do not explicitly incorporate knowledge of the disease agent. OBJECTIVE: The objective of this analysis was to design a simulated anthrax epidemic injection model that accounts for the complexity of the background data and enables sensitivity analyses based on uncertain disease-agent characteristics. MODEL REQUIREMENTS AND ASSUMPTIONS: Model requirements are described and used to limit the scope of model development. Major assumptions used to limit model complexity are also described. Available literature on inhalational anthrax is reviewed to ensure that the level of model detail reflects available disease knowledge. MODEL DESIGN: The model is divided into four components: 1) agent dispersion, 2) infection, 3) disease and behavior, and 4) data source. The agent-dispersion component uses a Gaussian plume model to compute spore counts on a fine grid. The infection component uses a cohort approach to identify infected persons by residential zip code, accounting for demographic covariates and spatial mobility. The disease and behavior component uses a discrete-event approach to simulate progression through disease stages and health-services utilization. The data-source component generates records to insert into background data sources. CONCLUSIONS: An epidemic simulation model was designed to enable evaluation of syndromic surveillance systems. The model addresses limitations of existing simulation approaches by accounting for such factors as spatial mobility and by explicitly modeling disease knowledge. Subsequent work entails software implementation and model validation.

Anthrax↗

[Food and nutrient consumption in Spain in 1940-1988 (and II). Comparative study of the main sources of information on food consumption].

BACKGROUND: This paper has two objectives. The first is to examine the consistency of the main nutritional studies carried out in Spain over the last fifty years. The second is to use these studies to describe the changes in the Spanish diet over this period and to characterize the present dietary pattern. MATERIAL AND METHODS: We have used three types of studies. First, food balance sheets elaborated by Barbancho, FAO, OECD and the Department of Agriculture. Second, surveys on the foods purchased by population groups, in particular the household budget surveys, and the "panel de consumo alimentario" from the Department of Agriculture. Third, food consumption surveys from Catalonia, Vasque Country, Murcia, Madrid, and Reus. RESULTS: Protein, lipid and total caloric intake have increased over the last fifty years. Carbohydrate intake has been stable. Caloric intake from lipids has increased, caloric intake from protein has been stable and that from carbohydrates has decreased. All studies are consistent in that, from 1980 onwards, caloric intake from protein has been 12.5-16.7%, caloric intake from carbohydrates has been 39.3-48.1%, and that from lipids has been 36.6-46.0%. The monounsaturated/saturated ratio has been 1.2-1.7 and the polyunsaturated/saturated ratio 0.4-0.7. All data sources show a high consumption of foods typical of the Mediterranean diet, in particular fruit, vegetables, fish and vegetable oil, rich in unsaturated fats. Consistency among data sources is higher when data are expressed as percentage of total caloric intake than when they are expelled in absolute quantities. CONCLUSIONS: All data sources suggest that the Spanish diet has changed with the economic development, but it still keeps most of the characteristics of the Mediterranean diet.

Cross-Sectional Studies↗

Challenges of identifying asian women for breast cancer screening.

PURPOSE/OBJECTIVES: To emphasize the need for multiple data sources to develop a comprehensive list of potential respondents for a study of breast cancer screening behavior among Asian American women. DESIGN: Descriptive, pilot. SETTING: An urban Michigan county. SAMPLE: 616 Chinese women age 40 and older. METHODS: Comparison of multiple data sources, including lists from membership directories of local Chinese organizations, a commercial survey company, health promotion events, and brief telephone interviews. FINDINGS: Of the 616 eligible women, 32% were identified through the membership directories of local Chinese organizations, 28% from a list obtained from the survey company, 22% from telephone directories, 10% from the attendance lists of health promotion events, and 8% from more than one source. CONCLUSIONS: Multiple sources are required to obtain a comprehensive list for specialized populations. Every data source has its advantages and disadvantages. The use of diverse sources helps to offset the limitations of each individual one. IMPLICATIONS FOR NURSING: Identifying potential participants from specialized populations represents a major issue for clinicians and researchers in nursing and other health-related disciplines. Strategies exist to facilitate the process.

Adult↗

Pill count, self-report, and pharmacy claims data to measure medication adherence in the elderly.

OBJECTIVE: To compare medication adherence calculated from four different data sources including a pill count and self-report obtained during a home medication history, as well as calculations based on refill frequency derived from a provincial prescription claims database (manual and electronic). DESIGN: Baseline medication adherence was collected as part of a prospective, randomized, controlled study. Mean medication adherence results obtained from the four data sources were compared using repeated-measures ANOVA followed by a Tukey's multiple range test. SETTING: A pharmacy consultation service located at an interdisciplinary wellness center for noninstitutionalized elderly. PATIENTS: 65 years or older, noninstitutionalized, taking one or more prescribed or nonprescribed medications. Clients would either present to the wellness center or be referred by the Provincial Home Care program. RESULTS: When calculated from self-report or manual or electronic prescription claims data, mean percent adherence by drug was high and not statistically different (95.8% +/- 17.1%, 107.6% +/- 40.3%, and 94.6% +/- 24.0%, respectively), whereas the pill count adherence was significantly lower at 74.0% +/- 41.5% (p < 0.0001). CONCLUSIONS: An unexpected finding was that the pill count technique used in this study of elderly clients using chronic, repeat medications appeared to underestimate medication adherence. Numerous other limitations of pill count, self-report, and a province-wide prescription claims database in estimating medication adherence are presented. When using medication adherence as a process measure, the researcher and practitioner should be aware of the limitations unique to the data source they choose, and interpret data cautiously.

Aged↗