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At least 1,063 records · Page 59Linked to original sources
PubMed2005

Results of multiple-slide, blinded review of Papanicolaou slides in the context of litigation. Determining what can be detected regularly and reliably.

BACKGROUND: Multiple-slide, blinded review has been endorsed by several cytology and pathology organizations as the most appropriate method for the review of cervicovaginal specimens in the context of litigation. This process involves review of litigation slides in a blinded manner by multiple independent cytotechnologists and the comparison of those results with those of validation cases that are comprised of known abnormalities with biopsy follow-up. To the authors' knowledge, the results of this method have not been previously published. METHODS: The results of the blinded review program at the Center for Cytopathology and Molecular Research at the Medical University of South Carolina for the years 1998-2004 were reviewed. RESULTS: A total of 135 litigation slides and 122 validation slides were reviewed. The interpretations of these cases were found to be significantly different (P < 0.001). Litigation cases were significantly more likely to be interpreted as either negative for intraepithelial lesion (NIL) or atypical squamous cells/atypical glandular cells (ASC/AGC) (P < 0.001). The results appeared to be independent of the individual cytotechnologists involved. Approximately 10% of litigation cases were called at least ASC/AGC by all observers and 4% were interpreted as NIL by all observers. For litigation cases, ASC/AGC was found to be just as reproducible as high-grade squamous intraepithelial lesion. The results demonstrated that only 10% of litigation cases are regularly and reliably identified as abnormal, whereas a single review as performed by an expert cytologist can be expected to classify 56% of cases as abnormal. CONCLUSIONS: This program suggests that a majority of litigation cases are not regularly and reliably identified as abnormal, and a single review will routinely overestimate the percentage of cases that are identified regularly and reliably.

Adult↗
PubMed1996

Assessment of joint review of radiologic studies by a primary care physician and a radiologist.

OBJECTIVES: To assess whether the joint review of radiologic studies by the primary care physician and the radiologist affects patient care and health care costs. DESIGN: Prospective study. SETTING: Student health clinic at a university hospital. PATIENTS: University students seen during acute care visits. INTERVENTION: Joint weekly review of all radiologic studies ordered at the student health clinic between July 1992 and June 1993 by a staff radiologist and internist. MEASUREMENTS AND MAIN RESULTS: The outcome measures were: (1) change of radiologic diagnosis after review process and its effect on patient management; (2) expenses saved or incurred by the review process. Of 323 films ordered, 305 were reviewed, resulting in revisions of 23 (8%) of the initial readings. Sixteen revisions (5%) led to a change in patient management; the remainder were clinically insignificant. In these 16 cases, cancellation or simplification of further workup resulted in savings of $1,967. The cost for extra physician time was $5,499. Thus, the review process incurred a net cost of $3,532. Except for the reduction in diagnostic studies, no therapeutic benefit for the patients could be identified. Film readings in our radiology department were conservative, with a positive predictive value of 85% and a negative predictive value of 99.7%. CONCLUSIONS: Routinely reviewing every radiologic study did not affect patient outcome in an outpatient clinic with low prevalence of disease. Given our radiologists' conservative film-reading practice, a review of only abnormal studies may prove more cost-effective in a healthy population. This type of assessment has implications for improving the efficiency of a changing health care system.

Ambulatory Care↗
PubMed2005

Assessing prescription medications for priority regulatory review.

Poor concordance exists between medications that receive a priority review in Canada and those given an expeditious review in the United States. The objectives of this study were to obtain an evaluation of the clinical significance of new drugs approved in both countries from expert clinical pharmacologists, and to examine the concordance of their aggregate assessment with whether or not the product received an expeditious review in either country. Five experts assessed 146 new medications approved in both Canada and the United States between 1996 and early 2002. Overall, the concordance between the experts' assessments was poor and there was large variation in products considered to be of sufficient importance for priority status. Nevertheless, the experts' evaluations suggested that several priority-reviewed products did not warrant such a review. Regulatory agencies select new medications of potential clinical significance to receive shorter review times to minimize the delay in access to them, but, in Canada, only a low proportion of priority-status products had review times within Health Canada's performance target. The large variation in the assessment of clinical significance suggests that a more appropriate strategy in Canada is to devote sufficient resources to reviewing all medications in a timely manner.

Canada↗
PubMed2003

Slide review in gynecologic oncology ensures completeness of reporting and diagnostic accuracy.

OBJECTIVE: We reviewed patient records in our tertiary care teaching hospital to assess the value of the mandatory slide review policy in gynecologic oncology with emphasis on completeness of reports. METHODS: Cases reviewed between October 2001 to September 2002 were studied. Clinical information was gathered from discussions at the weekly tumor board and from chart review. The standardized reporting guidelines in benchmark surgical pathology textbooks were used to assess the completeness of original pathology reports of excisional specimens. Diagnostic discrepancies were classified as major if the resultant change led to alteration of management or minor if it did not. RESULTS: Three hundred fifty-one cases were reviewed; 173 biopsies and 178 excisional specimens. Only 140 (78.7%) of the original pathology reports of the latter group conformed to standardized reporting guidelines. Of the 38 incomplete reports, 18 were missing critical information necessary for planning of further therapy, representing 10.1% of reports of all excisional specimens. We agreed with the original diagnosis in 252 cases (71.8%). Minor discrepancies were noted in 70 (19.9%) and major discrepancies in 29 cases (8.3%). No major discrepancy resulted from reviewing any of the vulvar specimens or cases that were already reviewed by gynecologic pathologists of other academic institutes. CONCLUSION: Mandatory slide review in gynecologic oncology is an important component in the management of gynecologic cancer patients because it completes reporting on missing parameters required for planning subsequent therapy in 10.1% of cases and recognizes discrepancies altering management in 8.3% of patients.

Female↗
PubMed1998

Radiologists' review of radiographs interpreted confidently by emergency physicians infrequently leads to changes in patient management.

STUDY OBJECTIVE: To determine whether radiologists' review of radiographs is unwarranted when emergency physicians are confident in their interpretations. METHODS: This was a prospective, descriptive study. Treating emergency physicians at a high-volume, urban teaching hospital and a moderate-volume nonteaching hospital indicated their confidence or lack of confidence in their plain-film radiographic study interpretations. All radiographs were then reviewed by radiologists according to the preexisting practice of each hospital. A total of 16,410 emergency department radiographic studies were included, comprising consecutive patients at each hospital. Charts of all discordant readings in the confident group were reviewed and judged clinically significant if treatment was altered. Charges for radiologic review of the confident ED interpretations were calculated. RESULTS: The ED physicians were confident in 9,599 sets of radiographs out of a total of 16,410 (58%). Discordant interpretation rates for the "confident" and "not confident" groups were 1.2% and 3.1%, respectively (difference, 1.9%; 95% confidence interval [CI] of the difference, 1.44% to 2.36%). Review of the 118 discordant interpretations in the confident group demonstrated that 11 were significant. Few management changes were made as a result of radiologists' review of these radiographs. Total radiology review charges for the confident group were $215,338. Therefore the average radiology charge for each significant discordant interpretation was $19,576. CONCLUSIONS: Of 9,599 sets of radiographs interpreted confidently by the emergency physicians in this study, there were 11 clinically significant discordant interpretations (0.1%). The standard practice of radiologists' review of all ED radiographs may not be justifiable.

Attitude of Health Personnel↗
PubMed2003

The effects of local review on informed consent documents from a multicenter clinical trials consortium.

There is increasing controversy about the appropriate role of the local institutional review board in the review of multicenter clinical studies. We evaluated the effects of the local review process at 25 study sites on the consent forms from two studies of the Tuberculosis Trials Consortium, a multicenter trials group. Two independent reviewers classified all changes made in the centrally approved consent forms; a third reviewer evaluated those changes if the two initial reviewers disagreed. The median time to initial local approval was 104.5 days (range 31-346). There were no changes in the study protocols as a result of local review. Consent forms became longer and less readable after local review, with a mean increase in grade level of 0.9 (+/-0.9) reading grade levels (p<0.001). A median of 46.5 changes (range 3-160) were made in the centrally approved forms. Most changes (85.2%) involved altering wording without affecting meaning. Errors were commonly introduced (11.2% of changes), and 33 of 50 (66%) locally approved consent forms contained at least one error in protocol presentation or a required consent form element. Local approval of two multicenter clinical trials was time-consuming and resulted in many changes in centrally approved consent forms. These changes frequently decreased readability and introduced errors.

Canada↗
PubMed1997

Routine review of patients after extraction of third molars: is it justified?

A prospective study of 80 patients undergoing the surgical removal of impacted mandibular third molar teeth under general anaesthesia was carried out. Patients were randomly allocated to either of two groups, one of which (n = 42) was reviewed 1-2 weeks postoperatively, and one of which was not (n = 38). Those who were not reviewed were discharged with a letter containing telephone numbers to contact in case of problems. Patients' satisfaction was gauged by means of a questionnaire completed either at the review appointment or by postal survey. Three-quarters of patients who were reviewed (34/42) and three-quarters of those who were not (9/12) preferred the method of follow-up that they experienced, whether reviewed or not. A policy of selective review may be appropriate whereby only patients whose operations were problematic or who had operative or postoperative complications are reviewed. Patients who are not reviewed should be given clear instructions to contact the department if they are concerned about their postoperative condition.

Adolescent↗
PubMed2001

Coding diagnoses and procedures using a high-quality clinical database instead of a medical record review.

A discharge abstract must be completed for each hospitalization. The most time-consuming component of this task is a complete review of the doctors' progress notes to identify and code all diagnoses and procedures. We have developed a clinical database that creates hospital discharge summaries. To compare diagnostic and procedural coding from a clinical database vs. the standard chart review by health records analysts (HRA). All patients admitted and discharged from general medical and surgical services at a teaching hospital in Ontario, Canada. Diagnostic and procedural codes were identified by reviewing discharge summaries generated from a clinical database. Independently, codes were identified by hospital health records analysts using chart review alone. Codes were compared with a gold standard case review conducted by a health records analyst and a doctor. Coding accuracy (percentage of codes in gold standard review) and completeness (percentage of gold standard codes identified). The study included 124 patients (mean length of stay 5.5 days; 66.4% medical patients). The accuracy of the most responsible diagnosis was 68.5% and 62.9% for the database (D) and chart review (C), respectively (P = 0.18). Overall, the database significantly improved the accuracy (D = 78.9% vs. C = 74.5%; P = 0.02) and completeness (D = 63.9% vs. C = 36.7%; P < 0.0001) of diagnostic coding. Although completeness of procedural coding was similar (D = 5.4% vs. C = 64.2%; P = NS), accuracy decreased with the database (D = 70.3% vs. C = 92.2%; P < 0.0001). Mean resource intensity weightings calculated from the codes (D = 1.3 vs. C = 1.4; P = NS) were similar. Coding from a clinical database may circumvent the need for HRAs to review doctors' progress notes, while maintaining the quality of coding in the discharge abstract.

Database Management Systems↗
PubMed2006

Clinical medication review by a pharmacist of elderly people living in care homes--randomised controlled trial.

OBJECTIVE: to measure the impact of pharmacist-conducted clinical medication review with elderly care home residents. DESIGN: randomised controlled trial of clinical medication review by a pharmacist against usual care. SETTING: sixty-five care homes for the elderly in Leeds, UK. PARTICIPANTS: a total of 661 residents aged 65+ years on one or more medicines. INTERVENTION: clinical medication review by a pharmacist with patient and clinical records. Recommendations to general practitioner for approval and implementation. Control patients received usual general practitioner care. MAIN OUTCOME MEASURES: primary: number of changes in medication per participant. Secondary: number and cost of repeat medicines per participant; medication review rate; mortality, falls, hospital admissions, general practitioner consultations, Barthel index, Standardised Mini-Mental State Examination (SMMSE). RESULTS: the pharmacist reviewed 315/331 (95.2%) patients in 6 months. A total of 62/330 (18.8%) control patients were reviewed by their general practitioner. The mean number of drug changes per patient were 3.1 for intervention and 2.4 for control group (P < 0.0001). There were respectively 0.8 and 1.3 falls per patient (P < 0.0001). There was no significant difference for GP consultations per patient (means 2.9 and 2.8 in 6 months, P = 0.5), hospitalisations (means 0.2 and 0.3, P = 0.11), deaths (51/331 and 48/330, P = 0.81), Barthel score (9.8 and 9.3, P = 0.06), SMMSE score (13.9 and 13.8, P = 0.62), number and cost of drugs per patient (6.7 and 6.9, P = 0.5) (pounds sterling 42.24 and pounds sterling 42.94 per 28 days). A total of 75.6% (565/747) of pharmacist recommendations were accepted by the general practitioner; and 76.6% (433/565) of accepted recommendations were implemented. CONCLUSIONS: general practitioners do not review most care home patients' medication. A clinical pharmacist can review them and make recommendations that are usually accepted. This leads to substantial change in patients' medication regimens without change in drug costs. There is a reduction in the number of falls. There is no significant change in consultations, hospitalisation, mortality, SMMSE or Barthel scores.

Accidental Falls↗
PubMedDate not supplied

A community-wide infant mortality review: findings and implications.

The authors present the results of a community-wide infant mortality review, describe implications for the delivery of maternal and child health services, and discuss the value of such reviews in addressing local public health concerns. The review included an analysis of birth and death certificates and medical record data; maternal interviews; review of cases and development of recommendations by provider panels; and convening of community groups to develop strategies to improve the health and health care of women and infants. The review focused on 287 infant deaths during 1990-1993. More than half of all neonatal deaths were attributable to "previable" or "borderline viable" births. Sexually transmitted infections were the most frequently identified underlying risk, and smoking was the most frequently identified prenatal risk. Homelessness, physical and sexual abuse, and alcohol use were at least twice as likely among women whose babies died than among a high risk comparison group. Panelists identified fragmented health care over the course of women's reproductive lives as a predominant theme. The authors conclude that: (a) The focus of maternal and child health care should shift to a model of women's health care that addresses the chronicity of social and clinical risks. (b) Infant mortality reviews are a valuable tool for community education, systems review, and policy development and can be applied to other public health issues with local significance. (c) Expectations about the review process's ability to produce conclusions about causality or recommendations narrowly geared to reducing infant mortality rates need to be reframed. (d) The model will be strengthened by greater participation of families affected by infant death.

Boston↗
PubMed2003

Number of responses on a review of systems questionnaire predicts the diagnosis of functional gastrointestinal disorders.

GOALS: We evaluated whether the number of positive responses on a review of systems questionnaire predicted the diagnosis of functional gastrointestinal (GI) disorders. STUDY: New patients to the University of Michigan GI clinics fill out a standardized questionnaire that includes a comprehensive review of systems which lists 87 items under 11 headings. We determined the number of items circled on the review of systems from the first 100 new patients seen in GI clinic in the year 2000. After a mean of 14 months follow-up, the final diagnoses in these patients were compared with the number of items circled on the review of systems. RESULTS: Completed questionnaires were available for review in 82/100 patients. Twenty-six patients were diagnosed with a functional GI disorder, 53 patients had a nonfunctional diagnosis, and 3 patients had no diagnosis determined. The mean number of items circled on the review of systems was 15.9 (SD = 11.2) for the functional GI group, compared with 5.9 (SD = 6.9) for the nonfunctional GI diagnosis group ( < 0.005). When the symptom headings were analyzed individually, the differences in general, gastroenterological, cardiovascular, urinary, neurological, eye, ear, nose and throat, and psychiatric symptoms were statistically significant. CONCLUSIONS: Patients with functional GI disorders have a significantly greater number of GI and non-GI symptoms on review of systems. If seven positive symptoms is used as a threshold, the standardized review of systems questionnaire had a sensitivity of 92% and specificity of 80% in detecting patients with functional GI disorders.

Adult↗
PubMed2006

Review of cervical smears from 76 women with invasive cervical cancer: cytological findings and medicolegal implications.

OBJECTIVE: To review cervical smears from 76 women which were taken prior to the diagnosis of invasive cervical cancer and to determine the appropriateness of the cytology reports issued on the smears. METHODS: Cervical smears, clinical records, cervical smear history and cytology reports from 76 women with invasive cervical cancer were reviewed. After microscopic review of the cervical smears, the cases were divided into two groups: Group 1 comprised 50 women who were found to have had at least one false-negative (F/N) smear report prior to the diagnosis of invasive cervical cancer. Group 2 comprised 26 women for whom no evidence of F/N reporting was found. RESULTS: A total of 209 cervical smears from the 50 women in group 1 were available for review (range 2-12 smears per woman); 100 of the 209 smears were considered to have been reported appropriately. Ninety-seven smears which had been reported originally as negative or inadequate were found, on review, to contain numerous severely dyskaryotic cells and were reclassified as F/N smears. All of the 50 women had at least one F/N smear and 29 had two or more. Twelve smears from eight women contained only a few (<200 severely dyskaryotic cells). Forty women developed invasive squamous carcinoma and 10 developed invasive adenocarcinoma. The stage at diagnosis ranged from 1A to stage 4. Seventy-one smears from the 24 women in group 2 were available for review (range 1-15 smears per woman). In two cases included in group 2, no smears were provided for review as the smears had been lost or mislaid. Review of the 71 smears confirmed the accuracy of the original cytological classification of the smear. Nineteen women were diagnosed with squamous cancer, two microinvasive cancer, one glassy cell, two adenocarcinomas, and one with adenosquamous carcinoma. One women was found to have an embryonal rhabdomyosarcoma of the corpus uteri involving the cervix. DISCUSSION/CONCLUSION: The medicolegal implications are discussed in the light of the above findings. Evidence of breach of duty of care was presented in all 50 cases in group I although causation was not established in every case. There was no evidence of failure of duty of care in terms of the standard of the cervical cytology reports issued or standard of clinical management in 17 of the 26 cases in group 2. However, in seven of the 26 cases in group 2, clinical management of the case was substandard due to failure to investigate symptoms of irregular bleeding regardless of a negative cytology report (two cases), failure to act upon a suspicious smear report or consecutive inadequate smear reports (two cases), failure of follow-up after treatment of CIN3 (two cases) and histological misdiagnosis (one case).

Adult↗
PubMed2004

Reviewing measures of outcome: reliability of data extraction.

RATIONALE, AIMS AND OBJECTIVES: Although there is wide acceptance of the necessary domains for the evaluation of measures of health outcome, there has been little development or evaluation of methods of data extraction, such as checklists. This study aimed to assess the inter-rater reliability of data extraction from published articles using a new electronic database developed for structured reviews of health outcome measures. METHODS: Domains considered important in the evaluation of measures of health outcome provided the foundation for a checklist for data extraction using a new electronic database. The database utilized Microsoft Access 2000 software (Microsoft Corporation, 2000). Following training, three independent reviewers extracted data from seven selected articles using the electronic database, and assessed article and measure quality against pre-defined criteria. Data extraction was compared for consistency and item content. Inter-reviewer agreement for categorical data was assessed by multiple kappa correlation. RESULTS: Analysis demonstrated strong agreement between reviewers for all aspects of data extraction. However, lack of clarity in published articles affected the ability to clearly identify measures of outcome. CONCLUSIONS: The high level of inter-reviewer agreement supports the use of multiple trained reviewers in data extraction for reviews of measures of outcome using the checklist and Access software described. The electronic database supports standardized data extraction from published articles, benefiting from the combination of data extraction and data entry in a single step. Adaptation of the database to support structured reviews of measures of outcome adopted in the evaluation of other health states is proposed.

Ankle Injuries↗
PubMed2001

FDA review practices and priorities for drugs used in cancer treatment.

The Federal Food, Drug, and Cosmetic Act and related regulations (21 U.S.C. 301 et seq.) give FDA staff the legal authority and responsibility to review the safety and effectiveness of drugs and biological products (including products used in cancer treatment), from preclinical testing through all phases of clinical research and marketing. FDA review activities in the oncology arena can be divided into five major categories: (1) initial review of investigational new drug (IND) applications; (2) ongoing review of premarketing research (including new research protocols submitted to existing INDs and IND safety reports describing adverse events with the new drug); (3) discussions with commercial sponsors regarding their clinical development plans, including the design and conduct of key studies that are intended to support initial marketing approval for a new product or to support the addition of new indications to the prescribing information for currently marketed products; (4) review of submitted new drug applications (NDAs) or biological licensing applications (BLAs); and (5) continuing review of the safety and effectiveness of marketed products. Through these review activities, FDA staff work to ensure that products approved for marketing for cancer treatment are effective and adequately safe for their intended uses and to ensure that the quality, effectiveness, and safety of products on the market are preserved or enhanced, so patients and physicians may use these products with confidence and with adequate safety. Because these review activities generally fall into a chronologic sequence, the following discussion parallels the development course of a typical new drug.

Antineoplastic Agents↗
PubMed2001

Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice.

OBJECTIVE: To determine whether a pharmacist can effectively review repeat prescriptions through consultations with elderly patients in general practice. DESIGN: Randomised controlled trial of clinical medication review by a pharmacist against normal general practice review. SETTING: Four general practices. PARTICIPANTS: 1188 patients aged 65 or over who were receiving at least one repeat prescription and living in the community. INTERVENTION: Patients were invited to a consultation at which the pharmacist reviewed their medical conditions and current treatment. MAIN OUTCOME MEASURES: Number of changes to repeat prescriptions over one year, drug costs, and use of healthcare services. RESULTS: 590 (97%) patients in the intervention group were reviewed compared with 233 (44%) in the control group. Patients seen by the pharmacist were more likely to have changes made to their repeat prescriptions (mean number of changes per patient 2.2 v 1.9; difference=0.31, 95% confidence interval 0.06 to 0.57; P=0.02). Monthly drug costs rose in both groups over the year, but the rise was less in the intervention group (mean difference 4.72 pound sterling per 28 days, - 7.04 pound sterling to - 2.41 pound sterling); equivalent to 61 pound sterling per patient a year. Intervention patients had a smaller rise in the number of drugs prescribed (0.2 v 0.4; mean difference -0.2, -0.4 to -0.1). There was no evidence that review of treatment by the pharmacist affected practice consultation rates, outpatient consultations, hospital admissions, or death rate. CONCLUSIONS: A clinical pharmacist can conduct effective consultations with elderly patients in general practice to review their drugs. Such review results in significant changes in patients' drugs and saves more than the cost of the intervention without affecting the workload of general practitioners.

Aged↗
PubMed2001

Expert consensus on the desirable characteristics of review criteria for improvement of health care quality.

OBJECTIVES: To identify the desirable characteristics of review criteria for quality improvement and to determine how they should be selected. BACKGROUND: Review criteria are the elements against which quality of care is assessed in quality improvement. Use of inappropriate criteria may impair the effectiveness of quality improvement activities and resources may be wasted in activities that fail to facilitate improved care. METHODS: A two round modified Delphi process was used to generate consensus amongst an international panel of 38 experts. A list of 40 characteristics of review criteria, identified from literature searches, was distributed to the experts who were asked to rate the importance and feasibility of each characteristic. Comments and suggestions for characteristics not included in the list were also invited. RESULTS: The Delphi process refined a comprehensive literature based list of 40 desirable characteristics of review criteria into a more precise list of 26 items. The expert consensus view is that review criteria should be developed through a well documented process involving consideration of valid research evidence, possibly combined with expert opinion, prioritisation according to health outcomes and strength of evidence, and pilot testing. Review criteria should also be accompanied by full clear information on how they might be used and how data might be collected and interpreted. CONCLUSION: The desirable characteristics for review criteria have been identified and will be of use in the development, evaluation, and selection of review criteria, thus improving the cost effectiveness of quality improvement activities in healthcare settings.

Consensus Statements as Topic↗
PubMedDate not supplied

Review of cytologic slides from the national women's hospital, New Zealand, cohort of women with cervical intraepithelial neoplasia 3 diagnosed in 1955-1976.

OBJECTIVE: To review cytologic slides, mostly at least 25 years old, from women attending National Women's Hospital, Auckland, who had been diagnosed histologically with cervical carcinoma in situ in 1955-1976. STUDY DESIGN: Smears comprised all those from the 2 years following diagnosis as well as all subsequent smears for women who developed "microinvasive" or invasive lower genital tract cancer. The Victorian Cytology Service performed the review using the Australian Modified Bethesda System. was 0.97. RESULTS: Nine percent of 4,930 retrieved slides were technically unsatisfactory. Original (Papanicolaou) and review coding were available for 4,477 slides. Using categories of equivalence, smears coded as normal (original, 59.2%; review, 61.4%) or showing possible or definite high grade abnormalities (original, 25.9%; review, 29.6%) were found in similar proportions. The kappa statistic (0.79) indicated a high level of agreement between original and review coding. In comparison with the review, the sensitivity of the original coding in detecting high grade abnormalities was 0.80, while the ability of the original assessment to categorize smears as not high grade (specificity) CONCLUSION: This comprehensive review found nearly all archived cytology slides to be technically satisfactory and the broad diagnostic cytologic categories from earlier periods (apart from benign lesions) to be concordant with those currently used.

Cohort Studies↗
PubMed1984

Quantitative reviewing of medical literature. An approach to synthesizing research results in clinical pediatrics.

The quantitative literature review is presented as a unique type of research endeavor complete with formal stages that parallel those associated with primary or experimental research. This article provides a tutorial overview of the quantitative literature review procedure and, in conjunction with the companion article published in this issue, serves to illustrate the application of this technique in the review process. The stages in quantitative review include: (1) problem formation; (2) data collection; (3) data evaluation; (4) analysis and interpretation; and (5) reporting results. It is argued that inferences made in the research review process are as central to the establishment of valid biomedical and clinical knowledge as inferences made in primary research. Despite some limitations, quantitative reviewing procedures constitute a significant advance over the traditional narrative methods of integrating empirical research in an area of interest. The use of quantitative reviewing procedures represents a paradigm shift in which the literature review is conceptualized as a unique form of scientific inquiry complete with formal stages and methods. The adoption of these methods should assist researchers in the behavioral and biomedical sciences in establishing scientifically valid data bases to guide theory development and direct future clinical investigation.

Data Collection↗