Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Pretesting”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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

At least 109 records · Page 6Linked to original sources
PubMed2006

Combined use of clinical pretest probability and D-dimer test in cancer patients with clinically suspected deep venous thrombosis.

BACKGROUND: The value of the D-dimer (DD) test in combination with the clinical pretest probability (PTP) has not been evaluated in cancer patients with suspected deep vein thrombosis (DVT), whereas this group of patients usually accounts for 10-25% of clinically suspected DVT. METHODS: A cohort of 2066 consecutive patients with clinically suspected DVT was investigated. Patients were judged to be positive or negative for DVT according to the outcomes of serial compression ultrasound and a 3-month follow-up period with imaging test verification of the symptomatic cases. Diagnostic accuracy indices of the DD test according to the PTP score were assessed in patients with and without cancer. RESULTS: Of the cohort, 244 (11%) were known to have cancer at presentation. A venous thromboembolic event was diagnosed in 41% of the patients with cancer and in 22% of the patients without malignancy. Among the cancer patients, 17% were considered to have a low PTP, 35% a moderate and 41% a high PTP. The negative predictive value (NPV) of the DD test was 100% (95% CI, 85-100) and 97% (95% CI, 88-99) among cancer patients with low PTP or low-moderate PTP. In the absence of malignancy, the corresponding NPV were 98% and 97%, respectively. The specificity of the DD test progressively decreased moving from the low to the higher PTP. CONCLUSIONS: In cancer patients with clinically suspected DVT, a negative DD might be useful in excluding the diagnosis within the low or low-moderate PTP groups. More studies are warranted to confirm these findings.

Aged↗
PubMedDate not supplied

Using quantitative and qualitative methods to pretest the publication. Take Charge of Your Diabetes: a Guide for Care.

Quantitative and qualitative methods used to pretest the guidebook Take Charge of Your Diabetes: A Guide for Care are presented in this paper. Questionnaires were used as the quantitative method (completed by 59 diabetes educators and 301 people with diabetes) and focus groups were used as the qualitative method (3 groups composed of 22 black men and women with diabetes) to examine the relevance, purpose, content, and presentation of the Guide. Findings from between-methods triangulation supported the relevance, clarity of messages, identification of groups that would be most likely to benefit, readability, understandability, and credibility of the Guide. Specific areas that needed modification were identified. Each evaluation method provided unique data; for example, quantifiable data on intention to change behavior was provided from one method and a recommendation that diversity be maintained was provided from the other method. The relative strengths and limitations of combining quantitative and qualitative approaches are described.

Adult↗
PubMed1993

Evaluation of an intervention for staff in a long-term care facility using a retrospective pretest design.

It has been previously established that human service workers often suffer from emotional exhaustion, which has been conceptualized by Maslach and Jackson as burnout. Burnout may be a particularly great risk in workers providing long-term geriatric care. The current study evaluated the effects of a series of three 3-hour sessions designed to address team building, communication skills, self-esteem, and stress management on a random sample of 51 of the 188 long-term care staff who participated. Using a retrospective pretest design, a statistically significant improvement from "then" to "today" was found for the three components of burnout: Depersonalization, Emotional Exhaustion, and Personal Accomplishment. Responses to an open-ended question about workshop effects corroborated the quantitative data, and effects noted were highly related to the defined objectives of the workshops.

Adult↗
PubMed2001

Statistical power for nonequivalent pretest-posttest designs. The impact of change-score versus ANCOVA models.

Nonequivalent controlled pretest-posttest designs are central to evaluation science, yet no practical and unified approach for estimating power in the two most widely used analytic approaches to these designs exists. This article fills the gap by presenting and comparing useful, unified power formulas for ANCOVA and change-score analyses, indicating the implications of each on sample-size requirements. The authors close with practical recommendations for evaluators. Mathematical details and a simple spreadsheet approach are included in appendices.

Analysis of Variance↗
PubMed2005

Pretest probability assessment derived from attribute matching.

BACKGROUND: Pretest probability (PTP) assessment plays a central role in diagnosis. This report compares a novel attribute-matching method to generate a PTP for acute coronary syndrome (ACS). We compare the new method with a validated logistic regression equation (LRE). METHODS: Eight clinical variables (attributes) were chosen by classification and regression tree analysis of a prospectively collected reference database of 14,796 emergency department (ED) patients evaluated for possible ACS. For attribute matching, a computer program identifies patients within the database who have the exact profile defined by clinician input of the eight attributes. The novel method was compared with the LRE for ability to produce PTP estimation <2% in a validation set of 8,120 patients evaluated for possible ACS and did not have ST segment elevation on ECG. 1,061 patients were excluded prior to validation analysis because of ST-segment elevation (713), missing data (77) or being lost to follow-up (271). RESULTS: In the validation set, attribute matching produced 267 unique PTP estimates [median PTP value 6%, 1st-3rd quartile 1-10%] compared with the LRE, which produced 96 unique PTP estimates [median 24%, 1st-3rd quartile 10-30%]. The areas under the receiver operating characteristic curves were 0.74 (95% CI 0.65 to 0.82) for the attribute matching curve and 0.68 (95% CI 0.62 to 0.77) for LRE. The attribute matching system categorized 1,670 (24%, 95% CI = 23-25%) patients as having a PTP < 2.0%; 28 developed ACS (1.7% 95% CI = 1.1-2.4%). The LRE categorized 244 (4%, 95% CI = 3-4%) with PTP < 2.0%; four developed ACS (1.6%, 95% CI = 0.4-4.1%). CONCLUSION: Attribute matching estimated a very low PTP for ACS in a significantly larger proportion of ED patients compared with a validated LRE.

Acute Disease↗
PubMed2000

A model for pretest probability of lymph node metastasis from cutaneous Melanoma.

Although many statistical models have been developed to predict survival in cutaneous melanoma, few predict the end point of regional lymph node metastasis shortly after the diagnosis of melanoma. We used routine clinical and histologic data from 573 patients referred to the Duke University Melanoma Clinic, Durham, NC, during the 1980s and 1990s who underwent lymph node resections during the first year after the diagnosis of primary cutaneous melanoma. The outcome we modeled (using the logistic regression model) was the probability of lymph node metastasis. We found that tumor thickness was the variable most significantly associated with the probability of nodal metastasis, and the presence of ulceration and tumor location also were significant, but age, sex, and mitotic rate were not. When the resulting logistic model predicted that the probability of nodal metastasis was more than .6, 93 of 115 patients had nodal metastasis. When the model predicted that the probability was less than .3, just 32 of 88 patients had positive nodes. Furthermore, after the result of the node sampling was known, Cox model analysis demonstrated that the pretest probability added significant information about subsequent survival.

Biopsy↗
PubMed2001

Pretest clinical diagnosis of coronary artery disease and stress myocardial perfusion scintigram.

BACKGROUND: To assess the probability of perfusion defects at exercise stress myocardial perfusion SPECT scintigraphy from pretest clinical diagnosis (medical personal history, previous ergometric investigation). To determine the value of clinical factors for probability of scintigraphic defects with respect to avoiding unnecessary investigation in subjects with low probability of abnormal scintigrams. MATERIAL AND METHODS: 2143 subjects (1235 men, 908 women) were investigated by SPECT perfusion scintigraphy at stepwise increasing exercise stress. They were divided into three groups with regard to their medical history and exercise test at scintigraphy: subjects without any signs of coronary artery disease (CAD), patients with high likelihood of CAD (i.e., typical anginal pain, in particular at stress, positive stress ECG changes, angiographically documented important CAD) and patients after myocardial infarction (MI). Important risk factors (hypertension, diabetes, age and sex), as well as the role of revascularisation procedures, were taken into account for multiple logistic regression in order to express their importance for the odds of scintigraphic defect visualisation. RESULTS: Perfusion scintigraphic defects (PSD) were found in 5.2% of subjects without signs of CAD, in contrast to patients with manifest CAD (68.8% with PSD) and in those after MI (90.2% with PSD). There were other important factors corroborating the likelihood of PSD (in decreasing order of importance): diabetes, male, ECG changes at stress, increasing age. Successful revascularisation improved scintigraphic images. CONCLUSION: The examination of CAD symptom-free subjects, in particular with atypical chest discomfort, is useless. SMPS in patients after documented MI is to be carried out for other intended purposes, not for CAD diagnosis only. SMPS is highly recommended in patients with CAD symptoms and high CAD probability in order to decide further treatment and prognosis.

Journal Article↗
PubMed1985

Pretest temperature effects on CAP syphilis serology survey samples.

The College of American Pathologists syphilis serology survey participants periodically question survey-sample stability when the samples have possibly been exposed to temperature extremes during shipment. In this study it was demonstrated that short-term pretest incubations at temperatures above 58 degrees C (136.4 degrees F) usually cause a reduction in both rapid plasma reagin and FTA-ABS reactivity. No reactivity changes occurred in either test with short-term exposures to temperatures between -80 degrees C and 58 degrees C.

Antibodies, Bacterial↗
PubMed1981

Preliminary analysis of O.E.C.D. disability on the pretest of the post census disability survey.

The paper reviews the U.S. experience with items from the OECD long-term disability questions. The OECD questions have not yet been used in their entirety in this country, but several surveys, including the National Health Interview Survey, 1977, the Survey of Income and Program Participation, 1978, and the Social Security Disability Study, 1978, have used selected items or ones similar to the OECD items. A number of methodological issues addressed in the Bureau of the Census pretest of the Postcensus Disability Survey, planned for 1980, will be discussed in this paper, and estimates of the percentage of persons with OECD type disability by age, based on several U.S. surveys, will be also presented.

Activities of Daily Living↗
PubMedDate not supplied

Pretest and post-test attitudes of nursing personnel toward a patient care information system.

This 3-year study was conducted for the following purposes: 1) to develop and to test an instrument to assess the attitudes of nursing personnel toward a patient care information system; 2) to collect pretest data regarding attitudes and selected demographic variables; and 3) to collect post-test attitude data to evaluate a computer-based training program and the actual transition into the computerized clinical information system. While several studies have been undertaken to understand more about the attitudes of nurses toward computer applications in the hospital setting and the variables that influenced them, no studies were identified that investigated the attitudes of nurses before and after transition into an automated system. A total of 224 nursing personnel participated in the two phases of data collection between 1990 and 1993. Factor analysis supported a 12-item general attitude scale with an alpha reliability value of 0.92. While respondents indicated positive attitudes at the outset, their attitudes became less positive during the actual start-up of the system. Specific attitude items receiving the highest and lowest mean ratings and narrative comments of respondents were used to identify areas requiring additional attention and problem solving.

Adult↗
PubMedDate not supplied

Life stress and risk of precancerous cervical lesions: a pretest directed by the life stress model.

PURPOSE/OBJECTIVES: To present the results of a pilot study to pretest instruments designed to measure selected variables named in the Life Stress Model, a model of health outcomes. Additional aims were to determine the effect of completing personal risk assessments for precancerous squamous-cell intraepithelial lesions of the cervic (SIL) on receptivity to cervical cancer prevention information and to extend knowledge of stressful life events experienced by inner-city women attending high-risk health clinics. DESIGN: Cross-sectional. SAMPLE: 20 adult women attending high-risk prenatal or human immunodeficiency virus (HIV) outpatient clinics in one of two New York City hospitals. Most were recovering drugs abusers; half were diagnosed with HIV infections. METHODS: Data were collected by self-report using standard measures. Demographics, medical histories of immunosuppressive states, and investigator-developed screening inventories of behavioral and dietary risk factors associated with SIL also were administered. MAIN RESEARCH VARIABLES: Life event stressors, psychological state, social support, symptom distress, and SIL diagnosis. FINDINGS: Instruments met acceptable psychometric standards for internal consistency, but the standard measure of stressful life events did not capture the full range of stressors experienced by this group of patients: hovering relatives, abusive spouses, HIV diagnosis, changes in welfare benefits, the HIV status of the unborn, and mandatory foster care. Although unable to recall cancer histories of family members, about half of the women who completed study instruments were interested in receiving more information cervical cancer. Exploratory analyses suggest that women diagnosed with SIL experience more psychological distress and family disfunction than women without SIL. CONCLUSIONS: Completing personal SIL risk assessments may stimulate patients' receptivity to cancer risk factor information. Health outcomes studies guided by the Life Stress Model may prove fruitful. IMPLICATIONS FOR NURSING PRACTICE: Cancer risk factor assessments may be an important method for promoting receptivity to cancer prevention information.

Adult↗
PubMed1999

Is there a diagnostic role for bone scanning of patients with a high pretest probability for metastatic renal cell carcinoma?

BACKGROUND: The utility of performing whole-body bone scintigraphy (BS) as part of a routine staging workup for patients with renal cell carcinoma (RCC) is currently being debated. This study investigated the diagnostic performance of BS in 36 patients with a high pretest probability for bone metastases due to abnormal laboratory tests, pain, or confirmed nonosseous metastases. METHODS: Planar whole-body BS was performed in all patients 3 hours after the intravenous injection of 555 MBq (15 mCi) of technetium-99m-3,3-diphosphono-1,2-propane dicarboxylic acid tetrasodium salt). RESULTS: In 14 of 36 patients, bone metastases could be confirmed either due to computed tomography or magnetic resonance imaging (n=11) or open site directed biopsy (n=3), respectively. The sensitivity ranged from 10% to 60%, depending on the applied visual threshold. The extent of the metastatic involvement was underestimated in all cases. No diagnostic pattern of tracer accumulation, clinical features, or laboratory tests was identified as enhancing the sensitivity for the detection of bone metastases in this population. CONCLUSIONS: The authors concluded that, even among preselected patients, BS has no diagnostic role in RCC and should therefore be omitted from the clinical workup.

Bone Neoplasms↗
PubMed1997

Reliability and validity of medical outcome and patient satisfaction measures among injured workers in Washington State: a pretest.

Several existing measures of medical outcomes and some newly constructed measures of patient satisfaction were tested for reliability and validity on a sample of 100 subjects who had suffered work-related injuries and illnesses in Washington State. Included in the measures of medical outcome were the SF-36 and the upper body mobility subscale of the Health Assessment Questionnaire. The newly constructed measures of patient satisfaction assessed areas such as satisfaction with the attending physician and with access to referrals. Also administered were assessments of job satisfaction, both prior to and since the injury, and a measure of chance health locus of control. The patient satisfaction and medical outcomes measures demonstrated good reliability and validity for use with this population. However, neither the measures of job satisfaction nor chance health locus of control were related to either patient satisfaction with medical care nor to medical outcomes.

Accidents, Occupational↗
PubMed1997

Pretest administration of glucose attenuates infantile amnesia for passive avoidance conditioning in rats.

Infantile amnesia in rats may be attenuated by a wide variety of retrieval cues which reactivate memory for the training episode. The present study investigated the effects of glucose on memory retrieval in infant rats. In Experiment 1, 17-day-old preweanling rats were trained to criterion on passive avoidance conditioning. Twenty-four hours later, each subject received a subcutaneous injection of either saline, 100 mg/kg, or 250 mg/kg of glucose just prior to testing. Saline animals displayed poor retention scores, suggesting infantile amnesia; however, glucose significantly attenuated the 24-hr retention loss. Experiment 2 attempted to replicate the previous experiment, control for age and general drug effects, and extend the dose of glucose to 400 mg/kg. The results of Experiment 2 were consistent with Experiment 1 and also indicated that infant subjects performed significantly worse than adults. Both 100 and 250 mg/kg of glucose significantly attenuated infantile amnesia; however, 400 mg/kg had no effect. These results support a retrieval failure view of infantile amnesia and extend the memory-influencing properties of glucose to infants. Context and neuroendocrine views of memory retrieval are discussed.

Age Factors↗
PubMed1993

Presymptomatic DNA-testing for Huntington disease: pretest attitudes and expectations of applicants and their partners in the Dutch program.

We studied the baseline attitudes, prior to testing, of 70 applicants at risk for Huntington disease (HD) and their partners in the Dutch presymptomatic DNA-testing program. Two thirds of the applicants were female; 36% already had children. The main reason (60%) for undertaking the test was for family planning. Other reasons were either to reduce uncertainty (43%) or to obtain certainty (38%). Partners of applicants stated that planning for the future was for them the most important reason (76%). Significantly more at-risk females (42%) than males (16%) anticipated an unfavorable test outcome. Quite remarkably, most applicants and partners denied that a positive result might have adverse effects on either personal mood, quality of life, or marriage. Only a few did not expect that a favorable result would induce relief. The eventual outcome of the test was expected to enable applicants to gain control over their future, whatever the results. Hence, we propose that the applicants form a self-selected group, based on their expectation that they will not be emotionally affected by either result.

Adult↗
PubMed1995

Does dyspnoea during dipyridamole cardiac stress testing indicate bronchospasm and is the pretest clinical history predictive of this side-effect?

This study investigates the acute effects of intravenous dipyridamole (0.7mg/kg) on pulmonary airflow in relation to clinical parameters suggestive of chronic obstructive pulmonary disease (COPD) in order to assess predictive and causative factors of dyspnoea during cardiac stress testing. Mild pulmonary airflow obstruction was noted in all patients, but reached statistical significance only in small airways (FEF75-85%: -7%; P=0.034). The changes in pulmonary function parameters were independent of the clinical history. Dyspnoea under dipyridamole stress testing occurred in parallel with angina, yet was not associated with ischaemic or non-ischaemic left ventricular dysfunction. These data do not support the use of dipyridamole stress testing in asthmatics, but show that (1) the acute effects of a diagnostic dose of dipyridamole on pulmonary airflow are mild even in patients with a history suggestive of COPD and (2) dyspnoea during dipyridamole testing is not necessarily indicative of bronchospasm.

Adult↗