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Conducting research with urban elders: issues of recruitment, data collection, and home visits.

The National Institutes of Health 1994 guidelines require inclusion of minorities in research. People seeking grants need to be aware of techniques for recruitment of minority populations. The Boston University Alzheimer's Disease Center addresses difficult recruitment issues that arise from a skeptical minority population. The approach uses home visits to circumvent many of the barriers to recruitment and retention of participants in research studies.

Aged↗

Observation: a valuable data collection strategy for research with children.

This study introduces the basic concepts of observational research by defining the terms and discussing some of the critical issues specific to observational research. Observational methods signify a systematic approach to quantifying behavior. A discussion of the major concerns in observational research is presented. These concerns include defining the coding categories; identifying the unit of measurement, the method of recording the observation, and deciding on a sampling strategy; training of observers; and interrater and intrarater reliability.

Clinical Nursing Research↗

Compliance with quality of life data collection in the National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial.

This paper describes compliance with the completion of a quality of life questionnaire in the Breast Cancer Prevention Trial, a large multi-centre randomized trial that is studying the efficacy of Tamoxifen in preventing breast cancer. In the first 4875 women enrolled in the control arm of the study, there was a very high rate of questionnaire completion at baseline, 3 months, 6 months and 12 months of follow-up (89.8 per cent completed forms at 12 months). The sample was examined according to demographic and risk factors, as well as by recruitment cohort. There was a significantly poorer compliance rate for the most recently recruited cohort that was followed-up during a time of substantial external negative publicity related to clinical trial research. Nevertheless, the overall compliance with completion of quality of life data in this trial is very high, which is probably attributable to the high educational status of the trial participants.

Adult↗

Progress toward meeting the 1990 nutrition objectives for the nation: nutrition services and data collection in state/territorial health agencies.

Promoting Health, Preventing Disease, Objectives for the Nation, specifies nutrition as a priority area for improving the health of Americans by 1990. Eleven of the 15 nutrition objectives target adults or the public while four address pregnant and lactating women, infants, and children. To determine progress by states toward achieving the nutrition objectives, the Association of State and Territorial Public Health Nutrition Directors conducted a survey in 1985 to which 54 state and territorial nutrition directors responded. Three-fourths of the nutrition personnel focused efforts on maternal and child populations, and were supported largely by federal funds from the Special Supplemental Food Program for Women, Infants, and Children (WIC) and the Maternal and Child Health Block Grant. Only 15 per cent were funded by state and local sources. While most agencies reported using nutrition consultation in adult health programs, only 25 per cent paid for these personnel. Data to monitor progress were commonly available for only five of the 15 objectives. Achievement of the nutrition objectives by states will require a more comprehensive approach to nutrition programming with increased allocation of appropriate resources and expansion of health data systems.

Adolescent↗

Adoption of the ASPAN clinical guideline for the prevention of unplanned perioperative hypothermia: a data collection tool.

Perioperative hypothermia remains a common occurrence despite the development and dissemination of a clinical practice guideline for the prevention of unplanned perioperative hypothermia by ASPAN. Unfortunately, a process for measuring compliance with and adoption of this guideline has yet to be developed. The purpose of this article is to describe a medical record abstraction method for determining the degree of adoption of the ASPAN Clinical Guideline for the Prevention of Unplanned Perioperative Hypothermia in the perianesthesia setting. Use of the instrument for future research is also explored.

Data Collection↗

Injury surveillance in a children's hospital--overcoming obstacles to data collection.

OBJECTIVE: To understand the problems involved in collection of injury surveillance (Glasgow Children Hospital Injury Reporting and Prevention Programme, CHIRPP) forms. METHODS: Glasgow CHIRPP forms were issued by the clerical staff to all eligible child carers for details of the injury or ingestions by the child, and the retrieval rate of forms was monitored. Reasons for the poor collection of forms were identified and rectified. RESULTS: The collection rate of Glasgow CHIRPP forms was poor when the system was introduced in 1993. It improved when the forms were issued by nursing staff, and considerable improvement was noted when the triage nurse was made responsible. CONCLUSIONS: When a named individual was made responsible there was an improvement in the retrieval of Glasgow CHIRPP forms. A few other simpler problems relating to the retrieval of forms were identified and rectified.

Child↗

Comparison of the reliability of plantar pressure measurements using the two-step and midgait methods of data collection.

The reliability of plantar pressure measurements obtained using the traditional midgait method compared with the two-step method was investigated. Using an EMED-SF system, the parameters of contact area, contact time, maximum force, and peak pressure at seven sites of the foot were assessed for reliability of measurement in 10 normal subjects. The results of the study indicate that the two-step method is as reliable as the midgait method and may be preferred for use in both research and clinical settings.

Adult↗

Reading a research article part III: the data collection instrument.

Parts I through III of this series of articles gave an introduction to some of the issues requiring attention when performing clinical studies and summarizing the results statistically as well as clinically. Statistical methods have been described for the identification of statistically significant differences and associations between an experimental group and a control group or over the course of time after an intervention. The next article will address the methods used for the determination of the strength or magnitude of these identified statistically significant differences.

Biomedical Research↗

Data collection and information presentation for optimal decision making by clinical managers--the Autocontrol Project.

The Autocontrol methodology has been developed in order to support the optimisation of decision-making and the use of resources in the context of a clinical unit. The theoretical basis relates to quality assurance and information systems and is influenced by management and cognitive research in the health domain. The methodology uses population rather than individual decision making and because of its dynamic feedback design promises to have rapid and profound effect on practice. Most importantly the health care professional is the principle user of the Autocontrol system. In this methodology we distinguish three types of evidence necessary for practice change: practice based or internal evidence, best evidence derived from the literature or external evidence concerning the practice in question, and process based evidence on how to optimise the process of practice change. The software used by the system is of the executive decision support type which facilitates interrogation of large databases. The Autocontrol system is designed to interrogate the data of the patient medical record however the latter often lacks data on concomitant resource use and this must be supplemented. This paper reviews the Autocontrol methodology and gives examples from current studies.

Blood Gas Analysis↗

Standardizing data collection and decision making with an expert system.

The software for the pilot system has been completed. The appropriateness of the risk factor weights needs to be evaluated by clinical testing. However, this does not prevent the system from being used to teach the philosophy of risk group identification and selection of different management strategies according to disease activity. The current system does demonstrate a dynamic relationship between caries risk assessment/activity and different management strategies. A formal scientific evaluation of the effectiveness of the system as a teaching tool is being developed.

Data Collection↗

A clinic's perspective on screening, recruitment and data collection.

This paper summarizes the approach of one university cardiology section with over a decade of experience in conducting National Institutes of Health and pharmaceutical cardiovascular trials. Many of the organizational and personnel issues discussed can be directly applied to most university cardiovascular clinical research settings. Other aspects reflect a very specialized approach but key features can be modified or adapted to smaller individual research clinics. In terms of organizational features, our multi-hospital recruitment effort is co-ordinated by a weekly clinical research conference which is attended by all nurse coordinators and cardiology fellows. Centralization of all clinic facilities and non-invasive laboratories, the central computer facility, and the availability of clinical research inpatient hospital beds facilitate our clinical research effort. An expanded role of the nurse co-ordinator is considered pivotal to trial performance. Suggestions are made as to the identification and recruitment of ideal nurse co-ordinators, maximizing their productivity, and retaining them. The key feature is the physicians' acceptance of the nurse co-ordinator as a colleague. The roles of the principal investigator and clinical cardiology fellows are delineated, and suggestions made for data entry and computer technical expertise to optimize nurse co-ordinator efficiency, allowing total focus on recruitment and follow-up.

Data Collection↗

Computer prompts to improve social interactions and data collection.

In this study we sought to improve the distribution and quality of staff-client interactions by comparing a traditional paper-and-pencil system of prompts and recording to a computerized system across 4 staff members. Results showed that the computer system produced more positive statements, an improved distribution of interaction among clients, and a larger increase in the delivery of positive reinforcement when compared to a traditional paper-and-pencil system. The use of computer prompts appears to provide a simple method of improving staff-client interactions and provides a method of documenting interactions and staff members' adherence to prescriptive programs.

Adolescent↗

Postdischarge surveillance of surgical site infections: a multi-method approach to data collection.

BACKGROUND: Surveillance of surgical site infections (SSIs) is an important clinical indicator of quality patient care, yet an increasing number of SSIs manifest after discharge and are not detected through standard surveillance methods. AIM: This study evaluated a multimethod approach to postdischarge surveillance of SSIs with use of a cesarean section procedure as a case study. METHOD: A postdischarge questionnaire was sent on day 30 to women (n = 277) who had undergone cesarean section. A follow-up telephone interview was conducted if the questionnaire had not been returned within 2 weeks, a diagnosis of infection could not be clearly determined from the responses given, or to confirm the diagnosis of infection. If follow-up could not be made, a chart audit was undertaken. RESULTS: A total response rate of 89% (247/277) was obtained. Twenty-one women with SSI were identified through questionnaire responses. Additional strategies of telephone follow-up and chart review of patients with possible infection and of nonresponders identified more postdischarge infections (33%, 14/42). The overall infection rate was 17% (42/247) compared with 2.8% (7/247) at discharge. CONCLUSION: Postdischarge surveillance approaches need to achieve the best possible response rate, reflect follow-up health care delivery patterns, be cost-effective, gather data from both patients and treating physicians, and use standard definitions to facilitate benchmarking with other health care facilities and surveillance systems. The inclusion of contacting nonresponders in any method of postdischarge surveillance is recommended to determine the most accurate infection rate.

Adolescent↗

Standards for data collection and monitoring in a telemedicine research network.

While a networked, nationwide health information system is financially and logistically impractical, the development of independent, regional systems is realistic and feasible. A Telemedicine Research Network (TRN) could connect a number of geographically disparate health systems. This would require the reconciliation of policies and practices in five principal areas: partner agreement on project scope; privacy, security and confidentiality; technical standards; telecommunications and computer infrastructure; change management and training. Initial establishment of a first-stage TRN would require very little technical development and would, instead, rely on trust among the partners. The development of standards-based TRNs will greatly increase the quality and quantity of telemedicine research.

Confidentiality↗

Automating data collection, analysis & documentation for medical research.

The personal computer (PC) has evolved into a powerful, cost-effective computing platform capable of performing many tasks associated with the management of scientific, clinical, or other information. These activities include: Control of an instrument by the PC; Data acquisition from an experiment or subject; Analysis of the data that the computer has collected; Presentation of the analyzed data in a form that makes it useful; Long term storage of data. Until recently, these tasks required the user to be familiar with a high level programming language (HLL) in order to fulfill these assignments. Arcane text based programs whose logic is often difficult to follow is gradually being replaced by visual programming using a terminology based on icons where ideas familiar to scientists and medical practitioners rely on graphic symbols rather than textual language to describe programming actions.

Microcomputers↗

Is radiation damage dependent on the dose rate used during macromolecular crystallography data collection?

This paper focuses on the radiation-damage effects when applying the same total X-ray dose to protein crystals at different dose rates. These experiments have been performed on both a selenomethionated protein and on bovine trypsin using dose rates that span nearly two orders of magnitude. The results show no clear dose-rate effect on the global indicators of radiation damage, but a small measurable dose-rate effect could be found when studying specific radiation damage. It is hypothesized that this observed dose-rate effect relates to differences in the steady-state free-radical concentration.

Animals↗

A move to electronic patient records in the community: a qualitative case study of a clinical data collection system, problems caused by inattention to users and human error.

With the move toward electronic patient records, many U.K. National Health Service (NHS) Trusts are using computers to make their workforces more clinically effective. This article examines one such system where clinicians are using hand-held computers to maintain up-to-date records on their clients. The effectiveness of the system is measured using standard human computer interaction concepts. The results are considered, leading us to the conclusion that for the effective use of information technology, industry and the NHS must ensure that the whole lifecycle of a project is considered together with its impact on users and its integration with the rest of the information systems.

Computer User Training↗

Principles of data collection applied to customer knowledge.

Are customers becoming more demanding or is the state of excellence in service in the United States in decline? With the dawning of the Age of the Global Marketplace and its attendant competition, American consumers have come to expect a higher standard in products and services. They naturally choose to purchase products that have proved to be well made and reliable. In brief, they require satisfaction. Yet business and medical journals, newspapers, and books all have been eager to tell the story of the sad state of customer service. The "demands of American consumers for high-quality service are higher than ever and businesses that ignore the new realities of customer satisfaction can jeopardize not only their future sales but also their very survival" (Szabo, 1989, p. 16).

Consumer Behavior↗