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[Interferon treatment of chronic hepatitis C--assessment of predictive factors to the effect of interferon treatment using multivariate analysis with the logistic regression model].

We treated 156 chronic hepatitis C patients with alpha-interferon (IFN) and assessed the response rate and the predictive factors to the effect of IFN treatment. Complete response (CR) rate was 39.1%, and CR with serum HCV-RNA disappearance rate was 29%. CR to IFN treatment was dependent on HCV serotype and serum HCV-RNA. Patients of serotype II and low serum HCV-RNA were effective to IFN treatment.

Adult↗

Logistic analysis of the effects of shovel trait on Carabelli's trait in a Mongoloid population.

Mongoloid populations differ from Caucasoids by having a high prevalence of shovel trait and a low prevalence of Carabelli's trait. This study was conducted to investigate the effects of the shovel trait on Carabelli's trait in a Mongoloid population. The research design sought a population that resides in an isolated area and exhibits low admixture with neighboring populations. The Mongoloid group selected for study was the Bunun tribe of aborigines who inhabit an alpine area in Taiwan. The effects of sex and age on Carabelli's trait were controlled in this investigation, as was the association between tooth size and Carabelli's trait. Results show that males were more likely to have Carabelli's trait expressed on teeth than females. The buccolingual diameter of Carabelli's trait teeth was larger than that of teeth without the trait. After adjusting for sex, age, and tooth size, the existence of the shovel trait increased the likelihood of having Carabelli's trait by a factor of three, an effect that is significant.

Adolescent↗

Cognitive-behavioral group psychotherapy of bulimia nervosa: importance of logistical variables.

Although much of the psychotherapy for psychiatric disorders is conducted on a weekly basis, several researchers in the field of bulimia nervosa have utilized a more intensive approach as a means to strengthen treatment effects. A second issue concerns the amount of emphasis that should be placed on encouraging the interruption of bulimic symptoms early in treatment. In the current study we systematically studied these two issues. Subjects were randomly assigned to one of four forms of cognitive-behavioral group psychotherapy, the four cells differing on the variables of intensity and emphasis on abstinence. The results indicate that a high intensity approach, an early abstinence approach, or a combination of these two approaches are all significantly more effective in inducing remission in patients with bulimia nervosa compared with a weekly psychotherapy that uses the same manual-based cognitive-behavioral therapy approach.

Adolescent↗

The logistics of drug monitoring.

Although opinions differ to some extent there is increasing belief in the value of monitoring plasma levels for effective therapy with neuropsychiatric drugs, especially with anticonvulsants. Monitoring should not be on a comprehensive and routine basis, but should be selective and discriminating. In these circumstances the expenditure incurred on the laboratory operations involved might work out for Britain at about pounds 5 million per year. This figure should be compared to a total annual expenditure from the prescribing of neuropsychiatric medication amounting to an estimated pounds 40 million per year. The benefits thus achieved in patient care, together with the possible economies in prescribing, could well merit this monitoring exercise. In terms of personnel and administration, the laboratory facilities could be organized on a regional, or on a district general hospital, basis.

Costs and Cost Analysis↗

Marketing and logistical strategies for continuing education programs.

Knowledge of market behavior and use of marketing strategies assist the continuing education department to increase its market share and attract a return audience. Market-oriented strategies involve defining the targeted audience and marketable topics, analyzing market behavior in terms of factors such as time, cost and location of conferences, and developing an effective program advertisement strategy.

Advertising↗

Medication refill logistics and refill adherence in HIV.

PURPOSE: Strict adherence to antiretroviral therapy is instrumental in viral suppression and treatment success. The relation between pharmacy-based factors and treatment adherence has been under-explored. We aimed to determine whether different medication refill mechanisms were associated with differences in antiretroviral refill adherence. METHODS: We conducted a retrospective cohort study of 110 HIV-infected subjects on standard antiretroviral regimens for >or=3 months cared for at the Philadelphia Veterans' Affairs Medical Center HIV clinic. The primary outcome was a pharmacy-based measure of antiretroviral refill adherence over the 3 months of treatment immediately prior to the study date. RESULTS: The group obtaining refills at the pharmacy had lower adherence [80% (interquartile range (IQR), 69-99%)] than the group obtaining refills via pill organizers dispensed by a pharmacist [99% (IQR, 97-100%), p=0.003] and the group obtaining refills via mail order [91% (IQR, 79-100%); p=0.04]. CONCLUSIONS: Mail ordering and pharmacists dispensing refills in pill organizers may each be effective strategies for improving medication adherence, although they target different barriers and differ in their degree of intensity. Each should be considered for adherence interventions in HIV and further studied in other disease and treatment settings.

Adult↗

Data monitoring and interim analyses in the pharmaceutical industry: ethical and logistical considerations.

The characteristics of data monitoring and the need for the use of data monitoring committees in clinical trials sponsored by the pharmaceutical industry differ from those of trials sponsored by government. Data monitoring is a continuous process in industry trials due to the regulatory requirements and the need to more thoroughly evaluate safety of new compounds. As part of this process, interim analyses are employed to make decisions about treatment effects. In some cases, such analyses may require the use of an external data monitoring committee to assist in the data review, analysis and decision making. A number of examples of interim analyses, with and without data monitoring committees, are discussed. Issues surrounding the need for external data monitoring committees and recommendations are presented. In particular the issues of sponsor participation in the data monitoring committee and controls of the decision making process are considered.

Clinical Trials Data Monitoring Committees↗