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PubMedDate not supplied

Adequacy of EMS data collection during pediatric cardiac arrest: are EMTs getting the whole story?

OBJECTIVE: To compare the initial emergency medical services (EMS) prehospital assessment of medical and traumatic cardiopulmonary arrest in the pediatric patient with that of the Office of the Medical Investigator (OMI) and assess differences and implications for EMS training and prevention. DESIGN: Retrospective review of ambulance run forms with the OMI autopsy confirmations. SETTING: An urban EMS system and the state Office of the Medical Investigator. PARTICIPANTS: Patients 15 years of age or less who were treated by prehospital personnel from November 1, 1990, to October 31, 1991, for a medical or traumatic arrest. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Ambulance runs were reported for 2,586 pediatric patients. Of these, 42 (1.6%) had suffered arrests, with 32 (76%) medical arrests and ten (24%) traumatic arrests. Children 1 year of age or less accounted for 75% of the medical arrests, while children more than 1 year of age accounted for 80% of the traumatic arrests (p = 0.003). Overall mortality was 81%. When EMS prehospital assessments of medical and traumatic arrests were compared with autopsy reports, there was good agreement for sudden infant death syndrome (SIDS) (kappa = 0.70), but poor agreement for child abuse (kappa = 0.37). CONCLUSION: The authors found good agreement between EMS prehospital assessments and autopsy diagnoses for identifying pediatric SIDS, but child abuse was not well identified prior to autopsy.

Adolescent↗
PubMed1993

Data collection and changing health care systems. 1. United Kingdom.

The adoption of "Read Clinical Codes" for computerised patient records could profoundly alter the nature and quality of Western medicine in the next decade. The increasing awareness of the need for a standardised coding system has led to the funding of a pilot project to test Read codes in Australian general practice. Read codes are a comprehensive nomenclature of clinical terms incorporating over 100,000 codes in a structured hierarchical form. Designed by a general practitioner, they are now owned, controlled, and developed by the British National Health Service (NHS). Selected as the basis for clinical coding across the NHS, they form the cornerstone of computerised patient records. Computer use has been encouraged in general practice in the UK, with financing schemes and functional inducements resulting in 70% of practices being at least partly computerised, and 84% of these using Read codes. Their promotion has been backed by a major development program to broaden the codes to include all clinical specialities, nursing, and professions allied to medicine. The codes will require significant adaptation for Australian use, including the development of an administrative chapter and a pharmaceutical classification. The impact of information management systems on health care in the UK has relevance for the continuing development of the Australian National Health Information Strategy and for future record keeping in general practice in Australia. If the trial proves successful, the adoption of Read codes as a standard for information management in patient medical records will need to be considered.

Abstracting and Indexing↗
PubMed1992

The role of automated speech recognition in endoscopic data collection.

Speech recognition technology has developed substantially in the past half decade. Currently, large vocabulary, speaker independent, discrete recognizers are the state-of-the-art. This will change. Moderate sized, continuous recognition systems now exist in research settings. However, it is unlikely that such systems will be widely available until the mid to late 1990's. The accuracy rates of current speech recognition systems are high. Consequently, speech accuracy is not the current limiting aspect of using ASR. The limiting aspect of using ASR technology is the approach to integrating speech functionality into applications. One approach is to use ATNs as models of natural language to support both an input strategy and a text generation system. ATNs provide approaches to both syntactical correctness and semantic richness. This is an approach which plays to the strengths of the discrete nature of current speech technology and also provides a methodology for the capture and archiving of highly detailed information. The ATN approach avoids the natural language parsing problem created by a fully free form dictation interface. Evolving along with the underlying speech technology are standards in the definitions and criteria used in endoscopic practice. There are clear benefits from standards in this area. However, it is likely that this will also take several years and may never yield a universally accepted lexicon. Furthermore, there will be user interface barriers to surmount in any system attempting to use speech as an input modality. Because of the relatively large vocabularies used in medical discourse, the user interface will need to be carefully crafted.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection↗
PubMed1995

International rankings of infant mortality and the United States' vital statistics natality data collecting system--failure and success.

BACKGROUND: International rankings of infant mortality rates have been consistently lower for the US than other industrialized countries, and this ranking has been falling. This study examines the influence of birth registrations among very low birthweight infants on these international rankings. METHODS: Birth rates of infants weighing < 1500 g (VLBW) reported by Japan, Sweden, the Netherlands, France, the UK and Canada were compared to the rates of infants of this weight born in the US, and these rates were correlated with the infant mortality rates reported by these countries. Also, deaths in the first 24 hours after birth were correlated with the reported mortality rates. RESULTS: Countries with the lowest infant mortality rates tended to have the lowest incidence of births < 500 g (correlation coefficient, r = 0.73) and of births 500-999 g (correlation coefficient, r = 0.81). When white and black newborns in the US were reported separately, the correlation coefficients were 0.96 and 0.97 for these weights. Furthermore, the countries with the lowest infant mortality rates registered the fewest number of deaths in the first 24 hours after birth, correlation coefficient, r = 0.78; when white and black newborns were reported separately, r = 0.95. In addition, the international rankings of the US, 1969-1988, when correlated with the annual birth rate of white infants < 500 g registered in this country was r = 0.78. CONCLUSION: Differences in birth registration practices for infants weighing < 1500 g are primarily responsible for the poor, deteriorating performance by the US in the international rankings of neonatal mortality rates.

Birth Rate↗
PubMed2005

Optimal experiment design for cardinal values estimation: guidelines for data collection.

Optimal experiment design for parameter estimation (OED/PE) is an interesting technique for modelling practices when aiming for maximum parameter estimation accuracy. Nowadays, experimental designs for secondary modelling within the field of predictive microbiology are mostly arbitrary or based on factorial design. The latter type of design is common practice in response surface modelling approaches. A number of levels of the factor(s) under study are selected and all possible treatment combinations are performed. It is however not always clear which levels and treatment combinations are most relevant. An answer to this question can be obtained from optimal experiment design for-in this particular case-parameter estimation. This technique is based on the extremisation of a scalar function of the Fisher information matrix. The type of scalar function determines the final focus of the optimised design. In this paper, optimal experiment designs are computed for the cardinal temperature model with inflection point (CTMI) and the cardinal pH model (CPM). A model output sensitivity analysis (depicting the sensitivity of the model output to a small change in the model parameters) yields a first indication of relevant temperature or pH treatments. Performed designs are: D-optimal design aiming for a maximum global parameter estimation accuracy (by minimising the determinant of the Fisher information matrix), and E-optimal design improving the confidence in the most uncertain model parameter (by maximising the smallest eigenvalue of the Fisher information matrix). Although lowering the information content of a set of experiments, boundary values on the design region need to be imposed during optimisation to exclude unworkable experiments and partly account for incorrect nominal parameter values. Opposed to the frequently applied equidistant or arbitrary treatment placement, optimal design results show that typically four informative temperature or pH levels are selected and replicate experiments are to be performed at these points. Informative experiments are typically placed at points with an extreme model output sensitivity.

Bacteria↗
PubMed2003

System to monitor task chair seating.

OBJECTIVE: To record chair data such as seat occupancy, back recline angle, lumbar engagement, and armrest location using an independent, unbiased real time data acquisition system. DESIGN: The system should be inconspicuous. The users should be able to work effectively in their environment oblivious to concurrent data collection. BACKGROUND: While human acquisition and measurement instruments provide an acceptable approach for collecting data on changing chair positions, they may bias data. Current data collection methods such as video playback can also be successful in collecting chair data, but are often time-consuming and expensive to set up. METHODS: Four key areas were concentrated upon for monitoring: seat, lumbar, back recline, and armrest position. A position switch was mounted to each locale and linked to a microprocessor to track the changing positions of the chair in real time. RESULTS: The chair provides time stamped data on the changes that take place to the chair. The data can be downloaded at the convenience of the user and researcher. CONCLUSIONS: The chair is complete and ready for data acquisition. It permits easy data collection on chair positions without hindering the user's movement. RELEVANCE: This tool provides an automated, independent method for collecting data on chair positions. Information can be collected and studies conducted on seated durations, chair back motion while seated, chair lumbar usage, and common armrest location while in a visual display terminal workstation.

Data Collection↗
PubMed2006

The ATTEMPT cohort: a multi-national longitudinal study of predictors, patterns and consequences of smoking cessation; introduction and evaluation of internet recruitment and data collection methods.

AIMS: The ATTEMPT study was designed to chart the natural history of smoking cessation and associated short-term health outcomes and effects on medical resource utilization among a cohort recruited across multiple countries. This paper describes the methods for recruitment and follow-up, the baseline population characteristics of the enrolled population and 1-year response rates. DESIGN: ATTEMPT is a multi-national prospective cohort study that used the internet for subject recruitment and online assessments every 3 months for 2.5 years. SETTING: Subjects were recruited via e-mail from existing internet panels [Canada (n = 208), France (n = 201), the United Kingdom (n = 200) and the United States (n = 1400]. SUBJECTS: Panel members who were aged 35-65 years, smoked at least five cigarettes per day and at initiation stated an intention to quit smoking within the next 3 months were eligible for this study. MEASUREMENTS: Measures included: attempts to quit, smoking status, smoking history, nicotine dependence and craving, methods used to quit smoking, reasons for quitting or failing to quit smoking, short-term health effects, health resource utilization, wellbeing, concern over weight gain, confidence in preventing weight gain, body weight and demographics. In addition, in-home assessments of weight were undertaken by field staff for a random sample of US participants. FINDINGS: Country-specific recruitment was completed within 17 days. The recruitment method produced a sample with characteristics broadly similar to those found in national surveys of smokers except for higher prevalence of obesity in the US and Canadian samples and higher educational level. At the end of 1 year the response rate was 52%, and there was little evidence of differential loss to follow-up by key subject characteristics. Weight reported in the survey was found to correlate highly with weight measured during in-home visits. CONCLUSION: This paper demonstrates the feasibility of enrolling and following a diverse cohort of smokers for self-reported health and behaviour measures via the internet.

Adult↗
PubMed2000

Transcutaneously tunneled central venous lines in cancer patients: an analysis of device-related morbidity factors based on prospective data collection.

BACKGROUND: Long-term transcutaneous tunneled central venous catheters are frequently placed in cancer patients, accounting for significant costs and morbidity. Factors influencing outcome, though, are poorly studied. METHODS: Between June 1991 and June 1993, 923 central venous tunneled catheters were placed in 791 patients at Memorial Sloan-Kettering Cancer Center. Placement-, device-, and patient-related parameters were charted prospectively (median follow-up: 120 days) and correlated to device-specific outcome events. RESULTS: Median patient age was 28.5 years (range: 0.025 - 84.5). Disease distribution included hematologic malignancies (64.7%), solid tumors (30.4%), and others (4.9%). Primary indications for line access included chemotherapy (72.8%), bone marrow transplantation (18.7%), total parenteral nutrition (6.4%), and drug administration (2.1%). There were 11 insertion complications (1.2%), including insertion failure (n = 6), hemorrhage (n = 4), and malposition (n = 1). Subsequent to placement, a proven or suspected device-specific complication occurred in 540 lines (58.5%). Per 10,000 catheter days, there were 17.6 infection episodes, 8.1 thrombotic complications, 6.9 instances of catheter breakage, 3.5 accidental or inadvertent cases of displacement, and 0.6 device leaks. Reasons for line removal or other termination of follow-up were patient's death (32.1%), treatment end (28%), infection (19.6%), suspected infection (6.3%), displacement (6.8%), thrombosis (3.1%), leak (1%), and others (3.1%). Median device-specific duration was 365 days, compared with a median complication-free device-specific duration of 167 days (P < 0.0001), reflecting a highly significant device salvage rate after complications. Catheter tip position emerged as the dominant independent prognostic factor for reduced device-specific duration or complication-free device-specific duration. CONCLUSIONS: Transcutaneous tunneled central venous lines can be placed safely, with a considerable incidence of subsequent device-specific complications, but a high salvage rate. Factors determining outcome are related to device placement, as well as the patient's disease status. In this study, patients alive 90 days after catheter placement had a 37% chance for a device complication, with a 20% chance for device loss. Future analyses of intermediate-term intravenous access should employ the measurement of device-specific outcome as a reference parameter to assess clinical results.

Adolescent↗
PubMed1996

CDC data systems collecting behavioral data on HIV counseling and testing.

This paper describes two systems, the HIV Counseling and Testing Data System and the National Health Interview Survey, AIDS Knowledge and Attitudes Supplement, that collect behavioral information on HIV counseling and testing in the United States. Together these data sources provide valuable information for planning and evaluating counseling and testing programs. While these two systems are not designed primarily for behavioral research, they both collect behavioral data, including the behavioral risk category of persons being tested.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Reproducibility of reported farming activities and pesticide use among breast cancer cases and controls. A comparison of two modes of data collection.

PURPOSE: Farming is associated with exposure to many potential hazards including pesticides and other agents, but the quality of self-reported data on farm exposures has not been well studied. METHODS: The reproducibility of self-reported farming history was evaluated among women in a population-based, case-control study of breast cancer in North Carolina. Thirty cases and 31 controls were randomly re-interviewed by telephone an average of 13.8 months after the initial interview. The initial interview was based on a farm-by-farm questionnaire, while the repeat interview was based on a shorter ever/never questionnaire. Agreement was estimated using proportions in exact agreement, kappa (kappa), and intraclass correlation coefficients (ICC). RESULTS: In general, group prevalences and means were higher on re-interview. Kappa estimates ranged from 0.15 to 0.84 among cases, and 0.26 to 0.87 among controls, with most estimates falling between 0.5 and 0.8. Moderate to almost perfect agreement (kappa) was observed for questions on crop work (0.47-0.70), crop type (0.56-0.82), pesticide application to tobacco (0.77), and farm residence (0.84). ICC estimates for continuous variables showed fair to substantial agreement (0.30 to 0.69 among cases, 0.38 to 0.69 among controls). Older cases, less educated cases, cases who lived on more than one farm, and cases with longer time intervals between interviews gave lower total agreement than similar groups of controls. CONCLUSIONS: Agreement estimates in this study are similar to those for other types of exposure information typically collected in epidemiologic studies. Nevertheless, a farm-by-farm method of exposure assessment may be preferable to an ever/never determination.

Agriculture↗
PubMed2002

Do interviewers' health beliefs and habits modify responses to sensitive questions? A study using data Collected from pregnant women by means of computer-assisted telephone interviews.

If interviewers' personal habits or attitudes influence respondents' answers to given questions, this may lead to bias, which should be taken into consideration when analyzing data. The authors examined a potential interviewer effect in a study of pregnant women in which exposure data were obtained through computer-assisted telephone interviews. The authors compared interviewer characteristics for 34 interviewers with the responses they obtained in 12,910 interviews carried out for the Danish National Birth Cohort Study. Response data on smoking and alcohol consumption in the first trimester of pregnancy were collected during the time period October 1, 1997-February 1, 1999. Overall, the authors found little evidence to suggest that interviewers' personal habits or attitudes toward smoking and alcohol consumption during pregnancy had consequences for the responses they obtained; neither did the interviewers' education, age, or parity correlate with the answers they obtained. In these data gathered through computer-assisted telephone interviews, interviewer effects arising from variations in interviewers' health beliefs and personal habits were found to be negligible. Thorough training of the interviewers and continuous supervision may have contributed to this finding.

Adult↗
PubMed2003

Influence of network topology and data collection on network inference.

We recently developed an approach for testing the accuracy of network inference algorithms by applying them to biologically realistic simulations with known network topology. Here, we seek to determine the degree to which the network topology and data sampling regime influence the ability of our Bayesian network inference algorithm, NETWORKINFERENCE, to recover gene regulatory networks. NETWORKINFERENCE performed well at recovering feedback loops and multiple targets of a regulator with small amounts of data, but required more data to recover multiple regulators of a gene. When collecting the same number of data samples at different intervals from the system, the best recovery was produced by sampling intervals long enough such that sampling covered propagation of regulation through the network but not so long such that intervals missed internal dynamics. These results further elucidate the possibilities and limitations of network inference based on biological data.

Algorithms↗
PubMed2004

A comparison of pressure ulcer prevalence: concerted data collection in the Netherlands and Germany.

OBJECTIVES: Because of a lack of epidemiological data of pressure ulcer (PU) among care dependent patients yearly prevalence measurements are held in the Netherlands and in Germany with identical methods. A comparison shows remarkable differences in the PU prevalence so that further analysis is needed to enlighten the reasons. DESIGN: With a standardized questionnaire all patients were examined by trained nurses of the participating facilities. SETTING: In-patients in 42 Dutch and 10 German acute care Hospitals. PARTICIPANTS: All patients who handed in their informed consent were included. In the Netherlands n = 8734, and in Germany n = 2832. MAIN OUTCOME MEASURES: For calculating the PU prevalence the sample was divided inpatients at risk and not at risk for PU in accordance to the Bradenscale. Comparisons between the Netherlands and Germany refer to population details, quota of patients at risk for PU and PU prevalence. Finally the impact of eight controlled variables on the PU occurrence was calculated in a logistic regression. RESULTS: Both samples showed the same sex distribution, the same mean age and the same distribution among the medical specialties. The share of patients at risk for PU is higher in the Netherlands (55%) than in Germany (38%). The frequency of PU is higher in the Dutch population (22%) than in the German one (12%). Regarding only the risk-patients the differences reduce. The prevalence in the Netherlands was 33%, in Germany it was 28%. The highest impact on PU occurrence had the age and the length of stay in hospital. The Country ranges on third position. CONCLUSIONS: The Dutch sample had a higher share of risk-patients and a higher PU frequency. A standardization appropriate to a risk assessment reduce the differences. For enlightening the remaining differences further research is needed.

Aged↗
PubMed1987

Comparison of 360 degrees and 180 degrees data collection in SPECT imaging.

The problem of using 360 degrees or 180 degrees data sampling techniques in transaxial SPECT imaging is still to be solved. A theoretical point source study for an ideal response detector has shown, for objects which are close enough to the origin of the reconstructed area, that there are significant differences between sections obtained by different sampling methods. A computer simulation study of line sources in a homogeneous attenuated medium has confirmed the results of clinical studies in which significant image distortion has been observed in 180 degrees sections but not in 360 degrees reconstructed images.

Computer Simulation↗
PubMed2005

A latent markov model for the analysis of longitudinal data collected in continuous time: states, durations, and transitions.

Markov models provide a general framework for analyzing and interpreting time dependencies in psychological applications. Recent work extended Markov models to the case of latent states because frequently psychological states are not directly observable and subject to measurement error. This article presents a further generalization of latent Markov models to allow for the analysis of rating data that are collected at arbitrary points in time. This extension offers new ways of investigating change processes by focusing explicitly on the durations that are spent in latent states. In an experience sampling application the author shows that such duration analyses can provide valuable insights about chronometric features of emotions.

Humans↗