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At least 127 records · Page 7Linked to original sources
PubMed2004

Can the addition of interpretative comments to laboratory reports influence outcome? An example involving patients taking thyroxine.

INTRODUCTION: There is little evidence that the addition of interpretative comments to biochemistry reports can influence outcome for patients. Interpretative comments on thyroid function test (TFT) requests were introduced in Hull in August 1999, providing the opportunity to determine whether feedback on hypothyroid patients taking thyroxine could lead to a reduction in the proportion whose thyroxine was inadequately replaced. PATIENTS AND METHODS: The study comprised 15 584 TFT requests, made from 1 August 1999 to 30 August 2002 by general practitioners (GPs), for 8281 patients taking thyroxine. Under-replacement of thyroxine, defined as a TSH concentration above the upper reference limit (i.e. 4.7 mU/L), was usually commented on in the biochemical report. RESULTS: In the first, second and third years following introduction of interpretative comments, the proportions of samples with a TSH concentration of >4.7 mU/L were 21.3%, 17.6% and 16.6%, respectively (chi(2)(trend) = 43.1, P <0.0001). The proportion with a TSH concentration of <0.1 mU/L showed a more modest change, from 12.5% in year 1 to 14.0% and 14.8% in years 2 and 3, respectively (chi(2)(trend) = 22.3, P <0.0001). CONCLUSION: This study shows that in the three years following the introduction of interpretative comments there was a 22% reduction in the number of GPs' samples indicating thyroxine under-replacement. It seems likely that these data provide evidence that comments can indeed influence the biochemical outcome of patients.

Antithyroid Agents↗
PubMed1991

Reactivity in self-recording: obtrusiveness of recording procedure and peer comments.

Reactivity refers to behavior change that occurs during self-recording without specific programming of consequences. We analyzed the effects of obtrusiveness of recording procedure and peer comments on reactivity to self-recording. Three first-grade students in Experiment 1 completed math questions during a 5-min work period. When we gave the children recording devices and told them to try to complete more questions than the highest number they had previously completed, math performance increased, as did the number of verbalizations about it. Two children showed more reactivity when they used the more obtrusive recording device. Because the increase in math performance corresponded closely to increases in peer comments, we manipulated peer comments directly in Experiment 2. Four second-grade students completed a math task and an alphabet task. Three of the students showed increased math performance during periods when peer comments occurred compared to periods when peer comments did not occur. Although the data from the math task suggested that peer comments can enhance reactivity, we did not observe this relationship with the alphabet task. These results suggest that the conditions necessary to produce desirable results through self-recording are complex and contextually specific.

Auditory Perception↗
PubMed2000

Medicare program; prospective payment system for hospital outpatient services. Health Care Financing Administration (HCFA), HHS. Interim final rule with comment period.

This interim final rule with comment period provides for the annual update to the Medicare hospital outpatient prospective payment system conversion factor that is used to calculate the payment amount for each payment group, effective January 1, 2001. It also updates the wage index values and incorporates the year 2001 changes in the procedure codes that are used to make payments under this system. In this rule, we are also responding to public comments received on those portions of the April 7, 2000 final rule with comment period (which established the hospital outpatient prospective payment system) that implemented related provisions of the Balanced Budget Refinement Act (BBRA) of 1999. In addition, we are responding to public comments on the August 3, 2000 interim final rule with comment period that modified the April 7, 2000 final rule with comment period by revising the criteria used to define new or innovative medical devices, drugs, and biologicals eligible for transitional pass-through payments and correcting the criteria for grandfathering provider-based Federally Qualified Health Centers (FQHC) into the prospective payment system.

Ambulatory Care↗
PubMed2001

Medicare and Medicaid programs; physicians' referrals to health care entities with which they have financial relationships. Health Care Financing Administration (HCFA), HHS. Final rule with comment period.

This final rule with 90-day comment period (Phase I of this rulemaking) incorporates into regulations the provisions in paragraphs (a), (b), and (h) of section 1877 of the Social Security Act (the Act). Under section 1877, if a physician or a member of a physician's immediate family has a financial relationship with a health care entity, the physician may not make referrals to that entity for the furnishing of designated health services (DHS) under the Medicare program, unless an exception applies. The following services are DHS: clinical laboratory services; physical therapy services; occupational therapy services; radiology services, including magnetic resonance imaging, computerized axial tomography scans, and ultrasound services; radiation therapy services and supplies; durable medical equipment and supplies; parenteral and enteral nutrients, equipment, and supplies; prosthetics, orthotics, and prosthetic devices and supplies; home health services; outpatient prescription drugs; and inpatient and outpatient hospital services. In addition, section 1877 of the Act provides that an entity may not present or cause to be presented a Medicare claim or bill to any individual, third party payer, or other entity for DHS furnished under a prohibited referral, nor may we make payment for a designated health service furnished under a prohibited referral. Paragraph (a) of section 1877 of the Act includes the general prohibition. Paragraph (b) of the Act includes exceptions that pertain to both ownership and compensation relationships, including an in-office ancillary services exception. Paragraph (h) includes definitions that are used throughout section 1877 of the Act, including the group practice definition and the definitions for each of the DHS. We intend to publish a second final rule with comment period (Phase II of this rulemaking) shortly addressing, to the extent necessary, the remaining sections of the Act. Phase II of this rulemaking will address comments concerning the ownership and investment exceptions in paragraphs (c) and (d) and the compensation exceptions in paragraph (e) of section 1877 of the Act. Phase II of this rulemaking will also address comments concerning the reporting requirements and sanctions provided by paragraphs (f) and (g) of the Act, respectively, and include further consideration of the general exception to the referral prohibition related to both ownership/investment and compensation for services furnished in an ambulatory surgical center (ASC), end-stage renal dialysis facility, or by a hospice in section 411.355(d) of the regulations (this exception presently is in force and effect as to clinical laboratory services). In addition, Phase II of this rulemaking will address section 1903(s) of the Act, which extends aspects of the referral prohibition to the Medicaid Program. Phase II will also address comments received in response to this rulemaking, as appropriate, and certain proposals for new exceptions to section 1877 of the Act not included in the 1998 proposed rulemaking, but suggested in the public comments.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2004

Medicaid program; time limitation on record keeping requirements under the drug rebate program. Interim final rule with comment period.

On August 29, 2003, we published a final rule with comment period in the Federal Register that finalized two specific provisions: it established new 3-year recordkeeping requirements for drug manufacturers under the Medicaid drug rebate program and set a 3-year time limitation during which manufacturers must report changes to average manufacturer price and best price for purposes of reporting data to us. In addition, it announced the pressing need for codification of fundamental recordkeeping requirements. On September 26, 2003, we issued a correction notice to change the effective date of the August 29, 2003 rule from October 1, 2003 to January 1, 2004. In this interim final rule with comment period, we are removing the 3-year recordkeeping requirements, replacing them with 10-year recordkeeping requirements on a temporary basis, and soliciting comments on the 10-year requirements. Manufacturers must retain records beyond the 10-year period if the records are the subject of an audit or a government investigation of which the manufacturer is aware. These provisions contain a sunset date with respect to the record retention requirements to ensure that we reexamine whether the retention rule remain necessary and effective. This interim final rule with comment period also responds to public comments on the August 29, 2003 final rule with comment period that pertain to the 3-year recordkeeping requirement at Sec. 447.534(h).

Forms and Records Control↗
PubMed2006

Medicare program; hospital outpatient prospective payment system and CY 2007 payment rates; CY 2007 update to the ambulatory surgical center covered procedures list; Medicare administrative contractors; and reporting hospital quality data for FY 2008 inpatient prospective payment system annual payment update program--HCAHPS survey, SCIP, and mortality. Final rule with comment period and final rule.

This final rule with comment period revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system, and to implement certain related provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 and the Deficit Reduction Act (DRA) of 2005. In this final rule with comment period, we describe changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2007. In addition, this final rule with comment period implements future CY 2009 required reporting on quality measures for hospital outpatient services paid under the prospective payment system. This final rule with comment period revises the current list of procedures that are covered when furnished in a Medicare-approved ambulatory surgical center (ASC), which are applicable to services furnished on or after January 1, 2007. This final rule with comment period revises the emergency medical screening requirements for critical access hospitals (CAHs). This final rule with comment period supports implementation of a restructuring of the contracting entities responsibilities and functions that support the adjudication of Medicare fee-for-service (FFS) claims. This restructuring is directed by section 1874A of the Act, as added by section 911 of the MMA. The prior separate Medicare intermediary and Medicare carrier contracting authorities under Title XVIII of the Act have been replaced with the Medicare Administrative Contractor (MAC) authority. This final rule continues to implement the requirements of the DRA that require that we expand the "starter set" of 10 quality measures that we used in FY 2005 and FY 2006 for the hospital inpatient prospective payment system (IPPS) Reporting Hospital Quality Data for the Annual Payment Update (RHQDAPU) program. We began to adopt expanded measures effective for payments beginning in FY 2007. In this rule, we are finalizing additional quality measures for the expanded set of measures for FY 2008 payment purposes. These measures include the HCAHPS survey, as well as Surgical Care Improvement Project (SCIP, formerly Surgical Infection Prevention (SIP)), and Mortality quality measures.

Forms and Records Control↗
PubMed2004

Do Barbary macaques 'comment' on what they see? A first report on vocalizations accompanying interactions of third parties.

Primates acquire knowledge about relationships of third parties and group structure by monitoring their conspecifics. We show that Barbary macaques (Macaca sylvanus) utter specific vocalizations while monitoring interactions of other group members. As they did not direct other behaviours to the interacting group members, we provisionally termed these vocalizations 'vocal comments'. We investigated the acoustic properties of these comments and the social contexts in which they occurred. Most adult males and females of two studied groups produced low-amplitude calls when observing close contact interactions of other group members. The acoustic features of these calls varied with characteristics of the commented situation. Our results suggest that such calls might not be directed towards the agents of the commented situation, but towards other group members. The vocal comments may signal the caller's awareness of the observed interaction and possibly attract the attention of others to the situation.

Animals↗
PubMed2004

How to reply to referees' comments when submitting manuscripts for publication.

BACKGROUND: The publication of articles in peer-reviewed scientific journals is a fairly complex and step-wise process that involves responding to referees' comments. Little guidance is available in the biomedical literature on how to deal with such comments. OBJECTIVE: The objective of this article is to provide guidance to novice writers on dealing with peer review comments in a way that maximizes the chance of subsequent acceptance. METHODS: This will be a literature review and review of the author's experience as a writer and referee. RESULTS: Where possible, the author should consider revising and resubmitting rather than sending an article elsewhere. A structured layout for responding to referees' comments is suggested that includes the 3 golden rules: (1) respond completely; (2) respond politely; and (3) respond with evidence. CONCLUSION: Responding to referees' comments requires the writer to overcome any feelings of personal attack, and to instead concentrate on addressing referees' concerns in a courteous, objective, and evidence-based way.

Editorial Policies↗
PubMed2003

Welsh women's comments about breast problems and the care given: a qualitative study in the community.

The aim of this study was to undertake a systematic analysis, using qualitative software, of the free text comments from a postal survey exploring women's experiences of breast symptoms, their expectations of treatment, knowledge of breast cancer risk factors and perceptions of risk, in 34 group general practices in South Wales. The 959 women who returned the questionnaire, out of 1126 (response rate 85%), comprised 497 women who consulted their general practitioner (GP) with a new breast symptom during the baseline data collection period and 462 controls who had not. When the survey was conducted the researchers did not know whether these women had cancer or had previously been treated for it. One-third (33.1%) of those returning the survey (n = 318) wrote comments. Compared to the rest, they were significantly more likely to have consulted their GP for a new breast symptom and to have stayed on at school and/or gone on to more education or training. The majority wrote about their own experience of breast symptoms and/or the care received in primary and secondary settings. The general tone was factual and when evaluation took place positive comments were more frequent than negative ones. Nothing suggested that the respondents had been upset or made more anxious by the preceding questions on such a potentially sensitive topic. Free text comments gathered in surveys can provide valuable data if systematically analysed. Doctors, particularly GPs, can be reassured that more women in this community sample who expressed an opinion on care were positive. The negative comments, however, highlight issues that still need to be addressed in therapeutic relationships.

Adolescent↗
PubMed1999

Reflections on written comments by women on their abuse.

In a study to differentiate injuries of physical abuse from non-physical abuse, 103 women wrote uninvited comments that were analyzed in two ways: Q-sort and phenomenology analyses. Q-sort identified two categories: helplessness and assertiveness. Comparisons with subject responses about current or previous violence indicated that women who wrote assertive comments were less likely to be in a violent relationship than women who wrote helpless comments. Phenomenological analysis indicated that women who were categorized as silent, received or subjective were in abusive relationships; some had been abused on the day of admission. Two women wrote comments considered subjective procedural; both were living with their abuser and stated that the abuse no longer occurred. Health-care professionals must question the appropriate goal to counsel abused women. Whether these two continua reflect a readiness to leave the relationship or result from having left, the comments by two women who say they are no longer being abused are more assertive and appear to show higher levels of knowing.

Adult↗
PubMed2005

Internet comments on media reporting of two adolescents' collective suicide attempt.

The presented study covered the analysis of 7 Internet media portrayals and 188 readers' spontaneous Internet comments about a case of two adolescents who survived a serious suicide attempt. Articles with photographs attracted the most responses (82%), irrespective of the length and content of the articles. More than half of the comments expressed readers' negative attitude (ironic 31% and angry 28%) while 21% of them remained neutral or indifferent. Twenty one percent of readers tried to initiate a serious discussion about the causes and prevention of suicide. An association was found between the style of media reporting and the number of readers' comments as well as certain aspects of the content of the comments. Inadequate reporting of suicidal behavior is associated with comments expressing oversimplified attitudes towards suicide. The influence of suicide reporting on the Internet on attitude formation in the general population should not be underestimated.

Adolescent↗
PubMed2002

Impact of a specific echocardiographic report comment regarding endocarditis prophylaxis on compliance with American Heart Association recommendations.

BACKGROUND: There is substantial underuse and overuse of antibiotic prophylaxis. Current American Heart Association (AHA) recommendations are heavily dependent on echocardiographic data that may not be familiar to referring physicians. We sought to determine the impact of a specific prophylaxis report comment on compliance with AHA recommendations. METHODS AND RESULTS: Using a standardized electronic reporting system, physicians interpreting approximately 50% of echocardiograms included a concluding comment classifying endocarditis risk and stating whether prophylaxis was indicated. The remaining reports were identical in format/content but did not include such comments. Of 1461 eligible outpatients during a 6-month period, 969 (66.3%) responded to a mail survey regarding prophylaxis instructions. Overall, 50% reported taking prophylaxes. Compliance with AHA recommendations was greater among those with a comment (73.2% versus 65.4% for those receiving versus those not receiving comments, respectively; P=0.011), with particular improvement among moderate-risk patients (69.5% versus 59.9%, P=0.024). CONCLUSIONS: An echocardiographic report statement regarding endocarditis risk and need for prophylaxis is a simple low-cost intervention that improves compliance with AHA recommendations. Interpreting physicians should become familiar with AHA recommendations and include a concluding statement addressing prophylaxis.

Adult↗
PubMed1991

[Development and evaluation of the comment aid system for therapeutic drug monitoring. I. Application to valproate].

A comment aid system for therapeutic drug monitoring (TDM), which produces the primary comment on the dosage regimen of valproate, was developed. This system produces consulting comments with a fuzzy theory, by using the dosage regimen of valproate, pharmacokinetic parameters estimated by the Bayesian method, and therapeutic effect and toxicity of anticonvulsants evaluated by the physician. For nearly 90% in 42 cases, comments of the system were agreeable comparing with the notes of TDM technologists. There are a few disagreements between this system and experts, mainly because the system does not use enough information about combination therapy with other anticonvulsants. Developed comment aid system shows some clinical and educational utility, and suggests significance and possibility of more useful and al around TDM expert system. Then this system might be available as a prototype of the TDM expert system.

Adolescent↗
PubMed1980

[Effects of stress comments on autonomic measures during the performance of a task (author's transl)].

The present study examined the effects of stressful comments on autonomic measures during the performance of a task. Thirty subjects were assigned at random to the stress condition (S group) and to the nonstress condition (NS group). Negative and stressful comments were given to the S group. Positive and comfortable comments were given to the NS group after the performance. The results showed that heart rates were much higher during the performance than during the adaptation and the rest period, although they were not affected by the negative comments. Vasoconstriction was significantly larger in the S group than in the NS group. In conclusion, vasoconstriction was more sensitive to the stressful comments than heart rate was.

Adolescent↗
PubMed1995

Medicare program; schedule of limits on home health agency costs per visit--HCFA. Notice with comment period.

This notice with comment period sets forth a revised schedule of limits on home health agency costs that may be paid under the Medicare program for cost reporting periods beginning on or after July 1, 1993. These limits replace the per-visit limits that were set forth in our July 8, 1993 notice with comment period (58 FR 36748). This notice also provides, in accordance with the provisions of the Omnibus Budget Reconciliation Act of 1993 (OBRA '93), that there will be no changes in the home health agency (HHA) cost limits for cost reporting periods beginning on or after July 1, 1994, and before July 1, 1996. In addition, this notice responds to public comments on the July 8, 1993 notice with comment period, which originally set forth the HHA cost limits for cost reporting periods beginning on or after July 1, 1993, and on the January 6, 1994 notice with comment period (59 FR 760), which announced the elimination of the hospital based add-on effective for cost reporting periods beginning on or after October 1, 1993.

Allied Health Personnel↗
PubMed1995

Medicare program; additions to and deletions from the current list of covered surgical procedures for ambulatory surgical centers--HCFA. Final notice with comment period.

This final notice with comment period implements section 1833(i)(1) of the Social Security Act, which requires, in part, that the list of covered ambulatory surgical center (ASC) procedures be reviewed and updated at least every 2 years. This notice announces the specific additions to and deletions from the list of surgical procedures for which facility services are covered when the procedures are performed in a Medicare-participating ASC, as well as the assigned payment groups for each addition. The notice also announces a change in our criteria for deleting procedures from the ASC list. This notice also responds to public comments received in response to our proposed notice published December 14, 1993 (58 FR 65357). In that notice, we requested comments on the proposed additions to and deletions from the list of covered surgical procedures for ASCs; the proposed quantitative change in our deletion criteria; the development of alternatives to the proposed quantitative deletion criteria; and the assignment of payment groups for each addition. Finally, this notice solicits public comment on certain additions to and deletions from the ASC list that had not been suggested in our December 1993 proposed notice. It also solicits public comment on the assignment of payment groups for certain new procedure codes.

Medicare↗
PubMed1982

Cost allocation plans for public assistance programs--Health and Human Services Department. Interim final rule with comment period.

This rule revises existing regulations concerning the preparation, submission and approval of State agency cost allocation plans used in computing claims for Federal Financial Participation under public assistance programs. It also reflects the transfer of responsibility for review and approval of the plans to the Division of Cost Allocation (DCA) in the Department's regional offices. This responsibility was previously assigned to the Social and Rehabilitation Service which was abolished by Secretarial Order published on March 9, 1977 (42 FR 13262). The current rule has been rewritten so that it is clearer, easier to understand and more specific. The Department's Informal Grant Appeals regulation relative to cost allocation plans and indirect cost rates (45 CFR Part 75) is also being updated and revised to make it consistent with Supart E, Cost allocation plans, of 45 CFR Part 95, General administration--grant programs (public assistance and medical assistance). Although these regulations are final, the Department has decided to invite public comments for the reasons described in the Supplementary Information below. Comments may be submitted in the manner described below. If changes are needed as a result of the comments received, those changes will be published in the Federal Register along with the comments received and the Department's responses to those comments.

Cost Allocation↗
PubMed1994

User comments on a clinical event monitor.

Columbia-Presbyterian Medical Center's health care providers have access to alerts and interpretations generated by an Arden Syntax-based clinical event monitor. They have the opportunity to send comments to the clinical information services staff. Over a period of 26 months, they sent 126 comments. The comments were analyzed using the critical incident technique, resulting in a hierarchy of categories that summarizes user concerns. The majority of comments (65) indicated that the messages were actually (8) or at least potentially useful (57). A minority (28) indicated that they were unhelpful (27) or actually harmful (1). Another group (27) made suggestions or asked questions. The comments have been very helpful for the maintenance of Medical Logic Modules (MLMs) and the clinical event monitor itself.

Academic Medical Centers↗