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PubMed1990

[A reliable method for evaluating the masticatory function in complete denture wearers, concerning a masticatory function evaluation chart based on food hardness].

The purpose of this study was to construct an evaluation chart to objectively and simply determine the extent of the masticatory function of complete denture wearers in daily clinical practice, and to describe the chart's clinical application. 58 different types of food were selected according to two criteria: their frequency of ingestion by complete denture wearers, and their convenience for determining the masticatory function. Then an anatomical artificial porcelain set of dentures was used to bite each food item, using only bicuspids and molars. Dentures were installed on an Instron Universal Testing Instrument to compression-cut the food. Food requiring the highest pressure was considered the hardest food. Then the masticatory function evaluation chart was constructed by using the hardness of the food as an index of relative masticatory difficulty. Using this chart, 95 complete denture wearers were tested to determine the masticatory function of their dentures. The following results were obtained: 1. The mean hardness of the 58 food items tested was 7.85 +/- 11.29 kg. The mean hardness of the 38 food items frequently ingested by complete denture wearers was 5.24 +/- 5.41 kg. 2. The differences in hardness of the foods tested were statistically processed, and the 58 food items were classified into 5 groups (I-V). This five-fold classification was used as a range for determining masticatory function. 3. A correlation coefficient of -0.697 (p less than 0.01) was found between the hardness of the food and the ease of eating the food. 4. A correlation coefficient of 0.548 (p less than 0.01) was found between the hardness of the food and the frequency of ingestion. 5. The masticatory function was determined on a 5-point scale from A to E according to the total number of food types that the subjects said that they could eat easily. The masticatory function increased progressively from A to E. The results of determining the masticatory function of the 95 complete denture wearers were as follows: Rank A 1.1%, B 10.5%, C 34.7%, D 29.5% and E 24.2%. 6. Persons who evaluated their own dentures positively comprised 86.0% of ranks D and E. On the other hand, persons who evaluated their own denture negatively were widely distributed from rank A through E, indicating that there were considerable individual differences. 7. It was concluded that the masticatory function evaluation chart was a reliable means of objectively and simply determining the masticatory function of complete denture wearers.

Bite Force↗
PubMed1985

Evaluation of pharmacy and therapeutics committee drug evaluation reports.

Pharmacy and therapeutics (P & T) committee drug evaluation reports prepared by pharmacies and drug information centers (DICs) and product package inserts were compared with standard guidelines to evaluate their quality. Letters were sent to 143 hospital pharmacies asking them to submit a previously prepared drug evaluation report on temazepam, moxalactam disodium, or atenolol. The reports and package inserts for these three drugs were evaluated by the presence of 40 elements derived from the published ASHP guidelines for drug evaluation report preparation. Responses were obtained from 124 (87%) pharmacies; however, only 80 reports (60 DIC-prepared and 20 pharmacy-prepared) were received. The reports contained a mean of 28 of the 40 (70%) possible elements. The most frequently omitted elements were AHFS number, potential unlabeled uses, drug-drug interactions, drug-disease-laboratory test interactions, risk and benefit data, prevention and treatment of side effects, comparisons with established treatment, and disadvantages of the drug under consideration. Although the reports prepared by the DICs and pharmacies contained the same amount of information, the DIC-prepared reports included data more frequently on supply sources, therapeutic indications, approved labeling, comparison with established treatment, bioavailability and pharmacokinetics, and recommendations. Most of the reports contained more elements than the corresponding package inserts. The product package inserts did not contain the comparative elements required for P & T committee decisions. Both the pharmacy- and DIC-prepared reports failed to contain all 40 elements recommended in the standard guidelines, suggesting the need for more thorough reports.

Atenolol↗
PubMed1997

[The evaluative cycle of the process of an overall geriatric evaluation program at a health center].

OBJECTIVE: To improve the procedures in an Elderly Persons' Care programme. DESIGN: A complete evaluative cycle of the care process, with an analysis phase and a phase to implement corrective measures. SETTING: Primary care. Ortuella (Bizkaia) Health Centre. PATIENTS AND PARTICIPANTS: Data on the first 50% on the list of residents over 75 in Ortuella were analysed in this evaluation (n = 249). Residents in elderly people's homes, people passing through and who had recently moved were excluded. In the re-evaluation all those still to be evaluated were analysed once corrective measures had been implemented (n = 81). INTERVENTIONS: After analysis of the first phase, corrective measures were applied, and both the coverage and the correct performance of activities generated in the development of the programme were re-evaluated. MEASUREMENTS AND MAIN RESULTS: There was similar coverage (72.3 to 66.7%). There was improvement in registration (76.9 to 90.7%), long-treatment card (60 to 85.7%), medicines (42.9 to 75%) and nutritional habits (46.1 to 57.1%). Action taken on visual (93.1 to 75%) and hearing (76 to 71.4%) pathologies deteriorated. CONCLUSIONS: The programme's procedures improved with simple corrective measures (a session concerning proper recording of the history and how to follow the protocol; professionals who controlled registration and coverage). A proper record was important.

Aged↗
PubMed1998

Evaluating Management of Protected Areas: Integrating Planning and Evaluation

/ An approach to evaluating the effectiveness of management of protected areas is proposed. This approach has been used in developing an evaluation strategy for the Fraser Island World Heritage Area in Australia. The main component of the strategy is built upon the desired outcomes specified in the management plan for the area and thus provides a basis for assessing the extent to which the plan's objectives are being achieved. A series of monitoring programs have been proposed to enable this assessment. Examples of monitoring programs developed as part of the evaluation strategy are presented. A second component of the strategy monitors the implementation of the management plan. A management information system has been developed to record and report on the extent to which the specific actions specified in the management plan have been implemented. The strategy is discussed in relation to seven objectives set for the evaluation program in its design phase.KEY WORDS: Planning; Evaluation; Monitoring; Management; Protected areas

Journal Article↗
PubMed1984

Evaluation of pesticides which pose carcinogenicity potential in animal testing. I. Developing a tumor data evaluation system.

A modified-Squire carcinogen ranking system has been developed by the Worker Health and Safety Unit of the California Department of Food and Agriculture to deal with pesticides which pose carcinogenic potentials. For pesticide products that have been adequately tested with sufficient data for such evaluation, this system can provide an in-depth review which is necessary for the better understanding of a chemical under investigation. Only with such understanding can a product be placed in its proper perspective with respect to its carcinogenic potency. When applying this rather intensive tumor data evaluation system, a total scoring point and carcinogenicity categorization may be provided, which, in conjunction with human exposure information, may be adequate for regulatory decision making. Based upon the adequacy of tumor data, seven pesticides were investigated using the current tumor data evaluation system. These pesticides were chosen to demonstrate the stepwise evaluation procedure for carcinogenicity evaluation.

Animals↗
PubMed2006

Evaluating complementary and alternative therapy services in primary and community care settings: a review of 25 service evaluations.

OBJECTIVES: To review evaluations of primary and community care complementary therapy services. To explore the impact evaluation reports may have had on funding decisions taken by NHS commissioners. DESIGN: We collected 32 reports for 25 services, principally in England. Reports were analysed for content using the structure-process-outcome model. Modified BESTCAM guidelines, which came out of a Delphi consensus exercise rating the ability of reports to address commissioners' priorities, were used to address the second objective. RESULTS: Most commonly, evaluators carried out data extraction of referral forms (10), costings of the service (9), patient satisfaction questionnaires (9) and patient health status questionnaires (8). Five service evaluations addressed NHS cost pressures, with another carrying out a cost effectiveness assessment with QALY. CONCLUSION: Addressing commissioners' priorities (e.g. GP consultations rates, prescription rates, secondary care referrals) in complementary therapy service evaluations may bolster chances of securing funding, but are unlikely to be enough on their own.

Biomedical Research↗
PubMed1998

Effect of evaluator and resident gender on the American Board of Internal Medicine evaluation scores.

OBJECTIVE: To examine the effects of resident and attending physician gender on the evaluation of residents in an internal medicine training program. DESIGN: Cross-sectional study. SETTING: Large urban academic internal medicine residency program. PARTICIPANTS: During their first 2 years of training, 132 residents (85 men, 47 women) received a total of 974 evaluations from 255 attending physicians (203 men, 52 women) from 1989 to 1995. MEASUREMENTS: The primary measurements were the numerical portions of the American Board of Internal Medicine evaluation form. Separate analyses were performed for each of the nine evaluation dimensions graded on a scale of 1 to 9. The primary outcome was the difference in the average scores received by each resident from male versus female attending physicians. RESULTS: Compared with female trainees, male residents received significantly higher scores from male attending physicians than from female attending physicians in six of the nine dimensions: clinical judgment, history, procedures, relationships, medical care, and overall. Similar trends, not reaching conventional levels of statistical significance, were observed in the other three categories: medical knowledge, physical exam, and attitude. These differences ranged from 0.24 to 0.60 points, and were primarily due to higher grading of male residents by male attending physicians than by female attending physicians. CONCLUSIONS: In one academic training program, we found a significant interaction in the grading process between the gender of internal medicine residents and the gender of their attending evaluators. This study raises the possibility that subtle aspects of gender bias may exist in medical training programs.

Bias↗
PubMed1998

Physiological and psychological evaluation for visual display colour readability: a visual evoked potential study and a subjective evaluation study.

This study was conducted, by subjective and objective evaluation, to clarify the complex relationships among VDT (visual display terminal) display colour readability and the related physical and physiological factors. Readability was defined as participants being able to read sentences easily on a VDT screen irrespective of their meanings. In the subjective evaluation, paired comparison tests and a colour impression test using the semantic differential (SD) method with factor analysis were carried out for 30 colour stimuli with different dominant wavelengths and stimulus purity values. The former test yielded identification of the most readable stimulus purity, which was in the range of 0.2 to 0.55 for any dominant wavelength. From the latter test, a 'conspicuousness factor' and a 'comfort factor' were extracted for evaluating readability. In the objective evaluation, three kinds of dominant wavelengths and three levels of stimulus purity were used. This evaluation showed that P100 peak latencies of colour-VEPs (visual evoked potentials) evoked by the subjectively optimal stimulus purity colours fully displayed on the screen were significantly shorter than those evoked by any other stimulus purity colours. Moreover, VEP P100 peak latencies evoked by the text colours that had the most readable stimulus purities were also shorter than those evoked by any other stimulus purity colours. Consequently, it was concluded that the optimum VDT display colour was that which had the most readable stimulus purity for each dominant wavelength, and that colour-VEP peak latency could serve as an indicator for quantification of VDT display colour readability.

Adult↗
PubMed2005

Sources of validity evidence for an internal medicine student evaluation system: an evaluative study of assessment methods.

BACKGROUND: Medical students' final clinical grades in internal medicine are based on the results of multiple assessments that reflect not only the students' knowledge, but also their skills and attitudes. OBJECTIVE: To examine the sources of validity evidence for internal medicine final assessment results comprising scores from 3 evaluations and 2 examinations. METHODS: The final assessment scores of 8 cohorts of Year 4 medical students in a 6-year undergraduate programme were analysed. The final assessment scores consisted of scores in ward evaluations (WEs), preceptor evaluations (PREs), outpatient clinic evaluations (OPCs), general knowledge and problem-solving multiple-choice questions (MCQs), and objective structured clinical examinations (OSCEs). Sources of validity evidence examined were content, response process, internal structure, relationship to other variables, and consequences. RESULTS: The median generalisability coefficient of the OSCEs was 0.62. The internal consistency reliability of the MCQs was 0.84. Scores for OSCEs correlated well with WE, PRE and MCQ scores with observed (disattenuated) correlation of 0.36 (0.77), 0.33 (0.71) and 0.48 (0.69), respectively. Scores for WEs and PREs correlated better with OSCE than MCQ scores. Sources of validity evidence including content, response process, internal structure and relationship to other variables were shown for most components. CONCLUSION: There is sufficient validity evidence to support the utilisation of various types of assessment scores for final clinical grades at the end of an internal medicine rotation. Validity evidence should be examined for any final student evaluation system in order to establish the meaningfulness of the student assessment scores.

Clinical Competence↗
PubMed2006

A 3-dimensional evaluation of the macular region: comparing digitized and film-based media with a clinical evaluation.

PURPOSE: To compare the results of stereoscopic macular evaluations using three different types of stereoscopic photographic equipment with those of a clinical examination when establishing the presence of possible macular oedema. METHODS: The study involved a clinical evaluation of the macular region in 57 eyes of 30 diabetes subjects with possible macular oedema. Clinical examinations were followed by photographic stereoscopic evaluations of the macular region using two digital systems (low and high resolution) and one film-based system. All the photographic recordings were classified by two consultants, who were trained in making macular gradations and blinded to the results of previous assessments. RESULTS: The low-resolution digital equipment was found to have relatively low optical resolution and found a significantly lower number of eyes with macular oedema compared with the clinical examination. The high-resolution digital equipment and the film-based equipment were found to have relatively high optical resolution. The number of eyes with macular oedema found by the high-resolution digital and film-based evaluations was comparable with the number found by the clinical examination. Low intra- and interobserver agreement was observed. CONCLUSION: All three photographic systems have disadvantages that make them suboptimal as tools for evaluating the presence of macular oedema. The film-based system seems the most reliable, while low-resolution digital equipment seems least useful. The development of new and objective measurements giving a 3-dimensional presentation of the macular region might be advantageous.

Depth Perception↗
PubMed2006

Evaluation of the mixing point in tinnitus sound therapy by a psychoacoustic matching protocol with a digital tinnitus evaluation system.

Directive counseling and sound therapy have been reported to effectively alleviate tinnitus suffering. Without objective evaluation, researchers doubt the real effect of sound therapy. This study was designed to evaluate the frequency and intensity of the theoretical 'mixing point' (MP) in sound therapy and to investigate its relationship with the minimal masking level (MML) of tinnitus. The tinnitus tones of 133 patients were successfully matched in frequency (dominant in 4-10 kHz) and loudness (83.09 +/- 12.04 dB) using a psychoacoustic matching protocol and a newly designed tinnitus evaluation system. The matching rate was 83%. The relationship between the MP and MML is described by a linear regression equation: MP = 0.90 x MML + 1.98 (r2 = 0.82, p < 0.0001). The results of matching and correlation analysis confirmed the consistency of the MP in sound therapy. The psychoacoustic characteristics of tinnitus can be objectively evaluated with our matching protocol and evaluation system.

Acoustic Stimulation↗
PubMed2001

Comparison of results of thoracic radiography, cytologic evaluation of bronchoalveolar lavage fluid, and histologic evaluation of lung specimens in dogs with respiratory tract disease: 16 cases (1996-2000).

OBJECTIVE: To compare results of thoracic radiography, cytologic evaluation of bronchoalveolar lavage (BAL) fluid, and histologic evaluation of biopsy and necropsy specimens in dogs with respiratory tract disease and to determine whether histologic evaluation provides important diagnostic information not attainable by the other methods. DESIGN: Retrospective study. ANIMALS: 16 dogs. PROCEDURE: BAL fluid was classified as normal, neutrophilic, eosinophilic, mononuclear, mixed, neoplastic, or nondiagnostic. Radiographic abnormalities were classified as interstitial, bronchial, bronchointerstitial, or alveolar. Histologic lesions were classified as inflammatory, fibrotic, or neoplastic, and the predominant site of histologic lesions was classified as the alveoli, interstitium, or airway. RESULTS: The predominant radiographic location of lesions correlated with the histologic location in 8 dogs. Of 11 dogs with histologic evidence of inflammatory disease, 8 had inflammatory BAL fluid. Of the 2 dogs with histologic evidence of neoplasia, 1 had BAL fluid suggestive of neoplasia, and the other had BAL fluid consistent with septic purulent inflammation. Two dogs without any histologic abnormalities had mononuclear or nondiagnostic BAL fluid. Two dogs with histologic evidence of fibrosis had mononuclear or mixed inflammatory BAL fluid. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that although thoracic radiography, cytologic evaluation of BAL fluid, and histologic evaluation of lung specimens are complementary, each method has limitations in regard to how well results reflect the underlying disease process in dogs with respiratory tract disease. Lung biopsy should be considered in cases where results of radiography and cytology are nondiagnostic.

Animals↗
PubMed2002

[A study on evaluation methods of masticatory ability for complete denture wearers--correlation between evaluation using a questionnaire and masticatory performance].

The purpose of this study was to investigate the relation between evaluation by a questionnaire on masticatory aspects of 20 foods, and masticatory performance obtained using the sieving method, previously used in many studies. After replacement of upper and lower complete dentures made newly, 28 edentulous patients voluntarily participated in this study. The basal seat area of each patient was scored and divided into two groups, and masticatory ability was evaluated by two methods: using a questionnaire and the sieving method. The following conclusions were drawn from the data: 1. Evaluation of masticatory ability by both methods used in this study were not associated with gender, age, and evaluation of the basal seat area. 2. Evaluation using a questionnaire and masticatory performance showed significant correlation, and Spearman's correlation coefficient was 0.628 (p < 0.001).

Aged↗
PubMed1999

[How do patients evaluate general practice? German results from the European Project on Patient Evaluation of General Practice Care (EUROPEP)].

German results from the European Project on Patient Evaluation of General Practice Care (EUROPEP). As part of the European collaborative study, "EUROPEP" 2224 patients in Germany (response rate 77.2%) filled in a questionnaire to evaluate their general practitioners (GP's) and the care they were delivering over the last 12 month. Overall satisfaction was high: 95.4% reported that they had no reasons to change to another GP. On a five-point scale ranging from 'excellent' to 'poor' the possibility to reach the practice on the phone was evaluated best (73.8% 'excellent') and waiting times were rated worst (31.0% 'excellent'). Also less often rated 'excellent' than other items were 'preparing the patient for what to expect from specialist or hospital care' (53.3%), 'the GP's knowledge on what s/he had done or told the patient during previous contacts' (54.3%) and 'helping the patient to deal with emotional problems related to her/his health status' (54.6%). Relevant differences between practices concerning evaluation of care and sociodemografic background of their patients were detected. Patient evaluation of care can contribute to make practices an their teams more responsive to patients needs.

Adult↗
PubMed2003

[Which are the elements of an international evaluation of research? Experiences from an evaluation of Swedish psychiatric research].

INTRODUCTION: In order to ensure the quality of research, it is necessary to perform an external evaluation of the quality and structure of the research environments on a regular basis and consider them in a national and international perspective. MATERIAL AND METHODS: There are several ways of evaluating research. The author mentions an audit-like expert evaluation based on his own experience from an evaluation of Swedish psychiatric research in 2000. RESULTS AND DISCUSSION: A short comparison with Danish psychiatric research is made. One of the advantages of this method is that the research evaluation can be carried out by the members of the research teams in an open dialogue among peers. This procedure makes it possible to focus on weaknesses and strengths with the purpose of planning future strategies and organisation in the most appropriate way. An obvious limitation, however, is the competence assigned to the expert group whose composition is important for the result.

Biomedical Research↗
PubMed2005

[Evaluation by undergraduate medical students of clinical clerkships in the department of anesthesiology--comparison with the evaluation in previous fiscal year].

BACKGROUND: Clinical Clerkships in the Department of Anesthesiology were evaluated by undergraduate medical students and compared with other clinical departments and those of previous fiscal year 2003. METHODS: Questionnaire surveys by 5 step Likert measure were conducted to ask the students for the evaluation of each department or division, and formative evaluation was performed after the all clerkships. The questionnaire consisted of 12 questions on 1) orientation, 2) learning chances and provision of teaching materials, 3) feedback, learning promotion and teaching attitude, 4) coordination of human relationship between medical staff and students, and 5) overall evaluation of teacher's physician. RESULTS: The average score of our department was 4.40 (mean, 5 th grade of all 26 departments/divisions), and the score of the question on provision of medical practice (4.71) was the best among the all departments/divisions. The evaluation grading was rather low for the question on chance for physical examinations (3.80). CONCLUSIONS: Reevaluation of the educational program in our department based on the results of the survey is essential for improvement of the program, and further provision of chances, especially for physical examinations, is also needed for undergraduate students in the program by including palliative medical care program.

Anesthesiology↗
PubMed1989

[Clinical methods for evaluating infarct size and its anatomic correlations. Study carried out in 193 cases. III. Comparison of data on the evaluation of the infarct size using the QRS score and a method of maximal creatine kinase determination in the serum].

AIMS: To compare two methods concerning the clinical evaluation of infarct size--one using a QRS score, the other based on peak Ck values--applied to the same population. CONCEPT AND PLACE OF THE STUDY: to determine--based on previously established correlations between a QRS score and the anatomic total infarct size on one hand, and between the peak CK values and the anatomic recent infarct size on the other hand--which myocardial infarction subgroup constitutes the best indication for each method. The study took place in a Coronary Care Unit of a Central Hospital. MATERIAL AND METHODS: 193 patients who died successively of acute myocardial infarction through out 4 years were studied. After establishing the exclusion critéria, the QRS score was calculated according to the method of Selvester modified by Wagner, and peak CK values were evaluated. Infarct size, either recent or old, was determined by means of an anatomical method developed by the authors and based on Hackel's and Alonso's previous works. Correlations were established between data from each clinical method and those from the anatomical method. Several myocardial infarction subgroups were considered for comparison of the correlations found in each subset. RESULTS AND CONCLUSIONS: As long as QRS score was regarded, significant correlations were found between the evaluation by QRS score and anatomical infarct size in the subgroups of patients with severe pump failure, prior myocardial infarction, or total loss of ventricular muscle mass of at least 20 percent; however, a significant correlation was missing when the whole myocardial infarction group was taken into consideration. When peak CK value were considered, a weak significant correlation was found between the evaluation by enzyme determination and anatomical infarct size in the whole group of patients, but a stronger correlation was present in the subgroups of patients with survival longer than 24 hours, anterior wall myocardial infarction, free wall cardiac rupture, or first acute myocardial infarction. In conclusion the choice of the method to be used in the clinical evaluation of infarct size should take into account the type of population beeing studied, and follow the results obtained in different myocardial infarction subgroups as mentioned above.

Creatine Kinase↗
PubMed1994

[New approaches to evaluation of nonspecific inhalation provocation (dose-response relationship) in the comparative evaluation of bronchial hyperreactivity within the scope of clinical trials].

For the performance of clinical drug trials in the therapy for bronchial hyperresponsiveness, unspecific inhalatory provocation tests are generally employed to judge therapeutic success. In particular, the parameter-specific provocation doses are considered to be the main target values. However, it must be considered that these provocation doses are not equally calculable for every patient in the same way and at any examination time. This leads to the fact that the number of evaluable case studies is often appreciably lower than the number of test participants and that a meaningful therapy group comparison may even not be possible under certain circumstances. An evaluation model is presented here in order to fully exploit the obtained data; in this the percentile changes of the function parameters (estimated by linear regression) at a defined dose of the provocation substance are analyzed. In analogy, a survival time model and, as a supplement, a best case/worst case analysis are performed for further statistical evaluation. With the present procedure, an evaluation with inclusion of all test participants is possible. In contrast to the previously used evaluation procedures, this allows a reliable statistical confirmation of the results of clinical tests in the therapy for bronchial hyperresponsiveness.

Aerosols↗