Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Outcomes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,369 records · Page 76Linked to original sources
PubMedDate not supplied

Impact of patient knowledge, patient-pharmacist relationship, and drug perceptions on adverse drug therapy outcomes.

The purpose of this project was to determine the relationship between adverse drug outcomes and knowledge of drugs, quality of a counseling relationship, and perceptions about drugs in an ambulatory clinic population. The presence of these three factors and other indicators of adverse outcomes were identified through a structured interview of 78 patients. Medical records were reviewed 3, 6, and 12 months after the initial interview to determine the presence of adverse drug outcomes. Four outcomes-hospitalizations, unscheduled clinic visits, emergency room visits, and changes in drug regimen-were assessed and categorized according to drug-related problem. Demographics of the group were recorded. Responses to the interview were analyzed to determine differences in counseling relationships between pharmacists and other health professionals. Logistic regression analysis was performed to determine the influence of independent variables on outcome. Relative risks for developing adverse outcomes given the presence of certain independent variables were calculated for significant associations. Significant relationships between predictor variables and adverse drug outcomes were identified for the following independent variables: female gender (RR = 5.2, CI 1.11, 24.31), three or more diseases (RR = 3.3, CI 1.13, 9.75), more drug knowledge and better perceptions (RR = 0.29, CI 0.10, 0.84), perception of no or low drug interference (RR = 0.18, CI 0.044, 0.745), and inadequate data collection by nurses and physicians as perceived by the patient (RR = 3.08, CI 1.09, 8.70). More knowledge and better perceptions about drugs were associated with a reduced risk of therapy changes due to drug-related problems. No association was found between the quality of the pharmacist-patient counseling relationship and adverse drug outcomes.

Activities of Daily Living↗
PubMedDate not supplied

Factors influencing the outcome of nerve repair.

The dependence of the nerve repair outcome on the following 7 factors was analyzed: regenerative potential of the interrupted nerve, local vascular and scar state, level of nerve lesion, applied surgical technique, length of nerve defect, preoperative interval and patient's age. Prospective study included 490 ruptures of peripheral nerves, operated in two years period and the final outcome was established 24-30 months after reparation. The influence of the each of mentioned factors on the treatment outcome was tested in experimental groups, in which total homogenization existed, according to all other factors which could cause the differences in the repair outcome. The obtained results point out that local vascular and scar state, applied surgical technique and the age of patients between 16 and 50 did not influence significantly the final results of treatment. According to the intensity of regenerative potentials, three groups of nerves could be recognized: with excellent (radial, musculocutaneus and femoral nerves), with moderate (median, ulnar and tibial nerves) and with poor regenerative potential (peroneal nerve). The level of repair significantly affected the final outcome only for nerves with moderate regenerative potential (median, ulnar and tibial nerves), while for nerves with excellent (radial nerve) and poor recovery potential (peroneal nerve), differences in outcome after high, intermediate and low level repairs were not significant. The length of the defect did not influence significantly the repair outcome for nerves with excellent regenerative potential (radial nerve), while for other nerves significant linear correlation existed between length of the defect and the repair results. Linear correlation also existed between the repair outcome and the preoperative interval. Border values of the length of the defect and for preoperative interval were calculated, which gave minimal and maximal possibilities for the successful recovery after the repair.

Adolescent↗
PubMed1998

Standardising health outcome measurements in general practice.

BACKGROUND: Outcome measures are gaining importance especially in areas such as divisions of general practice. The plethora of outcome measurements and the rhetoric surrounding this may make it difficult for doctors to decide the place of such measures in daily practice. An understanding of outcomes and their indicators is emerging as an essential requirement for good practice. OBJECTIVE: The aim of this paper is to propose a practical framework for describing health outcome measurements that may be applied to general practice. METHODS: This paper outlines the key features of outcomes measurements and proposes a model for understanding health outcome indicators using a set of indicators relevant to clinical practice. RESULTS: Pertinent to developing outcome terminology for use with patients in general practice are the four key features: a clear description of the indicator utility in practice comparability between practices endurance over time. CONCLUSION: To have reliability and validity and be able to deliver outcomes with practical and clinical significance, we need to be sure that the instruments we use are precisely defined. It is also important that the meaning is universally understood by all who might want to use the instruments. The product should also have cultural applicability beyond English. In clinical practice, the definition of the instrument aims not only to give the general practitioner a clear understanding of what is being measured but how it is used and the implications for its future use.

Family Practice↗
PubMed1998

[Outcome of patients who underwent surgical repair of aneurysm after subarachnoid hemorrhage].

BACKGROUND: Follow-up study of patients with surgical repair of aneurysmal subarachnoidal hemorrhage (SAH), looking for clinical outcome predictors. PATIENTS AND METHODS: Sixty two patients consecutively admitted to a teaching hospital, from January 1992 to December 1995 were included in the study. We studied preoperative, intraoperative and postoperative features looking for their relationship with the outcome. The ultimate outcome was evaluated by means of Glasgow Outcome Scale on discharge and 6 months later. RESULTS: Smoking (p = 0.0001) and arterial hypertension (AHT) (p = 0.0186) were more frequent in these patients than in general population, but without relationship to the outcome as with the age of the clinical status on admission. The greatest statistical relationship was found between the level of consciousness on postoperative awakening (measured by the Hunt and Hess scale), and the outcome (p = 2.53 x 10(-8). From our results we made an algorithm that correctly assigned 92% of studied patients to their outcome. CONCLUSIONS: All patients admitted on with aneurysm SAH deserve intensive care treatment besides their clinical grade. The level of consciousness on postoperative awakening was a good outcome predictor.

Adult↗
PubMed1998

Attitudes to the use of health outcome questionnaires in the routine care of patients with diabetes: a survey of general practitioners and practice nurses.

BACKGROUND: Despite the increasing availability of multidimensional health status and outcome measures of the patient's physical and emotional functioning, and a number of national initiatives to promote their use, little is known about the attitudes and behaviour of general practitioners (GPs) and practice nurses (PNs) regarding their use in evaluating the effectiveness of health care. What evidence there is remains largely anecdotal but supports the view that health outcome data is currently not used in the routine management of the patient. AIM: To investigate the attitudes and behaviour of GPs and PNs regarding the use of health outcome data in the routine care of patients with diabetes. METHOD: A questionnaire comprising 20 attitudinal and behavioural statements covering the use and benefits of health outcome data in the routine care of patients with diabetes were sent to 156 GPs and 114 PNs in the Doncaster area together with a covering letter and two examples of multidimensional health outcome measures. RESULTS: Completed questionnaires were received from 90 (58%) GPs and 49 (50% corrected for out of scope) nurses. Median response scores showed that both GPs and nurses expressed a positive overall attitude towards health outcome measurement giving responses favourable to it in 15 (75%) and 18 (90%) of the statements respectively. A key finding was that 48% and 46% of GPs and PNs were unclear as to how they would use health outcome data. CONCLUSION: While our findings reflect a favourable view towards the use of health outcome data for the routine management of the patient with diabetes in a general practice setting, a number of important barriers to their implementation have been identified. These include insufficient knowledge on their use, the need for easily interpretable data, and a lack of resources.

Adult↗
PubMed1995

Prediction of functional outcome and tissue loss in acute cortical infarction.

OBJECTIVE: To compare the acute Allen's Prognostic Score, Canadian Neurological Score, and subacute Barthel Index as predictors of outcome functional status and infarct size at 3 months in patients with acute cortical infarction. DESIGN: A prospective study of acute stroke predictors and outcome measurements in a cohort of sequential hospitalized patients. PATIENTS: Fifty-one patients with acute cortical infarction and without previous disability assessed 24 hours after onset with Allen's Prognostic Score and the Canadian Neurological Score and at 7 days with the Barthel Index. MAIN OUTCOME MEASURES: Mortality, Barthel Index, and volumetric measurement of infarct size on computed tomography 3 months after stroke. RESULTS: There were seven deaths. The outcome Barthel Index was measured in all 44 survivors, of whom 29 had computed tomography at the time outcome was determined. In a multivariate analysis, functional outcome was best predicted by Allen's Prognostic Score, a score of less than -15 having a sensitivity of 82% and specificity of 97% in predicting a poor outcome (Barthel Index, < or = 12 or death). Volumetric tissue loss was predicted only by Allen's Prognostic Score (r = .62, P < .001). CONCLUSIONS: Allen's Prognostic Score is a robust predictor of both functional outcome and tissue loss in acute cortical infarction and has a potentially important role in the analysis of the results of acute stroke intervention trials.

Activities of Daily Living↗
PubMed1995

Risk factors for impaired outcome after spontaneous intracerebral hemorrhage.

OBJECTIVE: To search out independent prognostic factors, including preictal variables for outcome of spontaneous intracerebral hemorrhage. DESIGN: Prospective follow-up study. PATIENTS: One hundred fifty-six consecutive patients (96 men and 60 women) aged 16 to 60 years admitted as emergencies after bleeding. MAIN OUTCOME MEASURES: Potential risk factors (baseline characteristics, health habits, and clinical variables) for death and impaired outcome were studied prospectively up to 1 year after hemorrhage. RESULTS: One year after hemorrhage, 64 patients (41%) were independent and 34 patients (22%) were dependent in the activities of daily living; 58 patients (37%) had died. Risk of death was predicted, after adjustment for sex, age, hypertension, and body mass index, by clinical condition at admission according to the Glasgow Coma Scale (P < .001) and the occurrence of subcortical hematoma (odds ratio [OR], 0.18; 95% confidence interval [CI], 0.04 to 0.91; P = .04). Risk of poor outcome (dependent state or death) was predicted, after adjustment for sex, hypertension, body mass index, cigarette smoking, presence of intraventricular hemorrhage, and surgery, significantly by the Glasgow Coma Scale (P < .001); presence of subcortical hematoma (OR, 0.04; 95% CI, 0.01 to 0.27; P < .001); volume of hematoma (P = .03); age (P = .004); amount of alcohol consumed within 1 week before hemorrhage (P = .03); and presence of cerebellar hematoma (OR, 0.13; 95% CI, 0.02 to 0.95; P = .04). Significant independent predictors of impaired outcome (assessed with the Glasgow Outcome Scale) were the Glasgow Coma Scale (P < .001); presence of subcortical hematoma (OR, 0.26; 95% CI, 0.10 to 0.67; P = .006); alcohol intake within 1 week (P = .002); and presence of cerebellar (OR, 0.16; 95% CI, 0.04 to 0.60; P = .008), intraventricular (OR, 2.74; 95% CI, 1.19 to 6.28; P = .02), or caudate hemorrhage (OR, 0.13; 95% CI, 0.02 to 0.77; P = .03). The mean erythrocyte corpuscular volume was directly associated with an impaired outcome (P < .05). CONCLUSION: In addition to severity and location of the hemorrhage, the age of the patient and the amount of alcohol consumed within 1 week seem to be independent determinants of outcome after intracerebral hemorrhage.

Adolescent↗
PubMed2002

Stroke or transient ischemic attacks with basilar artery stenosis or occlusion: clinical patterns and outcome.

BACKGROUND: Basilar artery occlusion (BAO) is associated with a high mortality rate, although cases with spontaneous favorable outcomes have recently been reported, and basilar artery stenosis (BAS) has received little consideration until now. OBJECTIVE: To study the prognostic clinical factors by testing numerous combinations of admission status characteristics of patients with brain ischemia caused by BAO or BAS. METHODS: We conducted a retrospective review from the Lausanne Stroke Registry (group 1) of patients with stroke or transient ischemic attack caused by BAS less than 50% or BAO as diagnosed by magnetic resonance angiography who were not treated by thrombolysis. Neurologic findings on admission were correlated with outcomes. We compared clinical patterns associated with poor outcomes in group 1 with those in patients with stroke who died from BAO or BAS (confirmed at autopsy) (group 2). RESULTS: Eighty-eight patients were studied. The outcomes of patients with stroke in group 1 (35/43) was poor (severe disability or death) in 54% of cases. A statistical analysis revealed that 4 factors-dysarthria, pupillary disorders, lower cranial nerve involvement, and consciousness disorders on admission-were strongly (P<.001) associated with poor outcomes. The multivariate analysis showed that the outcome was poor in 100% of cases in which consciousness disorders or the combination of the remaining 3 factors were present, whereas in the absence of these factors, a poor outcome was reported in only 11%. In 87% of the 45 patients with stroke in group 2, the same clinical patterns were present on admission. CONCLUSIONS: The prognosis of BAS greater than 50% or BAO is diverse and certain clinical characteristics seem to predict a lower risk of poor outcome. Their presence may help to decide the most suitable therapy.

Aged↗
PubMed1996

Partial retinal detachment at 3 months after threshold retinopathy of prematurity. Long-term structural and functional outcome. Multicenter Trial of Cryotherapy for Retinopathy of Prematurity Cooperative Group.

OBJECTIVE: To investigate the structural and functional outcome at age 4 1/2 years of eyes that had partial retinal detachment (RD) at 3 months after the occurrence of threshold retinopathy of prematurity; these eyes were involved in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study. METHODS: Of the 531 eyes in the randomized portion of the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study, 61 had partial RD at the 3-month examination. The extent of retinal involvement was recorded, and the presence of a foveal detachment was noted. At the examination conducted at age 4 1/2 years, the fundus structure was graded into cicatricial retinopathy of prematurity outcome categories by study ophthalmologists, and the visual acuity was measured by masked examiners using the Teller Acuity Card procedure and the crowded HOTV recognition acuity test. RESULTS: Of the 61 eyes, 7 eyes continued to have partial RD at age 4 1/2 years. Of the remaining eyes, 20 eyes had structural outcomes classified as favorable in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study, and 27 eyes had unfavorable structural outcomes. Data were unrecordable for 3 eyes and missing for 4 eyes. No difference in outcome was found for eyes with partial RD at 3 months that had undergone cryotherapy vs eyes that had served as controls. Only 6 eyes had a visual acuity better than 20/200. When partial RDs did not involve the fovea at 3 months, structural and functional outcomes at 4 1/2 years were better than when RDs involved the fovea. The best predictor of outcome was the extent of RD at 3 months. CONCLUSIONS: Partial RD present 3 months after threshold retinopathy of prematurity is unstable anatomically, and the visual outcome is generally poor. Structure and function at 4 1/2 years are related to the extent of RD and the involvement of the fovea at 3 months.

Child, Preschool↗
PubMed2006

Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention-deficit/hyperactivity disorder.

CONTEXT: Data from a previous prospective study of lobar volumes in children with attention-deficit/hyperactivity disorder (ADHD) are reexamined using a measure of cortical thickness. OBJECTIVE: To determine whether regional differences in cortical thickness or cortical changes across time characterize ADHD and predict or reflect its clinical outcome. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal study of 163 children with ADHD (mean age at entry, 8.9 years) and 166 controls recruited mainly from a local community in Maryland. Participants were assessed with magnetic resonance imaging. Ninety-seven patients with ADHD (60%) had 2 or more images and baseline and follow-up clinical evaluations (mean follow-up, 5.7 years). MAIN OUTCOME MEASURES: Cortical thickness across the cerebrum. Patients with ADHD were divided into better and worse outcome groups on the basis of a mean split in scores on the Children's Global Assessment Scale and persistence/remission of DSM-IV-defined ADHD. RESULTS: Children with ADHD had global thinning of the cortex (mean reduction, -0.09 mm; P=.02), most prominently in the medial and superior prefrontal and precentral regions. Children with worse clinical outcome had a thinner left medial prefrontal cortex at baseline than the better outcome group (-0.38 mm; P=.003) and controls (-0.25 mm; P=.002). Cortical thickness developmental trajectories did not differ significantly between the ADHD and control groups throughout except in the right parietal cortex, where trajectories converged. This normalization of cortical thickness occurred only in the better outcome group. CONCLUSIONS: Children with ADHD show relative cortical thinning in regions important for attentional control. Children with a worse outcome have "fixed" thinning of the left medial prefrontal cortex, which may compromise the anterior attentional network and encumber clinical improvement. Right parietal cortex thickness normalization in patients with a better outcome may represent compensatory cortical change.

Adolescent↗
PubMed1994

Outcomes following injury in a predominantly rural-population-based trauma center.

OBJECTIVE: To determine the incidence, severity, and outcomes of injury in patients treated in a rural-based level I trauma center and to compare the outcomes with a nationally indexed patient population--the Major Trauma Outcome Study. DESIGN: Retrospective evaluation of trauma registry data. SETTING: State of Illinois designated level I trauma center located in Urbana. PATIENTS: A total of 2246 trauma patients admitted from August 1989 through August 1992, with a mortality cohort of 158 patients. There were 1735 patients (77%) with Injury Severity Scores less than or equal to 19 and 511 patients (23%) with more severe injuries (Injury Severity Scores > or = 20). MAIN OUTCOME MEASURES: Mortality rates using the TRISS method, the Major Trauma Outcome Study, and final patient dispositions. RESULTS: The overall mortality rate, excluding those patients who were pronounced dead on arrival, was 125/2213 (5.6%). Eighty-six (69%) of these 125 patients had neurological Abbreviated Injury Scores of 3 or greater, with neurotrauma being a major contributor to their deaths. The m-statistic was 0.99 and the z-statistic was -3.30 for the entire group. The observed probability of survival met or exceeded the expected probability of survival when compared with the Major Trauma Outcome Study in all categories. CONCLUSION: Acceptable mortality rates compared with the Major Trauma Outcome Study can be achieved in a rural-community-based level I trauma center despite relatively small numbers of critically injured patients. Such outcomes may assist in justifying resource allocation for trauma centers in rural areas.

Abbreviated Injury Scale↗
PubMed2004

Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest.

CONTEXT: Most survivors of cardiac arrest are comatose after resuscitation, and meaningful neurological recovery occurs in a small proportion of cases. Treatment can be lengthy, expensive, and often difficult for families and caregivers. Physical examination is potentially useful in this clinical scenario, and the information obtained may help physicians and families make accurate decisions about treatment and/or withdrawal of care. OBJECTIVE: To determine the precision and accuracy of the clinical examination in predicting poor outcome in post-cardiac arrest coma. DATA SOURCES AND STUDY SELECTION: We searched MEDLINE for English-language articles (1966-2003) using the terms coma, cardiac arrest, prognosis, physical examination, sensitivity and specificity, and observer variation. Other sources came from bibliographies of retrieved articles and physical examination textbooks. Studies were included if they assessed the precision and accuracy of the clinical examination in prognosis of post-cardiac arrest coma in adults. Eleven studies, involving 1914 patients, met our inclusion criteria. DATA EXTRACTION: Two authors independently reviewed each study to determine eligibility, abstract data, and classify methodological quality using predetermined criteria. Disagreement was resolved by consensus. DATA SYNTHESIS: Summary likelihood ratios (LRs) were calculated from random effects models. Five clinical signs were found to strongly predict death or poor neurological outcome: absent corneal reflexes at 24 hours (LR, 12.9; 95% confidence interval [CI], 2.0-68.7), absent pupillary response at 24 hours (LR, 10.2; 95% CI, 1.8-48.6), absent withdrawal response to pain at 24 hours (LR, 4.7; 95% CI, 2.2-9.8), no motor response at 24 hours (LR, 4.9; 95% CI, 1.6-13.0), and no motor response at 72 hours (LR, 9.2; 95% CI, 2.1-49.4). The proportion of individuals' dying or having a poor neurological outcome was calculated by pooling the outcome data from the 11 studies (n = 1914) and used as an estimate of the pretest probability of poor outcome. The random effects estimate of poor outcome was 77% (95% CI, 72%-80%). The highest LR increases the pretest probability of 77% to a posttest probability of 97% (95% CI, 87%-100%). No clinical findings were found to have LRs that strongly predicted good neurological outcome. CONCLUSIONS: Simple physical examination maneuvers strongly predict death or poor outcome in comatose survivors of cardiac arrest. The most useful signs occur at 24 hours after cardiac arrest, and earlier prognosis should not be made by clinical examination alone. These data provide prognostic information, rather than treatment recommendations, which must be made on an individual basis incorporating many other variables.

Brain Death↗
PubMed2003

Unanticipated learning outcomes associated with commitment to change in continuing medical education.

INTRODUCTION: Educator-derived, predetermined instructional objectives are integral to the traditional instructional model and form the linkage between instructional design and postinstruction evaluation. The traditional model does not consider unanticipated learning outcomes. We explored the contribution of learner-identified desired outcomes compared with learner outcomes that were not named in the instructional design. METHOD: This study was conducted at a short course in pediatrics in which 43 physicians, advanced practice nurses, nurses, and physician assistants voluntarily self-identified committed- to changes (CTCs). We compared these CTC predicates with the predetermined instructional objectives that had been published in advance in the conference brochure and syllabus. CTCs whose predicates described the same features as the instructional objectives were considered to be anticipated learning outcomes. CTCs lacking correspondence with instructional objectives were considered to represent unanticipated learning outcomes. RESULTS: Of the 157 CTCs, 68% were anticipated learning outcomes because their predicates could be linked to the instructional objectives. The remaining 32% of CTCs did not correspond to any of the instructional objectives and thus represented unanticipated learning outcomes. DISCUSSION: These findings demonstrate that evaluations based on instructional objectives, although valuable, are incomplete because educational activities may also stimulate many unanticipated learning outcomes. Continuing medical education planners can gain a fuller assessment of the effect of their educational endeavors by including predetermined instructional objectives and encouraging the constructivist practice of recognizing unanticipated learning.

Attitude of Health Personnel↗
PubMed2004

Kinetics of viremia and acute liver injury in relation to outcome of neonatal woodchuck hepatitis virus infection.

The kinetics of serum viral responses and acute liver injury were studied during neonatal woodchuck hepatitis virus (WHV) infection in relation to the chronic or resolved outcome. The mean concentrations of serum WHV DNA and surface antigen were significantly higher by week 10 post infection in chronic infections compared to resolving infections, and diverged even further by the time of peak viral load development in serum (week 12). After week 12, these viral markers were detected less frequently with time and at lower concentrations in the resolved outcome. In both outcomes, mean serum activities of hepatic enzymes became increased significantly above baseline by weeks 10-12, peaked at week 14, and normalized by weeks 20-22, thus indicating transient acute liver injury. The increasing liver injury responses were comparable between outcomes at week 12, when serum viral load was markedly higher in the developing chronic infections. This suggested a deficiency in early non-cytolytic control of infection in the chronic outcome. At week 14, liver injury was significantly greater in the resolved outcome and associated with higher mean Fas ligand (FasL) and perforin messenger RNAs (mRNAs) in liver compared to the chronic outcome. This indicated greater immune-mediated killing of infected hepatocytes during resolution. Thus, chronicity as an outcome of neonatal WHV infection develops relatively early during the acute phase of infection due to reduced immune-mediated clearance of infected hepatocytes by both cytolytic and non-cytolytic processes.

Animals↗
PubMed1995

Monitoring cancer antigen 125 levels in induction chemotherapy for epithelial ovarian carcinoma and predicting outcome of second-look procedure.

A retrospective analysis of 45 patients with epithelial ovarian carcinoma who underwent second-look procedure after initial cytoreduction and platinum-based combination chemotherapy was undertaken. Each patient was evaluated for the result of CA 125 after a third course of chemotherapy, the result of CA 125 prior to second-look laparotomy, and the calculated slope of regression curve for CA 125. These results were compared for a normal value of CA 125 of < 35 and < 20 IU/ml. Of the 45 patients who underwent second-look procedure, 27 had a positive outcome, while 18 were negative for residual disease. For CA 125 levels obtained after the third course of chemotherapy, a level > or = 35 IU/ml predicted a positive second-look outcome in three patients, but was not statistically significant (P = 0.143) when compared to patients with normal levels. Of patients with CA 125 > or = 35 IU/ml immediately prior to second-look procedure, nine had a positive outcome for second look, a difference that was statistically significant (P = 0.006) when compared to patients with normal levels. For the calculation of the slope of the regression curve, no statistical difference (P = 0.838) was observed between the average of the slopes of the positive-outcome group and that the negative-outcome group. The only useful prediction of second-look procedure outcome identified in this group of patients was an elevated (> or = 35 IU/ml) CA 125 immediately prior to second-look procedure. Elevated levels at this time predicted the presence of disease in 100% of patients. For the other methods of analyzing CA 125 levels during therapy, the outcome of second look could not be predicted in patients with no clinical evidence of disease. Selecting a lower normal level of 20 IU/ml did not increase our ability to predict second-look procedure outcome.

Adult↗
PubMed2001

Predicting Affective Responses to Unexpected Outcomes.

In decisions under uncertainty, decision makers confront two uncertainties: the uncertain linkage between actions and outcomes and the uncertain linkage between these outcomes and his or her affective responses to them. The two studies reported here examine affective responses to expected and unexpected outcomes in various settings. In Study 1, a scenario-based laboratory experiment (N = 149), we examined subjects' predicted responses to a range of outcomes, as a function of how surprising the outcome was. Study 2, a field study (N = 127), involved the expectations of bowlers about their scores in an upcoming game and about their responses to various outcomes at, above, and below expectations. We also measured actual affective reactions after the bowlers had completed their games. Findings suggest that subjects both expect and experience a loss-averse, expectation-based value function broadly of the Prospect Theory type. They also anticipate, and experience, an amplifying effect of outcome surprise, though they underestimate its size. We argue that such underestimation, together with overtight prediction ranges, may expose subjects to much larger affective variation with outcome variability than they anticipate. Copyright 2001 Academic Press.

Journal Article↗
PubMed1988

Variables affecting outcome from severe brain injury in children.

This study evaluates the outcome of 56 severely brain injured children (mean age 6.2 +/- 2.1 years) and relates the Initial Glasgow Coma Scale (IGCS), initial intracranial pressure (ICP int), maximal intracranial pressure (ICP max) and minimal cerebral perfusion pressure (CPP min) to quality of survival. Forty-one children sustained head trauma, five severe central nervous system infections and 10 were of miscellaneous etiology. Therapy consisted of mechanical hyperventilation, moderate fluid restriction, dexamethasone and diagnosis specific measures when indicated. Outcome was categorized according to the Glasgow outcome scale at discharge from the hospital. An IGCS of 3 was associated with 100% mortality, 7 and above resulted in 72% good recovery, 28% poor outcome and no mortality. ICP int of less than 20 torr was noted in (67%) of the patients, and did not correlate with ICP max or outcome. Conversely, ICP int in excess of 40 torr correlated well with ICP max and outcome. ICP max of less than 20 torr resulted in 57% good recovery, 36% poor outcome and 7% mortality. ICP max greater than 40 torr resulted in 7% poor outcome and 93% mortality (p less than 0.001). In head trauma, 32 patients (78%) were alive with mean ICP max 16.9 +/- 3.1 and CPP min 65.5 +/- 8.5 torr compared to 9 patients (22%) who died with mean ICP max 53.7 +/- 10.8 and CPP min 6 +/- 3.9 torr, (p less than 0.01). In children with infectious etiology 60% survived with mean ICP max 16 +/- 3 and CPP min 96 +/- 16 torr.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Injuries↗
PubMed1989

Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. II. Causal-analytical investigations.

The influence of symptomatological and non-symptomatological factors on the long-term outcome of schizoaffective and schizophrenic disorders was investigated using the Analysis of Linear Structural Relationships (LISREL). The outcome was assessed employing the GAS, WHO/DAS, PIRS and the Bonn Criteria of Outcome. The analysis produced some interesting results in both groups, separately and in comparison with each other. The most striking difference between the two disorders concerns the finding that only symptomatological parameters directly influence the long-term outcome of schizoaffective disorders - melancholic episodes are correlated with favourable outcome, symptoms typical of schizophrenia with a relatively unfavourable outcome. Both symptomatological parameters (such as schizophrenic first-rank symptoms during course) and non-symptomatological parameters (such as life events or acuteness of onset) have a direct impact on the outcome. It was also found that "simple" depressive symptomatology (the presence of depressive symptoms not fulfilling the criteria of melancholic episodes according to DSM-III-R) has no influence on the long-term outcome of schizophrenia.

Adult↗