Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Monitoring”

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 1,387 records · Page 77Linked to original sources
PubMed1996

Approached to monitoring the results of long-term disease prevention trials: examples from the Women's Health Initiative.

We contrast monitoring therapeutic trials with monitoring prevention trails. We argue that in monitoring prevention trials one should place more emphasis on formally defined global measures of health, not simply on a single targeted disease, particularly when an intervention may reduce the incidence of some diseases but increase the incidence of others. We describe one approach, illustrated by the Women's Health Initiative. For each of several sets of hypothetical interim results ("scenarios"), members of the Data and Safety Monitoring Committee (DSMC) were asked whether they would continue or stop the trial. In parallel with this exercise, various statistical methods of monitoring that are based on (1) the primary targeted disease, (2) a combination of various disease outcomes, or (3) a mixture of both were applied to these scenarios. One objective was to find a statistical approach that mirrors the majority view of the DSMC. A second objective was to stimulate discussion among DSMC members in preparation for their task of monitoring the trial as the real data become available. We found that no single method fully matched the majority vote of the DSMC. However, a mixed approach requiring the primary outcome to be significant and the global index to be "supportive," with separate monitoring of adverse effects, corresponded with the majority vote quite well. This approach maintains the emphasis on the primary hypothesis while assuring that broader safety and ethical issues of multiple diseases are incorporated.

Bayes Theorem↗
PubMed1998

Clinical trials and treatment effects monitoring.

Treatment effects monitoring is the act of reviewing accumulated data by treatment group to determine whether a trial should continue unaltered. That monitoring is required for any trial where there is a risk of an aggregate form of harm for subjects because of continued use of an inferior treatment or because of failure to use a superior treatment. Institutional review boards (IRBs), in deciding whether to approve such research, require that (when appropriate) there is adequate provision for monitoring the data collected to ensure the safety of subjects. The focus here is on the conditions necessary to satisfy this requirement. The conditions discussed are timeliness of the monitoring, completeness of data for monitoring, competency of monitors, and freedom of monitors to act and recommend as they deem necessary, regardless of the wishes, desires, or dictates of sponsors.

Clinical Trials as Topic↗
PubMed1986

The role of reinforcement in reactive self-monitoring.

The role of reinforcement in reactive self-monitoring was investigated. Subjects for this study were three mentally retarded adults employed in a sheltered workshop. Changes in productivity rates in a party hat assembly task across experimental conditions (reinforcements, self-monitoring, and self-monitoring plus reinforcement) were evaluated. Findings showed that while reinforcement alone increased productivity, it was to a lesser degree and with less consistency than when combined with self-monitoring. In addition, self-monitoring alone did not increase productivity. These results support the Rachlin and Nelson and Hayes hypotheses that reactive effects of self-monitoring are dependent upon environmental contingencies. The results also showed that self-monitoring increases the salience of reinforcement.

Adult↗
PubMed2000

A Pain Monitoring Program for nurses: effect on the administration of analgesics.

Both physicians and nurses are responsible for adequate pain management. The aim of this study was to assess pain management behavior of physicians and nurses, and to evaluate the effects of a Pain Monitoring Program for nurses on the extent to which nurses administer analgesics. The Pain Monitoring Program consisted of two components: educating nurses about pain, pain assessment and pain management; and implementing daily pain assessment by means of a numeric rating scale. Several outcomes were distinguished to evaluate the administration of analgesics by nurses: the prescribed analgesics by physicians, the administered analgesics by nurses, and the discrepancy between the ordered and the administered analgesics. The effects of the Pain Monitoring Program on these outcomes were measured in a quasi-experimental design with a non-equivalent control group. In total, 703 patients participated: 358 patients in the control group and 345 in the intervention group. Patients were interviewed twice, i.e. at the beginning and at the end of hospitalization. Results of the control group showed that at the first interview 70% of the patients were prescribed analgesics by physicians and only 74% of those patients were actually administered analgesics by nurses. Consequently, 50% of the patients in pain received analgesics. The administered analgesics was in absolute agreement with the prescribed analgesics in 60% of the patients with routine analgesics and in 85% of the patients with PRN analgesics. The relative difference between ordered and administered routine analgesics was small, namely 15% for opioids and 20% for non-opioids. Similar results of the control group were found for the second interview. In addition, the results showed that the Pain Monitoring Program was effective in improving nurses' administration of analgesics. At the first interview more patients received analgesics that were prescribed on a PRN basis and the doses of administered routine non-opioids including PRN increased. At the time of the second interview, more patients received weak opioids. The Pain Monitoring Program was especially effective in patients with moderate to severe pain. However, the discrepancy between the analgesics ordered by physicians and actually administered by nurses did not change as a result of the Pain Monitoring Program. Based on this study it can be concluded that the use of a simple method such as a numeric rating scale together with pain education for nurses is effective in improving the administration of analgesics by nurses. These are important results because nurses play an essential role in helping patients to cope with their pain. Because the Pain Monitoring Program (PMP) was effective in a heterogeneous population in multiple care settings, the possibility of implementing the PMP in routine nursing practice should be considered.

Adult↗
PubMed1998

Ethical considerations of video monitoring psychiatric patients in seclusion and restraint.

Video monitoring of psychiatric patients in seclusion and restraint is reviewed from ethical and legal perspectives. Video monitoring invades privacy beyond patient expectations for routine hospital care and has the potential to harm personal dignity. The potential benefit of patient safety through monitoring must be balanced with the potential harm of monitoring to provide ethical justification. Because involuntary monitoring places patients in a position of extreme vulnerability to personal exposure, clinicians are obligated to protect these patients. A case illustrating problems with video monitoring along with recommendations for ethical use of video monitoring are presented in this article.

Adult↗
PubMed1996

Reality monitoring failure in schizophrenia: the role of selective attention.

Reality monitoring and selective attention have been repeatedly shown to be impaired in schizophrenia. Positive symptomatology has been found to be associated with deficits in both reality monitoring and selective attention. Therefore, a direct link between reality monitoring and selective attention was hypothesized. Thirty-two schizophrenic patients and 32 normal controls were administered the Stroop test as a measure of selective attention along with a test of three indices of reality monitoring, involving discrimination of: events vs. non-events, self- vs. externally-generated events, and oral vs. pictorial sources. A global memory test was administered for comparison. Results showed that schizophrenic patients were impaired in both reality monitoring and selective attention, and that these two were significantly correlated with each other in the schizophrenic sample. On the contrary, selective attention was not significantly correlated with memory efficiency in either group. Further, multiple regression analyses in schizophrenic patients showed that only selective attention contributed significantly to the variance in reality monitoring measures. Therefore, the results argue in favor of a specific role of a selective attention deficit in reality monitoring failure in schizophrenia.

Adult↗
PubMedDate not supplied

Immune monitoring of human gene therapy trials: potential application to leukemia and lymphoma.

Therapeutic genetically modified vaccines administered to patients with cancer are expected to induce and sustain tumor-specific immune responses. To measure these responses, monitoring strategies including a range of antibody-based and cellular assays have been developed. Single-cell cellular assays capable of detecting fewer than 1/10,000 of antigen-specific T lymphocytes in the tested population are currently in demand. ELISPOT assay, cytokine flow cytometry, and tetramer binding were recently compared by us in the context of monitoring of a dendritic cell-based multi-peptide vaccination trial in patients with metastatic melanoma. These single-cell assays were not found to be concordant in measurements of the frequency of peptide-specific T cells or in detecting pre- to post-vaccine changes in the frequency of these T cells. Implications of the results for monitoring of genetically modified vaccines are discussed, and the plan for a rational approach to monitoring and for selection of monitoring assays is proposed. Monitoring of human gene therapy or vaccination trials in patients with advanced cancers, who are often immunocompromised and thus poorly responsive, is a challenge. This challenge is best met by utilizing experienced reference laboratories for immune monitoring of clinical trials.

Cancer Vaccines↗
PubMed2003

Quantitation of HCV RNA with the microwell plate and COBAS Amplicor HCV Monitor assays.

BACKGROUND: We performed the Roche Amplicor Monitor hepatitis C virus (HCV) v2.0 microwell plate (MWP) assay for 2 years prior to bringing a COBAS instrument into the lab. Before reporting any results from the automated COBAS Amplicor Monitor HCV v2.0, we compared quantitative data with results on the same specimens from the manual Amplicor Monitor HCV. OBJECTIVE: To determine if the COBAS Amplicor Monitor assay yielded quantitative results that were comparable with those given by the manual Amplicor Monitor HCV. STUDY DESIGN: We tested 145 specimens with both assays. Specimens were chosen on the basis of having fallen within the linear range of the first assay. RESULTS: The log(10) mean (+/-standard deviation) for all 145 specimens was 5.976 (+/-0.597) for the COBAS and 6.142 (+/-0.597) for the MWP assay. When plotted as 145 pairs of numbers (log MWP result vs. log COBAS result), the linear regression line was displaced slightly downward from the line of equivalence by 0.1 log at the lower end and by 0.2 log at the upper end indicating the COBAS result was somewhat lower than the MWP result across the full range of the assay. The mean of the difference of the manual method and the COBAS for all 145 specimens was 0.166 log(10). A subset of 45 specimens for which we had HCV genotype data was analyzed separately. This set of specimens (of which 33 were genotype 1) also showed excellent concordance between the automated and manual methods. The two trendlines, one for genotype 1 and the other for genotypes 2, 3 and 4, were superimposable and thus the quantitative results were apparently not influenced by the genotypes, although the numbers were small (six HCV genotype 2, five HCV genotype 3 and one HCV genotype 4). CONCLUSIONS: We conclude that the automated Roche COBAS Amplicor Monitor v2.0 yields results that are comparable with the manual Amplicor Monitor assay for HCV genotype 1 and possibly also for genotypes 2, 3 and 4.

Genotype↗
PubMed2003

Experimental studies of electroosmotic flow dynamics in microfabricated devices during current monitoring experiments.

Electroosmotic flow (EOF) was monitored in glass microfluidic devices at rates up to 2 Hz with a precision of 0.2-1.0% using a technique based on the periodic photobleaching of a dilute, neutral fluorophore added to the running buffer. This EOF monitoring method was used to examine the performance of the current monitoring technique for measuring an average electroosmotic flow in a microfluidic device with a cross-T design. Flow measurements made with the current monitoring method gave a precision of 0.4-2.2%, but the periodic photobleaching method shows that the current monitoring technique causes changes in EOF as high as 41% during a single experiment. The periodic photobleaching method for EOF monitoring was also used to study EOF in channels on opposite sides of a cross-channel intersection. The opposite channels were shown to exhibit substantially different EOF dynamics during a current monitoring experiment as well as different steady-state EOF rates during normal operating conditions.

Journal Article↗
PubMed2003

Evaluation of a dietary targets monitor.

OBJECTIVE: To evaluate a two-page food frequency list for use as a Dietary Targets Monitor in large scale surveys to quantify consumptions of the key foods groups targeted in health promotion. DESIGN: Intakes of fruit and vegetables, starchy foods and fish estimated from a validated food frequency questionnaire (FFQ) were compared with a short food frequency list (the Dietary Targets Monitor) specifically designed to assess habitual frequency of consumption of foods in relation to dietary targets which form the basis of a National (Scottish) Food and Health Policy. SUBJECTS: A total of 1085 adults aged 25-64 y from the Glasgow MONICA Study. RESULTS: : The two questionnaires both collected data on frequencies of food consumption for fruit and vegetables, starchy foods and fish. Comparing the two questionnaires, there were consistent biases, best expressed as ratios (FFQ:Dietary Targets Monitor) between the methods for fruit and vegetables (1.33, 95% CI 1.29, 1.38) and 'starchy foods' (1.08, 95% CI 1.05, 1.12), the DTM showing systematic under-reporting by men. For fish consumption, there was essentially no bias between the methods (0.99, 95% CI 0.94, 1.03). Using calibration factors to adjust for biases, the Dietary Targets Monitor indicated that 16% of the subjects were achieving the Scottish Diet food target (400 g/day) for fruit and vegetable consumption. Nearly one-third (32%) of the subjects were eating the recommended intakes of fish (three portions per week). The Dietary Targets Monitor measure of starchy foods consumption was calibrated using FFQ data to be able to make quantitative estimates: 20% of subjects were eating six or more portions of starchy food daily. A similar estimation of total fat intake and saturated fat intake (g/day) allowed the categorization of subjects as low, moderate or high fat consumers, with broad agreement between the methods. The levels of agreement demonstrated by Bland-Altman analysis, were insufficient to permit use of the adjusted DTM to estimate quantitative consumption in smaller subgroups. CONCLUSIONS: The Dietary Targets Monitor provides a short, easily administered, dietary assessment tool with the capacity to monitor intakes for changes towards national dietary targets for several key foods and nutrients.

Adult↗
PubMed1991

Intraoperative cranial nerve monitoring during posterior skull base surgery.

Intraoperative monitoring of neurophysiologic function is rapidly evolving as an important adjunct during skull base surgery to reduce the incidence of neurologic deficit. Facial nerve monitoring is an excellent model, since electrical and mechanical evoked potentials can be directly presented to the surgeon in real-time through an acoustic loudspeaker display. The lower cranial nerves may also be monitored using similar electromyographic techniques. Auditory system monitoring is more difficult due to the low amplitude response that requires averaging and filtering to extract the evoked potential. In conjunction with auditory monitoring, improved hearing preservation may be further enhanced by concomitant facial nerve monitoring, since the surgeon is alerted to traumatic manipulations that may affect both facial and cochlear nerves. Techniques and interpretative issues are presented to maximize the efficacy and safety of cranial nerve monitoring.

Journal Article↗
PubMed1996

Uncertain value of electronic fetal monitoring in predicting cerebral palsy.

BACKGROUND: Electronic monitoring of the fetal heart rate is commonly performed, in part to detect hypoxia during delivery that may result in brain injury. It is not know whether specific abnormalities on electronic fetal monitoring are related to the risk of cerebral palsy. METHODS: Among 155,636 children born from 1983 through 1985 in four California counties, we identified singleton infants with birth weights of at least 2500 g who survived to three years of age and had moderate or severe cerebral palsy. The children with cerebral palsy were compared with randomly selected control children with respect to characteristics noted in the birth records. RESULTS: Seventy-eight of 95 children with cerebral palsy and 300 of 378 controls underwent intrapartum fetal monitoring. Characteristics found to be associated with an increased risk of cerebral palsy were multiple late decelerations in the heart rate, commonly defined as slowing of the heart rate well after the onset of uterine contractions (odds ratio, 3.9; 95 percent confidence interval, 1.7 to 9.3), and decreased beat-to-beat variability of the heart rate (odds ratio, 2.7; 95 percent confidence interval, 1.1 to 5.8); there was no association between the highest or lowest fetal heart rate recorded for each child and the risk of cerebral palsy. Even after adjustment for other risk factors, the association of abnormalities on fetal monitoring with an increased risk of cerebral palsy persisted (adjusted odds ratio, 2.7; 95 percent confidence interval, 1.4 to 5.4). The 21 children with cerebral palsy who had multiple late decelerations or decreased variability in heart rate on fetal monitoring represented only 0.19 percent of singleton infants with birth weights of 2500 g or more who had these fetal-monitoring findings, for a false positive rate of 99.8 percent. CONCLUSIONS: Specific abnormal findings on electronic monitoring of the fetal heart rate were associated with an increased risk of cerebral palsy. However, the false positive rate was extremely high. Since cesarean section is often performed when such abnormalities are noted and is associated with risk to the mother, our findings arouse concern that, if these indications were widely used, many cesarean sections would be performed without benefit and with the potential for harm.

Adult↗
PubMed2002

The effects of cardiovascular dynamics monitoring in the outpatient management of pregnancy hypertension.

OBJECTIVE: Our purpose was to assess the effects of the adjunctive use of cardiovascular dynamics monitoring in the ambulatory management of 199 pregnant patients with severe hypertension. STUDY DESIGN: A prospective, observational study was performed. Determinants of mean arterial pressure were computed by using the Hon monitor. Indicators of arterial compliance and effective blood volume were developed. All patients were monitored in the outpatient clinic; additionally, 19 patients self-tested at home. No rigid medication protocol was followed, but furosemide was used in most cases when cardiovascular dynamics monitoring patterns were consistent with volume loading. Otherwise, vasodilators were prescribed. The t test for independent samples was used to compare the home-monitored subgroup with the outpatient-only group. RESULTS: Pregnancy was prolonged by 74 +/- 63.9 days (mean +/- SD). Mean gestation was 37.6 +/- 2.9 weeks, and mean birth weight was 2882.4 +/- 837 g. The primary cesarean delivery rate was 23.7%, but only 15 (7.5%) cesarean deliveries were performed because of failed therapy. The 19 home-monitored patients gained 108 +/- 75 days (83.1 +/- 42.2 days beyond 20 weeks). CONCLUSION: Adjunctive cardiovascular dynamics monitoring may have a role in the evaluation and management of hypertension during pregnancy.

Adult↗
PubMed2005

Clinical evaluation of a novel ultrasound-based bladder volume monitor.

OBJECTIVE: Bladder volume monitors may be useful for surveillance of bladder volume and urine production in urologic patients. Therefore, we designed an ultrasonic bladder volume monitor and evaluated it in vitro using phantoms and in vivo in one male volunteer. The purpose of this study was to perform a more thorough in vivo evaluation of our monitor in urologic patients to investigate biological effects and variance over a wide range of bladder volumes. MATERIAL AND METHODS: Thirty urologic patients of either gender were examined using the bladder volume monitor, which is based on seven phased array ultrasonic transducers arranged in a circular pattern to optimize detection of the bladder walls. The monitor was set up to record bladder volume every 30 s during two sequential cystometries with infusion rates of 30 and 60 ml/min. The measured volumes were analyzed using regression analysis to determine volume increments (slopes), offset volume (intercept) and correlation (Pearson's correlation coefficient). RESULTS: In the male patients, the median correlation coefficient between the infused and measured volumes was 0.97 and the slope was 0.68 ml/ml, thus warranting a correction factor of approximately 1.47 with no general volume offset. In the female patients, small bladders were generally outside the field of view of the monitor. Consequently, the correlation coefficients and slopes were 0.834 (median) and 0.43 (mean), respectively, whereas volume offsets were generally negative. CONCLUSIONS: For examinations in male patients, the performance of the bladder volume monitor was adequate. However, for examinations in female patients, a minor redesign of the transducer unit is necessary to insure proper operation.

Adult↗
PubMed2006

Home monitoring in asthma self-management.

Peak flow monitoring of asthma came into vogue with the advent of asthma self-management programs. Because it offered an objective way to gauge asthma severity, it promised improvement in the accuracy of asthma monitoring over that attainable by symptom monitoring. This promise has not been fulfilled. The ensuing years have witnessed a debate concerning the relative merits of symptom and peak flow monitoring. The debate has focused both on the degree to which peak flow and symptom scores are related to one another and on the relative effectiveness of symptom and peak flow monitoring for asthma control. We review research relating to these topics. The work shows that the strength of the relationship between peak flow and symptoms is low to moderate and varies between individuals and that benefits of peak flow monitoring in asthma self-management provide, at best, no more than a small increment in effectiveness beyond that afforded by symptom monitoring.

Asthma↗
PubMed1987

A sequential tape monitor for toluene diisocyanate.

An electronic microcircuit controller has been designed to convert a commercially available continuous tape monitor for toluene diisocyanate (TDI) into a sequential sampler in order to eliminate deficiencies in response and resolution of fluctuating TDI concentrations. The modified monitor will collect up to fourteen 12-min samples per work shift. The sensitivity of the monitor was doubled approximately by the inclusion of a blue filter in the optics of the reader unit. Recalibration of several modified monitors indicated a wide range in response to TDI necessitating individual calibrations. No significant difference in response to the 2,4 and 2,6 isomers of toluene diisocyanate was noted for modified personal monitors, in contrast to a 25% lower response to 2,6-TDI by an area monitor in which the same detection tape was used. The modified monitor has shown a reliability rate of about 90% during a three-year field survey of TDI exposures.

Air Pollutants, Occupational↗
PubMed1996

Experience-related differences in diagnosis from medical images displayed on monitors.

OBJECTIVE: To compare diagnostic accuracy using conventional versus monitor-displayed medical images in order to determine if years of experience as a board-certified clinician influences diagnostic performance in either modality. MATERIALS AND METHODS: In separate observer performance studies, six radiologists and six pathologists differing in years of experience viewed clinical images, once in the conventional modality (X-ray film or light microscopy) and once using a monitor display. Readers also were surveyed regarding their experience with digital/video display systems. RESULTS: In both studies, performance was similar for conventional and monitor modalities. For the conventional displays, there was a positive correlation between years of clinical experience and performance. For the monitor displays, however, there was a strong negative correlation between years of clinical experience and performance. Performance using the monitor displays correlated highly with experience using digital/video systems in general. CONCLUSION: More exposure to and use of monitor displays, such as recreational video games and computers, may influence positively the clinician-monitor display system interaction and improve diagnostic performance.

Data Display↗
PubMed2003

Effects of biofilm formation on haemodialysis monitor disinfection.

BACKGROUND: Biofilms are composed of communities of micro-organisms adhering to essentially any surface. We evaluated whether biofilm formation in the hydraulic circuit of a purposely contaminated haemodialysis monitor would modify the efficacy of different disinfection modalities against bacteria and endotoxin concentrations. METHODS: A water-borne Pseudomonas aeruginosa (109) suspension was recirculated for 1 h and was left standing for 72 h (stationary phase) in the hydraulic circuit of the monitor. The monitor was then washed and disinfected by different physical (heat, 85 degrees C) or chemical (hypochlorite or peracetic acid) disinfection modalities (protocol A). In protocol B, the bacterial suspension was also recirculated for 1 h, but the monitor was then immediately washed and disinfected by different chemical disinfection modalities (hypochlorite or peracetic acid). RESULTS: Biofilm formation was revealed by scanning and confocal laser electron microscopy after the stationary phase (protocol A), but was absent when the monitor was immediately washed and disinfected (protocol B). In the presence of biofilm (protocol A), heat in association with citric acid was the most effective modality for reducing both colony forming units and endotoxin concentrations, whereas heat by itself was the least effective method of disinfection. Dwelling (60 h) with diluted peracetic acid completely prevented the formation of biofilm. In the absence of biofilm (protocol B), chemical disinfection proved to be effective against both colony forming units and endotoxin concentrations. CONCLUSIONS: We found that biofilm formation may markedly reduce the efficacy of presently available disinfection modalities. Therefore, different disinfection modalities and the combined action of descaling (by citric acid) and disinfection (physical/chemical agents) should be used periodically in haemodialysis monitors. In addition, dwelling with diluted peracetic acid should be adopted whenever monitors are not in use.

Bacterial Infections↗