SEARCH · Search PubMed

Results for “Data Files”

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.

SourceResearch connectionFrom yearThrough year

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

At least 1,765 records · Page 98Linked to original sources

PubMed1999

Pressures on safety net access: the level of managed care penetration and uninsurance rate in a community.

OBJECTIVE: To examine the effects of managed care penetration and the uninsurance rate in an area on access to care of low-income uninsured persons and to compare differences in access between low-income insured and uninsured persons across these different market areas. DATA SOURCES: Primarily the Community Tracking Study household survey. Other market-level data were obtained from the Community Tracking Study physician survey, American Hospital Association annual survey of hospitals, Area Resource File, HCFA Administrative Data, Bureau of Primary Care data on Community Health Centers. STUDY DESIGN: Individuals are grouped based on the level of managed care penetration and uninsurance rate in the site where they reside. Measures of managed care include overall managed care penetration in the site, and the level of Medicaid managed care penetration in the state. Uninsurance rate is defined as the percentage of people uninsured in the site. Measures of access include the percentage with a usual source of care, percentage with any ambulatory care use, and percentage of persons who reported unmet medical care needs. Estimates are adjusted to control for other confounding factors, including both individual and market-level characteristics. DATA COLLECTION: A survey, primarily telephoned, of households concentrated in 60 sites, defined as metropolitan statistical areas and nonmetropolitan areas. PRINCIPAL FINDINGS: Access to care for low-income uninsured persons is lower in states with high Medicaid managed care penetration, compared to uninsured persons in states with low Medicaid managed care penetration. Access to care for low-income uninsured persons is also lower in areas with high uninsurance rates. The "access gap" (differences in access between insured and uninsured persons) is also larger in areas with high Medicaid managed care penetration and areas with high uninsurance rates. CONCLUSIONS: Efforts to achieve cost savings under managed care may result in financial pressures that limit cross-subsidization of care to the medically indigent, particularly for those providers who are heavily dependent on Medicaid revenue. High demand for care (as reflected in high uninsurance rates) may further strain limited resources for indigent care, further limiting access to care for uninsured persons.

Health Services Accessibility↗

PubMed1989

Rheumatoid arthritis as seen from official data registers. Experience in Finland.

Computerized public data registers are an important data base for bodies monitoring public health. They can also be used for epidemiological research. The main problems in the use of the registers are administrative and qualitative. The use, and especially the linking of different registers together, is strictly regulated by law. The trend seems to be towards more strict regulations. Another problem is the quality of the data. The registers were designed for administrative purposes and therefore, the classification of data is not always suitable for research. In addition, errors are possible at several stages of the production and filing of the data. International comparisons are difficult because of differences in legislation and administrative rules. However, despite these problems, public data registers are an important resource for research, and their importance will grow with time and improvements in the quality of the registers.

Adult↗

PubMed1984

[Management software for reports of digestive endoscopies: an 8-month experience with 3500 tests].

A program using a 5 M-byte hard disk microcomputer system has been used routinely for eight months in our digestive endoscopy center, both to prepare medical reports and to store patient data. This program has been written by computer engineers in close collaboration with members of our medical staff. Using the program does not need any special training. The system is based on three main files: a) a text file contains text fragments of variable length (max. 300 characters), identified by a three character alpha-numeric code. These phrases, always the same, allow to standardize the reports; however, new formulations may be added at any time; b) a patient file stores medical data concerning the patients (max. 20,000 patients) in coded form. This file allows statistical studies and multifactorial sorting; c) a physician file stores the references of the correspondents (max. 1,000 physicians). Three main functions are available: a) report construction, b) statistical studies, c) fast edition of complete reports (available for the 45 last reports). Using this program should allow substantial savings by assuring a complete independence of report writing, which is done by the endoscopist himself. By establishing a thesaurus of keywords and keyphrases in digestive endoscopy, the method should facilitate multicenter studies.

Computers↗

PubMed2001

Comorbidity and survival of elderly head and neck carcinoma patients.

BACKGROUND: Alcohol and tobacco, the primary etiologic agents for head and neck carcinoma (HNCA), cause other chronic diseases and may contribute to the high prevalence of comorbid conditions and generally poor survival of persons with HNCA. METHODS: The authors explored the prognostic role of comorbidity in persons with HNCA using Health Care Finance Administration Medicare (HCFA) files linked with the appropriate files of the Surveillance, Epidemiology, and End Results (SEER) Program. The Charlson comorbidity index was applied to in-patient data from the HCFA files. The SEER data were used to ascertain survival and identify persons with HNCA diagnosed from 1985 to 1993 (n = 9386). RESULTS: In a proportional hazards regression model adjusted for age and historic stage at diagnosis, race, gender, marital status, socioeconomic status, histologic grade, anatomic site, treatment, and pre-1991 diagnosis, Charlson index scores of 0, 1, and 2+ had estimated relative hazards (RHs) with 95 confidence intervals (CIs) of 1.00, 1.33 (95% CI, 1.21-1.47), and 1.83 (95% CI, 1.64-2.05), respectively (P value for trend < 0.0001). The adjusted RH for a Charlson index score of 1 or more compared with 0, using stratified models, was found to be greater in whites (RH, 1.55; 95% CI, 1.43-1.67) than blacks (RH, 1.24; 95% CI, 0.96-1.60), local (RH, 1.72; 95% CI, 1.50-1.96) versus distant stage (RH, 1.25; 95% CI, 1.00-1.56), and age 65-74 years (RH, 1.53; 95% CI, 1.38-1.69) versus age 85+ years (RH, 1.42; 95% CI, 1.09-1.84). CONCLUSIONS: This study establishes comorbidity as a predictor of survival in an elderly HNCA population and lends support to the inclusion of comorbidity assessment in prognostic staging of patients with HNCA diagnosed after 65 years of age.

Aged↗

PubMed2006

The American Association for Pediatric Ophthalmology and Strabismus workforce distribution project.

PURPOSE: To describe data sources and functional utility of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) workforce database and associated map files. METHODS: Population data from the 2000 U.S. Census and current listings from the AAPOS and American Academy of Ophthalmology (AAO) databases were organized to demonstrate and analyze practitioner-to-population relationships for metropolitan statistical areas nationwide. An interactive map was developed to provide an intuitive graphical display of the data. RESULTS: A total of 749 active AAPOS members were distributed in 154 of 280 defined metropolitan statistical areas. Within these areas, a 0- to 20-year age subgroup varied from 17.8% to 42.6%, with an average of 30.4%. The AAPOS member-to-million-person ratio varied from 1.3 to 27, with higher numbers generally representing regions with population bases inadequately defined by Census Bureau statistical area definitions. Ratios for a majority of larger, better-defined areas ranged from 3 to 4 AAPOS members per million persons. Sizable areas with no AAPOS member presence were identified and tabulated. AAO members with a specified pediatric practice focus who were not AAPOS members were identified in 103 areas, possibly influencing patient choices and practitioner referrals for these regions. CONCLUSIONS: The AAPOS workforce database and related interactive map display practitioner and population data that may assist physicians and planners in targeting practice development and identifying potentially underserved areas.

Databases, Factual↗

PubMed1994

Critical analysis of the balanced force technique in endodontics.

The "balanced force" technique was introduced in 1985 and it was reported that the resistance of the dentin, as it circumferentially contacted the flutes of a file in a curved root canal, would be sufficient to override and mask any tendency of the file to straighten during rotational instrumentation. An alternative mechanism based on compressive force and file flexure is presented in this article. In a laboratory study, the apical force necessary to cause files of sizes #10 to #70 to bend and conform to an average canal curvature was determined. These measurements were then related to the apical forces applied to teeth when utilizing the Balanced Force technique in a simulated clinical setting. It was then proposed that the apically directed force necessary to prevent coronal movement of the file and to effect dentinal shearing during counterclockwise rotation placed the file in compression, flexing it to conform to the curvature of the canal. This explanation was consistent with the experimental data for the files used in this study up to size #60 for an average canal curvature and for average instrumentation forces.

Analysis of Variance↗

PubMed1990

Laboratory instrument evaluation using a personal computer.

A system in which data from multichannel biochemical analysers is downloaded to a personal computer using a communications package is described. BASIC programs were developed to format the data into a file structure suitable for importing into a commercial statistics software package. This allowed statistical comparisons to be made of patient data obtained from different instruments and facilitated evaluation of these instruments. Using this technique, many hundreds of patient results may be compared without requiring the data to be keyed into a computer. The techniques and programs used are described to show that these facilities can be developed by laboratory scientists with only rudimentary computer programming skills.

Autoanalysis↗

PubMed1991

A system to acquire and record physiological and behavioral data remotely from nonhuman primates.

We describe an integrated system to record physiological and behavioral variables from nonhuman primates in social groups. The system records data simultaneously from two animals in family groups of five. It synchronizes behavioral and physiological data within 16 ms, either on-line or from recordings. Behavioral data are entered by trained observers on-line or from videotape. Recordings of physiological data are produced on-line as stripchart records, tape recordings on the audio channels of video cassettes, and magnetic disk files. The physiological data include two arterial blood flows, arterial blood pressure and heart rate. The data are transmitted from freely behaving animals to a central site via radio telemetry. The infrared link controls the radio transmitter and physiological signal processing electronics, as well as two sources of drugs for each animal. All of the electronics are contained in a small, light backpack that can be worn by either male or female baboons.

Animals↗

PubMed2000

[Cholesterol determination in ambulatory general practice within the scope of the Brugg/AG quality circle].

Findings of studies designated by the acronyms 45, WOSCOP, LIPID and CARE have provided data that led physicians to rethink their "cholesterol testing behavior." Twelve physicians participated in a study conducted in cooperation with the quality circle of the Brugg region in Aargau. Each doctor collected data from the files of 100 patients and filled in a questionnaire. Cardiovascular risk factors and arteriosclerotic secondary illnesses were compiled along with demographic data. Moreover, information was gathered on whether the patient's cholesterol levels had been checked within the last five years. In total, 1183 questionnaires were evaluated, comprising 691 women and 492 men with an average age of 48.6 years. Cholesterol levels had been determined within the last five years in 61.2%. The individual testing behavior of the physicians varied. One-third tested all three blood lipid values (total cholesterol, HDL and triglyzerides) with an equivalent frequency. By contrast, one-third primarily only determined total cholesterol. The last one-third mostly tested total cholesterol and triglyzeride levels. The frequency of serum lipid tests increased proportionally to the number of risk factors. Cholesterol levels were tested less frequently (approx. 55%) in smokers and patients who never practiced sports than in patients with other risk factors (approx. 85%). The testing rate increased proportionally to the increasing number of arteriosclerotic secondary illnesses, but did not reach the one-hundred percent mark until 3 secondary illnesses were involved. Dietary counseling was the primary therapeutic intervention; medication was prescribed with a much rarer frequency. Although 75% of the patients with arteriosclerotic secondary illnesses had measurably higher cholesterol levels (> 5.2 mm/l), approx. one-third of the patients with coronary heart disease received therapy with cholesterol-lowering drugs as compared to only 16% of the patients with peripheral occlusive arterial disease. The conclusions that we can draw from these results for clinical practice are: if cholesterol levels are to be determined in order to evaluate a patient's cardiovascular risk, HDL cholesterol levels should also be tested since the ratio of these two values is a good predictor. To date, triglyzeride levels have not been identified as relevant risk factors for vascular events. Physicians evaluated the other risk factors variably, in particular with regard to obesity. For clinical practice, the potential risk factor of lack of exercise should be defined more accurately. In patients with clinically manifest arteriosclerotic secondary illnesses, serum lipids should be tested routinely and appropriate therapy induced when required.

Adult↗

PubMed1995

[Epidemiologic study of the factors influencing renal trauma in Cantabria].

OBJECTIVE: In this study, the most important factors that influence renal trauma (RT) were evaluated in patients that had suffered different types of accidents. METHODS: Data from 340 cases of RT that were seen over a period of 15 years were obtained. This was performed in two stages: first, data were obtained during this time period; secondly, the patients were followed after discharge from hospital. RESULTS: All this information was filed in a data base specifically for this purpose and were statistically analyzed to determine and quantify the types of RT and their incidence in relation to demographic and temporal factors, type of accident, etc. CONCLUSIONS: Weekends, alcohol, age, road traffic accidents, type of road, etc., are the most important factors that influence the development of RT. The incidence of RT in Cantabria is similar to that of the US and European countries.

Adolescent↗

PubMed2002

[PACS: from project to reality. Report of experiences on full digitalisation of the radiology department of a major hospital].

OBJECTIVE: To assess the time needed and the resulting effects of a complete digitalisation of a radiological department of a major hospital (856 beds, 28,000 in-patients, 35,000 out-patients/year) a pilot study was performed. This had to be done without interrupting routine services. RESULTS: After intensive preparations were performed and the hospital-network was completed, within a two year period all radiological functions (mammography excluded), reporting stations and archives were changed to a complete digital workflow. All modalities (provided by 3 different companies) are now connected by DICOM-work lists. The picture-files (4 GB/day) are automatically routed to the work-stations (n = 10), where the reporting and file shows are performed, to the digital archive and to the peripheral viewing-stations (n = 44). The distribution of the digital pictures takes place all over the hospital including the ORs and special units. We accomplished, to connect electronically the report and the image data. The clinical file shows are also performed completely digitally. The access to the data of the deep archive is possible by the dept. of radiology without any manual interaction. The film consumption was reduced to an amount of less than 10%, as compared to the prior PACS situation. Since PACS has been introduced the radiological productivity increased by more than 15% and throughput-time was clearly reduced. CONCLUSIONS: The complete digitalisation increases productivity and attractiveness of a hospital-radiology and helps to shorten diagnostic and therapeutic decision-making. The transfer from a conventional to a digital workflow is possible without interrupting the clinical services. Extensive preparations and ongoing assistance of such projects though are clearly needed.

Computer Systems↗

PubMed1993

[A proposal for a computerized clinical records file for a department of general surgery].

The author suggest a computerized program for filing clinical records of surgical institution. The proposed file is written in DB III plus (Ashton-Tate) and consists of one file .dbf and 4 files .prg. The database file contains anagraphic and clinical data of the patients. The program files make it possible to attribute a personal code to patients, print records of single patients, calculate the time of operation and assist in codifying diagnostic related groups (DRGs). The author stresses the utility of a medical computerized records system containing only few but important clinical data. It makes it possible to perform the most analysis of surgical series without the aid of a professional programmer.

Computer Systems↗

PubMed1996

Trauma recidivism in the elderly.

BACKGROUND: The incidence of recurrent trauma in the elderly is unknown. This study evaluated the risk of readmission for injury among elderly trauma patients compared with an uninjured geriatric cohort. The effects of age, sex, race, preexisting illness, and ISS on trauma recidivism were determined. METHODS: Population based retrospective cohort analysis of the elderly using administrative data from the Health Care Financing Administration was performed. The measured outcome was trauma admission within 5 years. The injured were identified using hospital discharge data and the Injury Severity Score generated by ICD-Map. The uninjured were identified from Medicare eligibility files. Comorbid illness was assessed using ICD-9CM codes from outpatient and inpatient data files. RESULTS: The injured members of the cohort had increased risk of subsequent new trauma admission (p < 0.001). Increasing Injury Severity Score, age, and comorbid illness are associated with trauma recidivism. CONCLUSION: Trauma in the elderly is recurrent. Further study is required to develop age and injury specific interventions to prevent recurrent injury.

Age Distribution↗

PubMed1992

Biostatistical manual (BIOSTAT) for potency control and for evaluation of effectiveness of the WHO-EPI vaccines: software for personal computers.

In accordance with WHO requirements, a specialized software has been developed for personal computers to analyse the potency data of the EPI vaccines and to evaluate the effectiveness of the vaccination. The software has three parts and allows users to create files from control data (BIOSTAT), to check the function of the software and statistical formulae (BIOSDEMO), and to understand the logic and structure of the data processing system and the statistical models (BIOSDOC).

Evaluation Studies as Topic↗

PubMed2004

Primary care follow up of patients discharged from the emergency department: a retrospective study.

BACKGROUND: The visit to the emergency department (ED) constitutes a brief, yet an important point in the continuum of medical care. The aim of our study was to evaluate the continuity of care of adult ED visitors. METHODS: We retrospectively reviewed all ED discharge summaries for over a month 's period. The ED chart, referral letter and the patient's primary care file were reviewed. Data collected included: age, gender, date and hour of ED visit, documentation of ED referral and ED discharge letter in the primary care file. RESULTS: 359 visits were eligible for the study. 192 (53.5%) of the patients were women, average age 54.1 +/- 18.7 years (mean +/- SD). 214 (59.6%) of the visits were during working hours of primary care clinics ("working hours"), while the rest were "out of hours" visits. Only 196 (54.6%) of patients had a referral letter, usually from their family physician. A third (71/214) of "working hours" visits were self referrals, the rate rose to 63.5% (92/145) of "out of hours" visits (p < 0.0001). The ED discharge letter was found in 50% (179/359) of the primary care files. A follow-up visit was documented in only 31% (111/359). Neither follow up visit nor discharge letter were found in 43% of the files (153/359). CONCLUSIONS: We have found a high rate of ED self referrals throughout the day together with low documentation rates of ED visits in the primary care charts. Our findings point to a poor continuity of care of ED attendees.

Adult↗

PubMed1993

Documented need for more effective diagnosis and treatment of familial hypercholesterolemia according to data from 502 heterozygotes in Utah.

A project to help Utah residents with heterozygous familial hypercholesterolemia (FH) identified affected individuals by collecting detailed questionnaires from: (1) very high-risk persons in computer files of screening data (very high cholesterol levels, very early coronary artery disease, and strong positive family history); (2) confirmed FH index cases from a university lipid clinic; and (3) relatives of any confirmed FH cases. Questionnaires were received from 2,143 persons identifying 101 living index cases and 502 relatives meeting the criteria for the diagnosis of FH. Finding new FH heterozygotes was about one fourth as expensive by tracing relatives of confirmed FH cases by evaluating very high-risk persons. Of those meeting criteria for the diagnosis of heterozygous FH, only 31% reported being told by their physicians that they had FH, only 42% indicated that they were taking a cholesterol-lowering prescription medication, and only 23% had reasonably controlled cholesterol levels (below the 90th percentile). However, the data also suggest that good control is achievable in motivated patients. Among 106 FH heterozygotes who were early responders to a second follow-up questionnaire, 79% were taking prescription medications, of whom 49% had achieved cholesterol levels below the 90th percentile, and 17% even achieved cholesterol levels below the 50th percentile. We conclude that most patients with heterozygous FH are not diagnosed and not adequately treated. We demonstrated how many of these persons needing help could be identified efficiently by tracing relatives of known index cases.

Adolescent↗

PubMed1984

Differentiation between diseases using a programmable hand-held calculator and Bayes' theorem: application to lower gastrointestinal tract disorders.

A program is presented for the Hewlett-Packard HP-41C programmable pocket calculator that computes posterior probabilities of more than 200 diseases on the basis of Bayes' theorem. Data for specific applications are stored in ASCII files. The program and data are retained in the non-volatile memory of the calculator. An example of the application of the program to six lower gastrointestinal tract disorders is given using data from the literature.

Bayes Theorem↗

PubMed2006

Relative income, race, and mortality.

This paper examines the relationship between relative income and mortality. Our research is motivated by recent literature that posits that, holding individual income fixed, those whose income are low relative to the incomes of those in a reference group will have worse health. We develop an empirical model in which an individual's health is a function of his or her own income and the incomes of those who live in the same geographical area. We show how this individual-level model can be estimated using semi-aggregated data on the mortality rates of people categorized by age, race, gender, and place of residence. The model is estimated using mortality data from the 1980 and 1990 Compressed Mortality Files, merged with income data from the 1980 and 1990 5% Public Use samples of the US Census. We find no evidence that having relatively wealthy neighbors, holding own income fixed, is associated with higher mortality. Instead, we find evidence that among some demographic and age groups--in particular working-aged black males--having relatively wealthy neighbors is associated with lower mortality. For example, among younger (aged 25-64) black men, an increase in the income of others is estimated to have a beneficial effect on mortality that is 40% as large as an equivalent increase in own income.

Adolescent↗