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At least 19 recordsLinked to original sources
PubMedDate not supplied

Cost-effective diagnostic test sequencing.

Proper diagnostic test selection and logical sequencing can minimize cost without compromising care. This study analyzes the logic for sequencing tests either in series (one after another) or in parallel (simultaneously). A model is created using 2 diagnostic tests for 2 diseases. Tests are assumed to have perfect performance characteristics. Factors involved in cost-effective test sequencing include cost of each test, test performance characteristics, per diem hospital charge, and the clinician's prior probability of the suspected diagnosis based on history, physical examination, and previous laboratory data. At a given point of clinical suspicion, cost-effective sequencing strategy should shift. In general, a cheap test can effectively be used in parallel even at low diagnostic probabilities; an expensive test should, in general, be used in series only when there is a high prior probability of diagnosis. High per diem hospitalization costs--such as for a patient in the intensive care unit--favor in parallel testing. Clinical acumen and suspicion of diagnosis (prior probability) primarily direct cost-effective diagnostic test sequencing. Decision analysis of diagnostic test sequencing represents a technique for making cost-effective decisions for sequencing and, thereby, minimizing costs while achieving optimal patient care.

Cost-Benefit Analysis↗
PubMed1989

Alternative test sequences for HIV screening of donated blood.

Human Immunodeficiency Virus (HIV) infection is extremely rare among volunteer blood donors. The highly sensitive Enzyme Linked Immunoassay (ELISA) test and the highly specific Western blot confirmation constitute the test sequence now used to minimize the possibility of transfusion associated HIV infection and to minimize the loss of donors due to false positive test results. The estimated operating characteristics for the test sequence permit the estimation of true infection rates which may be higher or lower than "observed" rates among subcategories of blood donors with progressively lower prevalence rates. The probability that a positive test result indicates true infection also declines with decreasing prevalence. The potential benefits of changing the test sequence so that complete HIV screening is implemented only for donations which are hepatitis-free include a reduction in the costs of Western blot testing and donor counseling, a reduction in the number of donors who use the blood bank inappropriately for personal HIV testing, and a more explicit recognition of the false positive problem when counseling donors.

AIDS Serodiagnosis↗
PubMed1988

[Effects of test-expectancies and test-sequence orders on the recognition failure of recallable words].

Two experiments examined the effects of test-expectancies and test-sequence orders on the phenomenon of recognition failure. In Experiment 1, 18 college students, half of which were male and the other half were female, were randomly divided into two experimental groups. Half of the subjects studied the 42 cue word-target pairs in anticipation of a cued recall test, while the remaining subjects studied the pairs in anticipation of a recognition test. In Experiment 2, 36 college students (18 male and 18 female students) were randomly divided into two experimental groups. Half of the subjects were tested successively, first for recognition and then for recall, and the remaining subjects were tested in the reverse order. The results showed that the magnitude of recognition failure decreased when the subjects expected the recognition test. There were no appreciable sequential testing effects on the magnitude of recognition failure, however. These results imply that the phenomenon of recognition failure is not an artifactual one in the recognition-recall testing order, and that the magnitude depends on encoding conditions.

Adult↗
PubMed1977

Test sequences in screening for breast cancer.

Published data of Stark and Way on the screening of 2,684 women at high risk of breast cancer are analyzed to arrive at a preferred sequence of screening tests. In the practical situation where palpation first signals a problem, the analysis suggests thermography to follow. Women with positive thermograms should then be biopsied, and those with negative thermograms should be mammographed. A positive mammogram calls for biopsy, and a negative one calls for close follow-up. For high-risk women whose breasts appear normal on palpation, a subsequent negative thermogram is not definitive enough to terminate investigation, but a negative mammogram after a negative palpation is enough evidence to waive further investigation for some time. A positive mammogram calls for immediate biopsy in any circumstance.

Breast Neoplasms↗
PubMed1987

Scheduling and programming of rapid finger sequences: tests and elaborations of the hierarchical editor model.

Is a response sequence executed only after the sequence has been fully programmed, as discrete processing models predict, or does execution begin before programming has been completed, as continuous processing models predict? To address this issue, we tested a discrete processing model of human motor performance, the hierarchical editor model of Rosenbaum, Inhoff, and Gordon (1984). This model was developed to account for data from experiments in which people perform one of two possible finger sequences, depending on the identity of a choice signal. The model assumes a hierarchically organized motor program that is first "edited" to resolve any uncertainties and is then "executed" to produce the desired responses. Three experiments reported here show that, contrary to the model's predictions and some well-known motor programming results (Sternberg, Monsell, Knoll, & Wright, 1978), the reaction time to begin a response sequence actually decreases with the length of the sequence under some choice conditions. We account for these results with a model that allows execution to begin while editing is still in progress. A key assumption in the model is that subjects schedule execution so that means and variances of interresponse times are minimized.

Attention↗
PubMed1992

Artificial nucleosome positioning sequences tested in yeast minichromosomes: a strong rotational setting is not sufficient to position nucleosomes in vivo.

DNA sequences that support bending around the histone octamer ('rotational setting') are considered to be a major determinant of nucleosome positions. TG5 is an artificial positioning sequence containing 100 bp of an (A/T)3NN(G/C)3NN motif repeated with a 10 bp period. It provides a strong rotational setting and is superior to natural sequences in nucleosome formation in vitro [Shrader, T.E. and Crothers, D.M. (1989) Proc. Natl. Acad. Sci. USA, 86, 7418-7422]. To investigate the contribution of the rotational setting to nucleosome positioning in vivo, TG sequences were inserted in a nucleosome, at the edge of a nucleosome and in a nuclease sensitive region of yeast minichromosomes and the chromatin structures were analysed. In none of the constructs were TG sequences folded in a positioned nucleosome, demonstrating that the rotational setting played a subordinate role in the rough positioning in vivo. The rotational setting might fine tune the positions. Positioned nucleosomes were found overlapping the ends of TG, indicating that a discontinuity of the 10 bp periodicity of (A/T)3 and (G/C)3 near the centre of a nucleosome might be favourable for positioning and serve as a translational signal.

Base Sequence↗
PubMed1991

Time domain analysis of oxygen uptake during pseudorandom binary sequence exercise tests.

Pseudorandom binary sequence (PRBS) exercise tests involve repeated switching between two work rates (WR) according to a computer-generated pattern. This paper presents an approach to analysis of O2 uptake (VO2) in the time domain. First, the autocorrelation function (ACF) of the input WR was recognized to be a triangular-shaped pulse that can be taken to be equivalent to a ramp increase followed by a ramp decrease in WR. Then the cross-correlation function of the input (WR) and the output (VO2) was treated as if it were the response to a triangular-shaped pulse. The cross-correlation function was analyzed by fitting a linear summation of the ramp form of a two-component exponential function to this triangular pulse. VO2 responses of eight subjects were obtained from two different PRBS tests, as well as step changes in WR. The first PRBS test consisted of 15 units, each 30 s in duration. Its ACF had a base width of 60 s. The ramp increase-ramp decrease model fit the data throughout the range of response. The second PRBS test had 63 units, each 5 s in duration; thus its ACF base width was 10 s. Again, the ramp model fit adequately. The data from the second PRBS test could be fit by the impulse form of the two-component exponential equation, although the fit in the first 30 s tended to be poorer. The time constants of VO2 dynamics estimated from step and PRBS tests were not significantly different. PRBS tests can be analyzed in the time domain, and the indicators of system dynamics reflect physiological properties similar to those investigated during step changes in WR.

Adult↗
PubMed2026

Real-World Testing Landscape and Costs of Companion Diagnostics and Comprehensive Genomic Profiling Across Nine Solid Tumors in Japan: A 10-Year Analysis.

INTRODUCTION: This study aimed to examine utilization, testing sequences, and associated genomic testing costs of companion diagnostics (CDx) and comprehensive genomic profiling (CGP) among Japanese patients with nine representative solid tumors. METHODS: This retrospective study used anonymized data, from Medical Data Vision Co., Ltd. (MDV; January 2015-March 2025) and JMDC Inc. (JMDC; January 2015-January 2025), for patients with solid tumors of nine cancer types who underwent CDx and/or CGP testing or received any cancer treatment. Patient demographics, distribution and testing sequences of CDx and CGP, and associated genomic testing costs per patient were evaluated. RESULTS: Proportions of CDx and CGP testing varied across nine cancer types. Most patients underwent CDx testing once or twice, although some cohorts, particularly with non-small cell lung cancer (NSCLC), were tested thrice or more. Biliary tract cancer demonstrated the highest proportions for CGP testing alone, and both CDx and CGP testing. For both CDx and CGP testing, the greatest median costs were observed for ovarian and breast cancers, with bimodal peaks near US dollars (USD) 4000 and USD 5000. Median CDx costs were equal to or higher for patients who underwent both CDx and CGP testing compared with those who had CDx testing alone, particularly in breast, pancreatic, prostate, and ovarian cancers. For CDx testing alone, NSCLC, ovarian cancer, and prostate cancer had the highest costs, with a small peak near USD 1333. These results were mostly consistent across databases. CONCLUSIONS: Multiple CDx testing followed by CGP testing increased genomic testing costs per patient. Early implementation of CGP testing could reduce redundant testing and associated delays in treatment, thereby contributing to lower overall healthcare costs and more efficient treatment selection amid rapid advances in targeted therapies.

Administrative claims database↗
PubMed1989

Effects of metric and harmonic rhythm on the detection of pitch alterations in melodic sequences.

Tested response time to alterations. Metric rhythm and harmonic rhythm of 13-note tonal sequences were either matched or mismatched. Metric rhythm (3/4 or 4/4 meter) was induced by dynamic accents. Harmonic rhythm was induced by implied chord progressions initiated on the first note and on either every third or every fourth note. Responses were not always faster for matched rhythms or for alterations occurring on the dynamic accent. Responses were consistently faster for sequences presented in 4/4 meter. Musically untrained Ss performed similarly to trained Ss, but were slower and more variable. Accuracy of recall on a music dictation task also favored 4/4 meter rather than matched rhythms. Coding of pitch content may have been facilitated by the structural framework of 4/4 meter rather than by expectancies arising from the match of temporal and pitch organization.

Adolescent↗
PubMed1976

Rational sequence of tests for pancreatic function.

Of 144 patients with suspected pancreatic disease in whom a 75Se-selenomethionine scan was performed, endoscopic retrograde pancreatography (ERP) was successful in 108 (75%). The final diagnosis is known in 100 patients and has been compared with scan and ERP findings. A normal scan reliably indicated a normal pancreas, but the scan was falsely abnormal in 30%. ERP distinguished between carcinoma and chronic pancreatitis in 84% of cases but was falsely normal in five patients with pancreatic disease. In extrahepatic biliary disease both tests tended to give falsely abnormal results. A sequence of tests to provide a rapid and reliable assessment of pancreatic function should be a radio-isotope scan, followed by ERP if the results of the scan are abnormal, and a Lundh test if the scan is abnormal but the findings on ERP are normal.

Acute Disease↗
PubMed1988

Automatic and strategic processes in picture naming.

Prior presentation of related priming stimuli can facilitate responding to subsequent targets. However, recent research has demonstrated that inhibition effects can be produced by related primes when some of the primes in the testing sequence directly name their targets. This study used a picture-naming task, manipulating strength of relation between the prime word and the target picture, and the presence of identical primes in the testing sequence. Related primes facilitated naming when identical primes were absent, but not when they were present, whereas the strength effect did not vary as a function of identical-prime presence. A second experiment replicated the strength effect and showed that it was not affected by the presence or absence of primary associates in the testing sequence. A comparison-strategy explanation of the inhibition effect is proposed, in which the strategy is superimposed on an automatic activation of related information.

Adult↗
PubMed1989

Topical anesthetics: effects on the Achilles tendon and H-reflexes. I. Able-bodied subjects.

Achilles tendon reflexes (ATR) and H-reflexes were monitored to determine changes in motor responses after the application of a benzocaine spray or an air spray to normal individuals. There was no change in ATR after application of the spray or the benzocaine, even when the sequence of reflex elicitation was reversed. The only significant change (p less than 0.05) in the H-reflex was an increase in its amplitude from baseline at all posttest times following (1) the placebo application when the H-reflex preceded the ATR (0.264 +/- 0.054V, ten minutes; 0.290 +/- 0.054V, 20 minutes; and 0.322 +/- 0.058V, 30 minutes), and (2) the benzocaine spray when the ATR preceded the H-reflex (0.277 +/- 0.084V, ten minutes; 0.309 +/- 0.152V, 20 minutes; and 0.329 +/- 0.131V, 30 minutes). Within-group comparisons revealed that a significantly greater H-reflex (p less than 0.05) was obtained at 20 and 30 minutes after air spray when H-reflex/ATR test sequence was used, whereas at 30 minutes after application of the benzocaine spray a significantly greater H-reflex was seen using the ATR/H-reflex test sequence. Changes in H-reflex amplitude appear to be as much a function of the reflex testing sequence as whether an air or benzocaine spray is used.

Achilles Tendon↗