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At least 19 recordsLinked to original sources
PubMed1995

A review of factors affecting treatment outcomes: Expected Treatment Outcome Scale.

The Expected Treatment Outcome Scales was developed to gather information on clients who abuse drugs or alcohol, to assess their severity of illness, and to evaluate the effectiveness of drug treatment in nonrandomized clinical studies. The scale is based upon a multiattribute value model reflecting the opinions of an expert panel. The experts identified 25 variables, or predictors of relapse, from which 48 questions were constructed. Answers to the questions are individually scored. These scores are summed to produce an overall Expected Treatment Outcome score. This paper focuses on the development and preliminary validation of the Expected Treatment Outcome Scale. Results of our analysis show a correlation of .89 between the experts' average ratings of hypothetical clients and scores based on our scale. This finding suggests that the Expected Treatment Outcome Scale has face validity and accurately simulates the experts' judgments regarding treatment outcome. Further research is necessary to assess the reliability as well as the concurrent and predictive validity of our instrument.

Adult↗
PubMed1999

Surgical versus orthodontic correction for Class II patients: age and severity in treatment planning and treatment outcome.

Treatment options for Class II malocclusion include orthognathic surgery. Treatment choices are particularly difficult for young patients because of the uncertainty regarding future growth. Surgical treatment has generally been considered necessary for older patients with more severe Class II problems. The treatment records of more than 500 patients with Class II malocclusion were reviewed. Patients were grouped according to their initial treatment plan (surgery or orthodontics) and treatment outcome (overjet [OJ] reduced to < 4 mm or not). Discriminant function analyses using data from the patient's pretreatment cephalogram were used to determine whether age, in combination with malocclusion severity, could predict the choice of treatment, and whether a simple set of pretreatment variables could predict the success or failure of OJ reduction. The derived equations were tested in a similar group of growing Class II children. Although the data showed clinicians use patient's age in determining treatment choice, age did not seem to be associated with treatment outcome. The majority of the variability that determined the success or failure of OJ reduction was not explained by patient's age or malocclusion severity. These findings suggest other factors, including psychosocial variables, need to be explored if we are to gain a better understanding of why treatments succeed or fail.

Adolescent↗
PubMed1991

Assessment of treatment outcome.

Treatment outcome research consists of two types: controlled clinical trials and in-house program evaluations. Controlled clinical trials are experimental studies designed to test whether or not a treatment is efficacious. In-house program evaluations provide information about the results (outcome) of an individual treatment program. The key components of clinical trials include control groups; randomization procedures; enumeration of those who were screened for inclusion in, those accepted into, and those excluded from the study; a description of the relevant patient characteristics of the sample studied; "double-blinding" for pharmacological studies; raters of treatment effects who are not the therapists for verbal therapies; objective measures of treatment response; follow-up of at least 70% of the original sample; and appropriate statistical analysis of the data collected. In-house program evaluations rarely have control groups or employ randomization. However, a description of the type of patients treated by the program, independent raters, and adequate follow-up of those entering treatment are essential for program evaluation; and the credibility of program evaluation would be enhanced by the use of objective measures of treatment response.

Alcoholism↗
PubMed1987

Lithium carbonate treatment of mania. Cerebrospinal fluid and urinary monoamine metabolites and treatment outcome.

Treatment of manic patients with lithium carbonate was associated with significant decreases in cerebrospinal fluid (CSF) 3-methoxy-4-hydroxyphenylglycol (MHPG) and urinary norepinephrine excretion. These measures, before treatment, were higher in manic patients than in either depressed or normal subjects and correlated significantly with severity of mania. Levels in CSF of homovanillic acid and 5-hydroxyindoleacetic acid did not correlate with severity or with change during lithium carbonate treatment. Responders (about 70% of the patients) did not differ from nonresponders in pretreatment mania ratings or neurotransmitter measures. The CSF MHPG and urinary norepinephrine excretion were reduced during lithium carbonate treatment in both responders and nonresponders. Unlike the case before treatment, urinary MHPG excretion was higher during treatment in nonresponders than in responders and correlated with several indexes of symptom severity. These results support a relationship between mania and increased noradrenergic function. Treatment outcome, however, was not related exclusively to the reduction of noradrenergic indexes by lithium carbonate since reductions were similar in both responders and nonresponders. Reduced noradrenergic activity may therefore be necessary but not sufficient for successful outcome during lithium carbonate treatment.

Adult↗
PubMed2005

Assessment of orthodontic treatment outcomes: early treatment versus late treatment.

This investigation compares the treatment outcome of early treatment (in the mixed dentition) with that of late treatment (early permanent dentition) using objective evaluation criteria. Pretreatment and post-treatment records of all patients (n = 512) completed from 1998 to 2000 in the graduate orthodontics clinic at the Indiana University School of Dentistry (IUSD) were evaluated by the American Board of Orthodontics Objective Grading System (ABO OGS) and Comprehensive Clinical Assessment (CCA) method developed at IUSD. Two definitions of early treatment were used in this study: (1) all patients started in the mixed dentition with early-treatment objectives and (2) female individuals were <10 years and male individuals were <10.5 years of age when treatment began. Comparison of the final results between early- vs late-treatment groups showed that the early-treatment group had significantly longer treatment time and worse CCA scores than the late-treatment group, regardless of the definition of the early-treatment group or whether the early-debond (premature treatment termination) cases were included or not. There was no significant difference between early- and late-treatment groups regarding the ABO OGS score, which indicated that the CCA method is more sensitive in detecting compromised outcomes for patients with long treatment times. Prematurely terminated treatment was more prevalent in the early-treatment group than in the late-treatment group. In this large sample of consecutive patients (n = 512), the disadvantages of early treatment was prolonged treatment time, worse CCA score, and a higher incidence of premature termination of treatment, which was attributed to patient/parent "burn-out."

Age Factors↗
PubMedDate not supplied

Mediators of drug treatment outcomes.

Treatment for drug use, like the process by which a person comes to use illicit drugs, may be seen to be at least in part a psychosocial process involving emotional, cognitive, and relationship domains. Treatment programs attempt to improve the psychosocial functioning of clients with the ultimate goal of effecting change in drug-use behaviors. In a longitudinal study of clients in an intensive outpatient treatment program using a cognitive behavioral model to treat crack cocaine use, it was found that length of treatment was directly associated with improvement in emotional well-being, cognitive functioning, and relationships. Of the three psychosocial domains, improvement in relationships had the strongest effect on self-reported decreases in cocaine usage, verified by urinalysis. Improvement in cognitive functioning had a small impact on cocaine use, whereas improvement in emotional well-being had almost no independent effect in this cognitive behavioral treatment program.

Adult↗
PubMedDate not supplied

Respiratory exacerbations in children with cystic fibrosis: physiotherapy treatment outcomes.

Treatment efficacy is crucial in cystic fibrosis (CF) as it impacts directly upon life expectancy, with its evaluation contributing to the evidence base for physiotherapy practice. This study assesses whether respiratory outcomes changed at the Royal Children's Hospital, Brisbane (RCH) over a period when physiotherapy airways clearance techniques altered All 1998 and 2000 admissions of children over two years of age to RCH for CF related respiratory exacerbations were included, totalling 248 admissions, 125 in 1998 and 123 in 2000. Data for respiratory effort, cough quality, sputum volume/weight, sputum colour and sputum stickiness were analysed. Respiratory function test (RFT) results included: forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and forced expiratory flow (FEF25-75%) and % of predicted values. Repeated measures ANOVA and appropriate post hoc tests evaluated changes occurring during the admissions. Independent-samples t-tests allowed comparison of the improvement in the two years. During hospital admission in both 1998 and 2000, a significant improvement in RFT results occurred. Similar improvements in 1998 and 2000 suggested no change in treatment efficacy had occurred. Significant changes during hospitalisation, in cough quality, sputum volume/weight, and sputum colour suggest that these variables are appropriate and simple physiotherapy outcome measures.

Adolescent↗
PubMed1990

Health locus of control beliefs and alcohol-related factors that may influence treatment outcomes.

Treatment programs have based their treatment approach on the premise that alcoholics should exert internal control over situations and events that affect them. Since chronic alcohol use affects the health of an individual, Walston and Walston's Multidimensional Health Locus of Control Scale was administered to 47 alcoholics in a treatment program. The population reflected a higher belief that health status is more under their own control than under the control of chance or powerful others. However, the results indicated that recovering alcoholics with a more powerful other health orientation tended to maintain membership longer with Alcoholics Anonymous, would seek help sooner, would begin heavy drinking at a later age, and would attempt formal treatment more often.

Adolescent↗
PubMed2000

Associations between staff feelings toward patients and treatment outcome at psychiatric treatment homes.

This paper presents, as part of a national Swedish research project, a study of associations between staff feelings toward patients and treatment outcome at 23 small psychiatric inpatient units. The outcome was measured with a composite scale based on structured interviews. Staff feelings were reported on a feeling checklist. Few and scattered correlations were found between staff feelings and treatment outcome when the whole group of patients was analyzed together. More meaningful patterns were found when data for psychotic and borderline patients were analyzed separately. For psychotic patients, positive outcome was associated with low levels of negative feelings throughout treatment. For borderline patients, positive outcome was associated with negative feelings at the beginning of treatment, followed by strong positive feelings in the later part. Staff feelings were more strongly associated with outcome for borderline patients than for psychotic patients. Patients with different structural diagnoses need different kinds of staff "feeling milieus."

Adolescent↗
PubMed2005

Prediction of post-treatment outcome after combined treatment with maxillary protraction and chincap appliances.

The aims of this study were to identify differences in the initial skeletal morphology between successful and unsuccessful groups and to establish a novel method for predicting the final outcome of treatment with a maxillary protraction appliance (MPA) and chincap. The cephalograms used in this study were taken from 32 Japanese girls (mean age 10.2 years) with a Class III malocclusion at the beginning of treatment with an MPA and chincap (T1), at removal of the appliance (T2), and during the final post-treatment period (T3). The subjects were divided into two groups according to the treatment outcome at T3. Lower face height (ANS-Me), total face height (N-Me), ratio of face height (ANS-Me/N-ANS), maxillary position, mandibular plane and gonial angle at T1 were all significantly larger in the unsuccessful group, compared with the successful group. Discriminant analysis indicated that lower face height and gonial angle were significant determinants for distinguishing between the two groups at T1. From T1 to T2, while the anterior displacement of the maxilla was almost the same in the two groups, SNB decreased by 1.6 degrees in the successful group and 0.4 degrees in the unsuccessful group. After orthopaedic treatment, a second phase of treatment with a multibracket system was performed (T2 to T3). From T2 to T3, SNA increased by 0.4 degrees in the successful group and decreased by 0.7 degrees in the unsuccessful group. These results indicate that the vertical dimensions of the craniofacial skeleton are important for predicting the prognosis of skeletal Class III patients treated with a MPA and chincap and that the discriminant formula established in this study is effective in predicting the final treatment outcome.

Cephalometry↗
PubMed2005

Validation of a behavioral health treatment outcome and assessment tool designed for naturalistic settings: The Treatment Outcome Package.

In 1994, the American Psychological Association and the Society for Psychotherapy Research convened a Core Battery Conference to develop a set of criteria for the selection of a universal core battery that could be used as a common outcome tool across all outcome studies. The Treatment Outcome Package (TOP) is a behavioral health assessment and outcome battery with modules for assessing a wide array of behavioral health symptoms and functioning, demographics, case-mix, and treatment satisfaction. It was developed to follow the design specifications set forth by the Core Battery Conference, but also to ensure the battery's applicability to naturalistic treatment settings in which randomization may be impossible. In this article we discuss a number of studies that evaluate the initial psychometrics of the items that comprise the mental health symptom and functional modules of the TOP. We conclude that the TOP has an excellent factor structure, good test-retest reliability, promising initial convergent and discriminant validity, measures the full range of pathology on each scale, and has some ability to distinguish between behavioral health clients and members of the general population.

Adult↗
PubMed1999

Substance dependence and personality disorders: comorbidity and treatment outcome in an inpatient treatment population.

OBJECTIVE: Personality disorders (PDs) are common among patients with substance dependence, and antisocial PD in particular has been found to have a significant impact on treatment outcomes. Relatively little is known about other comorbid PDs, however. This study was designed to clarify the distribution of PDs among substance dependent patients and assess their role in treatment outcome. METHOD: PDs and substance use disorders were diagnosed for 252 (181 male) consecutively admitted substance dependent inpatients using structured clinical interviews. A subsample of these (n = 104) were also followed for 1 year to monitor treatment outcome and relapse. RESULTS: Fifty percent of the patients were diagnosed with one or more personality disorders, but no consistent relationships between drug of choice and PDs were found. The likelihood of relapse, however, increased significantly with the diagnosis of a PD. Only 6% of the patients who received more than one PD diagnosis were maintaining sobriety at the end of 1 year compared with 44% of those with no PD diagnoses. A preference for cocaine was also a significant predictor of relapse. CONCLUSIONS: The low participation rate for the treatment outcome study and other methodological limitations render the study results tentative. Nevertheless, the findings suggest that more attention should be given to Axis II disorders in substance dependence research and treatment.

Adult↗
PubMed2006

The association between cocaine use and short-term outcomes for the treatment of heroin dependence: findings from the Australian Treatment Outcome Study (ATOS).

The aim of this study was to determine the prevalence of cocaine use among individuals presenting for treatment for heroin dependence, describe the clinical profile of heroin users who also use cocaine and to establish the effects of cocaine use on short term outcomes for the treatment for heroin dependence. A longitudinal follow-up of 549 heroin users recruited in Sydney for the Australian Treatment Outcome Study was conducted at 3-month post-baseline interview. At baseline, current cocaine use was common (39%) and was associated with increased drug use, needle risk taking and criminality. The 3-month prevalence of cocaine use declined significantly to 19%. Thirty-five per cent of those who had used cocaine at baseline continued to use at 3 months, while 9% of the sample had commenced cocaine use. Those who entered residential rehabilitation at baseline were less likely than other treatment entrants and the non-treatment group to have used cocaine at follow-up. Treatment retention was not affected by baseline cocaine use status; however, baseline cocaine users (CU) displayed higher levels of heroin use, polydrug use and drug-related problems. A poorer outcome was associated with the commencement or continuation of cocaine use, while cessation of cocaine use resulted in significant improvements on these measures. Cocaine use was common among individuals seeking treatment for heroin dependence and was an important moderator of treatment outcome. It appears that cocaine use has a strong negative effect on treatment outcome over and above that caused by polydrug use generally.

Adolescent↗
PubMed1994

Treatment outcome with implant-retained overdentures: Part I--Clinical findings and predictability of clinical treatment outcome.

This nationwide study was conducted to clinically evaluate treatment with implant-retained overdentures when applied on a large scale and to determine to what degree treatment results could be predicted from patient and treatment characteristics at baseline. A total of 429 patients who had received implant overdenture treatment were clinically investigated by two dentists. Implant survival was high, especially for implants placed in the mandible. Results for the maxilla appeared far less promising. Complications that were observed predominantly concerned inflammation of the peri-implant tissues and poor oral hygiene. The quality of the overdentures, as assessed on three conventional prosthetic parameters, was generally good. Nevertheless, overdentures on oral implants appear to require considerable maintenance. No statistically significant correlation could be found between patient and treatment characteristics at baseline and the clinical treatment outcome. So, although treatment outcome with implant-retained overdentures appeared favorable, clinical results were not individually predictable.

Dental Health Surveys↗
PubMed1999

The multigenerational treatment setting for the chemically dependent adolescent; impact on cost, quality and treatment outcomes.

The treatment outcome from homogeneous age group substance abuse treatment centers, whose clientele consist of adolescent chemical dependents, has never clearly been demonstrated to be superior to heterogeneous age group treatment. An analysis of research in several disciplines concerning outcome studies related to adolescent chemical dependency and mental health treatment, demonstrates that heterogeneous (multigenerational) treatment settings may be superior to homogeneous age group treatment. Other adolescent issues in the family and society that directly affect treatment philosophies in centers directed toward youth are compared to the treatment philosophies of adult centers. It is suggested that multigenerational treatment facilities cost less, require less staff, are better received by the client, and produce higher abstinence rates than adolescent-specific centers.

Adolescent↗
PubMed2003

Overview of 5-year followup outcomes in the drug abuse treatment outcome studies (DATOS).

Followup results from the Drug Abuse Treatment Outcome Studies (DATOS) 1-year and 5-year followups were used to describe the long-term outcomes of drug treatment and to further clarify the relationship between treatment duration and post-treatment outcomes in four treatment modalities: outpatient methadone, long-term residential (LTR), outpatient drug free (ODF), and short-term inpatient. Methods replicating those used in earlier analyses of the DATOS 1-year followup of 2,966 patients admitted to treatment in 1991-1993 and those of the Treatment Outcome Prospective Study patients admitted in 1979-1981 were employed. DATOS is a non-experimental longitudinal study conducted within the natural settings of 96 treatment programs in the U.S.A. The study followed patients during and after treatment at specified periods of time. Prevalence of drug use and behaviors were evaluated for the year prior to treatment; and the post-treatment time frames defined by the 1- and 5-year followups. In addition, the multivariate analytic technique of generalized estimating equations was used to examine the relationship of treatment duration and outcomes across both followups while also controlling for patient characteristics and pretreatment levels of behaviors. The 5-year stratified followup sample included 1,393 of the same individuals in the 1-year followup sample. Analyses were restricted to patients participating in both followups. Reductions in prevalence of cocaine use in the year after treatment (compared to the preadmission year) by patients were associated with longer treatment durations (particularly 6 months or more in LTR and ODF). In addition, reductions in illegal activity and increases in full-time employment were related to treatment stays of 6 months or longer for patients in LTR. The DATOS results from the 1-year and 5-year post-treatment followup combined suggest the stability of outcomes of substance abuse treatment. While results are generally consistent with the full 1-year followup, reduced sample size and bias of the sample toward patients with longer treatment retention may have attenuated the findings.

Adult↗