Dissertations / Theses on the topic 'Outcome analyses'
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Chen, Chen. "Bayesian Analyses of Mediational Models for Survival Outcome." University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1313684054.
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Wong, Sze Ying. "Neurodevelopmental outcomes of children born preterm : analyses into the validity of data collection and outcome reports." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/45429.
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Background and aims: Information on the neurodevelopmental outcomes of children born very preterm is required for multiple purposes. Reliable and up-to-date data sources are lacking. The overall aim of this thesis is to evaluate the validity and usability of the neurodevelopmental outcome data of very preterm children available from current data sources. The specific objectives were: 1) to examine the validity of outcome data recorded during routine follow-up assessment 2) to explore early childhood social-communication difficulties exhibited by very preterm children 3) to assess the stability over time of neurodevelopmental diagnoses made in early childhood. Methods: Three studies were conducted to meet the objectives. For studies 1 and 2, I recruited children born at < 30 weeks’ gestation at 2 years corrected age (age corrected for prematurity) from 13 participating study sites. In study 1, I compared the agreement between the neurodevelopmental outcomes of 190 children recorded at their routine NHS assessments and data obtained by a research assessment using the Bayley Scales of Infant Development, 3rd edition. In study 2, the social-communication skills of 141 children were determined using the parent-completed Quantitative Checklist of Autism in Toddlers (Q-CHAT) questionnaire and compared to published results from the general population. In study 3, I conducted a systematic review and using meta-analytic methods, I calculated the pooled sensitivity and specificity of early developmental assessment in identifying school-age cognitive deficit from 24 studies. Conclusions: 1) Compared with research assessment, routine NHS follow-up assessment had a low sensitivity but high specificity for identifying children with neurodevelopmental impairment. 2) Very preterm children display greater early childhood social-communication difficulties and autistic behaviour than the general population as measured by their parents on the Q-CHAT. 3) Early neurodevelopmental assessment has high specificity but low sensitivity for identifying later school-age cognitive deficits.
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Wood, Rhonda. "Application of exploratory analyses to career counseling process and outcome research data /." free to MU campus, to others for purchase, 2004. http://wwwlib.umi.com/cr/mo/fullcit?p3137765.
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Dunn, Ryan Lamar. "A meta-analytic review of marital therapy outcome research : general and comparative analyses /." The Ohio State University, 1993. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487847761307082.
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Rothrock, Ling. "Performance measures and outcome analyses of dynamic decision making in real-time supervisory control." Diss., Georgia Institute of Technology, 1995. http://hdl.handle.net/1853/25112.
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Tamegnon, Monelle. "Avoiding the redundant effect on regression analyses of including an outcome in the imputation model." Diss., University of Iowa, 2018. https://ir.uiowa.edu/etd/6301.
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Imputation is one well recognized method for handling missing data. Multiple imputation provides a framework for imputing missing data that incorporate uncertainty about the imputations at the analysis stage. An important factor to consider when performing multiple imputation is the imputation model. In particular, a careful choice of the covariates to include in the model is crucial. The current recommendation by several authors in the literature (Van Buren, 2012; Moons et al., 2006, Little and Rubin, 2002) is to include all variables that will appear in the analytical model including the outcome as covariates in the imputation model. When the goal of the analysis is to explore the relationship between the outcome and the variable with missing data (the target variable), this recommendation seems questionable. Should we make use of the outcome to fill-in the target variable missing observations and then use these filled-in observations along with the observed data on the target variable to explore the relationship of the target variable with the outcome? We believe that this approach is circular. Instead, we have designed multiple imputation approaches rooted in machines learning techniques that avoid the use of the outcome at the imputation stage and maintain reasonable inferential properties. We also compare our approaches performances to currently available methods.
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Åsberg, Signild. "Outcome of Stroke Prevention : Analyses Based on Data from Riks-Stroke and Other Swedish National Registers." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-171871.
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The aim of this thesis was to explore variations in stroke prevention and the effect of prevention on outcome. The studies were based on patients registered in the Swedish Stroke Register between 2001 and 2009 and although used to different extents in each paper, additional information was retrieved through linkage to The National Patient Register, the Cause of Death Register, the Prescribed Drug Register and the Total Population Register. Cardiovascular risk factors were prevalent among ischemic stroke (IS) patients; however, they were not always prescribed the drugs recommended, and increasing age was an important negative predictor (Paper I). After IS, the rate of hemorrhage in patients prescribed antiplatelet agents (2.4 per 100 person-years) was double to results from randomized controlled trails, but was similar for patients prescribed warfarin (2.5 per 100 person-years). Age ≥75 years and previous hemorrhage were associated with a moderately increased risk of future hemorrhage (Paper II). Among IS patients with atrial fibrillation, one-third was prescribed warfarin and two-thirds were prescribed antiplatelets. After adjustment for a propensity score (used to adjust for the non-randomized design), warfarin was associated with a reduced risk of death (0.67; 95% CI, 0.63-0.71) (Paper III). The rate of subsequent hemorrhagic stroke was 0.4 per 100 person-years and the risk did not change (HR 1.04; 95% CI, 0.73-1.48) when later years of the 2000s (inclusion period 2005-8: follow-up until 2009) was compared with earlier years (inclusion period 2001-4: follow-up until 2005) (Paper IV, cohort). Although the risk of first-ever hemorrhagic stroke more than doubled with warfarin than without, the risk did not change between 2006 and 2009 (Paper IV, case-control). In summary, the prescription of secondary preventive drugs varies with age, even though cardiovascular risk factors are prevalent in all ages. The risk of death and hemorrhage are affected by the type of antithrombotic prescribed. Therefore, it is important individual’s stroke and bleeding risks in stroke prevention are assessed.
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Vas, Edit. "Sedentary behaviour and physical activity during a 6-months multimodal lifestyle intervention in persons with mild stage of Alzheimer´s disease : Secondary analyses of existing data." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-54617.
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Purpose: The objective was to study how sedentary behaviour (SB) and physical activity (PA)change during a 6-months multimodal lifestyle intervention including a Multimodal Lifestyle Intervention, a Multimodal Lifestyle and Medical food intervention and a control subgroup, for people with prodromal Alzheimer's disease (AD). Further, the aim was to explore the predictive value of outcome expectancies and self-efficacy beliefs on level of PA in the two intervention subgroups. Methods: A secondary analysis of existing data (n=66) from MIND-AD trial with a descriptive evaluation design was conducted. Descriptive and non-parametric statistical analysis were used for between- and within groups analysis. To explore the predictive value of a model with self-efficacy and outcome expectancies at baseline on PA at 6 months, regression analysis was conducted. Effect size was calculated for between-group and withingroup differences. Results: Objectively measured PA increased in the Multimodal Intervention subgroup. SB did not change during the intervention. Outcome expectancies for that impact of exercise is beneficial for health in the long run increased during the intervention. Participants higherinitial outcome expectancies for the impact of exercise would lead to less AD-related difficulties predicted higher PA level at 6 months. Self-efficacy for exercise or outcome expectancies for the impact of exercise on AD-related difficulties did not change during the intervention. Conclusions: PA increased in the Multimodal Intervention subgroup. This difference could not be shown with PA measured by questionnaire which indicates that objective measurements are better suited to measuring PA in people with prodromal AD than subjective measurements. Increased outcome expectancies for that impact of exercise arebeneficial for health in the long run demonstrate the participants strengthened intentions to improve their long-term health. Increasing outcome expectancies to manage AD-related difficulties can be an important part of interventions targeting PA in people with prodromal AD.
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Gueguen, Juliette. "Evaluation des médecines complémentaires : quels compléments aux essais contrôlés randomisés et aux méta-analyses ?" Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS072/document.
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Les médecines complémentaires sont nombreuses et variées, leur recours est largement répandu et en hausse. Selon les pratiques, les données d’évaluation sont plus ou moins riches, mais il y a peu de conclusions consensuelles quant à leur efficacité, même en cas de littérature abondante. Nous commencerons par un état des lieux de l’adéquation des méthodes conventionnelles utilisées pour l’évaluation du médicament, à savoir de l’essai contrôlé randomisé (ECR) et des méta-analyses, pour l’évaluation des médecines complémentaires.A travers trois applications pratiques, nous réfléchirons ensuite à l’apport d’autres méthodes, moins reconnues à ce jour dans le champ de l’evidence based medecine mais pouvant apporter d’autres éclairages. En particulier, nous discuterons de l’intérêt des méthodes mixtes, des études qualitatives et de l’exploitation des grandes bases de données médico-administratives. Nous réaliserons une revue mixte sur l’évaluation de l’hypnose pour le travail et l’accouchement, une étude qualitative sur l’expérience du qi gong par des patientes hospitalisées pour anorexie mentale sévère, et nous étudierons le potentiel d’exploitation du Système National d'Information Inter Régimes de l'Assurance Maladie (SNIIRAM) pour évaluer les médecines complémentaires. Les deux premiers axes nous amèneront à questionner le choix des critères de jugement et des instruments de mesure utilisés dans les ECR et nous inciteront à accorder davantage de place et de légitimité à la perspective du patient. Plus largement, cela nous invitera à remettre en cause la suprématie traditionnellement accordée aux études quantitatives pour la remplacer par une vision non hiérarchique mais synergique des approches qualitatives et quantitatives. Le troisième axe nous permettra d’identifier les limites actuelles à l’exploitation du SNIIRAM pour l’évaluation des médecines complémentaires, à la fois sur le plan technique et sur le plan de la représentativité. Nous proposerons des mesures concrètes pour rendre possible et pertinente son exploitation dans le champ de l'évaluation des médecines complémentaires.Enfin, dans la discussion générale, nous tiendrons compte du fait que l’évaluation des médecines complémentaires n’a pas pour but d’autoriser ou non une mise sur le marché. Ainsi, contrairement à l'évaluation des médicaments, l'évaluation des médecines complémentaires ne s'inscrit pas toujours dans une visée de prise de décision. Nous soulignerons l’importance de tenir compte de la visée (visée de connaissance ou visée de décision) dans l’élaboration d’une stratégie de recherche et nous proposerons deux stratégies différentes en nous appuyant sur la littérature et les résultats issus de nos trois exemples d'application. Concernant la stratégie de recherche à visée de prise de décision, nous montrerons l’importance des étapes de définition de l’intervention, d’identification des critères de jugement pertinents, et d’optimisation de l’intervention, avant la réalisation d’essais pragmatiques visant à évaluer l’efficacité en vie réelle. Nous verrons comment la volonté d’évaluer ces pratiques nous renvoie à des défis en terme de réglementation et nous soulignerons par ailleurs la nécessité d’évaluer la sécurité de ces pratiques en développant des systèmes de surveillance adaptésComplementary medicines are numerous and varied, their use is widespread and increasing.Quality and quantity of evaluation data depend on the type of complementary medicines, but there are few consensual conclusions about their effectiveness, even in the case of abundant literature. We will start with an inventory of the adequacy of the conventional methods used for drug evaluation, namely randomized controlled trials (RCT) and meta-analyzes, for the evaluation of complementary medicines. Through three practical applications, we will then consider the contribution of other methods, less recognized to date in the field of evidence-based medicine but potentially contributive to shed light on other perspectives. In particular, we will discuss the advantages of mixed methods, qualitative studies and the exploitation of large health administrative databases. We will conduct a mixed-method review of the assessment of hypnosis for labor and childbirth, a qualitative study on the experience of qi gong by patients hospitalized for severe anorexia nervosa and we will study the potential of the French national health insurance database (SNIIRAM) to evaluate complementary medicines. The first two axis will lead us to question the choice of outcomes and measurement tools used in RCTs and to value and legitimate the patient's perspective. More broadly, it will invite us to question the hierarchical vision of qualitative and quantitative research that traditionally attributes supremacy to quantitative studies. It will encourage us to replace it with a synergistic vision of qualitative and quantitative approaches. The third axis will enable us to identify the current limits to the use of SNIIRAM for the evaluation of complementary medicines, both technically and in terms of representativeness. We will propose concrete measures to make its exploitation possible and relevant in the field of evaluation of complementary medicines.Finally, in the general discussion, we shall take account of the fact that the evaluation of complementary medicines is not part of a marketing authorization process. Thus, contrary to drug evaluation, complementary medicines evaluation does not always imply decision making. We will emphasize the importance of considering the aim (aim of knowledge or aim of decision) in the development of a research strategy. We will propose two different strategies based on the literature and the results from our three examples. Concerning the research strategy aimed at decision-making, we will show the importance of defining the intervention, identifying the relevant outcomes, and optimizing the intervention first, before carrying out pragmatic clinical trials to evaluate its effectiveness. We will discuss the regulatory challenges complementary medicine evaluation confronts us to, and stress the need to assess the safety of these practices by developing appropriate monitoring systems
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Dwan, Kerry Margaret. "Outcome reporting bias in meta-analysis." Thesis, University of Liverpool, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.526893.
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Introduction: The increased use of meta-analysis in systematic reviews of healthcare interventions has highlighted several types of bias that can arise during the completion of a randomised controlled trial (RCT). Publication bias has been recognised as a potential threat to the validity of meta-analysis and can make the readily available evidence unreliable for decision making. Until recently, outcome reporting bias (ORB) has received less attention. ORB occurs when outcomes are selectively reported for publication based on their results. This can impact upon the results of a meta-analysis, biasing the pooled treatment effect. Methods: Empirical evidence from a series of cohort studies that have assessed study publication bias and ORB in RCTs is reviewed and summarised. Methods for identifying ORB in a review and trial reports are discussed using several motivating examples. Guidelines are obtained and assessed from worldwide organisations and UK based charities that fund RCTs; with regards to trial registration, protocol adherence and trial publication. Statistical, educational and policy solutions are reviewed. A novel weighted linear regression is used to predict missing outcome data when bias is suspected in a review containing structurally related outcomes. A maximum bias bound previously proposed is further assessed using a simulation study to test the sensitivity of the method when heterogeneity is present. The outcome reporting bias in trials (ORBln study is introduced and the impact ORB has on this cohort of reviews from the Cochrane Library is assessed using the bound for maximum bias. Results: Four empirical studies that examined the association between outcome reporting bias and statistical significance found that statistically significant outcomes were more likely to be completely reported than non-significant outcomes (range of odds ratios: 2.2 to 4.7). Guidelines for 73 organisations and charities were reviewed; only eleven of these organisations or charities mentioned the publication of negative as well as positive outcomes. The simulation study indicates that the bound for maximum bias is a useful approach for reviewers to apply to assess the robustness of the conclusions of a review to ORB and can be applied in the presence of heterogeneity. Assessing the impact of ORB in the cohort of reviews in the ORBIT study indicates that ORB had an impact in 15% of the reviews considered. Conclusions: This work summarises the direct empirical evidence for the existence of study publication bias and ORB. Researchers need to be aware of the problems of both types of bias and efforts should be concentrated on improving the reporting of trials. There is a need to provide more detailed guidance for those conducting and reporting RCTs to help prevent the selective reporting of results. There are several complementary initiatives to either prevent ORB or to reduce the occurrence of ORB. Therefore, with the implementation and development of these solutions it is hoped that in the future ORB will become less of a problem. However, methods that detect ORB and adjust results for ORB can be useful while the initiatives are given time to make an impact.
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Hirst, William Mark. "Outcome measurement error in survival analysis." Thesis, University of Liverpool, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366352.
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Incavido, Danielle. "Analysis of variables influencing probation outcome." Connect to online version at OhioLINK ETD Connect to online version at Digital.Maag, 1998. http://hdl.handle.net/1989/3746.
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Thorne, Fiona Margaret. "Stakeholder analysis of outcome in chronic pain." Thesis, University of Leeds, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.485209.
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Determining what can be described as a 'good outcome' for people with chronic pain is problematic. It is not feasible to measure change in relation to whether individuals are within the bounds of the nonnal population as this is not possible for the majority (i.e. the pain will not cease· and return them to nonnal physical functioning). This investigation sought to derive service-user detennined criteria for the assessment of clinical significance in chronic pain. A total of 78 men and women aged 21-86 attending a local pain management out-patient clinic agreed to take part in the investigation. Participants were asked to describe an 'acceptable outcome' using common chronic pain outcome measures. Participants indicated a lower level of pain severity, impact and interference and higher level of activity as part of an acceptable outcome. Previous research has typically placed the threshold for clinically significant change at around 30%. The degree of change indicated by participants was notably higher (52.1 - 63.7%). There was considerable variation between participants. Those experiencing higher current pain intensity required a greater change in their pain experience for it to be described as an 'acceptable outcome'. For some parameters, younger age and female gender were also associated with requiring a greater degree of change. The majority of acceptable outcome ratings could be described as statistically reliable, depending on the specific pain parameter. Cut points for clinical significance were also derived for each outcome measure. Analyses revealed that a large degree of change would be required for participants to be described as experiencing a clinical significant alteration in their pain experience. Results suggest that change meeting service-user defined clinical significance criteria may be difficult to achieve in clinical practice. Suggestions for future research and possible clinical implications are discussed.
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Pickering, R. M. "Analysis of categorical data on pregnancy outcome." Thesis, University of Glasgow, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.280012.
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Trost, Stefanie. "Retrospektive Analyse des kurzfristigen Outcomes von Patienten mit Gastroschisis und Omphalocele am Zentrum für Kinder- und Jugendmedizin Leipzig." Doctoral thesis, Universitätsbibliothek Leipzig, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-83329.
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Hintergrund: Weltweit berichteten zahlreiche Studien von einer steigenden Inzidenz von Patienten mit angeborenen Bauchwanddefekten. Besonders die Zahl der Gastroschisis-Kinder hat deutlich zugenommen. Auch die Neonatologen der Universitätsklinik Leipzig beschrieben ein gehäuftes Auftreten von Patienten mit Gastroschisis und Omphalocele. Aufgabe der vorliegenden Arbeit war es, die Inzidenz dieser beiden Fehlbildungen am Universitätsklinikum Leipzig zu ermitteln und zu untersuchen, wie sich die Fallzahlen während des Untersuchungszeitraumes (1998-2008) entwickelt hatten. Zudem sollten Parameter identifiziert werden, die die Prognose der betroffenen Kinder bis zur Entlassung beeinflussten. Ein weiteres Anliegen dieser Studie war es, mithilfe einer ausführlichen Literaturrecherche, einen Überblick über die aktuelle Behandlung und Prognose der beiden Fehlbildungen zu geben.
Methoden: Im Rahmen einer retrospektiven Untersuchung erfolgte die Erhebung und Auswertung der Daten von 27 Kindern mit Gastroschisis sowie 19 Kindern mit Omphalocele, die zwischen 1998 und 2008 in der Universitätsklinik Leipzig behandelt wurden. Mithilfe des Mann-U-Whitney-Tests sowie des exakten Tests nach Fisher wurden zahlreiche Merkmale hinsichtlich ihrer Auswirkungen auf das Outcome überprüft. Als Parameter, die das Outcome widerspiegelten, galten der Beginn des enteralen Kostaufbaus mit Tee-Glucose-Lösung und Milch, die Dauer der parenteralen Nährstoffzufuhr und des Krankenhausaufenthaltes, sowie Nachoperationen, Komplikationen und die Letalität während des stationären Aufenthaltes.
Ergebnisse: An der Universitätsklinik Leipzig betrug die Inzidenz von Gastroschisis 14 pro 10 000 Lebendgeburten und von Omphalocele 9 pro 10 000 Lebendgeburten. Die Inzidenz blieb während des elfjährigen Beobachtungszeitraumes konstant.
Der Vergleich früh- und reifgeborener Gastroschisis-Patienten zeigte, dass eine Frühgeburt weder mit einem früheren Beginn der oralen Ernährung mit Tee-Glucose-Lösung (11 d vs. 14 d; p nicht signifikant) und Milch (17 d vs. 17 d; p nicht signifikant), noch mit einer Verkürzung der parenteralen Ernährung (36 d vs. 37 d; p nicht signifikant) und stationären Behandlung (48 d vs. 50 d; p nicht signifikant) einherging. Häufig verkomplizierten Infektionen (12/27) und sekundäre Darmverschlüsse (9/27) mit der Notwendigkeit einer zusätzlichen Operation den postoperativen Verlauf der Gastroschisis-Patienten. Letztgenannte Komplikation führte zu einer erheblich protrahierten parenteralen Ernährung (79 d vs. 31 d; p < 0,05) und stationären Behandlung (101 d vs. 38 d; p < 0,05), während Infektionen kaum Auswirkungen auf das Outcome hatten. Es zeigte sich, dass vorrangig Kinder mit kleinem Defekt (<= 4 cm) sowie mit prolabiertem Magen einen Ileus entwickelten. Neben Darmverschlüssen führten intestinale Begleitfehlbildungen tendenziell zu einer Verlängerung der Hospitalisierungszeit (73 d vs. 48,5 d; p nicht signifikant). Gelang die orale Zufuhr von Milch innerhalb der ersten 14 Lebenstage, so verringerte sich die Dauer der parenteralen Ernährung (30 d vs. 37 d; p < 0,05) und der stationären Behandlung (41 d vs. 67 d; p nicht signifikant).
Bei Patienten mit Omphalocele bestimmten vor allem die Größe der Omphalocele, der Inhalt des Bruchsackes sowie der Zeitpunkt des oralen Ernährungsbeginns die Prognose. Ein großer (> 4 cm) Bauchwanddefekt ging mit einer erhöhten Infektionsrate (4/7 vs. 1/11; p < 0,05), prolongierten parenteralen Nahrungszufuhr (26 d vs. 17 d; p < 0,05) sowie stationären Behandlung (46 d vs. 24 d; p nicht signifikant) einher. Extraintestinale Begleitanomalien zeigten sich jedoch häufiger bei Patienten mit kleinem Defekt (5/11 vs. 1/7; p nicht signifikant). Befand sich die Leber außerhalb der Abdominalhöhle, waren zusätzliche Fehlbildungen seltener (3/11 vs. 5/7; p < 0,05). Eine prolabierte Leber verzögerte tendenziell die parenterale Ernährung (24 d vs. 18 d; p nicht signifikant) und die Krankenhausverweildauer (46 d vs. 21 d; p nicht signifikant). Ein frühzeitiger Beginn des enteralen Kostaufbaus mit Milch innerhalb der ersten zehn Lebenstage führte hingegen zu einer Verkürzung der parenteralen Ernährung (17 d vs. 27 d; p < 0,05) und stationären Behandlung (22,5 d vs. 49 d; p nicht signifikant).
Schlussfolgerung: Die Inzidenz von Gastroschisis und Omphalocele blieb während des Beobachtungszeitraumes konstant.
Die Prognose der Gastroschisis-Patienten wurde durch eine Frühgeburt nicht verbessert, so dass eine Termingeburt angestrebt werden sollte. Die Daten der vorliegenden Arbeit legen nahe, dass ein frühzeitiger Nahrungsaufbau mit der oralen Zufuhr von Tee ab dem achten Lebenstag sowie Milch ab dem zehnten Lebenstag günstig für das Outcome hinsichtlich der Dauer der parenteralen Ernährung und des stationären Aufenthaltes ist. Darmverschlüsse stellten schwerwiegende Komplikationen dar und verschlechterten das Outcome maßgeblich.
Eine große Omphalocele sowie eine ausgetretene Leber erhöhten die Morbidität. Ebenso wie bei Gastroschisis-Kindern scheint ein frühzeitiger Beginn der enteralen Ernährung das Outcome der Omphalocele-Patienten hinsichtlich der Dauer der parenteralen Ernährung und Krankenhausbehandlung zu verbessern. Deshalb empfehlen wir ab dem fünften sowie siebten Lebenstag die enterale Ernährung mit Tee sowie Milch zu beginnen.
Ein großes Manko der vorliegenden Studie ist die kleine Fallzahl dieser retrospektiven, monozentrischen Erhebung. Zur besseren Erfassung der Patienten mit angeborenen Bauchwanddefekten und um aussagekräftige epidemiologische und prognostische Ergebnisse zu erhalten, bedarf es eines Fehlbildungsregisters in Sachsen, so wie es bereits in anderen Bundesländern angewandt wird.
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Wu, Tsung-Lin. "Classification models for disease diagnosis and outcome analysis." Diss., Georgia Institute of Technology, 2011. http://hdl.handle.net/1853/44918.
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In this dissertation we study the feature selection and classification problems and apply our methods to real-world medical and biological data sets for disease diagnosis.
Classification is an important problem in disease diagnosis to distinguish patients from normal population. DAMIP (discriminant analysis -- mixed integer program) was shown to be a good classification model, which can directly handle multigroup problems, enforce misclassification limits, and provide reserved judgement region. However, DAMIP is NP-hard and presents computational challenges. Feature selection is important in classification to improve the prediction performance, prevent over-fitting, or facilitate data understanding. However, this combinatorial problem becomes intractable when the number of features is large.
In this dissertation, we propose a modified particle swarm optimization (PSO), a heuristic method, to solve the feature selection problem, and we study its parameter selection in our applications. We derive theories and exact algorithms to solve the two-group DAMIP in polynomial time. We also propose a heuristic algorithm to solve the multigroup DAMIP. Computational studies on simulated data and data from UCI machine learning repository show that the proposed algorithm performs very well. The polynomial solution time of the heuristic method allows us to solve DAMIP repeatedly within the feature selection procedure.
We apply the PSO/DAMIP classification framework to several real-life medical and biological prediction problems. (1) Alzheimer's disease: We use data from several neuropsychological tests to discriminate subjects of Alzheimer's disease, subjects of mild cognitive impairment, and control groups. (2) Cardiovascular disease: We use traditional risk factors and novel oxidative stress biomarkers to predict subjects who are at high or low risk of cardiovascular disease, in which the risk is measured by the thickness of the carotid intima-media or/and the flow-mediated vasodilation. (3) Sulfur amino acid (SAA) intake: We use 1H NMR spectral data of human plasma to classify plasma samples obtained with low SAA intake or high SAA intake. This shows that our method helps for metabolomics study. (4) CpG islands for lung cancer: We identify a large number of sequence patterns (in the order of millions), search candidate patterns from DNA sequences in CpG islands, and look for patterns which can discriminate methylation-prone and methylation-resistant (or in addition, methylation-sporadic) sequences, which relate to early lung cancer prediction.
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Hubbard, Julia Bryn. "Psychotherapy Outcome for Eating Disorders: A Meta-Analysis." BYU ScholarsArchive, 2013. https://scholarsarchive.byu.edu/etd/3641.
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The purpose of this project was to summarize psychotherapy outcomes for eating disorders using meta-analysis. Psychotherapy was defined as any psychosocial treatment including face-to-face therapy, self-help, and Internet approaches. All primary studies, meeting inclusion/exclusion criteria from 1980 to 2010, were included. Results suggested that individuals treated with active treatments demonstrate better outcomes than those in control conditions (d= 0.33, p <.01, 95% CI [0.19-0.46]). CBT was the most often occurring treatment in the primary studies and a small effect, favoring CBT, was found when the treatment was compared to all other active treatments (d = 0.16, p = .02, 95% CI [0.03-0.28]). Internet and self-help approaches continue to show promise with Internet treatments demonstrating superior outcomes to control conditions (d = 0.54, p <.01, 95% CI [0.19-0.90]). More research is needed to determine whether these approaches can suffice as stand-alone treatments or if they are best used in addition to already well-established approaches (i.e., individual CBT). The meta-analysis also explored whether treatment type, outcome measure, diagnosis, attrition, and diagnostic severity moderate treatment effect. Finally, the meta-analysis updated and improved upon previous meta-analyses by focusing on randomized controlled trials, including all diagnoses of eating disorder, only combining effect sizes from similar conditions, including all possible studies that meet inclusion criteria, computing and comparing effect sizes for outcome measures beyond those considered primary to eating disorder treatment, and also addressing outcomes for all brands of psychotherapy including traditional talk therapy, self-help, and Internet approaches.
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Beyer, Stefanie. "Charakteristika, Therapie und Outcome von Patienten mit spinalem Glioblastom oder Gliosarkom - Ein systematischer Review." Doctoral thesis, Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-209213.
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Gliome stellen mit 30-40 % die häufigsten intrakraniellen Tumoren dar. Darunter ist das Glioblastom, auch als Glioblastoma multiforme bezeichnet, mit ca. 50 % am stärksten vertreten und macht somit allein etwa 20 % aller Hirntumoren aus (Russell und Rubinstein 1989). Neben einer Metastasierung über den Liquor können diese Tumoren auch sehr selten als primäre Neubildung im Rückenmark vorkommen. Ebenso ist dort die Entwicklung eines sekundären Glioblastoms aus dem fortschreitenden Wachstum eines niedriggradigen Astrozytoms heraus möglich (Sure et al. 1997). Aufgrund ihres diffus infiltrativen Wachstums sowie der infausten Prognose wird das Glioblastom in der WHO-Klassifikation dem Tumorgrad IV zugeordnet (Louis et al. 2007).
Ziel dieser vorliegenden medizinischen Dissertation ist es, mit Hilfe einer Meta-Analyse individueller Patientendaten einen integrativen Überblick über die bereits vorhandene Forschung dieser seltenen Erkrankung zu erlangen. Aus einer umfangreichen Literaturrecherche resultierten 82 geeignete Publikationen, sodass von insgesamt 157 Patienten unter anderem Daten zum Veröffentlichungszeitraum, Alter und Geschlecht des Patienten, Tumorbiologie und –lokalisation sowie Therapie und Outcome erhoben werden konnten. In der statistischen Auswertung wurde die Korrelation dieser Faktoren eingehend untersucht mit dem Ziel, signifikante Aspekte herauszufiltern, die das Überleben von Patienten mit spinalem Glioblastom positiv beeinflussen können.
Trotz einer stetigen Verbesserung der bildgebenden Diagnostik durch Magnetresonanztomographie und Computertomographie sowie multimodaler Tumortherapie zeigte sich in der Auswertung der Ergebnisse, dass das mediane Überleben der Patienten mit spinalem Glioblastom bzw. Gliosarkom auf nur rund neun Monate zu beziffern ist.
Dabei konnten sowohl das Alter bei Diagnosestellung als auch das Jahr der Veröffentlichung der jeweiligen Patientenfälle als statistisch signifikante und somit bedeutende prognostische Faktoren im Hinblick auf die Überlebenszeit der Patienten identifiziert werden.
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Friedewald, Thomas Michael. "Group benchmarking process, outcomes and analysis /." Thesis, Online version, 2001. http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.340865.
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Gong, Zhaojing. "Parametric Potential-Outcome Survival Models for Causal Inference." Thesis, University of Canterbury. Mathematics and Statistics, 2008. http://hdl.handle.net/10092/1803.
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Estimating causal effects in clinical trials is often complicated by treatment noncompliance and missing outcomes. In time-to-event studies, estimation is further complicated by censoring. Censoring is a type of missing outcome, the mechanism of which may be non-ignorable. While new estimates have recently been proposed to account for noncompliance and missing outcomes, few studies have specifically considered time-to-event outcomes, where even the intention-to-treat (ITT) estimator is potentially biased for estimating causal effects of assigned treatment.
In this thesis, we develop a series of parametric potential-outcome (PPO) survival models, for the analysis of randomised controlled trials (RCT) with time-to-event outcomes and noncompliance. Both ignorable and non-ignorable censoring mechanisms are considered. We approach model-fitting from a likelihood-based perspective, using the EM algorithm to locate maximum likelihood estimators. We are not aware of any previous work that addresses these complications jointly. In addition, we give new formulations for the average causal effect (ACE) and the complier average causal effect (CACE) to suit survival analysis. To illustrate the likelihood-based method proposed in this thesis, the HIP breast cancer trial data \citep{Baker98, Shapiro88} were re-analysed using specific PPO-survival models, the Weibull and log-normal based PPO-survival models, which assume that the failure time and censored time distributions both follow Weibull or log-normal distributions. Furthermore, an extended PPO-survival model is also derived in this thesis, which permits investigation into the impact of causal effect after accommodating certain pre-treatment covariates. This is an important contribution to the potential outcomes, survival and RCT literature. For comparison, the Frangakis-Rubin (F-R) model \citep{Frangakis99} is also applied to the HIP breast cancer trial data. To date, the F-R model has not yet been applied to any time-to-event data in the literature.
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Perez, López Faustino R., Vinay Pasupuleti, Edward Mezones-Holguín, Priyaleela Thota, Abhishek Deshpande, Adrian V. Hernández, and Vicente A. Benítes-Zapata. "Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials." Elsevier B.V, 2015. http://hdl.handle.net/10757/347325.
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faustino.perez@unizar.esObjective: To assess the effects of vitamin D supplementation during pregnancy on obstetric outcomes and birth variables. Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). Setting: Not applicable. Patient(s): Pregnant women and neonates. Intervention(s): PubMed and 5 other research databases were searched through March 2014 for RCTs evaluating vitamin D supplementation calcium/vitamins/ferrous sulfate vs. a control (placebo or active) during pregnancy. Main Outcome Measure(s): Measures were: circulating 25-hydroxyvitamin D [25(OH)D] levels, preeclampsia, gestational diabetes mellitus (GDM), small for gestational age (SGA), low birth weight, preterm birth, birth weight, birth length, cesarean section. Mantel-Haenszel fixed-effects models were used, owing to expected scarcity of outcomes. Effects were reported as relative risks and their 95% confidence intervals (CIs). Result(s): Thirteen RCTs (n ¼ 2,299) were selected. Circulating 25(OH)D levels were significantly higher at term, compared with the control group (mean difference: 66.5 nmol/L, 95% CI 66.2–66.7). Birth weight and birth length were significantly greater for neonates in the vitamin D group; mean difference: 107.6 g (95% CI 59.9–155.3 g) and 0.3 cm (95% CI 0.10–0.41 cm), respectively. Incidence of preeclampsia, GDM, SGA, low birth weight, preterm birth, and cesarean section were not influenced by vitamin D supplementation. Across RCTs, the doses and types of vitamin D supplements, gestational age at first administration, and outcomes were heterogeneous. Conclusion(s): Vitamin D supplementation during pregnancy was associated with increased circulating 25(OH)D levels, birth weight, and birth length, and was not associated with other maternal and neonatal outcomes. Larger, better-designed RCTs evaluating clinically relevant outcomes are necessary to reach a definitive conclusion. (Fertil Steril 2015;-:-–-. 2015 by American Society for Reproductive Medicine.)
Revisión por pares
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Korman, Yifaht. "Narrative coherence in brief good-outcome client-centered psychotherapy." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0034/MQ27360.pdf.
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Dobberstein, Trina A. Hines Edward R. "Performance gains on selected outcome measures a case analysis /." Normal, Ill. Illinois State University, 1991. http://wwwlib.umi.com/cr/ilstu/fullcit?p9203027.
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Thesis (Ph. D.)--Illinois State University, 1991.Title from title page screen, viewed December 8, 2005. Dissertation Committee: Edward R. Hines (chair), Ronald S. Halinski, John R. McCarthy, Patricia A. O'Connell, George A. Padavil. Includes bibliographical references (leaves 133-144) and abstract. Also available in print.
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Youssef, Ibrahim Mohamed. "Multi-Platform Molecular Data Integration and Disease Outcome Analysis." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/73580.
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One of the most common measures of clinical outcomes is the survival time. Accurately linking cancer molecular profiling with survival outcome advances clinical management of cancer. However, existing survival analysis relies intensively on statistical evidence from a single level of data, without paying much attention to the integration of interacting multi-level data and the underlying biology. Advances in genomic techniques provide unprecedented power of characterizing the cancer tissue in a more complete manner than before, opening the opportunity of designing biologically informed and integrative approaches for survival analysis. Many cancer tissues have been profiled for gene expression levels and genomic variants (such as copy number alterations, sequence mutations, DNA methylation, and histone modification). However, it is not clear how to integrate the gene expression and genetic variants to achieve a better prediction and understanding of the cancer survival.
To address this challenge, we propose two approaches for data integration in order to both biologically and statistically boost the features selection process for proper detection of the true predictive players of survival. The first approach is data-driven yet biologically informed. Consistent with the biological hierarchy from DNA to RNA, we prioritize each survival-relevant feature with two separate scores, predictive and mechanistic. With mRNA expression levels in concern, predictive features are those mRNAs whose variation in expression levels are associated with the survival outcome, and mechanistic features are those mRNAs whose variation in expression levels are associated with genomic variants (copy number alterations (CNAs) in this study). Further, we propose simultaneously integrating information from both the predictive model and the mechanistic model through our new approach GEMPS (Gene Expression as a Mediator for Predicting Survival). Applied on two cancer types (ovarian and glioblastoma multiforme), our method achieved better prediction power than peer methods. Gene set enrichment analysis confirms that the genes utilized for the final survival analysis are biologically important and relevant.
The second approach is a generic mathematical framework to biologically regularize the Cox's proportional hazards model that is widely used in survival analysis. We propose a penalty function that both links the mechanistic model to the clinical model and reflects the biological downstream regulatory effect of the genomic variants on the mRNA expression levels of the target genes. Fast and efficient optimization principles like the coordinate descent and majorization-minimization are adopted in the inference process of the coefficients of the Cox model predictors. Through this model, we develop the regulator-target gene relationship to a new one: regulator-target-outcome relationship of a disease. Assessed via a simulation study and analysis of two real cancer data sets, the proposed method showed better performance in terms of selecting the true predictors and achieving better survival prediction. The proposed method gives insightful and meaningful interpretability to the selected model due to the biological linking of the mechanistic model and the clinical model.
Other important forms of clinical outcomes are monitoring angiogenesis (formation of new blood vessels necessary for tumor to nourish itself and sustain its existence) and assessing therapeutic response. This can be done through dynamic imaging, in which a series of images at different time instances are acquired for a specific tumor site after injection of a contrast agent. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a noninvasive tool to examine tumor vasculature patterns based on accumulation and washout of the contrast agent. DCE-MRI gives indication about tumor vasculature permeability, which in turn indicates the tumor angiogenic activity. Observing this activity over time can reflect the tumor drug responsiveness and efficacy of the treatment plan. However, due to the limited resolution of the imaging scanners, a partial-volume effect (PVE) problem occurs, which is the result of signals from two or more tissues combining together to produce a single image concentration value within a pixel, with the effect of inaccurate estimation to the values of the pharmacokinetic parameters. A multi-tissue compartmental modeling (CM) technique supported by convex analysis of mixtures is used to mitigate the PVE by clustering pixels and constructing a simplex whose vertices are of a single compartment type. CAM uses the identified pure-volume pixels to estimate the kinetics of the tissues under investigation. We propose an enhanced version of CAM-CM to identify pure-volume pixels more accurately. This includes the consideration of the neighborhood effect on each pixel and the use of a barycentric coordinate system to identify more pure-volume pixels and to test those identified by CAM-CM. Tested on simulated DCE-MRI data, the enhanced CAM-CM achieved better performance in terms of accuracy and reproducibility.Ph. D.
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Tranchita, Anthony Phillip. "A Meta-analysis of the Alcohol Treatment Outcome Literature: 1993 to 2000." DigitalCommons@USU, 2002. https://digitalcommons.usu.edu/etd/6366.
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Alcohol misuse is a very common problem with high financial and personal costs. Treatment requires allocation of limited resources for optimal impact. Responsible decision making in this area should be based upon reasoned weighing of research evidence. Miller and colleagues completed a meta-analytic review of all controlled studies published before 1992 to help clinicians do just that. The coding system they employed examined methodological quality, as well as outcome, to obtain a rankordering of treatments that seem to have the most quality research support. The current study attempts to extend this work utilizing the same coding on studies published since 1992, and combine both databases of articles. Revised rank orderings of treatments and conclusions regarding variables related to outcomes are reported. Implications are discussed, along with limitations of this review. An upward trend in methodological quality over time was also discovered.
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Kanther, Nina-Christine [Verfasser]. "Intramedulläre Tumoren : Management- und Outcome-Analyse / Nina-Christine Kanther." Bonn : Universitäts- und Landesbibliothek Bonn, 2012. http://d-nb.info/1043698485/34.
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Kennedy, Christine. "Evaluating health interventions : a comparison of cost-benefit analysis and cost-effectiveness analysis employing radon-induced lung cancer prevention." Thesis, University of Oxford, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365808.
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Feldman-Sparber, Carol. "Analysis of Evidence-Based Course of Study Predictors for Improving the Post-school Outcomes of Post-Secondary Education and Employment for Students with Autism." Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1429015103.
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Holm, Hansen Christian. "Analysis of routinely collected repeated patient outcomes." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/9556.
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Clinical practice should be based on the best available evidence. Ideally such evidence is obtained through rigorously conducted, purpose-designed clinical studies such as randomised controlled trials and prospective cohort studies. However gathering information in this way requires a massive effort, can be prohibitively expensive, is time consuming, and may not always be ethical or practicable. When answers are needed urgently and purpose-designed prospective studies are not feasible, retrospective healthcare data may offer the best evidence there is. But can we rely on analysis with such data to give us meaningful answers? The current thesis studies this question through analysis with repeated psychological symptom screening data that were routinely collected from over 20,000 outpatients who attended selected oncology clinics in Scotland. Linked to patients’ oncology records these data offer a unique opportunity to study the progress of distress symptoms on an unprecedented scale in this population. However, the limitations to such routinely collected observational healthcare data are many. We approach the analysis within a missing data context and develop a Bayesian model in WinBUGS to estimate the posterior predictive distribution for the incomplete longitudinal response and covariate data under both Missing At Random and Missing Not At Random mechanisms and use this model to generate multiply imputed datasets for further frequentist analysis. Additional to the routinely collected screening data we also present a purpose-designed, prospective cohort study of distress symptoms in the same cancer outpatient population. This study collected distress outcome scores from enrolled patients at regular intervals and with very little missing data. Consequently it contained many of the features that were lacking in the routinely collected screening data and provided a useful contrast, offering an insight into how the screening data might have been were it not for the limitations. We evaluate the extent to which it was possible to reproduce the clinical study results with the analysis of the observational screening data. Lastly, using the modelling strategy previously developed we analyse the abundant screening data to estimate the prevalence of depression in a cancer outpatient population and the associations with demographic and clinical characteristics, thereby addressing important clinical research questions that have not been adequately studied elsewhere. The thesis concludes that analysis with observational healthcare data can potentially be advanced considerably with the use of flexible and innovative modelling techniques now made practicable with modern computing power.
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Richardson, Evelyn Cherita. "Meta-analysis of Student Assistance program Outcomes." Diss., Virginia Tech, 2009. http://hdl.handle.net/10919/77282.
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The main purpose of this study was to conduct a meta-analysis with data collected from seven schools in Southwest Virginia school district. Data was collected for students who were referred to the Student Assistance Programs at each school. Tracking forms were used to record data for each student. Each tracking form was completed by the Student Assistance Program coordinators for their respective schools. This research was conducted in order to evaluate measurable performance outcomes of Student Assistance Programs. The results highlight the positive effects that Student Assistance Programs, SAP members, and other individuals associated with Student Assistance Programs have on students in need. The positive effect from participation in Student Assistance Programs is encouraging. However, recommendations are made for future research and implications of the current research are discussed. The need for additional research on this topic is prominent throughout this document.Ph. D.
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Minasyan, Ararat. "Retrospektive Analyse zum Outcome von Patienten mit aneurysmaler Subarachnoidalblutung im Klinikum Chemnitz." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2018. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-234080.
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Einleitung
Die aneurysmale Subarachnoidalblutung und ihre Komplikationen stellen eine akut lebensbedrohliche Erkrankung dar. Aufgrund einer hohen Letalität und Morbidität sowie zahlreichen, nicht modifizierbaren Risikofaktoren und fehlenden eindeutigen Präventionsmaßnahmen bleibt diese Krankheit eines der aktuellen Themen der Neurochirurgie.
Ziel
Ziel dieser Studie ist der Vergleich der Behandlungsergebnisse von Patienten mit aneurysmaler SAB im Klinikum Chemnitz mit aktuellen Literaturdaten.
Material und Methode
In dieser Arbeit wurden die Daten von insgesamt 200 Patienten mit aneurysmaler Subarachnoidalblutung retrospektiv zusammengefasst. Es wurde eine Populationsanalyse zusammen mit einer Analyse der Korrelationen zwischen verschiedenen Ausgangs- und Verlaufsparametern mit dem allgemeinen Outcome und der Mortalität durchgeführt. Zusätzlich erfolgte eine Follow-up-Analyse der Mortalität und Morbidität bei 108 Patienten. Im statistischen Modell wurden eine Uni- und Bivariatanalyse sowie binäre und multinomiale logistische Regression angewendet. Kaplan-Meier-Kurven in Verbindung mit Cox-Regressionsanalysen wurden zur Beurteilung der Mortalität eingesetzt. Die Ergebnisse wurden mit Literaturdaten verglichen. Das Votum der Ethikkommission der TU Dresden liegt vor (EK 181052014 vom 15.09.2014).
Ergebnisse
Von 200 Patienten mit einem Durchschnittsalter von 52 J (20-82 J, Medianalter 51 ± 13,6 J) waren 69 Patienten männlich (34,5 %), 131 – weiblich (65,2 %). Das männlich : weiblich Verhältnis betrug 1:1,9. Der klinische Schweregrad der Patienten bei Aufnahme wurde durch die WFNS- und die HH-Skalen evaluiert. Zusätzlich wurden die BNI- und Fisher-Skalen zwecks Evaluation des radiologischen Schweregrades der aSAB eingesetzt. Die Patientendistribution anhand der WFNS-Skala war: WFNS °I – 42,0 %, WFNS °II – 10,0 %, WFNS °II – 16,5 %, WFNS °IV – 22,5%, WFNS °V – 9,0 %. Die Verteilung der Patienten durch die HH-Skala war vergleichbar. 14,5 % der Patienten hatten eine BNI 1, 41,5 % - BNI 2, 32,0 % – BNI 3, 10,5 % - BNI 4, 1,5 % - BNI 5 Blutung. Bei 5,5 % der Patienten lag eine Fisher 1, 10,5 %– Fisher 2, 28,0% - Fisher 3 und 56,0 % - Fisher 4 SAB vor. 77,5 % der Aneurysmata waren klein (<11mm), 18,5 % - groß (11-25mm), 4 % - Giant (>25mm). Die Aneurysmen war meist im Bereich der Acom (41,5 %) und MCA (36,5 %) lokalisiert. Insgesamt 94,5 % der Aneurysmen gehörten zur vorderen Zirkulation. Die primäre Mortalitätsrate betrug 14,5 %. 21,5% der Patienten hatten einen mRS von 0-1 bei Entlassung, 26,0 % - einen mRS 2-3, 38,0 % - einen mRS 4-5. Die mittlere Follow-up-Dauer betrug 71,3 ± 43,2 Monate (Spannweite 2-168 Monate). Von den initial Überlebenden und im Follow-up eingeschlossenen Patienten sind 10,2 % im Verlauf verstorben. 48,1 % hatten einen mRS 0-1, 30,6% mRS 2-3, 11,1 % - mRS 4-5.
Diskussion
Das Outcome der Patienten mit einer aSAB trägt einen multifaktoriellen Charakter. Die wesentlichen Prädiktoren des Outcomes sind das Alter, der klinische und radiologische Schweregrad der Blutung, die Notwendigkeit der Versorgung eines posthämorrhagischen Hydrozephalus (temporäre und dauerhafte CSF-Ableitung), ein Vasospasmus, DIND und Entgleisun-gen im Serum-Natrium-Spiegel. Die Mortalitätsrate bei der primären Versorgung der Patienten mit einer aSAB in unserer Ko-horte ist um etwa 5 % niedriger als in der Literatur angegeben. Die Mortalitätsrate steigert sich allmählich während der ersten 3 Wochen. Sie wird im Wesentlichen vom Patientengeschlecht, dem klinischen und radiologischen Schweregrad der Blutung, der Notwendigkeit einer Akutversorgung eines aufgetretenen Hydrozephalus, einem Vasospasmus, Entgleisungen im Serum-Natrium-Spiegel sowie der Notwendigkeit einer CSF-Dauerableitung beeinflusst. Die Notwendigkeit einer CSF-Außenableitung bei Aufnahme korreliert mit einem schlechten Zustand der Patienten bei Entlassung und im Follow-up. Der Vasospasmus ist ein unabhängiger Prädiktor eines primär schlechten Outcomes und einer hohen Mortalität, zeigt sich aber als nicht signifikanter Faktor im Langzeit-Follow-up. Die Shuntpflicht ist bei Patienten mit Elektrolytentgleisungen, beidseitigen EVDs und DIND 3-4fach erhöht, beeinflusst jedoch nur die primäre Morbidität/Mortalität. Entgleisungen im Serum-Natrium-Spiegel zeigten sich als unabhängiger Prädiktor eines schlechten Outcomes und erhöhter Mortalität sowohl während des stationären Aufenthaltes, als auch im Langzeit-Follow-up. Die Notwendigkeit einer dekompressiven Kraniektomie wiederspiegelt sich in einem niedrigen BI der Patienten im primären Outcome und ist Prädiktor eines schlechten Outcomes und erhöhter Mortalität im Langzeit-Follow-up.
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Nicholl, Laura. "Outcome measurement in multiple sclerosis : psychometric analysis and clinical applications." Thesis, University of Ulster, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.428781.
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Mietchen, Jonathan James. "Social Outcome Following Pediatric Traumatic Brain Injury: A Meta-Analysis." BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/7431.
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Objective: Children and adolescents with a history of traumatic brain injury (TBI) are at increased risk for developing social incompetence and impairment in broad psychosocial functioning. The aim of this study was to examine the relationship between history of TBI, social competence, and broad psychosocial functioning using meta-analytic methods. Methods: Studies relating to social outcome following pediatric TBI were searched for using scientific, academic databases. Sixteen studies (N=2,005) met inclusion criteria, and relevant data relating to social functioning was extracted. Meta-analytic methods were used in order to obtain Hedges's g effect size data for mild, moderate, and severe TBI groups. Meta-regressions were also used to examine the effect of potential moderating variables, including Glasgow Coma Scale (GCS), socioeconomic status (SES), gender, control group (typically developing (TD) or orthopedic injury (OI)), and time/age related variables. Finally, publication bias was calculated using funnel plots and Rosenthal's fail-safe N. Results: A dose-response effect was observed with mild (Hedges's g = -0.387), and moderate (Hedges's g = -0.459) groups demonstrating smaller effects when compared to the severe group (-0.814) on measures of broad psychosocial function. A dose-response effect was also observed on measures of social competence, with mild (Hedges's g = -0.098) and moderate (Hedges's g = -0.450) TBI groups demonstrating smaller effect sizes when compared to the severe TBI group (Hedges's g = -0.832). The GCS was a significant predictor of both broad psychosocial functioning (B = 0.065, p < 0.001) and social competence (B = 0.079, p < 0.001), such that more severe injuries predicted poorer social outcomes. Gender was a significant predictor of effect size (B = 0.018, p = 0.05), such that higher proportions of females was associated with smaller effect sizes. Finally, the type of control group used in these studies was also a significant predictor of effect size (B = 0.369, p = 0.03), such that studies that used TD produced larger effect sizes when compared to studies that used OI. Overall, there was little evidence for publication bias. Conclusions: Children and adolescents with a history of TBI demonstrated significant differences from their peers in social competence and broad psychosocial functioning following TBI. The severity of the injury is important in understanding and predicting social outcomes following pediatric TBI. Implications of these findings are discussed.
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Overfield, Thomas, and Baat Jeroen de. "Confidence Signaling, Gender, and Crowdfunding Outcomes." Thesis, Uppsala universitet, Företagsekonomiska institutionen, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-354438.
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Crowdfunding is a relatively new addition to the entrepreneurial range of funding options. It has been considered a “game changer’ and an “equalizer” for entrepreneurs seeking to finance new ventures. However, it shares several attributes with traditional funding methods as well as many of the same investor concerns. Since research is still scant on both crowdfunding as whole and on its fast-developing sub-categories this study endeavored to analyze two related topics in this area. Understanding how close this new paradigm is to the old is a focus of new research. In the case of this study perceived self-confidence of the crowdfunding project founder to the successful outcomes is examined. Additionally, to see if gender bias plays a part in this new era it is included as a control to determine if women need to project greater confidence than men to overcome these and achieve the same goals. Kickstarter.com is one of the oldest and most successful rewards based crowdfunding sites in the world. A sample of 9050 completed campaigns from here were used for this analysis. In the methodology qualitative coding was used to identify the linguistic symbols of confidence. To empirically investigate the research questions statistical analysis was carried out to seek the relationships between confidence signaling and successful crowdfunding performance as well as if gender bias has a moderating effect. The two hypotheses were not supported by the results of this study. Self-confidence was not a predictor of crowdfunding success and gender did not have a significant influence on the outcomes.
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Sudhues, Hanna. "Outcome-Analyse proximaler Oberarmfrakturen und distaler Radiusfrakturen bei geriatrischen Patienten." Diss., lmu, 2009. http://nbn-resolving.de/urn:nbn:de:bvb:19-101209.
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Mark, Henrike Katharina [Verfasser]. "Pathologiespezifisches Outcome nach Ellenbogengelenksarthroskopie : eine retrospektive Analyse / Henrike Katharina Mark." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2018. http://d-nb.info/1160515743/34.
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Meier, Amalia Sophia. "Discrete proportional hazards models for uncertain outcomes /." Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/9579.
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Peralta, Ruben, Adarsh Vijay, Ayman El-Menyar, Rafael Consunji, Husham Abdelrahman, Ashok Parchani, Ibrahim Afifi, Ahmad Zarour, Hassan Al-Thani, and Rifat Latifi. "Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time." Springer, 2015. http://hdl.handle.net/10150/610337.
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OBJECTIVE: We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). METHODS: A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all adult patients(≥18 years old) who received MTP (≥10 units) of packed red blood cell (PRBC) during the initial 24 h post traumatic injury. Data were analyzed with respect to FFB:PRBC ratio [(high ≥ 1:1.5) (HMTP) vs. (low < 1:1.5) (LMTP)] given at the first 4 h post-injury and also between (>4 and 24 h). Mortality, multiorgan failure (MOF) and infectious complications were studied as well. RESULTS: During the study period, a total of 4864 trauma patients were admitted to the hospital, 1.6 % (n = 77) of them met the inclusion criteria. Both groups were comparable with respect to initial pH, international normalized ratio, injury severity score, revised trauma score and development of infectious complications. However, HMTP was associated with lower crude mortality (41.9 vs. 78.3 %, p = 0.001) and lower rate of MOF (48.4 vs. 87.0 %, p = 0.001). The number of deaths was 3 times higher in LMTP in comparison to HMTP within the first 30 days (36 vs. 13 cases). The majority of deaths occurred within the first 24 h (80.5 % in LMTP and 69 % in HMTP) and particularly within the first 6 h (55 vs. 46 %). CONCLUSIONS: Aggressive attainment of high FFP/PRBC ratios as early as 4 h post-injury can substantially improve outcomes in trauma patients.
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Morris, Christopher H. "Meta-Analysis of Home Visiting Research with Low-Income Families: Client, Intervention, and Outcome Characteristics." DigitalCommons@USU, 1995. https://digitalcommons.usu.edu/etd/6077.
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Leaders in the field of home visiting and family support research have indicated that the inclusion of home visiting in comprehensive services for low-income families with young children can play a key role in improving a wide variety of outcomes for at-risk children and their families. These recommendations have been based in part on selected empirical findings from the home visiting literature. However, synthesis of empirical findings has proven difficult, due to the heterogeneity of this population and the diverse applications of home visiting as a service delivery strategy.
The present meta-analysis examined a representative sample of the peer-reviewed literature to provide a comprehensive, quantified description of the features and findings of this literature. The four research questions addressed by the meta-analysis provide a framework for this description. The first research question concerned a description of research designs and methodological features found in the literature. The second and third research questions concerned, respectively, descriptions of the samples and interventions employed in primary studies. The final research question concerned the examination of those domains in which primary studies measured outcomes, and the quantification of outcomes in terms of standardized mean difference effect sizes.
Summarization of primary studies' methodological features illustrated specific issues that may be addressed in the design of future home visiting research, and laid a basis for the examination of meta-analysis findings. The composition of primary studies' samples reflected the heterogeneity expected from a population defined by a parameter as broad as "low-income," yet included lacunae that may represent subgroups among the poor that are not being studied. Data providing an assessment of several types of intervention features have implications for questions of treatment efficacy, and for future home visiting research. Mean effect sizes in several domains were found to have a magnitude of practical significance for child and family outcomes. Findings of this project provide a structure for continued meta-analysis of this body of literature, and highlight potential areas for further primary research. Meta-analysis data lend support to previous recommendations, as well as point out gaps in our knowledge.
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Hughes, Kelly N. "Expressive Writing and Breast Cancer: Outcomes and Linguistic Analyses." DigitalCommons@USU, 2006. https://digitalcommons.usu.edu/etd/6230.
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This project examined the imp act of an expressive writing intervention as compared to a general health in formation control on breast cancer patients' postradiation treatment. It further examined the content of the expressive writing narratives. The sample included women who were completing radiation treatment for breast cancer at the Huntsman Cancer Institute and City of Hope hospital. The measures utilized in this study were self-report instruments targeting psychological distress (PANAS, JES) and general functioning (SIP), as well as demographic questionnaires. Results revealed the expressive writing intervention significantly impacted positive affect over time. Furthermore, participants from both the treatment and control groups evidenced improvements in psychological distress and general functioning over time. Linguistic analyses revealed participants' use of positive affect words increased across writing sessions, whereas the use of negative affect words and cognitive words did not change. Additionally, the use of past tense words decreased across writing sessions, whereas the use of present tense words increased and the use of future tense remained constant. The findings revealed from this study indicate that an expressive writing intervention can positively impact breast cancer patients up to 1 year postradiation treatment. Furthermore, the analysis of writing trends suggests that the use of positive affect words, the decrease in use of past tense words, along with the increase of present tense words across writing sessions, may be important linguistic components in positive outcomes.
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Mollon, Jennifer. "Statistical analysis of genome-genome interaction with reference to kidney transplant outcome." Thesis, King's College London (University of London), 2014. https://kclpure.kcl.ac.uk/portal/en/theses/statistical-analysis-of-genomegenome-interaction-with-reference-to-kidney-transplant-outcome(581ae9b3-83b5-4d13-985f-2c57a248bc07).html.
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Though widely believed to exist, few convincing examples of genetic interactions have been detected through statistical approaches in genome-wide association studies. The first piece of work in this thesis attempts to determine if there is evidence for the existence of such interactions within genes identified through protein-protein interactions. A software package is developed and applied to data from a recent publically available genetic study. No evidence was found for an enrichment of such interactions in the available data. The second study applies three current methods for interaction detection to a real data set with compelling evidence of an interaction. Sparse Partitioning, SNPHarvester and Random Jungle were selected, with the later two being followed by the HyperLasso as a post-processing step. Only one method, SNPHarvester, was able to detect the interaction. The third study outlines a local pilot project in renal transplant dysfunction. Genetic variants from donors and recipients are examined using survival analysis. Interactions between the two genomes are tested for an effect on the survival time of the kidney. Secondary renal phenotypes of acute rejection and progression to end-stage renal failure are also considered. There were no strongly significant associations discovered in this data. The final study is a multi-centre renal transplant study analysing over 2000 donor recipient pairs throughout the UK and Ireland. Although much larger than the pilot, this study also failed to detect any associations with graft survival time or the secondary phenotypes. SNPHarvester was applied to the data and there are some indications of potential interactions, but replication is essential before the results can be trusted. An outline of an extension to SNPHarvester to better handle survival data is presented. Results from all of these studies were largely negative. Detecting interactions in genome-wide data remains a difficult task. Narrowing the search space by filtering may be a better approach than attempting a genome-wide search, though SNPHarvester has proven to be useful and is a good choice if a true genome-wide search is required.
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Greenwald, Ashley E. "Effects of discrimination abilities on functional analysis outcomes." abstract and full text PDF (UNR users only), 2009. http://0-gateway.proquest.com.innopac.library.unr.edu/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1472954.
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Tahiri, Hassani Youssef. "Improving breast reconstruction outcomes: an evidence-based analysis." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=103554.
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Background: As breast reconstruction evolves, plastic surgeons continue to find ways to improve their reconstruction' outcomes. The aim of our study is to demonstrate how plastic surgery research impacts and improves current surgical practices. For instance, we designed three clinical studies which illustrate how research can affect current popular surgical practices, not only during the pre-operative period, but also intra-operative and post-operative periods. Methods: In the first study, we performed a meta-analysis to evaluate first the safety and efficacy of Thoracic ParaVertebral Block (TPVB) for breast surgery, and then to compare TPVB to General Anesthesia (GA) with regards to postoperative pain, nausea and vomiting, opioid consumption and length of hospital stay. To do so, an electronic and manual search of English- and French- language articles on TPVB in breast surgery (published up to June 2010) was performed. Two levels of screening were used to identify relevant articles. The Mantel-Haenszel method (fixed effect) was used to perform the meta-analysis.In the second study, we performed a systematic review to evaluate the existing literature, comparing the use of drains or not in reduction mammaplasty. We assessed first, if there is enough evidence to reach a conclusion regarding the routine use of drains after reduction mammaplasty, and then, if there is a need for more randomized control trials. To do so, we searched PubMed, EMBASE, the Cochrane Central Database of Clinical Trials (CENTRAL) on the Cochrane Library and Science Citation Index Expanded for original articles and reviews from January 1980 to June 2009. Finally, in the third study, we are presenting our clinical experience of using subcutaneous breast tissue expansion prior to reconstruction with Deep Inferior Epigastric Perforator (DIEP) flaps, and we are showing how our new technique eliminates the patch-like appearance of the skin paddle. We developed this technique; surgical technique that was never described or presented before. Over the past 2 years (January 2008 – January 2010), five patients underwent breast reconstruction using this three-stage approach. Retrospective analysis of patients' characteristics, breast history, surgical stay, complications and outcomes were performed. Results: Our first study demonstrated that pre-operative TPVB provides effective anesthesia for ambulatory / same-day breast surgery and can result in significant benefits over GA. However further studies are required to determine if these advantages would still persist if an optimal technique for outpatient GA is employed. Adjunctive ultrasonography may contribute to improve the safety of TPVB in breast surgery and requires further investigation.Our second study, we demonstrated that although placement of intra-operative drains after reduction mammaplasty is common practice, it should not be used routinely in reduction mammaplasty. Further randomized controlled trials are not warranted. Finally, our third study demonstrated how innovation in plastic surgery research can improve the final, post-operative aesthetic outcome. Subcutaneous breast tissue expansion followed by DIEP flap reconstruction can be performed safely, offering patients a completely autologous breast reconstruction with low morbidity, as well as eliminating the classical patch-like appearance of flap reconstructions.Conclusion:These three different studies illustrate how plastic surgery research can have an impact on breast reconstruction outcomes. The first two studies demonstrate with a strong level of evidence (meta-analysis and systematic review, respectively) that established pre-operative and post-operative factors can be changed for the benefit of the patient. Finally, we demonstrated how surgical technique innovation can improve the post-operative outcome.Contexte: Avec l'évolution de la chirurgie reconstructive du sein, les chirurgiens plasticiens continuent de trouver des moyens d'améliorer leurs reconstructions. Le but de notre étude est de démontrer, à travers trois études cliniques, comment la recherche en chirurgie plastique peut améliorer les pratiques chirurgicales courantes, durant les périodes pré-, intra- et postopératoires. Méthodes: Lors de notre première étude, nous avons effectué une méta-analyse afin d'évaluer la sécurité d'utilisation et l'efficacité des Blocs Thoraciques Para-Vertébraux (BTPV) pour la chirurgie du sein, en comparaison à l'Anesthésie Générale (AG). Pour cela, nous avons effectué une recherche électronique et manuelle d'articles écrits en anglais et français sur les BTPV en chirurgie du sein (publiés jusqu'en Juin 2010). Deux niveaux de sélection d'articles ont été utilisés. La méthode de Mantel-Haenszel (effets fixes) a été utilisée pour effectuer la méta-analyse. Lors de notre seconde étude, nous avons effectué une revue systématique afin d'évaluer la littérature existante qui compare l'utilisation de drains ou non lors des réductions mammaires. Pour cela, nous avons cherché Pub Med, EMBASE, le "Cochrane Central Database of Clinical Trials (CENTRAL) on the Cochrane Library" et le "Science Citation Index Expanded" pour les articles et revues de Janvier 1980 à Juin 2009. Finalement, lors de notre troisième étude, nous présentons notre expérience sur l'utilisation d'expanseurs sous cutanés de seins avant une reconstruction avec un lambeau basé sur la perforante de l'artère inferieure épigastrique profonde (lambeau DIEP). Nous démontrons comment notre nouvelle technique élimine l'apparence de patch du lambeau DIEP sur le sein. Nous avons développé cette technique; technique chirurgicale qui n'a jamais été décrite ou présentée auparavant. Au courant des deux dernières années (Janvier 2008 – Janvier 2010), cinq patients ont bénéficié de cette approche à trois étapes. Une analyse rétrospective des caractéristiques médicales des patients, de leur pathologie mammaire, de leurs hospitalisations, des complications et de leurs résultats, a été effectuée. Résultats: Notre première étude a démontré que les BTPV en préopératoire permettent une anesthésie effective pour les cas-de-jour de chirurgie du sein et démontrent des bénéfices supérieurs à l'AG. Cependant, plus d'études sont à faire afin de déterminer si ces avantages perdurent si une technique optimale pour une AG pour patients non-hospitalises est employée. L'échographie pourrait contribuer à améliorer la morbidité possible associée avec les BTPV en chirurgie du sein et devrait être étudiée en profondeur. Notre seconde étude a démontré que même si le placement routinier de drains en intra-opératoire après réduction mammaire est une pratique très populaire, cela ne devrait pas être utilisé de manière routinière après les réductions mammaires. Plus d'études randomisées contrôlées ne sont pas requises. Finalement, notre troisième étude a démontré comment l'innovation en recherche en chirurgie plastique peut améliorer le résultat final, postopératoire. L'expansion mammaire sous-cutanée suivie par reconstruction avec lambeau DIEP peut être effectuée en toute sécurité et offre aux patients une reconstruction mammaire totalement autologue, avec une faible morbidité, tout en éliminant l'apparence en forme de patch des reconstructions mammaires autologues classiques. Conclusion: Ces trois différentes études illustrent bien comment la recherche en chirurgie plastique peut affecter les résultats en reconstruction mammaire. Nos deux premières études démontrent avec un niveau d'évidence très élevé (méta-analyse puis revue systématique) que des pratiques préopératoires et intra-opératoires établies peuvent être modifiées au bénéfice des patients. Finalement, nous avons démontré comment une technique chirurgicale innovatrice peut améliorer les résultats postopératoires.
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Ishak, Khajak. "Meta-analysis of multiple outcomes : fundamentals and applications." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102511.
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Meta-analyses often consider the effect of a treatment on multiple, possibly related outcomes. Typically, summary estimates are derived from outcome-specific meta-analyses. Alternatively, a joint analysis can be conducted with a multivariate meta-analysis model, which also quantifies the correlation between the outcomes. This dissertation presents findings from analyses examining issues pertaining to the accuracy of the multivariate approach and its application to meta-analyses of longitudinal studies.Correlations measured in multivariate meta-analysis models can provide added insight about the treatment and disease. To be useful, however, the measured correlations must reflect the underlying biological relationships between treatment effects. I demonstrate, however, that correlations measured across studies may often be distorted by associations between the endpoints or random errors affecting outcomes within studies in a similar way. Thus, correlations measured in multivariate meta-analyses can be misleading.
To properly weight the contribution of each study, the variance of sampling distributions of each estimate is fixed to its observed value. In the multivariate case, however, the sampling distribution also involves covariances between effect estimates on the different outcomes. These are rarely available and must, therefore, be approximated from external information. I evaluated the impact of errors in these approximations on estimates of the parameters of the model in a simulation study. Summary effects and heterogeneity were estimated accurately, but the correlation parameter was prone to possibly large biases and lacked precision.
Longitudinal studies often report treatment effects measured at different times. Multivariate meta-analyses can account for the correlations inherent to this type of data. Alternatively, random-effects can be specified to capture the marginal correlations. I contrasted these and the standard time-specific meta-analysis approaches using data from a review of studies of deep brain stimulation. Multivariate models, and to a slightly lesser extent the random-effects models, provided better fit and more precise estimates in the interval with fewest observations. These models were also less affected by an apparently outlying observation. This suggests a potential borrowing of information from estimates at other times.
This work builds on research about the potential advantages and limitations of joint meta-analyses of multiple outcomes.
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KATSUNO, SATOSHI, ATSUSHI MISHIMA, KEISUKE YOKOI, HATSUKI HIBI, and MASANORI YAMAMOTO. "Surgical Outcome of Microscopic Vasectomy Reversal: an Analysis of 30 Cases." Nagoya University School of Medicine, 1997. http://hdl.handle.net/2237/16750.
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Lee, Tang. "Outcome prediction and genome-transcriptome correlation analysis in classical Hodgkin's lymphoma." Thesis, University of British Columbia, 2009. http://hdl.handle.net/2429/6929.
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Treatment outcome prediction in classical Hodgkin’s Lymphoma is currently standardized with the International Prognostic Score (IPS), a scoring system based on 7 clinical parameters: age, stage, sex, serum albumin, absolute lymphocyte count or percentage, hemoglobin, and white blood cell count. Known limitations of the system are that it is tailored for advanced-stage patients, and it is unable to identify patients with very poor prognosis. In our dataset of 100 cases, the IPS predicted only 28% of the treatment Failures correctly, and 78% treatment successes correctly. We examined the outcome predictive power of whole-tumour gene expression profiling (GEP) in comparison to the clinical parameters, to see whether additional predictive power can be gained by combining the two data sources. Random Forests and Sparse Multinomial Logistic Regression were used for classification and feature importance ranking. Receiver-Operator Characteristic (ROC) curves and Area Under the Curve (AUC) values did not suggest a significant improvement with GEP, but potentially important GEP predictors were revealed (CSDA, DPEP2, PDE4D, HBP1, etc) and only one of the seven clinical parameters (Ann Arbor Stage) was found to have predictive value.
The use of whole-tumour GEP warranted that very limited amount of data reflected the biology of the malignant Hodgkin Reed Sternberg (HRS) cells, since these cells take up only 1-2% of the whole tumour. Treatment response/outcome likely involves a significant contribution by the HRS cells, therefore examining only an enriched pool of micro-dissected HRS cells would be very beneficial. Twelve cases of micro-dissected HRS cells were available, and this limited sample size prevented the development of a reliable classification model. Instead, we gained insights into the biology of HRS cells by examining the relationship between DNA copy number (CN), as profiled by array CGH, and GEP. The second part of the thesis involved a single-sample strategy for the examination of the twelve cases and a joint analysis to compare between cases of different CN status. Sparse patterns of correlations with CN gains were found on chromosomes 2p, 6p, 9p, and 12p, including locus JAK2 which has known correlation with gain of 9p.
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Ataman, Ozlem. "Competing risks methodology applied to the analysis of cancer therapy outcome." Thesis, University College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.409683.
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Barnard, Alan J. "Involvement of the family physician in palliative care : an outcome analysis." Master's thesis, University of Cape Town, 2004. http://hdl.handle.net/11427/10133.
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Includes bibliographical references (leaves 60-63).An evaluation of the degree of involvement of family physicians in the care of patients with terminal illness was conducted. The outcome of this care was correlated with the degree of involvement. The background to the clinical situation, ethical issues and the context of the study in South Africa is explored, with special reference to the private practice milieu of medical practice.
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Arnalds, Holmfridur Osk. "Correspondence between Multiple-Respondent Anecdotal Assessments and Functional Analysis: Analyses of Rank-Order, Magnitude-of-Difference, and Overall Outcomes." Thesis, University of North Texas, 2016. https://digital.library.unt.edu/ark:/67531/metadc849776/.
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We administered the Motivation Assessment Scale (MAS) and the Questions About Behavioral Function (QABF) to five raters and compared the results with functional analysis outcomes for 12 cases in which agreement was obtained for at least four out of five raters on either anecdotal assessment. The scores for functional categories on the MAS and QABF were ranked by averaging the scores for the raters who agreed on the primary maintaining variable. Functional analysis results were ranked by examining average responding across all conditions. A comparison showed correspondence between the highest category and the highest functional analysis condition for 10 out of 11 cases for the MAS and all 10 cases for the QABF. Correspondence for the category and condition ranked second was found for 2 out of 11 cases for the MAS and 2 out of 10 cases for the QABF. The magnitude of difference between categories on the MAS/QABF did not appear to predict the amount of difference in responding in the corresponding functional analyses.
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Gilbreath, Donna Arlene. "PROJECTING THE RESULTS OF STATE SMOKING BAN INITIATIVES USING CARTOGRAPHIC ANALYSIS." UKnowledge, 2007. http://uknowledge.uky.edu/gradschool_theses/453.
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Because tobacco smoking causes 430,000 U.S. deaths annually, wide-reaching smoking bans are needed. Bans reduce cigarette consumption, encourage cessation, protect nonsmokers from second-hand smoke, and promote an attitude that smoking is undesirable. Therefore, bans may prevent future generations from suffering many smoking-related health problems. The federal government has not implemented widereaching smoking bans so it falls on individual states, counties, or communities to devise appropriate smoking policy. To date, smoking policy has been determined by legislators, who may have conflicts that prevent them from acting in the publics best interest. However, this method of implementing smoking policy may be changing. In 2005, Washington residents voted by ballot initiative to strengthen existing state smoking regulations. In 2006, Arizona, Nevada, and Ohio residents voted by ballot initiatives to implement strict statewide smoking bans. This research presents a way to predict how residents of other states might vote if given the opportunity. Two research hypotheses are tested and accepted: a positive relationship between favorable votes and urbanness, and a preference favoring smoking bans where smoking regulations already exist. Finally, a projection is made that a smoking ban vote in Kentucky would yield favorable results, and a map showing projected county votes is provided.