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1
Fanshawe, Thomas R., Michael Power, Sara Graziadio, José M. Ordóñez-Mena, John Simpson, and Joy Allen. "Interactive visualisation for interpreting diagnostic test accuracy study results." BMJ Evidence-Based Medicine 23, no. 1 (January 24, 2018): 13–16. http://dx.doi.org/10.1136/ebmed-2017-110862.
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Information about the performance of diagnostic tests is typically presented in the form of measures of test accuracy such as sensitivity and specificity. These measures may be difficult to translate directly into decisions about patient treatment, for which information presented in the form of probabilities of disease after a positive or a negative test result may be more useful. These probabilities depend on the prevalence of the disease, which is likely to vary between populations. This article aims to clarify the relationship between pre-test (prevalence) and post-test probabilities of disease, and presents two free, online interactive tools to illustrate this relationship. These tools allow probabilities of disease to be compared with decision thresholds above and below which different treatment decisions may be indicated. They are intended to help those involved in communicating information about diagnostic test performance and are likely to be of benefit when teaching these concepts. A substantive example is presented using C reactive protein as a diagnostic marker for bacterial infection in the older adult population. The tools may also be useful for manufacturers of clinical tests in planning product development, for authors of test evaluation studies to improve reporting and for users of test evaluations to facilitate interpretation and application of the results.
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Gorka, Artur, and Phantipa Thipwiwatpotjana. "The Importance of Fuzzy Preference in Course Assignment Problem." Mathematical Problems in Engineering 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/106727.
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This paper points out the importance of fuzzy preference by using a teaching course assignment problem as a case study. The model with fuzzy teaching preference provides a more satisfactory solution to a course assignment problem than assigning arbitrary weights. A method for improving a fuzzy membership function by using sensitivity analysis is devised. The method with fuzzy preferences is compared with a model using weighted probabilities.
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Chen, Xu, Bin Xu, Kunjie Yu, and Wenli Du. "Teaching-Learning-Based Optimization with Learning Enthusiasm Mechanism and Its Application in Chemical Engineering." Journal of Applied Mathematics 2018 (2018): 1–19. http://dx.doi.org/10.1155/2018/1806947.
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Teaching-learning-based optimization (TLBO) is a population-based metaheuristic search algorithm inspired by the teaching and learning process in a classroom. It has been successfully applied to many scientific and engineering applications in the past few years. In the basic TLBO and most of its variants, all the learners have the same probability of getting knowledge from others. However, in the real world, learners are different, and each learner’s learning enthusiasm is not the same, resulting in different probabilities of acquiring knowledge. Motivated by this phenomenon, this study introduces a learning enthusiasm mechanism into the basic TLBO and proposes a learning enthusiasm based TLBO (LebTLBO). In the LebTLBO, learners with good grades have high learning enthusiasm, and they have large probabilities of acquiring knowledge from others; by contrast, learners with bad grades have low learning enthusiasm, and they have relative small probabilities of acquiring knowledge from others. In addition, a poor student tutoring phase is introduced to improve the quality of the poor learners. The proposed method is evaluated on the CEC2014 benchmark functions, and the computational results demonstrate that it offers promising results compared with other efficient TLBO and non-TLBO algorithms. Finally, LebTLBO is applied to solve three optimal control problems in chemical engineering, and the competitive results show its potential for real-world problems.
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Bako, IA, PO Agada, PM Utoo, and AJ Ikughur. "Bed-Occupancy Management in the Emergency Wards of the Benue State University Teaching Hospital, Makurdi using the Queuing Model." Journal of Epidemiological Society of Nigeria 1 (February 28, 2017): 53–65. http://dx.doi.org/10.46912/jeson.15.
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Background: Patients who present at the Emergency Departments require specialized care and therefore should have access to beds, where necessary, in a timely manner. This study was aimed at using the queuing model to determine the optimal number of beds required for zero delay probability at the emergency wards of the Benue State University Teaching Hospital, Makurdi, Benue State Nigeria.
Methodology: The study used the M/G/C/C queuing model for bed optimization at the emergency wards. Information on arrival, length of stay and number of beds for each of the wards covering three years viz. 2014, 2015 and 2016 were obtained from the medical records department. The average arrival rate and average length of stay were used to determine the delay (blocking) probability and the other performance measures.
Results: The delay probabilities at the current bed capacities were 0.11, 0.069, 0.023 and 0.011 for the male, female, paediatric and gynaecology emergency wards respectively. The number of beds required for zero delay probabilities for the male, female, paediatric and gynaecology emergency wards were 16, 14, 14 and 6 respectively instead of the current number of beds: 8, 8, 9 and 4 respectively.
Conclusion: The study found that at the current bed capacity situation of the emergency wards of Benue State University Teaching Hospital, delay probabilities are on the average high. The model for the hospital emergency wards showed that the optimal bed capacities for Male, Female, Paediatric and Gynaecology Emergency wards are 16, 14, 14, and 6 respectively. The queuing model should be carried out at regular intervals across the wards and should be part of the management decision making processes of the hospital.
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Cooper, Darren, Steve Higgins, and Nadin Beckmann. "Online Instructional Videos as a Complimentary Method of Teaching Practical Rehabilitation Skills for Groups and Individuals." Journal of Educational Technology Systems 45, no. 4 (May 17, 2017): 546–60. http://dx.doi.org/10.1177/0047239516669104.
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Online instructional videos are becoming increasingly common within education. This study adopts a quasi-experimental 2 × 2 crossover design (control and experimental groups) to evaluate the efficacy of instructional videos to teach practical rehabilitation skills. The students performed practical sessions in class and were formatively assessed by their lecturers. The results demonstrate that the group effect was moderate with an effect size of 0.68, CI [0.04, 1.31]; the magnitude-based inferences indicate the probabilities the video was beneficial or trivial or harmful were 93.9% or 5.4% or 0.6%. The results of the study demonstrate that the instructional videos had a small to moderate beneficial effect on all assessed criteria.
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Harshith N, Monica Muthamma P.P, Kanakavalli K, Kundury, and Sujay Mugaloremutt Jayadeva. "A Study on Assessing Staff and Patient Perception on Electronic Prescription in a tertiary care Teaching Hospital." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 21, 2020): 1051–55. http://dx.doi.org/10.26452/ijrps.v11ispl4.4242.
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Electronic Prescription Concept is very predominant to enhance digitalization and Automation in the healthcare sector. The Electronic prescription concept may require still more time for full-scale implementation in India. The main goal of the study was to know about current practices adopted in Paperless prescriptions and to survey the consciousness of Electronic prescription among staff and patient family members. The study was conducted at a tertiary care teaching hospital in Mysore for three months. Questionnaires were designed for both the hospital staff in Intensive care units (ICU’S) and Patient family members. The survey included the demographics characteristics such as name, age, gender, relation with the patient, and their knowledge and with the electronic prescription. The sample survey size was 120. The study outcomes say that the implementation of the electronic prescription system has gone well as it has an extended way to go, and it is a long-term asset. The study results provide probabilities for the changes in the structure and processing excellence, which is significant as the issues could affect the adequacy of new technology and the speed of flow within an organization.
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Al Tamimi, Abdul-Rehman. "The Effect of Using Ausubel's Assimilation Theory and the Metacognitive Strategy (K.W.L) in Teaching Probabilities and Statistics Unit for First Grade Middle School Students’ Achievement and Mathematical Communication." European Scientific Journal, ESJ 13, no. 1 (January 31, 2017): 276. http://dx.doi.org/10.19044/esj.2017.v13n1p276.
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The study aimed to investigate the effect of using Ausubel's assimilation theory and the metacognitive strategy (K.W.L) in teaching statistics and probability unit for students of second grade – middle school students’ achievement and mathematical communication. The study sample consisted of 168 grade – middle school students in Hail. They were randomly divided into two experimental groups; the first (N=56) students and the second (N=56), and a control group (N=56). The first experimental group was studied using Ausubel's model; the second experimental group was studied using the metacognitive strategy (K.W.L); and the control group was studied using the conventional method. The research tools used in this study is an achievement test and scale for mathematical communication. The results showed that there were significant differences in achievement for the first and the second experimental group compared to the control group. Hence, this demonstrates the effectiveness of these two methods in teaching. The results showed statistically significant differences in mathematical communication due to the teaching methods. In addition, the second experimental group outperformed the first experimental group and the control group. The results also showed a statistically significant difference between pre-administration and the postadministration in favor of the post-administration for the three research groups. Further recommendations were suggested for future research.
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Ejiofor, Kingsley E. "Designers project: Afrotouch Brands." Emerald Emerging Markets Case Studies 7, no. 3 (June 23, 2017): 1–12. http://dx.doi.org/10.1108/eemcs-06-2016-0149.
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Subject area Entrepreneurship, Analysis of business problems. Study level/applicability Masters in business administration, Entrepreneurship management. Case overview The CEO of Afrotouch Brands, Mr Emeka Emmanuel, must decide what level of investment his company would need to implement to increase its market share and revenue, thus ensuring adequate business competitiveness. Afrotouch Brands was among the leading names in gift items and indoor furniture in Nigeria. Despite the business main outlet in Victoria Island, the highbrow commercial centre in the city of Lagos, it has other high-profile outlets in Port-Harcourt and Abuja. From the very beginning, Afrotouch Brands attracted a lot of well discerning individuals who patronized the business based on the quality, the wide variety, the uniqueness and the lovely ambience of the showroom. The case describes the various investment alternatives needed for business expansion and discusses the probabilities of possible outcomes. Afrotouch Brands could maintain the medium scale indoor furniture they are currently doing, embark on a large aggressive investment to expand the indoor medium scale furniture to a large scale, maintain their business strategy in gift items and accessories or invest in outdoor furniture manufacturing. The challenge is to decide which of these alternative investment strategies the company should undertake in view of the associated levels of risk and uncertainty inherent in their implementation. Expected learning outcomes This case study teaches students the following: fundamentals of decision trees construction; calculating and understanding expected monetary values; assessing probabilities; determination of risk profiles for each decision alternative; display of risk profiles graphically; and identification of business alternatives. Supplementary materials Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes. Subject code CSS 3: Entrepreneurship.
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Pitukhin, Evgeny A., and Olga A. Zyateva. "Analysis of the dynamics of the publication activity of the university in terms of employee categories." Perspectives of Science and Education 52, no. 4 (September 1, 2021): 566–76. http://dx.doi.org/10.32744/pse.2021.4.37.
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Introduction. In recent years, the goal of the state policy in the field of science and higher education was to make the universities occupy competing positions in international assessment systems, including scientific potential. Therefore, the universities need constructive solutions able to ensure the growth of the corresponding indicators. The purpose of the research is to analyze the dynamics of the publication activity of the university staff. Materials and methods. Data on the number of publications of university employees in the world's leading scientometric databases Web of Science and Scopus for the period from 2000-2020 served as the research materials. The study used classification, descriptive statistics and comparative data analysis. Research results. The categories of the teaching staff were determined, which to a greater extent affect the publication activity of the institution as a whole. As a result of a comparative analysis, all employees were divided into four categories according to the type of work (full-time teaching staff, external part-time workers, internal part-time workers and non-teaching staff), as well as into 6 groups depending on the number of publications ("0", "1-2", "3-4","5-6","7-8", "> 9"). The probabilities were calculated and matrices of statistical estimates of the transitions of employees of various categories from one group to another for each status were formed (the employees who continue to work at the university, newly hired or dismissed during the year). It was revealed that the drivers of scientific activity are the full-time teaching staff, except for those included in the group "0". Discussion and conclusion. The obtained matrices of transition probabilities will form the basis for modeling the number of employees in various groups and predicting the total number of publications of an institution. As a result, it will be possible not only to predict the total number of articles of the university while maintaining current trends, but also to consider various management scenarios in order to improve efficiency and meet the goals of the institution. This will help universities not only conduct self-analysis, but also manage the performance indicators of the institutions and departments, in terms of the growth of publication activity results.
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Stolz, Jörg, and Anaïd Lindemann. "The Titanic Game: Introducing Game Heuristics to Mixed Methods Theorizing and Data Analysis." Journal of Mixed Methods Research 14, no. 4 (November 12, 2019): 522–44. http://dx.doi.org/10.1177/1558689819885723.
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Despite tremendous interest in social games and game studies, the potential of game heuristics for the field of mixed methods remains unknown. This article introduces game heuristics to mixed methods research, showing how it was used in a specific study on the survival probabilities on the Titanic. Specifically, we describe how game heuristics was used to create the explanandum, code and interpret the qualitative material, and set up and interpret the quantitative model. Furthermore, we show and explicate how game heuristics was used to construct seven types of meta-inferences. The Titanic data set is especially interesting, since it is routinely used for statistical mono-method teaching; however, it can be shown that a mixed methods approach leads to a better explanation.
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Dunkerton, Suzanna, Yadava Jeve, Neil Walkinshaw, Eamonn Breslin, and Tanu Singhal. "Predicting Postpartum Hemorrhage (PPH) during Cesarean Delivery Using the Leicester PPH Predict Tool: A Retrospective Cohort Study." American Journal of Perinatology 35, no. 02 (August 28, 2017): 163–69. http://dx.doi.org/10.1055/s-0037-1606332.
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Objective The aim of the present study was to develop a toolkit combining various risk factors to predict the risk of developing a postpartum hemorrhage (PPH) during a cesarean delivery. Study Design A retrospective cohort study of 24,230 women who had cesarean delivery between January 2003 and December 2013 at a tertiary care teaching hospital within the United Kingdom serving a multiethnic population. Data were extracted from hospital databases, and risk factors for PPH were identified. Hothorn et al recursive partitioning algorithm was used to infer a conditional decision tree. For each of the identified combinations of risk factors, two probabilities were calculated: the probability of a patient producing ≥1,000 and ≥ 2,000 mL blood loss. Results The Leicester PPH predict score was then tested on the randomly selected remaining 25% (n = 6,095) of the data for internal validity. Reliability testing showed an intraclass correlation of 0.98 and mean absolute error of 239.8 mL with the actual outcome. Conclusion The proposed toolkit enables clinicians to predict the risk of postpartum hemorrhage. As a result, preventative measures for postpartum hemorrhage could be undertaken. Further external validation of the current toolkit is required.
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Vlasov, Dmitriy. "Analysis of the Possibilities of Using the Wald-Savage Test for the Study of Game Models." Scientific Research and Development. Economics of the Firm 9, no. 4 (January 11, 2021): 82–88. http://dx.doi.org/10.12737/2306-627x-2020-82-88.
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Within the framework of this article, the mechanisms for constructing and researching the game model for choosing the investor's optimal investment strategy in various information conditions are disclosed: building many players, building many players' strategies, the option of formalizing the payment function in the form of a game matrix, many optimality criteria, methods of justifying the choice of the strategy optimality criterion. Against the background of the application of classical criteria (Savage criterion, Wald criterion, Hodge-Lehman criterion, Hermeyer criterion), special attention is paid to the analysis of the possibilities of using the integrated Wald-Savage criterion for the study of game models, which allows to smooth the shortcomings of classical criteria and take into account the investor's appetite for risk. Attention is focused on the need to justify the choice of the criterion for the optimality of investment strategies, as well as the need of the researcher to clarify the states of nature and the probabilities of their implementations. The mechanisms for constructing and researching game models presented in this article can be used to improve methodological systems for teaching applied mathematical disciplines at an economic university, to build new variable educational disciplines on modern issues of decision theory, as well as within the framework of the system of advanced training in economics.
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Sweet, Robert, Ashley Pullman, Maria Adamuti-Trache, and Karen Robson. "Ethno-linguistic patterns of degree completion in BC universities: How important are high-school academic achievement and institution of entry?" Canadian Journal of Higher Education 49, no. 3 (January 9, 2020): 69–87. http://dx.doi.org/10.7202/1066636ar.
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We examine bachelor's degree completion in the British Columbia post-secondary system, which is noted for its multiple pathways to graduation and ethnically diverse student population. Employing an administrative longitudinal dataset, we compare how the probability of degree completion by students enrolled at research-intensive, teaching-intensive, and college-technical institutions differs by ethno-linguistic background and high school grades. Estimates from multi-level logistic regression modelsdemonstrate that Korean, Tagalog, and Vietnamese speakers have lower probabilities of degree completion than English-speaking students. The type of institution a student initially enters is, however, an important correlate of degree completion for all ethno-linguistic groups. Students with lower high school grades who initially enter a research-intensive institution are more likely to graduate compared with higher-achieving students who enter a teaching-intensive or college-technical institution. To improve completion by institutional type and among ethno-linguistic groups, our study highlights the need for research on why degree completion is lower at certain institutions for all ethno-linguistic groups and consistently lower among Korean, Tagalog, and Vietnamese speakers regardless of their level of academic achievement in high school or the type of post-secondary institution they initially entered.
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Sweet, Robert, Ashley Pullman, Maria Adamuti-Trache, and Karen Robson. "Ethno-linguistic patterns of degree completion in BC universities: How important are high-school academic achievement and institution of entry?" Canadian Journal of Higher Education 49, no. 3 (December 10, 2019): 69–87. http://dx.doi.org/10.47678/cjhe.v49i3.188531.
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We examine bachelor's degree completion in the British Columbia post-secondary system, which is noted for its multiple pathways to graduation and ethnically diverse student population. Employing an administrative longitudinal dataset, we compare how the probability of degree completion by students enrolled at research-intensive, teaching-intensive, and college-technical institutions differs by ethno-linguistic background and high school grades. Estimates from multi-level logistic regression modelsdemonstrate that Korean, Tagalog, and Vietnamese speakers have lower probabilities of degree completion than English-speaking students. The type of institution a student initially enters is, however, an important correlate of degree completion for all ethno-linguistic groups. Students with lower high school grades who initially enter a research-intensive institution are more likely to graduate compared with higher-achieving students who enter a teaching-intensive or college-technical institution. To improve completion by institutional type and among ethno-linguistic groups, our study highlights the need for research on why degree completion is lower at certain institutions for all ethno-linguistic groups and consistently lower among Korean, Tagalog, and Vietnamese speakers regardless of their level of academic achievement in high school or the type of post-secondary institution they initially entered.
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Panda, Rajendra Kumar, P. Ansuman Abhisek, Lalit Mohan Sika, Shweta Supriya Pradhan, Sidharth Srabana Routray, and Srikanta Mohanty. "Utilisation of antimicrobial agents in intensive care unit at a tertiary care teaching hospital in eastern India." International Journal of Basic & Clinical Pharmacology 8, no. 9 (August 28, 2019): 1951. http://dx.doi.org/10.18203/2319-2003.ijbcp20193672.
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Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed.
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Anishchenko, E. B., L. V. Trankovskaya, A. A. Vazhenina, and I. R. Miroshnichenko. "Hygienic assessment of the tension of the labor process and emotional state of the teaching staff of a medical university." Sanitarnyj vrač (Sanitary Doctor), no. 10 (October 1, 2020): 18–25. http://dx.doi.org/10.33920/med-08-2010-02.
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The medical condition of the higher-education teaching personnel of the university is reflected in the quality of the educational process in the educational institution and, as a consequence, in the formation of professional competencies of future graduates. It is known that workers in the fields of education and health care more than others are subject to stress, physical inactivity and, as a result, professional (emotional) burnout. The present study is devoted to the study of the state of health, activity, mood, professional (emotional) burnout of the teaching staff of a medical university, assessment of the intensity of their work process, professional risk. The study of well-being, activity, mood, professional (emotional) burnout was carried out using a questionnaire survey using well-known methods. The assessment of the intensity of the labor process was carried out in accordance with the Guidelines for the assessment of occupational health risks for workers. The assessment of occupational risk categories was carried out in accordance with the Guidelines for Assessing Occupational Risk for Workers' Health, as well as using a matrix of consequences and probabilities according to GOST Risk Management. Risk assessment technologies. It was found that the working conditions of the teaching staff of a medical university are tense 2 degrees. Evaluation of the functional emotional state showed that the teaching staff of a medical university has moderate emotional burnout, against the background of a high level of psychoemotional exhaustion. Indicators of well-being and mood have high (favorable) levels, while the activity indicator, on the contrary, has a low (unfavorable) value, presumably against the background of increasing employee fatigue. The occupational health risk of employees is medium (significant), the risk class according to the severity of the possible consequences of identified hazardous events is medium (T3), the probability of the consequences of a hazardous event is high (B4), the risk class is medium (C12).
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Balan, Marli Aparecida Joaquim, William Campo Meschial, Rosangela Geritana Santana, Simone Mancini Liduário Suzuki, and Magda Lúcia Félix de Oliveira. "Validation of an instrument for investigating knowledge on the initial assistance to burns victims." Texto & Contexto - Enfermagem 23, no. 2 (June 2014): 373–81. http://dx.doi.org/10.1590/0104-07072014000380013.
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This study featured a methodological quantitative approach and its objective was to validate an instrument on the initial assistance given to burns victims, on medical and nursing knowledge, using the theoretical stage of Pasquali's model. The data were collected in June - August 2008, in two parts: analysis of face validity and content validity by 18 judges; and analysis of internal consistency, undertaken through Item Response Theory, by 42 doctors and nurses from a teaching hospital in the North-West region of the Brazilian state of Paraná. Following the judges' analysis, 35 questions regarding general, medical and nursing knowledge showed agreement above 80% for the concepts. Through the internal consistency analysis applied to the general knowledge questions, three were discarded due to not being correlated with the construct. The remaining seven questions (70%) presented low discrimination of the respondents, varying levels of difficulty, and similar probabilities of correct random guesses. The final instrument contains 32 questions and is available for use.
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do Vale, Carliene, Poliano Bastos da Cruz, and Carlos Jorge Taborda Macedo. "The Effects of Compliance on the Results of Management of Support Foundations of Public Universities." Studies in Educational Management 6 (July 2020): 1–13. http://dx.doi.org/10.32038/sem.2020.06.01.
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This work proposes to study Support Foundations that are private non-profit organizations which support public universities by managing their teaching, research and extension projects. These foundations are inserted as the Third Sector Institutions. The research targets verify if the compliance level affects the surplus probability of support foundations. The sample includes thirty-four support foundations. The accounting statements analyzed were the balance sheet; the deficit and/or surplus demonstration; the statement of changes in shareholders’ equity; the cash flow statement and the explanatory notes for the years 2014, 2015 and 2016. The analysis was performed by a checklist, including 31 (thirty-one) items. It is important to highlight that the data estimation was developed using the logit estimator, on a robust error panel and was included time and state dummies. The results showed that 55% (fifty-five per cent) of the Support Foundations comply with the current legislation. Once foundations are according to the legislation, its surplus probabilities decrease.
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Poses, Roy M., D. Mark Chaput De Saintonge, Donna K. Mcclish, Wally R. Smith, Elizabeth C. Huber, F. Lynne W. Clemo, Brian P. Schmitt, et al. "An International Comparison of Physicians' Judgments of Outcome Rates of Cardiac Procedures and Attitudes toward Risk, Uncertainty, Justifiability, and Regret." Medical Decision Making 18, no. 2 (January 1998): 131–40. http://dx.doi.org/10.1177/0272989x9801800201.
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Objective. Compare U.K. and U.S. physicians' judgments of population probabilities of important outcomes of invasive cardiac procedures; and values held by them about risk, uncertainty, regret, and justifiability relevant to utilization of cardiac treatments. Design. Cross-sectional study. Setting. University hospital and VA medical center in the United States; two teaching hospitals in the United Kingdom. Participants. 171 housestaff and attendings at U.S. teaching hospitals; 51 physician trainees and consultants at U.K. hospitals. Measures. Judgments of probabilities of severe complications and deaths due to Swan-Ganz catheterization, cardiac catheterization, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG); judgments of malpractice risks for case vignettes; Nightingale's risk-aversion instrument; Gerrity's reaction-to-uncertainty instrument; questions about need to justify decisions; responses to case vignettes regarding regret. Results. The U.S. physicians judged rates of two bad outcomes of cardiac procedures (complications due to cardiac catheterization; death due to CABG) to be significantly higher (p ≤ 0.01) than did the U.K. physicians (U.S. medians, 5 and 3.5, respectively; U.K. medians 3 and 2). The median ratio of (risk of malpractice suit I error of omission)/(risk of suit I error of commission) judged by U.K. physicians, 3, was significantly (p = 0.0006) higher than that judged by U.S. physicians, 1.5. The U.K. physicians were less often risk-seeking in the context of possible losses than the U.S. physicians (odds ratio for practicing in the U.K. as a predictor of risk seeking 0.3, p = 0.003). The U.K. physicians had significantly more discomfort with uncertainty than did the U.S. physicians, as reflected by higher scores on the stress scale (U.K. median 48, U.S. 42, p = 0.0001) and the reluctance-to-disclose-uncertainty scale (U.K. 40, U.S. 37, p < 0.0001) of the Gerrity instrument. There was no clear international difference in perceived need to justify decisions, or in regret. Conclusions. The results were not clearly consistent with the uncertainty hypothesis that international practice variation is due to differences in judged rates of outcomes of therapy or with the imperfect-agency hypothesis that practice variation is due to differences in physicians' personal values. The causes and implications of practice variations remain unclear.
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Turner, Mark O., John R. Mayo, Nestor L. Müller, Michael Schulzer, and J. Mark FitzGerald. "The Value of Thoracic Computed Tomography Scans in Clinical Diagnosis: A Prospective Study." Canadian Respiratory Journal 13, no. 6 (2006): 311–16. http://dx.doi.org/10.1155/2006/859870.
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BACKGROUND: Computed tomography (CT) scans are used extensively to investigate chest disease because of their cross-sectional perspective and superior contrast resolution compared with chest radiographs. These advantages lead to a more accurate imaging assessment of thoracic disease. The actual use and evaluation of the clinical impact of thoracic CT has not been assessed since scanners became widely available.OBJECTIVE: To identify patterns of utilization, waiting times and the impact of CT scan results on clinical diagnoses.DESIGN: A before and after survey of physicians who had ordered thoracic CT scans.SETTING: Vancouver General Hospital – a tertiary care teaching centre in Vancouver, British Columbia.SUBJECTS: Physicians who had ordered CT scans.INTERVENTION: Physicians completed a standard questionnaire before and after the CT scan result was available.MEASUREMENTS: Changes in the clinical diagnosis, estimates of the probabilities for the diagnosis both before and after the CT scan, and waiting times.RESULTS: Four hundred fifty-four thoracic CT cases had completed questionnaires, of whom 80% were outpatients. A change in diagnosis was made in 48% of cases (25% with a normal CT scan and 23% with CT scan findings that indicated a different diagnosis). The largest change in probability scores for the clinical diagnosis before and after the CT scan was 43.9% for normal scans, while it was 36.3% for a different diagnosis and 26.3% for the same diagnosis. High-priority scans were associated with decreased waiting time (−7.89 days for each unit increase in priority).CONCLUSIONS: The CT scan results were associated with a change in diagnosis in 48% of cases. Normal scans constituted 25% of the total and had the greatest impact scores. Waiting times were highly correlated with increased urgency of the presenting problem.
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Kinnear, Benjamin, Philip A. Hagedorn, Matthew Kelleher, Courtney Ohlinger, and Jonathan Tolentino. "Integrating Bayesian reasoning into medical education using smartphone apps." Diagnosis 6, no. 2 (June 26, 2019): 85–89. http://dx.doi.org/10.1515/dx-2018-0065.
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Abstract Background Diagnostic reasoning is an important topic in medical education, and diagnostic errors are increasingly recognized as large contributors to patient morbidity and mortality. One way to improve learner understanding of the diagnostic process is to teach the concepts of Bayesian reasoning and to make these concepts practical for clinical use. Many clinician educators do not fully understand Bayesian concepts and they lack the tools to incorporate Bayesian reasoning into clinical practice and teaching. Methods The authors developed an interactive workshop using visual models of probabilities and thresholds, clinical cases, and available smartphone apps to teach learners about Bayesian concepts. Results Evaluations from 3 years of workshops at a national internal medicine chief resident conference showed high satisfaction, with narrative comments suggesting learners found the visual and smartphone tools useful for applying the concepts with future learners. Conclusions Visual models, clinical cases, and smartphone apps were well received by chief residents as a way to learn and teach Bayesian reasoning. Further study will be needed to understand if these tools can improve diagnostic accuracy or patient outcomes.
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Alagkiozidis, Ioannis, Kirstie Wilson, Nicole Ruffner, Jeremy Weedon, Eli Serur, Katherine Economos, Ovadia Abulafia, Yi-Chun Lee, and Ghadir Salame. "External Validation of a Nomogram for Predicting Survival of Women With Uterine Cancer in a Cohort of African American Patients." International Journal of Gynecologic Cancer 24, no. 1 (January 2014): 85–90. http://dx.doi.org/10.1097/igc.0000000000000039.
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ObjectiveThis study aimed to externally validate a nomogram for predicting overall survival of women with uterine cancer in an African American population.MethodsAfter the institutional review board approval, data from the uterine cancer database from 2 major teaching hospitals in Brooklyn, NY, were analyzed. The predicted survival for each patient was calculated with the use of the nonogram; the data were clustered in deciles and compared with the observed survival data.ResultsHigh incidence of aggressive histologic types (22% carcinosarcoma, 16% serous/clear cell), poorly differentiated (53% grade 3), and advanced stage (38% stage III or IV) tumors was found in our study population. The median follow-up for survivors was 52 months (range, 1–274 months). The observed and predicted 3-year overall survival probabilities were significantly different (62.5% vs 72.6%, P < 0.001). Similarly, the observed 5-year overall survival probability was significantly lower than the predicted by the nomogram (55.5% vs 63.4%, P < 0.001). The discrepancy between predicted and observed survival was more pronounced in the midrisk groups.ConclusionsThe nomogram is not an adequate tool to predict survival in the African American population with cancer of the uterine corpus. Race seems to be a significant, independent factor that affects survival and should be included in predictive models.
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Rodríguez-Benito, Andrea Jhoanna, and Margarita Durán-Gómez. "Implementation of educational technology for the development of computational thinking in fourth grade children in a public educational institution in Colombia." Revista Perspectivas 5, no. 2 (August 10, 2020): 20–29. http://dx.doi.org/10.22463/25909215.2827.
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Statistics are becoming more and more important in the teaching of mathematics, being an essential part of the curricula and school environments, for which this project seeks to solve a problem that was detected in the Ciudad Verde educational institution and that is related to the prediction, interpretation and calculation of probabilities in fourth grade students. When carrying out an analysis, it was possible to show that it is necessary to strengthen these probabilistic knowledge that are fundamental in the learning processes of students and that in fact are part of the daily context; therefore, the purpose is to seek that children are able to function in the community and with the skills to take on the challenges of innovation and change demanded by today's society, where information and communication technologies have gained more and more relevance in the training of students. In this way, the project incorporates the tools Schoology, Scratch and the application of computational thinking with a STEAM model, which will support the pedagogical strategy to solve the problem with the students under study of the Educational Institution, the results of the research allow demonstrate the strengthening in problem solving in probability issues using computational thinking through Scratch.
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Brinne Roos, Johanna, Per Bergenzaun, Kristina Groth, Lars Lundell, and Urban Arnelo. "Telepresence-teleguidance to facilitate training and quality assurance in ERCP: a health economic modeling approach." Endoscopy International Open 08, no. 03 (February 21, 2020): E326—E337. http://dx.doi.org/10.1055/a-1068-9153.
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Abstract Background and study aims The aims of this study was to document the clinical and training relevance of endoscopic retrograde cholangiopancreaticography (ERCP) teleguidance (as a clinical model for applied telemedicine) with health economic modeling methodologies. Methods Probabilities and consequences of complications after ERCP performed by either a novice-trainee or supported through teleguidance (TM) by an expert formed the basis of the health economic model. Results The main clinical and economic outcomes originated from the base case scenario representing a low-volume center. In the cohort the patient age was 62 years, 58 % were females, the expert was doing ≥ 250 ERCPs per year and 50 for the novice-trainee. The expert knowledge transferred was set to 50 % and the average complexity grade to 1.98. Given a willingness to pay threshold of 56,180 USD/ quality-adjusted life years (QALY), the probability of cost-effectiveness of TM assistance was 98.9 %. The probability of a QALY gain for patients having an ERCP, to which was added TM, was 91.6 %. Adding TM saved on an average 111.2 USD (95 % CI 959 to 1021 SEK) per patient, and remained cost-effective basically insensitive to the level of willingness to pay. Conclusion Teleguidance during an ERCP procedure has the potential to be the prefered option in many low- to medium-volume hospitals. The main mechanisms behind these effects are positive impact on several adverse patient outcomes, QALY increase, and decreased costs. TM should be considered for integration into future teaching curriculums in advanced upper gastrointestinal endoscopy.
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Sari, Dwi Ivayana, I. Ketut Budayasa, and Dwi Juniati. "ANALISIS PENYELESAIAN TUGAS PROBABILITAS SISANALISIS PENYELESAIAN TUGAS PROBABILITAS SISWA SD DITINJAU DARI PERBEDAAN KEMAMPUAN MATEMATIKA DAN GENDER." AKSIOMA: Jurnal Program Studi Pendidikan Matematika 7, no. 1 (June 11, 2018): 124. http://dx.doi.org/10.24127/ajpm.v7i1.1344.
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This study is aimed to analyze probabilistic thinking of elementary school students based on math ability and gender differences. Descriptive explorative approach was used to describe in depth probabilistic thinking of boys with high, middle, low math ability and girls with high, middle, low math ability. The result showed that probabilistic thinking of boy with high math ability indicated multistructural because his thinking quantitative and proportional. While probabilistic thinking of boys with middle, low math ability and girls with high, middle, low math ability indicated unistructural because their thinking quantitative and non proportional. Beside that, boys’ thinking in solving probability tasks was more analytical and flexible than girls’ thinking. So, students with math ability difference, gave difference response in solving probability tasks. This result found new strategy in solving probability comparison task. This result could contribute to curriculum developer to introduce probability in elementary school level and teachers could use discussion method in teaching probability material.
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Limbong, Nimrod. "HUBUNGAN KOMPETENSI DAN MOTIVASI KERJA DENGAN KOMITMEN GURU MELAKSANAKAN TUGAS PENDIDIKAN AGAMA KRISTEN SEKABUPATEN TOBA SAMOSIR." Jurakunman (Jurnal Akuntansi dan Manajemen) 14, no. 1 (April 26, 2021): 78. http://dx.doi.org/10.48042/jurakunman.v14i1.69.
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ABSTRACT
This research aims to see connection between teacher competence and work motivation with commitment of religion teacher embraced with spreading questionnaires. Hypothesis tested in this research are: (1) There is relation of teacher’s competence with commitment of religion teacher to implement job. (2) There is connection between motivation of teaching occupation of religion teacher. (3). There is connection between mastery of competence by the teacher and motivation of teaching to occupation of religion teacher.
This study use quantitative research method with the entire study population of teachers Pendidikan Agama Kristen (PAK) Kabupaten (Regency) Toba Samosir, amounting to 125 people and sample taken 30% of the total population of this study is that the sample as many 65 people.
The research instrument is enclosed questionnaires, trials conducted questionnaires to 30 teachers PAK outside the sample. Validity and reliability of the instrument by using SPSS 22. Validity of the test result shown in the corrected item total correlation greater than r table at 0,374 and reliability test instrument with Alpha Formula obtained r11 = 0,0881 at the high category with such instrument valid and reliable.
Data were analyzed using the following steps: 1) testing requirement analysis consisting of: (a) From the obtained value of normality test Sig. Shapiro-Wilk column. Test result above shows the value of competence (X1) = 0.05; Work motivation (X2) Of 0,063 and commitment Variable (Y) = 0. 292. These figures show that more than 0.05, then the data normal Distribution. b) obtained the probability of homogeneity test for the test Levena Sig.= 0.227 >0.05, then Ho is accepted, means there is no difference in variance between motivation and competence in running the task PAK commitment variable. This shows that the data variable duty commitment PAK homogeneity. 2) Hypothesis Testing consisting of: a) Competence to commitment correlation test shows the number 0,259. This relationship figure shows that there is correlation in the low category, competency with probabilities between task commitment PAK 0.037, 0.037 Figures < 0.05 means the two variables have a significant and purposeful relationship. b) correlation test was obtained that motivation to carry out the task PAK commitment rate was 0,642. This figure shows the correlations or relationship that is strong and direct. Probability between motivation and motivation to carry with 0,000 Commitment PAK task. Figures 0,000
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Durojaiye, Oyewole Christopher, Robin Morgan, Naziha Chelaghma, Joyeeta Palit, Christopher Keil, Rasha Omer, Katharine Cartwright, and Evangelos I. Kritsotakis. "External validity and clinical usefulness of a risk prediction model for 30 day unplanned hospitalization in patients receiving outpatient parenteral antimicrobial therapy." Journal of Antimicrobial Chemotherapy 76, no. 8 (April 25, 2021): 2204–12. http://dx.doi.org/10.1093/jac/dkab127.
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Abstract Objectives Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used to treat a variety of infections. However, hospital readmissions remain relatively common. We examined the external validity and clinical usefulness of a previously derived risk prediction model for 30 day unplanned hospitalization in patients receiving OPAT. Methods A retrospective cohort study was conducted at two large teaching hospitals in the UK. The design comprised quasi-external temporal validation on patients from the same OPAT setting as the model development, and broader external validation on patients from a different setting. The model predictors were age, prior hospitalizations in the preceding 12 months, Charlson comorbidity score, concurrent IV antimicrobial therapy, type of infection and mode of OPAT treatment. Discriminative ability, calibration and clinical usefulness were assessed. Results Data from 2578 OPAT patients were analysed. The rates of 30 day unplanned hospitalization were 11.5% (123/1073), 12.9% (140/1087) and 25.4% (106/418) in the model derivation, temporal validation and broader external validation cohorts, respectively. The discriminative ability of the prediction model was adequate on temporal validation (c-statistic 0.75; 95% CI: 0.71–0.79) and acceptable on broader validation (c-statistic 0.67; 95% CI: 0.61–0.73). In both external cohorts, the model displayed excellent calibration between observed and predicted probabilities. Decision curve analysis showed increased net benefit across a range of meaningful risk thresholds. Conclusions A simple risk prediction model for unplanned readmission in OPAT patients demonstrated reproducible predictive performance, broad clinical transportability and clinical usefulness. This model may help improve OPAT outcomes through better identification of high-risk patients and provision of tailored care.
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Lauseker, Michael, Joerg Hasford, Markus Pfirrmann, and Rüdiger Hehlmann. "Chronic Myeloid Leukaemia Patients Treated In Teaching Hospitals Seem To Have a Survival Advantage Compared To Other Settings." Blood 122, no. 21 (November 15, 2013): 3997. http://dx.doi.org/10.1182/blood.v122.21.3997.3997.
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Abstract Introduction Treatment of chronic myeloid leukaemia (CML) has changed considerably due to the advent of tyrosine kinase inhibitors. As a consequence, CML is nowadays increasingly treated in municipal hospitals (MH) and at office-based physicians (OBP) and not only in teaching hospitals (TH). It is unknown how this affects the outcomes of CML patients. Thus we analysed if patients at TH have a survival advantage in comparison to patients that are treated in MH or at OBP. Patients All patients with chronic phase Ph+ CML and admitted to the German CML Study IV [Hehlmann et al. JCO 2013, in press] were eligible for this analysis. Out of 1551 patients randomised, 13 did not match the inclusion criteria, 2 withdrew informed consent during the first days and 45 could not be considered due to missing covariates. Thus, 1491 patients were available for analysis and had complete covariates. Every study centre was classified into one of three categories: TH, MH and OBP. Additionally, the number of patients enrolled in the CML Study IV was taken as a proxy measure of experience with TKI-treatment. Methods Survival times were calculated starting with the date of diagnosis. Patients that were still alive were censored at the date of last observation. Cox models were estimated to assess the impact of centre type and experience with CML. The models were adjusted for the following covariates: risk category according to the EUTOS score, year of diagnosis, age at diagnosis, and Karnofsky performance status scale. Results Out of the 1491 patients, 532 patients (36%) were from TH, 618 (41%) from MH and 341 (23%) from OBP. Percentages of EUTOS high risk patients were fairly similar in the three groups (13% at TH, 12% at MH and 10% at OBP). Patients of OBP had a significantly better Karnofsky scale, while TH patients were younger than MH and OBP patients (median age at diagnosis: 50, 53 and respectively 54). Five-year overall survival was 92%, 89% and 88% in the groups of TH, MH and OBP patients, the median observation time was 5.6 years. In the multivariate Cox model for survival, TH patients had a lower risk of death than MH patients (Hazard ratio (HR): 0.633, 95%-Confidence Interval (CI): [0.414; 0.966], p=0.034) and OBP patients (HR: 0.609, 95%-CI: [0.363; 1.024], p=0.060). Other important risk factors were EUTOS high risk (HR: 1.854, 95%-CI: [1.190; 2.889]) and age (HR: 1.044, 95%-CI: [1.030; 1.058]), whereas experience with CML and year of diagnosis did not seem to have any influence. When the model was stratified according to treatment, only minor changes were observed. One possible explanation for the advantage of the TH patients may be the more successful treatment of blast crisis. Two years after blast crisis, survival probability for TH patients was 47.7% (95%-CI: 28.4-67.4%), while for the MH and the OBP patients it was 22.3% (8.9-39.7%) and respectively 25.0% (7.6-48.3%). On the one hand, we found a tendency for more frequent adverse events (AE) in TH patients, but on the other hand reporting at TH was slightly better with an average of 3.5 AE forms per year compared to 3.3 (MH) and 2.8 (OBP). Conclusions Our data show that there was a survival advantage for CML patients treated initially at a TH compared to those that were treated at MH and OBP. This finding even holds, when adjusting for age, Karnofsky scale, EUTOS score, experience with CML, and year of diagnosis. We could not find any hint that more experience with the treatment of CML patients led to better survival probabilities. As the data set was too small to be divided into a learning and a validation set and this analysis was not pre-specified, our results need to be confirmed by an independent data set. Disclosures: Hehlmann: Novartis: Research Funding; BMS: Consultancy.
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George, Glyn. "Parallel probabilities." Mathematical Gazette 104, no. 560 (June 18, 2020): 271–80. http://dx.doi.org/10.1017/mag.2020.50.
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After several years of teaching an introduction to probability and statistics for engineering degree students, my attention has been captured by some variations on the familiar general addition law of probability. Network analysis of components connected in parallel is one of many applications.
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Housten, Ashley J., Geetanjali R. Kamath, Therese B. Bevers, Scott B. Cantor, Nickell Dixon, Andre Hite, Michael A. Kallen, Viola B. Leal, Liang Li, and Robert J. Volk. "Does Animation Improve Comprehension of Risk Information in Patients with Low Health Literacy? A Randomized Trial." Medical Decision Making 40, no. 1 (December 3, 2019): 17–28. http://dx.doi.org/10.1177/0272989x19890296.
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Introduction. Enhanced visual effects, like animation, have the potential to improve comprehension of probabilistic risk information, particularly for those with lower health literacy. We tested the effect of presentation format on comprehension of colorectal cancer (CRC) screening probabilities to identify optimal risk communication strategies. Methods. Participants from a community foodbank and a cancer prevention center were randomized to 1 of 3 CRC screening risk presentations. The presentations used identical content but varied in format: 1) video with animated pictographs, 2) video with static pictographs, and 3) audiobooklet with static pictographs. Participants completed pre- and postpresentation surveys. The primary outcome was knowledge of probability/risk information regarding CRC screening, calculated as total, verbatim, and gist scores. Results. In total, 187 participants completed the study and were included in this analysis. Median age was 58 years (interquartile range [IQR]: 14 years), most participants were women (63%), and almost half had a high school education or less (46%). Approximately one-quarter had inadequate health literacy (Short Test of Functional Health Literacy in Adults marginal/inadequate: 28%; Brief Health Literacy Screener low: 18%), and about half had low numeracy (Subjective Numeracy Scale low: 54%; Graphical Literacy Measure low: 50%). We found no significant differences in total, verbatim, or gist knowledge across presentation formats (all P > 0.05). Discussion. Use of an animated pictograph to communicate risk does not appear to augment or impede knowledge of risk information. Regardless of health literacy level, difficulty understanding pictographs presenting numerical information persists. There may be a benefit to teaching or priming individuals on how to interpret numerical information presented in pictographs before communicating risk using visual methods. Trial Registry: NCT02151032
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Berthelot, S., E. Lang, H. Quan, and H. Stelfox. "LO085: Canadian in-hospital mortality for patients with emergency-sensitive conditions." CJEM 18, S1 (May 2016): S59. http://dx.doi.org/10.1017/cem.2016.122.
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Introduction: The emergency department (ED) hospital standardized mortality ratio (ED-HSMR) measures risk-adjusted mortality for patients admitted to hospital with conditions for which ED care may improve outcomes (emergency-sensitive conditions). This study aimed to describe in-hospital mortality across Canadian provinces using the ED-HSMR. Methods: Data were extracted from hospital discharge databases from April 2009 to March 2012. The ED-HSMR was calculated as the ratio of observed deaths among patients with emergency-sensitive conditions in a hospital during a year (2010-11 or 2011-12) to the expected deaths for the same patients during the reference year (2009-10), multiplied by 100. The expected deaths were estimated using predictive models fitted from the reference year for different hospital peer-groups (teaching, large, medium and small hospitals) adjusted for comorbidities, age, diagnosis, and hospital length of stay. Thirty-seven validated emergency-sensitive conditions were included (e.g., stroke, sepsis, shock). Aggregated provincial ED-HSMR values were derived from patient-level probabilities of death. A HSMR above or below 100 respectively means that more or fewer deaths than expected occurred in hospital within a province. Results: During the study period, 1,335,379 patients were admitted to 629 hospitals across 11 provinces and territories with an emergency-sensitive condition as the most responsible diagnosis, of which 8.9% died. More in-hospital deaths (95% confidence interval) than expected were respectively observed for the years 2010-11 and 2011-12 in Newfoundland [124.3 (116.3-132.6) & 117.6 (110.1-125.5)] and Nova Scotia [116.4 (110.7-122.5) & 108.7 (103.0-114.5)], while mortality was as expected in Prince Edward Island and Manitoba, and less than expected in other provinces and territories [Territories 67.3 (48.3-91.3) & 73.2 (55.0-95.5); New Brunswick 87.7 (82.5-93.1) & 90.4 (85.2-95.8); British Columbia 92.0 (89.6-94.4) & 87.1 (84.9-89.3); Saskatchewan 92.3 (87.1-97.4) & 90.8 (86.2-95.6); Ontario 94.0 (92.6-95.4) & 88.0 (86.6-89.3); Alberta 94.1 (91.1-97.2) & 91.0 (88.2-93.9); Québec 95.7 (93.8-97.6) & N/A]. Conclusion: Our study revealed important variation in risk-adjusted mortality for patients admitted to hospital with emergency-sensitive conditions among Canadian provinces. The results should trigger more in-depth evaluations to identify the causes for these regional variations.
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Upshur, Ross E. G. "Two Techniques for Teaching the Estimation of Prior Probabilities." Teaching and Learning in Medicine 12, no. 3 (July 2000): 141–44. http://dx.doi.org/10.1207/s15328015tlm1203_4.
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Ben, Mirian Dal, Maura Oliveira, Paola Cappellano, Jorge Sampaio, and Maria Beatriz Dias. "Evaluating the Cost-Effectiveness of Proposed Algorithms for C. difficile Infection in Different Pretest Probability Settings." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s224—s225. http://dx.doi.org/10.1017/ice.2020.769.
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Background: The use of real-time polymerase chain reaction (RT-PCR) as a first-line test for the diagnosis of Clostridioides difficile may result in overdiagnosis and overtreatment because the test is not capable of distinguishing infection from carriage. Toxin EIA assays have impeditive low sensitivity. Some algorithms using enzyme immunoassay for glutamate dehydrogenase (GDH) antigen and toxins A and B as the first step have been proposed to increase diagnostic performance. However, cost-effectiveness of different diagnostic algorithms would depend on the cost of each test and on the pretest probability in different settings. The objective of the present study was to evaluate the cost-effectiveness of 2 algorithms proposed by current guidelines to diagnose C. difficile infection by developing a mathematical model that would take into account the epidemiology and costs in our hospital. Methods: The study was conducted in a 480-bed tertiary-care teaching hospital in So Paulo, Brazil. All suspected C. difficile infection cases from January to December of 2017 were evaluated for pretest probability analysis. All stools collected from patients with a requested PCR test for suspected C. difficile infection were selected for additional testing to measure the specificity and sensitivity of each different test: C. diff GDH/Toxin A/B combined test, Toxin A/B Microplate Assay, GDH, and PCR. Toxigenic stool culture for C. difficile was considered the gold standard. A mathematical model was developed and simulations were done. The outcomes evaluated were: final annual costs with diagnostic tests in US dollars and number of patients receiving a false-positive or a false-negative diagnosis in a year simulation. Results: In total, 1,441 stool samples were tested by PCR for C. difficile in our institution from January 2017 to December 2017. Overall, 206 had a positive result, with a pretest probability of 14.3%. In our simulations, the PCR-based algorithm had an annual cost of US$279,914.25, with 4 false-negative results and 8 false-positive results. The implementation of a GDH/Toxin/PCR stepwise algorithm would have reduced the annual cost to US$160,488.75, with 6 false-negative results and 1 false-positive result. Simulations of annual cost and performance of the 2 algorithms have shown that the stepwise algorithm would still be advantageous in settings with higher pretest probabilities (Fig. 1). Conclusions: A stepwise algorithm based on GDH/Toxin before PCR seems to be more cost-effective, even in settings with higher pretest probabilities.Funding: NoneDisclosures: None
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DOS SANTOS FERREIRA, ROBSON, VERÔNICA YUMI KATAOKA, and MONICA KARRER. "TEACHING PROBABILITY WITH THE SUPPORT OF THE R STATISTICAL SOFTWARE." STATISTICS EDUCATION RESEARCH JOURNAL 13, no. 2 (November 28, 2014): 132–47. http://dx.doi.org/10.52041/serj.v13i2.286.
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The objective of this paper is to discuss aspects of high school students’ learning of probability in a context where they are supported by the statistical software R. We report on the application of a teaching experiment, constructed using the perspective of Gal’s probabilistic literacy and Papert’s constructionism. The results show improvement in students’ learning of basic concepts, such as: random experiment, estimation of probabilities, and calculation of probabilities using a tree diagram. The use of R allowed students to extend their reasoning beyond that developed from paper-and-pencil approaches, since it made it possible for them to work with a larger number of simulations, and go beyond the standard equiprobability assumption in coin tosses. First published November 2014 at Statistics Education Research Journal Archives
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Erreygers, Alexander, and Enrique Miranda. "A graphical study of comparative probabilities." Journal of Mathematical Psychology 104 (September 2021): 102582. http://dx.doi.org/10.1016/j.jmp.2021.102582.
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Frighetto, Luciana, Carlo A. Marra, H. Grant Stiver, Elizabeth A. Bryce, and Peter J. Jewesson. "Economic Impact of Standardized Orders for Antimicrobial Prophylaxis Program." Annals of Pharmacotherapy 34, no. 2 (February 2000): 154–60. http://dx.doi.org/10.1345/aph.19142.
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OBJECTIVE: To assess the effect and economic impact of an intervention aimed at standardizing the timing of preoperative antimicrobial prophylaxis from the perspective of a major teaching hospital. DESIGN: A pre/post study design in which a random sample of 60 procedures from a 12-month period in the preintervention phase were reviewed. A comparative sample of 60 procedures during a seven-month postintervention phase was selected. For each prophylactic course, preoperative dose administration details were classified as early (>2 h prior to incision), on time (0–2 h prior), delayed (0–3 h after), or late (>3 after). To determine the economic impact of this intervention, we used a predictive decision analytic model using institutional costs and the published probabilities of inpatient surgical wound infections (SWIs) following administration of antimicrobials timed according to the above criteria. Two conditions were analyzed: (1) an interdisciplinary two-stage therapeutic interchange program involving staff education and modification of preoperative antimicrobial orders to ensure timely administration and (2) no intervention. SETTING: An 1100-bed tertiary care, university-affiliated institution. PATIENTS: 120 randomly selected procedures involving inpatients who received a preoperative antibiotic. OUTCOME MEASURES: Differences in preoperative antimicrobial timing and cost avoidance associated with the intervention. RESULTS: In the preintervention phase, 68% of prophylactic courses were on time, 22% were early, and the balance were delayed or late. The incidence of on-time prophylaxis increased to 97% during the postintervention phase (p = 0.001). Operating room staff involvement in antimicrobial administration increased from 57% to 92% (p = 0.001). Based on a setup and annual intervention cost of $9100 CAN ($1 CAN = $0.68 US), an annual inpatient SWI avoidance of 51 cases, an average infection-associated extended hospital stay of four days, and an average treatment cost of $1957 CAN per inpatient SWI, we estimated that 153 hospital days were avoided and there was an annual cost avoidance of $90707 CAN ($1779 CAN saved per inpatient infection avoided) due to this intervention. Using sensitivity analyses, no plausible changes in the base case estimates altered the results of the economic model. CONCLUSIONS: An interdisciplinary approach to optimizing the timing of preoperative antimicrobial doses can impact positively on practice patterns and result in substantial cost avoidance. Costs incurred to implement such an intervention are small when compared with the annual cost avoidance to the institution.
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Беленкова, Жанна Тадеушевна, Оксана Борисовна Смирнова, and Дмитрий Владимирович Беленков. "ON THE METHODS OF TRAINING FOREIGN STUDENTS OF THE THEORY OF PROBABILITIES." Вестник Тверского государственного университета. Серия: Педагогика и психология, no. 4(53) (December 21, 2020): 146–54. http://dx.doi.org/10.26456/vtpsyped/2020.4.146.
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Обсуждается проблема обучения иностранных студентов теории вероятностей. Рассмотрены приемы обучения, направленные на повышение качества обучения иностранных студентов с недостаточным уровнем знаний русского языка решению текстовых задач. Предложено использование в обучении теории вероятностей совокупности приемов визуализации учебного материала и информационной структуры задачи, приведены примеры учебных вопросов различных типов, направленных на понимание ситуаций, описанных в задаче. The problem of teaching probability theory to foreign students is discussed. The methods of teaching are considered, aimed at improving the quality of teaching foreign students with an insufficient level of knowledge of the Russian language in solving word problems. It is proposed to use of a set of techniques for visualizing educational material and the information structure of a problem in teaching probability theory; examples of educational questions of various types aimed at understanding the situations described in the problem are given.
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Lyford, Alex, and Michael Czekanski. "Teaching students to estimate complex probabilities of board game events through simulation." Teaching Statistics 42, no. 3 (August 18, 2020): 117–25. http://dx.doi.org/10.1111/test.12235.
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Rubel, Laurie H. "Connecting Research to Teaching: Is 7/10 Always Equivalent to 700/1000?" Mathematics Teacher 104, no. 2 (September 2010): 144–47. http://dx.doi.org/10.5951/mt.104.2.0144.
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Consider the following problem: Compare the probabilities of the following two events: (1) 7 tails out of 10 tosses of a fair coin and (2) 700 tails out of 1000 tosses of a fair coin. Which of the events is more likely, or are they equally likely? (adapted from Fischbein and Schnarch 1997, p. 99)
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Rubel, Laurie H. "Connecting Research to Teaching: Is 7/10 Always Equivalent to 700/1000?" Mathematics Teacher 104, no. 2 (September 2010): 144–47. http://dx.doi.org/10.5951/mt.104.2.0144.
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Consider the following problem: Compare the probabilities of the following two events: (1) 7 tails out of 10 tosses of a fair coin and (2) 700 tails out of 1000 tosses of a fair coin. Which of the events is more likely, or are they equally likely? (adapted from Fischbein and Schnarch 1997, p. 99)
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Wathen, J. Kyle, and Peter F. Thall. "A simulation study of outcome adaptive randomization in multi-arm clinical trials." Clinical Trials 14, no. 5 (February 1, 2017): 432–40. http://dx.doi.org/10.1177/1740774517692302.
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Randomizing patients among treatments with equal probabilities in clinical trials is the established method to obtain unbiased comparisons. In recent years, motivated by ethical considerations, many authors have proposed outcome adaptive randomization, wherein the randomization probabilities are unbalanced, based on interim data, to favor treatment arms having more favorable outcomes. While there has been substantial controversy regarding the merits and flaws of adaptive versus equal randomization, there has not yet been a systematic simulation study in the multi-arm setting. A simulation study was conducted to evaluate four different Bayesian adaptive randomization methods and compare them to equal randomization in five-arm clinical trials. All adaptive randomization methods included an initial burn-in with equal randomization and some combination of other modifications to avoid extreme randomization probabilities. Trials either with or without a control arm were evaluated, using designs that may terminate arms early for futility and select one or more experimental treatments at the end. The designs were evaluated under a range of scenarios and sample sizes. For trials with a control arm and maximum same size 250 or 500, several commonly used adaptive randomization methods have very low probabilities of correctly selecting a truly superior treatment. Of those studied, the only adaptive randomization method with desirable properties has a burn-in with equal randomization and thereafter randomization probabilities restricted to the interval 0.10–0.90. Compared to equal randomization, this method has a favorable sample size imbalance but lower probability of correctly selecting a superior treatment. In multi-arm trials, compared to equal randomization, several commonly used adaptive randomization methods give much lower probabilities of selecting superior treatments. Aside from randomization method, conducting a multi-arm trial without a control arm may lead to very low probabilities of selecting any superior treatments if differences between the treatment success probabilities are small.
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Noone, E. T. "Chuck-a-luck: Learning Probability Concepts with Games of Chance." Mathematics Teacher 81, no. 2 (February 1988): 121–23. http://dx.doi.org/10.5951/mt.81.2.0121.
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Chuck-a-luck is a dice game that is easy to understand and to play. It offers an excellent means of teaching the fundamental idea of the expected value of a random variable. Furthermore, by using a simple BASIC program, the game can easily be simulated on the computer. For students to appreciate and follow the discussion, it is necessary for them to have a basic understanding of such elementary probability concepts as computing simple classical probabilities and computing the probabilities of independent and mutually exclusive events
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Yuan, Xiaobin, and Shesh N. Rai. "Confidence Intervals for Survival Probabilities: A Comparison Study." Communications in Statistics - Simulation and Computation 40, no. 7 (July 7, 2011): 978–91. http://dx.doi.org/10.1080/03610918.2011.560732.
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Flores, S. M., R. M. Ziff, and J. J. H. Simmons. "Percolation crossing probabilities in hexagons: a numerical study." Journal of Physics A: Mathematical and Theoretical 48, no. 2 (December 11, 2014): 025001. http://dx.doi.org/10.1088/1751-8113/48/2/025001.
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Wetzel, James N., Dennis O’Toole, and Steven Peterson. "Factors affecting student retention probabilities: A case study." Journal of Economics and Finance 23, no. 1 (March 1999): 45–55. http://dx.doi.org/10.1007/bf02752686.
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Pistorius, Pierre A., and Marthán N. Bester. "A longitudinal study of senescence in a pinniped." Canadian Journal of Zoology 80, no. 3 (March 1, 2002): 395–401. http://dx.doi.org/10.1139/z02-017.
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To measure the prevalence of senescence in southern elephant seals (Mirounga leonina Linn.) at Marion Island, changes in adult-female survival and breeding probabilities with age were quantified. Markrecapture data that had been collected over a 17-year period were analysed using recently developed software to obtain likelihood estimates of survival and capture probabilities. With recapture effort constant over the study period, capture probabilities during the breeding seasons were used as indices of breeding probabilities. Longevity in the population was assessed from the resighting of tagged and hence known-age individuals. Less than a 1% difference between prime-age survival and post prime age survival was found over 8 cohorts of marked females. In addition, no reduction in survival of very old individuals was detected, suggesting the absence of senescence in terms of reduced survival in southern elephant seals. No evidence of reproductive senescence in terms of reduced breeding probability with age was detected. Mortality throughout the population therefore resulted in no individuals surviving to the age where physiological decline would become a mortality agent or result in failure to breed. Five percent of female southern elephant seals survived to age 10 and 0.5% to age 17.
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Craig, Michael D., Andrew H. Grigg, Mark J. Garkaklis, Richard J. Hobbs, Carl D. Grant, Patricia A. Fleming, and Giles E. St J. Hardy. "Does habitat structure influence capture probabilities? A study of reptiles in a eucalypt forest." Wildlife Research 36, no. 6 (2009): 509. http://dx.doi.org/10.1071/wr09014.
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Pitfall traps are commonly used to examine differences in reptile communities among habitat types and disturbance regimes that differ in structure. However, capture rates and probabilities may be influenced by habitat structure, which invalidates comparisons of relative abundance among habitat types. To assess whether pitfall traps provide accurate reflections of density and whether habitat structure affects capture probabilities, we trapped at six sites in various jarrah-forest habitat types in south-western Australia, then intensively searched 150-m2 total-removal plots around each pitfall grid to obtain absolute densities of reptiles. Pitfall captures were significantly correlated with numbers on total-removal plots for Hemiergis initialis and Lerista distinguenda, indicating that pitfall traps provided accurate reflections of density for these species. Capture probabilities of H. initialis and L. distinguenda and all reptiles combined showed no significant correlations with any structural variables, indicating that capture probabilities were consistent across sites. We conclude that trapping provided accurate estimates of relative abundance for some species and that capture probabilities were not influenced by vegetation structure. Because many studies use trapping to estimate abundances among habitat types, we encourage researchers to investigate how vegetation structure influences capture probabilities, so that general patterns can be determined; we also suggest improvements for any future studies.
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Zerbolio, Dominic J. "A “Bag of Tricks” for Teaching about Sampling Distributions." Teaching of Psychology 16, no. 4 (December 1989): 207–9. http://dx.doi.org/10.1207/s15328023top1604_9.
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This classroom technique uses imaginary marbles, chips, and bags to create distributions of sample means, differences between independent sample means, mean difference scores, and raw score populations. With this technique, students more easily grasp the distinctions between raw score populations and sampling distributions, With these distinctions established, the need for different measures of variability for each distribution becomes apparent. Then, solutions for the probabilities of specific observations for each sampling distribution are easily generalized from the raw score model. Once students learn to answer probability questions for each sampling distribution, generalizing to hypothesis testing procedures is facilitated. The technique requires only the instructor's flair for the dramatic and the students' imagination to make it work.
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Ologhadien, Itolima. "Study of Unbiased Plotting Position Formulae for the Generalized Extreme Value (GEV) Distribution." European Journal of Engineering and Technology Research 6, no. 4 (June 17, 2021): 94–99. http://dx.doi.org/10.24018/ejers.2021.6.4.2468.
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The determination of appropriate quantile relations between the magnitude of extreme events and the corresponding exceedance probabilities is a prerequisite for optimum design of hydraulic structures. Various plotting position formulae have been proposed for estimating the exceedance probabilities or recurrence in. In this study, eight plotting position formulae recommended for GEV distribution were used for estimating the exceedance probabilities of annual maximum series of River Niger at Baro, Kouroussa and Shintaku hydrological stations. The performance measures of PPCC, RRMSE, PBIAS, MAE and NSE were calculated by applying their individual equations to each pair of observed AMS, arranged in ascending order, and exceedance probabilities calculated using each plotting positions. The result of the study show that Weibull was the best plotting position formula, seconded by Beard and thirdly, In – na and Ngugen. This study underscores the necessity to accurately size water infrastructure. In a recent paper, the author found GEV distribution the best – fit probability distribution model in Nigeria. Thus, the need to develop indepth understanding and accurate estimation of exceedance probabilities and return periods using the GEV distribution. Furthermore, this paper recommends similar studies to be conducted for Pearson Type 3(PR3) and Log Pearson Type 3 (LP3) distributions.
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Herreid, Clyde Freeman. "Case study teaching." New Directions for Teaching and Learning 2011, no. 128 (December 2011): 31–40. http://dx.doi.org/10.1002/tl.466.
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