bluuebunny/crossref_metadata_2025 huggingface dataset:
Pupil Progress and Grade Combinations
Authors: White William D.
Published: March 2007

This study demonstrates what seventh graders have known for a long time: the lowest spot on the totem pole is a difficult one from which to operate effectively.
Help for the Counselor
Authors: Goldman Leo
Published: March 2007

A specialist in the training of school counselors maintains he is not being inconsistent when he recommends more extensive training for coun selors and at the same time urges wider use of assistants with only limited training.
Every Student Every Day: Group Guidance in Action
Authors: Robinson Bertha M.
Published: March 2007

The homeroom idea may be in eclipse, but in at least one large high school this unit is an ef fective element in the school's guidance pro gram. She does not say so, but we infer that the principal's active and continuing interest has much to do with the success of the plan described here.
Until the Computers Arrive
Authors: Lucey Paul A. , Spence James R.
Published: March 2007

With the wonders of the computer as an aid to administration being celebrated on every hand, it is easy to forget that well organized men can organize a school well unelectronically. This article is a reminder.
Our First Need: Improved Teaching
Authors: Byrnes Robert F.
Published: March 2007

"It is the quality of the teacher and the quality of instruction that are important, far more central than the program of studies, the kind of building, the materials available, or the technical equipment which the school has."
The Counselor's Role, Real and Ideal
Authors: Cawelti Gordon
Published: March 2007

Differing viewpoints can be stimulating and productive. But when they are great and not recognized, as is often the case with the proper range of responsibility of the counselor, these differences are anything but desirable.
The Government and Consumer Education
Authors: Rowse Arthur E.
Published: March 2007

Although to most citizens the image of the federal government seems anything but indi vidual-oriented, the fact is that many units within that government work seriously and steadily to aid the consumer and his education.
Joint Council on Economic Education
Authors: Frankel M.L.
Published: March 2007

A continuing cooperative program-in which NASSP is one of the cooperating members—is producing a steady flow of materials and exper iences that will be helpful to any school seek ing to enrich its curriculum with learning activities in the area of consumer economics.
Education in Family Finance
Authors: Gibson Robert E.
Published: March 2007

A system of workshops offers teachers and administrators low-cost opportunities to update their expertise and develop instructional materials for nationwide use.
A Political Game for Histo Students
Authors: Maish David L. , Peryon Robert E.
Published: March 2007

High school students and their teachers are discovering what children have long known, that some of the best games are the ones made up to fit a particular place and set of players. A political game played in World History is a case in point.
"Spotty Fever"
Authors: Becker James W.
Published: March 2007

It is not yet clear whether an academic anti biotic can be developed that will successfully attack the infection Becker describes, nor is it certain that the patient will agree to take the remedy if it is discovered.
Drug Abuse
Authors: Larimore Granville W.
Published: March 2007

"Medical authorities and educators agree that helping pupils to develop well-adjusted per sonalities is basic in preventing drug abuse."
Hearing and Speech Conservation in Schools
Authors: Mandell Theodore , Walle Eugene L.
Published: March 2007

It's time for school people to speak up loudly enough to be heard on behalf of more and better services for that one student in every 20 who is in some degree handicapped by a communicative disorder of some kind.
Health Instruction in Washington State
Authors: Trucano Lucille
Published: March 2007

It's likely that the need for state-based support and advice is greater in the case of health edu cation than in any other field. This is a report on one state's efforts to be helpful without be ing dictatorial.
What Is the New Mathematics?
Authors: Willoughby Stephen S.
Published: March 2007

"... there is a great deal more involved in the changes in school mathematics than just new subject matter. Different ways of looking at mathematics and different ways of communicat ing with pupils have also been involved in the recent changes in the mathematics program."
How Provide for the Mathematically Talented?
Authors: Hlavaty Julius H. , Ruderman Harry D.
Published: March 2007

Providing suitable instruction for mathemati cally talented young people is a responsibility to be shared by everyone from the classroom teacher to the leaders of national curriculum projects. Here are ways in which educators at various levels can exercise this responsibility.
Changing Patterns of Action: A Proposal
Authors: Compton C. Arthur
Published: March 2007

This paper is a transcription of the third in a series of talks Mr. Compton gave last January to the morning assembly with which each school day opens at Phillips Exeter Academy. Although he was addressing himself specifically and point edly to a group of college-bound students and their teachers in an independent school, the challenges he offered can, with the change of only a few words here and there, be made applicable to secondary school students and teachers everywhere. All three talks were pub lished as a Faculty Paper by the Academy, which has granted us permission to reprint this essay.
The Beginning Teacher Project in New York State
Authors: McGinnis Cecelia
Published: March 2007

Central to the effectiveness of New York State's experimental teacher induction project are master teachers/team leaders. The State Educa tion Department is financing summer training sessions for them and also funding the hiring of substitute teachers during the school year to free time of master teachers to work with the beginners on their teams.
A Time to Teach— and a Time to Learn
Authors: Swanson Patricia
Published: March 2007

The initiation and development of NASSP' S three-year, experimental demonstration project on the induction of beginning teachers are described here by the assistant director of the program. She continues by presenting the major generalizations about working with new teachers toward which the evidence from this project appears to point.
Teacher Induction
Authors: Hunt Douglas W.
Published: March 2007

The director of NASSP'S teacher induction project summarizes what that project in its very short lifetime has been able to demonstrate. What he cannot say but the editor can is that we have here a most unusual development: a project of rather modest proportions, by contemporary standards, that actually has begun to influence practice in the schools.
The High School in the Big City
Authors: Havighurst Robert J.
Published: March 2007

"Improvement of the comprehensive high school in the big city is the major constructive task of secondary school teachers and administrators. As they accomplish this task, they will contribute to social urban renewal, and social urban renewal will contribute to the success of the compre hensive high school."
Utilizing Drug-Experienced Youth in Drug Education Programs
Authors: Freedman Marion , Stolow Arthur , Lewis David C.
Published: March 2007

"The technique of employing young persons who have had experience in the use of drugs as discussion leaders with high school students is a viable one. The young leaders demonstrated that they were capable of controlling a group and of creating an atmosphere conducive to the raising of questions which might not have been asked in a structured classroom setting."
Independent Study: Foreign Language Seminars
Authors: Fleury Dale F.
Published: March 2007

"The Seminar Program offers a way to organize an advanced foreign language class which con sists of several levels. It provides a workable method of individualizing instruction, by allow ing a teacher to work with small groups of in dividuals without slighting other students. But the program's greatest strength is that it puts the responsibility of learning on the student— where it belongs—giving him a valuable initia tion into the self-reliance that will be expected of him in schooling beyond high school and in life in general."
Standards for Building High School Speech Programs
Authors: Clark Richard W. , Nelson Oliver W.
Published: March 2007

"Whether a [speech] program is conceived as a distinct speech education program or viewed as an integral part of the English language arts program need not become a crucial issue. What really matters is that there be a program in which speech education is recognized as a neces sary and integral objective and function of secondary education."
College Preparatory Mathematics: Preparation for What?
Authors: Eilber Charles R.
Published: March 2007

"... The relevance of the secondary school col lege preparatory mathematics curriculum to the lives of the future historian, musician, teacher of English, or articulate layman is doubtful."
Innovations in Business Education: Two Examples
Authors: Hanson Garth A. , Stocker H. Robert
Published: March 2007

Two articles from recent literature in the field of business education have been selected for inclusion in this anthology of reprints as illustra tions of the ways in which the curriculum in business education reflects changes in both tech nology and job requirements.
Evaluating Civic Behavior
Authors: Nichols Daryl G. , Campbell Vincent N.
Published: March 2007

"Educational objectives must be appropriate to individual circumstances; what is relevant to a suburban middle-class youngster may be entirely inappropriate to an inner-city youth. To evalu ate civic behavior, then, we must not only state objectives in terms of desired behaviors, but we also must make sure that they are appropriate objectives for the target population."
Reconstructing Civics Instruction In Urban Secondary Schools
Authors: Patrick John J. , Messick Rosemary G.
Published: March 2007

"It appears that sharpening the instructional skills of teachers, improving the content of in structional materials, and altering the con straining climate in which instruction takes place are points of leverage for the improve ment of civics instruction. Emphasis must shift from hortatory pronouncements about the glories of inquiry-oriented civics instruction to the creation of conditions that make such in struction possible on a wide scale."
Deciding to Take the Risks
Authors: Ferguson Thomas D.
Published: March 2007

"Liability considerations, the approval of materials and speakers and trips that have an outspoken and direct point of view, the hard work of logistics and coordination—all of these require a brave populace, school board, adminis tration, faculty, and student body."
Drug Education
Authors: Lewis David C.
Published: March 2007

This paper suggests an approach to discussing drug problems with young people which the author has gained, as he says, by trial and error as he has participated in and observed the implementation of drug education programs in colleges, high schools, and junior high schools. Lewis discusses such a program's goals, methods, and content in clear detail and with rare understanding.
Computers and Education: A Bibliography
Authors: Walton Wesley W.
Published: March 2007

Books on computers and computing. Journal articles on educational computing. Brochures and pamphlets on computers. Special publications. Sources of information on computers.
How the Schools Can Prevent Drug Abuse
Authors: Lewis David C.
Published: March 2007

"... This program is based on the premise that the ultimate responsibility for drug taking rests with the student. Since the on-the-spot decision to take drugs is made by the student, education can be effective only if it is directed at the decision-making process."
The School and the Law
Authors: Ketcham Orman W.
Published: March 2007

"... In the decade of the sixties, both the le gality and the social reality of parens patriae were challenged on many fronts. A host of fac tors are different today in a juvenile's world from the turn of the century when the juvenile court philosophy was born. That is equally true, I'm sure, in secondary schools across our nation."
Restless Youth— What's the Message?
Authors: Zack Jacob B.
Published: March 2007

This paper discusses the bases for restlessness among youth today and describes dissent in the New York City school system. Particularly in structive is the development of consultative councils and the utilization of parents as aids to dealing constructively with student protest.
The Goshen Project in International/Intercultural Education
Authors: Orr Paul G. , Rockarts Dorothea G.
Published: March 2007

"The Goshen School was chosen by the Alabama State Department of Education as the school to house the pilot project in developing curriculum materials for teaching international education. Goshen offered a small, 12-grade school in rural Pike County, Alabama, with a faculty and student body that had not been previously involved in, or affected by, international activities."
Milton, Whitcomb, Winooski, and Rochester
Authors: Pierce Robert F.
Published: March 2007

Profile descriptions of four small schools pro vide a glimpse of new happenings in Vermont.
Staff Organization in the Smaller Secondary School
Authors: Buser Robert L. , Stuck Dean
Published: March 2007

Providing organizational guidelines for the innovator's consideration, a taxonomy of major functions and tasks within a high school organization, and a set of criteria for principals contemplating change, Buser and Stuck look at the possibility of organizational change suitable for smaller secondary schools.
Speech-Arts Approach As a First Course
Authors: Weirich Dorothy Q.
Published: March 2007

If Norman Cousins is right, that a prime weakness of education is inadequate attention to communications skills, then Miss Weirich's clear exposition of the philosophy, objectives, organization, and content of a first course in high school speech should be required reading for principals and curriculum committees in schools where speech is neglected.
The Student's Freedom of Religion
Authors: Hollister C.A. , Leigh Peter R.
Published: March 2007

We thank you for the flowers so sweet; We thank you for the food we eat; We thank you for the birds that sing; We thank you for everything.

Innocuous? Maybe, but a circuit court de clared it in violation of First Amendment guarantees, hence unacceptable in a school ceremony.

This article, Chapter 2 in a forthcoming book, summarizes recent trends in efforts to protect the student's freedom of religion.
Student Unrest: Some Causes and Cures
Authors: McKenna Bernard
Published: March 2007

The director of an NEA task force on student involvement outlines what must be done, in his opinion, to attack the bases of student un rest : a dull curriculum and non-motivating methods of teaching, lack of student involve ment in decision making, and poor human re lations. Repressive approaches to satisfy calls for law and order only result in negative be havior, he cautions.
An Uncensored Version of
Authors: Huberman Michael
Published: March 2007

Last October the London Times Educational Supplement pub lished an excerpt from an obscure brochure by Dr. Michael Huberman entitled "Reflections on Democratization of Secon dary and Higher Education." The brochure had been issued by UNESCO as one of a series of "Trend Papers" on themes assigned to the International Education Year (1970) by UNESCO'S General Conference.

All this sounds innocuous enough. However, the Times edi tors noted that "all but a few copies of [ the brochure ] have been destroyed on the orders of the [UNESCO] director general, M. Rene Maheu," suggesting that the Huberman paper was so strongly anti-establishment that it was suppressed.

We have investigated the alleged suppression and have found that the allegation is only partially accurate. Raymond Rodri guez, chief of the special UNESCO unit responsible for IEY, sent a copy of the full brochure (about 50 double-spaced typewritten pages) and invited publication in the BULLETIN. He took pains to say that the Trend Papers do not necessarily express official views of UNESCO.

A quick check shows that the version of Huberman's paper supplied by Mr. Rodriguez is somewhat blander (as well as much lengthier) than the excerpts published by the Times, suggesting that censorship has indeed occurred. (For example, where the Times version says, "The demand for open access to education is politically irresistible," the UNESCO version substitutes "strong" for "irresistible.")

In both the UNESCO and Times versions, however, it is clear that Huberman sides with the consumers of education. For ex ample, he favors giving them money or education vouchers to spend where they see fit. In the Times' words: "He challenges the academic world's perennial emphasis on quantity rather than quality, and the resulting 'squandering' by developed and de veloping countries alike on traditional types of education which suit only a minority of children and are 'Procrustean beds' for the remainder. He would like the beds-institutions and exami nations at all levels-to fit the consumer, not the reverse."

For scholars desiring a copy of the full Huberman paper, as released by UNESCO, the BULLETIN editors will fill orders at $2 per copy, or $1 each for 5 or more copies. Enclose check or money order; no billed orders will be accepted. Address NASSP, 1201 Sixteenth St. N.W., Washington, D.C. 20036.-The Editors.
The Making of a Principal—I970
Authors: Wogaman Thomas D.
Published: March 2007

Principals are generally hired by the superin tendent and board. Here is the case history of a high school principal hired in a kind of com munity-wide cooperative venture. Even students took part. There were a few drawbacks-and some real dividends.
The Schools and the Space Program
Authors: von Braun Wernher
Published: March 2007

The space program is more than putting men on the moon; it is an unprecedented search for new and fundamental knowledge, says Mr. von Braun. Yet there is a current hostility toward science and technology, representing reaction to overemphasis following Russia's early space success. He appeals to principals to check the current swing of the pendulum.
High School, I980
Authors: Eurich Alvin , Gores Harold B. , Sand Ole
Published: March 2007

At the final general session of the 1971 NASSP convention, three educators who have been identified with planning for the future shared the platform: Alvin Eurich, Harold Gores, and Ole Sand. Here is a shortened version of remarks already abbreviated by lack of time for full-scale addresses by these authorities.
Which Elements of School Programs Are Easier to Change and Which Are Most Difficult —And Why?
Authors: Trump J. Lloyd , Georgiades William
Published: March 2007

The NASSP Model Schools Program seeks to promote worthwhile changes in some 30 widely separated schools. The program was little more than a year old when data for this report were gathered. But one important conclusion could be drawn at once: Some changes can be made easily; others are resisted. This report sorts them out.
The Case for the Small High School
Authors: Cohodes Aaron
Published: March 2007

The best place to get a humanistic education is the small high school, where a student can find himself at his own rate. So think small, says Mr. Cohodes.
Grievance Procedures: The Principal's Role Where There Is a Negotiated Contract
Authors: Kramer Edward D.
Published: March 2007

The principal's role in grievance procedures differs from system to system, depending largely on governing policies and agreements. Whether there is a detailed negotiated contract or uni laterally adopted board policy, there must be order and structure if the principal's position is to be tenable. Here are two articles on grievance procedures, one dealing with a highly struc tured, the other with a vague and arbitrary situation.
The Reasonable Assertion of Authority
Authors: Fish Kenneth L.
Published: March 2007

Assertion of authority is more than "lowering the boom," according to this author, who says educators must understand what authority is all about if they are to operate effective schools.
Negotiations and Accountability
Authors: Hough Charles R.
Published: March 2007

School boards by state statutes are alone account able for the education of their communities' youth. What's needed, the writer contends, is a rectification of the statutes so that all parties to negotiations are accountable.
Negotiations: Ten Years Later
Authors: Donovan Bernard E.
Published: March 2007

This article surveys the last 10 years of col lective bargaining in education, pointing out the resultant benefits and problems. The author concludes that professionals must "grow up" in their negotiations, spending more time on the viial questions of education and less on mone tary or personal benefits.
Professionalism and Bureaucracy: Natural Conflict
Authors: Williams James O.
Published: March 2007

The case for bureaucracy is presented in this article, which stresses the need for creative school administrators to apply the principles of bureaucracy in a way that will avoid making hired hands of professional people.
Accountability in Teacher Education
Authors: Haynes Solon E. , Coyne Charles E.
Published: March 2007

The human factor, the authors say, makes the product of schools of education hard to eval uate. They describe, however, a successful teacher-training program that provides more actual classroom teaching activities much earlier than do most teacher education programs. The program has had remarkable and measurable results because it has held itself accountable for the end product: good teachers.
Decentralization as a Management Tool
Authors: Jones J.L.
Published: March 2007

Effective management requires the decentraliza tion of management functions. That's the basic premise of this article, which uses the term management interchangeably with organization, or better yet, leadership.
School Leaders—New Kinds of Thinking Needed To Lead Education into New Age
Authors: Burbach Harold J.
Published: March 2007

With the emergence of the Information Age, school leaders have the opportunity to make education a major institution in shaping the future. To succeed, however, this writer believes they will have to be more visionary. He profiles how they can revolutionize their thinking.
Principal as Instructional Manager: A Meta-Theory for Evaluation of Instruction
Authors: Notar Ellen Elms
Published: March 2007

We cannot assume that all teachers, however knowledgeable about their specific discipline, are familiar with concepts in learning principles. Instructional design systems theory pro vides that construct.
The Mechanized Journalist: Implications of Considering Media Organizations as Technological Systems
Authors: Bissland James H.
Published: March 2007

... efforts to reform journalism by altering its methodologies, democratizing the newsroom, or enhancing the education of journalists must reckon in the last analysis with the systemic interrelationships of culture, social structure and personality systems within news organizations.
Toward a Journalistic Context for the Study of Technology
Authors: Stricklin Michael
Published: March 2007

... we form a new context, one more appropriate for journalists, one that recognizes technology as merely a human artifact, good and/or bad only within the values humans create. Within this new context, ... ours is the responsibility of recognizing possible futures and their consequences.
Photography: A Transreductionist Approach: I
Authors: Straus Harley E.
Published: March 2007

Photographers are liars, deceiving themselves and their audiences. Concerned not with the art of photography, but with chatter of gadgetry and mechanics, they catalogue themselves along with their equipment. (Straus and Nesterenko, 1974, 3).
The Dilemma of Mass Communication: An Existential Point of View
Authors: Hardt Hanno
Published: March 2007

Man is what he is in communication; his existence is defined by his ability to remain in communication, not only with others as a prerequisite to any participation in the social process, but also with himself as a source of genuine feel ings and appreciations of his environment.
The Conversation: A Model for Communication and Responsibility
Authors: Trapp Mary E.
Published: March 2007

Within [the conversational communication model], dialogue and monologue are the dominant patterns of conversation; and dialogue is the more responsive, thus, more responsible, pattern. The conversational model which suggests this interpretation of responsibility is based primarily on ideas generated by the work of Dewey and secondarily on ideas generated by the work of Martin Buber.
Recent Developments in European Communications Theory
Authors: Nordenstreng Kaarle
Published: March 2007

The global trends in the field of mass communication research can be summarized in terms of two interrelated tendencies on change: (1) a tendency towards a more holistic framework, and (2) a tendency towards policy orientation.
The Uses and Limitations of Bernstein's Speech Codes
Authors: Carlyle Carolyn
Published: March 2007

Bernstein's work is stimulating insofar as it illustrates one way of thinking about how speech communication re flects and reforms culture. However, by concentrating solely on speech, he may be jumping to conclusions about the self concepts and world views of people within particular social setttings that would not be warranted if one were were to give the same consideration to other symbolic forms of communication those people use.
New Directions for Journalism Historiography
Authors: Atwood Roy
Published: March 2007

From one side ... the categories and frameworks with in which the history of journalism has been viewed must be turned upside down and inside out. But from another side, journalism historians can initiate revision by examining the history of journalism historiography itself from its deepest roots up.
Journalism and the Educational Views of Alexander Meiklejohn
Authors: Palmer Mack R.
Published: March 2007

"We believe more in facts than in longing, " [Meiklejohn] protested. Without ideals, without some connective tis sue offered to students jointly by the teacher and the curriculum, and without an awareness that the divisive ness of today's age is more the product of technologi cal specialization than of pluralistic factionalism, the contemporary university is in danger of defaulting on its primary assignment-education for democracy.
George Herbert Mead and Sigmund Freud: A Comparative Study of Psychoanalysis and Social Behaviorism
Authors: Jones Dan R.
Published: March 2007

While both Sigmund Freud and George Herbert Mead approach the study of the individual mind by specifying the importance of social influence on its formation and behavior, differences between them in emphasis and orientation exemplify the diversity which the new concern with group phenomena permitted.
Now I'm a small business ... do I need libraries?
Authors: Edmonds Diana
Published: March 2007

Analyses the author's experience of setting up and running her own business from the information needs perspective. Looks at information problems - lack of preparation; lack of time; lack of contacts; lack of an in-house library; lack of women in the business world. Goes on to describe information needs - start-up requirements; money; equipment; trade information and marketing information. Looks at information sources, including the accountant, bank manager, advice agencies, contact network and libraries. Concludes that libraries do have a role to play in providing information for small business, but that they need to make a stronger commitment to doing so.
Information sources in Accountancy and Finance
Authors: Mowat Mary
Published: March 2007

An introduction to and evaluation of information available in the fields of accountancy and finance, including major journals, information from government agencies and output from professional agencies.
Online business databases: an investigation into their users and uses
Authors: Willis Chris
Published: March 2007

The study investigates the use of business databases by British management. Based on a survey of users of ICC services and Jordanwatch, the survey includes original findings on who is using databases, which hosts they are accessing, what equipment they use, their reasons for searching, type of data accessed, frequency of down-loading, benefits, other sources used, set-up costs, annual expenditure and justifications for online searching.
Training in Business Information — what the practitioners want
Authors: Rennie Janet , Taylor Alyx
Published: March 2007

Librarians and information scientists working in the City and in the Food Industry were asked to assess the usefulness of the Business Information course at The City University. The results suggest that, in Business Information training generally, more emphasis should be placed on practical work and, in particular, on the use of online databases.
Making the most of statistics
Authors: Scott Doug
Published: March 2007

This paper guides the statistics user to a fuller understanding; it explains the technical terms employed by statisticians and outlines the pitfalls in interpreting statistical information.
Approaches to business information in Australia and the United Kingdom: observations and comparisons
Authors: Webb Sylvia P.
Published: March 2007

The business library scene in Australia is compared with that in the UK. Particular emphasis is given to development, both professional and technological. Case studies are presented illustrating the broadening spectrum of information work undertaken in Australia by (business information) specialists.
Free consumer market information
Authors: Mort David
Published: March 2007

An increasing number of companies providing consumer goods and services publish PR-driven reports on their products and market sectors. Much of the data is unavailable elsewhere. As it's also often available free of charge, this category of "grey" publishing deserves the attention of more business information specialists. This article outlines the nature of these neglected data sources and lists available reports.
How headhunters do their research
Authors: Webb Sylvia P.
Published: March 2007

Describes the process of research in the headhunting or executive search business. Outlines the sources of information - published, electronic and informal - used by researchers.
What Questions Do Patients with Curable Prostate Cancer Want Answered?
Authors: Feldman-Stewart Deb , Brundage Michael D. , Hayter Charles , Groome Patti , Curtis Nickel J. , Downes Heather , Mackillop William J.
Published: March 2007

Purpose. To determine the questions that recently diagnosed early-stage prostate cancer patients think should be addressed with patients like themselves. Study population. 56 patients diagnosed as having early-stage prostate cancer within the previous year. Methods. Surveys distributed to the patients included 93 questions that might be considered important. Respondents judged the importance (essential / desired / no opinion / avoid) of addressing each question, and indicated why those "essential" or "desired" were important. Results. 38 patients (68%) responded. Agreement on question importance, overall, was rather poor (mean 41.6%, kappa 0.17). There were, however, 20 questions that at least 67% of the respondents agreed were essential to address and 12 that they agreed were not essential. No question was relevant to the treatment decisions of more than 50% of respondents, but 91 questions were relevant to at least one respondent's decision. Conclusions. Although there was enough agreement to define a core set of questions that should be addressed with most patients, each of the remaining questions was also considered essential to some people. The core set, therefore, would not be adequate to satisfy any one patient's essential information needs. Whereas most questions would be needed to cover all patients' decision needs, only some are needed for any given patient. Such variability in information needs means that the subjective standard is the only viable legal standard for judging the adequacy of provision of information for the treatment decision. Key words: information needs; informed consent; prostate cancer; patient participation; patient education. (Med Decis Making 2000;20:7-19)
Further Explorations of Medical Decisions for Individuals and for Groups
Authors: Dekay Michael L. , Nickerson Carol A.E. , Ubel Peter A. , Hershey John C. , Spranca Mark D. , Asch David A.
Published: March 2007

Background. Important discrepancies between clinical practice and health policy may be related to the ways in which physicians and others make decisions about individuals and groups. Previous research has found that physicians and laypersons asked to consider an individual patient generally make different decisions than those asked to consider a group of comparable patients, but this discrepancy has not been observed in more recent studies. This study was designed to explore possible reasons for these findings. Methods. Prospective jurors ( N = 1,013) each made a recommendation regarding a risky treatment for an incurable blood condition. Perspective (individual vs group) was crossed with uncertainty frame (probability vs frequency) and response wording (original vs revised) in a 2 x 2 x 2 between-participants design. Results. When the strength of participants' recommendations was considered, the effects of perspective, uncertainty frame, and response wording were not statistically significant. When recommendations were dichotomized, participants in the revised-response-wording conditions were more likely to recommend treatment to the group than to the individual. Conclusions. These results conflict with previous findings for this scenario and suggest that reported differences between decisions for individuals and decisions for groups are not robust. Key words: decision making; expected utility theory; practice guidelines; risk; survey research. (Med Decis Making 2000;20:39-44)
Decision Making of Clinical Teams:
Authors: Christensen Caryn , Larson James R. , Abbott Ann , Ardolino Anthony , Franz Timothy , Pfeiffer Carol
Published: March 2007

This study examined the discussion of information among mixed-status clinical teams while constructing differential diagnoses. Twenty-four ad hoc teams, each consisting of a resident, an intern, and a third-year medical student, were given two hypothetical patient cases to discuss and diagnose. Prior to discussion, team members individually viewed different versions of a videotaped interview with a "patient" (trained actor) Each videotape contained some information that was present in all three versions (shared information) and some that was present in only that version (unique information). In addition, half of the time, the cases were constructed so that the unique information that appeared in only one tape was crucial for a correct diagnosis (a "hidden profile" condition) After viewing the videotapes, team members met to discuss the case and develop a differential diagnosis. Discussions were videotaped and analyzed. Overall, shared information was mentioned more often than unique information (p < 0.0001). Furthermore, teams offered incorrect diagnoses significantly more often for hidden-profile cases than for control cases (p < 0.01). The teams' overreliance on previously shared information (inability to appropriately utilize unique information) was detrimental when a correct diagnosis demanded the inclusion of such information. Clinical discussions that require the consideration of uniquely held information may be susceptible to error. Key words: clinical teams; decision making; communication patterns; diagnostic error; information sharing. (Med Decis Making 2000;20:45-50)
Can the Standard Gamble Be Used to Determine Utilities for Uncertain Health States?
Authors: Kennedy Erin D. , Detsky Allan S. , Llewellyn-Thomas Hilary A. , O'Connor Brenda I. , Varkul Mark , Hillary Steinhart A. , Cohen Zane , McLeod Robin S.
Published: March 2007

The objective of this study was to determine whether patients with Crohn's disease (CD) value the absolute reduction in postoperative recurrence risk attributable to therapy with mesalamine (5-ASA). One hundred subjects evaluated state A (taking 5-ASA; 25% risk of recurrence), state B (not taking 5-ASA; 40% risk of recurrence), and state C (100% risk of recurrence) by rank order, visual analog scale (VAS), and standard gamble (SG). Sixty-five of 91 patients (71 %) with completed and usable questionnaires had the same preference order for state A (25% risk), state B (40% risk), and state C (100% risk) on both the VAS and the SG. The mean scores for state A (25% risk), state B (40% risk), and state C (100% risk), respectively, were 67.5, 49.8, and 19.8 on the VAS and 0.977, 0.972, and 0.910 on the SG. Subgroup analyses using stepwise logistic regression showed that risk attitude seemed to be predictive of subjects' preferences for 5-ASA. These results suggest that most subjects seem to value the 15% absolute risk reduction offered by 5-ASA. Furthermore, the SG seems to be a feasible method for measuring utilities for uncertain health states in patients with CD. Key words: standard gamble; risk attitude; treatment interventions; uncertain health states. (Med Decis Making 2000;20:72-78)
A Time-tradeoff Method for Cost—Efifectiveness Models Applied to Radiology
Authors: Swan J. Shannon , Fryback Dennis G. , Lawrence William F. , Sainfort François , Hagenauer Mary Ellen , Heisey Dennis M.
Published: March 2007

Purpose. The wait tradeoff (WTO) is a simple time-tradeoff method designed for temporary health states that uses a realistic and intuitive interface for the patient/subject. This method was tested by assessing patients' preferences for magnetic resonance angiography (MRA) versus x-ray angiography (XRA). Materials and methods. The WTO was tested by telephone interview in 38 patients with atherosclerotic peripheral vascular disease, all having previously undergone both MRA and XRA. At indifference point, patients were ambivalent about having MRA or XRA and immediate treatment, versus having a waiting period for test results and treatment after a hypothetical "ideal test" that entailed no pain or risk. Results. The patients were willing to wait a mean of 42.1 days after the ideal test for results and treatment, as opposed to XRA. They were willing to wait only 16.1 days as opposed to MRA. This difference in waiting times was significant ( p = 0.0001) and indicates a clear preference for MRA, in agreement with known literature. Conclusion. The WTO method assesses preferences for these radiologic tests in an intuitive fashion that does not invoke artificial or irrelevant health states. This approach may also prove useful for other testing situations or short-term treatments being evaluated for cost-effectiveness. Key words: cost-effectiveness; utility assessment; magnetic resonance; angiography; technology assessment; time tradeoff. (Med Decis Making 2000;20:79-88)
A Comparison of Human and Machine-based Predictions of Successful Weaning from Mechanical Ventilation
Authors: Gottschalk Allan , Hyzer M. Chris , Geer Ralph T.
Published: March 2007

Purpose. To evaluate the ability of an appropriately trained neural network to correctly interpret a set of weaning parameters to predict the liberation of a patient from mechanical ventilation, and to contrast these predictions with those of human experts restricted to the same limited set of physiologic data. Methods. For each set of weaning parameters, a prediction was made by multiple realizations of a neural network and six expert volunteers. Results. The percentage of correct predictions made by the neural network when the decision threshold was set to 0.5 (range 0-1) was 83.3 ± 4.2 (mean ± SD) and that for the experts was 83.3 ± 4.7. Predictions by the network when the threshold was 0.5 had a sensitivity of 0.83 and a specificity of 0.84, compared with 0.90 and 0.77, respectively, for the experts. However, sensitivity and specificity comparable to those of the human experts could be obtained by adjusting the decision threshold of the network predictor so that only the most clearly ventilator-dependent patients would not be given a trial of extubation. Conclusion. When both are restricted to the same limited set of patient data, appropriately trained neural networks can be as effective as human experts in predicting whether weaning from mechanical ventilation will be successful. Key words: mechanical ventilation; weaning; neural networks; decision analysis; respiratory failure. (Med Decis Making 2000;20:160-169)
Using Localization Data from Image Interpretations to Improve Estimates of Performance Accuracy
Authors: Swensson Richard G.
Published: March 2007

A recently developed model uses the localization of abnormalities on images to improve statistical precision in measuring detection accuracy Az, the area below an observer's receiver operating characteristic (ROC) curve for ratings of sampled normal and abnormal cases. This study evaluated that improvement by investigating how much the standard error of estimated Az decreased when the statistical analysis included localization data. Comparisons of analyses with vs without localizations were made for: 1) the estimates of Az from observers' rating ROC curves for nodular lesions on clinical chest films and liver CT scans; 2) the probability of correct choices between paired samples of normal and abnormal cases (equivalent to Az); and 3) the sampling distributions of Az measured in Monte Carlo simulations of 2,000 independent rating experiments. Localization information considerably improved the precision of Az estimates, particularly when detection accuracy was low ( Az ~ 0.60). These data provided roughly the same benefits in estimation precision as would two-to-fourfold increases in the sizes of both 1) the samples of positive and negative cases and 2) the observer samples used to estimate Az means. Key words: ROC analysis; LROC; observer performance accuracy; observer vanability; detection; localization; image interpretation. (Med Decis Making 2000;20:170-185)
Optimal Gestational Age and Birth-weight Cutoffs to Predict Neonatal Morbidity
Authors: Kohn Michael A. , Vosti Caroline L. , Lezotte Dennis , Jones Richard H.
Published: March 2007

Background. Gestational age (GA) and birth weight (BW) criteria are used to identify newborns at risk for neonatal morbidity. Currently, preterm is GA less than 37 weeks; low birth weight is BW less than 2,500 grams; and small for gestational age (SGA) is BW less than the tenth percentile weight for the infant's GA. The optimal classification system balances the misclassification cost of false negatives against the cost of false positives. Objective. To calculate the relative misclassification costs implied by the current 37-week and 2,500-gram cutoffs, and to test the validity of the current definition of SGA as a predictor of term morbidities. Methods. GA, BW, and morbidity information were collected for 22,606 infants born between July 1981 and December 1992. Using this dataset, logistic regression coefficients were obtained modeling GA or BW as predictors of morbidities associated with prematurity. For a subset of 18,813 infants with GAs between 37 and 41 weeks, coefficients were obtained modeling both GA and BW as independent predictors of term morbidities. The logistic regression coefficients were used to calculate optimal birth weight, gestational age, and birth-weight-for-gestational-age cutoffs. Results. The current definitions of low birth weight and preterm imply that it is 18 to 28 times more costly to misclassify a sick infant as low-risk than to misclassify a well infant as high-risk. Conclusions. Gestational age alone is better than birth weight alone at predicting preterm morbidities. No birth-weight cutoff can adequately predict term morbidities. A single weight-percentile cutoff for all gestational ages should not be used to identify newborns at high risk for neonatal morbidity. Key words: gestational age; birth weight; neonatology; logistic models; ROC curve analysis. (Med Decis Making 2000;20:369-376)
Are Patients Capable of Using the Analytic Hierarchy Process and Willing to Use It to Help Make Clinical Decisions?
Authors: Dolan James G.
Published: March 2007

The analytic hierarchy process (AHP) is a user-friendly technique that enables a decision maker to elicit subjective values and combine them with more objective data in an explicit, unbiased manner. To determine whether patients are capable of using and willing to use the AHP to help make clinical decisions, the author asked 20 volunteers to perform an AHP analysis of the choice among five screening regimens for colon cancer. The patients were categorized as capable if they completed the analysis in ≤ 45 minutes and as willing if they indicated that they would prefer to go through this type of analysis before making a clinical decision. Eighteen (90%) were capable and willing. The difference between this result and 25%, the predefined null hypothesis, is significant: p = 1.6 × 10-9. These results indicate that AHP-based decision-making aids are likely to be acceptable to and within the capabilities of many patients. If so, they could serve as practical tools for improving the clinical decision- making process. Key words: decision making; analytic hierarchy process; physician-patient relationship; informed consent. (Med Decis Making 1995;15:76-80)
The Effects of Computer-assisted Electrocardiographic Interpretation on Physicians' Diagnostic Decisions
Authors: Hillson Steven D. , Connelly Donald P. , Yuanli Liu
Published: March 2007

Objective. To evaluate the effect of computer-assisted interpretation of electrocardiograms (ECGs) on diagnostic decision making by primary care physicians. Design. Randomized controlled trial. Setting. Primary care physicians' outpatient clinics in or near the Minneap olis/St. Paul metropolitan area. Participants. Forty family physicians and general internists who were members of either of two large consortia of clinics. Intervention. Subjects evaluated ten clinical vignettes accompanied by ECGs and reported their diagnostic impressions. The vignettes were based on actual patient visits. Half of the subjects received ECGs with computer-generated reports, the other half received the same ECGs without reports. Main outcome measures. ECG reading time; agreement with the clinical diagnosis; agreement with the computer report; diagnostic confidence. Results. The subjects receiving the reports were more likely to agree with the clinical diagnoses of the original cases, particularly for two vignettes in which the diagnoses were uncommon and were mentioned in the reports. The subjects receiving the reports were also more likely to make diagnoses that were consistent with the reports, even when the reports were erroneous. Those receiving the reports spent, on average, 15 seconds less time looking at each ECG, a 25% decrease. Conclusions. In simulated cases, primary care physicians appear to use computer interpre tations of ECGs when available, as shown by enhanced diagnostic accuracy and modestly reduced time spent reading the tracings. However, erroneous reports may mislead physi cians. Since the effects of computerized ECG interpretation do not appear to have been uniformly favorable in this mock-clinical setting, it will be important to evaluate the effects of this technology in actual practice. Key words: computer-assisted diagnosis; computer-as sisted decision making; physician decision making; electrocardiogram. (Med Decis Making 1995;15:107-112)