bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffusion of Knowledge In Dentistry
Authors: Chapko Michael K. 
Published: March 2009

AbstractThis paper presents data on the diffusion to dentists of information from the May 1981 American Dental Association conference and December 1983 National Institutes of Health (NIH) conference on pit and fissure sealants. A mail survey was sent to 521 (72.2¼ returned) randomly selected dentists in general practice and all 47 (76.6¼ returned) pedodontists in the State of Washington. Approximately 70¼ of the dentists were aware that the conferences had taken place and a little over 50¼ were aware of the conference recommendations. Awareness was related to: being a pedodontist, number of continuing education hours taken, number of refereed journals read, and being an officer in a dental organization
Medical Devices and Biomaterials Parhology
Authors: Kossovsky Nir , Kossowsky Ram 
Published: March 2009

AbstractThrough the postmortem examination, pathologists offer the ultimate clinico-pathologic assessment of the efficacy of medical care. Similarly, pathologists can offer a clinico-pathologic assessment of the efficacy of health care technology. Assessment by pathologists has diagnostic authority because it draws on the resources of the laboratories of surgical and necropsy pathology. In this essay we argue for enhancing the accuracy of medical device and biomaterials technology assessment by systematically collecting pathology-oriented data. We recommend the establishment of a pathology-based medical device registry to assess implantable medical device technology by accumulating reports routinely issued by pathology departments throughout the country. We further suggest the establishment of a university-based, industry-supported Medical Device and Biomaterials Pathology Institute to operate the registry, collect recovered, used health care devices, and generate definitive, pathology-based, primary data for he lth care technology assessment
Oral Radiology: An Expanding Technology in Search of a Direction
Authors: Gröndahl Hans-Göran 
Published: March 2009

AbstractOral radiology still seems to be expanding depending upon increasing availability of dental care. It is widely used more or less routinely, although investigations on efficacy, cost-benefit, and cost-effectiveness are sparse. Such studies should be encouraged and decision-making courses included in dental curricula. Decision-making aids and clinical algorithms should be developed to increase efficiency of oral radiology and to help in the abandonment of its routine use.
Development of Information-Based Planning in Niger
Authors: Mock Nancy , Setzer James , Sliney Ian , Hadizatou Gado , Bertrand William 
Published: March 2009

AbstractThe authors present their experiences in assisting the government of Niger to develop automated information systems for health care management. They discuss the structure of the health system, the role of donor assistance, the process of initiating automated systems, and the technical requirements and costs of the system. Finally, they draw general conclusions that may be useful for those attempting similar efforts.
On the Oxford Perinatal Care Model and Medical Education
Authors: Bulger Roger J. 
Published: March 2009

AbstractMedical education in the United States is torn between its allegiance to the Newtonian biomolecular paradigm of medical science that made it so successful in the past and a growing sense, both within academia and without, that medicine needs to become more interdisciplinary and population based. This article explores the potential of the Oxford Perinatal Care model as a useful tool for medical educators to bridge the curricular gap between these two paradigms. The Oxford model is based upon ongoing meta-analysis of all randomized control trials relating to perinatal medicine; interventions and technologies are placed into one of four categories, ranging from “forms of care that reduce negative outcomes” to “forms of care that should be abandoned.” This article proposes a strategy for the inclusion of this information into the U.S. medical school curriculum.
Physicians' Perceptions of Consensus Reports
Authors: Hill Martha N. , Weisman Carol S. 
Published: March 2009

AbstractIn a pretest-posttest panel survey of 595 eligible Maryland physicians practicing family or general medicine, internal medicine, cardiology, or nephrology, perceptions of consensus reports designed to alter medical practice are examined. On a 7-point scale, physicians reported positive or neutral views of descriptors, most favorably rating credible (mean = 2.25) and reliable (mean = 2.41), and least favorably rating biased (mean = 3.79). In a regression analysis of factors influencing changes in practice behavior congruent with consensus recommendations before and 1 year after the release of a consensus report on hypertension (8), these perceptions were not significant determinants. The strongest predictor of congruent practice behavior a year after the report was published was congruent practice behavior just prior to the report's release, and the second strongest predictor was perceived influence of the report's sources/sponsors.
Valuation of the Benefits of Risk-free Blood: Willingness to Pay for Hemoglobin Solutions
Authors: Eastaugh Steven R. 
Published: March 2009

AbstractThe dream of artificial blood has existed since the 1960s. Disease-free hemoglobin solutions will be commercially available in 1991. A willingness-to-pay (WTP) survey was undertaken to assess the tangible and intangible benefits to the public from this new product. The positive results suggest that third-party payers should cover this benefit and assist the diffusion of this new technology. From the perspective of industrial marketing, results suggest that there will be little consumer price resistance for hemoglobin solutions within the suggested price range of $225–300 per unit. Management implications of this new product are discussed.
Economic Evaluation of A Support Program for Caregivers of Demented Elderly
Authors: Drummond Michael F. , Mohide E. Ann , Tew Michelle , Streiner David L. , Pringle Dorothy M. , Gilbert J. Raymond 
Published: March 2009

AbstractAn economic evaluation was undertaken concurrently with a randomized trial comparing a Caregiver Support Program (CSP) with existing conventional community nursing care for those caring for elderly relatives at home. The differences in resource consumption were compared with changes in caregiver quality of life, as measured by the Caregiver Quality of Life Instrument (CQLI). A 20% difference from baseline in the CQLI favored the experimental (CSP) group, although this did not reach conventional levels of statistical significance. A comparison of improvement in quality of life with costs implies an incremental cost per quality-adjusted life year gained of Canadian $20,000 for the CSP, which compares favorably with other health care interventions. Further, larger studies are required to confirm this result.
Cost Comparison of Parenteral Estrogen and Conventional Hormonal Treatment in Patients With Prostatic Cancer
Authors: Henriksson Peter , Stege Reinhard 
Published: March 2009

AbstractThe present study compares the cost of antitumor therapy and adverse cardiovascular effects during the first year of treatment with oral estrogens, nonoral estrogens, or surgical castration in patients with prostatic cancer. We found a much higher cost for patients treated with orchidectomy and oral estrogens than for patients treated with nonoral estrogens. Twenty-five percent of the patients treated with oral estrogen suffered cardiovascular complications, compared to none of the patients treated by orchidectomy or nonoral estrogens. The initial cost of orchidectomy as compared to nonoral estrogen treatment was shown not to be balanced within the expected survival time of patients with advanced prostatic cancer. Furthermore, surgical castration causes psychological trauma to the patient. We recommend parenteral estrogen therapy as a low-cost therapeutic regimen in patients with prostatic cancer.
A Brief Introduction to Influence Diagnostics in Regression
Authors: Hoaglin David C. 
Published: March 2009

AbstractStatistical analyses that involve regression methods often encounter data in which some observations have substantial influence. This article presents a nontechnical discussion of influence and of two techniques, based on leaving out each individual observation in turn, for diagnosing influential data. An example illustrates the techniques in an analysis of recurrence rates in endoscopic treatment of bleeding peptic ulcers.
A Cost-Outcome Description of the Septic Work-Up for Bacterial Infection in Neonates in a Tertiary Care Hospital
Authors: Thomas Roger E. , Baker Philip 
Published: March 2009

AbstractAnalysis of the septic work-up of 194 neonates at Women's College Hospital, Toronto, showed that the only antepartum condition predicting neonatal sepsis was the mother being on antibiotics. The only postnatal condition predicting sepsis was a maternal postpartum white blood cell count over 11,000. The average cost for tests for a septic work-up in these 194 mother-neonate pairs was $71.48 (Canadian dollars), and the average cost of tests to find a septic case was $1,066.77.
Screening for Colorectal Cancer: What are the Costs?
Authors: Weller David , Moss John , Hiller Janet , Thomas David , Edwards John 
Published: March 2009

AbstractWe examined a screening program for colorectal cancer in South Australia in terms of its overall direct costs to society and costs to participants. The best estimate of the cost per cancer detected was $18,924 (Australian dollars). Potential improvements in health outcome through screening are discussed in light of these costs.
The Ranking Properties of Healthy-Years Equivalents and Quality-Adjusted Life-Years Under Certainty and Uncertainty
Authors: Johannesson Magnus 
Published: March 2009

AbstractThis paper investigates the theoretical properties of healthy-years equivalents (HYEs) and quality-adjusted life-years (QALYs). A distinction is made between ex ante HYEs (EA-HYEs) and expected HYEs (EXP-HYEs) and between risk-neutral quality-adjusted life-years (RN-QALYs) and risk-adjusted quality adjusted life-years (RA-QALYs). In the case of certainty, HYEs always rank health profiles according to individual preferences, whereas QALYs only rank health profiles according to individual preferences if constant proportional trade-off holds for all health states and if additive independence of quality in different periods holds. In the case of uncertainty, EA-HYEs always rank risky health profiles the same way as expected utility. The assumptions needed for the other measures to rank risky health profiles the same way as expected utility are: risk neutrality with respect to healthy time for EXP-HYEs; risk neutrality with respect to time in all health states and additive independence of quality in different periods for RN-HYEs; and constant proportional risk posture with respect to time in all health states and additive independence of quality in different periods for RA-QALYs.
Cost-Utility Analysis of Group Living in Dementia Care
Authors: Wimo Anders , Mattson Bengt , Krakau Ingvar , Eriksson Tua , Nelvig Anders , Karlsson Goran 
Published: March 2009

AbstractA cost-utility analysis (CUA) was applied to group living for dementia patients. A Markov-model of an expected life-length of 8 years was used. Forty-six patients in group living were compared to 39 patients living at home by inclusion and 23 institutionalized patients. When the cost per gained quality-adjusted life-year (QALY) was calculated, the group living alternative was the most favorable for the patients, giving a cost per paired QALY of US dollars > 0. In the extensive sensitivity analysis the main result was consistent but methodological problems were indicated.
The Use of Technology Assessment by Hospitals, Health Maintenance Organizations, and Third-Party Payers in the United States
Authors: Luce Bryan R. , Brown Ruth E. 
Published: March 2009

AbstractA case study design was used to determine the reliance on technology assessment of decisionmakers in hospitals, health maintenance organizations (HMOs), and third-party payers. Thirty different organizations were contacted and semistructured interviews conducted. The study found that hospitals, HMOs, and insurers are conducting technology assessments, but the form and sophistication of these analyses range widely. Hospitals are particularly focused on traditional financial analyses (“prudent purchasing”) with the exception of pharmacy committees, which generally conduct more sophisticated socio-economic analyses. HMOs and insurers conduct outcome assessments for coverage of expensive or controversial technologies but exclude economics. Technology assessment will become increasingly important in resource allocation decision making and it is in the interest of technology providers to foster better information, a more comprehensive assessment process, and a more efficient assessment system.
Assessment of Screening Tests for Transfusion-Associated Non-A Non-B Hepatitis
Authors: Fleurette Frederic , Durieux Pierre , Battista Renaldo N. , Benhamou Jean-Pierre , Degos Françoise , Brechot Christian , Courouce Anne-Marie , Janot Christian , Trepo Christian 
Published: March 2009

AbstractNon-A non-B hepatitis is the most common serious sequela of blood transfusion, and its screening has become an essential goal of blood transfusion centers. Before 1989, two surrogate screening tests (for alanine aminotransferase and for antibody to hepatitis B core antigen) were used; in 1989, a direct test for the antibody to hepatitis C virus (the main agent of this hepatitis) was developed. The French National Agency for the Development of Medical Evaluation undertook an investigation to determine the optimal prevention strategy for posttransfusion non-A and non-B hepatitis (PTH). A detailed literature review was performed, complemented by expert group opinion. The performance of each test was derived indirectly by calculating the number of cases of PTH averted by each test. Hepatitis C virus testing is probably the most promising strategy, but different policies can be developed given the uncertainties of scientific data. Cost considerations should be taken into account in identifying the best screening strategy.
Revisiting the Most Informed Consumer of Surgical Services: The Physician-Patient
Authors: Domenighetti Gianfranco , Casabianca Antoine , Gutzwiller Felix , Martinoli Sebastiano 
Published: March 2009

AbstractLittle is known about the consumption of medical and surgical services by the most informed consumer in the health care market: the physician-patient. Such knowledge should be important for the understanding of the role of information on consumption, supplier-induced demand, the doctor-patient relationship, unnecessary medical services, and the adequacy of professional practices to the real health needs of the “ordinary patient.” We measured by questionnaire the standardized consumption of seven common surgical procedures. Except for appendectomy, the age- and sex-standardized consumption for each of the common surgical procedures was always significantly higher in the general population than for the “gold standard” of physician-patients. The data suggest that (a) contrary to prior research, doctors have much lower rates of surgery than does the general population; and (b) in a fee-for-services health care market without financial barriers to medical care, less-informed patients are greater consumers of common surgical procedures.
The Influence of Health Technology Assessment on the Diffusion of MRI in Australia
Authors: Hailey David M. , Crowe Bernard L. 
Published: March 2009

AbstractA major assessment of magnetic resonance imaging (MRI) in Australia influenced the early use of this technology and informed policy decisions on future MRI services. However, the impact of the assessment, and of government policy, on the subsequent diffusion of MRI has been more modest, reflecting the limitations of the evaluation process in a complex health care system.
Assessing Technology Assessment: Early Results of the Quebec Experience
Authors: Jacob Robert , Battista Renaldo N. 
Published: March 2009

AbstractThe Quebec Council on Health Care Technology Assessment was created in 1988. Its functions are to promote, support, and produce health care technology assessments and to advise the Minister of Health. An independent review of the council’s first four years of operation was commissioned. The evaluation team concluded that the council showed very good results in terms of the scope, quality, and impact of its production and succeeded in establishing its credibility. However, the evaluation team suggested that the council adopt a more active strategy toward the promotion and diffusion of its reports. Some critical determinants of success of the Quebec experience in technology assessment are discussed.
Evaluation of Assistive Devices after a Course in Joint Protection
Authors: Nordenskiöld Ulla 
Published: March 2009

AbstractThis study assessed a joint protection education program and investigated the costs and effects of assistive devices. Fifty-three women with seropositive rheumatoid arthritis, whose ages ranged from 29 to 65 years, attended a standardized joint protection course (13 hours). A self-report questionnaire was constructed listing the most common devices, and the subjects were asked to check which devices they had received, which ones they used and did not use, and why. Pain during activities of daily living and when using assistive devices was measured using the visual analogue scale. Results show that the subjects reported great benefits from the joint protection course, assistive devices, and wrist orthosis. The women had tried 663 devices, 91 % of which were still being used. Pain decreased significantly (p < .001) when using assistive devices. The utility of 11 devices at a cost of SEK 1,683 per person can be described as increased capacity and ability to work at home, work outside the home, and perform leisure activities with less pain.
Are People Willing to Pay for a Community-Based Preventive Program
Authors: Lindholm Lars , Rosén Måns , Hellsten Gideon 
Published: March 2009

AbstractThis pilot study is the first known attempt to test the willingness-to-pay or willingness-to-accept (WTP/WTA) method of assessment on a community-based primary prevention program against cardiovas cular disease. The results indicate that the population's perceived WTA outweighs the program's costs by at least three to one. However, the methodological problems of using the WTP/WTA method in community-based programs are far from solved, and further research in this area is required.
Long-Term Technology Assessment: Mortality, Hospitalization, and Work Loss Due to Peptic Ulcer and Gastritis/Duodenitis in the Federal Republic of Germany
Authors: Bloom Bernard S. , Gessner Urs 
Published: March 2009

Once the effects of short-term data analysis of new medical technology appear clear, additional or long-term analyses are infrequently performed on subsequent information. This often leads to incomplete understanding of the technology's full medical, social, and economic effects.Available data for the Federal Republic of Germany on mortality, hospitalization, and work loss due to gastric and duodenal ulcer and gastritis/duodenitis allowed long-term analysis of direct and indirect impacts on the population from 1975 through 1984. Mortality rates declined for all ages (ρ ≤ 0.01) except for those age 75 and older, and nearly equally for all study diagnoses. Hospital discharge rates for all diagnoses rose slowly and steadily, while those for persons diagnosed with gastric ulcer, duodenal ulcer or gastritis/duodenitis declined sharply (ρ = 0.04). Declines of hospital discharges were greater for men than for women. The ongoing decline in rates of mortality and hospital discharges increased after 1977. Rates of work loss per 10,000 population-at-risk for study diagnoses were either stable or increasing until 1979, after which there was a marked decline (ρ = 0.03 for gastric ulcer, ρ = 0.02 for duodenal ulcer, ρ = 0.008 for gastritis/duodenitis). Work loss due to study diseases declined as a percentage of work loss for all diseases during the later study years. Only by examining many years' data could the accelerating declines be discerned, not only for mortality and hospitalizations, which have been examined before, but also for work loss, an infrequently analyzed effect of disease.
Population-Based study of Echocardiography: Time Trends in Utilization and Diagonistic Profile of an Evolving Technology, 1975–1987
Authors: Ballard David J. , Khandheria Bijoy K. , Tajik A. Tamil , Seward James B. , Weber Vernon P. , Melton L. Joseph 
Published: March 2009

AbstractWe evaluated trends in the use of echocardiography among residents of Olmsted County, Minnesota, from January 1, 1975, through June 30, 1987. Annual examinations per 100,000 population among Olmsted County residents increased 6-fold from 264 in 1975 to 1,644 in 1986. Given the pattern of echo use in Olmsted County, these population-based data project a potential annual utilization of 4 million echo exams in the United States. Marked increases over time in labeling of patients with regurgitant valvular heart disease were noted following the introduction of Doppler echocardiography. The diagnostic labeling associated with this evolving technology and the resultant apparent epidemic of valvular regurgitation present a significant clinical technology assessment dilemma.
The Introduction and Evaluation of MRI in Japan
Authors: Hisashige Akinori 
Published: March 2009

AbstractNot only is the number of computed tomography (CT) units relative to population in Japan the highest in the world, that of magnetic resonance imaging (MRI) units is second only to the United States. This study examines the diffusion pattern of MRI in Japan, as well as the factors that influence it. The number of MRI units has increased sharply, closely following CT, as has been the case in the United States. This pattern of diffusion in Japan was determined mainly by the following factors: the technological attributes of MRI; the market situation of the medical engineering industry; the reimbursement system of health insurance; and Japan's sociocultural background. However, the introduction of MRI in Japan was not linked to any formal assessment of its efficacy or effectiveness.
An Economic Evaluation of the Introduction of Vaccination Against Hepatitis a in a Peacekeeping Operation: The Case of the United Nations Protection Force in Yugoslavia
Authors: Jefferson Tom , Demicheli Vittorio , Wright David 
Published: March 2009

AbstractThe costs and benefits of vaccinating troops on United Nations tours in Yugoslavia against hepatitis A were compared. The marginal cost of one case of hepatitis A avoided by vaccination was calculated and compared with the marginal cost of achieving the same outcome by passive immunization. The cost-benefit ratio (medium estimate) for troops at low risk of contracting hepatitis A was 0.01 and for those at high risk was 0.03.Vaccinating troops against hepatitis A for a single deployment appears to be an inefficient procedure, especially in troops at low risk. However, in professional troops from countries of low hepatitis A endemicity who are likely to be involved in several operational deployments, vaccination becomes more efficient the more times the same troops are deployed.
Use of the Swedish Microcomputer Alarm System in Care for the Elderly and Disabled: Policy and Practice
Authors: Wallengren Brita , Lindgren Bjön , Ranstam Jonas , Samuelsson Sven-Mårten , Jendteg Stefan 
Published: March 2009

AbstractThis study describes the operation of an in-home alarm system in seven Swedish municipalities. Statistics on the diffusion of this technology, its costs, and the characteristics of its use are reported. Alarms were triggered by 60% of the users. Mean annual costs per recipient varied from SEK 1,985 to SEK 8,215, mainly reflecting different patterns of use.