bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical Technology Transfer in Major Chinese Hospitals
Authors: Hu Teh-wei 
Published: March 2009

AbstractThe objective of this article is to describe and analyze the decision-making process and its consequences for medical technology transfer in China. Data were obtained in 1987 from 35 elite teaching hospitals affiliated with 13 medical universities, directly supervised by the Ministry of Health in the People's Republic of China. This article focuses on three kinds of diagnostic equipment: computerized tomographs, ultrasonic diagnostic units, and high-power x-ray diagnostic apparatuses. Decision-making on the transfer of medical technology in China is decentralized. Most hospitals rely on foreign medical sales representatives and medical exhibits, and their decisions on the acquisition of equipment rely more on the services available than on the price of the product. Chinese hospitals also encounter serious infrastructure problems when buying medical equipment. A number of alternatives are suggested for improving the efficiency of medical technology transfer in China.
On the (Near) Equivalence of Cost-Effectiveness and Cost-Benefit Analyses
Authors: Phelps Charles E. , Mushlin Alvin I. 
Published: March 2009

AbstractMany people believe that cost-effectiveness (CE) and cost-benefit (CB) analyses require different assumptions. However, when CE analysis supports decisions to use medical resources, it makes the same assumptions that CB analysis requires. They are mathematically equivalent. Differences between CE and CB hinge more on reporting style than on fundamental assumptions.
Technology Assessment in the Connecticut Tumor Registry
Authors: Wyshak Grace , Burdick Elisabeth , Mosteller Frederick 
Published: March 2009

AbstractA search of literature using the Connecticut Tumor Registry (CTR) for technology assessment produced eight articles. These articles represent a small but apparently increasing percentage (2%) of total CTR publications. By keeping pace with the development and dissemination of medical technologies, the population-based CTR has been useful for assessing them, especially their adverse effects.
Technology Assessment in the Normative Aging Study
Authors: Antczak-bouckoms Alexia , Tulloch J. F. Camilla , Klawansky Sidney 
Published: March 2009

AbstractThis review of publications based on data from the Veterans Affairs Normative Aging Study identified four articles that were considered assessments of health care technologies. Three evaluated methods for research on body composition, the fourth studied ventricular size in patients with presenile dementia. Several additional articles are discussed that provided data on baseline values or risk factors for disease that might be useful in generating hypotheses to be tested in later assessments of technologies.
Use of A Clinical Data Registry to Evaluate Medical Technologies: Experience from the International Bone Marrow Transplant Registry
Authors: Rimm Alfred A. , Barr Judith T. , Horowitz Mary M. , Bortin Mortimer M. 
Published: March 2009

AbstractWe reviewed the 18 disease-specific evaluations that used the data base of the International Bone Marrow Transplant Registry to determine the effectiveness of alternative strategies for bone marrow transplant. We identify 17 treatment variables that physicians can control and report the associations between these variables and five clinical endpoints: stable engraftment, graft-versus-host disease, development of interstitial pneumonia, relapse, and disease-free survival. We also suggest policies to promote active participation in establishing and operating a registry.
Social Evaluation of Health Care Versus Personal Evaluation of Health States:Evidence on the Validity of Four Health-state Scaling Instruments Using Norwegian and Australian Surveys
Authors: Nord Erik , Richardson Jeff , Macarounas-Kirchmann Kelly 
Published: March 2009

AbstractIn most of the cost-utility literature, quality-adjusted life-year (QALY) gains are interpreted as a measure of social value. Given this interpretation, the validity of different multi-attribute health-state scaling instruments may be tested by comparing the values they provide on the 0–1 QALY scale with directly elicited preferences for person trade-offs between different treatments (equivalence of numbers of different patients treated). Norwegian and Australian public preferences as measured by the person trade-off suggest that the EuroQol Instrument assigns excessively low values to health states. This seems to be even more true of the McMaster Health Classification System. The Quality of Well-being Scale appears to compress states toward the middle of the 0–1 scale. By contrast, the Rosser/Kind index fits reasonably well with directly measured person trade-off data.
Benefits and Costs of Recombinant Human Erythropoietin for End-Stage Renal Failure: A Review: Benefits and Costs of Erythropoietin
Authors: McNamee Paul , van Doorslaer Eddy , Segaar Rob 
Published: March 2009

AbstractRecombinant human erythropoietin is an efficacious therapy in treatment of the anemia of end-stage renal failure. However, the scale of impact on quality of life and medical care resources remains uncertain. By reviewing the literature we evaluate cost-effectiveness of recombinant human erythropoietin and show how previous studies may have implicitly overestimated cost-effectiveness.
Acquiring Advanced Technology: Decision-making Strategies at Twelve Medical Centers
Authors: Weingart Saul N. 
Published: March 2009

AbstractThis study describes decision making regarding the acquisition of technology in 12 major medical centers. The financial impact of a project was the most widely cited criterion of decision, but financial considerations were less important than either the impact of a technology on the quality of clinical care or its contribution to teaching and research. Rarely were criteria set out explicitly or in advance. Although exemplary models exist, the technology assessment process at most institutions is described as “political,” “informal,” or “ad hoc.”
Survival from Localized Breast Cancer: Variability Across Trials and Registries
Authors: Klawansky Sidney , Berkey Catherine , Shah Nirav , Mosteller Frederick , Chalmers Thomas C. 
Published: March 2009

AbstractAge-specific (<50, 50–69 years) 10-year survival proportions in four European trials for node-negative, Stage I and II breast cancer patients differ significantly. These patients, identified as having the same stage as localized-breast cancer patients in the End Results Registry of the U.S. National Cancer Institute, had pooled survival proportions for the two age groups (0.713, 0.579) close to those of the registry (0.713, 0.607).
The Usefulness of Four Methods of Assessing the Benefits of Electrically Adjustable Beds in Relation to their Costs
Authors: Söderback Ingrid , Lassfolk Anita 
Published: March 2009

AbstractTen picture cards, interviews, time logs, and the Klein-Bell ADL scale were useful in assessing the benefits of electrically adjustable beds to patients but not to caregivers. The mean cost per bed per year of US $346 seems, in relation to the benefits, to be a worthwhile investment for increasing patients' quality of life.
Cost Savings through Technological Change in the Administration of Antibiotics
Authors: Liaropoulos Lycurgus L. 
Published: March 2009

AbstractOnce-daily antibiotics (ODAs) represent a technological change in hospital processes that can lead to substantial savings of scarce resources. In a three-hospital prospective study, five antibiotics were administered to 58 patients suffering from infections classified by major body system. Savings ranged from 10.9% to 38%, depending on hospital organization, method of delivery, and daily dose. Per-unit price proved a poor indicator of hospital cost, as variable delivery costs for labor and materials ranged from 11.6% to 39.5% of total costs.
Assessment of Screening for Cancer
Authors: Vecchia Carlo La , Levi Fabio , Franceschi Silvia , Boyle Peter 
Published: March 2009

AbstractScreening has a relevant role in and is likely to become an increasingly important instrument for cancer control in the near future. This overview summarizes some of the available evidence on the issue. Some of the opinions are well established. The apparent absence of consensus on other issues should be critically evaluated, too, because the evidence on some procedures is substantially more convincing than that on others. High costs, low compliance, poor curability, and substantial false positive rates, in a disease as relatively rare as cancer, often counterbalance in practice the theoretical benefits of diagnostic anticipation. In screening as well as in treatment for cancer, it is unlikely that major technical breakthroughs will occur in the near future. The evaluation of whether the benefits likely to be achieved by the screening program outweigh its disadvantages by a sufficient margin, therefore, should rely on large and carefully planned controlled studies.
Evaluation of Immunization Policies for PeaceKeeping Missions
Authors: Steffen Robert , Woodall Jack P. , Nagel Jörg , Desaules Madeleine 
Published: March 2009

AbstractThis article first examines data bases available to assess the risk of vaccine-preventable diseases (VPD). In the second part, immunization recommendations and practices are briefly evaluated in view of the risk of exposure to VPD and of the efficacy and safety of available vaccines.
Issues in Cochlear Prosthetics From an International Survey of Opinions
Authors: De Foa J. Lance , Loeb Gerald E. 
Published: March 2009

AbstractCochlear prostheses are beginning to be implanted regularly to restore hearing in profoundly deaf patients, but there is little agreement on the relative merits of the many different designs and rehabilitative procedures. We report on the responses to a technology assessment questionnaire that was sent to 120 researchers and clinicians worldwide who have been at the forefront of research in this field.
Technology Assessment in Health Care in Australia
Authors: Gross Paul F. 
Published: March 2009

In 1977, in the middle of a protracted debate on the costs and methods of paying for health care, the federal minister for health established a Committee on Applications and Costs of Modern Technology in Medical Practice. In 1978, the committee produced its report, which reviewed a number of cost containment strategies, including the reduction or regulation of fees paid to medical practitioners for specific procedures. It recommended that a national panel be established to collect information on medical technology and advise on its introduction in Australia.In 1982, the National Health Technology Advisory Panel (NHTAP) was created to identify and examine existing and emerging medical technology, to determine methods and priorities for assessment, and to make recommendations to the minister for health with respect to assessment and funding of new technology.
Innovations in Human Service Technologies: Strengthening Health Care Delivery Systems
Authors: Taft Susan Hoefflinger , Seitz Pauline 
Published: March 2009

AbstractThe authors report on innovative approaches to the organization of health services and the delivery of patient care in 19 U.S. hospitals and hospital networks. Strengthening patient care is the focus of this initiative. Hospital-wide interdisciplinary planning and the subsequent trial of new human service technologies are explored.
Translating Traditional Principles of System Development into a Process for Designing Clinical Information Systems
Authors: Gillis Pamela A. , Booth Holly , Graves Judith R. , Fehlauer Charles Steven , Soller Jerome 
Published: March 2009

AbstractTraditional software development methodologies enhanced by a clinical component result in information systems that support the practice of nursing. This paper describes the clinical informatics model used to develop and evaluate a mobile computer assessment tool. Data entry of atomic-level elements, with storage in a relational database, allows the synthesis and analysis by multiple disciplines to aid in real-time decision making. The system is designed to improve the recording and accessibility of patient data and nursing observations on a geriatric unit at the Salt Lake VA Medical Center.
Diffusion of Laparoscopic Cholecystectomy in Canada
Authors: Menon Devidas , Marshall Deborah 
Published: March 2009

AbstractPatterns of the diffusion of laparoscopic cholecystectomy in Canadian hospitals were determined by a telephone survey of 153 randomly selected hospitals over two years. Results were analyzed by region, hospital size, and type of hospital. Laparoscopic cholecystectomy has diffused very quickly compared with other technologies, before any comprehensive evaluation to consider its potential impact could take place.
Toward a Model for Quality Assessment in Heart Transplantation
Authors: Larsson A. , Möller Anders , Karlsson Ingela , Stolz-löfgren Marie , Pettersson Gösta , William-Olsson Eva Berglin , Shapiro Peter A. 
Published: March 2009

AbstractA model for quality assessment of heart transplantation that combines a scientific method for studying the recipients' quality of life and a basis for a method of clinical work by nurses and other health care professionals is discussed. Besides its use as a research method, this model also may serve as an instrument for documenting patients' biopsychosocial status, including coping capacity, and for evaluating nursing interventions.
The Acceptability of Prenatal Diagnosis in Japan
Authors: Kitai Hirokatsu , Watanabe Hisako , Sayama Mitsuko , Kanemune Miyuki , Nishiyama Mayumi , Nishino Ruriko , Itoh Kimihiko 
Published: March 2009

AbstractPrenatal diagnosis has been performed more frequently in Japan recently, but is still less popular than in the United States or Europe. Legal arrangements, insufficient economic support, and insufficient medical information provided to future parents may explain this difference. The acceptability of prenatal diagnosis, based on the concept of the cost of side effects and elective abortion, was found to be similar when examined through decision analysis and direct survey. Amniocentesis was considered useful for more than half of couples in Japan when the incidence of chromosomal abnormality is more than 0.5% and proper information about the decision to undergo this examination is provided to the pregnant woman and her family.
The Diffusion of Obstetric Technology into Rural U.S. Hospitals
Authors: Rosenblatt Roger A. , Saunders Gregory R. , Tressler Carolyn J. , Larson Eric H. , Nesbitt Thomas S. , Hart L. Gary 
Published: March 2009

AbstractWe determined the distribution and sophistication of obstetric technologies in all 80 maternity hospitals in the state of Washington and examined the effect of rural or urban location, birth volume, and physician staffing on technological intensity. Although smaller and more rural hospitals refer most premature and low-birth-weight infants to regional referral centers, sophisticated prenatal and intrapartum technologies are available in the majority of even the smallest and most remote rural units. Rural hospitals have slightly lower obstetrical intervention rates than do their urban counterparts, but the differences are not great.
Accrual of Patients to Randomized Clinical Trials: Factors Affecting Cancer Prevention and Control Research
Authors: Kaluzny Arnold D. , Lacey Linda M. , Warnecke Richard , Morrissey Joseph P. , Sondik Edward J. , Ford Leslie 
Published: March 2009

AbstractClinical judgment is increasingly being challenged by the need for randomized clinical trials. The 1987 National Cancer Institute mandate—that the Community Clinical Oncology Program (CCOP) accrue patients to cancer control protocols—provided an opportunity to examine the factors that affect accrual performance. An analysis of 52 CCOPs and their research bases participating in the program found that the availability of protocols, involvement with research base activities, a demonstrated link to community physicians (particularly those physicians, such as surgeons, who had access to patients), and the use of personal contacts to inform non-CCOP physicians about CCOP activities were important facilitating factors for accruing patients to cancer prevention and control trials.
On the General Concepts of Action and Ability: A Philosophical Introduction to the Theory of Handicaps
Authors: Nordenfelt Lennart 
Published: March 2009

AbstarctThe main task of this paper is to contribute to the theory of disabilities and handicaps, in particular their characterization and classification. It presents an analysis of the conditions for the successful performance of actions. By this procedure a list of reasons for failure of action, i.e., for disability and handicap, is obtained. This list can be used for a detailed classification of disabilities and handicaps. Some theories in modern philosophical action theory serve as platforms for the analysis.
Assessment of Rehabilitation Technologies in Stroke:Outcomes and Costs
Authors: Hass Ursula , Persson Jan , Brodin Håkan , Fredén-Karlsson Ingrid , Olsson Jan-Edvin , Berg Inger 
Published: March 2009

AbstarctInitial functional ability (Barthel Index, mean 57) was found to be an important predictor of functional ability 1 year after stroke (mean 80) and for costs during the period. On average the total cost for a stroke patient was about SEK 200,000; the main expense, accommodation, averaged about SEK 140,000, while assistive devices amounted to SEK 2,600. Those who use assistive devices, although having achieved a high functional ability, perceive and rate their life situation (Nottingham Health Profile) considerably more impaired than those without assistive devices.
Declining Cost-Effectiveness of Screening for Disease: The Case of Gastric Cancer in Japan
Authors: Babazono Akira , Hillman Alan L. 
Published: March 2009

AbstarctWe examined the cost-effectiveness of screening for gastric cancer in hypothetical cohorts of asymptomatic Japanese ages 40, 50, 60, and 70, followed for 10 years. Current screening recommendations in Japan are not optimal. Although indirect x-ray is the correct method, screening for gastric cancer may not be cost-effective for Japanese under the age of 50. Policymakers worldwide should monitor the changing incidence of disease as they consider and recommend screening policies.
Do Doctors and Patients Agree?: Views of the Outcome of Transurethral Resection of the Prostate
Authors: Black Nick , Petticrew Mark , Ginzler Maria , Flood Ann , Smith Joe , Williams Grant , Davies Jane , Doll Helen , Mcpherson Klim 
Published: March 2009

AbstractIn an attempt to establish the extent to which patients and doctors agree on the outcome of health care, the pre- and postoperative states of health of 388 men undergoing transurethral resection of the prostate for benign disease were studied. Generally, high levels of concordance (>70%) were obtained. The strongest agreement was for clearly defined events, such as episodes of acute retention (95%); the weakest agreement occurred over the most subjective symptoms, prognostic expectations, and ambiguous terms (around 60%). The level of agreement was not associated with any characteristics of the patient, surgeon, or treatment.
Informing the Mammography Coverage Debate: Results of Meta-analysis, Computer Modeling, and Issue Analysis
Authors: Simpson Kit N. , Snyder Lyle B. 
Published: March 2009

AbstractMethods of meta-analysis, computer modeling, and issue analysis are used to answer four key questions related to efficacy, cost, and political feasibility of legislating insurance coverage for mammography. The findings are presented, and the strengths and weaknesses of the combined use of these methods to inform policy debate at the regional level are discussed.
Comparison of Adjuvant Therapies Using Quality-Of-Life Considerations
Authors: Gelber Richard D. , Goldhirsch A. 
Published: March 2009

The benefit for patients with operable breast cancer treated with adjuvant systemic therapy is small, if reduction of early mortality within the context of randomized control trials is used for treatment comparison. One might consider that the 75%–85% of patients who die despite treatment are overtreated, as are patients who remain alive even without therapy within a given time frame. Larger treatment benefits in terms of avoided or delayed breast cancer relapse have been demonstrated even at early phases of follow-up in the vast majority of adjuvant trials. Exposure of all patients to adjuvant therapy at a time at which no symptoms of disease are present is detrimental in terms of quality of life.Based on our assumption that the quality of life of the patient is typically altered both by subjective toxic effects of adjuvant treatment and by the appearance of relapse, we developed a method of comparing treatment effects in terms of time without symptoms of disease and toxicity of treatment (TWiST). Because the impact of treatment on relapse rates appears earlier than survival effects in all adjuvant therapy trials, and because the value of time without relapse in terms of the quality of life of the patients is as yet poorly defined, we have generalized our method of comparing treatment attitudes to include individual qualitative judgment values. The experience gained from integrating quality-of-life issues into clinical trials for breast cancer might also be applied to other diseases characterized by a chronic course, toxic treatments, and gains in periods of relative or absolute freedom from toxic effects and progressive disease.
The Clinical Use of Nuclear Exercise Tests
Authors: Steingart Richard M. , Wassertheil-Smoller Sylvia , Budner Nancy , Tobin Jonathan , Wachspress Joseph , Lense Lloyd , Wexler John P. , Slagle Susan 
Published: March 2009

In the mid-1970s, after decades of clinical use, the utility of electrocardiographic exercise testing for the evaluation of patients with suspected ischemic heart disease was critically examined and questioned. Concurrent with this critique, two sophisticated, more expensive and powerful “nuclear” exercise tests were introduced sequentially for clinical use: myocardial perfusion imaging with thallium-201 and radionuclide ventriculography with technetium 99m. The published indications for the two tests are similar, and both have been shown to offer advantages over ECG stress testing in selected populations. However, few data are available regarding the comparative utility of thallium versus ventriculographic imaging. As part of a prospective study to assess the efficacy of cardiovascular nuclear medicine studies, we undertook the present analysis to assess the clinical evolution of these tests and to elucidate factors responsible for clinicians' choice for the often competing examinations. The study examined 213 consecutive patient referrals for thallium scintigraphy and 183 referrals for ventriculography, ranging from patients with no symptoms or highly non-specific chest pain syndromes (21% of referrals) to patients with proven coronary disease (28% of the referrals). Twenty-one percent of patients were referred to confirm the clinical impression that the patient did not have coronary disease, 40% to confirm its presence, and 37% to determine its severity.Analyses were undertaken to determine the factors that dictated a preference for thallium scintigraphy rather than ventriculography; only the physician's intent in testing and level of training were significant predictors for a particular nuclear test.
Healthy Children: Investing in the Future Office of Technology Assessment
Authors: Perry Seymour , Blanpain Jan , Hanft Ruth , Hutton John , Tanneberger Stephan 
Published: March 2009

Despite many gains, the United States could do better in preventing health problems in infants and young children, says the congressional Office of Technology Assessment (OTA) in its new report, Healthy Children: Investing in the Future.Rep. Henry Waxman (D-Calif.), Chairman, Subcommittee on Health and the Environment, Committee on Energy and Commerce, released the report at a hearing.