bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Traumatic Dental Injuries: Shift in Strategy
Authors: Andreasen Frances M. , Andreasen Jens O. 
Published: March 2009

AbsractA more conservative approach to the treatment of traumatic dental injuries has been made possible by knowledge concerning the pathogensis of external root resorption, increased knowledge about wound healing processes in the pulp and periodintium, as well as by advances in restorative dentistry (reattachment of crown fragments with a dentin bonding system, the use of adhesive bridges, and advances in autotransplantation and implantation). However, a rethinking by the public, clinicians, and third-party payers is necessary for these procedures to gain wider acceptance. The present article describes the state of the art of treating dental trauma in the hope that these advances cam become an accepted part of the dental trauma armamentarium and not merely scientific curiosities.
Patients' Quality of Life Following Extracorporeal Shock-Wave Lithotripsy and Percutaneous Nephrolithotomy for Renal Calculi
Authors: Mays Nicholas B. , Petruckevitch Ann , Snowdon Claire 
Published: March 2009

AbstractThe objective of this study was to test whether the relatively new, noninvasive technique of extracorporeal shock-wave lithotripsy (ESWL) for renal stones resulted in a measurably better outcome from the patients' point of view than percutaneous surgery. The claimed superiority of ESWL was not demonstrated with the data available.
Managing the Integration of Technologies: Development of the Immunoassay
Authors: Erickson Tamara J. 
Published: March 2009

AbstractMany factors, including cultural, economic, technical, and regulatory influences, affect how different technologies come together for today's medical diagnostic products. An analysis of the development of automated immunoassay systems reveals that companies used a variety of approaches to access needed technologies, that mature technologies play an important role in the development of new products, and that implementation seemed more important in these companies than strategy.
Problems with Toxicity Studies in the Assessment of New Drugs
Authors: Werkö Lars 
Published: March 2009

AbstractThe development of new medicines requires a lot of time and the efforts of many researchers. One of the most taxing parts of this endeavor is the need for long-term toxicity studies in different animals. This paper describes the development of two different medicines: zimeldine, an antidepressant, and omeprazole, a compound that acts against a specific enzyme in the gastric mucosa that is necessary for the production of gastric acid. Zimeldine was launched in the international market but had to be withdrawn when it caused severe unexpected adverse reactions. Omeprazole has been marketed successfully after a prolonged development phase characterized by difficult problems with the toxicity studies. Against the background of these two descriptions, this article questions the rationale for the present rules for long-term toxicity studies and emphasizes the need for leaders in the pharmaceutical industry to have a solid scientific background in order to be able to decide whether to abandon a project.
Carotid Endarterectomy for Asymptomatic Patients:Assessing Results of a Quantitative Synthesis
Authors: Langenbrunner John C. , Wortman Paul M. , Yeaton William H. , Holloway James J. 
Published: March 2009

AbstractCarotid endarterectomy (CE) surgery for asymptomatic patients remains controversial despite hundreds of published studies and recent randomized trials. Safety and efficacy are assessed using a quantitative synthesis method derived from meta-analysis and a “critical multiplist” inference approach. In addition, multivariate analyses reveal that use of a surgical shunt could further improve CE outcomes. Methods are examined for both their “confirmatory” and “exploratory” value.
Health Technologies for the Developing World: Promoting Self-reliance through Improving Local Procurement and Manufacturing Capabilities
Authors: Free Michael J. , Green Jonathan A. , Morrow Margaret M. 
Published: March 2009

AbstractTo reduce their dependency on donors or the international currency costs of essential health care products, developing countries are building or improving capability for local manufacturing or competitive international procurement. Through long-term strategic planning, public/private partnerships, collaboration with firms in industrialized nations, and farsighted donor policies, the capacity for alternative supply can be increased in stages from importation through local processing and packaging to full production and multiproduct enterprises.
The Spread of Upper Gastrointestinal Endoscopy in Japan and the United States:An International Comparative Analysis of Technology Diffusion
Authors: Kasumi William T. , Kasumi Asao , Ishikawa Benjamin 
Published: March 2009

AbstractThe use of upper gastrointestinal (Gl) fiberoptic endoscopy has spread at different times and rates in Japan than in the United States. Factors that explain this disparity and its effects on patient outcomes are reported. This essay outlines Japanese data in gastroenterology, giving an account of the resources and time that were spent on the development of upper Gl endoscopy in Japan. It also draws implications for the assessment of endoscopy for populations at high risk for gastric cancer.
Evaluating Treatments for Childhood Cancer: A Process for Critical Appraisal of the Literature and a Summary of the Results
Authors: Barr Ronald D. , Furlong William , Feeny David , Horsman John , Rosenbaum Peter , Weitzman Sheila 
Published: March 2009

AbstractAn overview of published studies on three common cancers in childhood was conducted to estimate the effectiveness and consequences of treatment. Of 1,016 separate citations, 316 were reviewed in detail but only 162 were deemed to be “useful.” An approach to a structured appraisal of the literature is presented.
Assessing School Health Education Programs
Authors: Dwyer Terence , Viney Rosalie , Jones Michael 
Published: March 2009

AbstractThis review focuses on the component of health education directed at achieving changes in health behavior. Much of the work in this field has centered on health behavior that has a role in preventing future disease. Because the evidence is strongest in relation to coronary heart disease (17), considerable effort has been devoted to this area. Walter et ai. (34) indicated that the most relevant forms of health behavior to be considered in school-based programs on heart disease are those relating to diet, physical activity, and smoking. Programs relating to each of these behaviors are addressed here.
Increasing Physician Acceptance of Technology Assessment Through a Focused Training Program
Authors: Goodman Gerald R. 
Published: March 2009

AbstractThis paper presents the framework for a one-semester course to give physicians a better understanding of the core concepts of technology assessment, using medical instrumentation technology as a vehicle to stimulate the discussion of technology assessment and its applications. An assessment matrix has been developed as an organizational tool to identify issues in assessment to be addressed under each topic and to identify those issues that are of key importance to particular technologies. At the end of the class, the physician-student should be able to identify major types of medical instrumentation and the instrument's principal application(s), to identify the techniques of technology assessment, and to analyze the economic, ethical, and legal issues that are applicable to instrumentation.
A Cost-Utility Analysis of Preoperative Total Parenteral Nutrition
Authors: Goel Vivek , Detsky Allan S. 
Published: March 2009

It has been suggested that preoperative total parentetal nutrition may be used to reduce the risk of nutrition-associated postoperative complications in high-risk patients. These patients can be identified based on their nutritional status. The efficiency of this intervention is assessed using the technique of cost-utility analysis. Data from multiple sources is integrated to perform the economic assessment.The cost-utility ratios for treating several malnourished patients with localized upper gastrointestinal cancer are below $40,000. These cost-utility ratios compare favorably with published results of other programs. The ratios increase considerably if patients who are better nourished (at lower risk of postoperative complication) receive the intervention. The analysis is very sensitive to the efficacy of the intervention.
Prognostic Factor Analysis and Treatment Results of Ovarian Cancer in Japan
Authors: Ochiai Kazunori , Sasaki Hiroshi , Terashima Yoshiteru , Fukushima Masanori 
Published: March 2009

AbstractPrognostic factors were analyzed among women with ovarian cancer. Stage, histologic subtype and grade, age, performance status, residual tumor size, and platinum-based chemotherapy were factors that significantly influenced the survival rate. Based on these findings, we performed maximal cytoreductive surgery and gave dose-intensified platinum-based chemotherapy to patients with advanced disease and were able to improve survival rate significantly.
An Elemental Resource for the Human-Task Interface
Authors: Kondraske George V. 
Published: March 2009

AbstarctThe elemental resource model (ERM) attempts to provide a quantitative and straightforward framework for characterizing the human system, tasks, and their interface. It evolved in large part from the general systems performance theory (GSPT), which was developed first and independently. Resource constructs are used exclusively for modeling the abstract idea ofsystem performanceand for subsequent measurement of performance resource capacities. Resource economic principles provide a cause-and-effect description of the human-task interface. While argued to have immediate utility, it also provides the motivation to consider coordinated, collaborative, long-term developments that could facilitate effective decision making and technology utilization in rehabilitation.
The Cost of the Swedish Handicap Service System: Implications for Technology Assessment
Authors: Jonsson Dick , Hass Ursula , Persson Jan 
Published: March 2009

AbstarctThe total cost of the Swedish handicap system is estimated at US $ 10.7 billion for 1989. The cost is distributed across different authorities with separate legal and financial responsibility. The concept of technology must be extended to include consideration of both the resources spent and benefits gained in the public sector and the magnitude and distribution of transfer payments from social insurance to fulfill its function in handicap policy decision making.
Hemophilia Home Treatment:Economic Analysis and Implications for Health Policy
Authors: Ross-Degnan Dennis , Soumerai Stephen B. , Avorn Jerry , Bohn Rhonda L. , Bright Rosalie , Aledort Louis M. 
Published: March 2009

AbstarctThis analysis describes the development of technology for home self-infusion of factor VIII in the treatment of hemophilia and its clinical, economic, and social consequences, and uses the case study of such home care treatment to illustrate the potentials and pitfalls of formal economic analyses of programs to treat chronically ill children. A comprehensive review of all original data on hemophilia programs, their related costs, and outcomes, conducted from 1966 through 1993, examined the economic outcomes for two hypothetical cohorts, one aged 0–4 years and the other aged 30–34 years. Including the measurement of treatment effects on the productivity of parental caregivers substantially increases the benefit-cost relationship of an intervention directed at chronically ill children. Increased economic productivity and societal return resulting from such a program for young adults exceeds those for a cohort of children, primarily due to assumptions related to discounting. However, estimation of quality-adjusted life years favors the younger age cohort, since children survive for a longer period of time and with each year survived comes a higher quality of life. Unlike simpler instances in which economic benefits can be shown to outweigh resource costs, policy decisions concerning services for chronically ill children raise an additional set of complex analytic issues. Inclusion of the benefits in productivity experienced by family caregivers provides an important added dimension to such analyses. The development of cost-benefit or cost-effectiveness analyses of these programs illustrates the importance of careful measurement of outcomes and explicit statements of underlying assumptions. Such an analysis of home care for children with hemophilia therefore demonstrates both the strengths and the limitations of this approach.
Maternity Patients' Advocates in the 1990s: Changing Debates and New Debaters
Authors: Shearer Madeleine H. 
Published: March 2009

AbstractBeginning in the 1960s, the maternity patients' movement in the United States was joined by lay, medical, and political critics who protested the escalating cost, poor and inequitable distribution, and overspecialization of medical care. During the 1970s some goals of the maternity patients' movement were met, including fathers' attendance at birth, care in low intervention birth centers, and keeping the newborn baby with the parents immediately after delivery. At the same time, however, perinatal care became ever more based on new technology, tests, and procedures, some of which were promoted by doctor-developers in continuing education courses and in expert witness testimony at malpractice trials. Primary obstetric units closed while urban and suburban centers advertised new services to people who could pay. In the 1990s the maternity patients' advocates have most of the same complaints as in 1970, as well as many new ones.
Effects and Costs of In-Vitro Fertilization: Again, Let's Be Honest
Authors: Haan Ger 
Published: March 2009

AbstractThe decision whether to enhance diffusion and to reimburse for the fertility treatment in-vitro fertilization (IVF) was postponed in the Netherlands until the results of a cost-effectiveness analysis were known. IVF appeared to be as cost-effective as its most important alternative, tubal surgery. But policy decisions still were not straightforward, obscuring important social and ethical issues.
Randomized Clinical Trials in Surgery
Authors: McPeek Bucknam , Mosteller Frederick , McKneally Martin 
Published: March 2009

When it is well conducted, a randomized clinical provides the strongest evidence available for evaluating the comparative effectiveness of the interventions tested. Over the last two generations, we have learned much about various devices for strengthening them and about methods of avoiding between in their design, execution, analysis, and reporting. In a trial, we seek evidence for a causal link between treatment and observed outcomes. Becaues the controlled trial depends on an argument based on exculsion (i.e., no other causes or differences affected the experimental groups), we strengthen its inference by taking steps to exclude any such differences.This article discusses a number of issues that deserve consideration: problems of multiplicity and generalizability, devices for strengthening trials, issues of power and sample size, the relationship between study design and reported gains, when to undertake a trial, the role of collaborative trials, and ways to make trials more feasible in clinical settings.
Editorial (Part II) Assessing the Technology of Developing Health Occupations: Obstacles, Risks, and Strategies for Future Work
Authors: Watts Nancy T. 
Published: March 2009

AbstractEfforts to expand technology assessment in developing fields, such as physical therapy, face major obstacles. These impediments include scarcity of assessment tools, weak organizational structure for research, and clinicians' reluctance to assess economic factors. Risks that could accompany future work and strategies for reducing problems are discussed.
Clinical Decision Analysis as a Means of Technology Assessment: The Effectiveness of Intraoperative Cholangiography
Authors: Scott Thomas E. , Jacoby Itzhak 
Published: March 2009

AbstractThree strategies for timely detection of common duct stones are examined by decision analysis: the use of intraoperative cholangiography (IOC) in ALL, NONE, or in SOME of the cases that are selected by the estimated probability of a common duct stone. Selective use of IOC is the most cost-effective option and offers a slightly lower mortality risk.
Discovery, Transfer, and Diffusion of Technologies for the Detection of Genetic Disorders:Policy Implications
Authors: Holtzman Neil A. 
Published: March 2009

AbstractMuch of the current interest in genetics stems from the Human Genome Project. Although the project will accelerate the identification of disease-related genes, as currently formulated it may retard discovery of gene function and effective treatments, thereby prolonging the stage in which people at risk of genetic diseases can be identified but not treated. This stage is fraught with ethical problems. The project's goal of sequencing the entire human genome could also detract from basic biological research, as could the growing interest of universities in biotechnology transfer to the commercial sector.
The Concept of Cost in the Economic Evaluation of Health Care:A Theoretical Inquiry
Authors: Johannesson Magnus 
Published: March 2009

AbstractThe costs included in economic evaluations of health care vary from study to study. Based on the theory of cost-benefit analysis, the costs that should be included in an economic evaluation are those not already included in the measurement of willingness to pay (net willingness to pay above any treatment costs paid by the individual) in a cost-benefit analysis or in the easurement of effectiveness in a cost-effectiveness analysis. These costs can be defined as the onsumption externality of the treatment (the change in production minus consumption for those included in the treatment program). For a full economic evaluation, the consequences for those included in the treatment program and a caring externality (altruism) should also be added.
The Effect of Allowing Clinical Discretion in Ordering Biochemical Tests: Evaluation by Complementar Methods
Authors: Buckingham Ken , Russell Ian , Ross Iain , Gibson Patrick , Paterson Neil 
Published: March 2009

AbstractWe describe the effects on costs, working patterns, and clinical behavior of installing a DAX “discretionary” biochemistry analyzer. Use of the new analyzer encouraged doctors to be more specific in requesting biochemical tests, which substantially reduced the number of tests requested and slightly reduced overall costs. Doctors preferred being able to order tests in this more specific way.
Individual Perception of Education and Treatment Versus Actual Outcome: A Theoretical Model Exemplified by an Interventional Study on Patients with Insulin-Dependent Diabetes Mellitus
Authors: Furu Margareta , Fischbein Siv , Rosenqvist Urban 
Published: March 2009

AbstractAn educational model is presented that stresses the importance of the interaction between individual characteristics and intentional educational influences on outcome variation. This model is exemplified by an interventional study of patients with insulin-dependent diabetes mellitus who, despite long-term conventional medical treatment, had been unable to achieve satisfactory hemoglobin Aic levels. Treatment modes and their importance for understanding variations in outcomes are discussed from the interactional perspective suggested in the model.
Utilities and Quality-Adjusted Life Years
Authors: Torrance George W. , Feeny David 
Published: March 2009

Utilities and quality-adjusted life years (QALYs) are reviewed, with particular focus on their use in technology assessment. This article provides a broad overview and perspective on these two techniques and their interrelationship, with reference to other sources for details of implementation. The historical development, assumptions, strengths/weaknesses, and applications of each are summarized.Utilities are specifically designed for individual decision-making under uncertainty, but, with additional assumptions, utilities can be aggregated across individuals to provide a group utility function. QALYs are designed to aggregate in a single summary measure the total health improvement for a group of individuals, capturing improvements from impacts on both quantity of life and quality of life– with quality of life broadly defined. Utilities can be used as the quality-adjustment weights for QALYs; they are particularly appropriate for that purpose, and this combination provides a powerful and highly useful variation on cost-effectiveness analysis known as cost-utility analysis.
Written Patient Information on Prescription Drugs: The Evolution of Government and Voluntary Programs in the United States
Authors: Nightingale Stuart L. 
Published: March 2009

AbstractThis paper describes the evolution of written patient information on prescription drugs, FDA's patient package insert proposal and its revocation before its implementation in the early 1980s, the status of voluntary and government efforts since that time, and a review of current trends in this area. The burgeoning practice of direct-to-consumer advertising of prescription drugs in the lay press is viewed within the context of these efforts. This paper also reviews the current developments in certain FDA regulated consumer products—over-the-counter drug labeling and nutrition labeling. The current state of patient information in the United States is reviewed in light of programs to improve prescription drug counseling, and current research in this area is discussed.
Treating Menorrhagia in Primary Care: An Overview of Drug Trials and a Survey of Prescribing Practice
Authors: Coulter Angela , Kelland Joanne , Peto Viv , Rees Margaret C. P. 
Published: March 2009

AbstractMenorrhagia can be treated by drug therapy or surgery. General practitioners (GPs) can prescribe drugs to reduce menstrual blood loss as first-line treatment, referring patients for surgical treatment if drug therapy fails. This study examined the efficacy of drugs used to treat menorrhagia and surveyed British GPs to discover the extent to which they prescribed the most effective drugs for this condition. The results suggest that treatment of this condition in primary care falls short of desirable standards. A meta-analysis of randomized trials of drug therapy revealed wide differences in efficacy and side effects. The most effective drug (tranexamic acid) is little used by British GPs, whereas the least effective drug (norethisterone) is the most frequently prescribed.
Outcomes Measurement: The Key to the Appropriate Use of Pharmaceuticals
Authors: Grey Rondi R. , Townsend Raymond J. , Sanders Charles A. 
Published: March 2009

AbstractOutcomes measurement will be key to the appropriate use of Pharmaceuticals as health care costs continue to rise. The generation of data showing the clinical, economic, and humanistic outcomes of pharmaceutical care will be essential to avoid decision making based solely on cost and to ensure that cost-effective, high-quality health care remains the health care system's top priority.
Health Transition and Needs-Based Technology Planning and Implementation
Authors: Sitthi-Amorn Chitr 
Published: March 2009

AbstractInvestment in health can offer additional benefits to development independent of economic improvement. Many technologies have been useful in improving the health of the people in the past. However, rapid and often unpredictable change has contributed to the inequity, inefficiency, and rising cost of health care. This paper outlines why a needs-based approach to assessing any new technology in the health sector is essential. To respond to changing needs, capacities within the health care system, several of which are described here, must be strengthened. Needs-based technology planning and implementation is affordable and feasible and is crucial in order that both health as a basic human right and good health at low cost can be attained.