bluuebunny/crossref_metadata_2025_split huggingface dataset:
DAILY COST PREDICTION MODEL IN NEONATAL INTENSIVE CARE
Authors: Zupancic John A. F. , Richardson Douglas K. , O'Brien Bernie J. , Schmidt Barbara , Weinstein Milton C. 
Published: November 2003

Objectives: One barrier to economic evaluation alongside neonatal randomized controlled trials is the expense of collecting detailed patient resource information. To reduce this data collection burden, we identified the key resource items that predict daily ancillary costs for extremely low birth weight infants.Methods: Participants were 385 infants enrolled in the Trial of Indomethacin Prophylaxis for Preterms in nine tertiary level neonatal intensive care units in Canada. Information on eighty-nine nonpersonnel resource items was abstracted from the hospital chart from admission to tertiary hospital discharge. Unit costs were derived from a provincially standardized cost accounting system. Using stepwise linear regression, models correlating total daily ancillary costs with key resource items were constructed for each of five periods of admission. Models were derived in a randomly split half of the total sample of patient days and validated against the remainder.Results: The 385 infants contributed resource information from 23,354 admission days. The regression model for weeks one to twelve included the covariates surfactant, chest radiograph, red blood cell transfusion, cranial ultrasound, abdominal radiograph, parenteral amino acid infusion, surgery, platelet transfusion, and echocardiogram and explained 91% of the variability in daily nonpersonnel costs (P<.0001). Models for other admission periods similarly included between four and eight covariates, were highly significant (P<.0001) and explained between 76% and 94% of daily ancillary cost variability. The regression equations showed excellent predictive power when applied to the second half of the patient data set.Conclusions: Daily nonpersonnel costs for extremely low birth weight infants are driven by a limited number of key resource variables. The ability to predict total ancillary costs with minimal data collection will facilitate inclusion of economic evaluations in neonatal trials.
HYPERBARIC OXYGEN TECHNOLOGY: AN OVERVIEW OF ITS APPLICATIONS, EFFICACY, AND COST-EFFECTIVENESS
Authors: Guo Shien , Counte Michael A. , Romeis James C. 
Published: November 2003

Objectives: To examine the growing evidence and the consensus in the medical community concerning the efficacy and cost-effectiveness of hyperbaric oxygen therapy (HBO2T) and to suggest future research areas to ensure the appropriate use of this technology.Methods: A literature search of articles published between 1985 and 2000 was conducted using PubMed to describe the growth of HBO2T-related articles published over the past fifteen years. In addition, articles involving the qualitative synthesis of the efficacy and cost-effectiveness of HBO2T in thirteen major application areas were identified and compared with the changing view of the medical community toward the evidence of HBO2T.Results: The total number of HBO2T-related articles published annually has steadily increased over the past fifteen years. This increase has gradually contributed to a consensus in the medical community concerning the evidence of efficacy in its major application areas. However, information regarding the cost-effectiveness of HBO2T is still extremely limited.Conclusions: Although evidence concerning the efficacy of HBO2T has been growing in the past, more evidence is still needed for some of its major application areas. Moreover, there is an urgent need to shift part of the research focus on HBO2T to its cost-effectiveness to provide decision makers with relevant information to evaluate this technology objectively.
COSTS OF FLEXIBLE SIGMOIDOSCOPY SCREENING FOR COLORECTAL CANCER IN THE UNITED KINGDOM
Authors: Whynes David K. , Frew Emma J. , Edwards Robert , Atkin Wendy S. 
Published: November 2003

Objectives: Colorectal cancer is one of the most commonly occurring cancers in industrialized countries, yet appears to be amenable to screening. Amongst the many possible protocols is once-only screening by means of flexible sigmoidoscopy. This protocol is currently being investigated in a UK multicenter trial and the study provides estimates of the expected resource costs.Methods: The direct health care costs of sigmoidoscopy and of all subsequent procedures were estimated from an audit of resource use of approximately 40,000 patients at thirteen centers. Patient-borne costs were estimated from the results of surveys conducted at twelve of these centers.Results: The health service costs of a flexible sigmoidoscopy was estimated at £56. The total costs of screening (including private costs) averaged £82 per person screened, although costs varied by center. The total health service costs of screening and subsequent management averaged approximately £91 per person screened, again with variations between centers.Conclusions: Even within a strict trial protocol, intercenter variation in costs can be detected, ascribable to variability in local management practices, local yield, and local patient-borne costs. Other recent estimates of flexible sigmoidoscopy costs vary widely. As these costs form the basis of technology assessment simulation models which, in turn, inform policy, obtaining realistic cost estimates within the appropriate health care setting is of paramount importance.
COMPARISON OF HOSPITAL COSTING METHODS IN AN ECONOMIC EVALUATION OF A MULTINATIONAL CLINICAL TRIAL
Authors: Reed Shelby D. , Friedman Joëlle Y. , Gnanasakthy Ari , Schulman Kevin A. 
Published: November 2003

Objectives: To develop and evaluate strategies for estimating hospitalization costs in multinational clinical trials.Methods: Hospital cost estimates for eleven diagnoses were collected from twelve countries participating in a trial of therapies for congestive heart failure. Estimates were combined with U.S.-based diagnosis-related group weights to compute country-specific unit cost estimates for all reasons for hospitalization. Variations of hospital costing methods were developed. The unit cost method assigns a country-specific unit cost estimate to each hospitalization. The other methods adjust for length of stay using a daily cost (DC) estimate for each diagnosis, based on either the mean length of stay (DC-mean method) or the median length of stay (DC-median method) for each diagnosis in each country. Additional modifications were explored through adjustment of the distribution of daily costs incurred during a hospital stay.Results: The mean cost for all hospitalizations was $10,242 (SD, 10,042) using the unit cost method, $10,242 (SD, 12,760) using the standard DC-mean method, and $13,967 (SD, 18,762) using the standard DC-median method. In comparisons of costs for all 5,486 hospitalizations incurred by a subset of 2,352 patients in the trial, the unit cost method provided 92% power to detect a $1,000 cost difference. The standard DC-mean method provided 76% power, and the standard DC-median method provided 44% power.Conclusions: Hospital costing methods that adjust for differences in length of stay require a significantly larger sample to attain comparable statistical power as methods that assign unadjusted unit cost estimates to hospitalization events.
COST-EFFECTIVENESS ANALYSIS: CAN WE REDUCE VARIABILITY IN COSTING METHODS?
Authors: Adam Taghreed , Evans David B. , Koopmanschap Marc A. 
Published: November 2003

Objectives: The need for consistency and standardization of methods for economic appraisals has been recognized for some time and has led to the development of several sets of guidelines for economic evaluations and for costs. Despite this, considerable diversity is still apparent in applied studies. Some of these diversities might be defensible, and some might not. The objectives of this study are to explore sources of variations in the methods used in applied studies and to discuss the nature of these variations and the possibility of reducing some of them.Methods: We first use a systematic approach to identify the major sources of variation in costing methods used in applied economic evaluations. We then compare the methods used with the recommendations made in available guidelines.Results: Four possible sources of variation are identified. The first is where guidelines do not agree in their recommendations; therefore, it is not surprising that applied studies use different methods. The second is where guidelines agree in principle but provide little detail on how to comply with their recommendations; and the third is where a particular methodological issue is not discussed in guidelines. The fourth reason is simply lack of compliance with accepted guidelines.Conclusions: Variability in costing methods used in applied studies raises questions about the validity of their results and makes it difficult to compare the results of different studies. We discuss the implications for the transferability and generalizability of results and suggest ways to minimize the variability in the methods so that the results of costing studies and economic evaluations can be of more value to policy-makers.
EVIDENCE OF IMPROVING COST-EFFECTIVENESS OF PEDIATRIC COCHLEAR IMPLANTATION
Authors: Sach T. , O'Neill C. , Whynes D.K. , Archbold S.M. , O'Donoghue G.M. 
Published: November 2003

Objectives: To examine the cost-effectiveness of pediatric cochlear implantation over time.Methods: A prospective study based on ninety-eight children implanted between 1989 and 1996 at Nottingham's Paediatric Cochlear Implantation Programme, UK. The influence of outcomes and other variables on total costs was examined using multivariate regression analysis.Results: Having controlled for potential confounding variables, total cost was negatively related to year of implant and positively related to the number of hours of rehabilitation (p=.000).Conclusions: Having controlled for outcomes (Categories of Auditory Performance and Speech Intelligibility Rating), the cost-effectiveness improved over time. This finding may be due to a learning curve and have policy implications.
Attention deficit hyperactivity disorder and neurocognitive correlates after childhood stroke
Authors: Max Jeffrey E. , Mathews Katherine , Manes Facundo F. , Robertson Brigitte A.M. , Fox Peter T. , Lancaster Jack L. , Lansing Amy E. , Schatz Amy , Collings Nicole 
Published: November 2003

AbstractWe investigated the frequency and neurocognitive correlates of attention deficit hyperactivity disorder and traits of this disorder (ADHD/Traits) after childhood stroke and orthopedic diagnosis in medical controls. Twenty-nine children with focal stroke lesions and individually matched children with clubfoot or scoliosis were studied with standardized psychiatric, intellectual, academic, adaptive, executive, and motivation function assessments. Lifetime ADHD/Traits were significantly more common in stroke participants with no prestroke ADHD than in orthopedic controls (16/28 vs. 7/29; Fisher's Exact p < .02). Lifetime ADHD/Traits in the orthopedic controls occurred exclusively in males with clubfoot (7/13; 54%). Participants with current ADHD/Traits functioned significantly worse (p < .005) than participants without current ADHD/Traits on all outcome measures. Within the stroke group, current ADHD/Traits was associated with significantly lower verbal IQ and arithmetic achievement (p < .04), more nonperseverative errors (p < .005), and lower motivation (p < .004). A principal components analysis of selected outcome variables significantly associated with current ADHD/Traits revealed “impaired neurocognition” and “inattention-apathy” factors. The latter factor was a more consistent predictor of current ADHD/Traits in regression analyses. These findings suggest that inattention and apathy are core features of ADHD/Traits after childhood stroke. This association may provide clues towards the understanding of mechanisms underlying the syndrome. (JINS, 2003, 9, 815–829.)
Exploring semantic memory by investigating buildup and release of proactive interference in healthy older adults and individuals with dementia of the Alzheimer type
Authors: Multhaup Kristi S. , Balota David A. , Faust Mark E. 
Published: November 2003

AbstractThere is debate regarding the integrity of semantic memory in dementia of the Alzheimer type (DAT). One view argues that DAT is associated with a breakdown in semantic memory; the other argues that DAT is associated with predominantly preserved semantic memory and a breakdown in retrieval. The classic release from proactive interference (RPI) paradigm was used to shed light on this debate. Individuals with early-stage DAT (n = 36) and healthy older adult controls (n = 45) participated in an RPI paradigm. Each trial was a Brown–Peterson task in which participants read three-word lists, counted (for 0, 3, 6, or 9 s), and recalled the words. Both groups showed significant proactive interference (PI), but the size of the PI was significantly smaller in the DAT group. The group difference in PI may be due to the faster forgetting rate in the DAT group. Both groups showed significant RPI and there was no group difference in size when RPI was considered in terms of PI levels. Both groups showed PI and RPI in prior list intrusions. The DAT group's significant buildup and release of PI based on semantic categories suggest predominantly preserved semantic memory activity, at least, in early-stage DAT individuals. (JINS, 2003, 9, 830–838.)
Working memory and relational reasoning in Klinefelter syndrome
Authors: Fales Christina L. , Knowlton Barbara J. , Holyoak Keith J. , Geschwind Daniel H. , Swerdloff Ronald S. , Gonzalo Irene Gaw 
Published: November 2003

AbstractKlinefelter syndrome (KS) is a sex chromosome abnormality associated with male infertility and mild cognitive deficits. Individuals with KS have been reported to have impaired verbal ability, as well as deficits in executive function. To further understand the nature of their deficits, we assessed specific elements of frontal lobe function such as working memory and relational reasoning. Men with KS exhibited a deficit in a transitive inference task in which participants ordered a set of names based on a list of propositions about the relative heights of the people named. This deficit was present even for items in which the propositions were given in order, so a chaining strategy could be used. Men with KS are also impaired on the n-back task, which uses letters as stimuli. In contrast, these men performed as well as controls in nonverbal reasoning (Raven's Progressive Matrices). These results suggest that men with KS have intact nonverbal reasoning abilities, but that a difficulty in encoding verbal information into working memory may underlie their executive and linguistic impairments. (JINS, 2003, 9, 839–846.)
Examining the range of normal intraindividual variability in neuropsychological test performance
Authors: Schretlen David J. , Munro Cynthia A. , Anthony James C. , Pearlson Godfrey D. 
Published: November 2003

AbstractNeuropsychologists often diagnose cerebral dysfunction based, in part, on marked variation in an individual's cognitive test performance. However, little is known about what constitutes the normal range of intraindividual variation. In this study, after excluding 54 individuals with significant health problems, we derived 32 z-transformed scores from 15 tests administered to 197 adult participants in a study of normal aging. The difference between each person's highest and lowest scores was computed to assess his or her maximum discrepancy (MD). The resulting MD values ranged from 1.6 to 6.1 meaning that the smallest MD shown by any person was 1.6 standard deviations (SDs) and the largest MD shown by any person was 6.1 SDs. Sixty-six percent of participants produced MD values that exceeded 3 SDs. Eliminating each person's highest and lowest test scores decreased their MDs, but 27% of the participants still produced MD values exceeding 3. Although MD values appeared to increase with age, adjusting test scores for age, which is standard in clinical practice, did not correct for this. These data reveal that marked intraindividual variability is very common in normal adults, and underscore the need to base diagnostic inferences on clinically recognizable patterns rather than psychometric variability alone. (JINS, 2003, 9, 864–870.)
Number processing after stroke: Anatomoclinical correlations in oral and written codes
Authors: Mayer Eugène , Reicherts Michael , Deloche Gérard , Willadino-Braga Lucia , Taussik Irène , Dordain Monique , Van Der Linden Martial , Annoni Jean-Marie 
Published: November 2003

AbstractCalculation and number-processing abilities were studied in 49 patients with chronic single vascular brain lesions by means of a standardized multitask assessment battery (EC301), as well as through other tasks, testing functions thought to be implicated in calculation such as language, visuo-perceptive abilities, verbal and spatial working memory, planning, and attention. The results show that (1) lesions involving parietal areas—particularly left parietal lesions—are prone to alter calculation processing. A more detailed analysis showed that patients with lesions involving left parietal areas were impaired in both digital (i.e., comprehension and production of numbers written in Arabic code) and oral (i.e., comprehension and production of numbers heard or expressed orally) processing while lesions involving right parietal areas lead to an impairment in digital processing only. However, linguistically related alphanumerical processing (i.e., comprehension and production of numbers written orthographically) was not influenced by parietal lesions. (2) Semantic representations (knowledge of the magnitude related to a given number) as well as rote arithmetical knowledge are also impaired following damage to parietal and particularly left parietal lesions, suggesting that these areas are also implicated in magnitude comparisons and in the retrieval of arithmetical facts. (3) Performance in calculation is highly correlated with language. (4) Moreover, we found a highly significant correlation between performances in oral calculation and verbal working memory, and between written-digit calculation and visuospatial working memory. Performances in regard to visuo-perceptive abilities, planning, and attention were less consistently correlated with calculation. These results stress the close correlation, but relative independence between calculation and language, as well as a dissociated sensitivity of oral and digital processing to brain lesions. (JINS, 2003, 9, 899–912.)
Presurgical cognitive deficits in patients receiving coronary
artery bypass graft surgery
Authors: Rankin Katherine P. , Kochamba Gary S. , Boone Kyle B. , Petitti Diana B. , Buckwalter J. Galen 
Published: November 2003

AbstractCoronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) can produce a higher incidence of neuropsychological complications than other types of highly invasive noncardiac vascular surgery. Cognitive complications most likely arise from either embolization or hypoxia. An alternative surgical procedure has been developed that allows CABG to be performed without stopping the heart (“off-pump” CABG, or OPCABG). This study examined the neuropsychological performance of patients undergoing OPCABG, hypothesizing that patients undergoing OPCABG would show fewer cognitive deficits than patients whose hearts were stopped. A 1-hr neuropsychological battery was administered preoperatively to 43 patients before prospective randomization to either CPB CABG or OPCABG, and again to 34 of those patients 2 to 3 months postoperatively by an examiner blind to surgical condition. Neuropsychological status did not change 2.5 months postsurgically in either OPCABG or CABG groups. However, both groups showed dramatic presurgical cognitive deficits in multiple domains, particularly verbal memory and psychomotor speed. This corroborates previous research suggesting that patients requiring CABG surgery may evidence significant presurgical cognitive deficits as a result of existing vascular disease. (JINS, 2003, 9, 913–924.)
The myth of testing construct validity using factor analysis or correlations with normal or mixed clinical populations: Lessons from memory assessment
Authors: Delis Dean C. , Jacobson Mark , Bondi Mark W. , Hamilton Joanne M. , Salmon David P. 
Published: November 2003

AbstractFor nearly a century, the primary method employed by psychologists to define and test the validity of constructs evaluated by assessment instruments has been shared-variance techniques such as intervariable correlations or factor analysis with large normative or mixed clinical samples. To illustrate the shortcomings of this approach, we conducted (1) correlational analyses of immediate- and delayed-memory measures separately in normal participants and in homogeneous samples of patients with either Alzheimer's disease or Huntington's disease; and (2) factor analysis of immediate and delayed-recall and recognition measures in a large, homogeneous sample of patients with Alzheimer's disease. The findings revealed that cognitive measures that share variance in the intact brain—thereby giving the facade of assessing a unitary construct—can dissociate and contribute to unique variance in the damaged brain, but only if the pathology occurs in brain regions known to disrupt vital cognitive processes tapped by those measures. The results illustrate that shared-variance procedures applied to normal or mixed clinical populations can mask some of the most vital cognitive constructs, such as the classic distinction between short- and long-term memory. Implications of these findings for research and clinical practice are discussed. (JINS, 2003, 9, 936–946.)
Should symptoms be scaled for intensity, frequency, or both?
Authors: CHANG CHIH-HUNG , CELLA DAVID , CLARKE SUSAN , HEINEMANN ALLEN W. , VON ROENN JAMIE H. , HARVEY RICHARD 
Published: November 2003

Objective: This study evaluated the comparability of two
5-point symptom self-report rating scales: Intensity (from “not
at all” to “very much”) and Frequency (from
“none of the time” to “all of the time”).
Questions from the Functional Assessment of Chronic Illness Therapy
(FACIT)-Fatigue 13-item scale was examined.Methods: Data from 161 patients (60 cancer, 51 stroke, 50 HIV)
were calibrated separately to fit an item response theory-based rating scale
model (RSM). The RSM specifies intersection parameters (step thresholds)
between two adjacent response categories and the item location
parameter that reflects the probability that a problem will be
endorsed. Along with patient fatigue scores (“measures”),
the spread of the step thresholds and between-threshold ranges were
examined. The item locations were also examined for differential item
functioning.Results: There was no mean raw score difference between intensity
and frequency rating scales (37.2 vs. 36.4, p = n.s.). The high
correlation (r = .86, p < .001) between the intensity
versus frequency scores indicated their essential equivalence. However,
frequency step thresholds covered more of the fatigue measurement continuum
and were more equidistant, and therefore reduced floor and ceiling
effects.Significance of results: These two scaling methods
produce essentially equivalent fatigue estimates; it is difficult to
justify assessing both. The frequency response scaling may be
preferable in that it provides fuller coverage of the fatigue
continuum, including slightly better differentiation of people with
relatively little fatigue, and a small group of the most fatigued
patients. Intensity response scaling offers slightly more precision
among the patients with significant fatigue.