tbuckley/cabot-search huggingface dataset:
ABC of learning and teaching in medicine: Work based assessment
Authors: J. J Norcini
Journal: BMJ (2003)

In 1990 psychologist George Miller proposed a framework for assessing clinical competence. At the lowest level of the pyramid is knowledge (knows), followed by competence (knows how), performance (shows how), and action (does). In this framework, Miller distinguished between “action” and the lower levels. “Action” focuses on what occurs in practice rather than what happens in an artificial testing situation. Work based methods of assessment target this highest level of the pyramid and collect information about doctors' performance in their normal practice. Other common methods of assessment, such as multiple choice questions, simulation tests, and objective structured clinical examinations (OSCEs) target the lower levels of the pyramid. Underlying this distinction is the sensible but still unproved assumption that assessments of actual practice are a much better reflection of routine performance than assessments done under test conditions.

This article explains what is meant by work based assessment and presents a classification scheme for current methods 



Fig 1 
Miller's pyramid for assessing clinical competence



Although the focus of this article is on practising doctors, work based assessment methods apply to medical students and trainees as well. These methods can be classified in many ways, but this article classifies them in two dimensions. The first dimension describes the basis for making judgments about the quality of performance. The second dimension is concerned with how data are collected.



Classification for work based assessment methods



### Outcomes

In judgments about the outcomes of their patients, the quality of a cardiologist, for example, might be judged by the mortality of his or her patients within 30 days of acute myocardial infarction. Historically, outcomes have been limited to mortality and morbidity, but in recent years the number of clinical end points has been expanded. Patients' satisfaction, functional status, cost effectiveness, and intermediate outcomes—for example, HbA1c and lipid concentrations for diabetic …
Abstract P286: The Prevalence of Comorbid Depression &amp; Diabetes across Racial/Ethnic Backgrounds: The National Health and Nutrition Examination Study
Authors: Veronica Y Womack, Peter De Chavez, Kiarri Andrews, Mercedes R Carnethon
Journal: Circulation (2014)

Background: Depression, both diagnosed and based on elevated symptom scores, is highly prevalent in individuals with Type II Diabetes (T2DM). Depression predisposes individuals to poorer glycemic control, higher rates of T2DM complications and elevated mortality. African Americans and Hispanics are less likely to be diagnosed with depression than non-Hispanic whites; however, prevalence studies in the general (i.e., non-diabetic) population report that rates of elevated depressive symptoms are similar across race/ethnic groups. Objective: To calculate the age-adjusted prevalence of comorbid depression and Type II Diabetes by race/ethnicity and to investigate whether the patterns vary according to treatment of depression or elevated depressive symptoms (EDS). We hypothesize that racial/ethnic differences in depression among adults with diabetes will vary according to whether depression is treated or based on elevated depressive symptoms. Methods: Participants from the National Health and Nutrition Examination Study (2005-2010) classified as White (n=459), Black (n=250), Mexican American (n=233), or “Other Racial/Ethnic Background” (n=149) and had T2DM (i.e., fasting glucose &gt;=126, clinician diagnosis, or diabetic medication use) and responses to current prescription drug use and depression syndrome measures were included in the analysis (n=1,091, Mean age=48.2 year). Undiagnosed depression was determined by an elevated depressive symptoms (EDS) score =&gt; 10 on the Patient Health Questionnaire-9 and no report of current antidepressant use. Treatment for depression was determined by self-reported current antidepressant use (e.g., SSRI, MAOI, and TCA). Weighted age-adjusted prevalence rates of depression among adults who have diabetes were stratified by race/ethnic background. Results: Twelve percent used antidepressants and 7% of the sample had EDS without antidepressant use. The age-adjusted prevalence of antidepressant use among adults with diabetes was higher in Whites (16%, 95% CI: 9%, 22%) than Black (9%, 95% CI: 3%, 15%), Mexican Americans (5%, 95% CI: 3%, 8%), and “Others” (6%, 95% CI: 1%, 10%). These prevalence estimates remained significantly different after adjusting for healthcare provider and income. The prevalence of EDS among adults with diabetes was not significantly different across race/ethnic background groups (Whites- 5%, 95% CI: 3%, 8%; Blacks- 8%, 95% CI: 2%, 13%; Mexican Americans- 8%, 95% CI: 3%, 13%; “Others”- 8%, 95% CI %, 14%). The prevalence estimates of EDS and antidepressants by race/ethnic group did not vary by gender. Conclusions: Although African Americans and Mexican-Americans with diabetes were as likely to experience EDS, they were less likely to have to be treated for depression. These findings highlight the importance of screening for both treated depression and EDS in individuals who have Type II Diabetes.
Chronic Kidney Disease Alarm Bells Rung
Authors: Mike Mitka
Journal: JAMA (2003)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Body-Fixed Sensors for Parkinson Disease
Authors: Anat Mirelman, Nir Giladi, Jeffrey M. Hausdorff
Journal: JAMA (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
COLLAPSE THERAPY OF BRONCHIECTASIS
Authors: E. Rist
Journal: Annals of Internal Medicine (1933)

Article1 October 1933COLLAPSE THERAPY OF BRONCHIECTASISE. RIST, M.D.E. RIST, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-7-4-417 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt was to be expected that artificial pneumothorax, having proved so strikingly efficient in healing ulcerative tuberculosis of the lungs, should also be attempted as a therapeutic measure against bronchiectasis. Indeed the attempt was made for the first time as early as 1903 by one of Forlanini's most brilliant followers, Riva-Rocci; and it was, we hear, crowned with success. Since then several authors have published cases of bronchiectasis treated by pneumothorax, with a variety of results; but the sum of those cases amounts to a comparatively small total. Whittemore and Balboni could in 1928 gather only 93 of them out... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Paris, France*Read at the Montreal Meeting of the American College of Physicians, February 8, 1933. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLOBECTOMY FOR BRONCHIECTASIS IN CHILDREN 1 October 1933Volume 7, Issue 4Page: 417-421KeywordsBronchiectasisLungs ePublished: 1 December 2008 Issue Published: 1 October 1933 PDF downloadLoading ...
Sequence-engineered mRNA Without Chemical Nucleoside Modifications Enables an Effective Protein Therapy in Large Animals
Authors: Andreas Thess, Stefanie Grund, Barbara L Mui, Michael J Hope, Patrick Baumhof, Mariola Fotin-Mleczek, Thomas Schlake
Journal: Molecular Therapy (2015)

Being a transient carrier of genetic information, mRNA could be a versatile, flexible, and safe means for protein therapies. While recent findings highlight the enormous therapeutic potential of mRNA, evidence that mRNA-based protein therapies are feasible beyond small animals such as mice is still lacking. Previous studies imply that mRNA therapeutics require chemical nucleoside modifications to obtain sufficient protein expression and avoid activation of the innate immune system. Here we show that chemically unmodified mRNA can achieve those goals as well by applying sequence-engineered molecules. Using erythropoietin (EPO) driven production of red blood cells as the biological model, engineered Epo mRNA elicited meaningful physiological responses from mice to nonhuman primates. Even in pigs of about 20 kg in weight, a single adequate dose of engineered mRNA encapsulated in lipid nanoparticles (LNPs) induced high systemic Epo levels and strong physiological effects. Our results demonstrate that sequence-engineered mRNA has the potential to revolutionize human protein therapies.
Coronary flow reserve measurement by guide wire based thermodilution : comparison to the Doppler wire
Authors: Nhj Nico Pijls, de B Bruyne, Gjw Jan Willem Bech, van de Fn Frans Vosse, F Billet, H Kusters, van Lm Gelder, O Nelis, J Jozef Bartunek, Jjrm Bonnier, Jacques J Koolen
Journal: Circulation (2000)
THE AMERICAN BOARD OF INTERNAL MEDICINE AFTER FOUR YEARS; ORGANIZATION, PURPOSES, AND THE EFFECTS OF SPECIAL BOARDS ON MEDICAL EDUCATION AND PRACTICE
Authors: E. E. Irons
Journal: Annals of Internal Medicine (1940)

Article1 July 1940THE AMERICAN BOARD OF INTERNAL MEDICINE AFTER FOUR YEARS; ORGANIZATION, PURPOSES, AND THE EFFECTS OF SPECIAL BOARDS ON MEDICAL EDUCATION AND PRACTICEE. E. IRONS, F.A.C.P.E. E. IRONS, F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-14-1-146 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWhen the American Board of Internal Medicine was organized, many of us thought that if what we had in mind could influence favorably the quality of medical preparation and practice in perhaps ten or fifteen years, the effort would be well worth while. However, the effects on younger men entering medicine have been immediate and startling in scope.In almost every large hospital many interns are now talking not about how soon they can get into practice, but about what more they can do, either by residencies, further basic science training or in positions of part time practice to qualify... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Read at the Cleveland meeting of the American College of Physicians April 1, 1940. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySubspecialization in Internal Medicine: A historical review, an analysis, and proposals for changeThe invention and development of American internal medicine 1 July 1940Volume 14, Issue 1Page: 146-152KeywordsMedical educationResidency ePublished: 1 December 2008 Issue Published: 1 July 1940 PDF downloadLoading ...
Perceptions of Physician Shortages
Authors: Theodore A. Petti
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
ATHEROSCLEROTIC OCCLUSION OF THE ABDOMINAL AORTA AND ILIAC ARTERIES: A STUDY OF 105 PATIENTS
Authors: J J MASSARELLI, J E ESTES
Journal: Annals of Internal Medicine (1957)

Article1 December 1957ATHEROSCLEROTIC OCCLUSION OF THE ABDOMINAL AORTA AND ILIAC ARTERIES: A STUDY OF 105 PATIENTSJOHN J. MASSARELLI JR., M.D., J. EARLE ESTES, M.D., F.A.C.P.JOHN J. MASSARELLI JR., M.D., J. EARLE ESTES, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-47-6-1125 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRapid progress has been made in the field of vascular surgery in recent years. Operations are performed daily on the abdominal aorta and its major peripheral arterial branches in numerous hospitals and medical centers throughout the land. Most of these procedures are performed on arteries affected by atherosclerosis, for which there is currently no effective medical therapy. Atherosclerosis of the large arteries may result in aneurysmal dilatation or in thrombo-atherosclerotic occlusion. Surgical treatment of abdominal aortic aneurysm is clearly indicated because of the very poor survival rate in untreated patients.1Not only is the survival rate poor, but two thirds...Bibliography1. Estes JE: Abdominal aortic aneurysm: A study of one hundred and two cases, Circulation 2: 258-264 (Aug.) 1950. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, Minnesota*From the Symposium on Diseases of the Large Arteries, presented at the Thirty-eighth Annual Session of The American College of Physicians, Boston, Massachusetts, April 9, 1957.From the Section of Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.The Mayo Foundation, Rochester, Minnesota, is a part of the Graduate School of the University of Minnesota.Requests for reprints should be addressed to Section of Publications, Mayo Clinic, Rochester, Minnesota. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byManifestations of acquired and congenital diseases of the aortaLumbar sympathectomy: A procedure of questionable value in the treatment of arteriosclerosis obliterans of the legsChronische Verschlußkrankheiten der ArterienDie chirurgische Behandlung chronischer Arterienverschlüsse der unteren Extremität, unter besonderer Berücksichtigung der Wiederherstellungschirurgie und ihrer strömungstechnischen ProblemeDie rekonstruktive chirurgische Behandlung des chronischen Aorta-Ilica-VerschlussesDIAGNOSIS OF CHRONIC AORTO-ILIAC OCCLUSIVE ARTERIAL DISEASE*EDGAR A. HINES JR., M.D., F.A.C.P.Intermittent ClaudicationII. Surgical Therapy of Occlusive Peripheral Atherosclerosis 1 December 1957Volume 47, Issue 6Page: 1125-1137KeywordsAbdominal aortic aneurysmAortaArteriesAtherosclerosisGraduate medical educationUlcersVascular surgery ePublished: 1 December 2008 Issue Published: 1 December 1957 PDF downloadLoading ...
88. AAV Clades: Their Ability To Recombine and Cross Species-Barriers
Authors: Luk H. Vandenberghe, Guangping Gao, Mauricio R. Alvira, Roberto Calcedo, James M. Wilson
Journal: Molecular Therapy (2004)

A study was performed to evaluate the molecular presence of AAV in both human and nonhuman primates. PCR methodology was used to clone and characterize the variability in the cap sequence. The biological properties of these capsid structures were assessed using pseudotyped rAAV in gene transfer, neutralizing antibody and in vitro recepterology studies. This variety of novel genotypes led to the identifications of several capsids that showed a remarkable serology, tropism and/or gene transfer efficiency. In order to better understand this variation on a molecular level, a full phylogenetic study was performed.
Loss at Chromosome 13q22.2 Indicates Poor Survival in a Group of Grade 2 and Grade 3 Astrocytomas
Authors: Anjan Misra, Ivan Smirnov, Scott Vandenberg, Marcus Ware, Chibo Hong, Yuichi Hirose, Sameer Kharbanda, Janice Nigro, Edward Pan, Lars Prestegarden, Ru-Fang Yeh, Joseph Costello, Allan Yates, Berndt Scheithauer, Peter Burger, Catarina Giannini, Heidi Phillips, Ken Aldape, Burt G. Feuerstein
Journal: Cancer Research (2006)

Proc Amer Assoc Cancer Res, Volume 47, 2006

4204 

Pathologic grade is the most significant predictor of outcome in astrocytic tumors. World Health Organization (WHO) grading is based on cellular atypia, mitotic activity, endothelial proliferation, and necrosis. Grade 2 tumors (low grade, median survival >5 yr) usually have cellular atypia, while grade 3 tumors (anaplastic, median survival ∼3.5 yr) usually have both atypia and mitotic activity. However, some grade 2 and 3 patients have poor survival, and some have good survival. There is no known marker that distinguishes the atypical survivors. We used DNA microarrays to study 21 consensus grade 2 and 41 consensus grade 3 astrocytomas. Consensus was defined as diagnostic agreement among at least 4 of 6 neuropathologists. We used cluster analysis to identify genetic groups, significance analysis of microarrays (SAM) to identify genetic differences between groups, and the COX proportional hazards model to identify genetic markers associated with survival. Our preliminary analysis suggests that copy number at small loci on chromomes 3, 4, 6, 9, and X differ in grades 2 and 3. Copy number loss at a ∼5Mb region on chromosome 13q22.2 is associated with poor survival irrespective of grade. This work was supported by NIH (NS42927 and CA85799) and the National Brain Tumor Foundation.
The Significance of the Discordant Occurrence of Lens Tumors in Humans versus Other Species
Authors: Daniel M. Albert, Paul O. Phelps, Krishna R. Surapaneni, Bradley A. Thuro, Heather A.D. Potter, Akihiro Ikeda, Leandro B.C. Teixeira, Richard R. Dubielzig
Journal: Ophthalmology (2015)
Exclusion of EDNRB and KIT as the basis for white spotting in Border Collies
Authors: Danika Metallinos, Jasper Rine
Journal: Genome biology (2000)

White spotting patterns in mammals can be caused by mutations in the genes for the endothelin B receptor and c-Kit, whose protein products are necessary for proper migration, differentiation or survival of the melanoblast population of cells. Although there are many different dog breeds that segregate white spotting patterns, no genes have been identified that are linked to these phenotypes.An intercross was generated from a female Newfoundland and a male Border Collie and the white spotting phenotypes of the intercross progeny were evaluated by measuring percentage surface area of white in the puppies. The Border Collie markings segregated as a simple autosomal recessive (7/25 intercross progeny had the phenotype). Two candidate genes, for the endothelin B receptor (EDNRB) and c-Kit (KIT), were evaluated for segregation with the white spotting pattern. Polymorphisms between the Border Collie and Newfoundland were identified for EDNRB using Southern analysis after a portion of the canine gene had been cloned. Polymorphisms for KIT were identified using a microsatellite developed from a bacterial artificial chromosome containing the canine gene.Both EDNRB and KIT were excluded as a cause of the white spotting pattern in at least two of the intercross progeny. Although these genes have been implicated in white spotting in other mammals, including horses, pigs, cows, mice and rats, they do not appear to be responsible for the white spotting pattern found in the Border Collie breed of dog.
Abstract P229: Pericardial Fat Density is Associated With Insulin Resistance in Treated HIV Infection: The SATURN-HIV Trial
Authors: Chris T Longenecker, Yiying Liu, Mark Schlucter, Grace A McComsey
Journal: Circulation (2015)

Objective: To examine associations of pericardial fat (PCF) volume and density with baseline and changes in insulin resistance among HIV+ subjects participating in a trial of statin therapy. Methods: SATURN-HIV was a 96-week double-blind, randomized trial of 10 mg daily rosuvastatin versus placebo among 147 HIV+ subjects on stable antiretroviral therapy with LDL-c ≤130mg/dL and evidence of heightened T-cell activation or increased inflammation (high sensitivity C-reactive protein ≥2mg/L). PCF volume (ml) and density (mean Hounsfield Units) were measured from coronary calcium CT scans at entry. Homeostatic model of insulin resistance (HOMA-IR) was calculated from insulin and glucose at entry, 24, 48, and 96 weeks. Pearson correlations and linear mixed modeling were used to explore relationships between PCF and insulin resistance. Results: Median (Q1, Q3) age was 46 (40, 53) years; 78% were male and 68% African American; 49% were on a protease inhibitor. Median HOMA-IR was 1.84 (1.06, 3.33) at baseline, and participants randomized to statin had larger 0-96 week mean percentage increase in HOMA-IR (+73% vs +33%, statin vs placebo, p=0.009). PCF density did not correlate with measures of total body adiposity (BMI r=0.057 and total body fat r=-0.034, both p&gt;0.4), but was negatively correlated to waist-hip ratio (-0.337, p&lt;0.001). In a linear mixed model, PCF density was associated with baseline HOMA-IR independent of PCF volume, BMI, metabolic syndrome, and biomarkers of immune activation and systemic inflammation; however, PCF density was not associated with longitudinal changes in HOMA-IR (see Table). Conclusions: Coronary calcium scans are widely used to assess cardiovascular risk and appropriateness of statin therapy. In this HIV+ population, PCF density, a simple measure obtained from these scans, appears to be a novel marker of insulin resistance that is independent of PCF volume. Larger, adequately powered studies are needed to determine if PCF density predicts development of insulin resistance on statin.