1,720,982 research outputs found
Proper modeling strategies selection for the assessment of post-infarction costs
No full textBACKGROUND:
The evaluation of the economic impact of ischemic disease has gained increasing interest. Such field of investigation is suffering however of the heterogeneity of methods used in evaluating costs, limiting the comparison of study results.
OBJECTIVE:
The aim of the study is to show how estimates of 1-year costs of treatment of patients with uncomplicated acute myocardial infarction can vary significantly in relation to the statistical method adopted in the analysis.
RESEARCH DESIGN AND METHODS:
The study analyses post-IMA costs as a function of demographic and clinical covariates, by applying the following statistical survival models: the parametric survival model assuming Weibull distribution, the Cox proportional hazard (PH) model and the Aalen additive regression for modelling costs. The Aalen approach is robust both for the non-proportionality in hazard and for departures from normality. In addition it is able to easily model the effect of covariates on the extreme costs. This cost analysis is based on data collected in the two COSTAMI trials (N=487).
RESULTS:
There is agreement in all models with the effects of the considered covariates (age, sex, duration of disease and presence of other pathologies). There is a clear tendency of both the Aalen and the Cox model to provide a lower mean cost estimate than the other model, but with the additional feature for the Aalen model to be able to cope with all the other models in furnishing unbiased estimates with the advantage of a greater flexibility in representing the covariates' effect on the cost process.
CONCLUSIONS:
An appropriate choice of the model is crucial in avoiding mis-interpretation of cost determinants of IMA patients. For our data set the Aalen model proved itself to be a realistic and informative way to characterize the effect of covariates on costs
Psychological aspects of risk appraisal in asphyxiation accidents: a review of the factors influencing children's perception and behaviour.
No full textKnowledge, practice and faith on Total Quality Management principles among workers in the Health Care System: Evidence from an Italian investigation
No full textGoing Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Evaluating hospital costs in type 2 diabetes care: does the choice of the model matter?
No full textBACKGROUND:
Awareness of the economic burden of diabetes has led to a number of studies on economic issues. However, comparison among cost-of-illness studies is problematic because different methods are used to arrive at a final cost estimate.
OBJECTIVE:
The aim of the study is to show how estimates of hospitalisation costs for diabetic patients can vary significantly in relation to the statistical method adopted in the analysis.
RESEARCH DESIGN AND METHODS:
The study analyses diabetic patients' costs as a function of demographic and clinical covariates, by applying the following statistical survival models: the parametric survival model assuming Weibull distribution, the Cox proportional hazard (PH) model and the Aalen additive regression for modelling costs. The Aalen approach is robust both for the non proportionality in hazard and for departures from normality. In addition it is able to easily model the effect of covariates on the extreme costs. This cost analysis is based on data collected for a retrospective observational study analysing repeated hospitalisations (N = 4816) in a cohort of 3892 diabetic patients.
RESULTS:
There is agreement in all models with the effects of the considered covariates (age, sex, duration of disease and presence of other pathologies). An effect of over- or under-estimation, according to the chosen model due to arguably inappropriate model fitting, was observed, being more evident for some specific profiles of the patients, and overall accounting for as much as 20% of the estimated effect. The Aalen model was able to cope with all the other models in furnishing unbiased estimates with the advantage of a greater flexibility in representing the covariates' effect on the cost process.
CONCLUSIONS:
An appropriate choice of the model is crucial in avoiding misinterpretation of cost determinants of type 2 diabetes care. For our data set the Aalen model proved itself to be a realistic and informative way to characterise the effect of covariates on costs
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Knowledge, practice and faith on Total Quality Management principles among workers in the Health Care System: Evidence from an Italian investigation
No full textOBJECTIVES:
This study surveys how well TQM principles are known and understood by health care professionals from the employees' point of view and the factors affecting it.
RESEARCH DESIGN AND SUBJECTS:
The Health Care System in Trieste was surveyed.
MEASURES:
The Total Quality Test was used, a novel and quick instrument aimed at routine assessment of the penetration and interiorization of TQM principles within the health care structure.
RESULTS:
Direct exposure to public, job role and time spent working within the same structure have been proved related to the penetration of TQM principles, whereas previous formative intervention did not prove to be associated with the penetration of TQM principles.
CONCLUSIONS:
The implementation of a quick and simple instrument to monitor the TQM implementation highlighted several critical areas for intervention
Survival for ethmoid sinus adenocarcinoma in European populations.
No full textAbstract
BACKGROUND: Adenocarcinoma of the ethmoid sinus is rare. EUROCARE data provide a good opportunity to study the survival of this rare disease in a population of continental size.
PATIENTS AND METHODS: A total of 204 cases, age 15 to 99 years, diagnosed with primary ethmoid sinus adenocarcinoma between 1983 and 1994, were analyzed. The data were contributed by 22 population-based cancer registries from the nine countries participating in EUROCARE. Relative survival by sex, age, period of diagnosis, region and stage, and adjusted relative excess risk (RER) of death, were estimated.
RESULTS: Survival was 83%, 58% and 46%, 1, 3 and 5 years, respectively after diagnosis. Five-year survival was best (60%) in patients of 55-64 years and worst (33%) in the oldest age group (> or =65 years). Five-year survival differ between European population: in Norway (55%, 95% confidence interval 26.4-80.9) and western Europe that includes populations from Eindhoven, Saarland, Geneva, Italy and France (56%, 95%CI 41.3-68.9) was higher than in the UK (41%, 95% CI 30.8-51.8) and eastern Europe which includes Slovakia and Slovenia, (22%, 95% CI 3.5-54.4). Five-year survival did not improve over time. Due to the rarity of the disease, all the survival differences did not reach the statistical significance.
CONCLUSIONS: Since no survival improvement with time was evident from this study, efforts should be made to improve early diagnosis. GPs and ENT specialists should be alerted to the disease and encouraged to take occupational histories in people with persistent nasal symptoms, which may lead to a reasonable suspicion of malignancy. Monitoring of exposed workers may also improve early diagnosis. Patients with suspected ethmoid cancer should be referred immediately a specialized diagnosis and treatment centre
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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