Improving Diagnosis in Health Care

Improving Diagnosis in Health Care
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 473
Release: 2015-12-29
Genre: Medical
ISBN: 0309377722

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Scientific and Technical Aerospace Reports

Scientific and Technical Aerospace Reports
Author:
Publisher:
Total Pages: 976
Release: 1990
Genre: Aeronautics
ISBN:

Lists citations with abstracts for aerospace related reports obtained from world wide sources and announces documents that have recently been entered into the NASA Scientific and Technical Information Database.

Small Clinical Trials

Small Clinical Trials
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 221
Release: 2001-01-01
Genre: Medical
ISBN: 0309171148

Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.

ANOVA

ANOVA
Author: Ellen R. Girden
Publisher: SAGE
Total Pages: 88
Release: 1992
Genre: Mathematics
ISBN: 9780803942578

Focusing on situations in which analysis of variance (ANOVA) involving the repeated measurement of separate groups of individuals is needed, Girden reveals the advantages, disadvantages, and counterbalancing issues of repeated measures situations. Using additive and nonadditive models to guide the analysis in each chapter, the book covers such topics as the rationale for partitioning the sum of squares, detailed analyses to facilitate the interpretation of computer printouts, the rationale for the F ratios in terms of expected means squares, validity assumptions for sphericity or circularity and approximate tests to perform when sphericity is not met.

Longitudinal Data Analysis

Longitudinal Data Analysis
Author: Garrett Fitzmaurice
Publisher: CRC Press
Total Pages: 633
Release: 2008-08-11
Genre: Mathematics
ISBN: 142001157X

Although many books currently available describe statistical models and methods for analyzing longitudinal data, they do not highlight connections between various research threads in the statistical literature. Responding to this void, Longitudinal Data Analysis provides a clear, comprehensive, and unified overview of state-of-the-art theory

Statistical Methods for the Analysis of Repeated Measurements

Statistical Methods for the Analysis of Repeated Measurements
Author: Charles S. Davis
Publisher: Springer Science & Business Media
Total Pages: 416
Release: 2008-01-10
Genre: Mathematics
ISBN: 0387215735

A comprehensive introduction to a wide variety of statistical methods for the analysis of repeated measurements. It is designed to be both a useful reference for practitioners and a textbook for a graduate-level course focused on methods for the analysis of repeated measurements. The important features of this book include a comprehensive coverage of classical and recent methods for continuous and categorical outcome variables; numerous homework problems at the end of each chapter; and the extensive use of real data sets in examples and homework problems.

The Prevention and Treatment of Missing Data in Clinical Trials

The Prevention and Treatment of Missing Data in Clinical Trials
Author: National Research Council
Publisher: National Academies Press
Total Pages: 163
Release: 2010-12-21
Genre: Medical
ISBN: 030918651X

Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.

Methods and Applications of Longitudinal Data Analysis

Methods and Applications of Longitudinal Data Analysis
Author: Xian Liu
Publisher: Elsevier
Total Pages: 531
Release: 2015-09-01
Genre: Mathematics
ISBN: 0128014822

Methods and Applications of Longitudinal Data Analysis describes methods for the analysis of longitudinal data in the medical, biological and behavioral sciences. It introduces basic concepts and functions including a variety of regression models, and their practical applications across many areas of research. Statistical procedures featured within the text include: - descriptive methods for delineating trends over time - linear mixed regression models with both fixed and random effects - covariance pattern models on correlated errors - generalized estimating equations - nonlinear regression models for categorical repeated measurements - techniques for analyzing longitudinal data with non-ignorable missing observations Emphasis is given to applications of these methods, using substantial empirical illustrations, designed to help users of statistics better analyze and understand longitudinal data. Methods and Applications of Longitudinal Data Analysis equips both graduate students and professionals to confidently apply longitudinal data analysis to their particular discipline. It also provides a valuable reference source for applied statisticians, demographers and other quantitative methodologists. - From novice to professional: this book starts with the introduction of basic models and ends with the description of some of the most advanced models in longitudinal data analysis - Enables students to select the correct statistical methods to apply to their longitudinal data and avoid the pitfalls associated with incorrect selection - Identifies the limitations of classical repeated measures models and describes newly developed techniques, along with real-world examples.