Utility of musculoskeletal ultrasound

A 37 year old runner presents with multiple aches and pains in the lower limb and foot with the most focal being swelling and tenderness in his Achilles tendon, most often after a workout. You are wondering how best to image his pathology.     

Combining environmental information.

Workshop proceedings and summary reports will appear in scientific periodicals and will also be available in various forms as technical reports from the NISS in Research Triangle Park, North Carolina. In particular, study papers from the workshop will be prepared that will serve as indicators of further research directions, as well as current summaries of the complex issue of combining environmental data. Potential applications and improvements in associated areas of scientific/statistical research include census sampling, geostatistics, and biological effect modeling. This workshop was an experiment in how to stimulate and foster research and collaborations across disciplinary lines. Its motivation derives, however, from ever-growing social, political, economic, and scientific needs; with such strong background, it is hoped that the workshop stimulus will be strong, compelling, and fruitful.     

外部环境建设实用集锦

在一座城市中,如果只有高楼林立,那么它的建筑和空间是平淡无味的,一个没有欣赏建筑与环境的空间是令人难以想象的。某国外著名建筑师这样说建筑与环境的关系。医院建筑作为民用建筑中最复杂的建筑更关心外部环境的塑造。对于拥有土地的医院来说,郁郁葱葱且有章有法的环境不是那么容易就打造出来的,尤其是刚刚要做外部环境的医院,更别     

Spirometric Measurements In Welders

Investigation of the effects of different oxygen concentrations on the tracheal ciliary activity in vitro show that there is a dose-response relationship. That means that low concentration of oxygen from 0.1% to 0.25% are toxic while concentrations of oxygen from around 1% do not seem to have any ciliastatic effect. Even if the oxygen concentration was increased to almost 100% no toxicity could be registered.

These results are in accordance with earlier investigations. The next question to be answered is if the oxygen supply through a normal circulartion is sufficient to maintain ciliary activity if the trachea is covered with pure argon. These experiments have been started.     

Health Utility Attributes for Chronic Conditions

Objective

To determine the importance of specific health utility attributes that comprise overall utility scores for a number of chronic health state conditions.

Study design

Cross-sectional study using data from a prospective national survey of the health of community-dwelling Canadians.

Study population

47 534 individuals who answered both health questions and utility questions (51.8% male).

Methods

The attributes making up the Health Utilities Index (HUI-Mark III) scores (i.e. vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain) for 21 chronic conditions were examined from the National Population Health Survey (NPHS) 1996 to 1997. Conditions included Alzheimer’s disease, arthritis/rheumatism, asthma, back problems excluding arthritis, bowel disorder, chronic bronchitis or emphysema, cancer, cataracts, diabetes, epilepsy, food allergies, glaucoma, heart disease, hypertension, migraine headaches, other allergies, sinusitis, stroke, stomach/intestinal ulcers, thyroid conditions and urinary incontinence. HUI-Mark III scores for patients without an NPHS-defined chronic condition were also collected. All conditions were mutually exclusive.

Results

The mean HUI-Mark III score for patients without a chronic health state was 0.953 ± 0.060. Individuals with Alzheimer’s disease (0.846 ± 0.168), stroke (0.869 ± 0.163) and arthritis/rheumatism (0.883 ± 0.132) had the lowest overall HUI-Mark III scores. Individuals with Alzheimer’s disease (28.6%), epilepsy (23.1%) and urinary incontinence (19.8%) reported higher scores on the emotional impairment attribute. Individuals with arthritis/rheumatism (24.7%) and back problems (20.6%) had high levels of pain/discomfort. Patients with stroke (16.4%) had low mobility scores.

Conclusion

By determining which attributes are important to chronic health conditions, this study provides health economists, researchers and policy makers with a reference of health state attributes for various chronic conditions.

     

Combining classification trees using MLE

We propose a probability distribution for an equivalence class of classification trees (that is, those that ignore the value of the cutpoints but retain tree structure). This distribution is parameterized by a central tree structure representing the true model, and a precision or concentration coefficient representing the variability around the central tree. We use this distribution to model an observed set of classification trees exhibiting variability in tree structure. We propose the maximum likelihood estimate of the central tree as the best tree to represent the set. This MLE retains the interpretability of a single tree model and has excellent generalizability. We implement an ascent search for the MLE tree structure using a data set of 13 classification trees that predict the presence or absence of cancer based on immune system parameters.     

Utility model of preventive behaviour.

The utility model of preventive behaviour is presented as an alternative to psychosociological analysis. All preventive actions are viewed as the consumption of those "goods" that affect the risk of illness or injury. Levels of consumption depend on, inter alia, utility (perceived benefit) and cost. Total utility yielded by risk affecting goods is the sum of that derived from the use value of the good, if any, and that from reduced anxiety which results from reduced risk. Many risk affecting goods are consumed mainly for their use value. An examination of the nature of risk affecting goods is presented, followed by an analysis of the factors that determine the anxiety associated with unwanted outcomes. The utility model places preventive behaviour within the framework of the economic theory of demand. The economic principles used in this analysis are explained and their relevance to the consumption of risk affecting goods is determined.     

Estimating Joint Health Condition Utility Values

Objectives

To predict health state utility values (HSUVs) for individuals with up to 4 conditions simultaneously.

Utility assessment in clinical decision making

In clinical decision analysis a quantitative value is attached to a longevity or a life quality by means of utility assessment. The actual value of the utility can determine the result of the decision analysis. In this article utility theory is briefly discussed. Four kinds of utility tests (direct scaling methods, the basic reference gamble, the time trade-off test and additive conjoint measurement) are introduced on the basis of an example and their pros and cons are discussed. It is concluded that additive conjoint measurement has the best formal infrastructure, but that the test method is not always easily applicable.