The validity and reliability of the global index of safety (GIS)

Objective: The global index of safety (GIS) is an adverse event (AE) based instrument designed to evaluate the safety profile of drugs. This paper presents the evaluation of the inter-rater reliability and validity of a 94-item GIS for antipsychotics through Rasch analysis.

Research design and methods: A total of 194 psychiatrists participating in an outpatient pharmacoepidemiologic study of olanzapine in schizophrenia rated the severity that each AE would have on a 5-point scale. Reliability was

determined through a paired comparison design involving the new independent ratings of 101 different psychiatrists participating in another study of olanzapine in acute inpatient units. Spearman's, Pearson's and Intra-class correlation (ICC) coefficients were used to estimate the interrater reliability of the AE weights. Validity was analyzed through the Rasch rating scale model.

Results: Reliability coefficient estimates were excellent (Spearman = 0.99, Pearson = 0.99, ICC = 0.98), supporting the inter-rater reliability of the item weights. Through goodness-of-fit statistics and the investigation of the hierarchy of item calibrations, Rasch analysis confirmed the validity of the instrument.

Conclusion: The data presented here on interrater reliability estimates of adverse events related to antipsychotic drugs indicate that GIS is a promising alternative for the evaluation of the safety profile of drugs.     

Critical Role of Trauma and Emergency Surgery Physicians in Patient Satisfaction: An Analysis of Consumer Assessment of Healthcare Providers and Systems,Hospital Version Data from 186,779 Patients and 168 Hospitals in a National Healthcare System

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Creating a sustainable collaborative consumer health application for chronic disease self-management

As the prevalence of chronic diseases increase, there is a need for consumer-centric health informatics applications that assist individuals with disease self-management skills. However, due to the cost of development of these applications, there is also a need to build a disease agnostic architecture so that they could be reused for any chronic disease. This paper describes the architecture of a collaborative virtual environment (VE) platform, LIVE©, that was developed to teach self-management skills and provide social support to those individuals with type 2 diabetes. However, a backend database allows for the application to be easily reused for any chronic disease. We tested its usability in the context of a larger randomized controlled trial of its efficacy. The usability was scored as ‘good’ by half of the participants in the evaluation. Common errors in the testing and solutions to address initial usability issues are discussed. Overall, LIVE© represents a usable and generalizable platform that will be adapted to other chronic diseases and health needs in future research and applications.     

手术前麻醉访视新思路-麻醉咨询室

目的为了增加患者对医生的信任度，减少医疗纠纷和投诉，消除医闹，让患者的知情权得到充分的体现；让每个患者都能按《消费者权益保护法》享受自己的权益。方法观察组(A组)访视除口头嘱咐患者手术、麻醉配合注意事项外还按不同麻醉方式另外统一分发由《麻醉咨询室》制定的相应的《XX麻醉手术配合要点告知与咨询》的宣传单；对照组(B组)访视只是口头嘱咐手术麻醉配合注意事项不分发任何与手术、麻醉注意事项相关的宣传单。结果观察组满意度和配合程度均显著高于对照组。讨论手术室是医院高风险的科室，手术患者知情权与告知工作的落实直接影响手术患者的满意度甚至直接影响到医院的社会效益与经济效益。《麻醉咨询室》加强了与手术患者的沟通，让患者的知情权得到充分的体现；让每个患者都能按《消费者权益保护法》享受自己的权益。由此可增加患者对医生的信任度，减少医疗纠纷和投诉，改善当今紧张的医患关系。《麻醉咨询室》对医院实施来说简单，对麻醉医师手术前访视来说方便；对患者来说体贴，值得广大医疗机构推广。     

我国网上药店资质安全现状调查研究

目的：对我国合法网上药店资质现状进行调查分析,了解国家主要监管政策,为网上药店的健康发展提供参考依据。方法：用网站调研的方法对我国33家合法网上药店进行逐个调查统计,计算网上药店资质安全项目比例。用文献研究的方法了解国家法律对资质安全的维护措施。结果：91%的网上药店给出的资质项目不齐全,93%的受访者能认识到资质安全的重要性但不了解其具体内容。结论：消费者对资质安全相关内容了解不全面,不会利用相关法律维护自身合法权益,网上药店应补充欠缺的资质文件,加大资质安全相关教育。     

Toxicologic evaluation of modified gum acacia: mutagenicity, acute and subchronic toxicity.

Modified gum acacia, produced from acacia gum by a process analogous to the production of modified food starch, was tested for mutagenicity in the microbial reverse mutation assay. The assay employed a wide range of dose levels, both with and without metabolic activation. Test results gave no indication that modified gum acacia possessed any mutagenic potential. The acute oral toxicity of modified gum acacia was determined in two studies employing Sprague-Dawley rats, and the LD50 values were found to be >2000 mg/kg. The primary dermal irritation potential of modified gum acacia was evaluated in rabbits by the Draize method. Test results indicated that modified gum acacia was slightly irritating by the Environmental Protection Agency (EPA) classification but not a primary irritant by Consumer Product Safety Commission (CPSC) guidelines. The subchronic toxicity of modified gum acacia was examined in Sprague-Dawley rats fed diets containing 0%, 1%, 2.5%, and 5% modified gum acacia for 13 weeks. No dose-related effects on survival, growth, hematology, blood chemistry, organ weights, or pathologic lesions were observed. Results of these studies indicate that modified gum acacia does not possess mutagenic potential and that animals are not adversely affected by acute or subchronic exposure to modified gum acacia.     

The effect of report cards on consumer choice in the health insurance market

We test the effect of report cards on consumer choice in the HMO market. Federal employees were provided with report cards on a limited basis in 1995 and then on a widespread basis in 1996. Exploiting this natural experiment, we find that subjective measures of quality and coverage influence plan choices, after controlling for plan premiums, expected out of pocket expenses and service coverages. The effect is stronger within a small sample of new hires compared to a larger sample of existing federal employees. We also find evidence that report cards increase the price elasticity of demand for health insurance.     

消费者对药品说明书知晓度的调查

目的:调查消费者对药品说明书内容的知晓状况。方法:对保定市及周边县城消费者进行随机抽样问卷调查,采用t检验、方差分析和LSD-t检验等方法对调查数据进行统计学处理。结果与结论:消费者对药品说明书知晓度较低,不同研究变量知晓度不同,其中不同文化程度、职业和居住地区的消费者知晓度存在统计学差异。建议从加强药学服务、改进药品说明书、普及医药知识和净化医药广告等几方面改进现状。     

分析患者就医的心理 优化医患关系

本文着重阐述了分析患者就医的消费心理的意义和几种常见的就医消费心态;因势利导,优化医患关系的几条原则;实施中的注意事项等问题,我们认为当前的医疗单位正处在既追求社会效益又讲求一定的经济效益的特殊历史阶段,患者就医的消费心理是联系医患双方切身利益的一个媒介,通过这一线索研究优化医患关系,具有实际意义。     

A behavioral window on the mind of the market: an application of the response time paradigm

This article focuses on the role of implicit knowledge consumers have about particular brands, products or names. The major findings of several studies, conducted at the Mind of the Market Laboratory at Harvard Business School, are presented with specific emphasis on studies in which response time measurements were the core method. The results revealed that implicit measures provide a rich understanding of the meaning conveyed by a product or brand. Moreover, there is also considerable evidence that implicit measures may be better than traditional explicit measures as predictors of consumer behavior. We discuss the implications for the study of consumer behavior and the importance of combining several methods including neuroimaging, which has received recent attention by marketers, economists and social scientists.