Statistical measures are described that used in diagnostic imaging for expressing observer agreement regard to categorical data. The characterize the reliability of methods and reproducibility disease classifications and, occasionally with great care, as surrogate accuracy. review concentrates on chance-corrected indices, κ weighted κ. Examples from literature illustrate method calculation effects both prevalence number rating categories. Other less frequently, including multiple-rater κ,...

Crossover studies (clinical trials in which each patient receives two or more treatments sequence) and self-controlled (in serves as his her own control) can produce results that are statistically clinically valid with far fewer patients than would otherwise be required. We investigated the use of crossover design 13 appeared Journal during 1978 1979. considered following important features analysis they applied to these studies: method by were assigned initial treatment (only 7 used random...

The rate of mortality from asthma has increased substantially in the United States since 1978. We analyzed patterns rates death Philadelphia between 1969 and 1991.

To evaluate the effects of methylphenidate on a variety aspects attention, ranging from laboratory-based impairment measures to caregiver ratings and work productivity, in individuals after traumatic brain injury.A total 34 adults with moderate severe injury attention complaints postacute phase recovery were enrolled 6-wk, double-blind, placebo-controlled, repeated crossover study methylphenidate, administered dose 0.3 mg/kg/dose, twice day. A wide range attentional was gathered weekly,...

Abstract Magnetization transfer imaging (MTI) has been shown to be sensitive both macroscopic and microscopic disease in multiple sclerosis (MS). In this study three‐dimensional MTI was used estimate the global burden of large volumes brain tissue. performed 15 MS patients 11 normal controls. seven on two different occasions. data were displayed as magnetization ratio (MTR) histograms analyzed. The peak height histograms, presumably reflecting residual amount tissue, lower compared with...

Gallbladder cancer has an unusual geographic and demographic distribution, suggesting many possible etiologies.A case-control study was undertaken at four hospitals in La Paz, Bolivia, one hospital Mexico City, Mexico. Eighty-four patients with newly diagnosed, histologically confirmed gallbladder were compared 126 control subjects without stones 264 cholelithiasis or choledocholithiasis cancer. All underwent abdominal surgery. Study interviewed regarding characteristics, medical history,...

PURPOSE: To determine annual rates of volumetric changes in the whole-brain parenchyma patients with relapsing-remitting and secondary progressive multiple sclerosis (MS) test hypothesis that these correlate clinical disability. MATERIALS AND METHODS: A computer-assisted segmentation technique thin-section magnetic resonance (MR) imaging was used 36 MS (27 relapsing-remitting, nine progressive) 20 control subjects to quantify brain cerebrospinal fluid volumes. degree atrophy, percentage...

Attention deficits after traumatic brain injury (TBI) are common and disabling. Many pharmacologic agents have been used to ameliorate attention deficits, considerable interest has focused on methylphenidate (MP) because of its documented efficacy in deficit disorder. However, clinical studies MP subjects with TBI yielded mixed results. We examined the effects attentional function individuals referred specifically for assessment treatment. Subjects were studied a double-blind,...

Clinical trials of medical treatments often compare two treated groups or a group with separate but concurrent control group. We have examined consecutive series 47 such parallel studies reported in the Journal 1978-1979, including 35 random assignment to group, discover how this approach is actually used. A major strength these as was frequent use randomized treatment assignment. Common problems included lack sufficient detail about methods randomization, failure provide enough patient...

Participation in home, extracurricular, and community activities is a desired outcome of rehabilitation services for children young people with cerebral palsy (CP). The purpose this study was to investigate the effect age gross motor function on participation among CP.Five hundred participants (277 males, 223 females) were grouped by Gross Motor Function Classification System (GMFCS) level. There 291 aged 6 12 years 209 13 21 years. 128 GMFCS level I, 220 levels II/III, 152 IV/V....

Bilateral myringotomy and pressure equalization tube insertion (BMT) is the most common surgery in children. Multiple anesthetic techniques for BMT have been proposed, but that which reliably promotes ideal recovery remains unclear. We sought to assess associations between regimens included single-agent (fentanyl or ketorolac) dual-agent analgesic therapy primary outcome of maximal postanesthesia care unit (PACU) pain score. Secondary outcomes in-hospital rescue administration, time, emesis...

Studies show that selective serotonin reuptake inhibitors are effective for severe premenstrual syndrome and dysphoric disorder. This study compares the efficacy of a inhibitor with tricyclic antidepressant to determine whether syndrome/premenstrual disorder is general or more serotonergic effect antidepressants.After 3 screening months, 189 subjects were randomized sertraline hydrochloride, desipramine placebo months double-blind treatment. The flexible dosage range was 50 150 mg/d. outcome...

We examined the relations between quantitative volumetric estimates of cerebral lesion load based on magnetization transfer imaging (MTI), clinical data, and measures neuropsychological function in 44 patients with clinically diagnosed MS. In this population we assessed correlation several MTI measures, neurologic (Kurtzke Expanded Disability Status Scale Ambulation Index), disease duration using Spearman9s coefficient. Patients were classified basis test performance as severely impaired,...

Study Design. This study used a repeated measures design to assess the effects of multiple sitting postures on various spinal angles. All subjects were tested in slouched, erect, forward inclined, and comfortable postures. Objectives. The purposes this evaluate changes head, cervical, lumbar, pelvic different positions also determine if there is relation between lumbar posture cervical during sitting. Summary Background Data. Clinicians commonly assert that head neck position strongly...

Abstract :Physicians modify drug schedules in response to their patients' clinical responses. Failure relieve symptoms or the emergence of drug‐related side effects may reflect nonadherence a prescribed schedule rather than incorrect therapeutic physician decisions. Using medication questionnaire and computerized event monitoring system (MEMS) monitor use, use was examined subjects with Parkinson's disease (PD). We report that prescription PD common approximated reported other chronic...

Sometimes questions of clinical interest can be addressed only by investigations without concurrent controls that are under the supervision investigator (internal controls). Such studies nearly always make use other types comparisons (external controls), such as historical controls. In this paper we examine treatments have weak internal or lack controls, illustrated recent examples from Journal. These a small but important and unique role in investigation. Five interrelated features add to...

Background Social participation provides youths with opportunities to develop their self-concept, friendships, and meaning in life. Youths cerebral palsy (CP) have been reported participate more home-based leisure activities fewer social experiences friends others than without disabilities. Objective The objective of this study was identify youth, family, service determinants the CP who are not family members. Design design a cross-sectional analysis. Methods participants were 209 13 21...

The Pediatric Craniofacial Collaborative Group established the Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction inform quality improvement efforts. aim of this study is determine perioperative management, outcomes, complications across North America delineate salient features current practices.Thirty-one institutions contributed data from June 2012 September 2015. Data extracted included...