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Measured Outcomes (measured + outcome)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Long-Term Follow-Up Results of Selective Laryngeal Adductor Denervation-Reinnervation Surgery for Adductor Spasmodic Dysphonia

THE LARYNGOSCOPE, Issue 4 2006
Dinesh K. Chhetri MD
Abstract Selective laryngeal adductor denervation-reinnervation surgery for the treatment of adductor spasmodic dysphonia was reported in 1999 in 21 patients with encouraging results. Here, we report long-term results of this procedure. Surgical outcome was evaluated using patient surveys and perceptual voice assessment. Measured outcomes included Voice Handicap Index (VHI)-10 scores, patient questionnaire, and perceptual evaluation for voice breaks and breathiness. Patient survey was obtained from 83 patients, and perceptual voice evaluation was performed in voice samples from 46 patients. Average follow-up interval was 49 months. Mean VHI-10 scores improved from a mean of 35.6 to 12.7. Eighty-three percent showed significantly improved VHI-10 scores, representing improved physical, social, and emotional well-being. There was a high degree of patient satisfaction, with 91% agreeing that their voice is more fluent after the surgery. Perceptual evaluation of postoperative voice samples revealed voice breaks in 26% (15% mild, 4% moderate, 7% severe) and breathiness in 30% (11% mild, 13% moderate, 6% severe). A majority of patients had stable, long-lasting resolution of spasmodic voice breaks. [source]

The behaviour of soil process models of ammonia volatilization at contrasting spatial scales

EUROPEAN JOURNAL OF SOIL SCIENCE, Issue 6 2008
R. Corstanje
Summary Process models are commonly used in soil science to obtain predictions at a spatial scale that is different from the scale at which the model was developed, or the scale at which information on model inputs is available. When this happens, the model and its inputs require aggregation or disaggregation to the application scale, and this is a complex problem. Furthermore, the validity of the aggregated model predictions depends on whether the model describes the key processes that determine the process outcome at the target scale. Different models may therefore be required at different spatial scales. In this paper we develop a diagnostic framework which allows us to judge whether a model is appropriate for use at one or more spatial scales both with respect to the prediction of variations at those scale and in the requirement for disaggregation of the inputs. We show that spatially nested analysis of the covariance of predictions with measured process outcomes is an efficient way to do this. This is applied to models of the processes that lead to ammonia volatilization from soil after the application of urea. We identify the component correlations at different scales of a nested scheme as the diagnostic with which to evaluate model behaviour. These correlations show how well the model emulates components of spatial variation of the target process at the scales of the sampling scheme. Aggregate correlations were identified as the most pertinent to evaluate models for prediction at particular scales since they measure how well aggregated predictions at some scale correlate with aggregated values of the measured outcome. There are two circumstances under which models are used to make predictions. In the first case only the model is used to predict, and the most useful diagnostic is the concordance aggregate correlation. In the second case model predictions are assimilated with observations which should correct bias in the prediction, and errors in the variance; the aggregate correlations would be the most suitable diagnostic. [source]

Cognitive training in Alzheimer's disease: a meta-analysis of the literature

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2006
D. I. Sitzer
Objective:, To systematically review the literature and summarize the effect of cognitive training (CT) for Alzheimer's disease (AD) patients on multiple functional domains. Method:, Effect sizes (Cohen's d) were calculated for 17 controlled studies identified through a comprehensive literature review. Results:, An overall effect size of 0.47 was observed for all CT strategies across all measured outcomes. Mean effect sizes were higher for restorative (0.54) than for compensatory (0.36) strategies. Domain-specific effect sizes ranged from 2.16 (verbal and visual learning) to ,0.38 (visuospatial functioning). Data are also presented on the relative impact of restorative and compensatory strategies for each domain of functioning. Conclusion:, CT evidenced promise in the treatment of AD, with primarily medium effect sizes for learning, memory, executive functioning, activities of daily living, general cognitive problems, depression, and self-rated general functioning. Restorative strategies demonstrated the greatest overall effect on functioning. Several limitations of the published literature are discussed. [source]

Meta-analysis comparing clinical effectiveness of drug-eluting stents, bare metal stents and coronary artery bypass surgery

INTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2007
Eun-Hwan Oh PhD MPH MHA BA
Abstract Objective, To compare clinical outcomes among patients receiving drug-eluting stents, bare metal stents, or coronary artery bypass grafting surgery (CABG) to treat coronary artery disease. Data sources, Randomised controlled trials were systematically selected from electronic database for head-to-head comparisons. The results from these head-to-head comparisons were used for an adjusted indirect comparison. Methods, Published randomised controlled trials were reviewed for outcome data in patients treated for coronary artery disease with drug-eluting stents, bare metal stents, or CABG. Head-to-head comparisons were conducted for drug-eluting stents versus bare metal stents and for CABG versus bare metal stents. Adjusted indirect comparison was used to compare drug-eluting stents and CABG. Mid-term clinical outcomes (range: 6,12 months) were investigated and included rates of mortality, myocardial infarction, thrombosis, target lesion revascularisation, target vessel revascularisation, restenosis and major adverse cardiac events. Results, Systematic literature search identified 23 randomised controlled trials (15 for drug-eluting stents vs. bare metal stents, 8 for CABG vs. bare metal stents). Head-to-head comparisons for both single and multiple vessel disease demonstrated that compared with bare metal stents, drug-eluting stents had better outcomes for target lesion revascularisation, target vessel revascularisation, restenosis and major adverse cardiac events. Except target lesion revascularisation, data were similarly favourable for CABG when compared with bare metal stents. Adjusted indirect comparison between drug-eluting stents and CABG in single vessel disease failed to detect significant differences in any of the measured outcomes. Multiple vessel disease data analysis demonstrated that target vessel revascularisation (odds ratio 3.41 [95% CI 2.29,5.08]) and major adverse cardiac events (1.89 [1.28,2.79]) were superior to drug-eluting stents in patients undergoing CABG. Conclusions, Drug-eluting stents and CABG were superior to bare metal stents in terms of target lesion revascularisation (drug-eluting stents only), target vessel revascularisation, restenosis and major adverse cardiac events. There was no difference in clinical outcomes when comparing CABG and drug-eluting stents in patients with single vessel disease, and CABG may be superior to drug-eluting stents for target vessel revascularisation and major adverse cardiac events in patients with multiple vessel disease. However, results may vary between subpopulations with different clinical or socioeconomic differences. [source]