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"Riffenburgh, R. H. (Robert H.)"
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Statistics in medicine
Medicine deals with treatments that work often but not always, so treatment success must be based on probability. Statistical methods lift medical research from the anecdotal to measured levels of probability. This book presents the common statistical methods used in 90% of medical research, along with the underlying basics, in two parts: a textbook section for use by students in health care training programs, e.g., medical schools or residency training, and a reference section for use by practicing clinicians in reading medical literature and performing their own research. The book does not require a significant level of mathematical knowledge and couches the methods in multiple examples drawn from clinical medicine, giving it applicable context.
eBook
Statistics in medicine
Statistics in Medicine, Third Edition makes medical statistics easy to understand by students, practicing physicians, and researchers.The book begins with databases from clinical medicine and uses such data to give multiple worked-out illustrations of every method.
eBook
Contrast-Enhanced MRI Evaluation of Bone–Patellar Tendon–Bone and Hamstring ACL Autograft Healing in Humans: A Prospective Randomized Study
Background:
Gadopentetate dimeglumine–enhanced magnetic resonance imaging (MRI), or gadolinium-enhanced MRI, was used to prospectively study the postoperative course of bone–patellar tendon–bone (BPTB) and combined semitendinosus and gracilis (STG) tendon autografts following arthroscopically assisted reconstruction of the anterior cruciate ligament (ACL) in humans. Gadopentetate dimeglumine is a contrast agent that has been shown to enhance the signal of vascularized tissue when examined by MRI.
Purpose:
To prospectively determine and compare the pattern and timing of autograft revascularization following arthroscopically assisted ACL reconstruction by BPTB or STG autografts.
Study Design:
Randomized controlled trial; Level of evidence, 1.
Methods:
A total of 73 patients (63 males, 10 females) with ACL tears who were scheduled to undergo reconstruction consented to participate in this study. The patients were randomized to receive arthroscopically assisted reconstruction of the ACL employing either BPTB or STG autografts. Gadolinium-enhanced MRI scans were scheduled at 3-month intervals during the first postoperative year to assess the integrity, timing, and pattern of enhancement of the ACL graft. The temporal sequence and morphologic characteristics of imaged signals were compared for both types of ACL reconstructions.
Results:
Based on all knees with 1 exception, there were no statistically significant differences in gadopentetate dimeglumine–mediated graft enhancement grade observed between BPTB and STG autografts.
Conclusion:
The results suggest that autograft revascularization probably varies in intensity and location during the time course of graft healing. The interval signal changes observed 3 to 9 months, but especially 6 to 9 months, postoperatively are due to increased contrast uptake as a reflection of ongoing neovascularization during the process of ligamentization.
Journal Article
Statistics in Medicine
Statistics in Medicine, Fourth Edition, helps medical and biomedical investigators design and answer questions about analyzing and interpreting data and predicting the sample size required to achieve useful results.It makes medical statistics easy for the non-biostatistician by outlining common methods used in 90% of medical research.
eBook
Oxygen saturation is not clinically useful in the exclusion of bacterial pneumonia in febrile infants
BackgroundAcute respiratory infection remains a common presentation to Emergency Departments. Oxygen saturations (Sao2) may be useful in determining which febrile infants require chest x-rays (CXR) in investigation for bacterial pneumonia (PNA). This study aimed to determine whether Sao2 is clinically useful in excluding bacterial PNA in febrile infants <24 months.MethodsA febrile infant registry was instituted at a tertiary care military hospital (55 000 annual patients, 27% children) from December 2002–December 2003. Eligible patients consisted of infants <3 months with temperature ≥38°C or 3–24 months with temperature ≥39°C. Bacterial PNA was defined in this cohort by a CXR revealing a ‘lobar infiltrate’ by a board-certified radiologist. Descriptive statistics are presented on groups who received CXR versus groups who did not, and on infants who had bacterial PNA versus those who did not. Student t tests were used to compare maximum temperature (Tmax), RR, and Sao2. Logistic regression for PNA was performed using age, sex, Tmax, RR, HR and Sao2. A Receiver Operator Characteristic (ROC) curve was created to show Sao2 cut-off points as related to sensitivity and specificity.Results985 patients (55% boys; median age: 12 months) met entry criteria. 790 underwent CXR and 82 were diagnosed with bacterial PNA. Sao2 was lower in infants with bacterial PNA (96.6%±2.5% vs 97.7%±1.8%, p<0.001). Sao2 was also predictive of bacterial PNA by logistic regression (p=0.017) but the ROC curve yielded a poor sensitivity/specificity profile (area under curve (AUC) of 0.6786).ConclusionsIn febrile infants, Sao2 was not found to be clinically useful for excluding bacterial PNA.
Journal Article
A Method of Sociometric Identification on the Basis of Multiple Measurements
Presented, under common statistical assumptions, is a method (multivariate discriminant analysis) to characterize groups by summaries of sets of measurements of some sociological event for each member in each group and thence to compare the groups. The method estimates \"distances\" (variance weighted) between centers (averages) of every pair of groups and tests the statistical significance of these differences. The group centers and pair differences are displayed as a generalized sociogram. The significances as perceived by various groups are compared, where a perceiving group may be one of the measured groups, a pooling of the measured groups, or an entirely different group. Simultaneous confidence intervals and reduction of number of variables are discussed. The identification of stereotypes of Hawaiian ethnic groups is presented as an illustration of the method.
Journal Article
