Open Access. Powered by Scholars. Published by Universities.®
Medical Biomathematics and Biometrics Commons™
Open Access. Powered by Scholars. Published by Universities.®
- Institution
Articles 1 - 5 of 5
Full-Text Articles in Medical Biomathematics and Biometrics
Identification Of Ovarian Cancer Symptoms In Health Insurance Claims Data., Paula Diehr, Sean Devlin
Identification Of Ovarian Cancer Symptoms In Health Insurance Claims Data., Paula Diehr, Sean Devlin
Paula Diehr
Background: Women with ovarian cancer have reported abdominal=pelvic pain, bloating, difficulty eating or feeling full quickly, and urinary frequency=urgency prior to diagnosis. We explored these findings in a general population using a dataset of insured women aged 40–64 and investigated the potential effectiveness of a routine review of claims data as a prescreen to identify women at high risk for ovarian cancer. Methods: Data from a large Washington State health insurer were merged with the Seattle-Puget Sound Surveillance, Epidemiology and End Results (SEER) cancer registry for 2000–2004. We estimated the prevalence of symptoms in the 36 months prior to diagnosis …
Prediction Of Fracture In Patients With Acute Musculoskeletal Ankle Trauma, Paula Diehr
Prediction Of Fracture In Patients With Acute Musculoskeletal Ankle Trauma, Paula Diehr
Paula Diehr
X-rays taken for ankle trauma contribute significantly to the cost of health care in this country. In an attempt to find clinical correlates of ankle fracture 36 detailed historical and physical examination variables were collected from 587 consecutive patients with ankle trauma, and ankle x-rays were taken of all patients. The association of each variable with the final diagnosis of fracture, rupture, or sprain was tested; 21 variables were significant predictors of fracture (vs. sprain and rupture) and 15 were not significantly associated with final diagnosis. The variables were used in a linear discriminant analysis to develop a rule which …
Prediction Of Pneumonia In Outpatients With Acute Cough - A Statistical Approach, Paula Diehr
Prediction Of Pneumonia In Outpatients With Acute Cough - A Statistical Approach, Paula Diehr
Paula Diehr
Cough is the fifth most common reason for physician visits, but data on acute cough have rarely been collected in a standardized manner and have not been analyzed in a multivariate fashion. We report data on 1819 patients presenting with cough, all of whom received a standardized history and physical, and a chest X-ray. Only 48 (2.6%) were found to have an acute radiographic infiltrate (pneumonia). The prevalence of common signs and symptoms is shown for the patients with and without pneumonia. Thirty-two of these findings were significant predictors of pneumonia (p less than 0.05, one-tailed). These 32 did not …
Cluster Analysis To Determine Headache Types, Paula Diehr
Cluster Analysis To Determine Headache Types, Paula Diehr
Paula Diehr
Cluster analysis was used to separate 726 headache patients into clusters of patients with similar symptoms. This was done to answer two questions: what "naturally occurring' groups of patients can be found? And how do these groups correspond to traditional headache types? When only two clusters were required, the best two clusters were tension and migraine-like. However, eight clusters could also be distinguished, and the migraine group then became very small. The clusters were tested for clinical interpretability by having 12 physicians name and prescribe treatment for the clusters. The suggested treatment was similar to what patients had actually received …
Acute Headaches; Presenting Symptoms And Diagnostic Rules To Identify Patients With Tension And Migraine Headache , Paula Diehr
Acute Headaches; Presenting Symptoms And Diagnostic Rules To Identify Patients With Tension And Migraine Headache , Paula Diehr
Paula Diehr
Headache is the ninth most common cause of physician visits, but data on acute headaches have not been collected in a standardized manner and have not been analyzed in a multivariate fashion. We report on 726 patients presenting with acute headaches, which were diagnosed as tension (38%), migraine (25%), no diagnosis (30%), and other (6%). The prevalence of 32 signs and symptoms is shown for each group. Four of these findings were significant predictors of tension headache, and 19 were significant predictors of migraine headache (p<.05). Several diagnostic rules are developed which classify nearly 90% of the headaches correctly, using only three to seven of the findings. On a new set of patients the classification was correct over 80% of the time. It is suggested that most acute headaches could be diagnosed over the telephone or by midlevel providers, which would provide substantial cost savings.