Indicators of breast cancer severity and appropriateness of surgery based on hospital administrative data in the Lazio Region, Italy

BACKGROUND: Administrative data can serve as an easily available source for epidemiological and evaluation studies. The aim of this study is to evaluate the use of hospital administrative data to determine breast cancer severity and the appropriateness of surgical treatment. METHODS: the study population consisted of 398 patients randomly selected from a cohort of women hospitalized for first-time breast cancer surgery in the Lazio Region, Italy. Tumor severity was defined in three different ways: 1) tumor size; 2) clinical stage (TNM); 3) severity indicator based on HIS data (SI). Sensitivity, specificity, and positive predictive value (PPV) of the severity indicator in evaluating appropriateness of surgery were calculated. The accuracy of HIS data was measured using Kappa statistic. RESULTS: Most of 387 cases were classified as T1 and T2 (tumor size), more than 70% were in stage I or II and the SI classified 60% of cases in medium-low category. Variation from guidelines indications identified under and over treatments. The accuracy of the SI to predict under-treatment was relatively good (58% of all procedures classified as under-treatment using pT where also classified as such using SI), and even greater predicting over-treatment (88.2% of all procedures classified as over treatment using pT where also classified as such using SI). Agreement between clinical chart and hospital discharge reports was K = 0.35. CONCLUSION: Our findings suggest that administrative data need to be used with caution when evaluating surgical appropriateness, mainly because of the limited ability of SI to predict tumor size and the questionable quality of HIS data as observed in other studies

Filosofías de la persona : tres visiones

Resumen: Las filosofías de la persona ocupan un lugar central en el pensamiento contemporáneo. Nacen como reacciones contra el reduccionismo positivista, contra el formalismo neokantiano y contra el relativismo historicista, y se proyectan ampliamente en la filosofía actual. Hay corrientes personalistas religiosas y no religiosas y, entre las primeras, cristianas y judías. Para esta presentación hemos escogido tres momentos de la noción de persona que consideramos especialmente relevantes porque contienen nociones nucleares que han repercutido en el pensamiento posterior: 1. La unidad integral entre cuerpo y subjetividad, es decir, la encarnación de la persona (Edmund Husserl), 2. La relación entre el cuerpo y el espíritu, tanto finito como infinito, es decir, la trascendencia de la persona (Edith Stein) y, 3. La intolerancia como negación de la persona ejemplificada con la crítica a las teorías revolucionarias (Albert Camus). En el primer caso se trata de un personalismo enraizado en una revalorización del cuerpo propio, en el segundo, de un personalismo cristiano que subraya la trascendencia y, en el tercero, de un personalismo ateo que converge sin embargo con los otros dos por la vía del rechazo a las posturas que niegan la persona

Indicators of breast cancer severity and appropriateness of surgery based on hospital administrative data in the Lazio Region, Italy-0

<p><b>Copyright information:</b></p><p>Taken from "Indicators of breast cancer severity and appropriateness of surgery based on hospital administrative data in the Lazio Region, Italy"</p><p>BMC Public Health 2006;6():25-25.</p><p>Published online 7 Feb 2006</p><p>PMCID:PMC1420286.</p><p>Copyright © 2006 Schifano et al; licensee BioMed Central Ltd.</p

I miei spaesati studenti

studenti stranieri universitari in scambio durante il periodo del covid Venezia lockdow