50 research outputs found

    Physician-Sponsored Managed Care Networks: Two Suggestions for Antitrust Reform

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    Transfer of Venue in Adulteration Seizures under the Flood, Drug, and Cosmetic Act

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    Law of Advertising

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    Physician-Sponsored Managed Care Networks: Two Suggestions for Antitrust Reform

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    Contextual information and assessor characteristics in complex question answering

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    The ciqa track investigates the role of interaction in answering complex questions: questions that relate two or more entities by some specified relationship. In our submission to the first ciqa track we were interested in the interplay between groups of variables: variables describing the question creators, the questions asked and the presentation of answers to the questions. We used two interaction forms - html questionnaires completed before answer assessment - to gain contextual information from the answer assessors to better understand what factors influence assessors when judging retrieved answers to complex questions. Our results indicate the importance of understanding the assessor's personal relationship to the question - their existing topical knowledge for example - and also the presentation of the answers - contextual information about the answer to aid in the assessment of the answer

    Intra-assessor consistency in question answering

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    In this paper we investigate the consistency of answer assessment in a complex question answering task examining features of assessor consistency, types of answers and question type

    Head to head comparisons of two modalities of perfusion adenosine stress echocardiography with simultaneous SPECT

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    <p>Abstract</p> <p>Background</p> <p>Real-time perfusion (RTP) contrast echocardiography can be used during adenosine stress echocardiography (ASE) to evaluate myocardial ischemia. We compared two different types of RTP power modulation techniques, angiomode (AM) and high-resolution grayscale (HR), with <sup>99m</sup>Tc-tetrofosmin single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia.</p> <p>Methods</p> <p>Patients with known or suspected coronary artery disease (CAD), admitted to SPECT, were prospectively invited to participate. Patients underwent RTP imaging (SONOS 5500) using AM and HR during Sonovue<sup>® </sup>infusion, before and throughout the adenosine stress, also used for SPECT. Analysis of myocardial perfusion and wall motion by RTP-ASE were done for AM and HR at different time points, blinded to one another and to SPECT. Each segment was attributed to one of the three main coronary vessel areas of interest.</p> <p>Results</p> <p>In 50 patients, 150 coronary areas were analyzed by SPECT and RTP-ASE AM and HR. SPECT showed evidence of ischemia in 13 out of 50 patients. There was no significant difference between AM and HR in detecting ischemia (p = 0.08). The agreement for AM and HR, compared to SPECT, was 93% and 96%, with Kappa values of 0.67 and 0.75, respectively (p < 0.001).</p> <p>Conclusion</p> <p>There was no significant difference between AM and HR in correctly detecting myocardial ischemia as judged by SPECT. This suggests that different types of RTP modalities give comparable data during RTP-ASE in patients with known or suspected CAD.</p

    Quantitative detection of myocardial ischaemia by stress echocardiography; a comparison with SPECT

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    <p>Abstract</p> <p>Aims</p> <p>Real-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique angio-mode (AM), provides images for off-line perfusion quantification using Qontrast<sup>® </sup>software, generating values of peak signal intensity (A), myocardial blood flow velocity (β) and myocardial blood flow (Axβ). By comparing rest and stress values, their respective reserve values (A-r, β-r, Axβ-r) are generated. We evaluated myocardial ischaemia by RTP-ASE Qontrast<sup>® </sup>quantification, compared to visual perfusion evaluation with <sup>99m</sup>Tc-tetrofosmin single-photon emission computed tomography (SPECT).</p> <p>Methods and Results</p> <p>Patients admitted to SPECT underwent RTP-ASE (SONOS 5500) using AM during Sonovue<sup>® </sup>infusion, before and throughout adenosine stress, also used for SPECT. Visual myocardial perfusion and wall motion analysis, and Qontrast<sup>® </sup>quantification, were blindly compared to one another and to SPECT, at different time points off-line.</p> <p>We analyzed 201 coronary territories (left anterior descendent [LAD], left circumflex [LCx] and right coronary [RCA] artery territories) in 67 patients. SPECT showed ischaemia in 18 patients and 19 territories. Receiver operator characteristics and kappa values showed significant agreement with SPECT only for β-r and Axβ-r in all segments: area under the curve 0.678 and 0.665; P < 0.001 and < 0.01, respectively. The closest agreements were seen in the LAD territory: kappa 0.442 for both β-r and Axβ-r; P < 0.01. Visual evaluation of ischaemia showed good agreement with SPECT: accuracy 93%; kappa 0.67; P < 0.001; without non-interpretable territories.</p> <p>Conclusion</p> <p>In this agreement study with SPECT, RTP-ASE Qontrast<sup>® </sup>quantification of myocardial ischaemia was less accurate and less feasible than visual evaluation and needs further development to be clinically useful.</p
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