Case-based exercises fail to improve medical students' information management skills: a controlled trial

BACKGROUND: Tomorrow's physicians must learn to access, retrieve, integrate and apply current information into ambulatory patient encounters, yet few medical schools teach 'real time' information management. METHODS: We compared two groups of clerkship students' information management skills using a standardized patient case. The intervention group participated in case-based discussions including exercises that required them to manage new information. The control group completed the same case discussions without information management exercises. RESULTS: After five weeks, there was no significant difference between the control and intervention groups' scores on the standardized patient case. However, third rotation students significantly outperformed first rotation students. CONCLUSION: Case-based exercises to teach information management failed to improve students' performance on a standardized patient case. Increased number of clinical rotations was associated with improved performance

Are decision trees a feasible knowledge representation to guide extraction of critical information from randomized controlled trial reports?

<p>Abstract</p> <p>Background</p> <p>This paper proposes the use of decision trees as the basis for automatically extracting information from published randomized controlled trial (RCT) reports. An exploratory analysis of RCT abstracts is undertaken to investigate the feasibility of using decision trees as a semantic structure. Quality-of-paper measures are also examined.</p> <p>Methods</p> <p>A subset of 455 abstracts (randomly selected from a set of 7620 retrieved from Medline from 1998 – 2006) are examined for the quality of RCT reporting, the identifiability of RCTs from abstracts, and the completeness and complexity of RCT abstracts with respect to key decision tree elements. Abstracts were manually assigned to 6 sub-groups distinguishing whether they were primary RCTs versus other design types. For primary RCT studies, we analyzed and annotated the reporting of intervention comparison, population assignment and outcome values. To measure completeness, the frequencies by which complete intervention, population and outcome information are reported in abstracts were measured. A qualitative examination of the reporting language was conducted.</p> <p>Results</p> <p>Decision tree elements are manually identifiable in the majority of primary RCT abstracts. 73.8% of a random subset was primary studies with a single population assigned to two or more interventions. 68% of these primary RCT abstracts were structured. 63% contained pharmaceutical interventions. 84% reported the total number of study subjects. In a subset of 21 abstracts examined, 71% reported numerical outcome values.</p> <p>Conclusion</p> <p>The manual identifiability of decision tree elements in the abstract suggests that decision trees could be a suitable construct to guide machine summarisation of RCTs. The presence of decision tree elements could also act as an indicator for RCT report quality in terms of completeness and uniformity.</p

A predictive assessment of genetic correlations between traits in chickens using markers

International audienceAbstractBackgroundGenomic selection has been successfully implemented in plant and animal breeding programs to shorten generation intervals and accelerate genetic progress per unit of time. In practice, genomic selection can be used to improve several correlated traits simultaneously via multiple-trait prediction, which exploits correlations between traits. However, few studies have explored multiple-trait genomic selection. Our aim was to infer genetic correlations between three traits measured in broiler chickens by exploring kinship matrices based on a linear combination of measures of pedigree and marker-based relatedness. A predictive assessment was used to gauge genetic correlations.MethodsA multivariate genomic best linear unbiased prediction model was designed to combine information from pedigree and genome-wide markers in order to assess genetic correlations between three complex traits in chickens, i.e. body weight at 35 days of age (BW), ultrasound area of breast meat (BM) and hen-house egg production (HHP). A dataset with 1351 birds that were genotyped with the 600 K Affymetrix platform was used. A kinship kernel (K) was constructed as K = λG + (1 − λ)A, where A is the numerator relationship matrix, measuring pedigree-based relatedness, and G is a genomic relationship matrix. The weight (λ) assigned to each source of information varied over the grid λ = (0, 0.2, 0.4, 0.6, 0.8, 1). Maximum likelihood estimates of heritability and genetic correlations were obtained at each λ, and the “optimum” λ was determined using cross-validation.ResultsEstimates of genetic correlations were affected by the weight placed on the source of information used to build K. For example, the genetic correlation between BW–HHP and BM–HHP changed markedly when λ varied from 0 (only A used for measuring relatedness) to 1 (only genomic information used). As λ increased, predictive correlations (correlation between observed phenotypes and predicted breeding values) increased and mean-squared predictive error decreased. However, the improvement in predictive ability was not monotonic, with an optimum found at some 0 < λ < 1, i.e., when both sources of information were used together.ConclusionsOur findings indicate that multiple-trait prediction may benefit from combining pedigree and marker information. Also, it appeared that expected correlated responses to selection computed from standard theory may differ from realized responses. The predictive assessment provided a metric for performance evaluation as well as a means for expressing uncertainty of outcomes of multiple-trait selection

The effect of profiling report on antibiotic prescription for upper respiratory tract infection

Introduction: Upper respiratory tract infection (URTI) is a common encounter in primary care and mostly viral in origin. Despite frequent reminders to primary care providers on judicious use of antibiotics for URTI, the practice is still rampant. Methods: As part of quality improvement initiative, an intervention was designed by distributing a profiling report on individual prescriber’s performance in comparison to colleagues on usage of antibiotic for URTI. The data were generated from electronic health record in three public primary care clinics in Malaysia and emailing monthly throughout 2011 to all providers. Results: There were 22,328 consultations for URTI in 2010 and 22,756 in 2011 with the incidence rates of URTI among overall consultations of 15.7% and 15.9% respectively. 60 doctors and medical assistants had performed consultations during the 2 year period. Following the intervention in 2011, the prescription rate of antibiotic for URTI is significantly reduced from 33.5% in 2010 to 23.3 % in 2011. Before intervention, individual prescription rate varies from 9.7% to 88.9% and reduced to 4.3% to 50.5% after intervention. Conclusion: Profiling report is a potential method of changing antibiotic prescribing habit among public primary care providers in Malaysia especially if the baseline adherence was poor and higher variation of prescribing rate

Using PCR-SSCP technique to investigate polymorphism of leptin gene in Kermani sheep

شناسایی ژنهاي موثر بر تعادل انرژي، تولید شیر و مصرف خوراك از علاقهمنديهاي اخیر پژوهشگران اصلاح نژاداست. در ایران علی رغم وجود منابع غنی حیوانی، تلاشهاي اندکی براي شناسایی ژنهاي کنترل کنندهي صفات درآنها صورت گرفته است. بنابراین، شناسایی ژنهاي کاندیداي موثر بر صفات اقتصادي میتواند به اصلاح نژاد گوسفنددر کشور کمک شایانی نماید. در این تحقیق براي بررسی چند شکلی ژن لپتین از 120 رأس گوسفند نر و مادهي کرمانیایستگاه اصلاح نژاد شهر بابک خونگیري شد. پس از استخراج DNA با استفاده از کیت استخراج استاندارد، واکنشزنجیرهاي پلیمراز براي تکثیر قطعهي 275 جفت بازي از اگزون سوم این ژن انجام شد. پس از تعیین چند شکلی فضاییتکرشتهاي، محصولات PCR ،الگوهاي باندي مربوط به ژن لپتین با استفاده از ژل آکریل آمید و رنگ آمیزي نیترات،A/B/F ،A/B/E ،A/B/C ،A/C ،A/B ،C/C ،A/A الگوي 10 ،مطالعه مورد نمونهي در لپتین ژن براي. آمد بدست، نقرهF/C/A ،E/D/B/A وF/C/B/A بدست آمد که نشان دهندهي چندشکلی بالاي در ژن لپتین گوسفندان نژاد کرمانی می-باشد