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  • 1
    Online Resource
    Online Resource
    Evaluating Consensus Among Physicians in Medical Knowledge Base Construction
    Georg Thieme Verlag KG ; 1993
    In:  Methods of Information in Medicine Vol. 32, No. 02 ( 1993), p. 137-145
    Details
    In: Methods of Information in Medicine, Georg Thieme Verlag KG, Vol. 32, No. 02 ( 1993), p. 137-145
    Abstract: This study evaluates inter-author variability in knowledge base construction. Seven board-certified internists independently profiled “acute perinephric abscess”, using as reference material a set of 109 peer-reviewed articles. Each participant created a list of findings associated with the disease, estimated the predictive value and sensitivity of each finding, and assessed the pertinence of each article for making each judgment. Agreement in finding selection was significantly different from chance: seven, six, and five participants selected the same finding 78.6, 9.8, and 1.6 times more often than predicted by chance. Findings with the highest sensitivity were most likely to be included by all participants. The selection of supporting evidence from the medical literature was significantly related to each physician’s agreement with the majority. The study shows that, with appropriate guidance, physicians can reproducibly extract information from the medical literature, and thus established a foundation for multi-author knowledge base construction.
    Type of Medium: Online Resource
    ISSN: 0026-1270 , 2511-705X
    URL: Article
    DOI: 10.1055/s-0038-1634907
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 1993
    detail.hit.zdb_id: 3500-2
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  • 2
    Online Resource
    Online Resource
    Use of hematopoietic colony-stimulating factors: the American Society of Clinical Oncology survey. The Health Services Research Committee of the American Society of Clinical Oncology.
    American Society of Clinical Oncology (ASCO) ; 1996
    In:  Journal of Clinical Oncology Vol. 14, No. 9 ( 1996-09), p. 2511-2520
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 14, No. 9 ( 1996-09), p. 2511-2520
    Abstract: Dissemination of use of the hematopoietic colony-stimulating factors (CSFs) is unprecedented in oncology, with almost all physicians having experience with granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) shortly after the drugs received Food and Drug Administration (FDA) approval in 1991. The American Society of Clinical Oncology (ASCO) Health Services Research Committee sought to assess patterns of use of CSFs before dissemination of its first-ever publication of ASCO guidelines. METHODS A questionnaire describing clinical scenarios was mailed to American oncologists and hematologists who practice medical oncology. In each scenario, the physician was asked whether he would prefer to use a CSF to prevent or treat neutropenia. RESULTS The response rate to the mailed survey was 49% (N = 475). Most physicians preferred to use CSFs for secondary prophylaxis in patients receiving chemotherapy at rates of 44% to 85%, rather than reduce doses. Patterns of use did not differ for palliative, curative, or adjuvant chemotherapy. While the majority of CSF patterns of care were similar to those recommended in the ASCO guidelines, more than half of the physicians chose to use CSFs in the treatment of febrile neutropenia, an area not supported in the subsequent guidelines. In general, physicians at academic medical centers and in Health Maintenance Organization (HMO) practices were more likely to prefer dose-reduction strategies over addition of CSFs, while fee-for-service physicians preferred the opposite strategies. CONCLUSION Variations in CSF preferences for use were related to differences in clinical characteristics (history of afebrile v febrile neutropenia), drug characteristics (G-CSF or GM-CSF), and physician practice characteristics (HMO or fee-for-service setting). However, before dissemination of the guidelines, the majority of American oncologists preferred strategies that were subsequently included in the ASCO CSF guidelines. CSF guidelines would be most likely to reduce CSF use for treatment of afebrile and uncomplicated febrile neutropenia.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1996.14.9.2511
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1996
    detail.hit.zdb_id: 2005181-5
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  • 3
    Online Resource
    Online Resource
    General discussion
    Royal Society of Chemistry (RSC) ; 1993
    In:  Faraday Discussions Vol. 95 ( 1993), p. 253-
    Details
    In: Faraday Discussions, Royal Society of Chemistry (RSC), Vol. 95 ( 1993), p. 253-
    Type of Medium: Online Resource
    ISSN: 1359-6640 , 1364-5498
    URL: Article
    DOI: 10.1039/fd9939500253
    Language: English
    Publisher: Royal Society of Chemistry (RSC)
    Publication Date: 1993
    detail.hit.zdb_id: 1472891-6
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  • 4
    Online Resource
    Online Resource
    Free-riding and the prisoner's dilemma: problems in funding economic analyses of phase III cancer clinical trials.
    American Society of Clinical Oncology (ASCO) ; 1995
    In:  Journal of Clinical Oncology Vol. 13, No. 9 ( 1995-09), p. 2457-2463
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 13, No. 9 ( 1995-09), p. 2457-2463
    Abstract: Both economic and clinical data on new agents are important to policy-makers who approve pharmaceuticals for widespread use. Randomized clinical trials have been used to evaluate both clinical results and total medical costs associated with new agents. With new expensive pharmaceutical agents, early assessments of economic benefit have taken on greater importance to physicians and patients. Who should provide financial support to these integrated economic and clinical analyses in clinical trials? Here we describe issues that hinder funding of economic analyses and propose potential support mechanisms. RESULTS The Cancer and Leukemia Group B (CALGB), a large, national cooperative group of academic and community hospitals in the United States, designed a non-small-cell lung cancer (NSCLC) treatment trial to compare two widely used supportive care regimens that varied 20-fold in cost. One important objective of this trial was to compare the cost-effectiveness of the two regimens. While funding for the clinical trial was supported by grants from the National Cancer Institute and the pharmaceutical companies involved in the trial, no specific funding agency was willing and/or able to provide financial support for the economic analyses. After 2 years of planning, the clinical trial was retracted when the funding for the economic analyses could not be secured. The prisoner's dilemma, individual reluctance to support a common social good, explains the lack of funding. CONCLUSION Economic theory predicts difficulties in evaluating cost-effectiveness of new pharmaceuticals and reluctance to support economic analyses of clinical trials. Economic analyses will require new sources of funds that will not take scarce resources from clinical trials groups. Options for funding include a new federal agency, coordinated work by existing agencies, or academic centers for economic analysis.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1995.13.9.2457
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1995
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    NCCN Task Force Report: Positron Emission Tomography (PET)/Computed Tomography (CT) Scanning in Cancer
    Harborside Press, LLC ; 2007
    In:  Journal of the National Comprehensive Cancer Network Vol. 5, No. S1 ( 2007-05), p. S-1-S-22
    Details
    In: Journal of the National Comprehensive Cancer Network, Harborside Press, LLC, Vol. 5, No. S1 ( 2007-05), p. S-1-S-22
    Abstract: The use of positron emission tomography (PET) is increasing rapidly in the United States, with the most common use of PET scanning related to oncology. It is especially useful in the staging and management of lymphoma, lung cancer, and colorectal cancer, according to a panel of expert radiologists, surgeons, radiation oncologists, nuclear medicine physicians, medical oncologists, and general internists convened in November 2006 by the National Comprehensive Cancer Network. The Task Force was charged with reviewing existing data and developing clinical recommendations for the use of PET scans in the evaluation and management of breast cancer, colon cancer, non-small cell lung cancer, and lymphoma. This report summarizes the proceedings of this meeting, including discussions of the background of PET, possible future developments, and the role of PET in oncology. ( JNCCN 2007;5(Suppl 1):S1–S22)
    Type of Medium: Online Resource
    ISSN: 1540-1405 , 1540-1413
    URL: Article
    DOI: 10.6004/jnccn.2007.2001
    Language: Unknown
    Publisher: Harborside Press, LLC
    Publication Date: 2007
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  • 6
    Online Resource
    Online Resource
    The National Oncologic PET Registry (NOPR): Design and Analysis Plan
    Society of Nuclear Medicine ; 2007
    In:  Journal of Nuclear Medicine Vol. 48, No. 11 ( 2007-11-01), p. 1901-1908
    Details
    In: Journal of Nuclear Medicine, Society of Nuclear Medicine, Vol. 48, No. 11 ( 2007-11-01), p. 1901-1908
    Type of Medium: Online Resource
    ISSN: 0161-5505
    URL: Article
    DOI: 10.2967/jnumed.107.043687
    RVK:
    XA 55300
    Language: English
    Publisher: Society of Nuclear Medicine
    Publication Date: 2007
    detail.hit.zdb_id: 2040222-3
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  • 7
    Online Resource
    Online Resource
    Decision analysis in non-small-cell lung cancer: not back to the drawing modeling board, back to the bedside.
    American Society of Clinical Oncology (ASCO) ; 1997
    In:  Journal of Clinical Oncology Vol. 15, No. 3 ( 1997-03), p. 870-872
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 15, No. 3 ( 1997-03), p. 870-872
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1997.15.3.870
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1997
    detail.hit.zdb_id: 2005181-5
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  • 8
    Online Resource
    Online Resource
    Economic analysis of adjuvant interferon alfa-2b in high-risk melanoma based on projections from Eastern Cooperative Oncology Group 1684.
    American Society of Clinical Oncology (ASCO) ; 1997
    In:  Journal of Clinical Oncology Vol. 15, No. 6 ( 1997-06), p. 2351-2358
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 15, No. 6 ( 1997-06), p. 2351-2358
    Abstract: Interferon alfa-2b (IFN) in a randomized clinical trial (E1684) prolonged relapse-free and total survival in high-risk resected melanoma. However, the costs and toxicities of IFN are barriers to its widespread use. This study was undertaken to analyze the projected costs and long-term benefits of IFN by combining prospectively collected data on IFN actual dosage, time of recurrence, and survival with secondary data on long-term melanoma recurrence risks to project the cost-effectiveness of adjuvant IFN compared with observation. PATIENTS AND METHODS Two hypothetical cohorts of 50-year-old melanoma patients whose mean IFN dosage and clinical results were directly taken from E1684 were included in the study. Melanoma recurrence risks beyond 5 years were derived from international databases. Melanoma recurrence care costs and quality-of-life adjustments, when considered, were based on expert consensus. End points were incremental costs, life-years gained, and cost per life-year gained with and without quality-of-life adjustments. RESULTS The IFN cohort was projected to have an increased (undiscounted) survival of 0.52 years at 7 years and 1.90 years over a lifetime. The projected incremental cost (in 1996 United States dollars) per life-year gained in the IFN cohort ranged from $13,700 after 35 years to $32,600 at 7 years, the median follow-up of E1684. Using assigned quality-of-life values for IFN and recurrence, the lifetime cost per quality adjusted life-year increased to $15,200. Even if treatment costs for recurrence were excluded, the lifetime incremental cost per life-year gained was $21,600. CONCLUSION The cost and toxicity of IFN must be balanced against its projected benefits in high-risk melanoma. The derived cost-effectiveness and cost-utility ratios for IFN were comparable to other cancer interventions for which cost-effectiveness analysis has been performed.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1997.15.6.2351
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1997
    detail.hit.zdb_id: 2005181-5
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  • 9
    Online Resource
    Online Resource
    Cost-effectiveness of routine radiation therapy following conservative surgery for early-stage breast cancer.
    American Society of Clinical Oncology (ASCO) ; 1998
    In:  Journal of Clinical Oncology Vol. 16, No. 3 ( 1998-03), p. 1022-1029
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 16, No. 3 ( 1998-03), p. 1022-1029
    Abstract: To examine the cost-effectiveness of radiation therapy following conservative surgery for early-stage breast cancer. METHODS Using a Markov model, a cost-utility analysis was performed to compare a strategy of radiation therapy versus no radiation therapy in a hypothetical cohort of 60-year-old women following conservative surgery. Local recurrence, distant recurrence, and survival rates used in the model were derived from randomized trial data. Utilities for the nonmetastatic health states were collected from actual patients. Direct medical costs were estimated using data from a single institution. Transportation and time costs were also estimated. Years of life, quality-adjusted life-years (QALYs), costs, and incremental cost/QALY over a 10-year time horizon were calculated by the model for each strategy. RESULTS The addition of radiation therapy results in a cost increase of $9,800 per patient, no change in life expectancy, and an increase of 0.35 QALYs per patient, which leads to an incremental cost-effectiveness ratio of $28,000/QALY, which is well below $50,000/QALY, a commonly cited threshold for cost-effective care. Sensitivity analysis shows the ratio to be heavily influenced by the cost of radiation therapy and the quality-of-life benefit that results from decreased risk of local recurrence. CONCLUSION Radiation therapy following conservative surgery is cost-effective compared with other accepted medical interventions. This study illustrates the importance of considering an intervention's effect on quality of life, as well as survival in defining cost-effectiveness.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.1998.16.3.1022
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 1998
    detail.hit.zdb_id: 2005181-5
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  • 10
    Online Resource
    Online Resource
    An evaluation of the risk/benefit ratio of low molecular weight heparin to reduce the high risk of venous thromboembolism in acute leukemia.
    American Society of Clinical Oncology (ASCO) ; 2011
    In:  Journal of Clinical Oncology Vol. 29, No. 15_suppl ( 2011-05-20), p. 6566-6566
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 29, No. 15_suppl ( 2011-05-20), p. 6566-6566
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2011.29.15_suppl.6566
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2011
    detail.hit.zdb_id: 2005181-5
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