Browsing by Subject "management"
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Item A Pragmatic Work Flow for Manual Medical Chart Review: A Systematic Literature Review(2014-12-01) Qiu, Taoran; Patricia A. Gwirtz; Kunlin JinThere has been a lack of detailed description of the manual medical chart review process with standardized steps for data abstraction. The aim of this practicum thesis is to develop a pragmatic and systematic work flow for the manual reviewing of medical records. The thesis is conducted by systematically reviewing publications from the last twenty years. The end product of this practicum report is series of twelve steps work flow for manual medical data abstraction.Item An Evaluation of Muscle Biopsies in a Managed Care Organization(2001-05-01) Saad, Jill Moore; S. Dan Dimitrijevich; Roderick HookerSaad, Jill Moore., An Evaluation of Muscle Biopsies in a Managed Care Organization. Master of Science (Biomedical Sciences), May 2001, 16 pp., 7 illustrations, Reference List, 17 titles. Objective: The goal of this study was to assess the use of the percutaneous muscle biopsy in diagnosing inflammatory muscle diseases and to examine the benefit of centralizing inflammatory myopathies under one department-rheumatology-within a large health maintenance organization. Methods: A retrospective review of 363 muscle biopsies and histopathology reports, spanning 25 years, formed the basis of this study. The databases used in this study were the medical record, an institutional rheumatology registry, and histopathology reports. Cytoarchitectural abnormalities, necrosis and regeneration formed the basis of muscle disease classification. The histopathology findings were interpreted against the patient’s clinical history, examination, and clinical tests to develop a final diagnosis. Results: Rheumatologists in this location performed two-thirds of the biopsies percutaneously using an intervertebral rongeur and surgeons performed one-third open biopsies. Over time open biopsies were phased out due to preference for the percutaneous method. The average age of all muscle biopsy patients was 45 (3 months to 88 years old) and 55% were male. Polymyositis was the most frequently identified myositis (62%), followed by dermatomyositis (19%), and inclusion body myositis (7%). Conclusion: The use of percutaneous muscle biopsies using an intervertebral rongeur is the method of choice because of convenience, quality of specimen, low morbidity, and limited discomfort. Centralizing inflammatory muscle diseases within one organization contributes to the efficiency and effectiveness of inflammatory muscle disease management.Item Asthma Outcomes of Children in a Pediatric Asthma Program: A Comparison of Outcomes Among Publicly and Privately Insured Participants(2010-05-01) Crowther, Anne E.; Reyes-Ortiz, CarlosThis study was a secondary analysis of the Asthma Management Program at Children’s Medical Center. The evaluation of outcomes of the six month program includes participants enrolled between June 2001 and August 2009 (n= 472). The program consisted of biweekly telephonic education and two home visits. In the bivariate analyses, privately insured children had significant lower means for emergency room visits, unscheduled clinic visits, and missed school days compared to those with public insurance (all p [less than] .05). All four asthma control outcomes improved from baseline to the 6 month followup (all p [less than] .001). In the multivariate longitudinal analyses, private insurance predicted lower number of emergency room consultations (beta 0.022, p [less than] .001) during the program.