Evaluation & the Health Professions current issue

Analyzing Longitudinal Data With the Linear Mixed Models Procedure in SPSS

West, B. T. — Tue, 25 Aug 2009 03:00:12 PDT

Many applied researchers analyzing longitudinal data share a common misconception: that specialized statistical software is necessary to fit hierarchical linear models (also known as linear mixed models [LMMs], or multilevel models) to longitudinal data sets. Although several specialized statistical software programs of high quality are available that allow researchers to fit these models to longitudinal data sets (e.g., HLM), rapid advances in general purpose statistical software packages have recently enabled analysts to fit these same models when using preferred packages that also enable other more common analyses. One of these general purpose statistical packages is SPSS, which includes a very flexible and powerful procedure for fitting LMMs to longitudinal data sets with continuous outcomes. This article aims to present readers with a practical discussion of how to analyze longitudinal data using the LMMs procedure in the SPSS statistical software package.

A Review of Software for Sample Size Determination

Dattalo, P. — Tue, 25 Aug 2009 03:00:12 PDT

The size of a sample is an important element in determining the statistical precision with which population values can be estimated. This article identifies and describes free and commercial programs for sample size determination. Programs are categorized as follows: (a) multiple procedure for sample size determination; (b) single procedure for sample size determination; and (c) Web-based. Programs are described in terms of (a) cost; (b) ease of use, including interface, operating system and hardware requirements, and availability of documentation and technical support; (c) file management, including input and output formats; and (d) analytical and graphical capabilities.

The Role of Education in Improving Physicians' Professional Use of Economic Evaluations of Health Interventions: Some Evidence From a Cross-Sectional Survey in Italy

Tue, 25 Aug 2009 03:00:12 PDT

A cross-sectional survey was carried out on a random sample of Italian physicians through a self-administered questionnaire to describe knowledge, attitudes, and professional behavior toward economic evaluations of health interventions. A response rate of 74.1% was achieved (760 questionnaires). Although many physicians show a positive attitude toward cost-minimization and, to a lesser extent, to cost-effectiveness analysis, they rated their methodological knowledge as unsatisfactory, and the professional use of the economic evaluations of the health interventions in clinical practice is quite low. Multiple logistic regression analysis showed that adequate knowledge and positive attitudes are associated with increased physicians’ use of health economic evaluations, as well as time dedicated to continuing medical education and previous training experience about health economics and management. Education and specific training may play an important role in promoting a more cost-conscious behavior of physicians.

The Relationship of Fennell Phases to Symptoms Among Patients With Chronic Fatigue Syndrome

Reynolds, N. L., Brown, M. M., Jason, L. A. — Tue, 25 Aug 2009 03:00:12 PDT

The Fennell Phase Inventory (FPI) is an instrument designed to measure phases of the illnesses known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The current study explored how the FPI was related to physical and psychological functioning as well as coping style. Based on FPI scores, 111 adults with ME/CFS were placed in one of three groups: crisis, stabilization, or resolution. Results showed that the crisis group demonstrated significantly worse functioning than at least one other group for depression, quality of life, mental functioning, anxiety, and self-efficacy; and utilized less adaptive coping styles. These results indicate that patients with ME/CFS who are in the crisis phase tend to experience more severe psychological and physical symptoms and utilize poorer coping strategies. Those in the resolution phase maintain the most adaptive coping strategies. Implications for these findings are discussed.

Medical Record Review Conduction Model for Improving Interrater Reliability of Abstracting Medical-Related Information

Engel, L., Henderson, C., Fergenbaum, J., Colantonio, A. — Tue, 25 Aug 2009 03:00:12 PDT

Medical record review (MRR) is often used in clinical research and evaluation, yet there is limited literature regarding best practices in conducting a MRR, and there are few studies reporting interrater reliability (IRR) from MRR data. The aim of this research was twofold: (a) to develop a MRR abstraction tool and standardize the MRR process and (b) to examine the IRR from MRR data. This study introduces the MRR-Conduction Model, which was used to implement a MRR, and examines the IRR between two abstractors who collected preinjury medical and psychiatric, incident-related medical and postinjury head symptom information from the medical records of 47 neurologically injured workers. Results showed that the percentage agreement was ≥85% and the unweighted statistic was ≥.60 for most variables, indicating substantial IRR. An effective and reliable MRR to abstract medical-related information requires planning and time. The MRR-Conduction Model is proposed to guide the process of creating a MRR.

Ethnocultural Empathy Among Students in Health Care Education

Rasoal, C., Jungert, T., Hau, S., Edvardsson Stiwne, E., Andersson, G. — Tue, 25 Aug 2009 03:00:12 PDT

In a multicultural society, ethnocultural empathy has become an important element in most health settings and development of this capacity has become a central component for health care professionals in their interactions with patients and clients. In this study, differences in basic empathy and ethnocultural empathy were explored in a sample of 365 undergraduate students at the beginning and end of four master’s programs in health care (medicine, psychology, nursing, and social work). Results showed that it was mainly psychology students in the first semester who had significantly higher general empathic skills and ethnocultural empathic skills compared to students in the other study programs. Few signs of differences between students in their first and in later semesters were obtained. The observed differences may be explained by (a) levels of admission grades and applications requirements or (b) different cultures and expectations from the surrounding milieus in the investigated study programs.

Bridging the Gap: Knowledge Seeking and Sharing in a Virtual Community of Emergency Practice

Curran, J. A., Murphy, A. L., Abidi, S. S. R., Sinclair, D., McGrath, P. J. — Tue, 25 Aug 2009 03:00:12 PDT

Disparities exist between rural and urban emergency departments with respect to knowledge resources such as online journals and clinical specialists. As knowledge is a critical element in the delivery of quality care, a web-based learning project was proposed to address the knowledge needs of emergency clinicians. One objective of this project was to evaluate the effectiveness of the online environment for knowledge exchange among rural and urban emergency clinicians. Descriptive and content analysis of the online discussion board revealed 202 postings with rural participants contributing the largest number of postings (75%; 152/202). Postings were used to establish a clinical presence (87/202), seek clinical information (52/202), and share clinical information (63/202). Postintervention survey results indicate that this modality introduced participants to new clinical experts and resources. The results provide direction for design of a virtual community of practice, which may reduce current knowledge resource disparities.