Mental Health and Substance Abuse Screening in Primary Care

ABSTRACT

An automated screening system for substance abuse and mental health problems was developed and implemented in a rural primary care clinic. Eighty-nine patients were assessed with this system. The incidence of identified problems, 35% in total, was consistent with that found in previous studies of patients in general and medical settings. Additionally, over half of the patients assessed felt at least some need for mental health or substance abuse treatment. Nonetheless, because of the staff's concerns over patient privacy, impeding patient flow, and the physician's perceived ability to adequately identify these problems without assistance, the system was not adopted.     

Errors in inspection and grading distributional aspects ofscreening and merarchal screening

Continuing the studies of Johnson et al (1980) and Johnson and Kotz (1981), further distributions arising from models of errors in inspection and grading of samples from finite, possibly stratified lots are obtained. Screening, and hierarchal screening forms of inspection are also considered, and the effects of errors on the advantages of these techniques assessed.     

上海地区干部健康体检胸部肿瘤的X线分析

目的回顾性分析1996年～2000年上海地区干部在我院健康体检胸部肿瘤的检出情况,探讨健康体检在早期发现胸部肿瘤的意义和方法。方法全部病例均经电视透视发现胸部异常阴影后,再摄取胸部正侧位片,并进一步进行各种检查初步明确诊断,经随访、手术及病理证实。结果被检出的160例胸部肿瘤中,肺恶性肿瘤87例,肺良性肿瘤23例,纵膈肿瘤45例,胸壁横膈肿瘤5例。67例周围型肺癌平均瘤体直径2.2cm,≤2cm的早期肺癌38例占56.72%。在电视透视发现的67例周围型肺癌和45例纵膈肿瘤中,分别有25例(37.31%)和21例(46.67%)在胸部平片中不能显示。结论定期胸部健康体检是早期发现胸部肿瘤的主要方法,在干部保健工作中有重要意义。胸部电视透视是健康体检早期发现胸部肿瘤的重要手段,采用肿瘤追踪筛查方法能有效地提高肺部肿瘤检出率。     

Supersaturated design including an orthogonal base

Recently, many supersaturated designs have been proposed. A supersaturated design is a fractional factorial design in which the number of factors is greater than the number of experimental runs. The main thrust of the previous studies has been to generate more columns while avoiding large values of squared inner products among all design columns. These designs would be appropriate if the probability for each factor being active is uniformly distributed. When factors can be partitioned into two groups, namely, with high and low probabilities of each factor being active, it is desirable to maintain orthogonality among columns to be assigned to the factors in the high-probability group. We discuss a supersaturated design including an orthogonal base which is suitable for this common situation. Mathematical results on the existence of the supersaturated designs are shown, and the construction of supersaturated designs is presented. We next discuss some properties of the proposed supersaturated designs based on the squared inner products.     

Effects of Risk and Time Preference and Expected Longevity on Demand for Medical Tests

Despite their conceptual importance, the effects of time preference, expected longevity, uncertainty, and risk aversion on behavior have not been analyzed empirically. We use data from the Health and Retirement Study (HRS) to assess the role of risk and time preference, expected longevity, and education on demand for three measures used for early detection of breast and cervical cancer—regular breast self-exams, mammograms, and Pap smears. We find that individuals with a higher life expectancy and lower time preference are more likely to undergo cancer screening. Less risk averse individuals tend to be more likely to undergo testing.     

Bayesian incorporation of repeated measurements in logistic discrimination

A common problem in medical statistics is the discrimination between two groups on the basis of diagnostic information. Information on patient characteristics is used to classify individuals into one of two groups: diseased or disease-free. This classification is often with respect to a particular disease. This discrimination has two probabilistic components: (1) the discrimination is not without error, and (2) in many cases the a priori chance of disease can be estimated. Logistic models (Cox 1970; Anderson 1972) provide methods for incorporating both of these components. The a posteriori probability of disease may be estimated for a patient on the basis of both current measurement of patient characteristics and prior information. The parameters of the logistic model may be estimated on the basis of a calibration trial. In practice, not one but several sets of measurements of one characteristic of the patient may be made on a questionable case. These measurements typically are correlated; they are far from independent. How should these correlated measurements be used? This paper presents a method for incorporating several sets of measurements in the classification of a case.     

Analysis of Revenue Maximization Under Two Movie‐Screening Policies

A few weeks before the start of a major season, movie distributors arrange a private screening of the movies to be released during that season for exhibitors and, subsequently, solicit bids for these movies (from exhibitors). Since the number of such solicitations far exceeds the number of movies that can be feasibly screened at a multiplex (i.e., a theater with multiple screens), the problem of interest for an exhibitor is that of choosing a subset of movies for which to submit bids to the distributors. We consider the problem of the selection and screening of movies for a multiplex to maximize the exhibitor's cumulative revenue over a fixed planning horizon. The release times of the movies that can potentially be selected during the planning horizon are known a priori. If selected for screening, a movie must be scheduled through its obligatory period, after which its run may or may not be extended. The problem involves two primary decisions: (i) the selection of a subset of movies for screening from those that can potentially be screened during the planning horizon and (ii) the determination of the duration of screening for the selected movies. We investigate two basic and popular screening policies: preempt‐resume and non‐preempt. In the preempt‐resume policy, the screening of a movie can be preempted and resumed in its post‐obligatory period. In the non‐preempt policy, a movie is screened continuously from its release time until the time it is permanently withdrawn from the multiplex. We show that optimizing under the preempt‐resume policy is strongly NP‐hard while the problem under the non‐preempt policy is polynomially solvable. We develop efficient algorithms for the problem under both screening policies and show that the revenue obtained from the preempt‐resume policy can be significantly higher as compared with that from the non‐preempt policy. Our work provides managers of multiplexes with valuable insights into the selection and screening of movies and offers an easy‐to‐use computational tool to compare the revenues obtainable from adopting these popular policies.     

A comparison of random balance and two-stage group screening designs: A case study

In this paper we focus on the problem of supersaturated (fewer runs than factors) screening experiments. We consider two major types of designs which have been proposed in this situ¬ation: random balance and two-stage group screening. We discuss the relative merits and demerits of each strategy. In addition, we compare the performance of these strategies by means of a case study in which 100 factors are screened in 20,42,62, and 84 runs.