Abstract:
OBJECTIVES:This paper explores several critical assumptions and methodological issues arising in cost-effectiveness analyses of genetic screening strategies in the reproductive setting. METHODS:Seven issues that arose in the development of a decision analysis of alternative strategies for cystic fibrosis carrier screening are discussed. Each of these issues required a choice in technique. RESULTS:The presentations of these analyses frequently mask underlying assumptions and methodological choices. Often there is no best choice. In the case of genetic screening in the reproductive setting, these underlying issues often touch on deeply felt human values. CONCLUSIONS:Space limitations for published papers often preclude explaining such choices in detail; yet these decisions determine the way the results should be interpreted. Those who develop these analyses need to make sure that the implications of important assumptions are understood by the clinicians who will use them. At the same time, clinicians need to enhance their understanding of what these models truly mean and how they address underlying clinical, ethical, and economic issues.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Asch DA,Hershey JC,Pauly MV,Patton JP,Jedrziewski MK,Mennuti MTdoi
10.2105/ajph.86.5.684subject
Has Abstractpub_date
1996-05-01 00:00:00pages
684-90issue
5eissn
0090-0036issn
1541-0048journal_volume
86pub_type
杂志文章abstract:OBJECTIVES:We describe trends in occupational and nonoccupational injury among working-age adults in Ontario. METHODS:We conducted an observational study of adults aged 15 to 64 over the period 2004 through 2011, estimating the incidence of occupational and nonoccupational injury from emergency department (ED) records...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.302223
更新日期:2015-02-01 00:00:00
abstract::The geographic distribution of newborn human immunodeficiency virus seroprevalence at zip code level was compared with the distribution of four sociodemographic variables. For New York City significant univariate correlations were found between HIV and low birthweight, drug use (as measured by hospital discharges), ma...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.81.suppl.25
更新日期:1991-05-01 00:00:00
abstract::Approximately 90,000 inmates are admitted annually to the New York City jail system, many of whom require a high level of medical or mental health services. According to our analysis of deaths in custody from 2001 to 2009, crude death rates have dropped significantly despite the increasing age of the population. Falli...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.301042
更新日期:2013-04-01 00:00:00
abstract::Fifty-one infants born to women employed at two capacitor manufacturing facilities with a history of high exposure to polychlorinated biphenyls (PCBs) had a mean birthweight of 153 grams less than that of 337 infants born to women who had worked in low-exposure areas (90 per cent confidence interval, -286 to -20 g); m...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.74.10.1153
更新日期:1984-10-01 00:00:00
abstract::To determine whether differences exist in the performance of United States Medical Graduate (USMG) and Foreign Medical Graduate (FMG) House Staff physicians, inpatient hospital audits evaluating individual physician performance on patient histories and physical examinations were conducted in 14 Maryland and Pennsylvan...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.70.1.23
更新日期:1980-01-01 00:00:00
abstract::Assessments of the consequences of deinstitutionalization tend to focus primarily on observable changes in psychiatric services. Equally critical, and less often noted, are changes in the target population of deinstitutionalization that have accrued as the result of new service initiatives and changing loci of care. Y...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.74.4.382
更新日期:1984-04-01 00:00:00
abstract::In recent years, advocates for increasing access to medical and oral health care have argued for expanding the scope of practice of dentists and physicians. Although this idea may have merit, significant legal and other barriers stand in the way of allowing dentists to do more primary health care, physicians to do mor...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2015.302654
更新日期:2015-09-01 00:00:00
abstract::The Model State Emergency Health Powers Act became a contentious document in more than 30 states in 2001 and 2002. Controversy has focused on recommendations by the authors of the Model Act that seemed to accord higher priority to collective action in emergencies than to protecting privacy and property. This situation...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.93.3.397
更新日期:2003-03-01 00:00:00
abstract::Although community development and social change are not explicit goals of community-oriented primary care (COPC), they are implicit in COPC's emphasis on community organization and local participation with health professionals in the assessment of health problems. These goals are also implicit in the shared understan...
journal_title:American journal of public health
pub_type: 历史文章,杂志文章
doi:10.2105/ajph.92.11.1713
更新日期:2002-11-01 00:00:00
abstract::In 1999, a cluster of encephalitis cases was detected in New York City. The city applied larvicide to standing water and aerially sprayed pesticides to control adult mosquitoes. The causative agent was West Nile virus, a type of encephalitis that had never before been transmitted in the western hemisphere. This experi...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.92.8.1218
更新日期:2002-08-01 00:00:00
abstract::To develop a protocol for prevention of hepatitis B virus (HBV) transmission in Wisconsin prisons, we interviewed 619 male prisoners at incarceration to obtain information on hepatitis B risk factors. We defined previous infections by the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.75.10.1182
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVES:In this article the author describes public health advocacy and proposes a conceptual framework for understanding how it works. METHODS:The proposed framework incorporates the image of an assembly line. The public health advocacy assembly line produces changes in societal resource allocation that are necess...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.90.5.722
更新日期:2000-05-01 00:00:00
abstract::Electronic health records and electronic health information exchange are essential to improving quality of care, reducing medical errors and health disparities, and advancing the delivery of patient-centered medical care. In the US correctional setting, these goals are critical because of the high numbers of Americans...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301845
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:The authors examined Americans' opinions about financial and treatment competence of people with mental health problems, potential for harm to self or others, and the use of legal means to force treatment. METHODS:The 1996 General Social Survey provided interview data with a nationally representative sample...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.89.9.1339
更新日期:1999-09-01 00:00:00
abstract::In December 2008, the National Institutes of Health (NIH) sponsored the first NIH Summit showcasing its investment and contribution to health disparities research and unveiling a framework for moving this important field forward. The Summit, titled "The Science of Eliminating Health Disparities," drew on extensive exp...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2010.191619
更新日期:2010-04-01 00:00:00
abstract::A representative sample of women living in metropolitan Los Angeles were asked what they heard and what they believed about mammography and whether they would obtain a mammogram if their doctor advised it. Forty percent of these women said they had not heard of mammography even after the procedure was described. Few o...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.69.11.1172
更新日期:1979-11-01 00:00:00
abstract::Objectives. To determine the impact of city-level cannabis decriminalization and medical marijuana laws (MMLs) on fatal traffic crashes in US cities.Methods. Using a census of fatal traffic crashes from the 2010 to 2017 Fatality Analysis Reporting System, we examined MMLs and cannabis decriminalization on fatal crashe...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2019.305484
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:We compared admission rates, outcomes, and performance of the CURB-65 mortality prediction score of homeless patients and nonhomeless patients with community-acquired pneumonia (CAP). METHODS:We compared homeless (n = 172) and nonhomeless (n = 1897) patients presenting to a Salt Lake City, Utah, emergency d...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301342
更新日期:2013-12-01 00:00:00
abstract::Data System. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state-based surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. PRAMS is conducted by the Centers for Disease Control and Prevention's Division of Reproductive Health in col...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2018.304563
更新日期:2018-10-01 00:00:00
abstract::Secular changes in height and weight measurements were examined in five- to 14-year-olds from 1973 to 1984. The age-sex specific 85th percentile was used to classify persons as overweight (based on ponderal index; kg/m3). Secular increases in weight (2.5 kg), and ponderosity (0.5-0.7 kg/m3) were found. Gains in ponder...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.78.1.75
更新日期:1988-01-01 00:00:00
abstract::This study examined the prevalence and correlates of unprotected anal intercourse among 758 young African American men who have sex with men. A quarter of the sample reported unprotected anal intercourse in the past 3 months; nonsupportive peer norms and not carrying condoms predicted risky sexual behavior. Effective ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.94.7.1122
更新日期:2004-07-01 00:00:00
abstract::Compared with their heterosexual peers, sexual minority women (SMW; e.g., queer, bisexual, lesbian, pansexual) have an elevated risk for unintended pregnancy.A team of social science and clinical researchers qualitatively documented the multilevel pathways leading to this disparity, particularly the contexts of contra...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2019.305211
更新日期:2019-12-01 00:00:00
abstract::This study was designed to evaluate the effectiveness of a large scale program to improve health care for high-risk adolescents. Seven clinics, funded to provide comprehensive primary care to adolescents, were compared to three non-funded clinics. The majority of the 2,788 adolescent patients sampled in these clinics ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.79.8.999
更新日期:1989-08-01 00:00:00
abstract::Oral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs. "Health commons" sites are enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, and oral health services. Successful intervention require...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.98.supplement_1.s89
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:The reported prevalence of occupational allergy to natural rubber latex is 8% to 17%, and that of latex-induced occupational asthma is 2.5% to 6%. Conversion of medical facilities to "latex-safe" can reduce employee sensitization, impairment, and disability. The purpose of this study was to determine the cos...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.89.7.1024
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVES:Under an ecodevelopmental framework, we examined lifetime segmented assimilation trajectories (diverging assimilation pathways influenced by prior life conditions) and related them to quality-of-life indicators in a diverse sample of 258 men in the Phoenix, AZ, metropolitan area. METHODS:We used a growth mi...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2009.167999
更新日期:2010-04-01 00:00:00
abstract::Cancer mortality in Texas 1969-80 was 25 per cent lower among Mexican American males compared to other Whites; among females, rates were only 4 per cent lower. Reduced mortality was primarily a result of lower rates for cancers of the most common sites: lung, colon, breast and prostate. However, for cancers of the sto...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.77.7.851
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVES:To describe the cesarean rates in different child policy periods and assess the medical necessity of cesareans during the 2-child policy period. METHODS:We collected hospital-level aggregate data on 93 745 deliveries and individual-level data on 27 977 deliveries from 6 hospitals in the Hubei and Gansu prov...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2018.304868
更新日期:2019-03-01 00:00:00
abstract::US national elections, which draw sizable numbers of older voters, take place during flu-shot season and represent an untapped opportunity for large-scale delivery of vaccinations. In 2012, Vote & Vax deployed a total of 1585 clinics in 48 states; Washington, DC; Guam; Puerto Rico; and the US Virgin Islands. Approxima...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2015.302628
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVES:This study examined the association between 2 dimensions of adults' self-rated health and residential stability in childhood. METHODS:Using data from the nationally representative survey Midlife in the United States, I assessed the impact of neighborhood and family stability on positive perceptions of globa...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.93.7.1144
更新日期:2003-07-01 00:00:00