Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-19T15:36:26.827Z Has data issue: false hasContentIssue false

Becoming More Efficient at Outcomes Research

Published online by Cambridge University Press:  10 March 2009

Leslie L. Roos
Affiliation:
University of Manitoba
Sandra M. Sharp
Affiliation:
University of Manitoba

Extract

This paper discusses several practical problems in research design: Is it worth doing a relatively “quick and dirty” study or is a more thorough study using all available infotmation necessary? All the desired information may either not be available or be time-consuming to collect. What are the likely biases in going ahead and doing the research with the data base “in hand”? Such issues are important because of the limited resources for technology assessment (in terms of money, number of researchers, and research interest) and the great number of unstudies technologies.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Abrams, H. B., Detsky, A. S., Roos, L. L., & Wajda, A.Is there a role for surgery in the acute management of infective endocarditis? A decision analysis and medical data base approach. Medical Decision Making, 1988, 8, 165–74.CrossRefGoogle Scholar
2. Andersen, T. F.Editorial: transnational collaboration in outcome research. International Newsletter on Regional Variations in Health Care, 1987, 4, 1.Google Scholar
3. Blumberg, M. S.Comments on HCFA hospital death rate statistical outliers. Health Services Research, 1987, 21, 716–39.Google ScholarPubMed
4. Brown, B. W.Statistical controversies in the design of clinical trials: Personal views. Controlled Clinical Trials, 1980, 2, 1327.CrossRefGoogle Scholar
5. Chipperfield, J. G., Roos, L. L., & Lyttle, D. Total knee replacement surgery in Manitoba: 1979–1984. Unpublished, 1988.Google Scholar
6. Collins, R., Yusuf, S., & Peto, R.Overview of randomized trials of diuretics in pregnancy. British Medical Journal, 1985, 290, 1723.CrossRefGoogle ScholarPubMed
7. Detsky, A. S.Using economic analysis to determine the resource consequences of choices made in planning clinical trials. Journal of Chronic Diseases, 1985, 38, 753–65.CrossRefGoogle ScholarPubMed
8. Evans, R. G.Strained mercy: The economics of Canadian health care. Toronto: Butterworths, 1984.Google Scholar
9. Feinleib, M.Data bases, data banks and data dredging: The agony and the ecstasy. Journal of Chronic Diseases, 1984, 37, 783–90.CrossRefGoogle ScholarPubMed
10. Fetter, R. B., & Freeman, J. L.Diagnosis related groups: Product line management within hospitals. Academy of Management Review, 1986; 11, 4154.CrossRefGoogle ScholarPubMed
11. Institute of Medicine. Assessing medical technologies. Washington, DC: National Academy Press, 1985.Google Scholar
12. Klingman, D., Pine, P., & Simon, J. Outcomes of surgery among Medicaid recipients in Georgia and Michigan, 1981–1982. Unpublished, 1988.Google Scholar
13. Kosecoff, J., Fink, A., Brook, R. H., & Chassin, M. R.The appropriateness of using a medical procedure: Is information in the medical record valid? Medical Care, 1987, 25, 196201.CrossRefGoogle Scholar
14. Luft, H. S., Bunker, J. P., & Enthoven, A. C.Should operations be regionalized? The empirical relation between surgical volume and mortality. New England Journal of Medicine, 1979, 301, 1364–69.CrossRefGoogle ScholarPubMed
15. Luft, H. S., & Hunt, S. S.Evaluating individual hospital quality through outcome statistics. Journal of the American Medical Association, 1986, 255, 2780–84.CrossRefGoogle ScholarPubMed
16. Maerki, S. C., Luft, H. S., & Hunt, S. S.Selecting categories of patients for regionalization: Implications of the relationship between volume and outcome. Medical Care, 1986, 24, 148–58.CrossRefGoogle ScholarPubMed
17. McCarthy, K. F.The elderly population's changing spatial distribution – Patterns of change since 1960. R-3240/2, Santa Monica, CA: The Rand Corporation, 1983.Google Scholar
18. McSherry, C. K.Quality assurance: The cost of utilization review and the educational value of medical audit in a university hospital. Surgery, 1976, 80, 122–29.Google ScholarPubMed
19. Neuhauser, D. Cost-effective clinical decision-making implications for the delivery of health services. In Bunker, J. P., Barnes, B. A., & Mosteller, F. (eds.), Costs, risks, and benefits of surgery. New York: Oxford University Press, 1977, 2839.Google Scholar
20. Roos, L. L., Cageorge, S. M., Austen, E., & Lohr, K. N.Using computers to identify complications after surgery. American Journal of Public Health, 1985, 75, 1288–95.CrossRefGoogle ScholarPubMed
21. Roos, L. L., Cageorge, S. M., Roos, N. P., & Danzinger, R. G.Centralization, certification, and monitoring: Readmissions and complications after surgery. Medical Care, 1986, 24, 1044–66.CrossRefGoogle ScholarPubMed
22. Roos, L. L., Sharp, S. M., & Wajda, A. Assessing data quality: A computerized approach. Social Sciences and Medicine, 1988, (in press).CrossRefGoogle Scholar
23. Roos, L. L., Nicol, J. P., & Cageorge, S. M.Using administrative data for longitudinal research: Comparisons with primary data collection. Journal of Chronic Diseases, 1987, 40, 4149.CrossRefGoogle ScholarPubMed
24. Roos, L. L., Nicol, J. P., Johnson, C., & Roos, N. P.Using administrative data banks for research and evaluation: A case study. Evaluation Quarterly, 1979, 3, 236–55.CrossRefGoogle Scholar
25. Roos, L. L., & Payne, H.Health care evaluation in a government agency: Goals, organization, and software. Canadian Journal of Program Evaluation, 1987, 2, 915.CrossRefGoogle Scholar
26. Roos, L. L., Roos, N. P., & Sharp, S. M. Monitoring adverse outcomes of surgery using administrative data. Health Care Financing Review (Suppl.), 1987, 516.Google Scholar
27. Roos, L. L., Roos, N. P., Cageorge, S. M., & Nicol, J. P.How good are data? Reliability of one health care data bank. Medical Care, 1982, 20, 266–76.CrossRefGoogle ScholarPubMed
28. Roos, L. L., Wajda, A., & Nicol, J. P.The art and science of record linkage: Methods that work with few identifiers. Computers in Biology and Medicine, 1986, 16, 4557.CrossRefGoogle ScholarPubMed
29. Roos, N. P.Impact of the organization of practice on quality of care and physician productivity. Medical Care, 1980, 18, 347–59.CrossRefGoogle ScholarPubMed
30. Roos, N. P.Hysterectomies in one Canadian province. A new look at risks and benefits. American Journal of Public Health, 1984, 74, 3946.CrossRefGoogle Scholar
31. Roos, N. P. & Ramsey, E.A population-based study of prostatectomy: Long term outcomes associated with differing surgical approaches. Journal of Urology, 1987, 137, 1184–88.CrossRefGoogle ScholarPubMed
32. Sackett, D. L., Haynes, B. B., & Tugwell, P.Clinical epidemiology:A basic science for clinical medicine. Boston, MA: Little, Brown and Co., 1985.Google Scholar
33. Schlottman, A. M., & Herzog, H. W.Career and geographic mobility interactions: Implications for age selectivity of migration. Journal of Human Resources, 1984, 19, 7296.CrossRefGoogle Scholar
34. Stern, R. W., & Epstein, A. M.Institutional responses to prospective payment based on diagnosis-related groups: Implications for cost, quality, and access. New England Journal of Medicine, 1985, 312, 621–27.CrossRefGoogle Scholar
35. Wagner, D. P., Knaus, W. A., & Draper, E. A.The case for adjusting hospital rates for severity of illness. Health Affairs, 1986, 5, 148–53.CrossRefGoogle ScholarPubMed
36. Webb, E. J., Campbell, D. T., Schwartz, R. D., Sechrest, L., & Grove, J. B.Nonreactive measures in the social sciences. Boston, MA: Houghton Mifflin, 1981.Google Scholar
37. Wennberg, J. E., McPherson, K., & Caper, P.Will payment based on diagnosis-related groups control hospital costs? New England Journal of Medicine, 1984, 311, 295300.CrossRefGoogle ScholarPubMed
38. Wennberg, J. E., Roos, N. P., Sola, L., Schori, A., & Jaffe, R.Use of claims data systems to evaluate health care outcomes: Mortality and reoperation following prostatectomy. Journal of the American Medical Association, 1987, 257, 933–36.CrossRefGoogle ScholarPubMed