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Industry and with other national pharmacovigi-lance centers (Green, 1998). Furthermore, electronic submission of ADR reports will greatly enhance the efficiency and accuracy of the data entry process. From a pharmacovigilance perspective, the AERS should result in higher quality data and greater immediate access to this data by those who review or work with the case reports.
The UDPRS and some have adapted the gold standard to accommodate new technological advances. To assess non-motor elements in PD exclusive of motor dimensions, a patient-based inventory, the Non-Motor Symptom Screening Questionnaire, has been developed and clinimetrically tested (Chaudhuri, 2004). Video-based techniques to assess individual components of the UPDRS at home in the patient's ambient environment have been tested in small series of patients (Nyholm et al., 2005). Likewise, for capturing motor fluctuations, rather than relying on paper-based diaries, new electronic-based diaries monitor time of data entry and remind the patient to enter data with signals throughout the day (Nyholm et al., 2004). These advances utilize standard assessment measures but capitalize on electronic advances to maximize accurate data collection, often without requiring the patient to come to the doctor's office.
These daily prognostic estimates can and are being used to assist in making decisions about individual patients. With the aid of modern clinical information systems, physicians are using these probabilities at the bedside in much the same way they use the results of laboratory tests. However, unlike the results of a blood test which is drawn directly from the patient, a risk probability is derived indirectly from patient characteristics and a reference database. Thus clinicians using this information must consider, as they do in interpreting laboratory tests or other reports, the impact of missing values, data entry errors, and other sources of bias. They must also consider the availability of new therapies and understand that the confidence interval for each estimate widens for each succeeding day, that trends are more important than absolute values, and that some prognostic factors and indicators of response to therapy are not measured by the physiological variables.
Each community pharmacy collects data on all prescription drugs and forwards data on reimbursable medicines to their local NHS section on a monthly basis. These data form the basis for the two prescription registries, the Odense University Phar-macoepidemiological Database (OPED) and the Pharmacoepidemiological Prescription Database of North Jutland (PDNJ) (Sorensen and Larsen, 1994 Gaist et al., 1997).
Why Is an International Otology Database Important There are many reports on the outcome of otological interventions in the literature. However, it is difficult to make direct comparisons between these reports because of the lack of uniformity in reporting outcomes and patient selection. The aim is to create an interactive otology database for surgeons in the UK and Europe. Methodology The proposed project is the creation of a common database on a website. Two levels of data entry are available (1) level I minimum database (only main outcomes are included for any otolaryngologist in Europe who wishes to join), and (2) level II comprehensive database (detailed information on pathologies, risk factors and surgical procedure are also recorded for invited otologists). As both databases share the same core data, clinicians using database I can still compare their outcome with those using database II. There has already been an international consensus on the content of the common otology...
Given the number of at least 200 accessible cases, a structured collection of clinical observations and systematic analysis of data will define the natural course of the NA syndromes and may provide a basis for treatment studies. The data registry should be internet-based and easily accessible so that physicians worldwide can share information on their patients. Data entry into the case record forms must be standardized to maintain quality and comparability across centers. To achieve this, an NA submodule has been established within the European Huntington's Disease Network (EHDN), where procedures to maintain data confidentiality are already established (Fig. 3).
Intracranial pressure (ICP) data form the basis for guiding the management of comatose head injury patients whose clinical examination is usually compromised by sedation and or chemoparalysis. The Guidelines for the Management of Severe Head Injury published by the American Association of Neurological Surgeons recommend that ICP monitoring be undertaken in patients with a head injury and an abnormal CT scan on admission. ICP monitoring may also be undertaken in patients with severe head injury and a normal CT scan if they have any two of three adverse characteristics including age over 40 years, unilateral or bilateral motor posturing, or systolic blood pressure less than 90 mmHg on admission, and are therefore at a high risk of developing raised ICP.
Information is the key to thwart terrorism and may be our best defense. Databases are required to have ready access to information. For a database to be effective, it must contain the appropriate data entry items, and the data must be retrievable. With proper planning, meaningful and useful databases can be developed. The database(s) criteria need to be defined, and SWGMGF is taking on this function as well. Criteria fields for information databases under consideration are multi-agency threat lists (virus, bacteria, fungi, protozoa, insects, toxins), recognizing synonyms, strain data and virulence, vaccine strains, DNA sequences (whole genomic and partial), bioengineering events, biomarkers, organism sources (laboratory, geographic, and natural), national experts and contact information, laboratory facilities, assays, scientific presentations, literature references and full text, research grants, characteristics (e.g., microscopic morphology, colony morphology), antibiotic resistance,...
Ideally, a basic data set should be common to all intensive care units nationally to allow meaningful comparisons to be made. This requires the data set to be detailed enough to answer questions posed but not so detailed that collection becomes unsustainable. Resources must be provided in terms of computer databases and staff to collect and analyse data. Those collecting the data should be provided with regular summary reviews to ensure that enthusiasm continues, and quality control is maintained. Methods of data entry should consider the time involved and the fact that most of those collecting data are not keyboard experts. Typographical mistakes destroy the value of collected data such that error trapping and data validation must form part of the housekeeping in any database used. Some audit topics require data collection that is not part of the basic data set. Collecting appropriate data requires clarity in setting the question to be answered and care in choosing data items that...
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