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PURPOSE To evaluate the accuracy and clinical utility of the Outpatient Bleeding Risk Index for estimating the probability of major bleeding in outpatients treated with warfarin. The index was previously derived in a retrospective cohort of 556 patients from a different hospital (derivation cohort). SUBJECTS AND METHODS We enrolled 264 outpatients(More)
BACKGROUND Warfarin is effective in the treatment and prevention of many venous thromboembolic disorders, but it often leads to bleeding. OBJECTIVE To develop a multicomponent program of management of warfarin therapy and to determine its effect on the frequency of warfarin-related major bleeding in older patients. DESIGN Randomized, controlled trial.(More)
To measure the effects of skin disease on patients' quality of life, we developed a 61-item self-administered survey instrument called Skindex. Skindex has eight scales, each of which addresses a construct, or an abstract component, in a comprehensive conceptual framework: cognitive effects, social effects, depression, fear, embarrassment, anger, physical(More)
To determine changes in hospital mortality that occurred in association with the dissemination of data by a regional initiative to profile hospital performance, we conducted a retrospective cohort study of patients admitted before and subsequent to dissemination of comparative data in 1992. The analysis included 101,060 consecutive eligible discharges from(More)
CONTEXT Major teaching hospitals are perceived as being more expensive than other hospitals and, thus, unattractive to managed care. However, little empirical data exist about their relative quality and efficiency. The current study compared severity-adjusted mortality and length of stay (LOS) in teaching and nonteaching hospitals. DESIGN Retrospective(More)
BACKGROUND Older persons frequently experience a decline in function following an acute medical illness and hospitalization. OBJECTIVE To test the hypothesis that a multicomponent intervention, called Acute Care for Elders (ACE), will improve functional outcomes and the process of care in hospitalized older patients. DESIGN Randomized controlled trial.(More)
BACKGROUND & AIMS Survival of patients with end-stage liver disease is variable and difficult to predict. A two-phase prospective cohort study was conducted at five teaching hospitals to develop and evaluate a model for prediction of death. METHODS Five hundred thirty-eight hospitalized patients with a history of chronic liver disease and two or more(More)
OBJECTIVE To compare the hospital costs of caring for medical patients on a special unit designed to help older people maintain or achieve independence in self-care activities with the costs of usual care. DESIGN A randomized controlled study. PARTICIPANTS A total of 650 medical patients (mean age 80 years, 67% women, 41% nonwhite) assigned randomly to(More)
Skindex is a quality-of-life instrument for skin diseases. To determine its convergent validity and its advantage relative to a generic measure, we compared responses of 132 dermatology patients to Skindex and the Medical Outcomes Study 36-item Short-Form Survey (SF-36). We hypothesized that (i) correlations between similar scales would be strong but not(More)
OBJECTIVE To learn how often patients receive skin cancer preventive services in dermatologists' offices. DESIGN Survey of dermatology patients and dermatologists. SETTING Dermatology practices of full-and part-time faculty at a midwestern medical school. PARTICIPANTS Patients were randomly selected from clinical sessions of 11 dermatologists. Of 200(More)