William B. Burton

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OBJECTIVE To determine factors predictive of failure to return for colposcopy among women with significant abnormalities on Papanicolaou smears in a high-risk clinical population. DESIGN Telephone survey. SETTING An urban community health center. PARTICIPANTS Two hundred seventy-nine women randomly selected from all women seen at the health center(More)
CONTEXT Universal tuberculin skin testing of children has been shown to be costly and inefficient. In response, several authorities have recommended targeted screening based on epidemiological risk. In 1996, the New York City Department of Health (NYCDOH) developed questions to identify children who require a tuberculin skin test. OBJECTIVE To determine(More)
Many people on the waiting list for organ donation die each year without receiving organs. The shortage of organs is even more pronounced in minority communities. Despite the fact that minorities are at higher risk, they may be less likely to support or consent to organ donation. This investigation was undertaken to study racial factors in organ donation,(More)
OBJECTIVE To evaluate the prevalence of coronary artery dilation in children with sickle cell disease (SCD). STUDY DESIGN This is a retrospective analysis performed in patients, between 10 and 19 years old, with SCD who underwent a routine transthoracic echocardiographic evaluation over a 20-month period. The left main, left anterior descending, and(More)
BACKGROUND About 1400 school-based health centers (SBHCs) provide care to 1.1 million children. However, it is unknown if access to on-site services is associated with a better outcome. OBJECTIVE To compare outcomes including hospitalizations, emergency department visits, and school absenteeism in elementary schoolchildren with asthma who were grouped(More)
The objective of this study was to determine whether rates of eye disease among the elderly are higher for residents of nursing homes than for persons who reside elsewhere. Articles reporting the prevalence of eye disease in geriatric populations (classified as nursing home or non-nursing home) were identified through a Medline search and a search of(More)
Evidence suggests that the quality and frequency of bedside clinical examination have declined. We undertook the study to (1) determine whether intensive instruction in physical examination enhances medical student skills and (2) develop a tool to evaluate those skills using a modified observed structured clinical examination (OSCE). This was a randomized,(More)
The authors describe their experience in developing a strategy-focused organization using the balanced scorecard methodology. They achieved this at Duke Children's Hospital by aligning the clinicians and administrators around a single integrated platform that linked improving business processes with achieving quality clinical outcomes. By organizing in this(More)
Decisions about care at the end of life are not only influenced by doctor-patient-family relationships and physician practice, but also by institutional "culture." An institutional assessment of the quality of care provided to dying hospitalized patients was undertaken to characterize and identify factors influencing it and to find opportunities for(More)
BACKGROUND The demands placed on medical trainees pose a challenge to personal wellbeing, leading to burnout and erosion of empathy. However, it is unclear at what point in medical education this decline begins. Although many schools have begun to design and implement wellness programs for their students, the medical education community's experience in(More)