在Kahler Grand的Student Lounge的布告欄上貼著前人整理的經驗
SUPERMARKET
For buying food, the nearest supermarket is "Hy-Vee" (open non-stop 7x24 h). About 15 minutes walk. You can buy food and general stuff for cooking, washing clothes etc.
HOW TO GET THERE
Go to Saint Mary's Hospital, before Saint Mary is an gas station -> Turn right = Down the hill and go until you reach the big road, the Hy-Vee is close to the crossroad.
WASHING CLOTHES:
Buy the bleach (soap for washing clothes) in Hy-Vee and go to ROM 337 here in Kahler. There are washers and dryers in this room. You need 4 x quarters for the machine.
PUBS
The nearest pub is "Chesters" on the university square, which is behind Kahler (100 m).
There is also "City Cafe"... It is 3 minutes walk. Ask others in Kahler to go for beer and show you the night life :-) - Have your id ready.
KAHLER KITCHEN
You can use all the cooking stuff (if not marked personal). But then wash it.
SHOPPING
For buying clothes or other stuff you can go to TJ MAX, APACHE MALL, WALMART etc.
BUS
You can use the buslines to get to shopping centers. Ask for the schedule of bus lines in Kahler; there are no buses on Sunday.
GO TO MINNEAPOLIS
You can go to Minneapolis with 'Go Rochester" located in Kahler lobby. It goes every hour and round trip is ~55 USD.
NEAR RESTAURANT -WALKING DISTANCE
. CHESTERS ...... General food
. RED LOBSTER ...SEE food
. MICHAL'S ......... Steak
. PESCARA ....... FISH and SEE food
2010年12月18日 星期六
2010年11月27日 星期六
2010年11月24日 星期三
SPSS 19 回來了
藍色巨人收購SPSS後所改名推出PASW (Predictive Analytics Software)(即18版的SPSS),隨著19版的推出,終於再度正名為SPSS。主推四個版本(以常用的模組來包裝)來賣:
希望在IBM的加持下愈來愈好。
IBM® SPSS® Statistics Base - includes:
IBM® SPSS® Statistics Base
IBM® SPSS® Statistics Standard - includes:
IBM® SPSS® Statistics Base
IBM® SPSS® Advanced Statistics
IBM® SPSS® Regression
IBM® SPSS® Statistics Premium - includes:
IBM® SPSS® Statistics Base
IBM® SPSS® Advanced Statistics
IBM® SPSS® Regression
IBM® SPSS® Custom Tables
IBM® SPSS® Data Preparation
IBM® SPSS® Missing Values
IBM® SPSS® Forecasting
IBM® SPSS® Decision Trees
IBM® SPSS® Direct Marketing
IBM® SPSS® Complex Samples
IBM® SPSS® Conjoint
IBM® SPSS® Neural Networks
IBM® SPSS® Bootstrapping
IBM® SPSS® Categories
IBM® SPSS® Exact Tests
IBM® SPSS® Visualization Designer
IBM® SPSS® SamplePower
IBM® SPSS® Modeler Professional - includes:
IBM® SPSS® Modeler Professional (with data mining capabilities only)
IBM® SPSS® Modeler Premium - includes:
IBM® SPSS® Modeler Premium (with integrated text analytics functionality)
IBM® SPSS® Data Entry Premium - includes:
IBM® SPSS® Data Collection Author
IBM® SPSS® Data Collection Interviewer
以一般的臨床資料分析,必須使用到Premium的版本。所以才叫Premium(額外費用;附加費)不是嗎?
- IBM SPSS Statistics Standard
- IBM SPSS Statistics Professional
- IBM SPSS Statistics Premium
- IBM SPSS Statistics for Educators
希望在IBM的加持下愈來愈好。
IBM® SPSS® Statistics Base - includes:
IBM® SPSS® Statistics Base
IBM® SPSS® Statistics Standard - includes:
IBM® SPSS® Statistics Base
IBM® SPSS® Advanced Statistics
IBM® SPSS® Regression
IBM® SPSS® Statistics Premium - includes:
IBM® SPSS® Statistics Base
IBM® SPSS® Advanced Statistics
IBM® SPSS® Regression
IBM® SPSS® Custom Tables
IBM® SPSS® Data Preparation
IBM® SPSS® Missing Values
IBM® SPSS® Forecasting
IBM® SPSS® Decision Trees
IBM® SPSS® Direct Marketing
IBM® SPSS® Complex Samples
IBM® SPSS® Conjoint
IBM® SPSS® Neural Networks
IBM® SPSS® Bootstrapping
IBM® SPSS® Categories
IBM® SPSS® Exact Tests
IBM® SPSS® Visualization Designer
IBM® SPSS® SamplePower
IBM® SPSS® Modeler Professional - includes:
IBM® SPSS® Modeler Professional (with data mining capabilities only)
IBM® SPSS® Modeler Premium - includes:
IBM® SPSS® Modeler Premium (with integrated text analytics functionality)
IBM® SPSS® Data Entry Premium - includes:
IBM® SPSS® Data Collection Author
IBM® SPSS® Data Collection Interviewer
以一般的臨床資料分析,必須使用到Premium的版本。所以才叫Premium(額外費用;附加費)不是嗎?
2010年11月23日 星期二
2010年11月5日 星期五
2010年9月14日 星期二
Dr. Amilcare Gentili 的網站
Dr. Amilcare Gentili 的網站對於骨科醫師而言相當有趣:
肌肉骨骼系統造影上有那些signs?可以進來挑戰看看。
Bucket handle tear在MRI上要如何看?
什麼是double PCL sign?什麼是double ACL sign?
有空可以進去挖挖寶。
肌肉骨骼系統造影上有那些signs?可以進來挑戰看看。
Bucket handle tear在MRI上要如何看?
什麼是double PCL sign?什麼是double ACL sign?
有空可以進去挖挖寶。
2010年8月31日 星期二
Endnote X4教育影片
從第三版的Endnote開始用,一下子10多年就過去了,Endnote的進步是非常快速的,可說是一年一版....???
Endnote X4提供了不少新的功能,可惜的是目前不能搭64位元版的Word,只能搭32位元版的Word。
Endnote X4的教育影片可在網站下載,也可以在Youtube上學習。
Enjoy!!!
Endnote X4提供了不少新的功能,可惜的是目前不能搭64位元版的Word,只能搭32位元版的Word。
Endnote X4的教育影片可在網站下載,也可以在Youtube上學習。
Enjoy!!!
2010年8月14日 星期六
肝硬化病人術後死亡率的評估
肝硬化病人是否要接受手術,手術後能否存活,是一個必須嚴肅面對的一個問題。
評估病人肝硬化的程度,可用Pugh-Child criteria,目前網路上已有許多簡易的計算機。
Univeristy of Washington Medical Center所提供的計算機:
評估病人肝硬化的程度,可用Pugh-Child criteria,目前網路上已有許多簡易的計算機。
Univeristy of Washington Medical Center所提供的計算機:
Criteria for Child-Pugh Classification
其說明可參見Medical Criteria dot com。
當肝硬化病人接受手術時,在Child B及C的患者,其死亡率極高。
Garrison et al在1984年於Ann Surg發表了肝硬化病人接受腹部手術後死亡的危險因子分析。 其中Table 2最為重要。
Child A: 死亡率 10%。Child B: 死亡率 31%。Child C: 死亡率 76%
Mansour 等人於1997發表於Surgery的結果也是差不多。
Child A: 死亡率 10%。Child B: 死亡率 30%。Child C: 死亡率 82%
腹部手術的死亡率那麼高,那麼肢體的手術呢?
長庚施麗媛等人於J Bone Joint Surg Am報告在肝硬化病人置換全膝人工關節的結果:肝硬化病人平均追蹤42個月後,死亡率15/42 (= 35.7%),但無人於術後30天內死亡,而所匹配的對照組平均追蹤74個月後死亡率2/42 (= 4.8%)。
長庚謝邦鑫等人於J Bone Joint Surg Br報告在肝硬化病人置換全髖人工關節的結果:術後30天內死亡率 26.7%。
2007年,Mayo Clinic的Teh等人利用Model for End-Stage Liver Disease (MELD)來預測肝硬化病人術後30內死亡的機率,若MELD < 8則為5.7%,若MELD > 20則大於50%。
MELD的網路計算機,Mayo Clinic很慷慨的提供大眾使用:Post-operative Mortality Risk in Patients with Cirrhosis
2010年8月12日 星期四
統計、流病、EBM 10:THE LANCET臨床研究導讀
THE LANCET臨床研究導讀(Handbook of Essential Concepts in Clinical Research)中文版 2008 由Elsevier Taiwan出版,力大圖書經銷。
這是一本好書,但中文版未曾仔細閱讀過,只讀過英文版,Schulz, K. F. 及Grimes, D. A.兩人合著,英國人的英文當然是比較難,但也比較有趣。必需注意的是在第七章關於Youden's J出現錯誤,書中誤植為predictive value positive + predictive value negative - 1,正確為sensitivity + specificity - 1。勘誤表出版於Lancet. 2008 Jun 14;371(9629):1998.。出錯的由來可能來自Armitage, P et al的Statistical Methods in Medical Reseach。
整本書的內容在Lancet 上於2002年及2005年出版。
Introduction
01. An overview of clinical research: the lay of the land.
Observational studies
02. Descriptive studies: what they can and cannot do.
03. Bias and causal associations in observational research.
04. Cohort studies: marching towards outcome.
05. Case-control studies: research in reverse.
06. Compared to what? Finding controls for case-control studies.
Screening tests
07. Uses and abuses of screening tests.
Letter 1: Screening in clinical trials
Letter 2: Screening in clinical trials
Erratum: Lancet. 2008 Jun 14;371(9629):1998
08. Refining clinical diagnosis with likelihood ratios.
Randomised controlled trials
09. Sample size calculations in randomized trials: mandatory and mystical.
10. Generation of allocation sequences in randomized trials: chance, not choice.
11. Allocation concealment in randomized trials: defending against deciphering.
12. Unequal group sizes in randomized trials: guarding against guessing.
13. Sample size slippages in randomized trials: exclusions and the lost and wayward.
14. Blinding in randomized trials: hiding who got what.
15. Multiplicity in randomized trials I: endpoints and treatments.
16. Multiplicity in randomized trials II: subgroup and interim analyses.
這是一本好書,但中文版未曾仔細閱讀過,只讀過英文版,Schulz, K. F. 及Grimes, D. A.兩人合著,英國人的英文當然是比較難,但也比較有趣。必需注意的是在第七章關於Youden's J出現錯誤,書中誤植為predictive value positive + predictive value negative - 1,正確為sensitivity + specificity - 1。勘誤表出版於Lancet. 2008 Jun 14;371(9629):1998.。出錯的由來可能來自Armitage, P et al的Statistical Methods in Medical Reseach。
整本書的內容在Lancet 上於2002年及2005年出版。
Introduction
01. An overview of clinical research: the lay of the land.
Observational studies
02. Descriptive studies: what they can and cannot do.
03. Bias and causal associations in observational research.
04. Cohort studies: marching towards outcome.
05. Case-control studies: research in reverse.
06. Compared to what? Finding controls for case-control studies.
Screening tests
07. Uses and abuses of screening tests.
Letter 1: Screening in clinical trials
Letter 2: Screening in clinical trials
Erratum: Lancet. 2008 Jun 14;371(9629):1998
08. Refining clinical diagnosis with likelihood ratios.
Randomised controlled trials
09. Sample size calculations in randomized trials: mandatory and mystical.
10. Generation of allocation sequences in randomized trials: chance, not choice.
11. Allocation concealment in randomized trials: defending against deciphering.
12. Unequal group sizes in randomized trials: guarding against guessing.
13. Sample size slippages in randomized trials: exclusions and the lost and wayward.
14. Blinding in randomized trials: hiding who got what.
15. Multiplicity in randomized trials I: endpoints and treatments.
16. Multiplicity in randomized trials II: subgroup and interim analyses.
2010年8月9日 星期一
Crowe's Classification
Crowe's Classification一直很難記,尤其是在臨床應用時。重點在於A/B之比值,才能對應至subluxation的百分比。
A: head-neck junction至tear drop之參考線之高度
B: Pelvic height
Group | Description |
I | Subluxation < 50% or proximal dislocation < 0.1 (10%) of the pelvic height |
II | Subluxation 50%–75% or proximal dislocation of 0.1 to 0.15 (10% to 15%) of pelvic height |
III | Subluxation 75%–100% or proximal dislocation of 0.15 to 0.20 (15% to 20%) of pelvic height |
IV | Subluxation > 100% or proximal dislocation of > 0.20 (20%) of pelvic height |
統計、流病、EBM 9: ABC of Epidemiology
當初在上課時,在同學的介紹之下發現了在 Kidney International 連載的文章 ABC of Epidemiology,也是橫跨三年的文章。他人之石可以攻錯,好文章分享。統計與流病是相輔相成的,正如Sir William Osler所說的"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all."
01. General and clinical epidemiology at square two: A new educational series for the renal physician.
02. Measuring disease occurrence
03. The randomized clinical trial: An unbeatable standard in clinical research?
04. The valuable contribution of observational studies to nephrology
05. Measures of effect: Relative risks, odds ratios, risk difference, and 'number needed to treat'
06. Bias in clinical research
07. Confounding: What it is and how to deal with it
08. Linear and logistic regression analysis
09. The analysis of survival data: the Kaplan–Meier method
10. The analysis of survival data in nephrology: basic concepts and methods of Cox regression
11. Survival analysis: time-dependent effects and time-varying risk factors
12. The effect of joint exposures: examining the presence of interaction
01. General and clinical epidemiology at square two: A new educational series for the renal physician.
02. Measuring disease occurrence
03. The randomized clinical trial: An unbeatable standard in clinical research?
04. The valuable contribution of observational studies to nephrology
05. Measures of effect: Relative risks, odds ratios, risk difference, and 'number needed to treat'
06. Bias in clinical research
07. Confounding: What it is and how to deal with it
08. Linear and logistic regression analysis
09. The analysis of survival data: the Kaplan–Meier method
10. The analysis of survival data in nephrology: basic concepts and methods of Cox regression
11. Survival analysis: time-dependent effects and time-varying risk factors
12. The effect of joint exposures: examining the presence of interaction
2010年8月3日 星期二
統計、流病、EBM 8:Explorations in Statistics
在 Advances in Physiology Education 連載Douglas Curran-Everett新的統計教學,內容有深有淺,值得仔細探索。特別的是以R為範本,在Supplemental Material中有R的程式碼供使用。
1. Explorations in statistics: standard deviations and standard errors. Adv Physiol Educ 2008;32:203-8.
2. Explorations in statistics: the bootstrap. Adv Physiol Educ 2009;33:286-92.
3. Explorations in statistics: confidence intervals. Adv Physiol Educ 2009;33:87-90.
4. Explorations in statistics: hypothesis tests and P values. Adv Physiol Educ 2009;33:81-6.
5. Explorations in statistics: power. Adv Physiol Educ 2010;34:41-3.
骨科常用的評估工具
Orthopaedic Scores 內有常用的主觀及客觀的各式骨科量表,如Harris Hip Score, Knee Society Score, Tegner Lysholm Knee Scoring System, American Foot and & Ankle Score, Constant Shoulder Score, Mayo Elbow Score, Mayo Wrist Score 等。
統計、流病、EBM 7:Series: Basic statistics for busy clinicians
在Allergologia et Immunopathologia 最近的連載,雖然標示為西班牙文,但實為英文,值得花一點時間看看。
Series: Basic statistics for busy clinicians
01 Sampling and questionnaires. V Perez-Fernandez. Allergol Immunopathol (Madr). 2008;36:228-33.
02 Design and debugging databases for statistical analysis. M M Rodríguez del Águila, P Garrido-Fernández. Allergol Immunopathol (Madr). 2009;37:93-7.
03 Descriptive statistics. S. Pérez-Vicente, M. Expósito Ruiz. Allergol Immunopathol (Madr).2009; 37(06) :314-20.
04 Measures of frequency, magnitude of association and impact in epidemiology. A.R. González-Ramírez, F. Rivas-Ruiz. Allergol Immunopathol (Madr).2010; 38 :147-52.
2010年8月1日 星期日
統計、流病、EBM 6: Circulation的統計教學
Circulation的統計教學,共三年的連載,是否要花三年來讀呢?
Statistical Primer for Cardiovascular Research
01. Editors' Note
02. Descriptive Statistics and Graphical Displays
03. Estimation From Samples
04. Hypothesis Testing: Means
05. Hypothesis Testing: Proportions
06. Correlation and Regression
07. Rank Score Tests
08. Survival Methods
09. Receiver-Operating Characteristic Analysis for Evaluating Diagnostic Tests and Predictive Models
10. Design of Randomized Controlled Trials
11. Evaluation of Randomized Controlled Trials
12. Propensity Scores in Cardiovascular Research
13. Meta-Analysis
14. Analysis of Variance
15. Multiple Comparisons Procedures
16. Repeated Measures
17. Multiple Linear Regression: Accounting for Multiple Simultaneous Determinants of a Continuous Dependent Variable
18. Logistic Regression
19. Survival Methods: Additional Topics
20. Genetic Association Studies
21. Genetic and Genomic Discovery Using Family Studies
22. Genetics and Genomics: Gene Expression Microarrays
23. A Primer in Longitudinal Data Analysis
Letter by Patel Regarding Article, "A Primer in Longitudinal Data Analysis"
24. Optimizing Trial Design: Sequential, Adaptive, and Enrichment Strategies
2010年7月11日 星期日
寫作鬼打牆 Writer's block
2010年6月24日 星期四
Heterotopic Ossification Classification
Heterotopic ossificaiton最常使用的分類為Brooker classificaiton:
Class I: Islands of bone within the soft tissue about the hip.
Class II: Bone spurs from the pelvis or proximal end of the femur, leaving at least 1 centimeter between opposing bone surfaces.
Class III: Bone spurs from the pelvis or proximal end of the femur, reducing the space between opposing bone surfaces to less than one centimeter.
Class IV: Apparent bone ankylosis of the hip.
Class I: Islands of bone within the soft tissue about the hip.
Class II: Bone spurs from the pelvis or proximal end of the femur, leaving at least 1 centimeter between opposing bone surfaces.
Class III: Bone spurs from the pelvis or proximal end of the femur, reducing the space between opposing bone surfaces to less than one centimeter.
Class IV: Apparent bone ankylosis of the hip.
Heterotopic Ossification Risk Factors
Risk Factors for Formation of Heterotopic Ossification
Patient factors
Technique factors
The anterolateral approach is associated with higher incidence of heterotopic ossification thant the posterolateral approach; however, the incidence of clinically significant heterotopic ossification is low with either approach.
The transtrochanteric approach has been associated with a higher incidence of heterotopic ossification.
Other studies demonstrated no significant difference in the rate of heterotopic ossification on the basis of surgical approach.
O'Rourke MR, Aggarwal A, Evans BG: Chapter 77. Late Complications and Management. Adult Hip. 2nd edition. p 1110.
Patient factors
- Previous heterotopic ossification
- Hypertrophic osteoarthritis
- Male gender
- Ankylosing spondylitis
- Diffuse idiopathic skeletal hyperostosis (DISH)
- Previous trauma to the hip
Technique factors
- Surgical approach
- Surgical trauma to the gluteus medius/minimus
- Femoral fracture
- Postoperative hematoma
- Dislocation
- Infection
The anterolateral approach is associated with higher incidence of heterotopic ossification thant the posterolateral approach; however, the incidence of clinically significant heterotopic ossification is low with either approach.
The transtrochanteric approach has been associated with a higher incidence of heterotopic ossification.
Other studies demonstrated no significant difference in the rate of heterotopic ossification on the basis of surgical approach.
O'Rourke MR, Aggarwal A, Evans BG: Chapter 77. Late Complications and Management. Adult Hip. 2nd edition. p 1110.
2010年6月19日 星期六
EndNote X4 推出了
為了因應M$ Office 2010,EndNote X4 推出了。
介紹一個應用Endnote 的好網站:
內容主要介紹Zotero 、Endnote 、Stata這三套軟體的使用,對於要寫論文的人而言,這是生活的工具,在Facebook上也有粉絲團。
2010年6月15日 星期二
Unhappy Triad
O'DONOGHUE等人於1950在JBJS-A上發表關於膝關節受傷的機轉
所指的受傷害結構為
1. 前十字韌帶(anterior cruciate ligament)
2. 內側副韌帶(medial collateral ligament; tibial collateral ligament)
3. 內側半月版(medial meniscus)
後來發現外側半月版受傷的比例較內側為高。
unhappy triad又稱為 terrible triad或 O'Donoghue's triad
所指的受傷害結構為
1. 前十字韌帶(anterior cruciate ligament)
2. 內側副韌帶(medial collateral ligament; tibial collateral ligament)
3. 內側半月版(medial meniscus)
後來發現外側半月版受傷的比例較內側為高。
unhappy triad又稱為 terrible triad或 O'Donoghue's triad
2010年6月14日 星期一
人際關係交流方式的變化
隨著科技的進步,人與人之間的交流的方式也隨之變化。從見面的人對人的溝通到使用facebook, twitter等工具,人與人相對的交流方式有著劇烈的轉變。從即時的溝通到非同時的塗鴉留言。大家都在電腦及電話面前等待非面對面的溝通,想想也有些荒謬,為什麼不直接見面或打個電話,或許是閱讀文字的魔力。
Too Much Homework is Counterproductive!
真是太可憐了,為什麼才小一而已功課就這麼多。
已經是晚上10點半了,功課才做到一半。
功課愈不好的人功課愈多,就愈晚睡覺,第二天學習及考試的效果愈差,這是一個惡性循還。
2010年6月10日 星期四
諸事不順的2010
今年已過了大半,回想這半年來,諸事不順。許多事情皆不如人意。
辛苦了那麼久,一點回饋也沒有。不過,事情總是會好轉的。
同學已畢業了4名。要加油!
不過今天得到一點點回饋了。Ganbade ne!
辛苦了那麼久,一點回饋也沒有。不過,事情總是會好轉的。
同學已畢業了4名。要加油!
不過今天得到一點點回饋了。Ganbade ne!
2010年5月30日 星期日
BMI 計算機
美國的National Heart Lung and Blood Institute提供了一個簡易的body mass index的計算機
Body mass index (BMI)分類
Body mass index (BMI)分類
- Underweight = <18.5
- Normal weight = 18.5-24.9
- Overweight = 25-29.9
- Obesity = BMI of 30 or greater
身體質量指數(BMI) | 腰圍 | |
(kg/m2) | (cm) | |
體重過輕 | BMI < 18.5 | |
正常範圍 | 18.5≦BMI<24 | |
異常範圍 | 過重:24≦BMI<27 | 男性:≧90公分 |
輕度肥胖:27≦BMI<30 | 女性:≧80公分 | |
中度肥胖:30≦BMI<35 | ||
重度肥胖:BMI≧35 |
2010年5月26日 星期三
NEJM Videos in Clinical Medicine
把New England Journal of Medicine的Video in Clinical Medicine的影片的連結作一小小的整理:
如何打CVP
如何作腰椎穿刺
如何作胸腔穿刺術
如何插胸管
如何打鎖骨下靜脈的CVP
如何作腹腔穿刺
如何插經口氣管內管
如何作膝關節關節抽吸術
如何作周邊靜脈套管插入術
如何作環甲切開術
如何插鼻胃管
如何打動脈導管
如何作骨髓抽吸術及生檢術
如何作PV
如何放股靜脈導管
如何作膿瘍的切開及引流
如何在男性放置導尿管
如何在女性放置導尿管
如何利用面罩作正壓換氣
如何作上下肢. 血壓比檢查(ABI)
如何作超音波引導的內頸靜脈套管插入術
如何度量血壓
如何修補撕裂傷
如何檢查喉頭及咽頭
如何作石膏副木
如何診斷中耳炎
如何置放臍靜脈導管
女兒嘉言錄
女兒嘉言錄 Part 1:
父母及女兒三人一同於經國大道散步,父親突發奇想問女兒道。
父:你有幾個 媽媽?
女:一個媽媽。
父:你有幾個哥哥?
⋯⋯女:兩個哥哥。(據說是正確答案)
父:你有幾個爸爸?
女:兩個爸爸。一個美國爸 爸和一個魔鬼爸爸。
父轉頭面向母。
母:...
女兒嘉言錄 Part 2:
女:我不喜歡魔鬼爸爸,因為他不乖。
女:我喜歡美國爸爸, 因為他很乖。
父:...(無言中...思考中...為什麼有兩個爸爸)
Ankle–Brachial Index 上下肢. 血壓比
上下肢. 血壓比檢查
Ankle–Brachial Index for Assessment of Peripheral Arterial Disease
ABI 要如何度量。NEJM上有良好的說明。
下肢dorsalis pedis artery及posterior tibial artery的收縮壓皆要度量,兩者取較高者。
上肢brachial artery的收縮壓取較高者。
上下肢. 血壓比 ankle-brachial index (ABI) 的計算方式:
ABI = 踝部的收縮壓/上臂的收縮壓
如何解釋
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2010年5月16日 星期日
2010年5月15日 星期六
Joel on Software
Joel on Software為Joel Spolsky的部落格,其主要的內容已出版成書,中文版為<約耳趣談軟體> 及<約耳續談軟體>,由悅知文化所出版。雖說是針對軟體產業的洞見,但對日常工作也是別有見地,尤其是在目前管理學及顧問公司當道的時代。
2010年4月18日 星期日
Parker and Palmer Score
Parker MJ, Palmer CR: A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg [Br] 1993: 75-B:797-8.
Paker and Palmer score是用於評估近端股骨骨折術後一年後死亡機率的工具。
內含Mobility score 及Abbreviated mental test score兩部分,附上spreadsheet方便使用。
Paker and Palmer score是用於評估近端股骨骨折術後一年後死亡機率的工具。
內含Mobility score 及Abbreviated mental test score兩部分,附上spreadsheet方便使用。
Mobility (Score is the total, 0 to 9): 3: No difficulty, 2: With an aid, 1: With help from another person, 0: Not at all
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Abbreviated mental test: 10個項目,正確得1分 |
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2010年4月16日 星期五
Intertrochanteric Fractures: 10 Tips to Improve Results
好文章分享:
Haidukewych GJ: Intertrochanteric Fractures: Ten Tips to Improve Results. The Journal of Bone and Joint Surgery (American). 2009;91:712-719.
Tip 1: Use the Tip-to-Apex Distance.
Tip 2: "No Lateral Wall, No Hip Screw"
- Lateral wall指的是reverse oblique及transtrochanteric fractures
Tip 3: Know the Unstable Intertrochanteric Fracture Patterns, and Nail Them.
Tip 4: Beware of the Anterior Bow of the Femoral Shaft.
Tip 5: When Using a Trochanteric Entry Nail, Start Slightly Medial to the Exact Tip of the Greater Trochanter.
Tip 6: Do Not Ream an Unreduced Fracture.
Tip 7: Be Cautious About the Nail Insertion Trajectory, and Do Not Use a Hammer to Seat the Nail.
Tip 8: Avoid Varus Angulation fo the Proximal Fragment - Use the Relationship Between the Tip of the Trochanter and the Center of the Femoral Head.
Tip 9: When Nailing, Lock the Nail Distally if the Fracture Is Axially or Rotationally Unstable.
Tip 10: Avoid Fracture Distraction When Nailing.
2010年4月13日 星期二
統計、流病及EBM 5
CDC 的流病入門課程(pdf),可以自己慢慢地自修。
Lang TA: Twenty statistical errors even you can find in biomedical research articles. Croat Med J. 2004;45:361-70.
American College of Physicians (ACP)所出版的好書
Lang TA, Secic M: How to report statistics in medicine: annotated guidelines for authors, editors, and reviewers. Second edition. 2006; Philadelphia: American College of Physicians.- 這本書教您如何報告醫學統計--值得擁有。缺點:未包括如何報告mixed model, GEE等較複雜方式。
Lang TA: Twenty statistical errors even you can find in biomedical research articles. Croat Med J. 2004;45:361-70.
免費的統計軟體
- John C. Pezzulo的著名網頁,可說是免費的統計軟體的大補帖,內含統計教學及線上統計軟體的相關連結。
- 許多好文章,可以進來挖寶。Bland-Altman Plot有詳細的說明。
線上生物統計
- GraphPad Quick Calcs
- 香港中文大學婦產科的線上生物統計(內含小小應用軟體可下載)
- VassarStats: Web Site for Statistical Computation
- Stats Calculator
- OpenEpi - The Epidemiology Calculator
天下文化出版的書籍,可說是本本精彩
- 史密斯(Woollcott Smith) 著, 鄭惟厚 譯, 高尼克(Larry Gonick) 繪. 看漫畫,學統計 The Cartoon Guide to Statistics. 台北: 天下文化, 2003.
- 墨爾(David S. Moore) 著, 鄭惟厚 譯. 統計,讓數字說話! STATISTICS. 台北: 天下文化, 1998.
- 墨爾(David S. Moore) 著, 鄭惟厚 譯. 統計學的世界Statistics, concepts and controversies, 5th ed. 台北: 天下文化, 2002.
- 拉森(Harold J. Larson) 著, 鄭惟厚 譯. 機率學的世界 Introduction to Probability. 台北: 天下文化, 2004.
- 瓊斯 (Gerald Everett Jones) 著, 葉偉文 譯. 別讓統計圖表唬弄你 How to Lie with Charts. 台北: 天下文化, 2005.
- 萊文森(Horace C. Levinson) 著, 葉偉文 譯. 統計你贏的機率 Chance, Luck, and Statistics. 台北: 天下文化, 2004.
- 薩爾斯伯格(David Salsburg) 著, 葉偉文 譯. 統計,改變了世界The Lady Tasting Tea. 台北: 天下文化, 2001.
- 赫夫(Darrell Huff) 著, 鄭惟厚 譯, 蓋斯(Irving Geis) 繪. 別讓統計數字騙了你 How to Lie with Statistics. 台北: 天下文化, 2005.
統計、流病及EBM 4
Aviva Petrie 等人在British Dentistry Journal上的文章(Aviva Petrie即是Medical Statistics at a Glance的作者之一)
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry: Part 1: Research designs 1. Br Dent J 2002;193:377-380.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry. Part 2: Research designs 2. Br Dent J 2002;193:435-440.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry. Part 3: Clinical trials 1. Br Dent J 2002;193:495-498.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry. Part 4: Clinical trials 2. Br Dent J 2002;193:557-561.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry, Part 5: Diagnostic tests for oral conditions. Br Dent J 2002;193:621-625.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry. Part 6: Multiple linear regression. Br Dent J 2002;193:675-682.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry. Part 7: repeated measures. Br Dent J 2003;194:17-21.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry, Part 8: Systematic reviews and meta-analyses. Br Dent J 2003;194:73-78.
- Petrie A, Bulman JS, Osborn JF: Further statistics in dentistry. Part 9: Bayesian statistics. Br Dent J 2003;194:129-134.
- Osborn JF, Bulman JS, Petrie A: Further statistics in dentistry. Part 10: Sherlock Holmes, evidence and evidence-based dentistry. Br Dent J 2003;194:189-195.
BMJ (British medical journal)
- 統計教學當然不可遺漏BMJ的好站 Statistics at Square One
- 入門者的流行病學 Epidemiology for the Uninitiated
- 如何閱讀期刊論文 How to read a paper: the basic of evidence-based medicine
統計、流病及EBM 3
在American Journal of Roentgenology 上關於統計的文章
- Beam CA, Blackmore CC, Karlik S, Reinhold C. Editors' Introduction to the Series. Am. J. Roentgenol. 2001; 176:323-325.
- Blackmore CC. The Challenge of Clinical Radiology Research. Am. J. Roentgenol. 2001; 176:327-331.
- Crewson PE, Applegate KE. Data Collection in Radiology Research. Am. J. Roentgenol. 2001; 177:755-761.
- Jarvik JG. The Research Framework. Am. J. Roentgenol. 2001; 176:873-878.
- Saini S. Radiologic Measurement of Tumor Size in Clinical Trials: Past, Present, and Future. Am. J. Roentgenol. 2001; 176:333-334.
- Beam CA. Statistically Engineering the Study for Success. Am. J. Roentgenol. 2002; 179:47-52.
- Joseph L, Reinhold C. Introduction to Probability Theory and Sampling Distributions. Am. J. Roentgenol. 2003; 180:917-923.
- Karlik SJ. Exploring and Summarizing Radiologic Data. Am. J. Roentgenol. 2003; 180:47-54.
- Karlik SJ. Visualizing Radiologic Data. Am. J. Roentgenol. 2003; 180:607-619.
- Blackmore CC, Cummings P. Observational Studies in Radiology. Am. J. Roentgenol. 2004; 183:1203-1208.
- Crewson PE. Reader Agreement Studies. Am. J. Roentgenol. 2005; 184:1391-1397.
- Dendukuri N, Reinhold C. Correlation and Regression. Am. J. Roentgenol. 2005; 185:3-18.
- Joseph L, Reinhold C. Statistical Inference for Continuous Variables. Am. J. Roentgenol. 2005; 184:1047-1056.
- Joseph L, Reinhold C. Statistical Inference for Proportions. Am. J. Roentgenol. 2005; 184:1057-1064.
- Obuchowski NA. Multivariate Statistical Methods. Am. J. Roentgenol. 2005; 185:299-309.
- Obuchowski NA. ROC Analysis. Am. J. Roentgenol. 2005; 184:364-372.
- Plevritis SK. Decision Analysis and Simulation Modeling for Evaluating Diagnostic Tests on the Basis of Patient Outcomes. Am. J. Roentgenol. 2005; 185:581-590.
- Stolberg HO, Norman G, Trop I. Survival Analysis. Am. J. Roentgenol. 2005; 185:19-22.
- Weinstein S, Obuchowski NA, Lieber ML. Clinical Evaluation of Diagnostic Tests. Am. J. Roentgenol. 2005; 184:14-19.
- Willis CE, Slovis TL. The ALARA Concept in Pediatric CR and DR: Dose Reduction in Pediatric Radiographic Exams -- A White Paper Conference. Am. J. Roentgenol. 2005; 184:373-374.
- Gatsonis C, Paliwal P. Meta-Analysis of Diagnostic and Screening Test Accuracy Evaluations: Methodologic Primer. Am. J. Roentgenol. 2006; 187:271-281.
統計、流病及EBM 2
在Clinical Orthopaedics and Related Research上關於統計、流病及EBM的文章 (因CORR改由Springer發行,但Springer只有2008年以後的版權,目前連結重新製作中)
- Schunemann HJ, Bone L. Evidence-based orthopaedics: a primer. Clin Orthop 2003(413):117-32.
- Montori VM, Swiontkowski MF, Cook DJ. Methodologic issues in systematic reviews and meta-analyses. Clin Orthop 2003(413):43-54.
- Mitchell SW. The history of instrumental precision in medicine. Univ Med Magazine, October 1841. Clin Orthop 2003(413):11-8; discussion.
- Kocher MS, Henley MB. It is money that matters: decision analysis and cost-effectiveness analysis. Clin Orthop 2003(413):106-16.
- Jackowski D, Guyatt G. A guide to health measurement. Clin Orthop 2003(413):80-9.
- Hartz A, Marsh JL. Methodologic issues in observational studies. Clin Orthop 2003(413):33-42.
- Griffin D, Audige L. Common statistical methods in orthopaedic clinical studies. Clin Orthop 2003(413):70-9.
- Gillespie LD, Gillespie WJ. Finding current evidence: search strategies and common databases. Clin Orthop 2003(413):133-45.
- Dirschl DR, Tornetta P 3rd, Bhandari M. Designing, conducting, and evaluating journal clubs in orthopaedic surgery. Clin Orthop 2003(413):146-57.
- Devereaux PJ, McKee MD, Yusuf S. Methodologic issues in randomized controlled trials of surgical interventions. Clin Orthop 2003(413):25-32.
- Brighton B, Bhandari M, Tornetta P 3rd, Felson DT. Hierarchy of evidence: from case reports to randomized controlled trials. Clin Orthop 2003(413):19-24.
- Bhandari M, Whang W, Kuo JC, Devereaux PJ, Sprague S, Tornetta P 3rd. The risk of false-positive results in orthopaedic surgical trials. Clin Orthop 2003(413):63-9.
- Bhandari M, Tornetta P 3rd, Guyatt GH. Glossary of evidence-based orthopaedic terminology. Clin Orthop 2003(413):158-63.
- Bhandari M, Tornetta P 3rd. Evidence-based orthopaedics: a paradigm shift. Clin Orthop 2003(413):9-10.
- Bernstein J, McGuire K, Freedman KB. Statistical sampling and hypothesis testing in orthopaedic research. Clin Orthop 2003(413):55-62.
- Beaton DE, Schemitsch E. Measures of health-related quality of life and physical function. Clin Orthop 2003(413):90-105.
統計、流病及EBM 1
以下是以前所收集的文章及網頁,分享給各位:
Tufts University 的 Gerard E. Dallal, PhD 所編纂的 BMJ (British Medical Journal) statistics note (整理的相當好)
在Radiology上有一系列關於統計的文章,內容相當新。值得花時間仔細閱讀。Radiology也整理出稿件中十大常見統計錯誤。
在Journal of Bone and Joint Surgery American Edition, British Edition 及Instructional Course Lecture上關於統計及流病的文章
- Bubbar VK, Kreder HJ: The intention-to-treat principle: a primer for the orthopaedic surgeon. J Bone Joint Surg Am 2006;88:2097-2099.
- Petrie A: Statistics in orthopaedic papers. J Bone Joint Surg Br 2006;88:1121-1136.
- Kocher MS, Zurakowski D. Clinical epidemiology and biostatistics: a primer for orthopaedic surgeons. J Bone Joint Surg Am 2004; 86:607-620.
- Bhandari M, Richards RR, Sprague S, Schemitsch EH. The quality of reporting of randomized trials in the Journal of Bone and Joint
Surgery from 1988 through 2000. J Bone Joint Surg Am. 2002;84:388-96. - Bhandari M, Morrow F, Kulkarni AV, Tornetta P 3rd. Meta-analyses in orthopaedic surgery. A systematic review of their methodologies. J Bone Joint Surg Am. 2001;83:15-24.
- Bhandari M, Guyatt GH, Montori V, Devereaux PJ, Swiontkowski MF. User's guide to the orthopaedic literature: how to use a systematic literature review. J Bone Joint Surg Am. 2001;83:1650-5.
- Lochner HV, Bhandari M, Tornetta P 3rd. Type-II error rates (beta errors) of randomized trials in orthopaedic trauma. J Bone Joint Surg Am. 2001;83:1650-5.
- Freedman KB, Back S, Bernstein J. Sample size and statistical power of randomised, controlled trials in orthopaedics. J Bone Joint Surg Br 2001; 83:397-402.
- Freedman KB, Bernstein J. Sample size and statistical power in clinical orthopaedic research. J Bone Joint Surg Am 1999; 81:1454-1460.
- Szabo RM. Principles of epidemiology for the orthopaedic surgeon. J Bone Joint Surg Am 1998; 80:111-120.
- Smith JS, Watts HG. Methods for locating missing patients for the purpose of long-term clinical studies. J Bone Joint Surg Am 1998; 80:431-438.
- Fuson RL, Sherman M, Van Vleet J, Wendt T. The conduct of orthopaedic clinical trials. J Bone Joint Surg Am. 1997; 79:1089-98.
- Ebramzadeh E, McKellop H, Dorey F, Sarmiento A. Challenging the validity of conclusions based on P-values alone: a critique of contemporary clinical research design and methods. Instr Course Lect 1994; 43:587-600.
- Dorey F, Nasser S, Amstutz H. The need for confidence intervals in the presentation of orthopaedic data. [PDF] J Bone Joint Surg Am 1993; 75:1844-1852.
- Dorey F, Amstutz HC. Discrepancies in the orthopaedic literature: why? A statistical explanation. Instr Course Lect 1993; 42:555-564.
- Santner TJ, Wypij D. Fundamentals of statistics for orthopaedists: Part IV. [PDF] J Bone Joint Surg Am 1987; 69:463-470.
- Santner TJ, Wypij D. Fundamentals of statistics for orthopaedists: Part III. [PDF] J Bone Joint Surg Am 1984; 66:1309-1318.
- Santner TJ, Burstein AH. Fundamentals of statistics for orthopaedists: Part II. [PDF] J Bone Joint Surg Am 1984; 66:794-799.
- Santner TJ. Fundamentals of statistics for orthopaedists: Part I. [PDF] J Bone Joint Surg Am 1984; 66:468-471.
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