2013年8月10日 星期六
2010年12月18日 星期六
HOW TO SURVIVE ROCHESTER, MN.
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
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
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.
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