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Hu YY, Peyre SE, Arriaga AF, Roth EM, Corso KA, Greenberg CC. War stories: a qualitative analysis of narrative teaching strategies in the operating room. Am J Surg 2011; 203:63-8. [PMID: 22088266 DOI: 10.1016/j.amjsurg.2011.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 08/12/2011] [Accepted: 08/12/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND "War stories" are commonplace in surgical education, yet little is known about their purpose, construct, or use in the education of trainees. METHODS Ten complex operations were videotaped and audiotaped. Narrative stories were analyzed using grounded theory to identify emergent themes in both the types of stories being told and the teaching objectives they illustrated. RESULTS Twenty-four stories were identified in 9 of the 10 cases (mean, 2.4/case). They were brief (mean, 58 seconds), illustrative of multiple teaching points (mean, 1.5/story), and appeared throughout the operations. Anchored in personal experience, these stories taught both clinical (eg, operative technique, decision making, error identification) and programmatic (eg, resource management, professionalism) topics. CONCLUSIONS Narrative stories are used frequently and intuitively by physicians to emphasize a variety of intraoperative teaching points. They socialize trainees in the culture of surgery and may represent an underrecognized approach to teaching the core competencies. More understanding is needed to maximize their potential.
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Hu YY, Arriaga A, Roth EM, Peyre SE, Swanson RS, Osteen RT, Schmitt P, Bader AM, Zinner MJ, Greenberg CC. Protecting patients from an unsafe system. J Am Coll Surg 2011. [DOI: 10.1016/j.jamcollsurg.2011.06.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Roth EM, Easter J, Hall RE, Kabana L, Mashio K, Hanada S, Clouser T, Remley GW. Person-in-the-Loop Testing of a Digital Power Plant Control Room. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/154193121005400405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is renewed interest in building new commercial nuclear power plants. Unlike existing plants that have traditional control rooms with large control boards, new plants will have compact digital control rooms. The transition to digital control rooms introduce opportunities for enhanced support (e.g., integrated displays; improved alarm systems; computerized procedures) as well as potential new challenges (e.g., shift from open to private workspaces; changes in workload distribution resulting from reduced control room crew size). This paper describes two simulator tests that were conducted as part of a person-in-the-loop test program to support development and validation of a control room for the US-APWR evolutionary pressurized water reactor plant. While the results are presented in the context of evaluation of a particular digital control room design, they have applicability to design of compact digital control rooms more generally, and point to areas where more research is needed.
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Abstract
OBJECTIVE In this article, the author provides an overview of cognitive analysis methods and how they can be used to inform system analysis and design. BACKGROUND Human factors has seen a shift toward modeling and support of cognitively intensive work (e.g., military command and control, medical planning and decision making, supervisory control of automated systems). Cognitive task analysis and cognitive work analysis methods extend traditional task analysis techniques to uncover the knowledge and thought processes that underlie performance in cognitively complex settings. METHODS The author reviews the multidisciplinary roots of cognitive analysis and the variety of cognitive task analysis and cognitive work analysis methods that have emerged. RESULTS Cognitive analysis methods have been used successfully to guide system design, as well as development of function allocation, team structure, and training, so as to enhance performance and reduce the potential for error. CONCLUSIONS A comprehensive characterization of cognitive work requires two mutually informing analyses: (a) examination of domain characteristics and constraints that define cognitive requirements and challenges and (b) examination of practitioner knowledge and strategies that underlie both expert and error-vulnerable performance. A variety of specific methods can be adapted to achieve these aims within the pragmatic constraints of particular projects. APPLICATION Cognitive analysis methods can be used effectively to anticipate cognitive performance problems and specify ways to improve individual and team cognitive performance (be it through new forms of training, user interfaces, or decision aids).
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Saleem JJ, Patterson ES, Militello L, Anders S, Falciglia M, Wissman JA, Roth EM, Asch SM. Impact of clinical reminder redesign on learnability, efficiency, usability, and workload for ambulatory clinic nurses. J Am Med Inform Assoc 2007; 14:632-40. [PMID: 17600106 PMCID: PMC1975803 DOI: 10.1197/jamia.m2163] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Computerized clinical reminders (CRs) were designed to reduce clinicians' reliance on their memory and to present evidence-based guidelines at point of care. However, the literature indicates that CR adoption and effectiveness has been variable. We examined the impact of four design modifications to CR software on learnability, efficiency, usability, and workload for intake nursing personnel in an outpatient clinic setting. These modifications were included in a redesign primarily to address barriers to effective CR use identified during a previous field study. DESIGN In a simulation experiment, 16 nurses used prototypes of the current and redesigned system in a within-subject comparison for five simulated patient encounters. Prior to the experimental session, participants completed an exploration session, where "learnability" of the current and redesigned systems was assessed. MEASUREMENTS Time, performance, and survey data were analyzed in conjunction with semi-structured debrief interview data. RESULTS The redesign was found to significantly increase learnability for first-time users as measured by time to complete the first CR, efficiency as measured by task completion time for two of five patient scenarios, usability as determined by all three groupings of questions taken from a commonly used survey instrument, and two of six workload subscales of the NASA Task Load Index (TLX) survey: mental workload and frustration. CONCLUSION Modest design modifications to existing CR software positively impacted variables that likely would increase the willingness for first-time nursing personnel to adopt and consistently use CRs.
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Greenberg CC, Roth EM, Sheridan TB, Gandhi TK, Gustafson ML, Zinner MJ, Dierks MM. Making the operating room of the future safer. Am Surg 2006; 72:1102-8; discussion 1126-48. [PMID: 17120955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
There is an increasing demand for interventions to improve patient safety, but there is limited data to guide such reform. In particular, because much of the existing research is outcome-driven, we have a limited understanding of the factors and process variations that influence safety in the operating room. In this article, we start with an overview of safety terminology, suggesting a model that emphasizes "safety" rather than "error" and that can encompass the spectrum of events occurring in the operating room. Next, we provide an introduction to techniques that can be used to understand safety at the point of care and we review the data that exists relating such studies to improved outcomes. Future work in this area will need to prospectively study the processes and factors that impact patient safety and vulnerability in the operating room.
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Greenberg CC, Roth EM, Sheridan TB, Gandhi TK, Gustafson ML, Zinner MJ, Dierks MM. Making the Operating Room of the Future Safer. Am Surg 2006. [DOI: 10.1177/000313480607201121] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is an increasing demand for interventions to improve patient safety, but there is limited data to guide such reform. In particular, because much of the existing research is outcome-driven, we have a limited understanding of the factors and process variations that influence safety in the operating room. In this article, we start with an overview of safety terminology, suggesting a model that emphasizes “safety” rather than “error” and that can encompass the spectrum of events occurring in the operating room. Next, we provide an introduction to techniques that can be used to understand safety at the point of care and we review the data that exists relating such studies to improved outcomes. Future work in this area will need to prospectively study the processes and factors that impact patient safety and vulnerability in the operating room.
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Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM. A prospective study of patient safety in the operating room. Surgery 2006; 139:159-73. [PMID: 16455323 DOI: 10.1016/j.surg.2005.07.037] [Citation(s) in RCA: 301] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2005] [Revised: 07/07/2005] [Accepted: 07/11/2005] [Indexed: 01/27/2023]
Abstract
BACKGROUND To better understand the operating room as a system and to identify system features that influence patient safety, we performed an analysis of operating room patient care using a prospective observational technique. METHODS A multidisciplinary team comprised of human factors experts and surgeons conducted prospective observations of 10 complex general surgery cases in an academic hospital. Minute-to-minute observations were recorded in the field, and later coded and analyzed. A qualitative analysis first identified major system features that influenced team performance and patient safety. A quantitative analysis of factors related to these systems features followed. In addition, safety-compromising events were identified and analyzed for contributing and compensatory factors. RESULTS Problems in communication and information flow, and workload and competing tasks were found to have measurable negative impact on team performance and patient safety in all 10 cases. In particular, the counting protocol was found to significantly compromise case progression and patient safety. We identified 11 events that potentially compromised patient safety, allowing us to identify recurring factors that contributed to or mitigated the overall effect on the patient's outcome. CONCLUSIONS This study demonstrates the role of prospective observational methods in exposing critical system features that influence patient safety and that can be the targets for patient safety initiatives. Communication breakdown and information loss, as well as increased workload and competing tasks, pose the greatest threats to patient safety in the operating room.
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Tramuta DA, Kereiakes DJ, Dippel EJ, Lengerich R, Broderick TM, Abbottsmith CW, Whang DD, Roth EM, Schneider JF, Howard W, Shimshak TM. Combination enoxaparin-abciximab therapy during coronary intervention: the next standard of care? THE JOURNAL OF INVASIVE CARDIOLOGY 2005; 12 Suppl C:3C-6C. [PMID: 10762860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Vicente * KJ, Mumaw RJ, Roth EM. Operator monitoring in a complex dynamic work environment: a qualitative cognitive model based on field observations. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2004. [DOI: 10.1080/14039220412331298929] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Patterson ES, Roth EM, Woods DD, Chow R, Gomes JO. Handoff strategies in settings with high consequences for failure: lessons for health care operations. Int J Qual Health Care 2004; 16:125-32. [PMID: 15051706 DOI: 10.1093/intqhc/mzh026] [Citation(s) in RCA: 286] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe strategies employed during handoffs in four settings with high consequences for failure. DESIGN ANALYSIS of observational data for evidence of use of 21 handoff strategies. SETTING NASA Johnson Space Center in Texas, nuclear power generation plants in Canada, a railroad dispatch center in the United States, and an ambulance dispatch center in Toronto. MAIN MEASURE Evidence of 21 handoff strategies from observations and interviews. RESULTS Nineteen of 21 strategies were used in at least one domain, on at least an 'as needed' basis. CONCLUSIONS An understanding of how handoffs are conducted in settings with high consequences for failure can jumpstart endeavors to modify handoffs to improve patient safety.
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Burns CM, Bisantz AM, Roth EM. Lessons from a comparison of work domain models: representational choices and their implications. HUMAN FACTORS 2004; 46:711-727. [PMID: 15709332 DOI: 10.1518/hfes.46.4.711.56810] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
As methods in cognitive work analysis become more widely applied, questions regarding the impact of modeling choices and similarities in modeling efforts across projects and domains are increasingly relevant. However, no explicit comparison of models of similar systems has been reported. This paper compares independently developed work domain analysis (WDA) models of two command and control environments. Similarities in model content and the types of nodes included provide evidence that WDA techniques can capture fundamental elements regarding purposes and constraints. These points of agreement provide a common starting point for developing work domain representations of military command and control systems. The comparison also revealed differences between the models. Although differences in content reflected differences in scope of coverage and level of detail, other differences corresponded to more fundamental choices in modeling approach. These included the treatment of sensors, level of integration in the model, and representation of particular abstract constraints. Examination of these more fundamental differences pointed to important degrees of freedom in how to represent a WDA and clarified the implications of these modeling choices for guiding design. Actual or potential applications of this research include aiding analysts in making work domain modeling choices as well as producing work domain models of command and control environments.
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Dippel EJ, Kereiakes DJ, Tramuta DA, Broderick TM, Shimshak TM, Roth EM, Hattemer CR, Runyon JP, Whang DD, Schneider JF, Abbottsmith CW. Coronary perforation during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb/IIIa blockade: an algorithm for percutaneous management. Catheter Cardiovasc Interv 2001; 52:279-86. [PMID: 11246236 DOI: 10.1002/ccd.1065] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Coronary perforation is an uncommon but potentially life-threatening complication of percutaneous coronary intervention. The use of both atheroablative technologies for coronary intervention and adjunctive platelet glycoprotein blockade pharmacology may increase the incidence of or risk for life-threatening bleeding complications following the occurrence of coronary artery perforation. The interventional database for 6,214 percutaneous coronary interventions performed between January 1995 and June 1999 was analyzed. Hospital charts and cine angiograms for all patients identified in the database as having had coronary perforation were reviewed. Coronary perforation complicated 0.58% of all procedures and was more commonly observed in patients with a history of congestive heart failure and following use of atheroablative interventional technologies (2.8%). There was no association of abciximab therapy with either the incidence of or classification for coronary perforation. Adverse clinical outcomes (death, emergency surgical exploration) were related to the angiographic classification of perforation and were more frequently observed in patients who experienced a class 3 coronary perforation. These data suggest that specific clinical and procedural demographic factors are associated with the occurrence and severity of angiographic coronary perforation. An angiographic perforation class-specific algorithm for treatment of coronary perforation is proposed.
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Kereiakes DJ, Obenchain RL, Barber BL, Smith A, McDonald M, Broderick TM, Runyon JP, Shimshak TM, Schneider JF, Hattemer CR, Roth EM, Whang DD, Cocks D, Abbottsmith CW. Abciximab provides cost-effective survival advantage in high-volume interventional practice. Am Heart J 2000; 140:603-10. [PMID: 11011333 DOI: 10.1067/mhj.2000.109647] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Placebo-controlled randomized trials of platelet glycoprotein (GP) IIb/IIIa blockade during percutaneous coronary intervention have demonstrated efficacy of these agents for reducing the risk of periprocedural ischemic events. However, cost-effectiveness of this adjunctive pharmacotherapy has been scrutinized. Extrapolation of cost-efficacy observations from clinical trials to "real world" interventional practice is problematic. METHODS Consecutive percutaneous coronary interventions (n = 1472) performed by Ohio Heart Health Center operators at The Christ Hospital, Cincinnati, Ohio, in 1997 were analyzed for procedural and long-term (6-month) outcomes and charges. Observations on cost and efficacy (survival) were adjusted for nonrandomized abciximab allocation by means of "propensity scoring" methods. RESULTS Abciximab therapy was associated with a survival advantage to 6 months after percutaneous coronary intervention. The average reduction in mortality rate at 6 months was 3.4% (unadjusted) and 4.9% when adjusted for nonrandomization. The average charge increment to 6 months was $1512 (unadjusted) and $950 when adjusted for nonrandomization. Patients deriving the greatest reduction in mortality rates also had a reduction in total cardiovascular charges to 6 months. Distinguishing demographics of this population included multivessel coronary intervention, coronary stent deployment, intervention within 1 week of myocardial infarction, and lower left ventricular ejection fraction. The average cost per life-year gained in this study was $2875 for all patients (unadjusted) and $1243 when adjusted for nonrandomization. CONCLUSIONS Abciximab provides a cost-effective survival advantage in high-volume interventional practice that compares favorably with currently accepted standards. Clinical and procedural demographics associated with increased cost-effectiveness included multivessel coronary intervention, stent deployment, recent (<1 week) myocardial infarction, and impaired left ventricular function.
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Kereiakes DJ, McDonald M, Broderick T, Roth EM, Whang DD, Martin LH, Howard WL, Schneider J, Shimshak T, Abbottsmith CW. Platelet glycoprotein IIb/IIIa receptor blockers: An appropriate-use model for expediting care in acute coronary syndromes. Am Heart J 2000; 139:S53-60. [PMID: 10650317 DOI: 10.1067/mhj.2000.103741] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kereiakes DJ, Broderick TM, Roth EM, Whang D, Mueller M, Lacock P, Anderson LC, Howard W, Blanck C, Schneider J, Abbottsmith CA. High platelet count in platelet-rich plasma reduces measured platelet inhibition by abciximab but not tirofiban nor eptifibatide glycoprotein IIb/IIIa receptor antagonists. J Thromb Thrombolysis 2000; 9:149-55. [PMID: 10613996 DOI: 10.1023/a:1018718914065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We evaluated the differential effect of platelet count in platelet-rich plasma (PRP) on the level of ex vivo inhibition of platelet aggregation provided by abciximab, eptifibatide, and tirofiban as part of a randomized, comparative trial of these agents on platelet function in patients with unstable angina pectoris undergoing percutaneous coronary intervention. Platelet count <350 K/microL in PRP reduced measured platelet inhibition by abciximab, but not eptifibatide nor tirofiban. This observation suggests the need for standardized, uniform platelet counts in PRP during future comparisons of the degree of platelet inhibition by these agents.
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Mumaw RJ, Roth EM, Vicente KJ, Burns CM. There is more to monitoring a nuclear power plant than meets the eye. HUMAN FACTORS 2000; 42:36-55. [PMID: 10917145 DOI: 10.1518/001872000779656651] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A fundamental challenge in studying cognitive systems in context is how to move from the specific work setting studied to a more general understanding of distributed cognitive work and how to support it. We present a series of cognitive field studies that illustrate one response to this challenge. Our focus was on how nuclear power plant (NPP) operators monitor plant state during normal operating conditions. We studied operators at two NPPs with different control room interfaces. We identified strong consistencies with respect to factors that made monitoring difficult and the strategies that operators have developed to facilitate monitoring. We found that what makes monitoring difficult is not the need to identify subtle abnormal indications against a quiescent background, but rather the need to identify and pursue relevant findings against a noisy background. Operators devised proactive strategies to make important information more salient or reduce meaningless change, create new information, and off-load some cognitive processing onto the interface. These findings emphasize the active problem-solving nature of monitoring, and highlight the use of strategies for knowledge-driven monitoring and the proactive adaptation of the interface to support monitoring. Potential applications of this research include control room design for process control and alarm systems and user interfaces for complex systems.
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Kereiakes DJ, Broderick TM, Roth EM, Whang D, Shimshak T, Runyon JP, Hattemer C, Schneider J, Lacock P, Mueller M, Abbottsmith CW. Time course, magnitude, and consistency of platelet inhibition by abciximab, tirofiban, or eptifibatide in patients with unstable angina pectoris undergoing percutaneous coronary intervention. Am J Cardiol 1999; 84:391-5. [PMID: 10468074 DOI: 10.1016/s0002-9149(99)00321-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Adjunctive platelet glycoprotein IIb/IIIa blockade during percutaneous coronary intervention (PCI) reduces platelet-mediated adverse ischemic outcomes. Although abciximab, eptifibatide, and tirofiban have received U.S. Food and Drug Administration approval for use, these agents differ in their pharmacodynamic profiles. Each of these agents has been compared in randomized trials with placebo for patients undergoing PCI, but no randomized comparative studies of these agents have been performed. We compared ex vivo platelet function by both standard light transmission aggregometry and rapid platelet function assay during and after administration of abciximab, eptifibatide, or tirofiban in approved dose regimens on a randomized basis at the time of PCI in patients with unstable angina pectoris. A reduced intensity of platelet inhibition by light transmission aggregometry was observed for tirofiban compared with either eptifibatide or abciximab. In addition, the 30-minute bolus strategy used for tirofiban was associated with delayed onset of maximal platelet inhibition relative to the initiation of bolus infusion. Whether the trends in platelet function observed in this study will be translated into differences in clinical outcomes awaits definition by larger scale randomized clinical trials comparing these platelet glycoprotein IIb/IIIa inhibitors.
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Kereiakes DJ, Mueller M, Howard W, Lacock P, Anderson LC, Broderick TM, Roth EM, Whang DD, Abbottsmith CW. Efficacy of abciximab induced platelet blockade using a rapid point of care assay. J Thromb Thrombolysis 1999; 7:265-76. [PMID: 10375388 DOI: 10.1023/a:1008931126871] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Anciximab provides potent, but variable degrees of platelet inhibition both during the duration of intravenous administration and at 12 hours following therapy. Platelet function was assessed using the PC-RPFA system in 78 patients scheduled for percutaneous coronary revascularization who were administered the standard abciximab weight-adjusted bolus and 12-hour infusion. The PC-RPFA system is a cartridge-based, semiautomated point-of-care whole-blood assay that incorporates fibrinogen-coated polystyrene beads, buffers, and a modified thrombin receptor activating peptide (Isotrap) in lyophilized form. The instrument detects the agglutination rate between the stimulated platelets and the fibrinogen-coated beads, and provides a quantitative digital display in less than 2 minutes. No differences in the level of platelet inhibition were observed in these abciximab-treated patients by diabetic status, gender, smoking, diagnosis (unstable angina, chronic stable angina, recent myocardial infarction), or abciximab treatment status (first time vs. retreatment). Nocorrelation of the PC-RPFA rate of platelet aggregation with clinical demographic factors was observed, with the exception of baseline hematocrit (r2 = 0.4556). The relationship between the PC-RPFA rate of aggregation and hematocrit reflects light absorbance by erythrocytes and is specific to the PC-RPFA system. The absolute rate of platelet aggregation (slope) reported by the PC-RPFA is correlated with percent aggregation, thus making it potentially possible to predict the level of aggregation without reference to a baseline (pretreatment) measure of platelet function. This correlation was closest for patients having <40% baseline aggregation (r2 = 0.55). Thus, PC-RPFA provides a rapid point-of-care assessment of platelet function that could allow for adjustment of abciximab dosing to achieve targeted levels of platelet inhibition. The utility of this device to optimize therapy with platelet glycoprotein IIb/IIIa inhibitors is currently being evaluated.
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Roth EM. Human Factors in Nuclear Safety Edited by Neville Stanton 1996, 352 pages, $64.95 Bristol, PA: Taylor & Francis ISBN 0-7484-0166-0. ERGONOMICS IN DESIGN 1998. [DOI: 10.1177/106480469800600310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Roth EM, Mervis CB. Fuzzy set theory and class inclusion relations in semantic categories. ACTA ACUST UNITED AC 1983. [DOI: 10.1016/s0022-5371(83)90310-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Roth EM, Williams RC. Viral-host relationships in chronic diseases of man. JOURNAL OF CHRONIC DISEASES 1973; 26:55-61. [PMID: 4348452 DOI: 10.1016/0021-9681(73)90005-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Alexander BK, Roth EM. The effects of acute crowding on aggressive behavior of Japanese monkeys. BEHAVIOUR 1971; 39:73-90. [PMID: 4999798 DOI: 10.1163/156853971x00195] [Citation(s) in RCA: 64] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Roth EM. Compendium of human responses to the aerospace environment. Volume 3. Sections 10-16. 14. Nutrition. NASA CR-1205 (3). NASA CONTRACTOR REPORT. NASA CR. UNITED STATES. NATIONAL AERONAUTICS AND SPACE ADMINISTRATION 1968:14:1-52. [PMID: 5305512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Roth EM. Compendium of human responses to the aerospace environment. Volume 3. Sections 10-16. 11. Inert gas. NASA CR-1205 (3). NASA CONTRACTOR REPORT. NASA CR. UNITED STATES. NATIONAL AERONAUTICS AND SPACE ADMINISTRATION 1968:11:1-51. [PMID: 4388845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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