el-Sayed, H, Goodall, SR & Hainsworth, R 1995, 'Re-evaluation of Evans blue dye dilution method of plasma volume measurement.', Clin Lab Haematol, vol. 17, no. 2, pp. 189-194.
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To simplify the method of plasma volume measurement by Evans blue dye dilution we used, for the first time, the same venous site for injection of dye and collection of samples. In a series of 49 studies the dye decay between 10 and 35 min after injection was highly linear (r = 0.991 +/- 0.01), indicating that contamination of samples is very unlikely. We repeated the measurements after eight weeks in nine patients; the mean difference was 16.4 +/- 19.6 ml, indicating a high degree of reproducibility. We found that extrapolation of the dye decay curve to time zero is required for accurate estimates of plasma volume. There was good agreement between the estimates of plasma volume obtained by extrapolation from only three samples taken at 10, 20 and 30 min after dye injection with the results obtained using all six samples. We also found good agreement between the estimates of plasma volume obtained by using standard curves constructed from four standard dilutions of 1.25, 2.5, 5 and 10 mg/l and those obtained by the use of standard curves constructed from the blank and only one standard dilution of 10 mg/l. We therefore conclude that the Evans blue technique can be simplified with minimal loss of accuracy, by using only one venous site for injection and withdrawal, withdrawing only three samples between 10 and 30 min after injection and using a two point calibration line.
SCOTT, A & HALL, J 1995, 'EVALUATING THE EFFECTS OF GP REMUNERATION - PROBLEMS AND PROSPECTS', HEALTH POLICY, vol. 31, no. 3, pp. 183-195.
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General practice reform is occurring in a number of countries. Little is known, however, of the effects of remunerating general practitioners on the costs and outcomes of care. Valuable lessons can be learned for the scope and design of future research,
Towler, B, Irwig, L, Glasziou, P, Haas, M, Plunkett, A & Salkeld, G 1995, 'The potential benefits and harms of screening for colorectal cancer', Australian Journal of Public Health, vol. 19, no. 1, pp. 24-28.
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Abstract: Australian guidelines for colorectal cancer screening for average‐risk populations vary from recommendations for annual screening by faecal occult blood testing for those over 40 years to recommendations that screening may be appropriate if requested by an informed patient aged 50 to 75 years. There are five large screening trials, of which three have published mortality data. A meta‐analysis of the mortality data suggests a 19 per cent reduction in colorectal cancer mortality (95 per cent confidence intervals 0.68 to 0.96) with Hemoccult screening. Because of the width of the confidence interval, decisions about the magnitude of the effect of screening should await further trial results, which should be available in the next few years. In the interim, we should examine issues of harm and costs in Australia. For example, in the major trials, over 80 per cent of positive results have been falsely positive and have required invasive investigation. Estimates of the cost‐effectiveness of screening for the Australian health system are not yet available and are essential. If the benefits of screening outweigh the harms and costs, a successful screening program would require provision of screening infrastructure and appropriate information to target populations, quality control for screening tests and investigations, recall mechanisms to ensure appropriate follow‐up of persons with positive results and the active participation of the Australian public and health practitioners.
Viney, R, Haas, M & Mooney, G 1995, 'Program budgeting and marginal analysis: A guide to resource allocation', New South Wales Public Health Bulletin, vol. 6, no. 4, pp. 29-29.
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