Non-comparative Evaluation Research Articles

Efficacy and safety of an anti-infection topical desiccating agent (DEBRICHEM) in hard-to-heal wounds.

A single centre, non-comparative evaluation was undertaken to observe the clinical results achieved when following best practice for the application of Debrichem. The treatment protocol involved use of this debridement product plus standard of care. The sample comprised 21 patients with complex, non-healing wounds of various aetiologies. One patient dropped out of the evaluation for unknown reasons. Wound types were either venous leg ulcers (n=16) or post-traumatic wounds (n=25). The mean wound duration was 22 months (range: 2 weeks-17 years). Over the 4-week follow-up period, there was a decline in the mean percentage of devitalised tissue present on the wounds, reducing from 69% at baseline to 49% at week 4. Most of the devitalised tissue was slough, for which the mean baseline percentage was 63% compared with an endpoint of 49%. Conversely, the mean percentage of granulation tissue increased from 31% at baseline to 51% at week 4. The mean visual analogue pain score reported during application was 4/10, where 0 represents no pain. However, general wound-related pain scores improved during the follow-up period, with no scores above 2 at week 2, compared with five at baseline. The results indicate that Debrichem is a safe and effective method of debridement that requires minimal training and is single use.

Phacoemulsification under Topical Anesthesia in a Tertiary Care Hospital

Introduction: The use of topical anaesthesia for cataract surgery dates back to 1884 when Knapp used 5% cocaine to anaesthetize cornea. The advancement in cataract surgery techniques like small stepped, self-sealing corneal incisions, phacoemulsification and advanced intraocular lenses has allowed the use of topical anaesthesia thus reducing surgical time and need of akinesia. Materials and Methods: Prospective non-comparative evaluation of patients’ and surgeon’s satisfaction under topical anaesthesia. All patients received topical anesthesia with proparacaine 0.5%. A 10-point visual analogue scale was given to patients to rate the level of pain felt during the operation. Also, the level of patient satisfaction, the need for supplemental anaesthesia, level of ocular motility, surgical complications and postoperative visual acuity were recorded. Results: Total number of cases were 156 out of which 86 (55.1%) were males and 70 (44.9%) were females. Nuclear sclerosis was most common type of cataract followed by mixed opacities. Majority of patients had no intraoperative movement and 30.8% of patients had some movement. Surgeon was dissatisfied in only 12.2% cases who had disturbing movements during surgery. Although majority of patients felt no pain (68%) or mild pain (23.7%) during surgery 8.3% cases had moderate to severe pain which required supplemental intracameral lidocaine. Conclusion: Topical anaesthesia is cost effective, provides high patient comfort during surgery, is less stressful for the patient, saves considerable time and complications compared to regional anaesthesia. Keywords: topical anaesthesia, phacoemulsification, pain assessment, surgeon`s satisfaction.

Two-layer reduced compression system for lower limb wounds: a non-comparative evaluation.

Leg ulceration is a debilitating condition in which various factors play a role in determining patients' quality of life (QoL), and compression therapy has been shown to improve QoL. The 3M Coban 2 Lite Compression System provides reduced compression (25-30 mmHg) ideal for patients with painful venous leg ulcers (VLU) who are unable to tolerate high-strength compression or those with mixed-aetiology leg ulcers (MLU) who have an ankle-brachial pressure index (ABPI)≥0.5. This non-comparative evaluation aims to report the initial clinical experiences with 3M Coban 2 Lite and evaluate the performance of this two-layer reduced compression bandage system in treating chronic VLUs and MLUs. In total, 30 patients (12 men (40%); mean age=68.5 years) were enroled for evaluation. The duration of the chronic wounds was 28 months (range=1.5-144 months); 16 patients had VLUs, while 14 had MLUs. Complete healing was achieved in 6 (20%) patients, and an overall mean reduction in wound surface area (4.11 cm2) was observed between the baseline and study endpoint (16 weeks). Thus, 3M Coban 2 Lite seems safe and effective for treating painful VLUs and MLUs in patients unable to tolerate high-strength compression.

179 Evaluating a Clinical Pharmacist Service in a Residential Care Unit

Abstract Background This study assessed the pharmacist role in an 80 bed residential care unit by: Quantifying the number and type of pharmacist interventions made and their acceptance rate.Assessing impact of pharmacist interventions on patient care.Assessing staff attitudes towards the clinical pharmacist service. Methods This was a non-blinded, non-comparative evaluation of the existing clinical pharmacist service in the unit. All residents were included. All pharmacist interventions over a 10-week period were recorded, then graded according to the Eadon scale1 by a consultant gerontologist and an experienced pharmacist to assess their impact on patient care. Results There were 615 pharmacist interventions. The most common interventions were: Drug Therapy Review, 34% (n=209) Technical Prescription, 26.5% (n=163) Administration, 15.3% (n=94) Drug Interaction, 10.4% (n=64) Medication Reconciliation, 8.5% (n=52) 98% (n=596) of interventions were rated as having significance to patient care, of which: 48.4% (n=298) and 41.8% (n=257) of the interventions rated as ‘significant and resulting in an improvement in the standard of care’1% (n=6) and 0.5% (n=3) rated as ‘very significant and preventing harm’. There was a statistically significant agreement between the evaluators, κw = 0.231 (95% CI, 0.156 to 0.307), p < .0005. The strength of agreement was fair. Of interventions requiring acceptance by medical team (n=335), 89.9% (n=301) were accepted. 95% (n=36) of staff who responded agreed or strongly agreed that improved patient safety resulted from the pharmacist’s involvement in multidisciplinary medication reviews. Over 92% (n=35) agreed or strongly agreed that their experience of the pharmacist was positive. Conclusion The pharmacist has an important role in our residential care unit. Their involvement in the medicines optimisation process positively impacts patient outcomes and prevents harm. Staff perceived a positive impact of the clinical pharmacist service provided on patient care and patient safety.

A multicentre, clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience.

Our aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed. This was a non-comparative evaluation of acute and chronic wounds that required debridement as part of their normal treatment regimen. Clinicians recorded wound changes including a subjective assessment level of devitalised tissue and wound bed preparation, presence of pain, wound status (e.g., wound size) and periwound skin condition. Data was also collected from clinicians and patients to provide information on clinical performance of the dressing. We recruited 100 patients with a variety of wound types into the study. Over 90% of the clinicians reported removal of devitalised tissue to enable a healing response in both chronic and acute wounds. Specifically, over the course of the evaluation period, levels of devitalised tissue (necrosis and slough) reduced from 85.5% to 26.3%, and this was accompanied by an increase in wound bed granulation from 12.0% to 33.7%. Correspondingly, there was a 40% reduction in wound area, hence a clinically relevant healing response was seen upon treatment with HRWD. It is also noteworthy that this patient population included a significant proportion of chronic wounds (51.4%) that showed no signs of wound progression within <4 weeks before study inclusion. Of these chronic wounds, 93% demonstrated wound progression upon treatment with HRWD. Despite reported pain levels being low pre- and post-dressing change, overall wound pain improved (reduced) in 48% of patients. Periwound skin condition showed a tendency towards improvement, and the fluid management capabilities of the HRWD was reported as good to excellent in the majority of cases. Wound infections were reduced by at least 60% over the evaluation period. A simple cost-effective analysis demonstrated significant savings using HRWD (£6.33) over current standard practice regimens of a four-step debridement process (£8.05), larval therapy (£306.39) and mechanical pad debridement (£11.46). HRWD was well tolerated and was demonstrated to be an efficient debridement tool providing rapid, effective and pain free debridement in a variety of wound types.

Investigating a comparative evaluation approach in explaining loyalty

PurposeThe purpose of this paper is to examine the superiority of comparative evaluation or relative attitudinal measurement approach in which the respondent evaluates one object with direct comparison with other objects. The study uses comparative and non-comparative approaches to examine the effects of service quality, value, and customer satisfaction on attitudinal loyalty in a service setting.Design/methodology/approachThe study uses the data collected from the survey of 300 customers of two large Indian banks.FindingsThe results provide partial support to the superiority of the comparative evaluation over non-comparative evaluation. Additionally, results indicate that service quality positively affects customer value, and both service quality and customer value have a direct positive effect on customer satisfaction. Customer satisfaction drives attitudinal loyalty which in turn leads to customers’ willingness to pay more.Research limitations/implicationsIn the study, two banks were used for comparative evaluation. Since consumers’ consideration set can consist of more than two alternatives, future studies can include more than two objects.Practical implicationsNon-comparative measurements do not always adequately explain customer loyalty and superior performance of firms. This could potentially lead to misinterpretations of effects of service quality improvement programs and thus sub-optimal management decisions. Managers should use comparative evaluation approach for measuring marketing variables wherever possible.Originality/valueAlthough the use of comparative evaluation is suggested in the literature (Dick and Basu, 1994), extant research has not systematically examined its superiority over non-comparative evaluation. This study empirically tests the comparative evaluation approach against the non-comparative approach by examining a comprehensive model involving the interrelationships among service quality, value, customer satisfaction, and their impact on attitudinal loyalty and willingness to pay more.

Evaluating the performance of a new carboxymethyl cellulose dressing in the community setting.

This article describes a single-centre, non-comparative evaluation set out to assess the clinical performance and patient acceptability of a new carboxymethyl cellulose (CMC) wound dressing. Twenty patients in a community setting, aged between 34-97 years, were recruited. The progression of various types of wounds with different levels of exudate was documented over 4 weeks. No adherence to the wound bed or painful removal was reported in 18 patients, and the peri-wound skin was the same or had improved in all patients. When compared with the previous CMC dressing used by the authors, the new CMC dressing reported a longer wear time. These findings show a positive clinical performance and suggest a potential financial advantage when using the new dressing.

Long-term outcomes of glaucoma drainage devices for glaucoma post-vitreoretinal surgery with silicone oil insertion: a prospective evaluation.

To evaluate long-term success of the Ahmed glaucoma valve (AGV) for refractory glaucoma after vitreoretinal surgery with silicone oil insertion. Prospective non-comparative evaluation of patients who underwent AGV insertion for management of post-vitreoretinal surgery glaucoma, post-silicone oil removal. Intraocular pressure (IOP), visual acuity, and glaucomatous neuropathy status were evaluated preoperatively and at multiple follow-up visits postoperatively. Success, using Kaplan-Meier analysis, was determined at the 12-month follow-up visit and at the last follow-up. Factors associated with failure were analysed. Twenty-seven eyes of 27 patients with a mean age of 28.3 ± 15.2years underwent a superior AGV implantation. The average follow-up after AGV implantation was 17.11 ± 8.36months (range: 9-60months). Kaplan-Meier survival analysis revealed a 62% success at 12months and 37% at 5years. A 48% rate of complications was noted, 22% of which were vision-threatening. Factors analysed, including patient age, interval between vitreoretinal surgery and silicone oil removal, interval between vitreoretinal surgery and AGV implantation, and phakic status, were not found to be associated with higher failure rates. Long-term success of AGV implantation for glaucoma after vitreoretinal surgery with silicone oil insertion is better than that reported for trabeculectomy, though complication rates remain high.

A novel reconstruction tool (syngo DynaCT Head Clear) in the post-processing of DynaCT images to reduce artefacts and improve image quality

BackgroundLatest generations of flat detector (FD) neuroangiography systems are able to obtain CT-like images of the brain parenchyma. Owing to the geometry of the C-arm system, cone beam artifacts are...

Clinical evaluation of a thin absorbent skin adhesive dressing for wound management

This article assesses the use of BeneHold Thin Absorbent Skin Adhesive (TASA) wound dressings in a large UK primary care organisation. These wound dressings are thin (0.12 mm), breathable, transparent, and are able to absorb and retain wound exudate. This non-comparative evaluation was undertaken to explore the clinical advantages this differentiated combination of physical properties offered. The dressings are CE-marked medical devices, and were used on patients with acute and chronic wounds that were assessed and classified as light to moderately exuding. Clinical performance was evaluated with respect to the dressing's ease of use (application and removal, conformability, mould-ability, rolling and edge-lift), debridement, protection of the peri-wound, wear time, fluid handling, wound bed residue, visibility of the wound, and clinical acceptability. The evaluating clinicians used an agreed audit tool to collect data from case reports to document the progression of wounds of various aetiologies, including chronic and acute, for a maximum period of four weeks. Qualitative feedback on dressing performance was also collected at the evaluation's end, both from the clinicians' and patients' perspectives Results: Some 15 patients were assessed. The wear time was up to seven days in many cases, and on average was 3.9 days longer than their previous dressings. Clinicians perceived that wounds progressed toward healing in all but two cases, where the wounds remained unchanged. Out of five cases where wounds presented with necrosis, all underwent significant autolytic debridement underneath the new dressings. Transparency was a noted benefit from both the clinicians' and patients' perspectives because it enabled continuous monitoring of the full wound bed and peri-wound skin without the need to disrupt the dressing. The dressing was well-received by both clinicians and patients in all fifteen cases. The thin absorbent skin adhesive dressing was found to be a promising new technology that could offer significant advantages to improve the quality, cost, and convenience of wound care. Further work is underway to validate these findings in larger and more homogeneous patient groups.

Brand Identification by Product Design: The Impact of Evaluation Mode and Familiarity

ABSTRACTDistinctive product design is a cornerstone of sustainable branding. Ideally, consumers will be able to identify brands by product design without seeing any logos. Once companies have established strong associations between product designs and brands in consumers’ minds, they seek protection against imitation as well as consistency in product lines. This research discusses methods for measuring consumers’ abilities to identify brands by product design. Study 1 shows that brand identification depends on the evaluation mode that the identification task evokes. Compared to a task that presents products side by side (comparative mode), participants are more likely to confuse copycats with an original design when they see only one product (noncomparative mode). Study 2 replicates findings of Study 1, demonstrating some robustness of effects across three countries (United States, Spain, Germany) and across three different product categories (beer, smartphones, cars). Study 2 further investigates how familiarity with the product influences brand identification. Although consumers with high (compared to low) familiarity are more likely to accurately identify an original product in a noncomparative evaluation mode, they are also more likely to confuse a copycat with the original product in this mode. Overall, this research extends knowledge about brand identification by product design and provides information brand managers may need for legal decisions in trademark or design patent cases. This research also provides information for brand managers making decisions regarding new product development, for example, product line extensions.

Product weakness finder: an opinion-aware system through sentiment analysis

Purpose – Extant methods of product weakness detection usually depend on time-consuming questionnaire with high artificial involvement, so the efficiency and accuracy are not satisfied. The purpose of this paper is to propose an opinion-aware analytical framework – PRODWeakFinder – to expect to detect product weaknesses through sentiment analysis in an effective way. Design/methodology/approach – PRODWeakFinder detects product weakness by considering both comparative and non-comparative evaluations in online reviews. For comparative evaluation, an aspect-oriented comparison network is built, and the authority is assessed for each node by network analysis. For non-comparative evaluation, sentiment score is calculated through sentiment analysis. The composite score of aspects is calculated by combing the two types of evaluations. Findings – The experiments show that the comparative authority score and the non-comparative sentiment score are not highly correlated. It also shows that PRODWeakFinder outperforms the baseline methods in terms of accuracy. Research limitations/implications – Semantic-based method such as ontology are expected to be applied to identify the implicit features. Furthermore, besides PageRank, other sophisticated network algorithms such as HITS will be further employed to improve the framework. Practical implications – The link-based network is more suitable for weakness detection than the weight-based network. PRODWeakFinder shows the potential on reducing overall costs of detecting product weaknesses for companies. Social implications – A quicker and more effective way would be possible for weakness detection, enabling to reduce product defects and improve product quality, and thus raising the overall social welfare. Originality/value – An opinion-aware analytical framework is proposed to sentiment mining of online product reviews, which offer important implications regarding how to detect product weaknesses.

Pricing Risk and Ambiguity: The Effect of Perspective Taking

In the valuation of uncertain prospects, a difference is often observed between selling and buying perspectives. This paper distinguishes between risk (known probabilities) and ambiguity (unknown probabilities) in decisions under uncertainty and shows that the valuation disparity increases under ambiguity compared to risk. It is found that both the comparative versus noncomparative evaluation of risky and ambiguous prospects and the uniqueness of the valuation perspective (either seller or buyer) moderate this increase in the disparity under ambiguity. The finding is consistent with recent theoretical accounts of pricing under uncertainty. We discuss implications for market behaviour and for the ambiguity paradigm as a research tool.

Topical anesthesia in phacoemulsification

Purpose:To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% (Oxybuprocaine) and Xylocaine (Lidocaine) gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery.Materials and Methods:Prospective non-comparative evaluation of patients’ and surgeon’s satisfaction at the end of the procedure. Three hundred patients (300 eyes) were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine (updated LEGACY phacoemulsifier, Alcon) and approach (clear corneal incision) and followed by a foldable intraocular lens (IOL) implantation.Results:None of the patients had severe pain during the procedure; only 2% (six of 300) required use of intravenous sedation (Propofol), both the surgeon’s and the patients’ satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience.Conclusion:Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon.

An Examination of Perceived Quality, Satisfaction, and Loyalty Relationship: Applicability of Comparative and Noncomparative Evaluation

This paper evaluates alternative measurement approaches to investigating the relationship amongst perceived quality, customer satisfaction, and loyalty. The authors define and measure the constructs within a relative attitudinal framework and compare these results to a noncomparative or individual evaluation of brands. In addition, loyalty is measured by and defined as a behavioral and attitudinal loyalty. The object of this research is teh botol whilst the subjects are undergraduate students in Surabaya and Yogyakarta. The proposed model, with satisfaction as a mediator between quality and loyalty, is found to be an acceptable representation of data across three brands of teh botol and for both comparative and noncomparative evaluation. The use of relative attitude, however, indicates a much stronger relationship amongst perceived quality, satisfaction, and loyalty than the attitude towards a brand when they are performed in individual evaluation. With respect to predictive ability, this study’s findings suggest that comparative evaluation has higher degree of applicability than does noncomparative evaluation.

A Long-term Study to Maximise Migraine Relief with Zolmitriptan

SummaryPart 1 of this international study was a randomised, double-blind, placebo-controlled study of 2.5 mg and 5 mg zolmitriptan (Zomig®) in the treatment of persistent migraine headache, two hours after an initial dose of2.5mg zolmitriptan. Part 2 was a non-comparative evaluation of long-term, unrestricted zolmitriptan use for treatment of initial, persistent and recurrent migraine headaches. In Part I, following the treatment of moderate or severe persistent headache, two-hour headache response rates with 5 mg zolmitriptan (51.6%. n = 322), 2.5mg zolmitriptan (49.7%, n = 324) and placebo (51.6%, n = 343) were not sisnificantly different. However, the pain-free response rate following the treatment of persistent migraine headache of any intensity was significantly higher with 5mg zolmitriptan than with placebo (36.0% vs. 25.4%; p < 0.001). This was predominantly due to effects in the subgroup of patients with mild headache. Thus, migraine relief in patients whose initial headache shows a partial response to 2.5 mg zolmitriptan may be maximised by a second 4mg dose. In Part 2 (involving 2499 evaluable patients), 65.8% of attacks were treated with a single dose of zolmitriptan (2.5 mg or 4 mg). Of those migraine attacks initially treated with 2.5 mg zolmitriptan, 70.3% required no further dose, similarly 62.7% of migraine attacks treated initially with 5 mg zolmitriptan only required a single dose. Over the whole attack (i.e. initial and any persistent headache), headache response rates to one or two zolrnitriptan doses were greater than 88.8%. ‘Level of pain’ was the primary factor influencing the choice of dose. Zolmitriptan provided consistent migraine headache relief in the majority of patients and was well tolerated.

Oral Ofloxacin Therapy for Lower Respiratory Tract Infection

We made an open, noncomparative evaluation of ofloxacin, 400 mg orally bid for 10 days, in 98 subjects with community-acquired pneumonia or pathogen-confirmed bronchitis. Thirty-nine (40%) of the subjects were treated in the hospital and 59 (60%) were treated as outpatients. The mean age of those treated was 56.2 years; 73 (74%) of the subjects either were more than 60 years old or had a history of chronic obstructive pulmonary disease, or both. There were 95 organisms initially isolated in sputum, aspirate, or lavage fluid; all were susceptible to ofloxacin, and none acquired resistance during therapy. Haemophilus influenzae was the most common pathogen (19 isolates), followed by Streptococcus pneumoniae (18) and Staphylococcus aureus (10). Clinical responses included cure in 70 patients (71%), improvement in 26 (27%), and failure in two (2%). After 10 days of therapy, pathogens persisted in two cases; in one case, Streptococcus salivarius was isolated, though it remained susceptible to ofloxacin, and in the other, Klebsiella pneumoniae was accompanied by superinfection due to a resistant strain of Serratia marcescens. We included in this study three confirmed cases of atypical pneumonia successfully treated with ofloxacin, two of them due to Mycoplasma pneumonia and one to Legionella pneumophila. Ofloxacin was well tolerated. Our data indicate that ofloxacin is effective and safe as specific and empiric treatment for many lower respiratory tract infections.

Oral pefloxacin mesylate in the treatment of continuous ambulatory peritoneal dialysis associated peritonitis: an open non-comparative study

Twenty-two (15 female and 7 male) patients with continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis were entered into an open non-comparative evaluation of oral pefloxacin mesylate. An initial loading dose of 800 mg was followed by 400 mg twice daily. Five patients were subsequently excluded or withdrawn. The mean age of the patients was 44 +/- 12.6 years. All three Gram-negative infections (Escherichia coli, Acinetobacter calcoaceticus, Serratia liquefaciens) and all three culture negative infections were cured after 21 days treatment. In contrast one of four (25%) Staphylococcus aureus infections was cured, two persisted during treatment and one relapsed, after treatments of between 10 and 25 days. One of seven (14%) Staph. epidermidis infections was cured, three persisted and three relapsed after treatments of between nine and 25 days. Two of the five persistent isolates became resistant: all four relapsed isolates remained sensitive. Twelve of the 22 (55%) patients had 16 side effects, most commonly skin or musculo-skeletal. Three stopped pefloxacin because of them, though one had taken an excessive dose in error. Pefloxacin mesylate is not optimal treatment for Gram-positive coccal peritonitis in patients on CAPD, but its role in Gram-negative disease needs further evaluation.

Care of the central venous catheterization site: the use of a transparent polyurethane film.

Studies of care of patients with central venous catheters report a 3-7% incidence of catheter-induced sepsis when sterile gauze and tape are used as an occlusive dressing. The technique requires that the dressing be changed three times each week for catheterization site inspection. From June 1979 to September 1980, a noncomparative evaluation of a transparent, self-adhesive, polyurethane dressing which is permeable to water vapor but not bacteria was performed. This dressing was used for the care of 100 consecutive patients with central venous catheters. Dressing life averaged 5.3 days with silicone rubber catheters and 4.3 days for polyvinyl chloride catheters. One patient developed catheter induced sepsis (incidence 1%). This dressing material: (1) is acceptable for use as a dressing of central venous catheters; (2) continuously permits inspection of the insertion sites; (3) decreases nursing hours; (4) provides a comfortable dressing which secures the catheter to the patient; and (5) is durable even when exposed to high humidity therapy devices, or when possible permits the patient to take showers.