International journal of technology assessment in health care
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It is difficult to study the epidemiology of ICUs, as they lack a uniform nomenclature and/or classification. The organization and distribution of intensive care medicine depend on the size and function of the hospital. The patients in ICUs are predominantly men, with a high proportion of elderly patients (greater than or equal to 70 years) constituting 25-30% of the total. ⋯ Most survivors of intensive care seem to return to normal or near normal functional level within one year. Compared to Western Europe, the United States has more ICU beds and a nearly ten times higher admission rate to intensive care. These variations can be seen as a result of a fundamental difference in the attitudes toward withdrawing or withholding life support.
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Int J Technol Assess Health Care · Jan 1989
Review Randomized Controlled Trial Clinical TrialNonexperimental data systems in surgery.
This article reviews nonexperimental data bases, emphasizing the present uses and future opportunities of routinely collected information. Data bases are discussed in terms of appropriate research designs. Possibilities for expanding available information through new data collection and through record linkage are stressed. The relationship of nonexperimental data systems to randomized trials and to clinical decision-making is examined.
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Int J Technol Assess Health Care · Jan 1989
Review Comparative StudyPragmatic versus explanatory trials.
This article considers the distinction between "explanatory" and "pragmatic" aims in clinical trials--the distinction between testing a biological hypothesis and providing evidence to permit a choice between alternative treatment policies. The choice of treatments to compare, the selection of patients for the trial, the study size, and how the treatment comparison should be made are among the matters discussed. In general, where explanatory and pragmatic aims conflict, the pragmatic aim will often take priority.