Clinical performance

ROC graphs are useful for visualizing the performance of binary (having two possible outcomes) classifiers. It is a well-known means for evaluating diagnostic tools in medicine, but in general it can be used for evaluation of all kinds of classification algorithms (Fawcett, 2005). 

ROC graphs are commonly used to assess the performance of a classifier. Sensitivity is plotted on the y-axis and 1-specificity on the x-axis. 

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Cling control agents Cbnical analyses Clinical chemistry Clinical performance Clinical trials Clinique aromatics Clinker... 

To remain safe and efficacious on the eye, contact lenses must maintain clear and wetted surfaces, provide an adequate supply of atmospheric oxygen to and adequate expulsion of carbon dioxide from the cornea, allow adequate flow of the eye s tear fluid, and avoid excessive abrasion of the ocular surface or eyeflds, all under a variety of environmental conditions. The clinical performance of a contact lens is controlled by the nature of the lens material the lens design the method and quaUty of manufacture the lens parameters or specifications prescribed by the practitioner and the cleaning, disinfection, and wearing procedures used by the patient. 

The popularity of the disposable lens concept is expected to continue, and the future should bring about lenses having enhanced clinical performance combined with the convenience of disposabdity. 

The compressive strength of polycarboxylate cements at cementing consistency is 55—85 MPa (8,000—12,000 psi). Typical diametral tensile strength ranges from 8—12 MPa (1160 1740 psi). The solubiHty and disintegration in distilled water after 7 days at 37°C is 0.04—0.08 wt %, and is not reflected in clinical performance. 

There is no meaningflil correlation between laboratory corrosion tests and clinical performance, but high in vitro corrosion rates on several high nickel dental prosthetic alloys (163), together with the prevalence of allergy to nickel caused by plated jewelry, gives cause for caution. 

The clinical performance of a hemodialy2er is usually described in terms of clearance, a term having its roots in renal physiology, which is defined as the rate of solute removal divided by the inlet flow concentration as shown in equation 7, where Cl is clearance in ml,/min and all other terms are as defined previously except that, in deference to convention, flow rates are now expressed in minutes rather than seconds and feed side (/) is now synonymous with blood flow on the luminal side. 

Centre for Medicines Research, 2004 Global Clinical Performances Metrics Programme Report, Industry Report, July 2004. 

Tyas, M. J. Beech, D. R. (1985). Clinical performance of three restorative materials for cervical abrasion lesions. Australian Dental Journal, 30, 260-4. 

The dissolution and ion release from dental silicate cement have been the most investigated characteristics with good reason, for they are central to its clinical performance. Erosion limits its life but release of fluoride has important clinical consequences. 

A drug product can be of no higher quality than the quality of the drug(s) and excipients (nondrug additives) from which the product is made. It is possible, however, for a product to be of much lower quality than its components, since quality and clinical performance are also related to ... 

Clearly the physicochemical properties of a drug are a decisive factor in its overall activity. Where possible, molecular structures should be optimized to obtain best clinical performance. Rarely does an oral drug have physicochemical features suitable for topical or transdermal therapy, and it can take a great deal of systematic research to identify where the best balance of activity and permeability lies. Experience with corticosteroids suggests that as much as a 100-fold improvement in clinical activity may be attainable through molecular design, for today s most potent topical corticosteroids are more active than hydrocortisone by a factor at least this large. 

Quality can not be guaranteed. One can increase the probability that a care is good or better . If the different components in the structure and process are improved the probability of a better patient outcome is increased. Sometimes it is not possible to measure patient outcomes. Instead surrogate outcomes of the process performance can be used especially if there is evidences for a link to real patient outcomes. For improvement and assessing improvement Donobedian suggests a mix of approaches in the structure, process, outcome model. For improving clinical performance Donobedian also suggests a stepwise approach as described in Box 3.1. 

An existing device is modified in such a way that it contains a novel feature, particularly if such a feature has an important physiological effect or where the modification might significantly affect the clinical performance and/or safety of the device. 

Section 1 of the guidelines establishes the context of the submission. It asks for a description of the drug, its use on the PBS and the therapies that wiU be co-administered or substituted. Section 2 asks for the best available evidence on the clinical performance of the drug, including the scientific and statistical rigour of randomised trials, and a preliminary economic evaluation based on evidence from the randomised trials. Section 3 describes when extrapolation beyond the preliminary economic evaluation maybe made and how adjustments can be made in a modelled economic evaluation. Section 4 requests a financial analysis from the perspective of the PBS and government health budgets. 

L. Sun, C.C. Berndt, K.A. Gross, A. Kucuk, Material fundamentals and clinical performance of plasma-sprayed hydroxyapatite coatings A review, J. Biomed. Mater. Res. 58 (2001) 570-592. 

The ends of the primary devices as proposed by Edwards [16] (after Harisson experiments [17]) frayed rather easily (Fig. 4), especially when they were bevel-edged. However, these devices showed rather good clinical performances in spite of an uncertain healing. Ruptures might occur near the anastomoses when... 

The example of other health workers in the USA nurse practitioners, physician assistants and optometrists demonstrates that non-medical professionals can be trained to adequately prescribe drugs within their area of expertise. Pilot projects, e.g. in the state of California, with psychologists prescribing psychopharmaceuticals with appropriate training and supervision were successful in that both the patients and supervising physicians were comfortable with the clinical performance of the trainees (De Leon and Wiggins, 1996, p. 226). 

Ratsula K. Clinical performance of a levonorgestrel-releasing intracervical contraceptive device during the first two years of use. Contraception 1989 39(2) 187-93. 

Suhonen S, Haukkamaa M, Jakobsson T, Rauramo I. Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women a comparative study. Contraception 2004 69 407-12. 

To validate the analytical and clinical performance of the method, four instruments, all with an equal configuration, were used. 

In conclusion, the approval of Restasis by the FDA is an important milestone in lipid emulsion research for ophthalmic application. This approval reflects the achievements of the last decade in terms of the availability of better ingredients, improved manufacturing processes, feasibility of sterilization, and better understanding of the optimization process. In all of the comparative studies done so far, positively charged SME achieved better ocular bioavailability regardless of the studied drug. Research efforts are underway to further explore the mechanism of interaction of positively charged SMEs with ocular tissues and to translate the results of this research into enhanced clinical performance. 

In summary, although the data are rather sparse, clinical performance in actual medical settings, particularly in surgery and anesthesia, appears to be significantly compromised by degrees of sleep loss typically experienced by residents during training. 

Engel W, Seime R, Powell V, D Alessandri R. Clinical performance of interns after being on call. South Med J 1987 80 761-763. 

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