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How much variation in CS rates can be explained by case mix differences? (2005)

Paranjothy, S. ; Frost, C. ; Thomas, J.

Oxford, UK and Malden, USA : Blackwell Science Ltd

BJOG 112 (2005), S. 0

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ISSN: 1471-0528

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Objective To quantify the amount of variation in caesarean section (CS) rates between maternity units explained by case mix differences.Design Cross-sectional study.Setting All 216 maternity units in England and Wales.Population Women giving birth at these maternity units between May and July 2000.Methods Logistic regression models were developed to investigate the relationship between case mix characteristics, and odds of (i) CS before labour, (ii) CS in labour. Using these results, overall CS rates standardised for case mix were calculated for each maternity unit. Random-effects meta-analysis was used to examine heterogeneity between maternity units.Main outcome measures CS before labour and CS during labour.Results Adjustment for case mix differences between maternity units explained 34% of the variance in CS rates. Odds of CS (before and in labour) increased with maternal age. Women from ethnic minority groups had lower odds of CS before labour, and increased odds of CS in labour. Women with a previous vaginal delivery had lower odds of CS, although the magnitude of this for CS before and in labour is markedly different.Conclusions Case mix adjustment is important to enable understanding of the factors that influence the CS rate. These include organisational and staffing levels as well as women's preferences for childbirth and clinician's attitudes. An understanding of how these factors influence the CS rate is essential for evaluation of quality and appropriateness of obstetric care provided to women.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1471-0528.2005.00501.x

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Browse and Search Patterns in a Digital Image Database (2000)

Frost, C. Olivia ; Taylor, Bradley ; Noakes, Anna ; [et al.]

Springer

Information retrieval 1 (2000), S. 287-313

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ISSN: 1573-7659

Keywords: browsing ; digital images ; image retrieval ; user studies

Source: Springer Online Journal Archives 1860-2000

Topics: Computer Science

Notes: Abstract A prototype image retrieval system with browse and search capabilities was developed to investigate patterns of searching a collection of digital visual images, as well as factors, such as image size, resolution, and download speed, which affect browsing. The subject populations were art history specialists and non-specialists. Through focus group interviews, a controlled test, post-test interviews and an online survey, data was gathered to compare preferences and actual patterns of use in browsing and searching. While specialists preferred direct search to browsing, and generalists used browsing as their preferred mode, both user groups found each mode to play a role depending on information need, and found value in a system combining both browse and direct search. There were no significant differences in performance among the search modes of browse, search, and combined browse/search models when the quasi-controlled study tested the different modes.