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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Annals of surgical oncology 5 (1998), S. 553-556 
    ISSN: 1534-4681
    Keywords: Database ; Oncology ; Concordance ; κ statistic ; Orthopaedics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Hospital databases contain vital demographic patient information, which is increasingly being used as a basis to dictate care. It is hypothesized that the validity of data administratively generated from such sources is suboptimal, especially for rare subspecialties. The authors examined three databases to determine their concordance in an academic orthopaedic oncology subspecialty practice. Methods: A 2-year retrospective review was performed on three databases searching for seven fundamental variables: additions/deletions; identification number; birthdate; procedure date; admit/discharge date; procedure code; and diagnostic code. Two university-maintained hospital databases (medical records and physician billing) were compared to the surgeon's personal handwritten daily log, which served as the “gold standard.” Results: All seven variables were in agreement with the physician's log in only 60% of the medical records and 61% of the physician billing patient entries (n=564). On more detailed statistical analysis using x2, cross tabulations, and the κ statistic for interobserver agreement, it was determined that poor concordance exists among the databases. Conclusion: Surgeons delivering quartenary care should maintain his or her own database because the hospital's information often differs on one or more important variables. Further investigation into the accuracy of hospital databases regarding commonly practiced medical disciplines appears warranted.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0897-3806
    Keywords: rotation-plasty ; osteosarcoma ; limb-salvage ; resection ; reconstruction ; knee ; children ; Life and Medical Sciences ; Miscellaneous Medical
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: Resection of malignant tumors about the knee, followed by reconstruction of the lower limb by rotating it through an arc of 180 degrees is becoming a popular method of treatment of osteosarcoma in growing children. Following rotation, the rotated ankle functions as the knee joint, powering a custom-made prosthesis. The functional result is superior to above-knee amputation with better propioceptive feedback and the absence of phantom limb pain. The children are able to climb stairs well and participate in running sports.The surgical technique is demanding, requiring a precise knowledge of the surgical anatomy. To be successful, the sciatic, peroneal, and tibial nerves must be preserved. The femoral and popliteal artery may be resected and reconstructed if necessary. The remaining growth of the child is determined so that the rotated ankle can be positioned at the level of the contralateral normal knee.
    Additional Material: 13 Ill.
    Type of Medium: Electronic Resource
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