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Statistical prediction using duration of cardiac asystole data
Başlık:
Statistical prediction using duration of cardiac asystole data
Yazar:
Binks, Keith, author.
ISBN:
9780438052871
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (66 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 76-08C.
Advisors: K. R. Clarke.
Özet:
The aims of this thesis are twofold: Firstly, to verify that the duration of cardiac asystole is a useful variable in helping to identify convulsions which are 'anoxic' in mechanism and then provide appropriate statistical diagnostic rules. Secondly to classify statistically as "anoxic" or "epileptic", the mechanism of the febrile convulsion suffered by children, immunised with whooping cough vaccine, and subsequently brain damaged. It is known that ocular compression can produce abnormally long asystole in patients who suffer anoxic seizures. It is also known that atropine can prevent both naturally occurring anoxic seizures and abnormal response to ocular compression. Our concern is with children who have been referred to the Electronencephalogram (E.E.G) department of Yorkhill Hospital, Glasgow after suffering one or more convulsions. Convulsions are either febrile or afebrile. Febrile convulsions are nearly always anoxic or epileptic in mechanism, while the majority of afebrile convulsions are reflex anoxic, syncopal or breath holding in mechanism. The clinical history was taken or retaken and, on the basis of this information, a clinical diagnosis was made. In the presence of a parent or attendant, ocular compression under E.E.G. and electrocardiogram (E.C.G.) monitoring was carried out. This gives rise to a reading for the duration of cardiac asystole. Some patients referred to the hospital with the diagnosis of epilepsy are, after examination, found to be anoxic, which is not surprising since their symptoms are often eleptiform. The difficulty of clinical diagnosis can be assessed from this study by noting the relative proportion of individuals who could not be classified, referred to as the "others" group from now on. The causes of mis-diagnosis are many-fold; the absence of one or more symptoms is probably the major cause. Others, such as a child with febrile convulsions who may have an occasional non-febrile convulsion, cloud the situation. The data naturally divides itself into three parts: F.C.: series 1 data, the data from the first one hundred children referred to the E.E.G. department of Yorkhill Hospital after one or more febrile convulsions, N.F.C. series 2 data, all the data from children referred to the E.E.G. department of Yorkhill Hospital after one or more afebrile convulsions, and finally F.C. series 3 data, all the data from children referred to the E.E.G. department of Yorkhill Hospital after one or more febrile convulsions. An analysis of series 1 data clearly demonstrates that the asystole reading data can be adequately described by a gamma distribution and the difference between the anoxic and epileptic samples can be explained by a difference only in the distributional scale parameter. Application of this result to standard Bayesian diagnostic theory leads to the result "if the asystole reading is > 2.7, the convulsion is more likely to be anoxic than epileptic in mechanism." The F.C. Series 3 data, the next of the febrile convulsive data, enables the febrile convulsion suffered by the "vaccine" damaged children to be statistically classified as "anoxic" or "epileptic". The results of the statistical analysis indicate that (i) the "vaccine" group consists of some individuals whose F.C. has been classified as "anoxic" and others whose F.C. has been classified as "epileptic" in mechanism. (ii) the "vaccine" group as a whole is statistically different to the "epileptic" group, but for the "anoxic" group no difference has been demonstrated. It was possible, using standard Bayesian techniques, to analyse N.F.C. series 2 data, to devise the following statistical diagnostic rules: (i) very low age and very low asystole reading implies blue breath holding. (ii) low age OR high age and high asystole reading implies reflex anoxic seizure. (iii) high age and low asystole reading implies syncope. The work clearly shows that the asystole reading resulting from investigation by ocular compression can be a useful diagnostic variable.
Notlar:
School code: 0547
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(684433.1) | 684433-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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