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Articles by Carl C. Holbek
Showing articles by "Carl C. Holbek"
Article
July 2010
Lean as a learning system in a hospital ward
PURPOSE – The purpose of this article is to discuss lean as a learning system in a hospital ward.
DESIGN/METHODOLOGY/APPROACH – Discusses lean as a learning system in a hospital ward.
FINDINGS – The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards’ context,...
Process optimization
Information management
Article
July 2010
Diagnosis of DVT with D-dimer testing and the Wells score
The following is a copy of an article from Evidence-Based Practice, 2007; 10(12):1-2.
Venous thromboembolism refers to a spectrum of disease that includes both pulmonary embolus and deep-venous thrombosis (DVT).
More than 250,000 people in the United States are diagnosed annually with venous thromboembolic disease;...
Coagulation/fibrinolysis
D-dimer
Article
April 2010
Benefit of using a D-dimer assay with a high clinical specificity
CONTEXT: Sensitive D-dimer assays have been developed to exclude the diagnosis of deep vein thrombosis (DVT) and have exhibited great success when used in conjunction with a diagnostic algorithm, including pretest probability scoring and a compression ultrasound (CUS).
Improving specificity of D-dimer assays would...
Coagulation/fibrinolysis
D-dimer
Article
April 2010
Creatinine measurement in the radiology department 1
Clinical laboratory measurement of serum/plasma creatinine concentration has been used to assess patient kidney function for well over 50 years. With incorporation of creatinine analyses to blood gas and other point-of-care platforms the test is now available outside the laboratory, at the bedside and in the clinic.
...
Point-of-care testing
Creatinine/urea
Kidneys/fluids
Article
April 2010
NT-proBNP as a biomarker of cardioembolic stroke
In about 30-40 % of ischemic strokes, even after an extensive clinical investigation, it is not possible to determine any one etiology. It is possible that a fraction of these strokes, named cryptogenic, happen after an episode of paroxystic atrial fibrillation (AF) that was not registered. Strokes due to atrial...
Cardiac markers
Natriuretic peptide
Article
January 2010
Blood oxygenation and spurious hypoxemia
One of the principal utilities of arterial blood gas
(ABG) analysis is to help assess blood oxygenation status. The two
ABG parameters used for this assessment are
pO2(a) (partial pressure of oxygen in arterial
blood) and sO2(a) (% of total hemoglobin that is
saturated with oxygen).
In health pO2(a) is
maintained...
Blood gases/acid-base
Point-of-care testing
Glucose
Hemoglobins
Article
October 2009
Diagnostic accuracy – Part 2
Predictive value and likelihood ratio
Sensitivity and specificity define the discriminative power of a diagnostic procedure, whereas predictive values relate to the predictive ability of a test to identify disease or its absence in individuals.
Predictive values are greatly influenced by the prevalence of the disease and should not be generalized beyond ...
Information management
Article
October 2009
Clinical aspects of pleural fluid pH
Pleural effusion, defined as excess fluid in the pleural space, can complicate the course of a large and pathologically diverse range of pulmonary and non-pulmonary diseases. Laboratory analysis of pleural fluid provides much useful information for the clinician whose diagnostic challenge is the patient presenting...
Point-of-care testing
Blood gases/acid-base
Glucose
Lactate
Hemoglobins
Article
July 2009
Clinical aspects of the anion gap
The anion gap (AG) is a calculated parameter derived from measured serum/plasma electrolyte concentrations. The clinical value of this calculated parameter is the main focus of this article.
Both increased and reduced anion gap have clinical significance, but the deviation from normal that has most clinical...
Electrolytes
Blood gases/acid-base
Glucose
Lactate
Creatinine/urea
Kidneys/fluids
Article
June 2009
Diagnostic accuracy – Part 1
Basic concepts: sensitivity and specificity, ROC analysis, STARD statement
The discriminative ability of a diagnostic procedure is called diagnostic accuracy, and a number of quantitative measures out of which sensitivity and specificity are mostly used in the biomedical literature can express it.
Each diagnostic-accuracy measure relates to some specific aspects of a diagnostic procedure....
Information management
