Social Security downsizing ; significant savings but some service quality and operational problems : report to Congressional requesters /

"B-243179"--P. [1].

Geostationary operational environmental satellite (GOES) data collection system; task 3 & 4 final report.

"TER-157-0003."

Job Training Partnership Act : review of audit findings related to the Downriver Community Conference program : report to Congressional requesters /

"B-234733"--P. 1.

An experimental research design for the modified operational program design for Minnesota's Work Equity Program /

"Draft."

Report of the Joint Committee of the General Assembly appointed under resolution approved December 14, 1872 [i.e. 1871] to investigate the conduct of the commissioners appointed under the act of the Legislature to audit all claims against the Western & Atlantic Railroad, etc.

No. 3 in a vol. with binder's title: Reports of legislative committees ... 1872.

Physical and operational features of a pulsed continuous countercurrent liquid-solids contactor /

"National Reactor Testing Station"--Cover.

Audit Information Management System (AIMS).

"This material was compiled by the Audit Division, National Office for Orientation of Management Officials in the national, regional and district offices of the Audit Information Management System (AIMS)."

Minnesota's double-barrelled implied consent law : a 1983 update of "Analytical study of the legal and operational aspects of the Minnesota law entitled ʻChemical test for intoxication,"̓ DOT/HS-806-170 (Robert H. Reeder) /

"December 1983."

The residential energy audit manual /

Originally published as: The residential conservation service auditor training manual.

Audit Report, Posts and Telegraphs

Superseded by its Report: Union Government (Posts and Telegraphs)

An audit of America;

A summary of the Report of the Committee on recent economic changes, of the President's Conference on unemployment, Herbert Hoover, chairman, including the reports of a sepcial staff of the National bureau of economic research, inc.

Annual Report. Audit of the Finances of the State of West Virginia, Showing in Detail the Sources of Revenue and the Purposes of Expenditures

Mode of access: Internet.

Annual report of the Department of Audit and Control /

Report year ends June 30.

Audit of selective and non-selective non-steroidal anti-inflammatory drug use in rural general practice

Aim: To identify the demographics and risk factors in a selected patient population prescribed non-selective and cyclo-oxygenase-2 (COX- 2) selective non-steroidal anti-inflammatory drugs (NSAIDs). Method: A structured clinical self-audit form was distributed in January to March 2001 to 155 interested general practitioners (GPs) in rural Queensland. Results: Seventy one GPs participated in the audit and contributed 1417 patient records - 790 patients had received nonselective NSAIDs and 627 had received COX-2 inhibitors (celecoxib or rofecoxib). Patients who received COX-2 inhibitors were significantly older, more likely to have clinically important concomitant illness, and more likely to be taking medication known to interact with NSAIDs. They were also twice as likely to have two or more risk factors for adverse effects. The most common reasons for switching from an NSAID to a COX-2 inhibitor were reported to be a previous side effect from an NSAID (primarily related to gastrointestinal effects) or the doctor's perception of the superior efficacy of COX-2 inhibitor therapy. Conclusions: This study has shown that COX-2 inhibitors were used in a distinctly different patient population compared to non-selective NSAIDs. There were significant variations in the demographics and number of risk factors - for example, cardiovascular and renal - between the two identified populations. These differences may be due to doctors selecting COX-2 inhibitors for patients at high risk of gastrointestinal complications. However, the prescribing pattern may also be partly due to misconceptions about the relative safety and efficacy of COX-2 inhibitor drugs.

Audit of consultant physicians' reply letters for referrals to clinics in a tertiary teaching hospital

Background: Doctors referring patients to consultant physicians seek reply letters which both educate and assist in ongoing patient management. Highly desirable attributes in specialist letters include clearly stated and justified: (i) diagnostic formulations, (ii) management regimens, (iii) use of clinical investigations, (iv) prog-nostic statements, (v) contingency plans and (vi) follow-up arrangements. Aim: To explicitly evaluate the quality of reply letters for new patients referred to clinics at a tertiary teaching hospital. Methods: Letters were sampled from outpatient clinics of 10 different medical specialties at Princess Alexandra Hospital in Brisbane, Australia. Reply letters for new patient referrals between 1 August 2000 and 31 October 2000 were retrieved, from which data were abstracted to calculate the proportion of letters satisfying prespecified quality attributes. Results: Of 297 new patient referrals, reply letters were retrieved for 204 (69%). Of these, 147 (72%) referrals were accompanied by a referral letter, mostly (113/147; 77%) from general practitioners. For 120 referrals involving diagnostic issues, 69 (56%) letters stated a diagnostic formulation. Of 114 letters recommending further clinical investigations, 61 (53%) described a rationale for such testing. In 125 cases where therapy was a key issue, 83 (66%) letters recommended changes to current treatment for which reasons were specified in 46 (55%) cases, and contingency plans provided in 13 (16%). Prognosis was mentioned in only 18 (9%) cases. Follow-up arrangements were detailed in 123 (60%) letters. Assessments of patient understanding and likely adherence to therapy were stated in less than 15% of -letters. Conclusions: Opportunities exist for improving quality of consultant physicians' reply letters in terms of greater use of problem lists, contingency plans, prognostic statements and patient-centred assessments, as well as more frequent enunciation of consultants' reasoning behind requests for further tests and changes to current management. Use of structured letter templates may facilitate more consistent inclusion of key information to referring doctors.