Objective: To determine the rate of metastasis of uveal melanoma on the basis of tumor thickness in millimeters.Methods: Retrospective medical record review. Results:The mean (median) patient age was 58 (59) years. A total of 8033 eyes were examined. Of the 285 eyes with iris melanoma, the mean tumor thickness was 2.7 mm and metastasis occurred in 0.5%, 4%, and 7% at 3, 5, and 10 years, respectively. Of the 492 eyes with ciliary body melanoma, the mean tumor thickness was 6.6 mm and metastasis occurred in 12%, 19%, and 33% at 3, 5, and 10 years, respectively. Of the 7256 eyes with choroidal melanoma, the mean tumor thickness was 5.5 mm and metastasis occurred in 8%, 15%, and 25% at 3, 5, and 10 years, respectively. For all uveal melanoma, metastasis at 5, 10, and 20 years was 6%, 12%, and 20% for small melanoma (0-3.0 mm thickness), 14%, 26%, and 37% for medium melanoma (3.1-8.0 mm), and 35%, 49%, and 67% for large melanoma (Ͼ8.0 mm). More specifically, metastasis per millimeter increment at 10 years was 6% (0-1.0 mm thickness), 12% (1.1-2.0 mm), 12% (2.1-3.0 mm), 16% (3.1-4.0 mm), 27% (4.1-5.0 mm), 28% (5.1-6.0 mm), 29% (6.1-7.0 mm), 41% (7.1-8.0 mm), 50% (8.1-9.0 mm), 44% (9.1-10.0 mm), and 51% (Ͼ10.0 mm). Clinical factors predictive of metastasis by multivariate analysis included increasing patient age, ciliary body location, increasing tumor diameter, increasing tumor thickness, having a brown tumor, and the presence of subretinal fluid, intraocular hemorrhage, or extraocular extension. Conclusion:Increasing millimeter thickness of uveal melanoma is associated with increasing risk for metastasis.

The Developmental Coordination Disorder Questionnaire (DCDQ) is a parent-completed measure designed to identify subtle motor problems in children of 8 to 14.6 years of age. The purpose of this study was to extend the lower age range to children aged 5 to 7 years, revise items to ensure clarity, develop new scoring, and evaluate validity of the revised questionnaire. Additional items with improved wording were generated by an expert panel. Analyses of internal consistency, factor loading, and qualitative/quantitative feedback from researchers, clinicians, and parents were used to select 15 items with the strongest psychometric properties. Internal consistency was high (alpha = .94). The expanded questionnaire was completed by the parents of 287 children, aged 5-15 years, who were typically developing. Logistic regression modeling was used to generate separate cutoff scores for three age groups (overall sensitivity = 85%, specificity = 71%). The revised DCDQ was then compared to other standardized measures in a sample of 232 children referred for therapy services. Differences in scores between children with and without DCD (p < .001) provide evidence of construct validity. Correlations between DCDQ scores and Movement Assessment Battery for Children (r = .55) and Test of Visual-Motor Integration (r = .42) scores support concurrent validity. The results provide evidence that the revised DCDQ is a valid clinical screening tool for DCD.

Although the promise of clinical decision support system-facilitated evidence-based medicine is strong, substantial work remains to be done to realize the potential benefits.

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EXECUTIVESUMMARYDue to the heritage and history of operations management, its research methodologies have been confined mainly to that of quantitative modeling and, on occasion, statistical analysis. The field has been changing dramatically in recent years. Firms now face numerous worldwide competitive challenges. many of which require major improvements in the operations function. Yet, the research methodologies in operations have largely remained stagnant. The paradigm on which these methodologies are based, while useful, limits the kinds of questions researchers can address.This paper presents a review and critique of the research in operations, itemizing the shortcomings identified by researchers in the field. These researchers suggest a new research agenda with an integrative view of operations' role in organizations, a wider application of alternative research methodologies, greater emphasis on benefit to the operations manager, cross-disciplinary research with other functional areas, a heavier emphasis on sociotechnical analysis over the entire production system, and empirical field studies. Some of the alternative research methodologies mentioned include longitudinal studies, field experiments, action research, and field studies.Following a description of the nature of research, three stages in the research cycle are identified: description, explanation, and testing. Although research can deal with any stage in this cycle, the majority of attention currently seems to focus on the explanation stage. The paper then discusses historical trends in the philosophy of science, starting with positivism, expanding into empiricism, and then leading to post-positivism.The impacts of each of these trends on research in operations (which remains largely in the positivist mode) are described. Discussion of the importance of a plurality of research methods concludes the section.A framework for research paradigms is then developed based on two key dimensions of research methodologies: the rational versus existential structure of the research process and the natural versus artificial basis for the information used in the research. These dimensions are then further explored in terms of thirteen characteristic measures. Next, research methodologies commonly used in other fields as well as operations are described in reference to this framework. Methodologies include those traditional to operations such as normative and descriptive modeling, simulation, surveys, case and field studies as well as those more common to other fields such as action research, historical analysis, expert panels, scenarios, interviewing, introspection, and hermeneutics. Examples from operations or allied fields are given to illustrate the methodologies.Past research publications in operations are plotted on the framework to see the limitations of our current paradigms relative to the richness of other fields. We tind that operations methodologies tend to ManuscriptJournal of Operations Management lie on the more rational end of the framework while s...

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The DCDQ is a succinct and useful measure for use by occupational therapists.