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Sample records for external quality assessment

  1. [Making best use of external quality assessment].

    PubMed

    Fried, Roman

    2015-02-01

    To receive a maximum benefit from external quality assessment, the laboratory has to fulfill certain requirements. There have to be standard operating procedures and checklists for the correct sample processing and analysis. It is equally important, that the staff has a basic understanding how this quality-tools work and that detected errors are used as a chance to improve the processes within the laboratory. The benefit of surveys for external quality assessment is not only limited to the analytical phase, but also to some aspects of the pre and post-analytical processes. Due to the many participants, the survey providers are able to collect a lot of practical knowledge. All participants can learn from this by reading the survey reports and commentaries. With this, and with special educational surveys, the providers of surveys are able to offer an opportunity of continuous education to the laboratories.

  2. External quality assessment of hormone determinations.

    PubMed

    Sturgeon, Catharine M

    2013-12-01

    Hormone determinations are of central importance to the practice of Clinical Endocrinology, and ensuring their correct use and performance is a multidisciplinary responsibility involving clinicians, laboratory staff, manufacturers of diagnostic systems and healthcare regulatory agencies. All these professional groups have, therefore, an interest in external quality assessment (EQA) as an audit tool that can identify areas where use of tests in routine practice requires improvement to reduce risks to patients. This chapter reviews the principles of EQA, and outlines its strengths and limitations, illustrated with example data from the UK National External Quality Assessment Service (UK NEQAS). The immunological nature of many hormone assays, often further complicated by heterogeneity of analyte structure and lack of suitable calibrators, presents special problems for the designers of EQA schemes in ensuring that specimens are appropriate and that target values are accurate. Laboratory users of EQA should have sufficient knowledge of the characteristics of the EQA schemes in which they participate to make informed interpretation of their data. The trend since the 1980s for in-house assays designed in individual laboratories to be superseded by automated assays provided by a small number of diagnostics manufacturers places a special responsibility on manufacturers to ensure reliable assay design and calibration. In collaboration with other parties EQA can help identify priorities for improved assay design and calibration. Although traditionally the focus of EQA has been on assessing the analytical phase it can also make some assessment of other important aspects of performance, e.g. the consistency of reference ranges and how results are interpreted. Overall, EQA has a valuable role both in laboratory accreditation and as an educational resource, thereby helping to ensure and improve the quality of laboratory services that support patient care.

  3. External Quality Assessments for Microbiologic Diagnosis of Diphtheria in Europe

    PubMed Central

    Both, Leonard; Neal, Shona; De Zoysa, Aruni; Mann, Ginder; Czumbel, Ida

    2014-01-01

    The European Diphtheria Surveillance Network (EDSN) ensures the reliable epidemiological and microbiologic assessment of disease prevalence in the European Union. Here, we describe a survey of current diagnostic techniques for diphtheria surveillance conducted across the European Union and report the results from three external quality assessment (EQA) schemes performed between 2010 and 2014. PMID:25297336

  4. External quality assessments for microbiologic diagnosis of diphtheria in Europe.

    PubMed

    Both, Leonard; Neal, Shona; De Zoysa, Aruni; Mann, Ginder; Czumbel, Ida; Efstratiou, Androulla

    2014-12-01

    The European Diphtheria Surveillance Network (EDSN) ensures the reliable epidemiological and microbiologic assessment of disease prevalence in the European Union. Here, we describe a survey of current diagnostic techniques for diphtheria surveillance conducted across the European Union and report the results from three external quality assessment (EQA) schemes performed between 2010 and 2014. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  5. Data connectivity: A critical tool for external quality assessment.

    PubMed

    Cheng, Ben; Cunningham, Brad; Boeras, Debrah I; Mafaune, Patron; Simbi, Raiva; Peeling, Rosanna W

    2016-01-01

    Point-of-care (POC) tests have been useful in increasing access to testing and treatment monitoring for HIV. Decentralising testing from laboratories to hundreds of sites around a country presents tremendous challenges in training and quality assurance. In order to address these concerns, companies are now either embedding connectivity in their new POC diagnostic instruments or providing some form of channel for electronic result exchange. These will allow automated key performance and operational metrics from devices in the field to a central database. Setting up connectivity between these POC devices and a central database at the Ministries of Health will allow automated data transmission, creating an opportunity for real-time information on diagnostic instrument performance as well as the competency of the operator through external quality assessment. A pilot programme in Zimbabwe shows that connectivity has significantly improve the turn-around time of external quality assessment result submissions and allow corrective actions to be provided in a timely manner. Furthermore, by linking the data to existing supply chain management software, stock-outs can be minimised. As countries are looking forward to achieving the 90-90-90 targets for HIV, such innovative technologies can automate disease surveillance, improve the quality of testing and strengthen the efficiency of health systems.

  6. Analytical performance specifications for external quality assessment - definitions and descriptions.

    PubMed

    Jones, Graham R D; Albarede, Stephanie; Kesseler, Dagmar; MacKenzie, Finlay; Mammen, Joy; Pedersen, Morten; Stavelin, Anne; Thelen, Marc; Thomas, Annette; Twomey, Patrick J; Ventura, Emma; Panteghini, Mauro

    2017-06-27

    External Quality Assurance (EQA) is vital to ensure acceptable analytical quality in medical laboratories. A key component of an EQA scheme is an analytical performance specification (APS) for each measurand that a laboratory can use to assess the extent of deviation of the obtained results from the target value. A consensus conference held in Milan in 2014 has proposed three models to set APS and these can be applied to setting APS for EQA. A goal arising from this conference is the harmonisation of EQA APS between different schemes to deliver consistent quality messages to laboratories irrespective of location and the choice of EQA provider. At this time there are wide differences in the APS used in different EQA schemes for the same measurands. Contributing factors to this variation are that the APS in different schemes are established using different criteria, applied to different types of data (e.g. single data points, multiple data points), used for different goals (e.g. improvement of analytical quality; licensing), and with the aim of eliciting different responses from participants. This paper provides recommendations from the European Federation of Laboratory Medicine (EFLM) Task and Finish Group on Performance Specifications for External Quality Assurance Schemes (TFG-APSEQA) and on clear terminology for EQA APS. The recommended terminology covers six elements required to understand APS: 1) a statement on the EQA material matrix and its commutability; 2) the method used to assign the target value; 3) the data set to which APS are applied; 4) the applicable analytical property being assessed (i.e. total error, bias, imprecision, uncertainty); 5) the rationale for the selection of the APS; and 6) the type of the Milan model(s) used to set the APS. The terminology is required for EQA participants and other interested parties to understand the meaning of meeting or not meeting APS.

  7. External quality assessment scheme and laboratory accreditation in Indonesia.

    PubMed

    Timan, Ina S; Aulia, Diana; Santoso, Witono

    2002-02-01

    The National Program on External Quality Assessment Scheme (NEQAS) in Indonesia was first started in 1979, organized by the Indonesian Ministry of Health collaborating with professional bodies. The first trial was for clinical chemistry test with 2 cycles per year, followed by the hematology NEQAS in 1986 in collaboration with WHO-Royal Post Graduate Medical School London. After that, the schemes for serology, microbiology and parasitology were also organized. Around 500-600 laboratories throughout Indonesia participated each year in these quality control schemes, 2-4 cycles per year. Samples would be sent to participants and results will be given back to each laboratory. Poor performers should participate in the workshop or training course conducted by the Central Health Laboratory to improve their results. Participation in this NEQAS is mandatory for obtaining the laboratory license, and the Ministry of Health uses these schemes as one of the means for monitoring and coordinating the performance of laboratories throughout Indonesia. There are also some other EQAS (External Quality Assessment Scheme) programs conducted by professional bodies, such as for hemostasis, clinical chemistry and serology. During the course of conducting these schemes, it could be observed that manual methods were gradually changed to the automatic methods, especially for the clinical chemistry and hematology laboratories, which counts also for improvements of their results. Since the last 6 years, the Ministry of Health also began to conduct the Accreditation System evaluation for hospitals, including the laboratory departments. There are 7 standards that were evaluated, such as the aspect of the organization, administration and management, staffing, facilities and equipment, standard operating procedures, research and developments and quality control. This accreditation program is still in progress for all public and private hospital laboratories.

  8. Quantitation of carboxyhaemoglobin in blood: external quality assessment of techniques.

    PubMed

    Barnett, K; Wilson, J F

    1998-06-01

    The performance of four dedicated carbon monoxide (CO)-oximeters (AVL, Chiron, IL, Radiometer), spectrophotometry with and without dithionite, spectrophotometry by second derivative, and the Whitehead and Worthington precipitation technique for the measurement of carboxyhaemoglobin in blood was compared by a mean of 136 participants in the United Kingdom National External Quality Assessment Scheme in 21 samples formulated to contain from 4% to 48% carboxyhaemoglobin. The dedicated instruments and spectrophotometry by second derivative were of significantly higher precision than the other techniques, producing fewer measurements rejected as being > 3 standard deviations from the sample mean and having a lower standard deviation for non-rejected measurements. The AVL instrument and spectrophotometry by second derivative had a significant positive bias compared to the other techniques. The Whitehead and Worthington method was of an unacceptably low precision.

  9. External quality assessment in resource–limited countries

    PubMed Central

    Carter, Jane Y

    2017-01-01

    Introduction Health laboratory services are a critical component of national health systems but face major operational challenges in resource-limited (RL) settings. New funding for health systems strengthening in RL countries has increased the demand for diagnostics and provided opportunities to address these constraints. An approach to sustainably strengthen national laboratory systems in sub-Saharan African countries is the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. External Quality Assessment (EQA) is a requirement for laboratory accreditation. EQA comprises proficiency testing (PT), rechecking of samples and on-site evaluation. Materials and methods A systematic literature search was conducted to identify studies addressing laboratory EQA and quality monitoring in RL countries. Unpublished reports were also sought from national laboratory authorities and personnel. Results PT schemes in RL countries are provided by commercial companies, institutions in developed countries and national programmes. Most government-supported PT schemes address single diseases using a vertical approach. Regional approaches to delivering PT have also been implemented across RL countries. Rechecking schemes address mainly tuberculosis (TB), malaria and human immunodeficiency virus (HIV); integrated rechecking programmes have been piloted. Constraints include sample transportation, communication of results, unknown proficiency of referee staff and limited resources for corrective action. Global competency assessment standards for malaria microscopists have been established. Conclusions EQA is vital for monitoring laboratory performance and maintaining quality of laboratory services, and is a valuable tool for identifying and assessing technology in use, identifying gaps in laboratory performance and targeting training needs. Accreditation of PT providers and competency of EQA personnel must be ensured. PMID:28392732

  10. External quality assessment for immunohistochemistry: experiences from NordiQC.

    PubMed

    Nielsen, S

    2015-07-01

    Immunohistochemistry (IHC) is applied routinely in surgical and clinical pathology, because it is essential for diagnosis and sub-classification of many neoplastic lesions. Despite its extensive use for more than 40 years, lack of standardization is a major problem; many factors during the pre-analytical, analytical and post-analytical phases affect the final results. Nordic immunohistochemical Quality Control (NordiQC) was established in 2003 to evaluate the inter-laboratory consistency of IHC, focusing mainly on the analytical part. More than 26,000 IHC slides have been evaluated during the period 2003-2013; 15 - 300 laboratories have participated in each assessment. Overall, 71% of the staining results assessed have been evaluated as sufficient for diagnostic use, while 29% were judged insufficient. All IHC protocols used for the stained slides submitted to NordiQC have been evaluated by focusing on the technical calibration performed by the laboratories, and specific parameters that gave sufficient or insufficient results have been identified. The most common causes for insufficient results were: inadequate calibration of the primary antibody, use of an inadequate primary antibody, inappropriate choice of epitope retrieval method, insufficient heat induced epitope retrieval (HIER) and use of an inadequate detection kit. Approximately 90% of the insufficient results were characterized by either a signal that was too weak or false negative staining, whereas in the remaining 10%, a poor signal-to-noise ratio or false positive staining was seen. Identification of positive and negative tissue controls to ensure appropriate calibration of the IHC assay combined with individually tailored suggestions for protocol optimization have improved IHC staining for many markers and thus inter-laboratory consistency of the IHC results. The overall data generated by NordiQC during 11 years clearly indicates that external quality assessment is a valuable and necessary supplement

  11. Assessing quality on the Sigma scale from proficiency testing and external quality assessment surveys.

    PubMed

    Westgard, James O; Westgard, Sten A

    2015-09-01

    There is a need to assess the quality being achieved for laboratory examinations that are being utilized to support evidence-based clinical guidelines. Application of Six Sigma concepts and metrics can provide an objective assessment of the current analytical quality of different examination procedures. A "Sigma Proficiency Assessment Chart" can be constructed for data obtained from proficiency testing and external quality assessment surveys to evaluate the observed imprecision and bias of method subgroups and determine quality on the Sigma scale. Data for hemoglobin A1c (HbA1c) from a 2014 survey by the College of American Pathologists (CAP) demonstrates that approximately two-thirds of the examination subgroups provide only two-Sigma quality when evaluated against the CAP requirement of an allowable total error of 6.0%. The weighted averages were 1.46 Sigma for a survey sample with an assigned value of 6.49% Hb (average bias 2.31%, CV 2.87%), 1.45 Sigma at 6.97% Hb (average bias 2.29%, CV 2.81%), and 1.75 at 9.65% Hb (average bias 1.55%, CV 2.71%). Maximum biases for examination subgroups were 5.7%, 5.8%, and 4.1%, respectively. Assessment of quality on the Sigma scale provides evidence of the analytical performance that is being achieved relative to requirements for intended use and should be useful for identifying and prioritizing improvements that are needed in the analytical quality of laboratory examinations. In spite of global and national standardization programs, bias is still a critical limitation of current HbA1c examination procedures.

  12. External Quality Assessment beyond the analytical phase: an Australian perspective

    PubMed Central

    Gay, Stephanie; McCaughey, Euan J.; Georgiou, Andrew

    2017-01-01

    External Quality Assessment (EQA) is the verification, on a recurring basis, that laboratory results conform to expectations for the quality required for patient care. It is now widely recognised that both the pre- and post-laboratory phase of testing, termed the diagnostic phases, are a significant source of laboratory errors. These errors have a direct impact on both the effectiveness of the laboratory and patient safety. Despite this, Australian laboratories tend to be focussed on very narrow concepts of EQA, primarily surrounding test accuracy, with little in the way of EQA programs for the diagnostic phases. There is a wide range of possibilities for the development of EQA for the diagnostic phases in Australia, such as the utilisation of scenarios and health informatics. Such programs can also be supported through advances in health information and communications technology, including electronic test ordering and clinical decision support systems. While the development of such programs will require consultation and support from the referring doctors, and their format will need careful construction to ensure that the data collected is de-identified and provides education as well as useful and informative data, we believe that there is high value in the development of such programs. Therefore, it is our opinion that all pathology laboratories should strive to be involved in an EQA program in the diagnostic phases to both monitor the diagnostic process and to identify, learn from and reduce errors and near misses in these phases in a timely fashion. PMID:28392728

  13. [External quality assessment of semen analysis in Poland].

    PubMed

    Jedrzejczak, Piotr; Talarczyk, Joanna; Taszarek-Hauke, Grazyna; Berger, Anna; Hauke, Jan; Pawelczyk, Leszek

    2012-11-01

    Semen analysis is an important part of male infertility diagnosis and should be performed according to international recommendations. The reliability of the results depends mainly on the qualifications of the laboratory analysts. External Quality Assessment Programmes (EQAP) are performed in laboratories worldwide in order to standardize the results. The aim of this study was to perform the first in Poland comparison of the results of sperm analysis from different laboratories. Forty two Polish laboratories were invited to participate in the EQAP and eight laboratories agreed to take part in the analysis. They were sent uniform semen samples, prepared in accordance with the WHO standards: one sample for the assessment of concentration, two for motility (on DVD) and two for the morphology of the sperm (Papanicolau staining). The reference group was comprised of three employees of the Andrologic Laboratory of Poznań University of Medical Sciences, who regularly take part in EQAP organized by ESHRE. The reference group analyzed the samples from the participating laboratories. Statistic features such as mean, median, standard deviation, minimal and maximal value, first and third quartile were assessed for every examined parameter Z-score index was used to compare the differences between assessed laboratories and the reference laboratory. The acceptable Z-score range was +/-1. Average concentration in the reference group was 43 mln/ml, while in the assessed laboratories (L) it was between 31 (L4) and 72.5 mln/ml (L1). Z-score for concentration analysis in three laboratories exceeded +/- 1 (2.51 for L1, 1.42 for L2 and -1.02 for L4). In the analysis of the first sample for progressive motility the reference group received 59%, while the values of participating laboratories varied from 42,5% (L1) to 80% (L4). Most of the centers achieved Z-score within the normal range, except for L1 and L4 (-1.48 and 1.88 respectively). The reference value for the second sample for

  14. National external quality assessment scheme for lymphocyte immunophenotyping in Belgium.

    PubMed

    Van Blerk, Marian; Bernier, Michel; Bossuyt, Xavier; Chatelain, Bernard; D'Hautcourt, Jean-Luc; Demanet, Christian; Kestens, Luc; Van Bockstaele, Dirk; Crucitti, Tania; Libeer, Jean-Claude

    2003-03-01

    In 2000, the Belgian Scientific Institute of Public Health introduced a voluntary external quality assessment scheme for lymphocyte immunophenotyping. This paper provides an analysis of the first six surveys. Specimens consisted of fresh EDTA-anticoagulated whole blood and were sent by overnight mail. The 41 participants were surveyed for methodology and were asked to report white blood cell count, percentage of lymphocytes, and percentages and absolute numbers of CD3+, CD4+, CD8+, and CD19+ cells. Median intralaboratory coefficients of variation were 1.0, 1.3, 1.7, and 3.2% for CD3+, CD4+, CD8+, and CD19+ cell percentages, respectively. Interlaboratory variability was consistently lower than 6.5% for CD3+ and CD4+CD3+ cell percentages, and lower than 9.5% for CD8+CD3+ cell percentages. Median coefficients of variation for the absolute values were higher, ranging from 10.1% for CD4+CD3+ cells to 16.5% for CD19+ cells. The percentage of CD4+CD3+ and CD8+ CD3+ cells was in several samples significantly lower than the percentage of total CD4+ and CD8+ cells. The number of laboratories measuring total CD4+ and CD8+ cells decreased by 30% during the programme. Between-laboratory variability remained stable over time. Analysis of individual laboratory performance indicated that some laboratories markedly improved their results.

  15. Standardization of tumor markers - priorities identified through external quality assessment.

    PubMed

    Sturgeon, Catharine

    2016-01-01

    Tumor markers are often heterogeneous substances that may be present in elevated concentrations in the serum of cancer patients. Typically measured by immunoassay, they contribute to clinical management, particularly in screening, case-finding, prognostic assessment, and post-treatment monitoring. Data both from external quality assessment (EQA) schemes and clinical studies demonstrate significant variation in tumor marker results obtained for the same specimen using different methods. Between-method between-laboratory coefficients of variation (CV) reported by EQA schemes generally reflect the complexity of the measurand, ranging from <5% for the structurally relatively simple α-fetoprotein (AFP) to >25% for the complex mucinous cancer antigen 19-9 (CA19-9). Improving the standardization of tumor marker measurements is particularly important for three reasons. The primary use of tumor markers is in monitoring cancer patients over long periods of time. Clinical interpretation of trends may consequently be affected if results are obtained in different laboratories using different methods or if a laboratory has to change method. Differences in results may have major implications for adoption of area-wide decision cut-offs and make implementation of these difficult. Method-related differences also make it difficult to compare clinical studies. Improving comparability of tumor marker results requires broad international agreement about which molecular forms of the measurand have clinical utility, identifying and adopting pure molecular forms as calibrants, and defining antibody specificities for their optimal detection. These aims have been achieved to varying extents for the most frequently measured serum tumor markers as described in this paper.

  16. Endorsing good quality assurance practices in molecular pathology: risks and recommendations for diagnostic laboratories and external quality assessment providers.

    PubMed

    Tembuyser, Lien; Dequeker, Elisabeth M C

    2016-01-01

    Quality assurance is an indispensable element in a molecular diagnostic laboratory. The ultimate goal is to warrant patient safety. Several risks that can compromise high quality procedures are at stake, from sample collection to the test performed by the laboratory, the reporting of test results to clinicians, and the organization of effective external quality assessment schemes. Quality assurance should therefore be safeguarded at each level and should imply a holistic multidisciplinary approach. This review aims to provide an overview of good quality assurance practices and discusses certain risks and recommendations to promote and improve quality assurance for both diagnostic laboratories and for external quality assessment providers. The number of molecular targets is continuously rising, and new technologies are evolving. As this poses challenges for clinical implementation and increases the demand for external quality assessment, the formation of an international association for improving quality assurance in molecular pathology is called for.

  17. Multiallelic synthetic quality control material: lessons learned from the cystic fibrosis external quality assessment scheme.

    PubMed

    Berwouts, Sarah; Christensen, Todd M; Brandon, Jill; Bejjani, Bassem A; Barton, David E; Dequeker, Elisabeth

    2011-09-01

    With the arrival of increasingly complex molecular tests, we are obliged to create new ways to monitor and troubleshoot the underperformance of these multiplex assays. A synthetic multiallelic quality control material has been designed to augment genomic DNA controls. We aimed to evaluate the control on a large scale, testing it on a wide variety of oligonucleotide ligation assays, test protocols, and analysis software. In addition, we investigated how laboratories treat untried and complex materials. The synthetic control monitored 32 cystic fibrosis transmembrane conductance regulator mutations and polymorphisms simultaneously. Participants of a cystic fibrosis external quality assessment scheme were invited to analyze the quality control. In total, 58 laboratories participated in this study. Twenty-seven (47%) laboratories detected 32 variants; another 27 laboratories (47%) detected from 31 to 4 variants and 4 participants reported no variants (6%). The main observations included administrative errors when indicating variants on a checklist, errors caused by misreading the instructions for use of the control or assay, and technical problems related to the assay used. Synthetic quality control materials proved to be valuable in troubleshooting underperforming assays and complement existing genomic controls. The study also revealed a strong need for increased quality control in the postanalytical phase of testing.

  18. External quality assessment scheme for haematology in Germany.

    PubMed

    Heller, S

    1995-01-01

    Quality control in haematology is performed in Germany for 20 years. Both cell count, haemoglobin measurement and differential count on smear with morphology exercise and probably diagnosis will be demanded by the participants. Until now this quality control is not mandatory, even efforts are done to change this circumstance, given by the main input of diagnostic value due to haematology results. So this regulation will be changed very soon, in order to submit haematological laboratories to governmental control, effected by the BAK (Bundesärztekammer), as already is done in clinical chemistry. For this EQA the participants cannot expected any financial support by any organization, nor public health, nor private assurance. The role of referee laboratories and reference values as well as difficulties for the adequate reference material are discussed. For the differential count other limits have to be established: recognition of pathological blood films is one of the most important point (in sense of morphological exercise) to ensure broad knowledge of "flag interpretation". Since the last year quality control for reticulocyte count and flow cytometry for immune status and leukemia-differentiation has been established.

  19. External quality assessment of transporting infectious substances in Canada.

    PubMed

    Tiffin, S M; Noble, M A

    1999-05-01

    To determine the degree of compliance with Transport Canada's Transportation of Dangerous Goods Regulations for transporting infectious substances in Canada. A three-phase study including observation of packages arriving at the British Columbia Centre for Disease Control (BCCDC) provincial laboratory; observation of requested samples of either an Escherichia coli culture or serum, not human immunodeficiency virus (HIV) or HbsAg positive, from laboratories; and a questionnaire concerning training and certification of packers in laboratories. During phase 1, 500 packages arriving at the BCCDC provincial laboratory were assessed. All arrived intact, with 384 (76.8%) in a firm outer package. Only 178 (35.6%) contained absorbent material. Six samples were known to contain human immunodefiency virus or hepatitis B; all were appropriately packaged. Of the remainder, 11 (2.2%) were considered overpackaged, 192 (38.4%) acceptably packaged and 191 (38.2%) inadequately packaged. In phase 2, 138 requested packages were assessed. All arrived intact, 132 (95.7%) in a firm outer package. Ninety-six (69.6%) contained absorbent material. Only six (4.3%) were considered inadequately packaged. In phase 3, 171 laboratories responded to a questionnaire. Fifty-nine were from small laboratories, 53 from intermediate laboratories and 23 from large laboratories. Most laboratories (55.4%) relied on in-house resources to train packers. Only 26 (15.3%) facilities had no certified packers, and 60.8% noted they had a formal copy of the regulations available in the laboratory. Laboratory characteristics associated with the likelihood of overpackaging included number of technologists (χ(2)=5.72; P=0.058), number of samples processed by laboratories (χ(2)=8.46; P=0.015) and being a private laboratory as opposed to being a hospital laboratory (Fisher Exact two-tailed 0.040). Canadian laboratories tend to package safely and within the acceptable range of regulation, although not within the

  20. Assessing the Organisational Impact of External Quality Assurance: Hypothesising Key Dimensions and Mechanisms

    ERIC Educational Resources Information Center

    Stensaker, Bjørn; Leiber, Theodor

    2015-01-01

    The aim of the article is to provide a framework in which the organisational impact of external quality assurance (EQA) can be assessed. Based on existing studies of the impact of EQA in universities and colleges it is suggested that greater systematisation of how impact is measured is needed for a better understanding of how EQA can be used as a…

  1. The Impact of External Quality Assessment on Universities: The Estonian Experience

    ERIC Educational Resources Information Center

    Vilgats, Birgit; Heidmets, Mati

    2011-01-01

    This article seeks to establish what impact external quality assessment had on universities in Estonia between 1997 and 2009. It is based on a study of the analysis of experts' reports of curricula accreditation and interviews with university and programme managers, undertaken between 2007 and 2009. The study included an analysis of 12 curricula…

  2. Assessing the Organisational Impact of External Quality Assurance: Hypothesising Key Dimensions and Mechanisms

    ERIC Educational Resources Information Center

    Stensaker, Bjørn; Leiber, Theodor

    2015-01-01

    The aim of the article is to provide a framework in which the organisational impact of external quality assurance (EQA) can be assessed. Based on existing studies of the impact of EQA in universities and colleges it is suggested that greater systematisation of how impact is measured is needed for a better understanding of how EQA can be used as a…

  3. The Impact of External Quality Assessment on Universities: The Estonian Experience

    ERIC Educational Resources Information Center

    Vilgats, Birgit; Heidmets, Mati

    2011-01-01

    This article seeks to establish what impact external quality assessment had on universities in Estonia between 1997 and 2009. It is based on a study of the analysis of experts' reports of curricula accreditation and interviews with university and programme managers, undertaken between 2007 and 2009. The study included an analysis of 12 curricula…

  4. Assessing quality and functionality of DNA isolated from FFPE tissues through external quality assessment in tissue banks.

    PubMed

    Ahmad-Nejad, Parviz; Duda, Angelika; Sucker, Antje; Werner, Martin; Bronsert, Peter; Stickeler, Elmar; Reifenberger, Guido; Malzkorn, Bastian; Oberländer, Martina; Habermann, Jens K; Bruch, Hans-Peter; Linnebacher, Michael; Schadendorf, Dirk; Neumaier, Michael

    2015-11-01

    Biobanks are becoming increasingly important for assessment of disease risk as well as identification and validation of new diagnostic biomarkers and druggable targets. The validity of data obtained from biobanks is critically limited by the biomaterial quality of the biological samples. External quality assessment (EQA) programs suitable to comprehensively measure the biomaterial quality in archived materials are currently lacking. We report on quantitative assay designs for the analysis of both structural and functional integrity of DNAs that were applied in a first pilot EQA within the priority program on tumor tissue biobanking funded by the German Cancer Aid. Participating biobanks isolated DNAs from a standardized set of 10 samples comprising sections of four different formalin-fixed paraffin-embedded tissues using their standard operating procedures. Isolated DNAs and analytical results were returned and analyzed centrally for nucleic acids yield, purity, fragmentation and amplificability at a quantitative level using dedicated assay designs. The amount of extracted DNA varied in isolates ranging between 1.5 μg and 25.8 μg. Quantification of DNA fragmentation and amplificability allowed to highlight considerable discrepancies in DNA quality. Amplicons yielded from the isolates of these identical EQA samples ranged from 105 to 411 bp suggesting differences between residual inhibitors of downstream enzymatic reactions. The quality of extraction of bioanalytes from biomaterial archives is heterogeneous even for stable biomolecules like DNA isolated with highly standardized methods. EQAs are appropriate tools to uncover strengths and weaknesses in biobanks in a systematic fashion. Biomaterial integrity is insufficiently reflected by standard methods, but needs to be assessed to improve biobank interoperability. Finally, our results also point towards the problem of measuring the quality of more delicate biomolecules like proteins or metabolites.

  5. The UK National External Quality Assessment Scheme (UK NEQAS) for molecular genetic testing in haemophilia.

    PubMed

    Perry, David J; Goodeve, Anne; Hill, Marian; Jennings, Ian; Kitchen, Steve; Walker, Isobel

    2006-11-01

    Molecular genetic analysis of families with haemophilia and other inherited bleeding disorders is now a common laboratory investigation. In contrast to phenotypic testing in which strict quality control is adhered to, in haemophilia molecular genetic testing there has been a lack of any external quality assurance schemes. In 1998 the UK National External Quality Assessment Scheme (UK NEQAS) established a pilot quality assurance scheme for molecular genetic testing in haemophilia. Results from three initial surveys highlighted problems with the quality of samples when used to screen for the intron 22 inversion within the F8 gene. The scheme was re-launched in 2003, and since that time there have been five exercises involving whole blood or immortalised cell line DNA. The results together with an overall summary of the exercise are subsequently returned to participants. Exercises to date have focused exclusively on haemophilia A and QA, material has included screening for the intron 1 and intron 22 inversions as well as sequence analysis. A paper exercise circulated in 2003 highlighted problems with the format of reports and, following feedback to participants, only a single error has been made in the subsequent four exercises. Participating laboratories now receive QA material every six months. Immortalised cell line material was introduced in 2005 and was shown to perform well. This will allow expansion of the scheme and a reduction in the dependence on blood donation.

  6. Higher quality of molecular testing, an unfulfilled priority: Results from external quality assessment for KRAS mutation testing in colorectal cancer.

    PubMed

    Tembuyser, Lien; Ligtenberg, Marjolijn J L; Normanno, Nicola; Delen, Sofie; van Krieken, J Han; Dequeker, Elisabeth M C

    2014-05-01

    Precision medicine is now a key element in clinical oncology. RAS mutational status is a crucial predictor of responsiveness to anti-epidermal growth factor receptor agents in metastatic colorectal cancer. In an effort to guarantee high-quality testing services in molecular pathology, the European Society of Pathology has been organizing an annual KRAS external quality assessment program since 2009. In 2012, 10 formalin-fixed, paraffin-embedded samples, of which 8 from invasive metastatic colorectal cancer tissue and 2 artificial samples of cell line material, were sent to more than 100 laboratories from 26 countries with a request for routine KRAS testing. Both genotyping and clinical reports were assessed independently. Twenty-seven percent of the participants genotyped at least 1 of 10 samples incorrectly. In total, less than 5% of the distributed specimens were genotyped incorrectly. Genotyping errors consisted of false negatives, false positives, and incorrectly genotyped mutations. Twenty percent of the laboratories reported a technical error for one or more samples. A review of the written reports showed that several essential elements were missing, most notably a clinical interpretation of the test result, the method sensitivity, and the use of a reference sequence. External quality assessment serves as a valuable educational tool in assessing and improving molecular testing quality and is an important asset for monitoring quality assurance upon incorporation of new biomarkers in diagnostic services.

  7. Establishing an external quality assessment scheme for point-of-care international normalized ratio in Thailand.

    PubMed

    Tientadakul, P; Chuntarut, A

    2015-08-01

    Effective warfarin therapy management has gained national interest, resulting in the increased use of point-of-care testing (POCT) for international normalized ratio (INR). External quality assessment (EQA) is recommended to ensure quality of the testing. CoaguChek XS and CoaguChek XS Plus are the only commonly available POCT INR monitors in Thailand. Therefore, Thailand NEQAS for Blood Coagulation initiated the scheme for POCT INR in 2013, including only hospitals using these devices. Questionnaires were sent to the hospitals, enquiring about their interest in EQA participation. Two surveys were distributed; each included five certified European Concerted Action on Anticoagulation (ECAA) INR plasma sets. Unsatisfactory performance was indicated by a 15% deviation from the certified mean INR value. There were 156 hospitals using the devices. Thirty-five hospitals responded to the questionnaires. Medical personnel undertaking POCT INR were limited to laboratory staff in 29 (83%) of these centers, and 31 hospitals actually participated. The medians of results from participants were the same or nearly the same as the certified mean INRs. External quality assessment for POCT INR in Thailand is feasible using the ECAA plasmas as control materials. The results therefore appear encouraging to other developing countries to establish their own EQA schemes. © 2014 John Wiley & Sons Ltd.

  8. [External assessment of analytic quality in hematology: a necessity in Latin America].

    PubMed

    Fink, N E; Fernández Alberti, A; Mazziotta, D

    1997-09-01

    The assurance of analytical quality in a clinical laboratory is achieved through an internal system of quality control complemented by an external evaluation program. Quality assurance provides a foundation for the confidence that is placed in laboratory results and their use in the diagnosis and treatment of diseases. Many laboratories in Latin American countries do not have appropriate systems in place to evaluate and control quality. Given the importance of diagnoses based on hematologic data, the Pan American Health Organization sponsored a course in quality control in hematology during the XI Latin American Congress of Clinical Biochemistry (Mexico, 1993), in which representatives from Argentina, Chile, Cuba, Mexico, Paraguay, Dominican Republic, and Uruguay participated. As part of the course, the following control materials were produced: secondary standard solution of cyanmethemoglobin, stabilized concentrated hemoglobin solution, and preserved human whole blood with pseudoleukocytes. These materials were sent to laboratories in the seven participating countries for use in analytical procedures, and the results were then subjected to an external evaluation to assess individual performance and the comparability of results among the group. The specific tasks carried out were: (1) determination of values for hemoglobin, hematocrit, and red and white blood cell counts by the procedures normally used in each laboratory; (2) recording of the data on special reporting forms; and (3) transmittal of those forms to the coordinator in each country. The results were analyzed with regard to both the procedure used and the participating country. Reference values were established by consensus following application of a statistical method to eliminate outlying values. Comparative analysis of the results showed the coefficients of variation (CV) of the hematocrit (4.5%), red blood cell count (11.0%), and white blood cell count (22.2%) to be higher than those reported from

  9. The experience of 3 years of external quality assessment of preimplantation genetic diagnosis for cystic fibrosis

    PubMed Central

    Deans, Zandra; Fiorentino, Francesco; Biricik, Anil; Traeger-Synodinos, Joanne; Moutou, Céline; De Rycke, Martine; Renwick, Pamela; SenGupta, Sioban; Goossens, Veerle; Harton, Gary

    2013-01-01

    Preimplantation genetic diagnosis (PGD) was first performed over 20 years ago and has become an accepted part of genetic testing and assisted reproduction worldwide. The techniques and protocols necessary to carry out genetic testing at the single-cell level can be difficult to master and have been developed independently by the laboratories worldwide offering preimplantation testing. These factors indicated the need for an external quality assessment (EQA) scheme for monogenic disease PGD. Toward this end, the European Society for Human Reproduction and Embryology came together with United Kingdom National External Quality Assessment Services for Molecular Genetics, to create a pilot EQA scheme followed by practical EQA schemes for all interested parties. Here, we detail the development of the pilot scheme as well as development and findings from the practical (clinical) schemes that have followed. Results were generally acceptable and there was marked improvement in results and laboratory scores for those labs that participated in multiple schemes. Data from the first three schemes indicate that the EQA scheme is working as planned and has helped laboratories improve their techniques and result reporting. The EQA scheme for monogenic PGD will continue to be developed to offer assessment for other monogenic disorders. PMID:23150080

  10. The Czech National External Quality Assessment of monoclonal immunoglobulin in the period of 1996 - 2005.

    PubMed

    Tichy, M; Palicka, V; Budina, M; Andrys, C; Maisnar, V; Vavrova, J; Hajek, R

    2008-01-01

    The aim of the presented study was to evaluate the results of SEKK "Gammopathy" (GP) control cycle (Czech National External Quality Assessment) that assessed the success rate of monoclonal immunoglobulin determination by clinical laboratories for the 1996 - 2005 period. The study summarizes the results of 20 "Gammopathy" control cycles during the ten-year period. Control cycles were repeated every 6 months. Patients who provided samples for individual SEKK "Gammopathy" control cycles were selected during routine diagnostic process in the University Hospital Hradec Kralove. Correct paraprotein typing in both A and B control samples (plasma, serum or urine) is required prior to certification. Assessment of paraprotein concentration is optional. The number of participating laboratories was gradually increasing from 26 in 1996 to 79 in 2005 (including 6 Slovak laboratories). The majority of laboratories used immunofixation electrophoresis as the method of paraprotein typing. In 2005, only one laboratory was still using immunoelectrophoresis. Typing was successful in approximately 70% of cases during the first 3 cycles and the success rate gradually increased to almost 96% by 2005. The only exception was GP 1/02 cycle with a sample of relatively rare IgD-lambda paraprotein and the success rate of 38% only. A sample of plasma without paraprotein was distributed 4 times. Several laboratories falsely identified fibrinogen as paraprotein each time. Results of "Gammopathy" control cycle for the past 10 years confirmed the value and legitimacy of this control cycle in the system of external quality control of SEKK laboratories.

  11. Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry.

    PubMed

    Vasikaran, Samuel D

    2015-05-01

    The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited.

  12. The use of CellaVision competency software for external quality assessment and continuing professional development.

    PubMed

    Horiuchi, Yuki; Tabe, Yoko; Idei, Mayumi; Bengtsson, Hans-Inge; Ishii, Kiyoshi; Horii, Takashi; Miyake, Kazunori; Satoh, Naotake; Miida, Takashi; Ohsaka, Akimichi

    2011-07-01

    Quality assessment of blood cell morphological testing, such as white blood cell (WBC) differential and its interpretation, is one of the most important and difficult assignments in haematology laboratories. A monthly survey was performed to assess the possible role of the proficiency testing program produced by CellaVision competency software (CCS) in external quality assessment (EQA) of the clinical laboratories of affiliated university hospitals and the effective utilisation of this program in continuing professional development (CPD). Four monthly proficiency surveys were conducted in collaboration with four clinical laboratories affiliated with the teaching hospitals of Juntendo University of Medicine in Japan. EQA results by the CCS proficiency testing program revealed a difference of performance levels of WBC differential and morphological interpretation and a discrepancy in the WBC differential criteria among laboratories. With regard to the utilisation of this proficiency program as a tool for CPD, this program successfully improved the performance of the low-scoring laboratories and less experienced individuals. The CCS proficiency testing program was useful for the quality assessment of laboratory performance, for education, and for the storage and distribution of cell images to be utilised for further standardisation and education.

  13. Specimen materials, target values and commutability for external quality assessment (proficiency testing) schemes.

    PubMed

    Miller, W Greg

    2003-01-01

    The objective of external quality assessment is to evaluate clinical acceptability of laboratory results. It is desirable to evaluate intermethod harmonization and traceability to a reference system. Conventional matrix-modified processed materials are used in most programs, because they can be produced in large quantities, can have multiple abnormal analytes in the same vial and have excellent stability. The principal limitation of these materials is non-commutability which makes them unsuitable for traceability or harmonization evaluation. Peer group evaluation is used which allows an individual laboratory to confirm appropriate use of a measurement technology and a manufacturer to monitor uniformity in their calibration transfer process. Authentic clinical specimen pools provide commutability but are limited by the quantity available and number of analytes at pathologic levels in the same vial. Hybrid approaches have used authentic clinical specimen pools in conjunction with non-commutable processed materials to determine method-specific matrix-corrected target values which have enabled evaluation of traceability to reference methods. Conventional processed materials are limited by non-commutability. Pooled clinical specimens are limited by availability. When used together, external quality assessment can evaluate traceability to reference systems and harmonization between test procedures.

  14. Country report: the Indonesian NEQAS on hematology. National External Quality Assessment Scheme.

    PubMed

    Silman, E; Wirawan, R; Timan, I S; Setiabudy, R; Aulia, D; Sosrosumihardjo, R

    1999-01-01

    Around six hundred clinical laboratories in all the province of Indonesia participated the Indonesian National External Quality Assessment Scheme (NEQAS) on Hematology (Program Nasional Pemantapan Kualitas Laboratorium Klinik bidang Hematologi). Automated analyzer gave better results compared to the manual method. For hemoglobin, the CV of automated analyzer and manual method were 2.8% and 9.1%, respectively. The CV of automated analyzer and manual method for leukocyte count were 8.3% and 32.3%; for erythrocyte count were 9.7% and 80.8%; and for thrombocyte count were 10.3% and 45.9%. We observe no significant improvement of the overall performance from 1986 to 1998. Quality control material for NEQAS on hematology is still a problem. The artificial particles seem not behave exactly like the human cells (leukocytes, thrombocytes).

  15. KRAS Mutations Testing in Colorectal Carcinoma Patients in Italy: From Guidelines to External Quality Assessment

    PubMed Central

    Normanno, Nicola; Pinto, Carmine; Castiglione, Francesca; Bardelli, Alberto; Gambacorta, Marcello; Botti, Gerardo; Nappi, Oscar; Siena, Salvatore; Ciardiello, Fortunato; Taddei, GianLuigi; Marchetti, Antonio

    2011-01-01

    Background Monoclonal antibodies directed against the epidermal growth factor receptor (EGFR) have been approved for the treatment of patients with metastatic colorectal carcinoma (mCRC) that do not carry KRAS mutations. Therefore, KRAS testing has become mandatory to chose the most appropriate therapy for these patients. Methodology/Principal Findings In order to guarantee the possibility for mCRC patients to receive an high quality KRAS testing in every Italian region, the Italian Association of Medical Oncology (AIOM) and the Italian Society of Pathology and Cytopathology -Italian division of the International Academy of Pathology (SIAPEC-IAP) started a program to improve KRAS testing. AIOM and SIAPEC identified a large panel of Italian medical oncologists, pathologists and molecular biologists that outlined guidelines for KRAS testing in mCRC patients. These guidelines include specific information on the target patient population, the biological material for molecular analysis, the extraction of DNA, and the methods for the mutational analysis that are summarized in this paper. Following the publication of the guidelines, the scientific societies started an external quality assessment scheme for KRAS testing. Five CRC specimens with known KRAS mutation status were sent to the 59 centers that participated to the program. The samples were validated by three referral laboratories. The participating laboratories were allowed to use their own preferred method for DNA extraction and mutational analysis and were asked to report the results within 4 weeks. The limit to pass the quality assessment was set at 100% of true responses. In the first round, only two centers did not pass (3%). The two centers were offered to participate to a second round and both centers failed again to pass. Conclusions The results of this first Italian quality assessment for KRAS testing suggest that KRAS mutational analysis is performed with good quality in the majority of Italian centers

  16. [Result survey analysis of prenatal chromosome karyotyping in an external quality assessment program].

    PubMed

    Wang, Wei; Chen, Yuanyuan; Chen, Xi; Zhong, Kun; He, Falin; Zhang, Yan; Bao, Liming; Zou, Lin; Wang, Zhiguo

    2014-08-01

    To analyze the results of prenatal karyotype of the external quality assessment program in 2013 in order to provide references and recommendations for improving the capability and performances of karyotype analysis of prenatal screening laboratories. Five lots of quality control cell photos were sent to 500 laboratories. The participants were asked to decide whether the photos have demonstrated any abnormal karyotype and determine the abnormal type. The results should be submitted before the deadline and compared with the standard results to evaluate the performances of the laboratory. One hundred forty three laboratories have returned their karyotype results for the survey. The standard answers were 7,XX,+18, 46,X,i(X)(q10), 46,XY,i(21)(q10) or 46,XY,+21,der(21;21)(q10;q10), 46,XY and 47,XY,+21 in sequential order, which were used to estimate the score of each participant. The pass rates for five lots were 97.9%, 97.2%, 95.8%, 100.0% and 97.9%, respectively. The total pass rate was 97.7%. The error rates were 2.1%, 2.8%, 4.2%, 0 and 2.1%, respectively. The total error rate was 2.3%. Some laboratories did not correctly identify the abnormal karyotypes, while some could not determine the right type of karyotype. The external quality assessment program of prenatal diagnosis of karyotype analysis should be conducted annually in order to improve the capability and performances of karyotype analysis of prenatal screening laboratories.

  17. External quality assessment of national public health laboratories in Africa, 2002–2009

    PubMed Central

    Perovic, Olga; Fensham, Vivian; McCarthy, Kerrigan; von Gottberg, Anne; de Gouveia, Linda; Poonsamy, Bhavani; Dini, Leigh; Rossouw, Jenny; Keddy, Karen; Alemu, Wondimagegnehu; Yahaya, Ali; Pierson, Antoine; Dolmazon, Virginie; Cognat, Sébastien; Ndihokubwayo, Jean Bosco

    2012-01-01

    Abstract Objective To describe findings from an external quality assessment programme involving laboratories in Africa that routinely investigate epidemic-prone diseases. Methods Beginning in 2002, the Regional Office for Africa of the World Health Organization (WHO) invited national public health laboratories and related facilities in Africa to participate in the programme. Three surveys comprising specimens and questionnaires associated with bacterial enteric diseases, bacterial meningitis, plague, tuberculosis and malaria were sent annually to test participants’ diagnostic proficiency. Identical surveys were sent to referee laboratories for quality control. Materials were prepared, packaged and shipped in accordance with standard protocols. Findings and reports were due within 30 days. Key methodological decisions and test results were categorized as acceptable or unacceptable on the basis of consensus feedback from referees, using established grading schemes. Findings Between 2002 and 2009, participation increased from 30 to 48 Member States of the WHO and from 39 to 78 laboratories. Each survey was returned by 64–93% of participants. Mean turnaround time was 25.9 days. For bacterial enteric diseases and meningitis components, bacterial identification was acceptable in 65% and 69% of challenges, respectively, but serotyping and antibiotic susceptibility testing and reporting were frequently unacceptable. Microscopy was acceptable for 73% of plague challenges. Tuberculosis microscopy was satisfactorily performed, with 87% of responses receiving acceptable scores. In the malaria component, 82% of responses received acceptable scores for species identification but only 51% of parasite quantitation scores were acceptable. Conclusion The external quality assessment programme consistently identified certain functional deficiencies requiring strengthening that were present in African public health microbiology laboratories. PMID:22461714

  18. External quality assessment of national public health laboratories in Africa, 2002-2009.

    PubMed

    Frean, John; Perovic, Olga; Fensham, Vivian; McCarthy, Kerrigan; von Gottberg, Anne; de Gouveia, Linda; Poonsamy, Bhavani; Dini, Leigh; Rossouw, Jenny; Keddy, Karen; Alemu, Wondimagegnehu; Yahaya, Ali; Pierson, Antoine; Dolmazon, Virginie; Cognat, Sébastien; Ndihokubwayo, Jean Bosco

    2012-03-01

    To describe findings from an external quality assessment programme involving laboratories in Africa that routinely investigate epidemic-prone diseases. Beginning in 2002, the Regional Office for Africa of the World Health Organization (WHO) invited national public health laboratories and related facilities in Africa to participate in the programme. Three surveys comprising specimens and questionnaires associated with bacterial enteric diseases, bacterial meningitis, plague, tuberculosis and malaria were sent annually to test participants' diagnostic proficiency. Identical surveys were sent to referee laboratories for quality control. Materials were prepared, packaged and shipped in accordance with standard protocols. Findings and reports were due within 30 days. Key methodological decisions and test results were categorized as acceptable or unacceptable on the basis of consensus feedback from referees, using established grading schemes. Between 2002 and 2009, participation increased from 30 to 48 Member States of the WHO and from 39 to 78 laboratories. Each survey was returned by 64-93% of participants. Mean turnaround time was 25.9 days. For bacterial enteric diseases and meningitis components, bacterial identification was acceptable in 65% and 69% of challenges, respectively, but serotyping and antibiotic susceptibility testing and reporting were frequently unacceptable. Microscopy was acceptable for 73% of plague challenges. Tuberculosis microscopy was satisfactorily performed, with 87% of responses receiving acceptable scores. In the malaria component, 82% of responses received acceptable scores for species identification but only 51% of parasite quantitation scores were acceptable. The external quality assessment programme consistently identified certain functional deficiencies requiring strengthening that were present in African public health microbiology laboratories.

  19. Assessing the Quality of PhD Dissertations. A Survey of External Committee Members

    ERIC Educational Resources Information Center

    Kyvik, Svein; Thune, Taran

    2015-01-01

    This article reports on a study of the quality assessment of doctoral dissertations, and asks whether examiner characteristics influence assessment of research quality in PhD dissertations. Utilising a multi-dimensional concept of quality of PhD dissertations, we look at differences in assessment of research quality, and particularly test whether…

  20. Assessing the Quality of PhD Dissertations. A Survey of External Committee Members

    ERIC Educational Resources Information Center

    Kyvik, Svein; Thune, Taran

    2015-01-01

    This article reports on a study of the quality assessment of doctoral dissertations, and asks whether examiner characteristics influence assessment of research quality in PhD dissertations. Utilising a multi-dimensional concept of quality of PhD dissertations, we look at differences in assessment of research quality, and particularly test whether…

  1. External Quality Assessment Scheme for reference laboratories - review of 8 years' experience.

    PubMed

    Kessler, Anja; Siekmann, Lothar; Weykamp, Cas; Geilenkeuser, Wolf Jochen; Dreazen, Orna; Middle, Jonathan; Schumann, Gerhard

    2013-05-01

    We describe an External Quality Assessment Scheme (EQAS) intended for reference (calibration) laboratories in laboratory medicine and supervised by the Scientific Division of the International Federation of Clinical Chemistry and Laboratory Medicine and the responsible Committee on Traceability in Laboratory Medicine. The official EQAS website, RELA (www.dgkl-rfb.de:81), is open to interested parties. Information on all requirements for participation and results of surveys are published annually. As an additional feature, the identity of every participant in relation to the respective results is disclosed. The results of various groups of measurands (metabolites and substrates, enzymes, electrolytes, glycated hemoglobins, proteins, hormones, thyroid hormones, therapeutic drugs) are discussed in detail. The RELA system supports reference measurement laboratories preparing for accreditation according to ISO 17025 and ISO 15195. Participation in a scheme such as RELA is one of the requirements for listing of the services of a calibration laboratory by the Joint Committee on Traceability in Laboratory Medicine.

  2. External Quality Assessment in Dutch Higher Education: Consultancy and Watchdog Roles.

    ERIC Educational Resources Information Center

    Zijderveld, Diederick C.

    1997-01-01

    Describes the system of external institutional evaluation in Netherlands universities, distinguishing between the organizations conducting the assessment itself and the follow-up. The primary assessing organization is a private one, funded and governed by the 14 universities, and uses discipline-based assessment teams. The follow-up assessment is…

  3. External quality assessment schemes raise standards: evidence from the UKNEQAS parasitology subschemes

    PubMed Central

    Kettelhut, M M; Chiodini, P L; Edwards, H; Moody, A

    2003-01-01

    Background: The burden of parasitic disease imported into the temperate zone is increasing, and in the tropics remains very high. Thus, high quality diagnostic parasitology services are needed, but to implement clinical governance a measure of quality of service is required. Aim: To examine performance in the United Kingdom National External Quality Assessment Scheme for Parasitology for evidence of improved standards in parasite diagnosis in clinical specimens. Methods: Analysis of performance was made for the period 1986 to 2001, to look for trends in performance scores. Results: An overall rise in performance in faecal and blood parasitology schemes was found from 1986 to 2001. This was seen particularly in the identification of ova, cysts, and larvae in the faecal scheme, the detection of Plasmodium ovale and Plasmodium vivax in the blood scheme, and also in the correct identification of non-malarial blood parasites. Despite this improvement, there are still problems. In the faecal scheme, participants still experience difficulty in recognising small protozoan cysts, differentiating vegetable matter from cysts, and detecting ova and cysts when more than one species is present. In the blood scheme, participants have problems in identifying mixed malarial infections, distinguishing between P ovale and P vivax, and estimating the percentage parasitaemia. The reasons underlying these problems have been identified via the educational part of the scheme, and have been dealt with by distributing teaching sheets and undertaking practical sessions. Conclusions: UK NEQAS for Parasitology has helped to raise the standard of diagnostic parasitology in the UK. PMID:14645352

  4. External Quality Assessment of Molecular Detection of Ebola Virus in China

    PubMed Central

    Wang, Guojing; Sun, Yu; Zhang, Kuo; Jia, Tingting; Hao, Mingju; Zhang, Dong; Chang, Le; Zhang, Lei; Zhang, Rui; Lin, Guigao; Peng, Rongxue; Li, Jinming

    2015-01-01

    In 2014, Ebola hemorrhagic fever broke out in West Africa. As contact between China and West Africa is frequent, the possibility that Ebola virus would enter China was high. Thus, an external assessment of the quality of Ebola virus detection was organized by the National Center for Clinical Laboratories in China. Virus-like particles encapsulating known sequences of epidemic strains of Ebola virus from 2014 were prepared as positive quality controls. The sample panel, which was composed of seven positive and three negative samples, was dispatched to 19 laboratories participating in this assessment of Ebola virus detection. Accurate detection was reported at 14 of the 19 participating laboratories, with a sensitivity of 91.43% and a specificity of 100%. Four participants (21.05%) reported false-negative results and were classified as “acceptable.” One participant (5.26%) did not detect any positive samples and was thus classified as “improvable.” Based on the results returned, the ability to detect weakly positive Ebola specimens should be improved. Furthermore, commercial assays and the standard primers offered by the Chinese Centers for Disease Control and Prevention were found to be most accurate and dependable for Ebola detection. A two-target detection approach is recommended for Ebola screening; this approach could reduce the probability of false-negative results. Additionally, standardization of operations and punctual adjustment of instruments are necessary for the control and prevention of Ebola virus. PMID:26177537

  5. Results of the National External Quality Assessment for Toxoplasmosis Serological Testing in China

    PubMed Central

    Zhang, Kuo; Wang, Lunan; Lin, Guigao; Sun, Yu; Zhang, Rui; Xie, Jiehong; Li, Jinming

    2015-01-01

    Background Toxoplasmosis is typically diagnosed by serologic testing. External quality assessment (EQA) of clinical laboratories could ensure the accuracy and reliability of serological tests. We assessed the quality of toxoplasma serological assays in Chinese clinical laboratories by an EQA performed between 2004 and 2013 by the National Center for Clinical Laboratories. Methodology and Findings EQA panels were prepared and shipped at room temperature to participating laboratories that employed toxoplasma IgG and IgM serological detection. By 2013, 5,384 EQA test reports for toxoplasma-specific IgM and 2,666 reports for toxoplasma-specific IgG were collected. Enzyme-linked immunosorbent (ELISA) and chemical immunofluorescent assays were the most commonly used detection methods. The overall coincidence rates of negative samples were better than those of positive samples. The overall EQA score for toxoplasma-specific IgM detection ranged between 84.3% and 99.6%. The ratio of laboratories that achieved correct IgG detection ranged from 61.1% to 99.3%. However, the inter- and intra-assay variabilities were found to be considerable. The most common problem was failure to detect low titers of antibody. Conclusion The EQA scheme showed an improvement in toxoplasma serological testing in China. However, further optimization of assay sensitivity to detect challenging samples remains a future challenge. PMID:26066047

  6. Current Landscape and New Paradigms of Proficiency Testing and External Quality Assessment for Molecular Genetics

    PubMed Central

    Kalman, Lisa V.; Lubin, Ira M.; Barker, Shannon; du Sart, Desiree; Elles, Rob; Grody, Wayne W.; Pazzagli, Mario; Richards, Sue; Schrijver, Iris; Zehnbauer, Barbara

    2015-01-01

    Context Participation in proficiency testing (PT) or external quality assessment (EQA) programs allows the assessment and comparison of test performance among different clinical laboratories and technologies. In addition to the approximately 2300 tests for individual genetic disorders, recent advances in technology have enabled the development of clinical tests which quickly and economically analyze the entire human genome. New PT/EQA approaches are needed to ensure the continued quality of these complex tests. Objective To review the availability and scope of PT/EQA for molecular genetic testing for inherited conditions in Europe, Australasia and the United States; to evaluate the successes and demonstrated value of available PT/EQA programs; and to examine the challenges to the provision of comprehensive PT/EQA posed by new laboratory practices and methodologies. Data Sources The available literature on this topic was reviewed and supplemented with personal experiences of several PT/EQA providers. Conclusions PT/EQA schemes are available for common genetic disorders tested in many clinical laboratories, but are not available for most genetic tests offered by only one or a few laboratories. Provision of broad, method-based PT schemes, such as DNA sequencing, would allow assessment of a large number of tests for which formal PT is not currently available. Participation in PT/EQA improves the quality of testing by identifying inaccuracies that laboratories can trace to errors in the testing process. Areas of research and development to ensure that PT/EQA programs can meet the needs of new and evolving genetic tests and technologies are identified and discussed. PMID:23808472

  7. Current landscape and new paradigms of proficiency testing and external quality assessment for molecular genetics.

    PubMed

    Kalman, Lisa V; Lubin, Ira M; Barker, Shannon; du Sart, Desiree; Elles, Rob; Grody, Wayne W; Pazzagli, Mario; Richards, Sue; Schrijver, Iris; Zehnbauer, Barbara

    2013-07-01

    Participation in proficiency testing (PT) or external quality assessment (EQA) programs allows the assessment and comparison of test performance among different clinical laboratories and technologies. In addition to the approximately 2300 tests for individual genetic disorders, recent advances in technology have enabled the development of clinical tests that quickly and economically analyze the entire human genome. New PT/EQA approaches are needed to ensure the continued quality of these complex tests. To review the availability and scope of PT/EQA for molecular genetic testing for inherited conditions in Europe, Australasia, and the United States; to evaluate the successes and demonstrated value of available PT/EQA programs; and to examine the challenges to the provision of comprehensive PT/EQA posed by new laboratory practices and methodologies. The available literature on this topic was reviewed and supplemented with personal experiences of several PT/EQA providers. Proficiency testing/EQA schemes are available for common genetic disorders tested in many clinical laboratories but are not available for most genetic tests offered by only one or a few laboratories. Provision of broad, method-based PT schemes, such as DNA sequencing, would allow assessment of many tests for which formal PT is not currently available. Participation in PT/EQA improves the quality of testing by identifying inaccuracies that laboratories can trace to errors in their testing processes. Areas of research and development to ensure that PT/EQA programs can meet the needs of new and evolving genetic tests and technologies are identified and discussed.

  8. How to conduct External Quality Assessment Schemes for the pre-analytical phase?

    PubMed

    Kristensen, Gunn B B; Aakre, Kristin Moberg; Kristoffersen, Ann Helen; Sandberg, Sverre

    2014-01-01

    In laboratory medicine, several studies have described the most frequent errors in the different phases of the total testing process, and a large proportion of these errors occur in the pre-analytical phase. Schemes for registration of errors and subsequent feedback to the participants have been conducted for decades concerning the analytical phase by External Quality Assessment (EQA) organizations operating in most countries. The aim of the paper is to present an overview of different types of EQA schemes for the pre-analytical phase, and give examples of some existing schemes. So far, very few EQA organizations have focused on the pre-analytical phase, and most EQA organizations do not offer pre-analytical EQA schemes (EQAS). It is more difficult to perform and standardize pre-analytical EQAS and also, accreditation bodies do not ask the laboratories for results from such schemes. However, some ongoing EQA programs for the pre-analytical phase do exist, and some examples are given in this paper. The methods used can be divided into three different types; collecting information about pre-analytical laboratory procedures, circulating real samples to collect information about interferences that might affect the measurement procedure, or register actual laboratory errors and relate these to quality indicators. These three types have different focus and different challenges regarding implementation, and a combination of the three is probably necessary to be able to detect and monitor the wide range of errors occurring in the pre-analytical phase.

  9. How to conduct External Quality Assessment Schemes for the pre-analytical phase?

    PubMed Central

    Kristensen, Gunn B.B.; Aakre, Kristin Moberg; Kristoffersen, Ann Helen; Sandberg, Sverre

    2014-01-01

    In laboratory medicine, several studies have described the most frequent errors in the different phases of the total testing process, and a large proportion of these errors occur in the pre-analytical phase. Schemes for registration of errors and subsequent feedback to the participants have been conducted for decades concerning the analytical phase by External Quality Assessment (EQA) organizations operating in most countries. The aim of the paper is to present an overview of different types of EQA schemes for the pre-analytical phase, and give examples of some existing schemes. So far, very few EQA organizations have focused on the pre-analytical phase, and most EQA organizations do not offer pre-analytical EQA schemes (EQAS). It is more difficult to perform and standardize pre-analytical EQAS and also, accreditation bodies do not ask the laboratories for results from such schemes. However, some ongoing EQA programs for the pre-analytical phase do exist, and some examples are given in this paper. The methods used can be divided into three different types; collecting information about pre-analytical laboratory procedures, circulating real samples to collect information about interferences that might affect the measurement procedure, or register actual laboratory errors and relate these to quality indicators. These three types have different focus and different challenges regarding implementation, and a combination of the three is probably necessary to be able to detect and monitor the wide range of errors occurring in the pre-analytical phase. PMID:24627720

  10. Evaluation and use of a synthetic quality control material, included in the European external quality assessment scheme for cystic fibrosis.

    PubMed

    Berwouts, Sarah; Gordon, Joan T; Rundell, Clark A; Barton, David E; Dequeker, Elisabeth

    2008-08-01

    Assuring high quality within the field of genetic testing is fundamental, as the results can have considerable impact on the patient and his or her family. The use of appropriate quality control (QC) samples is therefore essential. Diagnostic laboratories mainly use patient samples as QC material, which of course include a maximum of two mutations per sample. Bearing in mind that some assays (such as for cystic fibrosis [CF] testing) can test for more than 100 mutations, multiplex QC materials including more than two mutations could save valuable time and reagents. Based on this need, synthetic multiplex controls have been developed by Maine Molecular Quality Controls, Inc. (MMQCI) for CF. A synthetic control, containing six homozygous mutations and one polymorphism for CF transmembrane conductance regulator (CFTR), was evaluated by distributing it through the CF external quality assessment (EQA) scheme, along with the EQA samples in 2005. A total of 197 participants returned results of the yearly EQA scheme and 133 laboratories participated in the evaluation of the synthetic sample. Respectively, 76% and 73% of the participants were assigned as successful. This evaluation study revealed that the multiplex QC material performed well in the majority of assays and could be useful in method validation, as a tool to challenge interpretation skills, and as potential proficiency testing (PT) material.

  11. External quality assessment of urine particle identification: a Northern European experience.

    PubMed

    Kouri, Timo T; Makkonen, Pirjo

    2015-11-01

    External quality assessment (EQA) schemes for urinalysis have been provided by Labquality Ltd, the publicly owned EQA service provider in Finland, since the 1980s. In 2014, the scheme on urine particle identification had 329 participating laboratories, out of which 60% from 19 countries were outside Finland. Each of the four annual web-based rounds were distributed with four Sternheimer-stained images from a single patient sample, as viewed both by bright-field and phase-contrast optics. Participants reported classified categories either at the basic or at the advanced level. Participating laboratories received assessment of their analytical performance as compared to their peers, including reflections from clinical data and preanalytical detail of the specimen. In general, reporting of basic urine particles succeeded in the eight schemes during the years 2013-2014 as follows: red blood cells 82%-92%, white blood cells 82%-97%, squamous epithelial cells 92%-98%, casts 84%-94%, and small epithelial cells 73%-83% (minimum and maximum of expected or accepted reports). This basic level of differentiation is used in routine laboratory reports, or as verification of results produced by automated instruments. Considerable effort is needed to standardise national procedures and reporting formats, in order to improve the shown figures internationally. Future technologies may help to alleviate limitations created by single digital images. Despite improvements, degenerating cells and casts always exhibit intermediate forms creating disputable classifications. That is why assessment of performance should encompass justified acceptable categories into the assessed outcomes. Preanalytical and clinical detail provide essential added value to morphological findings.

  12. External quality assessment of medical laboratories in Croatia: preliminary evaluation of post-analytical laboratory testing.

    PubMed

    Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana

    2017-02-15

    Proper standardization of laboratory testing requires assessment of performance after the tests are performed, known as the post-analytical phase. A nationwide external quality assessment (EQA) scheme implemented in Croatia in 2014 includes a questionnaire on post-analytical practices, and the present study examined laboratory responses in order to identify current post-analytical phase practices and identify areas for improvement. In four EQA exercises between September 2014 and December 2015, 145-174 medical laboratories across Croatia were surveyed using the Module 11 questionnaire on the post-analytical phase of testing. Based on their responses, the laboratories were evaluated on four quality indicators: turnaround time (TAT), critical values, interpretative comments and procedures in the event of abnormal results. Results were presented as absolute numbers and percentages. Just over half of laboratories (56.3%) monitored TAT. Laboratories varied substantially in how they dealt with critical values. Most laboratories (65-97%) issued interpretative comments with test results. One third of medical laboratories (30.6-33.3%) issued abnormal test results without confirming them in additional testing. Our results suggest that the nationwide post-analytical EQA scheme launched in 2014 in Croatia has yet to be implemented to the full. To close the gaps between existing recommendations and laboratory practice, laboratory professionals should focus on ensuring that TAT is monitored and lists of critical values are established within laboratories. Professional bodies/institutions should focus on clarify and harmonized rules to standardized practices and applied for adding interpretative comments to laboratory test results and for dealing with abnormal test results.

  13. External quality assessment of medical laboratories in Croatia: preliminary evaluation of post-analytical laboratory testing

    PubMed Central

    Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana

    2017-01-01

    Introduction Proper standardization of laboratory testing requires assessment of performance after the tests are performed, known as the post-analytical phase. A nationwide external quality assessment (EQA) scheme implemented in Croatia in 2014 includes a questionnaire on post-analytical practices, and the present study examined laboratory responses in order to identify current post-analytical phase practices and identify areas for improvement. Materials and methods In four EQA exercises between September 2014 and December 2015, 145-174 medical laboratories across Croatia were surveyed using the Module 11 questionnaire on the post-analytical phase of testing. Based on their responses, the laboratories were evaluated on four quality indicators: turnaround time (TAT), critical values, interpretative comments and procedures in the event of abnormal results. Results were presented as absolute numbers and percentages. Results Just over half of laboratories (56.3%) monitored TAT. Laboratories varied substantially in how they dealt with critical values. Most laboratories (65-97%) issued interpretative comments with test results. One third of medical laboratories (30.6-33.3%) issued abnormal test results without confirming them in additional testing. Conclusion Our results suggest that the nationwide post-analytical EQA scheme launched in 2014 in Croatia has yet to be implemented to the full. To close the gaps between existing recommendations and laboratory practice, laboratory professionals should focus on ensuring that TAT is monitored and lists of critical values are established within laboratories. Professional bodies/institutions should focus on clarify and harmonized rules to standardized practices and applied for adding interpretative comments to laboratory test results and for dealing with abnormal test results. PMID:28392737

  14. Customer satisfaction survey to improve the European cystic fibrosis external quality assessment scheme.

    PubMed

    Berwouts, Sarah; Dequeker, Elisabeth

    2011-08-01

    The Cystic Fibrosis European Network, coordinated from within the Katholieke Universiteit Leuven, is the provider of the European cystic fibrosis external quality assessment (EQA) scheme. The network aimed to seek feedback from laboratories that participated in the cystic fibrosis scheme in order to improve services offered. In this study we analysed responses to an on-line customer satisfaction survey conducted between September and November 2009. The survey was sent to 213 laboratories that participated in the cystic fibrosis EQA scheme of 2008; 69 laboratories (32%) responded. Scores for importance and satisfaction were obtained from a five-point Likert scale for 24 attributes. A score of one corresponded to very dissatisfied/very unimportant and five corresponded to very satisfied/very important. Means were calculated and placed in a two-dimensional grid (importance-satisfaction analysis). Means were subtracted from each other to obtain gap values (gap-analysis). No attribute had a mean score below 3.63. The overall mean of satisfaction was 4.35. Opportunities for improvement enclosed clarity, usefulness and completeness of the general report and individual comments, and user-friendliness of the electronic datasheet. This type of customer satisfaction survey was a valuable instrument to identify opportunities to improve the cystic fibrosis EQA scheme. It should be conducted on a regular basis to reveal new opportunities in the future and to assess effectiveness of actions taken. Moreover, it could be a model for other EQA providers seeking feedback from participants. Overall, the customer satisfaction survey provided a powerful quality of care improvement tool.

  15. External quality assessment unravels interlaboratory differences in quality of RAS testing for anti-EGFR therapy in colorectal cancer.

    PubMed

    Tack, Véronique; Ligtenberg, Marjolijn J L; Tembuyser, Lien; Normanno, Nicola; Vander Borght, Sara; Han van Krieken, J; Dequeker, Elisabeth M C

    2015-03-01

    Regulations for the selection of patients with metastatic colorectal cancer for anti-EGFR treatment changed at the end of 2013. The set of mutations to be tested extended from KRAS codons 12 and 13 to KRAS and NRAS exons 2, 3, and 4. A European external quality assessment scheme monitored the performance of laboratories and evaluated the implementation of the new regulations. The 131 participating laboratories received 10 samples of formalin-fixed paraffin-embedded material, including RAS (exon 2, 3, 4) and BRAF mutations. Mock clinical data were provided for three cases. Using their routine methods, laboratories determined the genotypes and submitted three written reports. Assessors scored the results according to predefined evaluation criteria. Half of the participants (49.3%) had completely implemented the new test requirements (codons 12, 13, 59, 61, 117, and 146 of KRAS and NRAS), and 96 laboratories (73.3%) made no genotype mistakes. Correct nomenclature, according to the Human Genome Variation Society, was used by 82 laboratories (62.6%). Although regulations were effective for several months, many laboratories were not ready for full RAS testing in the context of anti-EGFR therapy. Nevertheless, in each participating country, there are laboratories that provide complete and correct testing. External quality assessments can be used to monitor implementation of new test regulations and to stimulate the laboratories to improve their testing procedures. Because the results of this program are available on the website of the European Society of Pathology, patients and clinicians can refer test samples to a reliable laboratory. ©AlphaMed Press.

  16. External Quality Assessment Unravels Interlaboratory Differences in Quality of RAS Testing for Anti-EGFR Therapy in Colorectal Cancer

    PubMed Central

    Tack, Véronique; Ligtenberg, Marjolijn J.L.; Tembuyser, Lien; Normanno, Nicola; Vander Borght, Sara; Han van Krieken, J.

    2015-01-01

    Background. Regulations for the selection of patients with metastatic colorectal cancer for anti-EGFR treatment changed at the end of 2013. The set of mutations to be tested extended from KRAS codons 12 and 13 to KRAS and NRAS exons 2, 3, and 4. A European external quality assessment scheme monitored the performance of laboratories and evaluated the implementation of the new regulations. Materials and Methods. The 131 participating laboratories received 10 samples of formalin-fixed paraffin-embedded material, including RAS (exon 2, 3, 4) and BRAF mutations. Mock clinical data were provided for three cases. Using their routine methods, laboratories determined the genotypes and submitted three written reports. Assessors scored the results according to predefined evaluation criteria. Results. Half of the participants (49.3%) had completely implemented the new test requirements (codons 12, 13, 59, 61, 117, and 146 of KRAS and NRAS), and 96 laboratories (73.3%) made no genotype mistakes. Correct nomenclature, according to the Human Genome Variation Society, was used by 82 laboratories (62.6%). Conclusion. Although regulations were effective for several months, many laboratories were not ready for full RAS testing in the context of anti-EGFR therapy. Nevertheless, in each participating country, there are laboratories that provide complete and correct testing. External quality assessments can be used to monitor implementation of new test regulations and to stimulate the laboratories to improve their testing procedures. Because the results of this program are available on the website of the European Society of Pathology, patients and clinicians can refer test samples to a reliable laboratory. PMID:25657200

  17. How appropriate is therapeutic drug monitoring for lithium? Data from the Belgian external quality assessment scheme.

    PubMed

    Delattre, I K; Van de Walle, P; Van Campenhout, C; Neels, H; Verstraete, A G; Wallemacq, P

    2015-06-01

    Lithium remains a mainstay in the management of mood disorders. As with many psychotropic drugs, lithium treatment requires continuous observation for adverse effects and strict monitoring of serum concentrations. The present study aimed to assess the appropriateness of lithium assays used by Belgian laboratories, and to evaluate acceptability of their clinical interpretations. Nine in-house serum samples spiked with predetermined concentrations of lithium were distributed to 114 participants in the Belgian external quality assessment scheme. Laboratories were requested to report the assay technique, lithium measurements and interpretations with regard to measured concentrations. Inter/intramethod imprecision and bias were reported and acceptability of clinical interpretations was assessed. The intramethod variability was evaluated by selecting methods used by 6 laboratories or more. Flame photometry (IL 943) was considered as the reference method. Laboratories returned assay results using colorimetry (69.3%), ion selective electrode (15.8%), flame photometry (8.8%), atomic absorption spectroscopy (5.2%) or mass spectrometry (0.9%). Lithium concentrations were systematically higher when measured with the Vitros assay (median bias: 4.0%), and were associated with consecutive biased interpretations. In contrast, the Thermo Scientific Infinity assay showed a significant negative bias (median bias: 9.4%). 36.0% of laboratories reported numerical values below their manufacturer cut-off for the blank sample; 16.6% of these laboratories detected residual lithium concentrations. The present study revealed assay-related differences in lithium measurements and their interpretations. Overall, there appeared to be a need to continue EQA of therapeutic drug monitoring for lithium in Belgium. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. External Quality Assessment in the Evaluation of Laboratory Performance of Faecal Culture.

    PubMed

    Kiiskinen, Salla J; Ojanen, Tarja; Björkman, Yvonne; Laitinen, Harri; Siitonen, Anja

    2017-01-01

    In Finland, all laboratories carrying out diagnostics of infectious diseases in humans are approved by the Regional State Administrative Agencies and are obligated to participate in External Quality Assurance rounds. Performance in these rounds is thought to reflect the quality of laboratory work. In the 6-year study period, 17 Finnish laboratories received 48 simulated faecal specimens for the culturing of diarrhoeal pathogens, yielding altogether 586 faecal culture External Quality Control specimens and 581 reports. The results were correct in 92% of all reports and in 67% of all specimens. False-negative Salmonella results were given for 2 of the 18 specimens, one with biochemically atypical Salmonella strain and the other with a low count of Salmonella cells. False-negative Shigella report was given for 6 of the 7 specimens in some participating laboratory. Detection of all common faecal pathogens is especially relevant to patient safety, public health, and epidemiological surveillance.

  19. Mutation nomenclature in practice: findings and recommendations from the cystic fibrosis external quality assessment scheme.

    PubMed

    Berwouts, Sarah; Morris, Michael A; Girodon, Emmanuelle; Schwarz, Martin; Stuhrmann, Manfred; Dequeker, Elisabeth

    2011-11-01

    Currently, two nomenclature systems are in use to describe sequence variants for cystic fibrosis: the established traditional nomenclature system and the more recent Human Genome Variation Society (HGVS) nomenclature system. We have evaluated the use of both systems in the laboratory reports of 217 participants in the cystic fibrosis external quality assessment scheme of 2009. The mutation c.1521_1523delCTT (p.Phe508del, F508del) was described by traditional and HGVS nomenclature by 32 of 216 (15%) laboratories that correctly identified the mutation, whereas 171 (79%) laboratories used traditional nomenclature only and 13 (6%) laboratories used HGVS nomenclature only. Overall, 29 of 631 (5%) reports used nomenclature that was evaluated as being seriously incorrect and/or misleading and 136 (22%) reports contained attempts at HGVS coding, of which 104 (76%) contained no coding errors; just 33 (24%) mentioned the correct cDNA name and cited the nucleotide reference sequence. We recognized an urgent need for more consistent and correct usage of nomenclature. We recommended that cystic fibrosis transmembrane conductance regulator testing reports should include a description of the identified sequence variants in both HGVS and traditional nomenclature and provided basic recommendations and other guidance.

  20. External quality assessment of point-of-care International Normalized Ratio (INR) testing in Europe.

    PubMed

    Stavelin, Anne; Meijer, Piet; Kitchen, Dianne; Sandberg, Sverre

    2011-09-26

    Point-of-care testing (POCT) of prothrombin time, expressed as International Normalized Ratio (INR), is widely used to monitor patients in oral anticoagulation treatment. Guidelines recommend that POCT users should participate in an external quality assessment (EQA) scheme whenever available. The aim of this study was to investigate which European countries provide EQA for POCT INR and to compare how these schemes are organized. Thirty European countries were invited to participate in this study. Those who reported that they provide EQA for POCT INR filled in a questionnaire dealing with different aspects of their schemes. Nineteen countries reported that they do not provide EQA for POCT INR, while 12 organizations from nine countries reported that they provide this service. Most of these countries circulate lyophilized samples with for the participants unknown target values. Samples with certified INR values and procedures using split samples with fresh patient samples are also used. The acceptability limits vary from 15% to 30%, and the total number of samples circulated per year varies from 1 to 12. Most of the countries organize educational activities together with their schemes. This study demonstrates that there is a wide variation in the way EQA for POCT INR is performed in Europe and that there are many European countries that do not provide this service. Even though our findings indicate that EQA for POCT INR draws some challenges, especially in providing suitable control materials, participation in such schemes is considered useful.

  1. International external quality assessment study for molecular detection of Lassa virus.

    PubMed

    Nikisins, Sergejs; Rieger, Toni; Patel, Pranav; Müller, Rolf; Günther, Stephan; Niedrig, Matthias

    2015-05-01

    Lassa virus (LASV) is a causative agent of hemorrhagic fever in West Africa. In recent years, it has been imported several times to Europe and North America. The method of choice for early detection of LASV in blood is RT-PCR. Therefore, the European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD) performed an external quality assessment (EQA) study for molecular detection of LASV. A proficiency panel of 13 samples containing various concentrations of inactivated LASV strains Josiah, Lib-1580/121, CSF, or AV was prepared. Samples containing the LASV-related lymphocytic choriomeningitis virus (LCMV) and negative sera were included as specificity controls. Twenty-four laboratories from 17 countries (13 European, one African, one Asian, two American countries) participated in the study. Thirteen laboratories (54%) reported correct results, 4 (17%) laboratories reported 1 to 2 false-negative results, and 7 (29%) laboratories reported 3 to 5 false-negative results. This EQA study indicates that most participating laboratories have a good or acceptable performance in molecular detection of LASV. However, several laboratories need to review and improve their diagnostic procedures.

  2. External quality assessment (EQA) in molecular immunohematology: the INSTAND proficiency test program

    PubMed Central

    Flegel, Willy A; Chiosea, Ion; Sachs, Ulrich J; Bein, Gregor

    2013-01-01

    Background Genotyping for red blood cell (RBC), platelet and granulocyte antigens is a new tool for clinical pathology, transfusion medicine services and blood banks. Proficiency in laboratory tests can be established by external quality assessments (EQAs), which are required for clinical application in many health care systems. There are few EQAs for molecular immunohematology. Methods We analyzed the participation and pass rates in an EQA for RBC, platelet and granulocyte antigens. This EQA was distributed by INSTAND, a large non-profit provider of proficiency tests, twice per year since fall 2006 as EQA no. 235 Immunohematology A (molecular diagnostic). The coordinators defined at the outset which alleles are mandatory for detection. Results The number of participants steadily increased from 51 to 73 per proficiency by fall 2012. More than 60 institutions utilized this EQA at least once a year. Approximately 80% of them participated in RBC, 68% in platelet and 22% in granulocyte systems. With the exceptions of RHD (82%) and granulocytes (85%), pass rates exceeded 93%. While the pass rate increased for granulocyte and decreased for the ABO system, the pass rates for the other systems changed little over 6 ½ years. Conclusions The INSTAND proficiency test program was regularly used for EQA by many institutions, particularly in Central Europe. While the technical standards and pass rates in the participating laboratories were high, there has been little improvement in pass rates since 2006. PMID:24111785

  3. External Quality Assessment Scheme for Biological Monitoring of Occupational Exposure to Toxic Chemicals

    PubMed Central

    Lee, Mi-Young; Kang, Seong-Kyu

    2011-01-01

    Objectives In this study, we summarized the External Quality Assessment Scheme (EQAS) for the biological monitoring of occupational exposure to toxic chemicals which started in 1995 and continued until a 31st round robin in the spring of 2010. The program was performed twice per year until 2009, and this was changed to once a year since 2010. The objective of the program is to ensure the reliability of the data related to biological monitoring from analytical laboratories. Methods One hundred and eighteen laboratories participated in the 31st round robin. The program offers 5 items for inorganic analysis: lead in blood, cadmium in blood, manganese in blood, cadmium in urine, and mercury in urine. It also offers 10 items for organic analysis, including hippuric acid, methylhippuric acid, mandelic acid, phenylglyoxylic acid, N-methylformamide, N-methylacetamide, trichloroacetic acid, total trichloro-compounds, trans,trans-muconic acid, and 2,5-hexanedione in urine. Target values were determined by statistical analysis using consensus values. All the data, such as chromatograms and calibration curves, were reviewed by the committee. Results The proficiency rate was below 70% prior to the first round robin and improved to over 90% for common items, such as PbB and HA, while those for other items still remained in the range of 60-90% and need to be improved up to 90%. Conclusion The EQAS has taken a primary role in improving the reliability of analytical data. A total quality assurance scheme is suggested, including the validation of technical documentation for the whole analytical procedure. PMID:22953206

  4. External quality assessment of patient HLA-B*57:01 testing prior to abacavir prescription.

    PubMed

    Darke, C; Corbin, S A

    2014-08-01

    Hypersensitivity reactions to the drug abacavir are strongly associated with possession of HLA-B*57:01. Hence, patients with HIV/AIDS who may be prescribed abacavir should be tested for this HLA allele and the drug withheld from those that possess B*57:01. The UK National External Quality Assessment Service for Histocompatibility and Immunogenetics has operated a scheme for B*57:01 testing since 2008 which, in 2013, involved 47 participants from 12 countries. A total of 24 B*57:01-positive, 2 B*57:03-positive and 22 B*57-negative blood samples (including 2 B*58 samples) were distributed to between 28 and 47 laboratories each year over 6 years. Participants, who were unaware of the samples' HLA types, tested and reported on their B*57/B*57:01 status. A total of 1868 reports were assessed over the 6 years. Of the 880 reports on B*57:01 samples, 93.4% were correctly assigned as B*57:01, 2.8% were assigned as groups of B*57 alleles including B*57:01, and 3.3% were reported as B*57 positive only. Over the 6 years, there were four (0.46%) false B*57:01 negative reports. All the B*57:03-positive and B*57-negative samples, involving 72 and 916 assignments, respectively, were essentially reported as B*57:01 negative. Thus, there were no false B57:01 positive assignments. The reporting of B*57:01 status over the last 3 years of the scheme was 99.8% sensitive and 100% specific. Over the last year, it was 100% sensitive and 100% specific.

  5. External Quality Assessment for the Determination of Diphtheria Antitoxin in Human Serum▿

    PubMed Central

    Di Giovine, Paolo; Pinto, Antonella; Ölander, Rose-Marie; Sesardic, Dorothea; Stickings, Paul; Berbers, Guy; Neal, Shona; Efstratiou, Androulla; Paberza, Ruta; Dauksiene, Snieguole; Bujko, Marina; Detcheva, Antoaneta; Joks, Unna; Levent, Belkis; von Hunolstein, Christina

    2010-01-01

    Accurate determination of diphtheria toxin antibodies is of value in determining the rates of immunity within broad populations or the immune status of individuals who may be at risk of infection, by assessing responses to vaccination and immunization schedule efficacy. Here we report the results of an external quality assessment (EQA) study for diphtheria serology, performed within the dedicated surveillance network DIPNET. Twelve national laboratories from 11 European countries participated by testing a standard panel of 150 sera using their current routine method: Vero cell neutralization test (NT), double-antigen enzyme-linked immunosorbent assay (ELISA; DAE), dual double-antigen time-resolved fluorescence immunoassay (dDA-DELFIA), passive hemagglutination assay (PHA), toxin binding inhibition assay (ToBI), and in-house or commercial ELISAs. The objective of the study was not to identify the best assay, as the advantages and drawbacks of methods used were known, but to verify if laboratories using their routine method would have categorized (as negative, equivocal, or positive) a serum sample in the same way. The performance of each laboratory was determined by comparing its results on a quantitative and qualitative basis to NT results from a single reference laboratory, as this test is considered the in vitro “gold standard.” The performance of laboratories using NT was generally very good, while the laboratories’ performance using other in vitro methods was variable. Laboratories using ELISA and PHA performed less well than those using DAE, dDA-DELFIA, or ToBI. EQA is important for both laboratories that use in vitro nonstandardized methods and those that use commercial ELISA kits. PMID:20610661

  6. Repeated HIV-1 resistance genotyping external quality assessments improve virology laboratory performance.

    PubMed

    Descamps, Diane; Delaugerre, Constance; Masquelier, Bernard; Ruffault, Annick; Marcelin, Anne-Geneviève; Izopet, Jacques; Chaix, Marie-Laure; Calvez, Vincent; Brun-Vézinet, Françoise; Costagliola, Dominique

    2006-02-01

    The performance of French virology laboratories belonging to the ANRS network has been assessed annually for 3 years. The performance of these laboratories was compared between the years 2002 and 2003. Ten and 7 coded samples were sent to 38 virology laboratories in 2002 and 45 virology laboratories in 2003, respectively. Each panel of coded samples included at least one HIV-negative control, a pair of duplicate specimens, samples with a wide range of viral loads, and samples with a large number of resistance mutations. The laboratories used their standard sequencing procedures and were asked to report the amino acids at codons associated with resistance mutations, based on the IAS-USA expert panel list. The reference amino acid sequences were defined as those most frequently reported by the participants. The specificity of detection of RT mutations was significantly better in 2003 (99.9%) than in 2002 (99.7%) (P = 0.05). There was no difference between 2002 and 2003 in the specificity of detection of protease mutations (99.6% and 99.8%) or the sensitivity of detection of RT mutations (98.8% and 98.2%). The sensitivity of detection of protease mutations improved significantly between 2002 and 2003 (97.6% and 99.0%, respectively; P = 0.037). The proportion of laboratories reporting fully accurate results, in terms of amplification, specificity, sensitivity, and reproducibility, tended to increase between 2002 and 2003 (P = 0.077). No errors were made by 19% of laboratories in 2002, compared to 42% in 2003. These results show the value of repeated external quality assessments.

  7. External quality assessment for the determination of diphtheria antitoxin in human serum.

    PubMed

    Di Giovine, Paolo; Pinto, Antonella; Olander, Rose-Marie; Sesardic, Dorothea; Stickings, Paul; Berbers, Guy; Neal, Shona; Efstratiou, Androulla; Paberza, Ruta; Dauksiene, Snieguole; Bujko, Marina; Detcheva, Antoaneta; Joks, Unna; Levent, Belkis; von Hunolstein, Christina

    2010-08-01

    Accurate determination of diphtheria toxin antibodies is of value in determining the rates of immunity within broad populations or the immune status of individuals who may be at risk of infection, by assessing responses to vaccination and immunization schedule efficacy. Here we report the results of an external quality assessment (EQA) study for diphtheria serology, performed within the dedicated surveillance network DIPNET. Twelve national laboratories from 11 European countries participated by testing a standard panel of 150 sera using their current routine method: Vero cell neutralization test (NT), double-antigen enzyme-linked immunosorbent assay (ELISA; DAE), dual double-antigen time-resolved fluorescence immunoassay (dDA-DELFIA), passive hemagglutination assay (PHA), toxin binding inhibition assay (ToBI), and in-house or commercial ELISAs. The objective of the study was not to identify the best assay, as the advantages and drawbacks of methods used were known, but to verify if laboratories using their routine method would have categorized (as negative, equivocal, or positive) a serum sample in the same way. The performance of each laboratory was determined by comparing its results on a quantitative and qualitative basis to NT results from a single reference laboratory, as this test is considered the in vitro "gold standard." The performance of laboratories using NT was generally very good, while the laboratories' performance using other in vitro methods was variable. Laboratories using ELISA and PHA performed less well than those using DAE, dDA-DELFIA, or ToBI. EQA is important for both laboratories that use in vitro nonstandardized methods and those that use commercial ELISA kits.

  8. International external quality assessment of molecular detection of Rift Valley fever virus.

    PubMed

    Escadafal, Camille; Paweska, Janusz T; Grobbelaar, Antoinette; le Roux, Chantel; Bouloy, Michèle; Patel, Pranav; Teichmann, Anette; Donoso-Mantke, Oliver; Niedrig, Matthias

    2013-01-01

    Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals resulting in considerable economic losses due to death and abortions among infected livestock. RVF also affects humans with clinical symptoms ranging from an influenza-like illness to a hemorrhagic fever. Over the past years, RVF virus (RVFV) has caused severe outbreaks in livestock and humans throughout Africa and regions of the world previously regarded as free of the virus. This situation prompts the need to evaluate the diagnostic capacity and performance of laboratories worldwide. Diagnostic methods for RVFV detection include virus isolation, antigen and antibody detection methods, and nucleic acid amplification techniques. Molecular methods such as reverse-transcriptase polymerase chain reaction and other newly developed techniques allow for a rapid and accurate detection of RVFV. This study aims to assess the efficiency and accurateness of RVFV molecular diagnostic methods used by expert laboratories worldwide. Thirty expert laboratories from 16 countries received a panel of 14 samples which included RVFV preparations representing several genetic lineages, a specificity control and negative controls. In this study we present the results of the first international external quality assessment (EQA) for the molecular diagnosis of RVF. Optimal results were reported by 64% of the analyses, 21% of the analyses achieved acceptable results and 15% of the results revealed that there is need for improvement. Evenly good performances were achieved by specific protocols which can therefore be recommended as an accurate molecular protocol for the diagnosis of RVF. Other protocols showed uneven performances revealing the need for improved optimization and standardization of these protocols.

  9. 2nd International External Quality Control Assessment for the Molecular Diagnosis of Dengue Infections

    PubMed Central

    Domingo, Cristina; Niedrig, Matthias; Teichmann, Anette; Kaiser, Marco; Rumer, Leonid; Jarman, Richard G.; Donoso-Mantke, Oliver

    2010-01-01

    Background Currently dengue viruses (DENV) pose an increasing threat to over 2.5 billion people in over 100 tropical and sub-tropical countries worldwide. International air travel is facilitating rapid global movement of DENV, increasing the risk of severe dengue epidemics by introducing different serotypes. Accurate diagnosis is critical for early initiation of preventive measures. Different reverse transcriptase PCR (RT-PCR) methods are available, which should be evaluated and standardized. Epidemiological and laboratory-based surveillance is required to monitor and guide dengue prevention and control programmes, i.e., by mosquito control or possible vaccination (as soon as an effective and safe vaccine becomes available). Objective The purpose of the external quality assurance (EQA) study described is to assess the efficiency and accuracy of dengue molecular diagnosis methods applied by expert laboratories. Study Design A panel of 12 human plasma samples was distributed and tested for DENV-specific RNA. The panel comprised 9 samples spiked with different DENV serotypes (DENV-1 to DENV-4), including 10-fold dilution series of DENV-1 and DENV-3. Two specificity controls consisted of a sample with a pool of 4 other flaviviruses and a sample with chikungunya virus. A negative control sample was also included. Results Thirty-seven laboratories (from Europe, Middle East Asia, Asia, the Americas/Caribbean, and Africa) participated in this EQA study, and reports including 46 sets of results were returned. Performance among laboratories varied according to methodologies used. Only 5 (10.9%) data sets met all criteria with optimal performance, and 4 (8.7%) with acceptable performance, while 37 (80.4%) reported results showed the need for improvement regarding accomplishment of dengue molecular diagnosis. Failures were mainly due to lack of sensitivity and the presence of false positives. Conclusions The EQA provides information on each laboratory's efficacy of RT

  10. Commutability of Possible External Quality Assessment Materials for Cardiac Troponin Measurement

    PubMed Central

    Zhang, Shunli; Zeng, Jie; Zhang, Chuanbao; Li, Yilong; Zhao, Haijian; Cheng, Fei; Yu, Songlin; Wang, Mo; Chen, Wenxiang

    2014-01-01

    Background The measurement of cardiac troponin is crucial in the diagnosis of myocardial infarction. The performance of troponin measurement is most conveniently monitored by external quality assessment (EQA) programs. The commutability of EQA samples is often unknown and the effectiveness of EQA programs is limited. Methods Commutability of possible EQA materials was evaluated. Commercial control materials used in an EQA program, human serum pools prepared from patient samples, purified analyte preparations, swine sera from model animals and a set of patient samples were measured for cTnI with 4 assays including Abbott Architect, Beckman Access, Ortho Vitros and Siemens Centaur. The measurement results were logarithm-transformed, and the transformed data for patient samples were pairwise analyzed with Deming regression and 95% prediction intervals were calculated for each pair of assays. The commutability of the materials was evaluated by comparing the logarithmic results of the materials with the limits of the intervals. Matrix-related biases were estimated for noncommutable materials. The impact of matrix-related bias on EQA was analyzed and a possible correction for the bias was proposed. Results Human serum pools were commutable for all assays; purified analyte preparations were commutable for 2 of the 6 assay pairs; commercial control materials and swine sera were all noncommutable; swine sera showed no reactivity to Vitros assay. The matrix-related biases for noncommutable materials ranged from −83% to 944%. Matrix-related biases of the EQA materials caused major abnormal between-assay variations in the EQA program and correction of the biases normalized the variations. Conclusion Commutability of materials has major impact on the effectiveness of EQA programs for cTnI measurement. Human serum pools prepared from patient samples are commutable and other materials are mostly noncommutable. EQA programs should include at least one human serum pool to allow

  11. European specialist porphyria laboratories: diagnostic strategies, analytical quality, clinical interpretation, and reporting as assessed by an external quality assurance program.

    PubMed

    Aarsand, Aasne K; Villanger, Jørild H; Støle, Egil; Deybach, Jean-Charles; Marsden, Joanne; To-Figueras, Jordi; Badminton, Mike; Elder, George H; Sandberg, Sverre

    2011-11-01

    The porphyrias are a group of rare metabolic disorders whose diagnosis depends on identification of specific patterns of porphyrin precursor and porphyrin accumulation in urine, blood, and feces. Diagnostic tests for porphyria are performed by specialized laboratories in many countries. Data regarding the analytical and diagnostic performance of these laboratories are scarce. We distributed 5 sets of multispecimen samples from different porphyria patients accompanied by clinical case histories to 18-21 European specialist porphyria laboratories/centers as part of a European Porphyria Network organized external analytical and postanalytical quality assessment (EQA) program. The laboratories stated which analyses they would normally have performed given the case histories and reported results of all porphyria-related analyses available, interpretative comments, and diagnoses. Reported diagnostic strategies initially showed considerable diversity, but the number of laboratories applying adequate diagnostic strategies increased during the study period. We found an average interlaboratory CV of 50% (range 12%-152%) for analytes in absolute concentrations. Result normalization by forming ratios to the upper reference limits did not reduce this variation. Sixty-five percent of reported results were within biological variation-based analytical quality specifications. Clinical interpretation of the obtained analytical results was accurate, and most laboratories established the correct diagnosis in all distributions. Based on a case-based EQA scheme, variations were apparent in analytical and diagnostic performance between European specialist porphyria laboratories. Our findings reinforce the use of EQA schemes as an essential tool to assess both analytical and diagnostic processes and thereby to improve patient care in rare diseases.

  12. [National Antimicrobial Resistance Surveillance System (NAMRSS) external quality assessment studies: 2011-2016].

    PubMed

    Süzük Yıldız, Serap; Şimşek, Hüsniye; Çöplü, Nilay; Gülay, Zeynep

    2017-07-01

    Establishment of sustainable and evidence-based surveillance systems are recommended for prevention of microbial resistance by the World Health Organization (WHO). As a necessity of these surveillance systems, participants are recommended to implement an external quality assessment (EQA) program. In this scope, National Antimicrobial Resistance Surveillance System (NARSS) has been established within the Public Health Institute of Turkey (PHIT) in our country since 2011. In the scope of this surveillance, NARSS EQA program has been implemented in a cycle per year and four isolates were sent to participants per cycle every year since 2011. In this study, it was aimed to evaluate the six years results of the EQA programs being implemented on NARSS participants between 2011 and 2016. The surveillance system consisted of 118 laboratories. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium/faecalis and Acinetobacter baumannii bacteria included in scope of the surveillance were sent to participants. Identification of bacteria to the species level, verification of the antibiotic susceptibility test results and existence of specified resistance of the isolates performed with valid test methods required from the participants. Identified isolates were cultured with routine microbiological methods and sent to participants in ambient temperature in triple carrying pouches inside suitable carrying media via PTT Cargo. The results were entered by means of passwords prepared by PHIT and sent to the web based system. The analysis of results were made with SPSS program. A total of twenty-three isolates were sent to participants between 2011 and 2016. It was determined that participants commonly preferred automated systems for bacterial identification and antibiotic sensitivity test results. The use of MALDI TOF MS system was determined to be raised up to 15.65% in 2016. It has been determined that

  13. Multicenter feasibility study to assess external quality assessment panels for Xpert MTB/RIF assay in South Africa.

    PubMed

    Scott, Lesley; Albert, Heidi; Gilpin, Chris; Alexander, Heather; DeGruy, Kyle; Stevens, Wendy

    2014-07-01

    External quality assessment (EQA) for the Xpert MTB/RIF assay is part of the quality system required for clinical and laboratory practice. Five newly developed EQA panels that use different matrices, including a lyophilized sample (Vircell, Granada, Spain), a dried tube specimen (CDC), liquid (Maine Molecular Quality Control, Inc. [MMQCI], Scarborough, ME), artificial sputum (Global Laboratory Initiative [GLI]), and a dried culture spot (National Health Laboratory Services [NHLS]), were evaluated at 11 GeneXpert testing sites in South Africa. The panels comprised Mycobacterium tuberculosis complex (MTBC)-negative, MTBC-positive (including rifampin [RIF] susceptible and RIF resistant), and nontuberculosis mycobacterial material that was inactivated and safe for transportation. Twelve qualitative and quantitative variables were scored as acceptable (1) or unacceptable (0); the overall panel performance score for the Vircell, CDC, GLI, and NHLS panels was 9 of 12, while the MMQCI panel scored 6 of 12 (owing to the need for cold chain maintenance). All panels showed good compatibility with Xpert MTB/RIF testing, and none showed PCR inhibition. The use of a liquid or dry matrix did not appear to be a distinguishing criterion, as both matrices had reduced scores on insufficient volumes, a need for extra consumables, and the ability to transfer to the Xpert MTB/RIF cartridge. EQA is an important component of the quality system required for diagnostic testing programs, but it must be complemented by routine monitoring of performance indicators and instrument verification. This study aims to introduce EQA concepts for Xpert MTB/RIF testing and evaluates five potential EQA panels.

  14. Preparation of control blood for external quality assessment of point-of-care international normalized ratio testing in the Netherlands.

    PubMed

    van den Besselaar, Anton M H P; Abdoel, Charmane F; Ardanary, Davina; van de Kamp, Gert; Versluijs, Fanny A C

    2014-06-01

    The aim of this study was to prepare control blood for an external quality assessment scheme (EQAS) for international normalized ratio (INR) point-of-care testing (POCT) in the Netherlands and to assess the performance of the participants. Control blood was prepared from dialyzed pooled patient plasma and washed human erythrocytes. Samples of control blood were mailed to participants of the Netherlands EQAS from October 2006 through December 2012. Most participants used CoaguChek XS (Roche Diagnostics, Mannheim, Germany) devices for POCT. The median between-center coefficient of variation (CV) of the reported INR decreased from 4.5% in 2006 to 2.6% in 2012. A few participants used the ProTime Microcoagulation System (ITC, Edison, NJ) for POCT. The median CV (per year) of the INR with the latter system was 7.0% to 10.6%. The control blood samples were useful for external quality assessment in the Netherlands. The participants' performance with the CoaguChek XS system improved with time, demonstrating the value of external quality assessment. Copyright© by the American Society for Clinical Pathology.

  15. Review of the national external quality assessment (EQA) scheme for breast pathology in the UK.

    PubMed

    Rakha, Emad A; Bennett, Rachel L; Coleman, Derek; Pinder, Sarah E; Ellis, Ian O

    2017-01-01

    The National Health Service Breast Screening Programme (NHSBSP; pathology) external quality assurance (EQA) scheme aims to provide a mechanism for examination and monitoring of concordance of pathology reporting within the UK. This study aims to review the breast EQA scheme performance data collected over a 24-year period following its introduction. Data on circulations, number of cases and diagnosis were collected. Detailed analyses with and without combinations of certain diagnostic entities, and over different time periods were performed. Overall, of 576 cases (172 benign, 11 atypical hyperplasia, 98 ductal carcinoma in situ/microinvasive and 295 invasive disease), consistency of assessment of diagnostic parameters was very high (overall k=0.80; k for benign diagnosis=0.79; k for invasive disease=0.91). For distinguishing benign versus malignant lesions, no further improvement is considered possible in view of the limitations of the scheme methodology. Although diagnostic consistency of atypical hyperplasia remains at a low level, combining it with the benign category results in a high level of agreement (k=0.93). The level of consistency of reporting prognostic information is variable and some items such as lymphovascular invasion and tumour size measurement may need further intervention to improve their reporting consistency. Although the level of consistency of reporting of histological grade remained at a moderate level overall (k=0.48), it was variable among cases and appears to have levelled off; no further significant improvement is expected and no significant impact of the previous publication of guidelines is observed. These results provide further evidence to indicate the value of the breast EQA scheme in monitoring performance and the identification of specific areas where improvement or new approaches are required. For most parameters, the concordance of reporting reached a plateaux a few years after the introduction of the EQA scheme. It is

  16. Quality of cervical cancer screening in Brazil: external assessment of the PMAQ

    PubMed Central

    Barcelos, Mara Rejane Barroso; Lima, Rita de Cássia Duarte; Tomasi, Elaine; Nunes, Bruno Pereira; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2017-01-01

    ABSTRACT OBJECTIVE To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening. METHODS This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context), demographic characteristics (user profile), and two domains related to the organization of basic services (work structure and process). The low quality of the screening was assessed from the lack of access, late examination, and lack of guidance. Crude and adjusted analyses by Poisson regression assessed the association between outcomes and independent variables. RESULTS The values of lack of access, late examination, and lack of guidance were 6.7%, 11.2%, and 19.2%, respectively. Problems of quality were lower according to the increase in Municipal Human Development Index and per capita household income, increasing with population size and municipal coverage of the Family Health Strategy. The Midwest region of the country presented the highest occurrences of low quality outcomes. Indigenous and yellow women had the highest prevalence of outcomes. Women with partner, who received the Bolsa Família Program, and who had paid work had less chances of having lack of access, late examination, and lack of guidance. The appropriate work process in health services decreased the likelihood of low quality in all indicators. CONCLUSIONS Investments in the work process of health teams, social cash transfer programs, and social conditions of the population are essential to improve the quality of the program of cervical cancer screening in Brazil. PMID:28746576

  17. [Assessment of the quality of laboratory diagnosis of intestinal parasitic diseases by the laboratories participating in the Federal System of External Quality Assessment of Clinical Laboratory Testing].

    PubMed

    Malakhov, V N; Dovgalev, A S; Astanina, S Iu; Serdiuk, A P

    2014-01-01

    In 2010-2013, the quality of microscopic detection of the causative agents ofparasitic diseases in the feces has been assessed by the specialists of the laboratories of the therapeutic-and-prophylactic institutions (TPIs) and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, which are participants of the Federal System of External Quality Assessment of Clinical Laboratory Testing. Thirty-two specimens containing 16 species of human helminths and 4 species of enteric protozoa in different combinations were examined. The findings suggest that the quality of microscopic detection of the causative agents of parasitic diseases is low in the laboratories of health care facilities and that the specialists of the laboratories of TPIs and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, do not not possess the knowledge and skills necessary to make a laboratory diagnosis of helminths and enteric protozoa. The average detection rates of helminths and protozoa were at a level of 64 and 36%, respectively. The correct results showed that the proportion of helminths and protozoa were 94.5 and 5.5%, respectively. According to the biological and epidemiological classification of helminths, there were higher detection rates for contact group parasites (Enterobius vermicularis and Hymenolepis nana) and geohelminths (Ascaris, Trichuris trichiura, and others). Biohelminths (Opisthorchis, tapeworms, and others) Were detectable slightly worse.

  18. External Quality Assessment for Detection of Fetal Trisomy 21, 18, and 13 by Massively Parallel Sequencing in Clinical Laboratories.

    PubMed

    Zhang, Rui; Zhang, Hongyun; Li, Yulong; Han, Yanxi; Xie, Jiehong; Li, Jinming

    2016-03-01

    An external quality assessment for detection of trisomy 21, 18, and 13 by massively parallel sequencing was implemented by the National Center for Clinical Laboratories of People's Republic of China in 2014. Simulated samples were prepared by mixing fragmented abnormal DNA with plasma from non-pregnant women. The external quality assessment panel, comprising 5 samples from pregnant healthy women, 2 samples with sex chromosome aneuploidies, and 13 samples with different concentrations of fetal fractions positive for trisomy 21, 18, and 13, was then distributed to participating laboratories. In total, 55.6% (47 of 84) of respondents correctly identified each of the samples in the panel. Seventeen false-negative and 87 gray zone results were reported, most [102 of 104 (98.1%)] of which were derived from for trisomy samples with effective fetal fractions <4%. No laboratories generated false-positive results. In addition, we observed varied diagnostic capabilities of different assays, with the assay on the basis of NextSeq CN500 performing better than others, whereas Z values generated by BGISEQ-100 fluctuated greatly. There were no significant correlations between the numbers of unique sequence reads and Z values from any trisomy sample generated by BGISEQ-100. Overall, most clinical laboratories detected samples containing effective fetal fractions >4%. Our study shows need for further laboratory training in the management of samples with low fetal fractions. For some assays, precision of Z values needs to be improved.

  19. Quality of cervical cancer screening in Brazil: external assessment of the PMAQ.

    PubMed

    Barcelos, Mara Rejane Barroso; Lima, Rita de Cássia Duarte; Tomasi, Elaine; Nunes, Bruno Pereira; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2017-07-20

    To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening. This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context), demographic characteristics (user profile), and two domains related to the organization of basic services (work structure and process). The low quality of the screening was assessed from the lack of access, late examination, and lack of guidance. Crude and adjusted analyses by Poisson regression assessed the association between outcomes and independent variables. The values of lack of access, late examination, and lack of guidance were 6.7%, 11.2%, and 19.2%, respectively. Problems of quality were lower according to the increase in Municipal Human Development Index and per capita household income, increasing with population size and municipal coverage of the Family Health Strategy. The Midwest region of the country presented the highest occurrences of low quality outcomes. Indigenous and yellow women had the highest prevalence of outcomes. Women with partner, who received the Bolsa Família Program, and who had paid work had less chances of having lack of access, late examination, and lack of guidance. The appropriate work process in health services decreased the likelihood of low quality in all indicators. Investments in the work process of health teams, social cash transfer programs, and social conditions of the population are essential to improve the quality of the program of cervical cancer screening in Brazil. Analisar se as variáveis demográficas, socioeconômicas e da organização dos serviços estão associadas à qualidade do rastreamento do câncer de colo uterino. Inqu

  20. An Internet-based external quality assessment in cytogenetics that audits a laboratory's analytical and interpretative performance.

    PubMed

    Hastings, Rosalind J; Maher, Eddy J; Quellhorst-Pawley, Bettina; Howell, Rodney T

    2008-10-01

    A novel approach to external quality assessment (EQA) using the Internet mimics the diagnostic situation so that multiple tests can be requested and EQA cases can be 'tailor made' to address a specific chromosome syndrome, disease, or clinical dilemma. The web-based EQA system was trialled on a large UK EQA scheme, UK NEQAS for Clinical Cytogenetics. It has also been used to implement a new Cytogenetics European Quality Assessment scheme, CEQA, set up with the intention of providing laboratories in countries without access to a local EQA scheme the opportunity of participation in EQA. Overall, Internet-based EQA allows for a varied EQA programme. Poor performance was detected in both CEQA and UK NEQAS constitutional EQA schemes and also in the UK NEQAS oncology EQA scheme. The Internet-based EQA overcomes submission delays due to international surface mail. There is also a reduction in administration and assessors' time compared to a retrospective EQA involving the submission of unique cases for EQA assessment, as participants analyse the same three Internet-based EQA cases simultaneously. Many EU27 (EU member states) laboratories still do not participate in their national EQA schemes, so until EQA participation becomes mandatory as a component of compulsory laboratory accreditation, the quality of laboratory diagnostic service is unpredictable.

  1. External quality assessment for molecular typing of Salmonella 2013-2015: performance of the European national public health reference laboratories.

    PubMed

    Jensen, M B F; Schjørring, S; Björkman, J T; Torpdahl, M; Litrup, E; Nielsen, E M; Niskanen, T

    2017-06-01

    We report the results of three consecutive External Quality Assessments (EQAs) for molecular subtyping of Salmonella to assess the performance of the European national public health reference laboratories (NPHRLs). The EQA included the molecular typing methods used for European enhanced surveillance of human Salmonella infections: pulsed field gel electrophoresis (PFGE), including gel analysis by the use of the software BioNumerics, and 5-locus multiple locus variable number of tandem repeat analysis (MLVA) for serovar Typhimurium. The participation in the PFGE laboratory part was higher (27/35) than in the gel analysis (19/35) and MLVA (15/35), suggestive of the need for capacity building in methods requiring specialized equipment (MLVA) or software (gel analysis). The majority (25/27) of the participating NPHRLs produced inter-laboratory comparable PFGE gel(s). Two laboratories continued to produce low-quality gels and should have additional technical assistance in the future. In particular, two gel quality evaluation parameters, measuring "image acquisition and running conditions" and "bands", were identified to cause gel quality problems throughout the EQAs. Despite the high number of laboratories participating in the PFGE laboratory part, the participation in gel analysis was low, although increasing. In the MLVA part, the NPHRLs correctly assigned 96% (405/420) allelic profiles according to the nomenclature. In conclusion, the EQAs identified critical parameters for unsuccessful performance and helped to offer assistance to those laboratories that needed it most. The assessments supported the development of quality in molecular typing and promoted the harmonization of subtyping methods used for EU/EEA-wide surveillance of human Salmonella infections.

  2. Molecular Genetics External Quality Assessment Pilot Scheme for Irinotecan-Related UGT1A1 Genotyping in China

    PubMed Central

    Zhang, Kuo; Wang, Lunan; Zhang, Rui; Xie, Jiehong; Li, Jinming

    2016-01-01

    Irinotecan is widely used in the treatment of solid tumors, especially in colorectal cancer and lung cancer. Molecular testing for UGT1A1 genotyping is increasingly required in China for optimum irinotecan administration. In order to determine the performance of laboratories with regard to the whole testing process for UGT1A1 to ensure the consistency and accuracy of the test results, the National Center for Clinical Laboratories conducted an external quality assessment program for UGT1A1*28 genotyping in 2015. The panel, which comprised of four known mutational samples and six wild-type samples, was distributed to 45 laboratories that test for the presence of UGT1A1*28 polymorphisms. Participating laboratories were allowed to perform polymorphism analysis by using their routine methods. The accuracy of the genotyping and reporting of results was analyzed. Other information from the individual laboratories, including the number of samples tested each month, accreditation/certification status, and test methodology, was reviewed. Forty-four of the 45 participants reported the correct results for all samples. There was only one genotyping error, with a corresponding analytical sensitivity of 99.44% (179/180 challenges; 95% confidence interval: 96.94−99.99%) and an analytical specificity of 100% (270/270 challenges; 95% confidence interval: 98.64−100%). Both commercial kits and laboratory development tests were commonly used by the laboratories, and pyrosequencing was the main methodology used (n = 26, 57.8%). The style of the written reports showed large variation, and many reports showed a shortage of information. In summary, the first UGT1A1 genotyping external quality assessment result demonstrated that UGT1A1 genotype analysis of good quality was performed in the majority of pharmacogenetic testing centers that were investigated. However, greater education on the reporting of UGT1A1 genetic testing results is needed. PMID:26820647

  3. External Quality Assessment for KRAS Testing Is Needed: Setup of a European Program and Report of the First Joined Regional Quality Assessment Rounds

    PubMed Central

    Bellon, Ellen; Ligtenberg, Marjolijn J.L.; Tejpar, Sabine; Cox, Karen; de Hertogh, Gert; de Stricker, Karin; Edsjö, Anders; Gorgoulis, Vassilis; Höfler, Gerald; Jung, Andreas; Kotsinas, Athanassios; Laurent-Puig, Pierre; López-Ríos, Fernando; Hansen, Tine Plato; Rouleau, Etienne; Vandenberghe, Peter; van Krieken, Johan J.M.

    2011-01-01

    The use of epidermal growth factor receptor–targeting antibodies in metastatic colorectal cancer has been restricted to patients with wild-type KRAS tumors by the European Medicines Agency since 2008, based on data showing a lack of efficacy and potential harm in patients with mutant KRAS tumors. In an effort to ensure optimal, uniform, and reliable community-based KRAS testing throughout Europe, a KRAS external quality assessment (EQA) scheme was set up. The first large assessment round included 59 laboratories from eight different European countries. For each country, one regional scheme organizer prepared and distributed the samples for the participants of their own country. The samples included unstained sections of 10 invasive colorectal carcinomas with known KRAS mutation status. The samples were centrally validated by one of two reference laboratories. The laboratories were allowed to use their own preferred method for histological evaluation, DNA isolation, and mutation analysis. In this study, we analyze the setup of the KRAS scheme. We analyzed the advantages and disadvantages of the regional scheme organization by analyzing the outcome of genotyping results, analysis of tumor percentage, and written reports. We conclude that only 70% of laboratories correctly identified the KRAS mutational status in all samples. Both the false-positive and false-negative results observed negatively affect patient care. Reports of the KRAS test results often lacked essential information. We aim to further expand this program to more laboratories to provide a robust estimate of the quality of KRAS testing in Europe, and provide the basis for remedial measures and harmonization. PMID:21441573

  4. [External quality assessment in clinical biochemistry laboratories: pilot study in 11 laboratories of Lomé (Togo)].

    PubMed

    Kouassi, Kafui; Fétéké, Lochina; Assignon, Selom; Dorkenoo, Ameyo; Napo-Koura, Gado

    2015-01-01

    This study aims to evaluate the performance of a few biochemistry analysis and make recommendations to the place of the stakeholders. It is a cross-sectional study conducted between the October 1(st), 2012 and the July 31, 2013 bearing on the results of 5 common examinations of clinical biochemistry, provided by 11 laboratories volunteers opening in the public and private sectors. These laboratories have analysed during the 3 cycles, 2 levels (medium and high) of serum concentration of urea, glucose, creatinine and serum aminotransferases. The performance of laboratories have been determined from the acceptable limits corresponding to the limits of total errors, defined by the French Society of Clinical Biology (SFBC). A system of internal quality control is implemented by all laboratories and 45% of them participated in international programs of external quality assessment (EQA). The rate of acceptable results for the entire study was of 69%. There was a significant difference (p<0.002) between the performance of the group of laboratories engaged in a quality approach and the group with default implementation of the quality approach. Also a significant difference was observed between the laboratories of the central level and those of the peripheral level of our health system (p<0.047). The performance of the results provided by the laboratories remains relatively unsatisfactory. It is important that the Ministry of Health put in place a national program of EQA with mandatory participation.

  5. Implementation of a national external quality assessment program for medical laboratories in Burkina Faso: challenges, lessons learned, and perspectives.

    PubMed

    Sakandé, Jean; Nikièma, Abdoulaye; Kabré, Elie; Sawadogo, Charles; Nacoulma, Eric W; Sanou, Mamadou; Sangaré, Lassana; Traoré-Ouédraogo, Rasmata; Sawadogo, Mamadou; Gershy-Damet, Guy Michel

    2014-02-01

    The National External Quality Assessment (NEQA) program of Burkina Faso is a proficiency testing program mandatory for all laboratories in the country since 2006. The program runs two cycles per year and covers all areas of laboratories. All panels were validated by the expert committee before dispatch under optimal storage and transport conditions to participating laboratories along with report forms. Performance in the last 5 years varied by panel, with average annual performance of bacteriology panels for all laboratories rising from 75% in 2006 to 81% in 2010 and with a best average performance of 87% in 2007 and 2008. During the same period, malaria microscopy performance varied from 85% to 94%, with a best average performance of 94% in 2010; chemistry performance increased from 87% to 94%, with a best average annual performance of 97% in 2009. Hematology showed more variation in performance, ranging from 61% to 86%, with a best annual average performance of 90% in 2008. Average annual performance for immunology varied less between 2006 and 2010, recording 97%, 90%, and 95%. Except for malaria microscopy, annual performances for enrolled panels varied substantially from year to year, indicating some difficulty in maintaining consistency in quality. The main challenges of the NEQA program observed between 2006 to 2010 were funding, sourcing, and safe transportation of quality panels to all laboratories countrywide.

  6. An educational web-based external quality assessment outcome and evaluation: first experiences with urinary sediment and hemostaseology.

    PubMed

    Schürer-Maly, Corneliac; Wood, William Graham; Falbo, Rosanna; Brambilla, Paolo; Heller, Christian; Schwarz, Patrick; Illigen, Dirk; Adler, Martin; Heitzmann, Nicole; Bauer, Daniel; Fischer, Martin; Spannagl, Michael

    2013-01-01

    External quality assessment is a standard procedure for many medical laboratories, especially those accredited according to ISO 15189. INSTAND has developed web-based quality control surveys (WQ) with integrated case-based learning in collaboration with the Institute for Teaching and Educational Research in Health Sciences (IDBG), University of Witten/Herdecke. The WQs were presented via a weblink using the learning management system CASUS. Laboratories registered with INSTAND for conventional EQAs covering the same topic were invited to participate in the WQs. Statistics were calculated with the INSTAND EQA-evaluation program and with the "Statistical Program for Social Sciences" (SPSS Version 20). While the two pilot surveys (hemostaseology) were designed for laboratory technicians, WQ III (urine sediment) addressed the whole laboratory team. From the invited laboratories more than 80% participated successfully and the evaluations showed that, in general, more than half the participants solved the tasks as a team. The web-based EQAs were well accepted by the users, with some technical problems in WQ III and moderate criticism on the images and relevance for daily practice in the evaluation sheets. Well above 80% would like to participate in further WQs and would recommend them to other laboratories. Thus web-based quality control surveys can emerge as an important supplement to conventional EQAs.

  7. [National External Quality Assessment for medical biology laboratories in Burkina Faso: an overview of three years of activity].

    PubMed

    Sakande, Jean; Nikièma, Abdoulaye; Kabré, Elie; Nacoulma, Eric; Sawadogo, Charles; Lingani, Virginie; Traoré, Lady Kady; Kouanda, Abdoulaye; Kientéga, Youssouf; Somda, Joseph; Kagambéga, Faustin; Sanou, Mahamoudou; Sangaré, Lassana; Traoré-Ouédraogo, Rasmata

    2010-01-01

    We report results of the National External Quality Assessment for (NEQA) laboratories in Burkina Faso, a country with limited resources located in West Africa whose epidemiology is dominated by infectious diseases. The national laboratory network consists of 160 laboratories including 40 private. The Government of Burkina Faso has adopted a national laboratory policy. One of the objectives of this policy is to improve the quality of laboratory results. One of the strategies to achieve this objective is the establishment of a NEQA. The NEQA is a panel testing also called proficiency testing. It is mandatory for all laboratories to participate to the NEQA. The NEQA is organized twice a year and covers all areas of laboratories (bacteriology-virology, biochemistry, hematology, parasitology and immunology). The review of three years of activity (2006-2008) shows the following results: (1) for microscopic examination of bacteria after Gram staining, the error rate decreased from 24.7% in 2006 to 13.1% in 2007 and 13% in 2008; (2) errors rate in reading slides for the microscopic diagnosis of malaria were 23.4%, 14.6% and 10.2% respectively in 2006, 2007 and 2008; (3) for biochemistry, the percentages of unsatisfactory results were respectively 12.5%, 14.8% and 13.8% in 2006, 2007 and 2008 for the overall parameters assessed. The analysis of the results generated by the laboratories during these three years shows a quality improvement. However, the NEQA should be strengthened through ongoing training and quality control of reagents and equipment.

  8. Fifteen years of Belgian experience with external quality assessment of semen analysis.

    PubMed

    Punjabi, U; Wyns, C; Mahmoud, A; Vernelen, K; China, B; Verheyen, G

    2016-11-01

    Semen analysis is difficult to standardize, quality control and quality assurance are necessary to ensure that results are accurate and precise. This Belgian EQA survey over a 15-year period, involving 121 laboratories, attempted to reduce interlaboratory variability and at the same time, encouraged participating laboratories to implement correct techniques as advised by the WHO. Over the total period, the median coefficient of variation (CV) for sperm count, irrespective of the method used was 19.2%, while using improved Neubauer chamber resulted in a significantly (p < 0.001) lower median CV (14.4%). The overall median CV for rapid progressive motility was high (37.1%), but progressive motility (15.1%) and total motility (13.8%) were acceptable. Sperm morphology revealed a large variability in 79.4% irrespective of the staining procedures or evaluation criteria used. Participation in the Belgian EQA is on voluntary basis. Both, participation and implementation of the correct techniques should be made mandatory for accreditation and benefit of patient treatment. The existing Belgian EQA program should now be harmonized with other existing EQA schemes in Europe. © 2016 American Society of Andrology and European Academy of Andrology.

  9. A pilot programme of external quality assessment for general haematology in Italy.

    PubMed

    Salvati, A M; Maffi, D; Caprari, P; Marsili, G

    1995-01-01

    In the years 1984-1989 the Istituto Superiore di Sanità organized an EQAS for haematology (SVEQE) in Italy. A series of trials for haemocytometry, abnormal haemoglobins, HbA2, HbF, red cell G6PD and peripheral blood films, were carried out with the participation of 126 hospital laboratories, in different regions. SVEQE was an educative programme, aiming at promotion of quality assurance (QA) in laboratory haematology. At the same time an attempt was made to survey the analytical methods and instruments and to estimate the "state of the art" by the dispersion of all results. Participant laboratories were not scored for their performances. The operative protocol was harmonized to the guidelines established by WHO and ICSH; the trial specimens were prepared from normal or pathologic blood samples provided by blood banks or hospital departments. The trials for haemocytometry demonstrated a wide use of completely automated analyzers and in a steady state of performance during about five years. CVs, mainly for WBV and PLT, were somewhat higher than in other countries, where national QA systems have been established for a long time. Such discrepancies were not surprising in a pilot programme and were likely to be caused by inadequate internal quality control. The exercises for abnormal haemoglobins, HbA2, HbF and G6PD pointed out the need of using standardized methods according to the recommendations of ICSH. A large number of participating laboratories took part in the trial for blood cell morphology, being convinced of the educative function of this exercise; it is important to continue with systematic surveys, even including rare haematological disorders amongst the selected cases.

  10. The External Quality Assessment Scheme (EQAS): Experiences of a medium sized accredited laboratory.

    PubMed

    Bhat, Vivek; Chavan, Preeti; Naresh, Chital; Poladia, Pratik

    2015-06-15

    We put forth our experiences of EQAS, analyzed the result discrepancies, reviewed the corrective actions and also put forth strategies for risk identification and prevention of potential errors in a medical laboratory. For hematology, EQAS samples - blood, peripheral and reticulocyte smears - were received quarterly every year. All the blood samples were processed on HMX hematology analyzer by Beckman-Coulter. For clinical chemistry, lyophilized samples were received and were processed on Siemens Dimension Xpand and RXL analyzers. For microbiology, EQAS samples were received quarterly every year as lyophilized strains along with smears and serological samples. In hematology no outliers were noted for reticulocyte and peripheral smear examination. Only one outlier was noted for CBC. In clinical chemistry outliers (SDI ≥ 2) were noted in 7 samples (23 parameters) out of total 36 samples (756 parameters) processed. Thirteen of these parameters were analyzed as random errors, 3 as transcriptional errors and seven instances of systemic error were noted. In microbiology, one discrepancy was noted in isolate identification and in the grading of smears for AFB by Ziehl Neelsen stain. EQAS along with IQC is a very important tool for maintaining optimal quality of services. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Intensive educational efforts combined with external quality assessment improve the preanalytical phase in general practitioner offices and nursing homes.

    PubMed

    Sølvik, Una Ørvim; Bjelkarøy, Wenche Iren; Berg, Kari van den; Saga, Anne Lise; Hager, Helle Borgstrøm; Sandberg, Sverre

    2017-05-05

    Errors in the preanalytical phase in clinical laboratories affect patient safety. The aim of this study was to evaluate the effect of intensive educational efforts together with external quality assessment (EQA) of the preanalytical phase from 2013 to 2015 to improve patient identification in primary health care in Norway. In addition, routines for venous and capillary blood sampling were investigated. A preanalytical EQA was circulated in 2013 by the Norwegian Quality Improvement of Laboratory Examinations (Noklus) to general practitioner offices and nursing homes (n=2000) to obtain information about important issues to focus on before launching an intensive educational program with courses, posters and visits in 2013-2015. Preanalytical EQA surveys were further circulated in 2014 and 2015. The response rate varied between 42% and 55%. The percentages of participants asking for the patients' name and the Norwegian identification number increased from about 8% in 2013 to about 35% in 2015. The increase was similar for those participating in only one EQA survey and for those who participated in EQA surveys both in 2013 and 2015. Guidelines for venous and capillary blood sampling were not always followed. Educational efforts more than the preanalytical EQA influenced the actions and resulted in an increase in the percentages of participants that followed the guidelines for patient identification. Some aspects of blood sampling routines need improvement.

  12. Application of HTB-SiHa Cells Transfected with a Recombinant Plasmid for External Quality Assessment of Chlamydia trachomatis PCR

    PubMed Central

    Zhang, Kuo; Huo, Hong; Sun, Yu; Wang, Lunan; Zhang, Rui; Lin, Guigao; Xie, Jiehong

    2014-01-01

    Background The participation of laboratories in external quality assessment (EQA) programs is required for the quality assurance of nucleic acid amplification of Chlamydia trachomatis. This study aimed to construct a new quality control (QC) material applicated in EQA of C. trachomatis PCR. Methods A QC material-HTB-SiHa cells transfected with a recombinant plasmid containing the cryptic plasmid sequence-was constructed for C. trachomatis PCR detection, and four different panels, each consisting of 4 positive samples with serial dilution of the constructed QC material and 1 negative sample, were distributed by the National Center for Clinical Laboratories among four groups of 275, 268, 317, and 304 participants across China from 2011 through 2012. A total of eight commercial kits were used for C. trachomatis PCR detection in participants. Results Nine laboratories reported false-positive results (0.9%). As the series dilution increased, the correct reporting of the data sets decreased; the lowest correct rate was 96.3% in the weakest positive samples (104 copies/mL). Eight laboratories reported false-positive results, and 42 laboratories reported false-negative results in the EQA detection of C. trachomatis. No significant differences were observed in the detection of the constructed C. trachomatis positive samples (97.9%, 98.5%, 100%, 98.5%; P=0.36) and negative samples (100%, 99.0%, 100%, 99.0%; P=0.764) using four commercial kits commonly used in China. Conclusions The results of the EQA study indicated that the constructed material provides a noninfectious, stable control material with sufficient volume for PCR detection of C. trachomatis. PMID:25187888

  13. Design and implementation of an external quality assessment program for HIV viral load measurements using dried blood spots.

    PubMed

    Prach, Lisa M; Puren, Adrian; Lippman, Sheri A; Carmona, Sergio; Stephenson, Sophie; Cutler, Ewalde; Barnhart, Scott; Liegler, Teri

    2015-03-01

    An external quality assurance program was developed for HIV-1 RNA viral load measurements taken from dried blood spots using a reference panel and field-collected specimens. The program demonstrated that accurate and reproducible quantitation can be obtained from field-collected specimens. Residual proviral DNA may confound interpretation in virologically suppressed subjects.

  14. Design and Implementation of an External Quality Assessment Program for HIV Viral Load Measurements Using Dried Blood Spots

    PubMed Central

    Prach, Lisa M.; Puren, Adrian; Lippman, Sheri A.; Carmona, Sergio; Stephenson, Sophie; Cutler, Ewalde; Barnhart, Scott

    2014-01-01

    An external quality assurance program was developed for HIV-1 RNA viral load measurements taken from dried blood spots using a reference panel and field-collected specimens. The program demonstrated that accurate and reproducible quantitation can be obtained from field-collected specimens. Residual proviral DNA may confound interpretation in virologically suppressed subjects. PMID:25520449

  15. The Italian external quality assessment for RAS testing in colorectal carcinoma identifies methods-related inter-laboratory differences.

    PubMed

    Normanno, Nicola; Pinto, Carmine; Castiglione, Francesca; Fenizia, Francesca; Barberis, Massimo; Marchetti, Antonio; Fontanini, Gabriella; De Rosa, Gaetano; Taddei, Gian Luigi

    2015-09-03

    In 2014 the European Medicines Agency included exon 2, 3 and 4 KRAS and NRAS testing for the selection of metastatic colorectal cancer (mCRC) patients eligible for the therapy with anti-EGFR monoclonal antibodies. The Italian Association of Medical Oncology (AIOM) and the Italian Society of Pathology and Cytology (SIAPEC) organized an external quality assessment (EQA) scheme for CRC to evaluate inter-laboratory consistency and to ensure standardization of the results in the transition from KRAS to all-RAS testing. Ten formalin fixed paraffin embedded specimens including KRAS/NRAS (exons 2, 3, 4) and BRAF (codon 600) mutations were validated by three referral laboratories and sent to 88 participant centers. Molecular pathology sample reports were also requested to each laboratory. A board of assessors from AIOM and SIAPEC evaluated the results according to a predefined scoring system. The scheme was composed of two rounds. In the first round 36% of the 88 participants failed, with 23 centers having at least one false positive or false negative while 9 centers did not meet the deadline. The genotyping error rate was higher when Sanger sequencing was employed for testing as compared with pyrosequencing (3 vs 1.3%; p = 0.01; Pearson Chi Square test). In the second round, the laboratories improved their performance, with 23/32 laboratories passing the round. Overall, 79/88 participants passed the RAS EQA scheme. Standardized Human Genome Variation Society nomenclature was incorrectly used to describe the mutations identified and relevant variations were noticed in the genotype specification. The results of the Italian RAS EQA scheme indicate that the mutational analyses are performed with good quality in many Italian centers, although significant differences in the methods used were highlighted. The relatively high number of centers failing the first round underlines the fundamental role in continued education covered by EQA schemes.

  16. Baseline Assessment of 25-Hydroxyvitamin D Reference Material and Proficiency Testing/External Quality Assurance Material Commutability: A Vitamin D Standardization Program Study.

    PubMed

    Phinney, Karen W; Sempos, Christopher T; Tai, Susan S-C; Camara, Johanna E; Wise, Stephen A; Eckfeldt, John H; Hoofnagle, Andrew N; Carter, Graham D; Jones, Julia; Myers, Gary L; Durazo-Arvizu, Ramon; Miller, W Greg; Bachmann, Lorin M; Young, Ian S; Pettit, Juanita; Caldwell, Grahame; Liu, Andrew; Brooks, Stephen P J; Sarafin, Kurtis; Thamm, Michael; Mensink, Gert B M; Busch, Markus; Rabenberg, Martina; Cashman, Kevin D; Kiely, Mairead; Galvin, Karen; Zhang, Joy Y; Kinsella, Michael; Oh, Kyungwon; Lee, Sun-Wha; Jung, Chae L; Cox, Lorna; Goldberg, Gail; Guberg, Kate; Meadows, Sarah; Prentice, Ann; Tian, Lu; Brannon, Patsy M; Lucas, Robyn M; Crump, Peter M; Cavalier, Etienne; Merkel, Joyce; Betz, Joseph M

    2017-09-01

    The Vitamin D Standardization Program (VDSP) coordinated a study in 2012 to assess the commutability of reference materials and proficiency testing/external quality assurance materials for total 25-hydroxyvitamin D [25(OH)D] in human serum, the primary indicator of vitamin D status. A set of 50 single-donor serum samples as well as 17 reference and proficiency testing/external quality assessment materials were analyzed by participating laboratories that used either immunoassay or LC-MS methods for total 25(OH)D. The commutability test materials included National Institute of Standards and Technology Standard Reference Material 972a Vitamin D Metabolites in Human Serum as well as materials from the College of American Pathologists and the Vitamin D External Quality Assessment Scheme. Study protocols and data analysis procedures were in accordance with Clinical and Laboratory Standards Institute guidelines. The majority of the test materials were found to be commutable with the methods used in this commutability study. These results provide guidance for laboratories needing to choose appropriate reference materials and select proficiency or external quality assessment programs and will serve as a foundation for additional VDSP studies.

  17. ASVCP quality assurance guidelines: external quality assessment and comparative testing for reference and in-clinic laboratories.

    PubMed

    Camus, Melinda S; Flatland, Bente; Freeman, Kathleen P; Cruz Cardona, Janice A

    2015-12-01

    The purpose of this document is to educate providers of veterinary laboratory diagnostic testing in any setting about comparative testing. These guidelines will define, explain, and illustrate the importance of a multi-faceted laboratory quality management program which includes comparative testing. The guidelines will provide suggestions for implementation of such testing, including which samples should be tested, frequency of testing, and recommendations for result interpretation. Examples and a list of vendors and manufacturers supplying control materials and services to veterinary laboratories are also included. © 2015 American Society for Veterinary Clinical Pathology.

  18. [External quality assurance in inpatient medical rehabilitation and prevention centers for mothers, fathers and children: development of instruments for assessing structural quality].

    PubMed

    Saupe-Heide, M; Gerlich, C; Lukasczik, M; Musekamp, G; Neuderth, S; Vogel, H

    2013-12-01

    As required by German law, inpatient institutions offering prevention and rehabilitation measures for mothers, fathers and children are obliged to implement external quality assurance measures. In 2 pilot projects funded by the German federal association of health insurance funds, external quality assurance procedures for in-hospital prevention and rehabilitation of mothers and fathers were analyzed with the aim of developing a set of instruments for the description of structural characteristics in this area of health care and to evaluate its appropriateness. Concerning structure-related quality, the project included a) designing and evaluating a questionnaire, b) the definition of assessment criteria for subsequent comparative data analyses, and c) the description and documentation of the current state in the field of rehabilitation and prevention for mothers, fathers and children. To document structural quality comprehensively, a modular questionnaire was developed and tested in a survey of 115 inpatient prevention and rehabilitation institutions for mothers, fathers and children. Involving an expert panel, preliminary basic and selection criteria were defined in order to assure a conducive assessment with regard to structural attributes. The majority of institutions had provider agreements for both prevention and rehabilitation. Measures for mothers/fathers with children were predominant; only 7 institutions exclusively treated mothers and fathers. Institution sizes varied strongly. Major indications included psychosomatics, dermatology, and pneumology. Overall, structural conditions of the institutions showed a high standard. Potential for development was found with regard to some aspects of the conceptual framework of institutional practice and the implementation of the International Classification of Functioning, Disability and Health (ICF) in diagnostics. In this article, the degrees of fulfillment with relation to the structural dimensions are presented

  19. First External Quality Assessment of Molecular and Serological Detection of Rift Valley Fever in the Western Mediterranean Region.

    PubMed

    Monaco, Federica; Cosseddu, Gian Mario; Doumbia, Baba; Madani, Hafsa; El Mellouli, Fatiha; Jiménez-Clavero, Miguel Angel; Sghaier, Soufien; Marianneau, Philippe; Cetre-Sossah, Catherine; Polci, Andrea; Lacote, Sandra; Lakhdar, Magtouf; Fernandez-Pinero, Jovita; Sari Nassim, Chabane; Pinoni, Chiara; Capobianco Dondona, Andrea; Gallardo, Carmina; Bouzid, Taoufiq; Conte, Annamaria; Bortone, Grazia; Savini, Giovanni; Petrini, Antonio; Puech, Lilian

    2015-01-01

    Rift Valley fever (RVF) is a mosquito-borne viral zoonosis which affects humans and a wide range of domestic and wild ruminants. The large spread of RVF in Africa and its potential to emerge beyond its geographic range requires the development of surveillance strategies to promptly detect the disease outbreaks in order to implement efficient control measures, which could prevent the widespread of the virus to humans. The Animal Health Mediterranean Network (REMESA) linking some Northern African countries as Algeria, Egypt, Libya, Mauritania, Morocco, Tunisia with Southern European ones as France, Italy, Portugal and Spain aims at improving the animal health in the Western Mediterranean Region since 2009. In this context, a first assessment of the diagnostic capacities of the laboratories involved in the RVF surveillance was performed. The first proficiency testing (external quality assessment--EQA) for the detection of the viral genome and antibodies of RVF virus (RVFV) was carried out from October 2013 to February 2014. Ten laboratories participated from 6 different countries (4 from North Africa and 2 from Europe). Six laboratories participated in the ring trial for both viral RNA and antibodies detection methods, while four laboratories participated exclusively in the antibodies detection ring trial. For the EQA targeting the viral RNA detection methods 5 out of 6 laboratories reported 100% of correct results. One laboratory misidentified 2 positive samples as negative and 3 positive samples as doubtful indicating a need for corrective actions. For the EQA targeting IgG and IgM antibodies methods 9 out of the 10 laboratories reported 100% of correct results, whilst one laboratory reported all correct results except one false-positive. These two ring trials provide evidence that most of the participating laboratories are capable to detect RVF antibodies and viral RNA thus recognizing RVF infection in affected ruminants with the diagnostic methods currently

  20. Variable sensitivity in molecular detection of Zika virus in European expert laboratories; external quality assessment, November 2016.

    PubMed

    Charrel, Remi; Mögling, Ramona; Pas, Suzan; Papa, Anna; Baronti, Cecile; Koopmans, Marion; Zeller, Hervé; LeParc-Goffart, Isabelle; Reusken, Chantal B

    2017-08-23

    Background: Zika virus (ZIKV) infections are a significant public health concern. A high capability for ZIKV detection is an absolute requirement for adequate preparedness and response strategies and individual patient care.Objectives: To assess and improve the capability of European expert laboratories for ZIKV molecular testing through an External Quality Assessment scheme.Study design: Laboratories were provided with a panel of 12 samples which included negative samples, samples containing African or Asian lineage ZIKV at variable concentrations (10(3) to 10(9) copies/ml) and samples containing dengue virus, yellow fever virus or chikungunya virus. Results were analysed based on sample outcomes and used extraction/detection. Samples with a ZIKV RNA status scored correctly by >50% of the laboratories were designated as core sample.Results: A total of 85 panel outcomes were submitted by 50 laboratories in 31 countries. Results designated all samples as core. 33% of panel outcomes identified all samples correctly (28/85), while 15% (13/85) had a score lower than 20 out of 24 points. Analysis at laboratory level showed that only 40% of the laboratories (20/50) representing 45% of the countries scored sufficiently, i.e. had at least one test operational that scored all core samples correctly.Conclusions: There is need for improvement of molecular detection of ZIKV in 60% of the participating laboratories. While the specificity of the tests was more robust, the results of the EQA showed large variation in test sensitivity. Improvement should focus on both nucleic acid extraction and ZIKV detection methods. Copyright © 2017 American Society for Microbiology.

  1. Improvement of coagulation laboratory practice in Thailand: the first-year experience of the national external quality assessment scheme for blood coagulation.

    PubMed

    Tientadakul, Panutsaya; Opartkiattikul, Nisarat; Wongtiraporn, Wanida

    2009-01-01

    In Thailand until 2005 there had been no external quality assessment scheme at the national level for blood coagulation tests. Only a few laboratories had an external quality assessment for these tests. In the year 2005, the Thailand National External Quality Assessment Scheme for Blood Coagulation was founded. To describe the establishment of the Thailand National External Quality Assessment Scheme for Blood Coagulation (including problems encountered and solutions), its progression and expansion, and the improvement of coagulation laboratory practice in Thailand during 2 trial surveys and 4 formal surveys conducted in the first 1 1/2 years. Between 2005 and 2006, the external quality assessment samples for prothrombin time/international normalized ratio and activated partial thromboplastin time were distributed to the participants as well as the instructions and suggestions for the improvement of laboratory practice. From the data collected, the all-method coefficient of variation of the international normalized ratio and activated partial thromboplastin time was calculated for each survey. The number of participants increased during the first 1 1/2 years that the surveys were conducted, from 109 to 127. Survey data demonstrate an improvement in response rate and an increase in the number of laboratories that determine their own reference ranges and repeat this for every change of reagent lot, using the appropriate anticoagulant. The increased precision of tests is indicated by the decrease of the all-method coefficient of variation of the international normalized ratio and activated partial thromboplastin time. Examples of individual laboratory improvement through feedback are also described. The improvement of coagulation laboratory practice both through the instructions provided and liaison with participants was observed during the course of this scheme.

  2. Large external quality assessment survey on thrombin generation with CAT: further evidence for the usefulness of normalisation with an external reference plasma.

    PubMed

    Perrin, Julien; Depasse, François; Lecompte, Thomas

    2015-07-01

    Calibrated Automated Thrombography (CAT) has been widely used to assess in vitro thrombin generation as an informative intermediary phenotype of coagulation. Interlaboratory exercises have documented a worrisome poor reproducibility. There are some data on the normalisation with an appropriate external reference plasma (RP). This multicentre study of the French-speaking CAT Club aimed at providing further evidence for the usefulness of such a normalisation. Lyophilised aliquots of a RP along with 3 plasmas (P1=normal; P2=hypo-; P3=hypercoagulable) were sent to 34 laboratories (corresponding to 38 instruments). CAT was studied using 1 and 5 pM tissue factor and other dedicated reagents. Normalisation with the local RP in use in the laboratory could also be performed. Interlaboratory CVs were calculated for each plasma before and after normalisation. Regarding endogenous thrombin potential, a good discrimination between the 3 plasmas was achieved in all laboratories but there was no overlap after normalisation only. CVs were generally not reduced with the use of local RP but were generally improved with normalisation using the external RP, often becoming lower than 10%. Regarding P2 however, the benefit of normalisation was poor, and there were analytical difficulties as well, some laboratories being unable to get a useable signal. We confirm that normalisation of CAT results with a suitable external RP is useful in "real life" practice as it often permits an acceptable level of interlaboratory variability. In case of frank hypocoagulability, further improvements are required to get reliable, potentially clinically relevant results. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Preanalytical external quality assessment of the Croatian Society of Medical Biochemistry and Laboratory Medicine and CROQALM: finding undetected weak spots.

    PubMed

    Nikolac, Nora; Krleza, Jasna Lenicek; Simundic, Ana-Maria

    2017-02-15

    The aim of this paper is to present results of first two years of preanalytical external quality assessment (EQA) in Croatia. This paper summarizes results from 6 rounds of preanalytical EQA during 2014-2016 in 161-175 Croatian laboratories (number ranged between cycles). EQA was designed as an online survey of the compliance with National recommendations for phlebotomy (NRP). Forty-seven questions in 5 categories are analyzed (materials and equipment, patient identification, patient preparation, sampling and storage). Additionally, preanalytical cases are presented. Overall performance scores (Question score (Qscore) for compliance with NRP and Case score (Cscore) for preanalytical cases) are calculated for each question/case as a proportion of laboratories with satisfactory procedure (x 100). Qscores and Cscores ≥ 70 were classified as acceptable (maximal score = 100). In investigation of compliance with NRP, acceptable Qscores were obtained for 34/47 questions. The lowest scores were observed for the availability of sterile disposable tourniquets (Qscore = 15) and safe-sharp needles (Qscore = 34), obtaining patients address as an identifier (Qscore = 21), using glycolysis inhibitor tubes for glucose concentration measurement (Qscore = 21) and verification of manufacturers declarations on temperature and time of storage (Qscore = 31). There was no statistically significant difference in overall Qscore according to different categories of phlebotomy procedures (P = 0.284). The results of preanalytical cases showed acceptable Cscore values for all cases (89-96). First two years of preanalytical EQA showed good compliance with the NRP and excellent expertise in resolving complex preanalytical issues. Major critical spots are lack of availability of safe-sharp needles, disposable tourniquets and glucose inhibitor tubes.

  4. First External Quality Assessment of Molecular and Serological Detection of Rift Valley Fever in the Western Mediterranean Region

    PubMed Central

    Monaco, Federica; Cosseddu, Gian Mario; Doumbia, Baba; Madani, Hafsa; El Mellouli, Fatiha; Jiménez-Clavero, Miguel Angel; Sghaier, Soufien; Marianneau, Philippe; Cetre-Sossah, Catherine; Polci, Andrea; Lacote, Sandra; Lakhdar, Magtouf; Fernandez-Pinero, Jovita; Sari Nassim, Chabane; Pinoni, Chiara; Capobianco Dondona, Andrea; Gallardo, Carmina; Bouzid, Taoufiq; Conte, Annamaria; Bortone, Grazia; Savini, Giovanni; Petrini, Antonio; Puech, Lilian

    2015-01-01

    Rift Valley fever (RVF) is a mosquito-borne viral zoonosis which affects humans and a wide range of domestic and wild ruminants. The large spread of RVF in Africa and its potential to emerge beyond its geographic range requires the development of surveillance strategies to promptly detect the disease outbreaks in order to implement efficient control measures, which could prevent the widespread of the virus to humans. The Animal Health Mediterranean Network (REMESA) linking some Northern African countries as Algeria, Egypt, Libya, Mauritania, Morocco, Tunisia with Southern European ones as France, Italy, Portugal and Spain aims at improving the animal health in the Western Mediterranean Region since 2009. In this context, a first assessment of the diagnostic capacities of the laboratories involved in the RVF surveillance was performed. The first proficiency testing (external quality assessment—EQA) for the detection of the viral genome and antibodies of RVF virus (RVFV) was carried out from October 2013 to February 2014. Ten laboratories participated from 6 different countries (4 from North Africa and 2 from Europe). Six laboratories participated in the ring trial for both viral RNA and antibodies detection methods, while four laboratories participated exclusively in the antibodies detection ring trial. For the EQA targeting the viral RNA detection methods 5 out of 6 laboratories reported 100% of correct results. One laboratory misidentified 2 positive samples as negative and 3 positive samples as doubtful indicating a need for corrective actions. For the EQA targeting IgG and IgM antibodies methods 9 out of the 10 laboratories reported 100% of correct results, whilst one laboratory reported all correct results except one false-positive. These two ring trials provide evidence that most of the participating laboratories are capable to detect RVF antibodies and viral RNA thus recognizing RVF infection in affected ruminants with the diagnostic methods currently

  5. Results of External Quality Assessment for Proviral DNA Testing of HIV Tropism in the Maraviroc Switch Collaborative Study

    PubMed Central

    Land, Sally; Pett, Sarah; Emery, Sean; Marks, Kat; Kelleher, Anthony D.; Kaye, Steve; Kaiser, Rolf; Schuelter, Eugene; Harrigan, Richard

    2013-01-01

    The Maraviroc Switch collaborative study (MARCH) is a study in aviremic patients on stable antiretroviral therapy and utilizes population-based sequencing of proviral DNA to determine HIV tropism and susceptibility to maraviroc. An external quality assessment (EQA) program was implemented to ensure competency in assessing the tropism of clinical samples conducted by MARCH laboratories (n = 14). The MARCH EQA has three prestudy phases assessing V3 loop sequencing and tropism determination using the bioinformatic algorithm geno2pheno, which generates a false-positive rate (FPR). DNA sequences with low FPRs are more likely to be from CXCR4-using (X4) viruses. Phase 1 of the EQA involved chromatogram interpretation. Phases 2, 2/3, and 3 involved patient and clonal samples. Clinical samples used in these phases were from treatment-experienced HIV-infected volunteers; 18/20 had viral loads of <50 copies/ml, and 10/15 were CXCR4-tropic on prior phenotyping. All samples were tested in triplicate, and any replicate with a geno2pheno FPR of <10% was designated X4. Performance was deemed adequate if ≤2 R5 and ≤1 X4 specimens were miscalled. For several clinical samples in the EQA, triplicate testing revealed marked DNA variability (FPR range, 0 to 96.7%). Therefore, a consensus-based approach was employed for each sample, i.e., a median FPR across laboratories was used to define sample tropism. Further sequencing analysis showed mixed viral populations in the clinical samples, explaining the differences in tropism predictions. All laboratories passed the EQA after achieving predefined competence thresholds in either of the phase 2 rounds. The use of clinical samples from patients resembling those who were likely to be screened in the MARCH, coupled with triplicate testing, revealed inherent DNA variability that might have been missed if single or duplicate testing and/or clonal samples alone were used. These data highlight the importance of intensive EQA of tropism

  6. Results of external quality assessment for proviral DNA testing of HIV tropism in the Maraviroc Switch collaborative study.

    PubMed

    Tu, Elise; Swenson, Luke C; Land, Sally; Pett, Sarah; Emery, Sean; Marks, Kat; Kelleher, Anthony D; Kaye, Steve; Kaiser, Rolf; Schuelter, Eugene; Harrigan, Richard

    2013-07-01

    The Maraviroc Switch collaborative study (MARCH) is a study in aviremic patients on stable antiretroviral therapy and utilizes population-based sequencing of proviral DNA to determine HIV tropism and susceptibility to maraviroc. An external quality assessment (EQA) program was implemented to ensure competency in assessing the tropism of clinical samples conducted by MARCH laboratories (n = 14). The MARCH EQA has three prestudy phases assessing V3 loop sequencing and tropism determination using the bioinformatic algorithm geno2pheno, which generates a false-positive rate (FPR). DNA sequences with low FPRs are more likely to be from CXCR4-using (X4) viruses. Phase 1 of the EQA involved chromatogram interpretation. Phases 2, 2/3, and 3 involved patient and clonal samples. Clinical samples used in these phases were from treatment-experienced HIV-infected volunteers; 18/20 had viral loads of <50 copies/ml, and 10/15 were CXCR4-tropic on prior phenotyping. All samples were tested in triplicate, and any replicate with a geno2pheno FPR of <10% was designated X4. Performance was deemed adequate if ≤2 R5 and ≤1 X4 specimens were miscalled. For several clinical samples in the EQA, triplicate testing revealed marked DNA variability (FPR range, 0 to 96.7%). Therefore, a consensus-based approach was employed for each sample, i.e., a median FPR across laboratories was used to define sample tropism. Further sequencing analysis showed mixed viral populations in the clinical samples, explaining the differences in tropism predictions. All laboratories passed the EQA after achieving predefined competence thresholds in either of the phase 2 rounds. The use of clinical samples from patients resembling those who were likely to be screened in the MARCH, coupled with triplicate testing, revealed inherent DNA variability that might have been missed if single or duplicate testing and/or clonal samples alone were used. These data highlight the importance of intensive EQA of tropism

  7. The relevance of external quality assessment for molecular testing for ALK positive non-small cell lung cancer: results from two pilot rounds show room for optimization.

    PubMed

    Tembuyser, Lien; Tack, Véronique; Zwaenepoel, Karen; Pauwels, Patrick; Miller, Keith; Bubendorf, Lukas; Kerr, Keith; Schuuring, Ed; Thunnissen, Erik; Dequeker, Elisabeth M C

    2014-01-01

    Molecular profiling should be performed on all advanced non-small cell lung cancer with non-squamous histology to allow treatment selection. Currently, this should include EGFR mutation testing and testing for ALK rearrangements. ROS1 is another emerging target. ALK rearrangement status is a critical biomarker to predict response to tyrosine kinase inhibitors such as crizotinib. To promote high quality testing in non-small cell lung cancer, the European Society of Pathology has introduced an external quality assessment scheme. This article summarizes the results of the first two pilot rounds organized in 2012-2013. Tissue microarray slides consisting of cell-lines and resection specimens were distributed with the request for routine ALK testing using IHC or FISH. Participation in ALK FISH testing included the interpretation of four digital FISH images. Data from 173 different laboratories was obtained. Results demonstrate decreased error rates in the second round for both ALK FISH and ALK IHC, although the error rates were still high and the need for external quality assessment in laboratories performing ALK testing is evident. Error rates obtained by FISH were lower than by IHC. The lowest error rates were observed for the interpretation of digital FISH images. There was a large variety in FISH enumeration practices. Based on the results from this study, recommendations for the methodology, analysis, interpretation and result reporting were issued. External quality assessment is a crucial element to improve the quality of molecular testing.

  8. External quality assessment of tumour marker analysis: state of the art and consequences for estimating diagnostic sensitivity and specificity.

    PubMed

    Reinauer, Hans; Wood, William Graham

    2005-05-30

    This review shows the current analytical quality for the following analytes used as tumour markers in the external quality assessment (EQA)-programmes of Instand e.V., a national EQA-organiser in Germany: Corticotropin (ACTH), growth hormone (GH, hGH), prolactin (PRL), chorionic gonadotropin (CG, hCG), calcitonin (CT, hCT), thyroglobulin (Tg), carcinoembryonic antigen (CEA), CA-Antigens 125, 72-4, 15-3 and 19-9, alpha foetoprotein (AFP) and prostate-specific antigen (PSA). The results from the participants show a large variation in the precision of the methods used as well as in the comparability of results between methods for the same analyte. In general, the hormones used as tumour markers show better performance than the "CA-markers", which are often inadequately standardised and defined. In the case of one CA-marker (CA 72-4/TAG 72-4), the differences between the lowest kit median concentration and highest kit median concentration for one sample pair were 440% and 580%. The corresponding figures for ACTH were 123% and 156% and for CEA 180% and 184%. The classical tumour markers such as carcinoembryonic antigen (CEA) and alpha foetoprotein (AFP) performed markedly better than the CA-markers and PSA with regards to both inter- and intra-method comparability. The inter-laboratory precision for a given kit and marker was acceptable in many cases. The results show that only results from the same kit/method for each tumour marker can be used for cumulative or time-dependent comparison of results - for example pre-operative and post-operative follow up. In the case of prostate specific antigen (PSA), the kits used for free and total PSA must come from the same producer, if the generally accepted ratios are to have any diagnostic value. The need for kit- and laboratory-specific reference ranges and cut-off values for setting diagnostic specificity and sensitivity is highlighted from the EQA-results. The situation for inter-method comparability for the CA-Markers has

  9. External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo.

    PubMed

    Mukadi, Pierre; Gillet, Philippe; Lukuka, Albert; Atua, Benjamin; Sheshe, Nicole; Kanza, Albert; Mayunda, Jean Bosco; Mongita, Briston; Senga, Raphaël; Ngoyi, John; Muyembe, Jean-Jacques; Jacobs, Jan; Lejon, Veerle

    2013-06-01

    To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first. A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113,530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites. Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%, P < 0.001). Malaria rapid diagnostic tests were used by 44.3% of laboratories, almost double the proportion observed in the previous quality assessment. The overall quality of blood film microscopy was poor but was improved by participation in external quality assessments. The failure to recognize trypanosomes in a country where sleeping sickness is endemic is a concern.

  10. External Quality Assessment of Non-University Study Programmes Which Were Developed and Submitted for Realisation: Experience and Problems

    ERIC Educational Resources Information Center

    Zibeniene, Gintaute

    2004-01-01

    The author analyzes the nature of study programme assessment with regard to the assurance of study quality. The organisation of the assessment process of the non-university study programmes which were developed and submitted for realisation in Lithuania and other countries is also presented and compared. It is being analysed whether it is possible…

  11. External quality assessment on the use of malaria rapid diagnostic tests in a non-endemic setting.

    PubMed

    Gillet, Philippe; Mukadi, Pierre; Vernelen, Kris; Van Esbroeck, Marjan; Muyembe, Jean-Jacques; Bruggeman, Cathrien; Jacobs, Jan

    2010-12-13

    Malaria rapid diagnostic tests (RDTs) are increasingly used as a tool for the diagnosis of malaria, both in endemic and in non-endemic settings. The present study reports the results of an external quality assessment (EQA) session on RDTs in a non-endemic setting. After validation of antigen stability during shipment at room temperature, three clinical samples and a questionnaire were sent to clinical laboratories in Belgium and the Grand Duchy of Luxembourg using malaria RDTs. Participants were asked to report the results of the RDTs as observations (visibility of the RDT control and test lines) and interpretations (report as formulated to the clinician). In addition, participants were invited to fill in a questionnaire on the place of RDTs in the diagnostic strategy of malaria. A total of 128/133 (96.2%) of clinical laboratories using RDTs participated. Six three-band and one four-band RDT brands were used. Analytical errors were rare and included (i) not recognizing invalid RDT results (1.6%) and (ii) missing the diagnosis of Plasmodium falciparum (0.8%). Minor errors were related to RDT test result interpretation and included (i) reporting "RDT positive" without species identification in the case of P. falciparum and non-falciparum species (16.9% and 6.5% respectively) and (ii) adding incorrect comments to the report (3.2%). Some of these errors were related to incorrect RDT package insert instructions such as (i) not reporting the possibility of mixed species infection in the case of P. falciparum and Plasmodium vivax (35.5% and 18.5% respectively) and (ii) the interpretation of P. vivax instead of non-falciparum species at the presence of a pan-species antigen line (4.0%). According to the questionnaire, 48.8% of participants processed ≤20 requests for malaria diagnosis in 2009. During opening hours, 93.6% of 125 participants used RDTs as an adjunct to microscopy but outside opening hours, nearly one third of 113 participants relied on RDTs as the primary

  12. External quality mechanisms for health care: summary of the ExPeRT project on visitatie, accreditation, EFQM and ISO assessment in European Union countries. External Peer Review Techniques. European Foundation for Quality Management. International Organization for Standardization.

    PubMed

    Shaw, C D

    2000-06-01

    This paper is a summary of the operation, findings and conclusions of a European Union project on external peer review techniques, termed 'ExPeRT', to research the scope, mechanisms and use of external quality mechanisms in the improvement of health care. Many of the themes outlined are described in detail in other papers that have been prepared specifically for this issue of The International Journal for Quality in Health Care. Although the emphasis of this project and of this issue of the Journal is on Europe, the conclusions are more widely relevant.

  13. External quality assurance in Malaysia.

    PubMed

    Nawawi, H; Lim, H H; Zakiah, I

    1999-01-01

    An activity supportive of the MOH QA Programme, the National EQAS for clinical chemistry monitors for analytical performance in core routine biochemical testing by the pathology laboratories, with unsatisfactory performance scores serving to alert against deficiencies or problems and the scores in subsequent challenges providing the feedback of effectiveness of remedial actions taken. While unacceptable individual analyte performance score (variance index score, VIS) indicated problems in instruments, reagent and calibrators, or the use of inherently poorer methods, repeated occurrence of unsatisfactory OMRVIS was traceable to generally poor laboratory management of usually inadequately-equipment small laboratories. The outcome has been one of slow but gradual improvement in the overall performance of participating laboratories, with a move towards methods upgrading and standardization to achieve greater concordance of results. Presently, the programme is limited to 61 government and 4 private hospital laboratories in the country for 12 commonly assayed clinical biochemistry analytes. It is hoped that the NEQAS could be extended to the other private laboratories and that of academic institutions. However, this is dependent to a large extent on the manpower and financial support obtainable by the organizing body of the programme in the future. Belk and Sunderman, 1947 demonstrated that laboratories participating in an quality assessment scheme could rapidly and dramatically improve their analytical performance. In some countries, participation has become mandatory, and acceptable performance is a requirement in laboratory accreditation. The need and value of the NEQAP is, therefore, evident. While there may be limitations in the national programme. efforts are being made at improving the programme within the means and resources of the organising body. The goals of the NEQAP are not just to monitor performance but also to educate. On this, matters related to and

  14. Japanese external quality assessment program to standardize HIV-1 drug-resistance testing (JEQS2010 program) using in vitro transcribed RNA as reference material.

    PubMed

    Yoshida, Shigeru; Hattori, Junko; Matsuda, Masakazu; Okada, Kiyomi; Kazuyama, Yukumasa; Hashimoto, Osamu; Ibe, Shiro; Fujisawa, Shin-ichi; Chiba, Hitoshi; Tatsumi, Masashi; Kato, Shingo; Sugiura, Wataru

    2015-03-01

    To design appropriate antiretroviral therapy regimens and avoid the emergence of human immunodeficiency virus (HIV)-1 variants with reduced susceptibility to antiretroviral drugs, genotypic drug-resistance testing (HIV genotyping) is strongly recommended. To monitor the quality of HIV genotyping in Japan, we performed an external quality assessment (EQA), named the Japanese external quality assessment program, to standardize HIV genotyping (JEQS). To accurately evaluate the quality of HIV genotyping, we employed as reference material (RM) a well-characterized sample, in vitro transcribed RNA (trRNA) that includes the HIV gag-pol sequence, and created a JEQS2010 panel consisting of three single variant and three mixed trRNA samples. All 11 participating laboratories showed high concordance rates (>96%) for the single variant samples. Eight laboratories also showed good rates of detecting minor variants, but three laboratories failed to detect the variants comprising one-half of the sample. These three laboratories used a common primer that had four internal mismatches to the minor trRNA clone. This program showed the usefulness of trRNA as RM, the high quality of HIV genotyping, and extensive interlaboratory variation in the ability to detect minor variants. These results suggest that improving the quality of HIV genotyping in Japan requires regularly implementing the EQA program and improving the HIV genotyping protocol in each laboratory.

  15. Assessing U.S. Public School Quality: The Advantages of Combining Internal "Consumer Ratings" with External NCLB Ratings

    ERIC Educational Resources Information Center

    Price, Heather E.

    2016-01-01

    The school quality assessment process under No Child Left Behind (NCLB) is criticized for oversimplifying and overemphasizing standardized test results and unfairly targeting diverse, urban schools. There has been much development in alternative test score evaluations, especially value-added models. These developments have tilted the public…

  16. Assessing U.S. Public School Quality: The Advantages of Combining Internal "Consumer Ratings" with External NCLB Ratings

    ERIC Educational Resources Information Center

    Price, Heather E.

    2016-01-01

    The school quality assessment process under No Child Left Behind (NCLB) is criticized for oversimplifying and overemphasizing standardized test results and unfairly targeting diverse, urban schools. There has been much development in alternative test score evaluations, especially value-added models. These developments have tilted the public…

  17. Most but not all laboratories can detect the recently emerged Neisseria gonorrhoeae porA mutants - results from the QCMD 2013 N. gonorrhoeae external quality assessment programme.

    PubMed

    Luijt, D; Di Lorenzo, C; van Loon, A M; Unemo, M

    2014-02-27

    We describe the results of the Quality Control for Molecular Diagnostics 2013 Neisseria gonorrhoeae external quality assessment programme that included an N. gonorrhoeae strain harbouring an N. meningitidis porA gene which causes false-negative results in molecular diagnostic assays targeting the gonococcal porA pseudogene. Enhanced awareness of the international transmission of such gonococcal strains is needed to avoid false-negative results in both in-house and commercial molecular diagnostic assays used in laboratories worldwide, but particularly in Europe.

  18. External Quality Arrangements for Scotland's Colleges

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2008

    2008-01-01

    This document represents an innovative and radical landmark in the development of external quality arrangements for Scotland's colleges. The quality framework and arrangements for annual engagement, subject-based aspect reports, and external review reflect new thinking nationally, within HMIE, in the Scottish Further and Higher Education Funding…

  19. LED fluorescence microscopy in the diagnosis of tuberculosis: Fading and restaining of smears for external quality assessment.

    PubMed

    Allassia, Sonia; Aranibar, Mónica; Boutonnet, Mónica; Caserío, Viviana; Etchart, Ana Alicia; Fajardo, Sandra; García, Mónica; Gomez, Noemí; Gunia, Alba Marisa; Gustincic, María Virginia; Izquierdo, Viviana; Jara, Arnaldo Andrés; Kozicky, Graciela; Matteo, Mario; Pellegrini, Carlos; Pellegrino, Silvia; Pérez Catalán, Sebastián; Poggi, Susana; Sacramone, Carina; Santiso, Gabriela María; Souto, Alejandro; Togneri, Ana María; Wolff, Lidia; Vilche, Sandra; Eletti, Daniel; Imaz, María Susana

    2016-01-01

    Blinded rechecking is a method proposed for external quality assurance (EQA) of auramine-stained acid-fast bacilli (AFB) smears using fluorescence microscopy (FM), however, this procedure is not well developed and slides fading over time could compromise its implementation. Since bleaching of fluorescent molecules involves temperature-dependent chemical reactions, it is likely that low temperatures could slow down this process. We stored auramine-stained slides under different environmental conditions, including -20°C, and examined them over time. The slides stored in all the environments faded. At -20°C, fading was not reduced in relation to room temperature. Restaining and re-examining smears after five months showed that the slides containing saliva and storage at -20°C were associated with failure in AFB reappearance. In conclusion, the practice of freezing slides until they are viewed should be discouraged as it has a negative effect on blinded rechecking by reducing reading concordance after restaining. Specimen quality should be considered when interpreting FM-EQA results.

  20. Thoughts on Internal and External Quality Assurance

    ERIC Educational Resources Information Center

    Zhang, Jianxin

    2012-01-01

    Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

  1. Thoughts on Internal and External Quality Assurance

    ERIC Educational Resources Information Center

    Zhang, Jianxin

    2012-01-01

    Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

  2. An assessment of the operation of an external quality assessment (EQA) scheme in histopathology in the South Thames (West) region: 1995-1998.

    PubMed Central

    Carter, R L; Cook, M G

    1998-01-01

    AIMS: To describe the design and organisation of a voluntary regional external quality assessment (EQA) scheme in histopathology, and to record the results obtained over a three year period. METHODS: A protocol is presented in which circulation of EQA slides alternated with teaching sessions. Procedures for the choice of suitable cases, evaluation of submitted diagnoses, and feedback of results to participants are described. The use of teaching sessions, complementary to the slide circulations, and dealing with current diagnostic problems is also outlined. RESULTS: Participation rates in the nine slide circulations varied between 66% and 89%, mean 85%. Overall scores were predictably high but 4% of returns, from 10 pathologists, were unsatisfactory. These low scores were typically isolated or intermittent and none of the participants fulfilled agreed criteria for chronic poor performers. CONCLUSIONS: This scheme has been well supported and overall performances have been satisfactory. The design was sufficiently discriminatory to reveal a few low scores which are analysed in detail. Prompt feedback of results to participants with identification of all "incomplete" and "wrong" diagnoses is essential. Involvement of local histopathologists in designing, running, and monitoring such schemes is important. PMID:10070332

  3. Interlaboratory comparison study on lead in blood, in external quality assessment schemes since 1996: a progress report.

    PubMed

    Pineau, Alain; Otz, Jocelyn; Guillard, Olivier; Fauconneau, Bernard; Dumont, Gilles; Françoise-Burg, Elizabeth

    2014-09-01

    In 1992, at the request of the French labor ministry, an External Quality Control for lead in whole blood (F-EQCPbB) came into being. After 15 years (1996-2011), the ministry wished to exploit the database collected with a sufficient number of laboratories. Indeed, the number of participating laboratories had decreased from 73 to 41. However, the key finding pertained to the highly improved performance of the laboratories, which was associated with a spread of the results over the entire range of tested PbB (9 and 700 µg/l). So, it was that in laboratories having participated for >10 years, the good scores rose between 1996 and 2011 from 49% to 93%. To sum up, analysis has shown progressive and highly pronounced diminution of CVs (%) for all the ranges having undergone testing. We have observed increasing use of inductively coupled plasma with mass spectrometry (from 9% in 2005 to 29% in 2011) and decreasing use of electrothermal atomic absorption spectrometry. That said, and provided that they are based on the same degree of expertise in metrology, on all tested concentrations the two analytical techniques yield results that are not statistically different. Thanks to the F-EQCPbB, laboratories have enhanced their proficiency and registered demonstrably improved performance.

  4. External Quality Assessment Programs in the US with an emphasis on urinary sediment testing: the College of American Pathologists experience.

    PubMed

    Glassy, Eric F; Blomberg, David J

    2015-08-11

    The College of American Pathologists (CAP) has maintained the highest standards for laboratory medicine through education, evaluation, and certification. One form of External Quality Assurance - proficiency testing (PT) - is the centerpiece of that mission. Over 500 medical and scientific experts oversee CAP PT programs which include more than 600 tests performed by 22,000 laboratories in over 100 countries. It is the most comprehensive laboratory peer-review comparison program in the world. The CAP offers four urine sediment PT products tailored to the needs of different laboratories. Each includes three or four digital images, shipped twice a year. The program is overseen by the Hematology and Clinical Microscopy Resource Committee. Images are graded if there is 80% or greater consensus of either referee or participant laboratories. Failing laboratories must analyze the reasons for the failure, report the results, and initiate corrective action. Over the years, there has been a progressive decline in the number of errors, demonstrating that education and regulatory oversight are major contributors to improved PT performance and, by extension, patient care. The PT urine sediment image databank is a unique resource, representing the consensus of many laboratories. Participant and referee responses identify which morphologic variants are unambiguous and which are more difficult to classify. The PT challenges include discussions of disease pathophysiology and key morphologic features. This teaching component is what helps to set the CAP's program apart. The discussions formed the basis for the Color Atlas of Urinary Sediment published by the CAP in 2010.

  5. Internal versus External Quality Management

    ERIC Educational Resources Information Center

    Hofman, Roelande H.; Dijkstra, Nynke J.; Hofman, W. H. Adriaan

    2008-01-01

    This article presents the findings of research into quality management in Dutch elementary schools using theories of school accountability and school improvement as fundamentals. The study is based on data gathered from almost 1000 school leaders. It attempts to determine whether different types of quality management exist in primary schools.…

  6. Internal versus External Quality Management

    ERIC Educational Resources Information Center

    Hofman, Roelande H.; Dijkstra, Nynke J.; Hofman, W. H. Adriaan

    2008-01-01

    This article presents the findings of research into quality management in Dutch elementary schools using theories of school accountability and school improvement as fundamentals. The study is based on data gathered from almost 1000 school leaders. It attempts to determine whether different types of quality management exist in primary schools.…

  7. External quality assessment of platelet disorder investigations: results of international surveys on diagnostic tests for dense granule deficiency and platelet aggregometry interpretation.

    PubMed

    Hayward, Catherine P M; Moffat, Karen A; Plumhoff, Elizabeth; Timleck, Marnie; Hoffman, Suzanne; Spitzer, Ernie; Van Cott, Elizabeth M; Meijer, Piet

    2012-09-01

    The quality of platelet aggregation and dense granule deficiency testing is important for diagnosing platelet function disorders. After a successful pilot exercise on diagnosing platelet dense granule deficiency by electron microscopy (EM), the North American Specialized Coagulation Laboratory Association (NASCOLA) has launched regular external quality assurance (EQA) for dense granule EM, as well as for the interpretation of platelet aggregation findings. EQA records were analyzed to assess performance. For EM EQA, between 2009 and 2011, there was excellent performance in distinguishing normal from dense granule-deficient samples and good (>70%) agreement on classifying most electron dense structures in platelets. For aggregation EQA, some normal variants were misclassified and overall case interpretations were more acceptable for rare disorders than for common findings. NASCOLA experiences with these EQAs indicate that there is a need to improve the quality of platelet disorder evaluations. For aggregometry interpretations, deficits in performance could be addressed by translating guideline recommendations into practice.

  8. External Quality Assessment for Tuberculosis Diagnosis and Drug Resistance in the European Union: A Five Year Multicentre Implementation Study

    PubMed Central

    Richter, Elvira; Ahmed, Nada; van der Werf, Marieke J.; Kodmon, Csaba; Drobniewski, Francis; Ruesch-Gerdes, Sabine

    2016-01-01

    Background External quality assurance (EQA) systems are essential to ensure accurate diagnosis of TB and drug-resistant TB. The implementation of EQA through organising regular EQA rounds and identification of training needs is one of the key activities of the European TB reference laboratory network (ERLTB-Net). The aim of this study was to analyse the results of the EQA rounds in a systematic manner and to identify potential benefits as well as common problems encountered by the participants. Methods The ERLTB-Net developed seven EQA modules to test laboratories’ proficiency for TB detection and drug susceptibility testing using both conventional and rapid molecular tools. All National TB Reference laboratories in the European Union and European Economic Area (EU/EEA) Member States were invited to participate in the EQA scheme. Results A total of 32 National TB Reference laboratories participated in six EQA rounds conducted in 2010–2014. The participation rate ranged from 52.9% - 94.1% over different modules and rounds. Overall, laboratories demonstrated very good proficiency proving their ability to diagnose TB and drug-resistant TB with high accuracy in a timely manner. A small number of laboratories encountered problems with identification of specific Non-tuberculous Mycobacteria (NTMs) (N = 5) and drug susceptibility testing to Pyrazinamide, Amikacin, Capreomycin, and Ethambutol (N = 4). Conclusions The European TB Reference laboratories showed a steady and high level of performance in the six EQA rounds. A network such as ERLTB-Net can be instrumental in developing and implementing EQA and in establishing collaboration between laboratories to improve the diagnosis of TB in the EU/EEA. PMID:27055064

  9. [Bringing criteria for external assessment of the quality of biochemical studies within the framework of the Federal System for External Evaluation of the Quality of Clinical Laboratory Studies, in conformity with requirements of the Order No. 45 of the Ministry of Health of Russia, 2/7/2000].

    PubMed

    Zaikin, E V; Malakhov, V N

    2000-07-01

    Criteria for external assessment of the quality of evaluation of 23 biochemical parameters of the blood, meeting the standards of accuracy determined by the Order No. 45 of Ministry of Health of Russia of February 7, 2000 for intralaboratory quality control have been estimated. According to the data of the Federal System for External Evaluation of the Quality of Clinical Laboratory Studies, the percentage of results of analyses of test sera meeting these criteria has been estimated. Introduction of new criteria for external assessment of the quality of biochemical tests into the practice of the Federal System will not notably modify the currently used criteria with regard to the majority of biochemical parameters, except introduction of more stringent criteria for albumin and magnesium and less stringent for creatine kinase.

  10. Conversion, correction, and International Scale standardization: results From a Multicenter External Quality Assessment Study for BCR-ABL1 testing.

    PubMed

    Griffiths, Michael; Patton, Simon J; Grossi, Alberto; Clark, Jordan; Paz, Maria Fe; Labourier, Emmanuel

    2015-04-01

    Monitoring BCR-ABL1 expression levels relative to clinically validated response criteria on the International Scale (IS) is vital in the optimal management of patients with chronic myeloid leukemia, yet significant variability remains across laboratories worldwide. To assess method performance, interlaboratory precision, and different IS standardization modalities in representative laboratories performing routine BCR-ABL1 testing. Fifteen blinded test specimens with 5-level nominal BCR-ABL1 to ABL1 IS percentage ratios ranging from 5% to 0.0005% and 4-level secondary IS reference panels, the ARQ IS Calibrator Panels, were tested by relative quantitative polymerase chain reaction in 15 laboratories in 5 countries. Both raw and IS percentage ratios calculated by using local conversion factors (CFs) or analytic correction parameters (CPs) were collected and analyzed. A total of 670 valid positive results were generated. BCR-ABL1 detection was associated with variable ABL1 quality metric passing rates (P < .001) and reached at least 0.01% in 13 laboratories. Intralaboratory precision was within 2.5-fold for all sample levels combined with a relative mean difference greater than 5-fold across laboratories. International Scale accuracy was increased by using both the CF and CP standardization methods. Classification agreement for major molecular response status was 90% after CF conversion and 93% after CP correction, with precision improved by 3-fold for the CP method. Despite preanalytic and analytic differences between laboratories, conversion and correction are effective IS standardization methods. Validated secondary reference materials can facilitate global diffusion of the IS without the need to perform sample exchange and improve the accuracy and precision of BCR-ABL1 quantitative measurements, including at low levels of residual disease.

  11. Aquatic Ecosystems, Water Quality, and Global Change: Challenges of conducting Multi-Stressor Vulnerability Assessments (External Review Draft)

    EPA Science Inventory

    This draft report investigates the issues and challenges associated with identifying, calculating, and mapping indicators of the relative vulnerability of water quality and aquatic ecosystems, across the United States, to the potential impacts of global change. Using a large set...

  12. Aquatic Ecosystems, Water Quality, and Global Change: Challenges of conducting Multi-Stressor Vulnerability Assessments (External Review Draft)

    EPA Science Inventory

    This draft report investigates the issues and challenges associated with identifying, calculating, and mapping indicators of the relative vulnerability of water quality and aquatic ecosystems, across the United States, to the potential impacts of global change. Using a large set...

  13. The accuracy of platelet counting in thrombocytopenic blood samples distributed by the UK National External Quality Assessment Scheme for General Haematology.

    PubMed

    De la Salle, Barbara J; McTaggart, Paul N; Briggs, Carol; Harrison, Paul; Doré, Caroline J; Longair, Ian; Machin, Samuel J; Hyde, Keith

    2012-01-01

    A knowledge of the limitations of automated platelet counting is essential for the effective care of thrombocytopenic patients and management of platelet stocks for transfusion. For this study, 29 external quality assessment specimen pools with platelet counts between 5 and 64 × 10(9)/L were distributed to more than 1,100 users of 23 different hematology analyzer models. The same specimen pools were analyzed by the international reference method (IRM) for platelet counting at 3 reference centers. The IRM values were on average lower than the all-methods median values returned by the automated analyzers. The majority (~67%) of the automated analyzer results overestimated the platelet count compared with the IRM, with significant differences in 16.5% of cases. Performance differed between analyzer models. The observed differences may depend in part on the nature of the survey material and analyzer technology, but the findings have implications for the interpretation of platelet counts at levels of clinical decision making.

  14. Diagnosis of West Nile Virus Human Infections: Overview and Proposal of Diagnostic Protocols Considering the Results of External Quality Assessment Studies

    PubMed Central

    Sambri, Vittorio; Capobianchi, Maria R.; Cavrini, Francesca; Charrel, Rémi; Donoso-Mantke, Olivier; Escadafal, Camille; Franco, Leticia; Gaibani, Paolo; Gould, Ernest A.; Niedrig, Matthias; Papa, Anna; Pierro, Anna; Rossini, Giada; Sanchini, Andrea; Tenorio, Antonio; Varani, Stefania; Vázquez, Ana; Vocale, Caterina; Zeller, Herve

    2013-01-01

    West Nile virus, genus Flavivirus, is transmitted between birds and occasionally other animals by ornithophilic mosquitoes. This virus also infects humans causing asymptomatic infections in about 85% of cases and <1% of clinical cases progress to severe neuroinvasive disease. The virus also presents a threat since most infections remain unapparent. However, the virus contained in blood and organs from asymptomatically infected donors can be transmitted to recipients of these infectious tissues. This paper reviews the presently available methods to achieve the laboratory diagnosis of West Nile virus infections in humans, discussing the most prominent advantages and disadvantages of each in light of the results obtained during four different External Quality Assessment studies carried out by the European Network for ‘Imported’ Viral Diseases (ENIVD). PMID:24072061

  15. First experience of a multicenter external quality assessment of molecular 16S rRNA gene detection in bone and joint infections.

    PubMed

    Plouzeau, Chloé; Bémer, Pascale; Valentin, Anne Sophie; Héry-Arnaud, Geneviève; Tandé, Didier; Jolivet-Gougeon, Anne; Vincent, Pascal; Kempf, Marie; Lemarié, Carole; Guinard, Jérôme; Bret, Laurent; Cognée, Anne Sophie; Gibaud, Sophie; Burucoa, Christophe; Corvec, Stéphane

    2015-02-01

    The objective of this study was to assess the performance of seven French laboratories for 16S rRNA gene detection by real-time PCR in the diagnosis of bone and joint infection (BJI) to validate a large multicenter study. External quality control (QC) was required owing to the differences in extraction procedures and the molecular equipment used in the different laboratories. Three proficiency sets were organized, including four bacterial DNA extracts and four bead mill-pretreated osteoarticular specimens. Extraction volumes, 16S rRNA gene primers, and sequencing interpretation rules were standardized. In order to assess each laboratory's ability to achieve the best results, scores were assigned, and each QC series was classified as optimal, acceptable, or to be improved. A total of 168 QCs were sent, and 160 responses were analyzed. The expected results were obtained for 93.8%, with the same proportion for extracts (75/80) and clinical specimens (75/80). For the specimens, there was no significant difference between manual and automated extraction. This QC demonstrated the ability to achieve good and homogeneous results using the same 16S rRNA gene PCR with different equipment and validates the possibility of high-quality multicenter studies using molecular diagnosis for BJI.

  16. First Experience of a Multicenter External Quality Assessment of Molecular 16S rRNA Gene Detection in Bone and Joint Infections

    PubMed Central

    Bémer, Pascale; Valentin, Anne Sophie; Héry-Arnaud, Geneviève; Tandé, Didier; Jolivet-Gougeon, Anne; Vincent, Pascal; Kempf, Marie; Lemarié, Carole; Guinard, Jérôme; Bret, Laurent; Cognée, Anne Sophie; Gibaud, Sophie; Burucoa, Christophe; Corvec, Stéphane

    2014-01-01

    The objective of this study was to assess the performance of seven French laboratories for 16S rRNA gene detection by real-time PCR in the diagnosis of bone and joint infection (BJI) to validate a large multicenter study. External quality control (QC) was required owing to the differences in extraction procedures and the molecular equipment used in the different laboratories. Three proficiency sets were organized, including four bacterial DNA extracts and four bead mill-pretreated osteoarticular specimens. Extraction volumes, 16S rRNA gene primers, and sequencing interpretation rules were standardized. In order to assess each laboratory's ability to achieve the best results, scores were assigned, and each QC series was classified as optimal, acceptable, or to be improved. A total of 168 QCs were sent, and 160 responses were analyzed. The expected results were obtained for 93.8%, with the same proportion for extracts (75/80) and clinical specimens (75/80). For the specimens, there was no significant difference between manual and automated extraction. This QC demonstrated the ability to achieve good and homogeneous results using the same 16S rRNA gene PCR with different equipment and validates the possibility of high-quality multicenter studies using molecular diagnosis for BJI. PMID:25411177

  17. Perceived health status and environmental quality in the assessment of external costs of waste disposal facilities. An empirical investigation.

    PubMed

    Giaccaria, Sergio; Frontuto, Vito

    2012-08-01

    Taxation for urban waste management has been reformed in Italy by the introduction of an environmental law in 2006. In the planning phase of waste management, externalities generated by new facilities remain widely unaccounted, with a consequent distortion for prices, often raising local conflicts. The paper presents a survey based on the choice modelling methodology, aimed to evaluate on a monetary scale the disamenity effect perceived by incinerator and landfills in an Italian urban context: the city of Turin. In a random utility framework the behaviour of respondents, whose choices are found to be driven by the endowment of information about technological options, socio-economic characteristics as income, education, family composition, and also by their health status was modelled. Furthermore, empirical evidence that the behaviour in residential location choices is affected by different aspects of the respondent life and in particular by the health status was found. Distinct estimates of willingness to accept compensation for disamenity effects of incinerator (Euro 2670) and landfill (Euro 3816) are elicited. The effect of health status of the respondents, their level of information about the waste disposal infrastructure, the presence of a subjective strong aversion (NIMBY) and the actual endowment and concentration of infrastructures are demonstrated to be significant factors determining the choice behaviour, but differentiated and specific for incinerators and landfills.

  18. Assessment of the Impacts of Global Change on Regional U.S. Air Quality (External Review Draft)

    EPA Science Inventory

    This report was prepared by the Global Change Research Program (GCRP) in the National Center for Environmental Assessment (NCEA) of the Office of Research and Development (ORD) at the U.S. Environmental Protection Agency (EPA). It is intended for managers and scientists worki...

  19. Assessment of the Impacts of Global Change on Regional U.S. Air Quality (External Review Draft)

    EPA Science Inventory

    This report was prepared by the Global Change Research Program (GCRP) in the National Center for Environmental Assessment (NCEA) of the Office of Research and Development (ORD) at the U.S. Environmental Protection Agency (EPA). It is intended for managers and scientists worki...

  20. The UK national external quality assessment scheme in blood group serology. Compatibility testing 1981-1982: performance and practice.

    PubMed

    Holburn, A M; Prior, D

    1984-01-01

    The design of exercises of compatibility testing was modified in 1981 in order better to accommodate participants' serological practices. Ten reference laboratories were also enrolled in order to determine the 'correct' results for each exercise. In 1981-1982 3.5 to 36% of participants missed incompatibilities in exercises in which undiluted antibodies were issued and this did not represent an improvement over performance obtained in 1979-1980. Surveys were undertaken of antiglobulin test procedures and revealed that serological practices continue to change, old techniques are being modified, new techniques are being employed but standardization shows little overall improvement. Surveys of quality control procedures and of cross-match procedures for agglutination in albumin and for agglutination of enzyme treated cells show equal lack of standardization.

  1. Experience with an external quality assessment programme for point-of-care-testing (POCT) devices for the determination of blood glucose.

    PubMed

    Wood, William Graham; Hanke, Rainer; Meissner, Dieane; Reinauer, Hans

    2003-01-01

    This article describes the preparation and internal and external evaluation of materials, critical issues in the external quality assessment (EQA) of point-of-care testing (POCT) devices for measuring blood glucose. A comparison was made between different materials, both of natural and synthetic origin and with and without stabilisers. The aims were to produce a material which was compatible with as many POCT-devices as possible and so reduce the number of materials sent out in each campaign as well as to optimise the precision and comparability of results between methods and devices. Although the use of near natural material--sterile-filtered plasma spiked with glucose--survived internal testing, this material proved to be unsuitable for EQA surveys. The study resulted in the reduction of materials for each survey to stabilised whole blood for one device, stabilised plasma for two devices and a synthetic material based on a polyethylene glycol matrix for all other devices. Samples were sent as pairs six times annually. The POCT-devices tested measured precisely but inaccurately in the synthetic material, when compared with the reference method (gas-chromatography coupled with isotope-dilution mass-spectrometry; GC-IDMS), so that the devices could only be evaluated for precision. The construction of ratios between the concentrations measured on the two samples distributed allowed an indirect assessment of accuracy. The need for surveillance of POCT devices is stressed in this publication, which combines theory and practice in setting up and running an EQA programme for blood glucose.

  2. The reliable assurance of detecting somatic mutations in cancer-related genes by next-generation sequencing: the results of external quality assessment in China

    PubMed Central

    Han, Yanxi; Yi, Lang; Xie, Jiehong; Yang, Xin; Fan, Gaowei; Wang, Guojing; Hao, Mingju; Zhang, Dong; Zhang, Kuo; Lin, Guigao; Li, Jinming

    2016-01-01

    To evaluate the proficiencies of laboratories utilizing next-generation sequencing (NGS) to detect somatic mutations in cancer-related genes, an external quality assessment (EQA) was implemented by the National Center for Clinical Laboratories of China in 2015. We prepared a panel of samples that comprised eight samples made by mixing synthetic mutated DNA fragments with normal human genomic DNA and one reference sample containing only genomic DNA. We validated our sample panel, and then distributed it to laboratories across China. We received complete results from 64 laboratories. The performances of 51.6 % (33/64) respondent labs were acceptable and 26.6 % (17/64) of the labs returned perfect results. In total, 449 mistakes were reported, including 201 false-negatives (201/449, 44.8 %) and 222 false-positives (222/449, 49.4 %) and 26 slightly discordant results (26/449, 5.8 %). We believe these unsatisfactory results and varied performances are mainly due to the enrichment methods used, the diverse sequencing chemistries of the different NGS platforms, and other errors within the sequencing process. The results indicate that our sample panel is suitable for use in EQA studies, and that further laboratory training in targeted NGS testing is urgently required. To address this, we propose a targeted NGS workflow with details on quality assurance procedures according to the current guidelines. PMID:27542269

  3. A survey of coagulation laboratory practices and satisfaction ratings of member laboratories of the Thailand National External Quality Assessment Scheme for blood coagulation.

    PubMed

    Chuntarut, A; Tientadakul, P; Wongkrajang, P

    2016-06-01

    The Thailand National External Quality Assessment Scheme (NEQAS) for blood coagulation was established in 2005. The objective of this study was to collect data of coagulation laboratory practices and satisfaction of NEQAS member. Two hundred seventy-six questionnaires were sent to laboratories that are members of NEQAS to obtain data relating to coagulation laboratory practice and satisfaction in 2014. Data from this survey were compared with data from the survey conducted in 2005 to evaluate levels of improvement. Of 276 questionnaires sent, 212 (76.8%) were returned. Improvements were characterized by the number of laboratories that (i) decreased use of 3.8% sodium citrate as anticoagulant; (ii) implemented use of at least two control levels for internal quality control; and (iii) implemented reporting of reference values with results, as well as establishing their own reference range and using geometric mean as the denominator for international normalized ratio calculation. For overall satisfaction, 179 of 206 (86.9%) participant laboratories reported being satisfied or very satisfied. Improvements in coagulation laboratory practices in Thailand were observed in every step of the total testing process. However, additional improvements are still needed, such as determination and use of a local reference range. © 2016 John Wiley & Sons Ltd.

  4. The reliable assurance of detecting somatic mutations in cancer-related genes by next-generation sequencing: the results of external quality assessment in China.

    PubMed

    Zhang, Rui; Ding, Jiansheng; Han, Yanxi; Yi, Lang; Xie, Jiehong; Yang, Xin; Fan, Gaowei; Wang, Guojing; Hao, Mingju; Zhang, Dong; Zhang, Kuo; Lin, Guigao; Li, Jinming

    2016-09-06

    To evaluate the proficiencies of laboratories utilizing next-generation sequencing (NGS) to detect somatic mutations in cancer-related genes, an external quality assessment (EQA) was implemented by the National Center for Clinical Laboratories of China in 2015. We prepared a panel of samples that comprised eight samples made by mixing synthetic mutated DNA fragments with normal human genomic DNA and one reference sample containing only genomic DNA. We validated our sample panel, and then distributed it to laboratories across China. We received complete results from 64 laboratories. The performances of 51.6 % (33/64) respondent labs were acceptable and 26.6 % (17/64) of the labs returned perfect results. In total, 449 mistakes were reported, including 201 false-negatives (201/449, 44.8 %) and 222 false-positives (222/449, 49.4 %) and 26 slightly discordant results (26/449, 5.8 %). We believe these unsatisfactory results and varied performances are mainly due to the enrichment methods used, the diverse sequencing chemistries of the different NGS platforms, and other errors within the sequencing process. The results indicate that our sample panel is suitable for use in EQA studies, and that further laboratory training in targeted NGS testing is urgently required. To address this, we propose a targeted NGS workflow with details on quality assurance procedures according to the current guidelines.

  5. External quality assessment of human neutrophil antigen (HNA)-specific antibody detection and HNA genotyping from 2000 to 2012.

    PubMed

    Lucas, G; Porcelijn, L; Fung, Y L; Green, F; Reil, A; Hopkins, M; Schuller, R; Green, A; de Haas, M; Bux, J

    2013-10-01

    Since 2000, Quality Assurance (QA) exercises for the detection and identification of granulocyte antibodies and DNA typing for human neutrophil antigens (HNA) have been distributed within the International Granulocyte Immunobiology Workshops, which are linked to International Society of Blood Transfusion. The exercises were standardised at the outset to enable laboratory performance to be monitored. Between 2000 and 2012, nine exercises were distributed to 20 laboratories. Overall, 45 examples of 42 unique samples containing defined granulocyte reactive antibodies were distributed for serological analysis together with 20 samples for HNA genotyping. The level of satisfactory serological performance was initially set at 50% and later increased to 70%, while the 'cut-off' for HNA genotyping was set at 100% after 2008. Failure to achieve the minimum score in the QA exercises in consecutive years resulted in temporary exclusion. In 2000, the 15 participating laboratories had a mean score of 56.1% for serological analysis and 13 laboratories attempted HNA-1a and -1b genotyping, while 11 attempted HNA-1c typing. Steady improvements in proficiency for serological testing and HNA typing occurred in subsequent exercises. In 2012, the mean score for serology was 88.5% and 12/13 laboratories scored 100% for HNA-1a, -1b, -1c, -3a, -3b, -4a, -4bw, -5a and -5bw genotyping. These QA exercises have provided an invaluable tool to monitor and improve the standard of granulocyte immunology investigations for participating laboratories, thereby enhancing performance for both clinical investigations and donor screening programmes to reduce the incidence of TRALI. © 2013 International Society of Blood Transfusion.

  6. Three Rounds of External Quality Assessment in France to Evaluate the Performance of 28 Platforms for Multiparametric Molecular Testing in Metastatic Colorectal and Non-Small Cell Lung Cancer.

    PubMed

    Dequeker, Elisabeth M C; Keppens, Cleo; Egele, Caroline; Delen, Sofie; Lamy, Aude; Lemoine, Antoinette; Sabourin, Jean-Christophe; Andrieu, Catherine; Ligtenberg, Marjolijn; Fetique, Dominique; Tops, Bastiaan; Descarpentries, Clotilde; Blons, Hélène; Denoux, Yves; Aube, Cécile; Penault-Llorca, Frederique; Hofman, Paul; Leroy, Karen; Le Marechal, Cédric; Doucet, Laurent; Duranton-Tanneur, Valérie; Pedeutour, Florence; Soubeyran, Isabelle; Côté, Jean-François; Emile, Jean-François; Vignaud, Jean-Michel; Monhoven, Nathalie; Haddad, Véronique; Laurent-Puig, Pierre; van Krieken, Han; Nowak, Frederique; Lonchamp, Etienne; Bellocq, Jean-Pierre; Rouleau, Etienne

    2016-03-01

    Personalized medicine has gained increasing importance in clinical oncology, and several clinically important biomarkers are implemented in routine practice. In an effort to guarantee high quality of molecular testing in France, three subsequent external quality assessment rounds were organized at the initiative of the National Cancer Institute between 2012 and 2014. The schemes included clinically relevant biomarkers for metastatic colorectal (KRAS, NRAS, BRAF, PIK3CA, microsatellite instability) and non-small cell lung cancer (EGFR, KRAS, BRAF, PIK3CA, ERBB2), and they represent the first multigene/multicancer studies throughout Europe. In total, 56 laboratories coordinated by 28 regional molecular centers participated in the schemes. Laboratories received formalin-fixed, paraffin-embedded samples and were asked to use routine methods for molecular testing to predict patient response to targeted therapies. They were encouraged to return results within 14 calendar days after sample receipt. Both genotyping and reporting were evaluated separately. During the three external quality assessment rounds, mean genotype scores were all above the preset standard of 90% for all biomarkers. Participants were mainly challenged in case of rare insertions or deletions. Assessment of the written reports showed substantial progress between the external quality assessment schemes on multiple criteria. Several essential elements such as the clinical interpretation of test results and the reason for testing still require improvement by continued external quality assessment education.

  7. Establishment of a proficiency panel for an external quality assessment programme for the detection of bacterial contamination in platelet concentrates using rapid and cultural detection methods.

    PubMed

    Vollmer, T; Schmidt, M; Hourfar, K; Schottstedt, V; Pichl, L; Gubbe, K; Knabbe, C; Dreier, J

    2016-05-01

    Platelet concentrates (PCs) are the main focus regarding the residual risk of transfusion-transmitted bacterial infections. Rapid screening methods for bacterial detection in platelets have been optimized over the last decade, but their external evaluation represents a complicated process. We developed a new type of proficiency panel for bacterial detection in PCs using currently available screening methods (especially rapid methods) suitable for external quality assessment programmes (EQAP). PC samples were inoculated with different bacteria at two concentrations (10E+03 CFU/ml, 10E+05 CFU/ml) and stored under temperature-controlled conditions (1-5 days). Bacterial growth was further prevented by the addition of 0-20 μg/ml cotrimoxazole. Samples were analysed prior to and after storage using rapid detection methods (Bactiflow (BF), bacteria-generic NAT) and cultural methods to determine the influence of storage and antibiotic treatment on bacterial counts and the result outcome. A pilot EQAP was performed with four participants. Testing under the evaluated conditions demonstrated that bacterial counts remained constant prior to and after storage. The supplementation of 10 μg/ml cotrimoxazole did not influence bacterial detection using the two rapid detection methods BF and NAT. Furthermore, the detection of bacteria using cultural methods is still possible despite of antibiotic supplementation. The pilot EQAP confirmed these results. A storage time of up to 3 days proved practicable, showing no considerable influence on bacterial count and outcome of test results. The established proficiency panel provided PC matrix-conform samples with stabilized bacterial counts which can be analysed in parallel by rapid and cultural detection methods. © 2016 International Society of Blood Transfusion.

  8. Organization and results of a pilot scheme for external quality assessment in clinical chemistry carried out in the Latium region, Italy.

    PubMed

    Morisi, G; Leonetti, G; Palombella, D; Patriarca, M; Menditto, A

    1995-01-01

    The results of an external quality assessment scheme (EQAS), carried out in the Latium region between October 1987 and December 1988, are reported. Ninety-four laboratories, both public and private, took part in the scheme. Aim of the scheme was to estimate the reliability of the clinical chemistry services in this region. The participating laboratories received eight control samples for EQA, every two months. The analytes to be determined in each sample were: glucose (GLU), urea (UR), total protein (TP), uric acid (UA), creatinine (CR), bilirubin (BIL), cholesterol (CHO), triglycerides (TRI), sodium (Na), potassium (K), calcium (Ca), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CPK), gamma glutamyl transferase (GGT), and alkaline phosphatase (ALP). Global laboratory performances were evaluated in terms of interlaboratory precision, accuracy--as deviation per cent from the target values and coefficient of variation (CV)--and percentage of results within pre-set acceptability limits. The deviations were reasonably low, whereas the CVs were rather high. The percentage of acceptable results was lower than 50% for the analytes urea, calcium, uric acid, creatine kinase and alkaline phosphatase. The performance of the examined laboratories was worse than those obtained in other regional and national EQAS, both in terms of CVs and percentage of acceptable results.

  9. Some practical thoughts on restructuring the current guideline of the Federal Medical Council (Richtlinie der Bundesärztekammer [RiliBAK]) in Germany for quality control of clinical laboratory analyses based on results from external quality assessment surveys.

    PubMed

    Wood, William Graham

    2005-01-01

    The present article presents a critical review of the current guidelines of the Federal Medical Council (Richtlinie der Bundesärztekammer--[RiliBAK]) in Germany, both for internal and external quality control. Examples have been chosen for analytes which present problems. These include thyrotropin (TSH) and human chorionic gonadotropin (hCG). Data are presented for the difference in analyte concentrations found between methods/kits and longitudinally for external quality assessment (EQA-) surveys for analytes using reference method values as target values. These include: calcium, aspartate aminotransferase (ASAT; GOT), aldosterone, cortisol, 17beta-oestradiol and total thyroxine (TT4). Furthermore, internal data from participating laboratories concerning laboratory internal precision and accuracy have been analysed to show the state of the art with regard to both parameters. Data analysis shows the need for a reintroduction of concentration-dependent assessment of performance (crossover system) for certain analytes, where clinically relevant concentrations are measured at the extremes of the calibration curve. The current guideline is at present being restructured and should include considerations made in this review of the state-of-the-art of clinical laboratory analysis.

  10. External quality assessment for enterovirus 71 and coxsackievirus A16 detection by reverse transcription-PCR using armored RNA as a virus surrogate.

    PubMed

    Song, Liqiong; Sun, Shipeng; Li, Bo; Pan, Yang; Li, Wenli; Zhang, Kuo; Li, Jinming

    2011-10-01

    Three armored RNAs (virus-like particles [VLPs]) containing target sequences from enterovirus 71 (EV71) and coxsackievirus A16 (CA16) and a pan-enterovirus (pan-EV) sequence were constructed and used in an external quality assessment (EQA) to determine the performance of laboratories in the detection of EV71 and CA16. The EQA panel, which consisted of 20 samples, including 14 positive samples with different concentrations of EV and either EV71 or CA16 armored RNAs, 2 samples with all 3 armored RNAs, and 4 negative-control samples (NaN(3)-preserved minimal essential medium [MEM] without VLPs), was distributed to 54 laboratories that perform molecular diagnosis of hand, foot, and mouth disease (HFMD) virus infections. A total of 41 data sets from 41 participants were returned; 5 (12.2%) were generated using conventional in-house reverse transcription-PCR (RT-PCR) assays, and 36 (87.8%) were generated using commercial real-time RT-PCR assays. Performance assessments of laboratories differed; 12 (29.3%) showed a need for improvement. Surprisingly, 4 laboratories were unable to detect EV71 RNA in any samples, even those containing the highest concentration of 10(7) IU/ml. Furthermore, the detection sensitivity for EV71 among all laboratories (82.1%) was substantially lower than that for EV (97.4%) or CA16 (95.1%). Overall, the results of the present study indicate that EQA should be performed periodically to help laboratories monitor their ability to detect HFMD viruses and to improve the comparability of results from different laboratories.

  11. 42 CFR 438.362 - Exemption from external quality review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Exemption from external quality review. 438.362... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.362 Exemption from external quality review. (a) Basis for exemption. The State may exempt an MCO or PIHP from EQR if...

  12. 42 CFR 438.362 - Exemption from external quality review.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Exemption from external quality review. 438.362... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.362 Exemption from external quality review. (a) Basis for exemption. The State may exempt an MCO or PIHP from EQR if...

  13. 42 CFR 438.352 - External quality review protocols.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false External quality review protocols. 438.352 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.352 External quality review protocols. Each protocol must specify— (a) The data to be gathered; (b) The sources of the...

  14. 42 CFR 438.354 - Qualifications of external quality review organizations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...; (iii) Quality assessment and improvement methods; and (iv) Research design and methodology, including... 42 Public Health 4 2011-10-01 2011-10-01 false Qualifications of external quality review... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review...

  15. Quality control of CD4+ T-lymphocyte enumeration: results from the last 9 years of the United Kingdom National External Quality Assessment Scheme for Immune Monitoring (1993-2001).

    PubMed

    Whitby, Liam; Granger, Viv; Storie, Ian; Goodfellow, Karen; Sawle, Alex; Reilly, John T; Barnett, David

    2002-04-15

    The human immunodeficiency virus (HIV) global epidemic has necessitated the routine enumeration of T-lymphocyte subsets, which has created a need for external quality assurance (EQA). The United Kingdom National External Quality Assessment Scheme (UK NEQAS) for Immune Monitoring provides EQA for 296 laboratories in 40 countries. In 1993, UK NEQAS developed and incorporated into its program stabilized whole blood that enables the accurate monitoring of laboratory performance. Overall, the mean interlaboratory coefficient of variation (CV) for percentage CD4(+) T-lymphocyte subset enumeration has fallen from 15% to less than 5%, as a direct result of the increased use of CD45/ side scatter (SSC) gating. Laboratories using alternative gating strategies (i.e., CD45/CD14 or forward scatter [FSC]/SSC) were about 7.4 times more likely to fail an EQA exercise. Furthermore, the adoption of single-platform technology resulted in a reduction of the overall mean interlaboratory CV for absolute CD4(+) T lymphocytes from 56% (prior to the widespread use of single-platform technology) to 9.7%. Individual laboratory deficiencies were also identified using a performance monitoring system and, through re-education by collaboration with the coordinating center, satisfactorily resolved. In conclusion, during the last 9 years, the UK NEQAS for Immune Monitoring program has highlighted the significant technological advances made by laboratories worldwide that undertake lymphocyte subset enumeration.

  16. [EXTERNAL QUALITY ASSESSMENT FOR THE LABORATORY IDENTIFICATION OF THE PATHOGENS OF PARASITIC DISEASES AS AN ELEMENT FOR IMPROVING THE POSTGRADUATE TRAINING OF SPECIALISTS].

    PubMed

    Dovgalev, A S; Astanina, S Yu; Malakhov, V N; Serdyuk, A P; Imamkuliev, K D; Gorbunova, Yu P; Pautova, E A; Prodeus, T V; Semenova, T A; Fedyanina, L V

    2016-01-01

    Within the framework of the Federal External Quality Assessment (EQA) System and in the context of postgraduate training improvement for health workers in 2010-2014, specialists from the laboratories of the therapeutic-prophylactic organizations and institutions of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare were examined for their professional competence in microscopically identifying the pathogens of parasitic diseases in feces. The virtual remote educational computer technology tools that included different combinations of 16 helminthic species, 5 intestinal protozoan species, and a number of artefacts, were used. The specialists from 984 laboratories of multidisciplinary therapeutic-prophylactic organizations and hygiene and epidemiology centers in all Federal Districts of the Russian Federation were covered. A total of 8245 replies were analyzed. The detection rate for helminths was 64.0%, including those by a taxonomic group (nematodes, 65.0%; cestodes, 72.0%; trematodes, 55.1%). There was a dynamic decrease in the above indicators. There were low detection rates for trematodes parasitizing the small intestine (Metagonimus, 10.2%; Nanophyetus, 26.2%) and hepatobiliary organs (Fasciola, 59.6%; Clonorchis, 34.9%). The similar trend was seen in the detection rates for the pathogens of geohelminthisms (ascariasis, trichocephaliasis, etc.) and contagious helminthisms (enterobiasis, hymenolepiasis). The level of competence in detecting and identifying intestinal protozoa was much lower than the similar rates for helminthism pathogens. EQA for the laboratory diagnosis of the pathogens of parasitic diseases, by using the virtual tools is a leading element of the postgraduate training system for laboratory specialists. The results of EQA for the laboratory diagnosis of the pathogens of parasitic diseases are a basic material for the development, and improvement of training modernization programs, by applying a modular

  17. SMS photograph-based external quality assessment of reading and interpretation of malaria rapid diagnostic tests in the Democratic Republic of the Congo.

    PubMed

    Mukadi, Pierre; Gillet, Philippe; Barbé, Barbara; Luamba, Jean; Lukuka, Albert; Likwela, Joris; Mumba, Dieudonné; Muyembe, Jean-Jacques; Lutumba, Pascal; Jacobs, Jan

    2015-01-28

    The present External Quality Assessment (EQA) assessed reading and interpretation of malaria rapid diagnostic tests (RDTs) in the Democratic Republic of the Congo (DRC). The EQA consisted of (i) 10 high-resolution printed photographs displaying cassettes with real-life results and multiple choice questions (MCQ) addressing individual health workers (HW), and (ii) a questionnaire on RDT use addressing the laboratory of health facilities (HF). Answers were transmitted through short message services (SMS). The EQA comprised 2344 HW and 1028 HF covering 10/11 provinces in DRC. Overall, median HW score (sum of correct answers on 10 MCQ photographs for each HW) was 9.0 (interquartile range 7.5 - 10); MCQ scores (the % of correct answers for a particular photograph) ranged from 54.8% to 91.6%. Most common errors were (i) reading or interpreting faint or weak line intensities as negative (3.3%, 7.2%, 24.3% and 29.1% for 4 MCQ photographs), (ii) failure to distinguish the correct Plasmodium species (3.4% to 7.0%), (iii) missing invalid test results (8.4% and 23.6%) and (iv) missing negative test results (10.0% and 12.4%). HW who were trained less than 12 months ago had best MCQ scores for 7/10 photographs as well as a significantly higher proportion of 10/10 scores, but absolute differences in MCQ scores were small. HW who had participated in a previous EQA performed significantly better for 4/10 photographs compared to those who had not. Except for two photographs, MCQ scores were comparable for all levels of the HF hierarchy and non-laboratory staff (HW from health posts) had similar performance as to laboratory staff. Main findings of the questionnaire were (i) use of other RDT products than recommended by the national malaria control programme (nearly 20% of participating HF), (ii) lack of training for a third (33.6%) of HF, (iii) high proportions (two-thirds, 66.5%) of HF reporting stock-outs. The present EQA revealed common errors in RDT reading and interpretation by

  18. External Music Examiners: Micro-Macro Tasks in Quality Assurance Practices

    ERIC Educational Resources Information Center

    Ross, Valerie

    2009-01-01

    External music examiners play a significant role in assessing, verifying and maintaining musical standards. Educational output endorsed by external examiners serves to verify, modify and legitimise internal behaviour. This article examines some of the "inside practices" of external music examiners in the context of quality assurance. It…

  19. Influence of storage conditions and extraction methods on the quantity and quality of circulating cell-free DNA (ccfDNA): the SPIDIA-DNAplas External Quality Assessment experience.

    PubMed

    Malentacchi, Francesca; Pizzamiglio, Sara; Verderio, Paolo; Pazzagli, Mario; Orlando, Claudio; Ciniselli, Chiara Maura; Günther, Kalle; Gelmini, Stefania

    2015-11-01

    Circulating cell-free DNA (ccfDNA) has been confirmed as a useful biomarker in cancer and pre-natal clinical practice. One of the main critical points in using ccfDNA is a lack of standardisation for sample processing methods, storage conditions, procedures for extraction, and quantification that can affect ccfDNA quality and quantity. We report the results obtained from the SPIDIA-DNAplas, one of the EU SPIDIA (Standardisation and improvement of generic pre-analytical tools and procedures for in vitro diagnostics) subprojects based on the implementation of an External Quality Assessment scheme for the evaluation of the influence of the pre-analytical phase on ccfDNA. This is the first reported quality control scheme targeting ccfDNA for pre-analytical phase studies. Fifty-six laboratories throughout Europe were recruited. The participating laboratories received the same plasma sample and extracted ccfDNA by using their own procedures, at defined plasma storage conditions, and sent the isolated ccfDNA to the SPIDIA facility for analyses. Laboratory performance was evaluated by using specific quality parameters such as ccfDNA integrity (by multiplex PCR) and yield (by qPCR). The analysis of the ccfDNA extracted by the laboratories showed that most of them (53 of 56) were able to recover ccfDNA but only 12.5% recovered non-fragmented ccfDNA. Extraction methods specifically designed for ccfDNA preserved the integrity profile. The evidence-based results of the SPIDIA-DNAplas EQA have been proposed as a basis for the development of a Technical Specification by the European Committee for standardisation (CEN).

  20. [The external quality assessment schemes for lead in blood organized by the French national agency for medicine and health product safety: a synthesis of 15 years of activity].

    PubMed

    Pineau, Alain; Otz, Jocelyne; Guillard, Olivier; Fauconneau, Bernard; Dumont, Gilles; François-Burg, Elisabeth

    2014-01-01

    In 1992, at the request of the French labor ministry following questions on the ability of medical biology laboratories to satisfactorily measure blood lead level (PbB), a national PbB quality control came into being. Only in 1996 did this external quality control include a number of laboratories sufficient to allow for a significant retrospective evaluation. After fifteen years (1996-2011), The French National Agency for Medicines and Health Products Safety wished to exploit the database collected. The number of participating laboratories went down from 73 to 41. On the other hand, the key finding pertained to the highly improved performance of the laboratories, which was associated with a spread decrease of the results over the entire range of tested PbBs (9 to 700 μg/L). Since 2006, we have observed increasing use of the inductively coupled plasma with mass spectrometry and decreasing use of electrothermal atomic absorption spectrometry. Provided that they rely on identical metrology expertise, the two analytical techniques lead to results on all the tested concentrations that are not statistically different.

  1. Analytical Bias Exceeding Desirable Quality Goal in 4 out of 5 Common Immunoassays: Results of a Native Single Serum Sample External Quality Assessment Program for Cobalamin, Folate, Ferritin, Thyroid-Stimulating Hormone, and Free T4 Analyses.

    PubMed

    Kristensen, Gunn B B; Rustad, Pål; Berg, Jens P; Aakre, Kristin M

    2016-09-01

    We undertook this study to evaluate method differences for 5 components analyzed by immunoassays, to explore whether the use of method-dependent reference intervals may compensate for method differences, and to investigate commutability of external quality assessment (EQA) materials. Twenty fresh native single serum samples, a fresh native serum pool, Nordic Federation of Clinical Chemistry Reference Serum X (serum X) (serum pool), and 2 EQA materials were sent to 38 laboratories for measurement of cobalamin, folate, ferritin, free T4, and thyroid-stimulating hormone (TSH) by 5 different measurement procedures [Roche Cobas (n = 15), Roche Modular (n = 4), Abbott Architect (n = 8), Beckman Coulter Unicel (n = 2), and Siemens ADVIA Centaur (n = 9)]. The target value for each component was calculated based on the mean of method means or measured by a reference measurement procedure (free T4). Quality specifications were based on biological variation. Local reference intervals were reported from all laboratories. Method differences that exceeded acceptable bias were found for all components except folate. Free T4 differences from the uncommonly used reference measurement procedure were large. Reference intervals differed between measurement procedures but also within 1 measurement procedure. The serum X material was commutable for all components and measurement procedures, whereas the EQA materials were noncommutable in 13 of 50 occasions (5 components, 5 methods, 2 EQA materials). The bias between the measurement procedures was unacceptably large in 4/5 tested components. Traceability to reference materials as claimed by the manufacturers did not lead to acceptable harmonization. Adjustment of reference intervals in accordance with method differences and use of commutable EQA samples are not implemented commonly. © 2016 American Association for Clinical Chemistry.

  2. External quality assessment of AFB smear microscopy performances and its associated factors in selected private health facilities in Addis Ababa, Ethiopia

    PubMed Central

    Mosissa, Lemi; Kebede, Abebaw; Mindaye, Tedla; Getahun, Muluwork; Tulu, Sisay; Desta, Kassu

    2016-01-01

    Tuberculosis (TB) is still a public health problem in sub Saharan African countries. In resource-limited settings, TB diagnosis relies on sputum smear microscopy, with low and variable sensitivities, especially in paucibacillary pediatric and HIV-associated TB patients. Tuberculosis microscopy centers have several weaknesses like overworking, insufficiently trained personnel, inconsistent reagent supplies, and poorly maintained equipments; thus, there is a critical need for investments in laboratory infrastructure, capacity building, and quality assurance schemes. The performance of TB microscopy centers in the private health facilities in Addis Ababa is not known so far. The main objective of the study was to assess laboratory performance of acid fast bacilli (AFB) smear microscopy and its associated factors in selected private health facilities in Addis Ababa, Ethiopia. A cross-sectional study was conducted in 33 selected private health facilities of Addis Ababa, Ethiopia comprising 7 hospitals, 2 NGO health centers, 23 higher clinics and 1 diagnostic laboratory that provide AFB smear microscopy services. The study was conducted from January to April 2014. A total of 283 stained sputum smears were randomly collected from participant laboratories for blinded rechecking, 320 panel slides were sent to 32 microscopy centers to evaluate their performance on AFB reading, staining and reporting. Checklists were used to assess quality issues of laboratories. Data were captured, cleaned, and analyzed using SPSS version 16.0; χ2 tests, kappa statistics were used for comparison purpose. P value < 0.05 considered statistically significant. Among the 32 participant laboratories, 2-scored 100%, 15 scored 80-95% & the remaining 15 scored 50-75% for overall proficiency test performance. There were 10 (3.15%) major errors and 121 (37.8%) minor errors. The sensitivity, specificity, PPV and NPV of panel reading by microscopy centers were 89%, 96%, 96%, and 90% respectively. Out of

  3. External quality assessment of AFB smear microscopy performances and its associated factors in selected private health facilities in Addis Ababa, Ethiopia.

    PubMed

    Mosissa, Lemi; Kebede, Abebaw; Mindaye, Tedla; Getahun, Muluwork; Tulu, Sisay; Desta, Kassu

    2016-01-01

    Tuberculosis (TB) is still a public health problem in sub Saharan African countries. In resource-limited settings, TB diagnosis relies on sputum smear microscopy, with low and variable sensitivities, especially in paucibacillary pediatric and HIV-associated TB patients. Tuberculosis microscopy centers have several weaknesses like overworking, insufficiently trained personnel, inconsistent reagent supplies, and poorly maintained equipments; thus, there is a critical need for investments in laboratory infrastructure, capacity building, and quality assurance schemes. The performance of TB microscopy centers in the private health facilities in Addis Ababa is not known so far. The main objective of the study was to assess laboratory performance of acid fast bacilli (AFB) smear microscopy and its associated factors in selected private health facilities in Addis Ababa, Ethiopia. A cross-sectional study was conducted in 33 selected private health facilities of Addis Ababa, Ethiopia comprising 7 hospitals, 2 NGO health centers, 23 higher clinics and 1 diagnostic laboratory that provide AFB smear microscopy services. The study was conducted from January to April 2014. A total of 283 stained sputum smears were randomly collected from participant laboratories for blinded rechecking, 320 panel slides were sent to 32 microscopy centers to evaluate their performance on AFB reading, staining and reporting. Checklists were used to assess quality issues of laboratories. Data were captured, cleaned, and analyzed using SPSS version 16.0; χ(2) tests, kappa statistics were used for comparison purpose. P value < 0.05 considered statistically significant. Among the 32 participant laboratories, 2-scored 100%, 15 scored 80-95% & the remaining 15 scored 50-75% for overall proficiency test performance. There were 10 (3.15%) major errors and 121 (37.8%) minor errors. The sensitivity, specificity, PPV and NPV of panel reading by microscopy centers were 89%, 96%, 96%, and 90% respectively. Out

  4. The Effectiveness of External Quality Audits: A Study of Australian Universities

    ERIC Educational Resources Information Center

    Shah, Mahsood

    2013-01-01

    External quality audits have been introduced in many countries as part of higher education reforms. This article is based on research on 30 Australian universities to assess the extent to which audits by the Australian Universities Quality Agency (AUQA) have improved quality assurance in the core and support areas of the universities. The article…

  5. The Effectiveness of External Quality Audits: A Study of Australian Universities

    ERIC Educational Resources Information Center

    Shah, Mahsood

    2013-01-01

    External quality audits have been introduced in many countries as part of higher education reforms. This article is based on research on 30 Australian universities to assess the extent to which audits by the Australian Universities Quality Agency (AUQA) have improved quality assurance in the core and support areas of the universities. The article…

  6. Externalizing Behaviors and Callous-Unemotional Traits: Different Associations With Sleep Quality.

    PubMed

    Denis, Dan; Akhtar, Reece; Holding, Benjamin C; Murray, Christina; Panatti, Jennifer; Claridge, Gordon; Sadeh, Avi; Barclay, Nicola L; O'Leary, Rachael; Maughan, Barbara; McAdams, Tom A; Rowe, Richard; Eley, Thalia C; Viding, Essi; Gregory, Alice M

    2017-08-01

    Sleep quality is associated with different aspects of psychopathology, but relatively little research has examined links between sleep quality and externalizing behaviors or callous-unemotional traits. We examined: (1) whether an association exists between sleep quality and externalizing behaviors; (2) whether anxiety mediates this association; (3) whether callous-unemotional traits are associated with sleep quality. Data from two studies were used. Study 1 involved 1556 participants of the G1219 study aged 18-27 years (62% female). Questionnaire measures assessed sleep quality, anxiety, externalizing behaviors, and callous-unemotional traits. Study 2 involved 338 participants aged 18-66 years (65% female). Questionnaires measured sleep quality, externalizing behaviors, and callous-unemotional traits. In order to assess objective sleep quality, actigraphic data were also recorded for a week from a subsample of study 2 participants (n = 43). In study 1, poorer sleep quality was associated with greater externalizing behaviors. This association was partially mediated by anxiety and moderated by levels of callous-unemotional traits. There was no significant relationship between sleep quality and callous-unemotional traits. In study 2, poorer sleep quality, as assessed via self-reported but not objective measures, was associated with higher levels of externalizing behaviors. Furthermore, in study 2, better sleep quality (indicated in both questionnaires and actigraphy measures: lower mean activity, and greater sleep efficiency) was associated with higher levels of callous-unemotional traits. Self-reports of poorer sleep quality are associated with externalizing behaviors, and this association is partially mediated by anxiety. Callous-unemotional traits are not associated with poor sleep and may even be related to better sleep quality. This is an exceptional finding given that poor sleep quality appears to be a characteristic of most psychopathology.

  7. Immunohistochemical demonstration of oestrogen and progesterone receptors: correlation of standards achieved on in house tumours with that achieved on external quality assessment material in over 150 laboratories from 26 countries

    PubMed Central

    Rhodes, A; Jasani, B; Balaton, A; Miller, K

    2000-01-01

    Aims—To investigate the sensitivity of immunohistochemical (IHC) assays for oestrogen receptors (ER) and progesterone receptors (PR) achieved by laboratories on breast tumours fixed and processed in their own department, and to compare this with the degree of sensitivity they achieve on tumours circulated as part of an external quality assessment (EQA) programme. Methods—On 10 occasions between April 1994 and June 1998, histological sections from breast cancers showing various degrees of expression of ER and PR were circulated for IHC staining to laboratories participating in the UK national external quality assessment scheme for immunocytochemistry (UK NEQAS-ICC). The staining of these tumours, in addition to that of tumours fixed and processed in the participants own laboratories (in house tumours), was assessed by a panel of four assessors, using the established UK NEQAS-ICC scoring system. For a selected assessment run, the degree of expression of participants in house tumours was evaluated by means of the semiquantitative quick score method. Results—Although the scores awarded for the staining of in house tumours were generally higher than those awarded for the staining of UK NEQAS tumours, there was also a significant positive correlation between the two sets of scores. Using the quick score method of evaluation for one of the assessment runs, 47% of in house tumours were classified as having a high degree of ER expression. Of the remaining cases, a significant proportion initially classified as having only low or medium expression of ER were found to have higher expression when stained by the organising laboratory. The UK NEQAS-ICC centre's routine assay for hormonal receptors was found to be 90–100% efficient in achieving optimal demonstration of breast tumours from over 150 different laboratories. Conclusions—The significant positive correlation between the results obtained on the UK NEQAS tumours and the in house tumours provides evidence for

  8. [Thromboelastography/-metry and external quality control. Results of a pilot study].

    PubMed

    Dick, A; Schwaiger, M; Jámbor, C

    2010-05-01

    Thromboelastography/thromboelastometry (TEG/ROTEM) is widely used in near-patient setting, especially in perioperative and intensive care medicine for the management of acute bleeding. Until now a comprehensive quality management especially an external quality control of TEG/ROTEM results is not established. Here we report about our results of a pilot survey performed in 2008 and 2009 integrated in the External Quality Assessment Schemes (EQAS) performed by INSTAND. According to this first EQAS data ROTEM results can be controlled in external quality schemes using lyophilized plasma samples. The clot firmness (A20) and clot formation kinetics characterized by the alpha-angle showed very good reproducibility both between the participants and between different surveys. Variations for CT and CFT were considerably higher especially in the plasma sample with reduced fibrinogen level. Regular participation in an external quality assurance will help to confirm this beneficial technology in emergency settings.

  9. Interaction of Theory and Practice to Assess External Validity.

    PubMed

    Leviton, Laura C; Trujillo, Mathew D

    2016-01-18

    Variations in local context bedevil the assessment of external validity: the ability to generalize about effects of treatments. For evaluation, the challenges of assessing external validity are intimately tied to the translation and spread of evidence-based interventions. This makes external validity a question for decision makers, who need to determine whether to endorse, fund, or adopt interventions that were found to be effective and how to ensure high quality once they spread. To present the rationale for using theory to assess external validity and the value of more systematic interaction of theory and practice. We review advances in external validity, program theory, practitioner expertise, and local adaptation. Examples are provided for program theory, its adaptation to diverse contexts, and generalizing to contexts that have not yet been studied. The often critical role of practitioner experience is illustrated in these examples. Work is described that the Robert Wood Johnson Foundation is supporting to study treatment variation and context more systematically. Researchers and developers generally see a limited range of contexts in which the intervention is implemented. Individual practitioners see a different and often a wider range of contexts, albeit not a systematic sample. Organized and taken together, however, practitioner experiences can inform external validity by challenging the developers and researchers to consider a wider range of contexts. Researchers have developed a variety of ways to adapt interventions in light of such challenges. In systematic programs of inquiry, as opposed to individual studies, the problems of context can be better addressed. Evaluators have advocated an interaction of theory and practice for many years, but the process can be made more systematic and useful. Systematic interaction can set priorities for assessment of external validity by examining the prevalence and importance of context features and treatment

  10. 77 FR 21086 - Patents External Quality Survey (formerly Customer Panel Quality Survey)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... United States Patent and Trademark Office Patents External Quality Survey (formerly Customer Panel Quality Survey) ACTION: Proposed collection; comment request. SUMMARY: The United States Patent and...@uspto.gov . Include ``0651- 0057 Patents External Quality Survey comment'' in the subject line of...

  11. 42 CFR 460.140 - Additional quality assessment activities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Additional quality assessment activities. 460.140... FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.140 Additional quality assessment activities. A PACE organization must meet external quality assessment and reporting requirements...

  12. 42 CFR 460.140 - Additional quality assessment activities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Additional quality assessment activities. 460.140... FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.140 Additional quality assessment activities. A PACE organization must meet external quality assessment and reporting requirements...

  13. International External Quality Assurance for Laboratory Diagnosis of Diphtheria ▿

    PubMed Central

    Neal, S. E.; Efstratiou, A.

    2009-01-01

    The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twenty-three centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained. PMID:19828749

  14. Higher Education Quality: Perception Differences among Internal and External Stakeholders

    ERIC Educational Resources Information Center

    Abidin, Munirul

    2015-01-01

    Conceptually, education quality of higher education can be determined by evaluation of their stakeholders's satisfaction level. The purpose of this study is to describe how students as external stakeholder and lecturers as internal stakeholder, perceived their satisfaction of learning experience in the university. This study was conducted in…

  15. Reconciling Organisational Culture and External Quality Assurance in Higher Education

    ERIC Educational Resources Information Center

    Naidoo, Dhaya

    2013-01-01

    Organisational culture and external quality assurance have both been presented as significant drivers of effectiveness, efficiency and excellence in higher education institutions. However, these assumptions have not been critically examined given the philosophical, conceptual and methodological contestations surrounding both constructs. A…

  16. Reconciling Organisational Culture and External Quality Assurance in Higher Education

    ERIC Educational Resources Information Center

    Naidoo, Dhaya

    2013-01-01

    Organisational culture and external quality assurance have both been presented as significant drivers of effectiveness, efficiency and excellence in higher education institutions. However, these assumptions have not been critically examined given the philosophical, conceptual and methodological contestations surrounding both constructs. A…

  17. Use of Six Sigma Worksheets for assessment of internal and external failure costs associated with candidate quality control rules for an ADVIA 120 hematology analyzer.

    PubMed

    Cian, Francesco; Villiers, Elisabeth; Archer, Joy; Pitorri, Francesca; Freeman, Kathleen

    2014-06-01

    Quality control (QC) validation is an essential tool in total quality management of a veterinary clinical pathology laboratory. Cost-analysis can be a valuable technique to help identify an appropriate QC procedure for the laboratory, although this has never been reported in veterinary medicine. The aim of this study was to determine the applicability of the Six Sigma Quality Cost Worksheets in the evaluation of possible candidate QC rules identified by QC validation. Three months of internal QC records were analyzed. EZ Rules 3 software was used to evaluate candidate QC procedures, and the costs associated with the application of different QC rules were calculated using the Six Sigma Quality Cost Worksheets. The costs associated with the current and the candidate QC rules were compared, and the amount of cost savings was calculated. There was a significant saving when the candidate 1-2.5s, n = 3 rule was applied instead of the currently utilized 1-2s, n = 3 rule. The savings were 75% per year (£ 8232.5) based on re-evaluating all of the patient samples in addition to the controls, and 72% per year (£ 822.4) based on re-analyzing only the control materials. The savings were also shown to change accordingly with the number of samples analyzed and with the number of daily QC procedures performed. These calculations demonstrated the importance of the selection of an appropriate QC procedure, and the usefulness of the Six Sigma Costs Worksheet in determining the most cost-effective rule(s) when several candidate rules are identified by QC validation. © 2014 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

  18. The efficacy of computer reminders on external quality assessment for point-of-care testing in Danish general practice: rationale and methodology for two randomized trials

    PubMed Central

    2011-01-01

    Background Point-of-care testing (POCT) is increasingly being used in general practice to assist general practitioners (GPs) in their management of patients with diseases. However, low adherence to quality guidelines in terms of split test procedures has been observed among GPs in parts of the Capital Region in Denmark. Computer reminders embedded in GPs electronic medical records (ComRem) may facilitate improved quality control behaviour, but more research is needed to identify what types of reminders work and when. The overall aim of this study is to evaluate the efficacy of ComRem to improve GPs adherence to quality guidelines. This article describes the rationale and methods of the study that constitute this research project. Methods/design The study is conducted as two randomised controlled trials (RCTs) among general practices in two districts of the Capital Region in Denmark. These districts contain a total of 739 GPs in 567 practices with a total of 1.1 million patients allocated to practice lists. In the first RCT (RCT A), ComRem is compared to postal reminder letters. In the second RCT (RCT B), ComRem is compared to usual activities (no reminders) with a crossover approach. In both of these studies, outcomes are measured by the number of split tests received by the laboratory. Conclusions This study will contribute to knowledge on the efficacy of ComRem in primary care. Because the study does not explore GPs' perceptions and experiences with regard to ComRem, we will subsequently conduct a qualitative survey focusing on these aspects. Trial registrations Study A: ClinicalTrials.gov identifier: NCT01152151 Study B: ClinicalTrials.gov identifier: NCT01152177 PMID:21781338

  19. Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems.

    PubMed

    Jensen, Todd M; Lippold, Melissa A; Mills-Koonce, Roger; Fosco, Gregory M

    2017-03-07

    The stepfamily literature is replete with between-group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well-being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent-child, parent-child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent-child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent-child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice.

  20. Higher Education Quality Assessment in China: An Impact Study

    ERIC Educational Resources Information Center

    Liu, Shuiyun

    2015-01-01

    This research analyses an external higher education quality assessment scheme in China, namely, the Quality Assessment of Undergraduate Education (QAUE) scheme. Case studies were conducted in three Chinese universities with different statuses. Analysis shows that the evaluated institutions responded to the external requirements of the QAUE…

  1. Higher Education Quality Assessment in China: An Impact Study

    ERIC Educational Resources Information Center

    Liu, Shuiyun

    2015-01-01

    This research analyses an external higher education quality assessment scheme in China, namely, the Quality Assessment of Undergraduate Education (QAUE) scheme. Case studies were conducted in three Chinese universities with different statuses. Analysis shows that the evaluated institutions responded to the external requirements of the QAUE…

  2. Longitudinal Associations between Externalizing Problems and Student-Teacher Relationship Quality for Young Children with ASD

    ERIC Educational Resources Information Center

    Eisenhower, Abbey S.; Blacher, Jan; Bush Hurst, Hillary

    2015-01-01

    The associations between student-teacher relationship (STR) quality and externalizing behavior problems in school were examined among 166 children with ASD (82% boys, ages 4-7 years) across three assessments over a 1.5-year period; IQs in the sample range from 50 to 139 (M = 88.7). Unlike other non-ASD populations, the association between STR…

  3. Has External Quality Assurance Actually Improved Quality in Higher Education over the Course of 20 Years of the "Quality Revolution"?

    ERIC Educational Resources Information Center

    Kristensen, Bente

    2010-01-01

    At the beginning of the last 20 years so-called "quality revolution" it was expected from most of the established national quality agencies that internal quality systems and the development of an internal quality culture would emerge automatically in the HEI from the external quality impact. The author argues that a better balance must be found…

  4. Has External Quality Assurance Actually Improved Quality in Higher Education over the Course of 20 Years of the "Quality Revolution"?

    ERIC Educational Resources Information Center

    Kristensen, Bente

    2010-01-01

    At the beginning of the last 20 years so-called "quality revolution" it was expected from most of the established national quality agencies that internal quality systems and the development of an internal quality culture would emerge automatically in the HEI from the external quality impact. The author argues that a better balance must be found…

  5. Professionalism, Profession and Quality Assurance Practitioners in External Quality Assurance Agencies in Higher Education

    ERIC Educational Resources Information Center

    Cheung, Jordan C. M.

    2015-01-01

    This article seeks to spark a dialectic discussion on the establishment of a set of professional competencies for quality assurance practitioners who serve in external quality assurance agencies in higher education. Such a need is identified due to the shortage of relevant and sufficient coverage in the quality assurance literature. To…

  6. Institutional Research and Assessment of the External Environment.

    ERIC Educational Resources Information Center

    Groff, Warren H.

    1986-01-01

    Identifies components of a comprehensive assessment of an educational institution's external environment; i.e., demographic trends, social indicators, economic trends, political change, technological advances, changes in the workplace, advances in information technologies, and value shifts. (DMM)

  7. Interrater Reliability in Large-Scale Assessments--Can Teachers Score National Tests Reliably without External Controls?

    ERIC Educational Resources Information Center

    Pantzare, Anna Lind

    2015-01-01

    In most large-scale assessment systems a set of rather expensive external quality controls are implemented in order to guarantee the quality of interrater reliability. This study empirically examines if teachers' ratings of national tests in mathematics can be reliable without using monitoring, training, or other methods of external quality…

  8. Interrater Reliability in Large-Scale Assessments--Can Teachers Score National Tests Reliably without External Controls?

    ERIC Educational Resources Information Center

    Pantzare, Anna Lind

    2015-01-01

    In most large-scale assessment systems a set of rather expensive external quality controls are implemented in order to guarantee the quality of interrater reliability. This study empirically examines if teachers' ratings of national tests in mathematics can be reliable without using monitoring, training, or other methods of external quality…

  9. External quality assurance in thrombosis and hemostasis: an international perspective.

    PubMed

    Olson, John D; Preston, F Eric; Nichols, William L

    2007-04-01

    External Quality Assurance in Thrombosis and Hemostasis (EQATH) was organized in 2005 as an international collaboration of external quality assurance (EQA) programs and organizations with a common interest in improving the quality of hemostasis testing. The goals include exchanging of information regarding program operations; exchanging split specimens among programs to determine if there are differences in practice; participating in value setting of standards; and providing outreach programs to locations in the world without EQA support of hemostasis testing in laboratories. The organization currently includes 11 EQA programs from 10 countries. A survey of program structure and function revealed variation in the size and structure among the programs. In general, the staffing levels paralleled the size and complexity of the program. The number of laboratory participants in the EQA programs ranged from 58 to 1700. The presentation of testing covered in the program (modules) ranged from a program with a single module of a single test, to programs with single modules of many different types of tests, to a program with 13 modules, each of which contains a limited scope of related tests. Participating laboratories were graded (pass/fail or out with consensus) by six of the EQA programs, whereas five programs report the results to the laboratory for self-evaluation. Of the 11 programs responding, seven have deemed status from an accrediting or licensing agency, and successful participation satisfied requirements for accreditation for the participating laboratory. This type of benchmarking activity and cooperative activity among EQA programs will lead to improvement of the programs.

  10. External induced contamination environment assessment for Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Leger, Lubert; Ehlers, Horst; Hakes, Charles; Theall, Jeff; Soares, Carlos

    1993-01-01

    An assessment of the Space Station Freedom performance as affected by the external induced contamination environment is in progress. The assessment procedure involves comparing the Space Station Freedom external contamination requirements, SSP 30426, Revision B (1991), with calculated molecular deposition, molecular column density, and other effects from potential sources of contamination. The current assessment comprises discussions of Space Shuttle proximity operations, Space Shuttle waste-water dumps (while docked to the Space Station), Space Station fluid and waste-gas venting, system gas leakage, external material outgassing, and a combined contamination assessment. This performance assessment indicates that Space Station Freedom contamination requirements are realistic and can be satisfied when all contamination sources are included.

  11. External induced contamination environment assessment for Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Leger, Lubert; Ehlers, Horst; Hakes, Charles; Theall, Jeff; Soares, Carlos

    1993-01-01

    An assessment of the Space Station Freedom performance as affected by the external induced contamination environment is in progress. The assessment procedure involves comparing the Space Station Freedom external contamination requirements, SSP 30426, Revision B (1991), with calculated molecular deposition, molecular column density, and other effects from potential sources of contamination. The current assessment comprises discussions of Space Shuttle proximity operations, Space Shuttle waste-water dumps (while docked to the Space Station), Space Station fluid and waste-gas venting, system gas leakage, external material outgassing, and a combined contamination assessment. This performance assessment indicates that Space Station Freedom contamination requirements are realistic and can be satisfied when all contamination sources are included.

  12. An In-Depth Study on the Impact of External Quality Assurance

    ERIC Educational Resources Information Center

    Stensaker, Bjorn; Langfeldt, Liv; Harvey, Lee; Huisman, Jeroen; Westerheijden, Don

    2011-01-01

    After more than two decades of external quality assurance, there is an increasing interest in questions concerning the impact and effects of this activity. Following an external evaluation of NOKUT--the Norwegian quality assurance agency, this article studies the impact of external quality assurance in detail by analysing quantitative and…

  13. Water Quality Assessment and Management

    EPA Pesticide Factsheets

    Overview of Clean Water Act (CWA) restoration framework including; water quality standards, monitoring/assessment, reporting water quality status, TMDL development, TMDL implementation (point & nonpoint source control)

  14. On the Roles of External Knowledge Representations in Assessment Design

    ERIC Educational Resources Information Center

    Mislevy, Robert J.; Behrens, John T.; Bennett, Randy E.; Demark, Sarah F.; Frezzo, Dennis C.; Levy, Roy; Robinson, Daniel H.; Rutstein, Daisy Wise; Shute, Valerie J.; Stanley, Ken; Winters, Fielding I.

    2010-01-01

    People use external knowledge representations (KRs) to identify, depict, transform, store, share, and archive information. Learning how to work with KRs is central to be-coming proficient in virtually every discipline. As such, KRs play central roles in curriculum, instruction, and assessment. We describe five key roles of KRs in assessment: (1)…

  15. External quality assessment of reading and interpretation of malaria rapid diagnostic tests among 1849 end-users in the Democratic Republic of the Congo through Short Message Service (SMS).

    PubMed

    Mukadi, Pierre; Gillet, Philippe; Lukuka, Albert; Mbatshi, Joêl; Otshudiema, John; Muyembe, Jean-Jacques; Buyze, Jozefien; Jacobs, Jan; Lejon, Veerle

    2013-01-01

    Although malaria rapid diagnostic tests (RDT) are simple to perform, they remain subject to errors, mainly related to the post-analytical phase. We organized the first large scale SMS based external quality assessment (EQA) on correct reading and interpretation of photographs of a three-band malaria RDT among laboratory health workers in the Democratic Republic of the Congo (DR Congo). High resolution EQA photographs of 10 RDT results together with a questionnaire were distributed to health facilities in 9 out of 11 provinces in DR Congo. Each laboratory health worker answered the EQA by Short Message Service (SMS). Filled-in questionnaires from each health facility were sent back to Kinshasa. A total of 1849 laboratory health workers in 1014 health facilities participated. Most frequent errors in RDT reading were i) failure to recognize invalid (13.2-32.5% ) or negative test results (9.8-12.8%), (ii) overlooking faint test lines (4.1-31.2%) and (iii) incorrect identification of the malaria species (12.1-17.4%). No uniform strategy for diagnosis of malaria at the health facility was present. Stock outs of RDTs occurred frequently. Half of the health facilities had not received an RDT training. Only two thirds used the RDT recommended by the National Malaria Control Program. Performance of RDT reading was positively associated with training and the technical level of health facility. Facilities with RDT positivity rates >50% and located in Eastern DR Congo performed worse. Our study confirmed that errors in reading and interpretation of malaria RDTs are widespread and highlighted the problem of stock outs of RDTs. Adequate training of end-users in the application of malaria RDTs associated with regular EQAs is recommended.

  16. External quality assurance in nongynecologic cytology: The Australasian experience.

    PubMed

    Shield, Paul W; Frost, Felicity; Finnimore, Jo L; Wright, R Gordon; Cummings, Margaret C

    2017-05-01

    The Royal College of Pathologists of Australasia Cytopathology Quality Assurance Program has operated an external quality assurance program in nongynecologic cytopathology since 1993. Glass slide preparations of a wide range of nongynecologic cases were circulated to approximately 200 cytopathology laboratories in 16 countries. General nongynecologic cytology cases were manufactured from residual specimens after routine diagnosis. Fine-needle aspiration (FNA) cases were made by sampling fresh tissue and making direct specimens. The majority of cases consisted of both air-dried and fixed preparations. Results returned to laboratories included illustrated case discussions highlighting diagnostic features, key differential diagnoses, and useful adjunctive tests. The current study reviewed >22,000 results for 123 nongynecologic cases. Cases found to cause the most diagnostic difficulties included serous effusion cases with metastatic carcinoma in a dispersed pattern, well-differentiated carcinoma, and cellular reactive cases; urine specimens with sparse malignant cells; reactive pneumocytes in a bronchoalveolar lavage; breast FNA cases with papillary lesions; gestational specimens; and fibroadenoma. FNA specimens from the lung and thyroid, particularly papillary thyroid carcinoma, generally were well reported. The use of multiple preparations of the same specimen has allowed interlaboratory comparison, and the quality assurance program has played an educational role as well as informing the laboratory accreditation process. Cancer Cytopathol 2017;125:349-361. © 2017 American Cancer Society. © 2017 American Cancer Society.

  17. [Risk assessment for clinical external application of calomel].

    PubMed

    Qiu, Heng; Wang, Qi

    2015-07-01

    Calomel is a common traditional Chinese medicine (TCM) containing mercury in clinical external application. Although the toxicity of calomel has attracted concern, there is no unified standard yet in clinical external application. Risk assessment is used for evaluating the potential health effects of hazardous substances. The purpose of this article was to evaluate the health risk of calomel in clinical external application on the basis of toxicity data, to ensure safe and rational application of TCM containing calomel. The toxicity data of transdermal administration of calomel or mercurous chloride were collected by searching the literature. The daily maximum exposure dosage of calomel in clinical external application was estimated by following the four procedures of risk assessment, and Margin of Safety (MOS) as an evaluation indicator was then calculated to evaluate the safety of calomel on clinical application. It has been reported that the adult in single transdermal administration of calomel at 1. 5 g was lethal. Based on the LOAEL of calomel for long-term transdermal exposure (1 month) in rats was 0.096 g · kg(-1) · d(-1), the NOAEL of calomel for patients (about 60 kg) by external application within 2 weeks was estimated to be 1.46 mg · kg(-1) · d(-1). When MOS value equals to 1, the daily maximum exposure of calomel in clinical external application within 2 weeks was calculated to be 1.1 g. The results suggest that daily single dose of calomel in clinical external application should be lower than 1.5 g for adults, and more attention should be paid to changes in hepatic and renal function of patients when repeated dose more than 1.1 g within 2 weeks. The approach of risk assessment could be helpful in rational application of TCM containing mercury.

  18. External validity of the pediatric cardiac quality of life inventory

    PubMed Central

    Marino, Bradley S.; Drotar, Dennis; Cassedy, Amy; Davis, Richard; Tomlinson, Ryan S.; Mellion, Katelyn; Mussatto, Kathleen; Mahony, Lynn; Newburger, Jane W.; Tong, Elizabeth; Cohen, Mitchell I.; Helfaer, Mark A.; Kazak, Anne E.; Wray, Jo; Wernovsky, Gil; Shea, Judy A.; Ittenbach, Richard

    2012-01-01

    Purpose The Pediatric Cardiac Quality of Life Inventory (PCQLI) is a disease-specific, health-related quality of life (HRQOL) measure for pediatric heart disease (HD). The purpose of this study was to demonstrate the external validity of PCQLI scores. Methods The PCQLI development site (Development sample) and six geographically diverse centers in the United States (Composite sample) recruited pediatric patients with acquired or congenital HD. Item response option variability, scores [Total (TS); Disease Impact (DI) and Psychosocial Impact (PI) subscales], patterns of correlation, and internal consistency were compared between samples. Results A total of 3,128 patients and parent participants (1,113 Development; 2,015 Composite) were analyzed. Response option variability patterns of all items in both samples were acceptable. Inter-sample score comparisons revealed no differences. Median item–total (Development, 0.57; Composite, 0.59) and item–subscale (Development, DI 0.58, PI 0.59; Composite, DI 0.58, PI 0.56) correlations were moderate. Subscale–subscale (0.79 for both samples) and subscale–total (Development, DI 0.95, PI 0.95; Composite, DI 0.95, PI 0.94) correlations and internal consistency (Development, TS 0.93, DI 0.90, PI 0.84; Composite, TS 0.93, DI 0.89, PI 0.85) were high in both samples. Conclusion PCQLI scores are externally valid across the US pediatric HD population and may be used for multi-center HRQOL studies. PMID:21188538

  19. Ten Years of External Quality Audit in Australia: Evaluating Its Effectiveness and Success

    ERIC Educational Resources Information Center

    Shah, Mahsood

    2012-01-01

    External quality audits are now being used in universities across the world to improve quality assurance, accountability for quality education and transparency of public funding of higher education. Some countries such as Australia, New Zealand, United Kingdom, Sweden and Denmark have had external quality audits for more than a decade but there…

  20. Ten Years of External Quality Audit in Australia: Evaluating Its Effectiveness and Success

    ERIC Educational Resources Information Center

    Shah, Mahsood

    2012-01-01

    External quality audits are now being used in universities across the world to improve quality assurance, accountability for quality education and transparency of public funding of higher education. Some countries such as Australia, New Zealand, United Kingdom, Sweden and Denmark have had external quality audits for more than a decade but there…

  1. [Quality assurance in inpatient treatment of depression. Aspects of quality monitoring and external quality assurance exemplified by a pilot project of inpatient treatment of depression].

    PubMed

    Wolfersdorf, M; Stieglitz, R D; Metzger, R; Ruppe, A; Stabenow, S; Hornstein, C; Keller, F; Schell, G; Berger, M

    1997-05-01

    Aspects of a Pilot Study on Depression Treatment According to Quality Monitoring and External Quality Assurance: Experiences and results of a pilot study on quality of the treatment of depressed inpatients in 4 different psychiatric hospitals (2 state mental hospitals, 1 university clinic, 1 psychiatric clinic at a city general hospital) according to so-called process and outcome quality, are reported. Outcome data (self-ratings, observer rating, clinical global impression admission versus discharge, patient satisfaction with treatment, duration of inpatient stay/and patient data are reported while comparing the 4 hospitals. Difficulties and problems of data collection, assessments and comparison of 4 different hospitals are discussed.

  2. Strategic Planning Techniques: Matching External Assessment with Internal Audit.

    ERIC Educational Resources Information Center

    Groff, Warren H.

    The literature on strategic planning, and the capabilities of Massachusetts system of public postsecondary education were assessed, as part of a 1981 leadership seminar. Teams from all public postsecondary education institutions in the state reviewed the basic concepts of strategic planning; critically analyzed the environment external to their…

  3. Integrated Science Assessment for Carbon Monoxide (Second External Review Draft)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes have been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evalu...

  4. Integrated Science Assessment for Lead (First External Review Draft)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) has been made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science ...

  5. Integrated Science Assessment for Particulate Matter (First External Review Draft)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Particulate Matter and related Annexes have been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and e...

  6. Integrated Science Assessment for Lead (Third External Review Draft)

    EPA Science Inventory

    EPA has announced that the Third External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) has been made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science ...

  7. Using Portfolios for External Assessment: An Experiment in Portugal

    ERIC Educational Resources Information Center

    Pereira de Eca, Maria Teresa Torres

    2005-01-01

    This article describes some of the conclusions reached from an experiment using portfolios for art external assessment at the end of secondary education (age 17+) conducted in five Portuguese schools in 2001-2003. Several positive outcomes were found. Students found portfolios to be motivating and fostering constructive learning, dialogue and…

  8. Using Portfolios for External Assessment: An Experiment in Portugal

    ERIC Educational Resources Information Center

    Pereira de Eca, Maria Teresa Torres

    2005-01-01

    This article describes some of the conclusions reached from an experiment using portfolios for art external assessment at the end of secondary education (age 17+) conducted in five Portuguese schools in 2001-2003. Several positive outcomes were found. Students found portfolios to be motivating and fostering constructive learning, dialogue and…

  9. Integrated Science Assessment for Particulate Matter (Second External Review Draft)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Particulate Matter (PM) have been made available for independent peer review and public review. The ISA reflects the latest scientific knowledge useful in indicating the kind...

  10. Integrated Science Assessment for Lead (Second External Review Draft)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) has been made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science...

  11. Integrated Science Assessment for Carbon Monoxide (First External Review Draft)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes have been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evalua...

  12. Mask industry quality assessment

    NASA Astrophysics Data System (ADS)

    Strott, Al; Bassist, Larry

    1994-12-01

    Product quality and timely delivery are two of the most important parameters in determining the success of a mask manufacturing facility. Because of the sensitivity of this data, very little was known about industry performance in these areas until an assessment was authored and presented at the 1993 BACUS Symposium by Larry Regis of Intel Corporation, Neil Paulsen of Intel Corporation, and James A. Reynolds of Reynolds Consulting. This data has been updated and will be published and presented at this year's BACUS Symposium. Contributor identities will again remain protected by utilizing Arthur Andersen & Company to compile the submittals. Participation was consistent with last year's representation of over 75% of the total merchant and captive mask volume in the United States. The data compiled includes shipments, customer return rate, customer return reasons from 1988 through Q2, 1994, performance to schedule, plate survival yield, and throughput time (TPT).

  13. Drinking water quality assessment.

    PubMed

    Aryal, J; Gautam, B; Sapkota, N

    2012-09-01

    Drinking water quality is the great public health concern because it is a major risk factor for high incidence of diarrheal diseases in Nepal. In the recent years, the prevalence rate of diarrhoea has been found the highest in Myagdi district. This study was carried out to assess the quality of drinking water from different natural sources, reservoirs and collection taps at Arthunge VDC of Myagdi district. A cross-sectional study was carried out using random sampling method in Arthunge VDC of Myagdi district from January to June,2010. 84 water samples representing natural sources, reservoirs and collection taps from the study area were collected. The physico-chemical and microbiological analysis was performed following standards technique set by APHA 1998 and statistical analysis was carried out using SPSS 11.5. The result was also compared with national and WHO guidelines. Out of 84 water samples (from natural source, reservoirs and tap water) analyzed, drinking water quality parameters (except arsenic and total coliform) of all water samples was found to be within the WHO standards and national standards.15.48% of water samples showed pH (13) higher than the WHO permissible guideline values. Similarly, 85.71% of water samples showed higher Arsenic value (72) than WHO value. Further, the statistical analysis showed no significant difference (P<0.05) of physico-chemical parameters and total coliform count of drinking water for collection taps water samples of winter (January, 2010) and summer (June, 2010). The microbiological examination of water samples revealed the presence of total coliform in 86.90% of water samples. The results obtained from physico-chemical analysis of water samples were within national standard and WHO standards except arsenic. The study also found the coliform contamination to be the key problem with drinking water.

  14. Project Quality Rating by Experts and Practitioners: Experience with Preffi 2.0 as a Quality Assessment Instrument

    ERIC Educational Resources Information Center

    Molleman, Gerard R. M.; Peters, Louk W. H.; Hosman, Clemens M. H.; Kok, Gerjo J.; Oosterveld, Paul

    2006-01-01

    Preffi 2.0 is an evidence-based Dutch quality assessment instrument for health promotion interventions. It is mainly intended for both planning and assessing one's own projects but can also be used to assess other people's projects (external use). This article reports a study on the reliability of Preffi as an external quality assessment…

  15. External failures as descriptor of quality in clinical microbiology laboratory services.

    PubMed

    Saarela, Ulla; Kivinen, Tuula; Sarkkinen, Hannu

    2005-01-01

    This study employed customer feedback surveys to assess the quality of the laboratory services provided by an accredited clinical microbiology laboratory. The purpose of the study was to classify external failures and determine the quantity of such errors, and to establish how much time was spent processing and correcting these errors, together with the costs arising. The study indicates that the quality of laboratory test results can be regarded as good based on the accuracy of the result. Customer needs were also well taken into account in practice because of the good quality of the service. However, improvements are required in providing customers with test results without delay. The cost of processing and correcting such errors was negligible. The use of a customer feedback system allows systematic monitoring of external failures. In the accredited laboratory under study, it is unnecessary to monitor continually the costs and working time involved in processing and correcting external failures. The most essential point is to monitor the effects of the quality measures taken to reduce the number of failures.

  16. Validation of a scenario-based assessment of critical thinking using an externally validated tool.

    PubMed

    Buur, Jennifer L; Schmidt, Peggy; Smylie, Dean; Irizarry, Kris; Crocker, Carlos; Tyler, John; Barr, Margaret

    2012-01-01

    With medical education transitioning from knowledge-based curricula to competency-based curricula, critical thinking skills have emerged as a major competency. While there are validated external instruments for assessing critical thinking, many educators have created their own custom assessments of critical thinking. However, the face validity of these assessments has not been challenged. The purpose of this study was to compare results from a custom assessment of critical thinking with the results from a validated external instrument of critical thinking. Students from the College of Veterinary Medicine at Western University of Health Sciences were administered a custom assessment of critical thinking (ACT) examination and the externally validated instrument, California Critical Thinking Skills Test (CCTST), in the spring of 2011. Total scores and sub-scores from each exam were analyzed for significant correlations using Pearson correlation coefficients. Significant correlations between ACT Blooms 2 and deductive reasoning and total ACT score and deductive reasoning were demonstrated with correlation coefficients of 0.24 and 0.22, respectively. No other statistically significant correlations were found. The lack of significant correlation between the two examinations illustrates the need in medical education to externally validate internal custom assessments. Ultimately, the development and validation of custom assessments of non-knowledge-based competencies will produce higher quality medical professionals.

  17. Portfolio Assessment and Quality Teaching

    ERIC Educational Resources Information Center

    Kim, Youb; Yazdian, Lisa Sensale

    2014-01-01

    Our article focuses on using portfolio assessment to craft quality teaching. Extant research literature on portfolio assessment suggests that the primary purpose of assessment is to serve learning, and portfolio assessments facilitate the process of making linkages among assessment, curriculum, and student learning (Asp, 2000; Bergeron, Wermuth,…

  18. Portfolio Assessment and Quality Teaching

    ERIC Educational Resources Information Center

    Kim, Youb; Yazdian, Lisa Sensale

    2014-01-01

    Our article focuses on using portfolio assessment to craft quality teaching. Extant research literature on portfolio assessment suggests that the primary purpose of assessment is to serve learning, and portfolio assessments facilitate the process of making linkages among assessment, curriculum, and student learning (Asp, 2000; Bergeron, Wermuth,…

  19. Externalities and electric power: an integrated assessment approach

    SciTech Connect

    Lee, R.

    1995-12-31

    This paper describes an integrated assessment approach for considering the options that electric utilities have to meet the anticipated demand for their power. The objective that this paper considers is one of meeting the demand for power, with an acceptable degree of reliability, at minimum cost. The total cost is the sum of the private cost of producing the electric power plus the external costs that result from its production. These external costs, or externalities, are effects on the well-being of third parties that producers and consumers of electric power do not take into account in their decisions. The external costs include many different types of effects such as illness, ecosystem damage, and road damage. The solution to the problem of minimizing total cost is addressed in two steps. The first step uses damage function methods to establish a common metric for the weights of the different objectives (i.e., external costs). The damage function analysis also reduces the dimensionality of the analysis in the second step, and identifies criteria to include in that analysis. The second step uses multi-criteria decision methods. This analysis includes the most important externalities that the damage function analysis identifies and, in addition, potentially important factors that can not be quantified reliably using damage function methods. An example of the latter are the damages from global climate change. The two-step method that this paper describes addresses many of the limitations of the damage function method and multi-criteria methods, that arise when they are used separately. This linked method can be used by electric utilities for their integrated resource planning. It can also be adapted to other applications.

  20. The Southeast Stream Quality Assessment

    USGS Publications Warehouse

    Van Metre, Peter C.; Journey, Celeste

    2014-01-01

    In 2014, the U.S. Geological Survey (USGS) National Water-Quality Assessment Program (NAWQA) is assessing stream quality across the Piedmont and southern Appalachian Mountains in the southeastern United States. The goal of the Southeast Stream Quality Assessment (SESQA) is to characterize multiple water-quality factors that are stressors to aquatic life—contaminants, nutrients, sediment, and streamflow alteration—and the relation of these stressors to ecological conditions in streams throughout the region. Findings will provide communities and policymakers with information on which human and environmental factors are the most critical in controlling stream quality and, thus, provide insights about possible approaches to protect or improve stream quality. The SESQA study will be the second regional study by the NAWQA program, and it will be of similar design and scope as the Midwest Stream Quality Assessment conducted in 2013 (Van Metre and others, 2012).

  1. The Effectiveness of the Higher Education Quality Assessment System: Problems and Countermeasures in China

    ERIC Educational Resources Information Center

    Guangli, Zhou

    2016-01-01

    The effectiveness of the higher education quality assessment system is essentially a matter of policy evaluation. On the macro level, such a system refers to external quality assessment, which includes government evaluation, quality certification, and university rankings. Depending on the degree of government intervention, the external quality…

  2. The Effectiveness of the Higher Education Quality Assessment System: Problems and Countermeasures in China

    ERIC Educational Resources Information Center

    Guangli, Zhou

    2016-01-01

    The effectiveness of the higher education quality assessment system is essentially a matter of policy evaluation. On the macro level, such a system refers to external quality assessment, which includes government evaluation, quality certification, and university rankings. Depending on the degree of government intervention, the external quality…

  3. An overview of the European Organization for External Quality Assurance Providers in Laboratory Medicine (EQALM)

    PubMed Central

    Stavelin, Anne; Albe, Xavier; Meijer, Piet; Sarkany, Erika; MacKenzie, Finlay

    2017-01-01

    The European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) was founded in 1996 and currently has members from 29 European countries and 6 countries from outside Europe. EQALM provides a forum for co-operation and exchange of knowledge on quality-related matters in laboratory medicine, especially with regard to external quality assessment (EQA) programs in Europe. In addition, EQALM represent the EQA providers in laboratory medicine at European level vis-ŕ-vis political, professional, scientific and other bodies, including patients’ organisations. To this end EQALM promotes activities such as organizing meetings with scientific and practical themes for members and other interested parties, issuing scientific publications, developing EQA projects and representing laboratory medicine EQA activities within other organisations and networks. EQALM is active in scientific and educational activity in different fields such as survey frequency, haematology, haemostasis, microbiology, nomenclature, virtual microscopy, traceability, accreditation, and quality assurance of the total testing process. The aim of this paper is to give an overview of the EQALM organisation. PMID:28392724

  4. The Influence of Strategy and External Quality Audit on University Performance: An Australian Perspective

    ERIC Educational Resources Information Center

    Shah, Mahsood; Nair, Sid

    2011-01-01

    External quality audits have been introduced in many parts of the world including Asia Pacific, Asia, Africa, Europe, and the Middle East. While external quality audits have been introduced for more than a decade in some countries like New Zealand, the United Kingdom (UK), Denmark, and Sweden, there is limited research on the extent to which such…

  5. The Influence of Strategy and External Quality Audit on University Performance: An Australian Perspective

    ERIC Educational Resources Information Center

    Shah, Mahsood; Nair, Sid

    2011-01-01

    External quality audits have been introduced in many parts of the world including Asia Pacific, Asia, Africa, Europe, and the Middle East. While external quality audits have been introduced for more than a decade in some countries like New Zealand, the United Kingdom (UK), Denmark, and Sweden, there is limited research on the extent to which such…

  6. Statistical diagnostics emerging from external quality control of real-time PCR.

    PubMed

    Marubini, E; Verderio, P; Raggi, Casini C; Pazzagli, M; Orlando, C

    2004-01-01

    Besides the application of conventional qualitative PCR as a valuable tool to enrich or identify specific sequences of nucleic acids, a new revolutionary technique for quantitative PCR determination has been introduced recently. It is based on real-time detection of PCR products revealed as a homogeneous accumulating signal generated by specific dyes. However, as far as we know, the influence of the variability of this technique on the reliability of the quantitative assay has not been thoroughly investigated. A national program of external quality assurance (EQA) for real-time PCR determination involving 42 Italian laboratories has been developed to assess the analytical performance of real-time PCR procedures. Participants were asked to perform a conventional experiment based on the use of an external reference curve (standard curve) for real-time detection of three cDNA samples with different concentrations of a specific target. In this paper the main analytical features of the standard curve have been investigated in an attempt to produce statistical diagnostics emerging from external quality control. Specific control charts were drawn to help biochemists take technical decisions aimed at improving the performance of their laboratories. Overall, our results indicated a subset of seven laboratories whose performance appeared to be markedly outside the limits for at least one of the standard curve features investigated. Our findings suggest the usefulness of the approach presented here for monitoring the heterogeneity of results produced by different laboratories and for selecting those laboratories that need technical advice on their performance.

  7. Toward development of a comprehensive external quality assurance program for polyfunctional intracellular cytokine staining assays

    PubMed Central

    Staats, Janet S.; Enzor, Jennifer H.; Sanchez, Ana M.; Rountree, Wes; Chan, Cliburn; Jaimes, Maria; Chan, Ray Chun-Fai; Gaur, Amitabh; Denny, Thomas N.; Weinhold, Kent J.

    2014-01-01

    The External Quality Assurance Program Oversight Laboratory (EQAPOL) Flow Cytometry Program assesses the proficiency of NIH/NIAID/DAIDS-supported and potentially other interested research laboratories in performing Intracellular Cytokine Staining (ICS) assays. The goal of the EQAPOL Flow Cytometry External Quality Assurance Program (EQAP) is to provide proficiency testing and remediation for participating sites. The program is not punitive; rather, EQAPOL aims to help sites identify areas for improvement. EQAPOL utilizes a highly standardized ICS assay to minimize variability and readily identify those sites experiencing technical difficulties with their assays. Here, we report the results of External Proficiency 3 (EP3) where participating sites performed a 7-color ICS assay. On average, sites perform well in the Flow Cytometry EQAP (median score is “Good”). The most common technical issues identified by the program involve protocol adherence and data analysis; these areas have been the focus of site remediation. The EQAPOL Flow Cytometry team is now in the process of expanding the program to 8-color ICS assays. Evaluating polyfunctional ICS responses would align the program with assays currently being performed in support of HIV immune monitoring assays. PMID:24968072

  8. Impact of external haematology proficiency testing programme on quality of laboratories.

    PubMed

    Saxena, Renu; Katoch, S C; Srinivas, Upendra; Rao, Seema; Anand, Hema

    2007-11-01

    A reliable and reproducible report from a laboratory needs internal quality control within the laboratory and participation in external proficiency testing programmes (EPTP). This study conducted at the Department of Haematology, All India Institute of Medical Sciences (AIIMS), New Delhi, which has been conducting an EPTP since 1992, was undertaken to assess the efficacy of this programme in improving the performance of participating laboratories in reporting test samples sent for Hb, total leucocyte count (TLC), reticulocyte count and assessment of peripheral blood smear (PBS). The samples were prepared in our laboratory according to the International Standards Organization (ISO) guidelines. The performance of individual laboratories was assessed using robust Z score, which is an indicator of acceptability of the test result. An improvement in the overall percentage of laboratories with acceptable reports was seen during the study period. It has increased from 38,40,40 per cent in 1992 to 85, 90,94.7 per cent in 2006 for Hb, TLC, reticulocyte count, respectively. However, the results for peripheral smear assessment improved only marginally. The external haematology proficiency testing programme run by our department for Hb, TLC, reticulocyte count, and peripheral blood smear assessment, has helped in improving the reporting standards of these parameters in Indian laboratories.

  9. Integrated Science Assessment (ISA) for Lead (Third External ...

    EPA Pesticide Factsheets

    EPA announced that the Third External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) was made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standards for Pb sufficiently protect public health and the environment. Lead (Pb) is one of six principal (or criteria) pollutants for which EPA has established NAAQS

  10. Integrated Science Assessment (ISA) for Lead (First External ...

    EPA Pesticide Factsheets

    EPA announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) was made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standards for Pb sufficiently protect public health and the environment. Lead (Pb) is one of six principal (or criteria) pollutants for which EPA has established NAAQS.

  11. External dose assessment in the Ukraine following the Chernobyl accident

    NASA Astrophysics Data System (ADS)

    Frazier, Remi Jordan Lesartre

    While the physiological effects of radiation exposure have been well characterized in general, it remains unclear what the relationship is between large-scale radiological events and psychosocial behavior outcomes in individuals or populations. To investigate this, the National Science Foundation funded a research project in 2008 at the University of Colorado in collaboration with Colorado State University to expand the knowledge of complex interactions between radiation exposure, perception of risk, and psychosocial behavior outcomes by modeling outcomes for a representative sample of the population of the Ukraine which had been exposed to radiocontaminant materials released by the reactor accident at Chernobyl on 26 April 1986. In service of this project, a methodology (based substantially on previously published models specific to the Chernobyl disaster and the Ukrainian population) was developed for daily cumulative effective external dose and dose rate assessment for individuals in the Ukraine for as a result of the Chernobyl disaster. A software platform was designed and produced to estimate effective external dose and dose rate for individuals based on their age, occupation, and location of residence on each day between 26 April 1986 and 31 December 2009. A methodology was developed to transform published 137Cs soil deposition contour maps from the Comprehensive Atlas of Caesium Deposition on Europe after the Chernobyl Accident into a geospatial database to access these data as a radiological source term. Cumulative effective external dose and dose rate were computed for each individual in a 703-member cohort of Ukrainians randomly selected to be representative of the population of the country as a whole. Error was estimated for the resulting individual dose and dose rate values with Monte Carlo simulations. Distributions of input parameters for the dose assessment methodology were compared to computed dose and dose rate estimates to determine which

  12. Irrigation water quality assessments

    USDA-ARS?s Scientific Manuscript database

    Increasing demands on fresh water supplies by municipal and industrial users means decreased fresh water availability for irrigated agriculture in semi arid and arid regions. There is potential for agricultural use of treated wastewaters and low quality waters for irrigation but this will require co...

  13. Geographic Information Systems to Assess External Validity in Randomized Trials.

    PubMed

    Savoca, Margaret R; Ludwig, David A; Jones, Stedman T; Jason Clodfelter, K; Sloop, Joseph B; Bollhalter, Linda Y; Bertoni, Alain G

    2017-08-01

    To support claims that RCTs can reduce health disparities (i.e., are translational), it is imperative that methodologies exist to evaluate the tenability of external validity in RCTs when probabilistic sampling of participants is not employed. Typically, attempts at establishing post hoc external validity are limited to a few comparisons across convenience variables, which must be available in both sample and population. A Type 2 diabetes RCT was used as an example of a method that uses a geographic information system to assess external validity in the absence of a priori probabilistic community-wide diabetes risk sampling strategy. A geographic information system, 2009-2013 county death certificate records, and 2013-2014 electronic medical records were used to identify community-wide diabetes prevalence. Color-coded diabetes density maps provided visual representation of these densities. Chi-square goodness of fit statistic/analysis tested the degree to which distribution of RCT participants varied across density classes compared to what would be expected, given simple random sampling of the county population. Analyses were conducted in 2016. Diabetes prevalence areas as represented by death certificate and electronic medical records were distributed similarly. The simple random sample model was not a good fit for death certificate record (chi-square, 17.63; p=0.0001) and electronic medical record data (chi-square, 28.92; p<0.0001). Generally, RCT participants were oversampled in high-diabetes density areas. Location is a highly reliable "principal variable" associated with health disparities. It serves as a directly measurable proxy for high-risk underserved communities, thus offering an effective and practical approach for examining external validity of RCTs. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Systems Perspectives on External Quality Assurance: Implications for Micro-States

    ERIC Educational Resources Information Center

    Houston, Don; Maniku, Ahmed Ali

    2005-01-01

    Quality assurance in higher education is a mess: the "problem" of quality is embedded in complex sets of interacting issues that are of concern to many and varied stakeholders. Developing higher education systems that have responded to issues of quality through a "best practice" model of external quality assurance has produced…

  15. Analyzing the potential for water quality externalities as the result of market water transfers

    NASA Astrophysics Data System (ADS)

    Connor, Jeffery D.; Perry, Gregory M.

    1999-09-01

    This article presents a comparative static framework for predicting the water quality outcomes of water trade. The focus is on a comprehensive treatment of water quality processes. Previous work has assumed that reductions in agriculturally induced water quality externalities are an increasing function of irrigation application rates. The comparative static framework used here allows for the possibility that water transfer can result in both positive and negative water quality externalities as the result of dilution, even when the rate of loading decreases. We apply our model to the Owyhee aquifer of eastern Oregon, an area where nitrate concentrations exceeded the EPA standard of 10 ppm in over 30% of area test wells in 1991. In conclusion, we describe conditions when water trade is most likely to generate positive versus negative water quality externalities. We also draw policy conclusions about the kinds of institutional rules best suited to balance trade-offs between gains to trade, water quality externalities, and transactions costs.

  16. [Current challenges of external quality assurance in the German healthcare system].

    PubMed

    Willms, Gerald; Bramesfeld, Anke; Pottkämper, Karen; Broge, Björn; Szecsenyi, Joachim

    2013-01-01

    External quality assurance has three main aims: to make service provision in medicine and nursing comparable, to systematically identify deficits in service quality and to support the introduction of measures for quality improvement. This article reflects on three major developments in mandatory external quality assurance in the German healthcare system that took place during the last five years. These developments include the implementation of cross-sectoral quality assurance, the utilisation of new data sources and a new focus on quality deficits and practicability. The article highlights the challenges that come along with these developments.

  17. Quality of Life Assessment.

    ERIC Educational Resources Information Center

    Gore, Peter H.

    Explaining the use of overlay methodology in the assessment of rural social service this paper describes a technique of visual juxtaposition wherein information is matched with geographic location. To ascertain whether senior citizen centers are located in areas of client concentration, for example, this model superimposes the location of senior…

  18. Quality Assessment in Action.

    ERIC Educational Resources Information Center

    Hawk, Thomas R.

    In 1985, an ad hoc committee was appointed to conduct a comprehensive examination of the educational effectiveness of the Community College of Philadelphia (CCP). The principles governing the assessment emphasized students' educational goals; cognitive and non-cognitive outcomes; differences among subgroups within the student population;…

  19. Quality assessment of urban environment

    NASA Astrophysics Data System (ADS)

    Ovsiannikova, T. Y.; Nikolaenko, M. N.

    2015-01-01

    This paper is dedicated to the research applicability of quality management problems of construction products. It is offered to expand quality management borders in construction, transferring its principles to urban systems as economic systems of higher level, which qualitative characteristics are substantially defined by quality of construction product. Buildings and structures form spatial-material basis of cities and the most important component of life sphere - urban environment. Authors justify the need for the assessment of urban environment quality as an important factor of social welfare and life quality in urban areas. The authors suggest definition of a term "urban environment". The methodology of quality assessment of urban environment is based on integrated approach which includes the system analysis of all factors and application of both quantitative methods of assessment (calculation of particular and integrated indicators) and qualitative methods (expert estimates and surveys). The authors propose the system of indicators, characterizing quality of the urban environment. This indicators fall into four classes. The authors show the methodology of their definition. The paper presents results of quality assessment of urban environment for several Siberian regions and comparative analysis of these results.

  20. Institutional Consequences of Quality Assessment

    ERIC Educational Resources Information Center

    Joao Rosa, Maria; Tavares, Diana; Amaral, Alberto

    2006-01-01

    This paper analyses the opinions of Portuguese university rectors and academics on the quality assessment system and its consequences at the institutional level. The results obtained show that university staff (rectors and academics, with more of the former than the latter) held optimistic views of the positive consequences of quality assessment…

  1. First external quality assurance program of the Italian HLA-B*57:01 Network assessing the performance of clinical virology laboratories in HLA-B*57:01 testing.

    PubMed

    Meini, Genny; Dello Russo, Cinzia; Allice, Tiziano; Barresi, Renata; D'Arrigo, Roberta; Falasca, Francesca; Lipsi, Maria Rosaria; Paolucci, Stefania; Zanussi, Stefania; Antonetti, Raffaele; Baldanti, Fausto; Basaglia, Giancarlo; Bruzzone, Bianca; Polilli, Ennio; Ghisetti, Valeria; Pucillo, Leopoldo Paolo; Turriziani, Ombretta; Pirazzoli, Antonella; Navarra, Pierluigi; Zazzi, Maurizio

    2016-05-01

    Since the HLA-B*57:01 allele is strongly associated with abacavir hypersensitivity reaction, testing for the presence of HLA-B*57:01 is mandatory before administration of abacavir. While HLA-B*57:01 testing is usually provided by pharmacogenetics, genetics or blood transfusion services, clinical virology laboratories can be an optimal opportunity for HLA-B*57:01 testing since they receive blood samples for routine HIV monitoring and have the expertise for convenient and less expensive PCR-based point mutation assays. The Italian HLA-B*57:01 Network gathers accredited clinical virology laboratories offering HLA-B*57:01 testing in Italy with the aim to share protocols, test new methods, develop and maintain external quality assurance (EQA) programs. A panel of 9HLA-B*57:01-positive and 16HLA-B*57:01-negative frozen blood samples were blindly distributed to 10 units including 9 clinical virology laboratories and one reference pharmacology laboratory. Each laboratory was free to use its own routine method for DNA extraction and HLA-B*57:01 testing. DNA was extracted by automated workstations in 6 units and by manual spin columns in 4. Eight units used the Duplicα Real Time HLA-B*57:01 kit by Euroclone and two units used two different PCR homemade protocols. All the 10 units correctly identified all the 25 samples. The first HLA-B*57:01 EQA program run in Italy showed that clinical virology units are equipped and proficient for providing HLA-B*57:01 testing by inexpensive assays easy to integrate into their routine. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. The Northeast Stream Quality Assessment

    USGS Publications Warehouse

    Van Metre, Peter C.; Riva-Murray, Karen; Coles, James F.

    2016-04-22

    In 2016, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) is assessing stream quality in the northeastern United States. The goal of the Northeast Stream Quality Assessment (NESQA) is to assess the quality of streams in the region by characterizing multiple water-quality factors that are stressors to aquatic life and evaluating the relation between these stressors and biological communities. The focus of NESQA in 2016 will be on the effects of urbanization and agriculture on stream quality in all or parts of eight states: Connecticut, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.Findings will provide the public and policymakers with information about the most critical factors affecting stream quality, thus providing insights about possible approaches to protect the health of streams in the region. The NESQA study will be the fourth regional study conducted as part of NAWQA and will be of similar design and scope to the first three, in the Midwest in 2013, the Southeast in 2014, and the Pacific Northwest in 2015 (http://txpub.usgs.gov/RSQA/).

  3. The California stream quality assessment

    USGS Publications Warehouse

    Van Metre, Peter C.; Egler, Amanda L.; May, Jason T.

    2017-03-06

    In 2017, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) project is assessing stream quality in coastal California, United States. The USGS California Stream Quality Assessment (CSQA) will sample streams over most of the Central California Foothills and Coastal Mountains ecoregion (modified from Griffith and others, 2016), where rapid urban growth and intensive agriculture in the larger river valleys are raising concerns that stream health is being degraded. Findings will provide the public and policy-makers with information regarding which human and natural factors are the most critical in affecting stream quality and, thus, provide insights about possible approaches to protect the health of streams in the region.

  4. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    ERIC Educational Resources Information Center

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  5. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    ERIC Educational Resources Information Center

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  6. AIR QUALITY CRITERIA CARBON MONOXIDE, EXTERNAL REVIEW DRAFT

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) promulgates the National Ambient Air Quality Standards (NAAQS) on the basis of scientific information contained in criteria documents. The last air quality criteria document for carbon monoxide (CO) was completed by EPA in 1991. This...

  7. AIR QUALITY CRITERIA CARBON MONOXIDE, EXTERNAL REVIEW DRAFT

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) promulgates the National Ambient Air Quality Standards (NAAQS) on the basis of scientific information contained in criteria documents. The last air quality criteria document for carbon monoxide (CO) was completed by EPA in 1991. This...

  8. 42 CFR 438.358 - Activities related to external quality review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.358... quality of care. (3) Calculation of performance measures in addition to those reported by an MCO or PIHP... conducted by an MCO or PIHP and validated by an EQRO. (5) Conduct of studies on quality that focus on...

  9. The Introduction of External Quality Assurance in South African Higher Education: An Analysis of Stakeholder Response

    ERIC Educational Resources Information Center

    Luckett, Kathy

    2007-01-01

    This paper analyses the take-up of proposals for a national quality assurance system in South Africa using different approaches to quality assurance to classify stakeholder responses to survey and interview questions. The context of the study was the introduction of an external quality assurance system for South African higher education by an…

  10. Academic Staff Views on External Quality Audit: Post Audit Evaluation in a Private Higher Education College

    ERIC Educational Resources Information Center

    Shah, Mahsood; Nair, Chenicheri Sid; Stanford, Sue-Ann

    2011-01-01

    Governments in many countries have funded independent agencies to undertake quality audits of higher education institutions. Such agencies ensure that universities and other higher education providers have effective systems and processes to assure quality assurance in core and support areas. While external quality audits have been in place for a…

  11. External Quality Assurance in Higher Education: Making Choices. Fundamentals of Educational Planning 85

    ERIC Educational Resources Information Center

    Martin, Michaela; Stella, Antony

    2007-01-01

    This booklet aims to provide policy advice and support to decision-makers and managers in the area of quality assurance in higher education. In order to do so, the authors describe and discuss major issues that decision-makers in charge of quality assurance need to consider for the creation or development of an external quality assurance (EQA)…

  12. [The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

    PubMed

    Men'shikov, V V

    2013-08-01

    The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

  13. Beam quality improvement of laser diode array by using off-axis external cavity.

    PubMed

    Zhouping, Su; Qihong, Lou; Jingxing, Dong; Jun, Zhou; Runrong, Wei

    2007-09-17

    A novel off-axis external cavity is designed for laser diode array to improve the beam quality. In this external cavity, a circle aperture with variable size is used as a spatial filter. The diameter of aperture is optimized to 1.2mm and the off-axis angle of external cavity is optimized at 2.6 deg. In the optimal case, the beam parameter product (BPP) of laser diode array is reduced to 121 mm.mrad from 1050 mm.mrad with external cavity optical efficiency of 81%.

  14. Self-regulation assessment among preschoolers with externalizing behavior problems.

    PubMed

    Graziano, Paulo A; Slavec, Janine; Ros, Rosmary; Garb, Leanna; Hart, Katie; Garcia, Alexis

    2015-12-01

    This study examined the construct validity and clinical utility of a brief self-regulation assessment (Head-Toes-Knees-Shoulders, HTKS) among a clinical sample of children with externalizing behavior problems (EBP). Participants for this study included 101 preschool children (72% male; Mage = 5.10 years; 79% Hispanic) with at-risk or clinically elevated levels of EBP. Self-regulation measures included the HTKS task, 4 standardized subtests from the Automated Working Memory Assessment (AWMA), parent and teacher reports of children's executive functioning (EF), and children's self-regulation performance across a series of executive functioning classroom games conducted as part of a summer treatment camp. Additional outcomes included school readiness as measured by standardized achievement tests, and parent and teacher reports of kindergarten readiness and behavioral impairment related to academic functioning. Performance on the HTKS task was moderately correlated with children's performance on the standardized working memory tasks and observed self-regulation performance in the classroom. Low to moderate correlations were observed between performance on the HTKS task and parent report of children's EF difficulties, as well as parent and teacher reports of children's kindergarten readiness and behavioral impairment related to academic functioning. Moderate to high correlations were observed between performance on the HTKS task and standardized academic outcomes. These findings highlight the promise of the HTKS task as a brief, ecologically valid, and integrative EF task tapping into both behavioral and cognitive aspects of self-regulation that are important for children with EBP's success in school.

  15. 42 CFR 438.352 - External quality review protocols.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... quality review protocols. Each protocol must specify— (a) The data to be gathered; (b) The sources of the data; (c) The activities and steps to be followed in collecting the data to promote its accuracy, validity, and reliability; (d) The proposed method or methods for validly analyzing and interpreting...

  16. 42 CFR 438.352 - External quality review protocols.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... quality review protocols. Each protocol must specify— (a) The data to be gathered; (b) The sources of the data; (c) The activities and steps to be followed in collecting the data to promote its accuracy, validity, and reliability; (d) The proposed method or methods for validly analyzing and interpreting...

  17. 42 CFR 438.352 - External quality review protocols.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... quality review protocols. Each protocol must specify— (a) The data to be gathered; (b) The sources of the data; (c) The activities and steps to be followed in collecting the data to promote its accuracy, validity, and reliability; (d) The proposed method or methods for validly analyzing and interpreting...

  18. 42 CFR 438.352 - External quality review protocols.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... quality review protocols. Each protocol must specify— (a) The data to be gathered; (b) The sources of the data; (c) The activities and steps to be followed in collecting the data to promote its accuracy, validity, and reliability; (d) The proposed method or methods for validly analyzing and interpreting...

  19. AIR QUALITY CRITERIA FOR LEAD (SECOND EXTERNAL REVIEW DRAFT)

    EPA Science Inventory

    The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including lead. Under the review process, EPA's Office of Research and Development develops a criteria docu...

  20. Air Quality Criteria for Lead (First External Review Draft)

    EPA Science Inventory

    Background:

    The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including lead. Under the review process, EPA's Office of Research and Development d...

  1. AIR QUALITY CRITERIA FOR LEAD (SECOND EXTERNAL REVIEW DRAFT)

    EPA Science Inventory

    The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including lead. Under the review process, EPA's Office of Research and Development develops a criteria docu...

  2. Air Quality Criteria for Lead (First External Review Draft)

    EPA Science Inventory

    Background:

    The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including lead. Under the review process, EPA's Office of Research and Development d...

  3. Quality of life in patients with varus gonarthrosis treated with high tibial osteotomy using the circular external fixator.

    PubMed

    Gunes, Taner; Erdem, Mehmet; Bostan, Bora; Yeniel, Kursad; Sen, Cengiz

    2008-03-01

    Generally, surgeon-driven musculoskeletal evaluation systems are used for evaluating outcomes of patients who are treated with high tibial osteotomy. In this study, we investigated the effects of high tibial osteotomy using circular external fixator on quality of life. Twenty-one high tibial osteotomy of 19 patients were evaluated. Quality of life assessment was made using Short Form -36 at preoperative, before fixator removal and 6 months after fixator removal. After applying fixator, the physical function and physical role scores of Short Form-36 decreased and emotional role score did not improve. In other categories, significant improvements were observed when fixator in place. At the sixth month after fixator removal, significant improvements were dedected in all categories of Short Form-36. Although there was a decrease in physical functions after fixator application in patients who were treated with high tibial osteotomy using circular external fixator, significant improvement occurred in quality of life after fixator removal.

  4. Assessing risks to ecosystem quality

    SciTech Connect

    Barnthouse, L.W.

    1995-12-31

    Ecosystems are not organisms. Because ecosystems do not reproduce, grow old or sick, and die, the term ecosystem health is somewhat misleading and perhaps should not be used. A more useful concept is ``ecosystem quality,`` which denotes a set of desirable ecosystem characteristics defined in terms of species composition, productivity, size/condition of specific populations, or other measurable properties. The desired quality of an ecosystem may be pristine, as in a nature preserve, or highly altered by man, as in a managed forest or navigational waterway. ``Sustainable development`` implies that human activities that influence ecosystem quality should be managed so that high-quality ecosystems are maintained for future generations. In sustainability-based environmental management, the focus is on maintaining or improving ecosystem quality, not on restricting discharges or requiring particular waste treatment technologies. This approach requires management of chemical impacts to be integrated with management of other sources of stress such as erosion, eutrophication, and direct human exploitation. Environmental scientists must (1) work with decision makers and the public to define ecosystem quality goals, (2) develop corresponding measures of ecosystem quality, (3) diagnose causes for departures from desired states, and (4) recommend appropriate restoration actions, if necessary. Environmental toxicology and chemical risk assessment are necessary for implementing the above framework, but they are clearly not sufficient. This paper reviews the state-of-the science relevant to sustaining the quality of aquatic ecosystems. Using the specific example of a reservoir in eastern Tennessee, the paper attempts to define roles for ecotoxicology and risk assessment in each step of the management process.

  5. Characterizing Observers Using External Noise and Observer Models: Assessing Internal Representations with External Noise

    ERIC Educational Resources Information Center

    Lu, Zhong-Lin; Dosher, Barbara Anne

    2008-01-01

    External noise methods and observer models have been widely used to characterize the intrinsic perceptual limitations of human observers and changes of the perceptual limitations associated with cognitive, developmental, and disease processes by highlighting the variance of internal representations. The authors conducted a comprehensive review of…

  6. A quality audit program for external beam radiotherapy

    SciTech Connect

    Hanson, W.F.; Stovall, M.

    1993-12-31

    For more than 25 years, the University of Texas M. D. Anderson Cancer Center has had a quality audit program using mailed dosimeters to verify radiation therapy machine output. Two programs, one compulsory and one voluntary, presently monitor therapy beams at more than 1000 megavoltage-therapy facilities. A successful program requires two major components: a high-precision thermoluminescent dosimeter (TLD) system and dedicated staff that interact closely with the users to resolve discrepancies. The TLD system, the logistics used, and the human interaction of these programs are described. Examples show that the programs can identify major discrepancies, exceeding 5 %, as well as discrepancies as small as 3%.

  7. First External Evaluations of Quality Assurance Agencies--Lessons Learned. ENQA Workshop Report 10

    ERIC Educational Resources Information Center

    Costes, Nathalie; Curvale, Bruno; Kraft, Michael G.; Llavori, Rafael; Malan, Thierry; Szanto, Tibor

    2010-01-01

    This report is a product of an ENQA (European Association for Quality Assurance in Higher Education) seminar on the first external evaluations of quality assurance agencies, held in Paris in July 2008. The seminar took stock of the achieved reviews of agencies to learn lessons from these first outcomes and, hence, provided a platform for…

  8. Parenting and Friendship Quality as Predictors of Internalizing and Externalizing Symptoms in Early Adolescence

    ERIC Educational Resources Information Center

    Gaertner, Alden E.; Fite, Paula J.; Colder, Craig R.

    2010-01-01

    Research indicates both parents and peers influence child and adolescent adjustment outcomes. Moreover, friendship quality has been found to buffer the influence of parenting on adolescent adjustment, particularly externalizing symptoms. Little to no research, however, has longitudinally examined whether friendship quality moderates the relation…

  9. Health-related external cost assessment in Europe: methodological developments from ExternE to the 2013 Clean Air Policy Package.

    PubMed

    van der Kamp, Jonathan; Bachmann, Till M

    2015-03-03

    "Getting the prices right" through internalizing external costs is a guiding principle of environmental policy making, one recent example being the EU Clean Air Policy Package released at the end of 2013. It is supported by impact assessments, including monetary valuation of environmental and health damages. For over 20 years, related methodologies have been developed in Europe in the Externalities of Energy (ExternE) project series and follow-up activities. In this study, we aim at analyzing the main methodological developments over time from the 1990s until today with a focus on classical air pollution-induced human health damage costs. An up-to-date assessment including the latest European recommendations is also applied. Using a case from the energy sector, we identify major influencing parameters: differences in exposure modeling and related data lead to variations in damage costs of up to 21%; concerning risk assessment and monetary valuation, differences in assessing long-term exposure mortality risks together with assumptions on particle toxicity explain most of the observed changes in damage costs. These still debated influencing parameters deserve particular attention when damage costs are used to support environmental policy making.

  10. Engineering Strategies and Methods for Avoiding Air-Quality Externalities: Dispersion Modeling, Home Energy Conservation, and Scenario Planning

    NASA Astrophysics Data System (ADS)

    Knox, Andrew James

    Energy conservation can improve air quality by reducing emissions from fuel combustion. The human health value retained through better air quality can then offset the cost of energy conservation. Through this thesis' innovative yet widely-accessible combination of air pollution dispersion modeling and atmospheric chemistry, it is estimated that the health value retained by avoiding emissions from Ontario's former coal-fired generating stations is 5.74/MWh (using an upper-bound value of 265,000 per year of life lost). This value is combined with energy modeling of homes in the first-ever assessment of the air-quality health benefits of low-energy buildings. It is shown that avoided health damages can equal 7% of additional construction costs of energy efficient buildings in Ontario. At 7%, health savings are a significant item in the cost analysis of efficient buildings. Looking to energy efficiency in the context of likely future low-resource natural gas scenarios, building efficient buildings today is shown to be more economically efficient than any building retrofit option. Considering future natural gas scarcity in the context of Ontario's Long-Term Energy Plan reveals that Ontario may be forced to return to coal-fired electricity. Projected coal use would result in externalities greater than $600 million/year; 80% more than air-quality externalities from Ontario's electricity in 1985. Radically aggressive investment in electricity conservation (75% reduction per capita by 2075) is one promising path forward that keeps air-quality externalities below 1985 levels. Non-health externalities are an additional concern, the quantification, and ultimately monetization, of which could be practical using emerging air pollution monitoring technologies. Energy, conservation, energy planning, and energy's externalities form a complex situation in which today's decisions are critical to a successful future. It is clear that reducing the demand for energy is essential and

  11. Developing standards for malaria microscopy: external competency assessment for malaria microscopists in the Asia-Pacific.

    PubMed

    Ashraf, Sania; Kao, Angie; Hugo, Cecilia; Christophel, Eva M; Fatunmbi, Bayo; Luchavez, Jennifer; Lilley, Ken; Bell, David

    2012-10-24

    Malaria diagnosis has received renewed interest in recent years, associated with the increasing accessibility of accurate diagnosis through the introduction of rapid diagnostic tests and new World Health Organization guidelines recommending parasite-based diagnosis prior to anti-malarial therapy. However, light microscopy, established over 100 years ago and frequently considered the reference standard for clinical diagnosis, has been neglected in control programmes and in the malaria literature and evidence suggests field standards are commonly poor. Microscopy remains the most accessible method for parasite quantitation, for drug efficacy monitoring, and as a reference of assessing other diagnostic tools. This mismatch between quality and need highlights the importance of the establishment of reliable standards and procedures for assessing and assuring quality. This paper describes the development, function and impact of a multi-country microscopy external quality assurance network set up for this purpose in Asia. Surveys were used for key informants and past participants for feedback on the quality assurance programme. Competency scores for each country from 14 participating countries were compiled for analyses using paired sample t-tests. In-depth interviews were conducted with key informants including the programme facilitators and national level microscopists. External assessments and limited retraining through a formalized programme based on a reference slide bank has demonstrated an increase in standards of competence of senior microscopists over a relatively short period of time, at a potentially sustainable cost. The network involved in the programme now exceeds 14 countries in the Asia-Pacific, and the methods are extended to other regions. While the impact on national programmes varies, it has translated in some instances into a strengthening of national microscopy standards and offers a possibility both for supporting revival of national microcopy

  12. Developing standards for malaria microscopy: external competency assessment for malaria microscopists in the Asia-Pacific

    PubMed Central

    2012-01-01

    Background Malaria diagnosis has received renewed interest in recent years, associated with the increasing accessibility of accurate diagnosis through the introduction of rapid diagnostic tests and new World Health Organization guidelines recommending parasite-based diagnosis prior to anti-malarial therapy. However, light microscopy, established over 100 years ago and frequently considered the reference standard for clinical diagnosis, has been neglected in control programmes and in the malaria literature and evidence suggests field standards are commonly poor. Microscopy remains the most accessible method for parasite quantitation, for drug efficacy monitoring, and as a reference of assessing other diagnostic tools. This mismatch between quality and need highlights the importance of the establishment of reliable standards and procedures for assessing and assuring quality. This paper describes the development, function and impact of a multi-country microscopy external quality assurance network set up for this purpose in Asia. Methods Surveys were used for key informants and past participants for feedback on the quality assurance programme. Competency scores for each country from 14 participating countries were compiled for analyses using paired sample t-tests. In-depth interviews were conducted with key informants including the programme facilitators and national level microscopists. Results External assessments and limited retraining through a formalized programme based on a reference slide bank has demonstrated an increase in standards of competence of senior microscopists over a relatively short period of time, at a potentially sustainable cost. The network involved in the programme now exceeds 14 countries in the Asia-Pacific, and the methods are extended to other regions. Conclusions While the impact on national programmes varies, it has translated in some instances into a strengthening of national microscopy standards and offers a possibility both for

  13. The Achilles' Heel of Quality: The Assessment of Student Learning.

    ERIC Educational Resources Information Center

    Knight, Peter T.

    2002-01-01

    Explores the dependability of assessments of student achievement when used for internal and external quality monitoring (IQM and EQM). Identifies problems and suggests responses, including a radical approach based on accepting that reliable national data about complex student achievements are not available. Asserts that reliance on EQM is unwise…

  14. An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios (External Review Draft)

    EPA Science Inventory

    EPA has released an external review draft entitled, An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios(External Review Draft). The public comment period and the external peer-review workshop are separate processes that provide opportunities ...

  15. External Peer Review of Assessment: An Effective Approach to Verifying Standards?

    ERIC Educational Resources Information Center

    Bloxham, Sue; Hudson, Jane; den Outer, Birgit; Price, Margaret

    2015-01-01

    There is growing international concern to regulate and assure standards in higher education. External peer review of assessment, often called external examining, is a well-established approach to assuring standards. Australian higher education is one of several systems without a history of external examining for undergraduate programmes that is…

  16. An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios (External Review Draft)

    EPA Science Inventory

    EPA has released an external review draft entitled, An Exploratory Study: Assessment of Modeled Dioxin Exposure in Ceramic Art Studios(External Review Draft). The public comment period and the external peer-review workshop are separate processes that provide opportunities ...

  17. Assessing the Exposome with External Measures: Commentary on the State of the Science and Research Recommendations.

    PubMed

    Turner, Michelle C; Nieuwenhuijsen, Mark; Anderson, Kim; Balshaw, David; Cui, Yuxia; Dunton, Genevieve; Hoppin, Jane A; Koutrakis, Petros; Jerrett, Michael

    2017-03-20

    The exposome comprises all environmental exposures that a person experiences from conception throughout the life course. Here we review the state of the science for assessing external exposures within the exposome. This article reviews (a) categories of exposures that can be assessed externally, (b) the current state of the science in external exposure assessment, (c) current tools available for external exposure assessment, and (d) priority research needs. We describe major scientific and technological advances that inform external assessment of the exposome, including geographic information systems; remote sensing; global positioning system and geolocation technologies; portable and personal sensing, including smartphone-based sensors and assessments; and self-reported questionnaire assessments, which increasingly rely on Internet-based platforms. We also discuss priority research needs related to methodological and technological improvement, data analysis and interpretation, data sharing, and other practical considerations, including improved assessment of exposure variability as well as exposure in multiple, critical life stages.

  18. Child diurnal cortisol rhythms, parenting quality, and externalizing behaviors in preadolescence.

    PubMed

    Martin, Christina Gamache; Kim, Hyoun K; Bruce, Jacqueline; Fisher, Philip A

    2014-02-01

    This study examined a neurobiologically informed model of the emergence of child externalizing behaviors in an ethnically diverse community sample of 232 9-12 year old children. Replicating extensive prior research, our analyses revealed that parents' inconsistent discipline and poor quality monitoring were predictive of child externalizing behavior. In addition, poor parental monitoring, but not inconsistent discipline, was associated with children having a significantly flatter morning-to-evening cortisol slope, which was in turn, related to higher levels of externalizing behaviors. An indirect effect of parental monitoring on externalizing behaviors, through child diurnal cortisol rhythms, was also supported. These findings highlight the role of the hypothalamic-pituitary-adrenal (HPA) axis and its hormonal end product, cortisol, in the relationship between the caregiving environment and the development of externalizing behaviors.

  19. Child Diurnal Cortisol Rhythms, Parenting Quality, and Externalizing Behaviors in Preadolescence

    PubMed Central

    Martin, Christina Gamache; Kim, Hyoun K.; Bruce, Jacqueline; Fisher, Philip A.

    2014-01-01

    This study examined a neurobiologically–informed model of the emergence of child externalizing behaviors in an ethnically diverse community sample of 232 9–12 year old children. Replicating extensive prior research, our analyses revealed that parents’ inconsistent discipline and poor quality monitoring were predictive of child externalizing behavior. In addition, poor parental monitoring, but not inconsistent discipline, was associated with children having a significantly flatter morning–to–evening cortisol slope, which was in turn, related to higher levels of externalizing behaviors. An indirect effect of parental monitoring on externalizing behaviors, through child diurnal cortisol rhythms, was also supported. These findings highlight the role of the hypothalamic–pituitary–adrenal (HPA) axis and its hormonal end product, cortisol, in the relationship between the caregiving environment and the development of externalizing behaviors. PMID:24485489

  20. The Midwest Stream Quality Assessment

    USGS Publications Warehouse

    ,

    2012-01-01

    In 2013, the U.S. Geological Survey (USGS) National Water-Quality Assessment Program (NAWQA) and USGS Columbia Environmental Research Center (CERC) will be collaborating with the U.S. Environmental Protection Agency (EPA) National Rivers and Streams Assessment (NRSA) to assess stream quality across the Midwestern United States. The sites selected for this study are a subset of the larger NRSA, implemented by the EPA, States and Tribes to sample flowing waters across the United States (http://water.epa.gov/type/rsl/monitoring/riverssurvey/index.cfm). The goals are to characterize water-quality stressors—contaminants, nutrients, and sediment—and ecological conditions in streams throughout the Midwest and to determine the relative effects of these stressors on aquatic organisms in the streams. Findings will contribute useful information for communities and policymakers by identifying which human and environmental factors are the most critical in controlling stream quality. This collaborative study enhances information provided to the public and policymakers and minimizes costs by leveraging and sharing data gathered under existing programs. In the spring and early summer, NAWQA will sample streams weekly for contaminants, nutrients, and sediment. During the same time period, CERC will test sediment and water samples for toxicity, deploy time-integrating samplers, and measure reproductive effects and biomarkers of contaminant exposure in fish or amphibians. NRSA will sample sites once during the summer to assess ecological and habitat conditions in the streams by collecting data on algal, macroinvertebrate, and fish communities and collecting detailed physical-habitat measurements. Study-team members from all three programs will work in collaboration with USGS Water Science Centers and State agencies on study design, execution of sampling and analysis, and reporting.

  1. Implications of environmental externalities assessments for solar thermal powerplants

    NASA Astrophysics Data System (ADS)

    Lee, A. D.; Baechler, M. C.

    1991-03-01

    Externalities are those impacts of one activity on other activities that are not priced in the marketplace. An externality is said to exist when two conditions hold: (1) the utility or operations of one economic agent, A, include nonmonetary variables whose values are chosen by another economic agent, B, without regard to the effects on A, and (2) B does not pay A compensation equal to the incremental costs inflicted on A. Electricity generation involves a wide range of potential and actual environmental impacts. Legislative, permitting, and regulatory requirements directly or indirectly control certain environmental impacts, implicitly causing them to become internalized in the cost of electricity generation. Electricity generation, however, often produces residual environmental impacts that meet the definition of an externality. Mechanisms have been developed by several states to include the costs associated with externalities in the cost-effectiveness analyses of new powerplants. This paper examines these costs for solar thermal plants and applies two states' scoring methodologies to estimate how including externalities would affect the levelized costs of power from a solar plant in the Pacific Northwest. It concludes that including externalities in the economics can reduce the difference between the levelized cost of a coal and solar plant by between 0.74 and 2.42 cents/kWh.

  2. Effect of Training and Level of External Auditory Feedback on the Singing Voice: Volume and Quality.

    PubMed

    Bottalico, Pasquale; Graetzer, Simone; Hunter, Eric J

    2016-07-01

    Previous research suggests that classically trained professional singers rely not only on external auditory feedback but also on proprioceptive feedback associated with internal voice sensitivities. The Lombard effect and the relationship between sound pressure level (SPL) and external auditory feedback were evaluated for professional and nonprofessional singers. Additionally, the relationship between voice quality, evaluated in terms of singing power ratio (SPR), and external auditory feedback, level of accompaniment, voice register, and singer gender was analyzed. The subjects were 10 amateur or beginner singers and 10 classically trained professional or semiprofessional singers (10 men and 10 women). Subjects sang an excerpt from the Star-Spangled Banner with three different levels of the accompaniment, 70, 80, and 90 dBA and with three different levels of external auditory feedback. SPL and SPR were analyzed. The Lombard effect was stronger for nonprofessional singers than professional singers. Higher levels of external auditory feedback were associated with a reduction in SPL. As predicted, the mean SPR was higher for professional singers than nonprofessional singers. Better voice quality was detected in the presence of higher levels of external auditory feedback. With an increase in training, the singer's reliance on external auditory feedback decreases. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  3. [Assessing user satisfaction, an objective for quality of care].

    PubMed

    Séné-Bourgeois, Martine; Mathieu-Chakroun, Isabelle; Margat, Aurore

    The assessment of user satisfaction constitutes a key indicator of the quality of care. It can be envisaged either as part of an internal strategy which favours the improvement of practices, an external strategy whose focus is more commercial and/or an exploratory strategy to develop care models. User satisfaction is expressed in particular through complaint letters and discharge questionnaires. These regulated schemes enable quality to be approached on an individual and collective level.

  4. External ocular hyperemia: a quantifiable indicator of spacecraft air quality.

    PubMed

    Ogle, J W; Cohen, K L

    1996-05-01

    Eye irritation consistently ranks as a top astronaut complaint but is difficult to measure. Exposure to internal air pollution hypothetically disrupts the eye's tear film, thereby exposing the crewmembers' conjunctivae to the irritating effects of the recirculated, contaminant-laden atmosphere of the space vehicle. Causes elude engineers and toxicologists, who report that measured irritants remain below established Spacecraft Maximum Allowable Concentrations. Lack of objective ocular endpoints stymies efforts to identify etiologies. Computers offer a practical means of analyzing ocular hyperemia in space. We use computer analysis to quantify redness and blood vessels of digitized images of bulbar conjunctivae in near real time. Custom software masks artifacts, lids and lashes for each photographic or telemedicine ocular image, Algorithms then generate semi-independent measurements of hyperemia. Computed difference scores between 34 pairs of images were compared with subjective difference scores as voted on by a panel of ophthalmology residents. Objective data were reliably extracted from ocular images and significantly correlated (r = 0.583, p < 0.05) with subjective scores. This ground-based methodology generates accurate and reliable ocular endpoint data without mass, volume, or power penalty. To assist in identifying and eliminating onboard ocular irritants, these objective data can be regressed against independent variables such as mission elapsed time, subjective astronaut complaints, levels of chemical and electromagnetic contaminants, nephthelometric and barothermal data. As missions lengthen, sensitive tools such as hyperemia quantification will become increasingly important for assessing and optimizing spacecraft environments.

  5. [Analysis of the results of the SEIMC External Quality Control Program. Year 2013].

    PubMed

    de Gopegui Bordes, Enrique Ruiz; Orta Mira, Nieves; Del Remedio Guna Serrano, M; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

    2015-07-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, molecular microbiology and HIV-1, HCV and HBV viral loads. This manuscript presents the analysis of results obtained of the participants from the 2013 SEIMC External Quality Control Programme, except viral loads controls, that they are summarized in a manuscript abroad. As a whole, the results obtained in 2013 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests.

  6. Orion Entry Handling Qualities Assessments

    NASA Technical Reports Server (NTRS)

    Bihari, B.; Tiggers, M.; Strahan, A.; Gonzalez, R.; Sullivan, K.; Stephens, J. P.; Hart, J.; Law, H., III; Bilimoria, K.; Bailey, R.

    2011-01-01

    The Orion Command Module (CM) is a capsule designed to bring crew back from the International Space Station (ISS), the moon and beyond. The atmospheric entry portion of the flight is deigned to be flown in autopilot mode for nominal situations. However, there exists the possibility for the crew to take over manual control in off-nominal situations. In these instances, the spacecraft must meet specific handling qualities criteria. To address these criteria two separate assessments of the Orion CM s entry Handling Qualities (HQ) were conducted at NASA s Johnson Space Center (JSC) using the Cooper-Harper scale (Cooper & Harper, 1969). These assessments were conducted in the summers of 2008 and 2010 using the Advanced NASA Technology Architecture for Exploration Studies (ANTARES) six degree of freedom, high fidelity Guidance, Navigation, and Control (GN&C) simulation. This paper will address the specifics of the handling qualities criteria, the vehicle configuration, the scenarios flown, the simulation background and setup, crew interfaces and displays, piloting techniques, ratings and crew comments, pre- and post-fight briefings, lessons learned and changes made to improve the overall system performance. The data collection tools, methods, data reduction and output reports will also be discussed. The objective of the 2008 entry HQ assessment was to evaluate the handling qualities of the CM during a lunar skip return. A lunar skip entry case was selected because it was considered the most demanding of all bank control scenarios. Even though skip entry is not planned to be flown manually, it was hypothesized that if a pilot could fly the harder skip entry case, then they could also fly a simpler loads managed or ballistic (constant bank rate command) entry scenario. In addition, with the evaluation set-up of multiple tasks within the entry case, handling qualities ratings collected in the evaluation could be used to assess other scenarios such as the constant bank angle

  7. Variation in Adherence to External Beam Radiotherapy Quality Measures Among Elderly Men With Localized Prostate Cancer

    SciTech Connect

    Bekelman, Justin E. Zelefsky, Michael J.; Jang, Thomas L.; Basch, Ethan M.; Schrag, Deborah

    2007-12-01

    Purpose: To characterize the variation in adherence to quality measures of external beam radiotherapy (EBRT) for localized prostate cancer and its relation to patient and provider characteristics in a population-based, representative sample of U.S. men. Methods and Materials: We evaluated EBRT quality measures proposed by a RAND expert panel of physicians among men aged {>=}65 years diagnosed between 2000 and 2002 with localized prostate cancer and treated with primary EBRT using data from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare program. We assessed the adherence to five EBRT quality measures that were amenable to analysis using SEER-Medicare data: (1) use of conformal RT planning; (2) use of high-energy (>10-MV) photons; (3) use of custom immobilization; (4) completion of two follow-up visits with a radiation oncologist in the year after therapy; and (5) radiation oncologist board certification. Results: Of the 11,674 patients, 85% had received conformal RT planning, 75% had received high-energy photons, and 97% had received custom immobilization. One-third of patients had completed two follow-up visits with a radiation oncologist, although 91% had at least one visit with a urologist or radiation oncologist. Most patients (85%) had been treated by a board-certified radiation oncologist. Conclusions: The overall high adherence to EBRT quality measures masked substantial variation in geography, socioeconomic status in the area of residence, and teaching affiliation of the RT facility. Future research should examine the reasons for the variations in these measures and whether the variation is associated with important clinical outcomes.

  8. External quality assurance of malaria nucleic acid testing for clinical trials and eradication surveillance.

    PubMed

    Murphy, Sean C; Hermsen, Cornelus C; Douglas, Alexander D; Edwards, Nick J; Petersen, Ines; Fahle, Gary A; Adams, Matthew; Berry, Andrea A; Billman, Zachary P; Gilbert, Sarah C; Laurens, Matthew B; Leroy, Odile; Lyke, Kristen E; Plowe, Christopher V; Seilie, Annette M; Strauss, Kathleen A; Teelen, Karina; Hill, Adrian V S; Sauerwein, Robert W

    2014-01-01

    Nucleic acid testing (NAT) for malaria parasites is an increasingly recommended diagnostic endpoint in clinical trials of vaccine and drug candidates and is also important in surveillance of malaria control and elimination efforts. A variety of reported NAT assays have been described, yet no formal external quality assurance (EQA) program provides validation for the assays in use. Here, we report results of an EQA exercise for malaria NAT assays. Among five centers conducting controlled human malaria infection trials, all centers achieved 100% specificity and demonstrated limits of detection consistent with each laboratory's pre-stated expectations. Quantitative bias of reported results compared to expected results was generally <0.5 log10 parasites/mL except for one laboratory where the EQA effort identified likely reasons for a general quantitative shift. The within-laboratory variation for all assays was low at <10% coefficient of variation across a range of parasite densities. Based on this study, we propose to create a Molecular Malaria Quality Assessment program that fulfills the need for EQA of malaria NAT assays worldwide.

  9. Quality of basic life support education and automated external defibrillator setting in schools in Ishikawa, Japan.

    PubMed

    Takamura, Akiteru; Ito, Sayori; Maruyama, Kaori; Ryo, Yusuke; Saito, Manami; Fujimura, Shuhei; Ishiura, Yuna; Hori, Ariyuki

    2017-03-01

    Automated external defibrillators (AED) have been installed in schools in Japan since 2004, and the government strongly recommends teaching basic life support (BLS). We therefore examined the quality of BLS education and AED installation in schools. We conducted a prefecture-wide questionnaire survey of all primary and junior high schools in 2016, to assess BLS education and AED installation against the recommendations of the Japan Circulation Society. The results were analyzed using descriptive statistics and chi-squared test. In total, 195 schools out of 315 (62%) responded, of which 38% have introduced BLS education for children. BLS training was held in a smaller proportion of primary schools (18%) than junior high schools (86%). More than 90% of primary school staff had undergone BLS training in the previous 2 years. The most common locations of AED were the gymnasium (32%) followed by entrance hall (28%), staffroom (25%), and infirmary (12%). The reasons given for location were that it was obvious (34%), convenient for staff (32%), could be used out of hours (17%), and the most likely location for a heart attack (15%). Approximately 18% of schools reported that it takes >5 min to reach the AED from the furthest point. BLS training, AED location, and understanding of both are not sufficient to save children's lives efficiently. Authorities should make recommendations about the correct number of AED, and their location, and provide more information to improve the quality of BLS training in schools. © 2016 Japan Pediatric Society.

  10. Assessment of anterior suspended flaps modification for external dacryocystorhinostomy.

    PubMed

    Tetikoglu, Mehmet; Sagdik, Haci Murat; Ozcura, Fatih; Aktas, Serdar

    2015-05-01

    The aim of this study was to evaluate the functional and/or anatomic success rate as well as complications of anterior suspended flaps modification for external dacryocystorhinostomy (DCR). This is a retrospective study that included 50 eyes of 47 patients who underwent anterior suspended flap external DCR surgery for nasolacrimal duct obstruction. Diagnosis of nasolacrimal duct obstruction was made through irrigation of the nasolacrimal drainage system. Anterior flaps of lacrimal sac and nasal mucosa, as large as possible, were created in all patients. Posterior flaps of lacrimal sac and exposed nasal mucosa were excised. After suturing the anterior flaps with two 6-0 Vicryl sutures, the third suture was passed through the orbicularis oculi at the subcutaneous level on 1 edge of incision, then from the middle of the anterior flaps and the other edge of the incision to the suspended anterior flaps. The success rate of 50 surgeries was 96%. In 37 eyes, no problems were reported during the surgery and the modified external DCR was performed successfully. The success rate of the modified external DCR was 100% in those patients. The average operation time was 34 ± 8.2 minutes. These results suggest that anterior suspended flap external DCR is a simple, safe technique with a very high success rate and a satisfactory surgical time.

  11. Quality of Life Effects of Automatic External Defibrillators in the Home: Results from the Home Automatic External Defibrillator Trial (HAT)

    PubMed Central

    Mark, Daniel B.; Anstrom, Kevin J.; McNulty, Steven E.; Flaker, Greg C.; Tonkin, Andrew M.; Smith, Warren M.; Toff, William D.; Dorian, Paul; Clapp-Channing, Nancy E.; Anderson, Jill; Johnson, George; Schron, Eleanor B.; Poole, Jeanne E.; Lee, Kerry L.; Bardy, Gust H.

    2010-01-01

    Background Public access automatic external defibrillators (AEDs) can save lives, but most deaths from out-of-hospital sudden cardiac arrest occur at home. The Home Automatic External Defibrillator Trial (HAT) found no survival advantage for adding a home AED to cardiopulmonary resuscitation (CPR) training for 7001 patients with a prior anterior wall myocardial infarction. Quality of life (QOL) outcomes for both the patient and spouse/companion were secondary endpoints. Methods A subset of 1007 study patients and their spouse/companions was randomly selected for ascertainment of QOL by structured interview at baseline and 12 and 24 months following enrollment. The primary QOL measures were the Medical Outcomes Study 36-Item Short-Form (SF-36) psychological well-being (reflecting anxiety and depression) and vitality (reflecting energy and fatigue) subscales. Results For patients and spouse/companions, the psychological well-being and vitality scales did not differ significantly between those randomly assigned an AED plus CPR training and controls who received CPR training only. None of the other QOL measures collected showed a clinically and statistically significant difference between treatment groups. Patients in the AED group were more likely to report being extremely or quite a bit reassured by their treatment assignment. Spouse/companions in the AED group reported being less often nervous about the possibility of using AED/CPR treatment than those in the CPR group. Conclusions Adding access to a home AED to CPR training did not affect quality of life either for patients with a prior anterior myocardial infarction or their spouse/companion but did provide more reassurance to the patients without increasing anxiety for spouse/companions. PMID:20362722

  12. [Analysis of the results of the SEIMC External Quality Control Program. Year 2012].

    PubMed

    de Gopegui Bordes, Enrique Ruiz; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

    2014-02-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2012 controls. As a whole, the results obtained in 2012 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests.

  13. [Analysis of the results of the SEIMC External Quality Control Program. Year 2014].

    PubMed

    Gopegui Bordes, Enrique Ruiz de; Guna Serrano, M Del Remedio; Orta Mira, Nieves; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

    2016-07-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2014 controls. As a whole, the results obtained in 2014 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of the SEIMC program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests.

  14. [Analysis of the results of the SEIMC External Quality Control Program. Year 2008].

    PubMed

    Serrano, María del Remedio Guna; Mira, Nieves Orta; de Gopegui, Enrique Ruiz; Ovies, María Rosario; Cardona, Concepción Gimeno; Pérez, José L

    2010-01-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria and virology. This article present the most relevant conclusions and lessons from the 2008 controls. As a whole, the results obtained in 2008 confirm the excellent skill and good technical standards of the microbiology laboratories in Spain found in previous editions. However, a few deviations can be obtained in any laboratory, even in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal an external controls in order to assure the maximal quality of the microbiological tests.

  15. [Analysis of the results of the SEIMC External Quality Control Program. Year 2009].

    PubMed

    de Gopegui Bordes, Enrique Ruiz; del Remedio Guna Serrano, M; Orta Mira, Nieves; Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción; Pérez, José L

    2011-03-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. In this article, the most important conclusions and lessons from the 2009 controls are presented. As a whole, the results obtained in 2009 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls in order to ensure maximal quality of microbiological tests.

  16. A Screening Assessment of the Potential Impacts of Climate Change on the Costs of Implementing Water Quality-Based Effluent Limits at Publicly-Owned Treatment Works (Potws) in the Great Lakes Region (External Review Draft)

    EPA Science Inventory

    EPA has released this draft document solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agency policy ...

  17. A Screening Assessment of the Potential Impacts of Climate Change on the Costs of Implementing Water Quality-Based Effluent Limits at Publicly-Owned Treatment Works (Potws) in the Great Lakes Region (External Review Draft)

    EPA Science Inventory

    EPA has released this draft document solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agency policy ...

  18. The evolution of external quality evaluation: observations from the Joint Commission on Accreditation of Healthcare Organizations.

    PubMed

    Schyve, P M

    2000-06-01

    The Joint Commission on Accreditation of Healthcare Organizations, the oldest health care accrediting body in the world, currently accredits almost 20000 organizations in the USA. Although continuing to be professionally-sponsored, accreditation's rapid growth in recent years has been driven by the external users of accreditation--government, purchasers, and public--rather than by the original users, the professionals themselves. This experience in the USA suggests that over time successful external quality evaluation mechanisms throughout the world will involve representatives of the public, purchasers, and government in establishing standards and setting policies. Without this involvement, these stakeholders are unlikely to find the mechanisms credible in addressing their needs, and will seek alternatives--adding cost and duplication to the external quality evaluation system. Successful mechanisms are also likely to provide more detailed information about an organization's performance to the public, purchasers, and the government, while creating evaluation processes that provide for innovation and support improvement in efficiency, as well as quality, through incorporation of aspects of the Baldrige and European Foundation for Quality Management approaches to organizational excellence. Finally, successful evaluation mechanisms are likely to create a special focus on the safety of care, incorporating aspects of the International Organization for Standardization's ISO 9000 approach to quality management. While the specific nature, priority, and timing of these changes will differ from country to country, they are likely to influence the evolution of external quality evaluation throughout the world. External evaluation of health care organizations' quality holds great promise, but its long-term success depends on responding to all those who will want to depend on it.

  19. A Network Approach to Curriculum Quality Assessment

    ERIC Educational Resources Information Center

    Jordens, J. Zoe; Zepke, Nick

    2009-01-01

    This paper argues for an alternative approach to quality assurance in New Zealand universities that locates evaluation not with external auditors but with members of the teaching team. In the process, aspects of network theories are introduced as the basis for an approach to quality assurance. From this, the concept of networks is extended to…

  20. A Network Approach to Curriculum Quality Assessment

    ERIC Educational Resources Information Center

    Jordens, J. Zoe; Zepke, Nick

    2009-01-01

    This paper argues for an alternative approach to quality assurance in New Zealand universities that locates evaluation not with external auditors but with members of the teaching team. In the process, aspects of network theories are introduced as the basis for an approach to quality assurance. From this, the concept of networks is extended to…

  1. 77 FR 36534 - Third External Review Draft Integrated Science Assessment for Ozone and Related Photochemical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... AGENCY Third External Review Draft Integrated Science Assessment for Ozone and Related Photochemical... External Review Draft Integrated Science Assessment for Ozone and Related Photochemical Oxidants'' (EPA/600... Standards (NAAQS) for ozone. EPA is releasing this draft document to seek review by the Clean Air...

  2. Co-Certification: A New Direction for External Assessment?

    ERIC Educational Resources Information Center

    Newbold, David

    2009-01-01

    The major European testing agencies have calibrated their exams to the levels of language proficiency described in the Common European Framework (CEFR). In Italy, where the Framework has been enthusiastically embraced, external exams are now frequently used within the state education system as they are believed to provide reliable, widely…

  3. Internal and External Ethnic Assessments in Eastern Europe

    ERIC Educational Resources Information Center

    Ahmed, Patricia; Feliciano, Cynthia; Emigh, Rebecca Jean

    2007-01-01

    Survey data for majority and minority ethnicities in Bulgaria, Hungary, Romania and Russia illustrate how internal ethnic identification and other social characteristics influence external ethnic classification. Logistic regressions show how interviewers use negative social characteristics (poverty, low education) to classify respondents as Roma…

  4. Still Balancing Improvement and Accountability? Developments in External Quality Assurance in the Nordic Countries 1996-2006

    ERIC Educational Resources Information Center

    Dano, Trine; Stensaker, Bjorn

    2007-01-01

    The role and function of external quality assurance is of great importance for the development of an internal quality culture in higher education. Research has shown that external quality assurance can stimulate but also create obstacles for institutional improvement. To strike a balance between improvement and accountability is, therefore, a key…

  5. Quality control program for the Hanford External Dosimetry thermoluminescent processing system

    SciTech Connect

    Baumgartner, W.V.; Endres, A.W.; Reese, S.R.

    1992-09-01

    The Hanford External Dosimetry Program is operated by Pacific Northwest Laboratory for the US Department of Energy (DOE). The program records official external occupational radiation doses for all Hanford Site employees and visitors in compliance with DOE Order requirements. This report documents the quality control (QC) program for External Dosimetry's thermoluminescent dosimeter (TLD) processing system. The focus of the External Dosimetry Program has been (1) to accurately calculate personnel radiation doses, and (2) to document the methods used to report doses in order, to meet DOE Laboratory Accreditation Program (DOELAP) criteria. The purpose of this report is to describe the QC procedures used for dosimeters and processing equipment. Use of QC procedures allows for the prompt correction of unusual data before it is reported.

  6. Quality control program for the Hanford External Dosimetry thermoluminescent processing system

    SciTech Connect

    Baumgartner, W.V.; Endres, A.W.; Reese, S.R.

    1992-09-01

    The Hanford External Dosimetry Program is operated by Pacific Northwest Laboratory for the US Department of Energy (DOE). The program records official external occupational radiation doses for all Hanford Site employees and visitors in compliance with DOE Order requirements. This report documents the quality control (QC) program for External Dosimetry`s thermoluminescent dosimeter (TLD) processing system. The focus of the External Dosimetry Program has been (1) to accurately calculate personnel radiation doses, and (2) to document the methods used to report doses in order, to meet DOE Laboratory Accreditation Program (DOELAP) criteria. The purpose of this report is to describe the QC procedures used for dosimeters and processing equipment. Use of QC procedures allows for the prompt correction of unusual data before it is reported.

  7. External Quality Arrangements for the Review of Modern Apprenticeship Off-the-Job Training

    ERIC Educational Resources Information Center

    Education Scotland, 2015

    2015-01-01

    This publication provides a quality framework to provide a structure for external review of Modern Apprenticeship off-the-job training.? The indicators in this framework are arranged under three key principles, addressing five questions which Education Scotland is adopting for evaluation purposes. These are underpinned by a wider principle on the…

  8. AIR QUALITY CRITERIA FOR PARTICULATE MATTER, VOLUMES I-III, (EXTERNAL REVIEW DRAFT, 1995)

    EPA Science Inventory

    There is no abstract available for these documents.

    If further information is requested, please refer to the bibliographic citation and contact the Technical Information Staff at the number listed above.

    • Air Quality Criteria for Particulate Matter, Volume I, Extern...

    • Air Quality Criteria for Ozone and Related Photochemical Oxidants (First External Review Draft)

      EPA Science Inventory

      This first external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants (Ozone Criteria Document) is being released in January 2005 for public comment and for review by EPA's Clean A...

    • Air Quality Criteria for Ozone and Related Photochemical Oxidants (First External Review Draft)

      EPA Science Inventory

      This first external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants (Ozone Criteria Document) is being released in January 2005 for public comment and for review by EPA's Clean A...

    • Air Quality Criteria for Ozone and Related Photochemical Oxidants (Second External Review Draft)

      EPA Science Inventory

      This second external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants, Volumes I-III (Ozone Criteria Document) is being released for public comment and for review by EPA's Clean Air Scientific Advisory Committee (CASAC) r...

    • Air Quality Criteria for Ozone and Related Photochemical Oxidants (Second External Review Draft)

      EPA Science Inventory

      This second external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants, Volumes I-III (Ozone Criteria Document) is being released for public comment and for review by EPA's Clean Air Scientific Advisory Committee (CASAC) r...

    • 42 CFR 438.354 - Qualifications of external quality review organizations.

      Code of Federal Regulations, 2014 CFR

      2014-10-01

      ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review..., policies, data systems, and processes; (ii) Managed care delivery systems, organizations, and financing... relationships. (ii) Deliver any health care services to Medicaid beneficiaries; (iii) Conduct, on the State's...

    • 42 CFR 438.354 - Qualifications of external quality review organizations.

      Code of Federal Regulations, 2010 CFR

      2010-10-01

      ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review..., policies, data systems, and processes; (ii) Managed care delivery systems, organizations, and financing... other State entity must be governed by a Board or similar body the majority of whose members are...

    • Quality of life effects of automatic external defibrillators in the home: results from the Home Automatic External Defibrillator Trial (HAT).

      PubMed

      Mark, Daniel B; Anstrom, Kevin J; McNulty, Steven E; Flaker, Greg C; Tonkin, Andrew M; Smith, Warren M; Toff, William D; Dorian, Paul; Clapp-Channing, Nancy E; Anderson, Jill; Johnson, George; Schron, Eleanor B; Poole, Jeanne E; Lee, Kerry L; Bardy, Gust H

      2010-04-01

      Public access automatic external defibrillators (AEDs) can save lives, but most deaths from out-of-hospital sudden cardiac arrest occur at home. The Home Automatic External Defibrillator Trial (HAT) found no survival advantage for adding a home AED to cardiopulmonary resuscitation (CPR) training for 7,001 patients with a prior anterior wall myocardial infarction. Quality of life (QOL) outcomes for both the patient and spouse/companion were secondary end points. A subset of 1,007 study patients and their spouse/companions was randomly selected for ascertainment of QOL by structured interview at baseline and 12 and 24 months after enrollment. The primary QOL measures were the Medical Outcomes Study 36-Item Short-Form psychological well-being (reflecting anxiety and depression) and vitality (reflecting energy and fatigue) subscales. For patients and spouse/companions, the psychological well-being and vitality scales did not differ significantly between those randomly assigned an AED plus CPR training and controls who received CPR training only. None of the other QOL measures collected showed a clinically and statistically significant difference between treatment groups. Patients in the AED group were more likely to report being extremely or quite a bit reassured by their treatment assignment. Spouse/companions in the AED group reported being less often nervous about the possibility of using AED/CPR treatment than those in the CPR group. Adding access to a home AED to CPR training did not affect QOL either for patients with a prior anterior myocardial infarction or their spouse/companion but did provide more reassurance to the patients without increasing anxiety for spouse/companions. Copyright 2010 Mosby, Inc. All rights reserved.

    • Higher Education Quality Assessment Model: Towards Achieving Educational Quality Standard

      ERIC Educational Resources Information Center

      Noaman, Amin Y.; Ragab, Abdul Hamid M.; Madbouly, Ayman I.; Khedra, Ahmed M.; Fayoumi, Ayman G.

      2017-01-01

      This paper presents a developed higher education quality assessment model (HEQAM) that can be applied for enhancement of university services. This is because there is no universal unified quality standard model that can be used to assess the quality criteria of higher education institutes. The analytical hierarchy process is used to identify the…

    • Higher Education Quality Assessment Model: Towards Achieving Educational Quality Standard

      ERIC Educational Resources Information Center

      Noaman, Amin Y.; Ragab, Abdul Hamid M.; Madbouly, Ayman I.; Khedra, Ahmed M.; Fayoumi, Ayman G.

      2017-01-01

      This paper presents a developed higher education quality assessment model (HEQAM) that can be applied for enhancement of university services. This is because there is no universal unified quality standard model that can be used to assess the quality criteria of higher education institutes. The analytical hierarchy process is used to identify the…

    • Photographic Analysis Technique for Assessing External Tank Foam Loss Events

      NASA Technical Reports Server (NTRS)

      Rieckhoff, T. J.; Covan, M.; OFarrell, J. M.

      2001-01-01

      A video camera and recorder were placed inside the solid rocket booster forward skirt in order to view foam loss events over an area on the external tank (ET) intertank surface. In this Technical Memorandum, a method of processing video images to allow rapid detection of permanent changes indicative of foam loss events on the ET surface was defined and applied to accurately count, categorize, and locate such events.

    • Assessing Discriminative Performance at External Validation of Clinical Prediction Models

      PubMed Central

      Nieboer, Daan; van der Ploeg, Tjeerd; Steyerberg, Ewout W.

      2016-01-01

      Introduction External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting. Methods We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1) the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2) the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury. Results The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples) and heterogeneous in scenario 2 (in 17%-39% of simulated samples). Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2. Conclusion The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect

    • Assessing Discriminative Performance at External Validation of Clinical Prediction Models.

      PubMed

      Nieboer, Daan; van der Ploeg, Tjeerd; Steyerberg, Ewout W

      2016-01-01

      External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting. We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1) the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2) the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury. The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples) and heterogeneous in scenario 2 (in 17%-39% of simulated samples). Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2. The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect regression coefficients.

  1. External Quality Assessment of stat test intralaboratory turnaround times. Pilot study from the Members of the Working Group for the Standardization and Promotion of Turnaround Time Control under the Auspices of the Comitato Italiano per la Standardizzazione dei Metodi Ematologici e di Laboratorio.

    PubMed

    Negri, M; Carraro, P; Caenaro, G; Cappelletti, P; Giavarina, D; Mezzena, G; Prandini, B; Rampoldi, E; Siviero, F

    1998-11-01

    We describe procedures, results and prospects of a pilot program in External Quality Assessment (EQA) of the stat test intralaboratory turnaround times. Our goals are to promote quality by systematic monitoring and comparison of performances by laboratories, continuous investigation into the state of the art of the processes from receipt of sample to transmission of results and creation of a data base for standardization of measures and definition of consensus values for turnaround time. Of 30 laboratories invited to participate, 25 took part, agreeing to record times of arrival and transmission for all determinations of three analytes (blood hemoglobin, serum/plasma potassium and plasma prothrombin time) for seven consecutive days and to continue for one or more further periods of seven days as necessary if there were less than 300 determinations for each analyte. Within a preset time limit, data were sent by e-mail on an Excel file and we sent back two reports per analyte, showing: i) the graph for time vs. percentage of tests completed and several measures of turnaround time; ii) results of all laboratories in graph form, allowing each laboratory to identify only its own data. The high proportion of participating laboratories among those invited (83%) encourages us to implement the EQA program systematically, on a half-yearly basis, extending it to all laboratories wishing to participate in Italy or elsewhere in Europe.

  2. [Analysis of the results of the SEIMC External Quality Control Program, 2007].

    PubMed

    Guna Serrano, María del Remedio; Orta Mira, Nieves; Ovies, María; Gimeno Cardona, Concepción; Pérez, José L

    2008-11-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most important conclusions and lessons drawn from the 2007 controls. As a whole, the results obtained in 2007 confirm the excellent skill and good technical standards found in previous years. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. A few deviations were observed in some controls, calling for critical reflection. Once again, the results of this program highlighted the need to complement internal with external controls, such as those offered by the SEIMC program.

  3. Carbon Nanotube Material Quality Assessment

    NASA Technical Reports Server (NTRS)

    Yowell, Leonard; Arepalli, Sivaram; Sosa, Edward; Niolaev, Pavel; Gorelik, Olga

    2006-01-01

    The nanomaterial activities at NASA Johnson Space Center focus on carbon nanotube production, characterization and their applications for aerospace systems. Single wall carbon nanotubes are produced by arc and laser methods. Characterization of the nanotube material is performed using the NASA JSC protocol developed by combining analytical techniques of SEM, TEM, UV-VIS-NIR absorption, Raman, and TGA. A possible addition of other techniques such as XPS, and ICP to the existing protocol will be discussed. Changes in the quality of the material collected in different regions of the arc and laser production chambers is assessed using the original JSC protocol. The observed variations indicate different growth conditions in different regions of the production chambers.

  4. Development of Handling Qualities Criteria for Rotorcraft with Externally Slung Loads

    NASA Technical Reports Server (NTRS)

    Hoh, Roger H.; Heffley, Robert K.; Mitchell, David G.

    2006-01-01

    Piloted simulations were performed on the NASA-Ames Vertical Motion Simulator (VMS) to explore handling qualities issues for large cargo helicopters, particularly focusing on external slung load operations. The purpose of this work was based upon the need to include handling qualities criteria for cargo helicopters in an upgrade to the U.S. Army's rotorcraft handling qualities specification, Aeronautical Design Standard-33 (ADS-33E-PRF). From the VMS results, handling qualities criteria were developed fro cargo helicopters carrying external slung loads in the degraded visual environment (DVE). If satisfied, these criteria provide assurance that the handling quality rating (HQR) will be 4 or better for operations in the DVE, and with a load mass ratio of 0.33 or less. For lighter loads, flying qualities were found to be less dependent on the load geometry and therefore the significance of the criteria is less. For heavier loads, meeting the criteria ensures the best possible handling qualities, albeit Level 2 for load mass ratios greater than 0.33.

  5. Second external quality assurance study for the serological diagnosis of hantaviruses in Europe.

    PubMed

    Escadafal, Camille; Avšič-Županc, Tatjana; Vapalahti, Olli; Niklasson, Bo; Teichmann, Anette; Niedrig, Matthias; Donoso-Mantke, Oliver

    2012-01-01

    Hantaviruses are endemic throughout the world and hosted by rodents and insectivores. Two human zoonoses, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS), are caused by hantaviruses and case fatality rates have reached 12% for HFRS and 50% for HPS in some outbreaks. Symptomatic hantavirus infections in Europe are summarised as HFRS mainly due to Puumala, Dobrava-Belgrade and Saaremaa virus. While HFRS has an overall low incidence in Europe, the number of cases varies from 100 per year in all Eastern and Southern Europe up to 1,000 per year only in Finland. To assess the quality of hantavirus diagnostics, the European Network for the Diagnostics of "Imported" Viral Diseases (ENIVD) organised a first external quality assurance (EQA) in 2002. The purpose of this second EQA study is to collect updated information on the efficiency and accurateness of hantavirus serological methods applied by expert laboratories. A serum panel of 14 samples was sent to 28 participants in Europe of which 27 sent results. Performance in hantavirus diagnosis varied not only on the method used but also on the laboratories and the subclass of antibodies tested. Commercial and in-house assays performed almost equally. Enzyme immunoassays were mainly used but did not show the best performances while immunoblot assays were the less employed and showed overall better performances. IgM antibodies were not detected in 61% of the positive IgM samples and IgM detection was not performed by 7% of the laboratories indicating a risk of overlooking acute infections in patients. Uneven performances using the same method is indicating that there is still a need for improving testing conditions and standardizing protocols.

  6. Differences between self-assessment and external rating of voice with regard to sex characteristics, age, and attractiveness.

    PubMed

    Sandmann, Katja; am Zehnhoff-Dinnesen, Antoinette; Schmidt, Claus-Michael; Rosslau, Ken; Lang-Roth, Ruth; Burgmer, Markus; Knief, Arne; Matulat, Peter; Vauth, Melanie; Deuster, Dirk

    2014-01-01

    This study investigates differences between the self-assessment and external rating of a person's voice with regard to sex characteristics, age, and attractiveness of the voice and mean fundamental frequency (F0). Cross-sectional study. A group of 47 participants with a balanced sex distribution was recruited and the following data were collected: videostroboscopy, voice range profile, F0, self-assessment questionnaire (attractiveness, masculinity or femininity of voice, and appearance), Voice Handicap Index, and questionnaires to determine levels of depression and quality of life. External rating was performed by four experts and four laymen. In both sexes, fair to moderate significant correlations between the self-assessment of masculinity (men)/femininity (women) of voice and masculinity/femininity of appearance could be found, but not between the self-assessment of attractiveness of voice and appearance. In men, a statistically significant correlation was found between external ratings and self-assessment of attractiveness and, with the exception of the female rating group, of masculinity. In women, self-assessment of femininity and attractiveness of voice did not correlate to a statistically significant extent with the evaluation of the external rater. Additionally, the statistical correlation between estimated and real ages was high. Although the objective parameters of age and gender identification could be rated with a high degree of accuracy, subjective parameters showed significant differences between self-assessment and external rating, in particular in rating women's voices. Taking these findings into account in treatments for modifying voice could impede successful interventions. As one consequence, we recommend summarizing target agreements in detail before the treatment. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  7. Nonpoint sources as external threats to coastal water quality: lessons from Park Service experience

    USGS Publications Warehouse

    Burroughs, R.H.

    1993-01-01

    Program design for nonpoint source control was considered through an analogous problem, external threats to national parks. Nonpoint sources are diffuse land activities that degrade water quality, and recent federal legislation seeks to limit them in coastal areas. External threats occur outside a park boundary but affect the purposes for, or resources within, a park. They have been subject to federal management for many decades. Nonpoint sources are a class of external threat. Therefore, programs to limit them should consider techniques used in part protection. These park techniques include 'hard approaches', which rely on power, usually through legal devices, and 'soft approaches', which utilize shared values and objectives. A linked approach, as exemplified at the Cape Cod National Seashore, appears most promising. In a linked approach, if a soft approach fails, the manager of the protected unit is empowered to take an alternative hard action to protect the resource.

  8. Risk assessment of external events in nuclear facilities.

    PubMed

    Rogani, Antonia; Tabet, Eugenio

    2004-01-01

    After the Chernobyl accident, a National Emergency Plan of protective measures for radiological emergencies has been set up in Italy to cope with nuclear risks which require actions at national level. Since the Italian nuclear power plants are, at present, not operational, the most relevant nuclear risk source identified in the National Emergency Plan is related to an accident occurring in a nuclear power plant near the Italian borders. However, risks related to severe accidents to other nuclear facilities present in Italy, such as provisional radioactive waste deposits or research centers are not taken into account in the Plan. In this paper the hypothetical radiological impact of a severe external event in a spent fuel storage pool has been evaluated, as this event appears to be one of those with the most severe consequences.

  9. Quality Assessment in Mexican Higher Education.

    ERIC Educational Resources Information Center

    Zorilla, Juan Fidel

    1998-01-01

    Examines the results of Mexico's quality-oriented higher-education policies, in place since 1984 and designed to encourage improved faculty performance through economic incentives. The policies were enhanced further in the mid-1990s by establishing medium-term improvement strategies and using external evaluators and international experience to…

  10. [Analysis of the results of the SEIMC External Quality Control Program. Year 2011].

    PubMed

    Ruiz de Gopegui Bordes, Enrique; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

    2013-02-01

    The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica [SEIMC]) includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2011 controls. Overall, the results obtained in 2011 confirm the excellent skill and good technical standards found in previous years. Nevertheless, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls, such as those offered by the SEIMC program, in order to ensure maximal quality of microbiological tests. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  11. The Logic of the Thai Higher Education Sector on Quality Assessment Policy

    ERIC Educational Resources Information Center

    Sae-Lao, Rattana

    2013-01-01

    Although the concept of quality has been an essential part of the higher education sector, the global quest for Quality Assessment (QA hereafter) has raised attention to quality to a new level. Van Vught and Westerheijden (1994) argue that the common charateristics of QA policy include: meta-level organization to conduct external evaluation,…

  12. The Logic of the Thai Higher Education Sector on Quality Assessment Policy

    ERIC Educational Resources Information Center

    Sae-Lao, Rattana

    2013-01-01

    Although the concept of quality has been an essential part of the higher education sector, the global quest for Quality Assessment (QA hereafter) has raised attention to quality to a new level. Van Vught and Westerheijden (1994) argue that the common charateristics of QA policy include: meta-level organization to conduct external evaluation,…

  13. Towards Quality Assessment in an EFL Programme

    ERIC Educational Resources Information Center

    Ali, Holi Ibrahim Holi; Al Ajmi, Ahmed Ali Saleh

    2013-01-01

    Assessment is central in education and the teaching-learning process. This study attempts to explore the perspectives and views about quality assessment among teachers of English as a Foreign Language (EFL), and to find ways of promoting quality assessment. Quantitative methodology was used to collect data. To answer the study questions, a…

  14. Key components of external facilitation in an acute stroke quality improvement collaborative in the Veterans Health Administration.

    PubMed

    Bidassie, Balmatee; Williams, Linda S; Woodward-Hagg, Heather; Matthias, Marianne S; Damush, Teresa M

    2015-05-14

    Facilitation is a key component for successful implementation in several implementation frameworks; however, there is a paucity of research specifying this component. As part of a stroke quality improvement intervention in the Veterans Health Administration (VHA), facilitation plus data feedback was compared to data feedback alone in 11 VA medical facilities. The objective of this study was to elucidate upon the facilitation components of the stroke quality improvement. We conducted a secondary evaluation of external facilitation using semi-structured interviews. Five facilitators and two program directors were interviewed. Qualitative analysis was performed on transcribed interviews to gain an understanding of the role and activities of external facilitators during the on-site and telephone facilitation. Quantitative frequencies were calculated from the self-reported time spent in facilitation tasks by facilitators. The external facilitators saw their role as empowering the clinical teams to take ownership of the process changes at the clinical sites to improve their performance quality. To fulfill this role, they reported engaging in a number of core tasks during telephone and on-site visits including: assessing the context in which the teams were currently operating, guiding the clinical teams through their planned changes and use of process improvement tools, identifying resources and making referrals, holding teams accountable for plan implementation with on-site visits, and providing support and encouragement to the teams. Time spent in facilitation activities changed across time from guiding change (early) to supporting efforts made by the clinical teams (later). Facilitation activity transitioned to more monitoring, problem solving, and intentional work to hand over the clinical improvement process to the site teams with the coach's role being increasingly that of a more distant consultant. Overall, this study demonstrated that external facilitation is not

  15. Healthcare quality maturity assessment model based on quality drivers.

    PubMed

    Ramadan, Nadia; Arafeh, Mazen

    2016-04-18

    Purpose - Healthcare providers differ in their readiness and maturity levels regarding quality and quality management systems applications. The purpose of this paper is to serve as a useful quantitative quality maturity-level assessment tool for healthcare organizations. Design/methodology/approach - The model proposes five quality maturity levels (chaotic, primitive, structured, mature and proficient) based on six quality drivers: top management, people, operations, culture, quality focus and accreditation. Findings - Healthcare managers can apply the model to identify the status quo, quality shortcomings and evaluating ongoing progress. Practical implications - The model has been incorporated in an interactive Excel worksheet that visually displays the quality maturity-level risk meter. The tool has been applied successfully to local hospitals. Originality/value - The proposed six quality driver scales appear to measure healthcare provider maturity levels on a single quality meter.

  16. The Spanish external quality assessment scheme for lead in blood.

    PubMed

    Marcuello, D

    1996-01-01

    In 1985 the Instituto Nacional de Seguridad e Higiene en el Trabajo (INSHT) established the "Programa Interlaboratorios de Control de Calidad de Plomo en Sangre (PICC-PbS)". The operation of this scheme is explained, criteria for evaluation of laboratory performance are defined and some results obtained are reviewed.

  17. The Spanish external quality assessment scheme for mercury in urine.

    PubMed

    Quintana, M J; Mazarrasa, O

    1996-01-01

    In 1986 the Instituto Nacional de Seguridad e Higiene en el Trabajo (INSHT), established the "Programa interlaboratorios de control de calidad de mercurio en orina (PICC-HgU)". The operation of this scheme is explained, criteria for evaluation of laboratory performance are defined and some results obtained are reviewed. Since the scheme started, an improvement in the overall performance of laboratories has been observed. The differences in the analytical methods used by laboratories do not seem to have a clear influence on the results.

  18. Assessment and Quality Social Studies

    ERIC Educational Resources Information Center

    Savage, Tom V.

    2003-01-01

    Those anonymous individuals who develop high-stakes tests by which educational quality is measured exercise great influence in defining educational quality. In this article, the author examines the impact of high-stakes testing on the welfare of the children and the quality of social studies instruction. He presents the benefits and drawbacks of…

  19. 49 CFR 192.925 - What are the requirements for using External Corrosion Direct Assessment (ECDA)?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Corrosion Direct Assessment (ECDA)? 192.925 Section 192.925 Transportation Other Regulations Relating to... External Corrosion Direct Assessment (ECDA)? (a) Definition. ECDA is a four-step process that combines... corrosion to the integrity of a pipeline. (b) General requirements. An operator that uses direct assessment...

  20. 49 CFR 192.925 - What are the requirements for using External Corrosion Direct Assessment (ECDA)?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Corrosion Direct Assessment (ECDA)? 192.925 Section 192.925 Transportation Other Regulations Relating to... External Corrosion Direct Assessment (ECDA)? (a) Definition. ECDA is a four-step process that combines... corrosion to the integrity of a pipeline. (b) General requirements. An operator that uses direct assessment...

  1. 49 CFR 192.925 - What are the requirements for using External Corrosion Direct Assessment (ECDA)?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Corrosion Direct Assessment (ECDA)? 192.925 Section 192.925 Transportation Other Regulations Relating to... External Corrosion Direct Assessment (ECDA)? (a) Definition. ECDA is a four-step process that combines... corrosion to the integrity of a pipeline. (b) General requirements. An operator that uses direct assessment...

  2. Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory.

    PubMed

    Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; de Souza, Nadja Lindany Alves; Amaral, Rita Goreti

    2014-09-01

    To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

  3. [External quality assurance of the first wave of the German Health Interview and Examination Survey for Adults (DEGS1)].

    PubMed

    Pelz, I; Pohlabeln, H; Reineke, A; Ahrens, W

    2013-05-01

    The quality management concept for the first wave of the German Health Interview and Examination Survey for Adults (DEGS1) included in addition to conducting internal quality assurance (QS) also the supervision by an external independent institute. After a restricted tendering procedure, the Leibniz Institute for Prevention Research and Epidemiology-BIPS was commissioned to conduct the external quality assurance. The external quality control included the review of the operation manuals, the training of the field staff, the execution of field work (including measurements), and the monitoring of sampling, response and data management. For the realization of the controls in these areas, test criteria were developed to reveal shortcomings early and to give recommendations for the internal quality assurance. This paper briefly describes the concept and the execution of the accompanying external quality assurance with regard to the above mentioned areas. An English full-text version of this article is available at SpringerLink as supplemental.

  4. Friendship Quality, Peer Group Affiliation, and Peer Antisocial Behavior as Moderators of the Link Between Negative Parenting and Adolescent Externalizing Behavior

    PubMed Central

    Lansford, Jennifer E.; Criss, Michael M.; Pettit, Gregory S.; Dodge, Kenneth A.; Bates, John E.

    2009-01-01

    Quality of peer relationships and perceived peer antisocial behavior were examined as moderators of the link between negative parenting and externalizing behavior problems in school from middle childhood to early adolescence. Data on negative parenting (i.e., unilateral parental decision making, low supervision and awareness, and harsh discipline) were collected from 362 parents in the summer preceding the adolescents’ entry into Grade 6. Adolescent reports of positive peer relationships and peer antisocial behavior were assessed in the winter of Grade 7. The outcome measure was teacher report of adolescent externalizing behavior in the spring of Grade 7, controlling for externalizing behavior in Grade 5. High levels of friendship quality and peer group affiliation attenuated the association between unilateral parental decision making and adolescent externalizing behavior in school; this was particularly true when adolescents associated with peers perceived to be low in antisocial behavior. In addition, having low-quality peer relationships and having peers perceived to be highly antisocial further amplified the association between unilateral parental decision making and adolescent externalizing behavior problems. Finally, high levels of friend and peer group antisocial behavior exacerbated the predictiveness of harsh discipline for adolescents’ externalizing behavior. PMID:20209019

  5. AIR QUALITY CRITERIA FOR LEAD, VOLUMES 1-4. (1983) FIRST EXTERNAL REVIEW DRAFT

    EPA Science Inventory

    The document evaluates and assesses scientific information on the health and welfare effects associated with exposure to various concentrations of lead in ambient air. The literature through 1983 has been reviewed thoroughly for information relevant to air quality criteria, altho...

  6. AIR QUALITY CRITERIA FOR LEAD, VOLUMES 1-4. (1983) FIRST EXTERNAL REVIEW DRAFT

    EPA Science Inventory

    The document evaluates and assesses scientific information on the health and welfare effects associated with exposure to various concentrations of lead in ambient air. The literature through 1983 has been reviewed thoroughly for information relevant to air quality criteria, altho...

  7. Assessing Quality in Home Visiting Programs

    ERIC Educational Resources Information Center

    Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

    2013-01-01

    Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

  8. Assessing quality in volcanic ash soils

    Treesearch

    Terry L. Craigg; Steven W. Howes

    2007-01-01

    Forest managers must understand how changes in soil quality resulting from project implementation affect long-term productivity and watershed health. Volcanic ash soils have unique properties that affect their quality and function; and which may warrant soil quality standards and assessment techniques that are different from other soils. We discuss the concept of soil...

  9. Assessing Quality in Home Visiting Programs

    ERIC Educational Resources Information Center

    Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

    2013-01-01

    Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

  10. Different configurations of laser vibrometry for quality control of electric motors with external rotor

    NASA Astrophysics Data System (ADS)

    Chiariotti, P.; Ciarmatori, R.; Castellini, P.; Bastari, A.; Paone, N.

    2012-06-01

    When designing a test bench for vibration based diagnostics of machines with external rotating parts, such as electric motors having a rotating external rotor, one may choose among single point vibrometry, rotational vibrometry or in-plane vibrometry. The paper discusses these different options, taking the assumption that the minimum number of measuring instruments is preferred when instrumenting a quality control system and provides an insight into advantages and limitations of each instrument. In particular the following issues are discussed: a) possible installation lay-outs; b) alignment problems (and possible advantages for diagnostics), c) typical signals and diagnostic features which can be observed. The research presented refers to electric motors for home appliances, but potentially has wider application fields to other rotating machines.

  11. Assessing the Quality of Teachers' Teaching Practices

    ERIC Educational Resources Information Center

    Chen, Weiyun; Mason, Stephen; Staniszewski, Christina; Upton, Ashley; Valley, Megan

    2012-01-01

    This study assessed the extent to which nine elementary physical education teachers implemented the quality of teaching practices. Thirty physical education lessons taught by the nine teachers to their students in grades K-5 were videotaped. Four investigators coded the taped lessons using the Assessing Quality Teaching Rubric (AQTR) designed and…

  12. Assessing the Quality of Teachers' Teaching Practices

    ERIC Educational Resources Information Center

    Chen, Weiyun; Mason, Stephen; Staniszewski, Christina; Upton, Ashley; Valley, Megan

    2012-01-01

    This study assessed the extent to which nine elementary physical education teachers implemented the quality of teaching practices. Thirty physical education lessons taught by the nine teachers to their students in grades K-5 were videotaped. Four investigators coded the taped lessons using the Assessing Quality Teaching Rubric (AQTR) designed and…

  13. The Benefits of Internalizing Air Quality and Greenhouse Gas Externalities in the US Energy System

    NASA Astrophysics Data System (ADS)

    Brown, Kristen E.

    The emission of pollutants from energy use has effects on both local air quality and the global climate, but the price of energy does not reflect these externalities. This study aims to analyze the effect that internalizing these externalities in the cost of energy would have on the US energy system, emissions, and human health. In this study, we model different policy scenarios in which fees are added to emissions related to generation and use of energy. The fees are based on values of damages estimated in the literature and are applied to upstream and combustion emissions related to electricity generation, industrial energy use, transportation energy use, residential energy use, and commercial energy use. The energy sources and emissions are modeled through 2055 in five-year time steps. The emissions in 2045 are incorporated into a continental-scale atmospheric chemistry and transport model, CMAQ, to determine the change in air quality due to different emissions reduction scenarios. A benefit analysis tool, BenMAP, is used with the air quality results to determine the monetary benefit of emissions reductions related to the improved air quality. We apply fees to emissions associated with health impacts, climate change, and a combination of both. We find that the fees we consider lead to reductions in targeted emissions as well as co-reducing non-targeted emissions. For fees on the electric sector alone, health impacting pollutant (HIP) emissions reductions are achieved mainly through control devices while Greenhouse Gas (GHG) fees are addressed through changes in generation technologies. When sector specific fees are added, reductions come mainly from the industrial and electricity generation sectors, and are achieved through a mix of energy efficiency, increased use of renewables, and control devices. Air quality is improved in almost all areas of the country with fees, including when only GHG fees are applied. Air quality tends to improve more in regions with

  14. Assessment of the effective dose equivalent for external photon radiation

    SciTech Connect

    Reece, W.D.; Poston, J.W.; Xu, X.G. )

    1993-02-01

    Beginning in January 1994, US nuclear power plants must change the way that they determine the radiation exposure to their workforce. At that time, revisions to Title 10 Part 20 of the Code of Federal Regulations will be in force requiring licensees to evaluate worker radiation exposure using a risk-based methodology termed the effective dose equivalent.'' A research project was undertaken to improve upon the conservative method presently used for assessing effective dose equivalent. In this project effective dose equivalent was calculated using a mathematical model of the human body, and tracking photon interactions for a wide variety of radiation source geometries using Monte Carlo computer code simulations. Algorithms were then developed to relate measurements of the photon flux on the surface of the body (as measured by dosimeters) to effective dose equivalent. This report (Volume I of a two-part study) describes: the concept of effective dose equivalent, the evolution of the concept and its incorporation into regulations, the variations in human organ susceptibility to radiation, the mathematical modeling and calculational techniques used, the results of effective dose equivalent calculations for a broad range of photon energiesand radiation source geometries. The study determined that for beam radiation sources the highest effective dose equivalent occurs for beams striking the front of the torso. Beams striking the rear of the torsoproduce the next highest effective dose equivalent, with effective dose equivalent falling significantly as one departs from these two orientations. For point sources, the highest effective dose equivalent occurs when the sources are in contact with the body on the front of the torso. For females the highest effective dose equivalent occurs when the source is on the sternum, for males when it is on the gonads.

  15. On the Roles of External Knowledge Representations in Assessment Design. CSE Report 722

    ERIC Educational Resources Information Center

    Mislevy, Robert J.; Behrens, John T.; Bennett, Randy E.; Demark, Sarah F.; Frezzo, Dennis C.; Levy, Roy; Robinson, Daniel H.; Rutstein, Daisy Wise; Shute, Valerie J.; Stanley, Ken; Winters, Fielding I.

    2007-01-01

    People use external knowledge representations (EKRs) to identify, depict, transform, store, share, and archive information. Learning how to work with EKRs is central to becoming proficient in virtually every discipline. As such, EKRs play central roles in curriculum, instruction, and assessment. Five key roles of EKRs in educational assessment are…

  16. 49 CFR 192.925 - What are the requirements for using External Corrosion Direct Assessment (ECDA)?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Corrosion Direct Assessment (ECDA)? 192.925 Section 192.925 Transportation Other Regulations Relating to... External Corrosion Direct Assessment (ECDA)? (a) Definition. ECDA is a four-step process that combines... corrosion to the integrity of a pipeline. (b) General requirements. An operator that uses direct...

  17. 49 CFR 192.925 - What are the requirements for using External Corrosion Direct Assessment (ECDA)?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Corrosion Direct Assessment (ECDA)? 192.925 Section 192.925 Transportation Other Regulations Relating to... External Corrosion Direct Assessment (ECDA)? (a) Definition. ECDA is a four-step process that combines... corrosion to the integrity of a pipeline. (b) General requirements. An operator that uses direct...

  18. Consistency of Report Card Grades and External Assessments in a Canadian Province

    ERIC Educational Resources Information Center

    Ross, John A.; Kostuch, Lynn

    2011-01-01

    The study investigated how well report card grades communicate to students and parents that state educational standards are being met, standards that are objectively measured by infrequently administered mandated assessments. Data sources were report card grades and external assessment scores for 2006-09 for Ontario Canada. The information that…

  19. The effects of alterations in the osseous external auditory canal on perceived sound quality.

    PubMed

    van Spronsen, Erik; Brienesse, Patrick; Ebbens, Fenna A; Waterval, Jerome J; Dreschler, Wouter A

    2015-10-01

    To evaluate the perceptual effect of the altered shape of the osseous external auditory canal (OEAC) on sound quality. Prospective study. Twenty subjects with normal hearing were presented with six simulated sound conditions representing the acoustic properties of six different ear canals (three normal ears and three cavities). The six different real ear unaided responses of these ear canals were used to filter Dutch sentences, resulting in six simulated sound conditions. A seventh unfiltered reference condition was used for comparison. Sound quality was evaluated using paired comparison ratings and a visual analog scale (VAS). Significant differences in sound quality were found between the normal and cavity conditions (all P < .001) using both the seven-point paired comparison rating and the VAS. No significant differences were found between the reference and normal conditions. Sound quality deteriorates when the OEAC is altered into a cavity. This proof of concept study shows that the altered acoustic quality of the OEAC after radical cavity surgery may lead to a clearly perceived deterioration in sound quality. Nevertheless, some questions remain about the extent to which these changes are affected by habituation and by other changes in middle ear anatomy and functionality. 4 © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  20. We Can't Go Home Again: Insights from a Quarter Century of Experiments in External Academic Quality Assurance

    ERIC Educational Resources Information Center

    Dill, David D.

    2010-01-01

    What have we learned from 25 years of experience with external academic quality assurance that can help design more effective framework conditions for assuring academic standards? The key elements appear to be the structure and means of evaluating national academic quality assurance agencies, the nature of academic quality information mandated by…

  1. We Can't Go Home Again: Insights from a Quarter Century of Experiments in External Academic Quality Assurance

    ERIC Educational Resources Information Center

    Dill, David D.

    2010-01-01

    What have we learned from 25 years of experience with external academic quality assurance that can help design more effective framework conditions for assuring academic standards? The key elements appear to be the structure and means of evaluating national academic quality assurance agencies, the nature of academic quality information mandated by…

  2. [Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

    PubMed

    Petzold, Thomas; Steinwitz, Adrienne; Schmitt, Jochen; Eberlein-Gonska, Maria

    2013-01-01

    Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of

  3. [External quality assurance in inpatient medical rehabilitation and prevention centers for mothers, fathers and children: comparative outcome quality analyses across rehabilitation/prevention centers].

    PubMed

    Lukasczik, M; Gerlich, C; Musekamp, G; Saupe-Heide, M; Löbmann, R; Vogel, H; Neuderth, S

    2014-01-01

    To date, there are no programs for external quality assurance for inpatient prevention and rehabilitation programs for mothers, fathers and children. Instruments for outcome quality assessment were evaluated with the goal of determining their ability to document differences between prevention/rehabilitation centers in quality-relevant outcome parameters. Referring to the ICF, relevant outcome variables were specified and operationalized using established questionnaires. Data from 45 inpatient prevention and rehabilitation centers for mothers, fathers and children were analyzed using multilevel modeling with risk adjustment. Intra-class correlations were computed to determine in which parameters differences between institutions could be found. The percentage of variability accounted for by patient vs. institution characteristics was computed while statistically controlling for relevant confounders. For prevention centers, substantial variation on the institutional level was found in 9 out of 15 parameters. Almost all institutions did not deviate significantly from the grand mean of the respective parameter. For rehabilitation centers, significant variability was found in 2 out of 10 parameters. The differences between most institutions remained within a range of expectable variability. The results imply that comparative analyses across hospitals are better suited to identify institutions with low quality rather than establish quality-based rankings of institutions. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

    PubMed

    Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

    2014-07-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines.

  5. Quality of life and satisfaction with information after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy: a long-term follow-up study.

    PubMed

    Nicolaisen, Marianne; Müller, Stig; Patel, Hitendra R H; Hanssen, Tove Aminda

    2014-12-01

    To assess patients' symptoms, quality of life and satisfaction with information three to four years after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy and to analyse differences between treatment groups and the relationship between disease-specific, health-related and overall quality of life and satisfaction with information. Radical prostate cancer treatments are associated with changes in quality of life. Differences between patients undergoing different treatments in symptoms and quality of life have been reported, but there are limited long-term data comparing radical prostatectomy with radical external beam radiotherapy and postoperative radiotherapy. A cross-sectional survey design was used. The study sample included 143 men treated with radical prostatectomy and/or radical external beam radiotherapy. Quality of life was measured using the 12-item Short Form Health Survey and the 50-item Expanded Prostate Cancer Index Composite Instrument. Questions assessing overall Quality of life and satisfaction with information were included. Descriptive statistics and interference statistical methods were applied to analyse the data. Radical external beam radiotherapy was associated with less urinary incontinence and better urinary function. There were no differences between the groups for disease-specific quality of life sum scores. Sexual quality of life was reported very low in all groups. Disease-specific quality of life and health-related quality of life were associated with overall quality of life. Patients having undergone surgery were more satisfied with information, and there was a positive correlation between quality of life and patient satisfaction. Pretreatment information and patient education lead to better quality of life and satisfaction. This study indicates a need for structured, pretreatment information and follow-up for all men going through radical prostate cancer treatment. Long-term quality of life

  6. Quality assessment of fructus psoraleae.

    PubMed

    Qiao, Chun-Feng; Han, Quan-Bin; Song, Jing-Zheng; Mo, Shi-Fu; Kong, Ling-Dong; Kung, Hsiang-Fu; Xua, Hong-Xi

    2006-06-01

    Two newly-reported benzofuran glycosides, named psoralenoside and isopsoralenoside, along with two major coumarins, psoralen and isopsoralen, were simultaneously determined in twenty-three samples of Fructus Psoraleae collected from different growth areas in China. The quantitative method was validated, and the mean recovery rates from fortified samples (n=5) of psoralenoside, isopsoralenoside, psoralen and isopsoralen, were 96.5%, 97.1%, 100.7%, and 99.3% with variation coefficient of 3.1%, 3.6%, 2.3%, and 2.2%, respectively. An interesting biotransformation relationship between the glycosides and the coumarins was revealed on the basis of the quality analysis results. It was also suggested that psoralenoside and isopsoralenoside should be used as key quality markers for Fructus Psoraleae, together with the commonly used psoralen and isopsoralen.

  7. Tools to assess tissue quality.

    PubMed

    Neumeister, Veronique M

    2014-03-01

    Biospecimen science has recognized the importance of tissue quality for accurate molecular and biomarker analysis and efforts are made to standardize tissue procurement, processing and storage conditions of tissue samples. At the same time the field has emphasized the lack of standardization of processes between different laboratories, the variability inherent in the analytical phase and the lack of control over the pre-analytical phase of tissue processing. The problem extends back into tissue samples in biorepositories, which are often decades old and where documentation about tissue processing might not be available. This review highlights pre-analytical variations in tissue handling, processing, fixation and storage and emphasizes the effects of these variables on nucleic acids and proteins in harvested tissue. Finally current tools for quality control regarding molecular or biomarker analysis are summarized and discussed.

  8. Assessing quality in Earth Science Education

    NASA Astrophysics Data System (ADS)

    Rollinson, Hugh

    1999-05-01

    Quality is an elusive concept — hard to define, but you recognise it when you come across it. This paper reviews the meaning of quality as applied in Higher Education and shows that there are, of necessity, a number of workable definitions of quality in Higher Education. The assessment of quality in Earth Science Higher Education in England during 1994-1995 is described. A number of general features of quality in Earth Sciences Education are drawn from this case study and the future direction of quality assurance is mapped. Three principles drawn from the definitions of quality and from the English teaching quality assessment exercise are applied to Earth Science Education in Africa. It is argued that different definitions of quality will apply in different societal contexts in Africa and that these may be used to shape the relevance of Geoscience Education. Increasing mobility of labour means that comparability of academic standards between African countries within a region is desirable and should be worked for. Finally, research in the UK shows that teaching quality is not necessarily dependent upon the size or research potential of a department, indicating that Africa can deliver high quality Earth Science Education.

  9. External quality assurance performance of clinical research laboratories in sub-saharan Africa.

    PubMed

    Amukele, Timothy K; Michael, Kurt; Hanes, Mary; Miller, Robert E; Jackson, J Brooks

    2012-11-01

    Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

  10. Assessing quality across healthcare subsystems in Mexico.

    PubMed

    Puig, Andrea; Pagán, José A; Wong, Rebeca

    2009-01-01

    Recent healthcare reform efforts in Mexico have focused on the need to improve the efficiency and equity of a fragmented healthcare system. In light of these reform initiatives, there is a need to assess whether healthcare subsystems are effective at providing high-quality healthcare to all Mexicans. Nationally representative household survey data from the 2006 Encuesta Nacional de Salud y Nutrición (National Health and Nutrition Survey) were used to assess perceived healthcare quality across different subsystems. Using a sample of 7234 survey respondents, we found evidence of substantial heterogeneity in healthcare quality assessments across healthcare subsystems favoring private providers over social security institutions. These differences across subsystems remained even after adjusting for socioeconomic, demographic, and health factors. Our analysis suggests that improvements in efficiency and equity can be achieved by assessing the factors that contribute to heterogeneity in quality across subsystems.

  11. Pesticide Environmental Accounting: a method for assessing the external costs of individual pesticide applications.

    PubMed

    Leach, A W; Mumford, J D

    2008-01-01

    The Pesticide Environmental Accounting (PEA) tool provides a monetary estimate of environmental and health impacts per hectare-application for any pesticide. The model combines the Environmental Impact Quotient method and a methodology for absolute estimates of external pesticide costs in UK, USA and Germany. For many countries resources are not available for intensive assessments of external pesticide costs. The model converts external costs of a pesticide in the UK, USA and Germany to Mediterranean countries. Economic and policy applications include estimating impacts of pesticide reduction policies or benefits from technologies replacing pesticides, such as sterile insect technique. The system integrates disparate data and approaches into a single logical method. The assumptions in the system provide transparency and consistency but at the cost of some specificity and precision, a reasonable trade-off for a method that provides both comparative estimates of pesticide impacts and area-based assessments of absolute impacts.

  12. Assessing Quality in Digital Reference Services.

    ERIC Educational Resources Information Center

    Lankes, R. David; Mcclure, Charles R.; Gross, Melissa

    2001-01-01

    Outlines a study to develop methods to assess the quality of digital reference services, test and refine measures and quality standards to describe digital reference services, and to produce a guidebook that describes how to collect and report data for these measures and standards. (Author/AEF)

  13. Quality Assessment in the Blog Space

    ERIC Educational Resources Information Center

    Schaal, Markus; Fidan, Guven; Muller, Roland M.; Dagli, Orhan

    2010-01-01

    Purpose: The purpose of this paper is the presentation of a new method for blog quality assessment. The method uses the temporal sequence of link creation events between blogs as an implicit source for the collective tacit knowledge of blog authors about blog quality. Design/methodology/approach: The blog data are processed by the novel method for…

  14. Quality Assessment for a University Curriculum.

    ERIC Educational Resources Information Center

    Hjalmered, Jan-Olof; Lumsden, Kenth

    1994-01-01

    In 1992, a national quality assessment report covering courses in all the Swedish schools of mechanical engineering was presented. This article comments on the general ideas and specific proposals presented, and offers an analysis of the consequences. Presents overall considerations regarding quality issues, the philosophy behind the new…

  15. Quality Assessment in the Blog Space

    ERIC Educational Resources Information Center

    Schaal, Markus; Fidan, Guven; Muller, Roland M.; Dagli, Orhan

    2010-01-01

    Purpose: The purpose of this paper is the presentation of a new method for blog quality assessment. The method uses the temporal sequence of link creation events between blogs as an implicit source for the collective tacit knowledge of blog authors about blog quality. Design/methodology/approach: The blog data are processed by the novel method for…

  16. Perceptual Quality Assessment of Screen Content Images.

    PubMed

    Yang, Huan; Fang, Yuming; Lin, Weisi

    2015-11-01

    Research on screen content images (SCIs) becomes important as they are increasingly used in multi-device communication applications. In this paper, we present a study on perceptual quality assessment of distorted SCIs subjectively and objectively. We construct a large-scale screen image quality assessment database (SIQAD) consisting of 20 source and 980 distorted SCIs. In order to get the subjective quality scores and investigate, which part (text or picture) contributes more to the overall visual quality, the single stimulus methodology with 11 point numerical scale is employed to obtain three kinds of subjective scores corresponding to the entire, textual, and pictorial regions, respectively. According to the analysis of subjective data, we propose a weighting strategy to account for the correlation among these three kinds of subjective scores. Furthermore, we design an objective metric to measure the visual quality of distorted SCIs by considering the visual difference of textual and pictorial regions. The experimental results demonstrate that the proposed SCI perceptual quality assessment scheme, consisting of the objective metric and the weighting strategy, can achieve better performance than 11 state-of-the-art IQA methods. To the best of our knowledge, the SIQAD is the first large-scale database published for quality evaluation of SCIs, and this research is the first attempt to explore the perceptual quality assessment of distorted SCIs.

  17. Assessing Quality in Digital Reference Services.

    ERIC Educational Resources Information Center

    Lankes, R. David; Mcclure, Charles R.; Gross, Melissa

    2001-01-01

    Outlines a study to develop methods to assess the quality of digital reference services, test and refine measures and quality standards to describe digital reference services, and to produce a guidebook that describes how to collect and report data for these measures and standards. (Author/AEF)

  18. Michigan lakes: An assessment of water quality

    USGS Publications Warehouse

    Minnerick, R.J.

    2004-01-01

    Michigan has more than 11,000 inland lakes, that provide countless recreational opportunities and are an important resource that makes tourism and recreation a $15-billion-dollar per-year industry in the State (Stynes, 2002). Knowledge of the water-quality characteristics of inland lakes is essential for the current and future management of these resources.Historically the U. S. Geological Survey (USGS) and the Michigan Department of Environmental Quality (MDEQ) jointly have monitored water quality in Michigan's lakes and rivers. During the 1990's, however, funding for surface-water-quality monitoring was reduced greatly. In 1998, the citizens of Michigan passed the Clean Michigan Initiative to clean up, protect, and enhance Michigan's environmental infrastructure. Because of expanding water-quality-data needs, the MDEQ and the USGS jointly redesigned and implemented the Lake Water-Quality Assessment (LWQA) Monitoring Program (Michigan Department of Environmental Quality, 1997).

  19. Assessing the Viability of External Searchable Resources on the American Board of Family Medicine's Certification Examination

    ERIC Educational Resources Information Center

    O'Neill, Thomas R.; Peabody, Michael R.; Stelter, Keith L.; Hagen, Michael D.

    2015-01-01

    (Purpose) The purpose of our study was to assess the need for an external searchable resource to be used in conjunction with the American Board of Family Medicine's (ABFM) Maintenance of Certification for Family Physicians (MC-FP) Examination, discuss the philosophical question of whether an ESR should be allowed on the examination, and outline…

  20. Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria (First External Review Draft, 2013)

    EPA Science Inventory

    EPA is announcing the availability of the First External Review Draft of the Integrated Science Assessment for Oxides of Nitrogen – Health Criteria for public comment and independent peer review. This draft document provides EPA’s evaluation and synthesis of the most polic...

  1. Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria (First External Review Draft, 2007)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and eva...

  2. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (First External Review Draft, Sep 2007)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluatio...

  3. Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria (Second External Review Draft, 2008)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation...

  4. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (Second External Review Draft, May 2008)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluati...

  5. Assessing Curriculum: An Internal and External Review with an Emphasis on Student Work.

    ERIC Educational Resources Information Center

    Hines, Jean D.; Albanese, Carolyn A.; Brown, Robert

    1999-01-01

    An interior-design program was evaluated internally by faculty and externally by a review team. The assessment focused both on student work and on the program and resources. Differences in the two evaluations confirmed the importance of outside evaluators' perspectives for program improvement. (SK)

  6. Integrated Science Assessment (ISA) for Particulate Matter (First External Review Draft, Dec 2008)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Particulate Matter and related Annexes have been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and e...

  7. Integrated Science Assessment (ISA) for Carbon Monoxide (First External Review Draft, Mar 2009)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of th...

  8. Integrated Science Assessment (ISA) for Carbon Monoxide (Second External Review Draft, Sep 2009)

    EPA Science Inventory

    EPA announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of t...

  9. Integrated Science Assessment (ISA) for Particulate Matter (Second External Review Draft, Jul 2009)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Particulate Matter (PM) have been made available for independent peer review and public review. The ISA reflects the latest scientific knowledge useful in indicating the kind...

  10. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (Second External Review Draft, Sep 2011)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Second External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant scienc...

  11. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (First External Review Draft, Feb 2011)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment for Ozone and Related Photochemical Oxidants has been made available for independent peer review and public review. This draft document represents a concise synthesis and evaluation of ...

  12. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (Third External Review Draft, Jun 2012)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Third External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant science...

  13. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (External Review Draft, Nov 2015)

    EPA Science Inventory

    EPA announced the availability of the external review draft of the Integrated Science Assessment for Sulfur Oxides– Health Criteria for public comment and independent peer review in a November 24, 2015 Federal Register Notice. This draft document provides EPA’s evaluati...

  14. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (Third External Review Draft, Jun 2012)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Third External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant science...

  15. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (Second External Review Draft, Sep 2011)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Second External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant scienc...

  16. Integrated Science Assessment (ISA) of Ozone and Related Photochemical Oxidants (First External Review Draft, Feb 2011)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment for Ozone and Related Photochemical Oxidants has been made available for independent peer review and public review. This draft document represents a concise synthesis and evaluation of ...

  17. Integrated Science Assessment (ISA) for Lead (First External Review Draft, May 2011)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) was made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science and will ...

  18. Integrated Science Assessment (ISA) for Lead (Second External Review Draft, Mar 2012)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) has been made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science...

  19. Integrated Science Assessment (ISA) for Lead (Third External Review Draft, Nov 2012)

    EPA Science Inventory

    EPA announced that the Third External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) was made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science and will ...

  20. Integrated Science Assessment of Ozone and Related Photochemical Oxidants (First External Review Draft)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment for Ozone and Related Photochemical Oxidants has been made available for independent peer review and public review. This draft document represents a concise synthesis and evaluation of ...

  1. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (Second External Review Draft, 2008)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation...

  2. Report of the Michigan Educational Assessment Program's External Advisory Panel on Evaluation.

    ERIC Educational Resources Information Center

    Anderson, Beverly; And Others

    This report is an evaluation of the Michigan Educational Assessment Program (MEAP) done by an external advisory panel. Panelists were selected in terms of availability and complementary skills. The program was evaluated by the Shepard method which consists of a checklist grouped into the areas of goals and purposes, technical aspects, management,…

  3. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (First External Review Draft, 2013)

    EPA Science Inventory

    EPA is announcing the availability of the First External Review Draft of the Integrated Science Assessment for Oxides of Nitrogen – Health Criteria for public comment and independent peer review. This draft document provides EPA’s evaluation and synthesis of the most polic...

  4. Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Second External Review Draft)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Second External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant scienc...

  5. Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Third External Review Draft)

    EPA Science Inventory

    EPA has released the Integrated Science Assessment of Ozone and Related Photochemical Oxidants (Third External Review Draft) for independent peer review and public review. This draft document represents a concise synthesis and evaluation of the most policy-relevant science...

  6. Integrated Science Assessment (ISA) for Lead (Third External Review Draft, Nov 2012)

    EPA Science Inventory

    EPA announced that the Third External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) was made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science and will ...

  7. Integrated Science Assessment (ISA) for Carbon Monoxide (First External Review Draft, Mar 2009)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of th...

  8. Integrated Science Assessment (ISA) for Lead (Second External Review Draft, Mar 2012)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) has been made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science...

  9. Integrated Science Assessment (ISA) for Particulate Matter (First External Review Draft, Dec 2008)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Particulate Matter and related Annexes have been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and e...

  10. Integrated Science Assessment (ISA) for Lead (First External Review Draft, May 2011)

    EPA Science Inventory

    EPA announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Lead (Pb) was made available for independent peer review and public review. This draft ISA represents a concise synthesis and evaluation of the most policy-relevant science and will ...

  11. Integrated Science Assessment (ISA) for Carbon Monoxide (Second External Review Draft, Sep 2009)

    EPA Science Inventory

    EPA announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of t...

  12. Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria (First External Review Draft, 2013)

    EPA Science Inventory

    EPA is announcing the availability of the First External Review Draft of the Integrated Science Assessment for Oxides of Nitrogen – Health Criteria for public comment and independent peer review. This draft document provides EPA’s evaluation and synthesis of the most polic...

  13. Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria (External Review Draft, Nov 2015)

    EPA Science Inventory

    EPA announced the availability of the external review draft of the Integrated Science Assessment for Sulfur Oxides– Health Criteria for public comment and independent peer review in a November 24, 2015 Federal Register Notice. This draft document provides EPA’s evaluati...

  14. Integrated Science Assessment (ISA) for Particulate Matter (Second External Review Draft, Jul 2009)

    EPA Science Inventory

    EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Particulate Matter (PM) have been made available for independent peer review and public review. The ISA reflects the latest scientific knowledge useful in indicating the kind...

  15. Integrated Science Assessment for Oxides of Nitrogen – Health Criteria (First External Review Draft, 2007)

    EPA Science Inventory

    EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Oxides of Nitrogen – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and eva...

  16. Comparability of antimicrobial susceptibility test results from 22 European countries and Israel: an external quality assurance exercise of the European Antimicrobial Resistance Surveillance System (EARSS) in collaboration with the United Kingdom National External Quality Assurance Scheme (UK NEQAS).

    PubMed

    Bronzwaer, S; Buchholz, U; Courvalin, P; Snell, J; Cornaglia, G; de Neeling, A; Aubry-Damon, H; Degener, J

    2002-12-01

    The goal of this exercise was to organize external quality assurance (QA) of antibiotic susceptibility testing for laboratories participating in EARSS and to assess the comparability of susceptibility test results across countries, and guidelines. In September 2000, UK NEQAS distributed a set of three Streptococcus pneumoniae strains, two Staphylococcus aureus strains and one Streptococcus haemolyticus strain. Laboratories reported the guideline followed, the interpretation of the susceptibility test result and the MIC, if tested. In this study we considered results 'concordant' if the reported interpretation of the participating laboratory agreed with the designated interpretation of reference laboratories. Overall, 433 (92%) of 471 laboratories from 23 countries reported back. Of the 8685 tests that were assessed, 8322 (96%) were interpreted correctly by the participants. Concordance for detection of penicillin non-susceptibility in the three S. pneumoniae strains was 96%, 90% and 87%, respectively. Laboratories performed extremely well in detecting oxacillin resistance in the homogeneously methicillin-resistant S. aureus (MRSA) strain, but the concordance rate dropped from 100% to 77% in the heterogeneously resistant MRSA strain. Concordance for detection of teicoplanin resistance in the S. haemolyticus strain was 82%. We stratified concordance rates first for country and then for guideline used, but observed only minor differences among countries and guidelines. Quantitative methods yielding an MIC were more concordant than non-MIC methods for penicillin resistance in the S. pneumoniae strains (94% versus 79%). The NCCLS guideline was the most frequently followed, by 61% of laboratories from 19 countries. This exercise shows that, overall, countries participating in EARSS are capable of delivering susceptibility data of good quality. The comparability of susceptibility data for penicillin resistance in S. pneumoniae and for homogeneous methicillin resistance in

  17. ANSS Backbone Station Quality Assessment

    NASA Astrophysics Data System (ADS)

    Leeds, A.; McNamara, D.; Benz, H.; Gee, L.

    2006-12-01

    In this study we assess the ambient noise levels of the broadband seismic stations within the United States Geological Survey's (USGS) Advanced National Seismic System (ANSS) backbone network. The backbone consists of stations operated by the USGS as well as several regional network stations operated by universities. We also assess the improved detection capability of the network due to the installation of 13 additional backbone stations and the upgrade of 26 existing stations funded by the Earthscope initiative. This assessment makes use of probability density functions (PDF) of power spectral densities (PSD) (after McNamara and Buland, 2004) computed by a continuous noise monitoring system developed by the USGS- ANSS and the Incorporated Research Institutions in Seismology (IRIS) Data Management Center (DMC). We compute the median and mode of the PDF distribution and rank the stations relative to the Peterson Low noise model (LNM) (Peterson, 1993) for 11 different period bands. The power of the method lies in the fact that there is no need to screen the data for system transients, earthquakes or general data artifacts since they map into a background probability level. Previous studies have shown that most regional stations, instrumented with short period or extended short period instruments, have a higher noise level in all period bands while stations in the US network have lower noise levels at short periods (0.0625-8.0 seconds), high frequencies (8.0- 0.125Hz). The overall network is evaluated with respect to accomplishing the design goals set for the USArray/ANSS backbone project which were intended to increase broadband performance for the national monitoring network.

  18. Determinants of Quality Perception in Educational Administration: Potential Conflict between the Requirements of Internal and External Customers.

    ERIC Educational Resources Information Center

    Galloway, R. L.; Wearn, Katrina

    1998-01-01

    Attempts to measure perceived quality, based on customers' views within the context of a (British) university faculty office, using a modified SERVQUAL instrument. Internal customers demonstrated that perceived quality is driven by task-focused issues, stressing clarity, accuracy, and reliability. External customers, whose usage is more casual,…

  19. Determinants of Quality Perception in Educational Administration: Potential Conflict between the Requirements of Internal and External Customers.

    ERIC Educational Resources Information Center

    Galloway, R. L.; Wearn, Katrina

    1998-01-01

    Attempts to measure perceived quality, based on customers' views within the context of a (British) university faculty office, using a modified SERVQUAL instrument. Internal customers demonstrated that perceived quality is driven by task-focused issues, stressing clarity, accuracy, and reliability. External customers, whose usage is more casual,…

  20. Guidelines for External Reviews of Quality Assurance Agencies in the European Higher Education Area. ENQA Occasional Papers 19

    ERIC Educational Resources Information Center

    ENQA (European Association for Quality Assurance in Higher Education), 2012

    2012-01-01

    In accordance with the ENQA (European Association for Quality Assurance in Higher Education) membership criteria laid down in the Statutes of ENQA, member agencies are required to undergo external reviews against the membership criteria, and thereby the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) as…

  1. Water quality assessment in Ecuador

    SciTech Connect

    Chudy, J.P.; Arniella, E.; Gil, E.

    1993-02-01

    The El Tor cholera pandemic arrived in Ecuador in March 1991, and through the course of the year caused 46,320 cases, of which 692 resulted in death. Most of the cases were confined to cities along Ecuador's coast. The Water and Sanitation for Health Project (WASH), which was asked to participate in the review of this request, suggested that a more comprehensive approach should be taken to cholera control and prevention. The approach was accepted, and a multidisciplinary team consisting of a sanitary engineer, a hygiene education specialist, and an institutional specialist was scheduled to carry out the assessment in late 1992 following the national elections.

  2. Cropland CEAP soil quality assessment update

    USDA-ARS?s Scientific Manuscript database

    One goal for the USDA cropland Conservation Effects Assessment Project (CEAP) was to assess the effects of various conservation practices on soil quality, which is a proactive process for quantifying the long-term impact of crop and soil management practices within agricultural watersheds. Our objec...

  3. National External Quality Assurance Program Pakistan (NEQAPP) –A Milestone in Proficiency Testing in Pakistan

    PubMed Central

    Ijaz, Aamir

    2016-01-01

    Objective The objective of this study was to highlight current status and importance of National External Quality Assurance Program Pakistan (NEQAPP). Study Design: Cross sectional study Place and duration of study Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) from August to October 2015. Methods The study data was extracted from electronic NEQAPP database. Results from 2014-2015 were evaluated for clinical chemistry, hematology, microbiology, and immunoassay programs. Frequencies of unsatisfactory results of individual analytes as well as of all the participating laboratories were calculated. Results Failure rate of newly enrolled laboratories were more as compared to those which were participating for the last two years. The percentages of unsatisfactory results of all laboratories were 19% and 15% in 2014 and 2015, respectively. Fifteen analytes were selected according to their increasing percentage of participation. Failure rate was highest for alkaline phosphatase (35%) followed by creatinine (22%) and urea (20%) in two years analysis. Performance of laboratories in each quarter was evaluated depending upon number of analytes in which they fail to pass. The major failures were due to clerical and technical errors as determined during data compilation of results. Conclusion There is an increase in trend of participating in NEQAPP by health care laboratories which is a step towards laboratory quality management system in Pakistan. Nonetheless, there is a need for improving quality of laboratory results. PMID:28149266

  4. Assessment of chances for external stress corrosion cracking in submarine pipelines

    SciTech Connect

    Mollan, R.; Eliassen, S.; Holt, T.; Ratkje, S.K.

    1982-11-08

    The possibility for stress corrosion cracking due to external environments to occur in submarine pipelines can not be excluded. The probability for stress corrosion to occur in submarine pipelines, however, considered to be for onshore pipelines mainly because calcareous deposits are expected to prevent buildup of the corrosive environment. Also the fact that the quality of surface preparation prior to coating for submarine pipelines normally is of a relatively high standard, contributes to reduce the probability for stresscorrosion cracking to occur.

  5. [Quality analysis by external users of the non-medical health transport unit of Alicante].

    PubMed

    Soriano Clemor, C; Cano, F Soriano; Gimeno, F Morant

    2011-01-01

    Non-medical health transport has great health, media and social repercussions and requires a very considerable amount of human and economic resources. To describe the quality, evaluated by external users of our Health Department, in order to know what are the most important elements for external users. Cross-sectional, descriptive observational study. Population to study: patients with a social security health card who come to the Hospital of Alicante and are non-medical health transport unit users. Waiting time to be delivered to hospital in 92.7% of the cases was less than an hour, and was between one and two hours for 7.2%. The most frequent destinations were rehabilitation service and outpatient clinics. When users were asked if the would recommend this service, 60.9% said "for sure" and 39.1% said "probably yes". This study allows us to know patient needs and expectations, as well as the factors they value the most and which of our work areas to improve. Copyright © 2009 SECA. Published by Elsevier Espana. All rights reserved.

  6. Dominant hand position improves the quality of external chest compression: a manikin study based on 2010 CPR guidelines.

    PubMed

    Jiang, Cheng; Jiang, Shan; Zhao, Yan; Xu, Bing; Zhou, Xian-long

    2015-04-01

    The 2010 cardiopulmonary resuscitation (CPR) guidelines increased the importance of external chest compression. However, the best hand position to be the compressing one has not been identified. To investigate the effects of dominant or nondominant external chest compression hand position during CPR. Medical students performed five cycles of conventional CPR and completed one questionnaire. The CPR performances were manually evaluated, and detailed aspects of the external chest compression quality were assessed via the SimMan® Essential system (Laerdal China Ltd., Hangzhou, China). One hundred fifty-seven students participated in the nondominant hand (NH) group, and 68 students participated in the dominant hand (DH) group. The manual evaluations revealed no differences between the two groups. The proportion of chest compressions "above 100 cpm [compressions per minute]" was higher in the DH group than in the NH group (97% vs. 92%, respectively, p = 0.002). The frequency distributions of the chest compression rates were also significantly different between the two groups (p < 0.0001). The distribution of the NH group was concentrated within "130-139" cpm, whereas this distribution was concentrated within "140-149" cpm in the DH group. The chest compression depth of the DH group was deeper than that of the NH group (p = 0.001). The depth of the fifth cycle was significantly decreased compared with those of cycles 1, 2, and 3 in the NH group. A greater number of full chest recoils were observed in the NH group (p = 0.02). The dominant hand position during CPR was associated with a higher chest compression rate, a greater chest compression depth, and delayed fatigue. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. 1999 mask industry quality assessment

    NASA Astrophysics Data System (ADS)

    Grenon, Brian J.

    1999-12-01

    This paper will summarize the results of the seventh annual mask industry assessment survey. This year there were 12 respondents. The specific responses from the participants have been kept confidential by having the participants send their responses to Arthur Anderson & Company prior to data evaluation. This year we will report the following information: total shipments, total customer returns, mask survival rate, delivery performance, average throughput time and safety records. The data reported will be for the period of 3Q98 through 2Q98. Additionally, we will present any trends that may be apparent in the data. This year's participants are Align-Rite, Dai Nippon Printing, IBM Essex Junction, Photronics/Toppan Texas, Compugraphics, DuPont Photomasks, Northrup-Grumman, Infineon, Taiwan Mask Corporation (TMC), Taiwan Semiconductor Manufacturing Corporation (TSMC) and Innova. In order to maintain some consistency, the format that has been used from past years will be maintained when possible.

  8. [External quality control system in medical microbiology and parasitology in the Czech Republic].

    PubMed

    Slosárek, M; Petrás, P; Kríz, B

    2004-11-01

    The External Quality Control System (EQAS) of laboratory activities in medical microbiology and parasitology was implemented in the Czech Republic in 1993 with coded sera samples for diagnosis of viral hepatitis and bacterial strains for identification distributed to first participating laboratories. The number of sample types reached 31 in 2003 and the number of participating laboratories rised from 79 in 1993 to 421 in 2003. As many as 15.130 samples were distributed to the participating laboratories in 2003. Currently, almost all microbiology and parasitology laboratories in the Czech Republic involved in examination of clinical material participate in the EQAS. Based on the 11-year experience gained with the EQAS in the Czech Republic, the following benefits were observed: higher accuracy of results in different tests, standardisation of methods and the use of most suitable test kits.

  9. Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

    NASA Astrophysics Data System (ADS)

    Álvarez R., J. T.; Tovar M., V. M.

    2008-08-01

    A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described—for eleven 60 Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 °C plus 24 hrs 80 °C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal DW = 2 Gy ṡ c ) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gy in terms of absorbed dose to water DW for 60 Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals.

  10. The Czech External Quality Control system in medical microbiology and parasitology.

    PubMed

    Slosárek, M; Kríz, B

    2000-11-01

    The External Quality Control (EQC) system in activities of laboratories engaged in medical microbiology and parasitology was established in the Czech Republic in 1993 when to the first laboratories which applied coded serum samples were sent for diagnosis of viral hepatitis and bacterial strains for identification. In the course of years the number of control areas increased and in 2000 there were 31 and the number of those interested in participation in EQC increased from 79 in 1993 to 434 in 2000. This year a total of 13,239 samples will be sent to laboratories. Gradually thus almost all microbiological and parasitological laboratories concerned with examination of clinical material became involved. Seven-year experience with EQC in the Czech Republic revealed that gradually the results of various examinations became more accurate, that methods became standardized and the most suitable examination sets are used.

  11. [Development of external quality control protocol for CyberKnife beams dosimetry: preliminary tests multicentre].

    PubMed

    Guinement, L; Marchesi, V; Veres, A; Lacornerie, T; Buchheit, I; Peiffert, D

    2013-01-01

    To develop an external quality control procedure for CyberKnife(®) beams. This work conducted in Nancy, has included a test protocol initially drawn by the medical physicist of Nancy and Lille in collaboration with Equal-Estro Laboratory. A head and neck anthropomorphic phantom and a water-equivalent homogeneous cubic plastic test-object, so-called "MiniCube", have been used. Powder and solid thermoluminescent dosimeters as well as radiochromic films have been used to perform absolute and relative dose studies, respectively. The comparison between doses calculated by Multiplan treatment planning system and measured doses have been studied in absolute dose. The dose distributions measured with films and treatment planning system calculations have been compared via the gamma function, configured with different tolerance criteria. This work allowed, via solid thermoluminescent dosimeter measurements, verifying the beam reliability with a reproducibility of 1.7 %. The absolute dose measured in the phantom irradiated by the seven participating centres has shown an error inferior to the standard tolerance limits (± 5 %), for most of participating centres. The relative dose measurements performed at Nancy and by the Equal-Estro laboratory allowed defining the most adequate parameters for gamma index (5 %/2mm--with at least 95 % of pixels satisfying acceptability criteria: γ<1). These parameters should be independent of the film analysis software. This work allowed defining a dosimetric external quality control for CyberKnife(®) systems, based on a reproducible irradiation plan through measurements performed with thermoluminescent dosimeters and radiochromic films. This protocol should be validated by a new series of measurement and taking into account the lessons of this work. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  12. [Simultaneous Detection of External and Internal Quality Parameters of Huping Jujube Fruits using Hyperspectral Imaging Technology].

    PubMed

    Xue, Jian-xin; Zhang, Shu-juan; Zhang, Jing-jing

    2015-08-01

    Nondestructive detection of external and internal quality parameters of jujube is crucial for improving jujube's shelf life and industry production. Hyperspectral imaging is an emerging technique that integrates conventional imaging and spectroscopy to acquire both spatial and spectral information from a sample. It takes the advantages of the conventional RGB, near-infrared spectroscopy, and multi-spectral imaging. In this work, hyperspectral imaging technology covered the range of 450~1000 nm has been evaluated for nondestructive determination of "natural defects" (shrink, crack, insect damage and peck injury) and soluble solids content (SSC) in Huping jujube fruit. 400 RGB images were acquired through four different defect (50 for each stage) and normal (200) classes of the Huping jujube samples. After acquiring hyperspectral images of Huping jujube fruits, the spectral data were extracted from region of interests (ROIs). Using Kennard-Stone algorithm, all kinds of samples were randomly divided into training set (280) and test set (120) according to the proportion of 3:1. Seven principal components (PCs) were selected based on principal component analysis (PCA), and seven textural feature variables (contrast, correlation, energy, homogeneity, variance, mean and entropy) were extracted by gray level co-occurrence matrix (GLCM). The least squares support vector machine (LS-SVM) models were built based on the PCs spectral, textural, combined PCs and textural features, respectively. The satisfactory results show the correct discrimination rate of 92.5% for the prediction samples, as well as correlation coefficient (Rp) of 0.944 for the prediction set to calculate SSC content based on PCs and textural features. The study demonstrated that hyperspectral image technique can be a reliable tool to simultaneous detection of external ("natural defects") and internal (SSC) quality parameters of Huping jujube fruits, which provided a theoretical reference for nondestructive

  13. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

    PubMed

    Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

    2016-04-01

    Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

  14. Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

    PubMed Central

    Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

    2015-01-01

    Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

  15. Pinpointing Chinese Early Childhood Teachers' Professional Development Needs through Self-Evaluation and External Observation of Classroom Quality

    ERIC Educational Resources Information Center

    Hu, Bi Ying; Zhou, Yisu; Li, Kejian

    2014-01-01

    This study compared Chinese kindergarten teachers' values and perceptions of program quality with trained raters' assessments of quality in order to gain insights into effective professional development for improving teacher quality. A total of 284 Chinese kindergarten teachers self-assessed the quality of their classroom teaching and rated their…

  16. Pinpointing Chinese Early Childhood Teachers' Professional Development Needs through Self-Evaluation and External Observation of Classroom Quality

    ERIC Educational Resources Information Center

    Hu, Bi Ying; Zhou, Yisu; Li, Kejian

    2014-01-01

    This study compared Chinese kindergarten teachers' values and perceptions of program quality with trained raters' assessments of quality in order to gain insights into effective professional development for improving teacher quality. A total of 284 Chinese kindergarten teachers self-assessed the quality of their classroom teaching and rated their…

  17. Review of the Oconee-3 probabilistic risk assessment: external events, core damage frequency. Volume 2

    SciTech Connect

    Hanan, N.A.; Ilberg, D.; Xue, D.; Youngblood, R.; Reed, J.W.; McCann, M.; Talwani, T.; Wreathall, J.; Kurth, P.D.; Bandyopadhyay, K.

    1986-03-01

    A review of the Oconee-3 Probabilistic Risk Assessment (OPRA) was conducted with the broad objective of evaluating qualitatively and quantitatively (as much as possible) the OPRA assessment of the important sequences that are ''externally'' generated and lead to core damage. The review included a technical assessment of the assumptions and methods used in the OPRA within its stated objective and with the limited information available. Within this scope, BNL performed a detailed reevaluation of the accident sequences generated by internal floods and earthquakes and a less detailed review (in some cases a scoping review) for the accident sequences generated by fires, tornadoes, external floods, and aircraft impact. 12 refs., 24 figs., 31 tabs.

  18. Automatic no-reference image quality assessment.

    PubMed

    Li, Hongjun; Hu, Wei; Xu, Zi-Neng

    2016-01-01

    No-reference image quality assessment aims to predict the visual quality of distorted images without examining the original image as a reference. Most no-reference image quality metrics which have been already proposed are designed for one or a set of predefined specific distortion types and are unlikely to generalize for evaluating images degraded with other types of distortion. There is a strong need of no-reference image quality assessment methods which are applicable to various distortions. In this paper, the authors proposed a no-reference image quality assessment method based on a natural image statistic model in the wavelet transform domain. A generalized Gaussian density model is employed to summarize the marginal distribution of wavelet coefficients of the test images, so that correlative parameters are needed for the evaluation of image quality. The proposed algorithm is tested on three large-scale benchmark databases. Experimental results demonstrate that the proposed algorithm is easy to implement and computational efficient. Furthermore, our method can be applied to many well-known types of image distortions, and achieves a good quality of prediction performance.

  19. Assessing product image quality for online shopping

    NASA Astrophysics Data System (ADS)

    Goswami, Anjan; Chung, Sung H.; Chittar, Naren; Islam, Atiq

    2012-01-01

    Assessing product-image quality is important in the context of online shopping. A high quality image that conveys more information about a product can boost the buyer's confidence and can get more attention. However, the notion of image quality for product-images is not the same as that in other domains. The perception of quality of product-images depends not only on various photographic quality features but also on various high level features such as clarity of the foreground or goodness of the background etc. In this paper, we define a notion of product-image quality based on various such features. We conduct a crowd-sourced experiment to collect user judgments on thousands of eBay's images. We formulate a multi-class classification problem for modeling image quality by classifying images into good, fair and poor quality based on the guided perceptual notions from the judges. We also conduct experiments with regression using average crowd-sourced human judgments as target. We compute a pseudo-regression score with expected average of predicted classes and also compute a score from the regression technique. We design many experiments with various sampling and voting schemes with crowd-sourced data and construct various experimental image quality models. Most of our models have reasonable accuracies (greater or equal to 70%) on test data set. We observe that our computed image quality score has a high (0.66) rank correlation with average votes from the crowd sourced human judgments.

  20. Assessment of External Hazards at Radioactive Waste and Used Fuel Management Facilities - 13505

    SciTech Connect

    Gerchikov, Mark; Schneider, Glenn; Khan, Badi; Alderson, Elizabeth

    2013-07-01

    One of the key lessons from the Fukushima accident is the importance of having a comprehensive identification and evaluation of risks posed by external events to nuclear facilities. While the primary focus has been on nuclear power plants, the Canadian nuclear industry has also been updating hazard assessments for radioactive waste and used fuel management facilities to ensure that lessons learnt from Fukushima are addressed. External events are events that originate either physically outside the nuclear site or outside its control. They include natural events, such as high winds, lightning, earthquakes or flood due to extreme rainfall. The approaches that have been applied to the identification and assessment of external hazards in Canada are presented and analyzed. Specific aspects and considerations concerning hazards posed to radioactive waste and used fuel management operations are identified. Relevant hazard identification techniques are described, which draw upon available regulatory guidance and standard assessment techniques such as Hazard and Operability Studies (HAZOPs) and 'What-if' analysis. Consideration is given to ensuring that hazard combinations (for example: high winds and flooding due to rainfall) are properly taken into account. Approaches that can be used to screen out external hazards, through a combination of frequency and impact assessments, are summarized. For those hazards that cannot be screened out, a brief overview of methods that can be used to conduct more detailed hazard assessments is also provided. The lessons learnt from the Fukushima accident have had a significant impact on specific aspects of the approaches used to hazard assessment for waste management. Practical examples of the effect of these impacts are provided. (authors)

  1. Quality Management Plan for the Environmental Assessment and Innovation Division

    EPA Pesticide Factsheets

    Quality management plan (QMP) which identifies the mission, roles, responsibilities of personnel with regard to quality assurance and quality management for the environmental assessment and innovation division.

  2. Electrical Inspection Oriented Thermal Image Quality Assessment

    NASA Astrophysics Data System (ADS)

    Lin, Ying; Wang, Menglin; Gong, Xiaojin; Guo, Zhihong; Geng, Yujie; Bai, Demeng

    2017-01-01

    This paper presents an approach to access the quality of thermal images that are specially used in electrical inspection. In this application, no reference images are given for quality assessment. Therefore, we first analyze the characteristics for these thermal images. Then, four quantitative measurements, which are one-dimensional (1D) entropy, two-dimensional (2D) entropy, centrality, and No-Reference Structural Sharpness (NRSS), are investigated to measure the information content, the centrality for objects of interest, and the sharpness of images. Moreover, in order to provide a more intuitive measure for human operators, we assign each image with a discrete rate based on these quantitative measurements via the k-nearest neighbor (KNN) method. The proposed approach has been validated in a dataset composed of 2,336 images. Experiments show that our quality assessment results are consistent with subjective assessment.

  3. Impact of external industrial sources on the regional and local air quality of Mexico Megacity

    NASA Astrophysics Data System (ADS)

    Almanza, V. H.; Molina, L. T.; Li, G.; Fast, J.; Sosa, G.

    2013-10-01

    The air quality of megacities can be influenced by external emissions sources on both global and regional scale, and at the same time their outflow emissions can exert an important impact to the surrounding environment. The present study evaluates an SO2 peak observed on 24 March 2006 at the suburban supersite T1 and ambient air quality monitoring stations located in the north region of the Mexico City Metropolitan Area (MCMA) during MILAGRO campaign. We found that this peak could be related to an important episodic emission event from Tizayuca region, northeast of the MCMA. Back trajectories analyses suggest that the emission event started in the early morning at 04:00 LST and lasted for about 9 h. The estimated emission rate is noticeably high, about 2 kg s-1. This finding suggests the possibility of "overlooked" emission sources in this region that could influence the air quality of the MCMA. This further motivated us to study the cement plants, including those in the State of Hidalgo and in the State of Mexico, and we found that they can contribute in the NE region of the basin (about 41.7%), at the suburban supersite T1 (41.23%) and at some monitoring stations their contribution can be even higher than from the Tula Industrial Complex. The contribution of Tula Industrial Complex to regional ozone levels is estimated. The model suggests low contribution to the MCMA (1 ppb to 4 ppb) and slightly higher at the suburban T1 (6 ppb) and rural T2 (5 ppb) supersites. However, the contribution could be as high as 10 ppb in the upper northwest region of the basin and in the southwest and south-southeast regions of State of Hidalgo. In addition, a first estimate of the potential contribution from flaring activities to regional ozone levels is presented. Emission rates are estimated with a CFD combustion model. Results suggest that up to 30% of the total regional ozone from TIC could be related to flaring activities. Finally, the influence in SO2 levels from technological

  4. External Quality Assurance Programs Managed by the U.S. Geological Survey in Support of the National Atmospheric Deposition Program/Mercury Deposition Network

    USGS Publications Warehouse

    Latysh, Natalie E.; Wetherbee, Gregory A.

    2007-01-01

    The U.S. Geological Survey (USGS) Branch of Quality Systems operates external quality assurance programs for the National Atmospheric Deposition Program/Mercury Deposition Network (NADP/MDN). Beginning in 2004, three programs have been implemented: the system blank program, the interlaboratory comparison program, and the blind audit program. Each program was designed to measure error contributed by specific components in the data-collection process. The system blank program assesses contamination that may result from sampling equipment, field exposure, and routine handling and processing of the wet-deposition samples. The interlaboratory comparison program evaluates bias and precision of analytical results produced by the Mercury Analytical Laboratory (HAL) for the NADP/MDN, operated by Frontier GeoSciences, Inc. The HAL's performance is compared with the performance of five other laboratories. The blind audit program assesses bias and variability of MDN data produced by the HAL using solutions disguised as environmental samples to ascertain true laboratory performance. This report documents the implementation of quality assurance procedures for the NADP/MDN and the operating procedures for each of the external quality assurance programs conducted by the USGS. The USGS quality assurance information provides a measure of confidence to NADP/MDN data users that measurement variability is distinguished from environmental signals.

  5. Impact of external industrial sources on the regional and local air quality of Mexico Megacity

    NASA Astrophysics Data System (ADS)

    Almanza, Victor; Molina, Luisa T.; Li, Guohui; Fast, Jerome; Sosa, Gustavo

    2014-05-01

    The air quality of megacities can be influenced by external emissions sources on both regional and global scales. At the same time their outflow emissions can exert an important impact to the surrounding environment. The present study evaluates an SO2 peak observed on 24 March 2006 at the suburban supersite and ambient air quality monitoring stations located in the northern region of the Mexico City Metropolitan Area (MCMA) during MILAGRO campaign. We found that this peak could be related to an important episodic emission event coming from Tizayuca region, northeast of the MCMA. Back trajectories analyses suggest that the emission event started in the early morning at 04:00 LST and lasted for about 9 hours. The estimated emission rate is high, about 2 kg s-1. This finding suggests the possibility of 'overlooked' emission sources in Tizayuca region that could influence the air quality of the MCMA. This further motivated us to study the cement plants, including those in the State of Hidalgo and the State of Mexico. We found that they can also contribute SO2 in the NE region of the basin, at the suburban supersite and that at some monitoring stations; their contribution can be even higher than from the Tula Industrial Complex (TIC). The contribution of TIC to regional ozone levels is also estimated. The model suggests low contribution to the MCMA and slightly higher contribution at the suburban and rural supersites. However, the contribution could be high in the upper northwest region of the basin and in the southwest and south-southeast regions of the State of Hidalgo. In addition, a first estimate of the potential contribution from flaring activities to regional ozone levels is presented. Results suggest that part of the total regional ozone from TIC-generated precursors could be related to flaring activities.

  6. Quality and Safety in Health Care, Part XIV: The External Environment and Research for Diagnostic Processes.

    PubMed

    Harolds, Jay A

    2016-09-01

    The work system in which diagnosis takes place is affected by the external environment, which includes requirements such as certification, accreditation, and regulations. How errors are reported, malpractice, and the system for payment are some other aspects of the external environment. Improving the external environment is expected to decrease errors in diagnosis. More research on improving the diagnostic process is needed.

  7. Probabilistic Safety Assessment of External Flooding Protection for Nuclear Power Plants in Germany

    NASA Astrophysics Data System (ADS)

    Berg, Heinz Peter; Goertz, Rudolf; Froehmel, Thomas; Winter, Christian

    Methods to systematically analyse existing nuclear power plants (NPP) regarding the adequacy of their existing protection equipment against external hazards, e.g. flooding, can be of deterministic as well as probabilistic nature. In the past the adequacy of the protection measures has been assessed only on a deterministic basis. The German regulatory body has issued probabilistic safety assessment (PSA) guidelines, which had been elaborated for a comprehensive integrated safety review of all NPP in operation. Amongst others the guidelines imply, that probabilistic considerations regarding external flooding are required. This paper presents a newly developed graded approach for the probabilistic assessment of external flooding. Main aspects are explained such as the underlying probabilistic considerations and the mathematical procedures for the calculation of exceedance frequencies, which have recently been developed and issued as part of the German Nuclear Safety Standard. Exemplarily it has been investigated if extreme events such as tsunami waves could be a hazard for NPP at coastal sites in Germany. Here it could be shown that due to limited source mechanisms and the specific morphological conditions in the North Sea no dedicated measures for protection against tsunamis in the German Bight are necessary.

  8. Graphical assessment of internal and external calibration of logistic regression models by using loess smoothers.

    PubMed

    Austin, Peter C; Steyerberg, Ewout W

    2014-02-10

    Predicting the probability of the occurrence of a binary outcome or condition is important in biomedical research. While assessing discrimination is an essential issue in developing and validating binary prediction models, less attention has been paid to methods for assessing model calibration. Calibration refers to the degree of agreement between observed and predicted probabilities and is often assessed by testing for lack-of-fit. The objective of our study was to examine the ability of graphical methods to assess the calibration of logistic regression models. We examined lack of internal calibration, which was related to misspecification of the logistic regression model, and external calibration, which was related to an overfit model or to shrinkage of the linear predictor. We conducted an extensive set of Monte Carlo simulations with a locally weighted least squares regression smoother (i.e., the loess algorithm) to examine the ability of graphical methods to assess model calibration. We found that loess-based methods were able to provide evidence of moderate departures from linearity and indicate omission of a moderately strong interaction. Misspecification of the link function was harder to detect. Visual patterns were clearer with higher sample sizes, higher incidence of the outcome, or higher discrimination. Loess-based methods were also able to identify the lack of calibration in external validation samples when an overfit regression model had been used. In conclusion, loess-based smoothing methods are adequate tools to graphically assess calibration and merit wider application.

  9. Soil quality assessment under emerging regulatory requirements.

    PubMed

    Bone, James; Head, Martin; Barraclough, Declan; Archer, Michael; Scheib, Catherine; Flight, Dee; Voulvoulis, Nikolaos

    2010-08-01

    New and emerging policies that aim to set standards for protection and sustainable use of soil are likely to require identification of geographical risk/priority areas. Soil degradation can be seen as the change or disturbance in soil quality and it is therefore crucial that soil and soil quality are well understood to protect soils and to meet legislative requirements. To increase this understanding a review of the soil quality definition evaluated its development, with a formal scientific approach to assessment beginning in the 1970s, followed by a period of discussion and refinement. A number of reservations about soil quality assessment expressed in the literature are summarised. Taking concerns into account, a definition of soil quality incorporating soil's ability to meet multifunctional requirements, to provide ecosystem services, and the potential for soils to affect other environmental media is described. Assessment using this definition requires a large number of soil function dependent indicators that can be expensive, laborious, prone to error, and problematic in comparison. Findings demonstrate the need for a method that is not function dependent, but uses a number of cross-functional indicators instead. This method to systematically prioritise areas where detailed investigation is required, using a ranking based against a desired level of action, could be relatively quick, easy and cost effective. As such this has potential to fill in gaps and compliment existing monitoring programs and assist in development and implementation of current and future soil protection legislation.

  10. Retinal image quality assessment using generic features

    NASA Astrophysics Data System (ADS)

    Fasih, Mahnaz; Langlois, J. M. Pierre; Ben Tahar, Houssem; Cheriet, Farida

    2014-03-01

    Retinal image quality assessment is an important step in automated eye disease diagnosis. Diagnosis accuracy is highly dependent on the quality of retinal images, because poor image quality might prevent the observation of significant eye features and disease manifestations. A robust algorithm is therefore required in order to evaluate the quality of images in a large database. We developed an algorithm for retinal image quality assessment based on generic features that is independent from segmentation methods. It exploits the local sharpness and texture features by applying the cumulative probability of blur detection metric and run-length encoding algorithm, respectively. The quality features are combined to evaluate the image's suitability for diagnosis purposes. Based on the recommendations of medical experts and our experience, we compared a global and a local approach. A support vector machine with radial basis functions was used as a nonlinear classifier in order to classify images to gradable and ungradable groups. We applied our methodology to 65 images of size 2592×1944 pixels that had been graded by a medical expert. The expert evaluated 38 images as gradable and 27 as ungradable. The results indicate very good agreement between the proposed algorithm's predictions and the medical expert's judgment: the sensitivity and specificity for the local approach are respectively 92% and 94%. The algorithm demonstrates sufficient robustness to identify relevant images for automated diagnosis.

  11. Quality assessment: A performance-based approach to assessments

    SciTech Connect

    Caplinger, W.H.; Greenlee, W.D.

    1993-08-01

    Revision C to US Department of Energy (DOE) Order 5700.6 (6C) ``Quality Assurance`` (QA) brings significant changes to the conduct of QA. The Westinghouse government-owned, contractor-operated (GOCO) sites have updated their quality assurance programs to the requirements and guidance of 6C, and are currently implementing necessary changes. In late 1992, a Westinghouse GOCO team led by the Waste Isolation Division (WID) conducted what is believed to be the first assessment of implementation of a quality assurance program founded on 6C.

  12. Impact of physical fitness and biometric data on the quality of external chest compression: a randomised, crossover trial.

    PubMed

    Russo, Sebastian G; Neumann, Peter; Reinhardt, Sylvia; Timmermann, Arnd; Niklas, André; Quintel, Michael; Eich, Christoph B

    2011-11-04

    During circulatory arrest, effective external chest compression (ECC) is a key element for patient survival. In 2005, international emergency medical organisations changed their recommended compression-ventilation ratio (CVR) from 15:2 to 30:2 to acknowledge the vital importance of ECC. We hypothesised that physical fitness, biometric data and gender can influence the quality of ECC. Furthermore, we aimed to determine objective parameters of physical fitness that can reliably predict the quality of ECC. The physical fitness of 30 male and 10 female healthcare professionals was assessed by cycling and rowing ergometry (focussing on lower and upper body, respectively). During ergometry, continuous breath-by-breath ergospirometric measurements and heart rate (HR) were recorded. All participants performed two nine-minute sequences of ECC on a manikin using CVRs of 30:2 and 15:2. We measured the compression and decompression depths, compression rates and assessed the participants' perception of exhaustion and comfort. The median body mass index (BMI; male 25.4 kg/m2 and female 20.4 kg/m2) was used as the threshold for subgroup analyses of participants with higher and lower BMI. HR during rowing ergometry at 75 watts (HR75) correlated best with the quality of ECC (r = -0.57, p < 0.05). Participants with a higher BMI and better physical fitness performed better and showed less fatigue during ECC. These results are valid for the entire cohort, as well as for the gender-based subgroups. The compressions of female participants were too shallow and more rapid (mean compression depth was 32 mm and rate was 117/min with a CVR of 30:2). For participants with a lower BMI and higher HR75, the compression depth decreased over time, beginning after four minutes for the 15:2 CVR and after three minutes for the 30:2 CVR. Although found to be more exhausting, a CVR of 30:2 was rated as being more comfortable. The quality of the ECC and fatigue can both be predicted by BMI and physical

  13. The range of replications technique for assessing the external validity of road safety evaluation studies.

    PubMed

    Elvik, Rune

    2012-03-01

    This paper introduces a simple statistical technique that can be used to assess the external validity of road safety evaluation studies. External validity refers to the possibility of generalising the results of research to other contexts than those in which it was made. There are several aspects of external validity. Two aspects that are often of interest concern the applicability of the results of road safety evaluation studies across countries and time. Can the results of studies made in one or more countries be applied in countries where studies have not been made? Can the results of studies made many years ago still be applied? The technique introduced in this paper is designed to provide support in answering these questions. The technique evaluates the stability of research results in time and space. The technique is based on cumulative meta-analysis and produces statistics that show the consistency of study results in time and space (across countries). The range of replications denotes the span of time and countries in which studies have been made. The idea is that if the results of studies are stable throughout the range of replications, one may have greater confidence in their external validity than if the results of research vary in time and between countries. The technique is illustrated by means of numerical examples.

  14. An assessment model for quality management

    NASA Astrophysics Data System (ADS)

    Völcker, Chr.; Cass, A.; Dorling, A.; Zilioli, P.; Secchi, P.

    2002-07-01

    SYNSPACE together with InterSPICE and Alenia Spazio is developing an assessment method to determine the capability of an organisation in the area of quality management. The method, sponsored by the European Space Agency (ESA), is called S9kS (SPiCE- 9000 for SPACE). S9kS is based on ISO 9001:2000 with additions from the quality standards issued by the European Committee for Space Standardization (ECSS) and ISO 15504 - Process Assessments. The result is a reference model that supports the expansion of the generic process assessment framework provided by ISO 15504 to nonsoftware areas. In order to be compliant with ISO 15504, requirements from ISO 9001 and ECSS-Q-20 and Q-20-09 have been turned into process definitions in terms of Purpose and Outcomes, supported by a list of detailed indicators such as Practices, Work Products and Work Product Characteristics. In coordination with this project, the capability dimension of ISO 15504 has been revised to be consistent with ISO 9001. As contributions from ISO 9001 and the space quality assurance standards are separable, the stripped down version S9k offers organisations in all industries an assessment model based solely on ISO 9001, and is therefore interesting to all organisations, which intend to improve their quality management system based on ISO 9001.

  15. Water quality issues and energy assessments

    SciTech Connect

    Davis, M.J.; Chiu, S.

    1980-11-01

    This report identifies and evaluates the significant water quality issues related to regional and national energy development. In addition, it recommends improvements in the Office assessment capability. Handbook-style formating, which includes a system of cross-references and prioritization, is designed to help the reader use the material.

  16. External Quality Assurance of New Zealand Tertiary Education Providers Matters: Life Jacket or Strait-Jacket? AIR 2001 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Weir, Annie

    The reality of external academic/quality audit has arrived for all tertiary education providers in New Zealand under the umbrella of the New Zealand Qualifications Authority. This paper reviews the development over the past decade of external quality assurance of tertiary providers by quality assurance authorities and their associated bodies. The…

  17. Objective Assessment of Quality Measurement and Improvement

    PubMed Central

    Damle, Aneel; Alavi, Karim

    2014-01-01

    Accurate quality measurement that allows for and results in improvement is essential to colon and rectal surgery. Currently, no consensus exists as to which variables are most important in measuring outcomes. Debate continues concerning the “best” variables to measure from a structural, process, and outcomes standpoint. Although American College of Surgeons National Surgical Quality Improvement Program provides an opportunity for outcomes measurement in general and vascular surgery, there is no specific quality improvement tool available for colon and rectal surgery. However, there is growing literature testing the validity of candidate variables to be used in such a data collection system. This article evaluates the current objective assessment measurements used for quality improvement in colon and rectal surgery. PMID:27053926

  18. Management by objectives and its impact on specialist prescription quality at discharge and in external consultations.

    PubMed

    Olmo, M; Galvan, L; Capdevila, J; Serna, C; Mangues, I; Schoenenberger, J A

    2011-01-01

    To verify that implementing a policy of management by objectives, based on collaboration between hospital pharmacy, primary care and specialised medical managers, improves prescription quality indicators in specialised care and reduces unwanted "induced" prescriptions (i.e. those issued by specialists, hospital doctors or the patients themselves) in primary care. A four year quasi-experimental controlled intervention study on prescription at discharge and in outpatient hospital consultations was conducted. In hospital A, a quality cycle was applied: assessment, identifying improvement opportunities, implementing corrective actions and re-assessment. However, it was not applied in control hospital B. The indicators chosen were the percentage of generic medicines prescribed, the percentage of prescriptions for new therapies with no added value and the percentage of prescriptions for ACE inhibitors recommended. In hospital A, an increase in indicators 1 and 3 has been observed, both being statistically significant, between the last year of intervention and the year previous to intervention. Hospital A managed to reduce indicator 2 to 4.5%, while this indicator increased in hospital B to 8.8%. Furthermore, a statistically significant difference in indicators between the two hospitals has been registered. Pay-for-Performance programs in prescription practices of hospital physicians are effective actions to improve quality indicators of medication use. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

  19. Deep Aesthetic Quality Assessment With Semantic Information.

    PubMed

    Kao, Yueying; He, Ran; Huang, Kaiqi

    2017-03-01

    Human beings often assess the aesthetic quality of an image coupled with the identification of the image's semantic content. This paper addresses the correlation issue between automatic aesthetic quality assessment and semantic recognition. We cast the assessment problem as the main task among a multi-task deep model, and argue that semantic recognition task offers the key to address this problem. Based on convolutional neural networks, we employ a single and simple multi-task framework to efficiently utilize the supervision of aesthetic and semantic labels. A correlation item between these two tasks is further introduced to the framework by incorporating the inter-task relationship learning. This item not only provides some useful insight about the correlation but also improves assessment accuracy of the aesthetic task. In particular, an effective strategy is developed to keep a balance between the two tasks, which facilitates to optimize the parameters of the framework. Extensive experiments on the challenging Aesthetic Visual Analysis dataset and Photo.net dataset validate the importance of semantic recognition in aesthetic quality assessment, and demonstrate that multitask deep models can discover an effective aesthetic representation to achieve the state-of-the-art results.

  20. Parasitology: United Kingdom National Quality Assessment Scheme.

    PubMed Central

    Hawthorne, M.; Chiodini, P. L.; Snell, J. J.; Moody, A. H.; Ramsay, A.

    1992-01-01

    AIMS: To assess the results from parasitology laboratories taking part in a quality assessment scheme between 1986 and 1991; and to compare performance with repeat specimens. METHODS: Quality assessment of blood parasitology, including tissue parasites (n = 444; 358 UK, 86 overseas), and faecal parasitology, including extra-intestinal parasites (n = 205; 141 UK, 64 overseas), was performed. RESULTS: Overall, the standard of performance was poor. A questionnaire distributed to participants showed that a wide range of methods was used, some of which were considered inadequate to achieve reliable results. Teaching material was distributed to participants from time to time in an attempt to improve standards. CONCLUSIONS: Since the closure of the IMLS fellowship course in 1972, fewer opportunities for specialised training in parasitology are available: more training is needed. Poor performance in the detection of malarial parasites is mainly attributable to incorrect speciation, misidentification, and lack of equipment such as an eyepiece graticule. PMID:1452791

  1. Quantification of an External Motion Surrogate for Quality Assurance in Lung Cancer Radiation Therapy

    PubMed Central

    Lettmaier, Sebastian

    2014-01-01

    The purpose of this work was to validate the stability of the end exhale position in deep expiration breath hold (DEBH) technique for quality assurance in stereotactic lung tumor radiation therapy. Furthermore, a motion analysis was performed for 20 patients to evaluate breathing periods and baseline drifts based on an external surrogate. This trajectory was detected using stereo infrared (IR) cameras and reflective body markers. The respiratory waveform showed large interpatient differences in the end exhale position during irradiation up to 18.8 mm compared to the global minimum. This position depends significantly on the tumor volume. Also the baseline drifts, which occur mostly in posterior direction, are affected by the tumor size. Breathing periods, which depend mostly on the patient age, were in a range between 2.4 s and 7.0 s. Fifteen out of 20 patients, who showed a reproducible end exhale position with a deviation of less than 5 mm, might benefit from DEBH due to smaller planning target volumes (PTV) compared to free breathing irradiation and hence sparing of healthy tissue. Patients with larger uncertainties should be treated with more complex motion compensation techniques. PMID:25525599

  2. Quantification of an external motion surrogate for quality assurance in lung cancer radiation therapy.

    PubMed

    Wölfelschneider, Jens; Brandt, Tobias; Lettmaier, Sebastian; Fietkau, Rainer; Bert, Christoph

    2014-01-01

    The purpose of this work was to validate the stability of the end exhale position in deep expiration breath hold (DEBH) technique for quality assurance in stereotactic lung tumor radiation therapy. Furthermore, a motion analysis was performed for 20 patients to evaluate breathing periods and baseline drifts based on an external surrogate. This trajectory was detected using stereo infrared (IR) cameras and reflective body markers. The respiratory waveform showed large interpatient differences in the end exhale position during irradiation up to 18.8 mm compared to the global minimum. This position depends significantly on the tumor volume. Also the baseline drifts, which occur mostly in posterior direction, are affected by the tumor size. Breathing periods, which depend mostly on the patient age, were in a range between 2.4 s and 7.0 s. Fifteen out of 20 patients, who showed a reproducible end exhale position with a deviation of less than 5 mm, might benefit from DEBH due to smaller planning target volumes (PTV) compared to free breathing irradiation and hence sparing of healthy tissue. Patients with larger uncertainties should be treated with more complex motion compensation techniques.

  3. Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

    SciTech Connect

    Alvarez R, J T; Tovar M, V M

    2008-08-11

    A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described--for eleven {sup 60}Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 deg. C plus 24 hrs 80 deg. C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal D{sub W} = 2 Gy{center_dot}c) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gy in terms of absorbed dose to water D{sub W} for {sup 60}Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals.

  4. Ten years' experience with an external quality control program for semen analysis.

    PubMed

    Mallidis, Con; Cooper, Trevor G; Hellenkemper, Barbara; Lablans, Martin; Uckert, Frank; Nieschlag, Eberhard

    2012-09-01

    To gauge the performance of laboratories and impact of the German semen analysis external quality control program (QuaDeGA) over its first 10 years. Retrospective analysis of QuaDeGA's twice yearly distribution of fixed semen samples and electronic material documenting sperm motility. Ranking of each participant's responses was determined according to their relation to a "target window." Multicenter. PAITENT(S): Healthy donors. None. Laboratory performance, World Health Organization (WHO) adherence. Over 19 runs, there was a steady increase of participants (280 laboratories), the largest group being private urologic practices. Although use of WHO-recommended Neubauer chamber (from 33% to 55%) and diluent (from 11% to 32%) increased, the opposite occurred with morphology staining protocols (from 41% to 19%). Overall, <8% of laboratories truly followed WHO guidelines. Median-based comparisons, replacing reference laboratories, resulted in a merging of performance rankings regardless of the protocols used. Adherence to WHO recommendations is low, with the majority of laboratories using methods expressly opposed by the guidelines. Participation in QuaDeGA was found to improve the performance of the laboratories involved in the program. However, the use of median-based ranking, while decreasing the extent of variance between laboratories, brings into question the significance of the rankings. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. An Assessment of the Pacific Regional Cancer Coalition: Outcomes and Implications of a Regional Coalition Internal and External Assessment

    PubMed Central

    Heckert, Karen A; Buenconsejo-Lum, Lee; Hedson, Johnny; Tamang, Suresh; Palafox, Neal

    2011-01-01

    Significance The Pacific Regional Cancer Coalition Signifi(PRCC) provides regional leadership in the US Affiliated Pacific Islands (USAPI) to implement the Regional Comprehensive Control Plan: 2007–2012, and to evaluate its coalition and partnerships. The Pacific Center of Excellence in the Elimination of Disparities (CEED), aims to reduce cancer disparities and conducts evaluation activities relevant to cancer prevention and control in the USAPI. Purpose The PRCC Self (internal) and Partner (external) Assessments were conducted to assess coalition functioning, regional and national partnerships, sustainability, and the role of regionalism for integrating all chronic disease prevention and control in the Pacific. Methods Self-administered questionnaires and key informant telephone interviews with PRCC members (N=20), and representatives from regional and national partner organizations were administered (N=26). Validated multi item measures using 5-point scales on coalition and partnership characteristics were used. Chronbach's alphas and averages for the measures were computed. Results Internal coalition measures: satisfaction (4.2, SD=0.48) communication (4.0, SD=0.56), respect (4.0, SD=0.60) were rated more highly than external partnership measures: resource sharing (3.5, SD=0.74), regionalism (3.9, SD=0.47), use of findings (3.9, SD=0.50). The PRCC specifically identified its level of “collaboration” with external partners including Pacific CEED. External partners identified its partnership with the PRCC in the “coalition” stage. Principal Conclusions PRCC members and external partners are satisfied with their partnerships. All groups should continue to focus on building collaboration with partners to reflect a truly regional approach to sustain the commitment, the coalitions and the programming to reduce cancer in the USAPI. PRCC and partners should also work together to integrate all chronic disease prevention and control efforts in the Pacific. PMID

  6. An assessment of the Pacific Regional Cancer Coalition: outcomes and implications of a regional coalition internal and external assessment.

    PubMed

    Sy, Angela U; Heckert, Karen A; Buenconsejo-Lum, Lee; Hedson, Johnny; Tamang, Suresh; Palafox, Neal

    2011-11-01

    The Pacific Regional Cancer Coalition (PRCC) provides regional leadership in the U.S. Affiliated Pacific Islands (USAPI) to implement the Regional Comprehensive Control Plan: 2007-2012, and to evaluate its coalition and partnerships. The Pacific Center of Excellence in the Elimination of Disparities (CEED), aims to reduce cancer disparities and conducts evaluation activities relevant to cancer prevention and control in the USAPI. The PRCC Self (internal) and Partner (external) Assessments were conducted to assess coalition functioning, regional and national partnerships, sustainability, and the role of regionalism for integrating all chronic disease prevention and control in the Pacific. Self-administered questionnaires and key informant telephone interviews with PRCC members (N=20), and representatives from regional and national partner organizations were administered (N=26). Validated multi item measures using 5-point scales on coalition and partnership characteristics were used. Chronbach's alphas and averages for the measures were computed. Internal coalition measures: satisfaction (4.2, SD=0.48) communication (4.0, SD=0.56), respect (4.0, SD=0.60) were rated more highly than external partnership measures: resource sharing (3.5, SD=0.74), regionalism (3.9, SD=0.47), use of findings (3.9, SD=0.50). The PRCC specifically identified its level of "collaboration" with external partners including Pacific CEED. External partners identified its partnership with the PRCC in the "coalition" stage. PRCC members and external partners are satisfied with their partnerships. All groups should continue to focus on building collaboration with partners to reflect a truly regional approach to sustain the commitment, the coalitions and the programming to reduce cancer in the USAPI. PRCC and partners should also work together to integrate all chronic disease prevention and control efforts in the Pacific.

  7. Water Quality Assessment using Satellite Remote Sensing

    NASA Astrophysics Data System (ADS)

    Haque, Saad Ul

    2016-07-01

    The two main global issues related to water are its declining quality and quantity. Population growth, industrialization, increase in agriculture land and urbanization are the main causes upon which the inland water bodies are confronted with the increasing water demand. The quality of surface water has also been degraded in many countries over the past few decades due to the inputs of nutrients and sediments especially in the lakes and reservoirs. Since water is essential for not only meeting the human needs but also to maintain natural ecosystem health and integrity, there are efforts worldwide to assess and restore quality of surface waters. Remote sensing techniques provide a tool for continuous water quality information in order to identify and minimize sources of pollutants that are harmful for human and aquatic life. The proposed methodology is focused on assessing quality of water at selected lakes in Pakistan (Sindh); namely, HUBDAM, KEENJHAR LAKE, HALEEJI and HADEERO. These lakes are drinking water sources for several major cities of Pakistan including Karachi. Satellite imagery of Landsat 7 (ETM+) is used to identify the variation in water quality of these lakes in terms of their optical properties. All bands of Landsat 7 (ETM+) image are analyzed to select only those that may be correlated with some water quality parameters (e.g. suspended solids, chlorophyll a). The Optimum Index Factor (OIF) developed by Chavez et al. (1982) is used for selection of the optimum combination of bands. The OIF is calculated by dividing the sum of standard deviations of any three bands with the sum of their respective correlation coefficients (absolute values). It is assumed that the band with the higher standard deviation contains the higher amount of 'information' than other bands. Therefore, OIF values are ranked and three bands with the highest OIF are selected for the visual interpretation. A color composite image is created using these three bands. The water quality

  8. The Impact of Identifying a Specific Purpose and External Audience for Writing on Second Graders' Writing Quality

    ERIC Educational Resources Information Center

    Block, Meghan K.

    2013-01-01

    The Common Core State Standards for English Language Arts and Literacy in History/Social Studies, Science, and Technical Subjects (CCSS) emphasize the importance of writing and specify that students should write for external, and, at times, unfamiliar audiences. Given the relationship between audience specification and quality writing in older…

  9. Child Reactivity Moderates the Over-Time Association between Mother-Child Conflict Quality and Externalizing Problems

    ERIC Educational Resources Information Center

    Nelson, Jackie A.

    2015-01-01

    Constructive parent-child conflict interactions that teach children to problem-solve and negotiate can enhance children's social adjustment. This paper identifies constructive and destructive qualities of mother-child conflict and explores whether child temperament moderated associations with changes in externalizing problems over time. One…

  10. The Impact of Identifying a Specific Purpose and External Audience for Writing on Second Graders' Writing Quality

    ERIC Educational Resources Information Center

    Block, Meghan K.

    2013-01-01

    The Common Core State Standards for English Language Arts and Literacy in History/Social Studies, Science, and Technical Subjects (CCSS) emphasize the importance of writing and specify that students should write for external, and, at times, unfamiliar audiences. Given the relationship between audience specification and quality writing in older…

  11. Recovery and replication of internalizing and externalizing dimensions within the personality assessment inventory.

    PubMed

    Ruiz, Mark A; Edens, John F

    2008-11-01

    In this study, we examined the internal structure of 13 Personality Assessment Inventory (PAI; Morey, 1991, 2007) scales in a corrections sample (N = 1,099). Previous findings regarding the PAI internal structure have been somewhat inconsistent. We investigated the utility of a 2-dimensional model comprised of internalization and externalization to organize the 11 PAI clinical scales and 2 additional scales, Suicidal Ideation and Aggression. We randomly divided the sample, and a factor analysis revealed a 2-dimensional model representing internalization and externalization. Confirmatory factor analyses conducted with an independent subsample revealed acceptable fit when the model was revised to include correlated error terms between mood and anxiety disorder scales. The revised model exhibited acceptable fit when cross-validated, had better fit than a 1-dimension model, and demonstrated preliminary construct validity in relation to extratest variables.

  12. Automated Data Quality Assessment of Marine Sensors

    PubMed Central

    Timms, Greg P.; de Souza, Paulo A.; Reznik, Leon; Smith, Daniel V.

    2011-01-01

    The automated collection of data (e.g., through sensor networks) has led to a massive increase in the quantity of environmental and other data available. The sheer quantity of data and growing need for real-time ingestion of sensor data (e.g., alerts and forecasts from physical models) means that automated Quality Assurance/Quality Control (QA/QC) is necessary to ensure that the data collected is fit for purpose. Current automated QA/QC approaches provide assessments based upon hard classifications of the gathered data; often as a binary decision of good or bad data that fails to quantify our confidence in the data for use in different applications. We propose a novel framework for automated data quality assessments that uses Fuzzy Logic to provide a continuous scale of data quality. This continuous quality scale is then used to compute error bars upon the data, which quantify the data uncertainty and provide a more meaningful measure of the data’s fitness for purpose in a particular application compared with hard quality classifications. The design principles of the framework are presented and enable both data statistics and expert knowledge to be incorporated into the uncertainty assessment. We have implemented and tested the framework upon a real time platform of temperature and conductivity sensors that have been deployed to monitor the Derwent Estuary in Hobart, Australia. Results indicate that the error bars generated from the Fuzzy QA/QC implementation are in good agreement with the error bars manually encoded by a domain expert. PMID:22163714

  13. [THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

    PubMed

    Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

    2015-08-01

    The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

  14. [Materials for carrying out external quality control in the determination of total protein].

    PubMed

    Pishak, V P; Iarmol'chuk, G M

    1998-06-01

    Quaternary bis-ammonium compound No. 82 (QAC-82) is a highly effective antibacterial biochemical stabilizer of total protein. In concentrations of 3.4-13.6 mmol/liter, it preserves the content of protein in the blood serum for 40 days at 18-20 degrees C. For preparing reference material, 5 ml human or animal serum is added to 95 ml 5.25 mM aqueous solution of QAC-82, mixed, stored at room temperature, and used for assessing the quality of total protein measurements by the biuret method.

  15. Clinical assessment of external rotation for the diagnosis of anterior shoulder hyperlaxity.

    PubMed

    Ropars, M; Fournier, A; Campillo, B; Bonan, I; Delamarche, P; Crétual, A; Thomazeau, H

    2010-12-01

    The aim of this study was to evaluate two methods of clinical assessment for external rotation of the shoulder to optimise the diagnosis of hyperlaxity in patients being selected for surgery for stabilisation of chronic anterior instability. External rotation was evaluated in 70 healthy student volunteers by two examiners (intertester study) using two methods of assessment at 15-day intervals (intratester study). The first method used was the protocol described for the Instability Severity Index Score (ISIS). In this case, the subject was evaluated in the sitting position, bilaterally with passive range of motion movements. The shoulder was considered hyperlax if ER1 was greater than 85°. With the second, so-called "elbow on the table" (EOT) method, the subject was evaluated in the decubitus dorsal position, unilaterally with passive range of motion. The subject was considered to be hyperlax if ER1 was greater than 90°. Kappa values for intra- and intertester agreement with the ISIS method were average, while they were satisfactory with the intraclass coefficient (ICC). Kappa values for inter- and intratester agreement with the EOT method were average and good, respectively. This tendency was confirmed by the ICC which went from good to excellent for the two examiners in both series of measurements using the EOT method, showing better reproducibility with this method. Our study confirms that the most reproducible method for assessing external rotation is obtained by unilateral assessment of the patient in the decubitus dorsal position, with passive range of motion. An ER1 of 90° is the necessary threshold for hyperlaxity because of elbow retropulsion with this method, which provides immediate and visual evaluation and eliminates the necessity of goniometry.

  16. Long-Term Continuous Ambulatory ECG Monitors and External Cardiac Loop Recorders for Cardiac Arrhythmia: A Health Technology Assessment

    PubMed Central

    Kabali, Conrad; Xie, Xuanqian; Higgins, Caroline

    2017-01-01

    Background Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as longterm continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of longterm continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia. Methods Based on our systematic search for studies published up to January 15, 2016, we did not identify any studies directly comparing the clinical effectiveness of longterm continuous ECG monitors and external loop recorders. Therefore, we conducted an indirect comparison, using a 24-hour Holter monitor as a common comparator. We used a meta-regression model to control for bias due to variation in device-wearing time and baseline syncope rate across studies. We conducted a similar systematic search for cost-utility and cost-effectiveness studies comparing the two types of devices; none were found. Finally, we used historical claims data (2006–2014) to estimate the future 5-year budget impact in Ontario, Canada, of continued public funding for both types of longterm ambulatory ECG monitors. Results Our clinical literature search yielded 7,815 non-duplicate citations, of which 12 cohort studies were eligible for indirect comparison. Seven studies assessed the effectiveness of longterm continuous monitors and five assessed external loop recorders. Both types of devices were more effective than a 24-hour Holter monitor, and we found no substantial difference between them in their ability to detect symptoms (risk difference 0.01; 95% confidence interval −0.18, 0.20). Using GRADE for network meta-analysis, we evaluated the

  17. Visual pattern degradation based image quality assessment

    NASA Astrophysics Data System (ADS)

    Wu, Jinjian; Li, Leida; Shi, Guangming; Lin, Weisi; Wan, Wenfei

    2015-08-01

    In this paper, we introduce a visual pattern degradation based full-reference (FR) image quality assessment (IQA) method. Researches on visual recognition indicate that the human visual system (HVS) is highly adaptive to extract visual structures for scene understanding. Existing structure degradation based IQA methods mainly take local luminance contrast to represent structure, and measure quality as degradation on luminance contrast. In this paper, we suggest that structure includes not only luminance contrast but also orientation information. Therefore, we analyze the orientation characteristic for structure description. Inspired by the orientation selectivity mechanism in the primary visual cortex, we introduce a novel visual pattern to represent the structure of a local region. Then, the quality is measured as the degradations on both luminance contrast and visual pattern. Experimental results on Five benchmark databases demonstrate that the proposed visual pattern can effectively represent visual structure and the proposed IQA method performs better than the existing IQA metrics.

  18. Assessing the quality of cost management

    SciTech Connect

    Fayne, V.; McAllister, A.; Weiner, S.B.

    1995-12-31

    Managing environmental programs can be effective only when good cost and cost-related management practices are developed and implemented. The Department of Energy`s Office of Environmental Management (EM), recognizing this key role of cost management, initiated several cost and cost-related management activities including the Cost Quality Management (CQM) Program. The CQM Program includes an assessment activity, Cost Quality Management Assessments (CQMAs), and a technical assistance effort to improve program/project cost effectiveness. CQMAs provide a tool for establishing a baseline of cost-management practices and for measuring improvement in those practices. The result of the CQMA program is an organization that has an increasing cost-consciousness, improved cost-management skills and abilities, and a commitment to respond to the public`s concerns for both a safe environment and prudent budget outlays. The CQMA program is part of the foundation of quality management practices in DOE. The CQMA process has contributed to better cost and cost-related management practices by providing measurements and feedback; defining the components of a quality cost-management system; and helping sites develop/improve specific cost-management techniques and methods.

  19. Quality versus quantity: assessing individual research performance

    PubMed Central

    Sahel, José-Alain

    2011-01-01

    Evaluating individual research performance is a complex task that ideally examines productivity, scientific impact, and research quality––a task that metrics alone have been unable to achieve. In January 2011, the French Academy of Sciences published a report on current bibliometric (citation metric) methods for evaluating individual researchers, as well as recommendations for the integration of quality assessment. Here, we draw on key issues raised by this report and comment on the suggestions for improving existing research evaluation practices. PMID:21613620

  20. Objective assessment of image quality VI: imaging in radiation therapy

    NASA Astrophysics Data System (ADS)

    Barrett, Harrison H.; Kupinski, Matthew A.; Müeller, Stefan; Halpern, Howard J.; Morris, John C., III; Dwyer, Roisin

    2013-11-01

    Earlier work on objective assessment of image quality (OAIQ) focused largely on estimation or classification tasks in which the desired outcome of imaging is accurate diagnosis. This paper develops a general framework for assessing imaging quality on the basis of therapeutic outcomes rather than diagnostic performance. By analogy to receiver operating characteristic (ROC) curves and their variants as used in diagnostic OAIQ, the method proposed here utilizes the therapy operating characteristic or TOC curves, which are plots of the probability of tumor control versus the probability of normal-tissue complications as the overall dose level of a radiotherapy treatment is varied. The proposed figure of merit is the area under the TOC curve, denoted AUTOC. This paper reviews an earlier exposition of the theory of TOC and AUTOC, which was specific to the assessment of image-segmentation algorithms, and extends it to other applications of imaging in external-beam radiation treatment as well as in treatment with internal radioactive sources. For each application, a methodology for computing the TOC is presented. A key difference between ROC and TOC is that the latter can be defined for a single patient rather than a population of patients.

  1. Causes of injuries resulting in hospitalisation in Australia: assessing coder agreement on external causes.

    PubMed

    McKenzie, K; Enraght-Moony, E L; Waller, G; Walker, S M; Harrison, J E; McClure, R J

    2009-06-01

    To assess extent of coder agreement for external causes of injury using ICD-10-AM for injury-related hospitalisations in Australian public hospitals. A random sample of 4850 discharges from 2002 to 2004 was obtained from a stratified random sample of 50 hospitals across four states in Australia. On-site medical record reviews were conducted and external cause codes were assigned blinded to the original coded data. Code agreement levels were grouped into the following agreement categories: block level, 3-character level, 4-character level, 5th-character level, and complete code level. At a broad block level, code agreement was found in over 90% of cases for most mechanisms (eg, transport, fall). Percentage disagreement was 26.0% at the 3-character level; agreement for the complete external cause code was 67.6%. For activity codes, the percentage of disagreement at the 3-character level was 7.3% and agreement for the complete activity code was 68.0%. For place of occurrence codes, the percentage of disagreement at the 4-character level was 22.0%; agreement for the complete place code was 75.4%. With 68% agreement for complete codes and 74% agreement for 3-character codes, as well as variability in agreement levels across different code blocks, place and activity codes, researchers need to be aware of the reliability of their specific data of interest when they wish to undertake trend analyses or case selection for specific causes of interest.

  2. Does Feather Corticosterone Reflect Individual Quality or External Stress in Arctic-Nesting Migratory Birds?

    PubMed Central

    Legagneux, Pierre; Harms, N. Jane; Gauthier, Gilles; Chastel, Olivier; Gilchrist, H. Grant; Bêty, Joël; Soos, Catherine

    2013-01-01

    The effects of environmental perturbations or stressors on individual states can be carried over to subsequent life stages and ultimately affect survival and reproduction. The concentration of corticosterone (CORT) in feathers is an integrated measure of hypothalamic–pituitary–adrenal activity during the molting period, providing information on the total baseline and stress-induced CORT secreted during the period of feather growth. Common eiders and greater snow geese replace all flight feathers once a year during the pre-basic molt, which occurs following breeding. Thus, CORT contained in feathers of pre-breeding individuals sampled in spring reflects the total CORT secreted during the previous molting event, which may provide insight into the magnitude or extent of stress experienced during this time period. We used data from multiple recaptures to disentangle the contribution of individual quality vs. external factors (i.e., breeding investment or environmental conditions) on feather CORT in arctic-nesting waterfowl. Our results revealed no repeatability of feather CORT within individuals of either species. In common eiders, feather CORT was not affected by prior reproductive investment, nor by pre-breeding (spring) body condition prior to the molting period. Individual feather CORT greatly varied according to the year, and August-September temperatures explained most of the annual variation in feather CORT. Understanding mechanisms that affect energetic costs and stress responses during molting will require further studies either using long-term data or experiments. Although our study period encompassed only five years, it nonetheless provides evidence that CORT measured in feathers likely reflects responses to environmental conditions experienced by birds during molt, and could be used as a metric to study carry-over effects. PMID:24391720

  3. Does feather corticosterone reflect individual quality or external stress in arctic-nesting migratory birds?

    PubMed

    Legagneux, Pierre; Harms, N Jane; Gauthier, Gilles; Chastel, Olivier; Gilchrist, H Grant; Bortolotti, Gary; Bêty, Joël; Soos, Catherine

    2013-01-01

    The effects of environmental perturbations or stressors on individual states can be carried over to subsequent life stages and ultimately affect survival and reproduction. The concentration of corticosterone (CORT) in feathers is an integrated measure of hypothalamic-pituitary-adrenal activity during the molting period, providing information on the total baseline and stress-induced CORT secreted during the period of feather growth. Common eiders and greater snow geese replace all flight feathers once a year during the pre-basic molt, which occurs following breeding. Thus, CORT contained in feathers of pre-breeding individuals sampled in spring reflects the total CORT secreted during the previous molting event, which may provide insight into the magnitude or extent of stress experienced during this time period. We used data from multiple recaptures to disentangle the contribution of individual quality vs. external factors (i.e., breeding investment or environmental conditions) on feather CORT in arctic-nesting waterfowl. Our results revealed no repeatability of feather CORT within individuals of either species. In common eiders, feather CORT was not affected by prior reproductive investment, nor by pre-breeding (spring) body condition prior to the molting period. Individual feather CORT greatly varied according to the year, and August-September temperatures explained most of the annual variation in feather CORT. Understanding mechanisms that affect energetic costs and stress responses during molting will require further studies either using long-term data or experiments. Although our study period encompassed only five years, it nonetheless provides evidence that CORT measured in feathers likely reflects responses to environmental conditions experienced by birds during molt, and could be used as a metric to study carry-over effects.

  4. Teachers' Opinions on Quality Criteria for Competency Assessment Programs

    ERIC Educational Resources Information Center

    Baartman, Liesbeth K. J.; Bastiaens, Theo J.; Kirschner, Paul A.; Van der Vleuten, Cees P. M.

    2007-01-01

    Quality control policies towards Dutch vocational schools have changed dramatically because the government questioned examination quality. Schools must now demonstrate assessment quality to a new Examination Quality Center. Since teachers often design assessments, they must be involved in quality issues. This study therefore explores teachers'…

  5. Quality Assessment of Domesticated Animal Genome Assemblies

    PubMed Central

    Seemann, Stefan E.; Anthon, Christian; Palasca, Oana; Gorodkin, Jan

    2015-01-01

    The era of high-throughput sequencing has made it relatively simple to sequence genomes and transcriptomes of individuals from many species. In order to analyze the resulting sequencing data, high-quality reference genome assemblies are required. However, this is still a major challenge, and many domesticated animal genomes still need to be sequenced deeper in order to produce high-quality assemblies. In the meanwhile, ironically, the extent to which RNAseq and other next-generation data is produced frequently far exceeds that of the genomic sequence. Furthermore, basic comparative analysis is often affected by the lack of genomic sequence. Herein, we quantify the quality of the genome assemblies of 20 domesticated animals and related species by assessing a range of measurable parameters, and we show that there is a positive correlation between the fraction of mappable reads from RNAseq data and genome assembly quality. We rank the genomes by their assembly quality and discuss the implications for genotype analyses. PMID:27279738

  6. Assessment of private economic benefits and positive environmental externalities of tea plantation in China.

    PubMed

    Xue, Hui; Ren, Xiaoyi; Li, Shiyu; Wu, Xu; Cheng, Hao; Xu, Bin; Gu, Baojing; Yang, Guofu; Peng, Changhui; Ge, Ying; Chang, Jie

    2013-10-01

    Tea plantations are rapidly expanding in China and other countries in the tropical and subtropical zones, driven by relatively high private economic benefit. However, the impact of tea plantations on the regional environment, including ecosystem services and disservices are unclear. In this study, we developed an assessment framework for determining the private economic benefits and environmental externalities (the algebraic sum of the regulating services and disservices) of tea plantations in China. Our results showed that tea plantations provided private economic benefits of 5,652 yuan ha(-1) year(-1) (7.6 yuan = 1 USD in 2007) for tea farmers, plus positive environmental externalities of 6,054 yuan ha(-1) year(-1) for the society. The environmental externalities were calculated as the sum of the value of four regulating services, including carbon sequestration (392 yuan ha(-1) year(-1)); soil retention (72 yuan ha(-1) year(-1)); soil fertility protection (3,189 yuan ha(-1) year(-1)) and water conservation (2,685 yuan ha(-1) year(-1)), and three disservices, including CO2 emission (-39 yuan ha(-1) year(-1)), N2O emission (-137 yuan ha(-1) year(-1)) and nonpoint source pollution (-108 yuan ha(-1) year(-1)). Before the private optimal level, the positive environmental externalities can be maintained by private economic benefits; if a social optimal level is required, subsidies from government are necessary.

  7. A PILOT EXTERNAL QUALITY ASSURANCE STUDY OF TRANSFUSION SCREENING FOR HIV, HCV AND HBSAG IN TWELVE AFRICAN COUNTRIES

    PubMed Central

    Bloch, Evan M; Shah, Avani; Kaidarova, Zhanna; Laperche, Syria; Lefrere, Jean-Jacques; van Hasselt, James; Zacharias, Peter; Murphy, Edward L

    2014-01-01

    Background and Objectives Serologic screening for the major transfusion transmissible viruses (TTV) is critical to blood safety and has been widely implemented. However, actual performance as measured by proficiency testing has not been well studied in Sub-Saharan Africa. Therefore, we conducted an external quality assessment of laboratories engaged in transfusion screening in the region. Materials and Methods Blinded test panels, each comprising 25 serum samples that were pedigreed for HIV, HBsAg, HCV and negative status, were sent to participating laboratories. The panels were tested using the laboratories’ routine donor screening methods and conditions. Sensitivity and specificity were calculated and multivariable analysis was used to compare performance against mode of testing, country and infrastructure. Results A total of 12 African countries and 44 laboratories participated in the study. The mean (range) sensitivities for HIV, HBsAg and HCV were 91.9% (14.3-100), 86.7% (42.9-100) and 90.1% (50-100), respectively. Mean specificities for HIV, HBsAg and HCV were 97.7%, 97% and 99.5% respectively. After adjusting for country and infrastructure, rapid tests had significantly lower sensitivity than enzyme immunoassays (EIA) for both HBsAg (p<0.0001) and HCV (p<0.05). Sensitivity also varied by country and selected infrastructure variables. Conclusion While specificity was high, sensitivity was more variable and deficient in a substantial number of testing laboratories. These findings underscore the importance of proficiency testing and quality control, particularly in Africa where TTV prevalence is high. PMID:25052195

  8. Assessment of two external telemetry systems (PhysioJacket and JET) in beagle dogs with telemetry implants.

    PubMed

    Chui, Ray W; Fosdick, Abigail; Conner, Ra'Shun; Jiang, Jian; Bruenner, Bernd A; Vargas, Hugo M

    2009-01-01

    Regulatory guidelines recommend the use of conscious, unrestrained animals for comprehensive cardiovascular safety assessment of a new therapeutic agent. Cardiovascular safety pharmacology studies normally use internal telemetry (surgical implants) in free-moving animals to monitor key ECG endpoints, like the QTc interval, but this technical approach is highly resource intensive. In toxicology studies, ECG recording is also typically performed under chemical or physical restraint, which has a number of disadvantages, e.g., anesthesia confounds, handling stress and limited data collection. External telemetry for ECG recording has the potential to overcome many of these restraint limitations, with the benefit of being a surgically non-invasive method. To evaluate this method, we used two jacket systems: Data Sciences International (DSI) JET and Integrated Telemetry Systems (ITS) PhysioJacket in implanted beagle dogs. Heart rate and cardiac intervals were monitored continuously for 22-24 h following oral administration of vehicle (water) or 1 mg/kg E-4031. Data obtained from each jacket system was compared with implant-derived data in the same animal. Significant increases in QT/QTcV (25-30 ms) were noted following treatment with 1 mg/kg E-4031 in both external jacket systems and with implanted telemetry. Throughout the recording periods, the normal variations in heart rate and ECG intervals observed in conscious dogs as detected with the jacket systems, mirrored the changes observed via implant telemetry. The overall findings from this study support the use of external telemetry technology as a viable alternative to implants. The data demonstrated that jackets were sufficiently sensitive to detect QT/QTcV changes following E-4031 administration, that were comparable to those derived from implants. As such, this method is an invaluable tool for obtaining high quality ECG data from repeat-dose toxicology studies.

  9. External quality-assurance programs managed by the U.S. Geological Survey in support of the National Atmospheric Deposition Program/National Trends Network

    USGS Publications Warehouse

    Latysh, Natalie E.; Wetherbee, Gregory A.

    2005-01-01

    The U.S. Geological Survey, Branch of Quality Systems, operates the external quality-assurance programs for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN). Beginning in 1978, six different programs have been implemented?the intersite-comparison program, the blind-audit program, the sample-handling evaluation program, the field-audit program, the interlaboratory-comparison program, and the collocated-sampler program. Each program was designed to measure error contributed by specific components in the data-collection process. The intersite-comparison program, which was discontinued in 2004, was designed to assess the accuracy and reliability of field pH and specific-conductance measurements made by site operators. The blind-audit and sample-handling evaluation programs, which also were discontinued in 2002 and 2004, respectively, assessed contamination that may result from sampling equipment and routine handling and processing of the wet-deposition samples. The field-audit program assesses the effects of sample handling, processing, and field exposure. The interlaboratory-comparison program evaluates bias and precision of analytical results produced by the contract laboratory for NADP, the Illinois State Water Survey, Central Analytical Laboratory, and compares its performance with the performance of international laboratories. The collocated-sampler program assesses the overall precision of wet-deposition data collected by NADP/NTN. This report documents historical operations and the operating procedures for each of these external quality-assurance programs. USGS quality-assurance information allows NADP/NTN data users to discern between actual environmental trends and inherent measurement variability.

  10. External quality-assurance results for the National Atmospheric Deposition Program and the National Trends Network during 1986

    USGS Publications Warehouse

    See, Randolph B.; Schroder, LeRoy J.; Willoughby, Timothy C.

    1988-01-01

    During 1986, the U.S. Geological Survey operated three programs to provide external quality-assurance monitoring of the National Atmospheric Deposition Program and National Trends Network. An intersite-comparison program was used to assess the accuracy of onsite pH and specific-conductance determinations at quarterly intervals. The blind-audit program was used to assess the effect of routine sample handling on the precision and bias of program and network wet-deposition data. Analytical results from four laboratories, which routinely analyze wet-deposition samples, were examined to determine if differences existed between laboratory analytical results and to provide estimates of the analytical precision of each laboratory. An average of 78 and 89 percent of the site operators participating in the intersite-comparison met the network goals for pH and specific conductance. A comparison of analytical values versus actual values for samples submitted as part of the blind-audit program indicated that analytical values were slightly but significantly (a = 0.01) larger than actual values for pH, magnesium, sodium, and sulfate; analytical values for specific conductance were slightly less than actual values. The decreased precision in the analyses of blind-audit samples when compared to interlaboratory studies indicates that a large amount of uncertainty in network deposition data may be a result of routine field operations. The results of the interlaboratory comparison study indicated that the magnitude of the difference between laboratory analyses was small for all analytes. Analyses of deionized, distilled water blanks by participating laboratories indicated that the laboratories had difficulty measuring analyte concentrations near their reported detection limits. (USGS)

  11. Results of external quality-assurance program for the National Atmospheric Deposition Program and National Trends Network during 1985

    USGS Publications Warehouse

    Brooks, M.H.; Schroder, L.J.; Willoughby, T.C.

    1988-01-01

    External quality assurance monitoring of the National Atmospheric Deposition Program (NADP) and National Trends Network (NTN) was performed by the U.S. Geological Survey during 1985. The monitoring consisted of three primary programs: (1) an intersite comparison program designed to assess the precision and accuracy of onsite pH and specific conductance measurements made by NADP and NTN site operators; (2) a blind audit sample program designed to assess the effect of routine field handling on the precision and bias of NADP and NTN wet deposition data; and (3) an interlaboratory comparison program designed to compare analytical data from the laboratory processing NADP and NTN samples with data produced by other laboratories routinely analyzing wet deposition samples and to provide estimates of individual laboratory precision. An average of 94% of the site operators participated in the four voluntary intersite comparisons during 1985. A larger percentage of participating site operators met the accuracy goal for specific conductance measurements (average, 87%) than for pH measurements (average, 67%). Overall precision was dependent on the actual specific conductance of the test solution and independent of the pH of the test solution. Data for the blind audit sample program indicated slight positive biases resulting from routine field handling for all analytes except specific conductance. These biases were not large enough to be significant for most data users. Data for the blind audit sample program also indicated that decreases in hydrogen ion concentration were accompanied by decreases in specific conductance. Precision estimates derived from the blind audit sample program indicate that the major source of uncertainty in wet deposition data is the routine field handling that each wet deposition sample receives. Results of the interlaboratory comparison program were similar to results of previous years ' evaluations, indicating that the participating laboratories

  12. A Model for Assessment: Integrating External Monitoring with Classroom-Based Practice

    ERIC Educational Resources Information Center

    Long, Caroline; Dunne, Tim; Mokoena, Gabriel

    2014-01-01

    The rationale for the introduction of standards in the United States in the late 1980s was that the quality of education would improve. Assessment instruments in the form of written tests were constructed in order to perform a monitoring function. The introduction of standards and the associated monitoring have been replicated in South Africa. It…

  13. A Model for Assessment: Integrating External Monitoring with Classroom-Based Practice

    ERIC Educational Resources Information Center

    Long, Caroline; Dunne, Tim; Mokoena, Gabriel

    2014-01-01

    The rationale for the introduction of standards in the United States in the late 1980s was that the quality of education would improve. Assessment instruments in the form of written tests were constructed in order to perform a monitoring function. The introduction of standards and the associated monitoring have been replicated in South Africa. It…

  14. RISK REDUCTION THROUGH USE OF EXTERNAL TECHNICAL REVIEWS, TECHNOLOGY READINESS ASSESSMENTS AND TECHNICAL RISK RATINGS - 9174

    SciTech Connect

    Cercy, M; Steven P Schneider, S; Kurt D Gerdes, K

    2008-12-12

    The U.S. Department of Energy's Office of Environmental Management (DOE-EM) was established to achieve the safe and compliant disposition of legacy wastes and facilities from defense nuclear applications. A large majority of these wastes and facilities are 'one-of-a-kind' and unique to DOE. Many of the programs to treat these wastes have been 'first-of-a-kind' and unprecedented in scope and complexity. This has meant that many of the technologies needed to successfully disposition these wastes were not yet developed or required significant re-engineering to be adapted for DOE-EM's needs. The DOE-EM program believes strongly in reducing the technical risk of its projects and has initiated several efforts to reduce those risks: (1) Technology Readiness Assessments to reduce the risks of deployment of new technologies; (2) External Technical Reviews as one of several steps to ensure the timely resolution of engineering and technology issues; and (3) Technical Risk Ratings as a means to monitor and communicate information about technical risks. This paper will present examples of how Technology Readiness Assessments, External Technical Reviews, and Technical Risk Ratings are being used by DOE-EM to reduce technical risks.

  15. RISK REDUCTION THROUGH USE OF EXTERNAL TECHNICAL REVIEWS, TECHNOLOGY READINESS ASSESSMENTS AND TECHNICAL RISK RATINGS - 9174

    SciTech Connect

    Cercy, M; Steven P Schneider, S; Kurt D Gerdes, K

    2009-01-15

    The U.S. Department of Energy's Office of Environmental Management (DOE-EM) was established to achieve the safe and compliant disposition of legacy wastes and facilities from defense nuclear applications. A large majority of these wastes and facilities are 'one-of-a-kind' and unique to DOE. Many of the programs to treat these wastes have been 'first-of-a-kind' and unprecedented in scope and complexity. This has meant that many of the technologies needed to successfully disposition these wastes were not yet developed or required significant re-engineering to be adapted for DOE-EM's needs. The DOE-EM program believes strongly in reducing the technical risk of its projects and has initiated several efforts to reduce those risks: (1) Technology Readiness Assessments to reduce the risks of deployment of new technologies; (2) External Technical Reviews as one of several steps to ensure the timely resolution of engineering and technology issues; and (3) Technical Risk Ratings as a means to monitor and communicate information about technical risks. This paper will present examples of how Technology Readiness Assessments, External Technical Reviews, and Technical Risk Ratings are being used by DOE-EM to reduce technical risks.

  16. Assessment of external costs for transport project evaluation: Guidelines in some European countries

    SciTech Connect

    Petruccelli, Umberto

    2015-09-15

    Many studies about the external costs generated by the transport system have been developed in the last twenty years. To standardize methodologies and assessment procedures to be used in the evaluation of the projects, some European countries recently have adopted specific guidelines that differ from each other in some aspects even sensibly. This paper presents a critical analysis of the British, Italian and German guidelines and is aimed at cataloguing the external cost types regarded and the assessment methods indicated as well as to highlight the differences of the results, in terms of applicability and reliability. The goal is to contribute to a European standardization process that would lead to the drafting of guidelines suited for all EU countries. - Highlights: • The analyzed guidelines agree on the methods to evaluate costs from air pollution, greenhouse gases and accidents. • They recommend respectively: dose-resp. approach; costs to reduce/permit emissions; whole direct, indirect and social costs. • For noise, DE guide indicates defensive expenditure or SP methods; IT guide, SP method; UK guide, the hedonic prices one. • For on territory impact, DE guide regards only the barrier effect; the IT one, also the soil consumption and system effects. • British guide proposes a qualitative methodology to estimate the impact on various landscapes and environments.

  17. Evolving Adjustments to External (Gamma) Slope Factors for CERCLA Risk and Dose Assessments - 12290

    SciTech Connect

    Walker, Stuart

    2012-07-01

    To model the external exposure pathway in risk and dose assessments of radioactive contamination at Superfund sites, the U.S. Environmental Protection Agency (EPA) uses slope factors (SFs), also known as risk coefficients, and dose conversion factors (DCFs). Without any adjustment these external radiation exposure pathways effectively assumes that an individual is exposed to a source geometry that is effectively an infinite slab. The concept of an 'infinite slab' means that the thickness of the contaminated zone and its aerial extent are so large that it behaves as if it were infinite in its physical dimensions. EPA has been making increasingly complex adjustments to account for the extent of the contamination and its corresponding radiation field to provide more accurate risk and dose assessment modeling when using its calculators. In most instances, the more accurate modeling results derived from these gamma adjustments are less conservative. The notable exception are for some radionuclides in rooms with contaminated walls, ceiling, and floors, and the receptor is in location of the room with the highest amount of radiation exposure, usually the corner of small rooms and the center of large conference rooms. (authors)

  18. External assessment of the Early Mortality Risk Score in patients with adenocarcinoma undergoing pancreaticoduodenectomy

    PubMed Central

    Joliat, Gaëtan-Romain; Petermann, David; Demartines, Nicolas; Schäfer, Markus

    2015-01-01

    Background Pancreaticoduodenectomies (PD) still have a substantial mortality rate. Recently, different scores have been published to predict the mortality risk pre-operatively after PD. This retrospective study was designed to perform an external assessment of an Early Mortality Risk Score (EMRS). Methods From 2000 to 2012, all PD cases performed at our institution were documented. Only patients treated for pancreatic head adenocarcinomas were included. Survival time and EMRS (based on age, tumour size, tumour differentiation and comorbidities) were calculated for every patient. Relative risks (RR) of early death 9 and 12 months after PD were then calculated. Results Of 270 PD for various aetiologies, 120 PD for adenocarcinomas were included. The median follow-up was 37 months, and the overall median survival was 19 months. EMRS of 4 showed a mortality RR of 5.1 at 9 months (P = 0.048) and of 4.5 at 12 months (P = 0.020). Conclusions EMRS of 4 is a predictor of tumour-related mortality at 9 and 12 months after PD for adenocarcinoma. The EMRS was externally assessed in our patient cohort and can be implemented in clinical practice. Clinical implications of this score still need to be studied. PMID:25906918

  19. Using Data Mining for Wine Quality Assessment

    NASA Astrophysics Data System (ADS)

    Cortez, Paulo; Teixeira, Juliana; Cerdeira, António; Almeida, Fernando; Matos, Telmo; Reis, José

    Certification and quality assessment are crucial issues within the wine industry. Currently, wine quality is mostly assessed by physicochemical (e.g alcohol levels) and sensory (e.g. human expert evaluation) tests. In this paper, we propose a data mining approach to predict wine preferences that is based on easily available analytical tests at the certification step. A large dataset is considered with white vinho verde samples from the Minho region of Portugal. Wine quality is modeled under a regression approach, which preserves the order of the grades. Explanatory knowledge is given in terms of a sensitivity analysis, which measures the response changes when a given input variable is varied through its domain. Three regression techniques were applied, under a computationally efficient procedure that performs simultaneous variable and model selection and that is guided by the sensitivity analysis. The support vector machine achieved promising results, outperforming the multiple regression and neural network methods. Such model is useful for understanding how physicochemical tests affect the sensory preferences. Moreover, it can support the wine expert evaluations and ultimately improve the production.

  20. [Epidemiological standards for assessing quality: a proposal

    PubMed

    Rattner

    1996-01-01

    This paper proposes a strategy for defining indicators to assess the quality of the process of health care, based on the identification of the objectives of the care being delivered and on the verification of whether the technical guidelines for the procedures are being enforced. The article goes on to apply the proposed methodology to the process of health care during childbirth, based on a perspective of comprehensive care and adopting both an individual and collective risk approach. It uses a data bank of 4,558 Simplified Perinatal Clinical Histories (CLAP/PAHO/WHO) from 12 hospitals.The indicators selected were: V.D.R.L., Rh blood typing, antitetanus vaccination, rate of cesarean sections, reception of the baby by a pediatrician at birth, Apgar score, evaluation of the gestational age by physical exam, rooming-in, exclusive breastfeeding upon discharge, and referral for a puerperal consultation. Methods for classification of hospitals were the sum of their scores for each indicator, gold standard, and ranking. This methodology warranted identification of one hospital with excellent quality of care, five with good care, two with fair care, and four whose performances were completely unsatisfactory. Finally, some remarks on the assessment of quality of health care are made and future developments are proposed.