The Development of a Checklist to Enhance Methodological Quality in Intervention Programs.

PubMed

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Sánchez-Martín, Milagrosa

2016-01-01

The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed.

The Development of a Checklist to Enhance Methodological Quality in Intervention Programs

PubMed Central

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Sánchez-Martín, Milagrosa

2016-01-01

The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed. PMID:27917143

[Method for the quality assessment of data collection processes in epidemiological studies].

PubMed

Schöne, G; Damerow, S; Hölling, H; Houben, R; Gabrys, L

2017-10-01

For a quantitative evaluation of primary data collection processes in epidemiological surveys based on accompaniments and observations (in the field), there is no description of test criteria and methodologies in relevant literature and thus no known application in practice. Therefore, methods need to be developed and existing procedures adapted. The aim was to identify quality-relevant developments within quality dimensions by means of inspection points (quality indicators) during the process of data collection. As a result we seek to implement and establish a methodology for the assessment of overall survey quality supplementary to standardized data analyses. Monitors detect deviations from standard primary data collection during site visits by applying standardized checklists. Quantitative results - overall and for each dimension - are obtained by numerical calculation of quality indicators. Score results are categorized and color coded. This visual prioritization indicates necessity for intervention. The results obtained give clues regarding the current quality of data collection. This allows for the identification of such sections where interventions for quality improvement are needed. In addition, process quality development can be shown over time on an intercomparable basis. This methodology for the evaluation of data collection quality can identify deviations from norms, focalize quality analyses and help trace causes for significant deviations.

What Is the Methodologic Quality of Human Therapy Studies in ISI Surgical Publications?

PubMed Central

Manterola, Carlos; Pineda, Viviana; Vial, Manuel; Losada, Héctor

2006-01-01

Objective: To determine the methodologic quality of therapy articles about humans published in ISI surgical journals, and to explore the association between methodologic quality, origin, and subject matter. Summary Background Data: It is supposed that ISI journals contain the best methodologic articles. Methods: This is a bibliometric study. All journals listed in the 2002 ISI under the subject heading of “Surgery” were included. A simple randomized sampling was conducted for selected journals (Annals of Surgery, The American Surgeon, Archives of Surgery, British Journal of Surgery, European Journal of Surgery, Journal of the American College of Surgeons, Surgery, and World Journal of Surgery). Published articles related to therapy on humans of the selected journals were reviewed and analyzed. All kinds of clinical designs were considered, excluding editorials, review articles, letters to the editor, and experimental studies. The variables considered were: place of origin, design, and the methodologic quality of articles, which was determined by applying a valid and reliable scale. The review was performed interchangeably and independently by 2 research teams. Descriptive and analytical statistics were used. Statistical significance was defined as P values less than 1%. Results: A total of 653 articles were studied. Studies came predominantly from the United States and Europe (43.6% and 36.8%, respectively). The subject areas most frequently found were digestive and hepatobiliopancreatic surgery (29.1% and 24.5%, respectively). Average and median methodologic quality scores of the entire series were 11.6 ± 4.9 points and 11 points, respectively. The association between methodologic quality and journals was determined. Also, the association between methodologic quality and origin was observed, but no association with subject area was verified. Conclusions: The methodologic quality of therapy articles published in the journals analyzed is low; however, statistical significance was determined between them. Association was observed between methodologic quality and origin, but not with subject matter. PMID:17060778

Methodologic quality and relevance of references in pharmaceutical advertisements in a Canadian medical journal.

PubMed Central

Lexchin, J; Holbrook, A

1994-01-01

OBJECTIVE: To evaluate the methodologic quality and relevance of references in pharmaceutical advertisements in the Canadian Medical Association Journal (CMAJ). DESIGN: Analytic study. DATA SOURCE: All 114 references cited in the first 22 distinct pharmaceutical advertisements in volume 146 of CMAJ. MAIN OUTCOME MEASURES: Mean methodologic quality score (modified from the 6-point scale used to assess articles in the American College of Physicians' Journal Club) and mean relevance score (based on a new 5-point scale) for all references in each advertisement. MAIN RESULTS: Twenty of the 22 companies responded, sending 78 (90%) of the 87 references requested. The mean methodologic quality score was 58% (95% confidence limits [CL] 51% and 65%) and the mean relevance score 76% (95% CL 72% and 80%). The two mean scores were statistically lower than the acceptable score of 80% (p < 0.05), and the methodologic quality score was outside the preset clinically significant difference of 15%. The poor rating for methodologic quality was primarily because of the citation of references to low-quality review articles and "other" sources (i.e., other than reports of clinical trials). Half of the advertisements had a methodologic quality score of less than 65%, but only five had a relevance score of less than 65%. CONCLUSIONS: Although the relevance of most of the references was within minimal acceptable limits, the methodologic quality was often unacceptable. Because advertisements are an important part of pharmaceutical marketing and education, we suggest that companies develop written standards for their advertisements and monitor their advertisements for adherence to these standards. We also suggest that the Pharmaceutical Advertising Advisory Board develop more stringent guidelines for advertising and that it enforce these guidelines in a consistent, rigorous fashion. PMID:8004560

Identifying Items to Assess Methodological Quality in Physical Therapy Trials: A Factor Analysis

PubMed Central

Cummings, Greta G.; Fuentes, Jorge; Saltaji, Humam; Ha, Christine; Chisholm, Annabritt; Pasichnyk, Dion; Rogers, Todd

2014-01-01

Background Numerous tools and individual items have been proposed to assess the methodological quality of randomized controlled trials (RCTs). The frequency of use of these items varies according to health area, which suggests a lack of agreement regarding their relevance to trial quality or risk of bias. Objective The objectives of this study were: (1) to identify the underlying component structure of items and (2) to determine relevant items to evaluate the quality and risk of bias of trials in physical therapy by using an exploratory factor analysis (EFA). Design A methodological research design was used, and an EFA was performed. Methods Randomized controlled trials used for this study were randomly selected from searches of the Cochrane Database of Systematic Reviews. Two reviewers used 45 items gathered from 7 different quality tools to assess the methodological quality of the RCTs. An exploratory factor analysis was conducted using the principal axis factoring (PAF) method followed by varimax rotation. Results Principal axis factoring identified 34 items loaded on 9 common factors: (1) selection bias; (2) performance and detection bias; (3) eligibility, intervention details, and description of outcome measures; (4) psychometric properties of the main outcome; (5) contamination and adherence to treatment; (6) attrition bias; (7) data analysis; (8) sample size; and (9) control and placebo adequacy. Limitation Because of the exploratory nature of the results, a confirmatory factor analysis is needed to validate this model. Conclusions To the authors' knowledge, this is the first factor analysis to explore the underlying component items used to evaluate the methodological quality or risk of bias of RCTs in physical therapy. The items and factors represent a starting point for evaluating the methodological quality and risk of bias in physical therapy trials. Empirical evidence of the association among these items with treatment effects and a confirmatory factor analysis of these results are needed to validate these items. PMID:24786942

Developing a stochastic conflict resolution model for urban runoff quality management: Application of info-gap and bargaining theories

NASA Astrophysics Data System (ADS)

Ghodsi, Seyed Hamed; Kerachian, Reza; Estalaki, Siamak Malakpour; Nikoo, Mohammad Reza; Zahmatkesh, Zahra

2016-02-01

In this paper, two deterministic and stochastic multilateral, multi-issue, non-cooperative bargaining methodologies are proposed for urban runoff quality management. In the proposed methodologies, a calibrated Storm Water Management Model (SWMM) is used to simulate stormwater runoff quantity and quality for different urban stormwater runoff management scenarios, which have been defined considering several Low Impact Development (LID) techniques. In the deterministic methodology, the best management scenario, representing location and area of LID controls, is identified using the bargaining model. In the stochastic methodology, uncertainties of some key parameters of SWMM are analyzed using the info-gap theory. For each water quality management scenario, robustness and opportuneness criteria are determined based on utility functions of different stakeholders. Then, to find the best solution, the bargaining model is performed considering a combination of robustness and opportuneness criteria for each scenario based on utility function of each stakeholder. The results of applying the proposed methodology in the Velenjak urban watershed located in the northeastern part of Tehran, the capital city of Iran, illustrate its practical utility for conflict resolution in urban water quantity and quality management. It is shown that the solution obtained using the deterministic model cannot outperform the result of the stochastic model considering the robustness and opportuneness criteria. Therefore, it can be concluded that the stochastic model, which incorporates the main uncertainties, could provide more reliable results.

Methodological Quality of Randomized Clinical Trials of Respiratory Physiotherapy in Coronary Artery Bypass Grafting Patients in the Intensive Care Unit: a Systematic Review

PubMed Central

Lorscheitter, Jaqueline; Stein, Cinara; Plentz, Rodrigo Della Méa

2017-01-01

Objective To assess methodological quality of the randomized controlled trials of physiotherapy in patients undergoing coronary artery bypass grafting in the intensive care unit. Methods The studies published until May 2015, in MEDLINE, Cochrane and PEDro were included. The primary outcome extracted was proper filling of the Cochrane Collaboration's tool's items and the secondary was suitability to the requirements of the CONSORT Statement and its extension. Results From 807 studies identified, 39 were included. Most at CONSORT items showed a better adequacy after the statement's publication. Studies with positive outcomes presented better methodological quality. Conclusion The methodological quality of the studies has been improving over the years. However, many aspects can still be better designed. PMID:28977205

Sugar-Sweetened Beverages and Obesity Risk in Children and Adolescents: A Systematic Analysis on How Methodological Quality May Influence Conclusions.

PubMed

Bucher Della Torre, Sophie; Keller, Amélie; Laure Depeyre, Jocelyne; Kruseman, Maaike

2016-04-01

In the context of a worldwide high prevalence of childhood obesity, the role of sugar-sweetened beverage (SSB) consumption as a cause of excess weight gain remains controversial. Conflicting results may be due to methodological issues in original studies and in reviews. The aim of this review was to systematically analyze the methodology of studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents, and the studies' ability to answer this research question. A systematic review of cohort and experimental studies published until December 2013 in peer-reviewed journals was performed on Medline, CINAHL, Web of Knowledge, and ClinicalTrials.gov. Studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents were included, and methodological quality to answer this question was assessed independently by two investigators using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Among the 32 identified studies, nine had positive quality ratings and 23 studies had at least one major methodological issue. Main methodological issues included SSB definition and inadequate measurement of exposure. Studies with positive quality ratings found an association between SSB consumption and risk of obesity or obesity (n=5) (ie, when SSB consumption increased so did obesity) or mixed results (n=4). Studies with a neutral quality rating found a positive association (n=7), mixed results (n=9), or no association (n=7). The present review shows that the majority of studies with strong methodology indicated a positive association between SSB consumption and risk of obesity or obesity, especially among overweight children. In addition, study findings highlight the need for the careful and precise measurement of the consumption of SSBs and of important confounders. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Clinical trials of homoeopathy.

PubMed Central

Kleijnen, J; Knipschild, P; ter Riet, G

1991-01-01

OBJECTIVE--To establish whether there is evidence of the efficacy of homoeopathy from controlled trials in humans. DESIGN--Criteria based meta-analysis. Assessment of the methodological quality of 107 controlled trials in 96 published reports found after an extensive search. Trials were scored using a list of predefined criteria of good methodology, and the outcome of the trials was interpreted in relation to their quality. SETTING--Controlled trials published world wide. MAIN OUTCOME MEASURES--Results of the trials with the best methodological quality. Trials of classical homoeopathy and several modern varieties were considered separately. RESULTS--In 14 trials some form of classical homoeopathy was tested and in 58 trials the same single homoeopathic treatment was given to patients with comparable conventional diagnosis. Combinations of several homoeopathic treatments were tested in 26 trials; isopathy was tested in nine trials. Most trials seemed to be of very low quality, but there were many exceptions. The results showed a positive trend regardless of the quality of the trial or the variety of homeopathy used. Overall, of the 105 trials with interpretable results, 81 trials indicated positive results whereas in 24 trials no positive effects of homoeopathy were found. The results of the review may be complicated by publication bias, especially in such a controversial subject as homoeopathy. CONCLUSIONS--At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials. PMID:1825800

Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews.

PubMed

Shea, Beverley J; Grimshaw, Jeremy M; Wells, George A; Boers, Maarten; Andersson, Neil; Hamel, Candyce; Porter, Ashley C; Tugwell, Peter; Moher, David; Bouter, Lex M

2007-02-15

Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use.

Abstract analysis method facilitates filtering low-methodological quality and high-bias risk systematic reviews on psoriasis interventions.

PubMed

Gómez-García, Francisco; Ruano, Juan; Aguilar-Luque, Macarena; Alcalde-Mellado, Patricia; Gay-Mimbrera, Jesús; Hernández-Romero, José Luis; Sanz-Cabanillas, Juan Luis; Maestre-López, Beatriz; González-Padilla, Marcelino; Carmona-Fernández, Pedro J; García-Nieto, Antonio Vélez; Isla-Tejera, Beatriz

2017-12-29

Article summaries' information and structure may influence researchers/clinicians' decisions to conduct deeper full-text analyses. Specifically, abstracts of systematic reviews (SRs) and meta-analyses (MA) should provide structured summaries for quick assessment. This study explored a method for determining the methodological quality and bias risk of full-text reviews using abstract information alone. Systematic literature searches for SRs and/or MA about psoriasis were undertaken on MEDLINE, EMBASE, and Cochrane database. For each review, quality, abstract-reporting completeness, full-text methodological quality, and bias risk were evaluated using Preferred Reporting Items for Systematic Reviews and Meta-analyses for abstracts (PRISMA-A), Assessing the Methodological Quality of Systematic Reviews (AMSTAR), and ROBIS tools, respectively. Article-, author-, and journal-derived metadata were systematically extracted from eligible studies using a piloted template, and explanatory variables concerning abstract-reporting quality were assessed using univariate and multivariate-regression models. Two classification models concerning SRs' methodological quality and bias risk were developed based on per-item and total PRISMA-A scores and decision-tree algorithms. This work was supported, in part, by project ICI1400136 (JR). No funding was received from any pharmaceutical company. This study analysed 139 SRs on psoriasis interventions. On average, they featured 56.7% of PRISMA-A items. The mean total PRISMA-A score was significantly higher for high-methodological-quality SRs than for moderate- and low-methodological-quality reviews. SRs with low-bias risk showed higher total PRISMA-A values than reviews with high-bias risk. In the final model, only 'authors per review > 6' (OR: 1.098; 95%CI: 1.012-1.194), 'academic source of funding' (OR: 3.630; 95%CI: 1.788-7.542), and 'PRISMA-endorsed journal' (OR: 4.370; 95%CI: 1.785-10.98) predicted PRISMA-A variability. Reviews with a total PRISMA-A score < 6, lacking identification as SR or MA in the title, and lacking explanation concerning bias risk assessment methods were classified as low-methodological quality. Abstracts with a total PRISMA-A score ≥ 9, including main outcomes results and explanation bias risk assessment method were classified as having low-bias risk. The methodological quality and bias risk of SRs may be determined by abstract's quality and completeness analyses. Our proposal aimed to facilitate synthesis of evidence evaluation by clinical professionals lacking methodological skills. External validation is necessary.

Comparison of methodological quality rating of systematic reviews on neuropathic pain using AMSTAR and R-AMSTAR.

PubMed

Dosenovic, Svjetlana; Jelicic Kadic, Antonia; Vucic, Katarina; Markovina, Nikolina; Pieper, Dawid; Puljak, Livia

2018-05-08

Systematic reviews (SRs) in the field of neuropathic pain (NeuP) are increasingly important for decision-making. However, methodological flaws in SRs can reduce the validity of conclusions. Hence, it is important to assess the methodological quality of NeuP SRs critically. Additionally, it remains unclear which assessment tool should be used. We studied the methodological quality of SRs published in the field of NeuP and compared two assessment tools. We systematically searched 5 electronic databases to identify SRs of randomized controlled trials of interventions for NeuP available up to March 2015. Two independent reviewers assessed the methodological quality of the studies using the Assessment of Multiple Systematic Reviews (AMSTAR) and the revised AMSTAR (R-AMSTAR) tools. The scores were converted to percentiles and ranked into 4 grades to allow comparison between the two checklists. Gwet's AC1 coefficient was used for interrater reliability assessment. The 97 included SRs had a wide range of methodological quality scores (AMSTAR median (IQR): 6 (5-8) vs. R-AMSTAR median (IQR): 30 (26-35)). The overall agreement score between the 2 raters was 0.62 (95% CI 0.39-0.86) for AMSTAR and 0.62 (95% CI 0.53-0.70) for R-AMSTAR. The 31 Cochrane systematic reviews (CSRs) were consistently ranked higher than the 66 non-Cochrane systematic reviews (NCSRs). The analysis of individual domains showed the best compliance in a comprehensive literature search (item 3) on both checklists. The results for the domain that was the least compliant differed: conflict of interest (item 11) was the item most poorly reported on AMSTAR vs. publication bias assessment (item 10) on R-AMSTAR. A high positive correlation between the total AMSTAR and R-AMSTAR scores for all SRs, as well as for CSRs and NCSRs, was observed. The methodological quality of analyzed SRs in the field of NeuP was not optimal, and CSRs had a higher quality than NCSRs. Both AMSTAR and R-AMSTAR tools produced comparable quality ratings. Our results point out to weaknesses in the methodology of existing SRs on interventions for the management NeuP and call for future improvement by better adherence to analyzed quality checklists, either AMSTAR or R-AMSTAR.

Identifying items to assess methodological quality in physical therapy trials: a factor analysis.

PubMed

Armijo-Olivo, Susan; Cummings, Greta G; Fuentes, Jorge; Saltaji, Humam; Ha, Christine; Chisholm, Annabritt; Pasichnyk, Dion; Rogers, Todd

2014-09-01

Numerous tools and individual items have been proposed to assess the methodological quality of randomized controlled trials (RCTs). The frequency of use of these items varies according to health area, which suggests a lack of agreement regarding their relevance to trial quality or risk of bias. The objectives of this study were: (1) to identify the underlying component structure of items and (2) to determine relevant items to evaluate the quality and risk of bias of trials in physical therapy by using an exploratory factor analysis (EFA). A methodological research design was used, and an EFA was performed. Randomized controlled trials used for this study were randomly selected from searches of the Cochrane Database of Systematic Reviews. Two reviewers used 45 items gathered from 7 different quality tools to assess the methodological quality of the RCTs. An exploratory factor analysis was conducted using the principal axis factoring (PAF) method followed by varimax rotation. Principal axis factoring identified 34 items loaded on 9 common factors: (1) selection bias; (2) performance and detection bias; (3) eligibility, intervention details, and description of outcome measures; (4) psychometric properties of the main outcome; (5) contamination and adherence to treatment; (6) attrition bias; (7) data analysis; (8) sample size; and (9) control and placebo adequacy. Because of the exploratory nature of the results, a confirmatory factor analysis is needed to validate this model. To the authors' knowledge, this is the first factor analysis to explore the underlying component items used to evaluate the methodological quality or risk of bias of RCTs in physical therapy. The items and factors represent a starting point for evaluating the methodological quality and risk of bias in physical therapy trials. Empirical evidence of the association among these items with treatment effects and a confirmatory factor analysis of these results are needed to validate these items. © 2014 American Physical Therapy Association.

The relationship between return on investment and quality of study methodology in workplace health promotion programs.

PubMed

Baxter, Siyan; Sanderson, Kristy; Venn, Alison J; Blizzard, C Leigh; Palmer, Andrew J

2014-01-01

To determine the relationship between return on investment (ROI) and quality of study methodology in workplace health promotion programs. Data were obtained through a systematic literature search of National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Database (HTA), Cost Effectiveness Analysis (CEA) Registry, EconLit, PubMed, Embase, Wiley, and Scopus. Included were articles written in English or German reporting cost(s) and benefit(s) and single or multicomponent health promotion programs on working adults. Return-to-work and workplace injury prevention studies were excluded. Methodological quality was graded using British Medical Journal Economic Evaluation Working Party checklist. Economic outcomes were presented as ROI. ROI was calculated as ROI = (benefits - costs of program)/costs of program. Results were weighted by study size and combined using meta-analysis techniques. Sensitivity analysis was performed using two additional methodological quality checklists. The influences of quality score and important study characteristics on ROI were explored. Fifty-one studies (61 intervention arms) published between 1984 and 2012 included 261,901 participants and 122,242 controls from nine industry types across 12 countries. Methodological quality scores were highly correlated between checklists (r = .84-.93). Methodological quality improved over time. Overall weighted ROI [mean ± standard deviation (confidence interval)] was 1.38 ± 1.97 (1.38-1.39), which indicated a 138% return on investment. When accounting for methodological quality, an inverse relationship to ROI was found. High-quality studies (n = 18) had a smaller mean ROI, 0.26 ± 1.74 (.23-.30), compared to moderate (n = 16) 0.90 ± 1.25 (.90-.91) and low-quality (n = 27) 2.32 ± 2.14 (2.30-2.33) studies. Randomized control trials (RCTs) (n = 12) exhibited negative ROI, -0.22 ± 2.41(-.27 to -.16). Financial returns become increasingly positive across quasi-experimental, nonexperimental, and modeled studies: 1.12 ± 2.16 (1.11-1.14), 1.61 ± 0.91 (1.56-1.65), and 2.05 ± 0.88 (2.04-2.06), respectively. Overall, mean weighted ROI in workplace health promotion demonstrated a positive ROI. Higher methodological quality studies provided evidence of smaller financial returns. Methodological quality and study design are important determinants.

Measuring e-Commerce service quality from online customer review using sentiment analysis

NASA Astrophysics Data System (ADS)

Kencana Sari, Puspita; Alamsyah, Andry; Wibowo, Sulistyo

2018-03-01

The biggest e-Commerce challenge to understand their market is to chart their level of service quality according to customer perception. The opportunities to collect user perception through online user review is considered faster methodology than conducting direct sampling methodology. To understand the service quality level, sentiment analysis methodology is used to classify the reviews into positive and negative sentiment for five dimensions of electronic service quality (e-Servqual). As case study in this research, we use Tokopedia, one of the biggest e-Commerce service in Indonesia. We obtain the online review comments about Tokopedia service quality during several month observations. The Naïve Bayes classification methodology is applied for the reason of its high-level accuracy and support large data processing. The result revealed that personalization and reliability dimension required more attention because have high negative sentiment. Meanwhile, trust and web design dimension have high positive sentiments that means it has very good services. The responsiveness dimension have balance sentiment positive and negative.

Development of an Optimization Methodology for the Aluminum Alloy Wheel Casting Process

NASA Astrophysics Data System (ADS)

Duan, Jianglan; Reilly, Carl; Maijer, Daan M.; Cockcroft, Steve L.; Phillion, Andre B.

2015-08-01

An optimization methodology has been developed for the aluminum alloy wheel casting process. The methodology is focused on improving the timing of cooling processes in a die to achieve improved casting quality. This methodology utilizes (1) a casting process model, which was developed within the commercial finite element package, ABAQUS™—ABAQUS is a trademark of Dassault Systèms; (2) a Python-based results extraction procedure; and (3) a numerical optimization module from the open-source Python library, Scipy. To achieve optimal casting quality, a set of constraints have been defined to ensure directional solidification, and an objective function, based on the solidification cooling rates, has been defined to either maximize, or target a specific, cooling rate. The methodology has been applied to a series of casting and die geometries with different cooling system configurations, including a 2-D axisymmetric wheel and die assembly generated from a full-scale prototype wheel. The results show that, with properly defined constraint and objective functions, solidification conditions can be improved and optimal cooling conditions can be achieved leading to process productivity and product quality improvements.

A quality evaluation methodology of health web-pages for non-professionals.

PubMed

Currò, Vincenzo; Buonuomo, Paola Sabrina; Onesimo, Roberta; de Rose, Paola; Vituzzi, Andrea; di Tanna, Gian Luca; D'Atri, Alessandro

2004-06-01

The proposal of an evaluation methodology for determining the quality of healthcare web sites for the dissemination of medical information to non-professionals. Three (macro) factors are considered for the quality evaluation: medical contents, accountability of the authors, and usability of the web site. Starting from two results in the literature the problem of whether or not to introduce a weighting function has been investigated. This methodology has been validated on a specialized information content, i.e., sore throats, due to the large interest such a topic enjoys with target users. The World Wide Web was accessed using a meta-search system merging several search engines. A statistical analysis was made to compare the proposed methodology with the obtained ranks of the sample web pages. The statistical analysis confirms that the variables examined (per item and sub factor) show substantially similar ranks and are capable of contributing to the evaluation of the main quality macro factors. A comparison between the aggregation functions in the proposed methodology (non-weighted averages) and the weighting functions, derived from the literature, allowed us to verify the suitability of the method. The proposed methodology suggests a simple approach which can quickly award an overall quality score for medical web sites oriented to non-professionals.

Methodological Quality of Consensus Guidelines in Implant Dentistry

PubMed Central

Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

2017-01-01

Background Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. Objective To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. Methods The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Results Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p < 0.05). Conclusions Methodological improvement of consensus guidelines published in major implant dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions. PMID:28107405

Interpreting drinking water quality in the distribution system using Dempster-Shafer theory of evidence.

PubMed

Sadiq, Rehan; Rodriguez, Manuel J

2005-04-01

Interpreting water quality data routinely generated for control and monitoring purposes in water distribution systems is a complicated task for utility managers. In fact, data for diverse water quality indicators (physico-chemical and microbiological) are generated at different times and at different locations in the distribution system. To simplify and improve the understanding and the interpretation of water quality, methodologies for aggregation and fusion of data must be developed. In this paper, the Dempster-Shafer theory also called theory of evidence is introduced as a potential methodology for interpreting water quality data. The conceptual basis of this methodology and the process for its implementation are presented by two applications. The first application deals with the interpretation of spatial water quality data fusion, while the second application deals with the development of water quality index based on key monitored indicators. Based on the obtained results, the authors discuss the potential contribution of theory of evidence as a decision-making tool for water quality management.

SERVQUAL Application and Adaptation for Educational Service Quality Assessments in Russian Higher Education

ERIC Educational Resources Information Center

Galeeva, Railya B.

2016-01-01

Purpose: The purpose of this study is to demonstrate an adaptation of the SERVQUAL survey method for measuring the quality of higher educational services in a Russian university context. We use a new analysis and a graphical technique for presentation of results. Design/methodology/approach: The methodology of this research follows the classic…

DPP-4 inhibitors for the treatment of type 2 diabetes: a methodology overview of systematic reviews.

PubMed

Ling, Juan; Ge, Long; Zhang, Ding-Hua; Wang, Yong-Feng; Xie, Zhuo-Lin; Tian, Jin-Hui; Xiao, Xiao-Hui; Yang, Ke-Hu

2018-06-01

To evaluate the methodological quality of systematic reviews (SRs), and summarize evidence of important outcomes from dipeptidyl peptidase-4 inhibitors (DPP4-I) in treating type 2 diabetes mellitus (T2DM). We included SRs of DPP4-I for the treatment of T2DM until January, 2018 by searching the Cochrane Library, PubMed, EMBASE and three Chinese databases. We evaluated the methodological qualities with the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool and the GRADE (The Grading of Recommendations Assessment, Development and Evaluation) approach. Sixty-three SRs (a total of 2,603,140 participants) receiving DPP4-I for the treatment of T2DM were included. The results of AMSTAR showed that the lowest quality was "a list of studies (included and excluded) item" with only one (1.6%) study provided, followed by the "providing a priori design" item with only four (6.3%) studies conforming to this item, the next were "the status of publication (gray literature) used as an inclusion criterion item", with only 18 (28.9%) studies conforming to these items. Only seven (11.1%) studies scored more than nine points in AMSTAR, indicating high methodological quality. For GRADE, of the 128 outcomes, high quality evidence was provided in only 28 (21.9%), moderate in 70 (54.7%), low in 27 (21.1%), and very low in three (2.3%). The methodological quality of SRs of DPP4-I for type 2 diabetes mellitus is not high and there are common areas for improvement. Furthermore, the quality of evidence level is moderate and more high quality evidence is needed.

Macroergonomic analysis and design for improved safety and quality performance.

PubMed

Kleiner, B M

1999-01-01

Macroergonomics, which emerged historically after sociotechnical systems theory, quality management, and ergonomics, is presented as the basis for a needed integrative methodology. A macroergonomics methodology was presented in some detail to demonstrate how aspects of microergonomics, total quality management (TQM), and sociotechnical systems (STS) can be triangulated in a common approach. In the context of this methodology, quality and safety were presented as 2 of several important performance criteria. To demonstrate aspects of the methodology, 2 case studies were summarized with safety and quality performance results where available. The first case manipulated both personnel and technical factors to achieve a "safety culture" at a nuclear site. The concept of safety culture is defined in INSAG-4 (International Atomic Energy Agency, 1991). as "that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance." The second case described a tire manufacturing intervention to improve quality (as defined by Sink and Tuttle, 1989) through joint consideration of technical and social factors. It was suggested that macroergonomics can yield greater performance than can be achieved through ergonomic intervention alone. Whereas case studies help to make the case, more rigorous formative and summative research is needed to refine and validate the proposed methodology respectively.

A Novel Consensus-Based Particle Swarm Optimization-Assisted Trust-Tech Methodology for Large-Scale Global Optimization.

PubMed

Zhang, Yong-Feng; Chiang, Hsiao-Dong

2017-09-01

A novel three-stage methodology, termed the "consensus-based particle swarm optimization (PSO)-assisted Trust-Tech methodology," to find global optimal solutions for nonlinear optimization problems is presented. It is composed of Trust-Tech methods, consensus-based PSO, and local optimization methods that are integrated to compute a set of high-quality local optimal solutions that can contain the global optimal solution. The proposed methodology compares very favorably with several recently developed PSO algorithms based on a set of small-dimension benchmark optimization problems and 20 large-dimension test functions from the CEC 2010 competition. The analytical basis for the proposed methodology is also provided. Experimental results demonstrate that the proposed methodology can rapidly obtain high-quality optimal solutions that can contain the global optimal solution. The scalability of the proposed methodology is promising.

A flood tide of systematic reviews on endodontic posts: methodological assessment using of R-AMSTAR.

PubMed

Schmitter, M; Sterzenbach, G; Faggion, C M; Krastl, G

2013-06-01

To help the dental practitioner solve a specific clinical problem, systematic reviews (SRs) are seen as the best guide. In addition to the unmanageable quantity of SRs, however, one should be aware of their variable quality. The present review describes the methodological quality of SRs on postendodontic restorations to work out the value of these reviews for the dental practitioner. SRs were searched in April 2012, independently and in triplicate. Post survival was used as measure of outcome. The methodological quality of included SRs was assessed with the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Kappa statistics were used to assess reviewer agreement. Three hundred sixty-three papers were retrieved from the initial search. Ten SRs were included. One SR achieved a high R-AMSTAR score, whereas the other nine SRs achieved scores that indicate a substantial lack of methodological quality. Especially the items "grey literature," "combination of findings," "likelihood of publication bias," and conflict of interest" showed low R-AMSTAR scores. The three reviews with the highest R-AMSTAR scores tended to conclude that fewer failures occurred when using nonmetal posts. The reviewer agreement was excellent (kappa ranged from 0.79 to 0.85) in the R-AMSTAR classification. The approach presented revealed a lack of SRs with high methodological quality. Thus, no decisive conclusion can be drawn with respect to this topic. It appears that there is a trend for the superiority of fiber-reinforced posts. SRs must be of high methodological quality. This can be achieved by taking into consideration the results of this review. Improved methodological quality would make SRs more supportive for the general practitioner.

How to Select a Questionnaire with a Good Methodological Quality?

PubMed

Paiva, Saul Martins; Perazzo, Matheus de França; Ortiz, Fernanda Ruffo; Pordeus, Isabela Almeida; Martins-Júnior, Paulo Antônio

2018-01-01

In the last decades, several instruments have been used to evaluate the impact of oral health problems on the oral health-related quality of life (OHRQoL) of individuals. However, some instruments lack thorough methodological validation or present conceptual differences that hinder comparisons with instruments. Thus, it can be difficult to clinicians and researchers to select a questionnaire that accurately reflect what are really meaningful to individuals. This short communication aimed to discuss the importance of use an appropriate checklist to select an instrument with a good methodological quality. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was developed to provide tools for evidence-based instrument selection. The COSMIN checklist comprises ten boxes that evaluate whether a study meets the standard for good methodological quality and two additional boxes to meet studies that use the Item Response Theory method and general requirements for results generalization, resulting in four steps to be followed. In this way, it is required at least some expertise in psychometrics or clinimetrics to a wide-ranging use of this checklist. The COSMIN applications include its use to ensure the standardization of cross-cultural adaptations and safer comparisons between measurement studies and evaluation of methodological quality of systematic reviews of measurement properties. Also, it can be used by students when training about measurement properties and by editors and reviewers when revising manuscripts on this topic. The popularization of COSMIN checklist is therefore necessary to improve the selection and evaluation of health measurement instruments.

Methodologic European external quality assurance for DNA sequencing: the EQUALseq program.

PubMed

Ahmad-Nejad, Parviz; Dorn-Beineke, Alexandra; Pfeiffer, Ulrike; Brade, Joachim; Geilenkeuser, Wolf-Jochen; Ramsden, Simon; Pazzagli, Mario; Neumaier, Michael

2006-04-01

DNA sequencing is a key technique in molecular diagnostics, but to date no comprehensive methodologic external quality assessment (EQA) programs have been instituted. Between 2003 and 2005, the European Union funded, as specific support actions, the EQUAL initiative to develop methodologic EQA schemes for genotyping (EQUALqual), quantitative PCR (EQUALquant), and sequencing (EQUALseq). Here we report on the results of the EQUALseq program. The participating laboratories received a 4-sample set comprising 2 DNA plasmids, a PCR product, and a finished sequencing reaction to be analyzed. Data and information from detailed questionnaires were uploaded online and evaluated by use of a scoring system for technical skills and proficiency of data interpretation. Sixty laboratories from 21 European countries registered, and 43 participants (72%) returned data and samples. Capillary electrophoresis was the predominant platform (n = 39; 91%). The median contiguous correct sequence stretch was 527 nucleotides with considerable variation in quality of both primary data and data evaluation. The association between laboratory performance and the number of sequencing assays/year was statistically significant (P <0.05). Interestingly, more than 30% of participants neither added comments to their data nor made efforts to identify the gene sequences or mutational positions. Considerable variations exist even in a highly standardized methodology such as DNA sequencing. Methodologic EQAs are appropriate tools to uncover strengths and weaknesses in both technique and proficiency, and our results emphasize the need for mandatory EQAs. The results of EQUALseq should help improve the overall quality of molecular genetics findings obtained by DNA sequencing.

Assessment of Methodological Quality of Economic Evaluations in Belgian Drug Reimbursement Applications

PubMed Central

Simoens, Steven

2013-01-01

Objectives This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. Materials and Methods For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Results Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Conclusions Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation. PMID:24386474

Systematic review and quality assessment of cost-effectiveness analysis of pharmaceutical therapies for advanced colorectal cancer.

PubMed

Leung, Henry W C; Chan, Agnes L F; Leung, Matthew S H; Lu, Chin-Li

2013-04-01

To systematically review and assess the quality of cost-effectiveness analyses (CEAs) of pharmaceutical therapies for metastatic colorectal cancer (mCRC). The MEDLINE, EMBASE, Cochrane, and EconLit databases were searched for the Medical Subject Headings or text key words quality-adjusted, QALY, life-year gained (LYG), and cost-effectiveness (January 1, 1999-December 31, 2009). Original CEAs of mCRC pharmacotherapy published in English were included. CEAs that measured health effects in units other than quality-adjusted life years or LYG and letters to the editor, case reports, posters, and editorials were excluded. Each article was independently assessed by 2 trained reviewers according to a quality checklist created by the Panel on Cost-Effectiveness in Health and Medicine. Twenty-four CEA studies pertaining to pharmaceutical therapies for mCRC were identified. All studies showed a wide variation in methodologic approaches, which resulted in a different range of incremental cost-effectiveness ratios reported for each regimen. We found common methodologic flaws in a significant number of CEA studies, including lack of clear description for critique of data quality; lack of method for adjusting costs for inflation and methods for obtaining expert judgment; no results of model validation; wide differences in the types of perspective, time horizon, study design, cost categories, and effect outcomes; and no quality assessment of data (cost and effectiveness) for the interventions evaluation. This study has shown a wide variation in the methodology and quality of cost-effectiveness analysis for mCRC. Improving quality and harmonization of CEA for cancer treatment is needed. Further study is suggested to assess the quality of CEA methodology outside the mCRC disease state.

Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions.

PubMed

Pollock, Michelle; Fernandes, Ricardo M; Hartling, Lisa

2017-03-23

Overviews of reviews (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. It is recommended that authors assess and report the methodological quality of SRs in overviews-for example, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Currently, there is variation in whether and how overview authors assess and report SR quality, and limited guidance is available. Our objectives were to: examine methodological considerations involved in using AMSTAR to assess the quality of Cochrane and non-Cochrane SRs in overviews of healthcare interventions; identify challenges (and develop potential decision rules) when using AMSTAR in overviews; and examine the potential impact of considering methodological quality when making inclusion decisions in overviews. We selected seven overviews of healthcare interventions and included all SRs meeting each overview's inclusion criteria. For each SR, two reviewers independently conducted AMSTAR assessments with consensus and discussed challenges encountered. We also examined the correlation between AMSTAR assessments and SR results/conclusions. Ninety-five SRs were included (30 Cochrane, 65 non-Cochrane). Mean AMSTAR assessments (9.6/11 vs. 5.5/11; p < 0.001) and inter-rater reliability (AC1 statistic: 0.84 vs. 0.69; "almost perfect" vs. "substantial" using the Landis & Koch criteria) were higher for Cochrane compared to non-Cochrane SRs. Four challenges were identified when applying AMSTAR in overviews: the scope of the SRs and overviews often differed; SRs examining similar topics sometimes made different methodological decisions; reporting of non-Cochrane SRs was sometimes poor; and some non-Cochrane SRs included other SRs as well as primary studies. Decision rules were developed to address each challenge. We found no evidence that AMSTAR assessments were correlated with SR results/conclusions. Results indicate that the AMSTAR tool can be used successfully in overviews that include Cochrane and non-Cochrane SRs, though decision rules may be useful to circumvent common challenges. Findings support existing recommendations that quality assessments of SRs in overviews be conducted independently, in duplicate, with a process for consensus. Results also suggest that using methodological quality to guide inclusion decisions (e.g., to exclude poorly conducted and reported SRs) may not introduce bias into the overview process.

Choosing Wisely: assessment of current US top five list recommendations’ trustworthiness using a pragmatic approach

PubMed Central

Horvath, Karl; Semlitsch, Thomas; Jeitler, Klaus; Abuzahra, Muna E; Posch, Nicole; Domke, Andreas; Siebenhofer, Andrea

2016-01-01

Objectives Identification of sufficiently trustworthy top 5 list recommendations from the US Choosing Wisely campaign. Setting Not applicable. Participants All top 5 list recommendations available from the American Board of Internal Medicine Foundation website. Main outcome measures/interventions Compilation of US top 5 lists and search for current German highly trustworthy (S3) guidelines. Extraction of guideline recommendations, including grade of recommendation (GoR), for suggestions comparable to top 5 list recommendations. For recommendations without guideline equivalents, the methodological quality of the top 5 list development process was assessed using criteria similar to that used to judge guidelines, and relevant meta-literature was identified in cited references. Judgement of sufficient trustworthiness of top 5 list recommendations was based either on an ‘A’ GoR of guideline equivalents or on high methodological quality and citation of relevant meta-literature. Results 412 top 5 list recommendations were identified. For 75 (18%), equivalents were found in current German S3 guidelines. 44 of these recommendations were associated with an ‘A’ GoR, or a strong recommendation based on strong evidence, and 26 had a ‘B’ or a ‘C’ GoR. No GoR was provided for 5 recommendations. 337 recommendations had no equivalent in the German S3 guidelines. The methodological quality of the development process was high and relevant meta-literature was cited for 87 top 5 list recommendations. For a further 36, either the methodological quality was high without any meta-literature citations or meta-literature citations existed but the methodological quality was lacking. For the remaining 214 recommendations, either the methodological quality was lacking and no literature was cited or the methodological quality was generally unsatisfactory. Conclusions 131 of current US top 5 list recommendations were found to be sufficiently trustworthy. For a substantial number of current US top 5 list recommendations, their trustworthiness remains unclear. Methodological requirements for developing top 5 lists are recommended. PMID:27855098

Measurement properties of translated versions of neck-specific questionnaires: a systematic review

PubMed Central

2011-01-01

Background Several disease-specific questionnaires to measure pain and disability in patients with neck pain have been translated. However, a simple translation of the original version doesn't guarantee similar measurement properties. The objective of this study is to critically appraise the quality of the translation process, cross-cultural validation and the measurement properties of translated versions of neck-specific questionnaires. Methods Bibliographic databases were searched for articles concerning the translation or evaluation of the measurement properties of a translated version of a neck-specific questionnaire. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist and criteria for measurement properties. Results The search strategy resulted in a total of 3641 unique hits, of which 27 articles, evaluating 6 different questionnaires in 15 different languages, were included in this study. Generally the methodological quality of the translation process is poor and none of the included studies performed a cross-cultural adaptation. A substantial amount of information regarding the measurement properties of translated versions of the different neck-specific questionnaires is lacking. Moreover, the evidence for the quality of measurement properties of the translated versions is mostly limited or assessed in studies of poor methodological quality. Conclusions Until results from high quality studies are available, we advise to use the Catalan, Dutch, English, Iranian, Korean, Spanish and Turkish version of the NDI, the Chinese version of the NPQ, and the Finnish, German and Italian version of the NPDS. The Greek NDI needs cross-cultural validation and there is no methodologically sound information for the Swedish NDI. For all other languages we advise to translate the original version of the NDI. PMID:21645355

Tracer methodology: an appropriate tool for assessing compliance with accreditation standards?

PubMed

Bouchard, Chantal; Jean, Olivier

2017-10-01

Tracer methodology has been used by Accreditation Canada since 2008 to collect evidence on the quality and safety of care and services, and to assess compliance with accreditation standards. Given the importance of this methodology in the accreditation program, the objective of this study is to assess the quality of the methodology and identify its strengths and weaknesses. A mixed quantitative and qualitative approach was adopted to evaluate consistency, appropriateness, effectiveness and stakeholder synergy in applying the methodology. An online questionnaire was sent to 468 Accreditation Canada surveyors. According to surveyors' perceptions, tracer methodology is an effective tool for collecting useful, credible and reliable information to assess compliance with Qmentum program standards and priority processes. The results show good coherence between methodology components (appropriateness of the priority processes evaluated, activities to evaluate a tracer, etc.). The main weaknesses are the time constraints faced by surveyors and management's lack of cooperation during the evaluation of tracers. The inadequate amount of time allowed for the methodology to be applied properly raises questions about the quality of the information obtained. This study paves the way for a future, more in-depth exploration of the identified weaknesses to help the accreditation organization make more targeted improvements to the methodology. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Q methodology, risk training and quality management.

PubMed

McKeown, M; Hinks, M; Stowell-Smith, M; Mercer, D; Forster, J

1999-01-01

The results of a Q methodological study of professional understandings of the notion of risk in mental health services within the UK are discussed in relation to the relevance for staff training and quality assurance. The study attempted to access the diversity of understandings of risk issues amongst a multi-professional group of staff (n = 60) attending inter-agency risk training workshops in 1998. Q methodology is presented as both an appropriate means for such inquiry and as a novel experiential technique for training purposes. A tentative argument is advanced that the qualitative accounts generated by Q research could assist in systematic reviews of quality, complementing the singularly quantitative approaches typically represented in the audit process.

Methodological quality of systematic reviews analyzing the use of laser therapy in restorative dentistry.

PubMed

Salmos, Janaina; Gerbi, Marleny E M M; Braz, Rodivan; Andrade, Emanuel S S; Vasconcelos, Belmiro C E; Bessa-Nogueira, Ricardo V

2010-01-01

The purpose of this study was to identify systematic reviews (SRs) that compared laser with other dental restorative procedures and to evaluate their methodological quality. A search strategy was developed and implemented for MEDLINE, the Cochrane Library, LILACS, and the Brazilian Dentistry Bibliography (1966- 2007). Inclusion criteria were: the article had to be an SR (+/- meta-analysis); primary focus was the use of laser in restorative dentistry; published in English, Spanish, Portuguese, Italian, German. Two investigators independently selected and evaluated the SRs. The overview quality assessment questionnaire (OQAQ) was used to evaluate methodological quality, and the results were averaged. There were 145 references identified, of which seven were SRs that met the inclusion criteria (kappa=0.81). Of the SRs, 71.4% appraised lasers in dental caries diagnosis. The mean overall OQAQ score was 4.4 [95% confidence interval (CI) 2.4- 6.5]. Of the SRs, 57.1% had major flaws, scoring < or = 4. SR methodological quality is low; therefore, clinicians should critically appraise them prior to considering their recommendations to guide patient care.

Design of the subject of quality engineering and security of the product of the degree in engineering in industrial design and development of product based in the methodology of the case

NASA Astrophysics Data System (ADS)

González, M. R.; Lambán, M. P.

2012-04-01

This paper presents the result of designing the subject Quality Engineering and Security of the Product, belonging to the Degree of Engineering in Industrial Design and Product Development, on the basis of the case methodology. Practical sessions of this subject are organized using the whole documents of the Quality System Management of the virtual company BeaLuc S.A.

Social cognition interventions for people with schizophrenia: a systematic review focussing on methodological quality and intervention modality.

PubMed

Grant, Nina; Lawrence, Megan; Preti, Antonio; Wykes, Til; Cella, Matteo

2017-08-01

People with a diagnosis of schizophrenia have significant social and functional difficulties. Social cognition was found to influences these outcomes and in recent years interventions targeting this domain were developed. This paper reviews the existing literature on social cognition interventions for people with a diagnosis of schizophrenia focussing on: i) comparing focussed (i.e. targeting only one social cognitive domain) and global interventions and ii) studies methodological quality. Systematic search was conducted on PubMed and PsycInfo. Studies were included if they were randomised control trials, participants had a diagnosis of schizophrenia or schizoaffective disorder, and the intervention targeted at least one out of four social cognition domains (i.e. theory of mind, affect recognition, social perception and attribution bias). All papers were assessed for methodological quality. Information on the intervention, control condition, study methodology and the main findings from each study were extracted and critically summarised. Data from 32 studies fulfilled the inclusion criteria, considering a total of 1440 participants. Taking part in social cognition interventions produced significant improvements in theory of mind and affect recognition compared to both passive and active control conditions. Results were less clear for social perception and attributional bias. Focussed and global interventions had similar results on outcomes. Overall study methodological quality was modest. There was very limited evidence showing that social cognitive intervention result in functional outcome improvement. The evidence considered suggests that social cognition interventions may be a valuable approach for people with a diagnosis of schizophrenia. However, evidence quality is limited by measure heterogeneity, modest study methodology and short follow-up periods. The findings point to a number of recommendations for future research, including measurement standardisation, appropriately powered studies and investigation of the impact of social cognition improvements on functioning problems. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Methodological standards in single-case experimental design: Raising the bar.

PubMed

Ganz, Jennifer B; Ayres, Kevin M

2018-04-12

Single-case experimental designs (SCEDs), or small-n experimental research, are frequently implemented to assess approaches to improving outcomes for people with disabilities, particularly those with low-incidence disabilities, such as some developmental disabilities. SCED has become increasingly accepted as a research design. As this literature base is needed to determine what interventions are evidence-based practices, the acceptance of SCED has resulted in increased critiques with regard to methodological quality. Recent trends include recommendations from a number of expert scholars and institutions. The purpose of this article is to summarize the recent history of methodological quality considerations, synthesize the recommendations found in the SCED literature, and provide recommendations to researchers designing SCEDs with regard to essential and aspirational standards for methodological quality. Conclusions include imploring SCED to increase the quality of their experiments, with particular consideration regarding the applied nature of SCED research to be published in Research in Developmental Disabilities and beyond. Copyright © 2018 Elsevier Ltd. All rights reserved.

Information security system quality assessment through the intelligent tools

NASA Astrophysics Data System (ADS)

Trapeznikov, E. V.

2018-04-01

The technology development has shown the automated system information security comprehensive analysis necessity. The subject area analysis indicates the study relevance. The research objective is to develop the information security system quality assessment methodology based on the intelligent tools. The basis of the methodology is the information security assessment model in the information system through the neural network. The paper presents the security assessment model, its algorithm. The methodology practical implementation results in the form of the software flow diagram are represented. The practical significance of the model being developed is noted in conclusions.

Methodological Quality of National Guidelines for Pediatric Inpatient Conditions

PubMed Central

Hester, Gabrielle; Nelson, Katherine; Mahant, Sanjay; Eresuma, Emily; Keren, Ron; Srivastava, Rajendu

2014-01-01

Background Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings (PRIS) network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children’s hospitals. The methodological quality of guidelines for priority conditions is unknown. Objective To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. Design We searched sources including PubMed for national guidelines published 2002–2012. Guidelines specific to one organism, test or treatment, or institution were excluded. Guidelines were rated by two raters using a validated tool (AGREE II) with an overall rating on a 7-point scale (7–highest). Inter-rater reliability was measured with a weighted kappa coefficient. Results 17 guidelines met inclusion criteria for 13 conditions, 7 conditions yielded no relevant national guidelines. The highest methodological quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5 and 6.5 respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3 respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78–0.87). Conclusions We identified a group of moderate to high methodological quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives. PMID:24677729

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

PubMed Central

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students’ academic success. PMID:27031506

Author-paper affiliation network architecture influences the methodological quality of systematic reviews and meta-analyses of psoriasis.

PubMed

Sanz-Cabanillas, Juan Luis; Ruano, Juan; Gomez-Garcia, Francisco; Alcalde-Mellado, Patricia; Gay-Mimbrera, Jesus; Aguilar-Luque, Macarena; Maestre-Lopez, Beatriz; Gonzalez-Padilla, Marcelino; Carmona-Fernandez, Pedro J; Velez Garcia-Nieto, Antonio; Isla-Tejera, Beatriz

2017-01-01

Moderate-to-severe psoriasis is associated with significant comorbidity, an impaired quality of life, and increased medical costs, including those associated with treatments. Systematic reviews (SRs) and meta-analyses (MAs) of randomized clinical trials are considered two of the best approaches to the summarization of high-quality evidence. However, methodological bias can reduce the validity of conclusions from these types of studies and subsequently impair the quality of decision making. As co-authorship is among the most well-documented forms of research collaboration, the present study aimed to explore whether authors' collaboration methods might influence the methodological quality of SRs and MAs of psoriasis. Methodological quality was assessed by two raters who extracted information from full articles. After calculating total and per-item Assessment of Multiple Systematic Reviews (AMSTAR) scores, reviews were classified as low (0-4), medium (5-8), or high (9-11) quality. Article metadata and journal-related bibliometric indices were also obtained. A total of 741 authors from 520 different institutions and 32 countries published 220 reviews that were classified as high (17.2%), moderate (55%), or low (27.7%) methodological quality. The high methodological quality subnetwork was larger but had a lower connection density than the low and moderate methodological quality subnetworks; specifically, the former contained relatively fewer nodes (authors and reviews), reviews by authors, and collaborators per author. Furthermore, the high methodological quality subnetwork was highly compartmentalized, with several modules representing few poorly interconnected communities. In conclusion, structural differences in author-paper affiliation network may influence the methodological quality of SRs and MAs on psoriasis. As the author-paper affiliation network structure affects study quality in this research field, authors who maintain an appropriate balance between scientific quality and productivity are more likely to develop higher quality reviews.

Prediction of ground water quality index to assess suitability for drinking purposes using fuzzy rule-based approach

NASA Astrophysics Data System (ADS)

Gorai, A. K.; Hasni, S. A.; Iqbal, Jawed

2016-11-01

Groundwater is the most important natural resource for drinking water to many people around the world, especially in rural areas where the supply of treated water is not available. Drinking water resources cannot be optimally used and sustained unless the quality of water is properly assessed. To this end, an attempt has been made to develop a suitable methodology for the assessment of drinking water quality on the basis of 11 physico-chemical parameters. The present study aims to select the fuzzy aggregation approach for estimation of the water quality index of a sample to check the suitability for drinking purposes. Based on expert's opinion and author's judgement, 11 water quality (pollutant) variables (Alkalinity, Dissolved Solids (DS), Hardness, pH, Ca, Mg, Fe, Fluoride, As, Sulphate, Nitrates) are selected for the quality assessment. The output results of proposed methodology are compared with the output obtained from widely used deterministic method (weighted arithmetic mean aggregation) for the suitability of the developed methodology.

About subjective evaluation of adaptive video streaming

NASA Astrophysics Data System (ADS)

Tavakoli, Samira; Brunnström, Kjell; Garcia, Narciso

2015-03-01

The usage of HTTP Adaptive Streaming (HAS) technology by content providers is increasing rapidly. Having available the video content in multiple qualities, using HAS allows to adapt the quality of downloaded video to the current network conditions providing smooth video-playback. However, the time-varying video quality by itself introduces a new type of impairment. The quality adaptation can be done in different ways. In order to find the best adaptation strategy maximizing users perceptual quality it is necessary to investigate about the subjective perception of adaptation-related impairments. However, the novelties of these impairments and their comparably long time duration make most of the standardized assessment methodologies fall less suited for studying HAS degradation. Furthermore, in traditional testing methodologies, the quality of the video in audiovisual services is often evaluated separated and not in the presence of audio. Nevertheless, the requirement of jointly evaluating the audio and the video within a subjective test is a relatively under-explored research field. In this work, we address the research question of determining the appropriate assessment methodology to evaluate the sequences with time-varying quality due to the adaptation. This was done by studying the influence of different adaptation related parameters through two different subjective experiments using a methodology developed to evaluate long test sequences. In order to study the impact of audio presence on quality assessment by the test subjects, one of the experiments was done in the presence of audio stimuli. The experimental results were subsequently compared with another experiment using the standardized single stimulus Absolute Category Rating (ACR) methodology.

Methods for the guideline-based development of quality indicators--a systematic review

PubMed Central

2012-01-01

Background Quality indicators (QIs) are used in many healthcare settings to measure, compare, and improve quality of care. For the efficient development of high-quality QIs, rigorous, approved, and evidence-based development methods are needed. Clinical practice guidelines are a suitable source to derive QIs from, but no gold standard for guideline-based QI development exists. This review aims to identify, describe, and compare methodological approaches to guideline-based QI development. Methods We systematically searched medical literature databases (Medline, EMBASE, and CINAHL) and grey literature. Two researchers selected publications reporting methodological approaches to guideline-based QI development. In order to describe and compare methodological approaches used in these publications, we extracted detailed information on common steps of guideline-based QI development (topic selection, guideline selection, extraction of recommendations, QI selection, practice test, and implementation) to predesigned extraction tables. Results From 8,697 hits in the database search and several grey literature documents, we selected 48 relevant references. The studies were of heterogeneous type and quality. We found no randomized controlled trial or other studies comparing the ability of different methodological approaches to guideline-based development to generate high-quality QIs. The relevant publications featured a wide variety of methodological approaches to guideline-based QI development, especially regarding guideline selection and extraction of recommendations. Only a few studies reported patient involvement. Conclusions Further research is needed to determine which elements of the methodological approaches identified, described, and compared in this review are best suited to constitute a gold standard for guideline-based QI development. For this research, we provide a comprehensive groundwork. PMID:22436067

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

PubMed Central

2013-01-01

Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words) PMID:23331384

A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews.

PubMed

Pluye, Pierre; Gagnon, Marie-Pierre; Griffiths, Frances; Johnson-Lafleur, Janique

2009-04-01

A new form of literature review has emerged, Mixed Studies Review (MSR). These reviews include qualitative, quantitative and mixed methods studies. In the present paper, we examine MSRs in health sciences, and provide guidance on processes that should be included and reported. However, there are no valid and usable criteria for concomitantly appraising the methodological quality of the qualitative, quantitative and mixed methods studies. To propose criteria for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies or study components. A three-step critical review was conducted. 2322 references were identified in MEDLINE, and their titles and abstracts were screened; 149 potentially relevant references were selected and the full-text papers were examined; 59 MSRs were retained and scrutinized using a deductive-inductive qualitative thematic data analysis. This revealed three types of MSR: convenience, reproducible, and systematic. Guided by a proposal, we conducted a qualitative thematic data analysis of the quality appraisal procedures used in the 17 systematic MSRs (SMSRs). Of 17 SMSRs, 12 showed clear quality appraisal procedures with explicit criteria but no SMSR used valid checklists to concomitantly appraise qualitative, quantitative and mixed methods studies. In two SMSRs, criteria were developed following a specific procedure. Checklists usually contained more criteria than needed. In four SMSRs, a reliability assessment was described or mentioned. While criteria for quality appraisal were usually based on descriptors that require specific methodological expertise (e.g., appropriateness), no SMSR described the fit between reviewers' expertise and appraised studies. Quality appraisal usually resulted in studies being ranked by methodological quality. A scoring system is proposed for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies for SMSRs. This scoring system may also be used to appraise the methodological quality of qualitative, quantitative and mixed methods components of mixed methods research.

Taxonomy-Based Approaches to Quality Assurance of Ontologies

PubMed Central

Perl, Yehoshua; Ochs, Christopher

2017-01-01

Ontologies are important components of health information management systems. As such, the quality of their content is of paramount importance. It has been proven to be practical to develop quality assurance (QA) methodologies based on automated identification of sets of concepts expected to have higher likelihood of errors. Four kinds of such sets (called QA-sets) organized around the themes of complex and uncommonly modeled concepts are introduced. A survey of different methodologies based on these QA-sets and the results of applying them to various ontologies are presented. Overall, following these approaches leads to higher QA yields and better utilization of QA personnel. The formulation of additional QA-set methodologies will further enhance the suite of available ontology QA tools. PMID:29158885

The methodological quality of systematic reviews published in high-impact nursing journals: a review of the literature.

PubMed

Pölkki, Tarja; Kanste, Outi; Kääriäinen, Maria; Elo, Satu; Kyngäs, Helvi

2014-02-01

To analyse systematic review articles published in the top 10 nursing journals to determine the quality of the methods employed within them. Systematic review is defined as a scientific research method that synthesises high-quality scientific knowledge on a given topic. The number of such reviews in nursing science has increased dramatically during recent years, but their methodological quality has not previously been assessed. A review of the literature using a narrative approach. Ranked impact factor scores for nursing journals were obtained from the Journal Citation Report database of the Institute of Scientific Information (ISI Web of Knowledge). All issues from the years 2009 and 2010 of the top 10 ranked journals were included. CINAHL and MEDLINE databases were searched to locate studies using the search terms 'systematic review' and 'systematic literature review'. A total of 39 eligible studies were identified. Their methodological quality was evaluated through the specific criteria of quality assessment, description of synthesis and strengths and weaknesses reported in the included studies. Most of the eligible systematic reviews included several different designs or types of quantitative study. The majority included a quality assessment, and a total of 17 different criteria were identified. The method of synthesis was mentioned in about half of the reviews, the most common being narrative synthesis. The weaknesses of reviews were discussed, while strengths were rarely highlighted. The methodological quality of the systematic reviews examined varied considerably, although they were all published in nursing journals with a high-impact factor. Despite the fact that systematic reviews are considered the most robust source of research evidence, they vary in methodological quality. This point is important to consider in clinical practice when applying the results to patient care. © 2013 Blackwell Publishing Ltd.

Association between bibliometric parameters, reporting and methodological quality of randomised controlled trials in vascular and endovascular surgery.

PubMed

Hajibandeh, Shahab; Hajibandeh, Shahin; Antoniou, George A; Green, Patrick A; Maden, Michelle; Torella, Francesco

2017-04-01

Purpose We aimed to investigate association between bibliometric parameters, reporting and methodological quality of vascular and endovascular surgery randomised controlled trials. Methods The most recent 75 and oldest 75 randomised controlled trials published in leading journals over a 10-year period were identified. The reporting quality was analysed using the CONSORT statement, and methodological quality with the Intercollegiate Guidelines Network checklist. We used exploratory univariate and multivariable linear regression analysis to investigate associations. Findings Bibliometric parameters such as type of journal, study design reported in title, number of pages; external funding, industry sponsoring and number of citations are associated with reporting quality. Moreover, parameters such as type of journal, subject area and study design reported in title are associated with methodological quality. Conclusions The bibliometric parameters of randomised controlled trials may be independent predictors for their reporting and methodological quality. Moreover, the reporting quality of randomised controlled trials is associated with their methodological quality and vice versa.

Systematic review of communication partner training in aphasia: methodological quality.

PubMed

Cherney, Leora R; Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey

2013-10-01

Twenty-three studies identified from a previous systematic review examining the effects of communication partner training on persons with aphasia and their communication partners were evaluated for methodological quality. Two reviewers rated the studies on defined methodological quality criteria relevant to each study design. There were 11 group studies, seven single-subject participant design studies, and five qualitative studies. Quality scores were derived for each study. The mean inter-rater reliability of scores for each study design ranged from 85-93%, with Cohen's Kappa indicating substantial agreement between raters. Methodological quality of research on communication partner training in aphasia was highly varied. Overall, group studies employed the least rigorous methodology as compared to single subject and qualitative research. Only two of 11 group studies complied with more than half of the quality criteria. No group studies reported therapist blinding and only one group study reported participant blinding. Across all types of studies, the criterion of treatment fidelity was most commonly omitted. Failure to explicitly report certain methodological quality criteria may account for low ratings. Using methodological rating scales specific to the type of study design may help improve the methodological quality of aphasia treatment studies, including those on communication partner training.

Correlation Between Quality of Evidence and Number of Citations in Top 50 Cited Articles on Elbow Medial Ulnar Collateral Ligament Surgery

PubMed Central

Jack, Robert A.; Sochacki, Kyle R.; Morehouse, Hannah A.; McCulloch, Patrick C.; Lintner, David M.; Harris, Joshua D.

2018-01-01

Background: Several studies have analyzed the most cited articles in shoulder, elbow, pediatrics, and foot and ankle surgery. However, no study has analyzed the quality of the most cited articles in elbow medial ulnar collateral ligament (UCL) surgery. Purpose: To (1) identify the top 50 most cited articles related to UCL surgery, (2) determine whether there was a correlation between the top cited articles and level of evidence, and (3) determine whether there was a correlation between study methodological quality and the top cited articles. Study Design: Systematic review. Methods: Web of Science and Scopus online databases were searched to identify the top 50 cited articles in UCL surgery. Level of evidence, number of times cited, year of publication, name of journal, country of origin, and study type were recorded for each study. Study methodological quality was analyzed for each article with the Modified Coleman Methodology Score (MCMS) and the Methodological Index for Non-randomized Studies (MINORS). Correlation coefficients were calculated. Results: The 50 most cited articles were published between 1981 and 2015. The number of citations per article ranged from 20 to 301 (mean ± SD, 71 ± 62 citations). Most articles (92%) were from the United States and were level 3 (16%), level 4 (58%), or unclassified (16%) evidence. There were no articles of level 1 evidence quality. The mean MCMS and MINORS scores were 28.1 ± 13.4 (range, 3-52) and 9.2 ± 3.6 (range, 2-19), respectively. There was no significant correlation between the mean number of citations and level of evidence or quality (rs = –0.01, P = .917), MCMS (rs = 0.09, P = .571), or MINORS (rs = –0.26, P = .089). Conclusion: The top 50 cited articles in UCL surgery constitute a low level of evidence and low methodological quality, including no level 1 articles. There was no significant correlation between the mean number of citations and level of evidence or study methodological quality. However, weak correlations were observed for later publication date and improved level of evidence and methodological quality. PMID:29780841

Measurement properties of translated versions of neck-specific questionnaires: a systematic review.

PubMed

Schellingerhout, Jasper M; Heymans, Martijn W; Verhagen, Arianne P; de Vet, Henrica C; Koes, Bart W; Terwee, Caroline B

2011-06-06

Several disease-specific questionnaires to measure pain and disability in patients with neck pain have been translated. However, a simple translation of the original version doesn't guarantee similar measurement properties. The objective of this study is to critically appraise the quality of the translation process, cross-cultural validation and the measurement properties of translated versions of neck-specific questionnaires. Bibliographic databases were searched for articles concerning the translation or evaluation of the measurement properties of a translated version of a neck-specific questionnaire. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist and criteria for measurement properties. The search strategy resulted in a total of 3641 unique hits, of which 27 articles, evaluating 6 different questionnaires in 15 different languages, were included in this study. Generally the methodological quality of the translation process is poor and none of the included studies performed a cross-cultural adaptation. A substantial amount of information regarding the measurement properties of translated versions of the different neck-specific questionnaires is lacking. Moreover, the evidence for the quality of measurement properties of the translated versions is mostly limited or assessed in studies of poor methodological quality. Until results from high quality studies are available, we advise to use the Catalan, Dutch, English, Iranian, Korean, Spanish and Turkish version of the NDI, the Chinese version of the NPQ, and the Finnish, German and Italian version of the NPDS. The Greek NDI needs cross-cultural validation and there is no methodologically sound information for the Swedish NDI. For all other languages we advise to translate the original version of the NDI.

Proactive telephone counseling for smoking cessation: meta-analyses by recruitment channel and methodological quality.

PubMed

Tzelepis, Flora; Paul, Christine L; Walsh, Raoul A; McElduff, Patrick; Knight, Jenny

2011-06-22

Systematic reviews demonstrated that proactive telephone counseling increases smoking cessation rates. However, these reviews did not differentiate studies by recruitment channel, did not adequately assess methodological quality, and combined different measures of abstinence. Twenty-four randomized controlled trials published before December 31, 2008, included seven of active recruitment, 16 of passive recruitment, and one of mixed recruitment. We rated methodological quality on selection bias, study design, confounders, blinding, data collection methods, withdrawals, and dropouts, according to the Quality Assessment Tool for Quantitative Studies. We conducted random effects meta-analysis to pool the results according to abstinence type and follow-up time for studies overall and segregated by recruitment channel, and methodological quality. The level of statistical heterogeneity was quantified by I(2). All statistical tests were two-sided. Methodological quality ratings indicated two strong, 10 moderate, and 12 weak studies. Overall, compared with self-help materials or no intervention control groups, proactive telephone counseling had a statistically significantly greater effect on point prevalence abstinence (nonsmoking at follow-up or abstinent for at least 24 hours, 7 days before follow-up) at 6-9 months (relative risk [RR] = 1.26, 95% confidence interval [CI] = 1.11 to 1.43, P < .001, I(2) = 21.4%) but not at 12-15 months after recruitment. This pattern also emerged when studies were segregated by recruitment channel (active, passive) or methodological quality (strong/moderate, weak). Overall, the positive effect on prolonged/continuous abstinence (abstinent for 3 months or longer before follow-up) was also statistically significantly greater at 6-9 months (RR = 1.58, CI = 1.26 to 1.98, P < .001, I(2) = 49.1%) and 12-18 months after recruitment (RR = 1.40, CI = 1.23 to 1.60, P < .001, I(2) = 18.5%). With the exception of point prevalence abstinence in the long term, these data support previous results showing that proactive telephone counseling has a positive impact on smoking cessation. Proactive telephone counseling increased prolonged/continuous abstinence long term for both actively and passively recruited smokers.

Changes in clinical trials methodology over time: a systematic review of six decades of research in psychopharmacology.

PubMed

Brunoni, André R; Tadini, Laura; Fregni, Felipe

2010-03-03

There have been many changes in clinical trials methodology since the introduction of lithium and the beginning of the modern era of psychopharmacology in 1949. The nature and importance of these changes have not been fully addressed to date. As methodological flaws in trials can lead to false-negative or false-positive results, the objective of our study was to evaluate the impact of methodological changes in psychopharmacology clinical research over the past 60 years. We performed a systematic review from 1949 to 2009 on MEDLINE and Web of Science electronic databases, and a hand search of high impact journals on studies of seven major drugs (chlorpromazine, clozapine, risperidone, lithium, fluoxetine and lamotrigine). All controlled studies published 100 months after the first trial were included. Ninety-one studies met our inclusion criteria. We analyzed the major changes in abstract reporting, study design, participants' assessment and enrollment, methodology and statistical analysis. Our results showed that the methodology of psychiatric clinical trials changed substantially, with quality gains in abstract reporting, results reporting, and statistical methodology. Recent trials use more informed consent, periods of washout, intention-to-treat approach and parametric tests. Placebo use remains high and unchanged over time. Clinical trial quality of psychopharmacological studies has changed significantly in most of the aspects we analyzed. There was significant improvement in quality reporting and internal validity. These changes have increased study efficiency; however, there is room for improvement in some aspects such as rating scales, diagnostic criteria and better trial reporting. Therefore, despite the advancements observed, there are still several areas that can be improved in psychopharmacology clinical trials.

Poor methodological quality and reporting standards of systematic reviews in burn care management.

PubMed

Wasiak, Jason; Tyack, Zephanie; Ware, Robert; Goodwin, Nicholas; Faggion, Clovis M

2017-10-01

The methodological and reporting quality of burn-specific systematic reviews has not been established. The aim of this study was to evaluate the methodological quality of systematic reviews in burn care management. Computerised searches were performed in Ovid MEDLINE, Ovid EMBASE and The Cochrane Library through to February 2016 for systematic reviews relevant to burn care using medical subject and free-text terms such as 'burn', 'systematic review' or 'meta-analysis'. Additional studies were identified by hand-searching five discipline-specific journals. Two authors independently screened papers, extracted and evaluated methodological quality using the 11-item A Measurement Tool to Assess Systematic Reviews (AMSTAR) tool and reporting quality using the 27-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Characteristics of systematic reviews associated with methodological and reporting quality were identified. Descriptive statistics and linear regression identified features associated with improved methodological quality. A total of 60 systematic reviews met the inclusion criteria. Six of the 11 AMSTAR items reporting on 'a priori' design, duplicate study selection, grey literature, included/excluded studies, publication bias and conflict of interest were reported in less than 50% of the systematic reviews. Of the 27 items listed for PRISMA, 13 items reporting on introduction, methods, results and the discussion were addressed in less than 50% of systematic reviews. Multivariable analyses showed that systematic reviews associated with higher methodological or reporting quality incorporated a meta-analysis (AMSTAR regression coefficient 2.1; 95% CI: 1.1, 3.1; PRISMA regression coefficient 6·3; 95% CI: 3·8, 8·7) were published in the Cochrane library (AMSTAR regression coefficient 2·9; 95% CI: 1·6, 4·2; PRISMA regression coefficient 6·1; 95% CI: 3·1, 9·2) and included a randomised control trial (AMSTAR regression coefficient 1·4; 95%CI: 0·4, 2·4; PRISMA regression coefficient 3·4; 95% CI: 0·9, 5·8). The methodological and reporting quality of systematic reviews in burn care requires further improvement with stricter adherence by authors to the PRISMA checklist and AMSTAR tool. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Methodological quality of systematic reviews in subfertility: a comparison of Cochrane and non-Cochrane systematic reviews in assisted reproductive technologies.

PubMed

Windsor, B; Popovich, I; Jordan, V; Showell, M; Shea, B; Farquhar, C

2012-12-01

Are there differences in the methodological quality of Cochrane systematic reviews (CRs) and non-Cochrane systematic reviews (NCRs) of assisted reproductive technologies? CRs on assisted reproduction are of higher methodological quality than similar reviews published in other journals. The quality of systematic reviews varies. This was a cross-sectional study of 30 CR and 30 NCR systematic reviews that were randomly selected from the eligible reviews identified from a literature search for the years 2007-2011. We extracted data on the reporting and methodological characteristics of the included systematic reviews. We assessed the methodological quality of the reviews using the 11-domain Measurement Tool to Assess the Methodological Quality of Systematic Reviews (AMSTAR) tool and subsequently compared CR and NCR systematic reviews. The AMSTAR quality assessment found that CRs were superior to NCRs. For 10 of 11 AMSTAR domains, the requirements were met in >50% of CRs, but only 4 of 11 domains showed requirements being met in >50% of NCRs. The strengths of CRs are the a priori study design, comprehensive literature search, explicit lists of included and excluded studies and assessments of internal validity. Significant failings in the CRs were found in duplicate study selection and data extraction (67% meeting requirements), assessment for publication bias (53% meeting requirements) and reporting of conflicts of interest (47% meeting requirements). NCRs were more likely to contain methodological weaknesses as the majority of the domains showed <40% of reviews meeting requirements, e.g. a priori study design (17%), duplicate study selection and data extraction (17%), assessment of study quality (27%), study quality in the formulation of conclusions (23%) and reporting of conflict of interests (10%). The AMSTAR assessment can only judge what is reported by authors. Although two of the five authors are involved in the production of CRs, the risk of bias was reduced by not involving these authors in the assessment of the systematic review quality. Not all systematic reviews are equal. The reader needs to consider the quality of the systematic review when they consider the results and the conclusions of a systematic review. There are no conflicts with any commercial organization. Funding was provided for the students by the summer studentship programme of the Faculty of Medical and Health Sciences of the University of Auckland.

Quality Perception within Corporate E-Learning Providers in Catalonia

ERIC Educational Resources Information Center

Sangra, Albert; Fernandez-Michels, Pedro

2011-01-01

Purpose: The paper seeks to describe the Catalan corporate e-learning providers from the perspective of quality perception, quality assessment and quality control. Design/methodology/approach: A literature review reveals key aspects of the definition of quality in e-learning. The results of the review constitute the basis for exploratory research…

Methodological quality of behavioural weight loss studies: a systematic review

PubMed Central

Lemon, S. C.; Wang, M. L.; Haughton, C. F.; Estabrook, D. P.; Frisard, C. F.; Pagoto, S. L.

2018-01-01

Summary This systematic review assessed the methodological quality of behavioural weight loss intervention studies conducted among adults and associations between quality and statistically significant weight loss outcome, strength of intervention effectiveness and sample size. Searches for trials published between January, 2009 and December, 2014 were conducted using PUBMED, MEDLINE and PSYCINFO and identified ninety studies. Methodological quality indicators included study design, anthropometric measurement approach, sample size calculations, intent-to-treat (ITT) analysis, loss to follow-up rate, missing data strategy, sampling strategy, report of treatment receipt and report of intervention fidelity (mean = 6.3). Indicators most commonly utilized included randomized design (100%), objectively measured anthropometrics (96.7%), ITT analysis (86.7%) and reporting treatment adherence (76.7%). Most studies (62.2%) had a follow-up rate >75% and reported a loss to follow-up analytic strategy or minimal missing data (69.9%). Describing intervention fidelity (34.4%) and sampling from a known population (41.1%) were least common. Methodological quality was not associated with reporting a statistically significant result, effect size or sample size. This review found the published literature of behavioural weight loss trials to be of high quality for specific indicators, including study design and measurement. Identified for improvement include utilization of more rigorous statistical approaches to loss to follow up and better fidelity reporting. PMID:27071775

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review

PubMed Central

Wang, Qing; Chen, Hao

2017-01-01

Background Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown. Objective To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis. Methods Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach. Results Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from “very low” to “low,” mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes. Conclusions TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice. PMID:29267324

Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: a review.

PubMed

Huedo-Medina, Tania B; Garcia, Marissa; Bihuniak, Jessica D; Kenny, Anne; Kerstetter, Jane

2016-03-01

Several systematic reviews/meta-analyses published within the past 10 y have examined the associations of Mediterranean-style diets (MedSDs) on cardiovascular disease (CVD) risk. However, these reviews have not been evaluated for satisfying contemporary methodologic quality standards. This study evaluated the quality of recent systematic reviews/meta-analyses on MedSD and CVD risk outcomes by using an established methodologic quality scale. The relation between review quality and impact per publication value of the journal in which the article had been published was also evaluated. To assess compliance with current standards, we applied a modified version of the Assessment of Multiple Systematic Reviews (AMSTARMedSD) quality scale to systematic reviews/meta-analyses retrieved from electronic databases that had met our selection criteria: 1) used systematic or meta-analytic procedures to review the literature, 2) examined MedSD trials, and 3) had MedSD interventions independently or combined with other interventions. Reviews completely satisfied from 8% to 75% of the AMSTARMedSD items (mean ± SD: 31.2% ± 19.4%), with those published in higher-impact journals having greater quality scores. At a minimum, 60% of the 24 reviews did not disclose full search details or apply appropriate statistical methods to combine study findings. Only 5 of the reviews included participant or study characteristics in their analyses, and none evaluated MedSD diet characteristics. These data suggest that current meta-analyses/systematic reviews evaluating the effect of MedSD on CVD risk do not fully comply with contemporary methodologic quality standards. As a result, there are more research questions to answer to enhance our understanding of how MedSD affects CVD risk or how these effects may be modified by the participant or MedSD characteristics. To clarify the associations between MedSD and CVD risk, future meta-analyses and systematic reviews should not only follow methodologic quality standards but also include more statistical modeling results when data allow. © 2016 American Society for Nutrition.

Mexico City Air Quality Research Initiative; Volume 5, Strategic evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1994-03-01

Members of the Task HI (Strategic Evaluation) team were responsible for the development of a methodology to evaluate policies designed to alleviate air pollution in Mexico City. This methodology utilizes information from various reports that examined ways to reduce pollutant emissions, results from models that calculate the improvement in air quality due to a reduction in pollutant emissions, and the opinions of experts as to the requirements and trade-offs that are involved in developing a program to address the air pollution problem in Mexico City. The methodology combines these data to produce comparisons between different approaches to improving Mexico City`smore » air quality. These comparisons take into account not only objective factors such as the air quality improvement or cost of the different approaches, but also subjective factors such as public acceptance or political attractiveness of the different approaches. The end result of the process is a ranking of the different approaches and, more importantly, the process provides insights into the implications of implementing a particular approach or policy.« less

The quality of instruments to assess the process of shared decision making: A systematic review.

PubMed

Gärtner, Fania R; Bomhof-Roordink, Hanna; Smith, Ian P; Scholl, Isabelle; Stiggelbout, Anne M; Pieterse, Arwen H

2018-01-01

To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument's content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations.

Author-paper affiliation network architecture influences the methodological quality of systematic reviews and meta-analyses of psoriasis

PubMed Central

Gomez-Garcia, Francisco; Alcalde-Mellado, Patricia; Gay-Mimbrera, Jesus; Aguilar-Luque, Macarena; Maestre-Lopez, Beatriz; Gonzalez-Padilla, Marcelino; Carmona-Fernandez, Pedro J.; Velez Garcia-Nieto, Antonio; Isla-Tejera, Beatriz

2017-01-01

Moderate-to-severe psoriasis is associated with significant comorbidity, an impaired quality of life, and increased medical costs, including those associated with treatments. Systematic reviews (SRs) and meta-analyses (MAs) of randomized clinical trials are considered two of the best approaches to the summarization of high-quality evidence. However, methodological bias can reduce the validity of conclusions from these types of studies and subsequently impair the quality of decision making. As co-authorship is among the most well-documented forms of research collaboration, the present study aimed to explore whether authors’ collaboration methods might influence the methodological quality of SRs and MAs of psoriasis. Methodological quality was assessed by two raters who extracted information from full articles. After calculating total and per-item Assessment of Multiple Systematic Reviews (AMSTAR) scores, reviews were classified as low (0-4), medium (5-8), or high (9-11) quality. Article metadata and journal-related bibliometric indices were also obtained. A total of 741 authors from 520 different institutions and 32 countries published 220 reviews that were classified as high (17.2%), moderate (55%), or low (27.7%) methodological quality. The high methodological quality subnetwork was larger but had a lower connection density than the low and moderate methodological quality subnetworks; specifically, the former contained relatively fewer nodes (authors and reviews), reviews by authors, and collaborators per author. Furthermore, the high methodological quality subnetwork was highly compartmentalized, with several modules representing few poorly interconnected communities. In conclusion, structural differences in author-paper affiliation network may influence the methodological quality of SRs and MAs on psoriasis. As the author-paper affiliation network structure affects study quality in this research field, authors who maintain an appropriate balance between scientific quality and productivity are more likely to develop higher quality reviews. PMID:28403245

Methodological Quality Assessment of Meta-Analyses of Hyperthyroidism Treatment.

PubMed

Qin, Yahong; Yao, Liang; Shao, Feifei; Yang, Kehu; Tian, Limin

2018-01-01

Hyperthyroidism is a common condition that is associated with increased morbidity and mortality. A number of meta-analyses (MAs) have assessed the therapeutic measures for hyperthyroidism, including antithyroid drugs, surgery, and radioiodine, however, the methodological quality has not been evaluated. This study evaluated the methodological quality and summarized the evidence obtained from MAs of hyperthyroidism treatments for radioiodine, antithyroid drugs, and surgery. We searched the PubMed, EMBASE, Cochrane Library, Web of Science, and Chinese Biomedical Literature Database databases. Two investigators independently assessed the meta-analyses titles and abstracts for inclusion. Methodological quality was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. A total of 26 MAs fulfilled the inclusion criteria. Based on the AMSTAR scores, the average methodological quality was 8.31, with large variability ranging from 4 to 11. The methodological quality of English meta-analyses was better than that of Chinese meta-analyses. Cochrane reviews had better methodological quality than non-Cochrane reviews due to better study selection and data extraction, the inclusion of unpublished studies, and better reporting of study characteristics. The authors did not report conflicts of interest in 53.8% meta-analyses, and 19.2% did not report the harmful effects of treatment. Publication bias was not assessed in 38.5% of meta-analyses, and 19.2% did not report the follow-up time. Large-scale assessment of methodological quality of meta-analyses of hyperthyroidism treatment highlighted methodological strengths and weaknesses. Consideration of scientific quality when formulating conclusions should be made explicit. Future meta-analyses should improve on reporting conflict of interest. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical trials in palliative care: a systematic review of their methodological characteristics and of the quality of their reporting.

PubMed

Bouça-Machado, Raquel; Rosário, Madalena; Alarcão, Joana; Correia-Guedes, Leonor; Abreu, Daisy; Ferreira, Joaquim J

2017-01-25

Over the past decades there has been a significant increase in the number of published clinical trials in palliative care. However, empirical evidence suggests that there are methodological problems in the design and conduct of studies, which raises questions about the validity and generalisability of the results and of the strength of the available evidence. We sought to evaluate the methodological characteristics and assess the quality of reporting of clinical trials in palliative care. We performed a systematic review of published clinical trials assessing therapeutic interventions in palliative care. Trials were identified using MEDLINE (from its inception to February 2015). We assessed methodological characteristics and describe the quality of reporting using the Cochrane Risk of Bias tool. We retrieved 107 studies. The most common medical field studied was oncology, and 43.9% of trials evaluated pharmacological interventions. Symptom control and physical dimensions (e.g. intervention on pain, breathlessness, nausea) were the palliative care-specific issues most studied. We found under-reporting of key information in particular on random sequence generation, allocation concealment, and blinding. While the number of clinical trials in palliative care has increased over time, methodological quality remains suboptimal. This compromises the quality of studies. Therefore, a greater effort is needed to enable the appropriate performance of future studies and increase the robustness of evidence-based medicine in this important field.

A methodology for evaluation of a markup-based specification of clinical guidelines.

PubMed

Shalom, Erez; Shahar, Yuval; Taieb-Maimon, Meirav; Lunenfeld, Eitan

2008-11-06

We introduce a three-phase, nine-step methodology for specification of clinical guidelines (GLs) by expert physicians, clinical editors, and knowledge engineers, and for quantitative evaluation of the specification's quality. We applied this methodology to a particular framework for incremental GL structuring (mark-up) and to GLs in three clinical domains with encouraging results.

Do Men Produce Higher Quality Ejaculates When Primed With Thoughts of Partner Infidelity?

PubMed

Pham, Michael N; Barbaro, Nicole; Holub, Andrew M; Holden, Christopher J; Mogilski, Justin K; Lopes, Guilherme S; Nicolas, Sylis C A; Sela, Yael; Shackelford, Todd K; Zeigler-Hill, Virgil; Welling, Lisa L M

2018-01-01

Sperm competition theory can be used to generate the hypothesis that men alter the quality of their ejaculates as a function of sperm competition risk. Using a repeated measures experimental design, we investigated whether men produce a higher quality ejaculate when primed with cues to sperm competition (i.e., imagined partner infidelity) relative to a control prime. Men ( n = 45) submitted two masturbatory ejaculates-one ejaculate sample for each condition (i.e., sperm competition and control conditions). Ejaculates were assessed on 17 clinical parameters. The results did not support the hypothesis: Men did not produce higher quality ejaculates in the sperm competition condition relative to the control condition. Despite the null results of the current research, there is evidence for psychological and physiological adaptations to sperm competition in humans. We discuss methodological limitations that may have produced the null results and present methodological suggestions for research on human sperm competition.

Randomized controlled drug trials on very elderly subjects: descriptive and methodological analysis of trials published between 1990 and 2002 and comparison with trials on adults.

PubMed

Le Quintrec, Jean-Laurent; Bussy, Caroline; Golmard, Jean-Louis; Hervé, Christian; Baulon, Alain; Piette, François

2005-03-01

Very elderly subjects (VES; aged 80 years or older) constitute a special population as they frequently present multiple diseases (polypathology). Results from trials on general adult populations therefore cannot be extrapolated to VES. We performed a census of randomized controlled trials (RCT) on VES published between 1990 and 2002, and carried out a descriptive and methodological analysis of these RCT/VES, comparing them with matched RCT on general adult populations (control RCT, RCT/C). We searched for RCT/VES in two international databases (EMBASE and MEDLINE) and then manually. RCT/C were matched to RCT/VES for disease area and year of publication. The methodological quality of each RCT was assessed with Chalmers' scale. We identified 84 RCT/VES, 63 of which were conclusive and 21, inconclusive. Subjects were institutionalized in 48 RCT, and community dwelling in 11 RCT (unspecified in 25 RCT). Efficacy was the main criterion in 75 RCT; tolerance in 9 RCT. Twenty-six RCT were published by geriatrics journals, and 58 by general medical journals. The RCT/VES covered most of the disease areas of geriatrics. The 84 RCT/VES had a mean methodological quality score of 0.578 +/- 0.157. The matched 84 RCT/C had a mean methodological quality score of 0.592 +/- 0.116 (p = .466). The methodological quality score of RCT/VES increased with the number of included subjects (p = .004) and the year of publication (p = .001). The methodological quality of RCT/VES is equivalent to that of RCT in general adult populations. Nevertheless, RCT/VES remain very scarce, and neglect certain diseases. RCT/VES and the inclusion of very elderly subjects in RCT on adults should be strongly encouraged.

Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review

PubMed Central

Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E.; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C.; Roy, Jean-Sébastien

2016-01-01

Objective: To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. Methods: A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. Results: The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. Conclusion: There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers. PMID:27488037

On the methodology of Engineering Geodesy

NASA Astrophysics Data System (ADS)

Brunner, Fritz K.

2007-09-01

Textbooks on geodetic surveying usually describe a very small number of principles which should provide the foundation of geodetic surveying. Here, the author argues that an applied field, such as engineering geodesy, has a methodology as foundation rather than a few principles. Ten methodological elements (ME) are identified: (1) Point discretisation of natural surfaces and objects, (2) distinction between coordinate and observation domain, (3) definition of reference systems, (4) specification of unknown parameters and desired precisions, (5) geodetic network and observation design, (6) quality control of equipment, (7) quality control of measurements, (8) establishment of measurement models, (9) establishment of parameter estimation models, (10) quality control of results. Each ME consists of a suite of theoretical developments, geodetic techniques and calculation procedures, which will be discussed. This paper is to be considered a first attempt at identifying the specific elements of the methodology of engineering geodesy. A better understanding of this methodology could lead to an increased objectivity, to a transformation of subjective practical experiences into objective working methods, and consequently to a new structure for teaching this rather diverse subject.

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.

Effectiveness of physical therapy interventions for children with cerebral palsy: A systematic review

PubMed Central

Anttila, Heidi; Autti-Rämö, Ilona; Suoranta, Jutta; Mäkelä, Marjukka; Malmivaara, Antti

2008-01-01

Background To assess the effectiveness of physical therapy (PT) interventions on functioning in children with cerebral palsy (CP). Methods A search was made in Medline, Cinahl, PEDro and the Cochrane library for the period 1990 to February 2007. Only randomized controlled trials (RCTs) on PT interventions in children with diagnosed CP were included. Two reviewers independently assessed the methodological quality and extracted the data. The outcomes measured in the trials were classified using the International Classification of Functioning, Disability and Health (ICF). Results Twenty-two trials were identified. Eight intervention categories were distinguished. Four trials were of high methodological quality. Moderate evidence of effectiveness was established for two intervention categories: effectiveness of upper extremity treatments on attained goals and active supination, and of prehensile hand treatment and neurodevelopmental therapy (NDT) or NDT twice a week on developmental status, and of constraint-induced therapy on amount and quality of hand use. Moderate evidence of ineffectiveness was found of strength training on walking speed and stride length. Conflicting evidence was found for strength training on gross motor function. For the other intervention categories the evidence was limited due to low methodological quality and the statistically insignificant results of the studies. Conclusion Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most PT interventions is available through RCTs. Moderate evidence was found for some effectiveness of upper extremity training. Well-designed trials are needed especially for focused PT interventions. PMID:18435840

Multi-centre audit of VMAT planning and pre-treatment verification.

PubMed

Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

2017-08-01

We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

Quality reporting of carotid intima-media thickness methodology; Current state of the science in the field of spinal cord injury.

PubMed

Hoskin, Jordan D; Miyatani, Masae; Craven, B Catharine

2017-03-30

Carotid intima-media thickness (cIMT) may be used increasingly as a cardiovascular disease (CVD) screening tool in individuals with spinal cord injury (SCI) as other routine invasive diagnostic tests are often unfeasible. However, variation in cIMT acquisition and analysis methods is an issue in the current published literature. The growth of the field is dependent on cIMT quality acquisition and analysis to ensure accurate reporting of CVD risk. The purpose of this study is to evaluate the quality of the reported methodology used to collect cIMT values in SCI. Data from 12 studies, which measured cIMT in individuals with SCI, were identified from the Medline, Embase and CINAHL databases. The quality of the reported methodologies was scored based on adherence to cIMT methodological guidelines abstracted from two consensus papers. Five studies were scored as 'moderate quality' in methodological reporting, having specified 9 to 11 of 15 quality reporting criterion. The remaining seven studies were scored as 'low quality', having reported less than 9 of 15 quality reporting criterion. No study had methodological reporting that was scored as 'high quality'. The overall reporting of quality methodology was poor in the published SCI literature. A greater adherence to current methodological guidelines is needed to advance the field of cIMT in SCI. Further research is necessary to refine cIMT acquisition and analysis guidelines to aid authors designing research and journals in screening manuscripts for publication.

Systematic review adherence to methodological or reporting quality.

PubMed

Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle; Mayhew, Alain; Skidmore, Becky; Stevens, Adrienne; Boutron, Isabelle; Sarkis-Onofre, Rafael; Bjerre, Lise M; Hróbjartsson, Asbjørn; Altman, Douglas G; Moher, David

2017-07-19

Guidelines for assessing methodological and reporting quality of systematic reviews (SRs) were developed to contribute to implementing evidence-based health care and the reduction of research waste. As SRs assessing a cohort of SRs is becoming more prevalent in the literature and with the increased uptake of SR evidence for decision-making, methodological quality and standard of reporting of SRs is of interest. The objective of this study is to evaluate SR adherence to the Quality of Reporting of Meta-analyses (QUOROM) and PRISMA reporting guidelines and the A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Overview Quality Assessment Questionnaire (OQAQ) quality assessment tools as evaluated in methodological overviews. The Cochrane Library, MEDLINE®, and EMBASE® databases were searched from January 1990 to October 2014. Title and abstract screening and full-text screening were conducted independently by two reviewers. Reports assessing the quality or reporting of a cohort of SRs of interventions using PRISMA, QUOROM, OQAQ, or AMSTAR were included. All results are reported as frequencies and percentages of reports and SRs respectively. Of the 20,765 independent records retrieved from electronic searching, 1189 reports were reviewed for eligibility at full text, of which 56 reports (5371 SRs in total) evaluating the PRISMA, QUOROM, AMSTAR, and/or OQAQ tools were included. Notable items include the following: of the SRs using PRISMA, over 85% (1532/1741) provided a rationale for the review and less than 6% (102/1741) provided protocol information. For reports using QUOROM, only 9% (40/449) of SRs provided a trial flow diagram. However, 90% (402/449) described the explicit clinical problem and review rationale in the introduction section. Of reports using AMSTAR, 30% (534/1794) used duplicate study selection and data extraction. Conversely, 80% (1439/1794) of SRs provided study characteristics of included studies. In terms of OQAQ, 37% (499/1367) of the SRs assessed risk of bias (validity) in the included studies, while 80% (1112/1387) reported the criteria for study selection. Although reporting guidelines and quality assessment tools exist, reporting and methodological quality of SRs are inconsistent. Mechanisms to improve adherence to established reporting guidelines and methodological assessment tools are needed to improve the quality of SRs.

Experienced quality factors: qualitative evaluation approach to audiovisual quality

NASA Astrophysics Data System (ADS)

Jumisko-Pyykkö, Satu; Häkkinen, Jukka; Nyman, Göte

2007-02-01

Subjective evaluation is used to identify impairment factors of multimedia quality. The final quality is often formulated via quantitative experiments, but this approach has its constraints, as subject's quality interpretations, experiences and quality evaluation criteria are disregarded. To identify these quality evaluation factors, this study examined qualitatively the criteria participants used to evaluate audiovisual video quality. A semi-structured interview was conducted with 60 participants after a subjective audiovisual quality evaluation experiment. The assessment compared several, relatively low audio-video bitrate ratios with five different television contents on mobile device. In the analysis, methodological triangulation (grounded theory, Bayesian networks and correspondence analysis) was applied to approach the qualitative quality. The results showed that the most important evaluation criteria were the factors of visual quality, contents, factors of audio quality, usefulness - followability and audiovisual interaction. Several relations between the quality factors and the similarities between the contents were identified. As a research methodological recommendation, the focus on content and usage related factors need to be further examined to improve the quality evaluation experiments.

Characteristics and quality of published animal research in the field of radiology.

PubMed

Yoon, Soo Jeong; Yoon, Dae Young; Cho, Young Kwon; Baek, Sora; Lim, Kyoung Ja; Seo, Young Lan; Yun, Eun Joo

2017-06-01

Background Animal research has played an important role in the field of radiology. Purpose To evaluate the characteristics and quality of published radiological animal research. Material and Methods A PubMed search was performed for radiological animal research articles (defined as studies using animal models with a radiologist as the first author) published in 1994, 2004, and 2014. The following information was extracted from each article: journal name, radiological subspecialty, imaging technique, animal species, number of animals used, number of authors, declared funding, country of origin, methodological quality, and ethical quality. Methodological and ethical quality of studies were assessed with seven-item (sample size calculation, animal age, animal sex, animal weight, inclusion and exclusion criteria, randomization, and blinded outcome assessment) and four-item (ethical review committee approval, anesthesia, pain control, and euthanasia) scales, respectively. Results The numbers of radiological animal studies markedly increased, from 91 in 1994 to 163 in 2004 and to 305 in 2014. One hundred and sixty-two (29.0%) articles focused on the neuroradiology/head and neck subspecialty, 233 (41.7%) used magnetic resonance imaging (MRI), 190 (34.0%) used mice, 254 (45.4%) used 10-30 animals, 297 (53.1%) had 4-7 authors, 392 (70.1%) were funded, and 222 (39.7%) were from the USA. Six of 7 methodological and 3/4 ethical quality items significantly improved over time. Conclusion The quantity and quality of radiological animal research has increased over the last two decades; however, methodological and ethical quality remains suboptimal.

Methodological Quality of Consensus Guidelines in Implant Dentistry.

PubMed

Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

2017-01-01

Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p < 0.05). Methodological improvement of consensus guidelines published in major implant dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions.

Anti-tobacco mass media and socially disadvantaged groups: a systematic and methodological review.

PubMed

Guillaumier, Ashleigh; Bonevski, Billie; Paul, Chris

2012-07-01

Only a limited amount of research has been conducted to explore whether there are socioeconomic status differences in responses to mass media. However, the methodological quality of this evidence has not been assessed, limiting confidence in conclusions that can be drawn regarding study outcomes. A systematic review of the effectiveness of anti-tobacco mass media campaigns with socially disadvantaged groups was conducted, and the methodological quality of included studies was assessed. Medline, The Cochrane Library, PsycInfo, Embase and Web of Science were searched using MeSH and keywords for quantitative studies conducted in Western countries prior to March 2012. A methodological quality assessment and narrative analysis of included studies was undertaken. Seventeen relevant studies (reported in 18 papers) were identified; however, weak study designs and selection bias were common characteristics, limiting strong conclusions about effectiveness. Using predominantly non-cessation related outcome measures reviewed papers indicated mixed results for mass media tobacco control campaign effectiveness among various social groups. Most studies assessed mass media impact on low socioeconomic status groups rather than highly socially disadvantaged groups. Methodological rigour of evaluations in this field must be improved to aid understanding regarding the effectiveness of mass media campaigns in driving cessation among disadvantaged groups. The results of this review indicate a gap in methodologically rigorous research into the effectiveness of mass media campaigns among socially disadvantaged groups, particularly the highly disadvantaged. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

PubMed

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students' academic success.

The quality of instruments to assess the process of shared decision making: A systematic review

PubMed Central

Bomhof-Roordink, Hanna; Smith, Ian P.; Scholl, Isabelle; Stiggelbout, Anne M.; Pieterse, Arwen H.

2018-01-01

Objective To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. Methods In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. Results We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Conclusions Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument’s content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations. PMID:29447193

A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

PubMed

Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

2017-01-01

This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

Assessment of reproductive and developmental effects of DINP, DnHP and DCHP using quantitative weight of evidence.

PubMed

Dekant, Wolfgang; Bridges, James

2016-11-01

Quantitative weight of evidence (QWoE) methodology utilizes detailed scoring sheets to assess the quality/reliability of each publication on toxicity of a chemical and gives numerical scores for quality and observed toxicity. This QWoE-methodology was applied to the reproductive toxicity data on diisononylphthalate (DINP), di-n-hexylphthalate (DnHP), and dicyclohexylphthalate (DCHP) to determine if the scientific evidence for adverse effects meets the requirements for classification as reproductive toxicants. The scores for DINP were compared to those when applying the methodology DCHP and DnHP that have harmonized classifications. Based on the quality/reliability scores, application of the QWoE shows that the three databases are of similar quality; but effect scores differ widely. Application of QWoE to DINP studies resulted in an overall score well below the benchmark required to trigger classification. For DCHP, the QWoE also results in low scores. The high scores from the application of the QWoE methodology to the toxicological data for DnHP represent clear evidence for adverse effects and justify a classification of DnHP as category 1B for both development and fertility. The conclusions on classification based on the QWoE are well supported using a narrative assessment of consistency and biological plausibility. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The economic burden of patient safety targets in acute care: a systematic review

PubMed Central

Mittmann, Nicole; Koo, Marika; Daneman, Nick; McDonald, Andrew; Baker, Michael; Matlow, Anne; Krahn, Murray; Shojania, Kaveh G; Etchells, Edward

2012-01-01

Background Our objective was to determine the quality of literature in costing of the economic burden of patient safety. Methods We selected 15 types of patient safety targets for our systematic review. We searched the literature published between 2000 and 2010 using the following terms: “costs and cost analysis,” “cost-effectiveness,” “cost,” and “financial management, hospital.” We appraised the methodologic quality of potentially relevant studies using standard economic methods. We recorded results in the original currency, adjusted for inflation, and then converted to 2010 US dollars for comparative purposes (2010 US$1.00 = 2010 €0.76). The quality of each costing study per patient safety target was also evaluated. Results We screened 1948 abstracts, and identified 158 potentially eligible studies, of which only 61 (39%) reported any costing methodology. In these 61 studies, we found wide estimates of the attributable costs of patient safety events ranging from $2830 to $10,074. In general hospital populations, the cost per case of hospital-acquired infection ranged from $2132 to $15,018. Nosocomial bloodstream infection was associated with costs ranging from $2604 to $22,414. Conclusion There are wide variations in the estimates of economic burden due to differences in study methods and methodologic quality. Greater attention to methodologic standards for economic evaluations in patient safety is needed. PMID:23097615

How Methodologic Differences Affect Results of Economic Analyses: A Systematic Review of Interferon Gamma Release Assays for the Diagnosis of LTBI

PubMed Central

Oxlade, Olivia; Pinto, Marcia; Trajman, Anete; Menzies, Dick

2013-01-01

Introduction Cost effectiveness analyses (CEA) can provide useful information on how to invest limited funds, however they are less useful if different analysis of the same intervention provide unclear or contradictory results. The objective of our study was to conduct a systematic review of methodologic aspects of CEA that evaluate Interferon Gamma Release Assays (IGRA) for the detection of Latent Tuberculosis Infection (LTBI), in order to understand how differences affect study results. Methods A systematic review of studies was conducted with particular focus on study quality and the variability in inputs used in models used to assess cost-effectiveness. A common decision analysis model of the IGRA versus Tuberculin Skin Test (TST) screening strategy was developed and used to quantify the impact on predicted results of observed differences of model inputs taken from the studies identified. Results Thirteen studies were ultimately included in the review. Several specific methodologic issues were identified across studies, including how study inputs were selected, inconsistencies in the costing approach, the utility of the QALY (Quality Adjusted Life Year) as the effectiveness outcome, and how authors choose to present and interpret study results. When the IGRA versus TST test strategies were compared using our common decision analysis model predicted effectiveness largely overlapped. Implications Many methodologic issues that contribute to inconsistent results and reduced study quality were identified in studies that assessed the cost-effectiveness of the IGRA test. More specific and relevant guidelines are needed in order to help authors standardize modelling approaches, inputs, assumptions and how results are presented and interpreted. PMID:23505412

Specific guidelines for assessing and improving the methodological quality of economic evaluations of newborn screening

PubMed Central

2012-01-01

Background Economic evaluation of newborn screening poses specific methodological challenges. Amongst others, these challenges refer to the use of quality adjusted life years (QALYs) in newborns, and which costs and outcomes need to be considered in a full evaluation of newborn screening programmes. Because of the increasing scale and scope of such programmes, a better understanding of the methods of high-quality economic evaluations may be crucial for both producers/authors and consumers/reviewers of newborn screening-related economic evaluations. The aim of this study was therefore to develop specific guidelines designed to assess and improve the methodological quality of economic evaluations in newborn screening. Methods To develop the guidelines, existing guidelines for assessing the quality of economic evaluations were identified through a literature search, and were reviewed and consolidated using a deductive iterative approach. In a subsequent test phase, these guidelines were applied to various economic evaluations which acted as case studies. Results The guidelines for assessing and improving the methodological quality of economic evaluations in newborn screening are organized into 11 categories: “bibliographic details”, “study question and design”, “modelling”, “health outcomes”, “costs”, “discounting”, “presentation of results”, “sensitivity analyses”, “discussion”, “conclusions”, and “commentary”. Conclusions The application of the guidelines highlights important issues regarding newborn screening-related economic evaluations, and underscores the need for such issues to be afforded greater consideration in future economic evaluations. The variety in methodological quality detected by this study reveals the need for specific guidelines on the appropriate methods for conducting sound economic evaluations in newborn screening. PMID:22947299

Systematic Reviews and Meta-Analyses of Home Telemonitoring Interventions for Patients With Chronic Diseases: A Critical Assessment of Their Methodological Quality

PubMed Central

2013-01-01

Background Systematic reviews and meta-analyses of home telemonitoring interventions for patients with chronic diseases have increased over the past decade and become increasingly important to a wide range of clinicians, policy makers, and other health care stakeholders. While a few criticisms about their methodological rigor and synthesis approaches have recently appeared, no formal appraisal of their quality has been conducted yet. Objective The primary aim of this critical review was to evaluate the methodology, quality, and reporting characteristics of prior reviews that have investigated the effects of home telemonitoring interventions in the context of chronic diseases. Methods Ovid MEDLINE, the Database of Abstract of Reviews of Effects (DARE), and Health Technology Assessment Database (HTA) of the Cochrane Library were electronically searched to find relevant systematic reviews, published between January 1966 and December 2012. Potential reviews were screened and assessed for inclusion independently by three reviewers. Data pertaining to the methods used were extracted from each included review and examined for accuracy by two reviewers. A validated quality assessment instrument, R-AMSTAR, was used as a framework to guide the assessment process. Results Twenty-four reviews, nine of which were meta-analyses, were identified from more than 200 citations. The bibliographic search revealed that the number of published reviews has increased substantially over the years in this area and although most reviews focus on studying the effects of home telemonitoring on patients with congestive heart failure, researcher interest has extended to other chronic diseases as well, such as diabetes, hypertension, chronic obstructive pulmonary disease, and asthma. Nevertheless, an important number of these reviews appear to lack optimal scientific rigor due to intrinsic methodological issues. Also, the overall quality of reviews does not appear to have improved over time. While several criteria were met satisfactorily by either all or nearly all reviews, such as the establishment of an a priori design with inclusion and exclusion criteria, use of electronic searches on multiple databases, and reporting of studies characteristics, there were other important areas that needed improvement. Duplicate data extraction, manual searches of highly relevant journals, inclusion of gray and non-English literature, assessment of the methodological quality of included studies and quality of evidence were key methodological procedures that were performed infrequently. Furthermore, certain methodological limitations identified in the synthesis of study results have affected the results and conclusions of some reviews. Conclusions Despite the availability of methodological guidelines that can be utilized to guide the proper conduct of systematic reviews and meta-analyses and eliminate potential risks of bias, this knowledge has not yet been fully integrated in the area of home telemonitoring. Further efforts should be made to improve the design, conduct, reporting, and publication of systematic reviews and meta-analyses in this area. PMID:23880072

Methodological quality of randomized trials published in the Journal of the American Podiatric Medical Association, 1999-2013.

PubMed

Landorf, Karl B; Menz, Hylton B; Armstrong, David G; Herbert, Robert D

2015-07-01

Randomized trials must be of high methodological quality to yield credible, actionable findings. The main aim of this project was to evaluate whether there has been an improvement in the methodological quality of randomized trials published in the Journal of the American Podiatric Medical Association (JAPMA). Randomized trials published in JAPMA during a 15-year period (January 1999 to December 2013) were evaluated. The methodological quality of randomized trials was evaluated using the PEDro scale (scores range from 0 to 10, with 0 being lowest quality). Linear regression was used to assess changes in methodological quality over time. A total of 1,143 articles were published in JAPMA between January 1999 and December 2013. Of these, 44 articles were reports of randomized trials. Although the number of randomized trials published each year increased, there was only minimal improvement in their methodological quality (mean rate of improvement = 0.01 points per year). The methodological quality of the trials studied was typically moderate, with a mean ± SD PEDro score of 5.1 ± 1.5. Although there were a few high-quality randomized trials published in the journal, most (84.1%) scored between 3 and 6. Although there has been an increase in the number of randomized trials published in JAPMA, there is substantial opportunity for improvement in the methodological quality of trials published in the journal. Researchers seeking to publish reports of randomized trials should seek to meet current best-practice standards in the conduct and reporting of their trials.

Methodological quality of randomized controlled trials of spinal manipulation and mobilization in tension-type headache, migraine, and cervicogenic headache.

PubMed

Fernández-de-las-Peñas, César; Alonso-Blanco, Cristina; San-Roman, Jesús; Miangolarra-Page, Juan C

2006-03-01

Literature review of quality of clinical trials. To determine the methodological quality of published randomized controlled trials that used spinal manipulation and/or mobilization to treat patients with tension-type headache (TTH), cervicogenic headache (CeH), and migraine (M) in the last decade. TTH, CeH, and M are the most prevalent types of headaches seen in adults. Individuals who have headaches frequently use physical therapy, manual therapy, or chiropractic care. Randomized controlled trials are considered an optimal method with which to assess the efficacy of any intervention. Computerized literature searches were performed in MEDLINE, EMBASE, COCHRANE, AMED, MANTIS, CINHAL, and PEDro databases. Randomized controlled trials in which spinal manipulation and/or mobilization had been used for TTH, CeH, and M published in a peer-reviewed journal as full text, and with at least 1 clinically relevant outcome measure (ie, headache intensity, duration, or frequency) were reviewed. The methodological quality of the studies was assessed independently by 2 reviewers using a set of predefined criteria. Only 8 studies met all the inclusion criteria. One clinical trial evaluated spinal manipulation and mobilization together, and the remaining 7 assessed spinal manipulative therapy. No controlled trials analyzing exclusively the effects of spinal mobilization were found. Methodological scores ranged from 35 to 56 points out of a theoretical maximum of 100 points, indicating an overall poor methodology of the studies. Only 2 studies obtained a high-quality score (greater than 50 points). No significant differences in quality scores were found based on the type of headache investigated. Methodological quality was not associated with the year of publication (before 2000, or later) nor with the results (positive, neutral, negative) reported in the studies. The most common flaws were a small sample size, the absence of a placebo control group, lack of blinded patients, and no description of the manipulative procedure. There are few published randomized controlled trials analyzing the effectiveness of spinal manipulation and/or mobilization for TTH, CeH, and M in the last decade. In addition, the methodological quality of these papers is typically low. Clearly, there is a need for high-quality randomized controlled trials assessing the effectiveness of these interventions in these headache disorders.

Prioritization Methodology for Chemical Replacement

NASA Technical Reports Server (NTRS)

Cruit, W.; Schutzenhofer, S.; Goldberg, B.; Everhart, K.

1993-01-01

This project serves to define an appropriate methodology for effective prioritization of efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semiquantitative approach derived from quality function deployment techniques (QFD Matrix). This methodology aims to weigh the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives. The results are being implemented as a guideline for consideration for current NASA propulsion systems.

Advancing High-Quality Literacy Research in Juvenile Justice: Methodological and Practical Considerations

ERIC Educational Resources Information Center

Houchins, David E.; Jolivette, Kristine; Shippen, Margaret E.; Lambert, Richard

2010-01-01

Special education researchers have made noteworthy progress toward conceptualizing literacy research questions, designing quality studies, and disseminating the results of their research. These advancements have been made through the establishment and refinement of quality research indicators. Unfortunately, this progress has mostly eluded the…

Implementation and evaluation of a multisite drug usage evaluation program across Australian hospitals - a quality improvement initiative

PubMed Central

2011-01-01

Background With the use of medicines being a broad and extensive part of health management, mechanisms to ensure quality use of medicines are essential. Drug usage evaluation (DUE) is an evidence-based quality improvement methodology, designed to improve the quality, safety and cost-effectiveness of drug use. The purpose of this paper is to describe a national DUE methodology used to improve health care delivery across the continuum through multi-faceted intervention involving audit and feedback, academic detailing and system change, and a qualitative assessment of the methodology, as illustrated by the Acute Postoperative Pain Management (APOP) project. Methods An established methodology, consisting of a baseline audit of inpatient medical records, structured patient interviews and general practitioner surveys, followed by an educational intervention and follow-up audit, is used. Australian hospitals, including private, public, metropolitan and regional, are invited to participate on a voluntary basis. De-identified data collected by hospitals are collated and evaluated nationally to provide descriptive comparative analyses. Hospitals benchmark their practices against state and national results to facilitate change. The educational intervention consists of academic detailing, group education, audit and feedback, point-of-prescribing prompts and system changes. A repeat data collection is undertaken to assess changes in practice. An online qualitative survey was undertaken to evaluate the APOP program. Qualitative assessment of hospitals' perceptions of the effectiveness of the overall DUE methodology and changes in procedure/prescribing/policy/clinical practice which resulted from participation were elicited. Results 62 hospitals participated in the APOP project. Among 23 respondents to the evaluation survey, 18 (78%) reported improvements in the documentation of pain scores at their hospital. 15 (65%) strongly agreed or agreed that participation in APOP directly resulted in increased prescribing of multimodal analgesia for pain relief in postoperative patients. Conclusions This national DUE program has facilitated the engagement and participation of a number of acute health care facilities to address issues relating to quality use of medicine. This approach has been perceived to be effective in helping them achieve improvements in patient care. PMID:21871132

Assessment of methodological quality of economic evaluations in belgian drug reimbursement applications.

PubMed

Simoens, Steven

2013-01-01

This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation.

A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews

PubMed Central

Jin, Ying-Hui; Wang, Guo-Hao; Sun, Yi-Rong; Li, Qi; Zhao, Chen; Li, Ge; Si, Jin-Hua; Li, Yan; Lu, Cui; Shang, Hong-Cai

2016-01-01

Objective To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines—for example, in enemas, foot massage and compressing the umbilicus. Design A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Result We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency. Conclusions There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical appraisal of systematic reviews/meta-analyses of TCMN interventions is particularly important to provide sound guidance for TCMN. PMID:28186925

A probabilistic assessment of health risks associated with short-term exposure to tropospheric ozone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Whitfield, R.G; Biller, W.F.; Jusko, M.J.

1996-06-01

The work described in this report is part of a larger risk assessment sponsored by the U.S. Environmental Protection Agency. Earlier efforts developed exposure-response relationships for acute health effects among populations engaged in heavy exertion. Those efforts also developed a probabilistic national ambient air quality standards exposure model and a general methodology for integrating probabilistic exposure-response relation- ships and exposure estimates to calculate overall risk results. Recently published data make it possible to model additional health endpoints (for exposure at moderate exertion), including hospital admissions. New air quality and exposure estimates for alternative national ambient air quality standards for ozonemore » are combined with exposure-response models to produce the risk results for hospital admissions and acute health effects. Sample results explain the methodology and introduce risk output formats.« less

Methodological quality assessment of paper-based systematic reviews published in oral health.

PubMed

Wasiak, J; Shen, A Y; Tan, H B; Mahar, R; Kan, G; Khoo, W R; Faggion, C M

2016-04-01

This study aimed to conduct a methodological assessment of paper-based systematic reviews (SR) published in oral health using a validated checklist. A secondary objective was to explore temporal trends on methodological quality. Two electronic databases (OVID Medline and OVID EMBASE) were searched for paper-based SR of interventions published in oral health from inception to October 2014. Manual searches of the reference lists of paper-based SR were also conducted. Methodological quality of included paper-based SR was assessed using an 11-item questionnaire, Assessment of Multiple Systematic Reviews (AMSTAR) checklist. Methodological quality was summarized using the median and inter-quartile range (IQR) of the AMSTAR score over different categories and time periods. A total of 643 paper-based SR were included. The overall median AMSTAR score was 4 (IQR 2-6). The highest median score (5) was found in the pain dentistry and periodontology fields, while the lowest median score (3) was found in implant dentistry, restorative dentistry, oral medicine, and prosthodontics. The number of paper-based SR per year and the median AMSTAR score increased over time (median score in 1990s was 2 (IQR 2-3), 2000s was 4 (IQR 2-5), and 2010 onwards was 5 (IQR 3-6)). Although the methodological quality of paper-based SR published in oral health has improved in the last few years, there is still scope for improving quality in most evaluated dental specialties. Large-scale assessment of methodological quality of dental SR highlights areas of methodological strengths and weaknesses that can be targeted in future publications to encourage better quality review methodology.

METHODOLOGICAL QUALITY OF ECONOMIC EVALUATIONS ALONGSIDE TRIALS OF KNEE PHYSIOTHERAPY.

PubMed

García-Pérez, Lidia; Linertová, Renata; Arvelo-Martín, Alejandro; Guerra-Marrero, Carolina; Martínez-Alberto, Carlos Enrique; Cuéllar-Pompa, Leticia; Escobar, Antonio; Serrano-Aguilar, Pedro

2017-01-01

The methodological quality of an economic evaluation performed alongside a clinical trial can be underestimated if the paper does not report key methodological features. This study discusses methodological assessment issues on the example of a systematic review on cost-effectiveness of physiotherapy for knee osteoarthritis. Six economic evaluation studies included in the systematic review and related clinical trials were assessed using the 10-question check-list by Drummond and the Physiotherapy Evidence Database (PEDro) scale. All economic evaluations were performed alongside a clinical trial but the studied interventions were too heterogeneous to be synthesized. Methodological quality of the economic evaluations reported in the papers was not free of drawbacks, and in some cases, it improved when information from the related clinical trial was taken into account. Economic evaluation papers dedicate little space to methodological features of related clinical trials; therefore, the methodological quality can be underestimated if evaluated separately from the trials. Future economic evaluations should follow more strictly the recommendations about methodology and the authors should pay special attention to the quality of reporting.

Methodological quality of meta-analyses on treatments for chronic obstructive pulmonary disease: a cross-sectional study using the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool.

PubMed

Ho, Robin S T; Wu, Xinyin; Yuan, Jinqiu; Liu, Siya; Lai, Xin; Wong, Samuel Y S; Chung, Vincent C H

2015-01-08

Meta-analysis (MA) of randomised trials is considered to be one of the best approaches for summarising high-quality evidence on the efficacy and safety of treatments. However, methodological flaws in MAs can reduce the validity of conclusions, subsequently impairing the quality of decision making. To assess the methodological quality of MAs on COPD treatments. A cross-sectional study on MAs of COPD trials. MAs published during 2000-2013 were sampled from the Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effect. Methodological quality was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. Seventy-nine MAs were sampled. Only 18% considered the scientific quality of primary studies when formulating conclusions and 49% used appropriate meta-analytic methods to combine findings. The problems were particularly acute among MAs on pharmacological treatments. In 48% of MAs the authors did not report conflict of interest. Fifty-eight percent reported harmful effects of treatment. Publication bias was not assessed in 65% of MAs, and only 10% had searched non-English databases. The methodological quality of the included MAs was disappointing. Consideration of scientific quality when formulating conclusions should be made explicit. Future MAs should improve on reporting conflict of interest and harm, assessment of publication bias, prevention of language bias and use of appropriate meta-analytic methods.

Systematic reviews addressing microsurgical head and neck reconstruction.

PubMed

Momeni, Arash; Jacobson, Joshua Y; Lee, Gordon K

2015-01-01

Systematic reviews frequently form the basis for clinical decision making and guideline development. Yet, the quality of systematic reviews has been variable, thus raising concerns about the validity of their conclusions. In the current study, a quality analysis of systematic reviews was performed, addressing microsurgical head and neck reconstruction. A PubMed search was performed to identify all systematic reviews published up to and including December 2012 in 12 surgical journals. Two authors independently reviewed the literature and extracted data from the included reviews. Discrepancies were resolved by consensus. Quality assessment was performed using AMSTAR. The initial search retrieved 1020 articles. After screening titles and abstracts, 987 articles were excluded. Full-text review of the remaining 33 articles resulted in further exclusion of 18 articles, leaving 15 systematic reviews for final analysis. A marked increase in the number of published systematic reviews over time was noted (P = 0.07). The median AMSTAR score was 5, thus reflecting a "fair" quality. No evidence for improvement in methodological quality over time was noted. The trend to publish more systematic reviews in microsurgical head and neck reconstruction is encouraging. However, efforts are indicated to improve the methodological quality of systematic reviews. Familiarity with criteria of methodological quality is critical to ensure future improvements in the quality of systematic reviews conducted in microsurgery.

Methodology for stereoscopic motion-picture quality assessment

NASA Astrophysics Data System (ADS)

Voronov, Alexander; Vatolin, Dmitriy; Sumin, Denis; Napadovsky, Vyacheslav; Borisov, Alexey

2013-03-01

Creating and processing stereoscopic video imposes additional quality requirements related to view synchronization. In this work we propose a set of algorithms for detecting typical stereoscopic-video problems, which appear owing to imprecise setup of capture equipment or incorrect postprocessing. We developed a methodology for analyzing the quality of S3D motion pictures and for revealing their most problematic scenes. We then processed 10 modern stereo films, including Avatar, Resident Evil: Afterlife and Hugo, and analyzed changes in S3D-film quality over the years. This work presents real examples of common artifacts (color and sharpness mismatch, vertical disparity and excessive horizontal disparity) in the motion pictures we processed, as well as possible solutions for each problem. Our results enable improved quality assessment during the filming and postproduction stages.

Epidemiological characteristics and methodological quality of meta-analyses on diabetes mellitus treatment: a systematic review.

PubMed

Wu, Xin Yin; Lam, Victor C K; Yu, Yue Feng; Ho, Robin S T; Feng, Ye; Wong, Charlene H L; Yip, Benjamin H K; Tsoi, Kelvin K F; Wong, Samuel Y S; Chung, Vincent C H

2016-11-01

Well-conducted meta-analyses (MAs) are considered as one of the best sources of clinical evidence for treatment decision. MA with methodological flaws may introduce bias and mislead evidence users. The aim of this study is to investigate the characteristics and methodological quality of MAs on diabetes mellitus (DM) treatments. Systematic review. Cochrane Database of Systematic Review and Database of Abstract of Reviews of Effects were searched for relevant MAs. Assessing methodological quality of systematic reviews (AMSTAR) tool was used to evaluate the methodological quality of included MAs. Logistic regression analysis was used to identify association between characteristics of MA and AMSTAR results. A total of 252 MAs including 4999 primary studies and 13,577,025 patients were included. Over half of the MAs (65.1%) only included type 2 DM patients and 160 MAs (63.5%) focused on pharmacological treatments. About 89.7% MAs performed comprehensive literature search and 89.3% provided characteristics of included studies. Included MAs generally had poor performance on the remaining AMSTAR items, especially in assessing publication bias (39.3%), providing lists of studies (19.0%) and declaring source of support comprehensively (7.5%). Only 62.7% MAs mentioned about harm of interventions. MAs with corresponding author from Asia performed less well in providing MA protocol than those from Europe. Methodological quality of MA on DM treatments was unsatisfactory. There is considerable room for improvement, especially in assessing publication bias, providing lists of studies and declaring source of support comprehensively. Also, there is an urgent need for MA authors to report treatment harm comprehensively. © 2016 European Society of Endocrinology.

Are normative sonographic values of kidney size in children valid and reliable? A systematic review of the methodological quality of ultrasound studies using the Anatomical Quality Assessment (AQUA) tool.

PubMed

Chhapola, Viswas; Tiwari, Soumya; Deepthi, Bobbity; Henry, Brandon Michael; Brar, Rekha; Kanwal, Sandeep Kumar

2018-06-01

A plethora of research is available on ultrasonographic kidney size standards. We performed a systematic review of methodological quality of ultrasound studies aimed at developing normative renal parameters in healthy children, by evaluating the risk of bias (ROB) using the 'Anatomical Quality Assessment (AQUA)' tool. We searched Medline, Scopus, CINAHL, and Google Scholar on June 04 2018, and observational studies measuring kidney size by ultrasonography in healthy children (0-18 years) were included. The ROB of each study was evaluated in five domains using a 20 item coding scheme based on AQUA tool framework. Fifty-four studies were included. Domain 1 (subject characteristics) had a high ROB in 63% of studies due to the unclear description of age, sex, and ethnicity. The performance in Domain 2 (study design) was the best with 85% of studies having a prospective design. Methodological characterization (Domain 3) was poor across the studies (< 10% compliance), with suboptimal performance in the description of patient positioning, operator experience, and assessment of intra/inter-observer reliability. About three-fourth of the studies had a low ROB in Domain 4 (descriptive anatomy). Domain 5 (reporting of results) had a high ROB in approximately half of the studies, the majority reporting results in the form of central tendency measures. Significant deficiencies and heterogeneity were observed in the methodological quality of USG studies performed to-date for measurement of kidney size in children. We hereby provide a framework for the conducting such studies in future. PROSPERO (CRD42017071601).

Evidence and practice in spine registries

PubMed Central

van Hooff, Miranda L; Jacobs, Wilco C H; Willems, Paul C; Wouters, Michel W J M; de Kleuver, Marinus; Peul, Wilco C; Ostelo, Raymond W J G; Fritzell, Peter

2015-01-01

Background and purpose We performed a systematic review and a survey in order to (1) evaluate the evidence for the impact of spine registries on the quality of spine care, and with that, on patient-related outcomes, and (2) evaluate the methodology used to organize, analyze, and report the “quality of spine care” from spine registries. Methods To study the impact, the literature on all spinal disorders was searched. To study methodology, the search was restricted to degenerative spinal disorders. The risk of bias in the studies included was assessed with the Newcastle-Ottawa scale. Additionally, a survey among registry representatives was performed to acquire information about the methodology and practice of existing registries. Results 4,273 unique references up to May 2014 were identified, and 1,210 were eligible for screening and assessment. No studies on impact were identified, but 34 studies were identified to study the methodology. Half of these studies (17 of the 34) were judged to have a high risk of bias. The survey identified 25 spine registries, representing 14 countries. The organization of these registries, methods used, analytical approaches, and dissemination of results are presented. Interpretation We found a lack of evidence that registries have had an impact on the quality of spine care, regardless of whether intervention was non-surgical and/or surgical. To improve the quality of evidence published with registry data, we present several recommendations. Application of these recommendations could lead to registries showing trends, monitoring the quality of spine care given, and ultimately improving the value of the care given to patients with degenerative spinal disorders. PMID:25909475

A systematic review of the association between radiographic and clinical osteoarthritis of hip and knee.

PubMed

Kinds, M B; Welsing, P M J; Vignon, E P; Bijlsma, J W J; Viergever, M A; Marijnissen, A C A; Lafeber, F P J G

2011-07-01

There is ongoing debate on whether an association between radiographic and clinical osteoarthritis (OA) exists. We hypothesized that the inconsistency in the detection of an association might be caused by different definitions of OA, by different radiographic protocols, and by scoring methods for radiographic damage and symptoms. The goal of this study was to evaluate which methodological criteria are important to detect an association between radiographic and clinical OA of hip and knee. A literature search was performed with the keywords 'OA', 'hip', 'knee', 'radiographic', and 'clinical' and results were screened for relevant studies. Quality criteria for study characteristics and methodology were developed. Studies were classified according to these criteria and the presence of an association between radiographic and clinical OA was scored. The importance of methodological quality and patient characteristics on the presence of an association was evaluated. The literature search resulted in 39 studies describing an association between radiographic and clinical OA. The frequency of an association between radiographic and clinical OA outcome measures diminished when less quality criteria were fulfilled. Specifically the criterion for standardized outcome measures appeared important in the detection of an association. The association was not influenced by patient characteristics. Only four studies were identified that fulfilled all quality criteria and in these studies an association was found for the knee joint and an inconsistent association was found for the hip joint. Methodological quality criteria are of importance to reveal an association between radiographic and clinical OA. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Beyond Technology Transfer: Quality of Life Impacts from R&D Outcomes

ERIC Educational Resources Information Center

Stone, Vathsala I.; Lockett, Michelle; Usiak, Douglas J.; Arthanat, Sajay

2010-01-01

This paper presents methodology and findings from three product efficacy studies that verify the quality of life benefits resulting from prior research, development, and transfer activities. The paper then discusses key lessons learned with implications for product evaluation practice. The studies assessed the quality of three assistive technology…

A methodology model for quality management in a general hospital.

PubMed

Stern, Z; Naveh, E

1997-01-01

A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.

Combining natural background levels (NBLs) assessment with indicator kriging analysis to improve groundwater quality data interpretation and management.

PubMed

Ducci, Daniela; de Melo, M Teresa Condesso; Preziosi, Elisabetta; Sellerino, Mariangela; Parrone, Daniele; Ribeiro, Luis

2016-11-01

The natural background level (NBL) concept is revisited and combined with indicator kriging method to analyze the spatial distribution of groundwater quality within a groundwater body (GWB). The aim is to provide a methodology to easily identify areas with the same probability of exceeding a given threshold (which may be a groundwater quality criteria, standards, or recommended limits for selected properties and constituents). Three case studies with different hydrogeological settings and located in two countries (Portugal and Italy) are used to derive NBL using the preselection method and validate the proposed methodology illustrating its main advantages over conventional statistical water quality analysis. Indicator kriging analysis was used to create probability maps of the three potential groundwater contaminants. The results clearly indicate the areas within a groundwater body that are potentially contaminated because the concentrations exceed the drinking water standards or even the local NBL, and cannot be justified by geogenic origin. The combined methodology developed facilitates the management of groundwater quality because it allows for the spatial interpretation of NBL values. Copyright © 2016 Elsevier B.V. All rights reserved.

[Methodological quality of articles on therapeutic procedures published in Cirugía Española. Evaluation of the period 2005-2008].

PubMed

Manterola, Carlos; Grande, Luís

2010-04-01

To determine methodological quality of therapy articles published in Cirugía Española and to study its association with the publication year, the centre of origin and subjects. A literature study which included all therapy articles published between 2005 and 2008. All kinds of clinical designs were considered, excluding editorials, review articles, letters to editor and experimental studies. Variables analysed included: year of publication, centre of origin, design, and methodological quality of articles. A valid and reliable scale was applied to determine methodological quality. A total of 243 articles [206 series of cases (84.8%), 27 cohort studies (11.1%), 9 clinical trials (3.7%) and 1 case control study (0.4%)] were found. Studies came preferentially from Catalonia and Valencia (22.3% and 12.3% respectively). Thematic areas most frequently found were hepato-bilio-pancreatic and colorectal surgery (20.0% and 16.6%, respectively). Average and median of the methodological quality score calculated for the entire series were 9.5+/-4.3 points and 8 points, respectively. Association between methodological quality and geographical area (p=0.0101), subject area (p=0.0267), and university origin (p=0.0369) was found. A significant increase of methodological quality by publication year was observed (p=0.0004). Methodological quality of therapy articles published in Cirugía Española between 2005 and 2008 is low; but an increase tendency with statistical significance was observed.

Reporting and methodological quality of meta-analyses in urological literature

PubMed Central

Xu, Jing

2017-01-01

Purpose To assess the overall quality of published urological meta-analyses and identify predictive factors for high quality. Materials and Methods We systematically searched PubMed to identify meta-analyses published from January 1st, 2011 to December 31st, 2015 in 10 predetermined major paper-based urology journals. The characteristics of the included meta-analyses were collected, and their reporting and methodological qualities were assessed by the PRISMA checklist (27 items) and AMSTAR tool (11 items), respectively. Descriptive statistics were used for individual items as a measure of overall compliance, and PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. Logistic regression was used to identify predictive factors for high qualities. Results A total of 183 meta-analyses were included. The mean PRISMA and AMSTAR scores were 22.74 ± 2.04 and 7.57 ± 1.41, respectively. PRISMA item 5, protocol and registration, items 15 and 22, risk of bias across studies, items 16 and 23, additional analysis had less than 50% adherence. AMSTAR item 1, “a priori” design, item 5, list of studies and item 10, publication bias had less than 50% adherence. Logistic regression analyses showed that funding support and “a priori” design were associated with superior reporting quality, following PRISMA guideline and “a priori” design were associated with superior methodological quality. Conclusions Reporting and methodological qualities of recently published meta-analyses in major paper-based urology journals are generally good. Further improvement could potentially be achieved by strictly adhering to PRISMA guideline and having “a priori” protocol. PMID:28439452

Methodological quality of systematic reviews addressing femoroacetabular impingement.

PubMed

Kowalczuk, Marcin; Adamich, John; Simunovic, Nicole; Farrokhyar, Forough; Ayeni, Olufemi R

2015-09-01

As the body of literature on femoroacetabular impingement (FAI) continues to grow, clinicians turn to systematic reviews to remain current with the best available evidence. The quality of systematic reviews in the FAI literature is currently unknown. The goal of this study was to assess the quality of the reporting of systematic reviews addressing FAI over the last 11 years (2003-2014) and to identify the specific methodological shortcomings and strengths. A search of the electronic databases, MEDLINE, EMBASE and PubMed, was performed to identify relevant systematic reviews. Methodological quality was assessed by two reviewers using the revised assessment of multiple systematic reviews (R-AMSTAR) scoring tool. An intraclass correlation coefficient (ICC) with 95 % confidence intervals (CI) was used to determine agreement between reviewers on R-AMSTAR quality scores. A total of 22 systematic reviews were assessed for methodological quality. The mean consensus R-AMSTAR score across all studies was 26.7 out of 40.0, indicating fair methodological quality. An ICC of 0.931, 95 % CI 0.843-0.971 indicated excellent agreement between reviewers during the scoring process. The systematic reviews addressing FAI are generally of fair methodological quality. Use of tools such as the R-AMSTAR score or PRISMA guidelines while designing future systematic reviews can assist in eliminating methodological shortcomings identified in this review. These shortcomings need to be kept in mind by clinicians when applying the current literature to their patient populations and making treatment decisions. Systematic reviews of highest methodological quality should be used by clinicians when possible to answer clinical questions.

Indirect Comparisons: A Review of Reporting and Methodological Quality

PubMed Central

Donegan, Sarah; Williamson, Paula; Gamble, Carrol; Tudur-Smith, Catrin

2010-01-01

Background The indirect comparison of two interventions can be valuable in many situations. However, the quality of an indirect comparison will depend on several factors including the chosen methodology and validity of underlying assumptions. Published indirect comparisons are increasingly more common in the medical literature, but as yet, there are no published recommendations of how they should be reported. Our aim is to systematically review the quality of published indirect comparisons to add to existing empirical data suggesting that improvements can be made when reporting and applying indirect comparisons. Methodology/Findings Reviews applying statistical methods to indirectly compare the clinical effectiveness of two interventions using randomised controlled trials were eligible. We searched (1966–2008) Database of Abstracts and Reviews of Effects, The Cochrane library, and Medline. Full review publications were assessed for eligibility. Specific criteria to assess quality were developed and applied. Forty-three reviews were included. Adequate methodology was used to calculate the indirect comparison in 41 reviews. Nineteen reviews assessed the similarity assumption using sensitivity analysis, subgroup analysis, or meta-regression. Eleven reviews compared trial-level characteristics. Twenty-four reviews assessed statistical homogeneity. Twelve reviews investigated causes of heterogeneity. Seventeen reviews included direct and indirect evidence for the same comparison; six reviews assessed consistency. One review combined both evidence types. Twenty-five reviews urged caution in interpretation of results, and 24 reviews indicated when results were from indirect evidence by stating this term with the result. Conclusions This review shows that the underlying assumptions are not routinely explored or reported when undertaking indirect comparisons. We recommend, therefore, that the quality of indirect comparisons should be improved, in particular, by assessing assumptions and reporting the assessment methods applied. We propose that the quality criteria applied in this article may provide a basis to help review authors carry out indirect comparisons and to aid appropriate interpretation. PMID:21085712

An Overview of Meta-Analyses of Danhong Injection for Unstable Angina.

PubMed

Zhang, Xiaoxia; Wang, Hui; Chang, Yanxu; Wang, Yuefei; Lei, Xiang; Fu, Shufei; Zhang, Junhua

2015-01-01

Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA). Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

An Overview of Meta-Analyses of Danhong Injection for Unstable Angina

PubMed Central

Zhang, Xiaoxia; Chang, Yanxu; Wang, Yuefei; Lei, Xiang; Fu, Shufei; Zhang, Junhua

2015-01-01

Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA). Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved. PMID:26539221

Methodological quality of systematic reviews on influenza vaccination.

PubMed

Remschmidt, Cornelius; Wichmann, Ole; Harder, Thomas

2014-03-26

There is a growing body of evidence on the risks and benefits of influenza vaccination in various target groups. Systematic reviews are of particular importance for policy decisions. However, their methodological quality can vary considerably. To investigate the methodological quality of systematic reviews on influenza vaccination (efficacy, effectiveness, safety) and to identify influencing factors. A systematic literature search on systematic reviews on influenza vaccination was performed, using MEDLINE, EMBASE and three additional databases (1990-2013). Review characteristics were extracted and the methodological quality of the reviews was evaluated using the assessment of multiple systematic reviews (AMSTAR) tool. U-test, Kruskal-Wallis test, chi-square test, and multivariable linear regression analysis were used to assess the influence of review characteristics on AMSTAR-score. Fourty-six systematic reviews fulfilled the inclusion criteria. Average methodological quality was high (median AMSTAR-score: 8), but variability was large (AMSTAR range: 0-11). Quality did not differ significantly according to vaccination target group. Cochrane reviews had higher methodological quality than non-Cochrane reviews (p=0.001). Detailed analysis showed that this was due to better study selection and data extraction, inclusion of unpublished studies, and better reporting of study characteristics (all p<0.05). In the adjusted analysis, no other factor, including industry sponsorship or journal impact factor had an influence on AMSTAR score. Systematic reviews on influenza vaccination showed large differences regarding their methodological quality. Reviews conducted by the Cochrane collaboration were of higher quality than others. When using systematic reviews to guide the development of vaccination recommendations, the methodological quality of a review in addition to its content should be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

'Emerging technologies for the changing global market' - Prioritization methodology for chemical replacement

NASA Technical Reports Server (NTRS)

Cruit, Wendy; Schutzenhofer, Scott; Goldberg, Ben; Everhart, Kurt

1993-01-01

This project served to define an appropriate methodology for effective prioritization of technology efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semiquantitative approach derived from quality function deployment techniques (QFD Matrix). This methodology aims to weight the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives. The results will be implemented as a guideline for consideration for current NASA propulsion systems.

Proposed methodology for estimating the impact of highway improvements on urban air pollution.

DOT National Transportation Integrated Search

1971-01-01

The aim of this methodology is to indicate the expected change in ambient air quality in the vicinity of a highway improvement and in the total background level of urban air pollution resulting from the highway improvement. Both the jurisdiction in w...

[Audit and feedback, and continuous quality improvement strategies to improve the quality of care for type 2 diabetes: a systematic review of literature].

PubMed

Vecchi, Simona; Agabiti, Nera; Mitrova, Susanna; Cacciani, Laura; Amato, Laura; Davoli, Marina; Bargagli, Anna Maria

2016-01-01

we analysed evidence on effective interventions to improve the quality of care and management in patients with diabetes type 2. This review focuses particularly on audit and feedback intervention, targeted to healthcare providers, and continuous quality improvement (CQI) involving health professionals and health care systems, respectively. we searched The Cochrane Library, PubMed, and EMBASE (search period: January 2005-December 2015) to identify systematic reviews (SR) and randomized controlled trials (RCTs) considering patients' outcomes and process measures as quality indicators in diabetes care. Selection of studies and data extraction were carried out independently by two reviewers. Methodological quality of individual studies was assessed using the checklist «Assessment of methodological quality of systematic review» (AMSTAR) and the Cochrane's tool, respectively. We produced summaries of results for each study design. the search process resulted in 810 citations. One SR and 7 RCTs that compared any intervention in which audit and feedback and CQI was a component vs. other interventions were selected. The SR found that audit and feedback activity was associated with improvements of glycaemic (mean difference: 0.26; 95%CI 0.08;0.44) and cholesterol control (mean difference: 0.03; 95%CI -0.04;0.10). CQI interventions were not associated with an improvement of quality of diabetes care. The RCTs considered in this review compared a broad range of interventions including feedback as unique activity or as part of more complex strategies. The methodological quality was generally poor in all the included trials. the available evidence suggests that audit and feedback and CQI improve quality of care in diabetic patients, although the effect is small and heterogeneous among process and outcomes indicators.

How to do a grounded theory study: a worked example of a study of dental practices

PubMed Central

2011-01-01

Background Qualitative methodologies are increasingly popular in medical research. Grounded theory is the methodology most-often cited by authors of qualitative studies in medicine, but it has been suggested that many 'grounded theory' studies are not concordant with the methodology. In this paper we provide a worked example of a grounded theory project. Our aim is to provide a model for practice, to connect medical researchers with a useful methodology, and to increase the quality of 'grounded theory' research published in the medical literature. Methods We documented a worked example of using grounded theory methodology in practice. Results We describe our sampling, data collection, data analysis and interpretation. We explain how these steps were consistent with grounded theory methodology, and show how they related to one another. Grounded theory methodology assisted us to develop a detailed model of the process of adapting preventive protocols into dental practice, and to analyse variation in this process in different dental practices. Conclusions By employing grounded theory methodology rigorously, medical researchers can better design and justify their methods, and produce high-quality findings that will be more useful to patients, professionals and the research community. PMID:21902844

Randomized clinical trials in dentistry: Risks of bias, risks of random errors, reporting quality, and methodologic quality over the years 1955–2013

PubMed Central

Armijo-Olivo, Susan; Cummings, Greta G.; Amin, Maryam; Flores-Mir, Carlos

2017-01-01

Objectives To examine the risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions and the development of these aspects over time. Methods We included 540 randomized clinical trials from 64 selected systematic reviews. We extracted, in duplicate, details from each of the selected randomized clinical trials with respect to publication and trial characteristics, reporting and methodologic characteristics, and Cochrane risk of bias domains. We analyzed data using logistic regression and Chi-square statistics. Results Sequence generation was assessed to be inadequate (at unclear or high risk of bias) in 68% (n = 367) of the trials, while allocation concealment was inadequate in the majority of trials (n = 464; 85.9%). Blinding of participants and blinding of the outcome assessment were judged to be inadequate in 28.5% (n = 154) and 40.5% (n = 219) of the trials, respectively. A sample size calculation before the initiation of the study was not performed/reported in 79.1% (n = 427) of the trials, while the sample size was assessed as adequate in only 17.6% (n = 95) of the trials. Two thirds of the trials were not described as double blinded (n = 358; 66.3%), while the method of blinding was appropriate in 53% (n = 286) of the trials. We identified a significant decrease over time (1955–2013) in the proportion of trials assessed as having inadequately addressed methodological quality items (P < 0.05) in 30 out of the 40 quality criteria, or as being inadequate (at high or unclear risk of bias) in five domains of the Cochrane risk of bias tool: sequence generation, allocation concealment, incomplete outcome data, other sources of bias, and overall risk of bias. Conclusions The risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions have improved over time; however, further efforts that contribute to the development of more stringent methodology and detailed reporting of trials are still needed. PMID:29272315

Spatial prediction of water quality variables along a main river channel, in presence of pollution hotspots.

PubMed

Rizo-Decelis, L D; Pardo-Igúzquiza, E; Andreo, B

2017-12-15

In order to treat and evaluate the available data of water quality and fully exploit monitoring results (e.g. characterize regional patterns, optimize monitoring networks, infer conditions at unmonitored locations, etc.), it is crucial to develop improved and efficient methodologies. Accordingly, estimation of water quality along fluvial ecosystems is a frequent task in environment studies. In this work, a particular case of this problem is examined, namely, the estimation of water quality along a main stem of a large basin (where most anthropic activity takes place), from observational data measured along this river channel. We adapted topological kriging to this case, where each watershed contains all the watersheds of the upstream observed data ("nested support effect"). Data analysis was additionally extended by taking into account the upstream distance to the closest contamination hotspot as an external drift. We propose choosing the best estimation method by cross-validation. The methodological approach in spatial variability modeling may be used for optimizing the water quality monitoring of a given watercourse. The methodology presented is applied to 28 water quality variables measured along the Santiago River in Western Mexico. Copyright © 2017 Elsevier B.V. All rights reserved.

Application of cooperative and non-cooperative games in large-scale water quantity and quality management: a case study.

PubMed

Mahjouri, Najmeh; Ardestani, Mojtaba

2011-01-01

In this paper, two cooperative and non-cooperative methodologies are developed for a large-scale water allocation problem in Southern Iran. The water shares of the water users and their net benefits are determined using optimization models having economic objectives with respect to the physical and environmental constraints of the system. The results of the two methodologies are compared based on the total obtained economic benefit, and the role of cooperation in utilizing a shared water resource is demonstrated. In both cases, the water quality in rivers satisfies the standards. Comparing the results of the two mentioned approaches shows the importance of acting cooperatively to achieve maximum revenue in utilizing a surface water resource while the river water quantity and quality issues are addressed.

Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment.

PubMed

Engel, Lisa; Chui, Adora; Beaton, Dorcas E; Green, Robin E; Dawson, Deirdre R

2018-03-07

To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments. Seven databases were searched in May 2015. Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected. This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis. The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments. Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials

PubMed Central

2014-01-01

Background Acupuncture and moxibustion have widely been used to treat lateral elbow pain (LEP). A comprehensive systematic review of randomized controlled trials (RCTs) including both English and Chinese databases was conducted to assess the efficacy of acupuncture and moxibustion in the treatment of LEP. Methods Revised STRICTA (2010) criteria were used to appraise the acupuncture procedures, the Cochrane risk of bias tool was used to assess the methodological quality of the studies. A total of 19 RCTs that compared acupuncture and/or moxibustion with sham acupuncture, another form of acupuncture, or conventional treatment were included. Results All studies had at least one domain rated as high risk or uncertain risk of bias in the Cochrane risk of bias tool. Results from three RCTs of moderate quality showed that acupuncture was more effective than sham acupuncture. Results from 10 RCTs of mostly low quality showed that acupuncture or moxibustion was superior or equal to conventional treatment, such as local anesthetic injection, local steroid injection, non-steroidal anti- inflammatory drugs, or ultrasound. There were six low quality RCTs that compared acupuncture and moxibustion combined with manual acupuncture alone, and all showed that acupuncture and moxibustion combined was superior to manual acupuncture alone. Conclusion Moderate quality studies suggest that acupuncture is more effective than sham acupuncture. Interpretations of findings regarding acupuncture vs. conventional treatment, and acupuncture and moxibustion combined vs. manual acupuncture alone are limited by the methodological qualities of these studies. Future studies with improved methodological design are warranted to confirm the efficacy of acupuncture and moxibustion for LEP. PMID:24726029

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

PubMed Central

2014-01-01

Background To ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implications about the usefulness of paediatric oral health interventions in practice. Methods We conducted a methodological survey including all paediatric dentistry reviews from the COHG. We extracted data on characteristics of included reviews, then assessed the methodological quality using a validated 11-item quality assessment tool (AMSTAR). Finally, we coded each review to indicate whether its authors concluded that an intervention should be implemented in practice, was not supported or was refuted by the evidence, or should be used only in research (inconclusive evidence). Results We selected 37 reviews; most concerned the prevention of caries. The methodological quality was high, except for the assessment of reporting bias. In 7 reviews (19%), the research showed that benefits outweighed harms; in 1, the experimental intervention was found ineffective; and in 29 (78%), evidence was insufficient to assess benefits and harms. In the 7 reviews, topical fluoride treatments (with toothpaste, gel or varnish) were found effective for permanent and deciduous teeth in children and adolescents, and sealants for occlusal tooth surfaces of permanent molars. Conclusions Cochrane reviews of paediatric dentistry were of high quality. They provided strong evidence that topical fluoride treatments and sealants are effective for children and adolescents and thus should be implemented in practice. However, a substantial number of reviews yielded inconclusive evidence. PMID:24716532

Telephone-quality pathological speech classification using empirical mode decomposition.

PubMed

Kaleem, M F; Ghoraani, B; Guergachi, A; Krishnan, S

2011-01-01

This paper presents a computationally simple and effective methodology based on empirical mode decomposition (EMD) for classification of telephone quality normal and pathological speech signals. EMD is used to decompose continuous normal and pathological speech signals into intrinsic mode functions, which are analyzed to extract physically meaningful and unique temporal and spectral features. Using continuous speech samples from a database of 51 normal and 161 pathological speakers, which has been modified to simulate telephone quality speech under different levels of noise, a linear classifier is used with the feature vector thus obtained to obtain a high classification accuracy, thereby demonstrating the effectiveness of the methodology. The classification accuracy reported in this paper (89.7% for signal-to-noise ratio 30 dB) is a significant improvement over previously reported results for the same task, and demonstrates the utility of our methodology for cost-effective remote voice pathology assessment over telephone channels.

Cognitive remediation in schizophrenia: A methodological appraisal of systematic reviews and meta-analyses.

PubMed

Bryce, Shayden; Sloan, Elise; Lee, Stuart; Ponsford, Jennie; Rossell, Susan

2016-04-01

Systematic reviews and meta-analyses are a primary source of evidence when evaluating the benefit(s) of cognitive remediation (CR) in schizophrenia. These studies are designed to rigorously synthesize scientific literature; however, cannot be assumed to be of high methodological quality. The aims of this report were to: 1) review the use of systematic reviews and meta-analyses regarding CR in schizophrenia; 2) conduct a systematic methodological appraisal of published reports examining the benefits of this intervention on core outcome domains; and 3) compare the correspondence between methodological and reporting quality. Electronic databases were searched for relevant articles. Twenty-one reviews met inclusion criteria and were scored according to the AMSTAR checklist-a validated scale of methodological quality. Five meta-analyses were also scored according to PRISMA statement to compare 'quality of conduct' with 'quality of reporting'. Most systematic reviews and meta-analyses shared strengths and fell within a 'medium' level of methodological quality. Nevertheless, there were consistent areas of potential weakness that were not addressed by most reviews. These included the lack of protocol registration, uncertainty regarding independent data extraction and consensus procedures, and the minimal assessment of publication bias. Moreover, quality of conduct may not necessarily parallel quality of reporting, suggesting that consideration of these methods independently may be important. Reviews concerning CR for schizophrenia are a valuable source of evidence. However, the methodological quality of these reports may require additional consideration. Enhancing quality of conduct is essential for enabling research literature to be interpreted with confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Methodologic quality and relevance of references in pharmaceutical advertisements in a Canadian medical journal.

PubMed

Lexchin, J; Holbrook, A

1994-07-01

To evaluate the methodologic quality and relevance of references in pharmaceutical advertisements in the Canadian Medical Association Journal (CMAJ). Analytic study. All 114 references cited in the first 22 distinct pharmaceutical advertisements in volume 146 of CMAJ. Mean methodologic quality score (modified from the 6-point scale used to assess articles in the American College of Physicians' Journal Club) and mean relevance score (based on a new 5-point scale) for all references in each advertisement. Twenty of the 22 companies responded, sending 78 (90%) of the 87 references requested. The mean methodologic quality score was 58% (95% confidence limits [CL] 51% and 65%) and the mean relevance score 76% (95% CL 72% and 80%). The two mean scores were statistically lower than the acceptable score of 80% (p < 0.05), and the methodologic quality score was outside the preset clinically significant difference of 15%. The poor rating for methodologic quality was primarily because of the citation of references to low-quality review articles and "other" sources (i.e., other than reports of clinical trials). Half of the advertisements had a methodologic quality score of less than 65%, but only five had a relevance score of less than 65%. Although the relevance of most of the references was within minimal acceptable limits, the methodologic quality was often unacceptable. Because advertisements are an important part of pharmaceutical marketing and education, we suggest that companies develop written standards for their advertisements and monitor their advertisements for adherence to these standards. We also suggest that the Pharmaceutical Advertising Advisory Board develop more stringent guidelines for advertising and that it enforce these guidelines in a consistent, rigorous fashion.

Evolution of the methodological quality of controlled clinical trials for myofascial trigger point treatments for the period 1978-2015: A systematic review.

PubMed

Stoop, Rahel; Clijsen, Ron; Leoni, Diego; Soldini, Emiliano; Castellini, Greta; Redaelli, Valentina; Barbero, Marco

2017-08-01

The methodological quality of controlled clinical trials (CCTs) of physiotherapeutic treatment modalities for myofascial trigger points (MTrP) has not been investigated yet. To detect the methodological quality of CCTs for physiotherapy treatments of MTrPs and demonstrating the possible increase over time. Systematic review. A systematic search was conducted in two databases, Physiotherapy Evidence Database (PEDro) and Medicine Medical Literature Analysis and Retrieval System online (MEDLINE), using the same keywords and selection procedure corresponding to pre-defined inclusion criteria. The methodological quality, assessed by the 11-item PEDro scale, served as outcome measure. The CCTs had to compare at least two interventions, where one intervention had to lay within the scope of physiotherapy. Participants had to be diagnosed with myofascial pain syndrome or trigger points (active or latent). A total of n = 230 studies was analysed. The cervico-thoracic region was the most frequently treated body part (n = 143). Electrophysical agent applications was the most frequent intervention. The average methodological quality reached 5.5 on the PEDro scale. A total of n = 6 studies scored the value of 9. The average PEDro score increased by 0.7 points per decade between 1978 and 2015. The average PEDro score of CCTs for MTrP treatments does not reach the cut-off of 6 proposed for moderate to high methodological quality. Nevertheless, a promising trend towards an increase of the average methodological quality of CCTs for MTrPs was recorded. More high-quality CCT studies with thorough research procedures are recommended to enhance methodological quality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Volume reconstruction optimization for tomo-PIV algorithms applied to experimental data

NASA Astrophysics Data System (ADS)

Martins, Fabio J. W. A.; Foucaut, Jean-Marc; Thomas, Lionel; Azevedo, Luis F. A.; Stanislas, Michel

2015-08-01

Tomographic PIV is a three-component volumetric velocity measurement technique based on the tomographic reconstruction of a particle distribution imaged by multiple camera views. In essence, the performance and accuracy of this technique is highly dependent on the parametric adjustment and the reconstruction algorithm used. Although synthetic data have been widely employed to optimize experiments, the resulting reconstructed volumes might not have optimal quality. The purpose of the present study is to offer quality indicators that can be applied to data samples in order to improve the quality of velocity results obtained by the tomo-PIV technique. The methodology proposed can potentially lead to significantly reduction in the time required to optimize a tomo-PIV reconstruction, also leading to better quality velocity results. Tomo-PIV data provided by a six-camera turbulent boundary-layer experiment were used to optimize the reconstruction algorithms according to this methodology. Velocity statistics measurements obtained by optimized BIMART, SMART and MART algorithms were compared with hot-wire anemometer data and velocity measurement uncertainties were computed. Results indicated that BIMART and SMART algorithms produced reconstructed volumes with equivalent quality as the standard MART with the benefit of reduced computational time.

Journal impact factor and methodological quality of surgical randomized controlled trials: an empirical study.

PubMed

Ahmed Ali, Usama; Reiber, Beata M M; Ten Hove, Joren R; van der Sluis, Pieter C; Gooszen, Hein G; Boermeester, Marja A; Besselink, Marc G

2017-11-01

The journal impact factor (IF) is often used as a surrogate marker for methodological quality. The objective of this study is to evaluate the relation between the journal IF and methodological quality of surgical randomized controlled trials (RCTs). Surgical RCTs published in PubMed in 1999 and 2009 were identified. According to IF, RCTs were divided into groups of low (<2), median (2-3) and high IF (>3), as well as into top-10 vs all other journals. Methodological quality characteristics and factors concerning funding, ethical approval and statistical significance of outcomes were extracted and compared between the IF groups. Additionally, a multivariate regression was performed. The median IF was 2.2 (IQR 2.37). The percentage of 'low-risk of bias' RCTs was 13% for top-10 journals vs 4% for other journals in 1999 (P < 0.02), and 30 vs 12% in 2009 (P < 0.02). Similar results were observed for high vs low IF groups. The presence of sample-size calculation, adequate generation of allocation and intention-to-treat analysis were independently associated with publication in higher IF journals; as were multicentre trials and multiple authors. Publication of RCTs in high IF journals is associated with moderate improvement in methodological quality compared to RCTs published in lower IF journals. RCTs with adequate sample-size calculation, generation of allocation or intention-to-treat analysis were associated with publication in a high IF journal. On the other hand, reporting a statistically significant outcome and being industry funded were not independently associated with publication in a higher IF journal.

TAPping into argumentation: Developments in the application of Toulmin's Argument Pattern for studying science discourse

NASA Astrophysics Data System (ADS)

Erduran, Sibel; Simon, Shirley; Osborne, Jonathan

2004-11-01

This paper reports some methodological approaches to the analysis of argumentation discourse developed as part of the two-and-a-half year project titled Enhancing the Quality of Argument in School Scienc'' supported by the Economic and Social Research Council in the United Kingdom. In this project researchers collaborated with middle-school science teachers to develop models of instructional activities in an effort to make argumentation a component of instruction. We begin the paper with a brief theoretical justification for why we consider argumentation to be of significance to science education. We then contextualize the use of Toulmin's Argument Pattern in the study of argumentation discourse and provide a justification for the methodological outcomes our approach generates. We illustrate how our work refines and develops research methodologies in argumentation analysis. In particular, we present two methodological approaches to the analysis of argumentation resulting in whole-class as well as small-group student discussions. For each approach, we illustrate our coding scheme and some results as well as how our methodological approach has enabled our inquiry into the quality of argumentation in the classroom. We conclude with some implications for future research in argumentation in science education.

Methodological issues of genetic association studies.

PubMed

Simundic, Ana-Maria

2010-12-01

Genetic association studies explore the association between genetic polymorphisms and a certain trait, disease or predisposition to disease. It has long been acknowledged that many genetic association studies fail to replicate their initial positive findings. This raises concern about the methodological quality of these reports. Case-control genetic association studies often suffer from various methodological flaws in study design and data analysis, and are often reported poorly. Flawed methodology and poor reporting leads to distorted results and incorrect conclusions. Many journals have adopted guidelines for reporting genetic association studies. In this review, some major methodological determinants of genetic association studies will be discussed.

Meat in context. On the relation between perceptions and contexts.

PubMed

Korzen, Sara; Lassen, Jesper

2010-04-01

Studies of the public perception of specific food qualities often report conflicting findings, and it is well known that actual market behaviour frequently deviates from the perceptions of food quality expressed in interviews or surveys. Rather than treating these kinds of disparity as the result of data being self-contradictory, this paper, which builds on sociological theories and an empirical study, suggests that the concept of context can contribute to a better understanding of the threatened paradoxes. First, the paper introduces and discusses context as a theoretical and methodological approach in studies of public perceptions of food quality. Second, a case study of the importance of different contexts for Danish public perceptions of meat quality is reported. The study involved a series of focus-group interviews with Danes. Its results demonstrate that public concerns about meat quality vary, depending on whether they relate to meat in an everyday context or production context. It is concluded that the deployment of context as a methodological and interpretive frame improves our understanding of disparities in the reporting of public perceptions of food qualities. Copyright 2009 Elsevier Ltd. All rights reserved.

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews.

PubMed

Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Hill, Bridget; Bialocerkowski, Andrea

2013-01-19

Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words).

Implementation and evaluation of a multisite drug usage evaluation program across Australian hospitals - a quality improvement initiative.

PubMed

Pulver, Lisa K; Wai, Angela; Maxwell, David J; Robertson, Marion B; Riddell, Steven

2011-08-29

With the use of medicines being a broad and extensive part of health management, mechanisms to ensure quality use of medicines are essential. Drug usage evaluation (DUE) is an evidence-based quality improvement methodology, designed to improve the quality, safety and cost-effectiveness of drug use. The purpose of this paper is to describe a national DUE methodology used to improve health care delivery across the continuum through multi-faceted intervention involving audit and feedback, academic detailing and system change, and a qualitative assessment of the methodology, as illustrated by the Acute Postoperative Pain Management (APOP) project. An established methodology, consisting of a baseline audit of inpatient medical records, structured patient interviews and general practitioner surveys, followed by an educational intervention and follow-up audit, is used. Australian hospitals, including private, public, metropolitan and regional, are invited to participate on a voluntary basis. De-identified data collected by hospitals are collated and evaluated nationally to provide descriptive comparative analyses. Hospitals benchmark their practices against state and national results to facilitate change. The educational intervention consists of academic detailing, group education, audit and feedback, point-of-prescribing prompts and system changes. A repeat data collection is undertaken to assess changes in practice.An online qualitative survey was undertaken to evaluate the APOP program. Qualitative assessment of hospitals' perceptions of the effectiveness of the overall DUE methodology and changes in procedure/prescribing/policy/clinical practice which resulted from participation were elicited. 62 hospitals participated in the APOP project. Among 23 respondents to the evaluation survey, 18 (78%) reported improvements in the documentation of pain scores at their hospital. 15 (65%) strongly agreed or agreed that participation in APOP directly resulted in increased prescribing of multimodal analgesia for pain relief in postoperative patients. This national DUE program has facilitated the engagement and participation of a number of acute health care facilities to address issues relating to quality use of medicine. This approach has been perceived to be effective in helping them achieve improvements in patient care.

Efficacy of surgery for rotator cuff tendinopathy: a systematic review.

PubMed

Toliopoulos, Panagiota; Desmeules, François; Boudreault, Jennifer; Roy, Jean-Sébastien; Frémont, Pierre; MacDermid, Joy C; Dionne, Clermont E

2014-01-01

The objective of this study is to review randomized controlled trials evaluating the efficacy of surgery for the treatment of rotator cuff (RC) tendinopathy. Studies up to August 2013 were located in the PubMed, Embase, CINAHL, and PEDro databases using relevant keywords. Studies were included if: (1) participants had rotator cuff tendinopathy, (2) the trials were conducted on an adult population (≥18 years old), (3) at least one of the interventions studied was a surgical procedure, (4) study design was a randomized controlled trial (RCT), and (5) the article was written in English or French. Characteristics of the included studies were extracted using a standardized form. Two independent raters reviewed the methodological quality of the studies using the Risk of Bias Assessment tool developed by the Cochrane Collaboration Group. Differences were resolved by consensus. Fifteen trials met our inclusion criteria. After consensus, the mean methodological quality for all studies was 58.9 ± 10.8 %. In three out of four RCTs of moderate or low methodological quality, no significant difference in treatment effectiveness was observed between open or arthroscopic acromioplasty compared to exercises in the treatment of RC tendinopathy. Based on two studies of low or moderate methodological quality, no difference in treatment effectiveness was observed between arthroscopic and open acromioplasty. Two other RCTs of low to moderate quality, however, found that arthroscopic acromioplasty yielded better results in the short-term for shoulder range of motion in flexion but that both procedures were comparable in the long-term. One additional study favored open acromioplasty over arthroscopic acromioplasty for the treatment of RC tendinopathy. Based on low- to moderate-quality evidence, acromioplasty, be it open or arthroscopic, is no more effective than exercises for the treatment of RC tendinopathy. Low-grade evidence also suggests that arthroscopic acromioplasty may yield better results in the short-term for shoulder range of motion in flexion compared to open acromioplasty, but long-term results are comparable between the two types of surgery. More high-quality RCTs are required in order to provide comprehensive treatment guidelines to healthcare providers.

Using Quality Tools and Methodologies to Improve a Hospital's Quality Position.

PubMed

Branco, Daniel; Wicks, Angela M; Visich, John K

2017-01-01

The authors identify the quality tools and methodologies most frequently used by quality-positioned hospitals versus nonquality hospitals. Northeastern U.S. hospitals in both groups received a brief, 12-question survey. The authors found that 93.75% of the quality hospitals and 81.25% of the nonquality hospitals used some form of process improvement methodologies. However, there were significant differences between the groups regarding the impact of quality improvement initiatives on patients. The findings indicate that in quality hospitals the use of quality improvement initiatives had a significantly greater positive impact on patient satisfaction and patient outcomes when compared to nonquality hospitals.

Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review.

PubMed

Eysenbach, Gunther; Powell, John; Kuss, Oliver; Sa, Eun-Ryoung

The quality of consumer health information on the World Wide Web is an important issue for medicine, but to date no systematic and comprehensive synthesis of the methods and evidence has been performed. To establish a methodological framework on how quality on the Web is evaluated in practice, to determine the heterogeneity of the results and conclusions, and to compare the methodological rigor of these studies, to determine to what extent the conclusions depend on the methodology used, and to suggest future directions for research. We searched MEDLINE and PREMEDLINE (1966 through September 2001), Science Citation Index (1997 through September 2001), Social Sciences Citation Index (1997 through September 2001), Arts and Humanities Citation Index (1997 through September 2001), LISA (1969 through July 2001), CINAHL (1982 through July 2001), PsychINFO (1988 through September 2001), EMBASE (1988 through June 2001), and SIGLE (1980 through June 2001). We also conducted hand searches, general Internet searches, and a personal bibliographic database search. We included published and unpublished empirical studies in any language in which investigators searched the Web systematically for specific health information, evaluated the quality of Web sites or pages, and reported quantitative results. We screened 7830 citations and retrieved 170 potentially eligible full articles. A total of 79 distinct studies met the inclusion criteria, evaluating 5941 health Web sites and 1329 Web pages, and reporting 408 evaluation results for 86 different quality criteria. Two reviewers independently extracted study characteristics, medical domains, search strategies used, methods and criteria of quality assessment, results (percentage of sites or pages rated as inadequate pertaining to a quality criterion), and quality and rigor of study methods and reporting. Most frequently used quality criteria used include accuracy, completeness, readability, design, disclosures, and references provided. Fifty-five studies (70%) concluded that quality is a problem on the Web, 17 (22%) remained neutral, and 7 studies (9%) came to a positive conclusion. Positive studies scored significantly lower in search (P =.02) and evaluation (P =.04) methods. Due to differences in study methods and rigor, quality criteria, study population, and topic chosen, study results and conclusions on health-related Web sites vary widely. Operational definitions of quality criteria are needed.

Rating methodological quality: toward improved assessment and investigation.

PubMed

Moyer, Anne; Finney, John W

2005-01-01

Assessing methodological quality is considered essential in deciding what investigations to include in research syntheses and in detecting potential sources of bias in meta-analytic results. Quality assessment is also useful in characterizing the strengths and limitations of the research in an area of study. Although numerous instruments to measure research quality have been developed, they have lacked empirically-supported components. In addition, different summary quality scales have yielded different findings when they were used to weight treatment effect estimates for the same body of research. Suggestions for developing improved quality instruments include: distinguishing distinct domains of quality, such as internal validity, external validity, the completeness of the study report, and adherence to ethical practices; focusing on individual aspects, rather than domains of quality; and focusing on empirically-verified criteria. Other ways to facilitate the constructive use of quality assessment are to improve and standardize the reporting of research investigations, so that the quality of studies can be more equitably and thoroughly compared, and to identify optimal methods for incorporating study quality ratings into meta-analyses.

Interventions to Improve Parental Communication About Sex: A Systematic Review

PubMed Central

Holland, Cynthia L.; Bost, James

2011-01-01

CONTEXT: The relative effectiveness of interventions to improve parental communication with adolescents about sex is not known. OBJECTIVE: To compare the effectiveness and methodologic quality of interventions for improving parental communication with adolescents about sex. METHODS: We searched 6 databases: OVID/Medline, PsychInfo, ERIC, Cochrane Review, Communication and Mass Media, and the Cumulative Index to Nursing and Allied Health Literature. We included studies published between 1980 and July 2010 in peer-reviewed English-language journals that targeted US parents of adolescents aged 11 to 18 years, used an experimental or quasi-experimental design, included a control group, and had a pretest/posttest design. We abstracted data on multiple communication outcomes defined by the integrative conceptual model (communication frequency, content, skills, intentions, self-efficacy, perceived environmental barriers/facilitators, perceived social norms, attitudes, outcome expectations, knowledge, and beliefs). Methodologic quality was assessed using the 11-item methodologic quality score. RESULTS: Twelve studies met inclusion criteria. Compared with controls, parents who participated in these interventions experienced improvements in multiple communication domains including the frequency, quality, intentions, comfort, and self-efficacy for communicating. We noted no effects on parental attitudes toward communicating or the outcomes they expected to occur as a result of communicating. Four studies were of high quality, 7 were of medium quality, and 1 was of lower quality. CONCLUSIONS: Our review was limited by the lack of standardized measures for assessing parental communication. Still, interventions for improving parent-adolescent sex communication are well designed and have some targeted effects. Wider dissemination could augment efforts by schools, clinicians, and health educators. PMID:21321027

The use of cost per life year gained as a measurement of cost-effectiveness in Spain: a systematic review of recent publications.

PubMed

Rodríguez Barrios, José Manuel; Pérez Alcántara, Ferran; Crespo Palomo, Carlos; González García, Paloma; Antón De Las Heras, Enrique; Brosa Riestra, Max

2012-12-01

The objective of this study was to evaluate the methodological characteristics of cost-effectiveness evaluations carried out in Spain, since 1990, which include LYG as an outcome to measure the incremental cost-effectiveness ratio. A systematic review of published studies was conducted describing their characteristics and methodological quality. We analyse the cost per LYG results in relation with a commonly accepted Spanish cost-effectiveness threshold and the possible relation with the cost per quality adjusted life year (QALY) gained when they both were calculated for the same economic evaluation. A total of 62 economic evaluations fulfilled the selection criteria, 24 of them including the cost per QALY gained result as well. The methodological quality of the studies was good (55%) or very good (26%). A total of 124 cost per LYG results were obtained with a mean ratio of 49,529 and a median of 11,490 (standard deviation of 183,080). Since 2003, a commonly accepted Spanish threshold has been referenced by 66% of studies. A significant correlation was found between the cost per LYG and cost per QALY gained results (0.89 Spearman-Rho, 0.91 Pearson). There is an increasing interest for economic health care evaluations in Spain, and the quality of the studies is also improving. Although a commonly accepted threshold exists, further information is needed for decision-making as well as to identify the relationship between the costs per LYG and per QALY gained.

Funding source and the quality of reports of chronic wounds trials: 2004 to 2011

PubMed Central

2014-01-01

Background Critical commentaries suggest that wound care randomised controlled trials (RCTs) are often poorly reported with many methodological flaws. Furthermore, interventions in chronic wounds, rather than being drugs, are often medical devices for which there are no requirements for RCTs to bring products to market. RCTs in wounds trials therefore potentially represent a form of marketing. This study presents a methodological overview of chronic wound trials published between 2004 and 2011 and investigates the influence of industry funding on methodological quality. Methods A systematic search for RCTs for the treatment of chronic wounds published in the English language between 2004 and 2011 (inclusive) in the Cochrane Wounds Group Specialised Register of Trials was carried out. Data were extracted on aspects of trial design, conduct and quality including sample size, duration of follow-up, specification of a primary outcome, use of surrogate outcomes, and risks of bias. In addition, the prevalence of industry funding was assessed and its influence on the above aspects of trial design, conduct and quality was assessed. Results A total of 167 RCTs met our inclusion criteria. We found chronic wound trials often have short durations of follow-up (median 12 weeks), small sample sizes (median 63), fail to define a primary outcome in 41% of cases, and those that do define a primary outcome, use surrogate measures of healing in 40% of cases. Only 40% of trials used appropriate methods of randomisation, 25% concealed allocation and 34% blinded outcome assessors. Of the included trials, 41% were wholly or partially funded by industry, 33% declared non-commercial funding and 26% did not report a funding source. Industry funding was not statistically significantly associated with any measure of methodological quality, though this analysis was probably underpowered. Conclusions This overview confirms concerns raised about the methodological quality of RCTs in wound care and illustrates that greater efforts must be made to follow international standards for conducting and reporting RCTs. There is currently minimal evidence of an influence of industry funding on methodological quality although analyses had limited power and funding source was not reported for a quarter of studies. PMID:24422753

[Education for patients with fibromyalgia. A systematic review of randomised clinical trials].

PubMed

Elizagaray-Garcia, Ignacio; Muriente-Gonzalez, Jorge; Gil-Martinez, Alfonso

2016-01-16

To analyse the effectiveness of education about pain, quality of life and functionality in patients with fibromyalgia. The search for articles was carried out in electronic databases. Eligibility criteria were: controlled randomised clinical trials (RCT), published in English and Spanish, that had been conducted on patients with fibromyalgia, in which the therapeutic procedure was based on patient education. Two independent reviewers analysed the methodological quality using the PEDro scale. Five RCT were selected, of which four offered good methodological quality. In three of the studies, patient education, in combination with another intervention based on therapeutic exercise, improved the outcomes in the variables assessing pain and quality of life as compared with the same procedures performed separately. Moreover, an RCT with a high quality methodology showed that patient education activated inhibitory neural pathways capable of lowering the level of pain. The quantitative analysis yields strong-moderate evidence that patient education, in combination with other therapeutic exercise procedures, offers positive results in the variables pain, quality of life and functionality. Patient education in itself has not proved to be effective for pain, quality of life or functionality in patients with fibromyalgia. There is strong evidence, however, of the effectiveness of combining patient education with exercise and active strategies for coping with pain, quality of life and functionality in the short, medium and long term in patients with fibromyalgia.

On the design of decoupling controllers for advanced rotorcraft in the hover case

NASA Technical Reports Server (NTRS)

Fan, M. K. H.; Tits, A.; Barlow, J.; Tsing, N. K.; Tischler, M.; Takahashi, M.

1991-01-01

A methodology for design of helicopter control systems is proposed that can account for various types of concurrent specifications: stability, decoupling between longitudinal and lateral motions, handling qualities, and physical limitations of the swashplate motions. This is achieved by synergistic use of analytical techniques (Q-parameterization of all stabilizing controllers, transfer function interpolation) and advanced numerical optimization techniques. The methodology is used to design a controller for the UH-60 helicopter in hover. Good results are achieved for decoupling and handling quality specifications.

Data Quality Assurance for Supersonic Jet Noise Measurements

NASA Technical Reports Server (NTRS)

Brown, Clifford A.; Henderson, Brenda S.; Bridges, James E.

2010-01-01

The noise created by a supersonic aircraft is a primary concern in the design of future high-speed planes. The jet noise reduction technologies required on these aircraft will be developed using scale-models mounted to experimental jet rigs designed to simulate the exhaust gases from a full-scale jet engine. The jet noise data collected in these experiments must accurately predict the noise levels produced by the full-scale hardware in order to be a useful development tool. A methodology has been adopted at the NASA Glenn Research Center s Aero-Acoustic Propulsion Laboratory to insure the quality of the supersonic jet noise data acquired from the facility s High Flow Jet Exit Rig so that it can be used to develop future nozzle technologies that reduce supersonic jet noise. The methodology relies on mitigating extraneous noise sources, examining the impact of measurement location on the acoustic results, and investigating the facility independence of the measurements. The methodology is documented here as a basis for validating future improvements and its limitations are noted so that they do not affect the data analysis. Maintaining a high quality jet noise laboratory is an ongoing process. By carefully examining the data produced and continually following this methodology, data quality can be maintained and improved over time.

Don’t forget the posters! Quality and content variables associated with accepted abstracts at a national trauma meeting

PubMed Central

Dossett, Lesly A.; Fox, Erin E.; del Junco, Deborah J.; Zaydfudim, Victor; Kauffmann, Rondi; Shelton, Julia; Wang, Weiwei; Cioffi, William G.; Holcomb, John B.; Cotton, Bryan A.

2014-01-01

BACKGROUND As a primary venue for presenting research results, abstracts selected for presentation at national meetings should be of the highest scientific merit and research quality. It is uncertain to what degree this is achieved as the methodological quality of abstracts submitted to national surgical meetings has not been previously described. The objective of this study was to evaluate abstracts presented at a leading trauma meeting for methodological quality. METHODS All abstracts accepted for the 2009 American Association for the Surgery of Trauma meeting were reviewed and scored for methodological quality based on 10 criteria (scores, 0–10; 10 being the highest). Criteria were based on nationally published methodology guidelines. Two independent reviewers who were blinded to institution, region, and author reviewed each abstract. RESULTS A total of 187 abstracts were accepted for presentation (67 oral and 120 posters). The most frequent clinical topics were shock/transfusion (23%), abdomen (12%), and nervous system (11%). Shock/transfusion abstracts were more common in the oral presentations (31% vs. 19%; p =0.06). Abstracts from the northeast and south regions were the most common in both oral (26% and 29%) and posters (25% and 24%). Basic science accounted for 12% of accepted studies, while 51% were clinical and 28% were health services/outcomes. Only 8% of abstracts presented randomized data and only 11% reported null findings. Overall abstract scores ranged from 3 to 10 (median, 7; mean, 7.4). Abstracts selected for poster presentation had an overall higher score than those selected for oral presentation (7.4 ±1.7 vs. 6.8 ±1.7; p =0.02). CONCLUSION Although oral presentations traditionally receive the most attention and interest, the methodological quality of abstracts accepted for poster presentation equals (and sometimes exceeds) that of oral abstracts. Attendees of these national meetings should reconsider their time spent in viewing and visiting these poster sessions as with the oral presentations. In light of our findings, we highly encourage that all members and guests attend the American Association for the Surgery of Trauma Poster Rounds at each year’s scientific assembly. PMID:22673278

Importance of methodology on (99m)technetium dimercapto-succinic acid scintigraphic image quality: imaging pilot study for RIVUR (Randomized Intervention for Children With Vesicoureteral Reflux) multicenter investigation.

PubMed

Ziessman, Harvey A; Majd, Massoud

2009-07-01

We reviewed our experience with (99m)technetium dimercapto-succinic acid scintigraphy obtained during an imaging pilot study for a multicenter investigation (Randomized Intervention for Children With Vesicoureteral Reflux) of the effectiveness of daily antimicrobial prophylaxis for preventing recurrent urinary tract infection and renal scarring. We analyzed imaging methodology and its relation to diagnostic image quality. (99m)Technetium dimercapto-succinic acid imaging guidelines were provided to participating sites. High-resolution planar imaging with parallel hole or pinhole collimation was required. Two core reviewers evaluated all submitted images. Analysis included appropriate views, presence or lack of patient motion, adequate magnification, sufficient counts and diagnostic image quality. Inter-reader agreement was evaluated. We evaluated 70, (99m)technetium dimercapto-succinic acid studies from 14 institutions. Variability was noted in methodology and image quality. Correlation (r value) between dose administered and patient age was 0.780. For parallel hole collimator imaging good correlation was noted between activity administered and counts (r = 0.800). For pinhole imaging the correlation was poor (r = 0.110). A total of 10 studies (17%) were rejected for quality issues of motion, kidney overlap, inadequate magnification, inadequate counts and poor quality images. The submitting institution was informed and provided with recommendations for improving quality, and resubmission of another study was required. Only 4 studies (6%) were judged differently by the 2 reviewers, and the differences were minor. Methodology and image quality for (99m)technetium dimercapto-succinic acid scintigraphy varied more than expected between institutions. The most common reason for poor image quality was inadequate count acquisition with insufficient attention to the tradeoff between administered dose, length of image acquisition, start time of imaging and resulting image quality. Inter-observer core reader agreement was high. The pilot study ensured good diagnostic quality standardized images for the Randomized Intervention for Children With Vesicoureteral Reflux investigation.

[What is the methodological quality of articles on therapeutic procedures published in Cirugía Española?].

PubMed

Manterola, Carlos; Busquets, Juli; Pascual, Marta; Grande, Luis

2006-02-01

The aim of this study was to determine the methodological quality of articles on therapeutic procedures published in Cirugía Española and to study its association with the publication year, center, and subject-matter. A bibliometric study that included all articles on therapeutic procedures published in Cirugía Española between 2001 and 2004 was performed. All kinds of clinical designs were considered, excluding editorials, review articles, letters to editor, and experimental studies. The variables analyzed were: year of publication, center, design, and methodological quality. Methodological quality was determined by a valid and reliable scale. Descriptive statistics (calculation of means, standard deviation and medians) and analytical statistics (Pearson's chi2, nonparametric, ANOVA and Bonferroni tests) were used. A total of 244 articles were studied (197 case series [81%], 28 cohort studies [12%], 17 clinical trials [7%], 1 cross sectional study and 1 case-control study [0.8%]). The studies were performed mainly in Catalonia and Murcia (22% and 16%, respectively). The most frequent subject areas were soft tissue and hepatobiliopancreatic surgery (23% and 19%, respectively). The mean and median of the methodological quality score calculated for the entire series was 10.2 +/- 3.9 points and 9.5 points, respectively. Methodological quality significantly increased by publication year (p < 0.001). An association between methodological quality and subject area was observed but no association was detected with the center performing the study. The methodological quality of articles on therapeutic procedures published in Cirugía Española between 2001 and 2004 is low. However, a statistically significant trend toward improvement was observed.

[Methodological quality and reporting quality evaluation of randomized controlled trials published in China Journal of Chinese Materia Medica].

PubMed

Yu, Dan-Dan; Xie, Yan-Ming; Liao, Xing; Zhi, Ying-Jie; Jiang, Jun-Jie; Chen, Wei

2018-02-01

To evaluate the methodological quality and reporting quality of randomized controlled trials(RCTs) published in China Journal of Chinese Materia Medica, we searched CNKI and China Journal of Chinese Materia webpage to collect RCTs since the establishment of the magazine. The Cochrane risk of bias assessment tool was used to evaluate the methodological quality of RCTs. The CONSORT 2010 list was adopted as reporting quality evaluating tool. Finally, 184 RCTs were included and evaluated methodologically, of which 97 RCTs were evaluated with reporting quality. For the methodological evaluating, 62 trials(33.70%) reported the random sequence generation; 9(4.89%) trials reported the allocation concealment; 25(13.59%) trials adopted the method of blinding; 30(16.30%) trials reported the number of patients withdrawing, dropping out and those lost to follow-up;2 trials （1.09%） reported trial registration and none of the trial reported the trial protocol; only 8(4.35%) trials reported the sample size estimation in details. For reporting quality appraising, 3 reporting items of 25 items were evaluated with high-quality,including: abstract, participants qualified criteria, and statistical methods; 4 reporting items with medium-quality, including purpose, intervention, random sequence method, and data collection of sites and locations; 9 items with low-quality reporting items including title, backgrounds, random sequence types, allocation concealment, blindness, recruitment of subjects, baseline data, harms, and funding;the rest of items were of extremely low quality(the compliance rate of reporting item<10%). On the whole, the methodological and reporting quality of RCTs published in the magazine are generally low. Further improvement in both methodological and reporting quality for RCTs of traditional Chinese medicine are warranted. It is recommended that the international standards and procedures for RCT design should be strictly followed to conduct high-quality trials. At the same time, in order to improve the reporting quality of randomized controlled trials, CONSORT standards should be adopted in the preparation of research reports and submissions. Copyright© by the Chinese Pharmaceutical Association.

Risk of bias in overviews of reviews: a scoping review of methodological guidance and four-item checklist.

PubMed

Ballard, Madeleine; Montgomery, Paul

2017-03-01

To assess the conditions under which employing an overview of systematic reviews is likely to lead to a high risk of bias. To synthesise existing guidance concerning overview practice, a scoping review was conducted. Four electronic databases were searched with a pre-specified strategy (PROSPERO 2015:CRD42015027592) ending October 2015. Included studies needed to describe or develop overview methodology. Data were narratively synthesised to delineate areas highlighted as outstanding challenges or where methodological recommendations conflict. Twenty-four papers met the inclusion criteria. There is emerging debate regarding overlapping systematic reviews; systematic review scope; quality of included research; updating; and synthesizing and reporting results. While three functions for overviews have been proposed-identify gaps, explore heterogeneity, summarize evidence-overviews cannot perform the first; are unlikely to achieve the second and third simultaneously; and can only perform the third under specific circumstances. Namely, when identified systematic reviews meet the following four conditions: (1) include primary trials that do not substantially overlap, (2) match overview scope, (3) are of high methodological quality, and (4) are up-to-date. Considering the intended function of proposed overviews with the corresponding methodological conditions may improve the quality of this burgeoning publication type. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Volume and methodological quality of randomized controlled trials in laparoscopic surgery: assessment over a 10-year period.

PubMed

Antoniou, Stavros A; Andreou, Alexandros; Antoniou, George A; Koch, Oliver O; Köhler, Gernot; Luketina, Ruzica-R; Bertsias, Antonios; Pointner, Rudolph; Granderath, Frank-Alexander

2015-11-01

Measures have been taken to improve methodological quality of randomized controlled trials (RCTs). This review systematically assessed the trends in volume and methodological quality of RCTs on minimally invasive surgery within a 10-year period. RCTs on minimally invasive surgery were searched in the 10 most cited general surgical journals and the 5 most cited journals of laparoscopic interest for the years 2002 and 2012. Bibliometric and methodological quality components were abstracted using the Scottish Intercollegiate Guidelines Network. The pooled number of RCTs from low-contribution regions demonstrated an increasing proportion of the total published RCTs, compensating for a concomitant decrease of the respective contributions from Europe and North America. International collaborations were more frequent in 2012. Acceptable or high quality RCTs accounted for 37.9% and 54.4% of RCTs published in 2002 and 2012, respectively. Components of external validity were poorly reported. Both the volume and the reporting quality of laparoscopic RCTs have increased from 2002 to 2012, but there seems to be ample room for improvement of methodological quality. Copyright © 2015 Elsevier Inc. All rights reserved.

Outcomes of Quality Assurance: A Discussion of Knowledge, Methodology and Validity

ERIC Educational Resources Information Center

Stensaker, Bjorn

2008-01-01

A common characteristic in many quality assurance schemes around the world is their implicit and often narrowly formulated understanding of how organisational change is to take place as a result of the process. By identifying some of the underlying assumptions related to organisational change in current quality assurance schemes, the aim of this…

Total Quality Management Elements and Results in Higher Education Institutions: The Greek Case

ERIC Educational Resources Information Center

Psomas, Evangelos; Antony, Jiju

2017-01-01

Purpose: The purpose of this paper is to determine the main total quality management (TQM) elements adopted and the respective results achieved by higher education institutions (HEIs) in Greece. Design/methodology/approach: A research study was designed and carried out in private sector Greek HEIs. Fifteen HEIs were approached through interviews…

Methodological quality is underrated in systematic reviews and meta-analyses in health psychology.

PubMed

Oliveras, Isabel; Losilla, Josep-Maria; Vives, Jaume

2017-06-01

In this paper, we compile and describe the main approaches proposed in the literature to include methodological quality (MQ) or risk of bias (RoB) into research synthesis. We also meta-review how the RoB of observational primary studies is being assessed and to what extent the results are incorporated in the conclusions of research synthesis. Electronic databases were searched for systematic reviews or meta-analyses related to health and clinical psychology. A random sample of 90 reviews published between January 2010 and May 2016 was examined. A total of 46 reviews (51%) performed a formal assessment of the RoB of primary studies. Only 17 reviews (19%) linked the outcomes of quality assessment with the results of the review. According to the previous literature, our results corroborate the lack of guidance to incorporate the RoB assessment in the results of systematic reviews and meta-analyses. Our recommendation is to appraise MQ according to domains of RoB to rate the degree of credibility of the results of a research synthesis, as well as subgroup analysis or meta-regression as analytical methods to incorporate the quality assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

40 CFR Appendix C to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Human Health Criteria and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... LAKES SYSTEM Pt. 132, App. C Appendix C to Part 132—Great Lakes Water Quality Initiative Methodologies...; or consuming fish from the water, and water-related recreation activities using the Methodologies for... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Great Lakes Water Quality Initiative...

40 CFR Appendix C to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Human Health Criteria and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... LAKES SYSTEM Pt. 132, App. C Appendix C to Part 132—Great Lakes Water Quality Initiative Methodologies...; or consuming fish from the water, and water-related recreation activities using the Methodologies for... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative...

Testing the methodology for dosimetry audit of heterogeneity corrections and small MLC-shaped fields: Results of IAEA multi-center studies

PubMed Central

Izewska, Joanna; Wesolowska, Paulina; Azangwe, Godfrey; Followill, David S.; Thwaites, David I.; Arib, Mehenna; Stefanic, Amalia; Viegas, Claudio; Suming, Luo; Ekendahl, Daniela; Bulski, Wojciech; Georg, Dietmar

2016-01-01

Abstract The International Atomic Energy Agency (IAEA) has a long tradition of supporting development of methodologies for national networks providing quality audits in radiotherapy. A series of co-ordinated research projects (CRPs) has been conducted by the IAEA since 1995 assisting national external audit groups developing national audit programs. The CRP ‘Development of Quality Audits for Radiotherapy Dosimetry for Complex Treatment Techniques’ was conducted in 2009–2012 as an extension of previously developed audit programs. Material and methods. The CRP work described in this paper focused on developing and testing two steps of dosimetry audit: verification of heterogeneity corrections, and treatment planning system (TPS) modeling of small MLC fields, which are important for the initial stages of complex radiation treatments, such as IMRT. The project involved development of a new solid slab phantom with heterogeneities containing special measurement inserts for thermoluminescent dosimeters (TLD) and radiochromic films. The phantom and the audit methodology has been developed at the IAEA and tested in multi-center studies involving the CRP participants. Results. The results of multi-center testing of methodology for two steps of dosimetry audit show that the design of audit procedures is adequate and the methodology is feasible for meeting the audit objectives. A total of 97% TLD results in heterogeneity situations obtained in the study were within 3% and all results within 5% agreement with the TPS predicted doses. In contrast, only 64% small beam profiles were within 3 mm agreement between the TPS calculated and film measured doses. Film dosimetry results have highlighted some limitations in TPS modeling of small beam profiles in the direction of MLC leave movements. Discussion. Through multi-center testing, any challenges or difficulties in the proposed audit methodology were identified, and the methodology improved. Using the experience of these studies, the participants could incorporate the auditing procedures in their national programs. PMID:26934916

The methodological and reporting quality of systematic reviews from China and the USA are similar.

PubMed

Tian, Jinhui; Zhang, Jun; Ge, Long; Yang, Kehu; Song, Fujian

2017-05-01

To compare the methodological and reporting quality of systematic reviews by authors from China and those from the United States (USA). From systematic reviews of randomized trials published in 2014 in English, we randomly selected 100 from China and 100 from the USA. The methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool, and reporting quality assessed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) tool. Compared with systematic reviews from the USA, those from China were more likely to be a meta-analysis, published in low-impact journals, and a non-Cochrane review. The mean summary Assessing the Methodological Quality of Systematic Reviews score was 6.7 (95% confidence interval: 6.5, 7.0) for reviews from China and 6.6 (6.1, 7.1) for reviews from the USA, and the mean summary Preferred Reporting Items for Systematic Reviews and Meta-analyses score was 21.2 (20.7, 21.6) for reviews from China and 20.6 (19.9, 21.3) for reviews from the USA. The differences in summary quality scores between China and the USA were statistically nonsignificant after adjusting for multiple review factors. The overall methodological and reporting quality of systematic reviews by authors from China are similar to those from the USA, although the quality of systematic reviews from both countries could be further improved. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Application of process mining to assess the data quality of routinely collected time-based performance data sourced from electronic health records by validating process conformance.

PubMed

Perimal-Lewis, Lua; Teubner, David; Hakendorf, Paul; Horwood, Chris

2016-12-01

Effective and accurate use of routinely collected health data to produce Key Performance Indicator reporting is dependent on the underlying data quality. In this research, Process Mining methodology and tools were leveraged to assess the data quality of time-based Emergency Department data sourced from electronic health records. This research was done working closely with the domain experts to validate the process models. The hospital patient journey model was used to assess flow abnormalities which resulted from incorrect timestamp data used in time-based performance metrics. The research demonstrated process mining as a feasible methodology to assess data quality of time-based hospital performance metrics. The insight gained from this research enabled appropriate corrective actions to be put in place to address the data quality issues. © The Author(s) 2015.

[Definition of low threshold volumes for quality assurance: conceptual and methodological issues involved in the definition and evaluation of thresholds for volume outcome relations in clinical care].

PubMed

Wetzel, Hermann

2006-01-01

In a large number of mostly retrospective association studies, a statistical relationship between volume and quality of health care has been reported. However, the relevance of these results is frequently limited by methodological shortcomings. In this article, criteria for the evidence and definition of thresholds for volume-outcome relations are proposed, e.g. the specification of relevant outcomes for quality indicators, analysis of volume as a continuous variable with an adequate case-mix and risk adjustment, accounting for cluster effects and considering mathematical models for the derivation of cut-off values. Moreover, volume thresholds are regarded as surrogate parameters for the indirect classification of the quality of care, whose diagnostic validity and effectiveness in improving health care quality need to be evaluated in prospective studies.

Reporting and Methodological Quality of Randomised Controlled Trials in Vascular and Endovascular Surgery.

PubMed

Hajibandeh, S; Hajibandeh, S; Antoniou, G A; Green, P A; Maden, M; Torella, F

2015-11-01

Randomised controlled trials (RCTs) are subject to bias if they lack methodological quality. Moreover, optimal and transparent reporting of RCT findings aids their critical appraisal and interpretation. The aim of this study was to ascertain whether the methodological and reporting quality of RCTs in vascular and endovascular surgery is improving. The most recent 75 and oldest 75 RCTs published in leading journals over a 10-year period (2003-2012) were identified. The reporting quality and methodological quality data of the old and new RCTs were extracted and compared. The former was analysed using the Consolidated Standards of Reporting Trials (CONSORT) statement, the latter with the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Reporting quality measured by CONSORT was better in the new studies than in the old studies (0.68 [95% CI, 0.66-0.7] vs. 0.60 [95% CI, 0.58-0.62], p < .001); however, both new and old studies had similar methodological quality measured by SIGN (0.9 [IQR 0.1] vs. .09 [IQR: 0.2], p = .787). Unlike clinical items, the methodological items of the CONSORT statement were not well reported in old and new RCTs. More trials in the new group were endovascular related (33.33% vs. 17.33%, p = .038) and industry sponsored (28% vs. 6.67%, p = .001). Despite some progress, there remains room for improvement in the reporting quality of RCTs in vascular and endovascular surgery. The methodological quality of recent RCTs is similar to that of trials performed >10 years ago. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Education in cardiopulmonary resuscitation in Russia: A systematic review of the available evidence

PubMed Central

Birkun, Alexei; Glotov, Maksim

2017-01-01

BACKGROUND: To summarise and appraise cumulative published scientific evidence relevant to cardiopulmonary resuscitation (CPR) education in Russia. DATA RESOURCES: We searched Medline, Scopus, Science Direct and Russian Science Citation Index databases from December 1991 to December 2016 to identify studies pertaining to the field of CPR education that were carried out by Russian researchers and/or investigated the topic of interest for Russia/Russian population. Reference lists of eligible publications, contents pages of relevant Russian journals and Google Scholar were also searched. There was no limitation based on publication language or study design. RESULTS: Of 7 964 unique citations identified, 22 studies were included. All studies were published from 2009 to 2016, mainly in Russian. Only three studies were reported to be randomized controlled. Non-medical individuals constituted 17% of studied populations. Most of the studies aimed to assess effects of CPR educational interventions, generally suggesting positive influence of the training conducted. The studies were highly heterogeneous as for methodological approaches, structure and duration of educational interventions, evaluation methods and criteria being used. Methodological quality was generally poor, with >40% publications not passing quality screening and only 2 studies meeting the criteria of moderate high quality. CONCLUSION: The results suggest paucity, low population coverage, high thematic and methodological heterogeneity and low quality of the studies addressing CPR education, which were carried out in the Russian Federation. There is a critical need in conducting methodologically consistent, large-scale, randomized, controlled studies evaluating and comparing efficiency of educational interventions for teaching CPR in different population categories of Russia. PMID:29123601

Psychometric evaluation of commonly used game-specific skills tests in rugby: A systematic review

PubMed Central

Oorschot, Sander; Chiwaridzo, Matthew; CM Smits-Engelsman, Bouwien

2017-01-01

Objectives To (1) give an overview of commonly used game-specific skills tests in rugby and (2) evaluate available psychometric information of these tests. Methods The databases PubMed, MEDLINE CINAHL and Africa Wide information were systematically searched for articles published between January 1995 and March 2017. First, commonly used game-specific skills tests were identified. Second, the available psychometrics of these tests were evaluated and the methodological quality of the studies assessed using the Consensus-based Standards for the selection of health Measurement Instruments checklist. Studies included in the first step had to report detailed information on the construct and testing procedure of at least one game-specific skill, and studies included in the second step had additionally to report at least one psychometric property evaluating reliability, validity or responsiveness. Results 287 articles were identified in the first step, of which 30 articles met the inclusion criteria and 64 articles were identified in the second step of which 10 articles were included. Reactive agility, tackling and simulated rugby games were the most commonly used tests. All 10 studies reporting psychometrics reported reliability outcomes, revealing mainly strong evidence. However, all studies scored poor or fair on methodological quality. Four studies reported validity outcomes in which mainly moderate evidence was indicated, but all articles had fair methodological quality. Conclusion Game-specific skills tests indicated mainly high reliability and validity evidence, but the studies lacked methodological quality. Reactive agility seems to be a promising domain, but the specific tests need further development. Future high methodological quality studies are required in order to develop valid and reliable test batteries for rugby talent identification. Trial registration number PROSPERO CRD42015029747. PMID:29259812

Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review.

PubMed

Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C; Roy, Jean-Sébastien

2016-09-30

To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers.

Is Article Methodological Quality Associated With Conflicts of Interest?: An Analysis of the Plastic Surgery Literature.

PubMed

Cho, Brian H; Lopez, Joseph; Means, Jessica; Lopez, Sandra; Milton, Jacqueline; Tufaro, Anthony P; May, James W; Dorafshar, Amir H

2017-12-01

Conflicts of interest (COI) are an emerging area of discussion within the field of plastic surgery. Recently, several reports have found that research studies that disclose COI are associated with publication of positive outcomes. We hypothesize that this association is driven by higher-quality studies receiving industry funding. This study aimed to investigate the association between industry support and study methodological quality. We reviewed all entries in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Journal of Plastic, Reconstructive, and Aesthetic Surgery within a 1-year period encompassing 2013. All clinical research articles were analyzed. Studies were evaluated blindly for methodology quality based on a validated scoring system. An ordinal logistic regression model was used to examine the association between methodology score and COI. A total of 1474 articles were reviewed, of which 483 met our inclusion criteria. These articles underwent methodological quality scoring. Conflicts of interest were reported in 28 (5.8%) of these articles. After adjusting for article characteristics in the ordinal logistic regression analysis, there was no significant association between articles with COI and higher methodological scores (P = 0.7636). Plastic surgery studies that disclose COI are not associated with higher methodological quality when compared with studies that do not disclose COI. These findings suggest that although the presence of COI is associated with positive findings, the association is not shown to be driven by higher-quality studies.

An evaluation of the quality of statistical design and analysis of published medical research: results from a systematic survey of general orthopaedic journals.

PubMed

Parsons, Nick R; Price, Charlotte L; Hiskens, Richard; Achten, Juul; Costa, Matthew L

2012-04-25

The application of statistics in reported research in trauma and orthopaedic surgery has become ever more important and complex. Despite the extensive use of statistical analysis, it is still a subject which is often not conceptually well understood, resulting in clear methodological flaws and inadequate reporting in many papers. A detailed statistical survey sampled 100 representative orthopaedic papers using a validated questionnaire that assessed the quality of the trial design and statistical analysis methods. The survey found evidence of failings in study design, statistical methodology and presentation of the results. Overall, in 17% (95% confidence interval; 10-26%) of the studies investigated the conclusions were not clearly justified by the results, in 39% (30-49%) of studies a different analysis should have been undertaken and in 17% (10-26%) a different analysis could have made a difference to the overall conclusions. It is only by an improved dialogue between statistician, clinician, reviewer and journal editor that the failings in design methodology and analysis highlighted by this survey can be addressed.

Methodological reporting of randomized controlled trials in major hepato-gastroenterology journals in 2008 and 1998: a comparative study

PubMed Central

2011-01-01

Background It was still unclear whether the methodological reporting quality of randomized controlled trials (RCTs) in major hepato-gastroenterology journals improved after the Consolidated Standards of Reporting Trials (CONSORT) Statement was revised in 2001. Methods RCTs in five major hepato-gastroenterology journals published in 1998 or 2008 were retrieved from MEDLINE using a high sensitivity search method and their reporting quality of methodological details were evaluated based on the CONSORT Statement and Cochrane Handbook for Systematic Reviews of interventions. Changes of the methodological reporting quality between 2008 and 1998 were calculated by risk ratios with 95% confidence intervals. Results A total of 107 RCTs published in 2008 and 99 RCTs published in 1998 were found. Compared to those in 1998, the proportion of RCTs that reported sequence generation (RR, 5.70; 95%CI 3.11-10.42), allocation concealment (RR, 4.08; 95%CI 2.25-7.39), sample size calculation (RR, 3.83; 95%CI 2.10-6.98), incomplete outecome data addressed (RR, 1.81; 95%CI, 1.03-3.17), intention-to-treat analyses (RR, 3.04; 95%CI 1.72-5.39) increased in 2008. Blinding and intent-to-treat analysis were reported better in multi-center trials than in single-center trials. The reporting of allocation concealment and blinding were better in industry-sponsored trials than in public-funded trials. Compared with historical studies, the methodological reporting quality improved with time. Conclusion Although the reporting of several important methodological aspects improved in 2008 compared with those published in 1998, which may indicate the researchers had increased awareness of and compliance with the revised CONSORT statement, some items were still reported badly. There is much room for future improvement. PMID:21801429

Security Quality Requirements Engineering (SQUARE) Methodology

DTIC Science & Technology

2005-11-01

such as Joint Application Development and the Accelerated Requirements Method [Wood 89, Hubbard 99] • Soft Systems Methodology [Checkland 89...investigated were misuse cases [Jacobson 92], Soft Systems Methodology (SSM) [Checkland 89], Quality Function Deployment (QFD) [QFD 05], Con- trolled...html (2005). [Checkland 89] Checkland, Peter. Soft Systems Methodology . Rational Analysis for a Problematic World. New York, NY: John Wiley & Sons

Prevalence and risk factors associated with musculoskeletal complaints among users of mobile handheld devices: A systematic review.

PubMed

Xie, Yanfei; Szeto, Grace; Dai, Jie

2017-03-01

This systematic review aimed at evaluating the prevalence and risk factors for musculoskeletal complaints associated with mobile handheld device use. Pubmed, Medline, Web of Science, CINAHL and Embase were searched. The methodological quality of included studies was assessed. Strength of evidence for risk factors was determined based on study designs, methodological quality and consistency of results. Five high-quality, eight acceptable-quality and two low-quality peer-reviewed articles were included. This review demonstrates that the prevalence of musculoskeletal complaints among mobile device users ranges from 1.0% to 67.8% and neck complaints have the highest prevalence rates ranging from 17.3% to 67.8%. This study also finds some evidence for neck flexion, frequency of phone calls, texting and gaming in relation to musculoskeletal complaints among mobile device users. Inconclusive evidence is shown for other risk factors such as duration of use and human-device interaction techniques due to inconsistent results or a limited number of studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

78 FR 5810 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... AHRQ Quality Indicators (QIs), their technical specifications, and associated methodological issues.... The time- limited workgroup is more restricted to specific clinical or methodological issues, while..., data enhancements, and methodological advances. The standing workgroup may potentially provide guidance...

78 FR 22883 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

... Quality Indicators (QIs), their technical specifications, and associated methodological issues. The...-limited workgroup is more restricted to specific clinical or methodological issues, while the standing... enhancements, and methodological advances. The standing workgroup may potentially provide guidance for the...

Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

PubMed Central

Płaszewski, Maciej; Bettany-Saltikov, Josette

2014-01-01

Background Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. Objectives Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. Design Systematic overview of systematic reviews. Methods Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute’s hierarchies were applied to analyze the levels of evidence from included reviews. Results From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. Conclusions Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms of their methodological rigor; otherwise they may be mistakenly regarded as high quality sources of evidence. Protocol registry number CRD42013003538, PROSPERO PMID:25353954

40 CFR Appendix A to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Aquatic Life Criteria and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... LAKES SYSTEM Pt. 132, App. A Appendix A to Part 132—Great Lakes Water Quality Initiative Methodologies... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Great Lakes Water Quality Initiative Methodologies for Development of Aquatic Life Criteria and Values A Appendix A to Part 132 Protection of...

40 CFR Appendix A to Part 132 - Great Lakes Water Quality Initiative Methodologies for Development of Aquatic Life Criteria and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... LAKES SYSTEM Pt. 132, App. A Appendix A to Part 132—Great Lakes Water Quality Initiative Methodologies... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Great Lakes Water Quality Initiative Methodologies for Development of Aquatic Life Criteria and Values A Appendix A to Part 132 Protection of...

Quality indicators for hip fracture care, a systematic review.

PubMed

Voeten, S C; Krijnen, P; Voeten, D M; Hegeman, J H; Wouters, M W J M; Schipper, I B

2018-05-17

Quality indicators are used to measure quality of care and enable benchmarking. An overview of all existing hip fracture quality indicators is lacking. The primary aim was to identify quality indicators for hip fracture care reported in literature, hip fracture audits, and guidelines. The secondary aim was to compose a set of methodologically sound quality indicators for the evaluation of hip fracture care in clinical practice. A literature search according to the PRISMA guidelines and an internet search were performed to identify hip fracture quality indicators. The indicators were subdivided into process, structure, and outcome indicators. The methodological quality of the indicators was judged using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. For structure and process indicators, the construct validity was assessed. Sixteen publications, nine audits and five guidelines were included. In total, 97 unique quality indicators were found: 9 structure, 63 process, and 25 outcome indicators. Since detailed methodological information about the indicators was lacking, the AIRE instrument could not be applied. Seven indicators correlated with an outcome measure. A set of nine quality indicators was extracted from the literature, audits, and guidelines. Many quality indicators are described and used. Not all of them correlate with outcomes of care and have been assessed methodologically. As methodological evidence is lacking, we recommend the extracted set of nine indicators to be used as the starting point for further clinical research. Future research should focus on assessing the clinimetric properties of the existing quality indicators.

Design guidelines for an umbilical cord blood stem cell therapy quality assessment model

NASA Astrophysics Data System (ADS)

Januszewski, Witold S.; Michałek, Krzysztof; Yagensky, Oleksandr; Wardzińska, Marta

The paper enlists the pivotal guidelines for producing an empirical umbilical cord blood stem cell therapy quality assessment model. The methodology adapted was single equation linear model with domain knowledge derived from MEDAFAR classification. The resulting model is ready for therapeutical application.

Integrating Kano’s Model into Quality Function Deployment for Product Design: A Comprehensive Review

NASA Astrophysics Data System (ADS)

Ginting, Rosnani; Hidayati, Juliza; Siregar, Ikhsan

2018-03-01

Many methods and techniques are adopted by some companies to improve the competitiveness through the fulfillment of customer satisfaction by enhancement and improvement the product design quality. Over the past few years, several researcher have studied extensively combining Quality Function Deployment and Kano’s model as design techniques by focusing on translating consumer desires into a product design. This paper presents a review and analysis of several literatures that associated to the integration methodology of Kano into the QFD process. Various of international journal articles were selected, collected and analyzed through a number of relevant scientific publications. In-depth analysis was performed, and focused in this paper on the results, advantages and drawbacks of its methodology. In addition, this paper also provides the analysis that acquired in this study related to the development of the methodology. It is hopedd this paper can be a reference for other researchers and manufacturing companies to implement the integration method of QFD- Kano for product design.

Effects of image processing on the detective quantum efficiency

NASA Astrophysics Data System (ADS)

Park, Hye-Suk; Kim, Hee-Joung; Cho, Hyo-Min; Lee, Chang-Lae; Lee, Seung-Wan; Choi, Yu-Na

2010-04-01

Digital radiography has gained popularity in many areas of clinical practice. This transition brings interest in advancing the methodologies for image quality characterization. However, as the methodologies for such characterizations have not been standardized, the results of these studies cannot be directly compared. The primary objective of this study was to standardize methodologies for image quality characterization. The secondary objective was to evaluate affected factors to Modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) according to image processing algorithm. Image performance parameters such as MTF, NPS, and DQE were evaluated using the international electro-technical commission (IEC 62220-1)-defined RQA5 radiographic techniques. Computed radiography (CR) images of hand posterior-anterior (PA) for measuring signal to noise ratio (SNR), slit image for measuring MTF, white image for measuring NPS were obtained and various Multi-Scale Image Contrast Amplification (MUSICA) parameters were applied to each of acquired images. In results, all of modified images were considerably influence on evaluating SNR, MTF, NPS, and DQE. Modified images by the post-processing had higher DQE than the MUSICA=0 image. This suggests that MUSICA values, as a post-processing, have an affect on the image when it is evaluating for image quality. In conclusion, the control parameters of image processing could be accounted for evaluating characterization of image quality in same way. The results of this study could be guided as a baseline to evaluate imaging systems and their imaging characteristics by measuring MTF, NPS, and DQE.

Dissemination of Periodontal Pathogens in the Bloodstream after Periodontal Procedures: A Systematic Review

PubMed Central

Horliana, Anna Carolina Ratto Tempestini; Chambrone, Leandro; Foz, Adriana Moura; Artese, Hilana Paula Carillo; Rabelo, Mariana de Sousa; Pannuti, Cláudio Mendes; Romito, Giuseppe Alexandre

2014-01-01

Background To date, there is no compilation of evidence-based information associating bacteremia and periodontal procedures. This systematic review aims to assess magnitude, duration, prevalence and nature of bacteremia caused by periodontal procedures. Study Design Systematic Review Types of Studies Reviewed MEDLINE, EMBASE and LILACS databases were searched in duplicate through August, 2013 without language restriction. Observational studies were included if blood samples were collected before, during or after periodontal procedures of patients with periodontitis. The methodological quality was assessed in duplicate using the modified Newcastle-Ottawa scale (NOS). Results Search strategy identified 509 potentially eligible articles and nine were included. Only four studies demonstrated high methodological quality, whereas five were of medium or low methodological quality. The study characteristics were considered too heterogeneous to conduct a meta-analysis. Among 219 analyzed patients, 106 (49.4%) had positive bacteremia. More frequent bacteria were S. viridans, A. actinomycetemcomitans P. gingivalis, M. micros and species Streptococcus and Actinomyces, although identification methods of microbiologic assays were different among studies. Clinical Implications Although half of the patients presented positive bacteremia after periodontal procedures, accurate results regarding the magnitude, duration and nature of bacteremia could not be confidentially assessed. PMID:24870125

Impact of voice- and knowledge-enabled clinical reporting--US example.

PubMed

Bushko, Renata G; Havlicek, Penny L; Deppert, Edward; Epner, Stephen

2002-01-01

This study shows qualitative and quantitative estimates of the national and the clinic level impact of utilizing voice and knowledge enabled clinical reporting systems. Using common sense estimation methodology, we show that the delivery of health care can experience a dramatic improvement in four areas as a result of the broad use of voice and knowledge enabled clinical reporting: (1) Process Quality as measured by cost savings, (2) Organizational Quality as measured by compliance, (3) Clinical Quality as measured by clinical outcomes and (4) Service Quality as measured by patient satisfaction. If only 15 percent of US physicians replaced transcription with modem clinical reporting voice-based methodology, about one half billion dollars could be saved. $6.7 Billion could be saved annually if all medical reporting currently transcribed was handled with voice-and knowledge-enabled dictation and reporting systems.

Rating the methodological quality of single-subject designs and n-of-1 trials: introducing the Single-Case Experimental Design (SCED) Scale.

PubMed

Tate, Robyn L; McDonald, Skye; Perdices, Michael; Togher, Leanne; Schultz, Regina; Savage, Sharon

2008-08-01

Rating scales that assess methodological quality of clinical trials provide a means to critically appraise the literature. Scales are currently available to rate randomised and non-randomised controlled trials, but there are none that assess single-subject designs. The Single-Case Experimental Design (SCED) Scale was developed for this purpose and evaluated for reliability. Six clinical researchers who were trained and experienced in rating methodological quality of clinical trials developed the scale and participated in reliability studies. The SCED Scale is an 11-item rating scale for single-subject designs, of which 10 items are used to assess methodological quality and use of statistical analysis. The scale was developed and refined over a 3-year period. Content validity was addressed by identifying items to reduce the main sources of bias in single-case methodology as stipulated by authorities in the field, which were empirically tested against 85 published reports. Inter-rater reliability was assessed using a random sample of 20/312 single-subject reports archived in the Psychological Database of Brain Impairment Treatment Efficacy (PsycBITE). Inter-rater reliability for the total score was excellent, both for individual raters (overall ICC = 0.84; 95% confidence interval 0.73-0.92) and for consensus ratings between pairs of raters (overall ICC = 0.88; 95% confidence interval 0.78-0.95). Item reliability was fair to excellent for consensus ratings between pairs of raters (range k = 0.48 to 1.00). The results were replicated with two independent novice raters who were trained in the use of the scale (ICC = 0.88, 95% confidence interval 0.73-0.95). The SCED Scale thus provides a brief and valid evaluation of methodological quality of single-subject designs, with the total score demonstrating excellent inter-rater reliability using both individual and consensus ratings. Items from the scale can also be used as a checklist in the design, reporting and critical appraisal of single-subject designs, thereby assisting to improve standards of single-case methodology.

Methodological quality and scientific impact of quantitative nursing education research over 18 months.

PubMed

Yucha, Carolyn B; Schneider, Barbara St Pierre; Smyer, Tish; Kowalski, Susan; Stowers, Eva

2011-01-01

The methodological quality of nursing education research has not been rigorously studied. The purpose of this study was to evaluate the methodological quality and scientific impact of nursing education research reports. The methodological quality of 133 quantitative nursing education research articles published between July 2006 and December 2007 was evaluated using the Medical Education Research Study Quality Instrument (MERSQI).The mean (+/- SD) MERSQI score was 9.8 +/- 2.2. It correlated (p < .05) with several scientific impact indicators: citation counts from Scopus (r = .223), Google Scholar (r = .224), and journal impact factor (r = .216); it was not associated with Web of Science citation count, funding, or h Index. The similarities between this study's MERSQI ratings for nursing literature and those reported for the medical literature, coupled with the association with citation counts, suggest that the MERSQI is an appropriate instrument to evaluate the quality of nursing education research.

Langley Wind Tunnel Data Quality Assurance-Check Standard Results

NASA Technical Reports Server (NTRS)

Hemsch, Michael J.; Grubb, John P.; Krieger, William B.; Cler, Daniel L.

2000-01-01

A framework for statistical evaluation, control and improvement of wind funnel measurement processes is presented The methodology is adapted from elements of the Measurement Assurance Plans developed by the National Bureau of Standards (now the National Institute of Standards and Technology) for standards and calibration laboratories. The present methodology is based on the notions of statistical quality control (SQC) together with check standard testing and a small number of customer repeat-run sets. The results of check standard and customer repeat-run -sets are analyzed using the statistical control chart-methods of Walter A. Shewhart long familiar to the SQC community. Control chart results are presented for. various measurement processes in five facilities at Langley Research Center. The processes include test section calibration, force and moment measurements with a balance, and instrument calibration.

Adapting total quality management for general practice: evaluation of a programme.

PubMed Central

Lawrence, M; Packwood, T

1996-01-01

OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. PMID:10161529

Testing the methodology for dosimetry audit of heterogeneity corrections and small MLC-shaped fields: Results of IAEA multi-center studies.

PubMed

Izewska, Joanna; Wesolowska, Paulina; Azangwe, Godfrey; Followill, David S; Thwaites, David I; Arib, Mehenna; Stefanic, Amalia; Viegas, Claudio; Suming, Luo; Ekendahl, Daniela; Bulski, Wojciech; Georg, Dietmar

2016-07-01

The International Atomic Energy Agency (IAEA) has a long tradition of supporting development of methodologies for national networks providing quality audits in radiotherapy. A series of co-ordinated research projects (CRPs) has been conducted by the IAEA since 1995 assisting national external audit groups developing national audit programs. The CRP 'Development of Quality Audits for Radiotherapy Dosimetry for Complex Treatment Techniques' was conducted in 2009-2012 as an extension of previously developed audit programs. The CRP work described in this paper focused on developing and testing two steps of dosimetry audit: verification of heterogeneity corrections, and treatment planning system (TPS) modeling of small MLC fields, which are important for the initial stages of complex radiation treatments, such as IMRT. The project involved development of a new solid slab phantom with heterogeneities containing special measurement inserts for thermoluminescent dosimeters (TLD) and radiochromic films. The phantom and the audit methodology has been developed at the IAEA and tested in multi-center studies involving the CRP participants. The results of multi-center testing of methodology for two steps of dosimetry audit show that the design of audit procedures is adequate and the methodology is feasible for meeting the audit objectives. A total of 97% TLD results in heterogeneity situations obtained in the study were within 3% and all results within 5% agreement with the TPS predicted doses. In contrast, only 64% small beam profiles were within 3 mm agreement between the TPS calculated and film measured doses. Film dosimetry results have highlighted some limitations in TPS modeling of small beam profiles in the direction of MLC leave movements. Through multi-center testing, any challenges or difficulties in the proposed audit methodology were identified, and the methodology improved. Using the experience of these studies, the participants could incorporate the auditing procedures in their national programs.

Considerations on methodological challenges for water footprint calculations.

PubMed

Thaler, S; Zessner, M; De Lis, F Bertran; Kreuzinger, N; Fehringer, R

2012-01-01

We have investigated how different approaches for water footprint (WF) calculations lead to different results, taking sugar beet production and sugar refining as examples. To a large extent, results obtained from any WF calculation are reflective of the method used and the assumptions made. Real irrigation data for 59 European sugar beet growing areas showed inadequate estimation of irrigation water when a widely used simple approach was used. The method resulted in an overestimation of blue water and an underestimation of green water usage. Dependent on the chosen (available) water quality standard, the final grey WF can differ up to a factor of 10 and more. We conclude that further development and standardisation of the WF is needed to reach comparable and reliable results. A special focus should be on standardisation of the grey WF methodology based on receiving water quality standards.

Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: A review of review.

PubMed

Chen, Xin-Lin; Mo, Chuan-Wei; Lu, Li-Ya; Gao, Ri-Yang; Xu, Qian; Wu, Min-Feng; Zhou, Qian-Yi; Hu, Yue; Zhou, Xuan; Li, Xian-Tao

2017-11-01

To assess the methodological quality of systematic reviews and meta-analyses regarding acupuncture intervention for stroke and the primary studies within them. Two researchers searched PubMed, Cumulative index to Nursing and Allied Health Literature, Embase, ISI Web of Knowledge, Cochrane, Allied and Complementary Medicine, Ovid Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang and Traditional Chinese Medical Database to identify systematic reviews and meta-analyses about acupuncture for stroke published from the inception to December 2016. Review characteristics and the criteria for assessing the primary studies within reviews were extracted. The methodological quality of the reviews was assessed using adapted Oxman and Guyatt Scale. The methodological quality of primary studies was also assessed. Thirty-two eligible reviews were identified, 15 in English and 17 in Chinese. The English reviews were scored higher than the Chinese reviews (P=0.025), especially in criteria for avoiding bias and the scope of search. All reviews used the quality criteria to evaluate the methodological quality of primary studies, but some criteria were not comprehensive. The primary studies, in particular the Chinese reviews, had problems with randomization, allocation concealment, blinding, dropouts and withdrawals, intent-to-treat analysis and adverse events. Important methodological flaws were found in Chinese systematic reviews and primary studies. It was necessary to improve the methodological quality and reporting quality of both the systematic reviews published in China and primary studies on acupuncture for stroke.

[Methodology for the comprehensive evaluation of the quality of performance of activities of medical and social experts].

PubMed

Moskalenko, V F; Gorban', Ie M; Marunich, V V; Ipatov, A V; Sergiieni, O V

2001-01-01

The paper scientifically substantiates methodology, approaches, criteria, and control indices for assessment of activities of establishments of medical-and-social performance. Most indices for efficiency and certain indices for week points in the work of establishments of the service depend on interaction thereof with curative- and prophylactic institutions; the best results with the problem of prevention of disability and rehabilitation of invalids are supposed to be achieved through collaborative efforts. Other criteria and intermediate indices having an effect on the quality of activities reflect the resource- and trained personnel supplies of establishments of the service, amount of work, organizational measures designed to raise the quality of medical-and-social expert performance.

Methodological quality and reporting of systematic reviews in hand and wrist pathology.

PubMed

Wasiak, J; Shen, A Y; Ware, R; O'Donohoe, T J; Faggion, C M

2017-10-01

The objective of this study was to assess methodological and reporting quality of systematic reviews in hand and wrist pathology. MEDLINE, EMBASE and Cochrane Library were searched from inception to November 2016 for relevant studies. Reporting quality was evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and methodological quality using a measurement tool to assess systematic reviews, the Assessment of Multiple Systematic Reviews (AMSTAR). Descriptive statistics and linear regression were used to identify features associated with improved methodological quality. A total of 91 studies were included in the analysis. Most reviews inadequately reported PRISMA items regarding study protocol, search strategy and bias and AMSTAR items regarding protocol, publication bias and funding. Systematic reviews published in a plastics journal, or which included more authors, were associated with higher AMSTAR scores. A large proportion of systematic reviews within hand and wrist pathology literature score poorly with validated methodological assessment tools, which may affect the reliability of their conclusions. I.

Development of a Valid and Reliable Knee Articular Cartilage Condition-Specific Study Methodological Quality Score.

PubMed

Harris, Joshua D; Erickson, Brandon J; Cvetanovich, Gregory L; Abrams, Geoffrey D; McCormick, Frank M; Gupta, Anil K; Verma, Nikhil N; Bach, Bernard R; Cole, Brian J

2014-02-01

Condition-specific questionnaires are important components in evaluation of outcomes of surgical interventions. No condition-specific study methodological quality questionnaire exists for evaluation of outcomes of articular cartilage surgery in the knee. To develop a reliable and valid knee articular cartilage-specific study methodological quality questionnaire. Cross-sectional study. A stepwise, a priori-designed framework was created for development of a novel questionnaire. Relevant items to the topic were identified and extracted from a recent systematic review of 194 investigations of knee articular cartilage surgery. In addition, relevant items from existing generic study methodological quality questionnaires were identified. Items for a preliminary questionnaire were generated. Redundant and irrelevant items were eliminated, and acceptable items modified. The instrument was pretested and items weighed. The instrument, the MARK score (Methodological quality of ARticular cartilage studies of the Knee), was tested for validity (criterion validity) and reliability (inter- and intraobserver). A 19-item, 3-domain MARK score was developed. The 100-point scale score demonstrated face validity (focus group of 8 orthopaedic surgeons) and criterion validity (strong correlation to Cochrane Quality Assessment score and Modified Coleman Methodology Score). Interobserver reliability for the overall score was good (intraclass correlation coefficient [ICC], 0.842), and for all individual items of the MARK score, acceptable to perfect (ICC, 0.70-1.000). Intraobserver reliability ICC assessed over a 3-week interval was strong for 2 reviewers (≥0.90). The MARK score is a valid and reliable knee articular cartilage condition-specific study methodological quality instrument. This condition-specific questionnaire may be used to evaluate the quality of studies reporting outcomes of articular cartilage surgery in the knee.

Emerging technologies for the changing global market

NASA Technical Reports Server (NTRS)

Cruit, Wendy; Schutzenhofer, Scott; Goldberg, Ben; Everhart, Kurt

1993-01-01

This project served to define an appropriate methodology for effective prioritization of technology efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semi-quantative approach derived from quality function deployment techniques (QFD Matrix). This methodology aims to weight the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives. The results will be implemented as a guideline for consideration for current NASA propulsion systems.

[Clinical practice guidelines in Peru: evaluation of its quality using the AGREE II instrument].

PubMed

Canelo-Aybar, Carlos; Balbin, Graciela; Perez-Gomez, Ángela; Florez, Iván D

2016-01-01

To evaluate the methodological quality of clinical practice guidelines (CPGs) put into practice by the Peruvian Ministry of Health (MINSA), 17 CPGs from the ministry, published between 2009 and 2014, were independently evaluated by three methodologic experts using the AGREE II instrument. The score of AGREE II domains was low and very low in all CPGs: scope and purpose (medium, 44%), clarity of presentation (medium, 47%), participation of decision-makers (medium, 8%), methodological rigor (medium, 5%), applicability (medium, 5%), and editorial independence (medium, 8%). In conclusion, the methodological quality of CPGs implemented by the MINSA is low. Consequently, its use could not be recommended. The implementation of the methodology for the development of CPGs described in the recentlypublished CPG methodological preparation manual in Peru is a pressing need.

Quality of Service in Networks Supporting Cultural Multimedia Applications

ERIC Educational Resources Information Center

Kanellopoulos, Dimitris N.

2011-01-01

Purpose: This paper aims to provide an overview of representative multimedia applications in the cultural heritage sector, as well as research results on quality of service (QoS) mechanisms in internet protocol (IP) networks that support such applications. Design/methodology/approach: The paper's approach is a literature review. Findings: Cultural…

A Monte Carlo analysis of breast screening randomized trials.

PubMed

Zamora, Luis I; Forastero, Cristina; Guirado, Damián; Lallena, Antonio M

2016-12-01

To analyze breast screening randomized trials with a Monte Carlo simulation tool. A simulation tool previously developed to simulate breast screening programmes was adapted for that purpose. The history of women participating in the trials was simulated, including a model for survival after local treatment of invasive cancers. Distributions of time gained due to screening detection against symptomatic detection and the overall screening sensitivity were used as inputs. Several randomized controlled trials were simulated. Except for the age range of women involved, all simulations used the same population characteristics and this permitted to analyze their external validity. The relative risks obtained were compared to those quoted for the trials, whose internal validity was addressed by further investigating the reasons of the disagreements observed. The Monte Carlo simulations produce results that are in good agreement with most of the randomized trials analyzed, thus indicating their methodological quality and external validity. A reduction of the breast cancer mortality around 20% appears to be a reasonable value according to the results of the trials that are methodologically correct. Discrepancies observed with Canada I and II trials may be attributed to a low mammography quality and some methodological problems. Kopparberg trial appears to show a low methodological quality. Monte Carlo simulations are a powerful tool to investigate breast screening controlled randomized trials, helping to establish those whose results are reliable enough to be extrapolated to other populations and to design the trial strategies and, eventually, adapting them during their development. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Terrorism, Radicalisation, Extremism, Authoritarianism and Fundamentalism: A Systematic Review of the Quality and Psychometric Properties of Assessments

PubMed Central

Scarcella, Akimi; Page, Ruairi; Furtado, Vivek

2016-01-01

Background Currently, terrorism and suicide bombing are global psychosocial processes that attracts a growing number of psychological and psychiatric contributions to enhance practical counter-terrorism measures. The present study is a systematic review that explores the methodological quality reporting and the psychometric soundness of the instruments developed to identify risk factors of terrorism, extremism, radicalisation, authoritarianism and fundamentalism. Method A systematic search strategy was established to identify instruments and studies developed to screen individuals at risk of committing extremist or terrorist offences using 20 different databases across the fields of law, medicine, psychology, sociology and politics. Information extracted was consolidated into two different tables and a 26-item checklist, reporting respectively background information, the psychometric properties of each tool, and the methodological quality markers of these tools. 37 articles met our criteria, which included a total of 4 instruments to be used operationally by professionals, 17 tools developed as research measures, and 9 inventories that have not been generated from a study. Results Just over half of the methodological quality markers required for a transparent methodological description of the instruments were reported. The amount of reported psychological properties was even fewer, with only a third of them available across the different studies. The category presenting the least satisfactory results was that containing the 4 instruments to be used operationally by professionals, which can be explained by the fact that half of them refrained from publishing the major part of their findings and relevant guidelines. Conclusions A great number of flaws have been identified through this systematic review. The authors encourage future researchers to be more thorough, comprehensive and transparent in their methodology. They also recommend the creation of a multi-disciplinary joint working group in order to best tackle this growing contemporary problem. PMID:28002457

Dissemination Bias in Systematic Reviews of Animal Research: A Systematic Review

PubMed Central

Mueller, Katharina F.; Briel, Matthias; Strech, Daniel; Meerpohl, Joerg J.; Lang, Britta; Motschall, Edith; Gloy, Viktoria; Lamontagne, Francois; Bassler, Dirk

2014-01-01

Background Systematic reviews of preclinical studies, in vivo animal experiments in particular, can influence clinical research and thus even clinical care. Dissemination bias, selective dissemination of positive or significant results, is one of the major threats to validity in systematic reviews also in the realm of animal studies. We conducted a systematic review to determine the number of published systematic reviews of animal studies until present, to investigate their methodological features especially with respect to assessment of dissemination bias, and to investigate the citation of preclinical systematic reviews on clinical research. Methods Eligible studies for this systematic review constitute systematic reviews that summarize in vivo animal experiments whose results could be interpreted as applicable to clinical care. We systematically searched Ovid Medline, Embase, ToxNet, and ScienceDirect from 1st January 2009 to 9th January 2013 for eligible systematic reviews without language restrictions. Furthermore we included articles from two previous systematic reviews by Peters et al. and Korevaar et al. Results The literature search and screening process resulted in 512 included full text articles. We found an increasing number of published preclinical systematic reviews over time. The methodological quality of preclinical systematic reviews was low. The majority of preclinical systematic reviews did not assess methodological quality of the included studies (71%), nor did they assess heterogeneity (81%) or dissemination bias (87%). Statistics quantifying the importance of clinical research citing systematic reviews of animal studies showed that clinical studies referred to the preclinical research mainly to justify their study or a future study (76%). Discussion Preclinical systematic reviews may have an influence on clinical research but their methodological quality frequently remains low. Therefore, systematic reviews of animal research should be critically appraised before translating them to a clinical context. PMID:25541734

Appraisal of systematic reviews on the management of peri-implant diseases with two methodological tools.

PubMed

Faggion, Clovis Mariano; Monje, Alberto; Wasiak, Jason

2018-06-01

This study aimed to evaluate and compare the performance of two methodological instruments to appraise systematic reviews and to identify potential disagreements of systematic review authors regarding risk of bias (RoB) evaluation of randomized controlled trials (RCTs) included in systematic reviews on peri-implant diseases. We searched Medline, Web of Science, Cochrane Library, PubMed Central, and Google Scholar for systematic reviews on peri-implant diseases published before July 11, 2017. Two authors independently evaluated the RoB and methodological quality of the systematic reviews by applying the Risk of Bias in Systematic Reviews (ROBIS) tool and Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist, respectively. We assessed the RoB scores of the same RCTs published in different systematic reviews. Of the 32 systematic reviews identified, 23 reviews addressed the clinical topic of peri-implantitis. A high RoB was detected for most systematic reviews (n=25) using ROBIS, whilst five systematic reviews displayed low methodological quality by AMSTAR. Almost 30% of the RoB comparisons (for the same RCTs) had different RoB ratings across systematic reviews. The ROBIS tool appears to provide more conservative results than AMSTAR checklist. Considerable disagreement was found among systematic review authors rating the same RCT included in different systematic reviews. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

11 CFR 9405.5 - Categories of exemptions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... descriptions of manufacturing process, quality control methodology, and test results. The following procedures... lawful national security intelligence investigation, information furnished by a confidential source; (v...

11 CFR 9405.5 - Categories of exemptions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... descriptions of manufacturing process, quality control methodology, and test results. The following procedures... lawful national security intelligence investigation, information furnished by a confidential source; (v...

11 CFR 9405.5 - Categories of exemptions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... descriptions of manufacturing process, quality control methodology, and test results. The following procedures... lawful national security intelligence investigation, information furnished by a confidential source; (v...

11 CFR 9405.5 - Categories of exemptions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... descriptions of manufacturing process, quality control methodology, and test results. The following procedures... lawful national security intelligence investigation, information furnished by a confidential source; (v...

A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995.

PubMed

Dantas, F; Fisher, P; Walach, H; Wieland, F; Rastogi, D P; Teixeira, H; Koster, D; Jansen, J P; Eizayaga, J; Alvarez, M E P; Marim, M; Belon, P; Weckx, L L M

2007-01-01

The quality of information gathered from homeopathic pathogenetic trials (HPTs), also known as 'provings', is fundamental to homeopathy. We systematically reviewed HPTs published in six languages (English, German, Spanish, French, Portuguese and Dutch) from 1945 to 1995, to assess their quality in terms of the validity of the information they provide. The literature was comprehensively searched, only published reports of HPTs were included. Information was extracted by two reviewers per trial using a form with 87 items. Information on: medicines, volunteers, ethical aspects, blinding, randomization, use of placebo, adverse effects, assessments, presentation of data and number of claimed findings were recorded. Methodological quality was assessed by an index including indicators of internal and external validity, personal judgement and comments of reviewers for each study. 156 HPTs on 143 medicines, involving 2815 volunteers, produced 20,538 pathogenetic effects (median 6.5 per volunteer). There was wide variation in methods and results. Sample size (median 15, range 1-103) and trial duration (mean 34 days) were very variable. Most studies had design flaws, particularly absence of proper randomization, blinding, placebo control and criteria for analysis of outcomes. Mean methodological score was 5.6 (range 4-16). More symptoms were reported from HPTs of poor quality than from better ones. In 56% of trials volunteers took placebo. Pathogenetic effects were claimed in 98% of publications. On average about 84% of volunteers receiving active treatment developed symptoms. The quality of reports was in general poor, and much important information was not available. The HPTs were generally of low methodological quality. There is a high incidence of pathogenetic effects in publications and volunteers but this could be attributable to design flaws. Homeopathic medicines, tested in HPTs, appear safe. The central question of whether homeopathic medicines in high dilutions can provoke effects in healthy volunteers has not yet been definitively answered, because of methodological weaknesses of the reports. Improvement of the method and reporting of results of HPTs are required. References to all included RCTs are available on-line at.

Comparison of methodologic quality and study/report characteristics between quantitative clinical nursing and nursing education research articles.

PubMed

Schneider, Barbara St Pierre; Nicholas, Jennifer; Kurrus, Jeffrey E

2013-01-01

To compare the methodologic quality and study/report characteristics between quantitative clinical nursing and nursing education research articles. The methodologic quality of quantitative nursing education research needs to advance to a higher level. Clinical research can provide guidance for nursing education to reach this level. One hundred quantitative clinical research articles from-high impact journals published in 2007 and 37 education research articles from high impact journals published in 2006 to 2007 were chosen for analysis. Clinical articles had significantly higher quality scores than education articles in three domains: number of institutions studied, type of data, and outcomes. The findings indicate three ways in which nursing education researchers can strengthen the methodologic quality of their quantitative research. With this approach, greater funding may be secured for advancing the science of nursing education.

A methodology for space-time classification of groundwater quality.

PubMed

Passarella, G; Caputo, M C

2006-04-01

Safeguarding groundwater from civil, agricultural and industrial contamination is matter of great interest in water resource management. During recent years, much legislation has been produced stating the importance of groundwater as a source for drinking water supplies, underlining its vulnerability and defining the required quality standards. Thus, schematic tools, able to characterise the quality and quantity of groundwater systems, are of very great interest in any territorial planning and/or water resource management activity. This paper proposes a groundwater quality classification method which has been applied to a real aquifer, starting from several studies published by the Italian National Hydrogeologic Catastrophe Defence Group (GNDCI). The methodology is based on the concentration values of several parameters used as indexes of the natural hydro-chemical water condition and of potential man-induced modifications of groundwater quality. The resulting maps, although representative of the quality, do not include any information on its evolution in time. In this paper, this "stationary" classification method has been improved by crossing the quality classes with three indexes of temporal behaviour during recent years. It was then applied to data from monitoring campaigns, performed in spring and autumn, from 1990 to 1996, in the plain of Modena aquifer (central Italy). The results are reported in the form of space-time classification table and maps.

Presentation of flight control design and handling quality commonality by separate surface stability augmentation for the family of commuter airplanes

NASA Technical Reports Server (NTRS)

Hensley, Douglas; Creighton, Thomas; Haddad, Raphael; Hendrich, Louis; Morgan, Louise; Russell, Mark; Swift, Gerald

1987-01-01

The methodology and results for a flight control design and implementation for common handling qualities by Separate Surface Stability Augmentation (SSSA) for the family of commuter airplanes are contained. The open and closed loop dynamics and the design results of augmenting for common handling qualities are presented. The physical and technology requirements are presented for implementing the SSSA system. The conclusion of this report and recommendations for changes or improvement are discussed.

Six Sigma arises from the ashes of TQM with a twist.

PubMed

Black, Ken; Revere, Lee

2006-01-01

This paper sets out to analyse the use of the Six Sigma methodology to improve quality in healthcare. It looks at how Six Sigma grew out of the concept of Total Quality Management (TQM). Six Sigma is a quality improvement methodology that has been widely adopted by companies since the early 1990s and has grown exponentially in the healthcare industry during the past five years. Some of the main tenets of Six Sigma have emerged from the principles of TQM, including the notion that the entire organization must support the quality effort; that there should be a vigorous education effort; and that a quality improvement process should emphasize root cause analysis. In spite of its early success, TQM "crashed and burned" for several reasons including the fact that financial benefits were difficult to assign to TQM efforts, root cause was not always determined resulting in recurring errors, there was no common metric to measure the level of quality attained, and quality efforts were sometimes aimed at processes or operations that were not critical to the customer. Six Sigma filled the vacuums created by these TQM failures in several ways. Under the Six Sigma methodology, quality improvement projects are carefully defined so that they can be successfully completed within a relatively short time frame. Financials are applied to each completed project so that management knows how much the project saves the institution. On each project, intense study is used to determine root cause analysis; and in the end, a metric known as "sigma level" can be assigned to signify the level of quality. Six Sigma has a "critical to quality" dimension that keeps the quality effort focused on improving only those things that really matter to the customer.

What's the Difference, Still? A Follow-Up Review of the Quantitative Research Methodology in Distance Learning

ERIC Educational Resources Information Center

Randolph, Justus

2005-01-01

A high quality review of the distance learning literature from 1992-1999 concluded that most of the research on distance learning had serious methodological flaws. This paper presents the results of a small-scale replication of that review. From three leading distance education journals, a sample of 66 articles was categorized by study type and…

Association between body composition and disease activity in rheumatoid arthritis. A systematic review.

PubMed

Alvarez-Nemegyei, José; Buenfil-Rello, Fátima Annai; Pacheco-Pantoja, Elda Leonor

2016-01-01

Reports regarding the association between body composition and inflammatory activity in rheumatoid arthritis (RA) have consistently yielded contradictory results. To perform a systematic review on the association between overweight/obesity and inflammatory activity in RA. FAST approach: Article search (Medline, EBSCO, Cochrane Library), followed by abstract retrieval, full text review and blinded assessment of methodological quality for final inclusion. Because of marked heterogeneity in statistical approach and RA activity assessment method, a meta-analysis could not be done. Results are presented as qualitative synthesis. One hundred and nineteen reports were found, 16 of them qualified for full text review. Eleven studies (8,147 patients; n range: 37-5,161) approved the methodological quality filter and were finally included. Interobserver agreement for methodological quality score (ICC: 0.93; 95% CI: 0.82-0.98; P<.001) and inclusion/rejection decision (k 1.00, P>.001) was excellent. In all reports body composition was assessed by BMI; however a marked heterogeneity was found in the method used for RA activity assessment. A significant association between BMI and RA activity was found in 6 reports having larger mean sample size: 1,274 (range: 140-5,161). On the other hand, this association was not found in 5 studies having lower mean sample size: 100 (range: 7-150). The modulation of RA clinical status by body fat mass is suggested because a significant association was found between BMI and inflammatory activity in those reports with a trend toward higher statistical power. The relationship between body composition and clinical activity in RA requires be approached with further studies with higher methodological quality. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Assessing medical professionalism: A systematic review of instruments and their measurement properties

PubMed Central

Li, Honghe; Liu, Yang; Wen, Deliang

2017-01-01

Background Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments’ measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations. Methods A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990–2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument’s usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee’s criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments. Results After screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar’s instrument for nursing students, Nurse Practitioners’ Roles and Competencies Scale, and Perceived Faculty Competency Inventory. Conclusion Although instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing instruments and to longitudinal studies. PMID:28498838

Introduction: the Interdisciplinary Nursing Quality Research Initiative.

PubMed

Naylor, Mary D; Lustig, Adam; Kelley, Heather J; Volpe, Ellen M; Melichar, Lori; Pauly, Mark V

2013-04-01

The Robert Wood Johnson Foundation launched the Interdisciplinary Nursing Quality Research Initiative (INQRI) program in 2005 to generate, disseminate, and translate research to understand how nurses contribute to and can improve patient care quality. This special edition of Medical Care provides an overview of the program's strategy, goals, and impact, highlighting cross-cutting issues addressed by the initiative. INQRI's leadership and select grantees discuss the implications of a collection of studies on the following: advances in the science of nursing's contribution to quality, measurement of quality, interdisciplinary collaboration, implementation methodology, dissemination and translation of findings, and the business case for nursing. A comprehensive review of the scholarly literature published in 2004 and 2009 found that the evidence linking nursing to quality of care has grown. The second paper discusses INQRI's work on measurement of quality of care, revealing the need for additional comprehensive measures. The third paper examines INQRI's focus on interdisciplinary collaboration, finding that it can enhance methodological approaches and result in substantive changes in health delivery systems. The fourth paper presents methodological challenges faced in health care implementation, emphasizing the need for standardized terms and research designs. The fifth paper addresses INQRI's commitment to translating research into practice, illustrating dissemination strategies and lessons learned. The final paper discusses how the INQRI program has contributed to the current evidence regarding the business case for nursing. This supplement describes the accomplishments of the INQRI program, discusses current issues in research design and implementation, and places INQRI research within the larger context regarding advances in nursing science.

Instruments evaluating the quality of the clinical learning environment in nursing education: A systematic review of psychometric properties.

PubMed

Mansutti, Irene; Saiani, Luisa; Grassetti, Luca; Palese, Alvisa

2017-03-01

The clinical learning environment is fundamental to nursing education paths, capable of affecting learning processes and outcomes. Several instruments have been developed in nursing education, aimed at evaluating the quality of the clinical learning environments; however, no systematic review of the psychometric properties and methodological quality of these studies has been performed to date. The aims of the study were: 1) to identify validated instruments evaluating the clinical learning environments in nursing education; 2) to evaluate critically the methodological quality of the psychometric property estimation used; and 3) to compare psychometric properties across the instruments available. A systematic review of the literature (using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines) and an evaluation of the methodological quality of psychometric properties (using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines). The Medline and CINAHL databases were searched. Eligible studies were those that satisfied the following criteria: a) validation studies of instruments evaluating the quality of clinical learning environments; b) in nursing education; c) published in English or Italian; d) before April 2016. The included studies were evaluated for the methodological quality of the psychometric properties measured and then compared in terms of both the psychometric properties and the methodological quality of the processes used. The search strategy yielded a total of 26 studies and eight clinical learning environment evaluation instruments. A variety of psychometric properties have been estimated for each instrument, with differing qualities in the methodology used. Concept and construct validity were poorly assessed in terms of their significance and rarely judged by the target population (nursing students). Some properties were rarely considered (e.g., reliability, measurement error, criterion validity), whereas others were frequently estimated, but using different coefficients and statistical analyses (e.g., internal consistency, structural validity), thus rendering comparison across instruments difficult. Moreover, the methodological quality adopted in the property assessments was poor or fair in most studies, compromising the goodness of the psychometric values estimated. Clinical learning placements represent the key strategies in educating the future nursing workforce: instruments evaluating the quality of the settings, as well as their capacity to promote significant learning, are strongly recommended. Studies estimating psychometric properties, using an increased quality of research methodologies are needed in order to support nursing educators in the process of clinical placements accreditation and quality improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

What is the effectiveness of obesity related interventions at retail grocery stores and supermarkets? -a systematic review.

PubMed

Adam, Abdulfatah; Jensen, Jørgen D

2016-12-28

The Prevalence of obesity and overweight has been increasing in many countries. Many factors have been identified as contributing to obesity including the food environment, especially the access, availability and affordability of healthy foods in grocery stores and supermarkets. Several interventions have been carried out in retail grocery/supermarket settings as part of an effort to understand and influence consumption of healthful foods. The review's key outcome variable is sale/purchase of healthy foods as a result of the interventions. This systematic review sheds light on the effectiveness of food store interventions intended to promote the consumption of healthy foods and the methodological quality of studies reporting them. Systematic literature search spanning from 2003 to 2015 (inclusive both years), and confined to papers in the English language was conducted. Studies fulfilling search criteria were identified and critically appraised. Studies included in this review report health interventions at physical food stores including supermarkets and corner stores, and with outcome variable of adopting healthier food purchasing/consumption behavior. The methodological quality of all included articles has been determined using a validated 16-item quality assessment tool (QATSDD). The literature search identified 1580 publications, of which 42 met the inclusion criteria. Most interventions used a combination of information (e.g. awareness raising through food labeling, promotions, campaigns, etc.) and increasing availability of healthy foods such as fruits and vegetables. Few used price interventions. The average quality score for all papers is 65.0%, or an overall medium methodological quality. Apart from few studies, most studies reported that store interventions were effective in promoting purchase of healthy foods. Given the diverse study settings and despite the challenges of methodological quality for some papers, we find efficacy of in-store healthy food interventions in terms of increased purchase of healthy foods. Researchers need to take risk of bias and methodological quality into account when designing future studies that should guide policy makers. Interventions which combine price, information and easy access to and availability of healthy foods with interactive and engaging nutrition information, if carefully designed can help customers of food stores to buy and consume more healthy foods.

Teaching mathematical word problem solving: the quality of evidence for strategy instruction priming the problem structure.

PubMed

Jitendra, Asha K; Petersen-Brown, Shawna; Lein, Amy E; Zaslofsky, Anne F; Kunkel, Amy K; Jung, Pyung-Gang; Egan, Andrea M

2015-01-01

This study examined the quality of the research base related to strategy instruction priming the underlying mathematical problem structure for students with learning disabilities and those at risk for mathematics difficulties. We evaluated the quality of methodological rigor of 18 group research studies using the criteria proposed by Gersten et al. and 10 single case design (SCD) research studies using criteria suggested by Horner et al. and the What Works Clearinghouse. Results indicated that 14 group design studies met the criteria for high-quality or acceptable research, whereas SCD studies did not meet the standards for an evidence-based practice. Based on these findings, strategy instruction priming the mathematics problem structure is considered an evidence-based practice using only group design methodological criteria. Implications for future research and for practice are discussed. © Hammill Institute on Disabilities 2013.

Knowledge discovery about quality of life changes of spinal cord injury patients: clustering based on rules by states.

PubMed

Gibert, Karina; García-Rudolph, Alejandro; Curcoll, Lluïsa; Soler, Dolors; Pla, Laura; Tormos, José María

2009-01-01

In this paper, an integral Knowledge Discovery Methodology, named Clustering based on rules by States, which incorporates artificial intelligence (AI) and statistical methods as well as interpretation-oriented tools, is used for extracting knowledge patterns about the evolution over time of the Quality of Life (QoL) of patients with Spinal Cord Injury. The methodology incorporates the interaction with experts as a crucial element with the clustering methodology to guarantee usefulness of the results. Four typical patterns are discovered by taking into account prior expert knowledge. Several hypotheses are elaborated about the reasons for psychological distress or decreases in QoL of patients over time. The knowledge discovery from data (KDD) approach turns out, once again, to be a suitable formal framework for handling multidimensional complexity of the health domains.

Epidemiology characteristics, reporting characteristics, and methodological quality of systematic reviews and meta-analyses on traditional Chinese medicine nursing interventions published in Chinese journals.

PubMed

Yang, Min; Jiang, Li; Wang, Aihong; Xu, Guihua

2017-02-01

To evaluate the epidemiological characteristics, reporting characteristics, and methodological quality of systematic reviews in the traditional Chinese medicine nursing field published in Chinese journals. The number of systematic reviews in the traditional Chinese medicine nursing field has increased, but their epidemiology, quality, and reporting characteristics have not been assessed completely. We generated an overview of reviews using a narrative approach. Four Chinese databases were searched for systematic reviews from inception to December 2015. The Preferred Reporting Items of Systematic Reviews and Meta-analyses and the Assessment of Multiple Systematic Reviews checklists were adopted to evaluate reporting and methodological quality, respectively. A total of 73 eligible systematic reviews, published from 2005 to 2015, were included. The deficiencies in reporting characteristics mainly lay in the lack of structured abstract or protocol, incomplete reporting of search strategies, study selection, and risk of bias. The deficiencies in methodological quality were reflected in the lack of a priori design and conflict of interest, incomplete literature searches, and assessment of publication bias. The quality of the evaluated reviews was unsatisfactory; attention should be paid to the improvement of reporting and methodological quality in the conduct of systematic reviews. © 2016 John Wiley & Sons Australia, Ltd.

Process perspective on image quality evaluation

NASA Astrophysics Data System (ADS)

Leisti, Tuomas; Halonen, Raisa; Kokkonen, Anna; Weckman, Hanna; Mettänen, Marja; Lensu, Lasse; Ritala, Risto; Oittinen, Pirkko; Nyman, Göte

2008-01-01

The psychological complexity of multivariate image quality evaluation makes it difficult to develop general image quality metrics. Quality evaluation includes several mental processes and ignoring these processes and the use of a few test images can lead to biased results. By using a qualitative/quantitative (Interpretation Based Quality, IBQ) methodology, we examined the process of pair-wise comparison in a setting, where the quality of the images printed by laser printer on different paper grades was evaluated. Test image consisted of a picture of a table covered with several objects. Three other images were also used, photographs of a woman, cityscape and countryside. In addition to the pair-wise comparisons, observers (N=10) were interviewed about the subjective quality attributes they used in making their quality decisions. An examination of the individual pair-wise comparisons revealed serious inconsistencies in observers' evaluations on the test image content, but not on other contexts. The qualitative analysis showed that this inconsistency was due to the observers' focus of attention. The lack of easily recognizable context in the test image may have contributed to this inconsistency. To obtain reliable knowledge of the effect of image context or attention on subjective image quality, a qualitative methodology is needed.

"Assessing the methodological quality of systematic reviews in radiation oncology: A systematic review".

PubMed

Hasan, Haroon; Muhammed, Taaha; Yu, Jennifer; Taguchi, Kelsi; Samargandi, Osama A; Howard, A Fuchsia; Lo, Andrea C; Olson, Robert; Goddard, Karen

2017-10-01

The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of global water quality - the potential of a data- and model-driven analysis

NASA Astrophysics Data System (ADS)

Bärlund, Ilona; Flörke, Martina; Alcamo, Joseph; Völker, Jeanette; Malsy, Marcus; Kaus, Andrew; Reder, Klara; Büttner, Olaf; Katterfeld, Christiane; Dietrich, Désirée; Borchardt, Dietrich

2016-04-01

The ongoing socio-economic development presents a new challenge for water quality worldwide, especially in developing and emerging countries. It is estimated that due to population growth and the extension of water supply networks, the amount of waste water will rise sharply. This can lead to an increased risk of surface water quality degradation, if the wastewater is not sufficiently treated. This development has impacts on ecosystems and human health, as well as food security. The United Nations Member States have adopted targets for sustainable development. They include, inter alia, sustainable protection of water quality and sustainable use of water resources. To achieve these goals, appropriate monitoring strategies and the development of indicators for water quality are required. Within the pre-study for a 'World Water Quality Assessment' (WWQA) led by United Nations Environment Programme (UNEP), a methodology for assessing water quality, taking into account the above-mentioned objectives has been developed. The novelty of this methodology is the linked model- and data-driven approach. The focus is on parameters reflecting the key water quality issues, such as increased waste water pollution, salinization or eutrophication. The results from the pre-study show, for example, that already about one seventh of all watercourses in Latin America, Africa and Asia show high organic pollution. This is of central importance for inland fisheries and associated food security. In addition, it could be demonstrated that global water quality databases have large gaps. These must be closed in the future in order to obtain an overall picture of global water quality and to target measures more efficiently. The aim of this presentation is to introduce the methodology developed within the WWQA pre-study and to show selected examples of application in Latin America, Africa and Asia.

Sexual health education interventions for young people: a methodological review.

PubMed Central

Oakley, A.; Fullerton, D.; Holland, J.; Arnold, S.; France-Dawson, M.; Kelley, P.; McGrellis, S.

1995-01-01

OBJECTIVES--To locate reports of sexual health education interventions for young people, assess the methodological quality of evaluations, identify the subgroup with a methodologically sound design, and assess the evidence with respect to the effectiveness of different approaches to promoting young people's sexual health. DESIGN--Survey of reports in English by means of electronic databases and hand searches for relevant studies conducted in the developed world since 1982. Papers were reviewed for eight methodological qualities. The evidence on effectiveness generated by studies meeting four core criteria was assessed. Judgments on effectiveness by reviewers and authors were compared. PAPERS--270 papers reporting sexual health interventions. MAIN OUTCOME MEASURE--The methodological quality of evaluations. RESULTS--73 reports of evaluations of sexual health interventions examining the effectiveness of these interventions in changing knowledge, attitudes, or behavioural outcomes were identified, of which 65 were separate outcome evaluations. Of these studies, 45 (69%) lacked random control groups, 44 (68%) failed to present preintervention and 38 (59%) postintervention data, and 26 (40%) omitted to discuss the relevance of loss of data caused by drop outs. Only 12 (18%) of the 65 outcome evaluations were judged to be methodologically sound. Academic reviewers were more likely than authors to judge studies as unclear because of design faults. Only two of the sound evaluations recorded interventions which were effective in showing an impact on young people's sexual behaviour. CONCLUSIONS--The design of evaluations in sexual health intervention needs to be improved so that reliable evidence of the effectiveness of different approaches to promoting young people's sexual health may be generated. PMID:7833754

Integrating automated support for a software management cycle into the TAME system

NASA Technical Reports Server (NTRS)

Sunazuka, Toshihiko; Basili, Victor R.

1989-01-01

Software managers are interested in the quantitative management of software quality, cost and progress. An integrated software management methodology, which can be applied throughout the software life cycle for any number purposes, is required. The TAME (Tailoring A Measurement Environment) methodology is based on the improvement paradigm and the goal/question/metric (GQM) paradigm. This methodology helps generate a software engineering process and measurement environment based on the project characteristics. The SQMAR (software quality measurement and assurance technology) is a software quality metric system and methodology applied to the development processes. It is based on the feed forward control principle. Quality target setting is carried out before the plan-do-check-action activities are performed. These methodologies are integrated to realize goal oriented measurement, process control and visual management. A metric setting procedure based on the GQM paradigm, a management system called the software management cycle (SMC), and its application to a case study based on NASA/SEL data are discussed. The expected effects of SMC are quality improvement, managerial cost reduction, accumulation and reuse of experience, and a highly visual management reporting system.

Background qualitative analysis of the European reference life cycle database (ELCD) energy datasets - part II: electricity datasets.

PubMed

Garraín, Daniel; Fazio, Simone; de la Rúa, Cristina; Recchioni, Marco; Lechón, Yolanda; Mathieux, Fabrice

2015-01-01

The aim of this paper is to identify areas of potential improvement of the European Reference Life Cycle Database (ELCD) electricity datasets. The revision is based on the data quality indicators described by the International Life Cycle Data system (ILCD) Handbook, applied on sectorial basis. These indicators evaluate the technological, geographical and time-related representativeness of the dataset and the appropriateness in terms of completeness, precision and methodology. Results show that ELCD electricity datasets have a very good quality in general terms, nevertheless some findings and recommendations in order to improve the quality of Life-Cycle Inventories have been derived. Moreover, these results ensure the quality of the electricity-related datasets to any LCA practitioner, and provide insights related to the limitations and assumptions underlying in the datasets modelling. Giving this information, the LCA practitioner will be able to decide whether the use of the ELCD electricity datasets is appropriate based on the goal and scope of the analysis to be conducted. The methodological approach would be also useful for dataset developers and reviewers, in order to improve the overall Data Quality Requirements of databases.

[Development of an optimized formulation of damask marmalade with low energy level using Taguchi methodology].

PubMed

Villarroel, Mario; Castro, Ruth; Junod, Julio

2003-06-01

The goal of this present study was the development of an optimized formula of damask marmalade low in calories applying Taguchi methodology to improve the quality of this product. The selection of this methodology lies on the fact that in real life conditions the result of an experiment frequently depends on the influence of several variables, therefore, one expedite way to solve this problem is utilizing factorial desings. The influence of acid, thickener, sweetener and aroma additives, as well as time of cooking, and possible interactions among some of them, were studied trying to get the best combination of these factors to optimize the sensorial quality of an experimental formulation of dietetic damask marmalade. An orthogonal array L8 (2(7)) was applied in this experience, as well as level average analysis was carried out according Taguchi methodology to determine the suitable working levels of the design factors previously choiced, to achieve a desirable product quality. A sensory trained panel was utilized to analyze the marmalade samples using a composite scoring test with a descriptive acuantitative scale ranging from 1 = Bad, 5 = Good. It was demonstrated that the design factors sugar/aspartame, pectin and damask aroma had a significant effect (p < 0.05) on the sensory quality of the marmalade with 82% of contribution on the response. The optimal combination result to be: citric acid 0.2%; pectin 1%; 30 g sugar/16 mg aspartame/100 g, damask aroma 0.5 ml/100 g, time of cooking 5 minutes. Regarding chemical composition, the most important results turned out to be the decrease in carbohydrate content compaired with traditional marmalade with a reduction of 56% in coloric value and also the amount of dietary fiber greater than similar commercial products. Assays of storage stability were carried out on marmalade samples submitted to different temperatures held in plastic bags of different density. Non percetible sensorial, microbiological and chemical changes were detected after 90 days of storage under controlled conditions.

Methodological and Reporting Quality of Comparative Studies Evaluating Health-Related Quality of Life of Colorectal Cancer Patients and Controls: A Systematic Review.

PubMed

Wong, Carlos K H; Guo, Vivian Y W; Chen, Jing; Lam, Cindy L K

2016-11-01

Health-related quality of life is an important outcome measure in patients with colorectal cancer. Comparison with normative data has been increasingly undertaken to assess the additional impact of colorectal cancer on health-related quality of life. This review aimed to critically appraise the methodological details and reporting characteristics of comparative studies evaluating differences in health-related quality of life between patients and controls. A systematic search of English-language literature published between January 1985 and May 2014 was conducted through a database search of PubMed, Web of Science, Embase, and Medline. Comparative studies reporting health-related quality-of-life outcomes among patients who have colorectal cancer and controls were selected. Methodological and reporting quality per comparison study was evaluated based on a 11-item methodological checklist proposed by Efficace in 2003 and a set of criteria predetermined by reviewers. Thirty-one comparative studies involving >10,000 patients and >10,000 controls were included. Twenty-three studies (74.2%) originated from European countries, with the largest number from the Netherlands (n = 6). Twenty-eight studies (90.3%) compared the health-related quality of life of patients with normative data published elsewhere, whereas the remaining studies recruited a group of patients who had colorectal cancer and a group of control patients within the same studies. The European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 was the most extensively used instrument (n = 16; 51.6%). Eight studies (25.8%) were classified as "probably robust" for clinical decision making according to the Efficace standard methodological checklist. Our further quality assessment revealed the lack of score differences reported (61.3%), contemporary comparisons (36.7%), statistical significance tested (38.7%), and matching of control group (58.1%), possibly leading to inappropriate control groups for fair comparisons. Meta-analysis of differences between the 2 groups was not available. In general, one-fourth of comparative studies that evaluated health-related quality of life of patients who had colorectal cancer achieved high quality in reporting characteristics and methodological details. Future studies are encouraged to undertake health-related quality-of-life measurement and adhere to a methodological checklist in comparison with controls.

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

PubMed Central

Petzold, Thomas; Deckert, Stefanie; Williamson, Paula R.; Schmitt, Jochen

2018-01-01

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems. PMID:29591538

Background qualitative analysis of the European Reference Life Cycle Database (ELCD) energy datasets - part I: fuel datasets.

PubMed

Garraín, Daniel; Fazio, Simone; de la Rúa, Cristina; Recchioni, Marco; Lechón, Yolanda; Mathieux, Fabrice

2015-01-01

The aim of this study is to identify areas of potential improvement of the European Reference Life Cycle Database (ELCD) fuel datasets. The revision is based on the data quality indicators described by the ILCD Handbook, applied on sectorial basis. These indicators evaluate the technological, geographical and time-related representativeness of the dataset and the appropriateness in terms of completeness, precision and methodology. Results show that ELCD fuel datasets have a very good quality in general terms, nevertheless some findings and recommendations in order to improve the quality of Life-Cycle Inventories have been derived. Moreover, these results ensure the quality of the fuel-related datasets to any LCA practitioner, and provide insights related to the limitations and assumptions underlying in the datasets modelling. Giving this information, the LCA practitioner will be able to decide whether the use of the ELCD fuel datasets is appropriate based on the goal and scope of the analysis to be conducted. The methodological approach would be also useful for dataset developers and reviewers, in order to improve the overall DQR of databases.

Improving the Quality of Experience Journals: Training Educational Psychology Students in Basic Qualitative Methodology

ERIC Educational Resources Information Center

Reynolds-Keefer, Laura

2010-01-01

This study evaluates the impact of teaching basic qualitative methodology to preservice teachers enrolled in an educational psychology course in the quality of observation journals. Preservice teachers enrolled in an educational psychology course requiring 45 hr of field experience were given qualitative methodological training as a part of the…

A new transmission methodology for quality assurance in radiotherapy based on radiochromic film measurements

PubMed Central

do Amaral, Leonardo L.; Pavoni, Juliana F.; Sampaio, Francisco; Netto, Thomaz Ghilardi

2015-01-01

Despite individual quality assurance (QA) being recommended for complex techniques in radiotherapy (RT) treatment, the possibility of errors in dose delivery during therapeutic application has been verified. Therefore, it is fundamentally important to conduct in vivo QA during treatment. This work presents an in vivo transmission quality control methodology, using radiochromic film (RCF) coupled to the linear accelerator (linac) accessory holder. This QA methodology compares the dose distribution measured by the film in the linac accessory holder with the dose distribution expected by the treatment planning software. The calculated dose distribution is obtained in the coronal and central plane of a phantom with the same dimensions of the acrylic support used for positioning the film but in a source‐to‐detector distance (SDD) of 100 cm, as a result of transferring the IMRT plan in question with all the fields positioned with the gantry vertically, that is, perpendicular to the phantom. To validate this procedure, first of all a Monte Carlo simulation using PENELOPE code was done to evaluate the differences between the dose distributions measured by the film in a SDD of 56.8 cm and 100 cm. After that, several simple dose distribution tests were evaluated using the proposed methodology, and finally a study using IMRT treatments was done. In the Monte Carlo simulation, the mean percentage of points approved in the gamma function comparing the dose distribution acquired in the two SDDs were 99.92%±0.14%. In the simple dose distribution tests, the mean percentage of points approved in the gamma function were 99.85%±0.26% and the mean percentage differences in the normalization point doses were −1.41%. The transmission methodology was approved in 24 of 25 IMRT test irradiations. Based on these results, it can be concluded that the proposed methodology using RCFs can be applied for in vivo QA in RT treatments. PACS number: 87.55.Qr, 87.55.km, 87.55.N‐ PMID:26699306

Quality indicators for musculoskeletal injury management in the emergency department: a systematic review.

PubMed

Strudwick, Kirsten; Nelson, Mark; Martin-Khan, Melinda; Bourke, Michael; Bell, Anthony; Russell, Trevor

2015-02-01

There is increasing importance placed on quality of health care for musculoskeletal injuries in emergency departments (EDs). This systematic review aimed to identify existing musculoskeletal quality indicators (QIs) developed for ED use and to critically evaluate their methodological quality. MEDLINE, EMBASE, CINAHL, and the gray literature, including relevant organizational websites, were searched in 2013. English-language articles were included that described the development of at least one QI related to the ED care of musculoskeletal injuries. Data extraction of each included article was conducted. A quality assessment was then performed by rating each relevant QI against the Appraisal of Indicators through Research and Evaluation (AIRE) Instrument. QIs with similar definitions were grouped together and categorized according to the health care quality frameworks of Donabedian and the Institute of Medicine. The search revealed 1,805 potentially relevant articles, of which 15 were finally included in the review. The number of relevant QIs per article ranged from one to 11, resulting in a total of 71 QIs overall. Pain (n = 17) and fracture management (n = 13) QIs were predominant. Ten QIs scored at least 50% across all AIRE Instrument domains, and these related to pain management and appropriate imaging of the spine. Methodological quality of the development of most QIs is poor. Recommendations for a core set of QIs that address the complete spectrum of musculoskeletal injury management in emergency medicine is not possible, and more work is needed. Currently, QIs with highest methodological quality are in the areas of pain management and medical imaging. © 2015 by the Society for Academic Emergency Medicine.

Quality of life assessment in children: a review of conceptual and methodological issues in multidimensional health status measures.

PubMed Central

Pal, D K

1996-01-01

STUDY OBJECTIVE: To clarify concepts and methodological problems in existing multidimensional health status measures for children. DESIGN: Thematic review of instruments found by computerised and manual searches, 1979-95. SUBJECTS: Nine health status instruments. MAIN RESULTS: Many instruments did not satisfy criteria of being child centered or family focussed; few had sufficient psychometric properties for research or clinical use; underlying conceptual assumptions were rarely explicit. CONCLUSIONS: Quality of life measures should be viewed cautiously. Interdisciplinary discussion is required, as well as discussion with children and parents, to establish constructs that are truly useful. PMID:8882220

Development of Innovative Business Model of Modern Manager's Qualities

ERIC Educational Resources Information Center

Yashkova, Elena V.; Sineva, Nadezda L.; Shkunova, Angelika A.; Bystrova, Natalia V.; Smirnova, Zhanna V.; Kolosova, Tatyana V.

2016-01-01

The paper defines a complex of manager's qualities based on theoretical and methodological analysis and synthesis methods, available national and world literature, research papers and publications. The complex approach methodology was used, which provides an innovative view of the development of modern manager's qualities. The methodological…

Applying Lean principles and Kaizen rapid improvement events in public health practice.

PubMed

Smith, Gene; Poteat-Godwin, Annah; Harrison, Lisa Macon; Randolph, Greg D

2012-01-01

This case study describes a local home health and hospice agency's effort to implement Lean principles and Kaizen methodology as a rapid improvement approach to quality improvement. The agency created a cross-functional team, followed Lean Kaizen methodology, and made significant improvements in scheduling time for home health nurses that resulted in reduced operational costs, improved working conditions, and multiple organizational efficiencies.

Terrorism, Radicalisation, Extremism, Authoritarianism and Fundamentalism: A Systematic Review of the Quality and Psychometric Properties of Assessments.

PubMed

Scarcella, Akimi; Page, Ruairi; Furtado, Vivek

2016-01-01

Currently, terrorism and suicide bombing are global psychosocial processes that attracts a growing number of psychological and psychiatric contributions to enhance practical counter-terrorism measures. The present study is a systematic review that explores the methodological quality reporting and the psychometric soundness of the instruments developed to identify risk factors of terrorism, extremism, radicalisation, authoritarianism and fundamentalism. A systematic search strategy was established to identify instruments and studies developed to screen individuals at risk of committing extremist or terrorist offences using 20 different databases across the fields of law, medicine, psychology, sociology and politics. Information extracted was consolidated into two different tables and a 26-item checklist, reporting respectively background information, the psychometric properties of each tool, and the methodological quality markers of these tools. 37 articles met our criteria, which included a total of 4 instruments to be used operationally by professionals, 17 tools developed as research measures, and 9 inventories that have not been generated from a study. Just over half of the methodological quality markers required for a transparent methodological description of the instruments were reported. The amount of reported psychological properties was even fewer, with only a third of them available across the different studies. The category presenting the least satisfactory results was that containing the 4 instruments to be used operationally by professionals, which can be explained by the fact that half of them refrained from publishing the major part of their findings and relevant guidelines. A great number of flaws have been identified through this systematic review. The authors encourage future researchers to be more thorough, comprehensive and transparent in their methodology. They also recommend the creation of a multi-disciplinary joint working group in order to best tackle this growing contemporary problem.

Quality Assurance of UMLS Semantic Type Assignments Using SNOMED CT Hierarchies.

PubMed

Gu, H; Chen, Y; He, Z; Halper, M; Chen, L

2016-01-01

The Unified Medical Language System (UMLS) is one of the largest biomedical terminological systems, with over 2.5 million concepts in its Metathesaurus repository. The UMLS's Semantic Network (SN) with its collection of 133 high-level semantic types serves as an abstraction layer on top of the Metathesaurus. In particular, the SN elaborates an aspect of the Metathesaurus's concepts via the assignment of one or more types to each concept. Due to the scope and complexity of the Metathesaurus, errors are all but inevitable in this semantic-type assignment process. To develop a semi-automated methodology to help assure the quality of semantic-type assignments within the UMLS. The methodology uses a cross-validation strategy involving SNOMED CT's hierarchies in combination with UMLS semantic types. Semantically uniform, disjoint concept groups are generated programmatically by partitioning the collection of all concepts in the same SNOMED CT hierarchy according to their respective semantic-type assignments in the UMLS. Domain experts are then called upon to review the concepts in any group having a small number of concepts. It is our hypothesis that a semantic-type assignment combination applicable only to a very small number of concepts in a SNOMED CT hierarchy is an indicator of potential problems. The methodology was applied to the UMLS 2013AA release along with the SNOMED CT from January 2013. An overall error rate of 33% was found for concepts proposed by the quality-assurance methodology. Supporting our hypothesis, that number was four times higher than the error rate found in control samples. The results show that the quality-assurance methodology can aid in effective and efficient identification of UMLS semantic-type assignment errors.

Virtual reality exposure therapy for the treatment of posttraumatic stress disorder: a methodological review using CONSORT guidelines.

PubMed

Motraghi, Terri E; Seim, Richard W; Meyer, Eric C; Morissette, Sandra B

2014-03-01

Virtual reality exposure therapy (VRET) is an extension of traditional exposure therapy and has been used to treat a variety of anxiety disorders. VRET utilizes a computer-generated virtual environment to present fear-relevant stimuli. Recent studies have evaluated the use of VRET for treatment of PTSD; however, a systematic evaluation of the methodological quality of these studies has yet to be conducted. This review aims to (a) identify treatment outcome studies examining the use of VRET for the treatment of PTSD and (b) appraise the methodological quality of each study using the 2010 Consolidating Standards of Reporting Trials (CONSORT) Statement and its 2008 extension for nonpharmacologic interventions. Two independent assessors conducted a database search (PsycINFO, Medline, CINAHL, Google Scholar) of studies published between January 1990 and June 2013 that reported outcome data comparing VRET with another type of treatment or a control condition. Next, a CONSORT quality appraisal of each study was completed. The search yielded nine unique studies. The CONSORT appraisal revealed that the methodological quality of studies examining VRET as a treatment for PTSD was variable. Although preliminary findings suggest some positive results for VRET as a form of exposure treatment for PTSD, additional research using well-specified randomization procedures, assessor blinding, and monitoring of treatment adherence is warranted. Movement toward greater standardization of treatment manuals, virtual environments, and equipment would further facilitate interpretation and consolidation of this literature. © 2013 Wiley Periodicals, Inc.

Nonlinear Flying Qualities Criteria for Large-Amplitude Maneuvers

DTIC Science & Technology

1984-12-01

theory which are pertinent to the formation of a nonlinear flying qualities methodology. This report surveys nonlinear system theory and describes...the development of an applied flying qualities methodology based on a canonical system theory and using research in relative controllability...The Nonlinear Flying Qualities (NFQ) for Large-Amplitude Maneuvers Program examined promising techniques from nonlinear analysis and nonlinear system

Does updating improve the methodological and reporting quality of systematic reviews?

PubMed

Shea, Beverley; Boers, Maarten; Grimshaw, Jeremy M; Hamel, Candyce; Bouter, Lex M

2006-06-13

Systematic reviews (SRs) must be of high quality. The purpose of our research was to compare the methodological and reporting quality of original versus updated Cochrane SRs to determine whether updating had improved these two quality dimensions. We identified updated Cochrane SRs published in issue 4, 2002 of the Cochrane Library. We assessed the updated and original versions of the SRs using two instruments: the 10 item enhanced Overview Quality Assessment Questionnaire (OQAQ), and an 18-item reporting quality checklist and flow chart based upon the Quality of Reporting of Meta-analyses (QUOROM) statement. At least two reviewers extracted data and assessed quality. We calculated the percentage (with a 95% confidence interval) of 'yes' answers to each question. We calculated mean differences in percentage, 95% confidence intervals and p-values for each of the individual items and the overall methodological quality score of the updated and pre-updated versions using OQAQ. We assessed 53 SRs. There was no significant improvement in the global quality score of the OQAQ (mean difference 0.11 (-0.28; 0.70 p = 0.52)). Updated reviews showed a significant improvement of 18.9 (7.2; 30.6 p < .01) on the OQAQ item assessing whether the conclusions drawn by the author(s) were supported by the data and/or analysis presented in the SR. The QUOROM statement showed that the quality of reporting of Cochrane reviews improved in some areas with updating. Improvements were seen on the items relating to data sources reported in the abstract, with a significant difference of 17.0 (9.8; 28.7 p = 0.01), review methods, reported in the abstract 35 (24.1; 49.1 p = 0.00), searching methods 18.9 (9.7; 31.6 p = 0.01), and data abstraction 18.9 (11.7; 30.9 p = 0.00). The overall quality of Cochrane SRs is fair-to-good. Although reporting quality improved on certain individual items there was no overall improvement seen with updating and methodological quality remained unchanged. Further improvement of quality of reporting is possible. There is room for improvement of methodological quality as well. Authors updating reviews should address identified methodological or reporting weaknesses. We recommend to give full attention to both quality domains when updating SRs.

Prevalence of self-medication in the adult population of Brazil: a systematic review

PubMed Central

Domingues, Paulo Henrique Faria; Galvão, Taís Freire; de Andrade, Keitty Regina Cordeiro; de Sá, Pedro Terra Teles; Silva, Marcus Tolentino; Pereira, Mauricio Gomes

2015-01-01

OBJECTIVE To evaluate the prevalence of self-medication in Brazil’s adult population. METHODS Systematic review of cross-sectional population-based studies. The following databases were used: Medline, Embase, Scopus, ISI, CINAHL, Cochrane Library, CRD, Lilacs, SciELO, the Banco de teses brasileiras (Brazilian theses database) (Capes) and files from the Portal Domínio Público (Brazilian Public Domain). In addition, the reference lists from relevant studies were examined to identify potentially eligible articles. There were no applied restrictions in terms of the publication date, language or publication status. Data related to publication, population, methods and prevalence of self-medication were extracted by three independent researchers. Methodological quality was assessed following eight criteria related to sampling, measurement and presentation of results. The prevalences were measured from participants who used at least one medication during the recall period of the studies. RESULTS The literature screening identified 2,778 records, from which 12 were included for analysis. Most studies were conducted in the Southeastern region of Brazil, after 2000 and with a 15-day recall period. Only five studies achieved high methodological quality, of which one study had a 7-day recall period, in which the prevalence of self-medication was 22.9% (95%CI 14.6;33.9). The prevalence of self-medication in three studies of high methodological quality with a 15-day recall period was 35.0% (95%CI 29.0;40.0, I2 = 83.9%) in the adult Brazilian population. CONCLUSIONS Despite differences in the methodologies of the included studies, the results of this systematic review indicate that a significant proportion of the adult Brazilian population self-medicates. It is suggested that future research projects that assess self-medication in Brazil standardize their methods. PMID:26083944

Impact Evaluation of Quality Assurance in Higher Education: Methodology and Causal Designs

ERIC Educational Resources Information Center

Leiber, Theodor; Stensaker, Bjørn; Harvey, Lee

2015-01-01

In this paper, the theoretical perspectives and general methodological elements of impact evaluation of quality assurance in higher education institutions are discussed, which should be a cornerstone of quality development in higher education and contribute to improving the knowledge about the effectiveness (or ineffectiveness) of quality…

Interest and limits of the six sigma methodology in medical laboratory.

PubMed

Scherrer, Florian; Bouilloux, Jean-Pierre; Calendini, Ors'Anton; Chamard, Didier; Cornu, François

2017-02-01

The mandatory accreditation of clinical laboratories in France provides an incentive to develop real tools to measure performance management methods and to optimize the management of internal quality controls. Six sigma methodology is an approach commonly applied to software quality management and discussed in numerous publications. This paper discusses the primary factors that influence the sigma index (the choice of the total allowable error, the approach used to address bias) and compares the performance of different analyzers on the basis of the sigma index. Six sigma strategy can be applied to the policy management of internal quality control in a laboratory and demonstrates through a comparison of four analyzers that there is no single superior analyzer in clinical chemistry. Similar sigma results are obtained using approaches toward bias based on the EQAS or the IQC. The main difficulty in using the six sigma methodology lies in the absence of official guidelines for the definition of the total error acceptable. Despite this drawback, our comparison study suggests that difficulties with defined analytes do not vary with the analyzer used.

How effective is the comprehensive approach to rehabilitation (CARe) methodology? A cluster randomized controlled trial.

PubMed

Bitter, Neis; Roeg, Diana; van Assen, Marcel; van Nieuwenhuizen, Chijs; van Weeghel, Jaap

2017-12-11

The CARe methodology aims to improve the quality of life of people with severe mental illness by supporting them in realizing their goals, handling their vulnerability and improving the quality of their social environment. This study aims to investigate the effectiveness of the CARe methodology for people with severe mental illness on their quality of life, personal recovery, participation, hope, empowerment, self-efficacy beliefs and unmet needs. A cluster Randomized Controlled Trial (RCT) was conducted in 14 teams of three organizations for sheltered and supported housing in the Netherlands. Teams in the intervention group received training in the CARe methodology. Teams in the control group continued working according to care as usual. Questionnaires were filled out at baseline, after 10 months and after 20 months. A total of 263 clients participated in the study. Quality of life increased in both groups, however, no differences between the intervention and control group were found. Recovery and social functioning did not change over time. Regarding the secondary outcomes, the number of unmet needs decreased in both groups. All intervention teams received the complete training program. The model fidelity at T1 was 53.4% for the intervention group and 33.4% for the control group. At T2 this was 50.6% for the intervention group and 37.2% for the control group. All clients improved in quality of life. However we did not find significant differences between the clients of the both conditions on any outcome measure. Possible explanations of these results are: the difficulty to implement rehabilitation-supporting practice, the content of the methodology and the difficulty to improve the lives of a group of people with longstanding and severe impairments in a relatively short period. More research is needed on how to improve effects of rehabilitation trainings in practice and on outcome level. ISRCTN77355880 , retrospectively registered (05/07/2013).

Methodology in diagnostic laboratory test research in clinical chemistry and clinical chemistry and laboratory medicine.

PubMed

Lumbreras-Lacarra, Blanca; Ramos-Rincón, José Manuel; Hernández-Aguado, Ildefonso

2004-03-01

The application of epidemiologic principles to clinical diagnosis has been less developed than in other clinical areas. Knowledge of the main flaws affecting diagnostic laboratory test research is the first step for improving its quality. We assessed the methodologic aspects of articles on laboratory tests. We included articles that estimated indexes of diagnostic accuracy (sensitivity and specificity) and were published in Clinical Chemistry or Clinical Chemistry and Laboratory Medicine in 1996, 2001, and 2002. Clinical Chemistry has paid special attention to this field of research since 1996 by publishing recommendations, checklists, and reviews. Articles were identified through electronic searches in Medline. The strategy combined the Mesh term "sensitivity and specificity" (exploded) with the text words "specificity", "false negative", and "accuracy". We examined adherence to seven methodologic criteria used in the study by Reid et al. (JAMA1995;274:645-51) of papers published in general medical journals. Three observers evaluated each article independently. Seventy-nine articles fulfilled the inclusion criteria. The percentage of studies that satisfied each criterion improved from 1996 to 2002. Substantial improvement was observed in reporting of the statistical uncertainty of indices of diagnostic accuracy, in criteria based on clinical information from the study population (spectrum composition), and in avoidance of workup bias. Analytical reproducibility was reported frequently (68%), whereas information about indeterminate results was rarely provided. The mean number of methodologic criteria satisfied showed a statistically significant increase over the 3 years in Clinical Chemistry but not in Clinical Chemistry and Laboratory Medicine. The methodologic quality of the articles on diagnostic test research published in Clinical Chemistry and Clinical Chemistry and Laboratory Medicine is comparable to the quality observed in the best general medical journals. The methodologic aspects that most need improvement are those linked to the clinical information of the populations studied. Editorial actions aimed to increase the quality of reporting of diagnostic studies could have a relevant positive effect, as shown by the improvement observed in Clinical Chemistry.

A Systematic Review of Economic Evaluation Methodologies Between Resource-Limited and Resource-Rich Countries: A Case of Rotavirus Vaccines.

PubMed

Thiboonboon, Kittiphong; Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Rattanavipapong, Waranya; Teerawattananon, Yot

2016-12-01

For more than three decades, the number and influence of economic evaluations of healthcare interventions have been increasing and gaining attention from a policy level. However, concerns about the credibility of these studies exist, particularly in studies from low- and middle- income countries (LMICs). This analysis was performed to explore economic evaluations conducted in LMICs in terms of methodological variations, quality of reporting and evidence used for the analyses. These results were compared with those studies conducted in high-income countries (HICs). Rotavirus vaccine was selected as a case study, as it is one of the interventions that many studies in both settings have explored. The search to identify individual studies on rotavirus vaccines was performed in March 2014 using MEDLINE and the National Health Service Economic Evaluation Database. Only full economic evaluations, comparing cost and outcomes of at least two alternatives, were included for review. Selected criteria were applied to assess methodological variation, quality of reporting and quality of evidence used. Eighty-five studies were included, consisting of 45 studies in HICs and 40 studies in LMICs. Seventy-five percent of the studies in LMICs were published by researchers from HICs. Compared with studies in HICs, the LMIC studies showed less methodological variety. In terms of the quality of reporting, LMICs had a high adherence to technical criteria, but HICs ultimately proved to be better. The same trend applied for the quality of evidence used. Although the quality of economic evaluations in LMICs was not as high as those from HICs, it is of an acceptable level given several limitations that exist in these settings. However, the results of this study may not reflect the fact that LMICs have developed a better research capacity in the domain of health economics, given that most of the studies were in theory led by researchers from HICs. Putting more effort into fostering the development of both research infrastructure and capacity building as well as encouraging local engagement in LMICs is thus necessary.

[Evaluation of the methodological quality of the Rémic (microbiology guidelines - bacteriology and mycology) of the Société française de microbiologie].

PubMed

Fonfrède, Michèle; Couaillac, Jean Paul; Augereau, Christine; De Moüy, Danny; Lepargneur, Jean Pierre; Szymanowicz, Anton; Watine, Joseph

2011-01-01

We have evaluated the methodological quality of the Rémic (microbiology guidelines - bacteriology and mycology) of the Société française de microbiologie (edition2007), using to AGREE criteria, which are consensual at an international level, in particular at the the World Health Organisation (WHO) and at the European Union. The methodological quality of the Rémic appears to be sub-optimal. These shortcomings in quality are mainly observed in AGREE domain n° 5 (applicability), in AGREE item n° 5 (patients' opinions were not considered), and in AGREE item n° 23 (conflicts of interest were not declared). The users of the Rémic must be aware of these few methodological shortcomings in order for them to be careful before they put its recommendation in practice. In conclusion, we advise the editors of the Rémic to insert at least a methodological chapter in their next edition.

Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation.

PubMed

Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

2017-02-01

To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Palestinian Primary Healthcare Centres. Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological quality of diabetic guideline. The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach's α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains 'Scope and Purpose' and 'Clarity of Presentation' had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for 'Applicability', 'Stakeholder Involvement', 'Rigour of Development' and 'Editorial Independence' were the lowest (27%, 35%, 36.5%, and 40%, respectively). The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group.

[Evaluation of quality of service in Early Intervention: A systematic review].

PubMed

Jemes Campaña, Inmaculada Concepción; Romero-Galisteo, Rita Pilar; Labajos Manzanares, María Teresa; Moreno Morales, Noelia

2018-06-07

Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "good" or "reasonable" score based on the COSMIN scale. Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Interventional Radiology Clinical Practice Guideline Recommendations for Neurovascular Disorders Are Not Based on High-Quality Systematic Reviews.

PubMed

Chong, A B; Taylor, M; Schubert, G; Vassar, M

2017-04-01

In recent years, clinical practice guidelines have been criticized for biased interpretations of research evidence, and interventional radiology is no exception. Our aim was to evaluate the methodologic quality and transparency of reporting in systematic reviews used as evidence in interventional radiology clinical practice guidelines for neurovascular disorders from the Society of Interventional Radiology. Our sources were 9 neurovascular disorder clinical practice guidelines from the Society of Interventional Radiology. We selected 65 systematic reviews and meta-analyses. A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) tools were used to assess the methodologic quality and reporting transparency of systematic reviews. Radial plots were created on the basis of average scores for PRISMA and AMSTAR items. On the basis of AMSTAR scores, 3 (4.62%) reviews were high-quality, 28 reviews (43.08%) were moderate-quality, and 34 reviews (52.31%) were low-quality, with an average quality score of 3.66 (34.32%; minimum, 0%; maximum, 81.82%). The average PRISMA score was 18.18 (69.41%). We were unable to obtain previous versions for 8 reviews, 7 of which were from the Cochrane Database of Systematic Reviews. The methodologic quality of systematic reviews needs to be improved. Although reporting clarity was much better than the methodologic quality, it still has room for improvement. The methodologic quality and transparency of reporting did not vary much among clinical practice guidelines. This study can also be applied to other medical specialties to examine the quality of studies used as evidence in their own clinical practice guidelines. © 2017 by American Journal of Neuroradiology.

Development of cookies made with cocoyam, fermented sorghum and germinated pigeon pea flour blends using response surface methodology.

PubMed

Okpala, Laura C; Okoli, Eric C

2014-10-01

Cookies were produced from blends of cocoyam, fermented sorghum and germinated pigeon pea flours. The study was carried out to evaluate the effects of varying the proportions of these components on the sensory and protein quality of the cookies. The sensory attributes studied were colour, taste, texture, crispness and general acceptability while the protein quality indices were biological value (BV) and net protein utilization (NPU). Mixture response surface methodology was used to model the sensory and protein quality with single, binary and ternary combinations of germinated pigeon pea, fermented sorghum and cocoyam flours. Results showed that BV and NPU of most of the cookies were above minimum acceptable levels. With the exception of cookies containing high levels of pigeon pea flour, cookies had acceptable sensory scores. Increase in pigeon pea flour resulted in increase in the BV and NPU. Regression equations suggested that the ternary blends produced the highest increase in all the sensory attributes (with the exception of colour).

Methodology and reporting of diagnostic accuracy studies of automated perimetry in glaucoma: evaluation using a standardised approach.

PubMed

Fidalgo, Bruno M R; Crabb, David P; Lawrenson, John G

2015-05-01

To evaluate methodological and reporting quality of diagnostic accuracy studies of perimetry in glaucoma and to determine whether there had been any improvement since the publication of the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines. A systematic review of English language articles published between 1993 and 2013 reporting the diagnostic accuracy of perimetry in glaucoma. Articles were appraised for methodological quality using the 14-item Quality assessment tool for diagnostic accuracy studies (QUADAS) and evaluated for quality of reporting by applying the STARD checklist. Fifty-eight articles were appraised. Overall methodological quality of these studies was moderate with a median number of QUADAS items rated as 'yes' equal to nine (out of a maximum of 14) (IQR 7-10). The studies were often poorly reported; median score of STARD items fully reported was 11 out of 25 (IQR 10-14). A comparison of the studies published in 10-year periods before and after the publication of the STARD checklist in 2003 found quality of reporting had not substantially improved. Methodological and reporting quality of diagnostic accuracy studies of perimetry is sub-optimal and appears not to have improved substantially following the development of the STARD reporting guidance. This observation is consistent with previous studies in ophthalmology and in other medical specialities. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

Methodology of quality improvement projects for the Texas Medicare population.

PubMed

Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C

1998-07-01

The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

Quantification of health benefits related with reduction of atmospheric PM₁₀ levels: implementation of population mobility approach.

PubMed

Tchepel, Oxana; Dias, Daniela

2011-06-01

This study is focused on the assessment of potential health benefits by meeting the air quality limit values (2008/50/CE) for short-term PM₁₀ exposure. For this purpose, the methodology of the WHO for Health Impact Assessment and APHEIS guidelines for data collection were applied to Porto Metropolitan Area, Portugal. Additionally, an improved methodology using population mobility data is proposed in this work to analyse number of persons exposed. In order to obtain representative background concentrations, an innovative approach to process air quality time series was implemented. The results provide the number of attributable cases prevented annually by reducing PM(10) concentration. An intercomparison of two approaches to process input data for the health risk analysis provides information on sensitivity of the applied methodology. The findings highlight the importance of taking into account spatial variability of the air pollution levels and population mobility in the health impact assessment.

Systematic review of guidelines for management of intermediate hepatocellular carcinoma using the Appraisal of Guidelines Research and Evaluation II instrument.

PubMed

Holvoet, Tom; Raevens, Sarah; Vandewynckel, Yves-Paul; Van Biesen, Wim; Geboes, Karen; Van Vlierberghe, Hans

2015-10-01

Hepatocellular carcinoma is the second leading cause of cancer-related mortality worldwide. Multiple guidelines have been developed to assist clinicians in its management. We aimed to explore methodological quality of these guidelines focusing on treatment of intermediate hepatocellular carcinoma by transarterial chemoembolization. A systematic search was performed for Clinical Practice Guidelines and Consensus statements for hepatocellular carcinoma management. Guideline quality was appraised using the Appraisal of Guidelines Research and Evaluation II instrument, which rates guideline development processes across 6 domains: 'Scope and purpose', 'Stakeholder involvement', 'Rigour of development', 'Clarity of presentation', 'Applicability' and 'Editorial independence'. Thematic analysis of guidelines was performed to map differences in recommendations. Quality of 21 included guidelines varied widely, but was overall poor with only one guideline passing the 50% mark on all domains. Key recommendations as (contra)indications and technical aspects were inconsistent between guidelines. Aspects on side effects and health economics were mainly neglected. Methodological quality of guidelines on transarterial chemoembolization in hepatocellular carcinoma management is poor. This results in important discrepancies between guideline recommendations, creating confusion in clinical practice. Incorporation of the Appraisal of Guidelines Research and Evaluation II instrument in guideline development may improve quality of future guidelines by increasing focus on methodological aspects. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Identifying approaches for assessing methodological and reporting quality of systematic reviews: a descriptive study.

PubMed

Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle; Mayhew, Alain; Skidmore, Becky; Stevens, Adrienne; Boutron, Isabelle; Sarkis-Onofre, Rafael; Bjerre, Lise M; Hróbjartsson, Asbjørn; Altman, Douglas G; Moher, David

2017-06-19

The methodological quality and completeness of reporting of the systematic reviews (SRs) is fundamental to optimal implementation of evidence-based health care and the reduction of research waste. Methods exist to appraise SRs yet little is known about how they are used in SRs or where there are potential gaps in research best-practice guidance materials. The aims of this study are to identify reports assessing the methodological quality (MQ) and/or reporting quality (RQ) of a cohort of SRs and to assess their number, general characteristics, and approaches to 'quality' assessment over time. The Cochrane Library, MEDLINE®, and EMBASE® were searched from January 1990 to October 16, 2014, for reports assessing MQ and/or RQ of SRs. Title, abstract, and full-text screening of all reports were conducted independently by two reviewers. Reports assessing the MQ and/or RQ of a cohort of ten or more SRs of interventions were included. All results are reported as frequencies and percentages of reports. Of 20,765 unique records retrieved, 1189 of them were reviewed for full-text review, of which 76 reports were included. Eight previously published approaches to assessing MQ or reporting guidelines used as proxy to assess RQ were used in 80% (61/76) of identified reports. These included two reporting guidelines (PRISMA and QUOROM) and five quality assessment tools (AMSTAR, R-AMSTAR, OQAQ, Mulrow, Sacks) and GRADE criteria. The remaining 24% (18/76) of reports developed their own criteria. PRISMA, OQAQ, and AMSTAR were the most commonly used published tools to assess MQ or RQ. In conjunction with other approaches, published tools were used in 29% (22/76) of reports, with 36% (8/22) assessing adherence to both PRISMA and AMSTAR criteria and 26% (6/22) using QUOROM and OQAQ. The methods used to assess quality of SRs are diverse, and none has become universally accepted. The most commonly used quality assessment tools are AMSTAR, OQAQ, and PRISMA. As new tools and guidelines are developed to improve both the MQ and RQ of SRs, authors of methodological studies are encouraged to put thoughtful consideration into the use of appropriate tools to assess quality and reporting.

Methodological quality of systematic reviews on treatments for depression: a cross-sectional study.

PubMed

Chung, V C H; Wu, X Y; Feng, Y; Ho, R S T; Wong, S Y S; Threapleton, D

2017-05-02

Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments. A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis. A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an 'a priori' design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report 'a priori' designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09-1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06-1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06-1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81-0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04-1.25), completed by more review authors (AOR 1.12, 95% CI 1.01-1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01-2.59) were associated with better performance in publication bias assessment. The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.

EQUIP: A European Survey of Quality Criteria for the Evaluation of Databases.

ERIC Educational Resources Information Center

Wilson, T. D.

1998-01-01

Reports on two stages of an investigation into the perceived quality of online databases. Presents data from 989 questionnaires from 600 database users in 12 European and Scandinavian countries and results of a test of the SERVQUAL methodology for identifying user expectations about database services. Lists statements used in the SERVQUAL survey.…

Towards a Predictive Model of Quality in Canadian Child Care Centers

ERIC Educational Resources Information Center

Goelman, Hillel; Forer, Barry; Kershaw, Paul; Doherty, Gillian; Lero, Donna; LaGrange, Annette

2006-01-01

This paper reports on the design, methodology, and results of a study of quality in 326 classrooms in 239 Canadian child care centers. This study, the largest and most extensive ever undertaken in Canada, used the Caregiver Interaction Scale (CIS) to rate the adult-child interactions in the classrooms and the Infant-Toddler Environment Rating…

Visual land-use compatibility and scenic-resource quality

Treesearch

William G. Hendrix

1977-01-01

The effect that land-use relationships have upon perceived quality of the visual landscape is discussed, and a case is made for expansion of fit-misfit theory into what has been called visual land-use compatibility. An assessment methodology that was designed to test people's perceptions of land-use relationships is presented and the results are discussed.

A Retention Assessment Process: Utilizing Total Quality Management Principles and Focus Groups

ERIC Educational Resources Information Center

Codjoe, Henry M.; Helms, Marilyn M.

2005-01-01

Retaining students is a critical topic in higher education. Methodologies abound to gather attrition data as well as key variables important to retention. Using the theories of total quality management and focus groups, this case study gathers and reports data from current college students. Key results, suggestions for replication, and areas for…

Unique Nature of the Quality of Life in the Context of Extreme Climatic, Geographical and Specific Socio-Cultural Living Conditions

ERIC Educational Resources Information Center

Kulik, Anastasia; Neyaskina, Yuliya; Frizen, Marina; Shiryaeva, Olga; Surikova, Yana

2016-01-01

This article presents the results of a detailed empirical research, aimed at studying the quality of life in the context of extreme climatic, geographical and specific sociocultural living conditions. Our research is based on the methodological approach including social, economical, ecological and psychological characteristics and reflecting…

Application of Autonomous Smart Inverter Volt-VAR Function for Voltage Reduction Energy Savings and Power Quality in Electric Distribution Systems: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ding, Fei; Nagarajan, Adarsh; Baggu, Murali

This paper evaluated the impact of smart inverter Volt-VAR function on voltage reduction energy saving and power quality in electric power distribution systems. A methodology to implement the voltage reduction optimization was developed by controlling the substation LTC and capacitor banks, and having smart inverters participate through their autonomous Volt-VAR control. In addition, a power quality scoring methodology was proposed and utilized to quantify the effect on power distribution system power quality. All of these methodologies were applied to a utility distribution system model to evaluate the voltage reduction energy saving and power quality under various PV penetrations and smartmore » inverter densities.« less

The reliability of the Glasgow Coma Scale: a systematic review.

PubMed

Reith, Florence C M; Van den Brande, Ruben; Synnot, Anneliese; Gruen, Russell; Maas, Andrew I R

2016-01-01

The Glasgow Coma Scale (GCS) provides a structured method for assessment of the level of consciousness. Its derived sum score is applied in research and adopted in intensive care unit scoring systems. Controversy exists on the reliability of the GCS. The aim of this systematic review was to summarize evidence on the reliability of the GCS. A literature search was undertaken in MEDLINE, EMBASE and CINAHL. Observational studies that assessed the reliability of the GCS, expressed by a statistical measure, were included. Methodological quality was evaluated with the consensus-based standards for the selection of health measurement instruments checklist and its influence on results considered. Reliability estimates were synthesized narratively. We identified 52 relevant studies that showed significant heterogeneity in the type of reliability estimates used, patients studied, setting and characteristics of observers. Methodological quality was good (n = 7), fair (n = 18) or poor (n = 27). In good quality studies, kappa values were ≥0.6 in 85%, and all intraclass correlation coefficients indicated excellent reliability. Poor quality studies showed lower reliability estimates. Reliability for the GCS components was higher than for the sum score. Factors that may influence reliability include education and training, the level of consciousness and type of stimuli used. Only 13% of studies were of good quality and inconsistency in reported reliability estimates was found. Although the reliability was adequate in good quality studies, further improvement is desirable. From a methodological perspective, the quality of reliability studies needs to be improved. From a clinical perspective, a renewed focus on training/education and standardization of assessment is required.

Interventions to improve parental communication about sex: a systematic review.

PubMed

Akers, Aletha Y; Holland, Cynthia L; Bost, James

2011-03-01

The relative effectiveness of interventions to improve parental communication with adolescents about sex is not known. To compare the effectiveness and methodologic quality of interventions for improving parental communication with adolescents about sex. We searched 6 databases: OVID/Medline, PsychInfo, ERIC, Cochrane Review, Communication and Mass Media, and the Cumulative Index to Nursing and Allied Health Literature. We included studies published between 1980 and July 2010 in peer-reviewed English-language journals that targeted US parents of adolescents aged 11 to 18 years, used an experimental or quasi-experimental design, included a control group, and had a pretest/posttest design. We abstracted data on multiple communication outcomes defined by the integrative conceptual model (communication frequency, content, skills, intentions, self-efficacy, perceived environmental barriers/facilitators, perceived social norms, attitudes, outcome expectations, knowledge, and beliefs). Methodologic quality was assessed using the 11-item methodologic quality score. Twelve studies met inclusion criteria. Compared with controls, parents who participated in these interventions experienced improvements in multiple communication domains including the frequency, quality, intentions, comfort, and self-efficacy for communicating. We noted no effects on parental attitudes toward communicating or the outcomes they expected to occur as a result of communicating. Four studies were of high quality, 7 were of medium quality, and 1 was of lower quality. Our review was limited by the lack of standardized measures for assessing parental communication. Still, interventions for improving parent-adolescent sex communication are well designed and have some targeted effects. Wider dissemination could augment efforts by schools, clinicians, and health educators.

The baby or the bath water? Lessons learned from the National Action Alliance for Suicide Prevention Research Prioritization Task Force literature review.

PubMed

Davis Molock, Sherry; Heekin, Janet M; Matlin, Samantha G; Barksdale, Crystal L; Gray, Ekwenzi; Booth, Chelsea L

2014-09-01

The Research Prioritization Task Force of the National Action Alliance for Suicide Prevention conducted a comprehensive literature review of suicide prevention/intervention trials to assess the quality of the scientific evidence. A literature "review of reviews" was conducted by searching the most widely used databases for mental health and public health research. The quality of the reviews was evaluated using the Revised Assessment of Multiple Systematic Reviews system; the quality of the scientific evidence for the suicide preventions/interventions was assessed using U.S. Preventive Services Task Force criteria. The reviews were limited to peer-reviewed publications with human subjects published in English. Ninety-eight systematic reviews and 45 primary sources on suicide prevention/interventions published between January 2000 and September 2012 were evaluated. The results suggest that the quality of both the systematic reviews and the scientific evidence for suicide preventions/interventions were mixed. The majority of the systematic reviews and prevention/interventions were evaluated as fair to poor in quality. There are many promising suicide prevention/intervention trials, but research findings are often inconclusive because of methodologic problems. Methodologic problems across systematic reviews include not conducting hand searches, not surveying gray literature, and being unable to aggregate data across studies. Methodologic problems with the scientific quality of the prevention/intervention trials include paucity of information on sample demographic characteristics, poorly defined outcomes, and excluding actively suicidal participants. Suggestions for ways to improve the quality of the systematic reviews and suicide preventions/interventions are provided. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Research across the disciplines: a road map for quality criteria in empirical ethics research.

PubMed

Mertz, Marcel; Inthorn, Julia; Renz, Günter; Rothenberger, Lillian Geza; Salloch, Sabine; Schildmann, Jan; Wöhlke, Sabine; Schicktanz, Silke

2014-03-01

Research in the field of Empirical Ethics (EE) uses a broad variety of empirical methodologies, such as surveys, interviews and observation, developed in disciplines such as sociology, anthropology, and psychology. Whereas these empirical disciplines see themselves as purely descriptive, EE also aims at normative reflection. Currently there is literature about the quality of empirical research in ethics, but little or no reflection on specific methodological aspects that must be considered when conducting interdisciplinary empirical ethics. Furthermore, poor methodology in an EE study results in misleading ethical analyses, evaluations or recommendations. This not only deprives the study of scientific and social value, but also risks ethical misjudgement. While empirical and normative-ethical research projects have quality criteria in their own right, we focus on the specific quality criteria for EE research. We develop a tentative list of quality criteria--a "road map"--tailored to interdisciplinary research in EE, to guide assessments of research quality. These quality criteria fall into the categories of primary research question, theoretical framework and methods, relevance, interdisciplinary research practice and research ethics and scientific ethos. EE research is an important and innovative development in bioethics. However, a lack of standards has led to concerns about and even rejection of EE by various scholars. Our suggested orientation list of criteria, presented in the form of reflective questions, cannot be considered definitive, but serves as a tool to provoke systematic reflection during the planning and composition of an EE research study. These criteria need to be tested in different EE research settings and further refined.

Research across the disciplines: a road map for quality criteria in empirical ethics research

PubMed Central

2014-01-01

Background Research in the field of Empirical Ethics (EE) uses a broad variety of empirical methodologies, such as surveys, interviews and observation, developed in disciplines such as sociology, anthropology, and psychology. Whereas these empirical disciplines see themselves as purely descriptive, EE also aims at normative reflection. Currently there is literature about the quality of empirical research in ethics, but little or no reflection on specific methodological aspects that must be considered when conducting interdisciplinary empirical ethics. Furthermore, poor methodology in an EE study results in misleading ethical analyses, evaluations or recommendations. This not only deprives the study of scientific and social value, but also risks ethical misjudgement. Discussion While empirical and normative-ethical research projects have quality criteria in their own right, we focus on the specific quality criteria for EE research. We develop a tentative list of quality criteria – a “road map” – tailored to interdisciplinary research in EE, to guide assessments of research quality. These quality criteria fall into the categories of primary research question, theoretical framework and methods, relevance, interdisciplinary research practice and research ethics and scientific ethos. Summary EE research is an important and innovative development in bioethics. However, a lack of standards has led to concerns about and even rejection of EE by various scholars. Our suggested orientation list of criteria, presented in the form of reflective questions, cannot be considered definitive, but serves as a tool to provoke systematic reflection during the planning and composition of an EE research study. These criteria need to be tested in different EE research settings and further refined. PMID:24580847

Correlation Between Quality of Evidence and Number of Citations in Top 50 Cited Articles on Elbow Medial Ulnar Collateral Ligament Surgery.

PubMed

Jack, Robert A; Sochacki, Kyle R; Morehouse, Hannah A; McCulloch, Patrick C; Lintner, David M; Harris, Joshua D

2018-04-01

Several studies have analyzed the most cited articles in shoulder, elbow, pediatrics, and foot and ankle surgery. However, no study has analyzed the quality of the most cited articles in elbow medial ulnar collateral ligament (UCL) surgery. To (1) identify the top 50 most cited articles related to UCL surgery, (2) determine whether there was a correlation between the top cited articles and level of evidence, and (3) determine whether there was a correlation between study methodological quality and the top cited articles. Systematic review. Web of Science and Scopus online databases were searched to identify the top 50 cited articles in UCL surgery. Level of evidence, number of times cited, year of publication, name of journal, country of origin, and study type were recorded for each study. Study methodological quality was analyzed for each article with the Modified Coleman Methodology Score (MCMS) and the Methodological Index for Non-randomized Studies (MINORS). Correlation coefficients were calculated. The 50 most cited articles were published between 1981 and 2015. The number of citations per article ranged from 20 to 301 (mean ± SD, 71 ± 62 citations). Most articles (92%) were from the United States and were level 3 (16%), level 4 (58%), or unclassified (16%) evidence. There were no articles of level 1 evidence quality. The mean MCMS and MINORS scores were 28.1 ± 13.4 (range, 3-52) and 9.2 ± 3.6 (range, 2-19), respectively. There was no significant correlation between the mean number of citations and level of evidence or quality ( r s = -0.01, P = .917), MCMS ( r s = 0.09, P = .571), or MINORS ( r s = -0.26, P = .089). The top 50 cited articles in UCL surgery constitute a low level of evidence and low methodological quality, including no level 1 articles. There was no significant correlation between the mean number of citations and level of evidence or study methodological quality. However, weak correlations were observed for later publication date and improved level of evidence and methodological quality.

Don't forget the posters! Quality and content variables associated with accepted abstracts at a national trauma meeting.

PubMed

Dossett, Lesly A; Fox, Erin E; del Junco, Deborah J; Zaydfudim, Victor; Kauffmann, Rondi; Shelton, Julia; Wang, Weiwei; Cioffi, William G; Holcomb, John B; Cotton, Bryan A

2012-05-01

As a primary venue for presenting research results, abstracts selected for presentation at national meetings should be of the highest scientific merit and research quality. It is uncertain to what degree this is achieved as the methodological quality of abstracts submitted to national surgical meetings has not been previously described. The objective of this study was to evaluate abstracts presented at a leading trauma meeting for methodological quality. All abstracts accepted for the 2009 American Association for the Surgery of Trauma meeting were reviewed and scored for methodological quality based on 10 criteria (scores, 0-10; 10 being the highest). Criteria were based on nationally published methodology guidelines. Two independent reviewers who were blinded to institution, region, and author reviewed each abstract. A total of 187 abstracts were accepted for presentation (67 oral and 120 posters). The most frequent clinical topics were shock/transfusion (23%), abdomen (12%), and nervous system (11%). Shock/transfusion abstracts were more common in the oral presentations (31% vs. 19%; p = 0.06). Abstracts from the northeast and south regions were the most common in both oral (26% and 29%) and posters (25% and 24%). Basic science accounted for 12% of accepted studies, while 51% were clinical and 28% were health services/outcomes. Only 8% of abstracts presented randomized data and only 11% reported null findings. Overall abstract scores ranged from 3 to 10 (median, 7; mean, 7.4). Abstracts selected for poster presentation had an overall higher score than those selected for oral presentation (7.4 ± 1.7 vs. 6.8 ± 1.7; p = 0.02). Although oral presentations traditionally receive the most attention and interest, the methodological quality of abstracts accepted for poster presentation equals (and sometimes exceeds) that of oral abstracts. Attendees of these national meetings should reconsider their time spent in viewing and visiting these poster sessions as with the oral presentations. In light of our findings, we highly encourage that all members and guests attend the American Association for the Surgery of Trauma Poster Rounds at each year's scientific assembly.

Quality Assurance and Its Impact from Higher Education Institutions' Perspectives: Methodological Approaches, Experiences and Expectations

ERIC Educational Resources Information Center

Bejan, Stelian Andrei; Janatuinen, Tero; Jurvelin, Jouni; Klöpping, Susanne; Malinen, Heikki; Minke, Bernhard; Vacareanu, Radu

2015-01-01

This paper reports on methodological approaches, experiences and expectations referring to impact analysis of quality assurance from the perspective of three higher education institutions (students, teaching staff, quality managers) from Germany, Finland and Romania. The presentations of the three sample institutions focus on discussing the core…

A Synthesis of a Quality Management Model for Education in Universities

ERIC Educational Resources Information Center

Srikanthan, G.; Dalrymple, John

2004-01-01

The paper attempts to synthesise the features of the model for quality management in education based on the approaches spelt out in four well-articulated methodologies for the practice of quality in higher education. Each methodology contributes to different views of education from the learners' and the institution's perspectives, providing…

Improved Atmospheric Soundings and Error Estimates from Analysis of AIRS/AMSU Data

NASA Technical Reports Server (NTRS)

Susskind, Joel

2007-01-01

The AIRS Science Team Version 5.0 retrieval algorithm became operational at the Goddard DAAC in July 2007 generating near real-time products from analysis of AIRS/AMSU sounding data. This algorithm contains many significant theoretical advances over the AIRS Science Team Version 4.0 retrieval algorithm used previously. Three very significant developments of Version 5 are: 1) the development and implementation of an improved Radiative Transfer Algorithm (RTA) which allows for accurate treatment of non-Local Thermodynamic Equilibrium (non-LTE) effects on shortwave sounding channels; 2) the development of methodology to obtain very accurate case by case product error estimates which are in turn used for quality control; and 3) development of an accurate AIRS only cloud clearing and retrieval system. These theoretical improvements taken together enabled a new methodology to be developed which further improves soundings in partially cloudy conditions, without the need for microwave observations in the cloud clearing step as has been done previously. In this methodology, longwave C02 channel observations in the spectral region 700 cm-' to 750 cm-' are used exclusively for cloud clearing purposes, while shortwave C02 channels in the spectral region 2195 cm-' to 2395 cm-' are used for temperature sounding purposes. The new methodology for improved error estimates and their use in quality control is described briefly and results are shown indicative of their accuracy. Results are also shown of forecast impact experiments assimilating AIRS Version 5.0 retrieval products in the Goddard GEOS 5 Data Assimilation System using different quality control thresholds.

Methodological issues in genetic association studies of inherited thrombophilia: original report of recent practice.

PubMed

Simundic, Ana-Maria; Nikolac, Nora; Topic, Elizabeta

2009-01-01

The aims of this article are to evaluate the methodological quality of genetic association studies on the inherited thrombophilia published during 2003 to 2005, to identify the most common mistakes made by authors of those studies, and to examine if overall quality of the article correlates with the quality of the journal. Articles were evaluated by 2 independent reviewers using the checklist of 16 items. A total of 58 eligible studies were identified. Average total score was 7.59 +/- 1.96. Total article score did not correlate with the journal impact factor (r = 0.3971; 95% confidence interval [CI], 0.1547-0.5944, P = .002). Total score did not differ across years (P = .624). Finally, it is concluded that methodological quality of genetic association studies is not optimal, and it does not depend on the quality of the journal. Journals should adopt methodological criteria for reporting the genetic association studies, and editors should encourage authors to strictly adhere to those criteria.

Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond's Checklist: A Narrative Review.

PubMed

Rezapour, Aziz; Jafari, Abdosaleh; Mirmasoudi, Kosha; Talebianpour, Hamid

2017-09-01

Health economic evaluation research plays an important role in selecting cost-effective interventions. The purpose of this study was to assess the quality of published articles in Iranian journals related to economic evaluation in health care programs based on Drummond's checklist in terms of numbers, features, and quality. In the present review study, published articles (Persian and English) in Iranian journals related to economic evaluation in health care programs were searched using electronic databases. In addition, the methodological quality of articles' structure was analyzed by Drummond's standard checklist. Based on the inclusion criteria, the search of databases resulted in 27 articles that fully covered economic evaluation in health care programs. A review of articles in accordance with Drummond's criteria showed that the majority of studies had flaws. The most common methodological weakness in the articles was in terms of cost calculation and valuation. Considering such methodological faults in these studies, it is anticipated that these studies would not provide an appropriate feedback to policy makers to allocate health care resources correctly and select suitable cost-effective interventions. Therefore, researchers are required to comply with the standard guidelines in order to better execute and report on economic evaluation studies.

Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond’s Checklist: A Narrative Review

PubMed Central

Rezapour, Aziz; Jafari, Abdosaleh; Mirmasoudi, Kosha; Talebianpour, Hamid

2017-01-01

Health economic evaluation research plays an important role in selecting cost-effective interventions. The purpose of this study was to assess the quality of published articles in Iranian journals related to economic evaluation in health care programs based on Drummond’s checklist in terms of numbers, features, and quality. In the present review study, published articles (Persian and English) in Iranian journals related to economic evaluation in health care programs were searched using electronic databases. In addition, the methodological quality of articles’ structure was analyzed by Drummond’s standard checklist. Based on the inclusion criteria, the search of databases resulted in 27 articles that fully covered economic evaluation in health care programs. A review of articles in accordance with Drummond’s criteria showed that the majority of studies had flaws. The most common methodological weakness in the articles was in terms of cost calculation and valuation. Considering such methodological faults in these studies, it is anticipated that these studies would not provide an appropriate feedback to policy makers to allocate health care resources correctly and select suitable cost-effective interventions. Therefore, researchers are required to comply with the standard guidelines in order to better execute and report on economic evaluation studies. PMID:29234174

Intentionality, degree of damage, and moral judgments.

PubMed

Berg-Cross, L G

1975-12-01

153 first graders were given Piagetian moral judgment problems with a new simplified methodology as well as the usual story-pair paradigm. The new methodology involved making quantitative judgments about single stories and examined the influence of level of intentionality and degree of damage upon absolute punishment ratings. Contrary to results obtained with a story-pair methodology, it was found that with single stories even 6-year-old children responded to the level of intention in the stories as well as the quantity and quality of damage involved. This suggested that Piaget's methodology may be forcing children to employ a simplifying strategy while under other conditions they are able to perform the mental operations necessary to make complex moral judgments.

Are validated outcome measures used in distal radial fractures truly valid?

PubMed Central

Nienhuis, R. W.; Bhandari, M.; Goslings, J. C.; Poolman, R. W.; Scholtes, V. A. B.

2016-01-01

Objectives Patient-reported outcome measures (PROMs) are often used to evaluate the outcome of treatment in patients with distal radial fractures. Which PROM to select is often based on assessment of measurement properties, such as validity and reliability. Measurement properties are assessed in clinimetric studies, and results are often reviewed without considering the methodological quality of these studies. Our aim was to systematically review the methodological quality of clinimetric studies that evaluated measurement properties of PROMs used in patients with distal radial fractures, and to make recommendations for the selection of PROMs based on the level of evidence of each individual measurement property. Methods A systematic literature search was performed in PubMed, EMbase, CINAHL and PsycINFO databases to identify relevant clinimetric studies. Two reviewers independently assessed the methodological quality of the studies on measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Level of evidence (strong / moderate / limited / lacking) for each measurement property per PROM was determined by combining the methodological quality and the results of the different clinimetric studies. Results In all, 19 out of 1508 identified unique studies were included, in which 12 PROMs were rated. The Patient-rated wrist evaluation (PRWE) and the Disabilities of Arm, Shoulder and Hand questionnaire (DASH) were evaluated on most measurement properties. The evidence for the PRWE is moderate that its reliability, validity (content and hypothesis testing), and responsiveness are good. The evidence is limited that its internal consistency and cross-cultural validity are good, and its measurement error is acceptable. There is no evidence for its structural and criterion validity. The evidence for the DASH is moderate that its responsiveness is good. The evidence is limited that its reliability and the validity on hypothesis testing are good. There is no evidence for the other measurement properties. Conclusion According to this systematic review, there is, at best, moderate evidence that the responsiveness of the PRWE and DASH are good, as are the reliability and validity of the PRWE. We recommend these PROMs in clinical studies in patients with distal radial fractures; however, more clinimetric studies of higher methodological quality are needed to adequately determine the other measurement properties. Cite this article: Dr Y. V. Kleinlugtenbelt. Are validated outcome measures used in distal radial fractures truly valid?: A critical assessment using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Bone Joint Res 2016;5:153–161. DOI: 10.1302/2046-3758.54.2000462. PMID:27132246

Reporting and methodological quality of survival analysis in articles published in Chinese oncology journals

PubMed Central

Zhu, Xiaoyan; Zhou, Xiaobin; Zhang, Yuan; Sun, Xiao; Liu, Haihua; Zhang, Yingying

2017-01-01

Abstract Survival analysis methods have gained widespread use in the filed of oncology. For achievement of reliable results, the methodological process and report quality is crucial. This review provides the first examination of methodological characteristics and reporting quality of survival analysis in articles published in leading Chinese oncology journals. To examine methodological and reporting quality of survival analysis, to identify some common deficiencies, to desirable precautions in the analysis, and relate advice for authors, readers, and editors. A total of 242 survival analysis articles were included to be evaluated from 1492 articles published in 4 leading Chinese oncology journals in 2013. Articles were evaluated according to 16 established items for proper use and reporting of survival analysis. The application rates of Kaplan–Meier, life table, log-rank test, Breslow test, and Cox proportional hazards model (Cox model) were 91.74%, 3.72%, 78.51%, 0.41%, and 46.28%, respectively, no article used the parametric method for survival analysis. Multivariate Cox model was conducted in 112 articles (46.28%). Follow-up rates were mentioned in 155 articles (64.05%), of which 4 articles were under 80% and the lowest was 75.25%, 55 articles were100%. The report rates of all types of survival endpoint were lower than 10%. Eleven of 100 articles which reported a loss to follow-up had stated how to treat it in the analysis. One hundred thirty articles (53.72%) did not perform multivariate analysis. One hundred thirty-nine articles (57.44%) did not define the survival time. Violations and omissions of methodological guidelines included no mention of pertinent checks for proportional hazard assumption; no report of testing for interactions and collinearity between independent variables; no report of calculation method of sample size. Thirty-six articles (32.74%) reported the methods of independent variable selection. The above defects could make potentially inaccurate, misleading of the reported results, or difficult to interpret. There are gaps in the conduct and reporting of survival analysis in studies published in Chinese oncology journals, severe deficiencies were noted. More endorsement by journals of the report guideline for survival analysis may improve articles quality, and the dissemination of reliable evidence to oncology clinicians. We recommend authors, readers, reviewers, and editors to consider survival analysis more carefully and cooperate more closely with statisticians and epidemiologists. PMID:29390340

Development and implementation of an audit tool for quality control of parenteral nutrition.

PubMed

García-Rodicio, Sonsoles; Abajo, Celia; Godoy, Mercedes; Catalá, Miguel Angel

2009-01-01

The aim of this article is to describe the development of a quality control methodology applied to patients receiving parenteral nutrition (PN) and to present the results obtained over the past 10 years. Development of the audit tool: In 1995, a total of 13 PN quality criteria and their standards were defined based on literature and past experiences. They were applied during 5 different 6-month audits carried out in subsequent years. According to the results of each audit, the criteria with lower validity were eliminated, while others were optimized and new criteria were introduced to complete the monitoring of other areas not previously examined. Currently, the quality control process includes 22 quality criteria and their standards that examine the following 4 different areas: (1) indication and duration of PN; (2) nutrition assessment, adequacy of the nutrition support, and monitoring; (3) metabolic and infectious complications; and (4) global efficacy of the nutrition support regimen. The authors describe the current definition of each criterion and present the results obtained in the 5 audits performed. In the past year, 9 of the 22 criteria reached the predefined standards. The areas detected for further improvements were: indication for PN, nutrition assessment, and management of catheter infections. The definition of quality criteria and their standards is an efficient method of providing a qualitative and quantitative analysis of the clinical care of patients receiving PN. It detects areas for improvement and assists in developing a methodology to work efficiently.

[Integrated Quality Management System (IQMS): a model for improving the quality of reproductive health care in rural Kenya].

PubMed

Herrler, Claudia; Bramesfeld, Anke; Brodowski, Marc; Prytherch, Helen; Marx, Irmgard; Nafula, Maureen; Richter-Aairijoki, Heide; Musyoka, Lucy; Marx, Michael; Szecsenyi, Joachim

2015-01-01

To develop a model aiming to improve the quality of services for reproductive health care in rural Kenya and designed to measure the quality of reproductive health services in such a way that allows these services to identify measures for improving their performance. The Integrated Quality Management System (IQMS) was developed on the basis of a pre-existing and validated model for quality promotion, namely the European Practice Assessment (EPA). The methodology for quality assessment and feedback of assessment results to the service teams was adopted from the EPA model. Quality assessment methodology included data assessment through staff, patient surveys and service visitation. Quality is assessed by indicators, and so indicators had to be developed that were appropriate for assessing reproductive health care in rural Kenya. A search of the Kenyan and international literature was conducted to identify potential indicators. These were then rated for their relevance and clarity by a panel of Kenyan experts. 260 indicators were rated as relevant and assigned to 29 quality dimensions and 5 domains. The implementation of IQMS in ten facilities showed that IQMS is a feasible model for assessing the quality of reproductive health services in rural Kenya. IQMS enables these services to identify quality improvement targets and necessary improvement measures. Both strengths and limitations of IQMS will be discussed. Copyright © 2015. Published by Elsevier GmbH.

Guidance on assessing the methodological and reporting quality of toxicologically relevant studies: A scoping review.

PubMed

Samuel, Gbeminiyi O; Hoffmann, Sebastian; Wright, Robert A; Lalu, Manoj Mathew; Patlewicz, Grace; Becker, Richard A; DeGeorge, George L; Fergusson, Dean; Hartung, Thomas; Lewis, R Jeffrey; Stephens, Martin L

2016-01-01

Assessments of methodological and reporting quality are critical to adequately judging the credibility of a study's conclusions and to gauging its potential reproducibility. To aid those seeking to assess the methodological or reporting quality of studies relevant to toxicology, we conducted a scoping review of the available guidance with respect to four types of studies: in vivo and in vitro, (quantitative) structure-activity relationships ([Q]SARs), physico-chemical, and human observational studies. Our aims were to identify the available guidance in this diverse literature, briefly summarize each document, and distill the common elements of these documents for each study type. In general, we found considerable guidance for in vivo and human studies, but only one paper addressed in vitro studies exclusively. The guidance for (Q)SAR studies and physico-chemical studies was scant but authoritative. There was substantial overlap across guidance documents in the proposed criteria for both methodological and reporting quality. Some guidance documents address toxicology research directly, whereas others address preclinical research generally or clinical research and therefore may not be fully applicable to the toxicology context without some translation. Another challenge is the degree to which assessments of methodological quality in toxicology should focus on risk of bias - as in clinical medicine and healthcare - or be broadened to include other quality measures, such as confirming the identity of test substances prior to exposure. Our review is intended primarily for those in toxicology and risk assessment seeking an entry point into the extensive and diverse literature on methodological and reporting quality applicable to their work. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Symptomatic spinal metastasis: A systematic literature review of the preoperative prognostic factors for survival, neurological, functional and quality of life in surgically treated patients and methodological recommendations for prognostic studies

PubMed Central

Nater, Anick; Martin, Allan R.; Sahgal, Arjun; Choi, David

2017-01-01

Purpose While several clinical prediction rules (CPRs) of survival exist for patients with symptomatic spinal metastasis (SSM), these have variable prognostic ability and there is no recognized CPR for health related quality of life (HRQoL). We undertook a critical appraisal of the literature to identify key preoperative prognostic factors of clinical outcomes in patients with SSM who were treated surgically. The results of this study could be used to modify existing or develop new CPRs. Methods Seven electronic databases were searched (1990–2015), without language restriction, to identify studies that performed multivariate analysis of preoperative predictors of survival, neurological, functional and HRQoL outcomes in surgical patients with SSM. Individual studies were assessed for class of evidence. The strength of the overall body of evidence was evaluated using GRADE for each predictor. Results Among 4,818 unique citations, 17 were included; all were in English, rated Class III and focused on survival, revealing a total of 46 predictors. The strength of the overall body of evidence was very low for 39 and low for 7 predictors. Due to considerable heterogeneity in patient samples and prognostic factors investigated as well as several methodological issues, our results had a moderately high risk of bias and were difficult to interpret. Conclusions The quality of evidence for predictors of survival was, at best, low. We failed to identify studies that evaluated preoperative prognostic factors for neurological, functional, or HRQoL outcomes in surgical patients with SSM. We formulated methodological recommendations for prognostic studies to promote acquiring high-quality evidence to better estimate predictor effect sizes to improve patient education, surgical decision-making and development of CPRs. PMID:28225772

Report of AAPM Task Group 162: Software for planar image quality metrology.

PubMed

Samei, Ehsan; Ikejimba, Lynda C; Harrawood, Brian P; Rong, John; Cunningham, Ian A; Flynn, Michael J

2018-02-01

The AAPM Task Group 162 aimed to provide a standardized approach for the assessment of image quality in planar imaging systems. This report offers a description of the approach as well as the details of the resultant software bundle to measure detective quantum efficiency (DQE) as well as its basis components and derivatives. The methodology and the associated software include the characterization of the noise power spectrum (NPS) from planar images acquired under specific acquisition conditions, modulation transfer function (MTF) using an edge test object, the DQE, and effective DQE (eDQE). First, a methodological framework is provided to highlight the theoretical basis of the work. Then, a step-by-step guide is included to assist in proper execution of each component of the code. Lastly, an evaluation of the method is included to validate its accuracy against model-based and experimental data. The code was built using a Macintosh OSX operating system. The software package contains all the source codes to permit an experienced user to build the suite on a Linux or other *nix type system. The package further includes manuals and sample images and scripts to demonstrate use of the software for new users. The results of the code are in close alignment with theoretical expectations and published results of experimental data. The methodology and the software package offered in AAPM TG162 can be used as baseline for characterization of inherent image quality attributes of planar imaging systems. © 2017 American Association of Physicists in Medicine.

Quality and reporting of diagnostic accuracy studies in TB, HIV and malaria: evaluation using QUADAS and STARD standards.

PubMed

Fontela, Patricia Scolari; Pant Pai, Nitika; Schiller, Ian; Dendukuri, Nandini; Ramsay, Andrew; Pai, Madhukar

2009-11-13

Poor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV. We identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004-2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively. Ninety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of withdrawals (6%) and reference test execution (10%), absence of index test review bias (19%) and reference test review bias (24%), and report of uninterpretable results (22%). In terms of quality of reporting, 9 STARD indicators were reported in less than 25% of the studies: methods for calculation and estimates of reproducibility (0%), adverse effects of the diagnostic tests (1%), estimates of diagnostic accuracy between subgroups (10%), distribution of severity of disease/other diagnoses (11%), number of eligible patients who did not participate in the study (14%), blinding of the test readers (16%), and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required authors to use STARD. Recently published diagnostic accuracy studies on commercial tests for TB, malaria and HIV have moderate to low quality and are poorly reported. The more frequent use of tools such as QUADAS and STARD may be necessary to improve the methodological and reporting quality of future diagnostic accuracy studies in infectious diseases.

Quality and Reporting of Diagnostic Accuracy Studies in TB, HIV and Malaria: Evaluation Using QUADAS and STARD Standards

PubMed Central

Fontela, Patricia Scolari; Pant Pai, Nitika; Schiller, Ian; Dendukuri, Nandini; Ramsay, Andrew; Pai, Madhukar

2009-01-01

Background Poor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV. Methods We identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004–2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively. Findings Ninety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of withdrawals (6%) and reference test execution (10%), absence of index test review bias (19%) and reference test review bias (24%), and report of uninterpretable results (22%). In terms of quality of reporting, 9 STARD indicators were reported in less than 25% of the studies: methods for calculation and estimates of reproducibility (0%), adverse effects of the diagnostic tests (1%), estimates of diagnostic accuracy between subgroups (10%), distribution of severity of disease/other diagnoses (11%), number of eligible patients who did not participate in the study (14%), blinding of the test readers (16%), and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required authors to use STARD. Conclusion Recently published diagnostic accuracy studies on commercial tests for TB, malaria and HIV have moderate to low quality and are poorly reported. The more frequent use of tools such as QUADAS and STARD may be necessary to improve the methodological and reporting quality of future diagnostic accuracy studies in infectious diseases. PMID:19915664

A systematic and transparent approach for assessing the methodological quality of intervention effectiveness research: the Study Design and Implementation Assessment Device (Study DIAD).

PubMed

Valentine, Jeffrey C; Cooper, Harris

2008-06-01

Assessments of studies meant to evaluate the effectiveness of interventions, programs, and policies can serve an important role in the interpretation of research results. However, evidence suggests that available quality assessment tools have poor measurement characteristics and can lead to opposing conclusions when applied to the same body of studies. These tools tend to (a) be insufficiently operational, (b) rely on arbitrary post-hoc decision rules, and (c) result in a single number to represent a multidimensional construct. In response to these limitations, a multilevel and hierarchical instrument was developed in consultation with a wide range of methodological and statistical experts. The instrument focuses on the operational details of studies and results in a profile of scores instead of a single score to represent study quality. A pilot test suggested that satisfactory between-judge agreement can be obtained using well-trained raters working in naturalistic conditions. Limitations of the instrument are discussed, but these are inherent in making decisions about study quality given incomplete reporting and in the absence of strong, contextually based information about the effects of design flaws on study outcomes. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

75 FR 5589 - Science Advisory Board Staff Office; Request for Public Nominations of Experts To Conduct a Peer...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... Conductivity Using Field Data: An Adaptation of the U.S. EPA's Standard Methodology for Deriving Water Quality... Adaptation of the U.S. EPA's Standard Methodology for Deriving Water Quality Criteria'' DATES: Nominations... Deriving Water Quality Criteria'' should be directed to Dr. Michael Slimak, ORD's Associate Director of...

The methodological quality of systematic reviews of animal studies in dentistry.

PubMed

Faggion, C M; Listl, S; Giannakopoulos, N N

2012-05-01

Systematic reviews and meta-analyses of animal studies are important for improving estimates of the effects of treatment and for guiding future clinical studies on humans. The purpose of this systematic review was to assess the methodological quality of systematic reviews and meta-analyses of animal studies in dentistry through using a validated checklist. A literature search was conducted independently and in duplicate in the PubMed and LILACS databases. References in selected systematic reviews were assessed to identify other studies not captured by the electronic searches. The methodological quality of studies was assessed independently and in duplicate by using the AMSTAR checklist; the quality was scored as low, moderate, or high. The reviewers were calibrated before the assessment and agreement between them was assessed using Cohen's Kappa statistic. Of 444 studies retrieved, 54 systematic reviews were selected after full-text assessment. Agreement between the reviewers was regarded as excellent. Only two studies were scored as high quality; 17 and 35 studies were scored as medium and low quality, respectively. There is room for improvement of the methodological quality of systematic reviews of animal studies in dentistry. Checklists, such as AMSTAR, can guide researchers in planning and executing systematic reviews and meta-analyses. For determining the need for additional investigations in animals and in order to provide good data for potential application in human, such reviews should be based on animal experiments performed according to sound methodological principles. Copyright © 2011 Elsevier Ltd. All rights reserved.

Methodological quality and descriptive characteristics of prosthodontic-related systematic reviews.

PubMed

Aziz, T; Compton, S; Nassar, U; Matthews, D; Ansari, K; Flores-Mir, C

2013-04-01

Ideally, healthcare systematic reviews (SRs) should be beneficial to practicing professionals in making evidence-based clinical decisions. However, the conclusions drawn from SRs are directly related to the quality of the SR and of the included studies. The aim was to investigate the methodological quality and key descriptive characteristics of SRs published in prosthodontics. Methodological quality was analysed using the Assessment of Multiple Reviews (AMSTAR) tool. Several electronic resources (MEDLINE, EMBASE, Web of Science and American Dental Association's Evidence-based Dentistry website) were searched. In total 106 SRs were located. Key descriptive characteristics and methodological quality features were gathered and assessed, and descriptive and inferential statistical testing performed. Most SRs in this sample originated from the European continent followed by North America. Two to five authors conducted most SRs; the majority was affiliated with academic institutions and had prior experience publishing SRs. The majority of SRs were published in specialty dentistry journals, with implant or implant-related topics, the primary topics of interest for most. According to AMSTAR, most quality aspects were adequately fulfilled by less than half of the reviews. Publication bias and grey literature searches were the most poorly adhered components. Overall, the methodological quality of the prosthodontic-related systematic was deemed limited. Future recommendations would include authors to have prior training in conducting SRs and for journals to include a universal checklist that should be adhered to address all key characteristics of an unbiased SR process. © 2013 Blackwell Publishing Ltd.

National Water Quality Laboratory - A Profile

USGS Publications Warehouse

Raese, Jon W.

2001-01-01

The U.S. Geological Survey (USGS) National Water Quality Laboratory (NWQL) is a full-service laboratory that specializes in environmental analytical chemistry. The NWQL's primary mission is to support USGS programs requiring environmental analyses that provide consistent methodology for national assessment and trends analysis. The NWQL provides the following: high-quality chemical data; consistent, published, state-of-the-art methodology; extremely low-detection levels; high-volume capability; biological unit for identifying benthic invertebrates; quality assurance for determining long-term water-quality trends; and a professional staff.

Advances in Human-Computer Interaction: Graphics and Animation Components for Interface Design

NASA Astrophysics Data System (ADS)

Cipolla Ficarra, Francisco V.; Nicol, Emma; Cipolla-Ficarra, Miguel; Richardson, Lucy

We present an analysis of communicability methodology in graphics and animation components for interface design, called CAN (Communicability, Acceptability and Novelty). This methodology has been under development between 2005 and 2010, obtaining excellent results in cultural heritage, education and microcomputing contexts. In studies where there is a bi-directional interrelation between ergonomics, usability, user-centered design, software quality and the human-computer interaction. We also present the heuristic results about iconography and layout design in blogs and websites of the following countries: Spain, Italy, Portugal and France.

Measurement properties of rheumatoid arthritis-specific quality-of-life questionnaires: systematic review of the literature.

PubMed

Lee, Jiyeon; Kim, Soo Hyun; Moon, Seung Hei; Lee, Eun-Hyun

2014-12-01

This study conducted a systematic review of the methodological quality of the psychometric evaluation process and the quality of measurement properties of rheumatoid arthritis (RA)-specific health-related quality-of-life (HRQOL) questionnaires with the purpose of obtaining the best evidence to help in the selection of the most appropriate instrument for measuring HRQOL in RA patients. A systematic literature search was performed to identify RA-specific HRQOL questionnaires in databases. The methodological quality of the studies was assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. The quality of the measurement properties was assessed using quality criteria. The evidence regarding the measurement properties was pooled using best-evidence synthesis, with considerations of the number and methodological quality of the studies, and the consistency of their findings in terms of the quality of the measurement properties. The search identified 37 studies describing 9 instruments. Best-evidence synthesis suggested that the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire had the strongest positive evidence, especially with respect to reliability, measurement error, and content validity, and moderate positive evidence with respect to hypothesis testing and responsiveness. The current evidence suggests that the best-validated instrument among the RA-specific HRQOL measures is the RAQoL questionnaire in terms of both methodological quality in the process of psychometric evaluation and the quality of the measurement properties. However, there is limited evidence regarding internal consistency and structural validity of the RAQoL. Further efforts are warranted to establish the psychometric quality of this questionnaire.

Health-Related Quality of Life in Non–Small-Cell Lung Cancer: An Update of a Systematic Review on Methodologic Issues in Randomized Controlled Trials

PubMed Central

Claassens, Lily; van Meerbeeck, Jan; Coens, Corneel; Quinten, Chantal; Ghislain, Irina; Sloan, Elizabeth K.; Wang, Xin Shelly; Velikova, Galina; Bottomley, Andrew

2011-01-01

Purpose This study is an update of a systematic review of health-related quality-of-life (HRQOL) methodology reporting in non–small-cell lung cancer (NSCLC) randomized controlled trials (RCTs). The objective was to evaluate HRQOL methodology reporting over the last decade and its benefit for clinical decision making. Methods A MEDLINE systematic literature review was performed. Eligible RCTs implemented patient-reported HRQOL assessments and regular oncology treatments for newly diagnosed adult patients with NSCLC. Included studies were published in English from August 2002 to July 2010. Two independent reviewers evaluated all included RCTs. Results Fifty-three RCTs were assessed. Of the 53 RCTs, 81% reported that there was no significant difference in overall survival (OS). However, 50% of RCTs that were unable to find OS differences reported a significant difference in HRQOL scores. The quality of HRQOL reporting has improved; both reporting of clinically significant differences and statistical testing of HRQOL have improved. A European Organisation for Research and Treatment of Cancer HRQOL questionnaire was used in 57% of the studies. However, reporting of HRQOL hypotheses and rationales for choosing HRQOL instruments were significantly less than before 2002 (P < .05). Conclusion The number of NSCLC RCTs incorporating HRQOL assessments has considerably increased. HRQOL continues to demonstrate its importance in RCTs, especially in those studies in which no OS difference is found. Despite the improved quality of HRQOL methodology reporting, certain aspects remain underrepresented. Our findings suggest need for an international standardization of HRQOL reporting similar to the CONSORT guidelines for clinical findings. PMID:21464420

Assessing medical professionalism: A systematic review of instruments and their measurement properties.

PubMed

Li, Honghe; Ding, Ning; Zhang, Yuanyuan; Liu, Yang; Wen, Deliang

2017-01-01

Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments' measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations. A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990-2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument's usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee's criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments. After screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar's instrument for nursing students, Nurse Practitioners' Roles and Competencies Scale, and Perceived Faculty Competency Inventory. Although instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing instruments and to longitudinal studies.

A low proportion of systematic reviews in physical therapy are registered: a survey of 150 published systematic reviews.

PubMed

Oliveira, Crystian B; Elkins, Mark R; Lemes, Ítalo Ribeiro; de Oliveira Silva, Danilo; Briani, Ronaldo V; Monteiro, Henrique Luiz; Azevedo, Fábio Mícolis de; Pinto, Rafael Zambelli

Systematic reviews provide the best evidence about the effectiveness of healthcare interventions. Although systematic reviews are conducted with explicit and transparent methods, discrepancies might occur between the protocol and the publication. To estimate the proportion of systematic reviews of physical therapy interventions that are registered, the methodological quality of (un)registered systematic reviews and the prevalence of outcome reporting bias in registered systematic reviews. A random sample of 150 systematic reviews published in 2015 indexed on the PEDro database. We included systematic reviews written in English, Italian, Portuguese and Spanish. A checklist for assessing the methodological quality of systematic reviews tool was used. Relative risk was calculated to explore the association between meta-analysis results and the changes in the outcomes. Twenty-nine (19%) systematic reviews were registered. Funding and publication in a journal with an impact factor higher than 5.0 were associated with registration. Registered systematic reviews demonstrated significantly higher methodological quality (median=8) than unregistered systematic reviews (median=5). Nine (31%) registered systematic reviews demonstrated discrepancies between protocol and publication with no evidence that such discrepancies were applied to favor the statistical significance of the intervention (RR=1.16; 95% CI: 0.63-2.12). A low proportion of systematic reviews in the physical therapy field are registered. The registered systematic reviews showed high methodological quality without evidence of outcome reporting bias. Further strategies should be implemented to encourage registration. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Clinical practice guidelines in breast cancer

PubMed Central

Tyagi, N. Kumar; Dhesy-Thind, S.

2018-01-01

Background A number of clinical practice guidelines (cpgs) concerning breast cancer (bca) screening and management are available. Here, we review the strengths and weaknesses of cpgs from various professional organizations and consensus groups with respect to their methodologic quality, recommendations, and implementability. Methods Guidelines from four groups were reviewed with respect to two clinical scenarios: adjuvant ovarian function suppression (ofs) in premenopausal women with early-stage estrogen receptor–positive bca, and use of sentinel lymph node biopsy (slnb) after neoadjuvant chemotherapy (nac) for locally advanced bca. Guidelines from the American Society of Clinical Oncology (asco); Cancer Care Ontario’s Program in Evidence Based Care (cco’s pebc); the U.S. National Comprehensive Cancer Network (nccn); and the St. Gallen International Breast Cancer Consensus Conference were reviewed by two independent assessors. Guideline methodology and applicability were evaluated using the agree ii tool. Results The quality of the cpgs was greatest for the guidelines developed by asco and cco’s pebc. The nccn and St. Gallen guidelines were found to have lower scores for methodologic rigour. All guidelines scored poorly for applicability. The recommendations for ofs were similar in three guidelines. Recommendations by the various organizations for the use of slnb after nac were contradictory. Conclusions Our review demonstrated that cpgs can be heterogeneous in methodologic quality. Low-quality cpg implementation strategies contribute to low uptake of, and adherence to, bca cpgs. Further research examining the barriers to recommendations—such as intrinsic guideline characteristics and the needs of end users—is required. The use of bca cpgs can improve the knowledge-to-practice gap and patient outcomes.

Guidelines for reporting evaluations based on observational methodology.

PubMed

Portell, Mariona; Anguera, M Teresa; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana

2015-01-01

Observational methodology is one of the most suitable research designs for evaluating fidelity of implementation, especially in complex interventions. However, the conduct and reporting of observational studies is hampered by the absence of specific guidelines, such as those that exist for other evaluation designs. This lack of specific guidance poses a threat to the quality and transparency of these studies and also constitutes a considerable publication hurdle. The aim of this study thus was to draw up a set of proposed guidelines for reporting evaluations based on observational methodology. The guidelines were developed by triangulating three sources of information: observational studies performed in different fields by experts in observational methodology, reporting guidelines for general studies and studies with similar designs to observational studies, and proposals from experts in observational methodology at scientific meetings. We produced a list of guidelines grouped into three domains: intervention and expected outcomes, methods, and results. The result is a useful, carefully crafted set of simple guidelines for conducting and reporting observational studies in the field of program evaluation.

Methodological quality of systematic reviews referenced in clinical practice guidelines for the treatment of opioid use disorder.

PubMed

Ross, Andrew; Rankin, Justin; Beaman, Jason; Murray, Kelly; Sinnett, Philip; Riddle, Ross; Haskins, Jordan; Vassar, Matt

2017-01-01

With efforts to combat opioid use disorder, there is an increased interest in clinical practice guidelines (CPGs) for opioid use disorder treatments. No literature exists examining the quality of systematic reviews used in opioid use disorder CPGs. This study aims to describe the methodological quality and reporting clarity of systematic reviews (SRs) used to create CPGs for opioid use disorder. From June to July 2016 guideline clearinghouses and medical literature databases were searched for relevant CPGs used in the treatment of opioid use disorder. Included CPGs must have been recognized by a national organization. SRs from the reference section of each CPG was scored by using AMSTAR (a measurement tool to assess the methodological quality of systematic reviews) tool and PRISMA (preferred reporting items for systematic reviews and meta-analyses) checklist. Seventeen CPGs from 2006-2016 were included in the review. From these, 57 unique SRs were extracted. SRS comprised 0.28% to 17.92% of all references found in the CPGs. All SRs obtained moderate or high methodological quality score on the AMSTAR tool. All reviews met at least 70% of PRISMA criteria. In PRISMA, underperforming areas included accurate title labeling, protocol registration, and risk of bias. Underperforming areas in AMSTAR included conflicts of interest, funding, and publication bias. A positive correlation was found between AMSTAR and PRISMA scores (r = .79). Although the SRs in the CPGs were of good quality, there are still areas for improvement. Systematic reviewers should consult PRISMA and AMSTAR when conducting and reporting reviews. It is important for CPG developers to consider methodological quality as a factor when developing CPG recommendations, recognizing that the quality of systematic reviews underpinning guidelines does not necessarily correspond to the quality of the guideline itself.

Methodological Quality Assessment of Meta-Analyses and Systematic Reviews of Probiotics in Inflammatory Bowel Disease and Pouchitis.

PubMed

Dong, Jinpei; Teng, Guigen; Wei, Tiantong; Gao, Wen; Wang, Huahong

2016-01-01

Probiotics are widely used for the induction and maintenance of remission in inflammatory bowel disease (IBD) and pouchitis. There are a large number of meta-analyses (MAs)/ systematic reviews (SRs) on this subject, the methodological quality of which has not been evaluated. This study aimed to evaluate the methodological quality of and summarize the evidence obtained from MAs/SRs of probiotic treatments for IBD and pouchitis patients. The PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases were searched to identify Chinese and English language MAs/SRs of the use of probiotics for IBD and pouchitis. The Assessment of Multiple Systematic Reviews (AMSTAR) scale was used to assess the methodological quality of the studies. A total of 36 MAs/SRs were evaluated. The AMSTAR scores of the included studies ranged from 1 to 10, and the average score was 5.81. According to the Canadian Agency for Drugs and Technologies in Health, 4 articles were classified as high quality, 24 articles were classified as moderate quality, and 8 articles were classified as low quality. Most of the MAs/SRs suggested that probiotics had potential benefits for patients with ulcerative colitis (UC), but failed to show effectiveness in the induction and maintenance of remission in Crohn's disease (CD). The probiotic preparation VSL#3 may play a beneficial role in pouchitis. The overall methodological quality of the current MAs/SRs in the field of probiotics for IBD and pouchitis was found to be low to moderate. More MAs/SRs of high quality are required to support using probiotics to treat IBD and pouchitis.

The methodological quality of nurse-sensitive indicators in Dutch hospitals: A descriptive exploratory research study.

PubMed

Kieft, R A M M; Stalpers, D; Jansen, A P M; Francke, A L; Delnoij, D M J

2018-06-01

Nurse-sensitive indicators (NSIs) are increasingly being developed and used to establish quality of nursing care in Western countries. The objective was to gain insights into the methodological quality of mandatory NSIs in Dutch hospitals, including indicators for pain, wound care, malnutrition and delirium. A descriptive exploratory design was used, starting with desk research into publicly available documents and reports describing the development of the NSIs included in this study. We used the validated Appraisal of Indicators through Research and Evaluation (AIRE) instrument to evaluate the methodological quality. Although the purpose and relevance of each individual NSI have been described, no detailed information about the criteria for selecting these topics is available. It is not clear which specific stakeholders participated and how their input was used. We found no information about the process of collecting and compiling scientific evidence. It is unclear whether and to what extent the usability of NSIs has been tested. The methodological quality of NSIs used in Dutch hospitals is less than optimal in various ways and it is therefore questionable if the indicators are accurate enough to identify changes or improve nursing practice. Our study also provides an example of how the methodological quality of NSIs can be assessed systematically, which is relevant considering the increasing use of NSIs in various countries. Copyright © 2018 Elsevier B.V. All rights reserved.

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review.

PubMed

Yang, Min; Jiang, Li; Wang, Qing; Chen, Hao; Xu, Guihua

2017-01-01

Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown. To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis. Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach. Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from "very low" to "low," mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes. TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice.

Is there an "abortion trauma syndrome"? Critiquing the evidence.

PubMed

Robinson, Gail Erlick; Stotland, Nada L; Russo, Nancy Felipe; Lang, Joan A; Occhiogrosso, Mallay

2009-01-01

The objective of this review is to identify and illustrate methodological issues in studies used to support claims that induced abortion results in an "abortion trauma syndrome" or a psychiatric disorder. After identifying key methodological issues to consider when evaluating such research, we illustrate these issues by critically examining recent empirical studies that are widely cited in legislative and judicial testimony in support of the existence of adverse psychiatric sequelae of induced abortion. Recent studies that have been used to assert a causal connection between abortion and subsequent mental disorders are marked by methodological problems that include, but not limited to: poor sample and comparison group selection; inadequate conceptualization and control of relevant variables; poor quality and lack of clinical significance of outcome measures; inappropriateness of statistical analyses; and errors of interpretation, including misattribution of causal effects. By way of contrast, we review some recent major studies that avoid these methodological errors. The most consistent predictor of mental disorders after abortion remains preexisting disorders, which, in turn, are strongly associated with exposure to sexual abuse and intimate violence. Educating researchers, clinicians, and policymakers how to appropriately assess the methodological quality of research about abortion outcomes is crucial. Further, methodologically sound research is needed to evaluate not only psychological outcomes of abortion, but also the impact of existing legislation and the effects of social attitudes and behaviors on women who have abortions.

Social Skills Interventions for Students with Challenging Behavior: Evaluating the Quality of the Evidence Base

ERIC Educational Resources Information Center

Hutchins, Nancy S.; Burke, Mack D.; Hatton, Heather; Bowman-Perrott, Lisa

2017-01-01

This study provides results on a methodological quality review of the single-case research literature from 1998 to 2014 on the use of social skills interventions for students with challenging behavior. A systematic review of the social skills literature was conducted with the intent of updating the Mathur et al. study of social skills…

Twenty years of meta-analyses in orthopaedic surgery: has quality kept up with quantity?

PubMed

Dijkman, Bernadette G; Abouali, Jihad A K; Kooistra, Bauke W; Conter, Henry J; Poolman, Rudolf W; Kulkarni, Abhaya V; Tornetta, Paul; Bhandari, Mohit

2010-01-01

As the number of studies in the literature is increasing, orthopaedic surgeons highly depend on meta-analyses as their primary source of scientific evidence. The objectives of this review were to assess the scientific quality and number of published meta-analyses on orthopaedics-related topics over time. We conducted, in duplicate and independently, a systematic review of published meta-analyses in orthopaedics in the years 2005 and 2008 and compared them with a previous systematic review of meta-analyses from 1969 to 1999. A search of electronic databases (MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews) was performed to identify meta-analyses published in 2005 and 2008. We searched bibliographies and contacted content experts to identify additional relevant studies. Two investigators independently assessed the quality of the studies, using the Oxman and Guyatt index, and abstracted relevant data. We included forty-five and forty-four meta-analyses from 2005 and 2008, respectively. While the number of meta-analyses increased fivefold from 1999 to 2008, the mean quality score did not change significantly over time (p = 0.067). In the later years, a significantly lower proportion of meta-analyses had methodological flaws (56% in 2005 and 68% in 2008) compared with meta-analyses published prior to 2000 (88%) (p = 0.006). In 2005 and 2008, respectively, 18% and 30% of the meta-analyses had major to extensive flaws in their methodology. Studies from 2008 with positive conclusions used and described appropriate criteria for the validity assessment less often than did those with negative results. The use of random-effects and fixed-effects models as pooling methods became more popular toward 2008. Although the methodological quality of orthopaedic meta-analyses has increased in the past twenty years, a substantial proportion continues to show major to extensive flaws. As the number of published meta-analyses is increasing, a routine checklist for scientific quality should be used in the peer-review process to ensure methodological standards for publication.

Improving the geomagnetic field modeling with a selection of high-quality archaeointensity data

NASA Astrophysics Data System (ADS)

Pavon-Carrasco, Francisco Javier; Gomez-Paccard, Miriam; Herve, Gwenael; Osete, Maria Luisa; Chauvin, Annick

2014-05-01

Geomagnetic field reconstructions for the last millennia are based on archeomagnetic data. However, the scatter of the archaeointensity data is very puzzling and clearly suggests that some of the intensity data might not be reliable. In this work we apply different selection criteria to the European and Western Asian archaeointensity data covering the last three millennia in order to investigate if the data selection affects geomagnetic field models results. Thanks to the recently developed archeomagnetic databases, new valuable information related to the methodology used to determine the archeointensity data is now available. We therefore used this information to rank the archaeointensity data in four quality categories depending on the methodology used during the laboratory treatment of the samples and on the number of specimens retained to calculate the mean intensities. Results show how the intensity geomagnetic field component given by the regional models hardly depends on the selected quality data used. When all the available data are used a different behavior of the geomagnetic field is observed in Western and Eastern Europe. However, when the regional model is obtained from a selection of high-quality intensity data the same features are observed at the European scale.

A methodology to analyze the quality of health information on the internet: the example of diabetic neuropathy.

PubMed

Chumber, Sundeep; Huber, Jörg; Ghezzi, Pietro

2015-02-01

The purpose of this work was to evaluate the criteria used to assess the quality of information on diabetic neuropathy on the Internet. Different search engines (Google, Yahoo, Bing, and Ask) and 1 governmental health website (MedlinePlus) were studied. The websites returned (200 for each search engine) were then classified according to their affiliation (eg, commercial, professional, patient groups). A scoring system was devised from the literature to assess quality of information. Websites were also analyzed using the 2 most widely used instruments for assessing the quality of health information, the Journal of the American Medical Association (JAMA) scoring system and the Health On the Net Foundation (HON) certification. Professional websites or health portals scored better according to most criteria. Google and MedlinePlus returned results scoring significantly higher than other engines in some of the criteria. The use of different instruments gave different results and indicates that the JAMA score and the HON certification may not be sufficient ones. This methodology could be used to evaluate the reliability and trustworthiness of information on the Internet on different topics to identify topic areas or websites where the available information is not appropriate. © 2014 The Author(s).

An overview of maternal separation effects on behavioural outcomes in mice: Evidence from a four-stage methodological systematic review.

PubMed

Tractenberg, Saulo G; Levandowski, Mateus L; de Azeredo, Lucas Araújo; Orso, Rodrigo; Roithmann, Laura G; Hoffmann, Emerson S; Brenhouse, Heather; Grassi-Oliveira, Rodrigo

2016-09-01

Early life stress (ELS) developmental effects have been widely studied by preclinical researchers. Despite the growing body of evidence from ELS models, such as the maternal separation paradigm, the reported results have marked inconsistencies. The maternal separation model has several methodological pitfalls that could influence the reliability of its results. Here, we critically review 94 mice studies that addressed the effects of maternal separation on behavioural outcomes. We also discuss methodological issues related to the heterogeneity of separation protocols and the quality of reporting methods. Our findings indicate a lack of consistency in maternal separation effects: major studies of behavioural and biological phenotypes failed to find significant deleterious effects. Furthermore, we identified several specific variations in separation methodological procedures. These methodological variations could contribute to the inconsistency of maternal separation effects by producing different degrees of stress exposure in maternal separation-reared pups. These methodological problems, together with insufficient reporting, might lead to inaccurate and unreliable effect estimates in maternal separation studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

A systematic review of model-based economic evaluations of diagnostic and therapeutic strategies for lower extremity artery disease.

PubMed

Vaidya, Anil; Joore, Manuela A; ten Cate-Hoek, Arina J; Kleinegris, Marie-Claire; ten Cate, Hugo; Severens, Johan L

2014-01-01

Lower extremity artery disease (LEAD) is a sign of wide spread atherosclerosis also affecting coronary, cerebral and renal arteries and is associated with increased risk of cardiovascular events. Many economic evaluations have been published for LEAD due to its clinical, social and economic importance. The aim of this systematic review was to assess modelling methods used in published economic evaluations in the field of LEAD. Our review appraised and compared the general characteristics, model structure and methodological quality of published models. Electronic databases MEDLINE and EMBASE were searched until February 2013 via OVID interface. Cochrane database of systematic reviews, Health Technology Assessment database hosted by National Institute for Health research and National Health Services Economic Evaluation Database (NHSEED) were also searched. The methodological quality of the included studies was assessed by using the Philips' checklist. Sixteen model-based economic evaluations were identified and included. Eleven models compared therapeutic health technologies; three models compared diagnostic tests and two models compared a combination of diagnostic and therapeutic options for LEAD. Results of this systematic review revealed an acceptable to low methodological quality of the included studies. Methodological diversity and insufficient information posed a challenge for valid comparison of the included studies. In conclusion, there is a need for transparent, methodologically comparable and scientifically credible model-based economic evaluations in the field of LEAD. Future modelling studies should include clinically and economically important cardiovascular outcomes to reflect the wider impact of LEAD on individual patients and on the society.

Using QALYs in telehealth evaluations: a systematic review of methodology and transparency.

PubMed

Bergmo, Trine S

2014-08-03

The quality-adjusted life-year (QALY) is a recognised outcome measure in health economic evaluations. QALY incorporates individual preferences and identifies health gains by combining mortality and morbidity into one single index number. A literature review was conducted to examine and discuss the use of QALYs to measure outcomes in telehealth evaluations. Evaluations were identified via a literature search in all relevant databases. Only economic evaluations measuring both costs and QALYs using primary patient level data of two or more alternatives were included. A total of 17 economic evaluations estimating QALYs were identified. All evaluations used validated generic health related-quality of life (HRQoL) instruments to describe health states. They used accepted methods for transforming the quality scores into utility values. The methodology used varied between the evaluations. The evaluations used four different preference measures (EQ-5D, SF-6D, QWB and HUI3), and utility scores were elicited from the general population. Most studies reported the methodology used in calculating QALYs. The evaluations were less transparent in reporting utility weights at different time points and variability around utilities and QALYs. Few made adjustments for differences in baseline utilities. The QALYs gained in the reviewed evaluations varied from 0.001 to 0.118 in implying a small but positive effect of telehealth intervention on patient's health. The evaluations reported mixed cost-effectiveness results. The use of QALYs in telehealth evaluations has increased over the last few years. Different methodologies and utility measures have been used to calculate QALYs. A more harmonised methodology and utility measure is needed to ensure comparability across telehealth evaluations.

Traditional chinese medicine: an update on clinical evidence.

PubMed

Xue, Charlie C L; Zhang, Anthony L; Greenwood, Kenneth M; Lin, Vivian; Story, David F

2010-03-01

As an alternative medical system, Traditional Chinese Medicine (TCM) has been increasingly used over the last several decades. Such a consumer-driven development has resulted in introduction of education programs for practitioner training, development of product and practitioner regulation systems, and generation of an increasing interest in research. Significant efforts have been made in validating the quality, effectiveness, and safety of TCM interventions evidenced by a growing number of published trials and systematic reviews. Commonly, the results of these studies were inconclusive due to the lack of quality and quantity of the trials to answer specific and answerable clinical questions. The methodology of a randomized clinical trial (RCT) is not free from bias, and the unique features of TCM (such as individualization and holism) further complicate effective execution of RCTs in TCM therapies. Thus, data from limited RCTs and systematic reviews need to be interpreted with great caution. Nevertheless, until new and specific methodology is developed that can adequately address these methodology challenges for RCTs in TCM, evidence from quality RCTs and systematic reviews still holds the credibility of TCM in the scientific community. This article summarizes studies on TCM utilization, and regulatory and educational development with a focus on updating the TCM clinical evidence from RCTs and systematic reviews over the last decade. The key issues and challenges associated with evidence-based TCM developments are also explored.

Impact of influent data frequency and model structure on the quality of WWTP model calibration and uncertainty.

PubMed

Cierkens, Katrijn; Plano, Salvatore; Benedetti, Lorenzo; Weijers, Stefan; de Jonge, Jarno; Nopens, Ingmar

2012-01-01

Application of activated sludge models (ASMs) to full-scale wastewater treatment plants (WWTPs) is still hampered by the problem of model calibration of these over-parameterised models. This either requires expert knowledge or global methods that explore a large parameter space. However, a better balance in structure between the submodels (ASM, hydraulic, aeration, etc.) and improved quality of influent data result in much smaller calibration efforts. In this contribution, a methodology is proposed that links data frequency and model structure to calibration quality and output uncertainty. It is composed of defining the model structure, the input data, an automated calibration, confidence interval computation and uncertainty propagation to the model output. Apart from the last step, the methodology is applied to an existing WWTP using three models differing only in the aeration submodel. A sensitivity analysis was performed on all models, allowing the ranking of the most important parameters to select in the subsequent calibration step. The aeration submodel proved very important to get good NH(4) predictions. Finally, the impact of data frequency was explored. Lowering the frequency resulted in larger deviations of parameter estimates from their default values and larger confidence intervals. Autocorrelation due to high frequency calibration data has an opposite effect on the confidence intervals. The proposed methodology opens doors to facilitate and improve calibration efforts and to design measurement campaigns.

Inventory of Personal Factors Influencing Conditioned Pain Modulation in Healthy People: A Systematic Literature Review.

PubMed

Hermans, Linda; Van Oosterwijck, Jessica; Goubert, Dorien; Goudman, Lisa; Crombez, Geert; Calders, Patrick; Meeus, Mira

2016-07-01

Conditioned pain modulation (CPM) is believed to play an important role in the development and exacerbation of chronic pain, because dysfunction of CPM is associated with a shift in balance between pain facilitation and pain inhibition. In many patients with central sensitization, CPM is less efficacious. Besides that, efficacy of CPM is highly variable in healthy people. Consequently, it seems that several individual variables may influence CPM. A systematic review examining personal factors influencing CPM was conducted. This systematic review follows the PRISMA guidelines. "Pubmed" and "Web of Science" were searched using different synonyms of CPM. Full-text clinical reports addressing the influence of personal factors on CPM in healthy adults were included. Checklists for RCTs and case-control studies provided by the Dutch Institute for Healthcare Improvement (CBO) and the Dutch Cochrane Centre were utilized to assess methodological quality. Levels of evidence and strength of conclusion were assigned using the CBO guidelines. Forty-six articles were identified that reported the influence of personal factors on CPM. Quality assessment revealed 10 studies with a methodological quality less than 50% wherefore they were excluded (21.8%), resulting in a general total methodological quality score of 72.5%. Overall younger adult age, male gender, ovulatory phase, positive expectations, attention to the conditioning stimulus, and carrier of the 5-HTTLPR long allele result in better CPM. It is advised for future studies to take these factors into account. Further research regarding the influence of oral contraceptives, catastrophizing, information about conditioning stimulation, distraction, physical activity, and genetics on CPM magnitude is required. © 2015 World Institute of Pain.

Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review.

PubMed

Jünger, Saskia; Payne, Sheila A; Brine, Jenny; Radbruch, Lukas; Brearley, Sarah G

2017-09-01

The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care. To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care. A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE. Original articles (English language) were included when reporting on empirical studies that had used the Delphi technique to develop guidance for good clinical practice in palliative care. Data extraction included a quality appraisal on the rigour in conduct of the studies and the quality of reporting. A total of 30 empirical studies (1997-2015) were considered for full-text analysis. Considerable differences were identified regarding the rigour of the design and the reporting of essential process and outcome parameters. Furthermore, discrepancies regarding the use of terms for describing the method were observed, for example, concerning the understanding of a 'round' or a 'modified Delphi study'. Substantial variation was found concerning the quality of the study conduct and the transparency of reporting of Delphi studies used for the development of best practice guidance in palliative care. Since credibility of the resulting recommendations depends on the rigorous use of the Delphi technique, there is a need for consistency and quality both in the conduct and reporting of studies. To allow a critical appraisal of the methodology and the resulting guidance, a reporting standard for Conducting and REporting of DElphi Studies (CREDES) is proposed.

Methodological Validation of Quality of Life Questionnaire for Coal Mining Groups-Indian Scenario

ERIC Educational Resources Information Center

Sen, Sayanti; Sen, Goutam; Tewary, B. K.

2012-01-01

Maslow's hierarchy-of-needs theory has been used to predict development of Quality of Life (QOL) in countries over time. In this paper an attempt has been taken to derive a methodological validation of quality of life questionnaire which have been prepared for the study area. The objective of the study is to standardize a questionnaire tool to…

Approaches and Methodological As Well As Interpretative Issues in Quality of Life Research in Malaysia

PubMed Central

Hasanah, C. I.

2003-01-01

Quality of life measures are designed to enable patients’ perspectives on the impact of health and healthcare interventions on their lives to be assessed and taken into account in clinical decision-making and research. This paper discusses some approaches, methodological as well as interpretative issues of health related quality of life research. PMID:23386798

Development and Validation of a Combined Methodology for Assessing the Total Quality Control of Herbal Medicinal Products – Application to Oleuropein Preparations

PubMed Central

Lemonakis, Nikolaos; Gikas, Evagelos; Halabalaki, Maria; Skaltsounis, Alexios-Leandros

2013-01-01

Oleuropein (OE) is a secoiridoid glycoside, which occurs mostly in the Oleaceae family presenting several pharmacological properties, including antioxidant, cardio-protective, anti-atherogenic effects etc. Based on these findings OE is commercially available, as Herbal Medicinal Product (HMP), claimed for its antioxidant effects. As there are general provisions of the medicine regulating bodies e.g. European Medicines Agency, the quality of the HMP’s must always be demonstrated. Therefore, a novel LC-MS methodology was developed and validated for the simultaneous quantification of OE and its main degradation product, hydroxytyrosol (HT), for the relevant OE claimed HMP’s. The internal standard (IS) methodology was employed and separation of OE, HT and IS was achieved on a C18 Fused Core column with 3.1 min overall run time employing the SIM method for the analytical signal acquisition. The method was validated according to the International Conference on Harmonisation requirements and the results show adequate linearity (r2 > 0.99) over a wide concentration range [0.1–15 μg/mL (n=12)] and a LLOQ value of 0.1 μg/mL, for both OE and HT. Furthermore, as it would be beneficial to control the quality taking into account all the substances of the OE claimed HMP’s; a metabolomics-like approach has been developed and applied for the total quality control of the different preparations employing UHPLC-HRMS-multivariate analysis (MVA). Four OE-claimed commercial HMP’s have been randomly selected and MVA similarity-based measurements were performed. The results showed that the examined samples could also be differentiated as evidenced according to their scores plot. Batch to batch reproducibility between the samples of the same brand has also been determined and found to be acceptable. Overall, the developed combined methodology has been found to be an efficient tool for the monitoring of the HMP’s total quality. Only one OE HMP has been found to be consistent to its label claim. PMID:24205178

The NCC project: A quality management perspective

NASA Technical Reports Server (NTRS)

Lee, Raymond H.

1993-01-01

The Network Control Center (NCC) Project introduced the concept of total quality management (TQM) in mid-1990. The CSC project team established a program which focused on continuous process improvement in software development methodology and consistent deliveries of high quality software products for the NCC. The vision of the TQM program was to produce error free software. Specific goals were established to allow continuing assessment of the progress toward meeting the overall quality objectives. The total quality environment, now a part of the NCC Project culture, has become the foundation for continuous process improvement and has resulted in the consistent delivery of quality software products over the last three years.

Effect of periodontal treatment on preterm birth rate: a systematic review of meta-analyses.

PubMed

López, Néstor J; Uribe, Sergio; Martinez, Benjamín

2015-02-01

Preterm birth is a major cause of neonatal morbidity and mortality in both developed and developing countries. Preterm birth is a highly complex syndrome that includes distinct clinical subtypes in which many different causes may be involved. The results of epidemiological, molecular, microbiological and animal-model studies support a positive association between maternal periodontal disease and preterm birth. However, the results of intervention studies carried out to determine the effect of periodontal treatment on reducing the risk of preterm birth are controversial. This systematic review critically analyzes the methodological issues of meta-analyses of the studies to determine the effect of periodontal treatment to reduce preterm birth. The quality of the individual randomized clinical trials selected is of highest relevance for a systematic review. This article describes the methodological features that should be identified a priori and assessed individually to determine the quality of a randomized controlled trial performed to evaluate the effect of periodontal treatment on pregnancy outcomes. The AMSTAR and the PRISMA checklist tools were used to assess the quality of the six meta-analyses selected, and the bias domain of the Cochrane Collaboration's Tool was applied to evaluate each of the trials included in the meta-analyses. In addition, the methodological characteristics of each clinical trial were assessed. The majority of the trials included in the meta-analyses have significant methodological flaws that threaten their internal validity. The lack of effect of periodontal treatment on preterm birth rate concluded by four meta-analyses, and the positive effect of treatment for reducing preterm birth risk concluded by the remaining two meta-analyses are not based on consistent scientific evidence. Well-conducted randomized controlled trials using rigorous methodology, including appropriate definition of the exposure, adequate control of confounders for preterm birth and application of effective periodontal interventions to eliminate periodontal infection, are needed to confirm the positive association between periodontal disease and preterm birth. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Methodological and reporting quality of systematic reviews on tuberculosis.

PubMed

Nicolau, I; Ling, D; Tian, L; Lienhardt, C; Pai, M

2013-09-01

Systematic reviews are used to inform tuberculosis (TB) guidelines. However, there are no data on whether TB systematic reviews are conducted well and reported transparently. We searched four databases for reviews published between 2005 and 2010. Methodological quality was evaluated using AMSTAR and quality of reporting was assessed using PRISMA. Of 152 articles, 137 (90%) met the inclusion criteria. Only 3 of 11 AMSTAR quality items were met in most reviews: appropriate methods to combine findings (67%), comprehensive literature search (72%) and presentation of characteristics of included studies (90%). The other eight items were met in 4-53% of the reviews. Only 4% of the reviews disclosed conflicts of interest. The majority of the PRISMA items were reported in more than 60-76% of the reviews. Only nine items were reported in less than 55% of the reviews, the lowest being the full-search strategy (30%), risk of bias across studies in the Methods (27%) and Results (21%) sections, and indication of a review protocol (15%). Systematic reviews in our survey were well reported but generally of moderate to low quality. Better training, use of reporting guidelines and registration of systematic reviews could improve the quality of TB reviews.

Static body postural misalignment in individuals with temporomandibular disorders: a systematic review

PubMed Central

Chaves, Thaís C.; Turci, Aline M.; Pinheiro, Carina F.; Sousa, Letícia M.; Grossi, Débora B.

2014-01-01

BACKGROUND: The association between body postural changes and temporomandibular disorders (TMD) has been widely discussed in the literature, however, there is little evidence to support this association. OBJECTIVES: The aim of the present study was to conduct a systematic review to assess the evidence concerning the association between static body postural misalignment and TMD. METHOD: A search was conducted in the PubMed/Medline, Embase, Lilacs, Scielo, Cochrane, and Scopus databases including studies published in English between 1950 and March 2012. Cross-sectional, cohort, case control, and survey studies that assessed body posture in TMD patients were selected. Two reviewers performed each step independently. A methodological checklist was used to evaluate the quality of the selected articles. RESULTS: Twenty studies were analyzed for their methodological quality. Only one study was classified as a moderate quality study and two were classified as strong quality studies. Among all studies considered, only 12 included craniocervical postural assessment, 2 included assessment of craniocervical and shoulder postures,, and 6 included global assessment of body posture. CONCLUSION: There is strong evidence of craniocervical postural changes in myogenous TMD, moderate evidence of cervical postural misalignment in arthrogenous TMD, and no evidence of absence of craniocervical postural misalignment in mixed TMD patients or of global body postural misalignment in patients with TMD. It is important to note the poor methodological quality of the studies, particularly those regarding global body postural misalignment in TMD patients. PMID:25590441

Mobile and Web 2.0 interventions for weight management: an overview of review evidence and its methodological quality

PubMed Central

Smith, Jane R.; Samaha, Laya; Abraham, Charles

2016-01-01

Abstract Background : The use of Internet and related technologies for promoting weight management (WM), physical activity (PA), or dietary-related behaviours has been examined in many articles and systematic reviews. This overview aims to summarize and assess the quality of the review evidence specifically focusing on mobile and Web 2.0 technologies, which are the most utilized, currently available technologies. Methods: Following a registered protocol (CRD42014010323), we searched 16 databases for articles published in English until 31 December 2014 discussing the use of either mobile or Web 2.0 technologies to promote WM or related behaviors, i.e. diet and physical activity (PA). Two reviewers independently selected reviews and assessed their methodological quality using the AMSTAR checklist. Citation matrices were used to determine the overlap among reviews. Results: Forty-four eligible reviews were identified, 39 of which evaluated the effects of interventions using mobile or Web 2.0 technologies. Methodological quality was generally low with only 7 reviews (16%) meeting the highest standards. Suggestive evidence exists for positive effects of mobile technologies on weight-related outcomes and, to a lesser extent, PA. Evidence is inconclusive regarding Web 2.0 technologies. Conclusions : Reviews on mobile and Web 2.0 interventions for WM and related behaviors suggest that these technologies can, under certain circumstances, be effective, but conclusions are limited by poor review quality based on a heterogeneous evidence base. PMID:27335330

Identifying individual changes in performance with composite quality indicators while accounting for regression to the mean.

PubMed

Gajewski, Byron J; Dunton, Nancy

2013-04-01

Almost a decade ago Morton and Torgerson indicated that perceived medical benefits could be due to "regression to the mean." Despite this caution, the regression to the mean "effects on the identification of changes in institutional performance do not seem to have been considered previously in any depth" (Jones and Spiegelhalter). As a response, Jones and Spiegelhalter provide a methodology to adjust for regression to the mean when modeling recent changes in institutional performance for one-variable quality indicators. Therefore, in our view, Jones and Spiegelhalter provide a breakthrough methodology for performance measures. At the same time, in the interests of parsimony, it is useful to aggregate individual quality indicators into a composite score. Our question is, can we develop and demonstrate a methodology that extends the "regression to the mean" literature to allow for composite quality indicators? Using a latent variable modeling approach, we extend the methodology to the composite indicator case. We demonstrate the approach on 4 indicators collected by the National Database of Nursing Quality Indicators. A simulation study further demonstrates its "proof of concept."

Is reflexology an effective intervention? A systematic review of randomised controlled trials.

PubMed

Ernst, Edzard

2009-09-07

To evaluate the evidence for and against the effectiveness of reflexology for treating any medical condition. Six electronic databases were searched from their inception to February 2009 to identify all relevant randomised controlled trials (RCTs). No language restrictions were applied. RCTs of reflexology delivered by trained reflexologists to patients with specific medical conditions. Condition studied, study design and controls, primary outcome measures, follow-up, and main results were extracted. 18 RCTs met all the inclusion criteria. The studies examined a range of conditions: anovulation, asthma, back pain, dementia, diabetes, cancer, foot oedema in pregnancy, headache, irritable bowel syndrome, menopause, multiple sclerosis, the postoperative state and premenstrual syndrome. There were > 1 studies for asthma, the postoperative state, cancer palliation and multiple sclerosis. Five RCTs yielded positive results. Methodological quality was evaluated using the Jadad scale. The methodological quality was often poor, and sample sizes were generally low. Most higher-quality trials did not generate positive findings. The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.

[Quality standards for duplex ultrasonographic assessment (duplex us) of abdominal aortic stent grafts].

PubMed

Diard, A; Becker, F; Pichot, O

2017-05-01

The quality standards of the French Society of Vascular Medicine for the ultrasound assessment of lower limb arteries in vascular medicine practice are based on the principle that these examinations have to meet two requirements: technical know-how (knowledge of devices and methodologies); medical know-how (level of examination matching the indication and purpose of the examination, interpretation and critical analysis of results). To describe an optimal level of examination adjusted to the indication or clinical hypothesis; to establish harmonious practices, methodologies, terminologies, results description and report; to provide good practice reference points and to promote a high quality process. The three levels of examination, indications and objectives for each level; the reference standard examination (level 2) and its variants according to indications; the minimal content of the exam report, the medical conclusion letter to the corresponding physician (synthesis, conclusion and management suggestions); commented glossary (anatomy, hemodynamics, signs and symptoms); technical basis; device settings. Here, we discuss duplex ultrasound for the supervision of the aortic stent grafts. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Optimization of composite flour biscuits by mixture response surface methodology.

PubMed

Okpala, Laura C; Okoli, Eric C

2013-08-01

Biscuits were produced from blends of pigeon pea, sorghum and cocoyam flours. The study was carried out using mixture response surface methodology as the optimization technique. Using the simplex centroid design, 10 formulations were obtained. Protein and sensory quality of the biscuits were analyzed. The sensory attributes studied were appearance, taste, texture, crispness and general acceptability, while the protein quality indices were biological value and net protein utilization. The results showed that while the addition of pigeon pea improved the protein quality, its addition resulted in reduced sensory ratings for all the sensory attributes with the exception of appearance. Some of the biscuits had sensory ratings, which were not significantly different (p > 0.05) from biscuits made with wheat. Rat feeding experiments indicated that the biological value and net protein utilization values obtained for most of the biscuits were above minimum recommended values. Optimization suggested biscuits containing 75.30% sorghum, 0% pigeon pea and 24.70% cocoyam flours as the best proportion of these components. This sample received good scores for the sensory attributes.

Tai Chi for Essential Hypertension

PubMed Central

Wang, Jie; Feng, Bo; Yang, Xiaochen; Liu, Wei; Teng, Fei; Li, Shengjie; Xiong, Xingjiang

2013-01-01

Objectives. To assess the current clinical evidence of Tai Chi for essential hypertension (EH). Search Strategy. 7 electronic databases were searched until 20 April, 2013. Inclusion Criteria. We included randomized trials testing Tai Chi versus routine care or antihypertensive drugs. Trials testing Tai Chi combined with antihypertensive drugs versus antihypertensive drugs were also included. Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results. 18 trials were included. Methodological quality of the trials was low. 14 trials compared Tai Chi with routine care. 1 trial compared Tai Chi with antihypertensive drugs. Meta-analysis all showed significant effect of TaiChi in lowering blood pressure (BP). 3 trials compared Tai Chi plus antihypertensive drugs with antihypertensive drugs. Positive results in BP were found in the other 2 combination groups. Most of the trials did not report adverse events, and the safety of Tai Chi is still uncertain. Conclusions. There is some encouraging evidence of Tai Chi for EH. However, due to poor methodological quality of included studies, the evidence remains weak. Rigorously designed trials are needed to confirm the evidence. PMID:23986780

The effectiveness of manual therapy in treating cervicogenic dizziness: a systematic review.

PubMed

Yaseen, Khalid; Hendrick, Paul; Ismail, Ayah; Felemban, Mohannad; Alshehri, Mansour Abdullah

2018-01-01

[Purpose] This review provides an evaluation of the evidence for the effectiveness of using manual therapy to treat cervicogenic dizziness. [Subjects and Methods] The literature was systematically searched on the May 2, 2016 using the following online databases: Medline, EMBASE, CINAHL and PEDro. This review included randomised controlled trials and compared the efficacy of manual therapy for the treatment of cervicogenic dizziness, compared to other types of intervention. This study measured changes based on dizziness intensity and frequency. [Results] The primary search found 30 articles, but only four articles met the inclusion criteria. Assessment of methodological quality was performed by two researchers using the PEDro scale. The level of evidence was determined using a recognised grading scale. Three out of the four articles were deemed to have high methodological quality, while the fourth was rated as moderate quality. The attributed level of evidence was moderate (level 2). [Conclusion] Manual therapy is potentially effective for managing cervicogenic dizziness. However, due to the heterogeneity of the results and techniques and the low number of studies, further research is recommended to provide conclusive evidence.

A Systematic and Transparent Approach for Assessing the Methodological Quality of Intervention Effectiveness Research: The Study Design and Implementation Assessment Device (Study DIAD)

ERIC Educational Resources Information Center

Valentine, Jeffrey C.; Cooper, Harris

2008-01-01

Assessments of studies meant to evaluate the effectiveness of interventions, programs, and policies can serve an important role in the interpretation of research results. However, evidence suggests that available quality assessment tools have poor measurement characteristics and can lead to opposing conclusions when applied to the same body of…

Studies in Ambulatory Care Quality Assessment in the Indian Health Service. Volume III: Comparison of Rural Private Practice, Health Maintenance Organizations, and the Indian Health Service.

ERIC Educational Resources Information Center

Nutting, Paul A.; And Others

Utilizing a quality assessment methodology for ambulatory patient care currently under development by the Indian Health Service's (IHS) Office of Research and Development, comparisons were made between results derived from a pilot test in IHS service units, 2 metropolitan Health Maintenance Organizations (HMO), and 3 rural private practices.…

Effect of IN718 Recycled Powder Reuse on Properties of Parts Manufactured by Means of Selective Laser Melting

NASA Astrophysics Data System (ADS)

Ardila, L. C.; Garciandia, F.; González-Díaz, J. B.; Álvarez, P.; Echeverria, A.; Petite, M. M.; Deffley, R.; Ochoa, J.

Powder quality control is essential to obtain parts with suitable mechanical properties in Selective Laser Melting manufacturing technique. One of the most important advantages of suchtechnique is that it allows an efficient use of the material, due to the possibility to recycle and reuse un-melted powder. Nevertheless, powder material properties may change due to repeated recycling, affecting this way the mechanicalbehavior of parts. In this paper the effect of powder reuse on its quality and on the mechanical properties of the resulting melted parts is studied via self-developed recycling methodology. The material considered for investigation was IN718, a nickel superalloy widely used in industry. After recycling powder up to 14 times, no significant changes were observed in powder and test parts properties. The results obtained in this work will help to validate powder recycling methodology for its use in current industrial Selective Laser Melting manufacturing.

Patient-reported outcomes in randomised controlled trials of prostate cancer: methodological quality and impact on clinical decision making.

PubMed

Efficace, Fabio; Feuerstein, Michael; Fayers, Peter; Cafaro, Valentina; Eastham, James; Pusic, Andrea; Blazeby, Jane

2014-09-01

Patient-reported outcomes (PRO) data from randomised controlled trials (RCTs) are increasingly used to inform patient-centred care as well as clinical and health policy decisions. The main objective of this study was to investigate the methodological quality of PRO assessment in RCTs of prostate cancer (PCa) and to estimate the likely impact of these studies on clinical decision making. A systematic literature search of studies was undertaken on main electronic databases to retrieve articles published between January 2004 and March 2012. RCTs were evaluated on a predetermined extraction form, including (1) basic trial demographics and clinical and PRO characteristics; (2) level of PRO reporting based on the recently published recommendations by the International Society for Quality of Life Research; and (3) bias, assessed using the Cochrane Risk of Bias tool. Studies were systematically analysed to evaluate their relevance for supporting clinical decision making. Sixty-five RCTs enrolling a total of 22 071 patients were evaluated, with 31 (48%) in patients with nonmetastatic disease. When a PRO difference between treatments was found, it related in most cases to symptoms only (n=29, 58%). Although the extent of missing data was generally documented (72% of RCTs), few reported details on statistical handling of this data (18%) and reasons for dropout (35%). Improvements in key methodological aspects over time were found. Thirteen (20%) RCTs were judged as likely to be robust in informing clinical decision making. Higher-quality PRO studies were generally associated with those RCTs that had higher internal validity. Including PRO in RCTs of PCa patients is critical for better evaluating the treatment effectiveness of new therapeutic approaches. Marked improvements in PRO quality reporting over time were found, and it is estimated that at least one-fifth of PRO RCTs have provided sufficient details to allow health policy makers and physicians to make critical appraisals of results. In this report, we have investigated the methodological quality of PCa trials that have included a PRO assessment. We conclude that including PRO is critical to better evaluating the treatment effectiveness of new therapeutic approaches from the patient's perspective. Also, at least one-fifth of PRO RCTs in PCa have provided sufficient details to allow health policy makers and physicians to make a critical appraisal of results. Copyright © 2013. Published by Elsevier B.V.

Expectations for methodology and translation of animal research: a survey of health care workers.

PubMed

Joffe, Ari R; Bara, Meredith; Anton, Natalie; Nobis, Nathan

2015-05-07

Health care workers (HCW) often perform, promote, and advocate use of public funds for animal research (AR); therefore, an awareness of the empirical costs and benefits of animal research is an important issue for HCW. We aim to determine what health-care-workers consider should be acceptable standards of AR methodology and translation rate to humans. After development and validation, an e-mail survey was sent to all pediatricians and pediatric intensive care unit nurses and respiratory-therapists (RTs) affiliated with a Canadian University. We presented questions about demographics, methodology of AR, and expectations from AR. Responses of pediatricians and nurses/RTs were compared using Chi-square, with P < .05 considered significant. Response rate was 44/114(39%) (pediatricians), and 69/120 (58%) (nurses/RTs). Asked about methodological quality, most respondents expect that: AR is done to high quality; costs and difficulty are not acceptable justifications for low quality; findings should be reproducible between laboratories and strains of the same species; and guidelines for AR funded with public money should be consistent with these expectations. Asked about benefits of AR, most thought that there are sometimes/often large benefits to humans from AR, and disagreed that "AR rarely produces benefit to humans." Asked about expectations of translation to humans (of toxicity, carcinogenicity, teratogenicity, and treatment findings), most: expect translation >40% of the time; thought that misleading AR results should occur <21% of the time; and that if translation was to occur <20% of the time, they would be less supportive of AR. There were few differences between pediatricians and nurses/RTs. HCW have high expectations for the methodological quality of, and the translation rate to humans of findings from AR. These expectations are higher than the empirical data show having been achieved. Unless these areas of AR significantly improve, HCW support of AR may be tenuous.

A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand

PubMed Central

2013-01-01

Background Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. Methods A systematic search of 17 electronic databases and 13 websites for the period 1981–2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Results Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. Conclusions There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous populations. Combining and tailoring best evidence and culturally-specific individual strategies into one coherent suicide prevention program for delivery to whole Indigenous communities and/or population groups at high risk of suicide offers considerable promise. PMID:23663493

Developing a methodology to predict PM10 concentrations in urban areas using generalized linear models.

PubMed

Garcia, J M; Teodoro, F; Cerdeira, R; Coelho, L M R; Kumar, Prashant; Carvalho, M G

2016-09-01

A methodology to predict PM10 concentrations in urban outdoor environments is developed based on the generalized linear models (GLMs). The methodology is based on the relationship developed between atmospheric concentrations of air pollutants (i.e. CO, NO2, NOx, VOCs, SO2) and meteorological variables (i.e. ambient temperature, relative humidity (RH) and wind speed) for a city (Barreiro) of Portugal. The model uses air pollution and meteorological data from the Portuguese monitoring air quality station networks. The developed GLM considers PM10 concentrations as a dependent variable, and both the gaseous pollutants and meteorological variables as explanatory independent variables. A logarithmic link function was considered with a Poisson probability distribution. Particular attention was given to cases with air temperatures both below and above 25°C. The best performance for modelled results against the measured data was achieved for the model with values of air temperature above 25°C compared with the model considering all ranges of air temperatures and with the model considering only temperature below 25°C. The model was also tested with similar data from another Portuguese city, Oporto, and results found to behave similarly. It is concluded that this model and the methodology could be adopted for other cities to predict PM10 concentrations when these data are not available by measurements from air quality monitoring stations or other acquisition means.

Economic Evaluation of Interventions for Prevention of Hospital Acquired Infections: A Systematic Review

PubMed Central

Kwetkat, Anja

2016-01-01

Objective This systematic review sought to assess the costs and benefits of interventions preventing hospital-acquired infections and to evaluate methodological and reporting quality. Methods We systematically searched Medline via PubMed and the National Health Service Economic Evaluation Database from 2009 to 2014. We included quasi-experimental and randomized trails published in English or German evaluating the economic impact of interventions preventing the four most frequent hospital-acquired infections (urinary tract infections, surgical wound infections, pneumonia, and primary bloodstream infections). Characteristics and results of the included articles were extracted using a standardized data collection form. Study and reporting quality were evaluated using SIGN and CHEERS checklists. All costs were adjusted to 2013 US$. Savings-to-cost ratios and difference values with interquartile ranges (IQRs) per month were calculated, and the effects of study characteristics on the cost-benefit results were analyzed. Results Our search returned 2067 articles, of which 27 met the inclusion criteria. The median savings-to-cost ratio across all studies reporting both costs and savings values was US $7.0 (IQR 4.2–30.9), and the median net global saving was US $13,179 (IQR 5,106–65,850) per month. The studies’ reporting quality was low. Only 14 articles reported more than half of CHEERS items appropriately. Similarly, an assessment of methodological quality found that only four studies (14.8%) were considered high quality. Conclusions Prevention programs for hospital acquired infections have very positive cost-benefit ratios. Improved reporting quality in health economics publications is required. PMID:26731736

Worldwide trends in volume and quality of published protocols of randomized controlled trials

PubMed Central

Alldinger, Ingo; Cieslak, Kasia P.; Wennink, Roos; Clarke, Mike; Ali, Usama Ahmed; Besselink, Marc G. H.

2017-01-01

Introduction Publishing protocols of randomized controlled trials (RCT) facilitates a more detailed description of study rational, design, and related ethical and safety issues, which should promote transparency. Little is known about how the practice of publishing protocols developed over time. Therefore, this study describes the worldwide trends in volume and methodological quality of published RCT protocols. Methods A systematic search was performed in PubMed and EMBASE, identifying RCT protocols published over a decade from 1 September 2001. Data were extracted on quality characteristics of RCT protocols. The primary outcome, methodological quality, was assessed by individual methodological characteristics (adequate generation of allocation, concealment of allocation and intention-to-treat analysis). A comparison was made by publication period (First, September 2001- December 2004; Second, January 2005-May 2008; Third, June 2008-September 2011), geographical region and medical specialty. Results The number of published RCT protocols increased from 69 in the first, to 390 in the third period (p<0.0001). Internal medicine and paediatrics were the most common specialty topics. Whereas most published RCT protocols in the first period originated from North America (n = 30, 44%), in the second and third period this was Europe (respectively, n = 65, 47% and n = 190, 48%, p = 0.02). Quality of RCT protocols was higher in Europe and Australasia, compared to North America (OR = 0.63, CI = 0.40–0.99, p = 0.04). Adequate generation of allocation improved with time (44%, 58%, 67%, p = 0.001), as did concealment of allocation (38%, 53%, 55%, p = 0.03). Surgical protocols had the highest quality among the three specialty topics used in this study (OR = 1.94, CI = 1.09–3.45, p = 0.02). Conclusion Publishing RCT protocols has become popular, with a five-fold increase in the past decade. The quality of published RCT protocols also improved, although variation between geographical regions and across medical specialties was seen. This emphasizes the importance of international standards of comprehensive training in RCT methodology. PMID:28296925

The Perfect Process Storm: Integration of CMMI, Agile, and Lean Six Sigma

DTIC Science & Technology

2012-12-01

struggled over the past few decades with a blizzard of process improvement methodologies such as Total Quality Manage- ment (TQM), Kaizen , JIT...the Japanese Kaizen system, targeting quality, effort, employee involvement, willingness to change, communication, and elimina- tion of waste in...blizzard of process improvement methodologies such as Total Quality Management (TQM), Kaizen , JIT Production, and Re-Engineering. These operations are

Q-SEA – a tool for quality assessment of ethics analyses conducted as part of health technology assessments

PubMed Central

Scott, Anna Mae; Hofmann, Björn; Gutiérrez-Ibarluzea, Iñaki; Bakke Lysdahl, Kristin; Sandman, Lars; Bombard, Yvonne

2017-01-01

Introduction: Assessment of ethics issues is an important part of health technology assessments (HTA). However, in terms of existence of quality assessment tools, ethics for HTA is methodologically underdeveloped in comparison to other areas of HTA, such as clinical or cost effectiveness. Objective: To methodologically advance ethics for HTA by: (1) proposing and elaborating Q-SEA, the first instrument for quality assessment of ethics analyses, and (2) applying Q-SEA to a sample systematic review of ethics for HTA, in order to illustrate and facilitate its use. Methods: To develop a list of items for the Q-SEA instrument, we systematically reviewed the literature on methodology in ethics for HTA, reviewed HTA organizations’ websites, and solicited views from 32 experts in the field of ethics for HTA at two 2-day workshops. We subsequently refined Q-SEA through its application to an ethics analysis conducted for HTA. Results: Q-SEA instrument consists of two domains – the process domain and the output domain. The process domain consists of 5 elements: research question, literature search, inclusion/exclusion criteria, perspective, and ethics framework. The output domain consists of 5 elements: completeness, bias, implications, conceptual clarification, and conflicting values. Conclusion: Q-SEA is the first instrument for quality assessment of ethics analyses in HTA. Further refinements to the instrument to enhance its usability continue. PMID:28326147

Survey of the prevalence and methodology of quality assurance for B-mode ultrasound image quality among veterinary sonographers.

PubMed

Hoscheit, Larry P; Heng, Hock Gan; Lim, Chee Kin; Weng, Hsin-Yi

2018-05-01

Image quality in B-mode ultrasound is important as it reflects the diagnostic accuracy and diagnostic information provided during clinical scanning. Quality assurance programs for B-mode ultrasound systems/components are comprised of initial quality acceptance testing and subsequent regularly scheduled quality control testing. The importance of quality assurance programs for B-mode ultrasound image quality using ultrasound phantoms is well documented in the human medical and medical physics literature. The purpose of this prospective, cross-sectional, survey study was to determine the prevalence and methodology of quality acceptance testing and quality control testing of image quality for ultrasound system/components among veterinary sonographers. An online electronic survey was sent to 1497 members of veterinary imaging organizations: the American College of Veterinary Radiology, the Veterinary Ultrasound Society, and the European Association of Veterinary Diagnostic Imaging, and a total of 167 responses were received. The results showed that the percentages of veterinary sonographers performing quality acceptance testing and quality control testing are 42% (64/151; 95% confidence interval 34-52%) and 26% (40/156: 95% confidence interval 19-33%) respectively. Of the respondents who claimed to have quality acceptance testing or quality control testing of image quality in place for their ultrasound system/components, 0% have performed quality acceptance testing or quality control testing correctly (quality acceptance testing 95% confidence interval: 0-6%, quality control testing 95% confidence interval: 0-11%). Further education and guidelines are recommended for veterinary sonographers in the area of quality acceptance testing and quality control testing for B-mode ultrasound equipment/components. © 2018 American College of Veterinary Radiology.

Methodology and guidelines for regulating traffic flows under air quality constraints in metropolitan areas.

DOT National Transportation Integrated Search

2010-02-01

This project developed a methodology to couple a new pollutant dispersion model with a traffic : assignment process to contain air pollution while maximizing mobility. The overall objective of the air : quality modeling part of the project is to deve...

A PRELIMINARY METHODOLOGY FOR EVALUATING THE COST-EFFECTIVENESS OF ALTERNATIVE INDOOR AIR QUALITY APPROACHES

EPA Science Inventory

The report defines a simplified methodology that can be used by indoor air quality (IAQ) diagnosticians, architects/engineers, building owners/operators, and the scientific community for preliminary comparison of the cost-effectiveness of alternative IAQ control measures for any ...

Quality Assessment of TPB-Based Questionnaires: A Systematic Review

PubMed Central

Oluka, Obiageli Crystal; Nie, Shaofa; Sun, Yi

2014-01-01

Objective This review is aimed at assessing the quality of questionnaires and their development process based on the theory of planned behavior (TPB) change model. Methods A systematic literature search for studies with the primary aim of TPB-based questionnaire development was conducted in relevant databases between 2002 and 2012 using selected search terms. Ten of 1,034 screened abstracts met the inclusion criteria and were assessed for methodological quality using two different appraisal tools: one for the overall methodological quality of each study and the other developed for the appraisal of the questionnaire content and development process. Both appraisal tools consisted of items regarding the likelihood of bias in each study and were eventually combined to give the overall quality score for each included study. Results 8 of the 10 included studies showed low risk of bias in the overall quality assessment of each study, while 9 of the studies were of high quality based on the quality appraisal of questionnaire content and development process. Conclusion Quality appraisal of the questionnaires in the 10 reviewed studies was successfully conducted, highlighting the top problem areas (including: sample size estimation; inclusion of direct and indirect measures; and inclusion of questions on demographics) in the development of TPB-based questionnaires and the need for researchers to provide a more detailed account of their development process. PMID:24722323

E-therapy for mental health problems: a systematic review.

PubMed

Postel, Marloes G; de Haan, Hein A; De Jong, Cor A J

2008-09-01

The widespread availability of the Internet offers opportunities for improving access to therapy for people with mental health problems. There is a seemingly infinite supply of Internet-based interventions available on the World Wide Web. The aim of the present study is to systematically assess the methodological quality of randomized controlled trials (RCTs) concerning e-therapy for mental health problems. Two reviewers independently assessed the methodological quality of the RCTs, based on a list of criteria for the methodological quality assessment as recommended by the Cochrane Back Review Group. The search yielded 14 papers that reported RCTs concerning e-therapy for mental-health problems. The methodological quality of studies included in this review was generally low. It is concluded that e-therapy may turn out to be an appropriate therapeutic entity, but the evidence needs to be more convincing. Recommendations are made concerning the method of reporting RCTs and the need to add some content items to an e-therapy study.

The temporal structure of pollution levels in developed cities.

PubMed

Barrigón Morillas, Juan Miguel; Ortiz-Caraballo, Carmen; Prieto Gajardo, Carlos

2015-06-01

Currently, the need for mobility can cause significant pollution levels in cities, with important effects on health and quality of life. Any approach to the study of urban pollution and its effects requires an analysis of spatial distribution and temporal variability. It is a crucial dilemma to obtain proven methodologies that allow an increase in the quality of the prediction and the saving of resources in the spatial and temporal sampling. This work proposes a new analytical methodology in the study of temporal structure. As a result, a model for estimating annual levels of urban traffic noise was proposed. The average errors are less than one decibel in all acoustics indicators. A new working methodology of urban noise has begun. Additionally, a general application can be found for the study of the impacts of pollution associated with traffic, with implications for urban design and possibly in economic and sociological aspects. Copyright © 2015 Elsevier B.V. All rights reserved.

Exploration of the integration of care for persons with a traumatic brain injury using social network analysis methodology

PubMed Central

Lamontagne, Marie-Eve

2013-01-01

Introduction Integration is a popular strategy to increase the quality of care within systems of care. However, there is no common language, approach or tool allowing for a valid description, comparison and evaluation of integrated care. Social network analysis could be a viable methodology to provide an objective picture of integrated networks. Goal of the article To illustrate social network analysis use in the context of systems of care for traumatic brain injury. Method We surveyed members of a network using a validated questionnaire to determine the links between them. We determined the density, centrality, multiplexity, and quality of the links reported. Results The network was described as moderately dense (0.6), the most prevalent link was knowledge, and four organisation members of a consortium were central to the network. Social network analysis allowed us to create a graphic representation of the network. Conclusion Social network analysis is a useful methodology to objectively characterise integrated networks. PMID:24250281

Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review

PubMed Central

Boulkedid, Rym; Abdoul, Hendy; Loustau, Marine; Sibony, Olivier; Alberti, Corinne

2011-01-01

Objective Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice. Methodology and Main Finding Three electronic data bases were searched over a 30 years period (1978–2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility. Conclusion The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys. PMID:21694759

Using Q Methodology in Quality Improvement Projects.

PubMed

Tiernon, Paige; Hensel, Desiree; Roy-Ehri, Leah

Q methodology consists of a philosophical framework and procedures to identify subjective viewpoints that may not be well understood, but its use in nursing is still quite limited. We describe how Q methodology can be used in quality improvement projects to better understand local viewpoints that act as facilitators or barriers to the implementation of evidence-based practice. We describe the use of Q methodology to identify nurses' attitudes about the provision of skin-to-skin care after cesarean birth. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Social exclusion in academia through biases in methodological quality evaluation: On the situation of women in science and philosophy.

PubMed

Leuschner, Anna

2015-12-01

Empirical studies show that academia is socially exclusive. I argue that this social exclusion works, at least partly, through the systematic methodological disqualification of contributions from members of underrepresented social groups. As methodological quality criteria are underdetermined their interpretation and weighting can be biased with relation to gender, race, social background, etc. Such biased quality evaluation can take place on a local or global level. The current situation of women in academic philosophy illuminates this. I conclude that only mechanical solutions can effectively change the situation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation.

PubMed

Harries, Bruce; Filiatrault, Lyne; Abu-Laban, Riyad B

2018-05-30

Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care. We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology. The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study. Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had this approach been used in the original study, insights regarding the benefits of nurse-initiated radiography using the OAR would have been achieved earlier, and thus potentially at a lower cost. In situations where the overarching aim is to accelerate implementation of practice improvement to benefit future patients, we believe that increased consideration should be given to the use of QI analytic methodology.

Is Hyperbaric Oxygen Therapy Effective for Traumatic Brain Injury? A Rapid Evidence Assessment of the Literature and Recommendations for the Field.

PubMed

Crawford, Cindy; Teo, Lynn; Yang, EunMee; Isbister, Caitlin; Berry, Kevin

This systematic review examines the efficacy of hyperbaric oxygen (HBO2) for traumatic brain injury (TBI) to make evidence-based recommendations for its application and future research. A comprehensive search was conducted to identify studies through 2014. Methodological quality was assessed and synthesis and interpretation of relevant data was performed. Twelve randomized trials were included. All mild TBI studies demonstrated minimal bias and no statistically significant differences between HBO2 and sham arms. Statistically significant improvement occurred over time within both groups. Moderate-to-severe TBI studies were of mixed quality, with majority of results favoring HBO2 compared with "standard care." The placebo analysis conducted was limited by lack of details. For mild TBI, results indicate HBO2 is no better than sham treatment. Improvements within both HBO2 and sham groups cannot be ignored. For acute treatment of moderate-to-severe TBI, although methodology appears flawed across some studies, because of the complexity of brain injury, HBO2 may be beneficial as a relatively safe adjunctive therapy if feasible. Further research should be considered to resolve the controversy surrounding this field, but only if methodological flaws are avoided and bias minimized.

Effects of Regular Classes in Outdoor Education Settings: A Systematic Review on Students’ Learning, Social and Health Dimensions

PubMed Central

Becker, Christoph; Lauterbach, Gabriele; Spengler, Sarah; Dettweiler, Ulrich; Mess, Filip

2017-01-01

Background: Participants in Outdoor Education Programmes (OEPs) presumably benefit from these programmes in terms of their social and personal development, academic achievement and physical activity (PA). The aim of this systematic review was to identify studies about regular compulsory school- and curriculum-based OEPs, to categorise and evaluate reported outcomes, to assess the methodological quality, and to discuss possible benefits for students. Methods: We searched online databases to identify English- and German-language peer-reviewed journal articles that reported any outcomes on a student level. Two independent reviewers screened studies identified for eligibility and assessed the methodological quality. Results: Thirteen studies were included for analysis. Most studies used a case-study design, the average number of participants was moderate (mean valued (M) = 62.17; standard deviation (SD) = 64.12), and the methodological quality was moderate on average for qualitative studies (M = 0.52; SD = 0.11), and low on average for quantitative studies (M = 0.18; SD = 0.42). Eight studies described outcomes in terms of social dimensions, seven studies in learning dimensions and four studies were subsumed under additional outcomes, i.e., PA and health. Eleven studies reported positive, one study positive as well as negative, and one study reported negative effects. PA and mental health as outcomes were underrepresented. Conclusion: Tendencies were detected that regular compulsory school- and curriculum-based OEPs can promote students in respect of social, academic, physical and psychological dimensions. Very little is known concerning students’ PA or mental health. We recommend conducting more quasi-experimental design and longitudinal studies with a greater number of participants, and a high methodological quality to further investigate these tendencies. PMID:28475167

The Tools of Quality in Electronic Engineering Education.

ERIC Educational Resources Information Center

Medrano, C. T.; Ube, M.; Plaza, I.; Blesa, A.

2002-01-01

Explores the integration of three factors in the lecture room that influence the function between students and society. Describes the innovation of quality in education that provides students with a work methodology in agreement with the professional world and allows continuous improvement in educational methodology. (Author/KHR)

Epidemiology, methodological and reporting characteristics of systematic reviews of nursing interventions published in China.

PubMed

Shi, Chunhu; Zhu, Lin; Wang, Xue; Qin, Chunxia; Xu, Qi; Tian, Jinhui

2014-12-01

The importance of systematic reviews (SRs) of nursing interventions' impact on practice makes their methodological quality and reporting characteristics especially important as it directly influence their utility for clinicians, patients and policy makers.The study aims to assess the methodological quality and reporting characteristics of SRs of nursing interventions in Chinese nursing journals. Three Chinese databases were searched for SRs of nursing interventions from inception to October 2011. The assessment of multiple systematic reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statements were used to assess methodological quality and reporting characteristics. Seventy-four SRs were included. The proportion of SRs complying with AMSTAR checklist items ranged from 0% to 82.4%. No SRs reported an 'a priori' design or conflict of interest. Only four items were found to be reported in more than 50% of the SRs: a list of included and excluded studies, the scientific quality of included studies, the appropriate use of methods to combine findings, and formulating conclusions appropriately. The majority of SRs of nursing interventions in China had major methodological and reporting flaws that limited their value to guide decisions. Chinese authors and journals should adopt and keep up with the AMSTAR and PRISMA statements to improve the quality of SRs in this field. © 2014 Wiley Publishing Asia Pty Ltd.

Extended cooperative control synthesis

NASA Technical Reports Server (NTRS)

Davidson, John B.; Schmidt, David K.

1994-01-01

This paper reports on research for extending the Cooperative Control Synthesis methodology to include a more accurate modeling of the pilot's controller dynamics. Cooperative Control Synthesis (CCS) is a methodology that addresses the problem of how to design control laws for piloted, high-order, multivariate systems and/or non-conventional dynamic configurations in the absence of flying qualities specifications. This is accomplished by emphasizing the parallel structure inherent in any pilot-controlled, augmented vehicle. The original CCS methodology is extended to include the Modified Optimal Control Model (MOCM), which is based upon the optimal control model of the human operator developed by Kleinman, Baron, and Levison in 1970. This model provides a modeling of the pilot's compensation dynamics that is more accurate than the simplified pilot dynamic representation currently in the CCS methodology. Inclusion of the MOCM into the CCS also enables the modeling of pilot-observation perception thresholds and pilot-observation attention allocation affects. This Extended Cooperative Control Synthesis (ECCS) allows for the direct calculation of pilot and system open- and closed-loop transfer functions in pole/zero form and is readily implemented in current software capable of analysis and design for dynamic systems. Example results based upon synthesizing an augmentation control law for an acceleration command system in a compensatory tracking task using the ECCS are compared with a similar synthesis performed by using the original CCS methodology. The ECCS is shown to provide augmentation control laws that yield more favorable, predicted closed-loop flying qualities and tracking performance than those synthesized using the original CCS methodology.

Use of methodological tools for assessing the quality of studies in periodontology and implant dentistry: a systematic review.

PubMed

Faggion, Clovis M; Huda, Fahd; Wasiak, Jason

2014-06-01

To evaluate the methodological approaches used to assess the quality of studies included in systematic reviews (SRs) in periodontology and implant dentistry. Two electronic databases (PubMed and Cochrane Database of Systematic Reviews) were searched independently to identify SRs examining interventions published through 2 September 2013. The reference lists of included SRs and records of 10 specialty dental journals were searched manually. Methodological approaches were assessed using seven criteria based on the Cochrane Handbook for Systematic Reviews of Interventions. Temporal trends in methodological quality were also explored. Of the 159 SRs with meta-analyses included in the analysis, 44 (28%) reported the use of domain-based tools, 15 (9%) reported the use of checklists and 7 (4%) reported the use of scales. Forty-two (26%) SRs reported use of more than one tool. Criteria were met heterogeneously; authors of 15 (9%) publications incorporated the quality of evidence of primary studies into SRs, whereas 69% of SRs reported methodological approaches in the Materials/Methods section. Reporting of four criteria was significantly better in recent (2010-2013) than in previous publications. The analysis identified several methodological limitations of approaches used to assess evidence in studies included in SRs in periodontology and implant dentistry. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effect of image sharpness on quantitative eye movement data and on image quality evaluation while viewing natural images

NASA Astrophysics Data System (ADS)

Vuori, Tero; Olkkonen, Maria

2006-01-01

The aim of the study is to test both customer image quality rating (subjective image quality) and physical measurement of user behavior (eye movements tracking) to find customer satisfaction differences in imaging technologies. Methodological aim is to find out whether eye movements could be quantitatively used in image quality preference studies. In general, we want to map objective or physically measurable image quality to subjective evaluations and eye movement data. We conducted a series of image quality tests, in which the test subjects evaluated image quality while we recorded their eye movements. Results show that eye movement parameters consistently change according to the instructions given to the user, and according to physical image quality, e.g. saccade duration increased with increasing blur. Results indicate that eye movement tracking could be used to differentiate image quality evaluation strategies that the users have. Results also show that eye movements would help mapping between technological and subjective image quality. Furthermore, these results give some empirical emphasis to top-down perception processes in image quality perception and evaluation by showing differences between perceptual processes in situations when cognitive task varies.

Cross-Sectional And Longitudinal Uncertainty Propagation In Drinking Water Risk Assessment

NASA Astrophysics Data System (ADS)

Tesfamichael, A. A.; Jagath, K. J.

2004-12-01

Pesticide residues in drinking water can vary significantly from day to day. However, drinking water quality monitoring performed under the Safe Drinking Water Act (SDWA) at most community water systems (CWSs) is typically limited to four data points per year over a few years. Due to limited sampling, likely maximum residues may be underestimated in risk assessment. In this work, a statistical methodology is proposed to study the cross-sectional and longitudinal uncertainties in observed samples and their propagated effect in risk estimates. The methodology will be demonstrated using data from 16 CWSs across the US that have three independent databases of atrazine residue to estimate the uncertainty of risk in infants and children. The results showed that in 85% of the CWSs, chronic risks predicted with the proposed approach may be two- to four-folds higher than that predicted with the current approach, while intermediate risks may be two- to three-folds higher in 50% of the CWSs. In 12% of the CWSs, however, the proposed methodology showed a lower intermediate risk. A closed-form solution of propagated uncertainty will be developed to calculate the number of years (seasons) of water quality data and sampling frequency needed to reduce the uncertainty in risk estimates. In general, this methodology provided good insight into the importance of addressing uncertainty of observed water quality data and the need to predict likely maximum residues in risk assessment by considering propagation of uncertainties.

Vending machine assessment methodology. A systematic review.

PubMed

Matthews, Melissa A; Horacek, Tanya M

2015-07-01

The nutritional quality of food and beverage products sold in vending machines has been implicated as a contributing factor to the development of an obesogenic food environment. How comprehensive, reliable, and valid are the current assessment tools for vending machines to support or refute these claims? A systematic review was conducted to summarize, compare, and evaluate the current methodologies and available tools for vending machine assessment. A total of 24 relevant research studies published between 1981 and 2013 met inclusion criteria for this review. The methodological variables reviewed in this study include assessment tool type, study location, machine accessibility, product availability, healthfulness criteria, portion size, price, product promotion, and quality of scientific practice. There were wide variations in the depth of the assessment methodologies and product healthfulness criteria utilized among the reviewed studies. Of the reviewed studies, 39% evaluated machine accessibility, 91% evaluated product availability, 96% established healthfulness criteria, 70% evaluated portion size, 48% evaluated price, 52% evaluated product promotion, and 22% evaluated the quality of scientific practice. Of all reviewed articles, 87% reached conclusions that provided insight into the healthfulness of vended products and/or vending environment. Product healthfulness criteria and complexity for snack and beverage products was also found to be variable between the reviewed studies. These findings make it difficult to compare results between studies. A universal, valid, and reliable vending machine assessment tool that is comprehensive yet user-friendly is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

Adherence of hip and knee arthroplasty studies to RSA standardization guidelines

PubMed Central

Mäkinen, Tatu J; Aro, Hannu T; Bragdon, Charles; Malchau, Henrik

2014-01-01

Background and purpose Guidelines for standardization of radiostereometry (RSA) of implants were published in 2005 to facilitate comparison of outcomes between various research groups. In this systematic review, we determined how well studies have adhered to these guidelines. Methods We carried out a literature search to identify all articles published between January 2000 and December 2011 that used RSA in the evaluation of hip or knee prosthesis migration. 2 investigators independently evaluated each of the studies for adherence to the 13 individual guideline items. Since some of the 13 points included more than 1 criterion, studies were assessed on whether each point was fully met, partially met, or not met. Results 153 studies that met our inclusion criteria were identified. 61 of these were published before the guidelines were introduced (2000–2005) and 92 after the guidelines were introduced (2006–2011). The methodological quality of RSA studies clearly improved from 2000 to 2011. None of the studies fully met all 13 guidelines. Nearly half (43) of the studies published after the guidelines demonstrated a high methodological quality and adhered at least partially to 10 of the 13 guidelines, whereas less than one-fifth (11) of the studies published before the guidelines had the same methodological quality. Commonly unaddressed guideline items were related to imaging methodology, determination of precision from double examinations, and also mean error of rigid-body fitting and condition number cutoff levels. Interpretation The guidelines have improved methodological reporting in RSA studies, but adherence to these guidelines is still relatively low. There is a need to update and clarify the guidelines for clinical hip and knee arthroplasty RSA studies. PMID:24954489

A methodology for model-based development and automated verification of software for aerospace systems

NASA Astrophysics Data System (ADS)

Martin, L.; Schatalov, M.; Hagner, M.; Goltz, U.; Maibaum, O.

Today's software for aerospace systems typically is very complex. This is due to the increasing number of features as well as the high demand for safety, reliability, and quality. This complexity also leads to significant higher software development costs. To handle the software complexity, a structured development process is necessary. Additionally, compliance with relevant standards for quality assurance is a mandatory concern. To assure high software quality, techniques for verification are necessary. Besides traditional techniques like testing, automated verification techniques like model checking become more popular. The latter examine the whole state space and, consequently, result in a full test coverage. Nevertheless, despite the obvious advantages, this technique is rarely yet used for the development of aerospace systems. In this paper, we propose a tool-supported methodology for the development and formal verification of safety-critical software in the aerospace domain. The methodology relies on the V-Model and defines a comprehensive work flow for model-based software development as well as automated verification in compliance to the European standard series ECSS-E-ST-40C. Furthermore, our methodology supports the generation and deployment of code. For tool support we use the tool SCADE Suite (Esterel Technology), an integrated design environment that covers all the requirements for our methodology. The SCADE Suite is well established in avionics and defense, rail transportation, energy and heavy equipment industries. For evaluation purposes, we apply our approach to an up-to-date case study of the TET-1 satellite bus. In particular, the attitude and orbit control software is considered. The behavioral models for the subsystem are developed, formally verified, and optimized.

[Pharmacological Treatment of Apathy in Parkinson's Disease: a Systematic Review of the Literature].

PubMed

Holguín Lew, Jorge Carlos; Caamaño Jaraba, Jessica; Gómez Alzate, Alejandra; Hidalgo López, Catalina; Marino Mondragón, Daniel Felipe; Restrepo Moreno, Sebastián; Rico Abella, Liz Evelin

2017-10-01

Apathy, defined as a deficit for initiating and maintaining action, is a symptom affecting patients with diverse psychiatric and neuropsychiatric diseases, including dementia, sequelae of traumatic brain injury, schizophrenia, depression, and Parkinson's disease (PD). Apathy negatively affects function and quality of life of PD patients, and it is an important cause of caregiver's distress. The pharmacological treatment of apathy in PD is the focus of this systematic review. A comprehensive search and systematic selection was performed in different databases of original research papers on the treatment of apathy in PD. The results were then consolidated, and a critical analysis was made of the research papers. The results are then discussed according to the methodological standards for systematic reviews of the literature. A total of 11 studies were included. Although some studies showed efficacy, all of them had important methodological limitations that hampered the interpretation of results. The results of the examined studies cannot be considered as evidence for guiding clinical decisions. So far, no evidence-based recommendations can be offered for the treatment of apathy in PD. More studies with better methodological quality are needed. It is a potentially fruitful area for research and one badly needed by both PD patients and their caregivers. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Improving the Quality of Patient Care Utilizing Tracer Methodology

DTIC Science & Technology

2011-01-25

Sharing Knowledge: Achieving Breakthrough Performance 2011 Military Health System Conference Improving the Quality of Patient Care Utilizing Tracer...Methodology 25 Jan 2011 Leslie Atkins, RN 1 Military Health System Conference T e Quadruple Aim Working Together, Achieving Success USA MEDDAC...25 JAN 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Improving the Quality of Patient Care Utilizing

Economic Evaluation of Interventions for Prevention of Hospital Acquired Infections: A Systematic Review.

PubMed

Arefian, Habibollah; Vogel, Monique; Kwetkat, Anja; Hartmann, Michael

2016-01-01

This systematic review sought to assess the costs and benefits of interventions preventing hospital-acquired infections and to evaluate methodological and reporting quality. We systematically searched Medline via PubMed and the National Health Service Economic Evaluation Database from 2009 to 2014. We included quasi-experimental and randomized trails published in English or German evaluating the economic impact of interventions preventing the four most frequent hospital-acquired infections (urinary tract infections, surgical wound infections, pneumonia, and primary bloodstream infections). Characteristics and results of the included articles were extracted using a standardized data collection form. Study and reporting quality were evaluated using SIGN and CHEERS checklists. All costs were adjusted to 2013 US$. Savings-to-cost ratios and difference values with interquartile ranges (IQRs) per month were calculated, and the effects of study characteristics on the cost-benefit results were analyzed. Our search returned 2067 articles, of which 27 met the inclusion criteria. The median savings-to-cost ratio across all studies reporting both costs and savings values was US $7.0 (IQR 4.2-30.9), and the median net global saving was US $13,179 (IQR 5,106-65,850) per month. The studies' reporting quality was low. Only 14 articles reported more than half of CHEERS items appropriately. Similarly, an assessment of methodological quality found that only four studies (14.8%) were considered high quality. Prevention programs for hospital acquired infections have very positive cost-benefit ratios. Improved reporting quality in health economics publications is required.

The Society for Implementation Research Collaboration Instrument Review Project: a methodology to promote rigorous evaluation.

PubMed

Lewis, Cara C; Stanick, Cameo F; Martinez, Ruben G; Weiner, Bryan J; Kim, Mimi; Barwick, Melanie; Comtois, Katherine A

2015-01-08

Identification of psychometrically strong instruments for the field of implementation science is a high priority underscored in a recent National Institutes of Health working meeting (October 2013). Existing instrument reviews are limited in scope, methods, and findings. The Society for Implementation Research Collaboration Instrument Review Project's objectives address these limitations by identifying and applying a unique methodology to conduct a systematic and comprehensive review of quantitative instruments assessing constructs delineated in two of the field's most widely used frameworks, adopt a systematic search process (using standard search strings), and engage an international team of experts to assess the full range of psychometric criteria (reliability, construct and criterion validity). Although this work focuses on implementation of psychosocial interventions in mental health and health-care settings, the methodology and results will likely be useful across a broad spectrum of settings. This effort has culminated in a centralized online open-access repository of instruments depicting graphical head-to-head comparisons of their psychometric properties. This article describes the methodology and preliminary outcomes. The seven stages of the review, synthesis, and evaluation methodology include (1) setting the scope for the review, (2) identifying frameworks to organize and complete the review, (3) generating a search protocol for the literature review of constructs, (4) literature review of specific instruments, (5) development of an evidence-based assessment rating criteria, (6) data extraction and rating instrument quality by a task force of implementation experts to inform knowledge synthesis, and (7) the creation of a website repository. To date, this multi-faceted and collaborative search and synthesis methodology has identified over 420 instruments related to 34 constructs (total 48 including subconstructs) that are relevant to implementation science. Despite numerous constructs having greater than 20 available instruments, which implies saturation, preliminary results suggest that few instruments stem from gold standard development procedures. We anticipate identifying few high-quality, psychometrically sound instruments once our evidence-based assessment rating criteria have been applied. The results of this methodology may enhance the rigor of implementation science evaluations by systematically facilitating access to psychometrically validated instruments and identifying where further instrument development is needed.

Reporting and methodological quality of survival analysis in articles published in Chinese oncology journals.

PubMed

Zhu, Xiaoyan; Zhou, Xiaobin; Zhang, Yuan; Sun, Xiao; Liu, Haihua; Zhang, Yingying

2017-12-01

Survival analysis methods have gained widespread use in the filed of oncology. For achievement of reliable results, the methodological process and report quality is crucial. This review provides the first examination of methodological characteristics and reporting quality of survival analysis in articles published in leading Chinese oncology journals.To examine methodological and reporting quality of survival analysis, to identify some common deficiencies, to desirable precautions in the analysis, and relate advice for authors, readers, and editors.A total of 242 survival analysis articles were included to be evaluated from 1492 articles published in 4 leading Chinese oncology journals in 2013. Articles were evaluated according to 16 established items for proper use and reporting of survival analysis.The application rates of Kaplan-Meier, life table, log-rank test, Breslow test, and Cox proportional hazards model (Cox model) were 91.74%, 3.72%, 78.51%, 0.41%, and 46.28%, respectively, no article used the parametric method for survival analysis. Multivariate Cox model was conducted in 112 articles (46.28%). Follow-up rates were mentioned in 155 articles (64.05%), of which 4 articles were under 80% and the lowest was 75.25%, 55 articles were100%. The report rates of all types of survival endpoint were lower than 10%. Eleven of 100 articles which reported a loss to follow-up had stated how to treat it in the analysis. One hundred thirty articles (53.72%) did not perform multivariate analysis. One hundred thirty-nine articles (57.44%) did not define the survival time. Violations and omissions of methodological guidelines included no mention of pertinent checks for proportional hazard assumption; no report of testing for interactions and collinearity between independent variables; no report of calculation method of sample size. Thirty-six articles (32.74%) reported the methods of independent variable selection. The above defects could make potentially inaccurate, misleading of the reported results, or difficult to interpret.There are gaps in the conduct and reporting of survival analysis in studies published in Chinese oncology journals, severe deficiencies were noted. More endorsement by journals of the report guideline for survival analysis may improve articles quality, and the dissemination of reliable evidence to oncology clinicians. We recommend authors, readers, reviewers, and editors to consider survival analysis more carefully and cooperate more closely with statisticians and epidemiologists. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Ultrasonic characterization of the fiber-matrix interfacial bond in aerospace composites.

PubMed

Aggelis, D G; Kleitsa, D; Matikas, T E

2013-01-01

The properties of advanced composites rely on the quality of the fiber-matrix bonding. Service-induced damage results in deterioration of bonding quality, seriously compromising the load-bearing capacity of the structure. While traditional methods to assess bonding are destructive, herein a nondestructive methodology based on shear wave reflection is numerically investigated. Reflection relies on the bonding quality and results in discernable changes in the received waveform. The key element is the "interphase" model material with varying stiffness. The study is an example of how computational methods enhance the understanding of delicate features concerning the nondestructive evaluation of materials used in advanced structures.

Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review

PubMed Central

Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie

2017-01-01

Background Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. Data sources A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010–2015). Study eligibility criteria All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Intervention Quality of reporting was assessed using the Key Methodological Score. Results 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Limitations Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. Conclusions & implications of key findings This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials, reporting being incomplete in the corresponding articles. PMID:29216190

A model to calculate consistent atmospheric emission projections and its application to Spain

NASA Astrophysics Data System (ADS)

Lumbreras, Julio; Borge, Rafael; de Andrés, Juan Manuel; Rodríguez, Encarnación

Global warming and air quality are headline environmental issues of our time and policy must preempt negative international effects with forward-looking strategies. As part of the revision of the European National Emission Ceilings Directive, atmospheric emission projections for European Union countries are being calculated. These projections are useful to drive European air quality analyses and to support wide-scale decision-making. However, when evaluating specific policies and measures at sectoral level, a more detailed approach is needed. This paper presents an original methodology to evaluate emission projections. Emission projections are calculated for each emitting activity that has emissions under three scenarios: without measures (business as usual), with measures (baseline) and with additional measures (target). The methodology developed allows the estimation of highly disaggregated multi-pollutant, consistent emissions for a whole country or region. In order to assure consistency with past emissions included in atmospheric emission inventories and coherence among the individual activities, the consistent emission projection (CEP) model incorporates harmonization and integration criteria as well as quality assurance/quality check (QA/QC) procedures. This study includes a sensitivity analysis as a first approach to uncertainty evaluation. The aim of the model presented in this contribution is to support decision-making process through the assessment of future emission scenarios taking into account the effect of different detailed technical and non-technical measures and it may also constitute the basis for air quality modelling. The system is designed to produce the information and formats related to international reporting requirements and it allows performing a comparison of national results with lower resolution models such as RAINS/GAINS. The methodology has been successfully applied and tested to evaluate Spanish emission projections up to 2020 for 26 pollutants but the methodology could be adopted for any particular region for different purposes, especially for European countries.

Reporting and methodological quality of meta-analyses in urological literature.

PubMed

Xia, Leilei; Xu, Jing; Guzzo, Thomas J

2017-01-01

To assess the overall quality of published urological meta-analyses and identify predictive factors for high quality. We systematically searched PubMed to identify meta-analyses published from January 1st, 2011 to December 31st, 2015 in 10 predetermined major paper-based urology journals. The characteristics of the included meta-analyses were collected, and their reporting and methodological qualities were assessed by the PRISMA checklist (27 items) and AMSTAR tool (11 items), respectively. Descriptive statistics were used for individual items as a measure of overall compliance, and PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. Logistic regression was used to identify predictive factors for high qualities. A total of 183 meta-analyses were included. The mean PRISMA and AMSTAR scores were 22.74 ± 2.04 and 7.57 ± 1.41, respectively. PRISMA item 5, protocol and registration, items 15 and 22, risk of bias across studies, items 16 and 23, additional analysis had less than 50% adherence. AMSTAR item 1, " a priori " design, item 5, list of studies and item 10, publication bias had less than 50% adherence. Logistic regression analyses showed that funding support and " a priori " design were associated with superior reporting quality, following PRISMA guideline and " a priori " design were associated with superior methodological quality. Reporting and methodological qualities of recently published meta-analyses in major paper-based urology journals are generally good. Further improvement could potentially be achieved by strictly adhering to PRISMA guideline and having " a priori " protocol.

Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.

PubMed

Terwee, Caroline B; Mokkink, Lidwine B; Knol, Dirk L; Ostelo, Raymond W J G; Bouter, Lex M; de Vet, Henrica C W

2012-05-01

The COSMIN checklist is a standardized tool for assessing the methodological quality of studies on measurement properties. It contains 9 boxes, each dealing with one measurement property, with 5-18 items per box about design aspects and statistical methods. Our aim was to develop a scoring system for the COSMIN checklist to calculate quality scores per measurement property when using the checklist in systematic reviews of measurement properties. The scoring system was developed based on discussions among experts and testing of the scoring system on 46 articles from a systematic review. Four response options were defined for each COSMIN item (excellent, good, fair, and poor). A quality score per measurement property is obtained by taking the lowest rating of any item in a box ("worst score counts"). Specific criteria for excellent, good, fair, and poor quality for each COSMIN item are described. In defining the criteria, the "worst score counts" algorithm was taken into consideration. This means that only fatal flaws were defined as poor quality. The scores of the 46 articles show how the scoring system can be used to provide an overview of the methodological quality of studies included in a systematic review of measurement properties. Based on experience in testing this scoring system on 46 articles, the COSMIN checklist with the proposed scoring system seems to be a useful tool for assessing the methodological quality of studies included in systematic reviews of measurement properties.

Appendix C: Background and Methodology for Alternative Certification Pilot. [2014 Teacher Prep Review

ERIC Educational Resources Information Center

Greenberg, Julie; Walsh, Kate; McKee, Arthur

2014-01-01

The "NCTQ Teacher Prep Review" evaluates the quality of programs that provide preservice preparation of public school teachers. As part of the "Review," this appendix reports on a pilot study of new standards for assessing the quality of alternative certification programs. Background and methodology for alternative…

Constraint-Driven Software Design: An Escape from the Waterfall Model.

ERIC Educational Resources Information Center

de Hoog, Robert; And Others

1994-01-01

Presents the principles of a development methodology for software design based on a nonlinear, product-driven approach that integrates quality aspects. Two examples are given to show that the flexibility needed for building high quality systems leads to integrated development environments in which methodology, product, and tools are closely…

VALIDATION OF AMBIENT WATER QUALITY CRITERIA (AWQC) BIOACCUMULATION METHODOLOGY USING FIELD DATA FROM GREEN BAY AND THE HUDSON RIVER

EPA Science Inventory

In 1998, EPA published its draft revision to the methodology for deriving ambient water quality criteria to protect human health. Four methods were proposed to determine lipid-normalized bioaccumulation factors based on freely-dissolved water concentrations (BAFs) for nonpolar or...

Lean interventions in healthcare: do they actually work? A systematic literature review

PubMed Central

Moraros, John; Lemstra, Mark; Nwankwo, Chijioke

2016-01-01

Purpose Lean is a widely used quality improvement methodology initially developed and used in the automotive and manufacturing industries but recently expanded to the healthcare sector. This systematic literature review seeks to independently assess the effect of Lean or Lean interventions on worker and patient satisfaction, health and process outcomes, and financial costs. Data sources We conducted a systematic literature review of Medline, PubMed, Cochrane Library, CINAHL, Web of Science, ABI/Inform, ERIC, EMBASE and SCOPUS. Study selection Peer reviewed articles were included if they examined a Lean intervention and included quantitative data. Methodological quality was assessed using validated critical appraisal checklists. Publically available data collected by the Saskatchewan Health Quality Council and the Saskatchewan Union of Nurses were also analysed and reported separately. Data extraction Data on design, methods, interventions and key outcomes were extracted and collated. Results of data synthesis Our electronic search identified 22 articles that passed methodological quality review. Among the accepted studies, 4 were exclusively concerned with health outcomes, 3 included both health and process outcomes and 15 included process outcomes. Our study found that Lean interventions have: (i) no statistically significant association with patient satisfaction and health outcomes; (ii) a negative association with financial costs and worker satisfaction and (iii) potential, yet inconsistent, benefits on process outcomes like patient flow and safety. Conclusion While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date simply does not support this claim. More rigorous, higher quality and better conducted scientific research is required to definitively ascertain the impact and effectiveness of Lean in healthcare settings. PMID:26811118

Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare.

PubMed

Nicolay, C R; Purkayastha, S; Greenhalgh, A; Benn, J; Chaturvedi, S; Phillips, N; Darzi, A

2012-03-01

The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery. MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business(™) Elite, the Health Management Information Consortium and PsycINFO(®) were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically. Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial. QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Developing methods for systematic reviewing in health services delivery and organisation

PubMed Central

Alborz, Alison; McNally, Rosalind

2007-01-01

Objectives To develop methods to facilitate the ‘systematic’ review of evidence from a range of methodologies on diffuse or ‘soft’ topics, as exemplified by ‘access to healthcare’. Data sources 28 bibliographic databases, research registers, organisational web sites or library catalogues. Reference lists from identified studies. Contact with experts and service users. Current awareness and contents alerting services in the area of learning disabilities. Review methods Inclusion criteria were English language literature from 1980 onwards, relating to people with learning disabilities of any age and all study designs. The main criteria for assessment was relevance to Guillifords’ model of access to health care which was adapted to the circumstances of people with learning disabilities. Selected studies were evaluated for scientific rigour then data was extracted and the results synthesised. Quality assessment was by an initial set of ‘generic’ quality indicators. This enabled further evidence selection before evaluation of findings according to specific criteria for qualitative, quantitative or mixed-method studies. Results 82 studies were fully evaluated. Five studies were rated ‘highly rigorous’, 22 ‘rigorous’, 46 ‘less rigorous’ and 9 ‘poor’ papers were retained as the sole evidence covering aspects of the guiding model. The majority of studies were quantitative but used only descriptive statistics. Most evidence lacked methodological detail, which often lowered final quality ratings. Conclusions The application of a consistent structure to quality evaluation can facilitate data appraisal, extraction and synthesis across a range of methodologies in diffuse or ‘soft’ topics. Synthesis can be facilitated further by using software, such as the Microsoft ‘Access’ database, for managing information. PMID:15606880

IMSF: Infinite Methodology Set Framework

NASA Astrophysics Data System (ADS)

Ota, Martin; Jelínek, Ivan

Software development is usually an integration task in enterprise environment - few software applications work autonomously now. It is usually a collaboration of heterogeneous and unstable teams. One serious problem is lack of resources, a popular result being outsourcing, ‘body shopping’, and indirectly team and team member fluctuation. Outsourced sub-deliveries easily become black boxes with no clear development method used, which has a negative impact on supportability. Such environments then often face the problems of quality assurance and enterprise know-how management. The used methodology is one of the key factors. Each methodology was created as a generalization of a number of solved projects, and each methodology is thus more or less connected with a set of task types. When the task type is not suitable, it causes problems that usually result in an undocumented ad-hoc solution. This was the motivation behind formalizing a simple process for collaborative software engineering. Infinite Methodology Set Framework (IMSF) defines the ICT business process of adaptive use of methods for classified types of tasks. The article introduces IMSF and briefly comments its meta-model.

Acupuncture for Functional Dyspepsia: What Strength Does It Have? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PubMed Central

Li, Jing; Li, Bo; Hu, Ya-Cai; Cai, Qiu-Han

2016-01-01

Background. Although the effectiveness of acupuncture therapy on functional dyspepsia (FD) has been systematically reviewed, the available reports are still contradictive and no robust evidence has been provided to date. Objective. To assess the current evidence of high quality on the effects of acupuncture for patients with FD. Methods. A comprehensive literature database search was conducted to identify randomized controlled trials (RCTs) comparing acupuncture therapies (including manual acupuncture and electroacupuncture) to sham acupuncture and medication use. A meta-analysis was performed following a strict methodology. Results. 16 RCTs involving 1436 participants were included. The majority of the trials were determined to be of low quality. Positive results were found for acupuncture in improving the Nepean Dyspepsia Index (NDI) and scores of the MOS 36-Item Short-Form Health Survey (SF-36), as well as in alleviating relevant symptoms (especially postprandial fullness and early satiation) of FD patients. Conclusion. Based on current available evidence, acupuncture therapy achieves statistically significant effect for FD in comparison with sham acupuncture and is superior to medication (prokinetic agents) in improving the symptoms and quality of life of FD patients. Nonetheless, despite stringent methodological analyses, the conclusion of our review still needs to be strengthened by additional RCTs of higher quality. PMID:28119758

Power Quality Improvement in Induction Furnace by Harmonic Reduction Using Dynamic Voltage Restorer

NASA Astrophysics Data System (ADS)

Saggu, Tejinder Singh; Singh, Lakhwinder

2016-06-01

Induction furnaces are used in wide quantity under different capacities for annual production of around 25 million tons of iron and steel in India. It plays a vital role in various manufacturing processes around the world for melting different types of metal scraps i. e. Copper, Cast Iron, Aluminium, Steel, Brass, Bronze, Silicon, Gold, Silver etc. which are further used in many other industrial applications. The induction furnace causes a huge disturbance to the utility and nearby consumers during its operation due to its non-linear characteristics. This is a serious phenomenon responsible for power quality degradation in the power system. This paper presents methodology to improve the power quality degradation caused by induction furnace using Dynamic Voltage Restorer (DVR) which is a type of custom power device. The real time data has been taken from an industry employing induction furnace for production of ingots from scrap material. The experimental readings are measured using power quality analyser equipment. The simulation of whole plant is done by analysing this same data and the simulation results are compared with actual onsite results. Then, solution methodology using DVR is presented which revealed that the implementation of DVR is an effective solution for voltage sag mitigation and harmonics improvement in induction furnace.

An overall index of environmental quality in coal mining areas and energy facilities.

PubMed

Vatalis, Konstantinos I; Kaliampakos, Demetrios C

2006-12-01

An approach to measuring environmental quality and trends in coal mining and industrial areas was attempted in this work. For this purpose, the establishment of a reference scale characterizing the status of environmental quality is proposed by developing an Environmental Quality Index (EQI). The methodology involves three main components: social research, the opinion of environmental experts, and the combination of new or existing indices. A survey of public opinion was carried out to identify the main environmental problems in the region of interest. Environmental experts carried out a survey, and the weights of specific environmental problems were obtained through a fuzzy Delphi method and pairwise comparison. The weight attributed to each environmental problem was computed, using new or existing indices (subindices) in the relevant literature. The EQI comprises a combination of the subindices with their own weights. The methodology was applied to a heavily industrialized coal basin in northwestern Macedonia, Greece. The results show that the new index may be used as a reliable tool for evaluating environmental quality in different areas. In addition, the study of EQI trends on an interannual basis can provide useful information on the efficiency of environmental policies already implemented by the responsible authorities.

Evaluation of the quality of the reporting of phase II clinical trials in oncology: A systematic review.

PubMed

Rivoirard, Romain; Langrand-Escure, Julien; Oriol, Mathieu; Tinquaut, Fabien; Chauvin, Franck; Rancoule, Chloé; Magné, Nicolas; Bourmaud, Aurélie

2018-05-01

To describe the current state of knowledge concerning the quality of reporting in phase II clinical trials in oncology and to describe the various methods published allowing this quality evaluation. databases including MEDLINE and COCHRANE were searched. Reviews and meta-analyses analyzing the quality of the reporting of phase II trials in oncology were included. Descriptive analysis of the results was performed. Thirteen publications were retained. Only 2 publications adopted a systematic approach of evaluation of the quality of reporting by overall scores. The Key Methodological Score (KMS), proposed by Grellety et al., gathering 3 items, seemed adapted for such an evaluation. A score of 3/3 was found in 16.1% of the 156 phase II trials analysed by this score. The other reviews used a qualitative analysis to evaluate the reporting, via an analysis of a single criterion, generally the statistical plan of the study. This item was considered as having been correctly reported in less than 50% of the analysed articles. The quality of reporting in phase II trials in oncology is a field that has been investigated very little (13 publications). When it is studied, the estimated level of quality is not satisfactory, whatever the method employed. The use of an overall score of evaluation is a path which should be pursued, in order to get reliable results. It also seems necessary to propose strong recommendations, which would create a consensus for the methodology and the reporting of these studies. Copyright © 2018 Elsevier B.V. All rights reserved.

Randomized clinical trials in dentistry: Risks of bias, risks of random errors, reporting quality, and methodologic quality over the years 1955-2013.

PubMed

Saltaji, Humam; Armijo-Olivo, Susan; Cummings, Greta G; Amin, Maryam; Flores-Mir, Carlos

2017-01-01

To examine the risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions and the development of these aspects over time. We included 540 randomized clinical trials from 64 selected systematic reviews. We extracted, in duplicate, details from each of the selected randomized clinical trials with respect to publication and trial characteristics, reporting and methodologic characteristics, and Cochrane risk of bias domains. We analyzed data using logistic regression and Chi-square statistics. Sequence generation was assessed to be inadequate (at unclear or high risk of bias) in 68% (n = 367) of the trials, while allocation concealment was inadequate in the majority of trials (n = 464; 85.9%). Blinding of participants and blinding of the outcome assessment were judged to be inadequate in 28.5% (n = 154) and 40.5% (n = 219) of the trials, respectively. A sample size calculation before the initiation of the study was not performed/reported in 79.1% (n = 427) of the trials, while the sample size was assessed as adequate in only 17.6% (n = 95) of the trials. Two thirds of the trials were not described as double blinded (n = 358; 66.3%), while the method of blinding was appropriate in 53% (n = 286) of the trials. We identified a significant decrease over time (1955-2013) in the proportion of trials assessed as having inadequately addressed methodological quality items (P < 0.05) in 30 out of the 40 quality criteria, or as being inadequate (at high or unclear risk of bias) in five domains of the Cochrane risk of bias tool: sequence generation, allocation concealment, incomplete outcome data, other sources of bias, and overall risk of bias. The risks of bias, risks of random errors, reporting quality, and methodological quality of randomized clinical trials of oral health interventions have improved over time; however, further efforts that contribute to the development of more stringent methodology and detailed reporting of trials are still needed.

The need for a comprehensive expert system development methodology

NASA Technical Reports Server (NTRS)

Baumert, John; Critchfield, Anna; Leavitt, Karen

1988-01-01

In a traditional software development environment, the introduction of standardized approaches has led to higher quality, maintainable products on the technical side and greater visibility into the status of the effort on the management side. This study examined expert system development to determine whether it differed enough from traditional systems to warrant a reevaluation of current software development methodologies. Its purpose was to identify areas of similarity with traditional software development and areas requiring tailoring to the unique needs of expert systems. A second purpose was to determine whether existing expert system development methodologies meet the needs of expert system development, management, and maintenance personnel. The study consisted of a literature search and personal interviews. It was determined that existing methodologies and approaches to developing expert systems are not comprehensive nor are they easily applied, especially to cradle to grave system development. As a result, requirements were derived for an expert system development methodology and an initial annotated outline derived for such a methodology.

Introduction to the special collection of papers on the San Luis Basin Sustainability Metrics Project: a methodology for evaluating regional sustainability.

PubMed

Heberling, Matthew T; Hopton, Matthew E

2012-11-30

This paper introduces a collection of four articles describing the San Luis Basin Sustainability Metrics Project. The Project developed a methodology for evaluating regional sustainability. This introduction provides the necessary background information for the project, description of the region, overview of the methods, and summary of the results. Although there are a multitude of scientifically based sustainability metrics, many are data intensive, difficult to calculate, and fail to capture all aspects of a system. We wanted to see if we could develop an approach that decision-makers could use to understand if their system was moving toward or away from sustainability. The goal was to produce a scientifically defensible, but straightforward and inexpensive methodology to measure and monitor environmental quality within a regional system. We initiated an interdisciplinary pilot project in the San Luis Basin, south-central Colorado, to test the methodology. The objectives were: 1) determine the applicability of using existing datasets to estimate metrics of sustainability at a regional scale; 2) calculate metrics through time from 1980 to 2005; and 3) compare and contrast the results to determine if the system was moving toward or away from sustainability. The sustainability metrics, chosen to represent major components of the system, were: 1) Ecological Footprint to capture the impact and human burden on the system; 2) Green Net Regional Product to represent economic welfare; 3) Emergy to capture the quality-normalized flow of energy through the system; and 4) Fisher information to capture the overall dynamic order and to look for possible regime changes. The methodology, data, and results of each metric are presented in the remaining four papers of the special collection. Based on the results of each metric and our criteria for understanding the sustainability trends, we find that the San Luis Basin is moving away from sustainability. Although we understand there are strengths and limitations of the methodology, we argue that each metric identifies changes to major components of the system. Published by Elsevier Ltd.

Photovoltaic Impact Assessment of Smart Inverter Volt-VAR Control on Distribution System Conservation Voltage Reduction and Power Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ding, Fei; Nagarajan, Adarsh; Chakraborty, Sudipta

This report presents an impact assessment study of distributed photovoltaic (PV) with smart inverter Volt-VAR control on conservation voltage reduction (CVR) energy savings and distribution system power quality. CVR is a methodology of flattening and lowering a distribution system voltage profile in order to conserve energy. Traditional CVR relies on operating utility voltage regulators and switched capacitors. However, with the increased penetration of distributed PV systems, smart inverters provide the new opportunity to control local voltage and power factor by regulating the reactive power output, leading to a potential increase in CVR energy savings. This report proposes a methodology tomore » implement CVR scheme by operating voltage regulators, capacitors, and autonomous smart inverter Volt-VAR control in order to achieve increased CVR benefit. Power quality is an important consideration when operating a distribution system, especially when implementing CVR. It is easy to measure the individual components that make up power quality, but a comprehensive method to incorporate all of these values into a single score has yet to be undertaken. As a result, this report proposes a power quality scoring mechanism to measure the relative power quality of distribution systems using a single number, which is aptly named the 'power quality score' (PQS). Both the CVR and PQS methodologies were applied to two distribution system models, one obtained from the Hawaiian Electric Company (HECO) and another obtained from Pacific Gas and Electric (PG&E). These two models were converted to the OpenDSS platform using previous model conversion tools that were developed by NREL. Multiple scenarios including various PV penetration levels and smart inverter densities were simulated to analyze the impact of smart inverter Volt-VAR support on CVR energy savings and feeder power quality. In order to analyze the CVR benefit and PQS, an annual simulation was conducted for each scenario.« less

Occupational Noise and Ischemic Heart Disease: A Systematic Review

PubMed Central

Dzhambov, Angel M; Dimitrova, Donka D

2016-01-01

Noise exposure might be a risk factor for ischemic heart disease (IHD). Unlike residential exposure, however, evidence for occupational noise is limited. Given that high-quality quantitative synthesis of existing data is highly warranted for occupational safety and policy, we aimed at conducting a systematic review and meta-analysis of the risks of IHD morbidity and mortality because of occupational noise exposure. We carried out a systematic search in MEDLINE, EMBASE, and on the Internet since April 2, 2015, in English, Spanish, Russian, and Bulgarian. A quality-scoring checklist was developed a priori to assess different sources of methodological bias. A qualitative data synthesis was performed. Conservative assumptions were applied when appropriate. A meta-analysis was not feasible because of unresolvable methodological discrepancies between the studies. On the basis of five studies, there was some evidence to suggest higher risk of IHD among workers exposed to objectively assessed noise >75–80 dB for <20 years (supported by one high, one moderate, and one low quality study, opposed by one high and one moderate quality study). Three moderate and two low quality studies out of six found self-rated exposure to be associated with higher risk of IHD, and only one moderate quality study found no effect. Out of four studies, a higher mortality risk was suggested by one moderate quality study relying on self-rated exposure and one of high-quality study using objective exposure. Sensitivity analyses showed that at higher exposures and in some vulnerable subgroups, such as women, the adverse effects were considerably stronger. Despite methodological discrepancies and limitations of the included studies, occupational noise appeared to be a risk factor for IHD morbidity. Results suggested higher risk for IHD mortality only among vulnerable subgroups. Workers exposed to high occupational noise should be considered at higher overall risk of IHD. PMID:27569404

Methodological quality of randomised controlled trials in burns care. A systematic review.

PubMed

Danilla, Stefan; Wasiak, Jason; Searle, Susana; Arriagada, Cristian; Pedreros, Cesar; Cleland, Heather; Spinks, Anneliese

2009-11-01

To evaluate the methodological quality of published randomised controlled trials (RCTs) in burn care treatment and management. Using a predetermined search strategy we searched Ovid MEDLINE (1950 to January 2008) database to identify all English RCTs related to burn care. Full text studies identified were reviewed for key demographic and methodological characteristics. Methodological trial quality was assessed using the Jadad scale. A total of 257 studies involving 14,535 patients met the inclusion criteria. The median Jadad score was 2 (out of a best possible score of 5). Information was given in the introduction and discussion sections of most RCTs, although insufficient detail was provided on randomisation, allocation concealment, and blinding. The number of RCTs increased between 1950 and 2008 (Spearman's rho=0.6129, P<0.001), although the reporting quality did not improve over the same time period (P=0.1896) and was better in RCTs with larger sample sizes (median Jadad score, 4 vs. 2 points, P<0.0001). Methodological quality did not correlate with journal impact factor (P=0.2371). The reporting standards of RCTs are highly variable and less than optimal in most cases. The advent of evidence-based medicine heralds a new approach to burns care and systematic steps are needed to improve the quality of RCTs in this field. Identifying and reviewing the existing number of RCTs not only highlights the need for burn clinicians to conduct more trials, but may also encourage burn health clinicians to consider the importance of conducting trials that follow appropriate, evidence-based standards.

Health economic evidence gaps and methodological constraints in low back pain and neck pain: Results of the Research Agenda for Health Economic Evaluation (RAHEE) project.

PubMed

van Dongen, J M; Ketheswaran, J; Tordrup, D; Ostelo, R W J G; Bertollini, R; van Tulder, M W

2016-12-01

Despite the increased interest in economic evaluations, there are difficulties in applying the results of such studies in practice. Therefore, the "Research Agenda for Health Economic Evaluation" (RAHEE) project was initiated, which aimed to improve the use of health economic evidence in practice for the 10 highest burden conditions in the European Union (including low back pain [LBP] and neck pain [NP]). This was done by undertaking literature mapping and convening an Expert Panel meeting, during which the literature mapping results were discussed and evidence gaps and methodological constraints were identified. The current paper is a part of the RAHEE project and aimed to identify economic evidence gaps and methodological constraints in the LBP and NP literature, in particular. The literature mapping revealed that economic evidence was unavailable for various commonly used LBP and NP treatments (e.g., injections, traction, and discography). Even if economic evidence was available, many treatments were only evaluated in a single study or studies for the same intervention were highly heterogeneous in terms of their patient population, control condition, follow-up duration, setting, and/or economic perspective. Up until now, this has prevented economic evaluation results from being statistically pooled in the LBP and NP literature, and strong conclusions about the cost-effectiveness of LBP and NP treatments can therefore not be made. The Expert Panel identified the need for further high-quality economic evaluations, especially on surgery versus conservative care and competing treatment options for chronic LBP. Handling of uncertainty and reporting quality were considered the most important methodological challenges. Copyright © 2017. Published by Elsevier Ltd.

Subjective comparison and evaluation of speech enhancement algorithms

PubMed Central

Hu, Yi; Loizou, Philipos C.

2007-01-01

Making meaningful comparisons between the performance of the various speech enhancement algorithms proposed over the years, has been elusive due to lack of a common speech database, differences in the types of noise used and differences in the testing methodology. To facilitate such comparisons, we report on the development of a noisy speech corpus suitable for evaluation of speech enhancement algorithms. This corpus is subsequently used for the subjective evaluation of 13 speech enhancement methods encompassing four classes of algorithms: spectral subtractive, subspace, statistical-model based and Wiener-type algorithms. The subjective evaluation was performed by Dynastat, Inc. using the ITU-T P.835 methodology designed to evaluate the speech quality along three dimensions: signal distortion, noise distortion and overall quality. This paper reports the results of the subjective tests. PMID:18046463

How does study quality affect the results of a diagnostic meta-analysis?

PubMed Central

Westwood, Marie E; Whiting, Penny F; Kleijnen, Jos

2005-01-01

Background The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three clinical stages assessed by the review. The results of regression analyses were also affected by whether or not a weighting (by sample size) was applied. Our analysis was severely limited by the completeness of reporting and the differences between the index tests evaluated and the reference standards used to confirm diagnoses in the primary studies. Few tests were evaluated by sufficient studies to allow meaningful use of meta-analytic pooling and investigation of heterogeneity. This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations. Conclusion Further work is needed to investigate the influence of methodological quality on the results of diagnostic meta-analyses. Large data sets of well-reported primary studies are needed to address this question. Without significant improvements in the completeness of reporting of primary studies, progress in this area will be limited. PMID:15943861

Toward a food service quality management system for compliance with the Mediterranean dietary model.

PubMed

Grigoroudis, Evangelos; Psaroudaki, Antonia; Diakaki, Christina

2013-01-01

The traditional diet of Cretan people in the 1960s is the basis of the Mediterranean dietary model. This article investigates the potential of this model to inspire proposals of meals by food-serving businesses, and suggests a methodology for the development of a quality management system, which will certify the delivery of food service according to this dietary model. The proposed methodology is built upon the principles and structure of the ISO 9001:2008 quality standard to enable integration with other quality, environmental, and food safety management systems.

River water quality management considering agricultural return flows: application of a nonlinear two-stage stochastic fuzzy programming.

PubMed

Tavakoli, Ali; Nikoo, Mohammad Reza; Kerachian, Reza; Soltani, Maryam

2015-04-01

In this paper, a new fuzzy methodology is developed to optimize water and waste load allocation (WWLA) in rivers under uncertainty. An interactive two-stage stochastic fuzzy programming (ITSFP) method is utilized to handle parameter uncertainties, which are expressed as fuzzy boundary intervals. An iterative linear programming (ILP) is also used for solving the nonlinear optimization model. To accurately consider the impacts of the water and waste load allocation strategies on the river water quality, a calibrated QUAL2Kw model is linked with the WWLA optimization model. The soil, water, atmosphere, and plant (SWAP) simulation model is utilized to determine the quantity and quality of each agricultural return flow. To control pollution loads of agricultural networks, it is assumed that a part of each agricultural return flow can be diverted to an evaporation pond and also another part of it can be stored in a detention pond. In detention ponds, contaminated water is exposed to solar radiation for disinfecting pathogens. Results of applying the proposed methodology to the Dez River system in the southwestern region of Iran illustrate its effectiveness and applicability for water and waste load allocation in rivers. In the planning phase, this methodology can be used for estimating the capacities of return flow diversion system and evaporation and detention ponds.

The Pennsylvania Trauma Outcomes Study Risk-Adjusted Mortality Model: Results of a Statewide Benchmarking Program

PubMed Central

WIEBE, DOUGLAS J.; HOLENA, DANIEL N.; DELGADO, M. KIT; McWILLIAMS, NATHAN; ALTENBURG, JULIET; CARR, BRENDAN G.

2018-01-01

Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups). Patient demographic variables, physiology, mechanism of injury, transfer status, injury severity, and pre-existing conditions were included as predictor variables. The statistical model had excellent discrimination (area under the curve = 0.94). Funnel plots of observed-to-expected identified five centers with lower than expected mortality and two centers with higher than expected mortality. No centers were outliers for management of penetrating trauma, but five centers had lower and three had higher than expected mortality for blunt trauma. It is feasible to use Trauma Quality Improvement Program methodology to develop risk-adjusted models for statewide trauma systems. Even with smaller numbers of trauma centers that are available in national datasets, it is possible to identify high and low outliers in performance. PMID:28541852

The Pennsylvania Trauma Outcomes Study Risk-Adjusted Mortality Model: Results of a Statewide Benchmarking Program.

PubMed

Wiebe, Douglas J; Holena, Daniel N; Delgado, M Kit; McWilliams, Nathan; Altenburg, Juliet; Carr, Brendan G

2017-05-01

Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups). Patient demographic variables, physiology, mechanism of injury, transfer status, injury severity, and pre-existing conditions were included as predictor variables. The statistical model had excellent discrimination (area under the curve = 0.94). Funnel plots of observed-to-expected identified five centers with lower than expected mortality and two centers with higher than expected mortality. No centers were outliers for management of penetrating trauma, but five centers had lower and three had higher than expected mortality for blunt trauma. It is feasible to use Trauma Quality Improvement Program methodology to develop risk-adjusted models for statewide trauma systems. Even with smaller numbers of trauma centers that are available in national datasets, it is possible to identify high and low outliers in performance.

Measurement properties of disease-specific questionnaires in patients with neck pain: a systematic review.

PubMed

Schellingerhout, Jasper M; Verhagen, Arianne P; Heymans, Martijn W; Koes, Bart W; de Vet, Henrica C; Terwee, Caroline B

2012-05-01

To critically appraise and compare the measurement properties of the original versions of neck-specific questionnaires. Bibliographic databases were searched for articles concerning the development or evaluation of the measurement properties of an original version of a self-reported questionnaire, evaluating pain and/or disability, which was specifically developed or adapted for patients with neck pain. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using a checklist, specifically designed for evaluating studies on measurement properties. The search strategy resulted in a total of 3,641 unique hits, of which 25 articles, evaluating 8 different questionnaires, were included in our study. The Neck Disability Index is the most frequently evaluated questionnaire and shows positive results for internal consistency, content validity, structural validity, hypothesis testing, and responsiveness, but a negative result for reliability. The other questionnaires show positive results, but the evidence for each measurement property is mostly limited, and at least 50% of the information on measurement properties per questionnaire is lacking. Our findings imply that studies of high methodological quality are needed to properly assess the measurement properties of the currently available questionnaires. Until high quality studies are available, we recommend using these questionnaires with caution. There is no need for the development of new neck-specific questionnaires until the current questionnaires have been adequately assessed.

A Comparison of Randomised Controlled Trials in Health and Education

ERIC Educational Resources Information Center

Torgerson, Carole J.; Torgerson, David J.; Birks, Yvonne F.; Porthouse, Jill

2005-01-01

Health care and educational trials face similar methodological challenges. Methodological reviews of health care trials have shown that a significant proportion have methodological flaws. Whether or not educational trials have a similar proportion of poor-quality trials is unknown. The authors undertook a methodological comparison between health…

The methodological quality of animal research in critical care: the public face of science

PubMed Central

2014-01-01

Background Animal research (AR) findings often do not translate to humans; one potential reason is the poor methodological quality of AR. We aimed to determine this quality of AR reported in critical care journals. Methods All AR published from January to June 2012 in three high-impact critical care journals were reviewed. A case report form and instruction manual with clear definitions were created, based on published recommendations, including the ARRIVE guidelines. Data were analyzed with descriptive statistics. Results Seventy-seven AR publications were reviewed. Our primary outcome (animal strain, sex, and weight or age described) was reported in 52 (68%; 95% confidence interval, 56% to 77%). Of the 77 publications, 47 (61%) reported randomization; of these, 3 (6%) reported allocation concealment, and 1 (2%) the randomization procedure. Of the 77 publications, 31 (40%) reported some type of blinding; of these, disease induction (2, 7%), intervention (7, 23%), and/or subjective outcomes (17, 55%) were blinded. A sample size calculation was reported in 4/77 (5%). Animal numbers were missing in the Methods section in 16 (21%) publications; when stated, the median was 32 (range 6 to 320; interquartile range, 21 to 70). Extra animals used were mentioned in the Results section in 31 (40%) publications; this number was unclear in 23 (74%), and >100 for 12 (16%). When reporting most outcomes, numbers with denominators were given in 35 (45%), with no unaccounted numbers in 24 (31%), and no animals excluded from analysis in 20 (26%). Most (49, 64%) studies reported >40, and another 19 (25%) reported 21 to 40 statistical comparisons. Internal validity limitations were discussed in 7 (9%), and external validity (to humans) discussed in 71 (92%), most with no (30, 42%) or only a vague (9, 13%) limitation to this external validity mentioned. Conclusions The reported methodological quality of AR was poor. Unless the quality of AR significantly improves, the practice may be in serious jeopardy of losing public support. PMID:25114829

Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals.

PubMed

Olley, Richard; Edwards, Ian; Avery, Mark; Cooper, Helen

2018-04-17

Objective The purpose of this systematic review was to evaluate and summarise available research on nurse staffing methods and relate these to outcomes under three overarching themes of: (1) management of clinical risk, quality and safety; (2) development of a new or innovative staffing methodology; and (3) equity of nursing workload. Methods The PRISMA method was used. Relevant articles were located by searching via the Griffith University Library electronic catalogue, including articles on PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medline. Only English language publications published between 1 January 2010 and 30 April 2016 focusing on methodologies in acute hospital in-patient units were included in the present review. Results Two of the four staffing methods were found to have evidenced-based articles from empirical studies within the parameters set for inclusion. Of the four staffing methodologies searched, supply and demand returned 10 studies and staffing ratios returned 11. Conclusions There is a need to develop an evidence-based nurse-sensitive outcomes measure upon which staffing for safety, quality and workplace equity, as well as an instrument that reliability and validly projects nurse staffing requirements in a variety of clinical settings. Nurse-sensitive indicators reflect elements of patient care that are directly affected by nursing practice In addition, these measures must take into account patient satisfaction, workload and staffing, clinical risks and other measures of the quality and safety of care and nurses' work satisfaction. i. What is known about the topic? Nurse staffing is a controversial topic that has significant patient safety, quality of care, human resources and financial implications. In acute care services, nursing accounts for approximately 70% of salaries and wages paid by health services budgets, and evidence as to the efficacy and effectiveness of any staffing methodology is required because it has workforce and industrial relations implications. Although there is significant literature available on the topic, there is a paucity of empirical evidence supporting claims of increased patient safety in the acute hospital setting, but some evidence exists relating to equity of workload for nurses. What does this paper add? This paper provides a contemporary qualitative analysis of empirical evidence using PRISMA methodology to conduct a systematic review of the available literature. It demonstrates a significant research gap to support claims of increased patient safety in the acute hospital setting. The paper calls for greatly improved datasets upon which research can be undertaken to determine any associations between mandated patient to nurse ratios and other staffing methodologies and patient safety and quality of care. What are the implications for practitioners? There is insufficient contemporary research to support staffing methodologies for appropriate staffing, balanced workloads and quality, safe care. Such research would include the establishment of nurse-sensitive patient outcomes measures, and more robust datasets are needed for empirical analysis to produce such evidence.

Innovative high-performance liquid chromatography method development for the screening of 19 antimalarial drugs based on a generic approach, using design of experiments, independent component analysis and design space.

PubMed

Debrus, B; Lebrun, P; Kindenge, J Mbinze; Lecomte, F; Ceccato, A; Caliaro, G; Mbay, J Mavar Tayey; Boulanger, B; Marini, R D; Rozet, E; Hubert, Ph

2011-08-05

An innovative methodology based on design of experiments (DoE), independent component analysis (ICA) and design space (DS) was developed in previous works and was tested out with a mixture of 19 antimalarial drugs. This global LC method development methodology (i.e. DoE-ICA-DS) was used to optimize the separation of 19 antimalarial drugs to obtain a screening method. DoE-ICA-DS methodology is fully compliant with the current trend of quality by design. DoE was used to define the set of experiments to model the retention times at the beginning, the apex and the end of each peak. Furthermore, ICA was used to numerically separate coeluting peaks and estimate their unbiased retention times. Gradient time, temperature and pH were selected as the factors of a full factorial design. These retention times were modelled by stepwise multiple linear regressions. A recently introduced critical quality attribute, namely the separation criterion (S), was also used to assess the quality of separations rather than using the resolution. Furthermore, the resulting mathematical models were also studied from a chromatographic point of view to understand and investigate the chromatographic behaviour of each compound. Good adequacies were found between the mathematical models and the expected chromatographic behaviours predicted by chromatographic theory. Finally, focusing at quality risk management, the DS was computed as the multidimensional subspace where the probability for the separation criterion to lie in acceptance limits was higher than a defined quality level. The DS was computed propagating the prediction error from the modelled responses to the quality criterion using Monte Carlo simulations. DoE-ICA-DS allowed encountering optimal operating conditions to obtain a robust screening method for the 19 considered antimalarial drugs in the framework of the fight against counterfeit medicines. Moreover and only on the basis of the same data set, a dedicated method for the determination of three antimalarial compounds in a pharmaceutical formulation was optimized to demonstrate both the efficiency and flexibility of the methodology proposed in the present study. Copyright © 2011 Elsevier B.V. All rights reserved.

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

A Methodological Proposal for Learning Games Selection and Quality Assessment

ERIC Educational Resources Information Center

Dondi, Claudio; Moretti, Michela

2007-01-01

This paper presents a methodological proposal elaborated in the framework of two European projects dealing with game-based learning, both of which have focused on "quality" aspects in order to create suitable tools that support European educators, practitioners and lifelong learners in selecting and assessing learning games for use in…

Evaluation of the methodological quality of studies of the performance of diagnostic tests for bovine tuberculosis using QUADAS.

PubMed

Downs, Sara H; More, Simon J; Goodchild, Anthony V; Whelan, Adam O; Abernethy, Darrell A; Broughan, Jennifer M; Cameron, Angus; Cook, Alasdair J; Ricardo de la Rua-Domenech, R; Greiner, Matthias; Gunn, Jane; Nuñez-Garcia, Javier; Rhodes, Shelley; Rolfe, Simon; Sharp, Michael; Upton, Paul; Watson, Eamon; Welsh, Michael; Woolliams, John A; Clifton-Hadley, Richard S; Parry, Jessica E

2018-05-01

There has been little assessment of the methodological quality of studies measuring the performance (sensitivity and/or specificity) of diagnostic tests for animal diseases. In a systematic review, 190 studies of tests for bovine tuberculosis (bTB) in cattle (published 1934-2009) were assessed by at least one of 18 reviewers using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) checklist adapted for animal disease tests. VETQUADAS (VQ) included items measuring clarity in reporting (n = 3), internal validity (n = 9) and external validity (n = 2). A similar pattern for compliance was observed in studies of different diagnostic test types. Compliance significantly improved with year of publication for all items measuring clarity in reporting and external validity but only improved in four of the nine items measuring internal validity (p < 0.05). 107 references, of which 83 had performance data eligible for inclusion in a meta-analysis were reviewed by two reviewers. In these references, agreement between reviewers' responses was 71% for compliance, 32% for unsure and 29% for non-compliance. Mean compliance with reporting items was 2, 5.2 for internal validity and 1.5 for external validity. The index test result was described in sufficient detail in 80.1% of studies and was interpreted without knowledge of the reference standard test result in only 33.1%. Loss to follow-up was adequately explained in only 31.1% of studies. The prevalence of deficiencies observed may be due to inadequate reporting but may also reflect lack of attention to methodological issues that could bias the results of diagnostic test performance estimates. QUADAS was a useful tool for assessing and comparing the quality of studies measuring the performance of diagnostic tests but might be improved further by including explicit assessment of population sampling strategy. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Data quality and feasibility of the Experience Sampling Method across the spectrum of severe psychiatric disorders: a protocol for a systematic review and meta-analysis.

PubMed

Vachon, Hugo; Rintala, Aki; Viechtbauer, Wolfgang; Myin-Germeys, Inez

2018-01-18

Due to a number of methodological advantages and theoretical considerations, more and more studies in clinical psychology research employ the Experience Sampling Method (ESM) as a data collection technique. Despite this growing interest, the absence of methodological guidelines related to the use of ESM has resulted in a large heterogeneity of designs while the potential effects of the design itself on the response behavior of the participants remain unknown. The objectives of this systematic review are to investigate the associations between the design characteristics and the data quality and feasibility of studies relying on ESM in severe psychiatric disorders. We will search for all published studies using ambulatory assessment with patients suffering from major depressive disorder, bipolar disorder, and psychotic disorder or individuals at high risk for these disorders. Electronic database searches will be performed in PubMed and Web of Science with no restriction on the publication date. Two reviewers will independently screen original studies in a title/abstract phase and a full-text phase based on the inclusion criteria. The information related to the design and sample characteristics, data quality, and feasibility will be extracted. We will provide results in terms of a descriptive synthesis, and when applicable, a meta-analysis of the findings will be conducted. Our results will attempt to highlight how the feasibility and data quality of ambulatory assessment might be related to the methodological characteristics of the study designs in severe psychiatric disorders. We will discuss these associations in different subsamples if sufficient data are available and will examine limitations in the reporting of the methods of ambulatory studies in the current literature. The protocol for this systematic review was registered on PROSPERO (PROSPERO 2017: CRD42017060322 ) and is available in full on the University of York website ( http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42017060322 ).

Methodological update in Medicina Intensiva.

PubMed

García Garmendia, J L

2018-04-01

Research in the critically ill is complex by the heterogeneity of patients, the difficulties to achieve representative sample sizes and the number of variables simultaneously involved. However, the quantity and quality of records is high as well as the relevance of the variables used, such as survival. The methodological tools have evolved to offering new perspectives and analysis models that allow extracting relevant information from the data that accompanies the critically ill patient. The need for training in methodology and interpretation of results is an important challenge for the intensivists who wish to be updated on the research developments and clinical advances in Intensive Medicine. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

PQScal (Power Quality Score Calculation for Distribution Systems with DER Integration)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Power Quality is of great importance to evaluate the “health” of a distribution system, especially when the distributed energy resource (DER) penetration becomes more significant. The individual components that make up power quality, such as voltage magnitude and unbalance, can be measured in simulations or in the field, however, a comprehensive method to incorporate all of these values into a single score doesn't exist. As a result, we propose a methodology to quantify the power quality health using the single number value, named as Power Quality Score (PQS). The PQS is dependent on six metrics that are developed based onmore » both components that directly impact power quality and those are often reference in the context of power quality. These six metrics are named as System Average Voltage Magnitude Violation Index (SAVMVI), System Average Voltage Fluctuation Index (SAVFI), System Average Voltage Unbalance Index (SAVUI), System Control Device Operation Index (SCDOI), System Reactive Power Demand Index (SRPDI) and System Energy Loss Index (SELI). This software tool, PQScal, is developed based on this novel PQS methodology. Besides of traditional distribution systems, PQScal can also measure the power quality for distribution systems with various DER penetrations. PQScal has been tested on two utility distribution feeders with distinct model characteristics and its effectiveness has been proved. In sum, PQScal can help utilities or other parties to measure the power quality of distribution systems with DER integration easily and effectively.« less

On the performance of metrics to predict quality in point cloud representations

NASA Astrophysics Data System (ADS)

Alexiou, Evangelos; Ebrahimi, Touradj

2017-09-01

Point clouds are a promising alternative for immersive representation of visual contents. Recently, an increased interest has been observed in the acquisition, processing and rendering of this modality. Although subjective and objective evaluations are critical in order to assess the visual quality of media content, they still remain open problems for point cloud representation. In this paper we focus our efforts on subjective quality assessment of point cloud geometry, subject to typical types of impairments such as noise corruption and compression-like distortions. In particular, we propose a subjective methodology that is closer to real-life scenarios of point cloud visualization. The performance of the state-of-the-art objective metrics is assessed by considering the subjective scores as the ground truth. Moreover, we investigate the impact of adopting different test methodologies by comparing them. Advantages and drawbacks of every approach are reported, based on statistical analysis. The results and conclusions of this work provide useful insights that could be considered in future experimentation.

Relationship between perceived politeness and spectral characteristics of voice

NASA Astrophysics Data System (ADS)

Ito, Mika

2005-04-01

This study investigates the role of voice quality in perceiving politeness under conditions of varying relative social status among Japanese male speakers. The work focuses on four important methodological issues: experimental control of sociolinguistic aspects, eliciting natural spontaneous speech, obtaining recording quality suitable for voice quality analysis, and assessment of glottal characteristics through the use of non-invasive direct measurements of the speech spectrum. To obtain natural, unscripted utterances, the speech data were collected with a Map Task. This methodology allowed us to study the effect of manipulating relative social status among participants in the same community. We then computed the relative amplitudes of harmonics and formant peaks in spectra obtained from the Map Task recordings. Finally, an experiment was conducted to observe the alignment between acoustic measures and the perceived politeness of the voice samples. The results suggest that listeners' perceptions of politeness are determined by spectral characteristics of speakers, in particular, spectral tilts obtained by computing the difference in amplitude between the first harmonic and the third formant.

Unified Theory for Aircraft Handling Qualities and Adverse Aircraft-Pilot Coupling

NASA Technical Reports Server (NTRS)

Hess, R. A.

1997-01-01

A unified theory for aircraft handling qualities and adverse aircraft-pilot coupling or pilot-induced oscillations is introduced. The theory is based on a structural model of the human pilot. A methodology is presented for the prediction of (1) handling qualities levels; (2) pilot-induced oscillation rating levels; and (3) a frequency range in which pilot-induced oscillations are likely to occur. Although the dynamics of the force-feel system of the cockpit inceptor is included, the methodology will not account for effects attributable to control sensitivity and is limited to single-axis tasks and, at present, to linear vehicle models. The theory is derived from the feedback topology of the structural model and an examination of flight test results for 32 aircraft configurations simulated by the U.S. Air Force/CALSPAN NT-33A and Total In-Flight Simulator variable stability aircraft. An extension to nonlinear vehicle dynamics such as that encountered with actuator saturation is discussed.

Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology.

PubMed

Esposito, Pasquale; Dal Canton, Antonio

2014-11-06

Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. The clinical audit consist of measuring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the effectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings.

Chinese herbal medicine for the treatment of primary hypertension: a methodology overview of systematic reviews.

PubMed

Xinke, Zhao; Yingdong, Li; Mingxia, Feng; Kai, Liu; Kaibing, Chen; Yuqing, Lu; Shaobo, Sun; Peng, Song; Bin, Liu

2016-10-20

Chinese herbal medicine has been used to treat hypertension in China and East Asia since centuries. In this study, we conduct an overview of systematic reviews of Chinese herbal medicine in the treatment of primary hypertension to 1) summarize the conclusions of these reviews, 2) evaluate the methodological quality of these reviews, and 3) rate the confidence in the effect on each outcome. We comprehensively searched six databases to retrieve systematic reviews of Chinese herbal medicine for primary hypertension from inception to December 31, 2015. We used AMSTAR to evaluate the methodological quality of included reviews, and we classified the quality of evidence for each outcome in included reviews using the GRADE approach. A total of 12 systematic reviews with 31 outcomes were included, among which 11 systematic reviews focus on the therapeutic effect of Chinese herbal medicine combined with conventional medicine or simple Chinese herbal medicine versus simple conventional medicine. Among the 11 items of AMSTAR, the lowest quality was "providing a priori design" item, none review conformed to this item, the next was "stating the conflict of interest" item, only three reviews conformed to this item. Five reviews scored less than seven in AMSTAR, which means that the overall methodological quality was fairly poor. For GRADE, of the 31 outcomes, the quality of evidence was high in none (0 %), moderate in three (10 %), low in 19 (61 %), and very low in nine (29 %). Of the five downgrading factors, risk of bias (100 %) was the most common downgrading factor in the included reviews, followed by imprecision (42 %), inconsistency (39 %), publication bias (39 %), and indirectness (0 %). The methodological quality of systematic reviews about Chinese herbal medicine for primary hypertension is fairly poor, and the quality of evidence level is low. Physicians should be cautious when applying the interventions in these reviews for primary hypertension patients in clinical practice.

Adding spatial flexibility to source-receptor relationships for air quality modeling.

PubMed

Pisoni, E; Clappier, A; Degraeuwe, B; Thunis, P

2017-04-01

To cope with computing power limitations, air quality models that are used in integrated assessment applications are generally approximated by simpler expressions referred to as "source-receptor relationships (SRR)". In addition to speed, it is desirable for the SRR also to be spatially flexible (application over a wide range of situations) and to require a "light setup" (based on a limited number of full Air Quality Models - AQM simulations). But "speed", "flexibility" and "light setup" do not naturally come together and a good compromise must be ensured that preserves "accuracy", i.e. a good comparability between SRR results and AQM. In this work we further develop a SRR methodology to better capture spatial flexibility. The updated methodology is based on a cell-to-cell relationship, in which a bell-shape function links emissions to concentrations. Maintaining a cell-to-cell relationship is shown to be the key element needed to ensure spatial flexibility, while at the same time the proposed approach to link emissions and concentrations guarantees a "light set-up" phase. Validation has been repeated on different areas and domain sizes (countries, regions, province throughout Europe) for precursors reduced independently or contemporarily. All runs showed a bias around 10% between the full AQM and the SRR. This methodology allows assessing the impact on air quality of emission scenarios applied over any given area in Europe (regions, set of regions, countries), provided that a limited number of AQM simulations are performed for training.

[Problems with Using Hospital Quality Reports as a Secondary Data Source for Health Services Research in Germany].

PubMed

Kraska, R A; de Cruppe, W; Geraedts, M

2017-07-01

Background Since 2005, German hospitals are required by law to publish structured quality reports (QRs). Because of the detailed data basis, the QRs are being increasingly used for secondary data analyses in health services research. Up until now, methodological difficulties that can cause distorted results of the analyses have essentially been overlooked. The aim of this study is to systematically list the methodological problems associated with using QR and to suggest solution strategies. Methods The QRs from 2006-2012 form the basis of the analyses and were aggregated in a database using an individualized data linkage procedure. Thereafter, a correlation analysis between a quality indicator and the staffing of hospitals was conducted, serving as an example for both cross-sectional as well as longitudinal studies. The resulting methodological problems are described qualitatively and quantitatively, and potential solutions are derived from the statistical literature. Results In each reporting year, 2-15% of the hospitals delivered no QR. In 2-16% of the QRs, it is not recognizable whether a report belongs to a hospital network or a single location. In addition, 6-66% of the location reports falsely contain data from the hospital network. 10% of the hospitals changed their institution code (IC), in 5% of the cases, the same "IC-location-number-combination" was used for different hospitals over the years. Therefore, 10-20% of the QRs cannot be linked with the IC as key variable. As a remedy for the linking of QR, the combination of the IC, the address and the number of beds represents a suitable solution. Using this solution, hospital network reports, location reports and missing reports can be identified and considered in an analysis. Conclusions Secondary data analyses with quality reports provide a high potential for error due to the inconsistent data base and the problems of the data linkage procedure. These can distort calculated parameters and limit the validity of results. Only the unequivocal identification of the reporting hospitals guarantees meaningful results. © Georg Thieme Verlag KG Stuttgart · New York.

Towards Reflective Writing Analytics: Rationale, Methodology and Preliminary Results

ERIC Educational Resources Information Center

Shum, Simon Buckingham; Sándor, Ágnes; Goldsmith, Rosalie; Bass, Randall; McWilliams, Mindy

2017-01-01

When used effectively, reflective writing tasks can deepen learners' understanding of key concepts, help them critically appraise their developing professional identity, and build qualities for lifelong learning. As such, reflective writing is attracting substantial interest from universities concerned with experiential learning, reflective…

DEVELOPMENT AND EVALUATION OF PM 2.5 SOURCE APPORTIONMENT METHODOLOGIES

EPA Science Inventory

The receptor model called Positive Matrix Factorization (PMF) has been extensively used to apportion sources of ambient fine particulate matter (PM_2.5), but the accuracy of source apportionment results currently remains unknown. In addition, air quality forecast model...

A novel methodology for interpreting air quality measurements from urban streets using CFD modelling

NASA Astrophysics Data System (ADS)

Solazzo, Efisio; Vardoulakis, Sotiris; Cai, Xiaoming

2011-09-01

In this study, a novel computational fluid dynamics (CFD) based methodology has been developed to interpret long-term averaged measurements of pollutant concentrations collected at roadside locations. The methodology is applied to the analysis of pollutant dispersion in Stratford Road (SR), a busy street canyon in Birmingham (UK), where a one-year sampling campaign was carried out between August 2005 and July 2006. Firstly, a number of dispersion scenarios are defined by combining sets of synoptic wind velocity and direction. Assuming neutral atmospheric stability, CFD simulations are conducted for all the scenarios, by applying the standard k-ɛ turbulence model, with the aim of creating a database of normalised pollutant concentrations at specific locations within the street. Modelled concentration for all wind scenarios were compared with hourly observed NO x data. In order to compare with long-term averaged measurements, a weighted average of the CFD-calculated concentration fields was derived, with the weighting coefficients being proportional to the frequency of each scenario observed during the examined period (either monthly or annually). In summary the methodology consists of (i) identifying the main dispersion scenarios for the street based on wind speed and directions data, (ii) creating a database of CFD-calculated concentration fields for the identified dispersion scenarios, and (iii) combining the CFD results based on the frequency of occurrence of each dispersion scenario during the examined period. The methodology has been applied to calculate monthly and annually averaged benzene concentration at several locations within the street canyon so that a direct comparison with observations could be made. The results of this study indicate that, within the simplifying assumption of non-buoyant flow, CFD modelling can aid understanding of long-term air quality measurements, and help assessing the representativeness of monitoring locations for population exposure studies.

Cardiac surgery report cards: comprehensive review and statistical critique.

PubMed

Shahian, D M; Normand, S L; Torchiana, D F; Lewis, S M; Pastore, J O; Kuntz, R E; Dreyer, P I

2001-12-01

Public report cards and confidential, collaborative peer education represent distinctly different approaches to cardiac surgery quality assessment and improvement. This review discusses the controversies regarding their methodology and relative effectiveness. Report cards have been the more commonly used approach, typically as a result of state legislation. They are based on the presumption that publication of outcomes effectively motivates providers, and that market forces will reward higher quality. Numerous studies have challenged the validity of these hypotheses. Furthermore, although states with report cards have reported significant decreases in risk-adjusted mortality, it is unclear whether this improvement resulted from public disclosure or, rather, from the development of internal quality programs by hospitals. An additional confounding factor is the nationwide decline in heart surgery mortality, including states without quality monitoring. Finally, report cards may engender negative behaviors such as high-risk case avoidance and "gaming" of the reporting system, especially if individual surgeon results are published. The alternative approach, continuous quality improvement, may provide an opportunity to enhance performance and reduce interprovider variability while avoiding the unintended negative consequences of report cards. This collaborative method, which uses exchange visits between programs and determination of best practice, has been highly effective in northern New England and in the Veterans Affairs Administration. However, despite their potential advantages, quality programs based solely on confidential continuous quality improvement do not address the issue of public accountability. For this reason, some states may continue to mandate report cards. In such instances, it is imperative that appropriate statistical techniques and report formats are used, and that professional organizations simultaneously implement continuous quality improvement programs. The statistical methodology underlying current report cards is flawed, and does not justify the degree of accuracy presented to the public. All existing risk-adjustment methods have substantial inherent imprecision, and this is compounded when the results of such patient-level models are aggregated and used inappropriately to assess provider performance. Specific problems include sample size differences, clustering of observations, multiple comparisons, and failure to account for the random component of interprovider variability. We advocate the use of hierarchical or multilevel statistical models to address these concerns, as well as report formats that emphasize the statistical uncertainty of the results.

Objective impairments of gait and balance in adults living with HIV-1 infection: a systematic review and meta-analysis of observational studies.

PubMed

Berner, Karina; Morris, Linzette; Baumeister, Jochen; Louw, Quinette

2017-08-01

Gait and balance deficits are reported in adults with HIV infection and are associated with reduced quality of life. Current research suggests an increased fall-incidence in this population, with fall rates among middle-aged adults with HIV approximating that in seronegative elderly populations. Gait and postural balance rely on a complex interaction of the motor system, sensory control, and cognitive function. However, due to disease progression and complications related to ongoing inflammation, these systems may be compromised in people with HIV. Consequently, locomotor impairments may result that can contribute to higher-than-expected fall rates. The aim of this review was to synthesize the evidence regarding objective gait and balance impairments in adults with HIV, and to emphasize those which could contribute to increased fall risk. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search of published observational studies was conducted in March 2016. Methodological quality was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Narrative synthesis of gait and balance outcomes was performed, and meta-analyses where possible. Seventeen studies were included, with fair to low methodological quality. All studies used clinical tests for gait-assessment. Gait outcomes assessed were speed, initiation-time and cadence. No studies assessed kinetics or kinematics. Balance was assessed using both instrumented and clinical tests. Outcomes were mainly related to center of pressure, postural reflex latencies, and timed clinical tests. There is some agreement that adults with HIV walk slower and have increased center of pressure excursions and -long loop postural reflex latencies, particularly under challenging conditions. Gait and balance impairments exist in people with HIV, resembling fall-associated parameters in the elderly. Impairments are more pronounced during challenging conditions, might be associated with disease severity, are not influenced by antiretroviral therapy, and might not be associated with peripheral neuropathy. Results should be interpreted cautiously due to overall poor methodological quality and heterogeneity. Locomotor impairments in adults with HIV are currently insufficiently quantified. Future research involving more methodological uniformity is warranted to better understand such impairments and to inform clinical decision-making, including fall-prevention strategies, in this population.

Does Value Stream Mapping affect the structure, process, and outcome quality in care facilities? A systematic review.

PubMed

Nowak, Marina; Pfaff, Holger; Karbach, Ute

2017-08-24

Quality improvement within health and social care facilities is needed and has to be evidence-based and patient-centered. Value Stream Mapping, a method of Lean management, aims to increase the patients' value and quality of care by a visualization and quantification of the care process. The aim of this research is to examine the effectiveness of Value Stream Mapping on structure, process, and outcome quality in care facilities. A systematic review is conducted. PubMed, EBSCOhost, including Business Source Complete, Academic Search Complete, PSYCInfo, PSYNDX, SocINDEX with Full Text, Web of Knowledge, and EMBASE ScienceDirect are searched in February 2016. All peer-reviewed papers evaluating Value Stream Mapping and published in English or German from January 2000 are included. For data synthesis, all study results are categorized into Donabedian's model of structure, process, and outcome quality. To assess and interpret the effectiveness of Value Stream Mapping, the frequencies of the results statistically examined are considered. Of the 903 articles retrieved, 22 studies fulfill the inclusion criteria. Of these, 11 studies are used to answer the research question. Value Stream Mapping has positive effects on the time dimension of process and outcome quality. It seems to reduce non-value-added time (e.g., waiting time) and length of stay. All study designs are before and after studies without control, and methodologically sophisticated studies are missing. For a final conclusion about Value Stream Mapping's effectiveness, more research with improved methodology is needed. Despite this lack of evidence, Value Stream Mapping has the potential to improve quality of care on the time dimension. The contextual influence has to be investigated to make conclusions about the relationship between different quality domains when applying Value Stream Mapping. However, for using this review's conclusion, the limitation of including heterogeneous and potentially biased results has to be considered.

The use of hierarchical clustering for the design of optimized monitoring networks

NASA Astrophysics Data System (ADS)

Soares, Joana; Makar, Paul Andrew; Aklilu, Yayne; Akingunola, Ayodeji

2018-05-01

Associativity analysis is a powerful tool to deal with large-scale datasets by clustering the data on the basis of (dis)similarity and can be used to assess the efficacy and design of air quality monitoring networks. We describe here our use of Kolmogorov-Zurbenko filtering and hierarchical clustering of NO2 and SO2 passive and continuous monitoring data to analyse and optimize air quality networks for these species in the province of Alberta, Canada. The methodology applied in this study assesses dissimilarity between monitoring station time series based on two metrics: 1 - R, R being the Pearson correlation coefficient, and the Euclidean distance; we find that both should be used in evaluating monitoring site similarity. We have combined the analytic power of hierarchical clustering with the spatial information provided by deterministic air quality model results, using the gridded time series of model output as potential station locations, as a proxy for assessing monitoring network design and for network optimization. We demonstrate that clustering results depend on the air contaminant analysed, reflecting the difference in the respective emission sources of SO2 and NO2 in the region under study. Our work shows that much of the signal identifying the sources of NO2 and SO2 emissions resides in shorter timescales (hourly to daily) due to short-term variation of concentrations and that longer-term averages in data collection may lose the information needed to identify local sources. However, the methodology identifies stations mainly influenced by seasonality, if larger timescales (weekly to monthly) are considered. We have performed the first dissimilarity analysis based on gridded air quality model output and have shown that the methodology is capable of generating maps of subregions within which a single station will represent the entire subregion, to a given level of dissimilarity. We have also shown that our approach is capable of identifying different sampling methodologies as well as outliers (stations' time series which are markedly different from all others in a given dataset).

A User-Oriented Methodology for DInSAR Time Series Analysis and Interpretation: Landslides and Subsidence Case Studies

NASA Astrophysics Data System (ADS)

Notti, Davide; Calò, Fabiana; Cigna, Francesca; Manunta, Michele; Herrera, Gerardo; Berti, Matteo; Meisina, Claudia; Tapete, Deodato; Zucca, Francesco

2015-11-01

Recent advances in multi-temporal Differential Synthetic Aperture Radar (SAR) Interferometry (DInSAR) have greatly improved our capability to monitor geological processes. Ground motion studies using DInSAR require both the availability of good quality input data and rigorous approaches to exploit the retrieved Time Series (TS) at their full potential. In this work we present a methodology for DInSAR TS analysis, with particular focus on landslides and subsidence phenomena. The proposed methodology consists of three main steps: (1) pre-processing, i.e., assessment of a SAR Dataset Quality Index (SDQI) (2) post-processing, i.e., application of empirical/stochastic methods to improve the TS quality, and (3) trend analysis, i.e., comparative implementation of methodologies for automatic TS analysis. Tests were carried out on TS datasets retrieved from processing of SAR imagery acquired by different radar sensors (i.e., ERS-1/2 SAR, RADARSAT-1, ENVISAT ASAR, ALOS PALSAR, TerraSAR-X, COSMO-SkyMed) using advanced DInSAR techniques (i.e., SqueeSAR™, PSInSAR™, SPN and SBAS). The obtained values of SDQI are discussed against the technical parameters of each data stack (e.g., radar band, number of SAR scenes, temporal coverage, revisiting time), the retrieved coverage of the DInSAR results, and the constraints related to the characterization of the investigated geological processes. Empirical and stochastic approaches were used to demonstrate how the quality of the TS can be improved after the SAR processing, and examples are discussed to mitigate phase unwrapping errors, and remove regional trends, noise and anomalies. Performance assessment of recently developed methods of trend analysis (i.e., PS-Time, Deviation Index and velocity TS) was conducted on two selected study areas in Northern Italy affected by land subsidence and landslides. Results show that the automatic detection of motion trends enhances the interpretation of DInSAR data, since it provides an objective picture of the deformation behaviour recorded through TS and therefore contributes to the understanding of the on-going geological processes.

Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation

PubMed Central

Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

2016-01-01

Introduction Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. Methods In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Results Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7–8) versus Group B: 8 (7–9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The results did not change after adjustment for impact factor. The compliance with AMSTAR and adherence to PRISMA checklist were comparable between systematic reviews and meta-analyses published in OA and non-OA journals (Group C, 46.0% versus Group D, 55.0%; p = 0.06), (Group C, 72.0% versus Group D, 76.0%; p = 0.1), respectively). Conclusion The epidemiological studies published in OA journals in the field of oncology approach the same methodological quality and quality of reporting as studies published in non-OA journals. PMID:27167982

Applying an Empirical Hydropathic Forcefield in Refinement May Improve Low-Resolution Protein X-Ray Crystal Structures

PubMed Central

Koparde, Vishal N.; Scarsdale, J. Neel; Kellogg, Glen E.

2011-01-01

Background The quality of X-ray crystallographic models for biomacromolecules refined from data obtained at high-resolution is assured by the data itself. However, at low-resolution, >3.0 Å, additional information is supplied by a forcefield coupled with an associated refinement protocol. These resulting structures are often of lower quality and thus unsuitable for downstream activities like structure-based drug discovery. Methodology An X-ray crystallography refinement protocol that enhances standard methodology by incorporating energy terms from the HINT (Hydropathic INTeractions) empirical forcefield is described. This protocol was tested by refining synthetic low-resolution structural data derived from 25 diverse high-resolution structures, and referencing the resulting models to these structures. The models were also evaluated with global structural quality metrics, e.g., Ramachandran score and MolProbity clashscore. Three additional structures, for which only low-resolution data are available, were also re-refined with this methodology. Results The enhanced refinement protocol is most beneficial for reflection data at resolutions of 3.0 Å or worse. At the low-resolution limit, ≥4.0 Å, the new protocol generated models with Cα positions that have RMSDs that are 0.18 Å more similar to the reference high-resolution structure, Ramachandran scores improved by 13%, and clashscores improved by 51%, all in comparison to models generated with the standard refinement protocol. The hydropathic forcefield terms are at least as effective as Coulombic electrostatic terms in maintaining polar interaction networks, and significantly more effective in maintaining hydrophobic networks, as synthetic resolution is decremented. Even at resolutions ≥4.0 Å, these latter networks are generally native-like, as measured with a hydropathic interactions scoring tool. PMID:21246043

Query Health: standards-based, cross-platform population health surveillance

PubMed Central

Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

2014-01-01

Objective Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Materials and methods Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. Results We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. Discussions This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Conclusions Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. PMID:24699371

Determination of fragrance content in perfume by Raman spectroscopy and multivariate calibration

NASA Astrophysics Data System (ADS)

Godinho, Robson B.; Santos, Mauricio C.; Poppi, Ronei J.

2016-03-01

An alternative methodology is herein proposed for determination of fragrance content in perfumes and their classification according to the guidelines established by fine perfume manufacturers. The methodology is based on Raman spectroscopy associated with multivariate calibration, allowing the determination of fragrance content in a fast, nondestructive, and sustainable manner. The results were considered consistent with the conventional method, whose standard error of prediction values was lower than the 1.0%. This result indicates that the proposed technology is a feasible analytical tool for determination of the fragrance content in a hydro-alcoholic solution for use in manufacturing, quality control and regulatory agencies.

Thorax and pelvis kinematics during walking, a comparison between children with and without cerebral palsy: A systematic review.

PubMed

Swinnen, Eva; Goten, Laura Vander; De Koster, Berdien; Degelaen, Marc

2016-01-01

Dysfunctional postural control and pathological thorax and pelvis motions are often observed in children with cerebral palsy (CP) and can be considered as an indicator of diminished dynamic stability. The aim of this study was to identify the differences between children with CP and typically developing children in three-dimensional thorax and pelvis kinematics during walking. Three electronic databases were searched by using different combinations of keywords. The methodological quality of the studies was assessed by two researchers with the Strobe quality checklist. Ten studies (methodological quality: 32% to 74%) with in total 259 children with CP and 220 typically developing children (mean age: 7.6 to 13.6 year) were included. Compared to typically developing children, children with bilateral CP showed an increased range of motion of the thorax, pelvis and spine during walking. The results of the children with unilateral CP were less clear. In general, children with bilateral CP showed larger movement amplitudes of the trunk compared to children without CP. This increase in movement amplitudes could influence the dynamic stability of the body during walking. In children with unilateral CP, the results were less obvious and further research on this topic is required.

Effectiveness of the Comprehensive Approach to Rehabilitation (CARe) methodology: design of a cluster randomized controlled trial.

PubMed

Bitter, Neis A; Roeg, Diana P K; van Nieuwenhuizen, Chijs; van Weeghel, Jaap

2015-07-22

There is an increasing amount of evidence for the effectiveness of rehabilitation interventions for people with severe mental illness (SMI). In the Netherlands, a rehabilitation methodology that is well known and often applied is the Comprehensive Approach to Rehabilitation (CARe) methodology. The overall goal of the CARe methodology is to improve the client's quality of life by supporting the client in realizing his/her goals and wishes, handling his/her vulnerability and improving the quality of his/her social environment. The methodology is strongly influenced by the concept of 'personal recovery' and the 'strengths case management model'. No controlled effect studies have been conducted hitherto regarding the CARe methodology. This study is a two-armed cluster randomized controlled trial (RCT) that will be executed in teams from three organizations for sheltered and supported housing, which provide services to people with long-term severe mental illness. Teams in the intervention group will receive the multiple-day CARe methodology training from a specialized institute and start working according the CARe Methodology guideline. Teams in the control group will continue working in their usual way. Standardized questionnaires will be completed at baseline (T0), and 10 (T1) and 20 months (T2) post baseline. Primary outcomes are recovery, social functioning and quality of life. The model fidelity of the CARe methodology will be assessed at T1 and T2. This study is the first controlled effect study on the CARe methodology and one of the few RCTs on a broad rehabilitation method or strength-based approach. This study is relevant because mental health care organizations have become increasingly interested in recovery and rehabilitation-oriented care. The trial registration number is ISRCTN77355880 .

A discussion of differences in preparation, performance and postreflections in participant observations within two grounded theory approaches.

PubMed

Berthelsen, Connie Bøttcher; Lindhardt, Tove; Frederiksen, Kirsten

2017-06-01

This paper presents a discussion of the differences in using participant observation as a data collection method by comparing the classic grounded theory methodology of Barney Glaser with the constructivist grounded theory methodology by Kathy Charmaz. Participant observations allow nursing researchers to experience activities and interactions directly in situ. However, using participant observations as a data collection method can be done in many ways, depending on the chosen grounded theory methodology, and may produce different results. This discussion shows that how the differences between using participant observations in classic and constructivist grounded theory can be considerable and that grounded theory researchers should adhere to the method descriptions of performing participant observations according to the selected grounded theory methodology to enhance the quality of research. © 2016 Nordic College of Caring Science.

Quality and methodological challenges in Internet-based mental health trials.

PubMed

Ye, Xibiao; Bapuji, Sunita Bayyavarapu; Winters, Shannon; Metge, Colleen; Raynard, Mellissa

2014-08-01

To review the quality of Internet-based mental health intervention studies and their methodological challenges. We searched multiple literature databases to identify relevant studies according to the Population, Interventions, Comparators, Outcomes, and Study Design framework. Two reviewers independently assessed selection bias, allocation bias, confounding bias, blinding, data collection methods, and withdrawals/dropouts, using the Quality Assessment Tool for Quantitative Studies. We rated each component as strong, moderate, or weak and assigned a global rating (strong, moderate, or weak) to each study. We discussed methodological issues related to the study quality. Of 122 studies included, 31 (25%), 44 (36%), and 47 (39%) were rated strong, moderate, and weak, respectively. Only five studies were rated strong for all of the six quality components (three of them were published by the same group). Lack of blinding, selection bias, and low adherence were the top three challenges in Internet-based mental health intervention studies. The overall quality of Internet-based mental health intervention needs to improve. In particular, studies need to improve sample selection, intervention allocation, and blinding.

The methodological quality of health economic evaluations for the management of hip fractures: A systematic review of the literature.

PubMed

Sabharwal, Sanjeeve; Carter, Alexander; Darzi, Lord Ara; Reilly, Peter; Gupte, Chinmay M

2015-06-01

Approximately 76,000 people a year sustain a hip fracture in the UK and the estimated cost to the NHS is £1.4 billion a year. Health economic evaluations (HEEs) are one of the methods employed by decision makers to deliver healthcare policy supported by clinical and economic evidence. The objective of this study was to (1) identify and characterize HEEs for the management of patients with hip fractures, and (2) examine their methodological quality. A literature search was performed in MEDLINE, EMBASE and the NHS Economic Evaluation Database. Studies that met the specified definition for a HEE and evaluated hip fracture management were included. Methodological quality was assessed using the Consensus on Health Economic Criteria (CHEC). Twenty-seven publications met the inclusion criteria of this study and were included in our descriptive and methodological analysis. Domains of methodology that performed poorly included use of an appropriate time horizon (66.7% of studies), incremental analysis of costs and outcomes (63%), future discounting (44.4%), sensitivity analysis (40.7%), declaration of conflicts of interest (37%) and discussion of ethical considerations (29.6%). HEEs for patients with hip fractures are increasing in publication in recent years. Most of these studies fail to adopt a societal perspective and key aspects of their methodology are poor. The development of future HEEs in this field must adhere to established principles of methodology, so that better quality research can be used to inform health policy on the management of patients with a hip fracture. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Funding source and the quality of reports of chronic wounds trials: 2004 to 2011.

PubMed

Hodgson, Robert; Allen, Richard; Broderick, Ellen; Bland, J Martin; Dumville, Jo C; Ashby, Rebecca; Bell-Syer, Sally; Foxlee, Ruth; Hall, Jill; Lamb, Karen; Madden, Mary; O'Meara, Susan; Stubbs, Nikki; Cullum, Nicky

2014-01-14

Critical commentaries suggest that wound care randomised controlled trials (RCTs) are often poorly reported with many methodological flaws. Furthermore, interventions in chronic wounds, rather than being drugs, are often medical devices for which there are no requirements for RCTs to bring products to market. RCTs in wounds trials therefore potentially represent a form of marketing. This study presents a methodological overview of chronic wound trials published between 2004 and 2011 and investigates the influence of industry funding on methodological quality. A systematic search for RCTs for the treatment of chronic wounds published in the English language between 2004 and 2011 (inclusive) in the Cochrane Wounds Group Specialised Register of Trials was carried out.Data were extracted on aspects of trial design, conduct and quality including sample size, duration of follow-up, specification of a primary outcome, use of surrogate outcomes, and risks of bias. In addition, the prevalence of industry funding was assessed and its influence on the above aspects of trial design, conduct and quality was assessed. A total of 167 RCTs met our inclusion criteria. We found chronic wound trials often have short durations of follow-up (median 12 weeks), small sample sizes (median 63), fail to define a primary outcome in 41% of cases, and those that do define a primary outcome, use surrogate measures of healing in 40% of cases. Only 40% of trials used appropriate methods of randomisation, 25% concealed allocation and 34% blinded outcome assessors. Of the included trials, 41% were wholly or partially funded by industry, 33% declared non-commercial funding and 26% did not report a funding source. Industry funding was not statistically significantly associated with any measure of methodological quality, though this analysis was probably underpowered. This overview confirms concerns raised about the methodological quality of RCTs in wound care and illustrates that greater efforts must be made to follow international standards for conducting and reporting RCTs. There is currently minimal evidence of an influence of industry funding on methodological quality although analyses had limited power and funding source was not reported for a quarter of studies.

Sensory re-education after nerve injury of the upper limb: a systematic review.

PubMed

Oud, Tanja; Beelen, Anita; Eijffinger, Elianne; Nollet, Frans

2007-06-01

To systematically review the available evidence for the effectiveness of sensory re-education to improve the sensibility of the hand in patients with a peripheral nerve injury of the upper limb. Studies were identified by an electronic search in the databases MEDLINE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), and the database of the Dutch National Institute of Allied Health Professions (Doconline) and by screening the reference lists of relevant articles. Two reviewers selected studies that met the following inclusion criteria: all designs except case reports, adults with impaired sensibility of the hand due to a peripheral nerve injury of the upper limb, and sensibility and functional sensibility as outcome measures. The methodological quality of the included studies was independently assessed by two reviewers. A best-evidence synthesis was performed, based on design, methodological quality and significant findings on outcome measures. Seven studies, with sample sizes ranging from 11 to 49, were included in the systematic review and appraised for content. Five of these studies were of poor methodological quality. One uncontrolled study (N = 1 3 ) was considered to be of sufficient methodological quality, and one randomized controlled trial (N = 49) was of high methodological quality. Best-evidence synthesis showed that there is limited evidence for the effectiveness of sensory re-education, provided by a statistically significant improvement in sensibility found in one high-quality randomized controlled trial. There is a need for further well-defined clinical trials to assess the effectiveness of sensory re-education of patients with impaired sensibility of the hand due to a peripheral nerve injury.

A systematic review of studies evaluating Australian indigenous community development projects: the extent of community participation, their methodological quality and their outcomes.

PubMed

Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca

2015-11-21

Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community development projects and little analysis of their effectiveness. This systematic review aims to identify the extent of community participation in community development projects implemented in Australian Indigenous communities, critically appraise the qualitative and quantitative methods used in their evaluation, and summarise their outcomes. Ten electronic peer-reviewed databases and two electronic grey literature databases were searched for relevant studies published between 1990 and 2015. The level of community participation and the methodological quality of the qualitative and quantitative components of the studies were assessed against standardised criteria. Thirty one evaluation studies of community development projects were identified. Community participation varied between different phases of project development, generally high during project implementation, but low during the evaluation phase. For the majority of studies, methodological quality was low and the methods were poorly described. Although positive qualitative or quantitative outcomes were reported in all studies, only two studies reported statistically significant outcomes. Partnerships between researchers, community members and service providers have great potential to improve methodological quality and community participation when research skills and community knowledge are integrated to design, implement and evaluate community development projects. The methodological quality of studies evaluating Australian Indigenous community development projects is currently too weak to confidently determine the cost-effectiveness of community development projects in improving the health and wellbeing of Indigenous Australians. Higher quality studies evaluating community development projects would strengthen the evidence base.

Instruments to assess patients with rotator cuff pathology: a systematic review of measurement properties.

PubMed

Longo, Umile Giuseppe; Saris, Daniël; Poolman, Rudolf W; Berton, Alessandra; Denaro, Vincenzo

2012-10-01

The aims of this study were to obtain an overview of the methodological quality of studies on the measurement properties of rotator cuff questionnaires and to describe how well various aspects of the design and statistical analyses of studies on measurement properties are performed. A systematic review of published studies on the measurement properties of rotator cuff questionnaires was performed. Two investigators independently rated the quality of the studies using the Consensus-based Standards for the selection of health Measurement Instruments checklist. This checklist was developed in an international Delphi consensus study. Sixteen studies were included, in which two measurement instruments were evaluated, namely the Western Ontario Rotator Cuff Index and the Rotator Cuff Quality-of-Life Measure. The methodological quality of the included studies was adequate on some properties (construct validity, reliability, responsiveness, internal consistency, and translation) but need to be improved on other aspects. The most important methodological aspects that need to be developed are as follows: measurement error, content validity, structural validity, cross-cultural validity, criterion validity, and interpretability. Considering the importance of adequate measurement properties, it is concluded that, in the field of rotator cuff pathology, there is room for improvement in the methodological quality of studies measurement properties. II.

Randomized controlled trials of simulation-based interventions in Emergency Medicine: a methodological review.

PubMed

Chauvin, Anthony; Truchot, Jennifer; Bafeta, Aida; Pateron, Dominique; Plaisance, Patrick; Yordanov, Youri

2018-04-01

The number of trials assessing Simulation-Based Medical Education (SBME) interventions has rapidly expanded. Many studies show that potential flaws in design, conduct and reporting of randomized controlled trials (RCTs) can bias their results. We conducted a methodological review of RCTs assessing a SBME in Emergency Medicine (EM) and examined their methodological characteristics. We searched MEDLINE via PubMed for RCT that assessed a simulation intervention in EM, published in 6 general and internal medicine and in the top 10 EM journals. The Cochrane Collaboration risk of Bias tool was used to assess risk of bias, intervention reporting was evaluated based on the "template for intervention description and replication" checklist, and methodological quality was evaluated by the Medical Education Research Study Quality Instrument. Reports selection and data extraction was done by 2 independents researchers. From 1394 RCTs screened, 68 trials assessed a SBME intervention. They represent one quarter of our sample. Cardiopulmonary resuscitation (CPR) is the most frequent topic (81%). Random sequence generation and allocation concealment were performed correctly in 66 and 49% of trials. Blinding of participants and assessors was performed correctly in 19 and 68%. Risk of attrition bias was low in three-quarters of the studies (n = 51). Risk of selective reporting bias was unclear in nearly all studies. The mean MERQSI score was of 13.4/18.4% of the reports provided a description allowing the intervention replication. Trials assessing simulation represent one quarter of RCTs in EM. Their quality remains unclear, and reproducing the interventions appears challenging due to reporting issues.

Using Indigenist and Indigenous methodologies to connect to deeper understandings of Aboriginal and Torres Strait Islander peoples' quality of life.

PubMed

Kite, Elaine; Davy, Carol

2015-12-01

The lack of a common description makes measuring the concept of quality of life (QoL) a challenge. Whether QoL incorporates broader social features or is attributed to health conditions, the diverse range of descriptions applied by various disciplines has resulted in a concept that is multidimensional and vague. The variety of theoretical conceptualisations of QoL confounds and confuses even the most astute. Measuring QoL in Aboriginal and Torres Strait Islander populations is even more challenging. Instruments commonly developed and used to measure QoL are often derived from research methodologies shaped by Western cultural perspectives. Often they are simply translated for use among culturally and linguistically diverse Aboriginal and Torres Strait Islander peoples. This has implications for Aboriginal and Torres Strait Islander populations whose perceptions of health are derived from within their specific cultures, value systems and ways of knowing and being. Interconnections and relationships between themselves, their communities, their environment and the natural and spiritual worlds are complex. The way in which their QoL is currently measured indicates that very little attention is given to the diversity of Aboriginal and Torres Strait Islander peoples' beliefs or the ways in which those beliefs shape or give structure and meaning to their health and their lives. The use of Indigenist or Indigenous methodologies in defining what Aboriginal and Torres Strait Islander peoples believe gives quality to their lives is imperative. These methodologies have the potential to increase the congruency between their perceptions of QoL and instruments to measure it.

Methodology for Air Quality Forecast Downscaling from Regional- to Street-Scale

NASA Astrophysics Data System (ADS)

Baklanov, Alexander; Nuterman, Roman; Mahura, Alexander; Amstrup, Bjarne; Hansen Saas, Bent; Havskov Sørensen, Jens; Lorenzen, Thomas; Weismann, Jakob

2010-05-01

The most serious air pollution events occur in cities where there is a combination of high population density and air pollution, e.g. from vehicles. The pollutants can lead to serious human health problems, including asthma, irritation of the lungs, bronchitis, pneumonia, decreased resistance to respiratory infections, and premature death. In particular air pollution is associated with increase in cardiovascular disease and lung cancer. In 2000 WHO estimated that between 2.5 % and 11 % of total annual deaths are caused by exposure to air pollution. However, European-scale air quality models are not suited for local forecasts, as their grid-cell is typically of the order of 5 to 10km and they generally lack detailed representation of urban effects. Two suites are used in the framework of the EC FP7 project MACC (Monitoring of Atmosphere Composition and Climate) to demonstrate how downscaling from the European MACC ensemble to local-scale air quality forecast will be carried out: one will illustrate capabilities for the city of Copenhagen (Denmark); the second will focus on the city of Bucharest (Romania). This work is devoted to the first suite, where methodological aspects of downscaling from regional (European/ Denmark) to urban scale (Copenhagen), and from the urban down to street scale. The first results of downscaling according to the proposed methodology are presented. The potential for downscaling of European air quality forecasts by operating urban and street-level forecast models is evaluated. This will bring a strong support for continuous improvement of the regional forecast modelling systems for air quality in Europe, and underline clear perspectives for the future regional air quality core and downstream services for end-users. At the end of the MACC project, requirements on "how-to-do" downscaling of European air-quality forecasts to the city and street levels with different approaches will be formulated.

How best to assess quality of life in informal carers of people with dementia; A systematic review of existing outcome measures

PubMed Central

Robinson, Jonah; Robalino, Shannon; Finch, Tracy; McColl, Elaine

2018-01-01

Background In the UK, there are currently 800 000 people living with dementia. This number is expected to double in the next 20 years. Two-thirds of people with dementia live in the community supported by informal carers. Caring for a person with dementia has adverse effects on psychological, physical, social wellbeing and quality of life. The measurement of quality of life of carers of people with dementia is increasingly of interest to health and social care practitioners and commissioners, policymakers, and carers themselves. However, there is lack of consensus on the most suitable instrument(s) for undertaking this. Methods A systematic review of the literature using COSMIN methodology. Searching of electronic databases (Medline, PsycINFO, CINAHL and Web of Science), reference list and citation searching of key papers was undertaken. COSMIN methodology was used to simultaneously extract data from and assess methodological quality of included studies, and make a recommendation for the instrument with the most high quality evidence for its measurement properties. Results Ten instruments were suitable for inclusion in this review. The Carer well-being and support questionnaire (CWS) has the best quality evidence for the greatest number of measurement of properties. The Caregiver Well-Being Scale is also worthy of consideration. There is not presently a measure which could be recommended for use in economic evaluations, however the Impact of Alzheimer’s Disease on the Caregiver questionnaire (IADCQ) could potentially be used following further investigation of its measurement properties in a representative population. Conclusion The CWS is the most appropriate instrument to recommend for the assessment of quality of life in informal carers of people with dementia at present. All instruments included in this review would benefit from more rigorous evaluation of their measurement properties. PMID:29538433

Evaluation of the Factors That Determine Quality in Higher Education: An Empirical Study

ERIC Educational Resources Information Center

Tsinidou, Maria; Gerogiannis, Vassilis; Fitsilis, Panos

2010-01-01

Purpose: The aim of this paper is to identify the quality determinants for education services provided by higher education institutions (HEIs) in Greece and to measure their relative importance from the students' points of view. Design/methodology/approach: A multi-criteria decision-making methodology was used for assessing the relative importance…

Improving Safety, Quality and Efficiency through the Management of Emerging Processes: The TenarisDalmine Experience

ERIC Educational Resources Information Center

Bonometti, Patrizia

2012-01-01

Purpose: The aim of this contribution is to describe a new complexity-science-based approach for improving safety, quality and efficiency and the way it was implemented by TenarisDalmine. Design/methodology/approach: This methodology is called "a safety-building community". It consists of a safety-behaviour social self-construction…

The public water supply protection value of forests: A watershed-scale ecosystem services based upon total organic carbon

USDA-ARS?s Scientific Manuscript database

We developed a cost-based methodology to assess the value of forested watersheds to improve water quality in public water supplies. The developed methodology is applicable to other source watersheds to determine ecosystem services for water quality. We assess the value of forest land for source wate...

Using Six Sigma for Performance Improvement in Business Curriculum: A Case Study

ERIC Educational Resources Information Center

Kukreja, Anil; Ricks, Joe M., Jr.; Meyer, Jean A.

2009-01-01

During the last few decades, a number of quality improvement methodologies have been used by organizations. This article provides a brief review of the quality improvement literature related to academia and a case study using Six Sigma methodology to analyze students' performance in a standardized examination. We found Six Sigma to be an effective…

Quality in the Basic Grant Delivery System: Volume 3, Methodology.

ERIC Educational Resources Information Center

Advanced Technology, Inc., McLean, VA.

The research methodology of a study to assess 1980-1981 award accuracy of the Basic Educational Opportunity Grants (BEOG), or Pell grants, is described. The study is the first stage of a three-stage quality control project. During the spring of 1981 a nationally representative sample of 305 public, private, and proprietary institutions was…

Development of Management Methodology for Engineering Production Quality

NASA Astrophysics Data System (ADS)

Gorlenko, O.; Miroshnikov, V.; Borbatc, N.

2016-04-01

The authors of the paper propose four directions of the methodology developing the quality management of engineering products that implement the requirements of new international standard ISO 9001:2015: the analysis of arrangement context taking into account stakeholders, the use of risk management, management of in-house knowledge, assessment of the enterprise activity according to the criteria of effectiveness

Translating Oral Health-Related Quality of Life Measures: Are There Alternative Methodologies?

ERIC Educational Resources Information Center

Brondani, Mario; He, Sarah

2013-01-01

Translating existing sociodental indicators to another language involves a rigorous methodology, which can be costly. Free-of-charge online translator tools are available, but have not been evaluated in the context of research involving quality of life measures. To explore the value of using online translator tools to develop oral health-related…

A systematic tale of two differing reviews: evaluating the evidence on public and private sector quality of primary care in low and middle income countries.

PubMed

Coarasa, Jorge; Das, Jishnu; Gummerson, Elizabeth; Bitton, Asaf

2017-04-12

Systematic reviews are powerful tools for summarizing vast amounts of data in controversial areas; but their utility is limited by methodological choices and assumptions. Two systematic reviews of literature on the quality of private sector primary care in low and middle income countries (LMIC), published in the same journal within a year, reached conflicting conclusions. The difference in findings reflects different review methodologies, but more importantly, a weak underlying body of literature. A detailed examination of the literature cited in both reviews shows that only one of the underlying studies met the gold standard for methodological robustness. Given the current policy momentum on universal health coverage and primary health care reform across the globe, there is an urgent need for high quality empirical evidence on the quality of private versus public sector primary health care in LMIC.

Quantitative weight of evidence assessment of higher-tier studies on the toxicity and risks of neonicotinoid insecticides in honeybees 1: Methods.

PubMed

Solomon, Keith R; Stephenson, Gladys L

2017-01-01

A quantitative weight of evidence (QWoE) methodology was developed and used to assess many higher-tier studies on the effects of three neonicotinoid insecticides: clothianidin (CTD), imidacloprid (IMI), and thiamethoxam (TMX) on honeybees. A general problem formulation, a conceptual model for exposures of honeybees, and an analysis plan were developed. A QWoE methodology was used to characterize the quality of the available studies from the literature and unpublished reports of studies conducted by or for the registrants. These higher-tier studies focused on the exposures of honeybees to neonicotinoids via several matrices as measured in the field as well as the effects in experimentally controlled field studies. Reports provided by Bayer Crop Protection and Syngenta Crop Protection and papers from the open literature were assessed in detail, using predefined criteria for quality and relevance to develop scores (on a relative scale of 0-4) to separate the higher-quality from lower-quality studies and those relevant from less-relevant results. The scores from the QWoEs were summarized graphically to illustrate the overall quality of the studies and their relevance. Through mean and standard errors, this method provided graphical and numerical indications of the quality and relevance of the responses observed in the studies and the uncertainty associated with these two metrics. All analyses were conducted transparently and the derivations of the scores were fully documented. The results of these analyses are presented in three companion papers and the QWoE analyses for each insecticide are presented in detailed supplemental information (SI) in these papers.

Control design for future agile fighters

NASA Technical Reports Server (NTRS)

Murphy, Patrick C.; Davidson, John B.

1991-01-01

The CRAFT control design methodology is presented. CRAFT stands for the design objectives addressed, namely, Control power, Robustness, Agility, and Flying Qualities Tradeoffs. The approach combines eigenspace assignment, which allows for direct specification of eigenvalues and eigenvectors, and a graphical approach for representing control design metrics that captures numerous design goals in one composite illustration. The methodology makes use of control design metrics from four design objective areas, namely, control power, robustness, agility, and flying qualities. An example of the CRAFT methodology as well as associated design issues are presented.

Water resources vulnerability assessment in the Adriatic Sea region: the case of Corfu Island.

PubMed

Kanakoudis, Vasilis; Tsitsifli, Stavroula; Papadopoulou, Anastasia; Cencur Curk, Barbara; Karleusa, Barbara

2017-09-01

Cross-border water resources management and protection is a complicated task to achieve, lacking a common methodological framework. Especially in the Adriatic region, water used for drinking water supply purposes pass from many different countries, turning its management into a hard task to achieve. During the DRINKADRIA project, a common methodological framework has been developed, for efficient and effective cross-border water supply and resources management, taking into consideration different resources types (surface and groundwater) emphasizing in drinking water supply intake. The common methodology for water resources management is based on four pillars: climate characteristics and climate change, water resources availability, quality, and security. The present paper assesses both present and future vulnerability of water resources in the Adriatic region, with special focus on Corfu Island, Greece. The results showed that climate change is expected to impact negatively on water resources availability while at the same time, water demand is expected to increase. Water quality problems will be intensified especially due to land use changes and salt water intrusion. The analysis identified areas where water resources are more vulnerable, allowing decision makers develop management strategies.

The Ocean Colour Climate Change Initiative: I. A Methodology for Assessing Atmospheric Correction Processors Based on In-Situ Measurements

NASA Technical Reports Server (NTRS)

Muller, Dagmar; Krasemann, Hajo; Brewin, Robert J. W.; Deschamps, Pierre-Yves; Doerffer, Roland; Fomferra, Norman; Franz, Bryan A.; Grant, Mike G.; Groom, Steve B.; Melin, Frederic;

Using Lean Six Sigma Methodology to Improve a Mass Immunizations Process at the United States Naval Academy.

PubMed

Ha, Chrysanthy; McCoy, Donald A; Taylor, Christopher B; Kirk, Kayla D; Fry, Robert S; Modi, Jitendrakumar R

2016-06-01

Lean Six Sigma (LSS) is a process improvement methodology developed in the manufacturing industry to increase process efficiency while maintaining product quality. The efficacy of LSS application to the health care setting has not been adequately studied. This article presents a quality improvement project at the U.S. Naval Academy that uses LSS to improve the mass immunizations process for Midshipmen during in-processing. The process was standardized to give all vaccinations at one station instead of giving a different vaccination at each station. After project implementation, the average immunizations lead time decreased by 79% and staffing decreased by 10%. The process was shown to be in control with a capability index of 1.18 and performance index of 1.10, resulting in a defect rate of 0.04%. This project demonstrates that the LSS methodology can be applied successfully to the health care setting to make sustainable process improvements if used correctly and completely. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Systematic review of studies on measurement properties of instruments for adults published in the American Journal of Occupational Therapy, 2009-2013.

PubMed

Yuen, Hon K; Austin, Sarah L

2014-01-01

We describe the methodological quality of recent studies on instrument development and testing published in the American Journal of Occupational Therapy (AJOT). We conducted a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist to appraise 48 articles on measurement properties of assessments for adults published in AJOT between 2009 and 2013. Most studies had adequate methodological quality in design and statistical analysis. Common methodological limitations included that methods used to examine internal consistency were not consistently linked to the theoretical constructs underpinning assessments; participants in some test-retest reliability studies were not stable during the interim period; and in several studies of reliability and convergent validity, sample sizes were inadequate. AJOT's dissemination of psychometric research evidence has made important contributions to moving the profession toward the American Occupational Therapy Association's Centennial Vision. This study's results provide a benchmark by which to evaluate future accomplishments. Copyright © 2014 by the American Occupational Therapy Association, Inc.

LC-MS based analysis of endogenous steroid hormones in human hair.

PubMed

Gao, Wei; Kirschbaum, Clemens; Grass, Juliane; Stalder, Tobias

2016-09-01

The quantification of endogenous steroid hormone concentrations in hair is increasingly used as a method for obtaining retrospective information on long-term integrated hormone exposure. Several different analytical procedures have been employed for hair steroid analysis, with liquid chromatography-mass spectrometry (LC-MS) being recognized as a particularly powerful analytical tool. Several methodological aspects affect the performance of LC-MS systems for hair steroid analysis, including sample preparation and pretreatment, steroid extraction, post-incubation purification, LC methodology, ionization techniques and MS specifications. Here, we critically review the differential value of such protocol variants for hair steroid hormones analysis, focusing on both analytical quality and practical feasibility issues. Our results show that, when methodological challenges are adequately addressed, LC-MS protocols can not only yield excellent sensitivity and specificity but are also characterized by relatively simple sample processing and short run times. This makes LC-MS based hair steroid protocols particularly suitable as a high-quality option for routine application in research contexts requiring the processing of larger numbers of samples. Copyright © 2016 Elsevier Ltd. All rights reserved.

The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

PubMed

Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

2014-12-01

We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

[Health survey in Quilombola communities (descendants of Afro-Brazilian slaves who escaped from slave plantations that existed in Brazil until abolition in 1888) in Vitória da Conquista in the state of Bahia (COMQUISTA Project), Brazil: methodological aspects and descriptive analysis].

PubMed

Bezerra, Vanessa Moraes; Medeiros, Danielle Souto de; Gomes, Karine de Oliveira; Souzas, Raquel; Giatti, Luana; Steffens, Ana Paula; Kochergin, Clavdia Nicolaevna; Souza, Cláudio Lima; Moura, Cristiano Soares de; Soares, Daniela Arruda; Santos, Luis Rogério Cosme Silva; Cardoso, Luiz Gustavo Vieira; Oliveira, Márcio Vasconcelos de; Martins, Poliana Cardoso; Neves, Orlando Sílvio Caires; Guimarães, Mark Drew Crosland

2014-06-01

The scope of this article was to present the methodology, preliminary descriptive results and the reliability of the instruments used in the COMQUISTA Project. It involved a cross-sectional study with adults (>18 years) and children (up to 5 years old) of Quilombola communities in Vitória da Conquista, Bahia. Data collection consisted of individual and household interviews, anthropometric and blood pressure measurements. A semi-structured questionnaire adapted from the Brazilian National Health Survey (PNS) was used and the interviews were conducted using handheld computers. 397 housing units were visited and 797 adults and 130 children were interviewed. The demographic profile of the Quilombolas was similar to the Brazilian population with respect to sex and age, however, they had precarious access to basic sanitation and a low socioeconomic status. The analysis of reliability revealed the adequacy of strategies adopted for quality assurance and control in the study. The methodology used was considered adequate to achieve the objectives and can be used in other populations. The results indicate the need for implementing strategies to improve the quality of life and reduce the degree of vulnerability of the Quilombolas.

METHODOLOGIES FOR CALIBRATION AND PREDICTIVE ANALYSIS OF A WATERSHED MODEL

EPA Science Inventory

The use of a fitted-parameter watershed model to address water quantity and quality management issues requires that it be calibrated under a wide range of hydrologic conditions. However, rarely does model calibration result in a unique parameter set. Parameter nonuniqueness can l...

Analytical Chemistry Division annual progress report for period ending November 30, 1977

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lyon, W.S.

1978-03-01

Activities for the year are summarized in sections on analytical methodology, mass and mass emission spectrometry, analytical services, bio-organic analysis, nuclear and radiochemical analysis, and quality assurance and safety. Presentations of research results in publications and reports are tabulated. (JRD)

Updated estimates of HAL n and RN- effects on pork quality: fresh and processed loin and ham.

PubMed

Cherel, P; Glénisson, J; Figwer, P; Pires, J; Damon, M; Franck, M; Le Roy, P

2010-12-01

A 1000-pig F2 intercross QTL detection experimental population was generated using two commercial sire lines. Independent carriers of HAL n and RN- mutations (10% and 14%, respectively) were included in this population as control genotypes. The effects of HAL n and RN- heterozygous genotypes on fresh and transformed loins and hams were estimated using a mixed model methodology. The results document the unfavorable effects of both mutations on meat quality. Smaller effects of HAL Nn genotype compared to HAL nn or RN-rn+ genotypes were estimated. Interestingly, effects of HAL Nn genotype on meat pH and loin color could be insignificant at 24-h postmortem, but translate into higher water losses on storage and cooking, and result in tougher cooked loin. Using the same methodology, significant effects of the PRKAG3 (RN) I199 allele on ultimate pH values but not on glycolytic potential were observed. Copyright © 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

A System Evaluation Theory Analyzing Value and Results Chain for Institutional Accreditation in Oman

ERIC Educational Resources Information Center

Paquibut, Rene Ymbong

2017-01-01

Purpose: This paper aims to apply the system evaluation theory (SET) to analyze the institutional quality standards of Oman Academic Accreditation Authority using the results chain and value chain tools. Design/methodology/approach: In systems thinking, the institutional standards are connected as input, process, output and feedback and leads to…

External Evaluation of Education and Teacher Work: The Brazilian Case

ERIC Educational Resources Information Center

Rothen, José Carlos; da Cunha Malheiros Santana, Andréia

2015-01-01

This article aims to discuss whether external evaluations are instruments to ensure increased quality of public school education. It is part of a research that investigated how evaluation results and the resulting indices were used in two schools in the state of São Paulo (Brazil). The methodology adopted was the case study, using different…

Analysis of health economics assessment reports for pharmaceuticals in France – understanding the underlying philosophy of CEESP assessment

PubMed Central

Toumi, Mondher; Motrunich, Anastasiia; Millier, Aurélie; Rémuzat, Cécile; Chouaid, Christos; Falissard, Bruno; Aballéa, Samuel

2017-01-01

ABSTRACT Background: Despite the guidelines for Economic and Public Health Assessment Committee (CEESP) submission having been available for nearly six years, the dossiers submitted continue to deviate from them, potentially impacting product prices. Objective: to review the reports published by CEESP, analyse deviations from the guidelines, and discuss their implications for the pricing and reimbursement process. Study design: CEESP reports published until January 2017 were reviewed, and deviations from the guidelines were extracted. The frequency of deviations was described by type of methodological concern (minor, important or major). Results: In 19 reports, we identified 243 methodological concerns, most often concerning modelling, measurement and valuation of health states and results presentation and sensitivity analyses; nearly 63% were minor, 33% were important and 4.5% were major. All reports included minor methodological concerns, and 17 (89%) included at least one important and/or major methodological concern. Global major methodological concerns completely invalidated the analysis in seven dossiers (37%). Conclusion: The CEESP submission dossiers fail to adhere to the guidelines, potentially invalidating the health economics analysis and resulting in pricing negotiations. As these negotiations tend to be unfavourable for the manufacturer, the industry should strive to improve the quality of the analyses submitted to CEESP. PMID:28804600

Sports Injury Surveillance Systems: A Review of Methods and Data Quality.

PubMed

Ekegren, Christina L; Gabbe, Belinda J; Finch, Caroline F

2016-01-01

Data from sports injury surveillance systems are a prerequisite to the development and evaluation of injury prevention strategies. This review aimed to identify ongoing sports injury surveillance systems and determine whether there are gaps in our understanding of injuries in certain sport settings. A secondary aim was to determine which of the included surveillance systems have evaluated the quality of their data, a key factor in determining their usefulness. A systematic search was carried out to identify (1) publications presenting methodological details of sports injury surveillance systems within clubs and organisations; and (2) publications describing quality evaluations and the quality of data from these systems. Data extracted included methodological details of the surveillance systems, methods used to evaluate data quality, and results of these evaluations. Following literature search and review, a total of 15 sports injury surveillance systems were identified. Data relevant to each aim were summarised descriptively. Most systems were found to exist within professional and elite sports. Publications concerning data quality were identified for seven (47%) systems. Validation of system data through comparison with alternate sources has been undertaken for only four systems (27%). This review identified a shortage of ongoing injury surveillance data from amateur and community sport settings and limited information about the quality of data in professional and elite settings. More surveillance systems are needed across a range of sport settings, as are standards for data quality reporting. These efforts will enable better monitoring of sports injury trends and the development of sports safety strategies.

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes

PubMed Central

Congdon, Peter

2016-01-01

Background: Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. Methods: This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. Results: As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Conclusions: Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables. PMID:27598184

What Are the Strength of Recommendations and Methodologic Reporting in Health Economic Studies in Orthopaedic Surgery?

PubMed

Makhni, Eric C; Steinhaus, Michael E; Swart, Eric; Bozic, Kevin J

2015-10-01

Cost-effectiveness research is an increasingly used tool in evaluating treatments in orthopaedic surgery. Without high-quality primary-source data, the results of a cost-effectiveness study are either unreliable or heavily dependent on sensitivity analyses of the findings from the source studies. However, to our knowledge, the strength of recommendations provided by these studies in orthopaedics has not been studied. We asked: (1) What are the strengths of recommendations in recent orthopaedic cost-effectiveness studies? (2) What are the reasons authors cite for weak recommendations? (3) What are the methodologic reporting practices used by these studies? The titles of all articles published in six different orthopaedic journals from January 1, 2004, through April 1, 2014, were scanned for original health economics studies comparing two different types of treatment or intervention. The full texts of included studies were reviewed to determine the strength of recommendations determined subjectively by our study team, with studies providing equivocal conclusions stemming from a lack or uncertainty surrounding key primary data classified as weak and those with definitive conclusions not lacking in high-quality primary data classified as strong. The reasons underlying a weak designation were noted, and methodologic practices reported in each of the studies were examined using a validated instrument. A total of 79 articles met our prespecified inclusion criteria and were evaluated in depth. Of the articles included, 50 (63%) provided strong recommendations, whereas 29 (37%) provided weak recommendations. Of the 29 studies, clinical outcomes data were cited in 26 references as being insufficient to provide definitive conclusions, whereas cost and utility data were cited in 13 and seven articles, respectively. Methodologic reporting practices varied greatly, with mixed adherence to framing, costs, and results reporting. The framing variables included clearly defined intervention, adequate description of a comparator, study perspective clearly stated, and reported discount rate for future costs and quality-adjusted life years. Reporting costs variables included economic data collected alongside a clinical trial or another primary source and clear statement of the year of monetary units. Finally, results reporting included whether a sensitivity analysis was performed. Given that a considerable portion of orthopaedic cost-effectiveness studies provide weak recommendations and that methodologic reporting practices varied greatly among strong and weak studies, we believe that clinicians should exercise great caution when considering the conclusions of cost-effectiveness studies. Future research could assess the effect of such cost-effectiveness studies in clinical practice, and whether the strength of recommendations of a study's conclusions has any effect on practice patterns. Given the increasing use of cost-effectiveness studies in orthopaedic surgery, understanding the quality of these studies and the reasons that limit the ability of studies to provide more definitive recommendations is critical. Highlighting the heterogeneity of methodologic reporting practices will aid clinicians in interpreting the conclusions of cost-effectiveness studies and improve future research efforts.

Systematic reviews identify important methodological flaws in stroke rehabilitation therapy primary studies: review of reviews.

PubMed

Santaguida, Pasqualina; Oremus, Mark; Walker, Kathryn; Wishart, Laurie R; Siegel, Karen Lohmann; Raina, Parminder

2012-04-01

A "review of reviews" was undertaken to assess methodological issues in studies evaluating nondrug rehabilitation interventions in stroke patients. MEDLINE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews were searched from January 2000 to January 2008 within the stroke rehabilitation setting. Electronic searches were supplemented by reviews of reference lists and citations identified by experts. Eligible studies were systematic reviews; excluded citations were narrative reviews or reviews of reviews. Review characteristics and criteria for assessing methodological quality of primary studies within them were extracted. The search yielded 949 English-language citations. We included a final set of 38 systematic reviews. Cochrane reviews, which have a standardized methodology, were generally of higher methodological quality than non-Cochrane reviews. Most systematic reviews used standardized quality assessment criteria for primary studies, but not all were comprehensive. Reviews showed that primary studies had problems with randomization, allocation concealment, and blinding. Baseline comparability, adverse events, and co-intervention or contamination were not consistently assessed. Blinding of patients and providers was often not feasible and was not evaluated as a source of bias. The eligible systematic reviews identified important methodological flaws in the evaluated primary studies, suggesting the need for improvement of research methods and reporting. Copyright © 2012 Elsevier Inc. All rights reserved.

Association between funding source, methodological quality and research outcomes in randomized controlled trials of synbiotics, probiotics and prebiotics added to infant formula: A Systematic Review

PubMed Central

2013-01-01

Background There is little or no information available on the impact of funding by the food industry on trial outcomes and methodological quality of synbiotics, probiotics and prebiotics research in infants. The objective of this study was to compare the methodological quality, outcomes of food industry sponsored trials versus non industry sponsored trials, with regards to supplementation of synbiotics, probiotics and prebiotics in infant formula. Methods A comprehensive search was conducted to identify published and unpublished randomized clinical trials (RCTs). Cochrane methodology was used to assess the risk of bias of included RCTs in the following domains: 1) sequence generation; 2) allocation concealment; 3) blinding; 4) incomplete outcome data; 5) selective outcome reporting; and 6) other bias. Clinical outcomes and authors’ conclusions were reported in frequencies and percentages. The association between source of funding, risk of bias, clinical outcomes and conclusions were assessed using Pearson’s Chi-square test and the Fisher’s exact test. A p-value < 0.05 was statistically significant. Results Sixty seven completed and 3 on-going RCTs were included. Forty (59.7%) were funded by food industry, 11 (16.4%) by non-industry entities and 16 (23.9%) did not specify source of funding. Several risk of bias domains, especially sequence generation, allocation concealment and blinding, were not adequately reported. There was no significant association between the source of funding and sequence generation, allocation concealment, blinding and selective reporting, majority of reported clinical outcomes or authors’ conclusions. On the other hand, source of funding was significantly associated with the domains of incomplete outcome data, free of other bias domains as well as reported antibiotic use and conclusions on weight gain. Conclusion In RCTs on infants fed infant formula containing probiotics, prebiotics or synbiotics, the source of funding did not influence the majority of outcomes in favour of the sponsors’ products. More non-industry funded research is needed to further assess the impact of funding on methodological quality, reported clinical outcomes and authors’ conclusions. PMID:24219082

Using Balanced Scorecard (BSC) approach to improve ergonomics programs.

PubMed

Fernandes, Marcelo Vicente Forestieri

2012-01-01

The purpose of this paper is to propose foundations for a theory of using the Balanced Scorecard (BSC) methodology to improve the strategic view of ergonomics inside the organizations. This approach may help to promote a better understanding of investing on an ergonomic program to obtain good results in quality and production, as well as health maintenance. It is explained the basics of balanced scorecard, and how ergonomists could use this to work with strategic enterprises demand. Implications of this viewpoint for the development of a new methodology for ergonomics strategy views are offered.

Quality of meta-analyses in major leading gastroenterology and hepatology journals: A systematic review.

PubMed

Liu, Pengfei; Qiu, Yuanyu; Qian, Yuting; Chen, Xiao; Wang, Yiran; Cui, Jin; Zhai, Xiao

2017-01-01

To appraise the current reporting methodological quality of meta-analyses in five leading gastroenterology and hepatology journals, and to identify the variables associated with the reporting quality. We systematically searched the literature of meta-analyses in Gastroenterology, Gut, Hepatology, Journal of Hepatology (J HEPATOL) and American Journal of Gastroenterology (AM J GASTROENTEROL) from 2006 to 2008 and from 2012 to 2014. Characteristics were extracted based on the PRISMA statement and the AMSTAR tool. Country, number of patients, funding source were also revealed and descriptively reported. A total of 127 meta-analyses were enrolled in this study and were compared among journals, study years, and other characters. Compliances with the PRISMA statement and the AMSTAR checklist were 20.8 ± 4.2 out of a maximum of 27 and 7.6 ± 2.4 out of a maximum of 11, respectively. Some domains were poorly reported including describing a protocol and/or registration (item 5, 0.0%), describing methods, and giving results of additional analyses (item 16, 45.7% and item 23, 48.0%) for PRISMA and duplicating study selection and data extraction (item 2, 53.5%), and providing a list of included and excluded studies (item 5, 14.2%) for AMSTAR. Publication in recent years showed a significantly better methodological quality than those published in previous years. This study shows that methodological reporting quality of MAs in the major gastroenterology and hepatology journals has improved in recent years after the publication of the developed PRISMA statement, and it can be further improved. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Critical appraisal of clinical trials in multiple system atrophy: Toward better quality.

PubMed

Castro Caldas, Ana; Levin, Johannes; Djaldetti, Ruth; Rascol, Olivier; Wenning, Gregor; Ferreira, Joaquim J

2017-10-01

Multiple system atrophy (MSA) is a rare neurodegenerative disease of undetermined cause. Although many clinical trials have been conducted, there is still no treatment that cures the disease or slows its progression. We sought to assess the clinical trials, methodology, and quality of reporting of clinical trails conducted in MSA patients. We conducted a systematic review of all trials with at least 1 MSA patient subject to any pharmacological/nonpharmacological interventions. Two independent reviewers evaluated the methodological characteristics and quality of reporting of trials. A total of 60 clinical trials were identified, including 1375 MSA patients. Of the trials, 51% (n = 31) were single-arm studies. A total of 28% (n = 17) had a parallel design, half of which (n = 13) were placebo controlled. Of the studies, 8 (13.3%) were conducted in a multicenter setting, 3 of which were responsible for 49.3% (n = 678) of the total included MSA patients. The description of primary outcomes was unclear in 60% (n = 40) of trials. Only 10 (16.7%) clinical trials clearly described the randomization process. Blinding of the participants, personnel, and outcome assessments were at high risk of bias in the majority of studies. The number of dropouts/withdrawals was high (n = 326, 23.4% among the included patients). Overall, the design and quality of reporting of the reviewed studies is unsatisfactory. The most frequent clinical trials were small and single centered. Inadequate reporting was related to the information on the randomization process, sequence generation, allocation concealment, blinding of participants, and sample size calculations. Although improved during the recent years, methodological quality and trial design need to be optimized to generate more informative results. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews.

PubMed

Jin, Ying-Hui; Wang, Guo-Hao; Sun, Yi-Rong; Li, Qi; Zhao, Chen; Li, Ge; Si, Jin-Hua; Li, Yan; Lu, Cui; Shang, Hong-Cai

2016-11-14

To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines-for example, in enemas, foot massage and compressing the umbilicus. A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency. There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical appraisal of systematic reviews/meta-analyses of TCMN interventions is particularly important to provide sound guidance for TCMN. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effects of efforts to optimise morbidity and mortality rounds to serve contemporary quality improvement and educational goals: a systematic review.

PubMed

Smaggus, Andrew; Mrkobrada, Marko; Marson, Alanna; Appleton, Andrew

2018-01-01

The quality and safety movement has reinvigorated interest in optimising morbidity and mortality (M&M) rounds. We performed a systematic review to identify effective means of updating M&M rounds to (1) identify and address quality and safety issues, and (2) address contemporary educational goals. Relevant databases (Medline, Embase, PubMed, Education Resource Information Centre, Cumulative Index to Nursing and Allied Health Literature, Healthstar, and Global Health) were searched to identify primary sources. Studies were included if they (1) investigated an intervention applied to M&M rounds, (2) reported outcomes relevant to the identification of quality and safety issues, or educational outcomes relevant to quality improvement (QI), patient safety or general medical education and (3) included a control group. Study quality was assessed using the Medical Education Research Study Quality Instrument and Newcastle-Ottawa Scale-Education instruments. Given the heterogeneity of interventions and outcome measures, results were analysed thematically. The final analysis included 19 studies. We identified multiple effective strategies (updating objectives, standardising elements of rounds and attaching rounds to a formal quality committee) to optimise M&M rounds for a QI/safety purpose. These efforts were associated with successful integration of quality and safety content into rounds, and increased implementation of QI interventions. Consistent effects on educational outcomes were difficult to identify, likely due to the use of methodologies ill-fitted for educational research. These results are encouraging for those seeking to optimise the quality and safety mission of M&M rounds. However, the inability to identify consistent educational effects suggests the investigation of M&M rounds could benefit from additional methodologies (qualitative, mixed methods) in order to understand the complex mechanisms driving learning at M&M rounds. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review.

PubMed

Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans; Søgaard, Karen

2014-10-01

The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. From 50 articles, 54 method names were identified and categorized into three groups: (1) Static positioning assessment (n = 19); (2) Semi-dynamic (n = 13); and (3) Dynamic functional assessment (n = 22). Fifteen studies were excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57%) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase utility for clinical practice.

Building Bridges to a Brighter Tomorrow: A Systematic Evidence Review of Interventions That Prepare Adolescents for Adulthood

PubMed Central

Krieger, Kathleen; Rutledge, Regina; Rabre, Alexander; Axelson, Sarah; Miller, Audra; White, LeBretia; Jackson, Christine

2018-01-01

Background. Data suggest that adverse social determinants during adolescence can set in motion a lifetime of poor social and health outcomes. Vulnerable youths are at particularly high risk in this regard. Objectives. To identify and assess the current evidence base for adolescent-focused interventions designed to influence adulthood preparation that could affect longer-term social determinants. Search Methods. Using a systematic review methodology, we conducted an initial assessment of intervention evaluations targeting 6 adulthood preparation subject (APS) areas to assess the quality and character of the evidence base. The review is specific to evaluated interventions that address at least 1 of the 6 APS areas: healthy relationships, adolescent development, financial literacy, parent–child communication, educational and career success, and healthy life skills. Selection Criteria. The inclusion criteria were as follows: (1) published in English in an independent, peer-reviewed journal; (2) conducted in developed, English-speaking countries; (3) implemented an intervention that addressed at least 1 of the 6 APS areas, delivered in an in-person setting; (4) included youths at the 5th- through 12th-grade levels or aged 10 to 18 years at some point during intervention implementation; (5) included an evaluation component with a comparison group and baseline and follow-up measures; (6) included behavioral measures as outcomes; and (7) reported statistical significance levels for the behavioral outcome measures. Data Collection and Analysis. We developed an abstraction form to capture details from each article, including key details of the intervention, such as services, implementer characteristics, and timing; adulthood preparation foci; evaluation design, methods, and key behavioral measures; and results, including key statistically significant results for behavior-based outcome measures. We assessed study quality by using several key factors, including randomization, baseline equivalence of treatment and control groups, attrition, and confounding factors. We characterized the quality of evidence as high, moderate, or low on the basis of the described design and execution of the research. Our assessment included only information stated explicitly in the manuscript. Main Results. A total of 36 independent intervention evaluations met the criteria for inclusion. Of these, 27 (75%) included significant findings for behavioral outcomes related to adulthood preparation. Quality was mixed across studies. Of the 36 studies reviewed, 27 used a randomized controlled design (15 group randomization, 12 individual randomization), whereas the others used observational pre–post designs. Ten studies used mixed-methods approaches. Most (n = 32) studies used self-report questionnaires at baseline with a follow-up questionnaire, and 14 studies included multiple follow-up points. Of the studies reviewed, 7 studies received a high-quality rating, indicating no significant issues identified within our quality criteria. We rated 23 studies as moderate quality, indicating methodological challenges within 1 of the quality criteria categories. The most common reasons studies were down-rated were poor baseline equivalency across treatment groups (or no discussion of baseline equivalency) and high levels of attrition. Finally, 6 studies received a low-quality rating because of methodological challenges across multiple quality domains. The studies broadly represented the APS areas. We identified no systematic differences in study quality across the APS areas. Author’s Conclusions. Although some of the intervention results indicate behavioral changes that may be linked to adulthood preparation skills, many of the extant findings are derived from moderate- or poor-quality studies. Additional work is needed to build the evidence base by using methodologically rigorous implementation and evaluation designs and execution. Public Health Implications. Interventions designed to help adolescents better prepare for adulthood may have the potential to affect their longer-term social determinants of health and well-being. More theory-driven approaches and rigorously evaluated interventions could strengthen the evidence base and improve the effectiveness of these adulthood preparation interventions. PMID:29443561

DB4US: A Decision Support System for Laboratory Information Management

PubMed Central

Hortas, Maria Luisa; Baena-García, Manuel; Lana-Linati, Jorge; González, Carlos; Redondo, Maximino; Morales-Bueno, Rafael

2012-01-01

Background Until recently, laboratory automation has focused primarily on improving hardware. Future advances are concentrated on intelligent software since laboratories performing clinical diagnostic testing require improved information systems to address their data processing needs. In this paper, we propose DB4US, an application that automates information related to laboratory quality indicators information. Currently, there is a lack of ready-to-use management quality measures. This application addresses this deficiency through the extraction, consolidation, statistical analysis, and visualization of data related to the use of demographics, reagents, and turn-around times. The design and implementation issues, as well as the technologies used for the implementation of this system, are discussed in this paper. Objective To develop a general methodology that integrates the computation of ready-to-use management quality measures and a dashboard to easily analyze the overall performance of a laboratory, as well as automatically detect anomalies or errors. The novelty of our approach lies in the application of integrated web-based dashboards as an information management system in hospital laboratories. Methods We propose a new methodology for laboratory information management based on the extraction, consolidation, statistical analysis, and visualization of data related to demographics, reagents, and turn-around times, offering a dashboard-like user web interface to the laboratory manager. The methodology comprises a unified data warehouse that stores and consolidates multidimensional data from different data sources. The methodology is illustrated through the implementation and validation of DB4US, a novel web application based on this methodology that constructs an interface to obtain ready-to-use indicators, and offers the possibility to drill down from high-level metrics to more detailed summaries. The offered indicators are calculated beforehand so that they are ready to use when the user needs them. The design is based on a set of different parallel processes to precalculate indicators. The application displays information related to tests, requests, samples, and turn-around times. The dashboard is designed to show the set of indicators on a single screen. Results DB4US was deployed for the first time in the Hospital Costa del Sol in 2008. In our evaluation we show the positive impact of this methodology for laboratory professionals, since the use of our application has reduced the time needed for the elaboration of the different statistical indicators and has also provided information that has been used to optimize the usage of laboratory resources by the discovery of anomalies in the indicators. DB4US users benefit from Internet-based communication of results, since this information is available from any computer without having to install any additional software. Conclusions The proposed methodology and the accompanying web application, DB4US, automates the processing of information related to laboratory quality indicators and offers a novel approach for managing laboratory-related information, benefiting from an Internet-based communication mechanism. The application of this methodology has been shown to improve the usage of time, as well as other laboratory resources. PMID:23608745

Epidemiology Characteristics, Methodological Assessment and Reporting of Statistical Analysis of Network Meta-Analyses in the Field of Cancer

PubMed Central

Ge, Long; Tian, Jin-hui; Li, Xiu-xia; Song, Fujian; Li, Lun; Zhang, Jun; Li, Ge; Pei, Gai-qin; Qiu, Xia; Yang, Ke-hu

2016-01-01

Because of the methodological complexity of network meta-analyses (NMAs), NMAs may be more vulnerable to methodological risks than conventional pair-wise meta-analysis. Our study aims to investigate epidemiology characteristics, conduction of literature search, methodological quality and reporting of statistical analysis process in the field of cancer based on PRISMA extension statement and modified AMSTAR checklist. We identified and included 102 NMAs in the field of cancer. 61 NMAs were conducted using a Bayesian framework. Of them, more than half of NMAs did not report assessment of convergence (60.66%). Inconsistency was assessed in 27.87% of NMAs. Assessment of heterogeneity in traditional meta-analyses was more common (42.62%) than in NMAs (6.56%). Most of NMAs did not report assessment of similarity (86.89%) and did not used GRADE tool to assess quality of evidence (95.08%). 43 NMAs were adjusted indirect comparisons, the methods used were described in 53.49% NMAs. Only 4.65% NMAs described the details of handling of multi group trials and 6.98% described the methods of similarity assessment. The median total AMSTAR-score was 8.00 (IQR: 6.00–8.25). Methodological quality and reporting of statistical analysis did not substantially differ by selected general characteristics. Overall, the quality of NMAs in the field of cancer was generally acceptable. PMID:27848997

Incorporation of lean methodology into pharmacy residency programs.

PubMed

John, Natalie; Snider, Holly; Edgerton, Lisa; Whalin, Laurie

2017-03-15

The implementation of lean methodology into pharmacy residency programs at a community teaching hospital is described. New Hanover Regional Medical Center, a community teaching hospital in southeastern North Carolina, fully adopted a lean culture in 2010. Given the success of lean strategies organizationally, this methodology was used to assist with the evaluation and development of its pharmacy residency programs in 2014. Lean tools and activities have also been incorporated into residency requirements and rotation learning activities. The majority of lean events correspond to the required competency areas evaluating leadership and management, teaching, and education. These events have included participation in and facilitation of various lean problem-solving and communication tools. The application of the 4 rules of lean has resulted in enhanced management of the programs and provides a set of tools by which continual quality improvement can be ensured. Regular communication and direct involvement of all invested parties have been critical in developing and sustaining new improvements. In addition to program enhancements, lean methodology offers novel methods by which residents may be incorporated into leadership activities. The incorporation of lean methodology into pharmacy residency programs has translated into a variety of realized and potential benefits for the programs, the preceptors and residents, and the health system. Specific areas of growth have included quality-improvement processes, the expansion of leadership opportunities for residents, and improved communication among program directors, preceptors, and residents. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Good reasons to implement quality assurance in nationwide breast cancer screening programs in Croatia and Serbia: results from a pilot study.

PubMed

Ciraj-Bjelac, Olivera; Faj, Dario; Stimac, Damir; Kosutic, Dusko; Arandjic, Danijela; Brkic, Hrvoje

2011-04-01

The purpose of this study is to investigate the need for and the possible achievements of a comprehensive QA programme and to look at effects of simple corrective actions on image quality in Croatia and in Serbia. The paper focuses on activities related to the technical and radiological aspects of QA. The methodology consisted of two phases. The aim of the first phase was the initial assessment of mammography practice in terms of image quality, patient dose and equipment performance in selected number of mammography units in Croatia and Serbia. Subsequently, corrective actions were suggested and implemented. Then the same parameters were re-assessed. Most of the suggested corrective actions were simple, low-cost and possible to implement immediately, as these were related to working habits in mammography units, such as film processing and darkroom conditions. It has been demonstrated how simple quantitative assessment of image quality can be used for optimisation purposes. Analysis of image quality parameters as OD, gradient and contrast demonstrated general similarities between mammography practices in Croatia and Serbia. The applied methodology should be expanded to larger number of hospitals and applied on a regular basis. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

[Methodological quality of an article on the treatment of gastric cancer adopted as protocol by some Chilean hospitals].

PubMed

Manterola, Carlos; Torres, Rodrigo; Burgos, Luis; Vial, Manuel; Pineda, Viviana

2006-07-01

Surgery is a curative treatment for gastric cancer (GC). As relapse is frequent, adjuvant therapies such as postoperative chemo radiotherapy have been tried. In Chile, some hospitals adopted Macdonald's study as a protocol for the treatment of GC. To determine methodological quality and internal and external validity of the Macdonald study. Three instruments were applied that assess methodological quality. A critical appraisal was done and the internal and external validity of the methodological quality was analyzed with two scales: MINCIR (Methodology and Research in Surgery), valid for therapy studies and CONSORT (Consolidated Standards of Reporting Trials), valid for randomized controlled trials (RCT). Guides and scales were applied by 5 researchers with training in clinical epidemiology. The reader's guide verified that the Macdonald study was not directed to answer a clearly defined question. There was random assignment, but the method used is not described and the patients were not considered until the end of the study (36% of the group with surgery plus chemo radiotherapy did not complete treatment). MINCIR scale confirmed a multicentric RCT, not blinded, with an unclear randomized sequence, erroneous sample size estimation, vague objectives and no exclusion criteria. CONSORT system proved the lack of working hypothesis and specific objectives as well as an absence of exclusion criteria and identification of the primary variable, an imprecise estimation of sample size, ambiguities in the randomization process, no blinding, an absence of statistical adjustment and the omission of a subgroup analysis. The instruments applied demonstrated methodological shortcomings that compromise the internal and external validity of the.

The quality of our drinking water: aluminium determination with an acoustic wave sensor.

PubMed

Veríssimo, Marta I S; Gomes, M Teresa S R

2008-06-09

A new methodology based on an inexpensive aluminium acoustic wave sensor is presented. Although the aluminium sensor has already been reported, and the composition of the selective membrane is known, the low detection limits required for the analysis of drinking water, demanded the inclusion of a preconcentration stage, as well as an optimization of the sensor. The necessary coating amount was established, as well as the best preconcentration protocol, in terms of oxidation of organic matter and aluminium elution from the Chelex-100. The methodology developed with the acoustic wave sensor allowed aluminium quantitation above 0.07 mg L(-1). Several water samples from Portugal were analysed using the acoustic wave sensor, as well as by UV-vis spectrophotometry. Results obtained with both methodologies were not statistically different (alpha=0.05), both in terms of accuracy and precision. This new methodology proved to be adequate for aluminium quantitation in drinking water and showed to be faster and less reagent consuming than the UV spectrophotometric methodology.