Urban air quality measurements using a sensor-based system

NASA Astrophysics Data System (ADS)

Ródenas, Mila; Hernández, Daniel; Gómez, Tatiana; López, Ramón; Muñoz, Amalia

2017-04-01

Air pollution levels in urban areas have increased the interest, not only of the scientific community but also of the general public, and both at the regional and at the European level. This interest has run in parallel to the development of miniaturized sensors, which only since very recently are suitable for air quality measurements. Certainly, their small size and price allows them to be used as a network of sensors capable of providing high temporal and spatial frequency measurements to characterize an area or city and with increasing potential, under certain considerations, as a complement of conventional methods. Within the frame of the LIFE PHOTOCITYTEX project (use of photocatalytic textiles to help reducing air pollution), CEAM has developed a system to measure gaseous compounds of importance for urban air quality characterization. This system, which allows an autonomous power supply, uses commercial NO, NO2, O3 and CO2 small sensors and incorporates measurements of temperature and humidity. A first version, using XBee boards (Radiofrequency) for communications has been installed in the urban locations defined by the project (tunnel and school), permitting the long-term air quality characterization of sites in the presence of the textiles. An improved second version of the system which also comprises a sensor for measuring particles and which uses GPRS for communications, has been developed and successfully installed in the city center of Valencia. Data are sent to a central server where they can be accessed by citizens in nearly real time and online and, in general, they can be utilized in the air quality characterization, for decision-making related to decontamination (traffic regulation, photocatalytic materials, etc.), in air quality models or in mobile applications of interest for the citizens. Within this work, temporal trends obtained with this system in different urban locations will be shown, discussing the impact of the characteristics of the

Quality Measures in Orthopaedic Sports Medicine: A Systematic Review.

PubMed

Abrams, Geoffrey D; Greenberg, Daniel R; Dragoo, Jason L; Safran, Marc R; Kamal, Robin N

2017-10-01

To report the current quality measures that are applicable to orthopaedic sports medicine physicians. Six databases were searched with a customized search term to identify quality measures relevant to orthopaedic sports medicine surgeons: MEDLINE/PubMed, EMBASE, the National Quality Forum (NQF) Quality Positioning System (QPS), the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC), the Physician Quality Reporting System (PQRS) database, and the American Academy of Orthopaedic Surgeons (AAOS) website. Results were screened by 2 Board-certified orthopaedic surgeons with fellowship training in sports medicine and dichotomized based on sports medicine-specific or general orthopaedic (nonarthroplasty) categories. Hip and knee arthroplasty measures were excluded. Included quality measures were further categorized based on Donabedian's domains and the Center for Medicare and Medicaid (CMS) National Quality Strategy priorities. A total of 1,292 quality measures were screened and 66 unique quality measures were included. A total of 47 were sports medicine-specific and 19 related to the general practice of orthopaedics for a fellowship-trained sports medicine specialist. Nineteen (29%) quality measures were collected within PQRS, with 5 of them relating to sports medicine and 14 relating to general orthopaedics. AAOS Clinical Practice Guidelines (CPGs) comprised 40 (60%) of the included measures and were all within sports medicine. Five (8%) additional measures were collected within AHRQ and 2 (3%) within NQF. Most quality measures consist of process rather than outcome or structural measures. No measures addressing concussions were identified. There are many existing quality measures relating to the practice of orthopaedic sports medicine. Most quality measures are process measures described within PQRS or AAOS CPGs. Knowledge of quality measures are important as they may be used to improve care, are increasingly being used to

Task-based measures of image quality and their relation to radiation dose and patient risk

PubMed Central

Barrett, Harrison H.; Myers, Kyle J.; Hoeschen, Christoph; Kupinski, Matthew A.; Little, Mark P.

2015-01-01

The theory of task-based assessment of image quality is reviewed in the context of imaging with ionizing radiation, and objective figures of merit (FOMs) for image quality are summarized. The variation of the FOMs with the task, the observer and especially with the mean number of photons recorded in the image is discussed. Then various standard methods for specifying radiation dose are reviewed and related to the mean number of photons in the image and hence to image quality. Current knowledge of the relation between local radiation dose and the risk of various adverse effects is summarized, and some graphical depictions of the tradeoffs between image quality and risk are introduced. Then various dose-reduction strategies are discussed in terms of their effect on task-based measures of image quality. PMID:25564960

Understanding Consumer Perceptions and Awareness of Hospital-Based Maternity Care Quality Measures.

PubMed

Maurer, Maureen; Firminger, Kirsten; Dardess, Pam; Ikeler, Kourtney; Sofaer, Shoshanna; Carman, Kristin L

2016-06-01

To explore factors that may influence use of comparative public reports for hospital maternity care. Four focus groups conducted in 2013 with 41 women and preintervention survey data collected in 2014 to 2015 from 245 pregnant women in North Carolina. As part of a larger randomized controlled trial, we conducted qualitative formative research to develop an intervention that will be evaluated through pre- and postintervention surveys. Analysis of focus group transcripts examined participants' perceptions of high-quality maternity care and the importance of different quality measures. Quantitative analysis included descriptive results of the preintervention survey and subgroup analyses to examine the impact of race, education, and being a first-time mom on outcomes. When describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care." At baseline, 28 percent of survey respondents had used quality information to choose a hospital. Survey respondents were more aware of some quality measures (e.g., breastfeeding support) than others (e.g., episiotomy rates). Public reporting efforts could help increase relevance of maternity care quality measures by creating measures that reflect women's concerns, clearly explaining the hospital's role in supporting quality care, and showing how available quality measures can inform decisions about childbirth. © Health Research and Educational Trust.

Using Clinical Data Standards to Measure Quality: A New Approach.

PubMed

D'Amore, John D; Li, Chun; McCrary, Laura; Niloff, Jonathan M; Sittig, Dean F; McCoy, Allison B; Wright, Adam

2018-04-01

 Value-based payment for care requires the consistent, objective calculation of care quality. Previous initiatives to calculate ambulatory quality measures have relied on billing data or individual electronic health records (EHRs) to calculate and report performance. New methods for quality measure calculation promoted by federal regulations allow qualified clinical data registries to report quality outcomes based on data aggregated across facilities and EHRs using interoperability standards.  This research evaluates the use of clinical document interchange standards as the basis for quality measurement.  Using data on 1,100 patients from 11 ambulatory care facilities and 5 different EHRs, challenges to quality measurement are identified and addressed for 17 certified quality measures.  Iterative solutions were identified for 14 measures that improved patient inclusion and measure calculation accuracy. Findings validate this approach to improving measure accuracy while maintaining measure certification.  Organizations that report care quality should be aware of how identified issues affect quality measure selection and calculation. Quality measure authors should consider increasing real-world validation and the consistency of measure logic in respect to issues identified in this research. Schattauer GmbH Stuttgart.

Quality Measures for the Care of Patients with Insomnia

PubMed Central

Edinger, Jack D.; Buysse, Daniel J.; Deriy, Ludmila; Germain, Anne; Lewin, Daniel S.; Ong, Jason C.; Morgenthaler, Timothy I.

2015-01-01

The American Academy of Sleep Medicine (AASM) commissioned five Workgroups to develop quality measures to optimize management and care for patients with common sleep disorders including insomnia. Following the AASM process for quality measure development, this document describes measurement methods for two desirable outcomes of therapy, improving sleep quality or satisfaction, and improving daytime function, and for four processes important to achieving these goals. To achieve the outcome of improving sleep quality or satisfaction, pre- and post-treatment assessment of sleep quality or satisfaction and providing an evidence-based treatment are recommended. To realize the outcome of improving daytime functioning, pre- and post-treatment assessment of daytime functioning, provision of an evidence-based treatment, and assessment of treatment-related side effects are recommended. All insomnia measures described in this report were developed by the Insomnia Quality Measures Workgroup and approved by the AASM Quality Measures Task Force and the AASM Board of Directors. The AASM recommends the use of these measures as part of quality improvement programs that will enhance the ability to improve care for patients with insomnia. Citation: Edinger JD, Buysse DJ, Deriy L, Germain A, Lewin DS, Ong JC, Morgenthaler TI. Quality measures for the care of patients with insomnia. J Clin Sleep Med 2015;11(3):311–334. PMID:25700881

Candidate Quality Measures for Hand Surgery.

PubMed

2017-11-01

measures of hand surgery quality using a validated methodology. These measures merit further development. Quality measures can be used to evaluate the quality of care provided by physicians and health systems and can inform quality and value-based reimbursement models. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Instrumentation for air quality measurements.

NASA Technical Reports Server (NTRS)

Loewenstein, M.

1973-01-01

Comparison of the new generation of air quality monitoring instruments with some more traditional methods. The first generation of air quality measurement instruments, based on the use of oxidant coulometric cells, nitrogen oxide colorimetry, carbon monoxide infrared analyzers, and other types of detectors, is compared with new techniques now coming into wide use in the air monitoring field and involving the use of chemiluminescent reactions, optical absorption detectors, a refinement of the carbon monoxide infrared analyzer, electrochemical cells based on solid electrolytes, and laser detectors.

[Comparative quality measurements part 3: funnel plots].

PubMed

Kottner, Jan; Lahmann, Nils

2014-02-01

Comparative quality measurements between organisations or institutions are common. Quality measures need to be standardised and risk adjusted. Random error must also be taken adequately into account. Rankings without consideration of the precision lead to flawed interpretations and enhances "gaming". Application of confidence intervals is one possibility to take chance variation into account. Funnel plots are modified control charts based on Statistical Process Control (SPC) theory. The quality measures are plotted against their sample size. Warning and control limits that are 2 or 3 standard deviations from the center line are added. With increasing group size the precision increases and so the control limits are forming a funnel. Data points within the control limits are considered to show common cause variation; data points outside special cause variation without the focus of spurious rankings. Funnel plots offer data based information about how to evaluate institutional performance within quality management contexts.

Clinical Decision Support-based Quality Measurement (CDS-QM) Framework: Prototype Implementation, Evaluation, and Future Directions

PubMed Central

Kukhareva, Polina V; Kawamoto, Kensaku; Shields, David E; Barfuss, Darryl T; Halley, Anne M; Tippetts, Tyler J; Warner, Phillip B; Bray, Bruce E; Staes, Catherine J

2014-01-01

Electronic quality measurement (QM) and clinical decision support (CDS) are closely related but are typically implemented independently, resulting in significant duplication of effort. While it seems intuitive that technical approaches could be re-used across these two related use cases, such reuse is seldom reported in the literature, especially for standards-based approaches. Therefore, we evaluated the feasibility of using a standards-based CDS framework aligned with anticipated EHR certification criteria to implement electronic QM. The CDS-QM framework was used to automate a complex national quality measure (SCIP-VTE-2) at an academic healthcare system which had previously relied on time-consuming manual chart abstractions. Compared with 305 manually-reviewed reference cases, the recall of automated measurement was 100%. The precision was 96.3% (CI:92.6%-98.5%) for ascertaining the denominator and 96.2% (CI:92.3%-98.4%) for the numerator. We therefore validated that a standards-based CDS-QM framework can successfully enable automated QM, and we identified benefits and challenges with this approach. PMID:25954389

Venous Thromboembolism Quality Measures Fail to Accurately Measure Quality.

PubMed

Lau, Brandyn D; Streiff, Michael B; Pronovost, Peter J; Haut, Elliott R

2018-03-20

Venous thromboembolism (VTE) is 1 of the most common causes of preventable harm for patients in hospitals. Consequently, the Joint Commission, the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, the United Kingdom Care Quality Commission, the Australian Commission on Safety and Quality in Health Care, the Maryland Health Services Cost Review Commission, and the American College of Surgeons have prioritized measuring and reporting VTE outcomes with the goal of reducing the incidence of and preventable harm from VTE. We developed a rubric for defect-free VTE prevention, graded each organizational VTE quality measure, and found that none of the current VTE-related quality measures adequately characterizes VTE prevention efforts or outcomes in hospitalized patients. Effective VTE prevention is multifactorial: clinicians must assess patients' risk for VTE and prescribe therapy appropriate for each patient's risk profile, patients must accept the prescribed therapy, and nurses must administer the therapy as prescribed. First, an ideal, defect-free VTE prevention process measure requires: (1) documentation of a standardized VTE risk assessment; (2) prescription of optimal, risk-appropriate VTE prophylaxis; and (3) administration of all risk-appropriate VTE prophylaxis as prescribed. Second, an ideal VTE outcome measure should define potentially preventable VTE as VTE that developed in patients who experienced any VTE prevention process failures. © 2018 American Heart Association, Inc.

An approach to bioassessment of water quality using diversity measures based on species accumulative curves.

PubMed

Xu, Guangjian; Zhang, Wei; Xu, Henglong

2015-02-15

Traditional community-based bioassessment is time-consuming because they rely on full species-abundance data of a community. To improve bioassessment efficiency, the feasibility of the diversity measures based on species accumulative curves for bioassessment of water quality status was studied based on a dataset of microperiphyton fauna. The results showed that: (1) the species accumulative curves well fitted the Michaelis-Menten equation; (2) the β- and γ-diversity, as well as the number of samples to 50% of the maximum species number (Michaelis-Menten constant K), can be statistically estimated based on the formulation; (3) the rarefied α-diversity represented a significant negative correlation with the changes in the nutrient NH4-N; and (4) the estimated β-diversity and the K constant were significantly positively related to the concentration of NH4-N. The results suggest that the diversity measures based on species accumulative curves might be used as a potential bioindicator of water quality in marine ecosystems. Copyright © 2014 Elsevier Ltd. All rights reserved.

More quality measures versus measuring what matters: a call for balance and parsimony

PubMed Central

Nelson, Eugene C; Pryor, David B; James, Brent; Swensen, Stephen J; Kaplan, Gary S; Weissberg, Jed I; Bisognano, Maureen; Yates, Gary R; Hunt, Gordon C

2012-01-01

External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs. PMID:22893696

More quality measures versus measuring what matters: a call for balance and parsimony.

PubMed

Meyer, Gregg S; Nelson, Eugene C; Pryor, David B; James, Brent; Swensen, Stephen J; Kaplan, Gary S; Weissberg, Jed I; Bisognano, Maureen; Yates, Gary R; Hunt, Gordon C

2012-11-01

External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs.

Health Care Quality: Measuring Obesity in Performance Frameworks.

PubMed

Zvenyach, Tracy; Pickering, Matthew K

2017-08-01

Obesity affects over one-third of Americans and leads to several chronic and costly comorbid conditions. The national movement toward value-based care calls for a refocusing of efforts to address the US obesity epidemic. To help set the stage, the current landscape of obesity-specific quality measures was evaluated. Seven quality measure databases and nine professional societies were searched. Inclusion and exclusion criteria were applied. Measures were then classified by domain and by implementation in national public programs. Eleven obesity-specific quality measures in adults were identified (nine process and two outcome). Three measures received National Quality Forum (NQF) endorsement. Two measures were actively used within Centers for Medicare and Medicaid Services (CMS) programs. Only one measure was both NQF-endorsed and used by CMS. Limitations exist with respect to obesity-specific quality metrics. Such gaps provide opportunities for obesity care specialists to engage and offer valuable insights and pragmatic approaches toward quality measurement. © 2017 The Obesity Society.

Measuring Rural Hospital Quality

ERIC Educational Resources Information Center

Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

2004-01-01

Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

Use of NEXRAD radar-based observations for quality control of in-situ rain gauge measurements

NASA Astrophysics Data System (ADS)

Nelson, B. R.; Prat, O.; Leeper, R.

2017-12-01

Rain gauge quality control is an often over looked important step in the archive of historical precipitation estimates. We investigate the possibilities that exist for using ground based radar networks for quality control of rain gauge measurements. This process includes the point to pixel comparisons of the rain gauge measurements with NEXRAD observations. There are two NEXRAD based data sets used for reference; the NCEP stage IV and the NWS MRMS gridded data sets. The NCEP stage IV data set is available at 4km hourly for the period 2002-present and includes the radar-gauge bias adjusted precipitation estimate. The NWS MRMS data set includes several different variables such as reflectivity, radar-only estimates, precipitation flag, and radar-gauge bias adjusted precipitation estimates. The latter product provides for much more information to apply quality control such as identification of precipitation type, identification of storm type and Z-R relation. In addition, some of the variables are available at 5-minute scale. The rain gauge networks that are investigated are the Climate Reference Network (CRN), the Fischer-Porter Hourly Precipitation Database (HPD), and the Hydrometeorological Automated Data System (HADS). The CRN network is available at the 5-minute scale, the HPD network is available at the 15-minute and hourly scale, and HADS is available at the hourly scale. The varying scales present challenges for comparisons. However given the higher resolution radar-based products we identify an optimal combination of rain gauge observations that can be compared to the radar-based information. The quality control process focuses on identifying faulty gauges in direct comparison while a deeper investigation focuses on event-based differences from light rain to extreme storms.

Advancing the use of community pharmacy quality measures: a qualitative study.

PubMed

Shiyanbola, Olayinka O; Mort, Jane R; Lyons, Kayley

2013-01-01

To describe consumers' ability to interpret pharmacy quality measures data presented in a report card, to examine the tools that consumers require to interpret the information available in a pharmacy quality report card, and to determine whether pharmacy quality measures influence consumers' choice of a pharmacy. Qualitative study. Three semistructured focus groups conducted in a private meeting space at a public library in Sioux Falls, SD, from April 2011 to May 2011. 29 laypeople. Participants' skills interpreting and using pharmacy quality information were examined based on mock report cards containing the Pharmacy Quality Alliance (PQA) quality measures. Consumer perceptions of pharmacy quality data. Participants reported difficulty understanding quality measures because of knowledge deficits. They wanted supportive resources on drug class of their medications to help them understand the measures. Participants had different opinions on whether their pharmacies should be compared with other pharmacies based on specific quality measures. For example, they favored the use of drug-drug interactions as a quality measure for comparing pharmacies, while medication adherence was deemed of limited use for comparison. Participants stated that pharmacy report cards would be useful information but would not prompt a change in pharmacy. However, participants perceived that this information would be useful in selecting a new pharmacy. The results suggest that consumers require simplification of PQA quality measures and supportive resources to interpret the measures. Consumers may favor certain quality measures based on their perception of the role of the pharmacist. Education is required before full use of this quality-of-care information can be realized.

Toward coordinated space-based air quality, carbon cycle, and ecosystem measurements to quantify air quality-ecosystem interactions

NASA Astrophysics Data System (ADS)

Neu, J. L.; Schimel, D.; Lerdau, M.; Drewry, D.; Fu, D.; Payne, V.; Bowman, K. W.; Worden, J. R.

2016-12-01

Tropospheric ozone concentrations are increasing in many regions of the world, and this ozone can severely damage vegetation. Ozone enters plants through their stomata and oxidizes tissues, inhibiting physiology and decreasing ecosystem productivity. Ozone has been experimentally shown to reduce crop production, with important implications for global food security as concentrations rise. Ozone damage to forests also alters productivity and carbon storage and may drive changes in species distributions and biodiversity. Process-based quantitative estimates of these ozone impacts on terrestrial ecosystems at continental to global scales as well as of feedbacks to air quality via production of volatile organic compounds (VOCs) are thus crucial to sustainable development planning. We demonstrate that leveraging planned and proposed missions to measure ozone, formaldehyde, and isoprene along with solar-induced fluorescence (SiF), evapotranspiration, and plant nitrogen content can meet the requirements of an integrated observing system for air quality-ecosystem interactions while also meeting the needs of the individual Air Quality, Carbon Cycle, and Ecosystems communities.

A Laser-Based Measuring System for Online Quality Control of Car Engine Block.

PubMed

Li, Xing-Qiang; Wang, Zhong; Fu, Lu-Hua

2016-11-08

For online quality control of car engine production, pneumatic measurement instrument plays an unshakeable role in measuring diameters inside engine block because of its portability and high-accuracy. To the limitation of its measuring principle, however, the working space between the pneumatic device and measured surface is too small to require manual operation. This lowers the measuring efficiency and becomes an obstacle to perform automatic measurement. In this article, a high-speed, automatic measuring system is proposed to take the place of pneumatic devices by using a laser-based measuring unit. The measuring unit is considered as a set of several measuring modules, where each of them acts like a single bore gauge and is made of four laser triangulation sensors (LTSs), which are installed on different positions and in opposite directions. The spatial relationship among these LTSs was calibrated before measurements. Sampling points from measured shaft holes can be collected by the measuring unit. A unified mathematical model was established for both calibration and measurement. Based on the established model, the relative pose between the measuring unit and measured workpiece does not impact the measuring accuracy. This frees the measuring unit from accurate positioning or adjustment, and makes it possible to realize fast and automatic measurement. The proposed system and method were finally validated by experiments.

A Laser-Based Measuring System for Online Quality Control of Car Engine Block

PubMed Central

Li, Xing-Qiang; Wang, Zhong; Fu, Lu-Hua

2016-01-01

For online quality control of car engine production, pneumatic measurement instrument plays an unshakeable role in measuring diameters inside engine block because of its portability and high-accuracy. To the limitation of its measuring principle, however, the working space between the pneumatic device and measured surface is too small to require manual operation. This lowers the measuring efficiency and becomes an obstacle to perform automatic measurement. In this article, a high-speed, automatic measuring system is proposed to take the place of pneumatic devices by using a laser-based measuring unit. The measuring unit is considered as a set of several measuring modules, where each of them acts like a single bore gauge and is made of four laser triangulation sensors (LTSs), which are installed on different positions and in opposite directions. The spatial relationship among these LTSs was calibrated before measurements. Sampling points from measured shaft holes can be collected by the measuring unit. A unified mathematical model was established for both calibration and measurement. Based on the established model, the relative pose between the measuring unit and measured workpiece does not impact the measuring accuracy. This frees the measuring unit from accurate positioning or adjustment, and makes it possible to realize fast and automatic measurement. The proposed system and method were finally validated by experiments. PMID:27834839

Quality measurement for rhinosinusitis: a review from the Quality Improvement Committee of the American Rhinologic Society.

PubMed

Rudmik, Luke; Mattos, Jose; Schneider, John; Manes, Peter R; Stokken, Janalee K; Lee, Jivianne; Higgins, Thomas S; Schlosser, Rodney J; Reh, Douglas D; Setzen, Michael; Soler, Zachary M

2017-09-01

Measuring quality outcomes is an important prerequisite to improve quality of care. Rhinosinusitis represents a high value target to improve quality of care because it has a high prevalence of disease, large economic burden, and large practice variation. In this study we review the current state of quality measurement for management of both acute (ARS) and chronic rhinosinusitis (CRS). The major national quality metric repositories and clearinghouses were queried. Additional searches included the American Academy of Otolaryngology-Head and Neck Surgery database, PubMed, and Google to attempt to capture any additional quality metrics. Seven quality metrics for ARS and 4 quality metrics for CRS were identified. ARS metrics focused on appropriateness of diagnosis (n = 1), antibiotic prescribing (n = 4), and radiologic imaging (n = 2). CRS quality metrics focused on appropriateness of diagnosis (n = 1), radiologic imaging (n = 1), and measurement of patient quality of life (n = 2). The Physician Quality Reporting System (PQRS) currently tracks 3 ARS quality metrics and 1 CRS quality metric. There are no outcome-based rhinosinusitis quality metrics and no metrics that assess domains of safety, patient-centeredness, and timeliness of care. The current status of quality measurement for rhinosinusitis has focused primarily on the quality domain of efficiency and process measures for ARS. More work is needed to develop, validate, and track outcome-based quality metrics along with CRS-specific metrics. Although there has been excellent work done to improve quality measurement for rhinosinusitis, there remain major gaps and challenges that need to be considered during the development of future metrics. © 2017 ARS-AAOA, LLC.

Measuring patient-perceived hospital service quality: a conceptual framework.

PubMed

Pai, Yogesh P; Chary, Satyanarayana T

2016-04-18

Purpose - Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognizing healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The purpose of this paper is to design a conceptual framework for measuring patient perceived hospital service quality (HSQ), based on existing service quality literature. Design/methodology/approach - Using HSQ theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure HSQ. The paper outlines patient perceived service quality dimensions. Findings - An instrument for measuring HSQ dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications - The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value - The paper helps academics and practitioners to assess HSQ from a patient perspective.

Measuring quality of adolescent preventive services of health plan enrollees and school-based health center users.

PubMed

Klein, Jonathan D; Handwerker, Lisa; Sesselberg, Tracy S; Sutter, Erika; Flanagan, Erinn; Gawronski, Beth

2007-08-01

To evaluate whether quality of care provided to adolescents enrolled in a community-based managed care plan was better for those who also received some care at school-based health centers (SBHCs). The Young Adult Health Care Survey (YAHCS) was administered to 374 adolescents (commercially insured, Medicaid-insured, and SBHC users) to assess risk behaviors, provision of preventive screening and counseling, and quality of care. SBHC users were most likely to report that their provider told them their discussions were confidential, and that they received screening/counseling on sexually transmitted diseases (STDs), HIV/AIDS, condom use, and birth control. Commercially insured adolescents were least likely to report discussion of sexual health issues. SBHC users had the highest mean YAHCS quality measure scores for screening/counseling on pregnancy/STDs, diet and exercise, and helpfulness of counseling provided; Medicaid-insured teens had the lowest scores on four of seven measures. Regression models controlled for demographics, use of screener, and site of care showed that use of a screener had a significant impact on six of seven quality measure models. Younger age predicted screening for risk behaviors; being female, African-American, and an SBHC user predicted screening on pregnancy/STDs. SBHCs may increase adolescents' access to confidential care, and SBHC providers may be more likely than those in other settings to screen and counsel patients about sexual health. Overall quality of preventive care reported by commercially insured adolescents may be better in some health content areas and worse in others compared with care reported by Medicaid-insured youth and SBHC users.

The Attributive Theory of Quality: A Model for Quality Measurement in Higher Education.

ERIC Educational Resources Information Center

Afshar, Arash

A theoretical basis for defining and measuring the quality of institutions of higher education, namely for accreditation purposes, is developed. The theory, the Attributive Theory of Quality, is illustrated using a calculation model that is based on general systems theory. The theory postulates that quality only exists in relation to the…

Large radius of curvature measurement based on the evaluation of interferogram-quality metric in non-null interferometry

NASA Astrophysics Data System (ADS)

Yang, Zhongming; Dou, Jiantai; Du, Jinyu; Gao, Zhishan

2018-03-01

Non-null interferometry could use to measure the radius of curvature (ROC), we have presented a virtual quadratic Newton rings phase-shifting moiré-fringes measurement method for large ROC measurement (Yang et al., 2016). In this paper, we propose a large ROC measurement method based on the evaluation of the interferogram-quality metric by the non-null interferometer. With the multi-configuration model of the non-null interferometric system in ZEMAX, the retrace errors and the phase introduced by the test surface are reconstructed. The interferogram-quality metric is obtained by the normalized phase-shifted testing Newton rings with the spherical surface model in the non-null interferometric system. The radius curvature of the test spherical surface can be obtained until the minimum of the interferogram-quality metric is found. Simulations and experimental results are verified the feasibility of our proposed method. For a spherical mirror with a ROC of 41,400 mm, the measurement accuracy is better than 0.13%.

Downhole steam quality measurement

DOEpatents

Lee, D.O.; Montoya, P.C.; Muir, J.F.; Wayland, J.R. Jr.

1985-06-19

The present invention relates to an empirical electrical method for remote sensing of steam quality utilizing flow-through grids which allow measurement of the electrical properties of a flowing two-phase mixture. The measurement of steam quality in the oil field is important to the efficient application of steam assisted recovery of oil. Because of the increased energy content in higher quality steam it is important to maintain the highest possible steam quality at the injection sandface. The effectiveness of a steaming operation without a measure of steam quality downhole close to the point of injection would be difficult to determine. Therefore, a need exists for the remote sensing of steam quality.

Redefining Quality Measurement in Cancer Care.

PubMed

Nardi, Elizabeth A; McCanney, James; Winckworth-Prejsnar, Katy; Schatz, Alyssa A; Adelson, Kerin; Neubauer, Marcus; Smith, Mary Lou; Walters, Ronald; Carlson, Robert W

2018-05-01

Quality measurement in oncology is increasing in significance as payment schemes shift from volume to value. As demand for quality measures increases, challenges in the development of quality measures, standardization across measures, and the limitations of health information technology have become apparent. Moreover, the time and financial burden associated with developing, tracking, and reporting quality measures are substantial. Despite these challenges, best practices and leaders in the field of quality measurement in oncology have emerged. To understand the current challenges and promising practices in quality measurement and to explore future considerations for measure development and measure reporting in oncology, NCCN convened the NCCN Policy Summit: Redefining Quality Measurement in Oncology. The summit included discussion of the current quality landscape and efforts to develop quality measures, use of quality measures in various programs, patient perspective of quality, and challenges and best practices for quality reporting. Copyright © 2018 by the National Comprehensive Cancer Network.

A Linear Algebra Measure of Cluster Quality.

ERIC Educational Resources Information Center

Mather, Laura A.

2000-01-01

Discussion of models for information retrieval focuses on an application of linear algebra to text clustering, namely, a metric for measuring cluster quality based on the theory that cluster quality is proportional to the number of terms that are disjoint across the clusters. Explains term-document matrices and clustering algorithms. (Author/LRW)

Human voice quality measurement in noisy environments.

PubMed

Ueng, Shyh-Kuang; Luo, Cheng-Ming; Tsai, Tsung-Yu; Yeh, Hsuan-Chen

2015-01-01

Computerized acoustic voice measurement is essential for the diagnosis of vocal pathologies. Previous studies showed that ambient noises have significant influences on the accuracy of voice quality assessment. This paper presents a voice quality assessment system that can accurately measure qualities of voice signals, even though the input voice data are contaminated by low-frequency noises. The ambient noises in our living rooms and laboratories are collected and the frequencies of these noises are analyzed. Based on the analysis, a filter is designed to reduce noise level of the input voice signal. Then, improved numerical algorithms are employed to extract voice parameters from the voice signal to reveal the health of the voice signal. Compared with MDVP and Praat, the proposed method outperforms these two widely used programs in measuring fundamental frequency and harmonic-to-noise ratio, and its performance is comparable to these two famous programs in computing jitter and shimmer. The proposed voice quality assessment method is resistant to low-frequency noises and it can measure human voice quality in environments filled with noises from air-conditioners, ceiling fans and cooling fans of computers.

Composite measures of watershed health from a water quality perspective.

PubMed

Mallya, Ganeshchandra; Hantush, Mohamed; Govindaraju, Rao S

2018-05-15

Water quality data at gaging stations are typically compared with established federal, state, or local water quality standards to determine if violations (concentrations of specific constituents falling outside acceptable limits) have occurred. Based on the frequency and severity of water quality violations, risk metrics such as reliability, resilience, and vulnerability (R-R-V) are computed for assessing water quality-based watershed health. In this study, a modified methodology for computing R-R-V measures is presented, and a new composite watershed health index is proposed. Risk-based assessments for different water quality parameters are carried out using identified national sampling stations within the Upper Mississippi River Basin, the Maumee River Basin, and the Ohio River Basin. The distributional properties of risk measures with respect to water quality parameters are reported. Scaling behaviors of risk measures using stream order, specifically for the watershed health (WH) index, suggest that WH values increased with stream order for suspended sediment concentration, nitrogen, and orthophosphate in the Upper Mississippi River Basin. Spatial distribution of risk measures enable identification of locations exhibiting poor watershed health with respect to the chosen numerical standard, and the role of land use characteristics within the watershed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Downhole steam quality measurement

DOEpatents

Lee, David O.; Montoya, Paul C.; Muir, James F.; Wayland, Jr., J. Robert

1987-01-01

An empirical method for the remote sensing of steam quality that can be easily adapted to downhole steam quality measurements by measuring the electrical properties of two-phase flow across electrode grids at low frequencies.

Performance of biometric quality measures.

PubMed

Grother, Patrick; Tabassi, Elham

2007-04-01

We document methods for the quantitative evaluation of systems that produce a scalar summary of a biometric sample's quality. We are motivated by a need to test claims that quality measures are predictive of matching performance. We regard a quality measurement algorithm as a black box that converts an input sample to an output scalar. We evaluate it by quantifying the association between those values and observed matching results. We advance detection error trade-off and error versus reject characteristics as metrics for the comparative evaluation of sample quality measurement algorithms. We proceed this with a definition of sample quality, a description of the operational use of quality measures. We emphasize the performance goal by including a procedure for annotating the samples of a reference corpus with quality values derived from empirical recognition scores.

Quality Measures for Dialysis: Time for a Balanced Scorecard.

PubMed

Kliger, Alan S

2016-02-05

Recent federal legislation establishes a merit-based incentive payment system for physicians, with a scorecard for each professional. The Centers for Medicare and Medicaid Services evaluate quality of care with clinical performance measures and have used these metrics for public reporting and payment to dialysis facilities. Similar metrics may be used for the future merit-based incentive payment system. In nephrology, most clinical performance measures measure processes and intermediate outcomes of care. These metrics were developed from population studies of best practice and do not identify opportunities for individualizing care on the basis of patient characteristics and individual goals of treatment. The In-Center Hemodialysis (ICH) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey examines patients' perception of care and has entered the arena to evaluate quality of care. A balanced scorecard of quality performance should include three elements: population-based best clinical practice, patient perceptions, and individually crafted patient goals of care. Copyright © 2016 by the American Society of Nephrology.

Quality Measures for Dialysis: Time for a Balanced Scorecard

PubMed Central

2016-01-01

Recent federal legislation establishes a merit-based incentive payment system for physicians, with a scorecard for each professional. The Centers for Medicare and Medicaid Services evaluate quality of care with clinical performance measures and have used these metrics for public reporting and payment to dialysis facilities. Similar metrics may be used for the future merit-based incentive payment system. In nephrology, most clinical performance measures measure processes and intermediate outcomes of care. These metrics were developed from population studies of best practice and do not identify opportunities for individualizing care on the basis of patient characteristics and individual goals of treatment. The In-Center Hemodialysis (ICH) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey examines patients' perception of care and has entered the arena to evaluate quality of care. A balanced scorecard of quality performance should include three elements: population-based best clinical practice, patient perceptions, and individually crafted patient goals of care. PMID:26316622

Nonstructural urban stormwater quality measures: building a knowledge base to improve their use.

PubMed

Taylor, André C; Fletcher, Tim D

2007-05-01

This article summarizes a research project that investigated the use, performance, cost, and evaluation of nonstructural measures to improve urban stormwater quality. A survey of urban stormwater managers from Australia, New Zealand, and the United States revealed a widespread trend of increasing use of nonstructural measures among leading stormwater management agencies, with at least 76% of 41 types of nonstructural measures being found to be increasing in use. Data gathered from the survey, an international literature review, and a multicriteria analysis highlighted four nonstructural measures of greatest potential value: mandatory town planning controls that promote the adoption of low-impact development principles and techniques; development of strategic urban stormwater management plans for a city, shire, or catchment; stormwater management measures and programs for construction/building sites; and stormwater management activities related to municipal maintenance operations such as maintenance of the stormwater drainage network and manual litter collections. Knowledge gained on the use and performance of nonstructural measures from the survey, literature review, and three trial evaluation projects was used to develop tailored monitoring and evaluation guidelines for these types of measure. These guidelines incorporate a new evaluation framework based on seven alternative styles of evaluation that range from simply monitoring whether a nonstructural measure has been fully implemented to monitoring its impact on waterway health. This research helps to build the stormwater management industry's knowledge base concerning nonstructural measures and provides a practical tool to address common impediments associated with monitoring and evaluating the performance and cost of these measures.

Quality measurement in diabetes care.

PubMed

Leas, Brian F; Berman, Bettina; Kash, Kathryn M; Crawford, Albert G; Toner, Richard W; Goldfarb, Neil I; Nash, David B

2009-10-01

This study aimed to evaluate diabetes quality measurement efforts, assess their strengths and areas for improvement, and identify gaps not adequately addressed by these measures. We conducted an environmental scan of diabetes quality measures, focusing on metrics included in the National Quality Measures Clearinghouse or promulgated by leading measurement organizations. Key informant interviews were also completed with thought leaders who develop, promote, and use quality measures. The environmental scan identified 146 distinct measures spanning 31 clinical processes or outcomes. This suggests a measurement system that is both redundant and inconsistent, with many different measures assessing the same clinical indicators. Interviewees believe that current diabetes measurement efforts are excessively broad and complex and expressed a need for better harmonization of these measures. Several gaps were also found, including a lack of measures focusing on population health, structural elements of health care, and prevention of diabetes.

[Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients].

PubMed

Martínez Sánchez, Lidia; Trenchs Sainz de la Maza, Victoria; Azkunaga Santibáñez, Beatriz; Nogué-Xarau, Santiago; Ferrer Bosch, Nuria; García González, Elsa; Luaces I Cubells, Carles

2016-02-01

To analyze the impact of quality-indicator-based measures for improving quality of care for acute poisoning in pediatric emergency departments. Recent assessments of quality indicators were compared with benchmark targets and with results from previous studies. The first study evaluated 6 basic indicators in the pediatric emergency departments of members of to the working group on poisoning of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). The second study evaluated 20 indicators in a single emergency department of GTI-SEUP members. Based on the results of those studies, the departments implemented the following corrective measures: creation of a team for gastric lavage follow-up, preparation of a new GTI-SEUP manual on poisoning, implementation of a protocol for poisoning incidents, and creation of specific poisoning-related fields for computerized patient records. The benchmark targets were reached on 4 quality indicators in the first study. Improvements were seen in the availability of protocols, as indicators exceeded the target in all the pediatric emergency departments (vs 29.2% of the departments in an earlier study, P < .001). No other significant improvements were observed. In the second study the benchmarks were reached on 13 indicators. Improvements were seen in compliance with incident reporting to the police (recently, 44.4% vs 19.2% previously, P = .036), case registration in the minimum basic data set (51.0% vs 1.9%, P < .001), and a trend toward increased administration of activated carbon within 2 hours (93.1% vs 83.5%, P = .099). No other significant improvements were seen. The corrective measures led to improvements in some quality indicators. There is still room for improvement in these emergency departamens' care of pediatric poisoning.

A proteomics performance standard to support measurement quality in proteomics.

PubMed

Beasley-Green, Ashley; Bunk, David; Rudnick, Paul; Kilpatrick, Lisa; Phinney, Karen

2012-04-01

The emergence of MS-based proteomic platforms as a prominent technology utilized in biochemical and biomedical research has increased the need for high-quality MS measurements. To address this need, National Institute of Standards and Technology (NIST) reference material (RM) 8323 yeast protein extract is introduced as a proteomics quality control material for benchmarking the preanalytical and analytical performance of proteomics-based experimental workflows. RM 8323 yeast protein extract is based upon the well-characterized eukaryote Saccharomyces cerevisiae and can be utilized in the design and optimization of proteomics-based methodologies from sample preparation to data analysis. To demonstrate its utility as a proteomics quality control material, we coupled LC-MS/MS measurements of RM 8323 with the NIST MS Quality Control (MSQC) performance metrics to quantitatively assess the LC-MS/MS instrumentation parameters that influence measurement accuracy, repeatability, and reproducibility. Due to the complexity of the yeast proteome, we also demonstrate how NIST RM 8323, along with the NIST MSQC performance metrics, can be used in the evaluation and optimization of proteomics-based sample preparation methods. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Composite Quality Measures for Common Inpatient Medical Conditions

PubMed Central

Chen, Lena M.; Staiger, Douglas O.; Birkmeyer, John D.; Ryan, Andrew M.; Zhang, Wenying; Dimick, Justin B.

2014-01-01

Background Public reporting on quality aims to help patients select better hospitals. However, individual quality measures are sub-optimal in identifying superior and inferior hospitals based on outcome performance. Objective To combine structure, process, and outcome measures into an empirically-derived composite quality measure for heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PNA). To assess how well the composite measure predicts future high and low performers, and explains variance in future hospital mortality. Research Design Using national Medicare data, we created a cohort of older patients treated at an acute care hospital for HF (n=1,203,595), AMI (n=625,595), or PNA (n=1,234,299). We ranked hospitals based on their July 2005 to June 2008 performance on the composite. We then estimated the odds of future (July to December 2009) 30-day, risk-adjusted mortality at the worst vs. best quintile of hospitals. We repeated this analysis using 2005-2008 performance on existing quality indicators, including mortality. Results The composite (vs. Hospital Compare) explained 68% (vs. 39%) of variation in future AMI mortality rates. In 2009, if an AMI patient had chosen a hospital in the worst vs. best quintile of performance using 2005-2008 composite (vs. Hospital Compare) rankings, he or she would have had 1.61 (vs. 1.39) times the odds of dying in 30 days (p-value for difference < 0.001). Results were similar for HF and PNA. Conclusions Composite measures of quality for HF, AMI, and PNA performed better than existing measures at explaining variation in future mortality and predicting future high and low performers. PMID:23942222

QRS detection based ECG quality assessment.

PubMed

Hayn, Dieter; Jammerbund, Bernhard; Schreier, Günter

2012-09-01

Although immediate feedback concerning ECG signal quality during recording is useful, up to now not much literature describing quality measures is available. We have implemented and evaluated four ECG quality measures. Empty lead criterion (A), spike detection criterion (B) and lead crossing point criterion (C) were calculated from basic signal properties. Measure D quantified the robustness of QRS detection when applied to the signal. An advanced Matlab-based algorithm combining all four measures and a simplified algorithm for Android platforms, excluding measure D, were developed. Both algorithms were evaluated by taking part in the Computing in Cardiology Challenge 2011. Each measure's accuracy and computing time was evaluated separately. During the challenge, the advanced algorithm correctly classified 93.3% of the ECGs in the training-set and 91.6 % in the test-set. Scores for the simplified algorithm were 0.834 in event 2 and 0.873 in event 3. Computing time for measure D was almost five times higher than for other measures. Required accuracy levels depend on the application and are related to computing time. While our simplified algorithm may be accurate for real-time feedback during ECG self-recordings, QRS detection based measures can further increase the performance if sufficient computing power is available.

Measuring quality in anatomic pathology.

PubMed

Raab, Stephen S; Grzybicki, Dana Marie

2008-06-01

This article focuses mainly on diagnostic accuracy in measuring quality in anatomic pathology, noting that measuring any quality metric is complex and demanding. The authors discuss standardization and its variability within and across areas of care delivery and efforts involving defining and measuring error to achieve pathology quality and patient safety. They propose that data linking error to patient outcome are critical for developing quality improvement initiatives targeting errors that cause patient harm in addition to using methods of root cause analysis, beyond those traditionally used in cytologic-histologic correlation, to assist in the development of error reduction and quality improvement plans.

Measurement properties of asthma-specific quality-of-life measures: protocol for a systematic review.

PubMed

Apfelbacher, Christian; Paudyal, Priya; Bülbül, Alpaslan; Smith, Helen

2014-07-24

Asthma is a frequent chronic inflammatory disease of the airways, and the assessment of health-related quality of life (HrQoL) is important in both research and routine care. Various asthma-specific measures of HrQoL exist but there is uncertainty which measures are best suited for use in research and routine care. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the measurement properties of the existing measures that were developed to measure asthma-specific quality of life. This study is a systematic review of the measurement properties of asthma-specific measures of health-related quality of life. PubMed and Embase will be searched using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing or comparing measurement properties of asthma-specific HRQL tools. Eligibility assessment and data abstraction will be performed independently by two reviewers. Evidence tables will be generated for study characteristics, instrument characteristics, measurement properties and interpretability. The quality of the measurement properties will be assessed using predefined criteria. Methodological quality of studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis will be undertaken if more than one study have investigated a particular measurement property. The proposed systematic review will produce a comprehensive assessment of measurement properties of existing measures of asthma-specific health-related quality of life. We also aim to derive recommendations in order to help researchers and practitioners alike in the choice of instrument. PROSPERO registration number: CRD42014010491.

DUQuE quality management measures: associations between quality management at hospital and pathway levels.

PubMed

Wagner, Cordula; Groene, Oliver; Thompson, Caroline A; Dersarkissian, Maral; Klazinga, Niek S; Arah, Onyebuchi A; Suñol, Rosa

2014-04-01

The assessment of integral quality management (QM) in a hospital requires measurement and monitoring from different perspectives and at various levels of care delivery. Within the DUQuE project (Deepening our Understanding of Quality improvement in Europe), seven measures for QM were developed. This study investigates the relationships between the various quality measures. It is a multi-level, cross-sectional, mixed-method study. As part of the DUQuE project, we invited a random sample of 74 hospitals in 7 countries. The quality managers of these hospitals were the main respondents. Furthermore, data of site visits of external surveyors assessing the participating hospitals were used. Three measures of QM at hospitals level focusing on integral systems (QMSI), compliance with the Plan-Do-Study-Act quality improvement cycle (QMCI) and implementation of clinical quality (CQII). Four measures of QM activities at care pathway level focusing on Specialized expertise and responsibility (SER), Evidence-based organization of pathways (EBOP), Patient safety strategies (PSS) and Clinical review (CR). Positive significant associations were found between the three hospitals level QM measures. Results of the relationships between levels were mixed and showed most associations between QMCI and department-level QM measures for all four types of departments. QMSI was associated with PSS in all types of departments. By using the seven measures of QM, it is possible to get a more comprehensive picture of the maturity of QM in hospitals, with regard to the different levels and across various types of hospital departments.

Linking Quality and Spending to Measure Value for People with Serious Illness.

PubMed

Ryan, Andrew M; Rodgers, Phillip E

2018-03-01

Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending-or are likely to within the next few years-the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs.

Linking Quality and Spending to Measure Value for People with Serious Illness

PubMed Central

Rodgers, Phillip E.

2018-01-01

Abstract Background: Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. Objective: To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. Design: We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Results: Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending—or are likely to within the next few years—the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. Conclusions: We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs. PMID:29091529

Evidence-Based Performance Measures: Quality Metrics for the Care of Patients Undergoing Breast Reconstruction.

PubMed

Manahan, Michele A; Wooden, William A; Becker, Stephen M; Cacioppo, Jason R; Edge, Stephen B; Grandinetti, Amanda C; Gray, Diedra D; Holley, Susan O; Karp, Nolan S; Kocak, Ergun; Rao, Roshni; Rosson, Gedge D; Schwartz, Jaime S; Sitzman, Thomas J; Soltanian, Hooman T; TerKonda, Sarvam P; Wallace, Anne M

2017-12-01

The American Society of Plastic Surgeons commissioned the Breast Reconstruction Performance Measure Development Work Group to identify and draft quality measures for the care of patients undergoing breast reconstruction surgery. Two outcome measures were identified. The first desired outcome was to reduce the number of returns to the operating room following reconstruction within 60 days of the initial reconstructive procedure. The second desired outcome was to reduce flap loss within 30 days of the initial reconstructive procedure. All measures in this report were approved by the American Society of Plastic Surgeons Breast Reconstruction Performance Measures Work Group and the American Society of Plastic Surgeons Executive Committee. The Work Group recommends the use of these measures for quality initiatives, Continuing Medical Education, Maintenance of Certification, American Society of Plastic Surgeons' Qualified Clinical Data Registry reporting, and national quality reporting programs.

Measuring Quality in Ethics Consultation.

PubMed

Bliss, Sally E; Oppenlander, Jane; Dahlke, Jacob M; Meyer, Gordon J; Williford, Eva M; Macauley, Robert C

2016-01-01

For all of the emphasis on quality improvement-as well as the acknowledged overlap between assessment of the quality of healthcare services and clinical ethics-the quality of clinical ethics consultation has received scant attention, especially in terms of empirical measurement. Recognizing this need, the second edition of Core Competencies for Health Care Ethics Consultation1 identified four domains of ethics quality: (1) ethicality, (2) stakeholders' satisfaction, (3) resolution of the presenting conflict/dilemma, and (4) education that translates into knowledge. This study is the first, to our knowledge, to directly measure all of these domains. Here we describe the quality improvement process undertaken at a tertiary care academic medical center, as well as the tools developed to measure the quality of ethics consultation, which include post-consultation satisfaction surveys and weekly case conferences. The information gained through these tools helps to improve not only the process of ethics consultation, but also the measurement and assurance of quality. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Toward an applied technology for quality measurement in health care.

PubMed

Berwick, D M

1988-01-01

Cost containment, financial incentives to conserve resources, the growth of for-profit hospitals, an aggressive malpractice environment, and demands from purchasers are among the forces today increasing the need for improved methods that measure quality in health care. At the same time, increasingly sophisticated databases and the existence of managed care systems yield new opportunities to observe and correct quality problems. Research on targets of measurement (structure, process, and outcome) and methods of measurement (implicit, explicit, and sentinel methods) has not yet produced managerially useful applied technology for quality measurement in real-world settings. Such an applied technology would have to be cheaper, faster, more flexible, better reported, and more multidimensional than the majority of current research on quality assurance. In developing a new applied technology for the measurement of health care quality, quantitative disciplines have much to offer, such as decision support systems, criteria based on rigorous decision analyses, utility theory, tools for functional status measurement, and advances in operations research.

Measuring Website Quality: Asymmetric Effect of User Satisfaction

ERIC Educational Resources Information Center

Kincl, Tomas; Strach, Pavel

2012-01-01

Website quality measurement tools have been largely static and have struggled to determine relevant attributes of user satisfaction. This study compares and contrasts attributes of user satisfaction based on usability guidelines seeking to identify practical easy-to-administer measurement tools. The website users assessed business school homepages…

SU-E-T-616: Plan Quality Assessment of Both Treatment Planning System Dose and Measurement-Based 3D Reconstructed Dose in the Patient

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

Olch, A

2015-06-15

Purpose: Systematic radiotherapy plan quality assessment promotes quality improvement. Software tools can perform this analysis by applying site-specific structure dose metrics. The next step is to similarly evaluate the quality of the dose delivery. This study defines metrics for acceptable doses to targets and normal organs for a particular treatment site and scores each plan accordingly. The input can be the TPS or the measurement-based 3D patient dose. From this analysis, one can determine whether the delivered dose distribution to the patient receives a score which is comparable to the TPS plan score, otherwise replanning may be indicated. Methods: Elevenmore » neuroblastoma patient plans were exported from Eclipse to the Quality Reports program. A scoring algorithm defined a score for each normal and target structure based on dose-volume parameters. Each plan was scored by this algorithm and the percentage of total possible points was obtained. Each plan also underwent IMRT QA measurements with a Mapcheck2 or ArcCheck. These measurements were input into the 3DVH program to compute the patient 3D dose distribution which was analyzed using the same scoring algorithm as the TPS plan. Results: The mean quality score for the TPS plans was 75.37% (std dev=14.15%) compared to 71.95% (std dev=13.45%) for the 3DVH dose distribution. For 3/11 plans, the 3DVH-based quality score was higher than the TPS score, by between 0.5 to 8.4 percentage points. Eight/11 plans scores decreased based on IMRT QA measurements by 1.2 to 18.6 points. Conclusion: Software was used to determine the degree to which the plan quality score differed between the TPS and measurement-based dose. Although the delivery score was generally in good agreement with the planned dose score, there were some that improved while there was one plan whose delivered dose quality was significantly less than planned. This methodology helps evaluate both planned and delivered dose quality. Sun Nuclear

FPGA-based firmware model for extended measurement systems with data quality monitoring

NASA Astrophysics Data System (ADS)

Wojenski, A.; Pozniak, K. T.; Mazon, D.; Chernyshova, M.

2017-08-01

Modern physics experiments requires construction of advanced, modular measurement systems for data processing and registration purposes. Components are often designed in one of the common mechanical and electrical standards, e.g. VME or uTCA. The paper is focused on measurement systems using FPGAs as data processing blocks, especially for plasma diagnostics using GEM detectors with data quality monitoring aspects. In the article is proposed standardized model of HDL FPGA firmware implementation, for use in a wide range of different measurement system. The effort was made in term of flexible implementation of data quality monitoring along with source data dynamic selection. In the paper is discussed standard measurement system model followed by detailed model of FPGA firmware for modular measurement systems. Considered are both: functional blocks and data buses. In the summary, necessary blocks and signal lines are described. Implementation of firmware following the presented rules should provide modular design, with ease of change different parts of it. The key benefit is construction of universal, modular HDL design, that can be applied in different measurement system with simple adjustments.

Measuring Customer Satisfaction and Quality of Service in Special Libraries.

ERIC Educational Resources Information Center

White, Marilyn Domas; Abels, Eileen G.; Nitecki, Danuta

This project tested the appropriateness of SERVQUAL (i.e., an instrument widely used in the service industry for assessing service quality based on repeated service encounters rather than a particular service encounter) to measure service quality in special libraries and developed a modified version for special libraries. SERVQUAL is based on an…

Dual redundant arm system operational quality measures and their applications - Dynamic measures

NASA Technical Reports Server (NTRS)

Lee, Sukhan; Kim, Sungbok

1990-01-01

Dual-arm dynamic operation quality measures are presented which quantify the efficiency and capability of generating Cartesian accelerations by two cooperative arms based on the analysis of dual-arm dynamic interactions. Dual-arm dynamic manipulability is defined as the efficiency of generating Cartesian accelerations under the dynamic and kinematic interactions between individual arms and an object under manipulation. The analysis of dual-arm dynamic interactions is based on the so-called Cartesian space agent model of an arm, which represents an individual arm as a force source acting upon a point mass with the effective Cartesian space arm dynamics and an environment or an object under manipulation. The Cartesian space agent model of an arm makes it possible to derive the dynamic and kinematic constraints involved in the transport, assembly and grasping modes of dual-arm cooperation. A task-oriented operational quality measure, (TOQd) is defined by evaluating dual-arm dynamic manipulability in terms of given task requirements. TOQd is used in dual-arm joint configuration optimization. Simulation results are shown. A complete set of forward dynamic equations for a dual-arm system is derived, and dual-arm dynamic operational quality measures for various modes of dual-arm cooperation allowing sliding contacts are established.

Clustering of reads with alignment-free measures and quality values.

PubMed

Comin, Matteo; Leoni, Andrea; Schimd, Michele

2015-01-01

The data volume generated by Next-Generation Sequencing (NGS) technologies is growing at a pace that is now challenging the storage and data processing capacities of modern computer systems. In this context an important aspect is the reduction of data complexity by collapsing redundant reads in a single cluster to improve the run time, memory requirements, and quality of post-processing steps like assembly and error correction. Several alignment-free measures, based on k-mers counts, have been used to cluster reads. Quality scores produced by NGS platforms are fundamental for various analysis of NGS data like reads mapping and error detection. Moreover future-generation sequencing platforms will produce long reads but with a large number of erroneous bases (up to 15 %). In this scenario it will be fundamental to exploit quality value information within the alignment-free framework. To the best of our knowledge this is the first study that incorporates quality value information and k-mers counts, in the context of alignment-free measures, for the comparison of reads data. Based on this principles, in this paper we present a family of alignment-free measures called D (q) -type. A set of experiments on simulated and real reads data confirms that the new measures are superior to other classical alignment-free statistics, especially when erroneous reads are considered. Also results on de novo assembly and metagenomic reads classification show that the introduction of quality values improves over standard alignment-free measures. These statistics are implemented in a software called QCluster (http://www.dei.unipd.it/~ciompin/main/qcluster.html).

Knowledge of quality performance measures associated with endoscopy among gastroenterology trainees and the impact of a web-based intervention

PubMed Central

Thompson, Jennifer S.; Lebwohl, Benjamin; Syngal, Sapna; Kastrinos, Fay

2013-01-01

Background Knowledge of quality measures in endoscopy among trainees is unknown. Objective To assess knowledge of endoscopy-related quality indicators among U.S. trainees and determine whether it improves with a Web-based intervention. Design Randomized, controlled study. Setting Multicenter. Participants This study involved trainees identified from the American Society for Gastrointestinal Endoscopy membership database. Intervention Participants were invited to complete an 18-question online test. Respondents were randomized to receive a Web-based tutorial (intervention) or not. The test was readministered 6 weeks after randomization to determine the intervention’s impact. Main Outcome Measurements Baseline knowledge of endoscopy-related quality indicators and impact of the tutorial. Results A total of 347 of 1220 trainees (28%) completed the test; the mean percentage of correct responses was 55%. For screening colonoscopy, 44% knew the adenoma detection rate benchmark, 42% identified the cecal intubation rate goal, and 74% knew the recommended minimum withdrawal time. A total of 208 of 347 trainees (59%) completed the second test; baseline scores were similar for the tutorial (n = 106) and no tutorial (n = 102) groups (56.4% vs 56.9%, respectively). Scores improved after intervention for the tutorial group (65%, P = .003) but remained unchanged in the no tutorial group. On multivariate analysis, each additional year in training (odds ratio [OR] 2.3; 95% confidence interval [CI], 1.5–3.4), training at an academic institution (OR 2.6; 95% CI, 1.1–6.3), and receiving the tutorial (OR 3.2; 95% CI, 1.7–5.9) were associated with scores in the upper tertile. Limitations Low response rate. Conclusion Knowledge of endoscopy-related quality performance measures is low among trainees but can improve with a Web-based tutorial. Gastroenterology training programs may need to incorporate a formal didactic curriculum to supplement practice-based learning of quality

A research agenda to advance quality measurement and improvement.

PubMed

Leatherman, Sheila T; Hibbard, Judith H; McGlynn, Elizabeth A

2003-01-01

In developing a conceptual framework for the design of a national quality measurement and reporting system (NQMRS), the Strategic Framework Board (SFB) recommends that such a system be built on a strong evidence base. To identify critical gaps in the evidence needed for a fully functional NQMRS and to recommend a starting point for the development of a research agenda. Selective review of literature in quality of care measurement and reporting and identification of strategic issues that must be addressed. There is some limited evidence that measurement and reporting can improve quality. Substantial advances have been made in the science of measurement and reporting but important gaps remain, specifically in (1) measurement methods and tools, (2) uses of quality performance data, (3) organizational and cultural factors, (4) information and informatics, and (5) impact evaluation/research. To achieve a sustainable research agenda, three strategic issues will have to be addressed: (1) the policy rationale for the research agenda, (2) adequate levels of public-sector funding, and (3) sustainability in a rapidly changing environment.

QUALITY ASSURANCE HANDBOOK FOR AIR POLLUTION MEASUREMENT SYSTEMS: VOLUME IV - METEOROLOGICAL MEASUREMENTS (REVISED - AUGUST 1994)

EPA Science Inventory

Procedures on installing, acceptance testing, operating, maintaining and quality assuring three types of ground-based, upper air meteorological measurement systems are described. he limitations and uncertainties in precision and accuracy measurements associated with these systems...

Reduced reference image quality assessment via sub-image similarity based redundancy measurement

NASA Astrophysics Data System (ADS)

Mou, Xuanqin; Xue, Wufeng; Zhang, Lei

2012-03-01

The reduced reference (RR) image quality assessment (IQA) has been attracting much attention from researchers for its loyalty to human perception and flexibility in practice. A promising RR metric should be able to predict the perceptual quality of an image accurately while using as few features as possible. In this paper, a novel RR metric is presented, whose novelty lies in two aspects. Firstly, it measures the image redundancy by calculating the so-called Sub-image Similarity (SIS), and the image quality is measured by comparing the SIS between the reference image and the test image. Secondly, the SIS is computed by the ratios of NSE (Non-shift Edge) between pairs of sub-images. Experiments on two IQA databases (i.e. LIVE and CSIQ databases) show that by using only 6 features, the proposed metric can work very well with high correlations between the subjective and objective scores. In particular, it works consistently well across all the distortion types.

Computer vision-based analysis of foods: a non-destructive colour measurement tool to monitor quality and safety.

PubMed

Mogol, Burçe Ataç; Gökmen, Vural

2014-05-01

Computer vision-based image analysis has been widely used in food industry to monitor food quality. It allows low-cost and non-contact measurements of colour to be performed. In this paper, two computer vision-based image analysis approaches are discussed to extract mean colour or featured colour information from the digital images of foods. These types of information may be of particular importance as colour indicates certain chemical changes or physical properties in foods. As exemplified here, the mean CIE a* value or browning ratio determined by means of computer vision-based image analysis algorithms can be correlated with acrylamide content of potato chips or cookies. Or, porosity index as an important physical property of breadcrumb can be calculated easily. In this respect, computer vision-based image analysis provides a useful tool for automatic inspection of food products in a manufacturing line, and it can be actively involved in the decision-making process where rapid quality/safety evaluation is needed. © 2013 Society of Chemical Industry.

Quality improvement in neurology: dementia management quality measures.

PubMed

Odenheimer, Germaine; Borson, Soo; Sanders, Amy E; Swain-Eng, Rebecca J; Kyomen, Helen H; Tierney, Samantha; Gitlin, Laura; Forciea, Mary Ann; Absher, John; Shega, Joseph; Johnson, Jerry

2014-03-01

Professional and advocacy organizations have long urged that dementia should be recognized and properly diagnosed. With the passage of the National Alzheimer's Project Act in 2011, an Advisory Council for Alzheimer's Research, Care, and Services was convened to advise the Department of Health and Human Services. In May 2012, the Council produced the first National Plan to address Alzheimer's disease, and prominent in its recommendations is a call for quality measures suitable for evaluating and tracking dementia care in clinical settings. Although other efforts have been made to set dementia care quality standards, such as those pioneered by RAND in its series Assessing Care of Vulnerable Elders (ACOVE), practitioners, healthcare systems, and insurers have not widely embraced implementation. This executive summary (full manuscript available at www.neurology.org) reports on a new measurement set for dementia management developed by an interdisciplinary Dementia Measures Work Group (DWG) representing the major national organizations and advocacy organizations concerned with the care of individuals with dementia. The American Academy of Neurology (AAN), the American Geriatrics Society, the American Medical Directors Association, the American Psychiatric Association, and the American Medical Association-convened Physician Consortium for Performance Improvement led this effort. The ACOVE measures and the measurement set described here apply to individuals whose dementia has already been identified and properly diagnosed. Although similar in concept to ACOVE, the DWG measurement set differs in several important ways; it includes all stages of dementia in a single measure set, calls for the use of functional staging in planning care, prompts the use of validated instruments in patient and caregiver assessment and intervention, highlights the relevance of using palliative care concepts to guide care before the advanced stages of illness, and provides evidence-based support

Hospital-Based Acute Care After Total Hip and Knee Arthroplasty: Implications for Quality Measurement.

PubMed

Trimba, Roman; Laughlin, Richard T; Krishnamurthy, Anil; Ross, Joseph S; Fox, Justin P

2016-03-01

Although hospital readmissions are being adopted as a quality measure after total hip or knee arthroplasty, they may fail accurately capture the patient's postdischarge experience. We studied 272,853 discharges from 517 hospitals to determine hospital emergency department (ED) visit and readmission rates. The hospital-level, 30-day, risk-standardized ED visit (median = 5.6% [2.4%-13.7%]) and hospital readmission (5.0% [2.6%-9.2%]) rates were similar and varied widely. A hospital's risk-standardized ED visit rate did not correlate with its readmission rate (r = -0.03, P = .50). If ED visits were included in a broader "readmission" measure, 246 (47.6%) hospitals would change perceived performance groups. Including ED visits in a broader, hospital-based, acute care measure may be warranted to better describe postdischarge health care utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

Challenges and Opportunities in Using Patient-Reported Outcomes in Quality Measurement in Rheumatology

PubMed Central

Wahl, Elizabeth; Yazdany, Jinoos

2016-01-01

Summary Use of Patient-reported outcome measures (PROs) in rheumatology research is widespread, but use of PRO data to evaluate the quality of rheumatologic care delivered is less well established. This article reviews the use of PROs in assessing healthcare quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. We first explore other countries’ experiences collecting and evaluating national PRO data to assess quality of care. We describe the current use of PROs as quality measures in rheumatology, and frame an agenda for future work supporting development of meaningful quality measures based on PROs. PMID:27133495

Impact of the present-on-admission indicator on hospital quality measurement: experience with the Agency for Healthcare Research and Quality (AHRQ) Inpatient Quality Indicators.

PubMed

Glance, Laurent G; Osler, Turner M; Mukamel, Dana B; Dick, Andrew W

2008-02-01

The Agency for Healthcare Research and Quality (AHRQ) has constructed Inpatient Quality Indicator (IQI) mortality measures to measure hospital quality using routinely available administrative data. With the exception of California, New York State, and Wisconsin, administrative data do not include a present-on-admission (POA) indicator to distinguish between preexisting conditions and complications. The extent to which the lack of a POA indicator biases quality assessment based on the AHRQ mortality measures is unknown. To examine the impact of the POA indicator on hospital quality assessment based on the AHRQ mortality measures using enhanced administrative data from California, which includes a POA indicator. Retrospective cohort study based on 2.07 million inpatient admissions between 1998 and 2000 in the California State Inpatient Database. The AHRQ IQI software was used to calculate risk-adjusted mortality rates using either (1) routine administrative data that included all the International Classification of Diseases (ICD)-9-CM codes or (2) enhanced administrative data that included only the ICD-9-CM codes representing preexisting conditions. The inclusion of the POA indicator frequently results in changes in the quality ranking of hospitals classified as high-quality or low-quality using routine administrative data. Twenty-seven percent (stroke) to 94% (coronary artery bypass graft) of hospitals classified as high-quality using routine administrative data were reclassified as intermediate- or low-quality hospitals using the enhanced administrative data. Twenty-five percent (congestive heart failure) to 76% (percutaneous coronary intervention) of hospitals classified as low-quality hospitals using enhanced administrative data were misclassified as intermediate-quality hospitals using routine administrative data. Despite the fact that the AHRQ IQIs were primarily intended to serve as a screening tool, they are being increasingly used to publicly report hospital

No-reference video quality measurement: added value of machine learning

NASA Astrophysics Data System (ADS)

Mocanu, Decebal Constantin; Pokhrel, Jeevan; Garella, Juan Pablo; Seppänen, Janne; Liotou, Eirini; Narwaria, Manish

2015-11-01

Video quality measurement is an important component in the end-to-end video delivery chain. Video quality is, however, subjective, and thus, there will always be interobserver differences in the subjective opinion about the visual quality of the same video. Despite this, most existing works on objective quality measurement typically focus only on predicting a single score and evaluate their prediction accuracies based on how close it is to the mean opinion scores (or similar average based ratings). Clearly, such an approach ignores the underlying diversities in the subjective scoring process and, as a result, does not allow further analysis on how reliable the objective prediction is in terms of subjective variability. Consequently, the aim of this paper is to analyze this issue and present a machine-learning based solution to address it. We demonstrate the utility of our ideas by considering the practical scenario of video broadcast transmissions with focus on digital terrestrial television (DTT) and proposing a no-reference objective video quality estimator for such application. We conducted meaningful verification studies on different video content (including video clips recorded from real DTT broadcast transmissions) in order to verify the performance of the proposed solution.

Quality measurement in physician-staffed emergency medical services: a systematic literature review.

PubMed

Haugland, Helge; Uleberg, Oddvar; Klepstad, Pål; Krüger, Andreas; Rehn, Marius

2018-05-15

Quality measurement of physician-staffed emergency medical services (P-EMS) is necessary to improve service quality. Knowledge and consensus on this topic are scarce, making quality measurement of P-EMS a high-priority research area. The aim of this review was to identify, describe and evaluate studies of quality measurement in P-EMS. The databases of MEDLINE and Embase were searched initially, followed by a search for included article citations in Scopus. The study eligibility criteria were: (1) articles describing the use of one quality indicator (QI) or more in P-EMS, (2) original manuscripts, (3) articles published from 1 January 1968 until 5 October 2016. The literature search identified 4699 records. 4543 were excluded after reviewing title and abstract. An additional 129 were excluded based on a full-text review. The remaining 27 papers were included in the analysis. Methodological quality was assessed using an adapted critical appraisal tool. The description of used QIs and methods of quality measurement was extracted. Variables describing the involved P-EMSs were extracted as well. In the included papers, a common understanding of which QIs to use in P-EMS did not exist. Fifteen papers used only a single QI. The most widely used QIs were 'Adherence to medical protocols', 'Provision of advanced interventions', 'Response time' and 'Adverse events'. The review demonstrated a lack of shared understanding of which QIs to use in P-EMS. Moreover, papers using only one QI dominated the literature, thus increasing the risk of a narrow perspective in quality measurement. Future quality measurement in P-EMS should rely on a set of consensus-based QIs, ensuring a comprehensive approach to quality measurement.

Knowledge of quality performance measures associated with endoscopy among gastroenterology trainees and the impact of a web-based intervention.

PubMed

Thompson, Jennifer S; Lebwohl, Benjamin; Syngal, Sapna; Kastrinos, Fay

2012-07-01

Knowledge of quality measures in endoscopy among trainees is unknown. To assess knowledge of endoscopy-related quality indicators among U.S. trainees and determine whether it improves with a Web-based intervention. Randomized, controlled study. Multicenter. This study involved trainees identified from the American Society for Gastrointestinal Endoscopy membership database. Participants were invited to complete an 18-question online test. Respondents were randomized to receive a Web-based tutorial (intervention) or not. The test was readministered 6 weeks after randomization to determine the intervention's impact. Baseline knowledge of endoscopy-related quality indicators and impact of the tutorial. A total of 347 of 1220 trainees (28%) completed the test; the mean percentage of correct responses was 55%. For screening colonoscopy, 44% knew the adenoma detection rate benchmark, 42% identified the cecal intubation rate goal, and 74% knew the recommended minimum withdrawal time. A total of 208 of 347 trainees (59%) completed the second test; baseline scores were similar for the tutorial (n = 106) and no tutorial (n = 102) groups (56.4% vs 56.9%, respectively). Scores improved after intervention for the tutorial group (65%, P = .003) but remained unchanged in the no tutorial group. On multivariate analysis, each additional year in training (odds ratio [OR] 2.3; 95% confidence interval [CI], 1.5-3.4), training at an academic institution (OR 2.6; 95% CI, 1.1-6.3), and receiving the tutorial (OR 3.2; 95% CI, 1.7-5.9) were associated with scores in the upper tertile. Low response rate. Knowledge of endoscopy-related quality performance measures is low among trainees but can improve with a Web-based tutorial. Gastroenterology training programs may need to incorporate a formal didactic curriculum to supplement practice-based learning of quality standards in endoscopy. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights

Data-quality measures for stakeholder-implemented watershed-monitoring programs

USGS Publications Warehouse

Greve, Adrienne I.

2002-01-01

Community-based watershed groups, many of which collect environmental data, have steadily increased in number over the last decade. The data generated by these programs are often underutilized due to uncertainty in the quality of data produced. The incorporation of data-quality measures into stakeholder monitoring programs lends statistical validity to data. Data-quality measures are divided into three steps: quality assurance, quality control, and quality assessment. The quality-assurance step attempts to control sources of error that cannot be directly quantified. This step is part of the design phase of a monitoring program and includes clearly defined, quantifiable objectives, sampling sites that meet the objectives, standardized protocols for sample collection, and standardized laboratory methods. Quality control (QC) is the collection of samples to assess the magnitude of error in a data set due to sampling, processing, transport, and analysis. In order to design a QC sampling program, a series of issues needs to be considered: (1) potential sources of error, (2) the type of QC samples, (3) inference space, (4) the number of QC samples, and (5) the distribution of the QC samples. Quality assessment is the process of evaluating quality-assurance measures and analyzing the QC data in order to interpret the environmental data. Quality assessment has two parts: one that is conducted on an ongoing basis as the monitoring program is running, and one that is conducted during the analysis of environmental data. The discussion of the data-quality measures is followed by an example of their application to a monitoring program in the Big Thompson River watershed of northern Colorado.

Quality-based purchasing in health care.

PubMed

Waters, Hugh R; Morlock, Laura L; Hatt, Laurel

2004-01-01

Quality-based purchasing is a growing trend that seeks to improve healthcare quality through the purchaser-provider relationship. This article provides a unifying conceptual framework, presents examples of the purchaser-provider relationship in countries at different income levels, and identifies important supporting mechanisms for quality-based purchasing. As countries become wealthier, a higher proportion of healthcare spending is channeled through pooled arrangements, allowing for greater involvement of purchasers in promoting the quality of service provision. Global and line item budgets are the most common type of provider payment system in low and middle-income countries. In these countries, improving public hospital performance through contracting and incentives is a key issue. In middle and high-income countries, there are several documented examples of governments contracting to private or non-governmental health care providers, resulting in higher perceived quality of care and lower delivery costs. Encouraging quality through employer purchasing arrangements has been promoted in several countries, particularly the United States. Community-based financing schemes are an increasingly common form of health financing in parts of sub-Saharan Africa and Asia, but these schemes still cover less than 10% of national populations in countries in which they are active. To date, there is little evidence of their impact on healthcare quality. The availability of information--concerning healthcare service provision and outcomes--determines the options for establishing and monitoring contract provisions and promoting quality. Regardless of the context, quality-based purchasing depends critically on informa-tion--reporting, monitoring, and providing useful information to healthcare consumers. In many low and middle-income countries, the lack of availability of information is the principal constraint on measuring performance, a critical component of quality-based

Measuring and improving the quality of mental health care: a global perspective

PubMed Central

Kilbourne, Amy M.; Beck, Kathryn; Spaeth‐Rublee, Brigitta; Ramanuj, Parashar; O'Brien, Robert W.; Tomoyasu, Naomi; Pincus, Harold Alan

2018-01-01

Mental disorders are common worldwide, yet the quality of care for these disorders has not increased to the same extent as that for physical conditions. In this paper, we present a framework for promoting quality measurement as a tool for improving quality of mental health care. We identify key barriers to this effort, including lack of standardized information technology‐based data sources, limited scientific evidence for mental health quality measures, lack of provider training and support, and cultural barriers to integrating mental health care within general health environments. We describe several innovations that are underway worldwide which can mitigate these barriers. Based on these experiences, we offer several recommendations for improving quality of mental health care. Health care payers and providers will need a portfolio of validated measures of patient‐centered outcomes across a spectrum of conditions. Common data elements will have to be developed and embedded within existing electronic health records and other information technology tools. Mental health outcomes will need to be assessed more routinely, and measurement‐based care should become part of the overall culture of the mental health care system. Health care systems will need a valid way to stratify quality measures, in order to address potential gaps among subpopulations and identify groups in most need of quality improvement. Much more attention should be devoted to workforce training in and capacity for quality improvement. The field of mental health quality improvement is a team sport, requiring coordination across different providers, involvement of consumer advocates, and leveraging of resources and incentives from health care payers and systems. PMID:29352529

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

PubMed

Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

2017-02-01

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Impact of Quality Improvement Educational Interventions on Documented Adherence to Quality Measures for Adults with Crohn's Disease.

PubMed

Greene, Laurence; Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Patel, Barry; Higgins, Peter D R

2015-09-01

In recent years, leading organizations in inflammatory bowel disease (IBD) have developed quality measures for the care of adults with Crohn's disease or ulcerative colitis. We used chart audits to assess the impact of quality improvement educational activities on documented adherence to Physician Quality Reporting System measures for IBD. Twenty community-based gastroenterologists were recruited to participate in baseline chart audits (n = 200), a series of 4 accredited educational activities with feedback, and follow-up chart audits (n = 200). Trained abstractors reviewed randomly selected charts of adults with moderate or severe Crohn's disease. The charts were retrospectively abstracted for physicians' documented performance of the 2013 Physician Quality Reporting System IBD quality measures. We compared the physicians' baseline and posteducation rates of documented adherence with 10 of these measures. In a secondary analysis, we compared preeducation with posteducation difference scores of low-performing physicians, those whose baseline documentation rates were in the lowest quartile, and the rest of the cohort. At baseline, documentation of mean provider-level adherence to the 10 quality measures ranged from 3% to 98% (grand mean = 35.8%). In the overall analysis, baseline and posteducation rates of documented adherence did not differ significantly for any of the measures. However, for 4 measures, preeducation to posteducation difference scores were significantly greater among low performers than physicians in the highest 3 quartiles. The results of this preliminary pragmatic study indicate that quality improvement education affords the potential to improve adherence to Physician Quality Reporting System quality measures for IBD among low-performing gastroenterologists.

A fuzzy-logic based decision-making approach for identification of groundwater quality based on groundwater quality indices.

PubMed

Vadiati, M; Asghari-Moghaddam, A; Nakhaei, M; Adamowski, J; Akbarzadeh, A H

2016-12-15

Due to inherent uncertainties in measurement and analysis, groundwater quality assessment is a difficult task. Artificial intelligence techniques, specifically fuzzy inference systems, have proven useful in evaluating groundwater quality in uncertain and complex hydrogeological systems. In the present study, a Mamdani fuzzy-logic-based decision-making approach was developed to assess groundwater quality based on relevant indices. In an effort to develop a set of new hybrid fuzzy indices for groundwater quality assessment, a Mamdani fuzzy inference model was developed with widely-accepted groundwater quality indices: the Groundwater Quality Index (GQI), the Water Quality Index (WQI), and the Ground Water Quality Index (GWQI). In an effort to present generalized hybrid fuzzy indices a significant effort was made to employ well-known groundwater quality index acceptability ranges as fuzzy model output ranges rather than employing expert knowledge in the fuzzification of output parameters. The proposed approach was evaluated for its ability to assess the drinking water quality of 49 samples collected seasonally from groundwater resources in Iran's Sarab Plain during 2013-2014. Input membership functions were defined as "desirable", "acceptable" and "unacceptable" based on expert knowledge and the standard and permissible limits prescribed by the World Health Organization. Output data were categorized into multiple categories based on the GQI (5 categories), WQI (5 categories), and GWQI (3 categories). Given the potential of fuzzy models to minimize uncertainties, hybrid fuzzy-based indices produce significantly more accurate assessments of groundwater quality than traditional indices. The developed models' accuracy was assessed and a comparison of the performance indices demonstrated the Fuzzy Groundwater Quality Index model to be more accurate than both the Fuzzy Water Quality Index and Fuzzy Ground Water Quality Index models. This suggests that the new hybrid fuzzy

A precipitation database of station-based daily and monthly measurements for West Africa: Overview, quality control and harmonization

NASA Astrophysics Data System (ADS)

Bliefernicht, Jan; Waongo, Moussa; Annor, Thompson; Laux, Patrick; Lorenz, Manuel; Salack, Seyni; Kunstmann, Harald

2017-04-01

West Africa is a data sparse region. High quality and long-term precipitation data are often not readily available for applications in hydrology, agriculture, meteorology and other needs. To close this gap, we use multiple data sources to develop a precipitation database with long-term daily and monthly time series. This database was compiled from 16 archives including global databases e.g. from the Global Historical Climatology Network (GHCN), databases from research projects (e.g. the AMMA database) and databases of the national meteorological services of some West African countries. The collection consists of more than 2000 precipitation gauges with measurements dating from 1850 to 2015. Due to erroneous measurements (e.g. temporal offsets, unit conversion errors), missing values and inconsistent meta-data, the merging of this precipitation dataset is not straightforward and requires a thorough quality control and harmonization. To this end, we developed geostatistical-based algorithms for quality control of individual databases and harmonization to a joint database. The algorithms are based on a pairwise comparison of the correspondence of precipitation time series in dependence to the distance between stations. They were tested for precipitation time series from gages located in a rectangular domain covering Burkina Faso, Ghana, Benin and Togo. This harmonized and quality controlled precipitation database was recently used for several applications such as the validation of a high resolution regional climate model and the bias correction of precipitation projections provided the Coordinated Regional Climate Downscaling Experiment (CORDEX). In this presentation, we will give an overview of the novel daily and monthly precipitation database and the algorithms used for quality control and harmonization. We will also highlight the quality of global and regional archives (e.g. GHCN, GSOD, AMMA database) in comparison to the precipitation databases provided by the

Quality of web-based information on cannabis addiction.

PubMed

Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele

2008-01-01

This study evaluated the quality of Web-based information on cannabis use and addiction and investigated particular content quality indicators. Three keywords ("cannabis addiction," "cannabis dependence," and "cannabis abuse") were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability, and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of the 94 Websites identified, 57 were included. Most were commercial sites. Based on outcome measures, the overall quality of the sites turned out to be poor. A global score (the sum of accountability, interactivity, content quality and esthetic criteria) appeared as a good content quality indicator. While cannabis education Websites for patients are widespread, their global quality is poor. There is a need for better evidence-based information about cannabis use and addiction on the Web.

Rapid core measure improvement through a "business case for quality".

PubMed

Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

2014-01-01

Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. © 2012 National Association for Healthcare Quality.

Quality measures for nurse practitioner practice evaluation.

PubMed

Kleinpell, Ruth; Kapu, April N

2017-08-01

Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

Comparative evaluation of two asthma care quality measures among Medicaid beneficiaries.

PubMed

Samnaliev, Mihail; Baxter, Jeffrey D; Clark, Robin E

2009-05-01

The relative performance of asthma care quality measures has not been evaluated in Medicaid populations. Using complete claims and pharmaceutical data for 19,076 patients with persistent asthma (based on Health Effectiveness and Data Information Set criteria) in five Medicaid populations, we compared the following two measures of asthma care quality: filling prescriptions for controller asthma medications within 1 year and the ratio of controller medication to the total number of asthma medication prescriptions filled within 1 year. We calculated whether meeting each quality measure was associated with decreased odds of emergency department (ED) treatment episodes. We then compared the odds ratios, receiver operating characteristic (ROC) curves, and deviances between models, using each measure to predict ED utilization in Medicaid populations. Although meeting each measure was associated with lower odds of ED utilization, this decrease was larger if the controller asthma medication measure was met rather than the ratio measure. Additionally, models using the controller medication measure had greater areas under the ROC curve and smaller deviances than models using the ratio measure. Both administrative measures of asthma care quality were associated with lower odds of ED utilization. The controller medication measure of asthma care quality may be better than the ratio measure in relation to emergency asthma care utilization by Medicaid beneficiaries.

Individualization and quality improvement: two new scales to complement measurement of program fidelity.

PubMed

Bond, Gary R; Drake, Robert E; Rapp, Charles A; McHugo, Gregory J; Xie, Haiyi

2009-09-01

Fidelity scales have been widely used to assess program adherence to the principles of an evidence-based practice, but they do not measure important aspects of quality of care. Pragmatic scales measuring clinical quality of services are needed to complement fidelity scales measuring structural aspects of program implementation. As part of the instrumentation developed for the National Implementing Evidence-Based Practices Project, we piloted a new instrument with two 5-item quality scales, Individualization (a client-level quality scale) and Quality Improvement (an organizational-level quality scale). Pairs of independent fidelity assessors conducted fidelity reviews in 49 sites in 8 states at baseline and at four subsequent 6-month intervals over a 2-year follow-up period. The assessors followed a standardized protocol to administer these quality scales during daylong site visits; during these same visits they assessed programs on fidelity to the evidence-based practice that the site was seeking to implement. Assessors achieved acceptable interrater reliability for both Individualization and Quality Improvement. Principal components factor analysis confirmed the 2-scale structure. The two scales were modestly correlated with each other and with the evidence-based practice fidelity scales. Over the first year, Individualization and Quality Improvement improved, but showed little or no improvement during the last year of follow-up. The two newly developed scales showed adequate psychometric properties in this preliminary study, but further research is needed to assess their validity and utility in routine clinical practice.

Air quality and ventilation fan control based on aerosol measurement in the bi-directional undersea Bømlafjord tunnel.

PubMed

Indrehus, Oddny; Aralt, Tor Tybring

2005-04-01

Aerosol, NO and CO concentration, temperature, air humidity, air flow and number of running ventilation fans were measured by continuous analysers every minute for a whole week for six different one-week periods spread over ten months in 2001 and 2002 at measuring stations in the 7860 m long tunnel. The ventilation control system was mainly based on aerosol measurements taken by optical scatter sensors. The ventilation turned out to be satisfactory according to Norwegian air quality standards for road tunnels; however, there was some uncertainty concerning the NO2 levels. The air humidity and temperature inside the tunnel were highly influenced by the outside metrological conditions. Statistical models for NO concentration were developed and tested; correlations between predicted and measured NO were 0.81 for a partial least squares regression (PLS1) model based on CO and aerosol, and 0.77 for a linear regression model based only on aerosol. Hence, the ventilation control system should not solely be based on aerosol measurements. Since NO2 is the hazardous polluter, modelling NO2 concentration rather than NO should be preferred in any further optimising of the ventilation control.

Does adding clinical data to administrative data improve agreement among hospital quality measures?

PubMed

Hanchate, Amresh D; Stolzmann, Kelly L; Rosen, Amy K; Fink, Aaron S; Shwartz, Michael; Ash, Arlene S; Abdulkerim, Hassen; Pugh, Mary Jo V; Shokeen, Priti; Borzecki, Ann

2017-09-01

Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA). For patients admitted for acute myocardial infarction (AMI), heart failure (HF) and pneumonia we examined changes in hospital performance on 30-d mortality and 30-d readmission rates as a result of adding clinical data to administrative data. We evaluated whether this enhancement yielded improved measures of hospital quality, based on concordance with other hospital quality indicators. For 30-d mortality, data enhancement improved model performance, and significantly changed hospital performance profiles; for 30-d readmission, the impact was modest. Concordance between enhanced measures of both outcomes, and with other hospital quality measures - including Joint Commission process measures, VA Surgical Quality Improvement Program (VASQIP) mortality and morbidity, and case volume - remained poor. Adding laboratory tests and vital signs to measure hospital performance on mortality and readmission did not improve the poor rates of agreement across hospital quality indicators in the VA. Efforts to improve risk adjustment models should continue; however, evidence of validation should precede their use as reliable measures of quality. Published by Elsevier Inc.

Quality based approach for adaptive face recognition

NASA Astrophysics Data System (ADS)

Abboud, Ali J.; Sellahewa, Harin; Jassim, Sabah A.

2009-05-01

Recent advances in biometric technology have pushed towards more robust and reliable systems. We aim to build systems that have low recognition errors and are less affected by variation in recording conditions. Recognition errors are often attributed to the usage of low quality biometric samples. Hence, there is a need to develop new intelligent techniques and strategies to automatically measure/quantify the quality of biometric image samples and if necessary restore image quality according to the need of the intended application. In this paper, we present no-reference image quality measures in the spatial domain that have impact on face recognition. The first is called symmetrical adaptive local quality index (SALQI) and the second is called middle halve (MH). Also, an adaptive strategy has been developed to select the best way to restore the image quality, called symmetrical adaptive histogram equalization (SAHE). The main benefits of using quality measures for adaptive strategy are: (1) avoidance of excessive unnecessary enhancement procedures that may cause undesired artifacts, and (2) reduced computational complexity which is essential for real time applications. We test the success of the proposed measures and adaptive approach for a wavelet-based face recognition system that uses the nearest neighborhood classifier. We shall demonstrate noticeable improvements in the performance of adaptive face recognition system over the corresponding non-adaptive scheme.

Cellular-enabled water quality measurements

NASA Astrophysics Data System (ADS)

Zhao, Y.; Kerkez, B.

2013-12-01

While the past decade has seen significant improvements in our ability to measure nutrients and other water quality parameters, the use of these sensors has yet to gain traction due to their costprohibitive nature and deployment expertise required on the part of researchers. Furthermore, an extra burden is incurred when real-time data access becomes an experimental requirement. We present an open-source hardware design to facilitate the real-time, low-cost, and robust measurements of water quality across large urbanized areas. Our hardware platform interfaces an embedded, vastly configurable, high-precision, ultra-low power measurement system, with a low-power cellular module. Each sensor station is configured with an IP address, permitting reliable streaming of sensor data to off-site locations as measurements are made. We discuss the role of high-quality hardware components during extreme event scenarios, and present preliminary performance metrics that validate the ability of the platform to provide streaming access to sensor measurements.

Measuring Inpatient Rehabilitation Facility Quality of Care: Discharge Self-Care Functional Status Quality Measure.

PubMed

Pardasaney, Poonam K; Deutsch, Anne; Iriondo-Perez, Jeniffer; Ingber, Melvin J; McMullen, Tara

2018-06-01

To describe the calculation and psychometric properties of the discharge self-care functional status quality measure implemented in the Centers for Medicare & Medicaid Services' (CMS) Inpatient Rehabilitation Facility (IRF) Quality Reporting Program on October 1, 2016. Medicare fee-for-service (FFS) patients from 38 IRFs that participated in the CMS Post-Acute Care Payment Reform Demonstration were included in this cohort study. Data came from the Continuity Assessment Record and Evaluation Item Set, IRF-Patient Assessment Instrument, and Medicare claims. For each patient, we calculated an expected discharge self-care score, risk-adjusted for demographic and baseline clinical characteristics. The performance score of each IRF equaled the percentage of patient stays where the observed discharge self-care score met or exceeded the expected score. We assessed the measure's discriminatory ability across IRFs and reliability. IRFs. Medicare FFS patients aged ≥21 years (N=4769). Not applicable. Facility-level discharge self-care quality measure performance score. A total of 4769 patient stays were included; 57% of stays were in women, and 12.1% were in patients aged <65 years. Stroke was the most common diagnosis (21.8%). The mean±SD performance score was 55.1%±16.6% (range, 25.8%-100%). About 54% of IRFs had scores significantly different from the percentage of stays that met or exceeded the expected discharge self-care score in the overall demonstration sample. The quality measure showed strong reliability, with intraclass correlation coefficients of .91. The discharge self-care quality measure showed strong discriminatory ability and reliability, representing an important initial step in evaluation of IRF self-care outcomes. A wide range in performance scores suggested a gap in quality of care across IRFs. Future work should include testing the measure with nationwide data from all IRFs. Published by Elsevier Inc.

A review of preference-based measures for the assessment of quality of life in children and adolescents with cerebral palsy.

PubMed

Mpundu-Kaambwa, Christine; Chen, Gang; Huynh, Elisabeth; Russo, Remo; Ratcliffe, Julie

2018-07-01

To examine the psychometric properties and suitability for use within the context of cerebral palsy research in children and adolescents of generic preference-based outcome measures (PROMs). Nine electronic databases were searched in this systematic review. The consensus-based standards for the selection of health measurement instruments (COSMIN) checklist were used to measure the psychometric properties of the PROMs. A meta-analysis was used to pool correlation coefficients for convergent validity using the Schmidt-Hunter method. Heterogeneity was assessed using the I-squared statistic (I 2 ). Four preference-based PROMs were identified from eight studies: Health Utilities Index-Mark 2 and 3 (HUI-2 and HUI-3, respectively), the Assessment Quality of Life-4 dimension (AQoL-4D) and the EuroQol-5 dimension 3 level (EQ-5D-3L). Only the HUI system was primarily developed for application with children/adolescents though health-state values for scoring the PROM were elicited from adults. The HUI-3 covered the most relevant constructs though it excludes important modules of health-related quality of life (HRQOL) such as activity limitations and participation restrictions. In terms of psychometric properties, evidence was presented for only five of COSMIN measurement properties: reliability (HUI3), measurement error (HUI-3), content validity (HUI-2 and HUI-3), Hypotheses testing (HUI-3 and AQoL-4D) and criterion validity (HUI-3). No papers reported on internal consistency, structural validity, cross-cultural validity or responsiveness of the preference-based measures in children and adolescents with cerebral palsy. This review highlights the dearth in studies using preference-based PROMs to measure HRQOL associated with cerebral palsy in children and adolescents. The HUI-3 demonstrated the strongest psychometric properties, though it does not cover all dimensions relevant to this population.

Paths to partnership: Veterans Health Administration's Journey in pilot testing breast cancer care quality measures.

PubMed

Hogg, Lori Hoffman

2014-01-01

Prioritizing personalized, proactive, patient-driven health care is among the Veterans Health Administration's (VHA's) transformational initiatives. As one of the largest integrated healthcare systems, the VHA sets standards for performance measures and outcomes achieved in quality of care. Evidence-based practice (EBP) is a hallmark in oncology nursing care. EBP can be linked to positive outcomes and improving quality that can be influenced directly by nursing interventions. VHA oncology nurses had the opportunity to partner with the Oncology Nursing Society (ONS), ONS Foundation, and the Joint Commission in the multiyear development of a comprehensive approach to quality cancer care. Building on a platform of existing measures and refining measurement sets culminated in testing evidence-based, nursing-sensitive quality measures for reliability through the ONS Foundation-supported Breast Cancer Care (BCC) Quality Measures Set. The BCC Measures afforded the VHA to have its many sites collectively assess documentation of the symptoms of patients with breast cancer, the use of colony-stimulating factors, and education about neutropenia precautions provided. Parallel paths of the groups, seeking evidence-based measures, led to the perfect partnership in the VHA's journey in pilot testing the BCC Measures in veterans with breast cancer. This generated further quality assessments and continuous improvement projects for spread and sustainability throughout the VHA.

Guiding principles and checklist for population-based quality metrics.

PubMed

Krishnan, Mahesh; Brunelli, Steven M; Maddux, Franklin W; Parker, Thomas F; Johnson, Douglas; Nissenson, Allen R; Collins, Allan; Lacson, Eduardo

2014-06-06

The Centers for Medicare and Medicaid Services oversees the ESRD Quality Incentive Program to ensure that the highest quality of health care is provided by outpatient dialysis facilities that treat patients with ESRD. To that end, Centers for Medicare and Medicaid Services uses clinical performance measures to evaluate quality of care under a pay-for-performance or value-based purchasing model. Now more than ever, the ESRD therapeutic area serves as the vanguard of health care delivery. By translating medical evidence into clinical performance measures, the ESRD Prospective Payment System became the first disease-specific sector using the pay-for-performance model. A major challenge for the creation and implementation of clinical performance measures is the adjustments that are necessary to transition from taking care of individual patients to managing the care of patient populations. The National Quality Forum and others have developed effective and appropriate population-based clinical performance measures quality metrics that can be aggregated at the physician, hospital, dialysis facility, nursing home, or surgery center level. Clinical performance measures considered for endorsement by the National Quality Forum are evaluated using five key criteria: evidence, performance gap, and priority (impact); reliability; validity; feasibility; and usability and use. We have developed a checklist of special considerations for clinical performance measure development according to these National Quality Forum criteria. Although the checklist is focused on ESRD, it could also have broad application to chronic disease states, where health care delivery organizations seek to enhance quality, safety, and efficiency of their services. Clinical performance measures are likely to become the norm for tracking performance for health care insurers. Thus, it is critical that the methodologies used to develop such metrics serve the payer and the provider and most importantly, reflect

Guiding Principles and Checklist for Population-Based Quality Metrics

PubMed Central

Brunelli, Steven M.; Maddux, Franklin W.; Parker, Thomas F.; Johnson, Douglas; Nissenson, Allen R.; Collins, Allan; Lacson, Eduardo

2014-01-01

The Centers for Medicare and Medicaid Services oversees the ESRD Quality Incentive Program to ensure that the highest quality of health care is provided by outpatient dialysis facilities that treat patients with ESRD. To that end, Centers for Medicare and Medicaid Services uses clinical performance measures to evaluate quality of care under a pay-for-performance or value-based purchasing model. Now more than ever, the ESRD therapeutic area serves as the vanguard of health care delivery. By translating medical evidence into clinical performance measures, the ESRD Prospective Payment System became the first disease-specific sector using the pay-for-performance model. A major challenge for the creation and implementation of clinical performance measures is the adjustments that are necessary to transition from taking care of individual patients to managing the care of patient populations. The National Quality Forum and others have developed effective and appropriate population-based clinical performance measures quality metrics that can be aggregated at the physician, hospital, dialysis facility, nursing home, or surgery center level. Clinical performance measures considered for endorsement by the National Quality Forum are evaluated using five key criteria: evidence, performance gap, and priority (impact); reliability; validity; feasibility; and usability and use. We have developed a checklist of special considerations for clinical performance measure development according to these National Quality Forum criteria. Although the checklist is focused on ESRD, it could also have broad application to chronic disease states, where health care delivery organizations seek to enhance quality, safety, and efficiency of their services. Clinical performance measures are likely to become the norm for tracking performance for health care insurers. Thus, it is critical that the methodologies used to develop such metrics serve the payer and the provider and most importantly, reflect

Quality Measures for Hospice and Palliative Care: Piloting the PEACE Measures

PubMed Central

Rokoske, Franziska S.; Durham, Danielle; Cagle, John G.; Hanson, Laura C.

2014-01-01

Abstract Background: The Carolinas Center for Medical Excellence launched the PEACE project in 2006, under contract with the Centers for Medicare & Medicaid Services (CMS), to identify, develop, and pilot test quality measures for hospice and palliative care programs. Objectives: The project collected pilot data to test the usability and feasibility of potential quality measures and data collection processes for hospice and palliative care programs. Settings/subjects: Twenty-two hospices participating in a national Quality Improvement Collaborative (QIC) submitted data from 367 chart reviews for pain care and 45 chart reviews for nausea care. Fourteen additional hospices completed a one-time data submission of 126 chart reviews on 60 potential patient-level quality measures across eight domains of care and an organizational assessment evaluating structure and processes of care. Design: Usability was assessed by examining the range, variability and size of the populations targeted by each quality measure. Feasibility was assessed during the second pilot study by surveying data abstractors about the abstraction process and examining the rates of missing data. The impact of data collection processes was assessed by comparing results obtained using different processes. Results: Measures shown to be both usable and feasible included: screening for physical symptoms on admission and documentation of treatment preferences. Methods of data collection and measure construction appear to influence observed rates of quality of care. Conclusions: We successfully identified quality measures with potential for use in hospices and palliative care programs. Future research is needed to understand whether these measures are sensitive to quality improvement interventions. PMID:24921162

Quality Assurance of Chemical Measurements.

ERIC Educational Resources Information Center

Taylor, John K.

1981-01-01

Reviews aspects of quality control (methods to control errors) and quality assessment (verification that systems are operating within acceptable limits) including an analytical measurement system, quality control by inspection, control charts, systematic errors, and use of SRMs, materials for which properties are certified by the National Bureau…

[Quality measurement using administrative data in mandatory quality assurance].

PubMed

Heller, Günther; Szecsenyi, Joachim; Willms, Gerald; Broge, Björn

2014-01-01

For several years, the use of administrative data in mandatory quality measurement has been requested by several stakeholders in Germany. Main advantages of using administrative data include the reduction of documentary expenditures and the possibility to perform longitudinal quality analyses across different healthcare units. After a short introduction, a brief overview of the current use of administrative data for mandatory quality assurance as well as current developments is given, which will then be further exemplified by decubital ulcer prophylaxis. By using administrative data coding expenditures in this clinical area could be reduced by nine million data fields. At the same time the population analysed was expanded resulting in a more than tenfold increase in potentially quality-relevant events. Finally, perspectives, further developments, possibilities as well as limits of quality measurement with administrative data are discussed. Copyright © 2014. Published by Elsevier GmbH.

Rural relevant quality measures for critical access hospitals.

PubMed

Casey, Michelle M; Moscovice, Ira; Klingner, Jill; Prasad, Shailendra

2013-01-01

To identify current and future relevant quality measures for Critical Access Hospitals (CAHs). Three criteria (patient volume, internal usefulness for quality improvement, and external usefulness for public reporting and payment reform) were used to analyze quality measures for their relevance for CAHs. A 6-member panel with expertise in rural hospital quality measurement and improvement provided input regarding the final measure selection. The relevant quality measures for CAHs include measures that are ready for reporting now and measures that need specifications to be finalized and/or a data reporting mechanism to be established. They include inpatient measures for specific medical conditions, global measures that address appropriate care across multiple medical conditions, and Emergency Department measures. All CAHs should publicly report on relevant quality measures. Acceptance of a single consolidated set of quality measures with common specifications for CAHs by all entities involved in regulation, accreditation, and payment; a phased process to implement the relevant measures; and the provision of technical assistance would help CAHs meet the challenge of reporting. © 2012 National Rural Health Association.

Assessing the Quality of Problems in Problem-Based Learning

ERIC Educational Resources Information Center

Sockalingam, Nachamma; Rotgans, Jerome; Schmidt, Henk

2012-01-01

This study evaluated the construct validity and reliability of a newly devised 32-item problem quality rating scale intended to measure the quality of problems in problem-based learning. The rating scale measured the following five characteristics of problems: the extent to which the problem (1) leads to learning objectives, (2) is familiar, (3)…

Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa

PubMed Central

Tripathi, Vandana; Stanton, Cynthia; Strobino, Donna; Bartlett, Linda

2015-01-01

Background High quality care is crucial in ensuring that women and newborns receive interventions that may prevent and treat birth-related complications. As facility deliveries increase in developing countries, there are concerns about service quality. Observation is the gold standard for clinical quality assessment, but existing observation-based measures of obstetric quality of care are lengthy and difficult to administer. There is a lack of consensus on quality indicators for routine intrapartum and immediate postpartum care, including essential newborn care. This study identified key dimensions of the quality of the process of intrapartum and immediate postpartum care (QoPIIPC) in facility deliveries and developed a quality assessment measure representing these dimensions. Methods and Findings Global maternal and neonatal care experts identified key dimensions of QoPIIPC through a modified Delphi process. Experts also rated indicators of these dimensions from a comprehensive delivery observation checklist used in quality surveys in sub-Saharan African countries. Potential QoPIIPC indices were developed from combinations of highly-rated indicators. Face, content, and criterion validation of these indices was conducted using data from observations of 1,145 deliveries in Kenya, Madagascar, and Tanzania (including Zanzibar). A best-performing index was selected, composed of 20 indicators of intrapartum/immediate postpartum care, including essential newborn care. This index represented most dimensions of QoPIIPC and effectively discriminated between poorly and well-performed deliveries. Conclusions As facility deliveries increase and the global community pays greater attention to the role of care quality in achieving further maternal and newborn mortality reduction, the QoPIIPC index may be a valuable measure. This index complements and addresses gaps in currently used quality assessment tools. Further evaluation of index usability and reliability is needed. The

Thin-slice vision: inference of confidence measure from perceptual video quality

NASA Astrophysics Data System (ADS)

Hameed, Abdul; Balas, Benjamin; Dai, Rui

2016-11-01

There has been considerable research on thin-slice judgments, but no study has demonstrated the predictive validity of confidence measures when assessors watch videos acquired from communication systems, in which the perceptual quality of videos could be degraded by limited bandwidth and unreliable network conditions. This paper studies the relationship between high-level thin-slice judgments of human behavior and factors that contribute to perceptual video quality. Based on a large number of subjective test results, it has been found that the confidence of a single individual present in all the videos, called speaker's confidence (SC), could be predicted by a list of features that contribute to perceptual video quality. Two prediction models, one based on artificial neural network and the other based on a decision tree, were built to predict SC. Experimental results have shown that both prediction models can result in high correlation measures.

WSN based indoor air quality monitoring in classrooms

NASA Astrophysics Data System (ADS)

Wang, S. K.; Chew, S. P.; Jusoh, M. T.; Khairunissa, A.; Leong, K. Y.; Azid, A. A.

2017-03-01

Indoor air quality monitoring is essential as the human health is directly affected by indoor air quality. This paper presents the investigations of the impact of undergraduate students' concentration during lecture due to the indoor air quality in classroom. Three environmental parameters such as temperature, relative humidity and concentration of carbon dioxide are measured using wireless sensor network based air quality monitoring system. This simple yet reliable system is incorporated with DHT-11 and MG-811 sensors. Two classrooms were selected to install the monitoring system. The level of indoor air quality were measured and students' concentration was assessed using intelligent test during normal lecturing section. The test showed significant correlation between the collected environmental parameters and the students' level of performances in their study.

Evidence-based quality indicators for stroke rehabilitation.

PubMed

Grube, Maike M; Dohle, Christian; Djouchadar, Diana; Rech, Petra; Bienek, Karen; Dietz-Fricke, Ursula; Jöbges, Michael; Kohler, Martin; Missala, Isabelle; Schönherr, Bertram; Werner, Cordula; Zeytountchian, Helen; Wissel, Jörg; Heuschmann, Peter U

2012-01-01

Previous stroke performance measures consider aspects of postacute treatment, but there are only few specific quality indicators or standards for poststroke rehabilitation. The purpose of this study was to develop a set of indicators for measuring the quality of postacute stroke rehabilitation in inpatient and outpatient facilities using a standardized evidence-based approach. Quality indicators were developed between January 2009 and February 2010 by an interdisciplinary board of healthcare professionals from rehabilitation centers cooperating in the Berlin Stroke Alliance. The Berlin Stroke Alliance is a regional network of >40 providers of acute treatment, rehabilitation, and aftercare aiming to improve stroke services within Berlin and Brandenburg. The indicators were developed according to published international recommendations and predefined methodological requirements. The applied standards included a systematic literature review, a rating of published evidence, an external peer review, and the evaluation in a pilot study before implementation. Of an initial list of 33 indicators, 20 indicators were rated as being appropriate. After completion of the pilot phase, we agreed on a set of 18 indicators. The indicators measure processes (9 indicators), outcomes (5 indicators), and structures (4 indicators) in the following domains of stroke rehabilitation: completion of diagnostics; secondary prevention; cognition and affect; speech and swallowing; management of complications; sensorimotor functions and mobility; discharge status; and aftercare. Documentation of evidence-based quality indicators for stroke rehabilitation in clinical routine is feasible and can serve as a first step toward implementing standardized cross-institutional quality assurance programs for stroke rehabilitation.

Quality measurement and improvement in liver transplantation.

PubMed

Mathur, Amit K; Talwalkar, Jayant

2018-06-01

There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Measurement properties of adult quality-of-life measurement instruments for eczema: protocol for a systematic review.

PubMed

Apfelbacher, Christian J; Heinl, Daniel; Prinsen, Cecilia A C; Deckert, Stefanie; Chalmers, Joanne; Ofenloch, Robert; Humphreys, Rosemary; Sach, Tracey; Chamlin, Sarah; Schmitt, Jochen

2015-04-16

Eczema is a common chronic or chronically relapsing skin disease that has a substantial impact on quality of life (QoL). By means of a consensus-based process, the Harmonising Outcome Measures in Eczema (HOME) initiative has identified QoL as one of the four core outcome domains to be assessed in all eczema trials (Allergy 67(9):1111-7, 2012). Various measurement instruments exist to measure QoL in adults with eczema, but there is a great variability in both content and quality (for example, reliability and validity) of the instruments used, and it is not always clear if the best instrument is being used. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the measurement properties of the existing measurement instruments that were developed and/or validated for the measurement of patient-reported QoL in adults with eczema. This study is a systematic review of the measurement properties of patient-reported measures of QoL developed and/or validated for adults with eczema. Medline via PubMed and EMBASE will be searched using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing, or comparing measurement properties of QoL instruments for adult patients with eczema. Eligibility assessment and data abstraction will be performed independently by two reviewers. Evidence tables will be generated for study characteristics, instrument characteristics, measurement properties, and interpretability. The quality of the measurement properties will be assessed using predefined criteria. Methodological quality of studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis will be undertaken if more than one study has investigated a particular measurement property. The proposed systematic review will produce a comprehensive assessment of measurement properties of existing QoL instruments in

Defining Multiple Chronic Conditions for Quality Measurement.

PubMed

Drye, Elizabeth E; Altaf, Faseeha K; Lipska, Kasia J; Spatz, Erica S; Montague, Julia A; Bao, Haikun; Parzynski, Craig S; Ross, Joseph S; Bernheim, Susannah M; Krumholz, Harlan M; Lin, Zhenqiu

2018-02-01

Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized rates of unplanned admissions for Accountable Care Organizations. To define the MCC cohort we: (1) identified potential chronic conditions; (2) set criteria for cohort conditions based on MCC framework and measure concept; (3) applied the criteria informed by empirical analysis, experts, and the public; (4) described "broader" and "narrower" cohorts; and (5) selected final cohort with stakeholder input. Subjects were patients with chronic conditions. Participants included 21.8 million Medicare fee-for-service beneficiaries in 2012 aged 65 years and above with ≥1 of 27 Medicare Chronic Condition Warehouse condition(s). In total, 10 chronic conditions were identified based on our criteria; 8 of these 10 were associated with notably increased admission risk when co-occurring. A broader cohort (2+ of the 8 conditions) included 4.9 million beneficiaries (23% of total cohort) with an admission rate of 70 per 100 person-years. It captured 53% of total admissions. The narrower cohort (3+ conditions) had 2.2 million beneficiaries (10%) with 100 admissions per 100 person-years and captured 32% of admissions. Most stakeholders viewed the broader cohort as best aligned with the measure concept. By systematically narrowing chronic conditions to those most relevant to the outcome and incorporating stakeholder input, we defined an MCC admission measure cohort supported by stakeholders. This approach can be used as a model for other MCC outcome measures.

RAPID, PCR-BASED METHODS FOR MEASURING THE QUALITY OF BATHING BEACH WATERS

EPA Science Inventory

The current methods for measuring the quality of recreational waters were developed in the 1970's and were recommended to the States by EPA in 1986. These methods detect and quantify Escherichia coli and enterococci, two bacteria that are consistently associated with fecal wast...

What Is Nursing Home Quality and How Is It Measured?

PubMed Central

Castle, Nicholas G.; Ferguson, Jamie C.

2010-01-01

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO) model is used to frame the discussion. Current quality indicators and quality initiatives are discussed, including those included in the Facility Quality Indicator Profile Report, Nursing Home Compare, deficiency citations included as part of Medicare/Medicaid certification, and the Advancing Excellence Campaign. Results: Current quality indicators are presented as a mix of structural, process, and outcome measures, each of which has noted advantages and disadvantages. We speculate on steps that need to be taken in the future to address and potentially improve the quality of care provided by nursing homes, including report cards, pay for performance, market-based incentives, and policy developments in the certification process. Areas for future research are identified throughout the review. Implications: We conclude that improvements in nursing home quality have likely occurred, but improvements are still needed. PMID:20631035

Machine Vision-Based Measurement Systems for Fruit and Vegetable Quality Control in Postharvest.

PubMed

Blasco, José; Munera, Sandra; Aleixos, Nuria; Cubero, Sergio; Molto, Enrique

Individual items of any agricultural commodity are different from each other in terms of colour, shape or size. Furthermore, as they are living thing, they change their quality attributes over time, thereby making the development of accurate automatic inspection machines a challenging task. Machine vision-based systems and new optical technologies make it feasible to create non-destructive control and monitoring tools for quality assessment to ensure adequate accomplishment of food standards. Such systems are much faster than any manual non-destructive examination of fruit and vegetable quality, thus allowing the whole production to be inspected with objective and repeatable criteria. Moreover, current technology makes it possible to inspect the fruit in spectral ranges beyond the sensibility of the human eye, for instance in the ultraviolet and near-infrared regions. Machine vision-based applications require the use of multiple technologies and knowledge, ranging from those related to image acquisition (illumination, cameras, etc.) to the development of algorithms for spectral image analysis. Machine vision-based systems for inspecting fruit and vegetables are targeted towards different purposes, from in-line sorting into commercial categories to the detection of contaminants or the distribution of specific chemical compounds on the product's surface. This chapter summarises the current state of the art in these techniques, starting with systems based on colour images for the inspection of conventional colour, shape or external defects and then goes on to consider recent developments in spectral image analysis for internal quality assessment or contaminant detection.

Initial investigation of dietitian perception of plant-based protein quality.

PubMed

Hughes, Glenna J; Kress, Kathleen S; Armbrecht, Eric S; Mukherjea, Ratna; Mattfeldt-Beman, Mildred

2014-07-01

Interest in plant-based diets is increasing, evidenced by scientific and regulatory recommendations, including Dietary Guidelines for Americans. Dietitians provide guidance in dietary protein selection but little is known about how familiar dietitians are with the quality of plant versus animal proteins or methods for measuring protein quality. Likewise, there is a need to explore their beliefs related to dietary recommendations. The aim of this study was to assess dietitians' perceptions of plant-based protein quality and to determine if these are affected by demographic factors such as age and dietary practice group (DPG) membership. This was a cross-sectional design using an online survey. The survey was sent to all members of the Missouri Dietetic Association. All completed surveys (136) were analyzed. The main outcome measures were responses to belief and knowledge questions about the protein quality of plant-based diets, along with demographic information including age and DPG membership. Descriptive statistics and frequencies were determined, and chi-square analysis was used to determine the associations between belief and knowledge responses and demographic characteristics. Responses to belief statements suggested a high level of support for plant-based diets. No associations were found between any of the belief questions and demographic factors. A majority of respondents were not familiar with protein quality determination methods that are currently recognized by global regulatory and advisory agencies. Potential barriers identified in shifting to a more plant-based diet were lack of interest and perceived difficulty. Knowledge among dietitians of plant-based protein quality in general, and methods of protein quality measurement more specifically, needs to be addressed to enhance their knowledge base for making dietary protein recommendations. Two potential avenues for training are university curricula and continuing education opportunities provided to

Measuring quality of dental care: Caries prevention services for children.

PubMed

Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

2015-08-01

The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P < .01); 18% to 37% of children with an elevated risk of experiencing caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P < .01) compared with sealants for 10- to 14-year-olds (range, 8.4-11.1%; χ(2) = 22.7; P < .01), overall sealant placement rates were lower for 10- to 14-year-olds. These evidence-based, caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention

An intelligent case-adjustment algorithm for the automated design of population-based quality auditing protocols.

PubMed

Advani, Aneel; Jones, Neil; Shahar, Yuval; Goldstein, Mary K; Musen, Mark A

2004-01-01

We develop a method and algorithm for deciding the optimal approach to creating quality-auditing protocols for guideline-based clinical performance measures. An important element of the audit protocol design problem is deciding which guide-line elements to audit. Specifically, the problem is how and when to aggregate individual patient case-specific guideline elements into population-based quality measures. The key statistical issue involved is the trade-off between increased reliability with more general population-based quality measures versus increased validity from individually case-adjusted but more restricted measures done at a greater audit cost. Our intelligent algorithm for auditing protocol design is based on hierarchically modeling incrementally case-adjusted quality constraints. We select quality constraints to measure using an optimization criterion based on statistical generalizability coefficients. We present results of the approach from a deployed decision support system for a hypertension guideline.

Quality Measures for the Care of Adult Patients with Obstructive Sleep Apnea

PubMed Central

Aurora, R. Nisha; Collop, Nancy A.; Jacobowitz, Ofer; Thomas, Sherene M.; Quan, Stuart F.; Aronsky, Amy J.

2015-01-01

Obstructive sleep apnea (OSA) is a prevalent disorder associated with a multitude of adverse outcomes when left untreated. There is significant heterogeneity in the evaluation and management of OSA resulting in variation in cost and outcomes. Thus, the goal for developing these measures was to have a way to evaluate the outcomes and reliability of the processes involved with the standard care approaches used in the diagnosis and management of OSA. The OSA quality care measures presented here focus on both outcomes and processes. The AASM commissioned the Adult OSA Quality Measures Workgroup to develop quality care measures aimed at optimizing care for adult patients with OSA. These quality care measures developed by the Adult OSA Quality Measures Workgroup are an extension of the original Centers for Medicare & Medicaid Services (CMS) approved Physician Quality Reporting System (PQRS) measures group for OSA. The measures are based on the available scientific evidence, focus on public safety, and strive to improve quality of life and cardiovascular outcomes for individual OSA patients. The three outcomes that were selected were as follows: (1) improve disease detection and categorization; (2) improve quality of life; and (3) reduce cardiovascular risk. After selecting these relevant outcomes, a total of ten process measures were chosen that could be applied and assessed for the purpose of accomplishing these outcomes. In the future, the measures described in this document may be reported through the PQRS in addition to, or as a replacement for, the current OSA measures group. The overall objective for the development of these measures is that implementation of these quality measures will result in improved patient outcomes, reduce the public health burden of OSA, and provide a measurable standard for evaluating and managing OSA. Citation: Aurora RN, Collop NA, Jacobowitz O, Thomas SM, Quan SF, Aronsky AJ. Quality measures for the care of adult patients with

Ground-based & satellite DOAS measurements integration for air quality evaluation/forecast management in the frame of QUITSAT Project.

NASA Astrophysics Data System (ADS)

Kostadinov, Ivan; Petritoli, Andrea; Giovanelli, Giorgio; Masieri, Samuele; Premuda, Margarita; Bortoli, Daniele; Ravegnani, Fabrizio; Palazzi, Elisa

The observations of the Earth's atmosphere from space provide excellent opportunities for the exploration of the sophisticated physical-chemical processes on both global and regional scales. The major interest during the last three decades was focused mainly on the stratosphere and the ozone depletion. More recently the continuous improvements of satellite sensors have revealed new opportunities for larger applications of space observations, attracting scientific interest to the lower troposphere and air quality issues. The air quality depends strongly on the anthropogenic activity and therefore regional environmental agencies along with policy makers are in need of appropriate means for its continuous monitoring and control to ensure the adoption of the most appropriate actions. The goal of the pilot project QUITSAT, funded by the Italian Space Agency, is to develop algorithms and procedures for the evaluation and prediction of the air quality in Lombardia and Emilia-Romagna regions (Italy) by means of integrating satellite observations with ground-based in-situ and remote sensing measurements. This work presents dedicated Differential Optical Absorption Spectroscopy (DOAS) measurements performed during the summer of 2007 and the winter of 2008. One of the DOAS instruments operate at Mt.Cimone station (2165m a.s.l) and the other two instruments conducted measurements in/near Bologna (90 m. a.s.l). Different observational geometry was adopted (zenith-sky, multi-axis and long-path) aimed to provide tropospheric NO2 columns and O3, SO2 and HCHO concentrations at ground level as an input data for QUITSAT procedures. Details of the instruments, the radiative transfer model used and the algorithms for retrieving and calculation of the target gases concentrations are presented. The obtained experimental results are correlated with the corresponding ones retrieved from SCIAMACHY /ENVISAT observations during the overpasses above the ground-based instruments. The analysis

Including quality attributes in efficiency measures consistent with net benefit: creating incentives for evidence based medicine in practice.

PubMed

Eckermann, Simon; Coelli, Tim

2013-01-01

Evidence based medicine supports net benefit maximising therapies and strategies in processes of health technology assessment (HTA) for reimbursement and subsidy decisions internationally. However, translation of evidence based medicine to practice is impeded by efficiency measures such as cost per case-mix adjusted separation in hospitals, which ignore health effects of care. In this paper we identify a correspondence method that allows quality variables under control of providers to be incorporated in efficiency measures consistent with maximising net benefit. Including effects framed from a disutility bearing (utility reducing) perspective (e.g. mortality, morbidity or reduction in life years) as inputs and minimising quality inclusive costs on the cost-disutility plane is shown to enable efficiency measures consistent with maximising net benefit under a one to one correspondence. The method combines advantages of radial properties with an appropriate objective of maximising net benefit to overcome problems of inappropriate objectives implicit with alternative methods, whether specifying quality variables with utility bearing output (e.g. survival, reduction in morbidity or life years), hyperbolic or exogenous variables. This correspondence approach is illustrated in undertaking efficiency comparison at a clinical activity level for 45 Australian hospitals allowing for their costs and mortality rates per admission. Explicit coverage and comparability conditions of the underlying correspondence method are also shown to provide a robust framework for preventing cost-shifting and cream-skimming incentives, with appropriate qualification of analysis and support for data linkage and risk adjustment where these conditions are not satisfied. Comparison on the cost-disutility plane has previously been shown to have distinct advantages in comparing multiple strategies in HTA, which this paper naturally extends to a robust method and framework for comparing efficiency of

A robot control formalism based on an information quality concept

NASA Technical Reports Server (NTRS)

Ekman, A.; Torne, A.; Stromberg, D.

1994-01-01

A relevance measure based on Jaynes maximum entropy principle is introduced. Information quality is the conjunction of accuracy and relevance. The formalism based on information quality is developed for one-agent applications. The robot requires a well defined working environment where properties of each object must be accurately specified.

History and background of quality measurement.

PubMed

Chun, Jonathan; Bafford, Andrea Chao

2014-03-01

Health care quality measurement has become increasingly emphasized, as providers and administrators respond to public and government demands for improved patient care. This article will review the evolution of surgical quality measurement and improvement from its infancy in the 1850s to the vast efforts being undertaken today.

Measurement properties of adult quality-of-life measurement instruments for eczema: a systematic review.

PubMed

Heinl, D; Prinsen, C A C; Deckert, S; Chalmers, J R; Drucker, A M; Ofenloch, R; Humphreys, R; Sach, T; Chamlin, S L; Schmitt, J; Apfelbacher, C

2016-03-01

The Harmonising Outcome Measures for Eczema (HOME) initiative has identified quality of life (QoL) as a core outcome domain to be evaluated in every eczema trial. It is unclear which of the existing QoL instruments is most appropriate for this domain. Thus, the aim of this review was to systematically assess the measurement properties of existing measurement instruments developed and/or validated for the measurement of QoL in adult eczema. We conducted a systematic literature search in PubMed and Embase identifying studies on measurement properties of adult eczema QoL instruments. For all eligible studies, we assessed the adequacy of the measurement properties and the methodological quality with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis summarizing findings from different studies was the basis to assign four degrees of recommendation (A-D). A total of 15 articles reporting on 17 instruments were included. No instrument fulfilled the criteria for category A. Six instruments were placed in category B, meaning that they have the potential to be recommended depending on the results of further validation studies. Three instruments had poor adequacy in at least one required adequacy criterion and were therefore put in category C. The remaining eight instruments were minimally validated and were thus placed in category D. Currently, no QoL instrument can be recommended for use in adult eczema. The Quality of Life Index for Atopic Dermatitis (QoLIAD) and the Dermatology Life Quality Index (DLQI) are recommended for further validation research. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Do prominent quality measurement surveys capture the concerns of persons with disability?

PubMed

Iezzoni, Lisa I; Marsella, Sarah A; Lopinsky, Tiffany; Heaphy, Dennis; Warsett, Kimberley S

2017-04-01

Demonstration programs nationwide aim to control costs and improve care for people dually-eligible for Medicare and Medicaid, including many persons with disability. Ensuring these initiatives maintain or improve care quality requires comprehensive evaluation of quality of care. To examine whether the common quality measures being used to evaluate the Massachusetts One Care duals demonstration program comprehensively address the concerns of persons with disability. Drawing upon existing conceptual frameworks, we developed a model of interrelationships of personal, health care, and environmental factors for achieving wellness for persons with disability. Based on this model, we specified a scheme to code individual quality measurement items and coded the items contained in 12 measures being used to assess Massachusetts One Care, which exclusively enrolls non-elderly adults with disability. Across these 12 measures, we assigned 376 codes to 302 items; some items received two codes. Taken together, the 12 measures contain items addressing most factors in our conceptual model that affect health care quality for persons with disability, including long-term services and supports. Some important gaps exist. No items examine sexual or reproductive health care, peer support, housing security, disability stigmatization, and specific services obtained outside the home like adult day care. Certain key concepts are covered only by a single or several of the 12 quality measures. Common quality metrics cover most - although not all-health care quality concerns of persons with disability. However, multiple different quality measures are required for this comprehensive coverage, raising questions about respondent burden. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality of Web-based information on cocaine addiction.

PubMed

Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Zullino, Daniele

2008-08-01

To evaluate the quality of web-based information on cocaine use and addiction and to investigate potential content quality indicators. Three keywords: cocaine, cocaine addiction and cocaine dependence were entered into two popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores aiding people without content expertise to assess quality of written health publication were used to verify their efficiency as quality indicators. Of the 120 websites identified, 61 were included. Most were commercial sites. The results of the study indicate low scores on each of the measures including content quality. A global score (the sum of accountability, interactivity, content quality and aesthetic criteria) appeared as a good content quality indicator. While cocaine education websites for patients are widespread, their global quality is poor. There is a need for better evidence-based information about cocaine use and addiction on the web. The poor and variable quality of web-based information and its possible impact on physician-patient relationship argue for a serious provider for patient talk about the health information found on Internet. Internet sites could improve their content using the global score as a quality indicator.

Measuring wood quality in standing trees--a review

Treesearch

Mark Rudnicki; Xiping Wang; Robert J. Ross; R. Bruce Allison; Kevin Perzynski

2017-01-01

This report summarizes a state-of-the-art review conducted on the topic of field measurement of the quality of wood in trees. The foundation science of micro-resistance drilling and acoustic-based techniques for use with woody materials is presented, and use of these techniques for the detection of biodeterioration in wood is discussed. Quantification of the physical...

Quality-of-life measures for use within care homes: a systematic review of their measurement properties.

PubMed

Aspden, Trefor; Bradshaw, Siobhan A; Playford, E Diane; Riazi, Afsane

2014-09-01

the aims of this review were (i) to identify quality-of-life (QoL) measures which have had their measurement properties validated in people residing in care homes or nursing homes, and to critically compare and summarise these instruments and (ii) to make recommendations for measurement instruments. bibliographic databases PsycINFO, PubMed, Cochrane, CINAHL and Embase were searched for articles evaluating measurement properties of QoL instruments in people residing in care homes. Methodological quality of studies was assessed using the consensus-based standards for the selection of health measurement instruments checklist. Measurement properties of instruments were appraised using a systematic checklist. the search strategy resulted in 3252 unique citations, of which 15 articles were included in this review. These articles assessed 13 instruments, 8 of which were dementia or Alzheimer specific instruments. The QUALIDEM, a dementia-specific observational instrument, had the widest array of information available on its measurement properties, which were mostly satisfactory. Most measurement instruments lacked information on hypotheses testing and content validity. Information on responsiveness and measurement error was not available for any instrument. for people with dementia living in care homes, the QUALIDEM is recommended for measuring QoL. For residents without dementia, we recommend Kane et al.'s Psychosocial Quality of Life Domains questionnaire. Studies of higher methodological quality, assessing a wider range of measurement properties are needed to allow a more fully informed choice of QoL instrument. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Tale of Two Cities - HSI-DOAS Measurements of Air Quality

NASA Astrophysics Data System (ADS)

Graves, Rosemarie; Leigh, Roland; Anand, Jasdeep; McNally, Michael; Lawrence, James; Monks, Paul

2013-04-01

Differential Optical Absorption Spectroscopy is now commonly used as an air quality measuring system; primarily through the measurements of nitrogen dioxide (NO2) both as a ground-based and satellite technique. CityScan is a Hemispherical Scanning Imaging Differential Optical Absorption Spectrometer (HSI-DOAS) which has been optimised to measure concentrations of nitrogen dioxide. CityScan has a 95˚ field of view (FOV) between the zenith and 5˚ below the horizon. Across this FOV there are 128 resolved elements which are measured concurrently, the spectrometer is rotated azimuthally 1˚ per second providing full hemispherical coverage every 6 minutes. CityScan measures concentrations of nitrogen dioxide over specific lines of sight and due to the extensive field of view of the instrument this produces measurements which are representative over city-wide scales. Nitrogen dioxide is an important air pollutant which is produced in all combustion processes and can reduce lung function; especially in sensitised individuals. These instruments aim to bridge the gap in spatial scales between point source measurements of air quality and satellite measurements of air quality offering additional information on emissions, transport and the chemistry of nitrogen dioxide. More information regarding the CityScan technique can be found at http://www.leos.le.ac.uk/aq/index.html. CityScan has been deployed in both London and Bologna, Italy during 2012. The London deployment took place as part of the large NERC funded ClearfLo project in January and July/August. CityScan was deployed in Bologna in June as part of the large EU project PEGASOS. Analysis of both of these campaigns of data will be used to give unprecedented levels of spatial information to air quality measurements whilst also showing the difference in air quality between a relatively isolated mega city and a smaller city situated in a very polluted region; in this case the Po Valley. Results from multiple City

Continuing Medical Education Improves Gastroenterologists' Compliance with Inflammatory Bowel Disease Quality Measures.

PubMed

Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Greene, Laurence; Patel, Barry; Higgins, Peter D R

2016-07-01

Low rates of compliance with quality measures for inflammatory bowel disease (IBD) have been reported for US gastroenterologists. We assessed the influence of quality improvement (QI) education on compliance with physician quality reporting system (PQRS) measures for IBD and measures related to National Quality Strategy (NQS) priorities. Forty community-based gastroenterologists participated in the QI study; 20 were assigned to educational intervention and control groups, respectively. At baseline, randomly selected charts of patients with moderate-to-severe ulcerative colitis were retrospectively reviewed for the gastroenterologists' performance of 8 PQRS IBD measures and 4 NQS-related measures. The intervention group participated in a series of accredited continuing medical education (CME) activities focusing on QI. Follow-up chart reviews were conducted 6 months after the CME activities. Independent t tests were conducted to compare between-group differences in baseline-to-follow-up rates of documented compliance with each measure. The analysis included 299 baseline charts and 300 follow-up charts. The intervention group had significantly greater magnitudes of improvement than the control group for the following measures: assessment of IBD type, location, and activity (+14 %, p = 0.009); influenza vaccination (+13 %, p = 0.025); pneumococcal vaccination (+20 %, p = 0.003); testing for latent tuberculosis before anti-TNF-α therapy (+10 %, p = 0.028); assessment of hepatitis B virus status before anti-TNF-α therapy (+9 %, p = 0.010); assessment of side effects (+17 %, p = 0.048), and counseling patients about cancer risks (+13 %, p = 0.013). QI-focused CME improves community-based gastroenterologists' compliance with IBD quality measures and measures aligned with NQS priorities.

Using Rasch Measurement to Validate an Instrument for Measuring the Quality of Classroom Teaching in Secondary Chemistry Lessons

ERIC Educational Resources Information Center

He, Peng; Liu, Xiufeng; Zheng, Changlong; Jia, Mengying

2016-01-01

This study intends to develop a standardized instrument for measuring classroom teaching and learning in secondary chemistry lessons. Based on previous studies and interviews with expert teachers, the progression of five quality levels was constructed hypothetically to represent the quality of chemistry lessons in Chinese secondary schools. The…

Measuring Up: Implementing a Dental Quality Measure in the Electronic Health Record Context

PubMed Central

Bhardwaj, Aarti; Ramoni, Rachel; Kalenderian, Elsbeth; Neumann, Ana; Hebballi, Nutan B; White, Joel M; McClellan, Lyle; Walji, Muhammad F

2015-01-01

Background Quality improvement requires quality measures that are validly implementable. In this work, we assessed the feasibility and performance of an automated electronic Meaningful Use dental clinical quality measure (percentage of children who received fluoride varnish). Methods We defined how to implement the automated measure queries in a dental electronic health record (EHR). Within records identified through automated query, we manually reviewed a subsample to assess the performance of the query. Results The automated query found 71.0% of patients to have had fluoride varnish compared to 77.6% found using the manual chart review. The automated quality measure performance was 90.5% sensitivity, 90.8% specificity, 96.9% positive predictive value, and 75.2% negative predictive value. Conclusions Our findings support the feasibility of automated dental quality measure queries in the context of sufficient structured data. Information noted only in the free text rather than in structured data would require natural language processing approaches to effectively query. Practical Implications To participate in self-directed quality improvement, dental clinicians must embrace the accountability era. Commitment to quality will require enhanced documentation in order to support near-term automated calculation of quality measures. PMID:26562736

Using collective expert judgements to evaluate quality measures of mass spectrometry images.

PubMed

Palmer, Andrew; Ovchinnikova, Ekaterina; Thuné, Mikael; Lavigne, Régis; Guével, Blandine; Dyatlov, Andrey; Vitek, Olga; Pineau, Charles; Borén, Mats; Alexandrov, Theodore

2015-06-15

Imaging mass spectrometry (IMS) is a maturating technique of molecular imaging. Confidence in the reproducible quality of IMS data is essential for its integration into routine use. However, the predominant method for assessing quality is visual examination, a time consuming, unstandardized and non-scalable approach. So far, the problem of assessing the quality has only been marginally addressed and existing measures do not account for the spatial information of IMS data. Importantly, no approach exists for unbiased evaluation of potential quality measures. We propose a novel approach for evaluating potential measures by creating a gold-standard set using collective expert judgements upon which we evaluated image-based measures. To produce a gold standard, we engaged 80 IMS experts, each to rate the relative quality between 52 pairs of ion images from MALDI-TOF IMS datasets of rat brain coronal sections. Experts' optional feedback on their expertise, the task and the survey showed that (i) they had diverse backgrounds and sufficient expertise, (ii) the task was properly understood, and (iii) the survey was comprehensible. A moderate inter-rater agreement was achieved with Krippendorff's alpha of 0.5. A gold-standard set of 634 pairs of images with accompanying ratings was constructed and showed a high agreement of 0.85. Eight families of potential measures with a range of parameters and statistical descriptors, giving 143 in total, were evaluated. Both signal-to-noise and spatial chaos-based measures performed highly with a correlation of 0.7 to 0.9 with the gold standard ratings. Moreover, we showed that a composite measure with the linear coefficients (trained on the gold standard with regularized least squares optimization and lasso) showed a strong linear correlation of 0.94 and an accuracy of 0.98 in predicting which image in a pair was of higher quality. The anonymized data collected from the survey and the Matlab source code for data processing can be found

Using collective expert judgements to evaluate quality measures of mass spectrometry images

PubMed Central

Palmer, Andrew; Ovchinnikova, Ekaterina; Thuné, Mikael; Lavigne, Régis; Guével, Blandine; Dyatlov, Andrey; Vitek, Olga; Pineau, Charles; Borén, Mats; Alexandrov, Theodore

2015-01-01

Motivation: Imaging mass spectrometry (IMS) is a maturating technique of molecular imaging. Confidence in the reproducible quality of IMS data is essential for its integration into routine use. However, the predominant method for assessing quality is visual examination, a time consuming, unstandardized and non-scalable approach. So far, the problem of assessing the quality has only been marginally addressed and existing measures do not account for the spatial information of IMS data. Importantly, no approach exists for unbiased evaluation of potential quality measures. Results: We propose a novel approach for evaluating potential measures by creating a gold-standard set using collective expert judgements upon which we evaluated image-based measures. To produce a gold standard, we engaged 80 IMS experts, each to rate the relative quality between 52 pairs of ion images from MALDI-TOF IMS datasets of rat brain coronal sections. Experts’ optional feedback on their expertise, the task and the survey showed that (i) they had diverse backgrounds and sufficient expertise, (ii) the task was properly understood, and (iii) the survey was comprehensible. A moderate inter-rater agreement was achieved with Krippendorff’s alpha of 0.5. A gold-standard set of 634 pairs of images with accompanying ratings was constructed and showed a high agreement of 0.85. Eight families of potential measures with a range of parameters and statistical descriptors, giving 143 in total, were evaluated. Both signal-to-noise and spatial chaos-based measures performed highly with a correlation of 0.7 to 0.9 with the gold standard ratings. Moreover, we showed that a composite measure with the linear coefficients (trained on the gold standard with regularized least squares optimization and lasso) showed a strong linear correlation of 0.94 and an accuracy of 0.98 in predicting which image in a pair was of higher quality. Availability and implementation: The anonymized data collected from the survey

DockQ: A Quality Measure for Protein-Protein Docking Models

PubMed Central

Basu, Sankar

2016-01-01

The state-of-the-art to assess the structural quality of docking models is currently based on three related yet independent quality measures: Fnat, LRMS, and iRMS as proposed and standardized by CAPRI. These quality measures quantify different aspects of the quality of a particular docking model and need to be viewed together to reveal the true quality, e.g. a model with relatively poor LRMS (>10Å) might still qualify as 'acceptable' with a descent Fnat (>0.50) and iRMS (<3.0Å). This is also the reason why the so called CAPRI criteria for assessing the quality of docking models is defined by applying various ad-hoc cutoffs on these measures to classify a docking model into the four classes: Incorrect, Acceptable, Medium, or High quality. This classification has been useful in CAPRI, but since models are grouped in only four bins it is also rather limiting, making it difficult to rank models, correlate with scoring functions or use it as target function in machine learning algorithms. Here, we present DockQ, a continuous protein-protein docking model quality measure derived by combining Fnat, LRMS, and iRMS to a single score in the range [0, 1] that can be used to assess the quality of protein docking models. By using DockQ on CAPRI models it is possible to almost completely reproduce the original CAPRI classification into Incorrect, Acceptable, Medium and High quality. An average PPV of 94% at 90% Recall demonstrating that there is no need to apply predefined ad-hoc cutoffs to classify docking models. Since DockQ recapitulates the CAPRI classification almost perfectly, it can be viewed as a higher resolution version of the CAPRI classification, making it possible to estimate model quality in a more quantitative way using Z-scores or sum of top ranked models, which has been so valuable for the CASP community. The possibility to directly correlate a quality measure to a scoring function has been crucial for the development of scoring functions for protein structure

A novel client service quality measuring model and an eHealthcare mitigating approach.

PubMed

Cheng, L M; Choi, Wai Ping Choi; Wong, Anita Yiu Ming

2016-07-01

Facing population ageing in Hong Kong, the demand of long-term elderly health care services is increasing. The challenge is to support a good quality service under the constraints faced by recent shortage of nursing and care services professionals without redesigning the work flow operated in the existing elderly health care industries. the existing elderly health care industries. The Total QoS measure based on Finite Capacity Queuing Model is a reliable method and an effective measurement for Quality of services. The value is good for measuring the staffing level and offers a measurement for efficiency enhancement when incorporate new technologies like ICT. The implemented system has improved the Quality of Service by more than 14% and the extra released manpower resource will allow clinical care provider to offer further value added services without actually increasing head count. We have developed a novel Quality of Service measurement for Clinical Care services based on multi-queue using finite capacity queue model M/M/c/K/n and the measurement is useful for estimating the shortage of staff resource in a caring institution. It is essential for future integration with the existing widely used assessment model to develop reliable measuring limits which allow an effective measurement of public fund used in health care industries. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Systematic uncertainties in RF-based measurement of superconducting cavity quality factors

DOE PAGES

Holzbauer, J. P.; Pischalnikov, Yu.; Sergatskov, D. A.; ...

2016-05-10

Q 0 determinations based on RF power measurements are subject to at least three potentially large systematic effects that have not been previously appreciated. Here, instrumental factors that can systematically bias RF based measurements of Q 0 are quantified and steps that can be taken to improve the determination of Q 0 are discussed.

Measuring and Assuring the Quality of Home Health Care

PubMed Central

Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.

1994-01-01

The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157

DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES FOR RESEARCH PROJECTS

EPA Science Inventory

The paper provides assistance with systematic planning using measurement quality objectives to those working on research projects. These performance criteria are more familiar to researchers than data quality objectives because they are more closely associated with the measuremen...

Transfer of knowledge from sound quality measurement to noise impact evaluation

NASA Astrophysics Data System (ADS)

Genuit, Klaus

2004-05-01

It is well known that the measurement and analysis of sound quality requires a complex procedure with consideration of the physical, psychoacoustical and psychological aspects of sound. Sound quality cannot be described only by a simple value based on A-weighted sound pressure level measurements. The A-weighted sound pressure level is sufficient to predict the probabilty that the human ear could be damaged by sound but the A-weighted level is not the correct descriptor for the annoyance of a complex sound situation given by several different sound events at different and especially moving positions (soundscape). On the one side, the consideration of the spectral distribution and the temporal pattern (psychoacoustics) is requested and, on the other side, the subjective attitude with respect to the sound situation, the expectation and experience of the people (psychology) have to be included in context with the complete noise impact evaluation. This paper describes applications of the newest methods of sound quality measurements-as it is well introduced at the car manufacturers-based on artifical head recordings and signal processing comparable to the human hearing used in noisy environments like community/traffic noise.

Innovative United Kingdom Approaches To Measuring Service Quality.

ERIC Educational Resources Information Center

Winkworth, Ian

2001-01-01

Reports on approaches to measuring the service quality of academic libraries in the United Kingdom. Discusses the role of government and the national background of quality measurement; measurement frameworks; better use of statistics; benchmarking; measuring user satisfaction; and possible future development. (Author/LRW)

Combining Quality and Curriculum-Based Measurement: A Suggested Assessment Protocol in Writing

ERIC Educational Resources Information Center

Ganzeveld, Paula

2015-01-01

Curriculum-Based Measures in writing (CBM-W) assesses a variety of fluency-based components of writing. While support exists for the use of CBM measures in the area of writing, there is a need to conduct further validation studies to investigate the utility of these measures within elementary and secondary classrooms. Since only countable indices…

Quantitative comparison of measurements of urgent care service quality.

PubMed

Qin, Hong; Prybutok, Victor; Prybutok, Gayle

2016-01-01

Service quality and patient satisfaction are essential to health care organization success. Parasuraman, Zeithaml, and Berry introduced SERVQUAL, a prominent service quality measure not yet applied to urgent care. We develop an instrument to measure perceived service quality and identify the determinants of patient satisfaction/ behavioral intentions. We examine the relationships among perceived service quality, patient satisfaction and behavioral intentions, and demonstrate that urgent care service quality is not equivalent using measures of perceptions only, differences of expectations minus perceptions, ratio of perceptions to expectations, and the log of the ratio. Perceptions provide the best measure of urgent care service quality.

Quality Measures for the Care of Patients with Narcolepsy

PubMed Central

Krahn, Lois E.; Hershner, Shelley; Loeding, Lauren D.; Maski, Kiran P.; Rifkin, Daniel I.; Selim, Bernardo; Watson, Nathaniel F.

2015-01-01

The American Academy of Sleep Medicine (AASM) commissioned a Workgroup to develop quality measures for the care of patients with narcolepsy. Following a comprehensive literature search, 306 publications were found addressing quality care or measures. Strength of association was graded between proposed process measures and desired outcomes. Following the AASM process for quality measure development, we identified three outcomes (including one outcome measure) and seven process measures. The first desired outcome was to reduce excessive daytime sleepiness by employing two process measures: quantifying sleepiness and initiating treatment. The second outcome was to improve the accuracy of diagnosis by employing the two process measures: completing both a comprehensive sleep history and an objective sleep assessment. The third outcome was to reduce adverse events through three steps: ensuring treatment follow-up, documenting medical comorbidities, and documenting safety measures counseling. All narcolepsy measures described in this report were developed by the Narcolepsy Quality Measures Work-group and approved by the AASM Quality Measures Task Force and the AASM Board of Directors. The AASM recommends the use of these measures as part of quality improvement programs that will enhance the ability to improve care for patients with narcolepsy. Citation: Krahn LE, Hershner S, Loeding LD, Maski KP, Rifkin DI, Selim B, Watson NF. Quality measures for the care of patients with narcolepsy. J Clin Sleep Med 2015;11(3):335–355. PMID:25700880

How Do Students Measure Service Quality in e-Learning? A Case Study regarding an Internet-Based University

ERIC Educational Resources Information Center

Martinez-Arguelles, Maria; Castan, Jose; Juan, Angel

2010-01-01

This article discusses the importance of measuring how students perceive quality of service in online higher education. The article also reviews the existing literature on measuring users' perceptions about quality in e-services. Even when there are a lot of articles on this matter, none of them focuses on e-learning services, so this paper tries…

International Airline Quality Measurement

DOT National Transportation Integrated Search

1998-01-01

Historically, airline quality has been measured through the use of surveys that ask the consumers to make a comparison between expectations and outcomes. This method was informative but very cumbersome in a rapidly changing environment. This paper ou...

Healthcare quality measurement in orthopaedic surgery: current state of the art.

PubMed

Auerbach, Andrew

2009-10-01

Improving quality of care in arthroplasty is of increasing importance to payors, hospitals, surgeons, and patients. Efforts to compel improvement have traditionally focused measurement and reporting of data describing structural factors, care processes (or 'quality measures'), and clinical outcomes. Reporting structural measures (eg, surgical case volume) has been used with varying degrees of success. Care process measures, exemplified by initiatives such as the Surgical Care Improvement Project measures, are chosen based on the strength of randomized trial evidence linking the process to improved outcomes. However, evidence linking improved performance on Surgical Care Improvement Project measures with improved outcomes is limited. Outcome measures in surgery are of increasing importance as an approach to compel care improvement with prominent examples represented by the National Surgical Quality Improvement Project. Although outcomes-focused approaches are often costly, when linked to active benchmarking and collaborative activities, they may improve care broadly. Moreover, implementation of computerized data systems collecting information formerly collected on paper only will facilitate benchmarking. In the end, care will only be improved if these data are used to define methods for innovating care systems that deliver better outcomes at lower or equivalent costs.

Adopting software quality measures for healthcare processes.

PubMed

Yildiz, Ozkan; Demirörs, Onur

2009-01-01

In this study, we investigated the adoptability of software quality measures for healthcare process measurement. Quality measures of ISO/IEC 9126 are redefined from a process perspective to build a generic healthcare process quality measurement model. Case study research method is used, and the model is applied to a public hospital's Entry to Care process. After the application, weak and strong aspects of the process can be easily observed. Access audibility, fault removal, completeness of documentation, and machine utilization are weak aspects and these aspects are the candidates for process improvement. On the other hand, functional completeness, fault ratio, input validity checking, response time, and throughput time are the strong aspects of the process.

A PROMIS Measure of Neuropathic Pain Quality

PubMed Central

Askew, Robert L.; Cook, Karon F.; Keefe, Francis J.; Nowinski, Cindy J; Cella, David; Revicki, Dennis A.; DeWitt, Esi M. Morgan; Michaud, Kaleb; Trence, Dace L.; Amtmann, Dagmar

2016-01-01

Objectives Neuropathic pain is a consequence of many chronic conditions. This study aimed to develop a unidimensional neuropathic pain scale whose scores represent levels of neuropathic pain and distinguish between individuals with neuropathic and non-neuropathic pain conditions. Methods A candidate item pool of 42 pain quality descriptors was administered to participants with osteoarthritis, rheumatoid arthritis, diabetic neuropathy, and cancer chemotherapy-induced peripheral neuropathy. A subset of pain quality descriptors (items) that best distinguished between participants with and those without neuropathic pain conditions were identified. Dimensionality of pain descriptors was evaluated in a development sample and cross-validated in a hold-out sample. Item responses were calibrated using an item response theory model, and scores were generated on a T-score metric. Neuropathic pain scale scores were evaluated in terms of reliability, validity, and the ability to distinguish between participants with and without conditions typically associated with neuropathic pain. Results Of the 42 initial items, 5 were identified for the Patient Reported Outcome Measurement Information System (PROMIS) Neuropathic Pain Quality scale (PROMIS-PQ-Neuro). The IRT-generated T-scores exhibited good discriminatory ability based on receiver operator characteristic analysis. Score thresholds were identified that optimize sensitivity and specificity. Construct, criterion, and discriminant validity, and reliability of scale scores were supported. Conclusions The 5-item PROMIS PQ-Neuro is a short and practical measure that can be used to identify patients more likely to have neuropathic pain and to distinguish levels of neuropathic pain. The data collected will support future research that targets other unidimensional pain quality domains (e.g., nociceptive pain). PMID:27565279

Performance-Based Service Quality Model: An Empirical Study on Japanese Universities

ERIC Educational Resources Information Center

Sultan, Parves; Wong, Ho

2010-01-01

Purpose: This paper aims to develop and empirically test the performance-based higher education service quality model. Design/methodology/approach: The study develops 67-item instrument for measuring performance-based service quality with a particular focus on the higher education sector. Scale reliability is confirmed using the Cronbach's alpha.…

Improved RF Measurements of SRF Cavity Quality Factors

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

Holzbauer, J. P.; Contreras, C.; Pischalnikov, Y.

SRF cavity quality factors can be accurately measured using RF-power based techniques only when the cavity is very close to critically coupled. This limitation is from systematic errors driven by non-ideal RF components. When the cavity is not close to critically coupled, these systematic effects limit the accuracy of the measurements. The combination of the complex base-band envelopes of the cavity RF signals in combination with a trombone in the circuit allow the relative calibration of the RF signals to be extracted from the data and systematic effects to be characterized and suppressed. The improved calibration allows accurate measurements tomore » be made over a much wider range of couplings. Demonstration of these techniques during testing of a single-spoke resonator with a coupling factor of near 7 will be presented, along with recommendations for application of these techniques.« less

Observational attachment theory-based parenting measures predict children's attachment narratives independently from social learning theory-based measures.

PubMed

Matias, Carla; O'Connor, Thomas G; Futh, Annabel; Scott, Stephen

2014-01-01

Conceptually and methodologically distinct models exist for assessing quality of parent-child relationships, but few studies contrast competing models or assess their overlap in predicting developmental outcomes. Using observational methodology, the current study examined the distinctiveness of attachment theory-based and social learning theory-based measures of parenting in predicting two key measures of child adjustment: security of attachment narratives and social acceptance in peer nominations. A total of 113 5-6-year-old children from ethnically diverse families participated. Parent-child relationships were rated using standard paradigms. Measures derived from attachment theory included sensitive responding and mutuality; measures derived from social learning theory included positive attending, directives, and criticism. Child outcomes were independently-rated attachment narrative representations and peer nominations. Results indicated that Attachment theory-based and Social Learning theory-based measures were modestly correlated; nonetheless, parent-child mutuality predicted secure child attachment narratives independently of social learning theory-based measures; in contrast, criticism predicted peer-nominated fighting independently of attachment theory-based measures. In young children, there is some evidence that attachment theory-based measures may be particularly predictive of attachment narratives; however, no single model of measuring parent-child relationships is likely to best predict multiple developmental outcomes. Assessment in research and applied settings may benefit from integration of different theoretical and methodological paradigms.

Nurse Reported Quality of Care: A Measure of Hospital Quality

PubMed Central

McHugh, Matthew D.; Stimpfel, Amy Witkoski

2013-01-01

As the primary providers of round-the-clock bedside care, nurses are well positioned to report on hospital quality of care. Researchers have not examined how nurses’ reports of quality correspond with standard process or outcomes measures of quality. We assess the validity of evaluating hospital quality by aggregating hospital nurses’ responses to a single item that asks them to report on quality of care. We found that a 10% increment in the proportion of nurses reporting excellent quality of care was associated with lower odds of mortality and failure to rescue; greater patient satisfaction; and higher composite process of care scores for acute myocardial infarction, pneumonia, and surgical patients. Nurse reported quality of care is a useful indicator of hospital performance. PMID:22911102

Quality Measures in Stroke

PubMed Central

Poisson, Sharon N.; Josephson, S. Andrew

2011-01-01

Stroke is a major public health burden, and accounts for many hospitalizations each year. Due to gaps in practice and recommended guidelines, there has been a recent push toward implementing quality measures to be used for improving patient care, comparing institutions, as well as for rewarding or penalizing physicians through pay-for-performance. This article reviews the major organizations involved in implementing quality metrics for stroke, and the 10 major metrics currently being tracked. We also discuss possible future metrics and the implications of public reporting and using metrics for pay-for-performance. PMID:23983840

Integrating Measurement Based New Knowledge on Wildland Fire Emissions and Chemistry into the AIRPACT Air Quality Forecasting for the Pacific Northwest

NASA Astrophysics Data System (ADS)

Nergui, T.; Lee, Y.; Chung, S. H.; Lamb, B. K.; Yokelson, R. J.; Barsanti, K.

2017-12-01

A number of chamber and field measurements have shown that atmospheric organic aerosols and their precursors produced from wildfires are significantly underestimated in the emission inventories used for air quality models for various applications such as regulatory strategy development, impact assessments of air pollutants, and air quality forecasting for public health. The AIRPACT real-time air quality forecasting system consistently underestimates surface level fine particulate matter (PM2.5) concentrations in the summer at both urban and rural locations in the Pacific Northwest, primarily result of errors in organic particulate matter. In this work, we implement updated chemical speciation and emission factors based on FLAME-IV (Fourth Fire Lab at Missoula Experiment) and other measurements in the Blue-Sky fire emission model and the SMOKE emission preprocessor; and modified parameters for the secondary organic aerosol (SOA) module in CMAQ chemical transport model of the AIRPACT modeling system. Simulation results from CMAQ version 5.2 which has a better treatment for anthropogenic SOA formation (as a base case) and modified parameterization used for fire emissions and chemistry in the model (fire-soa case) are evaluated against airborne measurements downwind of the Big Windy Complex Fire and the Colockum Tarps Fire, both of which occurred in the Pacific Northwest in summer 2013. Using the observed aerosol chemical composition and mass loadings for organics, nitrate, sulfate, ammonium, and chloride from aircraft measurements during the Studies of Emissions and Atmospheric Composition, Clouds, and Climate Coupling by Regional Surveys (SEAC4RS) and the Biomass Burning Observation Project (BBOP), we assess how new knowledge gained from wildfire measurements improve model predictions for SOA and its contribution to the total mass of PM2.5 concentrations.

Measuring up: Implementing a dental quality measure in the electronic health record context.

PubMed

Bhardwaj, Aarti; Ramoni, Rachel; Kalenderian, Elsbeth; Neumann, Ana; Hebballi, Nutan B; White, Joel M; McClellan, Lyle; Walji, Muhammad F

2016-01-01

Quality improvement requires using quality measures that can be implemented in a valid manner. Using guidelines set forth by the Meaningful Use portion of the Health Information Technology for Economic and Clinical Health Act, the authors assessed the feasibility and performance of an automated electronic Meaningful Use dental clinical quality measure to determine the percentage of children who received fluoride varnish. The authors defined how to implement the automated measure queries in a dental electronic health record. Within records identified through automated query, the authors manually reviewed a subsample to assess the performance of the query. The automated query results revealed that 71.0% of patients had fluoride varnish compared with the manual chart review results that indicated 77.6% of patients had fluoride varnish. The automated quality measure performance results indicated 90.5% sensitivity, 90.8% specificity, 96.9% positive predictive value, and 75.2% negative predictive value. The authors' findings support the feasibility of using automated dental quality measure queries in the context of sufficient structured data. Information noted only in free text rather than in structured data would require using natural language processing approaches to effectively query electronic health records. To participate in self-directed quality improvement, dental clinicians must embrace the accountability era. Commitment to quality will require enhanced documentation to support near-term automated calculation of quality measures. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

The association of Nursing Home Compare quality measures with market competition and occupancy rates.

PubMed

Castle, Nicholas G; Liu, Darren; Engberg, John

2008-01-01

Since 2002, the Centers for Medicare and Medicaid Services have reported quality measures on the Nursing Home Compare Web site. It has been assumed that nursing homes are able to make improvements on these measures. In this study researchers examined nursing homes to see whether they have improved their quality scores, after accounting for regression to the mean. Researchers also examined whether gains varied according to market competition or market occupancy rates. They identified some regression to the mean for the quality measure scores over time; nevertheless, they also determined that some nursing homes had indeed made small improvements in their quality measure scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, the greatest improvements occurred in the most competitive markets and in those with the Lowest average occupancy rates. As policies to promote more competition in Long-term care proceed, further reducing occupancy rates, further, albeit small, quality gains will likely be made in the future.

Traffic Data Quality Measurement : Final Report

DOT National Transportation Integrated Search

2004-09-15

One of the foremost recommendations from the FHWA sponsored workshops on Traffic Data Quality (TDQ) in 2003 was a call for "guidelines and standards for calculating data quality measures." These guidelines and standards are expected to contain method...

Issues in Measuring and Improving Health Care Quality

PubMed Central

Friedman, Maria A.

1995-01-01

This issue of the Health Care Financing Review focuses on issues and advances in measuring and improving the quality of care, particularly for Medicare and Medicaid beneficiaries. Discussions of quality-related topics are especially timely, given the growing and widespread interest in improving quality in the organization, financing, and delivery of health care services. This article has several purposes. The first is to provide a brief description of some of the causes underlying the growth of the health care quality movement; the second is to provide a contextual framework for discussion of some of the overarching themes that emerge in this issue. These themes include examining conceptual issues, developing quality measures for specific sites and populations, and creating or adapting data sets for quality-measurement purposes. PMID:10151882

Parameter-based estimation of CT dose index and image quality using an in-house android™-based software

NASA Astrophysics Data System (ADS)

Mubarok, S.; Lubis, L. E.; Pawiro, S. A.

2016-03-01

Compromise between radiation dose and image quality is essential in the use of CT imaging. CT dose index (CTDI) is currently the primary dosimetric formalisms in CT scan, while the low and high contrast resolutions are aspects indicating the image quality. This study was aimed to estimate CTDIvol and image quality measures through a range of exposure parameters variation. CTDI measurements were performed using PMMA (polymethyl methacrylate) phantom of 16 cm diameter, while the image quality test was conducted by using catphan ® 600. CTDI measurements were carried out according to IAEA TRS 457 protocol using axial scan mode, under varied parameters of tube voltage, collimation or slice thickness, and tube current. Image quality test was conducted accordingly under the same exposure parameters with CTDI measurements. An Android™ based software was also result of this study. The software was designed to estimate the value of CTDIvol with maximum difference compared to actual CTDIvol measurement of 8.97%. Image quality can also be estimated through CNR parameter with maximum difference to actual CNR measurement of 21.65%.

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

How do performance-based financing programmes measure quality of care? A descriptive analysis of 68 quality checklists from 28 low- and middle-income countries

PubMed Central

Josephson, Erik; Gergen, Jessica; Coe, Martha; Ski, Samantha; Madhavan, Supriya; Bauhoff, Sebastian

2017-01-01

Abstract This paper seeks to systematically describe the length and content of quality checklists used in performance-based financing programmes, their similarities and differences, and how checklists have evolved over time. We compiled a list of supply-side, health facility-based performance-based financing (PBF) programmes in low- and lower middle-income countries based on a document review. We then solicited PBF manuals and quality checklists from implementers and donors of these PBF mechanisms. We entered each indicator from each quality checklist into a database verbatim in English, and translated into English from French where appropriate, and categorized each indicator according to the Donabedian framework and an author-derived categorization. We extracted 8,490 quality indicators from 68 quality checklists across 32 PBF implementations in 28 countries. On average, checklists contained 125 indicators; within the same program, checklists tend to grow as they are updated. Using the Donabedian framework, 80% of indicators were structure-type, 19% process-type, and less than 1% outcome-type. The author-derived categorization showed that 57% of indicators relate to availability of resources, 24% to managing the facility and 17% assess knowledge and effort. There is a high degree of similarity in a narrow set of indicators used in checklists for common service types such as maternal, neonatal and child health. We conclude that performance-based financing offers an appealing approach to targeting specific quality shortfalls and advancing toward the Sustainable Development Goals of high quality coverage. Currently most indicators focus on structural issues and resource availability. There is scope to rationalize and evolve the quality checklists of these programs to help achieve national and global goals to improve quality of care. PMID:28549142

Dental Quality Measurement--A Practitioner Perspective.

PubMed

Amundson, Craig W

2016-04-01

This article reviews the HealthPartners Dental Group's experience with clinical quality measurement and provides information on the administrative infrastructure that supports measurement within the group. Some examples of the role measurement plays in operations and clinical practice are also reviewed.

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.

Measuring housing quality in the absence of a monetized real estate market.

PubMed

Rindfuss, Ronald R; Piotrowski, Martin; Thongthai, Varachai; Prasartkul, Pramote

2007-03-01

Measuring housing quality or value or both has been a weak component of demographic and development research in less developed countries that lack an active real estate (housing) market. We describe a new method based on a standardized subjective rating process. It is designed to be used in settings that do not have an active, monetized housing market. The method is applied in an ongoing longitudinal study in north-east Thailand and could be straightforwardly used in many other settings. We develop a conceptual model of the process whereby households come to reside in high-quality or low-quality housing units. We use this theoretical model in conjunction with longitudinal data to show that the new method of measuring housing quality behaves as theoretically expected, thus providing evidence of face validity.

APPLICATION OF DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES TO RESEARCH PROJECTS

EPA Science Inventory

The paper assists systematic planning for research projects. It presents planning concepts in terms that have some utility for researchers. For example, measurement quality objectives are more familiar to researchers than data quality objectives because these quality criteria are...

Publicly reported quality-of-care measures influenced Wisconsin physician groups to improve performance

PubMed Central

Lamb, Geoffrey C.; Smith, Maureen; Weeks, William B.; Queram, Christopher

2014-01-01

Public reporting of performance on quality measures is increasingly common but little is known about the impact, especially among physician groups. The Wisconsin Collaborative for Healthcare Quality (Collaborative) is a voluntary consortium of physician groups which has publicly reported quality measures since 2004, providing an opportunity to study the effect of this effort on participating groups. Analyses included member performance on 14 ambulatory measures from 2004–2009, a survey regarding reporting and its relationship to improvement efforts, and use of Medicare billing data to independently compare Collaborative members to the rest of Wisconsin, neighboring states and the rest of the United States. Faced with limited resources, groups prioritized their efforts based on the nature of the measure and their performance compared to others. The outcomes demonstrated that public reporting was associated with improvement in health quality and that large physician group practices will engage in improvement efforts in response. PMID:23459733

Evaluating Performance Measurement Systems in Nonprofit Agencies: The Program Accountability Quality Scale (PAQS).

ERIC Educational Resources Information Center

Poole, Dennis L.; Nelson, Joan; Carnahan, Sharon; Chepenik, Nancy G.; Tubiak, Christine

2000-01-01

Developed and field tested the Performance Accountability Quality Scale (PAQS) on 191 program performance measurement systems developed by nonprofit agencies in central Florida. Preliminary findings indicate that the PAQS provides a structure for obtaining expert opinions based on a theory-driven model about the quality of proposed measurement…

Commentary: measuring quality of care in osteoporosis.

PubMed

Silverman, Stuart L; Curtis, Jeffrey

2013-12-01

We know improving the quality of care in osteoporosis is an important goal. We have made some strides toward measuring quality of osteoporosis care, focusing on process measures regarding care that is provided. Unfortunately, improving care as measured by these process measures does not always yield improved outcomes. We need to hold health care providers and health care systems responsible not only for health care production but for production of health and well-being. However, there is a multiplicity of factors that will need to be considered to make this next step.

A Data Quality Filter for PMU Measurements: Description, Experience, and Examples

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

Follum, James D.; Amidan, Brett G.

Networks of phasor measurement units (PMUs) continue to grow, and along with them, the amount of data available for analysis. With so much data, it is impractical to identify and remove poor quality data manually. The data quality filter described in this paper was developed for use with the Data Integrity and Situation Awareness Tool (DISAT), which analyzes PMU data to identify anomalous system behavior. The filter operates based only on the information included in the data files, without supervisory control and data acquisition (SCADA) data, state estimator values, or system topology information. Measurements are compared to preselected thresholds tomore » determine if they are reliable. Along with the filter's description, examples of data quality issues from application of the filter to nine months of archived PMU data are provided. The paper is intended to aid the reader in recognizing and properly addressing data quality issues in PMU data.« less

Performance measurement in surgery through the National Quality Forum.

PubMed

Hyder, Joseph A; Roy, Nathalie; Wakeam, Elliot; Hernandez, Roland; Kim, Simon P; Bader, Angela M; Cima, Robert R; Nguyen, Louis L

2014-11-01

Performance measurement has become central to surgical practice. We systematically reviewed all endorsed performance measures from the National Quality Forum, the national clearing house for performance measures in health care, to identify measures relevant to surgical practice and describe measure stewardship, measure types, and identify gaps in measurement. Performance measures current to June 2014 were categorized by denominator statement as either assessing surgical practice in specific or as part of a mixed medical and surgical population. Measures were further classified by surgical specialty, Donabedian measure type, patients, disease and events targeted, reporting eligibility, and measure stewards. Of 637 measures, 123 measures assessed surgical performance in specific and 123 assessed surgical performance in aggregate. Physician societies (51 of 123, 41.5%) were more common than government agencies (32 of 123, 26.0%) among measure stewards for surgical measures, in particular, the Society for Thoracic Surgery (n = 32). Outcomes measures rather than process measures were common among surgical measures (62 of 123, 50.4%) compared with aggregate medical/surgical measures (46 of 123, 37.4%). Among outcomes measures, death alone was the most commonly specified outcome (24 of 62, 38.7%). Only 1 surgical measure addressed patient-centered care and only 1 measure addressed hospital readmission. We found 7 current surgical measures eligible for value-based purchasing. Surgical society stewards and outcomes measure types, particularly for cardiac surgery, were well represented in the National Quality Forum. Measures addressing patient-centered outcomes and the value of surgical decision-making were not well represented and may be suitable targets for measure innovation. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A Delphi Study to Examine the Quality Measurement Standards by Online Instructors Using the Quality Matters™ Rubric as a Basis for Creating Instructional Materials

ERIC Educational Resources Information Center

Robinson, Daniel J.

2017-01-01

Quality measurement tools such as the Rubric for Online Instruction (ROI) and Quality Matters (QM) have developed guidelines by providing research based educational criteria for planning, creating, and implementing quality online education courses. This dissertation reviews QM program standards and identifies the primary characteristics of…

Measuring the Mathematical Quality of Instruction

ERIC Educational Resources Information Center

Journal of Mathematics Teacher Education, 2011

2011-01-01

In this article, we describe a framework and instrument for measuring the mathematical quality of mathematics instruction. In describing this framework, we argue for the separation of the "mathematical quality of instruction" (MQI), such as the absence of mathematical errors and the presence of sound mathematical reasoning, from pedagogical…

HOS network-based classification of power quality events via regression algorithms

NASA Astrophysics Data System (ADS)

Palomares Salas, José Carlos; González de la Rosa, Juan José; Sierra Fernández, José María; Pérez, Agustín Agüera

2015-12-01

This work compares seven regression algorithms implemented in artificial neural networks (ANNs) supported by 14 power-quality features, which are based in higher-order statistics. Combining time and frequency domain estimators to deal with non-stationary measurement sequences, the final goal of the system is the implementation in the future smart grid to guarantee compatibility between all equipment connected. The principal results are based in spectral kurtosis measurements, which easily adapt to the impulsive nature of the power quality events. These results verify that the proposed technique is capable of offering interesting results for power quality (PQ) disturbance classification. The best results are obtained using radial basis networks, generalized regression, and multilayer perceptron, mainly due to the non-linear nature of data.

Development and validation of the Pediatric Stroke Quality of Life Measure.

PubMed

Fiume, Andrea; Deveber, Gabrielle; Jang, Shu-Hyun; Fuller, Colleen; Viner, Shani; Friefeld, Sharon

2018-06-01

To develop and validate a disease-specific parent proxy and child quality of life (QoL) measure for patients aged 2 to 18 years surviving cerebral sinovenous thrombosis (CSVT) and arterial ischaemic stroke (AIS). Utilizing qualitative and quantitative methods, we developed a 75-item Pediatric Stroke Quality of Life Measure (PSQLM) questionnaire. We mailed the PSQLM and a standardized generic QoL measure, Pediatric Quality of Life Inventory (PedsQL), to 353 families. Stroke type, age at stroke, and neurological outcome on the Pediatric Stroke Outcome Measure were documented. We calculated the internal consistency, validity, and reliability of the PSQLM. The response rate was 29%, yielding a sample of 101 patients (mean age 9y 9mo [SD 4.30]; 69 AIS [68.3%], 32 CSVT [31.7%]). The internal consistency of the PSQLM was high (Cronbach's α=0.94-0.97). Construct validity for the PSQLM was moderately strong (r=0.3-0.4; p<0.003) and, as expected, correlation with the PedsQL was moderate, suggesting the PSQLM operationalizes QoL distinct from the PedsQL. Test-retest reliability at 2 weeks was very good (intraclass correlation coefficient [ICC] 0.85-0.95; 95% confidence interval 0.83-0.97) and good agreement was established between parent and child report (ICC 0.63-0.76). The PSQLM demonstrates sound psychometric properties. Further research will seek to increase its clinical utility by reducing length and establishing responsiveness for descriptive and longitudinal evaluative assessment. A pediatric stroke-specific quality of life (QoL) measurement tool for assessments based on perceptions of importance and satisfaction. Moderate-to-high reliability and validity established for a new clinical scale evaluating QoL among children with stroke. Perceived QoL measured using the Pediatric Stroke Quality of Life Measure appears lower in children with neurological impairment. © 2018 Mac Keith Press.

Toward the Development of Integrative Risk-Adjusted Measures of Quality Using Large Clinical Data Bases: The Case of Anesthesia Services.

ERIC Educational Resources Information Center

Fleming, Steven T.

1992-01-01

The concept of risk-adjusted measures of quality is discussed, and a methodology is proposed for risk-adjusting and integrating multiple adverse outcomes of anesthesia services into measures for quality assurance and quality improvement programs. Although designed for a new anesthesiology database, the methods should apply to other health…

Best-Quality Vessel Identification Using Vessel Quality Measure in Multiple-Phase Coronary CT Angiography.

PubMed

Hadjiiski, Lubomir; Liu, Jordan; Chan, Heang-Ping; Zhou, Chuan; Wei, Jun; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella

2016-01-01

The detection of stenotic plaques strongly depends on the quality of the coronary arterial tree imaged with coronary CT angiography (cCTA). However, it is time consuming for the radiologist to select the best-quality vessels from the multiple-phase cCTA for interpretation in clinical practice. We are developing an automated method for selection of the best-quality vessels from coronary arterial trees in multiple-phase cCTA to facilitate radiologist's reading or computerized analysis. Our automated method consists of vessel segmentation, vessel registration, corresponding vessel branch matching, vessel quality measure (VQM) estimation, and automatic selection of best branches based on VQM. For every branch, the VQM was calculated as the average radial gradient. An observer preference study was conducted to visually compare the quality of the selected vessels. 167 corresponding branch pairs were evaluated by two radiologists. The agreement between the first radiologist and the automated selection was 76% with kappa of 0.49. The agreement between the second radiologist and the automated selection was also 76% with kappa of 0.45. The agreement between the two radiologists was 81% with kappa of 0.57. The observer preference study demonstrated the feasibility of the proposed automated method for the selection of the best-quality vessels from multiple cCTA phases.

The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

PubMed

Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

2016-02-01

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision. ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients.

Researches of fruit quality prediction model based on near infrared spectrum

NASA Astrophysics Data System (ADS)

Shen, Yulin; Li, Lian

2018-04-01

With the improvement in standards for food quality and safety, people pay more attention to the internal quality of fruits, therefore the measurement of fruit internal quality is increasingly imperative. In general, nondestructive soluble solid content (SSC) and total acid content (TAC) analysis of fruits is vital and effective for quality measurement in global fresh produce markets, so in this paper, we aim at establishing a novel fruit internal quality prediction model based on SSC and TAC for Near Infrared Spectrum. Firstly, the model of fruit quality prediction based on PCA + BP neural network, PCA + GRNN network, PCA + BP adaboost strong classifier, PCA + ELM and PCA + LS_SVM classifier are designed and implemented respectively; then, in the NSCT domain, the median filter and the SavitzkyGolay filter are used to preprocess the spectral signal, Kennard-Stone algorithm is used to automatically select the training samples and test samples; thirdly, we achieve the optimal models by comparing 15 kinds of prediction model based on the theory of multi-classifier competition mechanism, specifically, the non-parametric estimation is introduced to measure the effectiveness of proposed model, the reliability and variance of nonparametric estimation evaluation of each prediction model to evaluate the prediction result, while the estimated value and confidence interval regard as a reference, the experimental results demonstrate that this model can better achieve the optimal evaluation of the internal quality of fruit; finally, we employ cat swarm optimization to optimize two optimal models above obtained from nonparametric estimation, empirical testing indicates that the proposed method can provide more accurate and effective results than other forecasting methods.

Quality of life in dementia: a systematically conducted narrative review of dementia-specific measurement scales.

PubMed

Bowling, Ann; Rowe, Gene; Adams, Sue; Sands, Paula; Samsi, Kritika; Crane, Maureen; Joly, Louise; Manthorpe, Jill

2015-01-01

Ascertaining the quality of life (QoL) in people with dementia is important for evaluating service outcomes and cost-effectiveness. This paper identifies QoL measures for people with dementia and assesses their properties. A systematic narrative review identified articles using dementia QoL measures. Electronic databases searched were AMED, CINAHL, EMBASE, Index to Theses, IBSS, MEDLINE, PsycINFO, Sociological Abstracts, and Web of Science. All available years and languages (if with an English language abstract) were included. Searches yielded 6806 citations; 3043 were multiple duplicates (759 being true duplicates). Abstracts were read; 182 full papers were selected/obtained, of which 126 were included as relevant. Few measures were based on rigorous conceptual frameworks. Some referenced Lawton's model (Dementia Quality of Life [DQOL] and Quality of Life in Alzheimer's Disease [QOL-AD]), though these tapped part of this only; others claimed relationship to a health-related QoL concept (e.g. DEMQOL), though had less social relevance; others were based on limited domains (e.g. activity, affect) or clinical opinions (Quality of Life in Late-Stage Dementia [QUALID]). Many measures were based on proxy assessments or observations of people with dementia's QoL, rather than their own ratings. The Bath Assessment of Subjective Quality of Life in Dementia (BASQID) was developed involving people with dementia and caregivers, but excluded some of their main themes. All measures were tested on selective samples only (ranging from community to hospital clinics, or subsamples/waves of existing population surveys), in a few sites. Their general applicability remains unknown, and predictive validity remains largely untested. The lack of consensus on measuring QoL in dementia suggests a need for a broader, more rigorously tested QoL measure.

Quality Measurement in Early Childhood Settings

ERIC Educational Resources Information Center

Zaslow, Martha, Ed.; Martinez-Beck, Ivelisse, Ed.; Tout, Kathryn, Ed.; Halle, Tamara, Ed.

2011-01-01

What constitutes quality in early childhood settings, and how can it best be measured with today's widely used tools and promising new approaches? Find authoritative answers in this book, a must-have for high-level administrators and policymakers as more and more states adopt early childhood Quality Rating and Improvement Systems. The most…

Low-Cost Sensor Units for Measuring Urban Air Quality

NASA Astrophysics Data System (ADS)

Popoola, O. A.; Mead, M.; Stewart, G.; Hodgson, T.; McLoed, M.; Baldovi, J.; Landshoff, P.; Hayes, M.; Calleja, M.; Jones, R.

2010-12-01

Measurements of selected key air quality gases (CO, NO & NO2) have been made with a range of miniature low-cost sensors based on electrochemical gas sensing technology incorporating GPS and GPRS for position and communication respectively. Two types of simple to operate sensors units have been designed to be deployed in relatively large numbers. Mobile handheld sensor units designed for operation by members of the public have been deployed on numerous occasions including in Cambridge, London and Valencia. Static sensor units have also been designed for long-term autonomous deployment on existing street furniture. A study was recently completed in which 45 sensor units were deployed in the Cambridge area for a period of 3 months. Results from these studies indicate that air quality varies widely both spatially and temporally. The widely varying concentrations found suggest that the urban environment cannot be fully understood using limited static site (AURN) networks and that a higher resolution, more dispersed network is required to better define air quality in the urban environment. The results also suggest that higher spatial and temporal resolution measurements could improve knowledge of the levels of individual exposure in the urban environment.

A no-reference video quality assessment metric based on ROI

NASA Astrophysics Data System (ADS)

Jia, Lixiu; Zhong, Xuefei; Tu, Yan; Niu, Wenjuan

2015-01-01

A no reference video quality assessment metric based on the region of interest (ROI) was proposed in this paper. In the metric, objective video quality was evaluated by integrating the quality of two compressed artifacts, i.e. blurring distortion and blocking distortion. The Gaussian kernel function was used to extract the human density maps of the H.264 coding videos from the subjective eye tracking data. An objective bottom-up ROI extraction model based on magnitude discrepancy of discrete wavelet transform between two consecutive frames, center weighted color opponent model, luminance contrast model and frequency saliency model based on spectral residual was built. Then only the objective saliency maps were used to compute the objective blurring and blocking quality. The results indicate that the objective ROI extraction metric has a higher the area under the curve (AUC) value. Comparing with the conventional video quality assessment metrics which measured all the video quality frames, the metric proposed in this paper not only decreased the computation complexity, but improved the correlation between subjective mean opinion score (MOS) and objective scores.

The stroke impact scale: performance as a quality of life measure in a community-based stroke rehabilitation setting.

PubMed

Richardson, Marina; Campbell, Nerissa; Allen, Laura; Meyer, Matthew; Teasell, Robert

2016-07-01

The objective of this study was to assess the psychometric properties of the Stroke Impact Scale (SIS). Data was derived from a study assessing a community-based stroke rehabilitation program. Patients were administered the SIS and Euroqol-5D (EQ-5D-5L) on admission to the study, and at six month and 12 month follow-up. The psychometric performance of each domain of the SIS was assessed at each time point. A total of 164 patients completed outcome measures at baseline, 108 patients at six months and 37 patients at 12 months. Correlation of the SIS domains with the EQ-5D-5L suggested that the dimensions of health contributing to a patient's perception of health-related quality of life changes over time. The SIS performed well in a sample of patients undergoing stroke rehabilitation in the community. Our findings suggest that the multidimensionality of the SIS may allow health professionals to track patient progress and tailor rehabilitation interventions to target the dimensions of health that are most important to a patient's overall health and perceived quality of life over time. Implications for Rehabilitation There is an increased need for valid and reliable measures to evaluate the outcomes of patients recovering from stroke in the community. The Stroke Impact Scale (SIS) measures multiple domains of health and is well-suited for use in patients recovering from stroke in the community. There is a high level of internal consistency in the eight SIS domains with no evidence of floor effects; ceiling effects were noted for several domains. Correlation of the SIS with the Euroqol-5D suggested that the dimensions of health contributing to a patient's perception of health related quality of life changes over time.

Assessing decision quality in patient-centred care requires a preference-sensitive measure

PubMed Central

Kaltoft, Mette; Cunich, Michelle; Salkeld, Glenn; Dowie, Jack

2014-01-01

A theory-based instrument for measuring the quality of decisions made using any form of decision technology, including both decision-aided and unaided clinical consultations is required to enable person- and patient-centred care and to respond positively to individual heterogeneity in the value aspects of decision making. Current instruments using the term ‘decision quality’ have adopted a decision- and thus condition-specific approach. We argue that patient-centred care requires decision quality to be regarded as both preference-sensitive across multiple relevant criteria and generic across all conditions and decisions. MyDecisionQuality is grounded in prescriptive multi criteria decision analysis and employs a simple expected value algorithm to calculate a score for the quality of a decision that combines, in the clinical case, the patient’s individual preferences for eight quality criteria (expressed as importance weights) and their ratings of the decision just taken on each of these criteria (expressed as performance rates). It thus provides an index of decision quality that encompasses both these aspects. It also provides patients with help in prioritizing quality criteria for future decision making by calculating, for each criterion, the Incremental Value of Perfect Rating, that is, the increase in their decision quality score that would result if their performance rating on the criterion had been 100%, weightings unchanged. MyDecisionQuality, which is a web-based generic and preference-sensitive instrument, can constitute a key patient-reported measure of the quality of the decision-making process. It can provide the basis for future decision improvement, especially when the clinician (or other stakeholders) completes the equivalent instrument and the extent and nature of concordance and discordance can be established. Apart from its role in decision preparation and evaluation, it can also provide real time and relevant documentation for the patient�

The Child Care Ecology Inventory: A Domain-Specific Measure of Home-Based Child Care Quality to Promote Social Competence for School Readiness

ERIC Educational Resources Information Center

Rusby, Julie C.; Jones, Laura Backen; Crowley, Ryann; Smolkowski, Keith

2013-01-01

This study investigates the reliability and validity of the Child Care Ecology Inventory (CCEI), a measure of the quality of family child care in the social domain. The CCEI focuses on research-based environmental features and caregiving practices for promoting positive social development in preschool-age children. A total of 198 family child care…

Quality assessment of color images based on the measure of just noticeable color difference

NASA Astrophysics Data System (ADS)

Chou, Chun-Hsien; Hsu, Yun-Hsiang

2014-01-01

Accurate assessment on the quality of color images is an important step to many image processing systems that convey visual information of the reproduced images. An accurate objective image quality assessment (IQA) method is expected to give the assessment result highly agreeing with the subjective assessment. To assess the quality of color images, many approaches simply apply the metric for assessing the quality of gray scale images to each of three color channels of the color image, neglecting the correlation among three color channels. In this paper, a metric for assessing color images' quality is proposed, in which the model of variable just-noticeable color difference (VJNCD) is employed to estimate the visibility thresholds of distortion inherent in each color pixel. With the estimated visibility thresholds of distortion, the proposed metric measures the average perceptible distortion in terms of the quantized distortion according to the perceptual error map similar to that defined by National Bureau of Standards (NBS) for converting the color difference enumerated by CIEDE2000 to the objective score of perceptual quality assessment. The perceptual error map in this case is designed for each pixel according to the visibility threshold estimated by the VJNCD model. The performance of the proposed metric is verified by assessing the test images in the LIVE database, and is compared with those of many well-know IQA metrics. Experimental results indicate that the proposed metric is an effective IQA method that can accurately predict the image quality of color images in terms of the correlation between objective scores and subjective evaluation.

Sleep Quality Estimation based on Chaos Analysis for Heart Rate Variability

NASA Astrophysics Data System (ADS)

Fukuda, Toshio; Wakuda, Yuki; Hasegawa, Yasuhisa; Arai, Fumihito; Kawaguchi, Mitsuo; Noda, Akiko

In this paper, we propose an algorithm to estimate sleep quality based on a heart rate variability using chaos analysis. Polysomnography(PSG) is a conventional and reliable system to diagnose sleep disorder and to evaluate its severity and therapeatic effect, by estimating sleep quality based on multiple channels. However, a recording process requires a lot of time and a controlled environment for measurement and then an analyzing process of PSG data is hard work because the huge sensed data should be manually evaluated. On the other hand, it is focused that some people make a mistake or cause an accident due to lost of regular sleep and of homeostasis these days. Therefore a simple home system for checking own sleep is required and then the estimation algorithm for the system should be developed. Therefore we propose an algorithm to estimate sleep quality based only on a heart rate variability which can be measured by a simple sensor such as a pressure sensor and an infrared sensor in an uncontrolled environment, by experimentally finding the relationship between chaos indices and sleep quality. The system including the estimation algorithm can inform patterns and quality of own daily sleep to a user, and then the user can previously arranges his life schedule, pays more attention based on sleep results and consult with a doctor.

The development of effects-based air quality management regimes

NASA Astrophysics Data System (ADS)

Longhurst, J. W. S.; Irwin, J. G.; Chatterton, T. J.; Hayes, E. T.; Leksmono, N. S.; Symons, J. K.

This paper considers the evolution of attempts to control and manage air pollution, principally but not exclusively focussing upon the challenge of managing air pollution in urban environments. The development and implementation of a range of air pollution control measures are considered. Initially the measures implemented primarily addressed point sources, a small number of fuel types and a limited number of pollutants. The adequacy of such a source-control approach is assessed within the context of a changing and challenging air pollution climate. An assessment of air quality management in the United Kingdom over a 50-year timeframe exemplifies the range of issues and challenges in contemporary air quality management. The need for new approaches is explored and the development and implementation of an effects-based, risk management system for air quality regulation is evaluated.

Fish community-based measures of estuarine ecological quality and pressure-impact relationships

NASA Astrophysics Data System (ADS)

Fonseca, Vanessa F.; Vasconcelos, Rita P.; Gamito, Rita; Pasquaud, Stéphanie; Gonçalves, Catarina I.; Costa, José L.; Costa, Maria J.; Cabral, Henrique N.

2013-12-01

Community-based responses of fish fauna to anthropogenic pressures have been extensively used to assess the ecological quality of estuarine ecosystems. Several methodologies have been developed recently combining metrics reflecting community structure and function. A fish community facing significant environmental disturbances will be characterized by a simplified structure, with lower diversity and complexity. However, estuaries are naturally dynamic ecosystems exposed to numerous human pressures, making it difficult to distinguish between natural and anthropogenic-induced changes to the biological community. In the present work, the variability of several fish metrics was assessed in relation to different pressures in estuarine sites. The response of a multimetric index (Estuarine Fish Assessment Index) was also analysed. Overall, fish metrics and the multimetric index signalled anthropogenic stress, particularly environmental chemical pollution. The fish assemblage associated with this type of pressure was characterized by lower species diversity, lower number of functional guilds, lower abundance of marine migrants and of piscivorous individuals, and higher abundance of estuarine resident species. A decreased ecological quality status, based on the EFAI, was also determined for sites associated with this pressure group. Ultimately, the definition of each pressure groups favoured a stressor-specific analysis, evidencing pressure patterns and accounting for multiple factors in a highly dynamic environment.

Autonomous Quality Control of Joint Orientation Measured with Inertial Sensors.

PubMed

Lebel, Karina; Boissy, Patrick; Nguyen, Hung; Duval, Christian

2016-07-05

Clinical mobility assessment is traditionally performed in laboratories using complex and expensive equipment. The low accessibility to such equipment, combined with the emerging trend to assess mobility in a free-living environment, creates a need for body-worn sensors (e.g., inertial measurement units-IMUs) that are capable of measuring the complexity in motor performance using meaningful measurements, such as joint orientation. However, accuracy of joint orientation estimates using IMUs may be affected by environment, the joint tracked, type of motion performed and velocity. This study investigates a quality control (QC) process to assess the quality of orientation data based on features extracted from the raw inertial sensors' signals. Joint orientation (trunk, hip, knee, ankle) of twenty participants was acquired by an optical motion capture system and IMUs during a variety of tasks (sit, sit-to-stand transition, walking, turning) performed under varying conditions (speed, environment). An artificial neural network was used to classify good and bad sequences of joint orientation with a sensitivity and a specificity above 83%. This study confirms the possibility to perform QC on IMU joint orientation data based on raw signal features. This innovative QC approach may be of particular interest in a big data context, such as for remote-monitoring of patients' mobility.

Quality measures and assurance for AI (Artificial Intelligence) software

NASA Technical Reports Server (NTRS)

Rushby, John

1988-01-01

This report is concerned with the application of software quality and evaluation measures to AI software and, more broadly, with the question of quality assurance for AI software. Considered are not only the metrics that attempt to measure some aspect of software quality, but also the methodologies and techniques (such as systematic testing) that attempt to improve some dimension of quality, without necessarily quantifying the extent of the improvement. The report is divided into three parts Part 1 reviews existing software quality measures, i.e., those that have been developed for, and applied to, conventional software. Part 2 considers the characteristics of AI software, the applicability and potential utility of measures and techniques identified in the first part, and reviews those few methods developed specifically for AI software. Part 3 presents an assessment and recommendations for the further exploration of this important area.

The development of NEdSERV: quantitative instrumentation to measure service quality in nurse education.

PubMed

Roberts, P

1999-07-01

The political climate of health care provision and education for health care in the latter years of the 20th century is evolving from the uncertainty of newly created markets to a more clearly focused culture of collaboration, dissemination of good practice, with an increased emphasis on quality provision and its measurement. The need for provider units to prove and improve efficiency and effectiveness through evidence-based quality strategies in order to stay firmly in the market place has never been more necessary. The measurement of customer expectations and perceptions of delivered service quality is widely utilized as a basis for customer retention and business growth in both commercial and non-profit organizations. This paper describes the methodological development of NEdSERV--quantitative instrumentation designed to measure and respond to ongoing stakeholder expectations and perceptions of delivered service quality within nurse education.

The evolving landscape of quality measurement for heart failure

PubMed Central

Fitzgerald, Ashley A.; Allen, Larry A.; Masoudi, Frederick A.

2013-01-01

Heart failure (HF) is a major cause of mortality and morbidity, representing a leading cause of death and hospitalization among U.S. Medicare beneficiaries. Advances in science have generated effective interventions to reduce adverse outcomes in HF, particularly in patients with reduced left ventricular ejection fraction. Unfortunately, effective therapies for heart failure are often not utilized in an effective, safe, timely, equitable, patient-centered, and efficient manner. Further, the risk of adverse outcomes for HF remains high. The last decades have witnessed the growth of efforts to measure and improve the care and outcomes of patients with HF. This paper will review the evolution of quality measurement for HF, including a brief history of quality measurement in medicine; the measures that have been employed to characterize quality in heart failure; how the measures are obtained; how measures are employed; and present and future challenges surrounding quality measurement in heart failure. PMID:22548579

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

Rural Clinician Evaluation of Children's Health Care Quality Measures: An Oregon Rural Practice-based Research Network (ORPRN) Study.

PubMed

Fagnan, Lyle J; Michaels, LeAnn; Ramsey, Katrina; Shearer, Stefan; Droppers, Oliver; Gallia, Charles

2015-01-01

Responding to quality metrics is an accepted and expected component of the current health care environment. Little is known about which measures physicians identify as a priority when reporting the quality of care to their patients, especially the care of children in rural settings. The objective of this study is for physicians caring for children in rural communities to identify which of the initial core sets of 24 child health quality measures are useful and are a priority for reporting and improving care. A survey was sent to rural Oregon physicians who provide care to children. Of 955 eligible physicians, 172 (18%) completed the survey. The majority of respondents were family physicians (84%), and most respondents (58%) were in private practice. The child health measures stratified into 3 priority tiers: high, medium, and low priority. The top-tier priority measures included childhood immunization status, well-child visits, adolescent immunization status, body mass index assessment, and developmental screening. Dental treatment services, adequate prenatal care, and lower-birth-weight infants were among the lower-tier measures. The priority measures identified by rural family physicians reflect the relevance of the selected measures to their daily practice responsibilities, with missed opportunities to improve community health. © Copyright 2015 by the American Board of Family Medicine.

The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

PubMed

Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

2016-01-01

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision.ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients. © Georg Thieme Verlag KG Stuttgart · New York.

Quality of Life. Volume I: Conceptualization and Measurement.

ERIC Educational Resources Information Center

Schalock, Robert L., Ed.; Siperstein, Gary N., Ed.

This volume deals with the conceptualization and measurement of quality of life for persons with mental retardation and developmental disabilities. Part 1, "The Conceptualization of Quality of Life," contains: "Self Advocacy: Foundation for Quality of Life" (Nancy A. Ward and Kenneth D. Keith); "Quality of Life and the Individual's Perspective"…

Moving healthcare quality forward with nursing-sensitive value-based purchasing.

PubMed

Kavanagh, Kevin T; Cimiotti, Jeannie P; Abusalem, Said; Coty, Mary-Beth

2012-12-01

To underscore the need for health system reform and emphasize nursing measures as a key component in our healthcare reimbursement system. Nursing-sensitive value-based purchasing (NSVBP) has been proposed as an initiative that would help to promote optimal staffing and practice environment through financial rewards and transparency of structure, process, and patient outcome measures. This article reviews the medical, governmental, institutional, and lay literature regarding the necessity for, method of implementation of, and potential impact of NSVBP. Research has shown that adverse events and mortality are highly dependent on nurse staffing levels and skill mix. The National Database of Nursing Quality Indicators (NDNQI), along with other well-developed indicators, can be used as nursing-sensitive measurements for value-based purchasing initiatives. Nursing-sensitive measures are an important component of value-based purchasing. Value-based purchasing is in its infancy. Devising an effective system that recognizes and incorporates nursing measures will facilitate the success of this initiative. NSVBP needs to be designed and incentivized to decrease adverse events, hospital stays, and readmission rates, thereby decreasing societal healthcare costs. NSVBP has the potential for improving the quality of nursing care by financially motivating hospitals to have an optimal nurse practice environment capable of producing optimal patient outcomes by aligning cost effectiveness for hospitals to that of the patient and society. © 2012 Sigma Theta Tau International.

Moving Healthcare Quality Forward With Nursing-Sensitive Value-Based Purchasing

PubMed Central

Kavanagh, Kevin T; Cimiotti, Jeannie P; Abusalem, Said; Coty, Mary-Beth

2012-01-01

Purpose: To underscore the need for health system reform and emphasize nursing measures as a key component in our healthcare reimbursement system. Design and Methods: Nursing-sensitive value-based purchasing (NSVBP) has been proposed as an initiative that would help to promote optimal staffing and practice environment through financial rewards and transparency of structure, process, and patient outcome measures. This article reviews the medical, governmental, institutional, and lay literature regarding the necessity for, method of implementation of, and potential impact of NSVBP. Findings: Research has shown that adverse events and mortality are highly dependent on nurse staffing levels and skill mix. The National Database of Nursing Quality Indicators (NDNQI), along with other well-developed indicators, can be used as nursing-sensitive measurements for value-based purchasing initiatives. Nursing-sensitive measures are an important component of value-based purchasing. Conclusions: Value-based purchasing is in its infancy. Devising an effective system that recognizes and incorporates nursing measures will facilitate the success of this initiative. NSVBP needs to be designed and incentivized to decrease adverse events, hospital stays, and readmission rates, thereby decreasing societal healthcare costs. Clinical Relevance: NSVBP has the potential for improving the quality of nursing care by financially motivating hospitals to have an optimal nurse practice environment capable of producing optimal patient outcomes by aligning cost effectiveness for hospitals to that of the patient and society. PMID:23066956

Instructional Alignment as a Measure of Teaching Quality

ERIC Educational Resources Information Center

Polikoff, Morgan S.; Porter, Andrew C.

2014-01-01

Recent years have seen the convergence of two major policy streams in U.S. K-12 education: standards/accountability and teacher quality reforms. Work in these areas has led to the creation of multiple measures of teacher quality, including measures of their instructional alignment to standards/assessments, observational and student survey measures…

Infrastructure for quality transformation: measurement and reporting in veterans administration intensive care units.

PubMed

Render, Marta L; Freyberg, Ron W; Hasselbeck, Rachael; Hofer, Timothy P; Sales, Anne E; Deddens, James; Levesque, Odette; Almenoff, Peter L

2011-06-01

BACKGROUND Veterans Health Administration (VA) intensive care units (ICUs) develop an infrastructure for quality improvement using information technology and recruiting leadership. METHODS Setting Participation by the 183 ICUs in the quality improvement program is required. Infrastructure includes measurement (electronic data extraction, analysis), quarterly web-based reporting and implementation support of evidence-based practices. Leaders prioritise measures based on quality improvement objectives. The electronic extraction is validated manually against the medical record, selecting hospitals whose data elements and measures fall at the extremes (10th, 90th percentile). results are depicted in graphic, narrative and tabular reports benchmarked by type and complexity of ICU. RESULTS The VA admits 103 689±1156 ICU patients/year. Variation in electronic business practices, data location and normal range of some laboratory tests affects data quality. A data management website captures data elements important to ICU performance and not available electronically. A dashboard manages the data overload (quarterly reports ranged 106-299 pages). More than 85% of ICU directors and nurse managers review their reports. Leadership interest is sustained by including ICU targets in executive performance contracts, identification of local improvement opportunities with analytic software, and focused reviews. CONCLUSION Lessons relevant to non-VA institutions include the: (1) need for ongoing data validation, (2) essential involvement of leadership at multiple levels, (3) supplementation of electronic data when key elements are absent, (4) utility of a good but not perfect electronic indicator to move practice while improving data elements and (5) value of a dashboard.

Quality appraisal of generic self-reported instruments measuring health-related productivity changes: a systematic review

PubMed Central

2014-01-01

Background Health impairments can result in disability and changed work productivity imposing considerable costs for the employee, employer and society as a whole. A large number of instruments exist to measure health-related productivity changes; however their methodological quality remains unclear. This systematic review critically appraised the measurement properties in generic self-reported instruments that measure health-related productivity changes to recommend appropriate instruments for use in occupational and economic health practice. Methods PubMed, PsycINFO, Econlit and Embase were systematically searched for studies whereof: (i) instruments measured health-related productivity changes; (ii) the aim was to evaluate instrument measurement properties; (iii) instruments were generic; (iv) ratings were self-reported; (v) full-texts were available. Next, methodological quality appraisal was based on COSMIN elements: (i) internal consistency; (ii) reliability; (iii) measurement error; (iv) content validity; (v) structural validity; (vi) hypotheses testing; (vii) cross-cultural validity; (viii) criterion validity; and (ix) responsiveness. Recommendations are based on evidence syntheses. Results This review included 25 articles assessing the reliability, validity and responsiveness of 15 different generic self-reported instruments measuring health-related productivity changes. Most studies evaluated criterion validity, none evaluated cross-cultural validity and information on measurement error is lacking. The Work Limitation Questionnaire (WLQ) was most frequently evaluated with moderate respectively strong positive evidence for content and structural validity and negative evidence for reliability, hypothesis testing and responsiveness. Less frequently evaluated, the Stanford Presenteeism Scale (SPS) showed strong positive evidence for internal consistency and structural validity, and moderate positive evidence for hypotheses testing and criterion validity. The

A Structured-Grid Quality Measure for Simulated Hypersonic Flows

NASA Technical Reports Server (NTRS)

Alter, Stephen J.

2004-01-01

A structured-grid quality measure is proposed, combining three traditional measurements: intersection angles, stretching, and curvature. Quality assesses whether the grid generated provides the best possible tradeoffs in grid stretching and skewness that enable accurate flow predictions, whereas the grid density is assumed to be a constraint imposed by the available computational resources and the desired resolution of the flow field. The usefulness of this quality measure is assessed by comparing heat transfer predictions from grid convergence studies for grids of varying quality in the range of [0.6-0.8] on an 8'half-angle sphere-cone, at laminar, perfect gas, Mach 10 wind tunnel conditions.

Measuring Service Quality in a Tertiary Institution.

ERIC Educational Resources Information Center

Soutar, Geoffrey; McNeil, Margaret

1996-01-01

Measures service quality from the viewpoint of customers (students at an Australian university), using the SERVQUAL model. Obtains evaluations of academic and administrative aspects of the educational service. Makes significant negative evaluations of administrative service quality (resulting from communication problems). Satisfaction with the…

Serengeti real estate: density vs. fitness-based indicators of lion habitat quality.

PubMed

Mosser, Anna; Fryxell, John M; Eberly, Lynn; Packer, Craig

2009-10-01

Habitat quality is typically inferred by assuming a direct relationship between consumer density and resource abundance, although it has been suggested that consumer fitness may be a more accurate measure of habitat quality. We examined density vs. fitness-based measures of habitat quality for lions in the Serengeti National Park, Tanzania. A 40-year average of female reproductive success (yearling cubs per female) was best explained by proximity to river confluences, whereas patterns of productivity (yearling cubs per km(2)) and adult female density (individuals per km(2)) were associated with more general measures of habitat quality and areas of shelter in poor habitat. This suggests that density may not accurately distinguish between high-quality 'source' areas and low-quality sites that merely provide refuges for effectively non-reproductive individuals. Our results indicate that density may be a misleading indicator of real estate value, particularly for populations that do not conform to an ideal free distribution.

The impact of the Internet on quality measurement.

PubMed

Bates, D W; Gawande, A A

2000-01-01

Consumers are eager for information about health. However, their use of such data has been limited to date. When consumers do consider data in making health care choices, they rely more on word-of-mouth reputation than on traditional quality measures, although this information has not necessarily been readily accessible. The Internet changes the exercise of quality measurement in several ways. First, quality information--including reputation--will be more readily available. Second, consumers will increasingly use it. Third, the Internet provides a low-cost, standard platform that will make it vastly easier for providers to collect quality information and pass it on to others. However, major barriers still stand in the way of public access to quality information on the Internet as well as of having that access actually improve patients' care.

Quality of in-hospital stroke care according to evidence-based performance measures: results from the first audit of stroke, Catalonia, Spain.

PubMed

Abilleira, Sònia; Gallofré, Miquel; Ribera, Aida; Sánchez, Emília; Tresserras, Ricard

2009-04-01

Evidence-based standards are used worldwide to determine quality of care. We assessed quality of in-hospital stroke care in all acute-care hospitals in Catalonia by determining adherence to 13 evidence-based performance measures (PMs) of process of care. Data on PMs were collected by retrospective review of medical records of consecutive stroke admissions (January to June, 2005). Compliance with PMs was calculated according to 3 hospital levels determined by their annual stroke case-load (level 1, <150 admissions/yr; level 2, 150 to 350; and level 3, >350). We defined sampling weights that represented each patient's inverse probability of inclusion in the study sample. Sampling weights were applied to produce estimates of compliance. Factors that predicted good/bad compliance were determined by multivariate weighted logistic regression models. An external monitoring of 10% of cases recruited at each hospital was undertaken, after random selection, to assess quality of data. We analyzed data from 1791 stroke cases (17% of all stroke admissions). Global interobserver agreement was 0.7. Eight PMs achieved compliances >or=75%, 4 of which were more than 90%, and the remaining showed adherences measures showed poor compliances compared to acute care-related ones, which achieved more satisfactory adherences.

Measuring Quality in Online Education: A Meta-Synthesis

ERIC Educational Resources Information Center

Esfijani, Azam

2018-01-01

This article presents a meta-synthesis review of quality of online education (QOE) measurement approaches. In order to survey the existing body of knowledge, a qualitative method was employed to investigate what quality of online education is comprised of and how the concept has been measured through the literature. To achieve this, a total of 112…

dBBQs: dataBase of Bacterial Quality scores.

PubMed

Wanchai, Visanu; Patumcharoenpol, Preecha; Nookaew, Intawat; Ussery, David

2017-12-28

It is well-known that genome sequencing technologies are becoming significantly cheaper and faster. As a result of this, the exponential growth in sequencing data in public databases allows us to explore ever growing large collections of genome sequences. However, it is less known that the majority of available sequenced genome sequences in public databases are not complete, drafts of varying qualities. We have calculated quality scores for around 100,000 bacterial genomes from all major genome repositories and put them in a fast and easy-to-use database. Prokaryotic genomic data from all sources were collected and combined to make a non-redundant set of bacterial genomes. The genome quality score for each was calculated by four different measurements: assembly quality, number of rRNA and tRNA genes, and the occurrence of conserved functional domains. The dataBase of Bacterial Quality scores (dBBQs) was designed to store and retrieve quality scores. It offers fast searching and download features which the result can be used for further analysis. In addition, the search results are shown in interactive JavaScript chart framework using DC.js. The analysis of quality scores across major public genome databases find that around 68% of the genomes are of acceptable quality for many uses. dBBQs (available at http://arc-gem.uams.edu/dbbqs ) provides genome quality scores for all available prokaryotic genome sequences with a user-friendly Web-interface. These scores can be used as cut-offs to get a high-quality set of genomes for testing bioinformatics tools or improving the analysis. Moreover, all data of the four measurements that were combined to make the quality score for each genome, which can potentially be used for further analysis. dBBQs will be updated regularly and is freely use for non-commercial purpose.

Development of a standardized measure to assess food quality: a proof of concept.

PubMed

Jomaa, L H; Hwalla, N C; Zidek, J M

2016-11-09

Food-based dietary guidelines are promoted to improve diet quality. In applying dietary recommendations, such as the MyPlate, the number of servings in a food group is the unit of measure used to make food selections. However, within each food group, different foods can vary greatly in their nutritional quality despite often having similar energy (caloric) values. This study aimed to develop a novel unit of measure that accounts for both the quantity of energy and the quality of nutrients, as defined by caloric and micronutrient density, respectively, in foods and to demonstrate its usability in identifying high quality foods within a food group. A standardized unit of measure reflecting the quality of kilocalories for nutrition (qCaln) was developed through a mathematical function dependent on the energy content (kilocalories per 100 g) and micronutrient density of foods items within a food group. Nutrition composition of 1806 food items was extracted from the USDA nutrient database. For each food item analyzed, qCaln ratios were calculated to compare qCaln to its caloric content. Finally, a case example was developed comparing two plates adapted from the MyPlate. Examples of food items with highest and lowest qCaln ratios were displayed for five food groups: vegetables, fruits/fruit juices, milk/dairy products, meats/meat alternatives, and breads/cereals. Additionally, the applicability of the qCaln was presented through comparing two plates, adopted from the USDA MyPlate, to show differences in food quality. The newly developed qCaln measure can be used to rank foods in terms of their nutrient density while accounting for their energy content. The proposed metric can provide consumers, public health professionals, researchers, and policy makers with an easy-to-understand measure of food quality and a practical tool to assess diet quality among individuals and population groups.

Developing a Health-Related Quality-of-Life Measure for People with Intellectual Disability

ERIC Educational Resources Information Center

Clark, Lauren; Pett, Marjorie A.; Cardell, Elizabeth M.; Guo, Jia-Wen; Johnson, Erin

2017-01-01

Using principles of community-based participatory research we developed a new theory-based measure of health-related quality of life (HRQOL) for individuals with intellectual disability (ID). We recruited adults with ID (n = 129) to take part in interviews and review successive versions of HRQOL items. Critical input about content and…

ACCF/AHA methodology for the development of quality measures for cardiovascular technology: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures.

PubMed

Bonow, Robert O; Douglas, Pamela S; Buxton, Alfred E; Cohen, David J; Curtis, Jeptha P; Delong, Elizabeth; Drozda, Joseph P; Ferguson, T Bruce; Heidenreich, Paul A; Hendel, Robert C; Masoudi, Frederick A; Peterson, Eric D; Taylor, Allen J

2011-09-27

Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardiovascular care by convening a joint ACCF/AHA Task Force on Performance Measures. The Task Force is charged with identifying the clinical topics appropriate for the development of performance measures and with assembling writing committees composed of clinical and methodological experts in collaboration with appropriate subspecialty societies. The Task Force has also created methodology documents that offer guidance in the development of process, outcome, composite, and efficiency measures. Cardiovascular performance measures using existing ACCF/AHA methodology are based on Class I or Class III guidelines recommendations, usually with Level A evidence. These performance measures, based on evidence-based ACCF/AHA guidelines, remain the most rigorous quality measures for both internal quality improvement and public reporting. However, many of the tools for diagnosis and treatment of cardiovascular disease involve advanced technologies, such as cardiac imaging, for which there are often no underlying guideline documents. Because these technologies affect the quality of cardiovascular care and also have the potential to contribute to cardiovascular health expenditures, there is a need for more critical assessment of the use of technology, including the development of quality and performance measures in areas in which guideline recommendations are absent. The evaluation of quality in the use of cardiovascular technologies requires consideration of multiple parameters that differ from other healthcare processes. The present document describes methodology for development of 2 new classes of quality measures in these situations, appropriate use measures and structure/safety measures. Appropriate use measures are based on

Theory and practice for measuring health care quality

PubMed Central

Berwick, Donald M.; Knapp, Marian Gilbert

1987-01-01

As competition, cost control, and new modes of delivery emerge in health care, there is a need to reexamine both the traditional definitions of health care quality and the methods by which it is measured. Industries other than health care have much to teach regarding the methods for obtaining, analyzing, and displaying data; techniques for problem identification, problem solving, and reassessment; and ideas about organizational factors that produce a high quality product or service. The Quality-of-Care Measurement Department at the Harvard Community Health Plan has built a program that draws from a distinguished health care quality assurance tradition and incorporates techniques that have been successful in other industries. PMID:10312319

Air Quality Measurements for Science and Policy

EPA Science Inventory

Air quality measurements and the methods used to conduct them are vital to advancing our knowledge of the source-to-receptor-to-health effects continuum^1-3. This information then forms the basis for evaluating and managing air quality to protect human health and welfa...

Measuring Indoor Air Quality of Hookah Lounges

PubMed Central

Fiala, Steven C.; Pawlak, Rebecca L.

2012-01-01

Many states have implemented smoke-free workplace laws to protect employees and customers from exposure to secondhand smoke. However, exemptions in these laws have allowed indoor tobacco smoking in hookah lounges to proliferate in recent years. To describe the amount of secondhand smoke in hookah lounges, we measured the indoor air quality of 10 hookah lounges in Oregon. Air quality measurements ranged from “unhealthy” to “hazardous” according to Environmental Protection Agency standards, indicating a potential health risk for patrons and employees. PMID:22994168

Study on an Air Quality Evaluation Model for Beijing City Under Haze-Fog Pollution Based on New Ambient Air Quality Standards

PubMed Central

Li, Li; Liu, Dong-Jun

2014-01-01

Since 2012, China has been facing haze-fog weather conditions, and haze-fog pollution and PM2.5 have become hot topics. It is very necessary to evaluate and analyze the ecological status of the air environment of China, which is of great significance for environmental protection measures. In this study the current situation of haze-fog pollution in China was analyzed first, and the new Ambient Air Quality Standards were introduced. For the issue of air quality evaluation, a comprehensive evaluation model based on an entropy weighting method and nearest neighbor method was developed. The entropy weighting method was used to determine the weights of indicators, and the nearest neighbor method was utilized to evaluate the air quality levels. Then the comprehensive evaluation model was applied into the practical evaluation problems of air quality in Beijing to analyze the haze-fog pollution. Two simulation experiments were implemented in this study. One experiment included the indicator of PM2.5 and was carried out based on the new Ambient Air Quality Standards (GB 3095-2012); the other experiment excluded PM2.5 and was carried out based on the old Ambient Air Quality Standards (GB 3095-1996). Their results were compared, and the simulation results showed that PM2.5 was an important indicator for air quality and the evaluation results of the new Air Quality Standards were more scientific than the old ones. The haze-fog pollution situation in Beijing City was also analyzed based on these results, and the corresponding management measures were suggested. PMID:25170682

A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes.

PubMed

Driessen, Sara R C; Van Zwet, Erik W; Haazebroek, Pascal; Sandberg, Evelien M; Blikkendaal, Mathijs D; Twijnstra, Andries R H; Jansen, Frank Willem

2016-12-01

The current health care system has an urgent need for tools to measure quality. A wide range of quality indicators have been developed in an attempt to differentiate between high-quality and low-quality health care processes. However, one of the main issues of currently used indicators is the lack of case-mix correction and improvement possibilities. Case-mix is defined as specific (patient) characteristics that are known to potentially affect (surgical) outcome. If these characteristics are not taken into consideration, comparisons of outcome among health care providers may not be valid. The objective of the study was to develop and test a quality assessment tool for laparoscopic hysterectomy, which can serve as a new outcome quality indicator. This is a prospective, international, multicenter implementation study. A web-based application was developed with 3 main goals: (1) to measure the surgeon's performance using 3 primary outcomes (blood loss, operative time, and complications); (2) to provide immediate individual feedback using cumulative observed-minus-expected graphs; and (3) to detect consistently suboptimal performance after correcting for case-mix characteristics. All gynecologists who perform laparoscopic hysterectomies were requested to register their procedures in the application. A patient safety risk factor checklist was used by the surgeon for reflection. Thereafter a prospective implementation study was performed, and the application was tested using a survey that included the System Usability Scale. A total of 2066 laparoscopic hysterectomies were registered by 81 gynecologists. Mean operative time was 100 ± 39 minutes, blood loss 127 ± 163 mL, and the complication rate 6.1%. The overall survey response rate was 75%, and the mean System Usability Scale was 76.5 ± 13.6, which indicates that the application was good to excellent. The majority of surgeons reported that the application made them more aware of their performance, the outcomes, and

Implications of measures of quality of life for policy development.

PubMed

Mosteller, F

1987-01-01

Quality of life measurements can lead to legislative programs for health, new policies for the health care system, and possibly new attitudes in the courts. Clinical decisions, public health evaluations, and advice for legislatures and courts require diverse measures. We illustrate potential use of such measures with reimbursement problems, programs like Head Start, mainstreaming the handicapped, day care and prenatal care, terminal care for the elderly, monitoring programs, and chronic disabilities. The many treatment policies discussed at the Portugal Conference show the need for quality of life measures in clinical trials. The courts, although considering quality of life, do not seem to consider quality of life measures. If scientists and medical experts wish to establish or change the positions of the courts, consensus conferences appear more effective than regulation or new legislation. To contribute more than they now do to policy, workers measuring quality of life need to develop a variety of measures and methods. They, then, must apply them to medical and health problems, build up a substantial literature, and set priorities for the research needs of the field.

Adaptive measurements of urban runoff quality

NASA Astrophysics Data System (ADS)

Wong, Brandon P.; Kerkez, Branko

2016-11-01

An approach to adaptively measure runoff water quality dynamics is introduced, focusing specifically on characterizing the timing and magnitude of urban pollutographs. Rather than relying on a static schedule or flow-weighted sampling, which can miss important water quality dynamics if parameterized inadequately, novel Internet-enabled sensor nodes are used to autonomously adapt their measurement frequency to real-time weather forecasts and hydrologic conditions. This dynamic approach has the potential to significantly improve the use of constrained experimental resources, such as automated grab samplers, which continue to provide a strong alternative to sampling water quality dynamics when in situ sensors are not available. Compared to conventional flow-weighted or time-weighted sampling schemes, which rely on preset thresholds, a major benefit of the approach is the ability to dynamically adapt to features of an underlying hydrologic signal. A 28 km2 urban watershed was studied to characterize concentrations of total suspended solids (TSS) and total phosphorus. Water quality samples were autonomously triggered in response to features in the underlying hydrograph and real-time weather forecasts. The study watershed did not exhibit a strong first flush and intraevent concentration variability was driven by flow acceleration, wherein the largest loadings of TSS and total phosphorus corresponded with the steepest rising limbs of the storm hydrograph. The scalability of the proposed method is discussed in the context of larger sensor network deployments, as well the potential to improving control of urban water quality.

Application of the acoustic voice quality index for objective measurement of dysphonia severity.

PubMed

Núñez-Batalla, Faustino; Díaz-Fresno, Estefanía; Álvarez-Fernández, Andrea; Muñoz Cordero, Gabriela; Llorente Pendás, José Luis

Over the past several decades, many acoustic parameters have been studied as sensitive to and to measure dysphonia. However, current acoustic measures might not be sensitive measures of perceived voice quality. A meta-analysis which evaluated the relationship between perceived overall voice quality and several acoustic-phonetic correlates, identified measures that do not rely on the extraction of the fundamental period, such the measures derived from the cepstrum, and that can be used in sustained vowel as well as continuous speech samples. A specific and recently developed method to quantify the severity of overall dysphonia is the acoustic voice quality index (AVQI) that is a multivariate construct that combines multiple acoustic markers to yield a single number that correlates reasonably with overall vocal quality. This research is based on one pool of voice recordings collected in two sets of subjects: 60 vocally normal and 58 voice disordered participants. A sustained vowel and a sample of connected speech were recorded and analyzed to obtain the six parameters included in the AVQI using the program Praat. Statistical analysis was completed using SPSS for Windows, version 12.0. Correlation between perception of overall voice quality and AVQI: A significant difference exists (t(95) = 9.5; p<.000) between normal and dysphonic voices. The findings of this study demonstrate the clinical feasibility of the AVQI as a measure of dysphonia severity. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Measurement properties of a new quality of life measure for patients with work disability associated with musculoskeletal pain.

PubMed

Coutu, M F; Durand, M J; Loisel, P; Dupuis, G; Gervais, S

2005-09-01

The Quality of Life Systemic Inventory (QLSI) measures patients' goal attainment based on the system control theory. It quantifies the perceived impact of the disorder and the gap between the present and aspired states. To evaluate concurrent validity and responsiveness of the QLSI among workers on sick leave due to musculoskeletal disorders (MSDs). Participants (10 women; 29 men) were recruited at a work rehabilitation centre and had more than 4 weeks of absence from work due to MSDs compensated by the Workers' Compensation Board. Concurrent validity and external responsiveness were based on baseline and post-treatment measures of external criteria. Criteria and related instruments were the following: perception of disability (Roland-Morris Disability Questionnaire); health-related quality of life (SF-12); stress (Psychological Stress Measure) and distress (Psychological Distress Index). Regression analyses revealed significant correlations between QLSI scores and the Psychological Distress Index (r2 = .11 to .19 and .66; p < .001), with either the SF-12 mental component scale (r2 = .18 and .11; p < .01) or the Roland-Morris Disability Questionnaire (r2 = .04 and .10; p < .05). All measures showed highly significant change over time. Results support the concurrent validity and responsiveness of the QLSI, with an MSD population. This instrument could serve in future research as an outcome measurement instrument in the evaluation of more long-term effects of rehabilitation programs.

Towards the XML schema measurement based on mapping between XML and OO domain

NASA Astrophysics Data System (ADS)

Rakić, Gordana; Budimac, Zoran; Heričko, Marjan; Pušnik, Maja

2017-07-01

Measuring quality of IT solutions is a priority in software engineering. Although numerous metrics for measuring object-oriented code already exist, measuring quality of UML models or XML Schemas is still developing. One of the research questions in the overall research leaded by ideas described in this paper is whether we can apply already defined object-oriented design metrics on XML schemas based on predefined mappings. In this paper, basic ideas for mentioned mapping are presented. This mapping is prerequisite for setting the future approach to XML schema quality measuring with object-oriented metrics.

Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement.

PubMed

Block, Lauren; Flynn, Sarah J; Cooper, Lisa A; Lentz, Caroline; Hull, Tammie; Dietz, Katherine B; Boonyasai, Romsai T

2018-01-10

The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners' knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression. All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p < 0.01). Scores improved significantly among staff from all job types. Licensed practical nurses and staff who had been in their current job at least a year were more likely to answer questions correctly than registered nurses and those in their current job less than a year. Attitudes toward correct blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm. We designed, implemented, and

Students Matter: Quality Measurements in Online Courses

ERIC Educational Resources Information Center

Unal, Zafer; Unal, Aslihan

2016-01-01

Quality Matters (QM) is a peer review process designed to certify the quality of online courses and online components. It has generated widespread interest and received national recognition for its peer-based approach to quality assurance and continuous improvement in online education. While the entire QM online course design process is…

Rural southeast Texas air quality measurements during the 2006 Texas Air Quality Study.

PubMed

Schade, Gunnar W; Khan, Siraj; Park, Changhyoun; Boedeker, Ian

2011-10-01

The authors conducted air quality measurements of the criteria pollutants carbon monoxide, nitrogen oxides, and ozone together with meteorological measurements at a park site southeast of College Station, TX, during the 2006 Texas Air Quality Study II (TexAQS). Ozone, a primary focus of the measurements, was above 80 ppb during 3 days and above 75 ppb during additional 8 days in summer 2006, suggestive of possible violations of the ozone National Ambient Air Quality Standard (NAAQS) in this area. In concordance with other air quality measurements during the TexAQS II, elevated ozone mixing ratios coincided with northerly flows during days after cold front passages. Ozone background during these days was as high as 80 ppb, whereas southerly air flows generally provided for an ozone background lower than 40 ppb. Back trajectory analysis shows that local ozone mixing ratios can also be strongly affected by the Houston urban pollution plume, leading to late afternoon ozone increases of as high as 50 ppb above background under favorable transport conditions. The trajectory analysis also shows that ozone background increases steadily the longer a southern air mass resides over Texas after entering from the Gulf of Mexico. In light of these and other TexAQS findings, it appears that ozone air quality is affected throughout east Texas by both long-range and regional ozone transport, and that improvements therefore will require at least a regionally oriented instead of the current locally oriented ozone precursor reduction policies.

Application of an IRT Polytomous Model for Measuring Health Related Quality of Life

ERIC Educational Resources Information Center

Tejada, Antonio J. Rojas; Rojas, Oscar M. Lozano

2005-01-01

Background: The Item Response Theory (IRT) has advantages for measuring Health Related Quality of Life (HRQOL) as opposed to the Classical Tests Theory (CTT). Objectives: To present the results of the application of a polytomous model based on IRT, specifically, the Rating Scale Model (RSM), to measure HRQOL with the EORTC QLQ-C30. Methods: 103…

Examining the Relationship Between Perceived Quality of Care and Actual Quality of Care as Measured by 30-Day Readmission Rates.

PubMed

Salinas, Stanley R

To test the relationship between patient experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and actual quality of care, as measured by 30-day readmission rates. Both HCAHPS data and outcome data reported to the Centers of Medicare & Medicaid Services (CMS). This secondary, nationwide (N = 4060), hospital-level study focused only on acute care hospitals. HCAHPS question 22 "Would you recommend this hospital to your friends and family?" was used to determine level of overall satisfaction, and 30-day readmission rates, as reported to the CMS, was used as a proxy for actual quality of care. A statistically significant relationship was found between patient experience and actual quality outcomes. The results of this study reinforce the inclusion of patient experience in Medicare's Value Based Purchasing program as a matter of good public policy.

[Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital: measurable changes in academic quality indicators?].

PubMed

Lorenzen, J; Habermann, C; Utler, C; Grzyska, U; Weber, C; Adam, G; Koops, A

2009-10-01

To evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. After implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. The evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. The evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological University Hospital after implementation of a QM system according to DIN ISO 9001:2000. Georg Thieme Verlag KG Stuttgart-New York.

Measurement properties of quality of life measurement instruments for infants, children and adolescents with eczema: protocol for a systematic review.

PubMed

Heinl, Daniel; Prinsen, Cecilia A C; Drucker, Aaron M; Ofenloch, Robert; Humphreys, Rosemary; Sach, Tracey; Flohr, Carsten; Apfelbacher, Christian

2016-02-09

Eczema is a common chronic or chronically relapsing, inflammatory skin disease that exerts a substantial negative impact on quality of life (QoL). The Harmonising Outcome Measures for Eczema (HOME) initiative has used a consensus-based process which identified QoL as one of the four core outcome domains to be assessed in all eczema clinical trials. A number of measurement instruments exist to measure QoL in infants, children, and adolescents with eczema, and there is a great variability in both content and quality of the instruments used. Therefore, the objective of the proposed research is to comprehensively and systematically assess the measurement properties of the existing measurement instruments that were developed and/or validated for the measurement of patient-reported QoL in infants, children, and adolescents with eczema. This study is a systematic review of the measurement properties of patient-reported measures of QoL developed and/or validated for infants, children, and adolescents with eczema. A systematic literature search will be carried out in MEDLINE via PubMed and EMBASE using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing, or comparing measurement properties of QoL instruments for infants, children, and adolescents with eczema. Two reviewers will independently perform eligibility assessment and data abstraction. Evidence tables will be used to record study characteristics, instrument characteristics, measurement properties, and interpretability. The adequacy of the measurement properties will be assessed using predefined criteria. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist will be used to evaluate the methodological quality of included studies. A best evidence synthesis will be undertaken if more than one study has examined a particular measurement property. The proposed systematic review will yield a comprehensive assessment

Correlation of Neonatal Intensive Care Unit Performance Across Multiple Measures of Quality of Care

PubMed Central

Profit, J; Zupancic, JAF; Gould, JB; Pietz, K; Kowalkowski, MA; Draper, D; Hysong, SJ; Petersen, LA

2014-01-01

Objectives To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. Design We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Setting Twenty-two regional NICUs in California. Patients In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Main Outcomes Measures Pneumothorax, growth velocity, health care–associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. Results The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations only 6 were significant (P < .05). Correlations between pairs of quality measures were strong (ρ > .5) for 1 pair, moderate (.3 < |ρ| < .5) for 8 pairs, weak (.1 < |ρ| < .3) for 5 pairs and negligible (|ρ| < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care–associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. Conclusion In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest. PMID:23403539

Measuring the quality of health care: state of the art.

PubMed

Donaldson, M S; Nolan, K

1997-05-01

September 12-13, 1996, in Washington, DC, the Institute of Medicine, as part of its Special Initiative on Health Care Quality, held an invitational conference to illustrate exemplary quality measurement and to discuss the results. Patient reports, innovative uses of outcome measures for quality improvement, risk adjustment, assessment in integrated health plans and health care settings, clinical guidelines, and projects on disseminating information on quality measurement techniques and tools were among the topics represented. Brent James described studies undertaken to reduce adverse drug events (ADEs). When implementing any measurement system where error is a possible factor, it is important to emphasize identifying problems for the purpose of learning, not judgment. Lucian Leape agreed that staff involved must feel that the purpose of the study is to examine system problems, not individuals' mistakes. David Classen described a nonproprietary computerized disease-management program designed to reduce ADEs in infectious diseases. "A QUALITY VISION": Robert Brook said that the relationship between cost or resources devoted to care and quality is not well understood and is certainly not simple. He also said that although investments in measurement strategies are needed to make them better, that doesn't mean we shouldn't attempt to use the measurements we have now. Mark Chassin said that the presentations at the conference provided evidence that should allow us to conclude beyond a reasonable doubt that quality can be measured-with a degree of scientific precision equal to that of most of the measures used to take care of patients every day.

Observed characteristics of dust storm events over the western United States using meteorological, satellite, and air quality measurements

NASA Astrophysics Data System (ADS)

Lei, H.; Wang, J. X. L.

2014-08-01

To improve dust storm identification over the western United States, historical dust events measured by air quality and satellite observations are analyzed based on their characteristics in data sets of regular meteorology, satellite-based aerosol optical depth (AOD), and air quality measurements. Based on the prevailing weather conditions associated with dust emission, dust storm events are classified into the following four typical types: (1) The key feature of cold front-induced dust storms is their rapid process with strong dust emissions. (2) Events caused by meso- to small-scale weather systems have the highest levels of emissions. (3) Dust storms caused by tropical disturbances show a stronger air concentration of dust and last longer than those in (1) and (2). (4) Dust storms triggered by cyclogenesis last the longest. In this paper, sample events of each type are selected and examined to explore characteristics observed from in situ and remote-sensing measurements. These characteristics include the lasting period, surface wind speeds, areas affected, average loading on ground-based optical and/or air quality measurements, peak loading on ground-based optical and/or air quality measurements, and loading on satellite-based aerosol optical depth. Based on these analyses, we compare the characteristics of the same dust events captured in different data sets in order to define the dust identification criteria. The analyses show that the variability in mass concentrations captured by in situ measurements is consistent with the variability in AOD from stationary and satellite observations. Our analyses also find that different data sets are capable of identifying certain common characteristics, while each data set also provides specific information about a dust storm event. For example, the meteorological data are good at identifying the lasting period and area impacted by a dust event; the ground-based air quality and optical measurements can capture the peak

Measuring perceived video quality of MPEG enhancement by people with impaired vision

PubMed Central

Fullerton, Matthew; Woods, Russell L.; Vera-Diaz, Fuensanta A.; Peli, Eli

2007-01-01

We used a new method to measure the perceived quality of contrast-enhanced motion video. Patients with impaired vision (n = 24) and normally-sighted subjects (n = 6) adjusted the level of MPEG-based enhancement of 8 videos (4 minutes each) drawn from 4 categories. They selected the level of enhancement that provided the preferred view of the videos, using a reducing-step-size staircase procedure. Most patients made consistent selections of the preferred level of enhancement, indicating an appreciation of and a perceived benefit from the MPEG-based enhancement. The selections varied between patients and were correlated with letter contrast sensitivity, but the selections were not affected by training, experience or video category. We measured just noticeable differences (JNDs) directly for videos, and mapped the image manipulation (enhancement in our case) onto an approximately linear perceptual space. These tools and approaches will be of value in other evaluations of the image quality of motion video manipulations. PMID:18059909

ACCF/AHA methodology for the development of quality measures for cardiovascular technology: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures.

PubMed

Bonow, Robert O; Douglas, Pamela S; Buxton, Alfred E; Cohen, David J; Curtis, Jeptha P; Delong, Elizabeth; Drozda, Joseph P; Ferguson, T Bruce; Heidenreich, Paul A; Hendel, Robert C; Masoudi, Frederick A; Peterson, Eric D; Taylor, Allen J

2011-09-27

Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardiovascular care by convening a joint ACCF/AHA Task Force on Performance Measures. The Task Force is charged with identifying the clinical topics appropriate for the development of performance measures and with assembling writing committees composed of clinical and methodological experts in collaboration with appropriate subspecialty societies. The Task Force has also created methodology documents that offer guidance in the development of process, outcome, composite, and efficiency measures. Cardiovascular performance measures using existing ACCF/AHA methodology are based on Class I or Class III guidelines recommendations, usually with Level A evidence. These performance measures, based on evidence-based ACCF/AHA guidelines, remain the most rigorous quality measures for both internal quality improvement and public reporting. However, many of the tools for diagnosis and treatment of cardiovascular disease involve advanced technologies, such as cardiac imaging, for which there are often no underlying guideline documents. Because these technologies affect the quality of cardiovascular care and also have the potential to contribute to cardiovascular health expenditures, there is a need for more critical assessment of the use of technology, including the development of quality and performance measures in areas in which guideline recommendations are absent. The evaluation of quality in the use of cardiovascular technologies requires consideration of multiple parameters that differ from other healthcare processes. The present document describes methodology for development of 2 new classes of quality measures in these situations, appropriate use measures and structure/safety measures. Appropriate use measures are based on

Machine-Learning Based Channel Quality and Stability Estimation for Stream-Based Multichannel Wireless Sensor Networks.

PubMed

Rehan, Waqas; Fischer, Stefan; Rehan, Maaz

2016-09-12

Wireless sensor networks (WSNs) have become more and more diversified and are today able to also support high data rate applications, such as multimedia. In this case, per-packet channel handshaking/switching may result in inducing additional overheads, such as energy consumption, delays and, therefore, data loss. One of the solutions is to perform stream-based channel allocation where channel handshaking is performed once before transmitting the whole data stream. Deciding stream-based channel allocation is more critical in case of multichannel WSNs where channels of different quality/stability are available and the wish for high performance requires sensor nodes to switch to the best among the available channels. In this work, we will focus on devising mechanisms that perform channel quality/stability estimation in order to improve the accommodation of stream-based communication in multichannel wireless sensor networks. For performing channel quality assessment, we have formulated a composite metric, which we call channel rank measurement (CRM), that can demarcate channels into good, intermediate and bad quality on the basis of the standard deviation of the received signal strength indicator (RSSI) and the average of the link quality indicator (LQI) of the received packets. CRM is then used to generate a data set for training a supervised machine learning-based algorithm (which we call Normal Equation based Channel quality prediction (NEC) algorithm) in such a way that it may perform instantaneous channel rank estimation of any channel. Subsequently, two robust extensions of the NEC algorithm are proposed (which we call Normal Equation based Weighted Moving Average Channel quality prediction (NEWMAC) algorithm and Normal Equation based Aggregate Maturity Criteria with Beta Tracking based Channel weight prediction (NEAMCBTC) algorithm), that can perform channel quality estimation on the basis of both current and past values of channel rank estimation. In the end

Machine-Learning Based Channel Quality and Stability Estimation for Stream-Based Multichannel Wireless Sensor Networks

PubMed Central

Rehan, Waqas; Fischer, Stefan; Rehan, Maaz

2016-01-01

Wireless sensor networks (WSNs) have become more and more diversified and are today able to also support high data rate applications, such as multimedia. In this case, per-packet channel handshaking/switching may result in inducing additional overheads, such as energy consumption, delays and, therefore, data loss. One of the solutions is to perform stream-based channel allocation where channel handshaking is performed once before transmitting the whole data stream. Deciding stream-based channel allocation is more critical in case of multichannel WSNs where channels of different quality/stability are available and the wish for high performance requires sensor nodes to switch to the best among the available channels. In this work, we will focus on devising mechanisms that perform channel quality/stability estimation in order to improve the accommodation of stream-based communication in multichannel wireless sensor networks. For performing channel quality assessment, we have formulated a composite metric, which we call channel rank measurement (CRM), that can demarcate channels into good, intermediate and bad quality on the basis of the standard deviation of the received signal strength indicator (RSSI) and the average of the link quality indicator (LQI) of the received packets. CRM is then used to generate a data set for training a supervised machine learning-based algorithm (which we call Normal Equation based Channel quality prediction (NEC) algorithm) in such a way that it may perform instantaneous channel rank estimation of any channel. Subsequently, two robust extensions of the NEC algorithm are proposed (which we call Normal Equation based Weighted Moving Average Channel quality prediction (NEWMAC) algorithm and Normal Equation based Aggregate Maturity Criteria with Beta Tracking based Channel weight prediction (NEAMCBTC) algorithm), that can perform channel quality estimation on the basis of both current and past values of channel rank estimation. In the end

[QUALITY MEASURES IN MEDICINE-- A PLEA FOR NEW, VALUE BASED THINKING].

PubMed

Fisher, Menachem; Wagner, Oded; Keinarl, Talia; Solt, Ido

2015-09-01

Quality is an important and basic conduct of complex systems in general and health systems in particular. Quality is a cornerstone of medicine, necessary in the eyes of the community of consumers, caregivers, and the systems that manage both. In Israel, the Ministry of Health has set the quality issue on the agenda of healthcare organizations in all existing frameworks. In this article we seek to offer an acceptable alternative perspective, in examining the quality of public health. We suggest highlighting the ethical aspect of medical care, while reducing the quantitative monitoring component of existing quality metrics. Relying solely on indices has negative effects that might cause damage. The proposed alternative focuses on the personal responsibility of health care providers, using. values and moral reasonin.

Measuring quality in services for children with an intellectual disability.

PubMed

Koornneef, Erik

2006-01-01

To evaluate the application of one particular quality measurement tool, the SERVQUAL instrument, as a potential mechanism to measure quality in services for children with disabilities Staff and family of children with an intellectual disability in two organisations providing specialist therapy and day completed an adapted SERVQUAL questionnaire. A total of 81 SERVQUAL questionnaires were distributed and 59 questionnaires were returned (response rate of 73 per cent). The SERVQUAL instrument can be considered as a useful diagnostic tool to identify particular strengths and areas for improvement in services for people with disabilities as the instrument lends itself for the monitoring of the effectiveness of quality improvement initiatives over time. The findings also showed relatively high customer expectations and the organisations involved in this research are currently not meeting all of these high expectations as significant quality gaps were found in the areas of reliability and responsiveness. The sample size was relatively small and the measurement of quality using the SERVQUAL instrument remains a challenge, due to the conceptual and empirical difficulties. The SERVQUAL instrument is probably most be attractive to service managers and funding organisations because of its ability to identify gaps in the quality of the service. The tool had been used to measure quality in services for people with disabilities and the research has shown that this tool might be an important additional quality measurement tool for services.

National Quality Forum Colon Cancer Quality Metric Performance: How Are Hospitals Measuring Up?

PubMed

Mason, Meredith C; Chang, George J; Petersen, Laura A; Sada, Yvonne H; Tran Cao, Hop S; Chai, Christy; Berger, David H; Massarweh, Nader N

2017-12-01

To evaluate the impact of care at high-performing hospitals on the National Quality Forum (NQF) colon cancer metrics. The NQF endorses evaluating ≥12 lymph nodes (LNs), adjuvant chemotherapy (AC) for stage III patients, and AC within 4 months of diagnosis as colon cancer quality indicators. Data on hospital-level metric performance and the association with survival are unclear. Retrospective cohort study of 218,186 patients with resected stage I to III colon cancer in the National Cancer Data Base (2004-2012). High-performing hospitals (>75% achievement) were identified by the proportion of patients achieving each measure. The association between hospital performance and survival was evaluated using Cox shared frailty modeling. Only hospital LN performance improved (15.8% in 2004 vs 80.7% in 2012; trend test, P < 0.001), with 45.9% of hospitals performing well on all 3 measures concurrently in the most recent study year. Overall, 5-year survival was 75.0%, 72.3%, 72.5%, and 69.5% for those treated at hospitals with high performance on 3, 2, 1, and 0 metrics, respectively (log-rank, P < 0.001). Care at hospitals with high metric performance was associated with lower risk of death in a dose-response fashion [0 metrics, reference; 1, hazard ratio (HR) 0.96 (0.89-1.03); 2, HR 0.92 (0.87-0.98); 3, HR 0.85 (0.80-0.90); 2 vs 1, HR 0.96 (0.91-1.01); 3 vs 1, HR 0.89 (0.84-0.93); 3 vs 2, HR 0.95 (0.89-0.95)]. Performance on metrics in combination was associated with lower risk of death [LN + AC, HR 0.86 (0.78-0.95); AC + timely AC, HR 0.92 (0.87-0.98); LN + AC + timely AC, HR 0.85 (0.80-0.90)], whereas individual measures were not [LN, HR 0.95 (0.88-1.04); AC, HR 0.95 (0.87-1.05)]. Less than half of hospitals perform well on these NQF colon cancer metrics concurrently, and high performance on individual measures is not associated with improved survival. Quality improvement efforts should shift focus from individual measures to defining composite measures

Design on wireless auto-measurement system for lead rail straightness measurement based on PSD

NASA Astrophysics Data System (ADS)

Yan, Xiugang; Zhang, Shuqin; Dong, Dengfeng; Cheng, Zhi; Wu, Guanghua; Wang, Jie; Zhou, Weihu

2016-10-01

Straightness detection is not only one of the key technologies for the product quality and installation accuracy of all types of lead rail, but also an important dimensional measurement technology. The straightness measuring devices now available have disadvantages of low automation level, limiting by measuring environment, and low measurement efficiency. In this paper, a wireless measurement system for straightness detection based on position sensitive detector (PSD) is proposed. The system has some advantage of high automation-level, convenient, high measurement efficiency, easy to transplanting and expanding, and can detect straightness of lead rail in real-time.

Qualitative Exploration of the Suitability of Capability Based Instruments to Measure Quality of Life in Family Carers of People with Dementia

PubMed Central

Jones, Carys; Edwards, Rhiannon Tudor; Hounsome, Barry

2014-01-01

Background. In an ageing population, many individuals find themselves becoming a carer for an elderly relative. This qualitative study explores aspects of quality of life affected by caring for a person with dementia, with the aim of identifying whether capability based questionnaires are suitable for measuring carer quality of life. Methods. Semistructured interviews lasting up to an hour were conducted, November 2010–July 2011, with eight family carers of people with dementia. Interviews typically took place at the participants' homes and were recorded and transcribed verbatim. Framework analysis was used to code and analyse data. Domains from three capability based questionnaires (ICECAP-O, Carer Experience Scale, and ASCOT) were used as initial codes. Similar codes were grouped into categories, and broader themes were developed from these categories. Results. Four themes were identified: social network and relationships; interactions with agencies; recognition of role; and time for oneself. Conclusions. By identifying what affects carers' quality of life, an appropriate choice can be made when selecting instruments for future carer research. The themes identified had a high degree of overlap with the capability instruments, suggesting that the capabilities approach would be suitable for future research involving carers of people with dementia. PMID:24967332

Influence of Continuing Medical Education on Rheumatologists' Performance on National Quality Measures for Rheumatoid Arthritis.

PubMed

Sapir, Tamar; Rusie, Erica; Greene, Laurence; Yazdany, Jinoos; Robbins, Mark L; Ruderman, Eric M; Carter, Jeffrey D; Patel, Barry; Moreo, Kathleen

2015-12-01

In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits. Twenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists' documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence. Mean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts). This pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve

Dual redundant arm system operational quality measures and their applications - Static measures

NASA Technical Reports Server (NTRS)

Lee, Sukhan; Kim, Sungbok

1990-01-01

The authors present dual-arm system static operational quality measures which quantify the efficiency and capability of a dual-arm system in generating Cartesian velocities and static forces. First, they define and analyze the kinematic interactions between the two arms incurred by the various modes of dual-arm cooperation, such as transport, assembly, and grasping modes of cooperation, and specify the kinematic constraints imposed on individual arms in Cartesian space due to the kinematic interactions. Dual-arm static manipulability is presented. Finally, dual-arm operational quality is scaled by a task-oriented operational quality measure (TOQs) obtained by the comparison between the desired and actual static manipulabilities. TOQs is used in the optimization of dual-arm joint configurations. Simulation results are shown.

Quality of life and urolithiasis: the patient - reported outcomes measurement information system (PROMIS).

PubMed

Patel, Nishant; Brown, Robert D; Sarkissian, Carl; De, Shubha; Monga, Manoj

2017-01-01

With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life. We evaluated the impact of urolithiasis on quality of life using the NIH-sponsored PROMIS-43 questionnaire. Patients reporting to the kidney stone clinic were interviewed to collect information on stone history and demographic information and were asked to complete the PROMIS-43 questionnaire. Quality of life scores were analyzed using gender and age matched groups for the general US population. Statistical comparisons were made based on demographic information and patient stone history. Statistical significance was P<0.05. 103 patients completed the survey. 36% of respondents were male, the average age of the group was 52 years old, with 58% primary income earners, and 35% primary caregivers. 7% had never passed a stone or had a procedure while 17% passed 10 or more stones in their lifetime. Overall, pain and physical function were worse in patients with urolithiasis. Primary income earners had better quality of life while primary caregivers and those with other chronic medical conditions were worse. Patients on dietary and medical therapy had better quality of life scores. Urolithiasis patients subjectively have worse pain and physical function than the general population. The impact of pain on quality of life was greatest in those patients who had more stone episodes, underscoring the importance of preventive measures. Stone prevention measures improve quality of life. Copyright® by the International Brazilian Journal of Urology.

The Aeroflex: A Bicycle for Mobile Air Quality Measurements

PubMed Central

Elen, Bart; Peters, Jan; Van Poppel, Martine; Bleux, Nico; Theunis, Jan; Reggente, Matteo; Standaert, Arnout

2013-01-01

Fixed air quality stations have limitations when used to assess people's real life exposure to air pollutants. Their spatial coverage is too limited to capture the spatial variability in, e.g., an urban or industrial environment. Complementary mobile air quality measurements can be used as an additional tool to fill this void. In this publication we present the Aeroflex, a bicycle for mobile air quality monitoring. The Aeroflex is equipped with compact air quality measurement devices to monitor ultrafine particle number counts, particulate mass and black carbon concentrations at a high resolution (up to 1 second). Each measurement is automatically linked to its geographical location and time of acquisition using GPS and Internet time. Furthermore, the Aeroflex is equipped with automated data transmission, data pre-processing and data visualization. The Aeroflex is designed with adaptability, reliability and user friendliness in mind. Over the past years, the Aeroflex has been successfully used for high resolution air quality mapping, exposure assessment and hot spot identification. PMID:23262484

The Aeroflex: a bicycle for mobile air quality measurements.

PubMed

Elen, Bart; Peters, Jan; Poppel, Martine Van; Bleux, Nico; Theunis, Jan; Reggente, Matteo; Standaert, Arnout

2012-12-24

Fixed air quality stations have limitations when used to assess people's real life exposure to air pollutants. Their spatial coverage is too limited to capture the spatial variability in, e.g., an urban or industrial environment. Complementary mobile air quality measurements can be used as an additional tool to fill this void. In this publication we present the Aeroflex, a bicycle for mobile air quality monitoring. The Aeroflex is equipped with compact air quality measurement devices to monitor ultrafine particle number counts, particulate mass and black carbon concentrations at a high resolution (up to 1 second). Each measurement is automatically linked to its geographical location and time of acquisition using GPS and Internet time. Furthermore, the Aeroflex is equipped with automated data transmission, data pre-processing and data visualization. The Aeroflex is designed with adaptability, reliability and user friendliness in mind. Over the past years, the Aeroflex has been successfully used for high resolution air quality mapping, exposure assessment and hot spot identification. 

Measurement of Health Care Quality in Atopic Dermatitis - Development and Application of a Set of Quality Indicators.

PubMed

Steinke, S; Beikert, F C; Langenbruch, A; Fölster-Holst, R; Ring, J; Schmitt, J; Werfel, T; Hintzen, S; Franzke, N; Augustin, M

2018-05-15

Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. 1) Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. 2) Application of the indicators to a cross-sectional study and creation of a global process quality index. An expert committee consisting of 10 members of the German guideline group on atopic dermatitis condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1,678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 (no quality achieved) to 100 (full quality achieved)) displaying the quality of health care. In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcome indicators as the median SCORAD (SCORing Atopic Dermatitis; rp =0.08), Dermatology Life Quality Index (DLQI; rp = 0.256), and Patient Benefit Index (PBI; rp = -0.151). Process quality of AD care is moderate to good. The health care process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness, and feasibility of the proposed quality indicators for AD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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.

Quality measures in applications of image restoration.

PubMed

Kriete, A; Naim, M; Schafer, L

2001-01-01

We describe a new method for the estimation of image quality in image restoration applications. We demonstrate this technique on a simulated data set of fluorescent beads, in comparison with restoration by three different deconvolution methods. Both the number of iterations and a regularisation factor are varied to enforce changes in the resulting image quality. First, the data sets are directly compared by an accuracy measure. These values serve to validate the image quality descriptor, which is developed on the basis of optical information theory. This most general measure takes into account the spectral energies and the noise, weighted in a logarithmic fashion. It is demonstrated that this method is particularly helpful as a user-oriented method to control the output of iterative image restorations and to eliminate the guesswork in choosing a suitable number of iterations.

Quality of care: measuring a neglected driver of improved health

PubMed Central

Kruk, Margaret E

2017-01-01

Abstract The quality of care provided by health systems contributes towards efforts to reach sustainable development goal 3 on health and well-being. There is growing evidence that the impact of health interventions is undermined by poor quality of care in lower-income countries. Quality of care will also be crucial to the success of universal health coverage initiatives; citizens unhappy with the quality and scope of covered services are unlikely to support public financing of health care. Moreover, an ethical impetus exists to ensure that all people, including the poorest, obtain a minimum quality standard of care that is effective for improving health. However, the measurement of quality today in low- and middle-income countries is inadequate to the task. Health information systems provide incomplete and often unreliable data, and facility surveys collect too many indicators of uncertain utility, focus on a limited number of services and are quickly out of date. Existing measures poorly capture the process of care and the patient experience. Patient outcomes that are sensitive to health-care practices, a mainstay of quality assessment in high-income countries, are rarely collected. We propose six policy recommendations to improve quality-of-care measurement and amplify its policy impact: (i) redouble efforts to improve and institutionalize civil registration and vital statistics systems; (ii) reform facility surveys and strengthen routine information systems; (iii) innovate new quality measures for low-resource contexts; (iv) get the patient perspective on quality; (v) invest in national quality data; and (vi) translate quality evidence for policy impact. PMID:28603313

Measuring quality of care: considering conceptual approaches to quality indicator development and evaluation.

PubMed

Stelfox, Henry T; Straus, Sharon E

2013-12-01

In this article, we describe one approach for developing and evaluating quality indicators. We focus on describing different conceptual approaches to quality indicator development, review one approach for developing quality indicators, outline how to evaluate quality indicators once developed, and discuss quality indicator maintenance. The key steps for developing quality indicators include specifying a clear goal for the indicators; using methodologies to incorporate evidence, expertise, and patient perspectives; and considering contextual factors and logistics of implementation. The Strategic Framework Board and the National Quality Measure Clearinghouse have developed criteria for evaluating quality indicators that complement traditional psychometric evaluations. Optimal strategies for quality indicator maintenance and dissemination have not been determined, but experiences with clinical guideline maintenance may be informative. For quality indicators to effectively guide quality improvement efforts, they must be developed, evaluated, maintained, and implemented using rigorous evidence-informed practices. Copyright © 2013 Elsevier Inc. All rights reserved.

Are the CMS Hospital Outpatient Quality Measures Relevant for Rural Hospitals?

ERIC Educational Resources Information Center

Casey, Michelle M.; Prasad, Shailendra; Klingner, Jill; Moscovice, Ira

2012-01-01

Context: Quality measures focused on outpatient settings are of increasing interest to policy makers, but little research has been conducted on hospital outpatient quality measures, especially in rural settings. Purpose: To evaluate the relevance of Centers for Medicare and Medicaid Services' (CMS) outpatient quality measures for rural hospitals,…

Measurement of Quality of Life II. From the Philosophy of Life to Science

PubMed Central

Ventegodt, Soren; Merrick, Joav; Andersen, Niels Jorgen

2003-01-01

We believe it should be possible to make operational the philosophical ideas of the good life in order to make it the object of scientific research. The Quality of Life Research Center in Copenhagen, Denmark has therefore spent the last several years with these questions and tried to find practical and evidence-based scientific solutions.This paper describes the theoretical road taken in moving from the abstract philosophy of life to the actual questionnaire. It presents an important aspect of our work with the quality-of-life (QOL) concept though the last decade. We have developed the quality-of-life philosophy; the SEQOL, QOL5, and QOL1 questionnaires; the quality-of-life theory; and the quality-of-life research methodology. We carried out quality-of-life population surveys and developed techniques for improving quality of life with the chronically sick patient. This paper presents the struggle to create a rating scale for the generic measurement of the global quality of life, based on quality-of-life theory, derived from quality-of-life philosophy. The developed rating scale is a ratio scale combining a Likert scale, a visual analogue scale, and a numerical scale, to a reduced combination scale. This allows for the extraction of as much information from the respondents as possible without exhausting them unduly or demanding more than can be reasonably expected. PMID:14570987

Measurement of quality of life II. From the philosophy of life to science.

PubMed

Ventegodt, Søren; Merrick, Joav; Andersen, Niels Jørgen

2003-10-13

We believe it should be possible to make operational the philosophical ideas of the good life in order to make it the object of scientific research. The Quality of Life Research Center in Copenhagen, Denmark has therefore spent the last several years with these questions and tried to find practical and evidence-based scientific solutions. This paper describes the theoretical road taken in moving from the abstract philosophy of life to the actual questionnaire. It presents an important aspect of our work with the quality-of-life (QOL) concept though the last decade. We have developed the quality-of-life philosophy; the SEQOL, QOL5, and QOL1 questionnaires; the quality-of-life theory; and the quality-of-life research methodology. We carried out quality-of-life population surveys and developed techniques for improving quality of life with the chronically sick patient. This paper presents the struggle to create a rating scale for the generic measurement of the global quality of life, based on quality-of-life theory, derived from quality-of-life philosophy. The developed rating scale is a ratio scale combining a Likert scale, a visual analogue scale, and a numerical scale, to a reduced combination scale. This allows for the extraction of as much information from the respondents as possible without exhausting them unduly or demanding more than can be reasonably expected.

Correlation of neonatal intensive care unit performance across multiple measures of quality of care.

PubMed

Profit, Jochen; Zupancic, John A F; Gould, Jeffrey B; Pietz, Kenneth; Kowalkowski, Marc A; Draper, David; Hysong, Sylvia J; Petersen, Laura A

2013-01-01

To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Twenty-two regional NICUs in California. In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Pneumothorax, growth velocity, health care-associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations, 6 were significant (ρ < .05). Correlations between pairs of measures of quality of care were strong (ρ ≥ .5) for 1 pair, moderate (range, ρ ≥ .3 to ρ < .5) for 8 pairs, weak (range, ρ ≥ .1 to ρ < .3) for 5 pairs, and negligible (ρ < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care-associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest.

The Need for Comprehensive Health Care Quality Measures for Older Adults.

PubMed

MacLeod, Stephanie; Schwebke, Kay; Hawkins, Kevin; Ruiz, Joann; Hoo, Emma; Yeh, Charlotte S

2017-10-24

Research indicates that older adults receive only about half of their recommended care, with varying quality and limited attention to social issues impacting their health through the most commonly used quality measures. Additionally, many existing measures neglect to address nonclinical social determinants of health. Evidence of the need for more comprehensive measures for seniors is growing. The primary purpose of this article, which is supported by a limited review of literature, is to describe gaps among current quality measures in addressing certain nonclinical needs of older adults, including key social determinants of health. In doing so, the authors describe their position on the need for expanded measures to incorporate these factors to improve care and quality of life. The authors conducted a limited review of the literature to inform this article, focusing specifically on selected measures for older adults rather than a broader systematic review of all measures. Most research identified was related to clinical practice guidelines rather than quality measures of care as applied to older adults. Furthermore, the literature reviewed reflected limited evidence of efforts to tailor quality measures for the unique social needs of older adults, confirming a potential gap in this area. A growing need exists for improved quality measures specifically designed to help providers address the unique social needs of older adults. Filling this gap will improve overall understanding of seniors and help them to achieve optimal health and successful aging.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

From Theory to Practice: Measuring end-of-life communication quality using multiple goals theory.

PubMed

Van Scoy, L J; Scott, A M; Reading, J M; Chuang, C H; Chinchilli, V M; Levi, B H; Green, M J

2017-05-01

To describe how multiple goals theory can be used as a reliable and valid measure (i.e., coding scheme) of the quality of conversations about end-of-life issues. We analyzed conversations from 17 conversations in which 68 participants (mean age=51years) played a game that prompted discussion in response to open-ended questions about end-of-life issues. Conversations (mean duration=91min) were audio-recorded and transcribed. Communication quality was assessed by three coders who assigned numeric scores rating how well individuals accomplished task, relational, and identity goals in the conversation. The coding measure, which results in a quantifiable outcome, yielded strong reliability (intra-class correlation range=0.73-0.89 and Cronbach's alpha range=0.69-0.89 for each of the coded domains) and validity (using multilevel nonlinear modeling, we detected significant variability in scores between games for each of the coded domains, all p-values <0.02). Our coding scheme provides a theory-based measure of end-of-life conversation quality that is superior to other methods of measuring communication quality. Our description of the coding method enables researches to adapt and apply this measure to communication interventions in other clinical contexts. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Quality of web-based information on social phobia: a cross-sectional study.

PubMed

Khazaal, Yasser; Fernandez, Sebastien; Cochand, Sophie; Reboh, Isabel; Zullino, Daniele

2008-01-01

The objective of the study is to evaluate the quality of web-based information on social phobia and to investigate particular quality indicators. Two keywords, "Social phobia" and "Social Anxiety Disorder", were entered into five popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability, and content quality. "Health On the Net" (HON) quality label and DISCERN scale scores aiding people without content expertise to assess quality of written health publication were used to verify their efficiency as quality indicators. This study evaluates the quality of web-based information on social phobia. On the 200 identified links, 58 were included. On the basis of outcome measures, the overall quality of the sites turned out to be poor. DISCERN and HON label were indicators of good quality indicators. Accountability criteria were poor indicators of site quality. Although social phobia education Websites for patients are common, educational material highly varies in quality and content. There is a need for better evidence-based information about social phobia on the Web and a need to reconsider the role of accountability criteria as indicators of site quality. Clinicians should advise patients of the HON label and DISCERN as useful indicators of site quality. (c) 2007 Wiley-Liss, Inc.

Using PROMIS Pain Interference Items to Improve Quality Measurement in Inpatient Rehabilitation Facilities.

PubMed

Schalet, Benjamin D; Kallen, Michael A; Heinemann, Allen W; Deutsch, Anne; Cook, Karon F; Foster, Linda; Cella, David

2018-05-24

To evaluate the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference items for use in a quality measure and to compare the resulting quality score, along with internal reliability and validity, to a similar item set in the Minimum Data Set Version 3.0 (MDS). Cross-sectional, observational study. One freestanding inpatient rehabilitation facility (IRF) and one large hospital-based IRF. Patients with neurologic disorders. Of 1055 consecutive admissions, 26% were excluded based on clinician-determined cognitive impairment or emotional distress. Of the remainder, 50% consented and completed the survey near the end of their IRF stay (N = 391). Of these, more than half (57%) reported pain over the last day (n = 224). Psychometric statistics and quality scores were computed from a 55-question survey, including the MDS and PROMIS pain interference items. Estimates for internal reliability were higher for the PROMIS 2-item scale compared to the MDS: Cronbach α (0.86 vs 0.48) and interitem correlations (0.75 vs 0.31). The PROMIS-2 items were better able to detect differences in patients with mild and severe pain intensity (Cohen d = 1.57) relative to the corresponding MDS items (Cohen d = 0.81). Two quality scores based on the PROMIS-2 items, reflecting low and high levels of pain interference, showed 46% or 12% of patients meeting these thresholds. This compared to a 30% rate when patients were classified by the MDS as experiencing pain interference. PROMIS pain interference items appear to be more internally consistent than similar MDS items. The graded PROMIS items permit the creation of multiple quality scores, showing predictable overlap with corresponding MDS quality scores. Because PROMIS items provide finer distinctions, they allow greater latitude in reporting quality scores. We recommend further study of pain interference scores across IRFs to improve their reliability and validity. Copyright © 2018 AMDA – The Society for

Quality control algorithms for rainfall measurements

NASA Astrophysics Data System (ADS)

Golz, Claudia; Einfalt, Thomas; Gabella, Marco; Germann, Urs

2005-09-01

One of the basic requirements for a scientific use of rain data from raingauges, ground and space radars is data quality control. Rain data could be used more intensively in many fields of activity (meteorology, hydrology, etc.), if the achievable data quality could be improved. This depends on the available data quality delivered by the measuring devices and the data quality enhancement procedures. To get an overview of the existing algorithms a literature review and literature pool have been produced. The diverse algorithms have been evaluated to meet VOLTAIRE objectives and sorted in different groups. To test the chosen algorithms an algorithm pool has been established, where the software is collected. A large part of this work presented here is implemented in the scope of the EU-project VOLTAIRE ( Validati on of mu ltisensors precipit ation fields and numerical modeling in Mediter ran ean test sites).

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument.

PubMed

Mokkink, Lidwine B; Prinsen, Cecilia A C; Bouter, Lex M; Vet, Henrica C W de; Terwee, Caroline B

2016-01-19

COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) is an initiative of an international multidisciplinary team of researchers who aim to improve the selection of outcome measurement instruments both in research and in clinical practice by developing tools for selecting the most appropriate available instrument. In this paper these tools are described, i.e. the COSMIN taxonomy and definition of measurement properties; the COSMIN checklist to evaluate the methodological quality of studies on measurement properties; a search filter for finding studies on measurement properties; a protocol for systematic reviews of outcome measurement instruments; a database of systematic reviews of outcome measurement instruments; and a guideline for selecting outcome measurement instruments for Core Outcome Sets in clinical trials. Currently, we are updating the COSMIN checklist, particularly the standards for content validity studies. Also new standards for studies using Item Response Theory methods will be developed. Additionally, in the future we want to develop standards for studies on the quality of non-patient reported outcome measures, such as clinician-reported outcomes and performance-based outcomes. In summary, we plea for more standardization in the use of outcome measurement instruments, for conducting high quality systematic reviews on measurement instruments in which the best available outcome measurement instrument is recommended, and for stopping the use of poor outcome measurement instruments.

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument

PubMed Central

Mokkink, Lidwine B.; Prinsen, Cecilia A. C.; Bouter, Lex M.; de Vet, Henrica C. W.; Terwee, Caroline B.

2016-01-01

Background: COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) is an initiative of an international multidisciplinary team of researchers who aim to improve the selection of outcome measurement instruments both in research and in clinical practice by developing tools for selecting the most appropriate available instrument. Method: In this paper these tools are described, i.e. the COSMIN taxonomy and definition of measurement properties; the COSMIN checklist to evaluate the methodological quality of studies on measurement properties; a search filter for finding studies on measurement properties; a protocol for systematic reviews of outcome measurement instruments; a database of systematic reviews of outcome measurement instruments; and a guideline for selecting outcome measurement instruments for Core Outcome Sets in clinical trials. Currently, we are updating the COSMIN checklist, particularly the standards for content validity studies. Also new standards for studies using Item Response Theory methods will be developed. Additionally, in the future we want to develop standards for studies on the quality of non-patient reported outcome measures, such as clinician-reported outcomes and performance-based outcomes. Conclusions: In summary, we plea for more standardization in the use of outcome measurement instruments, for conducting high quality systematic reviews on measurement instruments in which the best available outcome measurement instrument is recommended, and for stopping the use of poor outcome measurement instruments. PMID:26786084

NMF-Based Image Quality Assessment Using Extreme Learning Machine.

PubMed

Wang, Shuigen; Deng, Chenwei; Lin, Weisi; Huang, Guang-Bin; Zhao, Baojun

2017-01-01

Numerous state-of-the-art perceptual image quality assessment (IQA) algorithms share a common two-stage process: distortion description followed by distortion effects pooling. As for the first stage, the distortion descriptors or measurements are expected to be effective representatives of human visual variations, while the second stage should well express the relationship among quality descriptors and the perceptual visual quality. However, most of the existing quality descriptors (e.g., luminance, contrast, and gradient) do not seem to be consistent with human perception, and the effects pooling is often done in ad-hoc ways. In this paper, we propose a novel full-reference IQA metric. It applies non-negative matrix factorization (NMF) to measure image degradations by making use of the parts-based representation of NMF. On the other hand, a new machine learning technique [extreme learning machine (ELM)] is employed to address the limitations of the existing pooling techniques. Compared with neural networks and support vector regression, ELM can achieve higher learning accuracy with faster learning speed. Extensive experimental results demonstrate that the proposed metric has better performance and lower computational complexity in comparison with the relevant state-of-the-art approaches.

Changes in quality of life after elective surgery: an observational study comparing two measures.

PubMed

Kronzer, Vanessa L; Jerry, Michelle R; Ben Abdallah, Arbi; Wildes, Troy S; McKinnon, Sherry L; Sharma, Anshuman; Avidan, Michael S

2017-08-01

Our main objective was to compare the change in a validated quality of life measure to a global assessment measure. The secondary objectives were to estimate the minimum clinically important difference (MCID) and to describe the change in quality of life by surgical specialty. This prospective cohort study included 7902 adult patients undergoing elective surgery. Changes in the Veterans RAND 12-Item Health Survey (VR-12), composed of a physical component summary (PCS) and a mental component summary (MCS), were calculated using preoperative and postoperative questionnaires. The latter also contained a global assessment question for quality of life. We compared PCS and MCS to the global assessment using descriptive statistics and weighted kappa. MCID was calculated using an anchor-based approach. Analyses were pre-specified and registered (NCT02771964). By the change in VR-12 scores, an equal proportion of patients experienced improvement and deterioration in quality of life (28% for PCS, 25% for MCS). In contrast, by the global assessment measure, 61% reported improvement, while only 10% reported deterioration. Agreement with the global assessment was slight for both PCS (kappa = 0.20, 57% matched) and MCS (kappa = 0.10, 54% matched). The MCID for the overall VR-12 score was approximately 2.5 points. Patients undergoing orthopedic surgery showed the most improvement in quality of life measures, while patients undergoing gastrointestinal/hepatobiliary or urologic surgery showed the most deterioration. Subjective global quality of life report does not agree well with a validated quality of life instrument, perhaps due to patient over-optimism.

NEMA image quality phantom measurements and attenuation correction in integrated PET/MR hybrid imaging.

PubMed

Ziegler, Susanne; Jakoby, Bjoern W; Braun, Harald; Paulus, Daniel H; Quick, Harald H

2015-12-01

In integrated PET/MR hybrid imaging the evaluation of PET performance characteristics according to the NEMA standard NU 2-2007 is challenging because of incomplete MR-based attenuation correction (AC) for phantom imaging. In this study, a strategy for CT-based AC of the NEMA image quality (IQ) phantom is assessed. The method is systematically evaluated in NEMA IQ phantom measurements on an integrated PET/MR system. NEMA IQ measurements were performed on the integrated 3.0 Tesla PET/MR hybrid system (Biograph mMR, Siemens Healthcare). AC of the NEMA IQ phantom was realized by an MR-based and by a CT-based method. The suggested CT-based AC uses a template μ-map of the NEMA IQ phantom and a phantom holder for exact repositioning of the phantom on the systems patient table. The PET image quality parameters contrast recovery, background variability, and signal-to-noise ratio (SNR) were determined and compared for both phantom AC methods. Reconstruction parameters of an iterative 3D OP-OSEM reconstruction were optimized for highest lesion SNR in NEMA IQ phantom imaging. Using a CT-based NEMA IQ phantom μ-map on the PET/MR system is straightforward and allowed performing accurate NEMA IQ measurements on the hybrid system. MR-based AC was determined to be insufficient for PET quantification in the tested NEMA IQ phantom because only photon attenuation caused by the MR-visible phantom filling but not the phantom housing is considered. Using the suggested CT-based AC, the highest SNR in this phantom experiment for small lesions (<= 13 mm) was obtained with 3 iterations, 21 subsets and 4 mm Gaussian filtering. This study suggests CT-based AC for the NEMA IQ phantom when performing PET NEMA IQ measurements on an integrated PET/MR hybrid system. The superiority of CT-based AC for this phantom is demonstrated by comparison to measurements using MR-based AC. Furthermore, optimized PET image reconstruction parameters are provided for the highest lesion SNR in NEMA IQ phantom

Quality measurement and benchmarking of HPV vaccination services: a new approach.

PubMed

Maurici, Massimo; Paulon, Luca; Campolongo, Alessandra; Meleleo, Cristina; Carlino, Cristiana; Giordani, Alessandro; Perrelli, Fabrizio; Sgricia, Stefano; Ferrante, Maurizio; Franco, Elisabetta

2014-01-01

A new measurement process based upon a well-defined mathematical model was applied to evaluate the quality of human papillomavirus (HPV) vaccination centers in 3 of 12 Local Health Units (ASLs) within the Lazio Region of Italy. The quality aspects considered for evaluation were communicational efficiency, organizational efficiency and comfort. The overall maximum achievable value was 86.10%, while the HPV vaccination quality scores for ASL1, ASL2 and ASL3 were 73.07%, 71.08%, and 67.21%, respectively. With this new approach it is possible to represent the probabilistic reasoning of a stakeholder who evaluates the quality of a healthcare provider. All ASLs had margins for improvements and optimal quality results can be assessed in terms of better performance conditions, confirming the relationship between the resulting quality scores and HPV vaccination coverage. The measurement process was structured into three steps and involved four stakeholder categories: doctors, nurses, parents and vaccinated women. In Step 1, questionnaires were administered to collect different stakeholders' points of view (i.e., subjective data) that were elaborated to obtain the best and worst performance conditions when delivering a healthcare service. Step 2 of the process involved the gathering of performance data during the service delivery (i.e., objective data collection). Step 3 of the process involved the elaboration of all data: subjective data from step 1 are used to define a "standard" to test objective data from step 2. This entire process led to the creation of a set of scorecards. Benchmarking is presented as a result of the probabilistic meaning of the evaluated scores.

Patients’ perceived value of pharmacy quality measures: a mixed-methods study

PubMed Central

Shiyanbola, Olayinka O; Mort, Jane R

2015-01-01

Objective To describe patients’ perceived value and use of quality measures in evaluating and choosing community pharmacies. Design Focus group methodology was combined with a survey tool. During the focus groups, participants assessed the value of the Pharmacy Quality Alliance's quality measures in evaluating and choosing a pharmacy. Also, participants completed questionnaires rating their perceived value of quality measures in evaluating a pharmacy (1 being low value and 5 being high) or choosing a pharmacy (yes/no). Thematic analysis and descriptive statistics were used to analyse the focus groups and surveys, respectively. Setting Semistructured focus groups were conducted in a private meeting space of an urban and a rural area of a Mid-western State in the USA. Participants Thirty-four adults who filled prescription medications in community pharmacies for a chronic illness were recruited in community pharmacies, senior centres and public libraries. Results While comments indicated that all measures were important, medication safety measures (eg, drug-drug interactions) were valued more highly than others. Rating of quality measure utility in evaluating a pharmacy ranged from a mean of 4.88 (‘drug-drug interactions’) to a mean of 4.0 (‘absence of controller therapy for patients with asthma’). Patients were hesitant to use quality information in choosing a pharmacy (depending on the participant's location) but might consider if moving to a new area or having had a negative pharmacy experience. Use of select quality measures to choose a pharmacy ranged from 97.1% of participants using ‘drug-drug interactions’ (medication safety measure) to 55.9% using ‘absence of controller therapy for patients with asthma’. Conclusions The study participants valued quality measures in evaluating and selecting a community pharmacy, with medication safety measures valued highest. The participants reported that the quality measures would not typically cause a

Normalized Movement Quality Measures for Therapeutic Robots Strongly Correlate With Clinical Motor Impairment Measures

PubMed Central

Celik, Ozkan; O’Malley, Marcia K.; Boake, Corwin; Levin, Harvey S.; Yozbatiran, Nuray; Reistetter, Timothy A.

2016-01-01

In this paper, we analyze the correlations between four clinical measures (Fugl–Meyer upper extremity scale, Motor Activity Log, Action Research Arm Test, and Jebsen-Taylor Hand Function Test) and four robotic measures (smoothness of movement, trajectory error, average number of target hits per minute, and mean tangential speed), used to assess motor recovery. Data were gathered as part of a hybrid robotic and traditional upper extremity rehabilitation program for nine stroke patients. Smoothness of movement and trajectory error, temporally and spatially normalized measures of movement quality defined for point-to-point movements, were found to have significant moderate to strong correlations with all four of the clinical measures. The strong correlations suggest that smoothness of movement and trajectory error may be used to compare outcomes of different rehabilitation protocols and devices effectively, provide improved resolution for tracking patient progress compared to only pre-and post-treatment measurements, enable accurate adaptation of therapy based on patient progress, and deliver immediate and useful feedback to the patient and therapist. PMID:20388607

Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.

Using Computer-Extracted Data from Electronic Health Records to Measure the Quality of Adolescent Well-Care

PubMed Central

Gardner, William; Morton, Suzanne; Byron, Sepheen C; Tinoco, Aldo; Canan, Benjamin D; Leonhart, Karen; Kong, Vivian; Scholle, Sarah Hudson

2014-01-01

Objective To determine whether quality measures based on computer-extracted EHR data can reproduce findings based on data manually extracted by reviewers. Data Sources We studied 12 measures of care indicated for adolescent well-care visits for 597 patients in three pediatric health systems. Study Design Observational study. Data Collection/Extraction Methods Manual reviewers collected quality data from the EHR. Site personnel programmed their EHR systems to extract the same data from structured fields in the EHR according to national health IT standards. Principal Findings Overall performance measured via computer-extracted data was 21.9 percent, compared with 53.2 percent for manual data. Agreement measures were high for immunizations. Otherwise, agreement between computer extraction and manual review was modest (Kappa = 0.36) because computer-extracted data frequently missed care events (sensitivity = 39.5 percent). Measure validity varied by health care domain and setting. A limitation of our findings is that we studied only three domains and three sites. Conclusions The accuracy of computer-extracted EHR quality reporting depends on the use of structured data fields, with the highest agreement found for measures and in the setting that had the greatest concentration of structured fields. We need to improve documentation of care, data extraction, and adaptation of EHR systems to practice workflow. PMID:24471935

Adherence to non-vitamin-K-antagonist oral anticoagulant medications based on the Pharmacy Quality Alliance measure.

PubMed

McHorney, Colleen A; Crivera, Concetta; Laliberté, François; Nelson, Winnie W; Germain, Guillaume; Bookhart, Brahim; Martin, Silas; Schein, Jeffrey; Lefebvre, Patrick; Deitelzweig, Steven

2015-12-01

CMS Star Ratings help inform beneficiaries about the performance of health and drug plans. Medication adherence is currently weighted at nearly half of a Part D plan's Star Ratings. Including the adherence to non-vitamin-K-antagonist oral anticoagulants (NOACs) as a measure in the Star Ratings program may increase a plan's incentives to improve patient adherence. To assess the adherence to medication of patients who used the NOACs rivaroxaban, dabigatran, or apixaban in 2014 based on the Pharmacy Quality Alliance (PQA) adherence measure. Healthcare claims from the Humana database between July 2013 and December 2014 were analyzed. Adult patients with ≥2 dispensings of NOAC agents in 2014, at least 180 days apart, with >60 days of supply, and ≥180 days of continuous enrollment prior to the index NOAC were identified. The PQA measure was calculated as the percentage of patients who had a proportion of days covered (PDC) ≥0.8. Multivariate logistic regression analyses were also conducted adjusting for baseline confounders. A total of 11,095 rivaroxaban, 6548 dabigatran, and 3532 apixaban users were identified. Based on the PQA adherence measure (PDC ≥0.8), a significantly higher proportion of rivaroxaban users (72.7%) was found to be adherent compared to dabigatran (67.2%: p < 0.001) and apixaban (69.5%: p < 0.001) users. Compared to apixaban users, the adjusted likelihood of being adherent was significantly higher for rivaroxaban users (unadjusted OR [95% CI]: 1.17 [1.08-1.27], p < 0.001; adjusted OR [95% CI]: 1.20 (1.10-1.31), p < 0.001) and significantly lower for dabigatran users (unadjusted OR [95% CI]: 0.90 [0.82-0.98], p = 0.019; adjusted OR [95% CI]: 0.85 [0.77-0.93], p < 0.001). Limitations of the study are potential inaccuracies in claims data, possible change in patterns over time, and the impossibility of knowing whether all supplied tablets were taken. Using the PQA's adherence measure, rivaroxaban users were found to have

An Analysis of FM Jamming and Noise Quality Measures

DTIC Science & Technology

1993-12-01

equipment setup is shown in figure 6. For reasons of practicality and manageability , all equipment was chosen to be commercially available and of a fairly...bins based on the size of the parameter F. It computes a smoothed "Turner Noise Qaulity " similar to the noise quality measure employed by Daly in his...recý.orate for :nf-,aton Doe,A-,ým5 1o- A c-t•s. )2 15 efferso Oarts H,9gPay, Srte 1204. ArtOngton, VA 222024302 and to the Of"ce of Management and aucige

Implementing and using quality measures for children's health care: perspectives on the state of the practice.

PubMed

Shaller, Dale

2004-01-01

care quality measurement and improvement based on rigorous cost-bigorous cost-benefit analysis and documentation of quantifiable successes; 2) develop new measures to fill the gaps in critical areas (including adolescent health care, behavioral health, and chronic conditions) that can be applied at the hospital and ambulatory care provider levels; 3) invest in building needed research capacity, a trained pool of users of quality measures, and the capacity among providers to understand and use quality-improvement methods and tools; 4) invest in developing an information infrastructure that will support the efficient collection and use of measures for multiple purposes, including clinical practice, quality measurement, and quality improvement; and 5) develop increased public awareness and support for quality measurement based on improved strategies for communicating with consumers, purchasers, providers, and policy makers. Several implications are suggested by these perspectives for the future direction of quality measurement in children's health care. First, to meet the funding needs identified, many funders must improve coordination to reduce the noise and fragmentation generated by numerous competing or redundant activities. Improved coordination among funders will help assure maximum impact and the efficient use of scarce resources. Second, the importance attached to standardization of measures by both users and developers may conflict at times with the need for innovation and flexibility. Child health quality leaders will need to manage this tension between standardization and innovation to maintain an appropriate balance between the benefits of both. Finally, many of the obstacles identified are not unique to children's health care. Child health quality leaders will need to determine to what extent their efforts to overcome these obstacles can be successfully undertaken independently as opposed to in concert with groups concerned about other populations and sectors

Measuring melasma patients' quality of life using willingness to pay and time trade-off methods in thai population

PubMed Central

2011-01-01

Background Melasma is a common hyperpigmentation disorder that has a significant effect on an individual's quality of life. However, there is no preference-based measurement that reflects quality of life in patients with melasma. The objective of this study was to assess the impact of melasma on quality of life by using a health status measurement - the Dermatology Life Quality Index (DLQI) - and a preference-based measurement - Willingness to Pay (WTP) and Time Trade-Off (TTO). Methods A cross-sectional descriptive study was conducted. Seventy-eight patients with melasma who attended the melasma clinic at Siriraj Hospital from February to March 2009 were recruited in this study. The Thai version of the DLQI, questionnaires about WTP, standard TTO, and daily TTO were used to assess patients' quality of life. Results Seventy-seven (98.7%) patients were female with a mean age of 47.8 ± 7.9 years. The mean health utility based on standard TTO was 0.96. The utility obtained by the daily TTO method was 0.92 and was significantly correlated with an economically inactive occupation (p < 0.05). The mean monthly WTP for the most effective treatment was 1,157 baht (7.2% of monthly income), ranging from 100 to 5,000 baht (1 USD ~ 35.1 baht). The WTP was significantly correlated with monthly personal income and the total DLQI score. Conclusion The WTP method could be a useful tool with which to measure the quality of life of patients with melasma. PMID:22182399

e-Measures: insight into the challenges and opportunities of automating publicly reported quality measures

PubMed Central

Garrido, Terhilda; Kumar, Sudheen; Lekas, John; Lindberg, Mark; Kadiyala, Dhanyaja; Whippy, Alan; Crawford, Barbara; Weissberg, Jed

2014-01-01

Using electronic health records (EHR) to automate publicly reported quality measures is receiving increasing attention and is one of the promises of EHR implementation. Kaiser Permanente has fully or partly automated six of 13 the joint commission measure sets. We describe our experience with automation and the resulting time savings: a reduction by approximately 50% of abstractor time required for one measure set alone (surgical care improvement project). However, our experience illustrates the gap between the current and desired states of automated public quality reporting, which has important implications for measure developers, accrediting entities, EHR vendors, public/private payers, and government. PMID:23831833

Measuring Software Product Quality: The ISO 25000 Series and CMMI

DTIC Science & Technology

2004-06-14

performance objectives” covers objectives and requirements for product quality, service quality , and process performance. Process performance objectives...such that product quality, service quality , and process performance attributes are measurable and controlled throughout the project (internal and

Measuring the impact of computer resource quality on the software development process and product

NASA Technical Reports Server (NTRS)

Mcgarry, Frank; Valett, Jon; Hall, Dana

1985-01-01

The availability and quality of computer resources during the software development process was speculated to have measurable, significant impact on the efficiency of the development process and the quality of the resulting product. Environment components such as the types of tools, machine responsiveness, and quantity of direct access storage may play a major role in the effort to produce the product and in its subsequent quality as measured by factors such as reliability and ease of maintenance. During the past six years, the NASA Goddard Space Flight Center has conducted experiments with software projects in an attempt to better understand the impact of software development methodologies, environments, and general technologies on the software process and product. Data was extracted and examined from nearly 50 software development projects. All were related to support of satellite flight dynamics ground-based computations. The relationship between computer resources and the software development process and product as exemplified by the subject NASA data was examined. Based upon the results, a number of computer resource-related implications are provided.

National Quality Measures for Child Mental Health Care: Background, Progress, and Next Steps

PubMed Central

Murphy, J. Michael; Scholle, Sarah Hudson; Hoagwood, Kimberly Eaton; Sachdeva, Ramesh C.; Mangione-Smith, Rita; Woods, Donna; Kamin, Hayley S.; Jellinek, Michael

2013-01-01

OBJECTIVE: To review recent health policies related to measuring child health care quality, the selection processes of national child health quality measures, the nationally recommended quality measures for child mental health care and their evidence strength, the progress made toward developing new measures, and early lessons learned from these national efforts. METHODS: Methods used included description of the selection process of child health care quality measures from 2 independent national initiatives, the recommended quality measures for child mental health care, and the strength of scientific evidence supporting them. RESULTS: Of the child health quality measures recommended or endorsed during these national initiatives, only 9 unique measures were related to child mental health. CONCLUSIONS: The development of new child mental health quality measures poses methodologic challenges that will require a paradigm shift to align research with its accelerated pace. PMID:23457148

COMPUTERIZED NEEDS-ORIENTED QUALITY MEASUREMENT EVALUATION SYSTEM (CONQUEST)

EPA Science Inventory

CONQUEST is an easy-to-use quality improvement software tool that uses a common structure and language to help users identity, understand, compare, evaluate, and select among 1,200 clinical performance measures that can be used to assess and improve quality of care. CONQUEST's in...

Implications of weight-based stigma and self-bias on quality of life among individuals with Schizophrenia

PubMed Central

Barber, Jessica; Palmese, Laura; Reutenauer, Erin L.; Grilo, Carlos; Tek, Cenk

2011-01-01

Obesity has been associated with significant stigma and weight-related self-bias in community and clinical studies, but these issues have not been studied among individuals with schizophrenia. A consecutive series of 70 obese individuals with schizophrenia or schizoaffective disorder underwent assessment for perceptions of weight-based stigmatization, self-directed weight-bias, negative affect, medication compliance, and quality of life. Levels of weight-based stigmatization and self-bias were compared to levels reported for non-psychiatric overweight/obese samples. Weight measures were unrelated to stigma, self-bias, affect, and quality of life. Weight-based stigmatization was lower than published levels for non-psychiatric samples, whereas levels of weight-based self-bias did not differ. After controlling for negative affect, weight-based self-bias predicted an additional 11% of the variance in the quality of life measure. Individuals with schizophrenia and schizoaffective disorder reported weight-based self-bias to the same extent as non-psychiatric samples despite reporting less weight stigma. Weight-based self-bias was associated with poorer quality of life after controlling for negative affect. PMID:21716053

The Relationship between Health Plan Performance Measures and Physician Network Overlap: Implications for Measuring Plan Quality

PubMed Central

Maeng, Daniel D; Scanlon, Dennis P; Chernew, Michael E; Gronniger, Tim; Wodchis, Walter P; McLaughlin, Catherine G

2010-01-01

Objective To examine the extent to which health plan quality measures capture physician practice patterns rather than plan characteristics. Data Source We gathered and merged secondary data from the following four sources: a private firm that collected information on individual physicians and their health plan affiliations, The National Committee for Quality Assurance, InterStudy, and the Dartmouth Atlas. Study Design We constructed two measures of physician network overlap for all health plans in our sample and linked them to selected measures of plan performance. Two linear regression models were estimated to assess the relationship between the measures of physician network overlap and the plan performance measures. Principal Findings The results indicate that in the presence of a higher degree of provider network overlap, plan performance measures tend to converge to a lower level of quality. Conclusions Standard health plan performance measures reflect physician practice patterns rather than plans' effort to improve quality. This implies that more provider-oriented measurement, such as would be possible with accountable care organizations or medical homes, may facilitate patient decision making and provide further incentives to improve performance. PMID:20403064

A near-optimal low complexity sensor fusion technique for accurate indoor localization based on ultrasound time of arrival measurements from low-quality sensors

NASA Astrophysics Data System (ADS)

Mitilineos, Stelios A.; Argyreas, Nick D.; Thomopoulos, Stelios C. A.

2009-05-01

A fusion-based localization technique for location-based services in indoor environments is introduced herein, based on ultrasound time-of-arrival measurements from multiple off-the-shelf range estimating sensors which are used in a market-available localization system. In-situ field measurements results indicated that the respective off-the-shelf system was unable to estimate position in most of the cases, while the underlying sensors are of low-quality and yield highly inaccurate range and position estimates. An extensive analysis is performed and a model of the sensor-performance characteristics is established. A low-complexity but accurate sensor fusion and localization technique is then developed, which consists inof evaluating multiple sensor measurements and selecting the one that is considered most-accurate based on the underlying sensor model. Optimality, in the sense of a genie selecting the optimum sensor, is subsequently evaluated and compared to the proposed technique. The experimental results indicate that the proposed fusion method exhibits near-optimal performance and, albeit being theoretically suboptimal, it largely overcomes most flaws of the underlying single-sensor system resulting in a localization system of increased accuracy, robustness and availability.

Application of psychometric theory to the measurement of voice quality using rating scales.

PubMed

Shrivastav, Rahul; Sapienza, Christine M; Nandur, Vuday

2005-04-01

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the mid-range of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have been interpreted to show that listeners perceive voice quality in an idiosyncratic manner. Based on psychometric theory, the present research explored an alternative explanation for the poor interlistener agreement observed in previous research. This approach suggests that poor agreement between listeners may result, in part, from measurement errors related to a variety of factors rather than true differences in the perception of voice quality. In this study, 10 listeners rated breathiness for 27 vowel stimuli using a 5-point rating scale. Each stimulus was presented to the listeners 10 times in random order. Interlistener agreement and reliability were calculated from these ratings. Agreement and reliability were observed to improve when multiple ratings of each stimulus from each listener were averaged and when standardized scores were used instead of absolute ratings. The probability of exact agreement was found to be approximately .9 when using averaged ratings and standardized scores. In contrast, the probability of exact agreement was only .4 when a single rating from each listener was used to measure agreement. These findings support the hypothesis that poor agreement reported in past research partly arises from errors in measurement rather than individual differences in the perception of voice quality.

Measuring the Quality of Professional Development Training

ERIC Educational Resources Information Center

Gaumer Erickson, Amy S.; Noonan, Patricia M.; Brussow, Jennifer; Supon Carter, Kayla

2017-01-01

High-quality, evidence-based professional development is essential to ensure that teachers obtain the knowledge, strategies and skills necessary to positively impact student learning. While the primary form of professional development, training has rarely been evaluated for quality beyond the satisfaction of those being trained. The Observation…

LiDAR for Air Quality Measurements

DOT National Transportation Integrated Search

2017-02-02

The overall goal of this research is to investigate a unique light detection and ranging (LiDAR) technology for ambient air quality measurement of particulate matter. The ODU team has recently received a state-of-the-art elastic LiDAR from NASA Langl...

Hybrid architecture for encoded measurement-based quantum computation

PubMed Central

Zwerger, M.; Briegel, H. J.; Dür, W.

2014-01-01

We present a hybrid scheme for quantum computation that combines the modular structure of elementary building blocks used in the circuit model with the advantages of a measurement-based approach to quantum computation. We show how to construct optimal resource states of minimal size to implement elementary building blocks for encoded quantum computation in a measurement-based way, including states for error correction and encoded gates. The performance of the scheme is determined by the quality of the resource states, where within the considered error model a threshold of the order of 10% local noise per particle for fault-tolerant quantum computation and quantum communication. PMID:24946906

Evaluating fundamentals of care: The development of a unit-level quality measurement and improvement programme.

PubMed

Parr, Jenny M; Bell, Jeanette; Koziol-McLain, Jane

2018-06-01

The project aimed to develop a unit-level quality measurement and improvement programme using evidence-based fundamentals of care. Feedback from patients, families, whānau, staff and audit data in 2014 indicated variability in the delivery of fundamental aspects of care such as monitoring, nutrition, pain management and environmental cleanliness at a New Zealand District Health Board. A general inductive approach was used to explore the fundamentals of care and design a measurement and improvement programme, the Patient and Whānau Centred Care Standards (PWCCS), focused on fundamental care. Five phases were used to explore the evidence, and design and test a measurement and improvement framework. Nine identified fundamental elements of care were used to define expected standards of care and develop and test a measurement and improvement framework. Four six-monthly peer reviews have been undertaken since June 2015. Charge Nurse Managers used results to identify quality improvements. Significant improvement was demonstrated overall, in six of the 27 units, in seven of the nine standards and three of the four measures. In all, 89% (n = 24) of units improved their overall result. The PWCCS measurement and improvement framework make visible nursing fundamentals of care in line with continuous quality improvement to increase quality of care. Delivering fundamentals of care is described by nurses as getting ?back to basics'. Patient and family feedback supports the centrality of fundamentals of care to their hospital experience. Implementing a unit-level fundamentals of care quality measurement and improvement programme clarifies expected standards of care, highlights the contribution of fundamentals of care to quality and provides a mechanism for ongoing improvements. © 2018 John Wiley & Sons Ltd.

Tests to measure the quality of spermatozoa at spermiation

PubMed Central

Amann, Rupert P.

2010-01-01

This commentary is to critique the revised World Health Organization (WHO) semen analysis manual as it pertains to characteristics of a spermatozoon at spermiation. The aims of the revised WHO manual include improving the 'quality of semen analysis' without any restriction to clinical use. Furthermore, the manual states that semen analysis may be useful for (a) 'investigating male fertility status' and (b) 'monitoring spermatogenesis during and following male fertility regulation.' However, if the analysis of ejaculated spermatozoa is intended for the purposes described in (b), then cells that are abnormal at spermiation must be identified. This paper takes the position that the manual does not identify methods to estimate the quality of spermatozoa at spermiation. Instead, it uses a 'gold standard' of sperm passing through the cervical mucus or arriving near the site of fertilization. Although this standard is appropriate for drawing conclusions regarding the probability that an individual could impregnate his partner, it is not appropriate for studying illness of the testes per se. Herein, the measures of sperm quality presented in the WHO manual are critiqued with respect to the detection of spermatozoa that were abnormal at spermiation vs. those that became abnormal subsequently. Quality assessments based on the percentage of motile or 'viable' spermatozoa are meaningless. Alternative quality attributes defining spermatozoa at spermiation are presented in this paper. In conclusion, assessment of spermatozoal quality at spermiation, on the basis of quality attributes of individual ejaculated spermatozoa, is best achieved through application of (a) a new paradigm for the morphological evaluation of sperm quality and (b) modern analytical techniques to evaluate, in an adequate sample, several appropriate independent attributes in each spermatozoon in order to more accurately identify the proportion of abnormal spermatozoa. PMID:20111084

The measurement of quality of care in the Veterans Health Administration.

PubMed

Halpern, J

1996-03-01

The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the

Evaluating the quality of a cell counting measurement process via a dilution series experimental design.

PubMed

Sarkar, Sumona; Lund, Steven P; Vyzasatya, Ravi; Vanguri, Padmavathy; Elliott, John T; Plant, Anne L; Lin-Gibson, Sheng

2017-12-01

Cell counting measurements are critical in the research, development and manufacturing of cell-based products, yet determining cell quantity with accuracy and precision remains a challenge. Validating and evaluating a cell counting measurement process can be difficult because of the lack of appropriate reference material. Here we describe an experimental design and statistical analysis approach to evaluate the quality of a cell counting measurement process in the absence of appropriate reference materials or reference methods. The experimental design is based on a dilution series study with replicate samples and observations as well as measurement process controls. The statistical analysis evaluates the precision and proportionality of the cell counting measurement process and can be used to compare the quality of two or more counting methods. As an illustration of this approach, cell counting measurement processes (automated and manual methods) were compared for a human mesenchymal stromal cell (hMSC) preparation. For the hMSC preparation investigated, results indicated that the automated method performed better than the manual counting methods in terms of precision and proportionality. By conducting well controlled dilution series experimental designs coupled with appropriate statistical analysis, quantitative indicators of repeatability and proportionality can be calculated to provide an assessment of cell counting measurement quality. This approach does not rely on the use of a reference material or comparison to "gold standard" methods known to have limited assurance of accuracy and precision. The approach presented here may help the selection, optimization, and/or validation of a cell counting measurement process. Published by Elsevier Inc.

Developing Resident-Sensitive Quality Measures: A Model From Pediatric Emergency Medicine.

PubMed

Schumacher, Daniel J; Holmboe, Eric S; van der Vleuten, Cees; Busari, Jamiu O; Carraccio, Carol

2017-12-05

To begin closing the gap with respect to quality measures available for use among residents, the authors sought to identify and develop resident-sensitive quality measures (RSQMs) for use in the pediatric emergency department (PED) setting. In May 2016, the authors reviewed National Quality Measures Clearinghouse (NQMC) measures to identify resident-sensitive measures. To create additional measures focused on common, acute illnesses (acute asthma exacerbation, bronchiolitis, closed head injury [CHI]) in the PED, the authors used a nominal group technique (NGT) and Delphi process from September to December 2016. To achieve a local focus for developing these measures, all NGT and Delphi participants were from Cincinnati Children's Hospital Medical Center. Delphi participants rated measures developed through the NGT in two areas: importance of measure to quality care and likelihood that measure represents the work of a resident. The review of NQMC measures identified 28 of 183 as being potentially resident-sensitive. The NGT produced 67 measures for asthma, 46 for bronchiolitis, and 48 for CHI. These were used in the first round of the Delphi process. After two rounds, 18 measures for asthma, 21 for bronchiolitis, and 22 for CHI met automatic inclusion criteria. In round three, participants categorized the potential final measures by their top 10 and next 5. This study describes a template for identifying and developing RSQMs that may promote high-quality care delivery during and following training. Next steps should include implementing and seeking validity evidence for the locally developed measures.

Measurement properties of quality-of-life measurement instruments for infants, children and adolescents with eczema: a systematic review.

PubMed

Heinl, D; Prinsen, C A C; Sach, T; Drucker, A M; Ofenloch, R; Flohr, C; Apfelbacher, C

2017-04-01

Quality of life (QoL) is one of the core outcome domains identified by the Harmonising Outcome Measures for Eczema (HOME) initiative to be assessed in every eczema trial. There is uncertainty about the most appropriate QoL instrument to measure this domain in infants, children and adolescents. To systematically evaluate the measurement properties of existing measurement instruments developed and/or validated for the measurement of QoL in infants, children and adolescents with eczema. A systematic literature search in PubMed and Embase, complemented by a thorough hand search of reference lists, retrieved studies on measurement properties of eczema QoL instruments for infants, children and adolescents. For all eligible studies, we judged the adequacy of the measurement properties and the methodological study quality with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results from different studies were summarized in a best-evidence synthesis and formed the basis to assign four degrees of recommendation. Seventeen articles, three of which were found by hand search, were included. These 17 articles reported on 24 instruments. No instrument can be recommended for use in all eczema trials because none fulfilled all required adequacy criteria. With adequate internal consistency, reliability and hypothesis testing, the U.S. version of the Childhood Atopic Dermatitis Impact Scale (CADIS), a proxy-reported instrument, has the potential to be recommended depending on the results of further validation studies. All other instruments, including all self-reported ones, lacked significant validation data. Currently, no QoL instrument for infants, children and adolescents with eczema can be highly recommended. Future validation research should primarily focus on the CADIS, but also attempt to broaden the evidence base for the validity of self-reported instruments. © 2016 British Association of Dermatologists.

Prediction of HDR quality by combining perceptually transformed display measurements with machine learning

NASA Astrophysics Data System (ADS)

Choudhury, Anustup; Farrell, Suzanne; Atkins, Robin; Daly, Scott

2017-09-01

We present an approach to predict overall HDR display quality as a function of key HDR display parameters. We first performed subjective experiments on a high quality HDR display that explored five key HDR display parameters: maximum luminance, minimum luminance, color gamut, bit-depth and local contrast. Subjects rated overall quality for different combinations of these display parameters. We explored two models | a physical model solely based on physically measured display characteristics and a perceptual model that transforms physical parameters using human vision system models. For the perceptual model, we use a family of metrics based on a recently published color volume model (ICT-CP), which consists of the PQ luminance non-linearity (ST2084) and LMS-based opponent color, as well as an estimate of the display point spread function. To predict overall visual quality, we apply linear regression and machine learning techniques such as Multilayer Perceptron, RBF and SVM networks. We use RMSE and Pearson/Spearman correlation coefficients to quantify performance. We found that the perceptual model is better at predicting subjective quality than the physical model and that SVM is better at prediction than linear regression. The significance and contribution of each display parameter was investigated. In addition, we found that combined parameters such as contrast do not improve prediction. Traditional perceptual models were also evaluated and we found that models based on the PQ non-linearity performed better.

Health related quality of life measures in Arabic speaking populations: a systematic review on cross-cultural adaptation and measurement properties.

PubMed

Al Sayah, Fatima; Ishaque, Sana; Lau, Darren; Johnson, Jeffrey A

2013-02-01

This systematic review was conducted to identify generic health related quality of life (HRQL) measures translated into Arabic, and evaluate their cross-cultural adaptation and measurement properties. Six databases were searched, relevant journals were hand searched, and reference lists of included studies were reviewed. Previously established criteria were used to evaluate the cross-cultural adaptation of the identified instruments and their measurement properties. Twenty studies that reported the Arabic translations and adaptations of HRQL measures and/or their measurement properties were included in this review. The identified instruments were SF-36, RAND-36, WHOQOL-Bref, COOP/WONCA charts, EQ-5D, and QLI. Cross-cultural adaptations of all measures were of moderate to good quality, and evaluation of measurement properties was limited due to insufficiency of evidence. Based on cross-cultural adaptation evaluation, each instrument is more applicable to the population for whom it was adapted, and to other Arabic populations of similar culture and language specific idioms. This review facilitates the selection among existing Arabic versions of generic HRQL for use in particular Arabic countries. However, each of the translated versions requires further investigation of measurement properties before more concrete recommendations could be made.

Measuring Quality of Care in Community Mental Health: Validation of Concordant Clinician and Client Quality-of-Care Scales.

PubMed

Luther, Lauren; Fukui, Sadaaki; Garabrant, Jennifer M; Rollins, Angela L; Morse, Gary; Henry, Nancy; Shimp, Dawn; Gearhart, Timothy; Salyers, Michelle P

2018-04-12

Measuring quality of care can transform care, but few tools exist to measure quality from the client's perspective. The aim of this study was to create concordant clinician and client self-report quality-of-care scales in a sample of community mental health clinicians (n = 189) and clients (n = 469). The client scale had three distinct factors (Person-Centered Care, Negative Staff Interactions, and Inattentive Care), while the clinician scale had two: Person-Centered Care and Discordant Care. Both versions demonstrated adequate internal consistency and validity with measures related to satisfaction and the therapeutic relationship. These measures are promising, brief quality assessment tools.

Distributor- Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale.

PubMed

Mehralian, Gholamhossein; Babapour, Jafar; Peiravian, Farzad

2016-01-01

In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor-retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor-retailer interface.

Distributor– Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale

PubMed Central

Mehralian, Gholamhossein; Babapour, Jafar; peiravian, farzad

2016-01-01

In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor–retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor–retailer interface. PMID:28243297

The role of quality measurement in a competitive marketplace.

PubMed

Epstein, A M

1996-01-01

Quality measurement is not a new idea. However, in recent years, several new trends have gained prominence: greater interest in publicly reported information on quality of care, access to care, and patient satisfaction; an increased focus on health plans and integrated systems of care rather than on institutional providers and practitioners as the unit of observation; wide adoption of the techniques of continuous quality improvement within the health care sector; increased use of clinical practice guidelines to improve care for a broad range of medical conditions; incorporation of computer technology into the clinical setting; and greater appreciation for health outcomes as a measure of quality of care. This chapter first reviews the changes in the medical landscape that have seeded these trends and the distinction between quality assurance and quality improvement. It then focuses on public policy concerns, in particular on the emergence of publicly disseminated information about quality of care, now often called "quality report cards." The major prototypes of these reports developed to date, the responses to quality reporting by different members of the delivery system, and the major criticisms of this approach are reviewed. The chapter concludes by predicting probable developments and the strategies most likely to move health care forward in a productive direction.

Population management, systems-based practice, and planned chronic illness care: integrating disease management competencies into primary care to improve composite diabetes quality measures.

PubMed

Kimura, Joe; DaSilva, Karen; Marshall, Richard

2008-02-01

The increasing prevalence of chronic illnesses in the United States requires a fundamental redesign of the primary care delivery system's structure and processes in order to meet the changing needs and expectations of patients. Population management, systems-based practice, and planned chronic illness care are 3 potential processes that can be integrated into primary care and are compatible with the Chronic Care Model. In 2003, Harvard Vanguard Medical Associates, a multispecialty ambulatory physician group practice based in Boston, Massachusetts, began implementing all 3 processes across its primary care practices. From 2004 to 2006, the overall diabetes composite quality measures improved from 51% to 58% for screening (HgA1c x 2, low-density lipoprotein, blood pressure in 12 months) and from 13% to 17% for intermediate outcomes (HgA1c measures for patients with planned visits compared to those who had no planned visits. This study illustrates how 1 delivery system integrated these disease management functions into the front lines of primary care and the positive impact of those changes on overall diabetes quality of care.

MEASURING BASE-FLOW CHEMISTRY AS AN INDICATOR OF REGIONAL GROUND-WATER QUALITY IN THE MID-ATLANTIC COASTAL PLAIN

EPA Science Inventory

Water quality in headwater (first-order) streams of the Mid-Atlantic Coastal Plain during base flow in the winter and spring is related to land use, hydrogeology, and other natural and human influences. A random survey of water quality in 174 headwater streams in the Mid-Atlantic...

An Entropy-Based Measure for Assessing Fuzziness in Logistic Regression

PubMed Central

Weiss, Brandi A.; Dardick, William

2015-01-01

This article introduces an entropy-based measure of data–model fit that can be used to assess the quality of logistic regression models. Entropy has previously been used in mixture-modeling to quantify how well individuals are classified into latent classes. The current study proposes the use of entropy for logistic regression models to quantify the quality of classification and separation of group membership. Entropy complements preexisting measures of data–model fit and provides unique information not contained in other measures. Hypothetical data scenarios, an applied example, and Monte Carlo simulation results are used to demonstrate the application of entropy in logistic regression. Entropy should be used in conjunction with other measures of data–model fit to assess how well logistic regression models classify cases into observed categories. PMID:29795897

An Entropy-Based Measure for Assessing Fuzziness in Logistic Regression.

PubMed

Weiss, Brandi A; Dardick, William

2016-12-01

This article introduces an entropy-based measure of data-model fit that can be used to assess the quality of logistic regression models. Entropy has previously been used in mixture-modeling to quantify how well individuals are classified into latent classes. The current study proposes the use of entropy for logistic regression models to quantify the quality of classification and separation of group membership. Entropy complements preexisting measures of data-model fit and provides unique information not contained in other measures. Hypothetical data scenarios, an applied example, and Monte Carlo simulation results are used to demonstrate the application of entropy in logistic regression. Entropy should be used in conjunction with other measures of data-model fit to assess how well logistic regression models classify cases into observed categories.

Network-based production quality control

NASA Astrophysics Data System (ADS)

Kwon, Yongjin; Tseng, Bill; Chiou, Richard

2007-09-01

This study investigates the feasibility of remote quality control using a host of advanced automation equipment with Internet accessibility. Recent emphasis on product quality and reduction of waste stems from the dynamic, globalized and customer-driven market, which brings opportunities and threats to companies, depending on the response speed and production strategies. The current trends in industry also include a wide spread of distributed manufacturing systems, where design, production, and management facilities are geographically dispersed. This situation mandates not only the accessibility to remotely located production equipment for monitoring and control, but efficient means of responding to changing environment to counter process variations and diverse customer demands. To compete under such an environment, companies are striving to achieve 100%, sensor-based, automated inspection for zero-defect manufacturing. In this study, the Internet-based quality control scheme is referred to as "E-Quality for Manufacturing" or "EQM" for short. By its definition, EQM refers to a holistic approach to design and to embed efficient quality control functions in the context of network integrated manufacturing systems. Such system let designers located far away from the production facility to monitor, control and adjust the quality inspection processes as production design evolves.

Development and Pilot Testing of Caregiver-Reported Pediatric Quality Measures for Transitions Between Sites of Care.

PubMed

Desai, Arti D; Burkhart, Q; Parast, Layla; Simon, Tamara D; Allshouse, Carolyn; Britto, Maria T; Leyenaar, JoAnna K; Gidengil, Courtney A; Toomey, Sara L; Elliott, Marc N; Schneider, Eric C; Mangione-Smith, Rita

Few measures exist to assess pediatric transition quality between care settings. The study objective was to develop and pilot test caregiver-reported quality measures for pediatric hospital and emergency department (ED) to home transitions. On the basis of an evidence review, we developed draft caregiver-reported quality measures for transitions between sites of care. Using the RAND-UCLA Modified Delphi method, a multistakeholder panel endorsed measures for further development. Measures were operationalized into 2 surveys, which were administered to caregivers of patients (n = 2839) discharged from Seattle Children's Hospital between July 1 and September 1, 2014. Caregivers were randomized to mail or telephone survey mode. Measure scores were computed as a percentage of eligible caregivers who endorsed receiving the indicated care. Differences in scores were examined according to survey mode and caregiver characteristics. The Delphi panel endorsed 6 of 8 hospital to home transition measures and 2 of 3 ED to home transitions measures. Scores differed significantly according to mode for 1 measure. Caregivers with lower levels of educational attainment and/or Spanish-speaking caregivers reported significantly higher scores on 3 of the measures. The largest difference was reported for the measure that assessed whether caregivers received assistance with scheduling follow-up appointments; 92% score for caregivers with lower educational attainment versus 79% for caregivers with higher educational attainment (P < .001). We developed 8 new, evidence-based quality measures to assess transition quality from the perspective of caregivers. Pilot testing of these measures in a single institution yielded valuable insights for future testing and implementation of these measures. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review.

PubMed

Dobson, F; Hinman, R S; Hall, M; Terwee, C B; Roos, E M; Bennell, K L

2012-12-01

To systematically review the measurement properties of performance-based measures to assess physical function in people with hip and/or knee osteoarthritis (OA). Electronic searches were performed in MEDLINE, CINAHL, Embase, and PsycINFO up to the end of June 2012. Two reviewers independently rated measurement properties using the consensus-based standards for the selection of health status measurement instrument (COSMIN). "Best evidence synthesis" was made using COSMIN outcomes and the quality of findings. Twenty-four out of 1792 publications were eligible for inclusion. Twenty-one performance-based measures were evaluated including 15 single-activity measures and six multi-activity measures. Measurement properties evaluated included internal consistency (three measures), reliability (16 measures), measurement error (14 measures), validity (nine measures), responsiveness (12 measures) and interpretability (three measures). A positive rating was given to only 16% of possible measurement ratings. Evidence for the majority of measurement properties of tests reported in the review has yet to be determined. On balance of the limited evidence, the 40 m self-paced test was the best rated walk test, the 30 s-chair stand test and timed up and go test were the best rated sit to stand tests, and the Stratford battery, Physical Activity Restrictions and Functional Assessment System were the best rated multi-activity measures. Further good quality research investigating measurement properties of performance measures, including responsiveness and interpretability in people with hip and/or knee OA, is needed. Consensus on which combination of measures will best assess physical function in people with hip/and or knee OA is urgently required. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Measuring quality progress

NASA Astrophysics Data System (ADS)

Lambert, Larry D.

The study by the American Productivity & Quality Center (APQC) was commissioned by Loral Space Information Systems, Inc. and the National Aeronautics and Space Administration (NASA) to evaluate internal assessment systems. APQC benchmarked approaches to the internal assessment of quality management systems in three phases. The first phase included work conducted for the International Benchmarking Clearinghouse (IBC) and consisted of an in-depth analysis of the 1991 Malcolm Baldrige National Quality Award criteria. The second phase was also performed for the IBC and compared the 1991 award criteria among the following quality awards: Deming Prize, Malcolm Baldrige National Quality Award, The President's Award for Quality and Productivity Improvement, The NASA Excellence Award (The George M. Lowe Trophy) for Quality and Productivity Improvement and the Shigeo Shingo Award for Excellence in Manufacturing. The third phase compared the internal implementation approaches of 23 companies selected from American industry for their recognized, formal assessment systems.

Measuring quality progress

NASA Technical Reports Server (NTRS)

Lambert, Larry D.

1992-01-01

The study by the American Productivity & Quality Center (APQC) was commissioned by Loral Space Information Systems, Inc. and the National Aeronautics and Space Administration (NASA) to evaluate internal assessment systems. APQC benchmarked approaches to the internal assessment of quality management systems in three phases. The first phase included work conducted for the International Benchmarking Clearinghouse (IBC) and consisted of an in-depth analysis of the 1991 Malcolm Baldrige National Quality Award criteria. The second phase was also performed for the IBC and compared the 1991 award criteria among the following quality awards: Deming Prize, Malcolm Baldrige National Quality Award, The President's Award for Quality and Productivity Improvement, The NASA Excellence Award (The George M. Lowe Trophy) for Quality and Productivity Improvement and the Shigeo Shingo Award for Excellence in Manufacturing. The third phase compared the internal implementation approaches of 23 companies selected from American industry for their recognized, formal assessment systems.

Correction of stream quality trends for the effects of laboratory measurement bias

USGS Publications Warehouse

Alexander, Richard B.; Smith, Richard A.; Schwarz, Gregory E.

1993-01-01

We present a statistical model relating measurements of water quality to associated errors in laboratory methods. Estimation of the model allows us to correct trends in water quality for long-term and short-term variations in laboratory measurement errors. An illustration of the bias correction method for a large national set of stream water quality and quality assurance data shows that reductions in the bias of estimates of water quality trend slopes are achieved at the expense of increases in the variance of these estimates. Slight improvements occur in the precision of estimates of trend in bias by using correlative information on bias and water quality to estimate random variations in measurement bias. The results of this investigation stress the need for reliable, long-term quality assurance data and efficient statistical methods to assess the effects of measurement errors on the detection of water quality trends.

Water Quality Index for measuring drinking water quality in rural Bangladesh: a cross-sectional study.

PubMed

Akter, Tahera; Jhohura, Fatema Tuz; Akter, Fahmida; Chowdhury, Tridib Roy; Mistry, Sabuj Kanti; Dey, Digbijoy; Barua, Milan Kanti; Islam, Md Akramul; Rahman, Mahfuzar

2016-02-09

Public health is at risk due to chemical contaminants in drinking water which may have immediate health consequences. Drinking water sources are susceptible to pollutants depending on geological conditions and agricultural, industrial, and other man-made activities. Ensuring the safety of drinking water is, therefore, a growing problem. To assess drinking water quality, we measured multiple chemical parameters in drinking water samples from across Bangladesh with the aim of improving public health interventions. In this cross-sectional study conducted in 24 randomly selected upazilas, arsenic was measured in drinking water in the field using an arsenic testing kit and a sub-sample was validated in the laboratory. Water samples were collected to test water pH in the laboratory as well as a sub-sample of collected drinking water was tested for water pH using a portable pH meter. For laboratory testing of other chemical parameters, iron, manganese, and salinity, drinking water samples were collected from 12 out of 24 upazilas. Drinking water at sample sites was slightly alkaline (pH 7.4 ± 0.4) but within acceptable limits. Manganese concentrations varied from 0.1 to 5.5 mg/L with a median value of 0.2 mg/L. The median iron concentrations in water exceeded WHO standards (0.3 mg/L) at most of the sample sites and exceeded Bangladesh standards (1.0 mg/L) at a few sample sites. Salinity was relatively higher in coastal districts. After laboratory confirmation, arsenic concentrations were found higher in Shibchar (Madaripur) and Alfadanga (Faridpur) compared to other sample sites exceeding WHO standard (0.01 mg/L). Of the total sampling sites, 33 % had good-quality water for drinking based on the Water Quality Index (WQI). However, the majority of the households (67 %) used poor-quality drinking water. Higher values of iron, manganese, and arsenic reduced drinking water quality. Awareness raising on chemical contents in drinking water at household level is required to

Health-related quality of life measurement in oncology: advances and opportunities.

PubMed

Cella, David; Stone, Arthur A

2015-01-01

The concept of health-related quality of life has a long history in the field of oncology treatment and research. We present a brief history of how the concept has evolved in oncology and the sentinel events in that process. We then focus on advances in measurement science as applied to health-related quality of life measures and argue that a compelling new set of measurement tools is now available, including brief, generic measures with good psychometric qualities (exemplified by the new PROMIS measures and the possibility of a common metric spanning all diseases). The last section of the paper turns to emerging opportunities for these measures, including in clinical trials, healthcare reform, and regulatory deliberations. Our conclusion is that health-related quality of life is more important today than it has ever been, and that the time has come for an even wider adoption of the new measures. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Measuring Environmental Quality in the Southern Appalachian Mountains

Treesearch

Linwood Pendleton; Brent Sohngen; Robert Mendelsohn; Thomas Holmes

1998-01-01

This study presents a method for valuing recreational environmental quality in the forests of the southeastern United States. The paper offers a method for choosing, measuring, and valuing forest attributes. Surveys and popular recreation literature are used to identify forest attributes that contribute to recreational quality. Standard ecological techniques are...

Model-based monitoring of stormwater runoff quality.

PubMed

Birch, Heidi; Vezzaro, Luca; Mikkelsen, Peter Steen

2013-01-01

Monitoring of micropollutants (MP) in stormwater is essential to evaluate the impacts of stormwater on the receiving aquatic environment. The aim of this study was to investigate how different strategies for monitoring of stormwater quality (combining a model with field sampling) affect the information obtained about MP discharged from the monitored system. A dynamic stormwater quality model was calibrated using MP data collected by automatic volume-proportional sampling and passive sampling in a storm drainage system on the outskirts of Copenhagen (Denmark) and a 10-year rain series was used to find annual average (AA) and maximum event mean concentrations. Use of this model reduced the uncertainty of predicted AA concentrations compared to a simple stochastic method based solely on data. The predicted AA concentration, obtained by using passive sampler measurements (1 month installation) for calibration of the model, resulted in the same predicted level but with narrower model prediction bounds than by using volume-proportional samples for calibration. This shows that passive sampling allows for a better exploitation of the resources allocated for stormwater quality monitoring.

Measuring quality of life in cleft lip and palate patients: currently available patient-reported outcomes measures.

PubMed

Eckstein, Donna A; Wu, Rebecca L; Akinbiyi, Takintope; Silver, Lester; Taub, Peter J

2011-11-01

Patient-reported outcomes in cleft lip and palate treatment are critical for patient care. Traditional surgical outcomes focused on objective measures, such as photographs, anatomic measurements, morbidity, and mortality. Although these remain important, they leave many questions unanswered. Surveys that include aesthetics, speech, functionality, self-image, and quality of life provide more thorough outcomes assessment. It is vital that reliable, valid, and comprehensive questionnaires are available to craniofacial surgeons. The authors performed a literature review to identify questionnaires validated in cleft lip and palate patients. Qualifying instruments were assessed for adherence to guidelines for development and validation by the scientific advisory committee and for content. The authors identified 44 measures used in cleft lip and palate studies. After 15 ad hoc questionnaires, eight generic instruments, 11 psychiatric instruments, and one non-English language questionnaire were excluded, nine measures remained. Of these, four were never validated in the cleft population. Analysis revealed one craniofacial-specific measure (Youth Quality of Life-Facial Differences), two voice-related measures (Patient Voice-Related Quality of Life and Cleft Audit Protocol for Speech-Augmented), and two oral health-related measures (Child Oral Health Impact Profile and Child Oral Health Quality of Life). The Youth Quality of Life-Facial Differences, Child Oral Health Impact Profile, and Child Oral Health Quality of Life questionnaires were sufficiently validated. None was created specifically for clefts, resulting in content limitations. There is a lack of comprehensive, valid, and reliable questionnaires for cleft lip and palate surgery. For thorough assessment of satisfaction, further research to develop and validate cleft lip and palate surgery-specific instruments is needed.

DOGMA: domain-based transcriptome and proteome quality assessment.

PubMed

Dohmen, Elias; Kremer, Lukas P M; Bornberg-Bauer, Erich; Kemena, Carsten

2016-09-01

Genome studies have become cheaper and easier than ever before, due to the decreased costs of high-throughput sequencing and the free availability of analysis software. However, the quality of genome or transcriptome assemblies can vary a lot. Therefore, quality assessment of assemblies and annotations are crucial aspects of genome analysis pipelines. We developed DOGMA, a program for fast and easy quality assessment of transcriptome and proteome data based on conserved protein domains. DOGMA measures the completeness of a given transcriptome or proteome and provides information about domain content for further analysis. DOGMA provides a very fast way to do quality assessment within seconds. DOGMA is implemented in Python and published under GNU GPL v.3 license. The source code is available on https://ebbgit.uni-muenster.de/domainWorld/DOGMA/ CONTACTS: e.dohmen@wwu.de or c.kemena@wwu.de Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The choices, choosing model of quality of life: linkages to a science base.

PubMed

Gurland, Barry J; Gurland, Roni V

2009-01-01

A previous paper began with a critical review of current models and measures of quality of life and then proposed criteria for judging the relative merits of alternative models: preference was given to finding a model with explicit mechanisms, linkages to a science base, a means of identifying deficits amenable to rational restorative interventions, and with embedded values of the whole person. A conjectured model, based on the processes of accessing choices and choosing among them, matched the proposed criteria. The choices and choosing (c-c) process is an evolved adaptive mechanism dedicated to the pursuit of quality of life, driven by specific biological and psychological systems, and influenced also by social and environmental forces. In this paper the c-c model is examined for its potential to strengthen the science base for the field of quality of life and thus to unify many approaches to concept and measurement. A third paper in this set will lay out a guide to applying the c-c model in evaluating impairments of quality of life and will tie this evaluation to corresponding interventions aimed at relieving restrictions or distortions of the c-c process; thus helping people to preserve and improve their quality of life. The fourth paper will demonstrate empirical analyses of the relationship between health imposed restrictions of options for living and conventional indicators of diminished quality of life. (c) 2008 John Wiley & Sons, Ltd.

Useful measures and models for analytical quality management in medical laboratories.

PubMed

Westgard, James O

2016-02-01

The 2014 Milan Conference "Defining analytical performance goals 15 years after the Stockholm Conference" initiated a new discussion of issues concerning goals for precision, trueness or bias, total analytical error (TAE), and measurement uncertainty (MU). Goal-setting models are critical for analytical quality management, along with error models, quality-assessment models, quality-planning models, as well as comprehensive models for quality management systems. There are also critical underlying issues, such as an emphasis on MU to the possible exclusion of TAE and a corresponding preference for separate precision and bias goals instead of a combined total error goal. This opinion recommends careful consideration of the differences in the concepts of accuracy and traceability and the appropriateness of different measures, particularly TAE as a measure of accuracy and MU as a measure of traceability. TAE is essential to manage quality within a medical laboratory and MU and trueness are essential to achieve comparability of results across laboratories. With this perspective, laboratory scientists can better understand the many measures and models needed for analytical quality management and assess their usefulness for practical applications in medical laboratories.

SAGES quality initiative: an introduction.

PubMed

Lidor, Anne; Telem, Dana; Bower, Curtis; Sinha, Prashant; Orlando, Rocco; Romanelli, John

2017-08-01

The Medicare program has transitioned to paying healthcare providers based on the quality of care delivered, not on the quantity. In May 2015, SAGES held its first ever Quality Summit. The goal of this meeting was to provide us with the information necessary to put together a strategic plan for our Society over the next 3-5 years, and to participate actively on a national level to help develop valid measures of quality of surgery. The transition to value-based medicine requires that providers are now measured and reimbursed based on the quality of services they provide rather than the quantity of patients in their care. As of 2014, quality measures must cover 3 of the 6 available National Quality domains. Physician quality reporting system measures are created via a vigorous process which is initiated by the proposal of the quality measure and subsequent validation. Commercial, non-profit, and governmental agencies have now been engaged in the measurement of hospital performance through structural measures, process measures, and increasingly with outcomes measures. This more recent focus on outcomes measures have been linked to hospital payments through the Value-Based Purchasing program. Outcomes measures of quality drive CMS' new program, MACRA, using two formats: Merit-based incentive programs and alternative payment models. But, the quality of information now available is highly variable and difficult for the average consumer to use. Quality metrics serve to guide efforts to improve performance and for consumer education. Professional organizations such as SAGES play a central role in defining the agenda for improving quality, outcomes, and safety. The mission of SAGES is to improve the quality of patient care through education, research, innovation, and leadership, principally in gastrointestinal and endoscopic surgery.