The data quality analyzer: A quality control program for seismic data

NASA Astrophysics Data System (ADS)

Ringler, A. T.; Hagerty, M. T.; Holland, J.; Gonzales, A.; Gee, L. S.; Edwards, J. D.; Wilson, D.; Baker, A. M.

2015-03-01

The U.S. Geological Survey's Albuquerque Seismological Laboratory (ASL) has several initiatives underway to enhance and track the quality of data produced from ASL seismic stations and to improve communication about data problems to the user community. The Data Quality Analyzer (DQA) is one such development and is designed to characterize seismic station data quality in a quantitative and automated manner. The DQA consists of a metric calculator, a PostgreSQL database, and a Web interface: The metric calculator, SEEDscan, is a Java application that reads and processes miniSEED data and generates metrics based on a configuration file. SEEDscan compares hashes of metadata and data to detect changes in either and performs subsequent recalculations as needed. This ensures that the metric values are up to date and accurate. SEEDscan can be run as a scheduled task or on demand. The PostgreSQL database acts as a central hub where metric values and limited station descriptions are stored at the channel level with one-day granularity. The Web interface dynamically loads station data from the database and allows the user to make requests for time periods of interest, review specific networks and stations, plot metrics as a function of time, and adjust the contribution of various metrics to the overall quality grade of the station. The quantification of data quality is based on the evaluation of various metrics (e.g., timing quality, daily noise levels relative to long-term noise models, and comparisons between broadband data and event synthetics). Users may select which metrics contribute to the assessment and those metrics are aggregated into a "grade" for each station. The DQA is being actively used for station diagnostics and evaluation based on the completed metrics (availability, gap count, timing quality, deviation from a global noise model, deviation from a station noise model, coherence between co-located sensors, and comparison between broadband data and synthetics

Quality assured measurements of animal building emissions: gas concentrations.

PubMed

Heber, Albert J; Ni, Ji-Qin; Lim, Teng T; Tao, Pei-Chun; Schmidt, Amy M; Koziel, Jacek A; Beasley, David B; Hoff, Steven J; Nicolai, Richard E; Jacobson, Larry D; Zhang, Yuanhui

2006-10-01

Comprehensive field studies were initiated in 2002 to measure emissions of ammonia (NH3), hydrogen sulfide (H2S), carbon dioxide (CO2), methane (CH4), nonmethane hydrocarbons (NMHC), particulate matter <10 microm in diameter, and total suspended particulate from swine and poultry production buildings in the United States. This paper focuses on the quasicontinuous gas concentration measurement at multiple locations among paired barns in seven states. Documented principles, used in air pollution monitoring at industrial sources, were applied in developing quality assurance (QA) project plans for these studies. Air was sampled from multiple locations with each gas analyzed with one high quality commercial gas analyzer that was located in an environmentally controlled on-farm instrument shelter. A nominal 4 L/min gas sampling system was designed and constructed with Teflon wetted surfaces, bypass pumping, and sample line flow and pressure sensors. Three-way solenoids were used to automatically switch between multiple gas sampling lines with > or =10 min sampling intervals. Inside and outside gas sampling probes were between 10 and 115 m away from the analyzers. Analyzers used chemiluminescence, fluorescence, photoacoustic infrared, and photoionization detectors for NH3, H2S, CO2, CH4, and NMHC, respectively. Data were collected using personal computer-based data acquisition hardware and software. This paper discusses the methodology of gas concentration measurements and the unique challenges that livestock barns pose for achieving desired accuracy and precision, data representativeness, comparability and completeness, and instrument calibration and maintenance.

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.

MERCURY MEASUREMENTS USING DIRECT-ANALYZER ...

EPA Pesticide Factsheets

Under EPA's Water Quality Research Program, exposure studies are needed to determine how well control strategies and guidance are working. Consequently, reliable and convenient techniques that minimize waste production are of special interest. While traditional methods for determining mercury in solid samples involve the use of aggressive chemicals to dissolve the matrix and the use of other chemicals to properly reduce the mercury to the volatile elemental form, pyrolysis-based analyzers can be used by directly weighing the solid in a sampling boat and initiating the instrumental analysis for total mercury. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at con

Improving respiration measurements with gas exchange analyzers.

PubMed

Montero, R; Ribas-Carbó, M; Del Saz, N F; El Aou-Ouad, H; Berry, J A; Flexas, J; Bota, J

2016-12-01

Dark respiration measurements with open-flow gas exchange analyzers are often questioned for their low accuracy as their low values often reach the precision limit of the instrument. Respiration was measured in five species, two hypostomatous (Vitis Vinifera L. and Acanthus mollis) and three amphistomatous, one with similar amount of stomata in both sides (Eucalyptus citriodora) and two with different stomata density (Brassica oleracea and Vicia faba). CO 2 differential (ΔCO 2 ) increased two-fold with no change in apparent R d , when the two leaves with higher stomatal density faced outside. These results showed a clear effect of the position of stomata on ΔCO 2 . Therefore, it can be concluded that leaf position is important to guarantee the improvement of respiration measurements increasing ΔCO 2 without affecting the respiration results by leaf or mass units. This method will help to increase the accuracy of leaf respiration measurements using gas exchange analyzers. Copyright © 2016 Elsevier GmbH. 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 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.

Nonparametric rank regression for analyzing water quality concentration data with multiple detection limits.

PubMed

Fu, Liya; Wang, You-Gan

2011-02-15

Environmental data usually include measurements, such as water quality data, which fall below detection limits, because of limitations of the instruments or of certain analytical methods used. The fact that some responses are not detected needs to be properly taken into account in statistical analysis of such data. However, it is well-known that it is challenging to analyze a data set with detection limits, and we often have to rely on the traditional parametric methods or simple imputation methods. Distributional assumptions can lead to biased inference and justification of distributions is often not possible when the data are correlated and there is a large proportion of data below detection limits. The extent of bias is usually unknown. To draw valid conclusions and hence provide useful advice for environmental management authorities, it is essential to develop and apply an appropriate statistical methodology. This paper proposes rank-based procedures for analyzing non-normally distributed data collected at different sites over a period of time in the presence of multiple detection limits. To take account of temporal correlations within each site, we propose an optimal linear combination of estimating functions and apply the induced smoothing method to reduce the computational burden. Finally, we apply the proposed method to the water quality data collected at Susquehanna River Basin in United States of America, which clearly demonstrates the advantages of the rank regression models.

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 of intestinal edema using an impedance analyzer circuit.

PubMed

Radhakrishnan, Ravi S; Shah, Kunal; Xue, Hasen; Moore-Olufemi, Stacey D; Moore, Frederick A; Weisbrodt, Norman W; Allen, Steven J; Gill, Brijesh; Cox, Charles S

2007-03-01

Acute intestinal edema adversely affects intestinal transit, permeability, and contractility. Current resuscitation modalities, while effective, are associated with development of acute intestinal edema. Knowledge of levels of tissue edema would allow clinicians to monitor intestinal tissue water and may help prevent the detrimental effects of edema. However, there is no simple method to measure intestinal tissue water without biopsy. We sought to develop a tissue impedance analyzer to measure tissue edema, without the need for invasive biopsy. Oscillating voltage input was applied to the analyzer circuit and an oscilloscope measured the voltage output across any load. Rats were randomized to three groups: sham, mild edema (80 mL/kg of NS resuscitation), and severe edema (80 mL/kg of NS resuscitation with intestinal venous hypertension). Intestinal edema was measured by wet-to-dry tissue weight ratio. Bowel impedance was measured and converted to capacitance using a standard curve. Acute intestinal edema causes a significant increase in bowel capacitance. This capacitance can be used to predict tissue water concentration. Using an impedance analyzer circuit, it is possible to measure intestinal edema reliably and quickly. This may prove to be a useful tool in the resuscitation of critically ill patients.

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.

Earnings Quality Measures and Excess Returns

PubMed Central

Perotti, Pietro; Wagenhofer, Alfred

2014-01-01

This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988–2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature. PMID:26300582

Earnings Quality Measures and Excess Returns.

PubMed

Perotti, Pietro; Wagenhofer, Alfred

2014-06-01

This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988-2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature.

Quality improvement in neurology: AAN Parkinson disease quality measures

PubMed Central

Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

2010-01-01

Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY

Candidate Quality Measures for Hand Surgery.

PubMed

2017-11-01

Quality measures are tools used by physicians, health care systems, and payers to evaluate performance, monitor the outcomes of interventions, and inform quality improvement efforts. A paucity of quality measures exist that address hand surgery care. We completed a RAND/UCLA (University of California Los Angeles) Delphi Appropriateness process with the goal of developing and evaluating candidate hand surgery quality measures to be used for national quality measure development efforts. A consortium of 9 academic upper limb surgeons completed a RAND/UCLA Delphi Appropriateness process to evaluate the importance, scientific acceptability, usability, and feasibility of 44 candidate quality measures. These addressed hand problems the panelists felt were most appropriate for quality measure development. Panelists rated the measures on an ordinal scale between 1 (definitely not valid) and 9 (definitely valid) in 2 rounds (preliminary round and final round) with an intervening face-to-face discussion. Ratings from 1 to 3 were considered not valid, 4 to 6 as equivocal or uncertain, and 7 to 9 as valid. If no more than 2 of the 9 ratings were outside the 3-point range that included the median (1-3, 4-6, or 7-9), the panelists were considered to be in agreement. If 3 or more of the panelists' ratings of a measure were within the 1 to 3 range and 3 or more ratings were in the 7 to 9 range, the panelists were considered to be in disagreement. There was agreement on 43% (19) of the measures as important, 27% (12) as scientifically sound, 48% (21) as usable, and 59% (26) as feasible to complete. Ten measures met all 4 of these criteria and were, therefore, considered valid measurements of quality. Quality measures that were developed address outcomes (patient-reported outcomes for assessment and improvement of function) and processes of care (utilization rates of imaging, antibiotics, occupational therapy, ultrasound, and operative treatment). The consortium developed 10

Measuring the quality of therapeutic apheresis care in the pediatric intensive care unit.

PubMed

Sussmane, Jeffrey B; Torbati, Dan; Gitlow, Howard S

2012-01-01

Our goal was to measure the quality of care provided in the Pediatric Intensive Care Unit (PICU) during Therapeutic Apheresis (TA). We described the care as a step by step process. We designed a flow chart to carefully document each step of the process. We then defined each step with a unique clinical indictor (CI) that represented the exact task we felt provided quality care. These CIs were studied and modified for 1 year. We measured our performance in this process by the number of times we accomplished the CI vs. the total number of CIs that were to be performed. The degree of compliance, with these clinical indicators, was analyzed and used as a metric for quality by calculating how close the process is running exactly as planned or "in control." The Apheresis Process was in control (compliance) for 47% of the indicators, as measured in the aggregate for the first observational year. We then applied the theory of Total Quality Management (TQM) through our Design, Measure, Analyze, Improve, and Control (DMAIC) model. We were able to improve the process and bring it into control by increasing the compliance to > 99.74%, in the aggregate, for the third and fourth quarter of the second year. We have implemented TQM to increase compliance, thus control, of a highly complex and multidisciplinary Pediatric Intensive Care therapy. We have shown a reproducible and scalable measure of quality for a complex clinical process in the PICU, without additional capital expenditure. Copyright © 2011 Wiley-Liss, Inc.

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.

Comparison of nitrous oxide (N2O) analyzers for high-precision measurements of atmospheric mole fractions

NASA Astrophysics Data System (ADS)

Lebegue, B.; Schmidt, M.; Ramonet, M.; Wastine, B.; Yver Kwok, C.; Laurent, O.; Belviso, S.; Guemri, A.; Philippon, C.; Smith, J.; Conil, S.; Jost, H. J.; Crosson, E. R.

2015-10-01

Over the last few decades, in-situ measurements of atmospheric N2O mole fractions have been performed using gas chromatographs (GCs) equipped with electron capture detectors (ECDs). When trying to meet the World Meteorological Organization's (WMO) quality goal, this technique becomes very challenging as the detectors are highly non-linear and the GCs at remote stations require a considerable amount of maintenance by qualified technicians to maintain good short-term and long-term repeatability. With more robust optical spectrometers being now available for N2O measurements, we aim to identify a robust and stable analyzer that can be integrated into atmospheric monitoring networks, such as the Integrated Carbon Observation System (ICOS). In this study, we tested seven analyzers that were developed and commercialized from five different companies and compared the results with established techniques. Each instrument was characterized during a time period of approximately eight weeks. The test protocols included the characterization of the short-term and long-term repeatability, drift, temperature dependence, linearity and sensitivity to water vapor. During the test period, ambient air measurements were compared under field conditions at the Gif-sur-Yvette station. All of the analyzers showed a standard deviation better than 0.1 ppb for the 10 min averages. Some analyzers would benefit from improvements in temperature stability to reduce the instrument drift, which could then help in reducing the frequency of calibrations. For most instruments, the water vapor correction algorithms applied by companies are not sufficient for high-precision atmospheric measurements, which results in the need to dry the ambient air prior to analysis.

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

Improving inferior vena cava filter retrieval rates with the define, measure, analyze, improve, control methodology.

PubMed

Sutphin, Patrick D; Reis, Stephen P; McKune, Angie; Ravanzo, Maria; Kalva, Sanjeeva P; Pillai, Anil K

2015-04-01

To design a sustainable process to improve optional inferior vena cava (IVC) filter retrieval rates based on the Define, Measure, Analyze, Improve, Control (DMAIC) methodology of the Six Sigma process improvement paradigm. DMAIC, an acronym for Define, Measure, Analyze, Improve, and Control, was employed to design and implement a quality improvement project to increase IVC filter retrieval rates at a tertiary academic hospital. Retrievable IVC filters were placed in 139 patients over a 2-year period. The baseline IVC filter retrieval rate (n = 51) was reviewed through a retrospective analysis, and two strategies were devised to improve the filter retrieval rate: (a) mailing of letters to clinicians and patients for patients who had filters placed within 8 months of implementation of the project (n = 43) and (b) a prospective automated scheduling of a clinic visit at 4 weeks after filter placement for all new patients (n = 45). The effectiveness of these strategies was assessed by measuring the filter retrieval rates and estimated increase in revenue to interventional radiology. IVC filter retrieval rates increased from a baseline of 8% to 40% with the mailing of letters and to 52% with the automated scheduling of a clinic visit 4 weeks after IVC filter placement. The estimated revenue per 100 IVC filters placed increased from $2,249 to $10,518 with the mailing of letters and to $17,022 with the automated scheduling of a clinic visit. Using the DMAIC methodology, a simple and sustainable quality improvement intervention was devised that markedly improved IVC filter retrieval rates in eligible patients. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

The quality of dying and death measurement instruments: A systematic psychometric review.

PubMed

Gutiérrez Sánchez, Daniel; Pérez Cruzado, David; Cuesta-Vargas, Antonio I

2018-04-19

To identify instruments that could assess the quality of dying and death and their psychometric properties. To assess the methodological quality of studies on measurement properties. A high quality of death is regarded as a goal at the end of life and, therefore, an assessment of the end of life experience is essential. Many instruments have been developed to evaluate the quality of dying and death. The selection of the most appropriate measure to be used in clinical and research settings is crucial. Psychometric systematic review. We systematically searched ProQuest Medline, SciELO and ProQuest PsycINFO from 1970 - May 2016. Identification and evaluation of instruments that assessed quality of dying and death. Papers were evaluated by two independent reviewers according to the COSMIN checklist with a 4-point scale. A total of 19 studies were included in this review. Seven instruments were found that were specifically designed for assessing quality of dying and death. A retrospective carer proxy report to evaluate this construct was used in most of the papers. The methodological quality of the studies was fair for most of the psychometric characteristics analyzed. Many instruments have been developed to assess the quality of dying and death. The Quality of Dying and Death Questionnaire is the best available measure of the quality of dying and death. It is the only questionnaire identified in this review where all psychometric properties according to the COSMIN checklist have been evaluated. © 2018 John Wiley & Sons Ltd.

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.

Variation in US outpatient antibiotic prescribing quality measures according to health plan and geography.

PubMed

Roberts, Rebecca M; Hicks, Lauri A; Bartoces, Monina

2016-08-01

Antibiotic prescribing has become increasingly viewed as an issue related to patient safety and quality of care. The objective of this study was to better understand the differences between health plan reporting and the geographic variation seen in quality measures related to antibiotic use. We focused on 3 measures from the Healthcare Effectiveness Data and Information Set (HEDIS) related to antibiotic prescribing and testing to guide antibiotic prescribing. We analyzed data for 3 relevant measures for the years 2008 to 2012, including only commercial health plans. We analyzed the following 3 HEDIS measures: 1) "Appropriate Testing for Children With Pharyngitis," 2) "Appropriate Treatment for Children With Upper Respiratory Infections," and 3) "Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis." Out of these 3 measures, health plans consistently performed poorly on the adult bronchitis measure. Performance was better on the 2 measures focused on the pediatric population. We also saw geographic variation between measures when looking at Census divisions across all years. There is wide variation between individual health plan performance on the measures related to antibiotic use. Geographic differences were also observed on these measures, with health plans in the South Central Census division performing worse than other parts of the country. Stakeholders, such as public health, advocacy groups, foundations, and professional societies, interested in improving the quality of care that patients receive related to antibiotic use in the outpatient setting should consider how existing measures and working with health plans could be used to improve prescribing.

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.

Application of Six Sigma Model to Evaluate the Analytical Quality of Four HbA1c Analyzers.

PubMed

Maesa, Jos Eacute M; Fern Aacute Ndez-Riejos, Patricia; S Aacute Nchez-Mora, Catalina; Toro-Crespo, Mar Iacute A De; Gonz Aacute Lez-Rodriguez, Concepci Oacute N

2017-01-01

The Six Sigma Model is a global quality management system applicable to the determination of glycated hemoglobin (HbA1c). In addition, this model can ensure the three characteristics influencing the patient risk: the correct performance of the analytical method with low inaccuracy and bias, the quality control strategy used by the laboratory, and the necessary quality of the analyte. The aim of this study is to use the Six Sigma Model for evaluating quality criteria in the determination of glycated hemoglobin HbA1c and its application to assess four different HbA1c analyzers. Four HbA1c analyzers were evaluated: HA-8180V®, D-100®, G8®, and Variant II Turbo®. For 20 consecutive days, two levels of quality control (high and low) provided by the manufacturers were measured in each of the instruments. Imprecision (CV), bias, and Sigma values (σ) were calculated with the data obtained and a method decision chart was developed considering a range of quality requirements (allowable total error, TEa). For a TEa = 3%, HA-8180V = 1.54 σ, D-100 = 1.63 σ, G8 = 2.20 σ, and Variant II Turbo = -0.08 σ. For a TEa = 4%, HA-8180V = 2.34 σ, D-100 = 2.32 σ, G8 = 3.74 σ, and Variant II Turbo = 0.16 σ. For a TEa = 10%, HA8180V = 7.12 σ, D-100 = 6.46 σ, G8 = 13.0 σ, and Variant II Turbo = 1.56 σ. Applying the Stockholm consensus and its subsequent Milan review to the results: the maximum level in quality requirements for HbA1c is an allowable total error (TEa) = 3%, G8 is located in region 2 σ (2.20), which is a poor result, and HA-8180V and D-100 are both in region 1 σ (1.54 and 1.63, respectively), which is an unacceptable analytical performance.

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.

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.

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.

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

CSTT Update: Fuel Quality Analyzer

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

Brosha, Eric L.; Lujan, Roger W.; Mukundan, Rangachary

These are slides from a presentation. The following topics are covered: project background (scope and approach), developing the prototype (timeline), update on intellectual property, analyzer comparisons (improving humidification, stabilizing the baseline, applying clean-up strategy, impact of ionomer content and improving clean-up), proposed operating mode, considerations for testing in real-world conditions (Gen 1 analyzer electronics development, testing partner identified, field trial planning), summary, and future work.

Methodology for analyzing environmental quality indicators in a dynamic operating room environment.

PubMed

Gormley, Thomas; Markel, Troy A; Jones, Howard W; Wagner, Jennifer; Greeley, Damon; Clarke, James H; Abkowitz, Mark; Ostojic, John

2017-04-01

Sufficient quantities of quality air and controlled, unidirectional flow are important elements in providing a safe building environment for operating rooms. To make dynamic assessments of an operating room environment, a validated method of testing the multiple factors influencing the air quality in health care settings needed to be constructed. These include the following: temperature, humidity, particle load, number of microbial contaminants, pressurization, air velocity, and air distribution. The team developed the name environmental quality indicators (EQIs) to describe the overall air quality based on the actual measurements of these properties taken during the mock surgical procedures. These indicators were measured at 3 different hospitals during mock surgical procedures to simulate actual operating room conditions. EQIs included microbial assessments at the operating table and the back instrument table and real-time analysis of particle counts at 9 different defined locations in the operating suites. Air velocities were measured at the face of the supply diffusers, at the sterile field, at the back table, and at a return grille. The testing protocol provided consistent and comparable measurements of air quality indicators between institutions. At 20 air changes per hour (ACH), and an average temperature of 66.3°F, the median of the microbial contaminants for the 3 operating room sites ranged from 3-22 colony forming units (CFU)/m 3 at the sterile field and 5-27 CFU/m 3 at the back table. At 20 ACH, the median levels of the 0.5-µm particles at the 3 sites were 85,079, 85,325, and 912,232 in particles per cubic meter, with a predictable increase in particle load in the non-high-efficiency particulate air-filtered operating room site. Using a comparison with cleanroom standards, the microbial and particle counts in all 3 operating rooms were equivalent to International Organization for Standardization classifications 7 and 8 during the mock surgical

Analyzing the quality robustness of chemotherapy plans with respect to model uncertainties.

PubMed

Hoffmann, Anna; Scherrer, Alexander; Küfer, Karl-Heinz

2015-01-01

Mathematical models of chemotherapy planning problems contain various biomedical parameters, whose values are difficult to quantify and thus subject to some uncertainty. This uncertainty propagates into the therapy plans computed on these models, which poses the question of robustness to the expected therapy quality. This work introduces a combined approach for analyzing the quality robustness of plans in terms of dosing levels with respect to model uncertainties in chemotherapy planning. It uses concepts from multi-criteria decision making for studying parameters related to the balancing between the different therapy goals, and concepts from sensitivity analysis for the examination of parameters describing the underlying biomedical processes and their interplay. This approach allows for a profound assessment of a therapy plan, how stable its quality is with respect to parametric changes in the used mathematical model. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

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.

Improvement of graphite crystal analyzer for light elements on X-ray fluorescence holography measurement

NASA Astrophysics Data System (ADS)

Happo, Naohisa; Hada, Takuma; Kubota, Atsushi; Ebisu, Yoshihiro; Hosokawa, Shinya; Kimura, Koji; Tajiri, Hiroo; Matsushita, Tomohiro; Hayashi, Kouichi

2018-05-01

Using a graphite crystal analyzer, focused monochromatic fluorescent X-rays can be obtained on an X-ray fluorescence holography (XFH) measurement. To measure the holograms of elements lighter than Ti, we improved a cylindrical-type crystal analyzer and constructed a small C-shaped analyzer. Using the constructed C-shaped analyzer, a Ca Kα hologram of a fluorite single crystal was obtained, from which we reconstructed a clear atomic image. The XFH measurements for the K, Ca, and Sc elements become possible using the presently constructed analyzer.

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.

The singing power ratio as an objective measure of singing voice quality in untrained talented and nontalented singers.

PubMed

Watts, Christopher; Barnes-Burroughs, Kathryn; Estis, Julie; Blanton, Debra

2006-03-01

A growing body of contemporary research has investigated differences between trained and untrained singing voices. However, few studies have separated untrained singers into those who do and do not express abilities related to singing talent, including accurate pitch control and production of a pleasant timbre (voice quality). This investigation studied measures of the singing power ratio (SPR), which is a quantitative measure of the resonant quality of the singing voice. SPR reflects the amplification or suppression in the vocal tract of the harmonics produced by the sound source. This measure was acquired from the voices of untrained talented and nontalented singers as a means to objectively investigate voice quality differences. Measures of SPR were acquired from vocal samples with fast Fourier transform (FFT) power spectra to analyze the amplitude level of the partials in the acoustic spectrum. Long-term average spectra (LTAS) were also analyzed. Results indicated significant differences in SPR between groups, which suggest that vocal tract resonance, and its effect on perceived vocal timbre or quality, may be an important variable related to the perception of singing talent. LTAS confirmed group differences in the tuning of vocal tract harmonics.

Technical methods for analyzing pricing measures to reduce transportation emissions.

DOT National Transportation Integrated Search

1998-08-01

State transportation and air quality planners have requested the Environmental Protection : Agency (EPA) and the Department of Transportation (DOT) for assistance in how to : quantify the impacts of transportation pricing measures in their regional t...

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.

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

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.

Field intercomparison of four methane gas analyzers suitable for eddy covariance flux measurements

NASA Astrophysics Data System (ADS)

Peltola, O.; Mammarella, I.; Haapanala, S.; Burba, G.; Vesala, T.

2013-06-01

Performances of four methane gas analyzers suitable for eddy covariance measurements are assessed. The assessment and comparison was performed by analyzing eddy covariance data obtained during summer 2010 (1 April to 26 October) at a pristine fen, Siikaneva, Southern Finland. High methane fluxes with pronounced seasonality have been measured at this fen. The four participating methane gas analyzers are commercially available closed-path units TGA-100A (Campbell Scientific Inc., USA), RMT-200 (Los Gatos Research, USA), G1301-f (Picarro Inc., USA) and an early prototype open-path unit Prototype-7700 (LI-COR Biosciences, USA). The RMT-200 functioned most reliably throughout the measurement campaign, during low and high flux periods. Methane fluxes from RMT-200 and G1301-f had the smallest random errors and the fluxes agree remarkably well throughout the measurement campaign. Cospectra and power spectra calculated from RMT-200 and G1301-f data agree well with corresponding temperature spectra during a high flux period. None of the gas analyzers showed statistically significant diurnal variation for methane flux. Prototype-7700 functioned only for a short period of time, over one month, in the beginning of the measurement campaign during low flux period, and thus, its overall accuracy and season-long performance were not assessed. The open-path gas analyzer is a practical choice for measurement sites in remote locations due to its low power demand, whereas for G1301-f methane measurements interference from water vapor is straightforward to correct since the instrument measures both gases simultaneously. In any case, if only the performance in this intercomparison is considered, RMT-200 performed the best and is the recommended choice if a new fast response methane gas analyzer is needed.

Research on the Implementation of Technological Measures for Controlling Indoor Environmental Quality in Green Residential Buildings

NASA Astrophysics Data System (ADS)

Wang, Ruozhu; Liu, Pengda; Qian, Yongmei

2018-02-01

This paper analyzes the design technology of controlling indoor quality in engineering practice, it is proposed that, in framework system of green residential building design, how to realize the design idea of controlling the indoor environment quality, and the design technology with feasibility, including the sunshine and lighting, indoor air quality and thermal environment, sound insulation and noise reduction measures, etc.. The results of all will provide a good theoretical supportting for the design of green residential building.

Mineral/Water Analyzer

NASA Technical Reports Server (NTRS)

1983-01-01

An x-ray fluorescence spectrometer developed for the Viking Landers by Martin Marietta was modified for geological exploration, water quality monitoring, and aircraft engine maintenance. The aerospace system was highly miniaturized and used very little power. It irradiates the sample causing it to emit x-rays at various energies, then measures the energy levels for sample composition analysis. It was used in oceanographic applications and modified to identify element concentrations in ore samples, on site. The instrument can also analyze the chemical content of water, and detect the sudden development of excessive engine wear.

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

Image Processing for Bioluminescence Resonance Energy Transfer Measurement-BRET-Analyzer.

PubMed

Chastagnier, Yan; Moutin, Enora; Hemonnot, Anne-Laure; Perroy, Julie

2017-01-01

A growing number of tools now allow live recordings of various signaling pathways and protein-protein interaction dynamics in time and space by ratiometric measurements, such as Bioluminescence Resonance Energy Transfer (BRET) Imaging. Accurate and reproducible analysis of ratiometric measurements has thus become mandatory to interpret quantitative imaging. In order to fulfill this necessity, we have developed an open source toolset for Fiji- BRET-Analyzer -allowing a systematic analysis, from image processing to ratio quantification. We share this open source solution and a step-by-step tutorial at https://github.com/ychastagnier/BRET-Analyzer. This toolset proposes (1) image background subtraction, (2) image alignment over time, (3) a composite thresholding method of the image used as the denominator of the ratio to refine the precise limits of the sample, (4) pixel by pixel division of the images and efficient distribution of the ratio intensity on a pseudocolor scale, and (5) quantification of the ratio mean intensity and standard variation among pixels in chosen areas. In addition to systematize the analysis process, we show that the BRET-Analyzer allows proper reconstitution and quantification of the ratiometric image in time and space, even from heterogeneous subcellular volumes. Indeed, analyzing twice the same images, we demonstrate that compared to standard analysis BRET-Analyzer precisely define the luminescent specimen limits, enlightening proficient strengths from small and big ensembles over time. For example, we followed and quantified, in live, scaffold proteins interaction dynamics in neuronal sub-cellular compartments including dendritic spines, for half an hour. In conclusion, BRET-Analyzer provides a complete, versatile and efficient toolset for automated reproducible and meaningful image ratio analysis.

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 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.

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...

Within-Hospital Variation in 30-Day Adverse Events: Implications for Measuring Quality.

PubMed

Burke, Robert E; Glorioso, Thomas; Barón, Anna K; Kaboli, Peter J; Ho, P Michael

Novel measures of hospital quality are needed. Because quality improvement efforts seek to reduce variability in processes and outcomes, hospitals with higher variability in adverse events may be delivering poorer quality care. We sought to evaluate whether within-hospital variability in adverse events after a procedure might function as a quality metric that is correlated with facility-level mortality rates. We analyzed all percutaneous coronary interventions (PCIs) performed in the Veterans Health Administration (VHA) system from 2007 to 2013 to evaluate the correlation between within-hospital variability in 30-day postdischarge adverse events (readmission, emergency department visit, and repeat revascularization), and facility-level mortality rates, after adjustment for patient demographics, comorbidities, PCI indication, and PCI urgency. The study cohort included 47,567 patients at 48 VHA hospitals. The overall 30-day adverse event rate was 22.0% and 1-year mortality rate was 4.9%. The most variable sites had relative changes of 20% in 30-day rates of adverse events period-to-period. However, within-hospital variability in 30-day events was not correlated with 1-year mortality rates (correlation coefficient = .06; p = .66). Thus, measuring within-hospital variability in postdischarge adverse events may not improve identification of low-performing hospitals. Evaluation in other conditions, populations, and in relationship with other quality metrics may reveal stronger correlations with care quality.

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.

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

Analysis and discussion on the experimental data of electrolyte analyzer

NASA Astrophysics Data System (ADS)

Dong, XinYu; Jiang, JunJie; Liu, MengJun; Li, Weiwei

2018-06-01

In the subsequent verification of electrolyte analyzer, we found that the instrument can achieve good repeatability and stability in repeated measurements with a short period of time, in line with the requirements of verification regulation of linear error and cross contamination rate, but the phenomenon of large indication error is very common, the measurement results of different manufacturers have great difference, in order to find and solve this problem, help enterprises to improve quality of product, to obtain accurate and reliable measurement data, we conducted the experimental evaluation of electrolyte analyzer, and the data were analyzed by statistical analysis.

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)

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.

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

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...

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.

Chief Complaint-Based Performance Measures: A New Focus For Acute Care Quality Measurement

PubMed Central

Griffey, Richard T; Pines, Jesse M.; Farley, Heather L.; Phelan, Michael P; Beach, Christopher; Schuur, Jeremiah D; Venkatesh, Arjun K.

2014-01-01

Performance measures are increasingly important to guide meaningful quality improvement efforts and value-based reimbursement. Populations included in most current hospital performance measures are defined by recorded diagnoses using International Disease Classification (ICD)-9 codes in administrative claims data. While the diagnosis-centric approach allows the assessment of disease-specific quality, it fails to measure one of the primary functions of emergency department (ED) care which involves diagnosing, risk-stratifying, and treating patients’ potentially life-threatening conditions based on symptoms (i.e. chief complaints). In this paper we propose chief complaint-based quality measures as a means to enhance the evaluation of quality and value in emergency care. We discuss the potential benefits of chief-complaint based measures, describe opportunities to mitigate challenges, propose an example measure set, and present several recommendations to advance this paradigm in ED-based performance measurement. PMID:25443989

Cotton micronaire measurements by small portable near infrared (nir) analyzers

USDA-ARS?s Scientific Manuscript database

A key quality and processing parameter for cotton fiber is micronaire, which is a function of the fiber’s maturity and fineness. Near Infrared (NIR) spectroscopy has previously shown the ability to measure micronaire, primarily in the laboratory and using large, research-grade laboratory NIR instru...

Oxygen effects on glucose measurements with a reference analyzer and three handheld meters.

PubMed

Tang, Z; Louie, R F; Payes, M; Chang, K C; Kost, G J

2000-01-01

Oxygen may affect glucose meter and reference analyzer measurements. We evaluated the effects of changes in blood oxygen tension (Po2) on Accu-Chek Comfort Curve (Roche Diagnostics, Indianapolis, IN), Precision G, (Abbott Laboratories, Bedford, MA) and One Touch II (Lifescan, Milpitas, CA) glucose meter measurements, and on Yellow Springs Instruments (YSI) (Yellow Springs, OH) reference analyzer measurements. Venous blood drawn from healthy volunteers was adjusted to three glucose levels of 80, 200, and 400 mg/dL, each tonometered with six different Po2 levels (40, 80, 160, 240, 320, and 400 torr). To quantitate oxygen effects on reference analyzer measurements, glucose differences between test sample (Po2 changed) and control (Po2 80 torr) were calculated (YSItest-YSIcontrol). The threshold for determination of oxygen effects was +/-2 SD, where 2 SD was fro

Design and Measurement of a Digital Phase Locked BWO for Accurately Extracting the Quality Factors in a Biconcave Resonator System

NASA Astrophysics Data System (ADS)

Gao, Yuanci; Charles, Jones R.; Yu, Guofen; Jyotsna, Dutta M.

2012-03-01

A long loop phase locked backward-wave oscillator (BWO) for a high quality factor resonator system operating at D-band frequencies (130-170GHz) was described, the phase noise of the phased locked BWO was analyzed and measured at typical frequencies. When it used with a high quality factor open resonator for measuring the quality factor of simple harmonic resonators based on the magnitude transfer characteristic, this system has proven to be capable of accurate measuring the quality factor as high as 0.8 million with an uncertainty of less than 1.3% (Lorentzian fitting) at typical frequencies in the range of 130GHz-170GHz.

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

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.

Ion temperature fluctuation measurements using a retarding field analyzer

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

Nedzelskiy, I. S.; Silva, C.; Duarte, P.

2011-04-15

The retarding field analyzer (RFA) is a widely used diagnostic tool for the ion temperature measurement in the scrape-off-layer (SOL) of the thermonuclear plasma devices. However, the temporal resolution in the standard RFA application is restricted to the ms timescale. In this paper, a dc operation of the RFA is considered, which allows for the measurement of the plasma ion temperature fluctuations. The method is based on the relation for the RFA current-voltage (I-V) characteristic resulted from a common RFA model of shifted Maxwellian distribution of the analyzed ions, and the measurements of two points on the exponentially decaying regionmore » of the I-V characteristic with two differently dc biased RFA electrodes. The method has been tested and compared with conventional RFA measurements of the ion temperature in the tokamak ISTTOK SOL plasma. An ion temperature of T{sub i}= 17 eV is obtained near the limiter position. The agreement between the results of the two methods is within {approx}25%. The amplitude of the ion temperature fluctuations is found to be around 5 eV at this location. The method has been validated by taking into account the effect of fluctuations in the plasma potential and the noise contamination, proving the reliability of the results obtained. Finally, constrains to the method application are discussed that include a negligible electron emission from the RFA grids and the restriction to operate in the exponentially decaying region of the I-V characteristic.« less

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

Using Organization Risk Analyzer (ORA) to Explore the Relationship of Nursing Unit Communication to Patient Safety and Quality Outcomes

PubMed Central

Effken, Judith A.; Carley, Kathleen M.; Gephart, Sheila; Verran, Joyce A.; Bianchi, Denise; Reminga, Jeff; Brewer, Barbara

2011-01-01

Purpose We used Organization Risk Analyzer (ORA), a dynamic network analysis tool, to identify patient care unit communication patterns associated with patient safety and quality outcomes. Although ORA had previously had limited use in healthcare, we felt it could effectively model communication on patient care units. Methods Using a survey methodology, we collected communication network data from nursing staff on seven patient care units on two different days. Patient outcome data were collected via a separate survey. Results of the staff survey were used to represent the communication networks for each unit in ORA. We then used ORA's analysis capability to generate communication metrics for each unit. ORA's visualization capability was used to better understand the metrics. Results We identified communication patterns that correlated with two safety (falls and medication errors) and five quality (e.g., symptom management, complex self care, and patient satisfaction) outcome measures. Communication patterns differed substantially by shift. Conclusion The results demonstrate the utility of ORA for healthcare research and the relationship of nursing unit communication patterns to patient safety and quality outcomes. PMID:21536492

The influence of water vapor on atmospheric exchange measurements with an ICOS* based Laser absorption analyzer

NASA Astrophysics Data System (ADS)

Bunk, Rüdiger; Quan, Zhi; Wandel, Matthias; Yi, Zhigang; Bozem, Heiko; Kesselmeier, Jürgen

2014-05-01

humidified. The difference in perceived CO concentration showed a clear correlation to the water vapor content in the sample air. For COS we could show that changes in water vapor also impacted on the perceived COS concentrations; the raise of the water vapor concentration would lead to an increasing underestimation of the COS concentration. Drying the air using a Nafion Dryer before entering the COS/CO Analyzer eliminated any water vapor induced artifacts and showed no adverse effects on the quality of the conducted measurements. *Integrated cavity output spectroscopy

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.

Electrostatic analyzer measurements of ionospheric thermal ion populations

DOE PAGES

Fernandes, P. A.; Lynch, K. A.

2016-07-09

Here, we define the observational parameter regime necessary for observing low-altitude ionospheric origins of high-latitude ion upflow/outflow. We present measurement challenges and identify a new analysis technique which mitigates these impediments. To probe the initiation of auroral ion upflow, it is necessary to examine the thermal ion population at 200-350 km, where typical thermal energies are tenths of eV. Interpretation of the thermal ion distribution function measurement requires removal of payload sheath and ram effects. We use a 3-D Maxwellian model to quantify how observed ionospheric parameters such as density, temperature, and flows affect in situ measurements of the thermalmore » ion distribution function. We define the viable acceptance window of a typical top-hat electrostatic analyzer in this regime and show that the instrument's energy resolution prohibits it from directly observing the shape of the particle spectra. To extract detailed information about measured particle population, we define two intermediate parameters from the measured distribution function, then use a Maxwellian model to replicate possible measured parameters for comparison to the data. Liouville's theorem and the thin-sheath approximation allow us to couple the measured and modeled intermediate parameters such that measurements inside the sheath provide information about plasma outside the sheath. We apply this technique to sounding rocket data to show that careful windowing of the data and Maxwellian models allows for extraction of the best choice of geophysical parameters. More widespread use of this analysis technique will help our community expand its observational database of the seed regions of ionospheric outflows.« less

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...

Correlating wine quality indicators to chemical and sensory measurements.

PubMed

Hopfer, Helene; Nelson, Jenny; Ebeler, Susan E; Heymann, Hildegarde

2015-05-12

Twenty-seven commercial Californian Cabernet Sauvignon wines of different quality categories were analyzed with sensory and chemical methods. Correlations between five quality proxies-points awarded during a wine competition, wine expert scores, retail price, vintage, and wine region-were correlated to sensory attributes, volatile compounds, and elemental composition. Wine quality is a multi-faceted construct, incorporating many different layers. Depending on the quality proxy studied, significant correlations between quality and attributes, volatiles and elements were found, some of them previously reported in the literature.

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.

Measurement of Quality of Nursing Practice in Congenital Cardiac Care.

PubMed

Connor, Jean Anne; Mott, Sandra; Green, Angela; Larson, Carol; Hickey, Patricia

2016-03-01

The impact of nursing care on patients' outcomes has been demonstrated in adult and pediatric settings. However, limited attention has been given to standardized measurement of pediatric nursing care. A collaborative group, the Consortium for Congenital Cardiac Care Measurement of Nursing Practice, was formed to address this gap. The purpose of this study was to assess the current state of measurement of the quality of pediatric cardiovascular nursing in freestanding children's hospitals across the United States. A qualitative descriptive design was used to assess the state of measurement of nursing care from the perspective of experts in pediatric cardiovascular nursing. Nurse leaders from 20 sites participated in audiotaped phone interviews. The data were analyzed by using conventional content analysis. Each level of data coding was increasingly comprehensive. Guided by Donabedian's quality framework of structure, process, and outcome, 2 encompassing patterns emerged: (1) structure and process of health care delivery and (2) structure and process of evaluation of care. Similarities in the structure of health care delivery included program expansion and subsequent hiring of nurses with a bachelor of science in nursing and experienced nurses to provide safety and optimal outcomes for patients. Programs varied in how they evaluated care in terms of structure, measurement, collection and dissemination of data. External factors and response to internal processes of health care delivery were similar in different programs; evaluation was more varied. Seven opportunities for measurement that address both structure and process of nursing care were identified to be developed as benchmarks. ©2016 American Association of Critical-Care Nurses.

Infrared analyzers for breast milk analysis: fat levels can influence the accuracy of protein measurements.

PubMed

Kwan, Celia; Fusch, Gerhard; Bahonjic, Aldin; Rochow, Niels; Fusch, Christoph

2017-10-26

Currently, there is a growing interest in lacto-engineering in the neonatal intensive care unit, using infrared milk analyzers to rapidly measure the macronutrient content in breast milk before processing and feeding it to preterm infants. However, there is an overlap in the spectral information of different macronutrients, so they can potentially impact the robustness of the measurement. In this study, we investigate whether the measurement of protein is dependent on the levels of fat present while using an infrared milk analyzer. Breast milk samples (n=25) were measured for fat and protein content before and after being completely defatted by centrifugation, using chemical reference methods and near-infrared milk analyzer (Unity SpectraStar) with two different calibration algorithms provided by the manufacturer (released 2009 and 2015). While the protein content remained unchanged, as measured by elemental analysis, measurements by infrared milk analyzer show a difference in protein measurements dependent on fat content; high fat content can lead to falsely high protein content. This difference is less pronounced when measured using the more recent calibration algorithm. Milk analyzer users must be cautious of their devices' measurements, especially if they are changing the matrix of breast milk using more advanced lacto-engineering.

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.

[Quality assurance using routine data. Is outcome quality now measurable?].

PubMed

Kostuj, T; Smektala, R

2010-12-01

Health service quality in Germany can be shown by the data from the external quality assurance program (BQS) but as these records are limited to the period of in-hospital stay no information about outcome after discharge from hospital can be obtained. Secondary routine administrative data contain information about long-term outcome, such as mortality, subsequent revision and the need for care following surgical treatment due to a hip fracture.Experiences in the use of secondary data dealing with treatment of hip fractures from the BQS are available in our department. In addition we analyzed routine administrative data from the health insurance companies Knappschaft Bahn-See and AOK in a cooperative study with the WidO (scientific institute of the AOK). These routine data clearly show a bias because of poor quality in coding as well as broad interpretation possibilities of some of the ICD-10 codes used.Consequently quality assurance using routine data is less valid than register-based conclusions. Nevertheless medical expertise is necessary to avoid misinterpretation of routine administrative data.

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.

[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.

Rapid measurement of macronutrients in breast milk: How reliable are infrared milk analyzers?

PubMed

Fusch, Gerhard; Rochow, Niels; Choi, Arum; Fusch, Stephanie; Poeschl, Susanna; Ubah, Adelaide Obianuju; Lee, Sau-Young; Raja, Preeya; Fusch, Christoph

2015-06-01

Significant biological variation in macronutrient content of breast milk is an important barrier that needs to be overcome to meet nutritional needs of preterm infants. To analyze macronutrient content, commercial infrared milk analyzers have been proposed as efficient and practical tools in terms of efficiency and practicality. Since milk analyzers were originally developed for the dairy industry, they must be validated using a significant number of human milk samples that represent the broad range of variation in macronutrient content in preterm and term milk. Aim of this study was to validate two milk analyzers for breast milk analysis with reference methods and to determine an effective sample pretreatment. Current evidence for the influence of (i) aliquoting, (ii) storage time and (iii) temperature, and (iv) vessel wall adsorption on stability and availability of macronutrients in frozen breast milk is reviewed. Breast milk samples (n = 1188) were collected from 63 mothers of preterm and term infants. Milk analyzers: (A) Near-infrared milk analyzer (Unity SpectraStar, USA) and (B) Mid-infrared milk analyzer (Miris, Sweden) were compared to reference methods, e.g. ether extraction, elemental analysis, and UPLC-MS/MS for fat, protein, and lactose, respectively. For fat analysis, (A) measured precisely but not accurately (y = 0.55x + 1.25, r(2) = 0.85), whereas (B) measured precisely and accurately (y = 0.93x + 0.18, r(2) = 0.86). For protein analysis, (A) was precise but not accurate (y = 0.55x + 0.54, r(2) = 0.67) while (B) was both precise and accurate (y = 0.78x + 0.05, r(2) = 0.73). For lactose analysis, both devices (A) and (B) showed two distinct concentration levels and measured therefore neither accurately nor precisely (y = 0.02x + 5.69, r(2) = 0.01 and y = -0.09x + 6.62, r(2) = 0.02 respectively). Macronutrient levels were unchanged in two independent samples of stored breast milk (-20 °C measured with IR; -80 °C measured with wet chemistry) over a

Strategic Orientation and Nursing Home Response to Public Reporting of Quality Measures: An Application of the Miles and Snow Typology

PubMed Central

Zinn, Jacqueline S; Spector, William D; Weimer, David L; Mukamel, Dana B

2008-01-01

Objective To assess whether differences in strategic orientation of nursing homes as identified by the Miles and Snow typology are associated with differences in their response to the publication of quality measures on the Nursing Home Compare website. Data Sources Administrator survey of a national 10 percent random sample (1,502 nursing homes) of all facilities included in the first publication of the Nursing Home Compare report conducted in May–June 2004; 724 responded, yielding a response rate of 48.2 percent. Study Design The dependent variables are dichotomous, indicating whether or not action was taken and the type of action taken. Four indicator variables were created for each of the four strategic types: Defender, Analyzer, Prospector, and Reactor. Other variables were included in the seven logistic regression models to control for factors other than strategic type that could influence nursing home response to public disclosure of their quality of care. Data Collection/Extraction Methods Survey data were merged with data on quality measures and organizational characteristics from the first report (November 2002). Principal Findings About 43 percent of surveyed administrators self-typed as Defenders, followed by Analyzers (33 percent), and Prospectors (19 percent). The least self-selected strategic type was the Reactor (6.6 percent). In general, results of the regression models indicate differences in response to quality measure publication by strategic type, with Prospectors and Analyzers more likely, and Reactors less likely, to respond than Defenders. Conclusions While almost a third of administrators took no action at all, our results indicate that whether, when, and how nursing homes reacted to publication of federally reported quality measures is associated with strategic orientation. PMID:18370969

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

Eddy Covariance Measurements of Methane Flux Using an Open-Path Gas Analyzer

NASA Astrophysics Data System (ADS)

Burba, G.; Anderson, T.; Zona, D.; Schedlbauer, J.; Anderson, D.; Eckles, R.; Hastings, S.; Ikawa, H.; McDermitt, D.; Oberbauer, S.; Oechel, W.; Riensche, B.; Starr, G.; Sturtevant, C.; Xu, L.

2008-12-01

Methane is an important greenhouse gas with a warming potential of about 23 times that of carbon dioxide over a 100-year cycle (Houghton et al., 2001). Measurements of methane fluxes from the terrestrial biosphere have mostly been made using flux chambers, which have many advantages, but are discrete in time and space and may disturb surface integrity and air pressure. Open-path analyzers offer a number of advantages for measuring methane fluxes, including undisturbed in- situ flux measurements, spatial integration using the Eddy Covariance approach, zero frequency response errors due to tube attenuation, confident water and thermal density terms from co-located fast measurements of water and sonic temperature, and remote deployment due to lower power demands in the absence of a pump. The prototype open-path methane analyzer is a VCSEL (vertical-cavity surface-emitting laser)-based instrument. It employs an open Herriott cell and measures levels of methane with RMS noise below 6 ppb at 10 Hz sampling in controlled laboratory environment. Field maintenance is minimized by a self-cleaning mechanism to keep the lower mirror free of contamination. Eddy Covariance measurements of methane flux using the prototype open-path methane analyzer are presented for the period between 2006 and 2008 in three ecosystems with contrasting weather and moisture conditions: (1) Fluxes over a short-hydroperiod sawgrass wetland in the Florida Everglades were measured in a warm and humid environment with temperatures often exceeding 25oC, variable winds, and frequent heavy dew at night; (2) Fluxes over coastal wetlands in an Arctic tundra were measured in an environment with frequent sub-zero temperatures, moderate winds, and ocean mist; (3) Fluxes over pacific mangroves in Mexico were measured in an environment with moderate air temperatures high winds, and sea spray. Presented eddy covariance flux data were collected from a co-located prototype open-path methane analyzer, LI-7500, and

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.

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…

Applying revised gap analysis model in measuring hotel service quality.

PubMed

Lee, Yu-Cheng; Wang, Yu-Che; Chien, Chih-Hung; Wu, Chia-Huei; Lu, Shu-Chiung; Tsai, Sang-Bing; Dong, Weiwei

2016-01-01

With the number of tourists coming to Taiwan growing by 10-20 % since 2010, the number has increased due to an increasing number of foreign tourists, particularly after deregulation allowed admitting tourist groups, followed later on by foreign individual tourists, from mainland China. The purpose of this study is to propose a revised gap model to evaluate and improve service quality in Taiwanese hotel industry. Thus, service quality could be clearly measured through gap analysis, which was more effective for offering direction in developing and improving service quality. The HOLSERV instrument was used to identify and analyze service gaps from the perceptions of internal and external customers. The sample for this study included three main categories of respondents: tourists, employees, and managers. The results show that five gaps influenced tourists' evaluations of service quality. In particular, the study revealed that Gap 1 (management perceptions vs. customer expectations) and Gap 9 (service provider perceptions of management perceptions vs. service delivery) were more critical than the others in affecting perceived service quality, making service delivery the main area of improvement. This study contributes toward an evaluation of the service quality of the Taiwanese hotel industry from the perspectives of customers, service providers, and managers, which is considerably valuable for hotel managers. It was the aim of this study to explore all of these together in order to better understand the possible gaps in the hotel industry in Taiwan.

Retarding field analyzer for ion energy distribution measurements at a radio-frequency biased electrode

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

Gahan, D.; Hopkins, M. B.; Dolinaj, B.

2008-03-15

A retarding field energy analyzer designed to measure ion energy distributions impacting a radio-frequency biased electrode in a plasma discharge is examined. The analyzer is compact so that the need for differential pumping is avoided. The analyzer is designed to sit on the electrode surface, in place of the substrate, and the signal cables are fed out through the reactor side port. This prevents the need for modifications to the rf electrode--as is normally the case for analyzers built into such electrodes. The capabilities of the analyzer are demonstrated through experiments with various electrode bias conditions in an inductively coupledmore » plasma reactor. The electrode is initially grounded and the measured distributions are validated with the Langmuir probe measurements of the plasma potential. Ion energy distributions are then given for various rf bias voltage levels, discharge pressures, rf bias frequencies - 500 kHz to 30 MHz, and rf bias waveforms - sinusoidal, square, and dual frequency.« less

Comprehensive laboratory and field testing of cavity ring-down spectroscopy analyzers measuring H2O, CO2, CH4 and CO

NASA Astrophysics Data System (ADS)

Yver Kwok, C.; Laurent, O.; Guemri, A.; Philippon, C.; Wastine, B.; Rella, C. W.; Vuillemin, C.; Truong, F.; Delmotte, M.; Kazan, V.; Darding, M.; Lebègue, B.; Kaiser, C.; Xueref-Rémy, I.; Ramonet, M.

2015-09-01

To develop an accurate measurement network of greenhouse gases, instruments in the field need to be stable and precise and thus require infrequent calibrations and a low consumption of consumables. For about 10 years, cavity ring-down spectroscopy (CRDS) analyzers have been available that meet these stringent requirements for precision and stability. Here, we present the results of tests of CRDS instruments in the laboratory (47 instruments) and in the field (15 instruments). The precision and stability of the measurements are studied. We demonstrate that, thanks to rigorous testing, newer models generally perform better than older models, especially in terms of reproducibility between instruments. In the field, we see the importance of individual diagnostics during the installation phase, and we show the value of calibration and target gases that assess the quality of the data. Finally, we formulate recommendations for use of these analyzers in the field.

Comprehensive laboratory and field testing of cavity ring-down spectroscopy analyzers measuring H2O, CO2, CH4 and CO

NASA Astrophysics Data System (ADS)

Yver Kwok, C.; Laurent, O.; Guemri, A.; Philippon, C.; Wastine, B.; Rella, C. W.; Vuillemin, C.; Truong, F.; Delmotte, M.; Kazan, V.; Darding, M.; Lebègue, B.; Kaiser, C.; Ramonet, M.

2015-04-01

To develop an accurate measurement network of greenhouse gases, instruments in the field need to be stable and precise and thus require infrequent calibrations and a low consumption of consumables. For about ten years, cavity ring-down spectroscopy (CRDS) analyzers have been available that meet these stringent requirements for precision and stability. Here, we present the results of tests of CRDS instruments in the laboratory (47 instruments) and in the field (15 instruments). The precision and stability of the measurements are studied. We demonstrate that, thanks to rigorous testing, newer models generally perform better than older models, especially in terms of reproducibility between instruments. In the field, we see the importance of individual diagnostics during the installation phase, and we show the value of calibration and target gases that assess the quality of the data. Finally, we formulate recommendations for use of these analyzers in the field.

Measurements of volatile compound contents in resins using a moisture analyzer.

PubMed

Hashimoto, Masanori; Nagano, Futami; Endo, Kazuhiko; Ohno, Hiroki

2010-02-01

The contents of volatile adhesive compounds, such as water, solvents, and residual unpolymerized monomers, affect the integrity and durability of adhesive bonding. However, there is no method available that can be used to rapidly assess the residual solvent or water contents of adhesive resins. This study examined the effectiveness of a digital moisture analyzer to measure the volatile compound contents of resins. Five self-etching adhesives and seven experimental light-cured resins prepared with different contents (0, 10, and 20% by weight) of water or solvents (acetone and ethanol) were examined in this study. The resins were prepared using different methods (with and without air blast or light-curing) to simulate the clinical conditions of adhesive application. Resin weight changes (% of weight loss) were determined as the residual volatile compound contents, using the moisture analyzer. After the measurements, the resin films were examined using a scanning electron microscope. The weight changes of the resins were found to depend on the amount of water or solvents evaporating from the resin. Water and solvents were evaporated by air blast or light-curing, but some of the water and solvents remained in the cured resin. The moisture analyzer is easy to operate and is a useful instrument for using to measure the residual volatile compound contents of adhesive resin.

Analyzer for measuring gas contained in the pore space of rocks

NASA Astrophysics Data System (ADS)

Kudasik, Mateusz; Skoczylas, Norbert

2017-10-01

In the present paper, the authors discussed the functioning of their own analyzer for measuring gas contained in the pore space of high strength rocks. A sample is placed inside a hermetic measuring chamber, and then undergoes impact milling as a result of colliding with the vibrating blade of a knife which is rotationally driven by a high-speed brushless electric motor. The measuring chamber is equipped with all the necessary sensors, i.e. gas, pressure, and temperature sensors. Trial tests involving the comminution of dolomite and anhydrite samples demonstrated that the constructed device is able to break up rocks into grains so fine that they are measured in single microns, and the sensors used in the construction ensure balancing of the released gas. The tests of the analyzer showed that the metrological concept behind it, together with the way it was built, make it fit for measurements of the content and composition of selected gases from the rock pore space. On the basis of the conducted tests of balancing the gases contained in the two samples, it was stated that the gas content of Sample no. 1 was (0.055  ±  0.002) cm3 g-1, and Sample no. 2 contained gas at atmospheric pressure, composed mostly of air.

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…

2-D energy analyzer for low energy electrons

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

Karkare, Siddharth, E-mail: ssk226@cornell.edu; Cultrera, Luca; Hwang, Yoon-Woo

2015-03-15

A 2-D electron energy analyzer is designed and constructed to measure the transverse and longitudinal energy distribution of low energy (<1 eV) electrons. The analyzer operates on the principle of adiabatic invariance and motion of low energy electrons in a strong longitudinal magnetic field. The operation of the analyzer is studied in detail and a design to optimize the energy resolution, signal to noise ratio, and physical size is presented. An energy resolution better than 6 meV has been demonstrated. Such an analyzer is a powerful tool to study the process of photoemission which limits the beam quality in modernmore » accelerators.« less

Measuring Mitochondrial Function in Permeabilized Cells Using the Seahorse XF Analyzer or a Clark-Type Oxygen Electrode.

PubMed

Divakaruni, Ajit S; Rogers, George W; Murphy, Anne N

2014-05-27

Measurements of mitochondrial respiration in intact cells can help define metabolism and its dysregulation in fields such as cancer, metabolic disease, immunology, and neurodegeneration. Although cells can be offered various substrates in the assay medium, many cell types can oxidize stored pools of energy substrates. A general bioenergetic profile can therefore be obtained using intact cells, but the inability to control substrate provision to the mitochondria can restrict an in-depth, mechanistic understanding. Mitochondria can be isolated from intact cells, but the yield and quality of the end product is often poor and prone to subselection during isolation. Plasma membrane permeabilization of cells provides a solution to this challenge, allowing experimental control of the medium surrounding the mitochondria. This unit describes techniques to measure respiration in permeabilized adherent cells using a Seahorse XF Analyzer or permeabilized suspended cells in a Hansatech Oxygraph. Copyright © 2014 John Wiley & Sons, Inc.

Network Compression as a Quality Measure for Protein Interaction Networks

PubMed Central

Royer, Loic; Reimann, Matthias; Stewart, A. Francis; Schroeder, Michael

2012-01-01

With the advent of large-scale protein interaction studies, there is much debate about data quality. Can different noise levels in the measurements be assessed by analyzing network structure? Because proteomic regulation is inherently co-operative, modular and redundant, it is inherently compressible when represented as a network. Here we propose that network compression can be used to compare false positive and false negative noise levels in protein interaction networks. We validate this hypothesis by first confirming the detrimental effect of false positives and false negatives. Second, we show that gold standard networks are more compressible. Third, we show that compressibility correlates with co-expression, co-localization, and shared function. Fourth, we also observe correlation with better protein tagging methods, physiological expression in contrast to over-expression of tagged proteins, and smart pooling approaches for yeast two-hybrid screens. Overall, this new measure is a proxy for both sensitivity and specificity and gives complementary information to standard measures such as average degree and clustering coefficients. PMID:22719828

Measuring the quality of provided services for patients with chronic kidney disease.

PubMed

Bahadori, Mohammadkarim; Raadabadi, Mehdi; Heidari Jamebozorgi, Majid; Salesi, Mahmood; Ravangard, Ramin

2014-09-01

The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction. This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014. This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test. The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001). Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and

Rapid measurement of macronutrients in breast milk: How reliable are infrared milk analyzers?✩

PubMed Central

Fusch, Gerhard; Rochow, Niels; Choi, Arum; Fusch, Stephanie; Poeschl, Susanna; Ubah, Adelaide Obianuju; Lee, Sau-Young; Raja, Preeya; Fusch, Christoph

2016-01-01

SUMMARY Background & aims Significant biological variation in macronutrient content of breast milk is an important barrier that needs to be overcome to meet nutritional needs of preterm infants. To analyze macronutrient content, commercial infrared milk analyzers have been proposed as efficient and practical tools in terms of efficiency and practicality. Since milk analyzers were originally developed for the dairy industry, they must be validated using a significant number of human milk samples that represent the broad range of variation in macronutrient content in preterm and term milk. Aim of this study was to validate two milk analyzers for breast milk analysis with reference methods and to determine an effective sample pretreatment. Current evidence for the influence of (i) aliquoting, (ii) storage time and (iii) temperature, and (iv) vessel wall adsorption on stability and availability of macronutrients in frozen breast milk is reviewed. Methods Breast milk samples (n = 1188) were collected from 63 mothers of preterm and term infants. Milk analyzers: (A) Near-infrared milk analyzer (Unity SpectraStar, USA) and (B) Mid-infrared milk analyzer (Miris, Sweden) were compared to reference methods, e.g. ether extraction, elemental analysis, and UPLC-MS/MS for fat, protein, and lactose, respectively. Results For fat analysis, (A) measured precisely but not accurately (y = 0.55x + 1.25, r2 = 0.85), whereas (B) measured precisely and accurately (y = 0.93x + 0.18, r2 = 0.86). For protein analysis, (A) was precise but not accurate (y = 0.55x + 0.54, r2 = 0.67) while (B) was both precise and accurate (y = 0.78x + 0.05, r2 = 0.73). For lactose analysis, both devices (A) and (B) showed two distinct concentration levels and measured therefore neither accurately nor precisely (y = 0.02x + 5.69, r2 = 0.01 and y = −0.09x + 6.62, r2 = 0.02 respectively). Macronutrient levels were unchanged in two independent samples of stored breast milk (−20 °C measured with IR; −80 �

Expert system for analyzing eddy current measurements

DOEpatents

Levy, Arthur J.; Oppenlander, Jane E.; Brudnoy, David M.; Englund, James M.; Loomis, Kent C.

1994-01-01

A method and apparatus (called DODGER) analyzes eddy current data for heat exchanger tubes or any other metallic object. DODGER uses an expert system to analyze eddy current data by reasoning with uncertainty and pattern recognition. The expert system permits DODGER to analyze eddy current data intelligently, and obviate operator uncertainty by analyzing the data in a uniform and consistent manner.

A Portable, Field-Deployable Analyzer for Isotopic Water Measurements

NASA Astrophysics Data System (ADS)

Berman, E. S.; Gupta, M.; Huang, Y. W.; Lacelle, D.; McKay, C. P.; Fortson, S.

2015-12-01

Water stable isotopes have for many years been used to study the hydrological cycle, catchment hydrology, and polar climate among other applications. Typically, discrete water samples are collected and transported to a laboratory for isotope analysis. Due to the expense and labor associated with such sampling, isotope studies have generally been limited in scope and time-resolution. Field sampling of water isotopes has been shown in recent years to provide dense data sets with the increased time resolution illuminating substantially greater short term variability than is generally observed during discrete sampling. A truly portable instrument also opens the possibility to utilize the instrument as a tool for identifying which water samples would be particularly interesting for further laboratory investigation. To make possible such field measurements of liquid water isotopes, Los Gatos Research has developed a miniaturized, field-deployable liquid water isotope analyzer. The prototype miniature liquid water isotope analyzer (mini-LWIA) uses LGR's patented Off-Axis ICOS (Integrated Cavity Output Spectroscopy) technology in a rugged, Pelican case housing for easy transport and field operations. The analyzer simultaneously measures both δ2H and δ18O from liquid water, with both manual and automatic water introduction options. The laboratory precision for δ2H is 0.6 ‰, and for δ18O is 0.3 ‰. The mini-LWIA was deployed in the high Arctic during the summer of 2015 at Inuvik in the Canadian Northwest Territories. Samples were collected from Sachs Harbor, on the southwest coast of Banks Island, including buried basal ice from the Lurentide Ice Sheet, some ice wedges, and other types of ground ice. Methodology and water analysis results from this extreme field deployment will be presented.

The data quality analyzer: a quality control program for seismic data

USGS Publications Warehouse

Ringler, Adam; Hagerty, M.T.; Holland, James F.; Gonzales, A.; Gee, Lind S.; Edwards, J.D.; Wilson, David; Baker, Adam

2015-01-01

The quantification of data quality is based on the evaluation of various metrics (e.g., timing quality, daily noise levels relative to long-term noise models, and comparisons between broadband data and event synthetics). Users may select which metrics contribute to the assessment and those metrics are aggregated into a “grade” for each station. The DQA is being actively used for station diagnostics and evaluation based on the completed metrics (availability, gap count, timing quality, deviation from a global noise model, deviation from a station noise model, coherence between co-located sensors, and comparison between broadband data and synthetics for earthquakes) on stations in the Global Seismographic Network and Advanced National Seismic System.

Information quality measurement of medical encoding support based on usability.

PubMed

Puentes, John; Montagner, Julien; Lecornu, Laurent; Cauvin, Jean-Michel

2013-12-01

Medical encoding support systems for diagnoses and medical procedures are an emerging technology that begins to play a key role in billing, reimbursement, and health policies decisions. A significant problem to exploit these systems is how to measure the appropriateness of any automatically generated list of codes, in terms of fitness for use, i.e. their quality. Until now, only information retrieval performance measurements have been applied to estimate the accuracy of codes lists as quality indicator. Such measurements do not give the value of codes lists for practical medical encoding, and cannot be used to globally compare the quality of multiple codes lists. This paper defines and validates a new encoding information quality measure that addresses the problem of measuring medical codes lists quality. It is based on a usability study of how expert coders and physicians apply computer-assisted medical encoding. The proposed measure, named ADN, evaluates codes Accuracy, Dispersion and Noise, and is adapted to the variable length and content of generated codes lists, coping with limitations of previous measures. According to the ADN measure, the information quality of a codes list is fully represented by a single point, within a suitably constrained feature space. Using one scheme, our approach is reliable to measure and compare the information quality of hundreds of codes lists, showing their practical value for medical encoding. Its pertinence is demonstrated by simulation and application to real data corresponding to 502 inpatient stays in four clinic departments. Results are compared to the consensus of three expert coders who also coded this anonymized database of discharge summaries, and to five information retrieval measures. Information quality assessment applying the ADN measure showed the degree of encoding-support system variability from one clinic department to another, providing a global evaluation of quality measurement trends. Copyright © 2013

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.

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.

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

Application of an electronic image analyzer to dimensional measurements from neutron radiographs

NASA Technical Reports Server (NTRS)

Vary, A.; Bowles, K. J.

1973-01-01

Means of obtaining improved dimensional measurements from neutron radiographs of nuclear fuel elements are discussed. The use of video-electronic image analysis relative to edge definition in radiographic images is described. Based on this study, an edge definition criterion is proposed for overcoming image unsharpness effects in taking accurate diametral measurements from radiographs. An electronic density slicing method for automatic edge definition is described. Results of measurements made with video micrometry are compared with scanning microdensitometer and micrometric physical measurements. An image quality indicator for estimating photographic and geometric unsharpness is described.

Competency-Based Education: A Framework for Measuring Quality Courses

ERIC Educational Resources Information Center

Krause, Jackie; Dias, Laura Portolese; Schedler, Chris

2015-01-01

The growth of competency-based education in an online environment requires the development and measurement of quality competency-based courses. While quality measures for online courses have been developed and standardized, they do not directly align with emerging best practices and principles in the design of quality competency-based online…

Computing health quality measures using Informatics for Integrating Biology and the Bedside.

PubMed

Klann, Jeffrey G; Murphy, Shawn N

2013-04-19

The Health Quality Measures Format (HQMF) is a Health Level 7 (HL7) standard for expressing computable Clinical Quality Measures (CQMs). Creating tools to process HQMF queries in clinical databases will become increasingly important as the United States moves forward with its Health Information Technology Strategic Plan to Stages 2 and 3 of the Meaningful Use incentive program (MU2 and MU3). Informatics for Integrating Biology and the Bedside (i2b2) is one of the analytical databases used as part of the Office of the National Coordinator (ONC)'s Query Health platform to move toward this goal. Our goal is to integrate i2b2 with the Query Health HQMF architecture, to prepare for other HQMF use-cases (such as MU2 and MU3), and to articulate the functional overlap between i2b2 and HQMF. Therefore, we analyze the structure of HQMF, and then we apply this understanding to HQMF computation on the i2b2 clinical analytical database platform. Specifically, we develop a translator between two query languages, HQMF and i2b2, so that the i2b2 platform can compute HQMF queries. We use the HQMF structure of queries for aggregate reporting, which define clinical data elements and the temporal and logical relationships between them. We use the i2b2 XML format, which allows flexible querying of a complex clinical data repository in an easy-to-understand domain-specific language. The translator can represent nearly any i2b2-XML query as HQMF and execute in i2b2 nearly any HQMF query expressible in i2b2-XML. This translator is part of the freely available reference implementation of the QueryHealth initiative. We analyze limitations of the conversion and find it covers many, but not all, of the complex temporal and logical operators required by quality measures. HQMF is an expressive language for defining quality measures, and it will be important to understand and implement for CQM computation, in both meaningful use and population health. However, its current form might allow

Computing Health Quality Measures Using Informatics for Integrating Biology and the Bedside

PubMed Central

Murphy, Shawn N

2013-01-01

Background The Health Quality Measures Format (HQMF) is a Health Level 7 (HL7) standard for expressing computable Clinical Quality Measures (CQMs). Creating tools to process HQMF queries in clinical databases will become increasingly important as the United States moves forward with its Health Information Technology Strategic Plan to Stages 2 and 3 of the Meaningful Use incentive program (MU2 and MU3). Informatics for Integrating Biology and the Bedside (i2b2) is one of the analytical databases used as part of the Office of the National Coordinator (ONC)’s Query Health platform to move toward this goal. Objective Our goal is to integrate i2b2 with the Query Health HQMF architecture, to prepare for other HQMF use-cases (such as MU2 and MU3), and to articulate the functional overlap between i2b2 and HQMF. Therefore, we analyze the structure of HQMF, and then we apply this understanding to HQMF computation on the i2b2 clinical analytical database platform. Specifically, we develop a translator between two query languages, HQMF and i2b2, so that the i2b2 platform can compute HQMF queries. Methods We use the HQMF structure of queries for aggregate reporting, which define clinical data elements and the temporal and logical relationships between them. We use the i2b2 XML format, which allows flexible querying of a complex clinical data repository in an easy-to-understand domain-specific language. Results The translator can represent nearly any i2b2-XML query as HQMF and execute in i2b2 nearly any HQMF query expressible in i2b2-XML. This translator is part of the freely available reference implementation of the QueryHealth initiative. We analyze limitations of the conversion and find it covers many, but not all, of the complex temporal and logical operators required by quality measures. Conclusions HQMF is an expressive language for defining quality measures, and it will be important to understand and implement for CQM computation, in both meaningful use and population

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"…

Systems Analyze Water Quality in Real Time

NASA Technical Reports Server (NTRS)

2010-01-01

A water analyzer developed under Small Business Innovation Research (SBIR) contracts with Kennedy Space Center now monitors treatment processes at water and wastewater facilities around the world. Originally designed to provide real-time detection of nutrient levels in hydroponic solutions for growing plants in space, the ChemScan analyzer, produced by ASA Analytics Inc., of Waukesha, Wisconsin, utilizes spectrometry and chemometric algorithms to automatically analyze multiple parameters in the water treatment process with little need for maintenance, calibration, or operator intervention. The company has experienced a compound annual growth rate of 40 percent over its 15-year history as a direct result of the technology's success.

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…

Measurements of Auger Electron Diffraction Using a 180° Deflection Toroidal Analyzer

NASA Astrophysics Data System (ADS)

Shiraki, Susumu; Ishii, Hideshi; Nihei, Yoshimasa; Owari, Masanori

A 180° deflection toroidal analyzer is a novel electron spectrometer, which allows the simultaneous registration of the wide range of polar angles in a given azimuth of the sample. Therefore, measurements of photo- and Auger electron intensities over π steradians can be performed rapidly by azimuthal rotation of the sample. Using this analyzer, two-dimensional patterns of electron-beam-excited O KVV and Mg KVV Auger electron diffraction (AED) from a MgO(001) surface were measured in short acquisition times. The AED patterns obtained were compared with theoretical ones calculated by the multiple-scattering scheme. The agreement between experimental and theoretical data was good for both O KVV and Mg KVV transitions.

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…

Systematic evidence-based quality measurement life-cycle approach to measure retirement in CHIPRA.

PubMed

Dougherty, Denise; Mistry, Kamila B; Lindly, Olivia; Desoto, Maushami; LLanos, Karen; Chesley, Francis

2014-01-01

In 2009, Centers for Medicare and Medicaid Services (CMS) publicly released an initial child core set (CCS) of health care quality measures for voluntary reporting by state Medicaid and Children's Health Insurance Program (CHIP) programs. CMS is responsible for implementing the reporting program and for updating the CCS annually. We assessed selected CCS measures for potential retirement. We identified a 23-member external advisory group to provide relevant expertise. We worked with the group to identify 4 major criteria with multiple subcomponents for assessing the measures. We provided information corresponding to each criterion and subcriterion, using a variety of sources such as the 2009 Medicaid Analytic eXtract (MAX), state-level Medicaid and CHIP data submitted to the CMS, and summaries of published literature on clinical and quality improvement effectiveness related to the CCS topics. Using this information, the group: 1) used a modified Delphi process to score the measures in 2 anonymous scoring rounds (on a scale of 1 to 9 in each round); 2) voted on whether each measure should be retired; and 3) provided narrative explanations of their choices (which formed the basis of our qualitative findings). Recommendations were reviewed by CMS before promulgation to state programs. The Subcommittee of the National Advisory Council on Healthcare Research and Quality (SNAC) recommended that the 4 major criteria be importance, scientific acceptability, feasibility, and usability. The SNAC recommended 3 measures for retirement: access to primary care; testing for strep before recommending antibiotics for pharyngitis; and annual HbA1c testing of children with diabetes. Explanations for suggesting retirement of the measures included: views that the well-visit measures were a better measure of access than the primary care measure; a likely ceiling effect (pharyngitis); and the paucity of clinical evidence and low prevalence (both for HbA1c). CMS recommended that state

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.

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…

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…

Comparative Robustness of Recent Methods for Analyzing Multivariate Repeated Measures Designs

ERIC Educational Resources Information Center

Seco, Guillermo Vallejo; Gras, Jaime Arnau; Garcia, Manuel Ato

2007-01-01

This study evaluated the robustness of two recent methods for analyzing multivariate repeated measures when the assumptions of covariance homogeneity and multivariate normality are violated. Specifically, the authors' work compares the performance of the modified Brown-Forsythe (MBF) procedure and the mixed-model procedure adjusted by the…

Stackable differential mobility analyzer for aerosol measurement

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

Cheng, Meng-Dawn; Chen, Da-Ren

2007-05-08

A multi-stage differential mobility analyzer (MDMA) for aerosol measurements includes a first electrode or grid including at least one inlet or injection slit for receiving an aerosol including charged particles for analysis. A second electrode or grid is spaced apart from the first electrode. The second electrode has at least one sampling outlet disposed at a plurality different distances along its length. A volume between the first and the second electrode or grid between the inlet or injection slit and a distal one of the plurality of sampling outlets forms a classifying region, the first and second electrodes for chargingmore » to suitable potentials to create an electric field within the classifying region. At least one inlet or injection slit in the second electrode receives a sheath gas flow into an upstream end of the classifying region, wherein each sampling outlet functions as an independent DMA stage and classifies different size ranges of charged particles based on electric mobility simultaneously.« less

Stackable differential mobility analyzer for aerosol measurement

DOEpatents

Cheng, Meng-Dawn [Oak Ridge, TN; Chen, Da-Ren [Creve Coeur, MO

2007-05-08

A multi-stage differential mobility analyzer (MDMA) for aerosol measurements includes a first electrode or grid including at least one inlet or injection slit for receiving an aerosol including charged particles for analysis. A second electrode or grid is spaced apart from the first electrode. The second electrode has at least one sampling outlet disposed at a plurality different distances along its length. A volume between the first and the second electrode or grid between the inlet or injection slit and a distal one of the plurality of sampling outlets forms a classifying region, the first and second electrodes for charging to suitable potentials to create an electric field within the classifying region. At least one inlet or injection slit in the second electrode receives a sheath gas flow into an upstream end of the classifying region, wherein each sampling outlet functions as an independent DMA stage and classifies different size ranges of charged particles based on electric mobility simultaneously.

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

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.

[A heart function measuring and analyzing instrument based on single-chip microcomputer].

PubMed

Rong, Z; Liang, H; Wang, S

1999-05-01

An Introduction a measuring and analyzing instrument, based on the single-chip microcomputer, which provides sample gathering, processing, controlling, adjusting, keyboard and printing. All informations are provided and displayed in Chinese.

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.

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.

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

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.

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

PubMed Central

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

2018-01-01

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

Inductance analyzer based on auto-balanced circuit for precision measurement of fluxgate impedance

NASA Astrophysics Data System (ADS)

Setiadi, Rahmondia N.; Schilling, Meinhard

2018-05-01

An instrument for fluxgate sensor impedance measurement based on an auto-balanced circuit has been designed and characterized. The circuit design is adjusted to comply with the fluxgate sensor characteristics which are low impedance and highly saturable core with very high permeability. The system utilizes a NI-DAQ card and LabVIEW to process the signal acquisition and evaluation. Some fixed reference resistances are employed for system calibration using linear regression. A multimeter HP 34401A and impedance analyzer Agilent 4294A are used as calibrator and validator for the resistance and inductance measurements. Here, we realized a fluxgate analyzer instrument based on auto-balanced circuit, which measures the resistance and inductance of the device under test with a small error and much lower excitation current to avoid core saturation compared to the used calibrator.

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.

W-state Analyzer and Multi-party Measurement-device-independent Quantum Key Distribution

PubMed Central

Zhu, Changhua; Xu, Feihu; Pei, Changxing

2015-01-01

W-state is an important resource for many quantum information processing tasks. In this paper, we for the first time propose a multi-party measurement-device-independent quantum key distribution (MDI-QKD) protocol based on W-state. With linear optics, we design a W-state analyzer in order to distinguish the four-qubit W-state. This analyzer constructs the measurement device for four-party MDI-QKD. Moreover, we derived a complete security proof of the four-party MDI-QKD, and performed a numerical simulation to study its performance. The results show that four-party MDI-QKD is feasible over 150 km standard telecom fiber with off-the-shelf single photon detectors. This work takes an important step towards multi-party quantum communication and a quantum network. PMID:26644289

A WebGIS-based system for analyzing and visualizing air quality data for Shanghai Municipality

NASA Astrophysics Data System (ADS)

Wang, Manyi; Liu, Chaoshun; Gao, Wei

2014-10-01

An online visual analytical system based on Java Web and WebGIS for air quality data for Shanghai Municipality was designed and implemented to quantitatively analyze and qualitatively visualize air quality data. By analyzing the architecture of WebGIS and Java Web, we firstly designed the overall scheme for system architecture, then put forward the software and hardware environment and also determined the main function modules for the system. The visual system was ultimately established with the DIV + CSS layout method combined with JSP, JavaScript, and some other computer programming languages based on the Java programming environment. Moreover, Struts, Spring, and Hibernate frameworks (SSH) were integrated in the system for the purpose of easy maintenance and expansion. To provide mapping service and spatial analysis functions, we selected ArcGIS for Server as the GIS server. We also used Oracle database and ESRI file geodatabase to store spatial data and non-spatial data in order to ensure the data security. In addition, the response data from the Web server are resampled to implement rapid visualization through the browser. The experimental successes indicate that this system can quickly respond to user's requests, and efficiently return the accurate processing results.

Exploring the use of random regression models with legendre polynomials to analyze measures of volume of ejaculate in Holstein bulls.

PubMed

Carabaño, M J; Díaz, C; Ugarte, C; Serrano, M

2007-02-01

Artificial insemination centers routinely collect records of quantity and quality of semen of bulls throughout the animals' productive period. The goal of this paper was to explore the use of random regression models with orthogonal polynomials to analyze repeated measures of semen production of Spanish Holstein bulls. A total of 8,773 records of volume of first ejaculate (VFE) collected between 12 and 30 mo of age from 213 Spanish Holstein bulls was analyzed under alternative random regression models. Legendre polynomial functions of increasing order (0 to 6) were fitted to the average trajectory, additive genetic and permanent environmental effects. Age at collection and days in production were used as time variables. Heterogeneous and homogeneous residual variances were alternatively assumed. Analyses were carried out within a Bayesian framework. The logarithm of the marginal density and the cross-validation predictive ability of the data were used as model comparison criteria. Based on both criteria, age at collection as a time variable and heterogeneous residuals models are recommended to analyze changes of VFE over time. Both criteria indicated that fitting random curves for genetic and permanent environmental components as well as for the average trajector improved the quality of models. Furthermore, models with a higher order polynomial for the permanent environmental (5 to 6) than for the genetic components (4 to 5) and the average trajectory (2 to 3) tended to perform best. High-order polynomials were needed to accommodate the highly oscillating nature of the phenotypic values. Heritability and repeatability estimates, disregarding the extremes of the studied period, ranged from 0.15 to 0.35 and from 0.20 to 0.50, respectively, indicating that selection for VFE may be effective at any stage. Small differences among models were observed. Apart from the extremes, estimated correlations between ages decreased steadily from 0.9 and 0.4 for measures 1 mo apart

Agreement of serum potassium measured by blood gas and biochemistry analyzer in patients with moderate to severe hyperkalemia.

PubMed

Acikgoz, Seyyid Bilal; Genc, Ahmet Bilal; Sipahi, Savas; Yildirim, Mehmet; Cinemre, Behice; Tamer, Ali; Solak, Yalcin

2016-05-01

Several studies investigated the agreement between central laboratory biochemistry analyzers and blood gas analyzers for potassium measurements. However, data are scarce when the potassium level is moderate to severely high. We aimed to evaluate the agreement between central laboratory biochemistry analyzers and blood gas analyzer in terms of serum potassium level measurement because differences in potassium at this level translate into very different clinical actions. This was a retrospective medical record review study in which patients who presented to the emergency department and had serum potassium levels ≥6mmol/L were included. Patients who did not have simultaneous potassium measurement by blood gas analyzer were excluded. We included all patients meeting potassium criteria irrespective of their underlying disease or comorbidities. We evaluated agreement between the measurement methods with Pearson correlation, Bland-Altman plot, and Sign test. A total of 118 blood sample pairs were included. The mean serum potassium level measured by biochemistry analyzer was 6.78±0.79mmol/L, whereas it was 6.16±0.86mmol/L by blood gas analyzer (P<.001, Sign test). There was a strong correlation (P<.001, r=0.864) between the 2 methods, but agreement was relatively poor. Blood gas analyzer tended to measure potassium significantly lower than measured by biochemistry analyzer. The mean difference between the methods was 0.62±0.43mmol/L. In patients with moderate to severe hyperkalemia, blood gas analyzer and biochemistry analyzer gives significantly different serum potassium results which may be clinically important. Copyright © 2016 Elsevier Inc. All rights reserved.

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)

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.

Impact of image quality on OCT angiography based quantitative measurements.

PubMed

Al-Sheikh, Mayss; Ghasemi Falavarjani, Khalil; Akil, Handan; Sadda, SriniVas R

2017-01-01

To study the impact of image quality on quantitative measurements and the frequency of segmentation error with optical coherence tomography angiography (OCTA). Seventeen eyes of 10 healthy individuals were included in this study. OCTA was performed using a swept-source device (Triton, Topcon). Each subject underwent three scanning sessions 1-2 min apart; the first two scans were obtained under standard conditions and for the third session, the image quality index was reduced using application of a topical ointment. En face OCTA images of the retinal vasculature were generated using the default segmentation for the superficial and deep retinal layer (SRL, DRL). Intraclass correlation coefficient (ICC) was used as a measure for repeatability. The frequency of segmentation error, motion artifact, banding artifact and projection artifact was also compared among the three sessions. The frequency of segmentation error, and motion artifact was statistically similar between high and low image quality sessions (P = 0.707, and P = 1 respectively). However, the frequency of projection and banding artifact was higher with a lower image quality. The vessel density in the SRL was highly repeatable in the high image quality sessions (ICC = 0.8), however, the repeatability was low, comparing the high and low image quality measurements (ICC = 0.3). In the DRL, the repeatability of the vessel density measurements was fair in the high quality sessions (ICC = 0.6 and ICC = 0.5, with and without automatic artifact removal, respectively) and poor comparing high and low image quality sessions (ICC = 0.3 and ICC = 0.06, with and without automatic artifact removal, respectively). The frequency of artifacts is higher and the repeatability of the measurements is lower with lower image quality. The impact of image quality index should be always considered in OCTA based quantitative measurements.

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.

Analyzing the efficiency of short-term air quality plans in European cities, using the CHIMERE air quality model.

PubMed

Thunis, P; Degraeuwe, B; Pisoni, E; Meleux, F; Clappier, A

2017-01-01

Regional and local authorities have the obligation to design air quality plans and assess their impacts when concentration levels exceed the limit values. Because these limit values cover both short- (day) and long-term (year) effects, air quality plans also follow these two formats. In this work, we propose a methodology to analyze modeled air quality forecast results, looking at emission reduction for different sectors (residential, transport, agriculture, etc.) with the aim of supporting policy makers in assessing the impact of short-term action plans. Regarding PM 10 , results highlight the diversity of responses across European cities, in terms of magnitude and type that raises the necessity of designing area-specific air quality plans. Action plans extended from 1 to 3 days (i.e., emissions reductions applied for 24 and 72 h, respectively) point to the added value of trans-city coordinated actions. The largest benefits are seen in central Europe (Vienna, Prague) while major cities (e.g., Paris) already solve a large part of the problem on their own. Eastern Europe would particularly benefit from plans based on emission reduction in the residential sectors; while in northern cities, agriculture seems to be the key sector on which to focus attention. Transport is playing a key role in most cities whereas the impact of industry is limited to a few cities in south-eastern Europe. For NO 2 , short-term action plans focusing on traffic emission reductions are efficient in all cities. This is due to the local character of this type of pollution. It is important, however, to stress that these results remain dependent on the selected months available for this study.

Multifunctional System for Observing, Measuring and Analyzing Stimulation-Evoked Neurochemical Signaling

PubMed Central

Kimble, Christopher J.; Boesche, Joshua B.; Eaker, Diane R.; Kressin, Kenneth R.; Trevathan, James K.; Paek, Seungleal; Asp, Anders J.; McIntosh, Malcolm B.; Lujan, J. Luis

2017-01-01

The ability to measure neurotransmitter activity using implanted electrochemical sensors offers researchers a potent technique for analyzing neural activity across specific neural circuitry. We have developed a wirelessly controlled device, WINCS Harmoni, to observe and measure neurotransmitter dynamics at up to four separate sensors, with high temporal and spatial resolution. WINCS Harmoni also incorporates a versatile neurostimulator that can be synchronized with electrochemical recording. The WINCS Harmoni platform is thus optimally suited for probing the neurochemical effects of neurostimulation, and may in turn enable the development of personalized therapies for multiple brain disorders. PMID:29202131

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. 

Using fuzzy gap analysis to measure service quality of medical tourism in Taiwan.

PubMed

Ho, Li-Hsing; Feng, Shu-Yun; Yen, Tieh-Min

2015-01-01

The purpose of this paper is intended to create a model to measure quality of service, using fuzzy linguistics to analyze the quality of service of medical tourism in Taiwan so as to find the direction for improvement of service quality in medical tourism. The study developed fuzzy questionnaires based on the characteristics of medical tourism quality of service in Taiwan. Questionnaires were delivered and recovered from February to April 2014, using random sampling according to the proportion of medical tourism companies in each region, and 150 effective samples were obtained. The critical quality of service level is found through the fuzzy gap analysis using questionnaires examining expectations and perceptions of customers, as the direction for continuous improvement. From the study, the primary five critical service items that improve the quality of service for medical tourism in Taiwan include, in order: the capability of the service provider to provide committed medical tourism services reliably and accurately, facility service providers in conjunction with the services provided, the cordial and polite attitude of the service provider eliciting a sense of trust from the customer, professional ability of medical (nursing) personnel in hospital and reliability of service provider. The contribution of this study is to create a fuzzy gap analysis to assess the performance of medical tourism service quality, identify key quality characteristics and provide a direction for improvement and development for medical tourism service quality in Taiwan.

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.

Filtering high resolution hyperspectral imagery and analyzing it for quantification of water quality parameters and aquatic vegetation

NASA Astrophysics Data System (ADS)

Pande-Chhetri, Roshan

High resolution hyperspectral imagery (airborne or ground-based) is gaining momentum as a useful analytical tool in various fields including agriculture and aquatic systems. These images are often contaminated with stripes and noise resulting in lower signal-to-noise ratio, especially in aquatic regions where signal is naturally low. This research investigates effective methods for filtering high spatial resolution hyperspectral imagery and use of the imagery in water quality parameter estimation and aquatic vegetation classification. The striping pattern of the hyperspectral imagery is non-parametric and difficult to filter. In this research, a de-striping algorithm based on wavelet analysis and adaptive Fourier domain normalization was examined. The result of this algorithm was found superior to other available algorithms and yielded highest Peak Signal to Noise Ratio improvement. The algorithm was implemented on individual image bands and on selected bands of the Maximum Noise Fraction (MNF) transformed images. The results showed that image filtering in the MNF domain was efficient and produced best results. The study investigated methods of analyzing hyperspectral imagery to estimate water quality parameters and to map aquatic vegetation in case-2 waters. Ground-based hyperspectral imagery was analyzed to determine chlorophyll-a (Chl-a) concentrations in aquaculture ponds. Two-band and three-band indices were implemented and the effect of using submerged reflectance targets was evaluated. Laboratory measured values were found to be in strong correlation with two-band and three-band spectral indices computed from the hyperspectral image. Coefficients of determination (R2) values were found to be 0.833 and 0.862 without submerged targets and stronger values of 0.975 and 0.982 were obtained using submerged targets. Airborne hyperspectral images were used to detect and classify aquatic vegetation in a black river estuarine system. Image normalization for water

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,…

Using machine-learning methods to analyze economic loss function of quality management processes

NASA Astrophysics Data System (ADS)

Dzedik, V. A.; Lontsikh, P. A.

2018-05-01

During analysis of quality management systems, their economic component is often analyzed insufficiently. To overcome this issue, it is necessary to withdraw the concept of economic loss functions from tolerance thinking and address it. Input data about economic losses in processes have a complex form, thus, using standard tools to solve this problem is complicated. Use of machine learning techniques allows one to obtain precise models of the economic loss function based on even the most complex input data. Results of such analysis contain data about the true efficiency of a process and can be used to make investment decisions.

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.

MERCURY MEASUREMENTS USING DIRECT-ANALYZER METHODOLOGY

EPA Science Inventory

Under EPA's Water Quality Research Program, exposure studies are needed to determine how well control strategies and guidance are working. Consequently, reliable and convenient techniques that minimize waste production are of special interest. While traditional methods for determ...

FIELD DEMONSTRATION AND QUALITY ASSURANCE ...

EPA Pesticide Factsheets

The Demonstration of innovative field devices for the measurement of mercury in soil and sediment is being conducted under the EPA's SITE Program in February 2003 at the United States Department of Energy's (DOE) Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee and the Tennessee Department of Environment and Conservation's Department of Energy Oversight facility in Oak Ridge, Tennessee. The primary purpose of the Demonstration is to evaluate innovative field devices for the measurement of mercury in soil and sediment based on their performance and cost as compared to a conventional, off-site laboratory analytical method. The five field measurement devices listed below will be demonstrated: .Metorex's X-M ET 2000 Metal Master Analyzer, X-Ray Fluorescence Analyzer .Milestone Inc.'s Direct Mercury Analyzer (DMA-80), Thermal Decomposition Instrument.NITON's XL-700 Series Multi-Element Analyzer, X-Ray Fluorescence Analyzer .Ohio Lumex's RA-915+ Portable Mercury Analyzer, Atomic Absorption Spectrometer, Thermal Decompostion Attachment RP 91C .MTI, Inc.'s PDV 5000 Hand Held Instrument, Anodic Stripping Voltamm eter<1). This Demonstration Plan describes the procedures that will be used to verify the performance and cost of each field measurement device. The plan incorporates the quality assurance and quality control elements needed to generate data of sufficient quality to document each device's performance and cost. A separate Innovative Technology Verifica

Exhaled nitric oxide measurements: correction equation to compare hand-held device to stationary analyzer.

PubMed

Pizzimenti, Stefano; Bugiani, Massimiliano; Piccioni, Pavilio; Heffler, Enrico; Carosso, Aurelia; Guida, Giuseppe; Rolla, Giovanni

2008-09-01

Exhaled nitric oxide (FE(NO)) is a reliable non-invasive marker of airway inflammation. In 2003 FE(NO) chemiluminescence analyzer (NIOX; Aerocrine AB, Solna, Sweden) was approved by U.S. Food and Drug Administration for monitoring asthma therapy. Recently, the same company developed a portable device using electrochemical sensors (NIOX-MINO; Aerocrine AB). The aim of our study was to compare NIOX-MINO FE(NO) values to those obtained by NIOX and to calculate a correction equation. Two adequate measurements obtained by NIOX and NIOX-MINO were recorded in 32 subjects (16 females, mean age 41 years). FE(NO) values measured by NIOX-MINO were systematically higher than those obtained by NIOX (47.1ppb, IC 95% 35.2-59.1 and 36.9ppb, IC 95% 25.0-49.0, respectively). There was a significant correlation (r=0.998, p<0.001) between FE(NO) measured by the two analyzers and the following conversion equation was calculated as: FE(NO(NIOX))=-1.656(SE=0.61)+0.808(SE=0.009)x FE(NO(NIOX-MINO)) DISCUSSION: FE(NO) values measured by the portable nitric oxide analyzer are reliable and strongly correlated with values obtained by the standard stationary device, with a systematic difference observed between the two instruments' values that can be described by the conversion equation we provided. This equation will help clinicians and researchers to compare data obtainable by the two analyzers.

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).

Particulate matter air quality assessment over southeast United States using satellite and ground measurements

NASA Astrophysics Data System (ADS)

Gupta, Pawan

Fine particles (PM2.5, particles with aerodynamic diameter less than 2.5 mum) can penetrate deep inside the human lungs and recent scientific studies have shown thousands of deaths occur each year around the world, prematurely, due to a high concentration of particulate matter. Therefore, monitoring and forecasting of surface level fine particulate matter air quality is very important. Typically air quality measurements are made from ground stations. In recent years, linear regression relationships between satellite derived aerosol optical thickness (AOT) and surface measured PM2.5 mass concentration are formed and used to estimate PM2.5 in the areas where surface measurements are not available. This type of simple linear relationships varies with regions and seasons, and does not provide accurate enough estimation of surface level pollution and many studies have shown that AOT alone is not sufficient for PM2.5 mass concentration estimations. Furthermore, AOT represents aerosol loading in the entire column of the atmosphere whereas PM2.5 is measured at the surface; hence, the knowledge of vertical distribution of aerosols coupled with meteorology becomes critical in PM2.5 estimations. In this dissertation I used three years (2004-2006) of coincident hourly PM2.5, MODerate resolution Imaging Spectroradiometer (MODIS) derived AOT, and Rapid Update Cycle (RUC) analyzed meteorological fields to assess PM2.5 air quality in the Southeast United States. I explored the use of two-variate (TVM), multi-variate (MVM) and artificial neural network (ANN) methods for estimating PM2.5 over 85 stations in the region. First, satellite data were analyzed for sampling biases, quality, and impact of clouds. Results show that MODIS-Terra AOT data was available only about 50% of the days in any given month due to cloud over and unfavorable surface conditions, but this produced a sampling bias of less than 2 mugm-3. Results indicate that there is up to three fold improvements in the

Resolution-Enhanced Harmonic and Interharmonic Measurement for Power Quality Analysis in Cyber-Physical Energy System.

PubMed

Liu, Yanchi; Wang, Xue; Liu, Youda; Cui, Sujin

2016-06-27

Power quality analysis issues, especially the measurement of harmonic and interharmonic in cyber-physical energy systems, are addressed in this paper. As new situations are introduced to the power system, the impact of electric vehicles, distributed generation and renewable energy has introduced extra demands to distributed sensors, waveform-level information and power quality data analytics. Harmonics and interharmonics, as the most significant disturbances, require carefully designed detection methods for an accurate measurement of electric loads whose information is crucial to subsequent analyzing and control. This paper gives a detailed description of the power quality analysis framework in networked environment and presents a fast and resolution-enhanced method for harmonic and interharmonic measurement. The proposed method first extracts harmonic and interharmonic components efficiently using the single-channel version of Robust Independent Component Analysis (RobustICA), then estimates the high-resolution frequency from three discrete Fourier transform (DFT) samples with little additional computation, and finally computes the amplitudes and phases with the adaptive linear neuron network. The experiments show that the proposed method is time-efficient and leads to a better accuracy of the simulated and experimental signals in the presence of noise and fundamental frequency deviation, thus providing a deeper insight into the (inter)harmonic sources or even the whole system.

Resolution-Enhanced Harmonic and Interharmonic Measurement for Power Quality Analysis in Cyber-Physical Energy System

PubMed Central

Liu, Yanchi; Wang, Xue; Liu, Youda; Cui, Sujin

2016-01-01

Power quality analysis issues, especially the measurement of harmonic and interharmonic in cyber-physical energy systems, are addressed in this paper. As new situations are introduced to the power system, the impact of electric vehicles, distributed generation and renewable energy has introduced extra demands to distributed sensors, waveform-level information and power quality data analytics. Harmonics and interharmonics, as the most significant disturbances, require carefully designed detection methods for an accurate measurement of electric loads whose information is crucial to subsequent analyzing and control. This paper gives a detailed description of the power quality analysis framework in networked environment and presents a fast and resolution-enhanced method for harmonic and interharmonic measurement. The proposed method first extracts harmonic and interharmonic components efficiently using the single-channel version of Robust Independent Component Analysis (RobustICA), then estimates the high-resolution frequency from three discrete Fourier transform (DFT) samples with little additional computation, and finally computes the amplitudes and phases with the adaptive linear neuron network. The experiments show that the proposed method is time-efficient and leads to a better accuracy of the simulated and experimental signals in the presence of noise and fundamental frequency deviation, thus providing a deeper insight into the (inter)harmonic sources or even the whole system. PMID:27355946

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.

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

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.

The Deflection Plate Analyzer: A Technique for Space Plasma Measurements Under Highly Disturbed Conditions

NASA Technical Reports Server (NTRS)

Wright, Kenneth H., Jr.; Dutton, Ken; Martinez, Nelson; Smith, Dennis; Stone, Nobie H.

2004-01-01

A technique has been developed to measure the characteristics of space plasmas under highly disturbed conditions; e.g., non-Maxwellian plasmas with strong drifting populations and plasmas contaminated by spacecraft outgassing. The present method is an extension of the capabilities of the Differential Ion Flux Probe (DIFP) to include a mass measurement that does not include either high voltage or contamination sensitive devices such as channeltron electron multipliers or microchannel plates. This reduces the complexity and expense of instrument fabrication, testing, and integration of flight hardware as compared to classical mass analyzers. The new instrument design is called the Deflection Plate Analyzer (DPA) and can deconvolve multiple ion streams and analyze each stream for ion flux intensity (density), velocity (including direction of motion), mass, and temperature (or energy distribution). The basic functionality of the DPA is discussed. The performance characteristics of a flight instrument as built for an electrodynamic tether mission, the Propulsive Small Expendable Deployer System (ProSEDS), and the instrument s role in measuring key experimental conditions are also discussed.

The Deflection Plate Analyzer: A Technique for Space Plasma Measurements Under Highly Disturbed Conditions

NASA Technical Reports Server (NTRS)

Wright, Kenneth H., Jr.; Dutton, Ken; Martinez, Nelson; Smith, Dennis; Stone, Nobie H.

2003-01-01

A technique has been developed to measure the characteristics of space plasmas under highly disturbed conditions; e.g., non-Maxwellian plasmas with strong drifting populations and plasmas contaminated by spacecraft outgassing. The present method is an extension of the capabilities of the Differential Ion Flux Probe (DIFP) to include a mass measurement that does not include either high voltage or contamination sensitive devices such as channeltron electron multipliers or microchannel plates. This reduces the complexity and expense of instrument fabrication, testing, and integration of flight hardware as compared to classical mass analyzers. The new instrument design is called the Deflection Plate Analyzer (DPA) and can deconvolve multiple ion streams and analyze each stream for ion flux intensity (density), velocity (including direction of motion), mass, and temperature (or energy distribution). The basic functionality of the DPA is discussed. The performance characteristics of a flight instrument as built for an electrodynamic tether mission, the Propulsive Small Expendable Deployer System (ProSEDS), and the instrument s role in measuring key experimental conditions are also discussed.

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

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

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...

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

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...

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

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 Characteristics of the Quality of Life Index When Used with Adults Who Have Severe Mental Retardation. Brief Report.

ERIC Educational Resources Information Center

Campo, Stephanie F.; And Others

1996-01-01

The Quality of Life Index was completed by 120 residential staff for 60 adults with severe to profound mental retardation residing in group homes. Measurement integrity was analyzed through use of principal components analysis, confirmatory rotation of components, and Cronbach alphas. Results are compared with results obtained from a more…

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

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

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.

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.

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.

An approach for estimating measurement uncertainty in medical laboratories using data from long-term quality control and external quality assessment schemes.

PubMed

Padoan, Andrea; Antonelli, Giorgia; Aita, Ada; Sciacovelli, Laura; Plebani, Mario

2017-10-26

The present study was prompted by the ISO 15189 requirements that medical laboratories should estimate measurement uncertainty (MU). The method used to estimate MU included the: a) identification of quantitative tests, b) classification of tests in relation to their clinical purpose, and c) identification of criteria to estimate the different MU components. Imprecision was estimated using long-term internal quality control (IQC) results of the year 2016, while external quality assessment schemes (EQAs) results obtained in the period 2015-2016 were used to estimate bias and bias uncertainty. A total of 263 measurement procedures (MPs) were analyzed. On the basis of test purpose, in 51 MPs imprecision only was used to estimate MU; in the remaining MPs, the bias component was not estimable for 22 MPs because EQAs results did not provide reliable statistics. For a total of 28 MPs, two or more MU values were calculated on the basis of analyte concentration levels. Overall, results showed that uncertainty of bias is a minor factor contributing to MU, the bias component being the most relevant contributor to all the studied sample matrices. The model chosen for MU estimation allowed us to derive a standardized approach for bias calculation, with respect to the fitness-for-purpose of test results. Measurement uncertainty estimation could readily be implemented in medical laboratories as a useful tool in monitoring the analytical quality of test results since they are calculated using a combination of both the long-term imprecision IQC results and bias, on the basis of EQAs results.

Comparison of Two Procedures for Analyzing Small Sets of Repeated Measures Data

ERIC Educational Resources Information Center

Vallejo, Guillermo; Livacic-Rojas, Pablo

2005-01-01

This article compares two methods for analyzing small sets of repeated measures data under normal and non-normal heteroscedastic conditions: a mixed model approach with the Kenward-Roger correction and a multivariate extension of the modified Brown-Forsythe (BF) test. These procedures differ in their assumptions about the covariance structure of…

Evaluation of cross-cultural adaptation and measurement properties of breast cancer-specific quality-of-life questionnaires: a systematic review.

PubMed

Oliveira, Indiara Soares; da Cunha Menezes Costa, Lucíola; Fagundes, Felipe Ribeiro Cabral; Cabral, Cristina Maria Nunes

2015-05-01

To assess the procedures of translation, cross-cultural adaptation, and measurement properties of breast cancer-specific quality-of-life questionnaires. Searches were conducted in the databases MEDLINE, EMBASE, CINAHL, and SciELO using the keywords: "Questionnaires," "Quality of life," and "Breast cancer." The studies were analyzed in terms of methodological quality according to the guidelines for the procedure of cross-cultural adaptation and the quality criteria for measurement properties of questionnaires. We found 24 eligible studies. Most of the articles assessed the translation and measurement properties of the instrument EORTC QLQ-BR23. Description about translation and cross-cultural adaptation was incomplete in 11 studies. Translation and back translation were the most tested phases, and synthesis of the translation was the most omitted phase in the articles. Information on assessing measurement properties was provided incompletely in 23 articles. Internal consistency was the most tested property in all of the eligible articles, but none of them provided information on agreement. Construct validity was adequately tested in only three studies that used the FACT-B and QLQ-BR23. Eight articles provided information on reliability; however, only four found positive classification. Responsiveness was tested in four articles, and ceiling and floor effects were tested in only three articles. None of the instruments showed fully adequate quality. There is limited evidence on cross-cultural adaptations and measurement properties; therefore, it is recommended that caution be exercised when using breast cancer-specific quality-of-life questionnaires that have been translated, adapted, and tested.

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...

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.

ANALYZING WATER QUALITY WITH IMAGES ACQUIRED FROM AIRBORNE SENSORS

EPA Science Inventory

Monitoring different parameters of water quality can be a time consuming and expensive activity. However, the use of airborne light-sensitive (optical) instruments may enhance the abilities of resource managers to monitor water quality in rivers in a timely and cost-effective ma...

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.

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.

A Survey to Evaluate Facilitators and Barriers to Quality Measurement and Improvement: Adapting Tools for Implementation Research in Palliative Care Programs.

PubMed

Dy, Sydney M; Al Hamayel, Nebras Abu; Hannum, Susan M; Sharma, Ritu; Isenberg, Sarina R; Kuchinad, Kamini; Zhu, Junya; Smith, Katherine; Lorenz, Karl A; Kamal, Arif H; Walling, Anne M; Weaver, Sallie J

2017-12-01

Although critical for improving patient outcomes, palliative care quality indicators are not yet widely used. Better understanding of facilitators and barriers to palliative care quality measurement and improvement might improve their use and program quality. Development of a survey tool to assess palliative care team perspectives on facilitators and barriers to quality measurement and improvement in palliative care programs. We used the adapted Consolidated Framework for Implementation Research to define domains and constructs to select instruments. We assembled a draft survey and assessed content validity through pilot testing and cognitive interviews with experts and frontline practitioners for key items. We analyzed responses using a constant comparative process to assess survey item issues and potential solutions. We developed a final survey using these results. The survey includes five published instruments and two additional item sets. Domains include organizational characteristics, individual and team characteristics, intervention characteristics, and process of implementation. Survey modules include Quality Improvement in Palliative Care, Implementing Quality Improvement in the Palliative Care Program, Teamwork and Communication, Measuring the Quality of Palliative Care, and Palliative Care Quality in Your Program. Key refinements from cognitive interviews included item wording on palliative care team members, programs, and quality issues. This novel, adaptable instrument assesses palliative care team perspectives on barriers and facilitators for quality measurement and improvement in palliative care programs. Next steps include evaluation of the survey's construct validity and how survey results correlate with findings from program quality initiatives. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.

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

Metabolic analyzer. [for measuring metabolic rate and breathing dynamics of human beings

NASA Technical Reports Server (NTRS)

Rummel, J. A.; Perry, C. L. (Inventor)

1974-01-01

An apparatus is described for the measurement of metabolic rate and breathing dynamics in which inhaled and exhaled breath are sensed by sealed, piston-displacement type spirometers. These spirometers electrically measure the volume of inhaled and exhaled breath. A mass spectrometer analyzes simultaneously for oxygen, carbon dioxide, nitrogen and water vapor. Computation circuits are responsive to the outputs of the spirometers, mass spectrometer, temperature, pressure and timing signals and compute oxygen consumption, carbon dioxide production, minute volume and respiratory exchange ratio. A selective indicator provides for read-out of these data at predetermined cyclic intervals.

Process Analyzer

NASA Technical Reports Server (NTRS)

1994-01-01

The ChemScan UV-6100 is a spectrometry system originally developed by Biotronics Technologies, Inc. under a Small Business Innovation Research (SBIR) contract. It is marketed to the water and wastewater treatment industries, replacing "grab sampling" with on-line data collection. It analyzes the light absorbance characteristics of a water sample, simultaneously detects hundreds of individual wavelengths absorbed by chemical substances in a process solution, and quantifies the information. Spectral data is then processed by ChemScan analyzer and compared with calibration files in the system's memory in order to calculate concentrations of chemical substances that cause UV light absorbance in specific patterns. Monitored substances can be analyzed for quality and quantity. Applications include detection of a variety of substances, and the information provided enables an operator to control a process more efficiently.

Can a Focus on Preventable Events Help Untangle the Quality Measurement Mess?

PubMed

Miller, Michael

2016-01-01

The success of a shift from paying for volume to paying for value depends on our ability to measure quality. Unfortunately, current approaches to measuring quality and linking quality to payment have frustrated providers and failed to provide essential information to patients. Shifting to a focus on preventable events could go a long way toward clarifying and simplifying quality measurement, but successful adoption of that approach requires overcoming several substantive and political challenges.

Assessing quality of care for migraineurs: a model health plan measurement set.

PubMed

Leas, Brian F; Gagne, Joshua J; Goldfarb, Neil I; Rupnow, Marcia F T; Silberstein, Stephen

2008-08-01

Quality of care measures are increasingly important to health plans, purchasers, physicians, and patients. Appropriate measures can be used to assess quality and evaluate improvement and are necessary components of pay-for-performance programs. Despite the broad scope of activity in the development of quality measures, migraine headache has received little attention. Given the enormous costs associated with migraine, especially in terms of lost productivity and preventable health care utilization, health plans could gain from a structured approach to measuring the quality of migraine care their beneficiaries receive. A potential migraine quality measurement set was developed through a review of migraine care literature and guidelines, interviews with leaders in migraine care, health care purchasing, and managed care, and the assembly of an advisory board. The board discussed candidate measures and established consensus on a testable measurement set. Twenty measures were developed, focused primarily on diagnosis and utilization. Areas of utilization include physician visits, emergency department visits, hospitalizations, and imaging. Use of both acute and preventive medications is included. More complex aspects of migraine care are also addressed, including triptan overuse, the relationship between acute and preventive medications, and follow-up after emergency department visits. The measures are currently being tested in health plans to assess their feasibility and value. A compelling case can be made for the development of migraine-specific quality measures for health plans. This effort to develop and test a starter set of measures should lead to new and innovative efforts to assess and improve quality of care for migraineurs.

A rocket-borne electrostatic analyzer for measurement of energetic particle flux

NASA Technical Reports Server (NTRS)

Pozzi, M. A.; Smith, L. G.; Voss, H. D.

1979-01-01

A rocket-borne electrostatic analyzer experiment is described. It is used to measure energetic particle flux (0.9 to 14 keV) in the nighttime midlatitude E region. Energetic particle precipitation is believed to be a significant nighttime ionization source, particularly during times of high geomagnetic activity. The experiment was designed for use in the payload of a Nike Apache sounding rocket. The electrostatic analyzer employs two cylindrical parallel plates subtending a central angle of 90 deg. The voltage waveform supplied to the plates is a series of steps synchronized to the spin of the payload during flight. Both positive and negative voltages are provided, extending the detection capabilities of the instrument to both electrons and protons (and positive ions). The development, construction and operation of the instrument is described together with a preliminary evaluation of its performance in a rocket flight.

Quality Assurance and Control Considerations in Environmental Measurements and Monitoring

NASA Astrophysics Data System (ADS)

Sedlet, Jacob

1982-06-01

Quality assurance and quality control have become accepted as essential parts of all environmental surveillance, measurements, and monitoring programs, both nuclear and non-nuclear. The same principles and details apply to each. It is primarily the final measurement technique that differs. As the desire and need to measure smaller amounts of pollutants with greater accuracy has increased, it has been recognized that quality assurance and control programs are cost-effective in achieving the expected results. Quality assurance (QA) consists of all the actions necessary to provide confidence in the results. Quality control (QC) is a part of QA, and consists of those actions and activities that permit the control of the individual steps in the environmental program. The distinction between the two terms is not always clearly defined, but a sharp division is not necessary. The essential principle of QA and QC is a commitment to high quality results. The essential components of a QA and QC program are a complete, written procedures manual for all parts of the environmental program, the use of standard or validated procedures, participation in applicable interlaboratory comparison or QA programs, replicate analysis and measurement, training of personnel, and a means of auditing or checking that the QA and QC programs are properly conducted. These components are discussed below in some detail.

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.

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.

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

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.

Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality.

PubMed

Backman, Chantal; Vanderloo, Saskia; Forster, Alan John

2016-09-01

Measuring and monitoring overall health system performance is complex and challenging but is crucial to improving quality of care. Today's health care organizations are increasingly being held accountable to develop and implement actions aimed at improving the quality of care, reducing costs, and achieving better patient-centered care. This paper describes the development of the Collaborative for Excellence in Healthcare Quality (CEHQ), a 5-year initiative to achieve higher quality of patient care in university hospitals across Canada. This bottom-up initiative took place between 2010 and 2015, and was successful in engaging health care leaders in the development of a common framework and set of performance measures for reporting and benchmarking, as well as working on initiatives to improve performance. Despite its successes, future efforts are needed to provide clear national leadership on standards for measuring performance. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Measuring, evaluating and improving hospital quality parameters/dimensions--an integrated healthcare quality approach.

PubMed

Zineldin, Mosad; Camgöz-Akdağ, Hatice; Vasicheva, Valiantsina

2011-01-01

This paper aims to examine the major factors affecting cumulative summation, to empirically examine the major factors affecting satisfaction and to address the question whether patients in Kazakhstan evaluate healthcare similarly or differently from patients in Egypt and Jordan. A questionnaire, adapted from previous research, was distributed to Kazakhstan inpatients. The questionnaire contained 39 attributes about five newly-developed quality dimensions (5Qs), which were identified to be the most relevant attributes for hospitals. The questionnaire was translated into Russian to increase the response rate and improve data quality. Almost 200 usable questionnaires were returned. Frequency distribution, factor analysis and reliability checks were used to analyze the data. The three biggest concerns for Kazakhstan patients are: infrastructure; atmosphere; and interaction. Hospital staffs concern for patients' needs, parking facilities for visitors, waiting time and food temperature were all common specific attributes, which were perceived as concerns. These were shortcomings in all three countries. Improving health service quality by applying total relationship management and the 5Qs model together with a customer-orientation strategy is recommended. Results can be used by hospital staff to reengineer and redesign creatively their quality management processes and help move towards more effective healthcare quality strategies. Patients in three countries have similar concerns and quality perceptions. The paper describes a new instrument and method. The study assures relevance, validity and reliability, while being explicitly change-oriented. The authors argue that patient satisfaction is a cumulative construct, summing satisfaction as five different qualities (5Qs): object; processes; infrastructure; interaction and atmosphere.

Measurement of laser spot quality

NASA Technical Reports Server (NTRS)

Milster, T. D.; Treptau, J. P.

1991-01-01

Several ways of measuring spot quality are compared. We examine in detail various figures of merit such as full width at half maximum (FWHM), full width at 1/(e exp 2) maximum, Strehl ratio, and encircled energy. Our application is optical data storage, but results can be applied to other areas like space communications and high energy lasers. We found that the optimum figure of merit in many cases is Strehl ratio.

What Is Nursing Home Quality and How Is It Measured?

ERIC Educational Resources Information Center

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)…

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

Development of a Five-Dimensional Measure of Adult Sleep Quality

ERIC Educational Resources Information Center

Fortunato, Vincent J.; LeBourgeois, Monique K.; Harsh, John

2008-01-01

This article describes the development of a measure of adult sleep quality: the Adult Sleep-Wake Scale (ADSWS). The ADSWS is a self-report pencil-and-paper measure of sleep quality consisting of five behavioral dimensions (Going to Bed, Falling Asleep, Maintaining Sleep, Reinitiating Sleep, and Returning to Wakefulness). Data were collected from…

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.

Incorporating Measures of Sleep Quality into Cancer Studies

PubMed Central

Redeker, Nancy S.; Pigeon, Wilfred R.; Boudreau, Eilis A.

2014-01-01

Introduction/background Sleep disturbance may influence the development of cancer and responses to treatment. It is also closely tied to recovery and quality of life in cancer patients, survivors, and caregivers, and recent studies have begun to show beneficial effects of sleep promoting interventions. Despite the importance of sleep to cancer and its treatment and the availability of numerous tools for measuring sleep quality and quantity, sleep measurements are underutilized in cancer studies. Methods This review, written for cancer researchers interested in incorporating sleep measures into their studies, is designed to raise awareness about the importance of sleep and suggest strategies for including sleep evaluation in cancer studies. Conclusions Inclusion of readily available sleep measures may ultimately improve cancer care by facilitating studies that lead to a greater understanding of how sleep and sleep disturbance influence all aspects of cancer care and the patient experience. PMID:25510361

Project ATLANTA (Atlanta Land use Analysis: Temperature and Air Quality): Use of Remote Sensing and Modeling to Analyze How Urban Land Use Change Affects Meteorology and Air Quality Through Time

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.; Luvall, Jeffrey C.; Estes, Maurice G., Jr.

1999-01-01

This paper presents an overview of Project ATLANTA (ATlanta Land use ANalysis: Temperature and Air-quality) which is an investigation that seeks to observe, measure, model, and analyze how the rapid growth of the Atlanta, Georgia metropolitan area since the early 1970's has impacted the region's climate and air quality. The primary objectives for this research effort are: (1) To investigate and model the relationships between land cover change in the Atlanta metropolitan, and the development of the urban heat island phenomenon through time; (2) To investigate and model the temporal relationships between Atlanta urban growth and land cover change on air quality; and (3) To model the overall effects of urban development on surface energy budget characteristics across the Atlanta urban landscape through time. Our key goal is to derive a better scientific understanding of how land cover changes associated with urbanization in the Atlanta area, principally in transforming forest lands to urban land covers through time, has, and will, effect local and regional climate, surface energy flux, and air quality characteristics. Allied with this goal is the prospect that the results from this research can be applied by urban planners, environmental managers and other decision-makers, for determining how urbanization has impacted the climate and overall environment of the Atlanta area. Multiscaled remote sensing data, particularly high resolution thermal infrared data, are integral to this study for the analysis of thermal energy fluxes across the Atlanta urban landscape.

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.

Integration of satellite data and in situ measurements to improve coastal water quality monitoring

NASA Astrophysics Data System (ADS)

Lacava, Teodosio

2015-04-01

Coastal areas are "sensitive" zones exposed to different natural hazards and anthropic risks. The increasing level of urbanization, the even more irrational exploitation of those areas and, more generally, climate changes are some of the most relevant phenomena able to strongly change such sites. For these reasons, it is necessary to implement an adequate water quality monitoring system able to give a reliable description of water status for reducing the negative effects which coastal marine waters are exposed to. Remote sensing data offer a relevant contribution in this framework, providing, with a quite good level of accuracy, information about the spatial distribution of sea water constituents over large areas with high temporal rates and at relatively low costs. On the other hand, in situ measurements allow to analyze the history of these elements at a very small scale, both in terms of investigated area and period. The integration of these two kind of information may improve the monitoring in the space-time domain of a specific area, allowing also for a calibration, at local scale, of the satellite data/products. In this paper results achieved in such a context while carrying out two projects on Mediterranean Sea water quality will be described. More than 15 years of MODIS Ocean Colour data have been analyzed and compared with different specific in-situ and airborne data concerning different areas of Mediterranean Sea collected in the framework of the following projects: IOSMOS (IOnian Sea water quality MOnitoring by Satellite data, OP ERDF Basilicata) and MOMEDAS (MOnitoraggio delle acque del mar MEditerraneo mediante DAti Satellitari, OP Basilicata ESF). Specifically, preliminary achievements regarding the analysis of Chlorophyll-a (Chl-a) and diffuse attenuation coefficient at 490 nm (Kd 490) products as well as suspended sediment material (SSM) transport phenomena and the Sea Surface Temperature (SST) variations occurring in the analyzed areas will be

Eliciting and Analyzing Quality Requirements: Management Influences on Software Quality Requirements

DTIC Science & Technology

2005-03-01

their portable devices [ Balfanz 04] can be applied to many of the quality requirements issues within the development life cycle: " Neither usability or...Systems. New York, NY: Wiley Computer Publishing, 2001. [ Balfanz 04] Balfanz , D.; Durfee, G; & Smetters, D. K. "Search of Usable Security: Five Lessons from

Quality of Care Measures for the Management of Unhealthy Alcohol Use

PubMed Central

Hepner, Kimberly A.; Watkins, Katherine E.; Farmer, Carrie M.; Rubenstein, Lisa; Pedersen, Eric R.; Pincus, Harold Alan

2017-01-01

There is a paucity of quality measures to assess the care for the range of unhealthy alcohol use, ranging from risky drinking to alcohol use disorders. Using a two-phase expert panel review process, we sought to develop an expanded set of quality of care measures for unhealthy alcohol use, focusing on outpatient care delivered in both primary care and specialty care settings. This process generated 25 candidate measures. Eight measures address screening and assessment, 11 address aspects of treatment, and six address follow-up. These quality measures represent high priority targets for future development, including creating detailed technical specifications and pilot testing them to evaluate their utility in terms of feasibility, reliability, and validity. PMID:28340902

Suprathreshold measures of taste perception in children - Association with dietary quality and body weight.

PubMed

Feeney, Emma L; O'Brien, Sinead A; Scannell, Amalia G M; Markey, Anne; Gibney, Eileen R

2017-06-01

Childhood obesity is an increasing problem in the Western world, and is affected by a multitude of interacting factors. Recent evidence suggests that taste perception may differ between obese and normal weight children. Evidence also suggests that perception of sweet and bitter taste is linked to differential food liking of various foods. To date, most studies have focused on single food items or food groups, rather than an overall view of dietary quality, and mainly on bitterness. Thus it is unclear whether taste perception is associated with dietary quality in children. Our objective was to examine the link between taste perception, dietary quality and body weight in Irish school children, in conjunction with other known influences of body weight. Taste perception was measured using the gLMS for bitter, salty and sweet stimuli. Detailed dietary intake data were collected from 525 children aged 7-13 via a 3-day diet history. Energy misreporters were identified and excluded from the dietary analyses, leaving n = 483 children. Dietary quality was assessed using Healthy Eating Index. Salivary DNA was collected and analyzed for variations in the bitter receptor gene TAS2R38. Sex differences were observed whereby intensity perception of sweetness was lower in the overweight/obese males, while no association was observed for sweet taste in the females. Despite the differences in weight status, taste perception was not associated with differences in overall dietary quality, measured via HEI score, in this cohort. Prospective cohort studies in children are necessary to better understand the association between taste intensity, food intake and weight over time. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of e-learning on quality of cervical-length measurements.

PubMed

van Os, M A; van der Ven, A J; Bloemendaal, P M; Pajkrt, E; de Groot, C J M; Mol, B W J; Haak, M C

2015-09-01

To assess the effect of implementation of a newly developed e-learning module on the quality of cervical-length measurements. With the introduction of cervical-length (CL) measurement in a research setting, a CL measurement e-learning module (CLEM) was developed with the purpose to enhance the knowledge and skills of experienced ultrasonographers. CLEM was designed specifically for ultrasonographers who perform ultrasound in a general obstetrical practice but who do not regularly perform CL measurements. CLEM consists of five theoretical questions and three caliper-placement tests to learn the CL measurement technique. The quality of the CL measurements of CLEM participants was compared with images of non-participants using a CL measurement image score (CIS), defined as the sum of six items which assess the quality of the image. Each CLEM participant submitted five CL images and the images of non-CLEM participants were selected randomly from an ultrasound database. The CIS of the CLEM participants (n = 61) were significantly higher than those of non-CLEM participants (n = 23) (164.9 vs 155.6, respectively; P = 0.03). Visualization of the internal os and positioning of the calipers on the internal and external ora were found to have significantly higher CIS among the CLEM participants than among the non-CLEM participants (P = 0.001 and P < 0.001, respectively). Introducing CLEM may improve the quality of CL measurements obtained by trained and untrained sonographers. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Benchmarking strategies for measuring the quality of healthcare: problems and prospects.

PubMed

Lovaglio, Pietro Giorgio

2012-01-01

Over the last few years, increasing attention has been directed toward the problems inherent to measuring the quality of healthcare and implementing benchmarking strategies. Besides offering accreditation and certification processes, recent approaches measure the performance of healthcare institutions in order to evaluate their effectiveness, defined as the capacity to provide treatment that modifies and improves the patient's state of health. This paper, dealing with hospital effectiveness, focuses on research methods for effectiveness analyses within a strategy comparing different healthcare institutions. The paper, after having introduced readers to the principle debates on benchmarking strategies, which depend on the perspective and type of indicators used, focuses on the methodological problems related to performing consistent benchmarking analyses. Particularly, statistical methods suitable for controlling case-mix, analyzing aggregate data, rare events, and continuous outcomes measured with error are examined. Specific challenges of benchmarking strategies, such as the risk of risk adjustment (case-mix fallacy, underreporting, risk of comparing noncomparable hospitals), selection bias, and possible strategies for the development of consistent benchmarking analyses, are discussed. Finally, to demonstrate the feasibility of the illustrated benchmarking strategies, an application focused on determining regional benchmarks for patient satisfaction (using 2009 Lombardy Region Patient Satisfaction Questionnaire) is proposed.

A standard for measuring metadata quality in spectral libraries

NASA Astrophysics Data System (ADS)

Rasaiah, B.; Jones, S. D.; Bellman, C.

2013-12-01

A standard for measuring metadata quality in spectral libraries Barbara Rasaiah, Simon Jones, Chris Bellman RMIT University Melbourne, Australia barbara.rasaiah@rmit.edu.au, simon.jones@rmit.edu.au, chris.bellman@rmit.edu.au ABSTRACT There is an urgent need within the international remote sensing community to establish a metadata standard for field spectroscopy that ensures high quality, interoperable metadata sets that can be archived and shared efficiently within Earth observation data sharing systems. Metadata are an important component in the cataloguing and analysis of in situ spectroscopy datasets because of their central role in identifying and quantifying the quality and reliability of spectral data and the products derived from them. This paper presents approaches to measuring metadata completeness and quality in spectral libraries to determine reliability, interoperability, and re-useability of a dataset. Explored are quality parameters that meet the unique requirements of in situ spectroscopy datasets, across many campaigns. Examined are the challenges presented by ensuring that data creators, owners, and data users ensure a high level of data integrity throughout the lifecycle of a dataset. Issues such as field measurement methods, instrument calibration, and data representativeness are investigated. The proposed metadata standard incorporates expert recommendations that include metadata protocols critical to all campaigns, and those that are restricted to campaigns for specific target measurements. The implication of semantics and syntax for a robust and flexible metadata standard are also considered. Approaches towards an operational and logistically viable implementation of a quality standard are discussed. This paper also proposes a way forward for adapting and enhancing current geospatial metadata standards to the unique requirements of field spectroscopy metadata quality. [0430] BIOGEOSCIENCES / Computational methods and data processing [0480

The quality of systematic reviews of health-related outcome measurement instruments.

PubMed

Terwee, C B; Prinsen, C A C; Ricci Garotti, M G; Suman, A; de Vet, H C W; Mokkink, L B

2016-04-01

Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.

The Development of Quality Measures for the Performance and Interpretation of Esophageal Manometry

PubMed Central

Yadlapati, Rena; Gawron, Andrew J.; Keswani, Rajesh N.; Bilimoria, Karl; Castell, Donald O.; Dunbar, Kerry B.; Gyawali, Chandra P.; Jobe, Blair A.; Katz, Philip O.; Katzka, David A.; Lacy, Brian E.; Massey, Benson T.; Richter, Joel E.; Schnoll-Sussman, Felice; Spechler, Stuart J.; Tatum, Roger; Vela, Marcelo F.; Pandolfino, John E.

2016-01-01

Background and Aims Esophageal manometry (EM) is the gold standard for the diagnosis of esophageal motility disorders. Variations in the performance and interpretation of EM result in discrepant diagnoses and unnecessary repeated procedures, and may negatively impact patient outcomes. A method to benchmark the procedural quality of EM is needed. The primary aim of this study was to develop quality measures for performing and interpreting EM. Methods The RAND/University of California, Los Angeles Appropriateness Methodology (RAM) was utilized. Fifteen experts in esophageal manometry were invited to be a part of the panel. Potential quality measures were identified through a literature search and interviews with experts. The expert panel ranked the proposed quality measures for appropriateness via a two-round process on the basis of RAM. Results Fourteen experts participated in all processes. A total of 29 measures were considered; 17 of these measures were ranked as appropriate and related to competency (2), pre-procedure (2), procedure (3) and interpretation (10). The latter 10 were integrated into a single composite measure. Thus, 8 final measures were determined to be appropriate quality measures for EM. Five strong recommendations were also endorsed by the experts, however they were not ranked as appropriate quality measures. Conclusions Eight formally validated quality measures for the performance and interpretation of EM were developed on the basis of RAM. These measures represent key aspects of a high-quality EM study and should be uniformly adopted. Evaluation of these measures in clinical practice is needed to assess their impact on outcomes. PMID:26499925

The Role of Measurement Quality on Practical Guidelines for Assessing Measurement and Structural Invariance

ERIC Educational Resources Information Center

Kang, Yoonjeong; McNeish, Daniel M.; Hancock, Gregory R.

2016-01-01

Although differences in goodness-of-fit indices (?GOFs) have been advocated for assessing measurement invariance, studies that advanced recommended differential cutoffs for adjudicating invariance actually utilized a very limited range of values representing the quality of indicator variables (i.e., magnitude of loadings). Because quality of…

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…

CAN RAPID MEASURES OF RECREATIONAL WATER QUALITY PREDICT SWIMMING ASSOCIATED GASTROINTESTINAL ILLNESS?

EPA Science Inventory

Standard methods to measure recreational water quality require at least 24 hours to obtain results making it impossible to assess the quality of water within a single day. Methods to measure recreational water quality in two hours or less have been developed. Application of rapid...

Identifying Measures Used for Assessing Quality of YouTube Videos with Patient Health Information: A Review of Current Literature.

PubMed

Gabarron, Elia; Fernandez-Luque, Luis; Armayones, Manuel; Lau, Annie Ys

2013-02-28

Recent publications on YouTube have advocated its potential for patient education. However, a reliable description of what could be considered quality information for patient education on YouTube is missing. To identify topics associated with the concept of quality information for patient education on YouTube in the scientific literature. A literature review was performed in MEDLINE, ISI Web of Knowledge, Scopus, and PsychINFO. Abstract selection was first conducted by two independent reviewers; discrepancies were discussed in a second abstract review with two additional independent reviewers. Full text of selected papers were analyzed looking for concepts, definitions, and topics used by its authors that focused on the quality of information on YouTube for patient education. In total, 456 abstracts were extracted and 13 papers meeting eligibility criteria were analyzed. Concepts identified related to quality of information for patient education are categorized as expert-driven, popularity-driven, or heuristic-driven measures. These include (in descending order): (1) quality of content in 10/13 (77%), (2) view count in 9/13 (69%), (3) health professional opinion in 8/13 (62%), (4) adequate length or duration in 6/13 (46%), (5) public ratings in 5/13 (39%), (6) adequate title, tags, and description in 5/13 (39%), (7) good description or a comprehensive narrative in 4/13 (31%), (8) evidence-based practices included in video in 4/13 (31%), (9) suitability as a teaching tool in 4/13 (31%), (10) technical quality in 4/13 (31%), (11) credentials provided in video in 4/13 (31%), (12) enough amount of content to identify its objective in 3/13 (23%), and (13) viewership share in 2/13 (15%). Our review confirms that the current topics linked to quality of information for patient education on YouTube are unclear and not standardized. Although expert-driven, popularity-driven, or heuristic-driven measures are used as proxies to estimate the quality of video information

Identifying Measures Used for Assessing Quality of YouTube Videos with Patient Health Information: A Review of Current Literature

PubMed Central

Fernandez-Luque, Luis; Armayones, Manuel; Lau, Annie YS

2013-01-01

Background Recent publications on YouTube have advocated its potential for patient education. However, a reliable description of what could be considered quality information for patient education on YouTube is missing. Objective To identify topics associated with the concept of quality information for patient education on YouTube in the scientific literature. Methods A literature review was performed in MEDLINE, ISI Web of Knowledge, Scopus, and PsychINFO. Abstract selection was first conducted by two independent reviewers; discrepancies were discussed in a second abstract review with two additional independent reviewers. Full text of selected papers were analyzed looking for concepts, definitions, and topics used by its authors that focused on the quality of information on YouTube for patient education. Results In total, 456 abstracts were extracted and 13 papers meeting eligibility criteria were analyzed. Concepts identified related to quality of information for patient education are categorized as expert-driven, popularity-driven, or heuristic-driven measures. These include (in descending order): (1) quality of content in 10/13 (77%), (2) view count in 9/13 (69%), (3) health professional opinion in 8/13 (62%), (4) adequate length or duration in 6/13 (46%), (5) public ratings in 5/13 (39%), (6) adequate title, tags, and description in 5/13 (39%), (7) good description or a comprehensive narrative in 4/13 (31%), (8) evidence-based practices included in video in 4/13 (31%), (9) suitability as a teaching tool in 4/13 (31%), (10) technical quality in 4/13 (31%), (11) credentials provided in video in 4/13 (31%), (12) enough amount of content to identify its objective in 3/13 (23%), and (13) viewership share in 2/13 (15%). Conclusions Our review confirms that the current topics linked to quality of information for patient education on YouTube are unclear and not standardized. Although expert-driven, popularity-driven, or heuristic-driven measures are used as proxies to

Measuring and Costing Quality in Education: Using Quality and Productivity Methods To Improve Schools.

ERIC Educational Resources Information Center

Spanbauer, Stanley J.

The Measurement and Costing Model (MCM) described in this book was developed and tested at Fox Valley Technical College (FVTC), Wisconsin, to enhance the college's quality improvement process and to serve as a guide to other institutions interested in improving their quality. The book presents a description of the model and outlines seven steps…

Optical steam quality measurement system and method

DOEpatents

Davidson, James R.; Partin, Judy K.

2006-04-25

An optical measurement system is presented that offers precision on-line monitoring of the quality of steam. Multiple wavelengths of radiant energy are passed through the steam from an emitter to a detector. By comparing the amount of radiant energy absorbed by the flow of steam for each wavelength, a highly accurate measurement of the steam quality can be determined on a continuous basis in real-time. In an embodiment of the present invention, the emitter, comprises three separate radiant energy sources for transmitting specific wavelengths of radiant energy through the steam. In a further embodiment, the wavelengths of radiant energy are combined into a single beam of radiant energy for transmission through the steam using time or wavelength division multiplexing. In yet a further embodiment, the single beam of radiant energy is transmitted using specialized optical elements.

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

On-line hydrogen-isotope measurements of organic samples using elemental chromium: An extension for high temperature elemental-analyzer techniques

USGS Publications Warehouse

Gehre, Matthias; Renpenning, Julian; Gilevska, Tetyana; Qi, Haiping; Coplen, Tyler B.; Meijer, Harro A.J.; Brand, Willi A.; Schimmelmann, Arndt

2015-01-01

The high temperature conversion (HTC) technique using an elemental analyzer with a glassy carbon tube and filling (temperature conversion/elemental analysis, TC/EA) is a widely used method for hydrogen isotopic analysis of water and many solid and liquid organic samples with analysis by isotope-ratio mass spectrometry (IRMS). However, the TC/EA IRMS method may produce inaccurate δ2H results, with values deviating by more than 20 mUr (milliurey = 0.001 = 1‰) from the true value for some materials. We show that a single-oven, chromium-filled elemental analyzer coupled to an IRMS substantially improves the measurement quality and reliability for hydrogen isotopic compositions of organic substances (Cr-EA method). Hot chromium maximizes the yield of molecular hydrogen in a helium carrier gas by irreversibly and quantitatively scavenging all reactive elements except hydrogen. In contrast, under TC/EA conditions, heteroelements like nitrogen or chlorine (and other halogens) can form hydrogen cyanide (HCN) or hydrogen chloride (HCl) and this can cause isotopic fractionation. The Cr-EA technique thus expands the analytical possibilities for on-line hydrogen-isotope measurements of organic samples significantly. This method yielded reproducibility values (1-sigma) for δ2H measurements on water and caffeine samples of better than 1.0 and 0.5 mUr, respectively. To overcome handling problems with water as the principal calibration anchor for hydrogen isotopic measurements, we have employed an effective and simple strategy using reference waters or other liquids sealed in silver-tube segments. These crimped silver tubes can be employed in both the Cr-EA and TC/EA techniques. They simplify considerably the normalization of hydrogen-isotope measurement data to the VSMOW-SLAP (Vienna Standard Mean Ocean Water-Standard Light Antarctic Precipitation) scale, and their use improves accuracy of the data by eliminating evaporative loss and associated isotopic fractionation while

Diffractive interference optical analyzer (DiOPTER)

NASA Astrophysics Data System (ADS)

Sasikumar, Harish; Prasad, Vishnu; Pal, Parama; Varma, Manoj M.

2016-03-01

This report demonstrates a method for high-resolution refractometric measurements using, what we have termed as, a Diffractive Interference Optical Analyzer (DiOpter). The setup consists of a laser, polarizer, a transparent diffraction grating and Si-photodetectors. The sensor is based on the differential response of diffracted orders to bulk refractive index changes. In these setups, the differential read-out of the diffracted orders suppresses signal drifts and enables time-resolved determination of refractive index changes in the sample cell. A remarkable feature of this device is that under appropriate conditions, the measurement sensitivity of the sensor can be enhanced by more than two orders of magnitude due to interference between multiply reflected diffracted orders. A noise-equivalent limit of detection (LoD) of 6x10-7 RIU was achieved in glass. This work focuses on devices with integrated sample well, made on low-cost PDMS. As the detection methodology is experimentally straightforward, it can be used across a wide array of applications, ranging from detecting changes in surface adsorbates via binding reactions to estimating refractive index (and hence concentration) variations in bulk samples. An exciting prospect of this technique is the potential integration of this device to smartphones using a simple interface based on transmission mode configuration. In a transmission configuration, we were able to achieve an LoD of 4x10-4 RIU which is sufficient to explore several applications in food quality testing and related fields. We are envisioning the future of this platform as a personal handheld optical analyzer for applications ranging from environmental sensing to healthcare and quality testing of food products.

Use of an acoustic helium analyzer for measuring lung volumes.

PubMed

Krumpe, P E; MacDannald, H J; Finley, T N; Schear, H E; Hall, J; Cribbs, D

1981-01-01

We have evaluated the use of an acoustic gas analyzer (AGA) for the measurement of total lung capacity (TLC) by single-breath helium dilution. The AGA has a rapid response time (0-90% response = 160 ms for 10% He), is linear for helium concentration of 0.1-10%, is stable over a wide range of ambient temperatures, and is small and portable. We plotted the output of the AGA vs. expired lung volume after a vital capacity breath of 10% He. However, since the AGA is sensitive to changes in speed of sound relative to air, the AGA output signal also reports an artifact due to alveolar gases. We corrected for this artifact by replotting a single-breath expiration after a vital capacity breath of room air. Mean alveolar helium concentration (HeA) was then measured by planimetry, using this alveolar gas curve as the base line. TLC was calculated using the HeA from the corrected AGA output and compared with TLC calculated from HeA simultaneously measured using a mass spectrometer (MS). In 12 normal subjects and 9 patients with chronic obstructive pulmonary disease (COPD) TLC-AGA and TLC-MS were compared by linear regression analysis; correlation coefficient (r) was 0.973 for normals and 0.968 for COPD patients (P less than 0.001). This single-breath; estimation of TLC using the corrected signal of the AGA vs. Expired volume seems ideally suited for the measurement of subdivisions of lung volume in field studies.

NOTE: Measuring oxidative gelation of aqueous flour suspensions using the Rapid Visco Analyzer

USDA-ARS?s Scientific Manuscript database

The Rapid Visco Analyzer (RVA) was investigated as a tool to measure oxidative gelation capacity (OGC) of aqueous wheat-flour suspensions. One, club-wheat patent flour was used to determine optimal hydration time and 33 straight-grade flours (representing 12 hard and 31 soft varieties) were used to ...

Field and Laboratory Measurements of Carbon Dioxide Mixing Ratios in Air Using the LI-COR LI-7000 CO2/H2O Analyzer

NASA Astrophysics Data System (ADS)

Murphy, P. C.; Lerner, B. M.; Williams, E. J.

2003-12-01

Air measurements of CO2 were made with a LI-COR LI-7000 CO2/H2O analyzer on the NOAA ship Ronald H. Brown during the New England Air Quality Study (NEAQS 2002) field campaign. This instrument is an improved version of the older model LI-6262 CO2/H2O analyzer, which uses a non-dispersive IR radiation absorption technique. During NEAQS, we operated the LI-7000 without temperature regulation, using a simple 2-point calibration scheme. An intercomparison between our measurements of atmospheric CO2 mixing ratios and those measured by a more sophisticated method, using temperature-regulation and a multipoint calibration with a LI-6252 CO2 analyzer (operated by AOML) shows generally good results ([CO2]AL = [CO2]AOML x 1.015 (0.010) - 5.7 (3.8) ppmv; R2 = 0.9889) in highly variable air masses. During subsequent laboratory studies, we evaluated the instrument for the manufacturer's claims of improvement in signal noise, sample gas temperature equilibration and zero drift with temperature. Further work examined the instrument's susceptibility to rapid temperature changes, which has been previously demonstrated to introduce error of several ppmv ° C-1 in the LI-6252. A change in the LI-7000 optical bench temperature of 12 ° C in 1 hour caused a sampling error of ˜3 ppmv CO2. Therefore, our lab investigations indicate that the LI-7000 would benefit from a temperature-controlled enclosure, as is used by the AOML group.

Measuring the Multifaceted Nature of Infant and Toddler Care Quality

ERIC Educational Resources Information Center

Mangione, Peter L.; Kriener-Althen, Kerry; Marcella, Jennifer

2016-01-01

Research Findings: The quality of group care infants and toddlers experience relates to their concurrent and later development. Recent quality improvement initiatives point to the need for ecologically valid measures that assess the multifaceted nature of child care quality. In this article, we present the psychometric properties of an infant and…

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).

A comparison of video review and feedback device measurement of chest compressions quality during pediatric cardiopulmonary resuscitation.

PubMed

Hsieh, Ting-Chang; Wolfe, Heather; Sutton, Robert; Myers, Sage; Nadkarni, Vinay; Donoghue, Aaron

2015-08-01

To describe chest compression (CC) rate, depth, and leaning during pediatric cardiopulmonary resuscitation (CPR) as measured by two simultaneous methods, and to assess the accuracy and reliability of video review in measuring CC quality. Resuscitations in a pediatric emergency department are videorecorded for quality improvement. Patients aged 8-18 years receiving CPR under videorecording were eligible for inclusion. CPR was recorded by a pressure/accelerometer feedback device and tabulated in 30-s epochs of uninterrupted CC. Investigators reviewed videorecorded CPR and measured rate, depth, and release by observation. Raters categorized epochs as 'meeting criteria' if 80% of CCs in an epoch were done with appropriate depth (>45 mm) and/or release (<2.5 kg leaning). Comparison between device measurement and video was made by Spearman's ρ for rate and by κ statistic for depth and release. Interrater reliability for depth and release was measured by κ statistic. Five patients underwent videorecorded CPR using the feedback device. 97 30-s epochs of CCs were analyzed. CCs met criteria for rate in 74/97 (76%) of epochs; depth in 38/97 (39%); release in 82/97 (84%). Agreement between video and feedback device for rate was good (ρ = 0.77); agreement was poor for depth and release (κ 0.04-0.41). Interrater reliability for depth and release measured by video was poor (κ 0.04-0.49). Video review measured CC rate accurately; depth and release were not reliably or accurately assessed by video. Future research should focus on the optimal combination of methods for measuring CPR quality. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

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

Measuring Teaching Quality in Several European Countries

ERIC Educational Resources Information Center

van de Grift, Wim J. C. M.

2014-01-01

Teaching quality has been observed in large representative samples from Flanders (Belgium), Lower Saxony (Germany), the Slovak Republic, and The Netherlands. This study reveals that measures of "creating a safe and stimulating climate", "clear and activating instruction", and "teaching learning strategies" were…

Overview: Measuring Early Learning Quality and Outcomes (MELQO)

ERIC Educational Resources Information Center

Brookings Institution, 2017

2017-01-01

The Measuring Early Learning Quality and Outcomes (MELQO) initiative began in 2014 in anticipation of a new global emphasis on early childhood development (ECD). Led by UNESCO, the World Bank, the Center for Universal Education at the Brookings Institution, and UNICEF, the initiative aims to promote feasible, accurate and useful measurement of…

Measuring Infiltration Rates in Homes as a Basis for Understanding Indoor Air Quality

NASA Astrophysics Data System (ADS)

Jerz, G. G.; Lamb, B. K.; Pressley, S. N.; O'Keeffe, P.; Fuchs, M.; Kirk, M.

2015-12-01

Infiltration rates, or the rate of air exchange, of houses are important to understand because ventilation can be a dominate factor in determining indoor air quality. There are chemicals that are emitted from surfaces or point sources inside the home which are harmful to humans; these chemicals come from various objects including furniture, cleaning supplies, building materials, gas stoves, and the surrounding environment. The use of proper ventilation to cycle cleaner outdoor air into the house can be crucial for maintaining healthy living conditions in the home. At the same time, there can also be outdoor pollutants which infiltrate the house and contribute to poor indoor air quality. In either case, it is important to determine infiltration rates as a function of outdoor weather conditions, the house structure properties and indoor heating and cooling systems. In this work, the objective is to measure ventilation rates using periodic releases of a tracer gas and measuring how quickly the tracer concentration decays. CO2 will be used as the tracer gas because it is inert and harmless at low levels. An Arduino timer is connected to a release valve which controls the release of 9.00 SLPM of CO2 into the uptake vent within the test home. CO2 will be released until there is at least a 200 to 300 ppm increase above ambient indoor levels. Computers with CO2 sensors and temperature/pressure sensors attached will be used to record data from different locations within the home which will continuously record data up to a week. The results from these periodic ventilation measurements will be analyzed with respect to outdoor wind and temperature conditions and house structure properties. The data will be used to evaluate an established indoor air quality model.

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

Implementation of Quality Assurance and Quality Control Measures in the National Phenology Database

NASA Astrophysics Data System (ADS)

Gerst, K.; Rosemartin, A.; Denny, E. G.; Marsh, L.; Barnett, L.

2015-12-01

The USA National Phenology Network (USA-NPN; www.usanpn.org) serves science and society by promoting a broad understanding of plant and animal phenology and the relationships among phenological patterns and environmental change. The National Phenology Database has over 5.5 million observation records for plants and animals for the period 1954-2015. These data have been used in a number of science, conservation and resource management applications, including national assessments of historical and potential future trends in phenology, regional assessments of spatio-temporal variation in organismal activity, and local monitoring for invasive species detection. Customizable data downloads are freely available, and data are accompanied by FGDC-compliant metadata, data-use and data-attribution policies, and vetted documented methodologies and protocols. The USA-NPN has implemented a number of measures to ensure both quality assurance and quality control. Here we describe the resources that have been developed so that incoming data submitted by both citizen and professional scientists are reliable; these include training materials, such as a botanical primer and species profiles. We also describe a number of automated quality control processes applied to incoming data streams to optimize data output quality. Existing and planned quality control measures for output of raw and derived data include: (1) Validation of site locations, including latitude, longitude, and elevation; (2) Flagging of records that conflict for a given date for an individual plant; (3) Flagging where species occur outside known ranges; (4) Flagging of records when phenophases occur outside of the plausible order for a species; (5) Flagging of records when intensity measures do not follow a plausible progression for a phenophase; (6) Flagging of records when a phenophase occurs outside of the plausible season, and (7) Quantification of precision and uncertainty for estimation of phenological metrics

Air quality measurements-From rubber bands to tapping the rainbow.

PubMed

Hidy, George M; Mueller, Peter K; Altshuler, Samuel L; Chow, Judith C; Watson, John G

2017-06-01

It is axiomatic that good measurements are integral to good public policy for environmental protection. The generalized term for "measurements" includes sampling and quantitation, data integrity, documentation, network design, sponsorship, operations, archiving, and accessing for applications. Each of these components has evolved and advanced over the last 200 years as knowledge of atmospheric chemistry and physics has matured. Air quality was first detected by what people could see and smell in contaminated air. Gaseous pollutants were found to react with certain materials or chemicals, changing the color of dissolved reagents such that their light absorption at selected wavelengths could be related to both the pollutant chemistry and its concentration. Airborne particles have challenged the development of a variety of sensory devices and laboratory assays for characterization of their enormous range of physical and chemical properties. Advanced electronics made possible the sampling, concentration, and detection of gases and particles, both in situ and in laboratory analysis of collected samples. Accurate and precise measurements by these methods have made possible advanced air quality management practices that led to decreasing concentrations over time. New technologies are leading to smaller and cheaper measurement systems that can further expand and enhance current air pollution monitoring networks. Ambient air quality measurement systems have a large influence on air quality management by determining compliance, tracking trends, elucidating pollutant transport and transformation, and relating concentrations to adverse effects. These systems consist of more than just instrumentation, and involve extensive support efforts for siting, maintenance, calibration, auditing, data validation, data management and access, and data interpretation. These requirements have largely been attained for criteria pollutants regulated by National Ambient Air Quality Standards

Navigating in the turbulent sea of data: the quality measurement journey.

PubMed

Lloyd, Robert C

2010-03-01

This article provides a roadmap for your quality measurement journey. It begins with a discussion of 3 approaches to measurement (improvement, accountability and research) and challenges readers to be clear about why they are measuring. Key milestones along the quality measurement journey are then presented and a framework for selecting measures, developing clear operational definitions, building data collection plans, and understanding the variation that exists in data is outlined. The article ends with a discussion of why data need to be linked to improvement strategies. Copyright 2010 Elsevier Inc. All rights reserved.

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

Measures and Indicators of Vgi Quality: AN Overview

NASA Astrophysics Data System (ADS)

Antoniou, V.; Skopeliti, A.

2015-08-01

The evaluation of VGI quality has been a very interesting and popular issue amongst academics and researchers. Various metrics and indicators have been proposed for evaluating VGI quality elements. Various efforts have focused on the use of well-established methodologies for the evaluation of VGI quality elements against authoritative data. In this paper, a number of research papers have been reviewed and summarized in a detailed report on measures for each spatial data quality element. Emphasis is given on the methodology followed and the data used in order to assess and evaluate the quality of the VGI datasets. However, as the use of authoritative data is not always possible many researchers have turned their focus on the analysis of new quality indicators that can function as proxies for the understanding of VGI quality. In this paper, the difficulties in using authoritative datasets are briefly presented and new proposed quality indicators are discussed, as recorded through the literature review. We classify theses new indicators in four main categories that relate with: i) data, ii) demographics, iii) socio-economic situation and iv) contributors. This paper presents a dense, yet comprehensive overview of the research on this field and provides the basis for the ongoing academic effort to create a practical quality evaluation method through the use of appropriate quality indicators.

Crowding measures associated with the quality of emergency department care: a systematic review.

PubMed

Stang, Antonia S; Crotts, Jennifer; Johnson, David W; Hartling, Lisa; Guttmann, Astrid

2015-06-01

Despite the substantial body of literature on emergency department (ED) crowding, to the best of our knowledge, there is no agreement on the measure or measures that should be used to quantify crowding. The objective of this systematic review was to identify existing measures of ED crowding that have been linked to quality of care as defined by the Institute of Medicine (IOM) quality domains (safe, effective, patient-centered, efficient, timely, and equitable). Six major bibliographic databases were searched from January 1980 to January 2012, and hand searches were conducted of relevant journals and conference proceedings. Observational studies (cross-sectional, cohort, and case-control), quality improvement studies, quasi-experimental (e.g., before/after) studies, and randomized controlled trials were considered for inclusion. Studies that did not provide measures of ED crowding were excluded. Studies that did not provide quantitative data on the link between crowding measures and quality of care were also excluded. Two independent reviewers assessed study eligibility, completed data extraction, and assessed study quality using the Newcastle-Ottawa Quality Assessment Scale (NOS) for observational studies and a modified version of the NOS for cross-sectional studies. The search identified 7,413 articles. Thirty-two articles were included in the review: six cross-sectional, one case-control, 23 cohort, and two retrospective reviews of performance improvement data. Methodologic quality was moderate, with weaknesses in the reporting of study design and methodology. Overall, 15 of the crowding measures studied had quantifiable links to quality of care. The three measures most frequently linked to quality of care were the number of patients in the waiting room, ED occupancy (percentage of overall ED beds filled), and the number of admitted patients in the ED awaiting inpatient beds. None of the articles provided data on the link between crowding measures and the IOM

Next day discharge rate has little use as a quality measure for individual physician performance.

PubMed

Inabnit, Christopher; Markwell, Stephen; Gruwell, Jack; Jaeger, Cassie; Millburg, Lance; Griffen, David

2018-06-18

Emergency Department (ED) physicians' next day discharge rate (NDDR), the percentage of patients who were admitted from the ED and subsequently discharged within the next calendar day was hypothesized as a potential measure for unnecessary admissions. The objective was to determine if NDDR has validity as a measure for quality of individual ED physician performance. Hospital admission data was obtained for thirty-six ED physicians for calendar year 2015. Funnel plots were used to identify NDDR outliers beyond 95% control limits. A mixed model logistic regression was built to investigate factors contributing to NDDR. To determine yearly variation, data from calendar years 2014 and 2016 were analyzed, again by funnel plots and logistic regression. Intraclass correlation coefficient was used to estimate the percent of total variation in NDDR attributable to individual ED physicians. NDDR varied significantly among ED physicians. Individual ED physician outliers in NDDR varied year to year. Individual ED physician contribution to NDDR variation was minimal, accounting for 1%. Years of experience in Emergency Medicine practice was not correlated with NDDR. NDDR does not appear to be a reliable independent quality measure for individual ED physician performance. The percent of variance attributable to the ED physician was 1%. Copyright © 2018. Published by Elsevier Inc.

Benchmarking Strategies for Measuring the Quality of Healthcare: Problems and Prospects

PubMed Central

Lovaglio, Pietro Giorgio

2012-01-01

Over the last few years, increasing attention has been directed toward the problems inherent to measuring the quality of healthcare and implementing benchmarking strategies. Besides offering accreditation and certification processes, recent approaches measure the performance of healthcare institutions in order to evaluate their effectiveness, defined as the capacity to provide treatment that modifies and improves the patient's state of health. This paper, dealing with hospital effectiveness, focuses on research methods for effectiveness analyses within a strategy comparing different healthcare institutions. The paper, after having introduced readers to the principle debates on benchmarking strategies, which depend on the perspective and type of indicators used, focuses on the methodological problems related to performing consistent benchmarking analyses. Particularly, statistical methods suitable for controlling case-mix, analyzing aggregate data, rare events, and continuous outcomes measured with error are examined. Specific challenges of benchmarking strategies, such as the risk of risk adjustment (case-mix fallacy, underreporting, risk of comparing noncomparable hospitals), selection bias, and possible strategies for the development of consistent benchmarking analyses, are discussed. Finally, to demonstrate the feasibility of the illustrated benchmarking strategies, an application focused on determining regional benchmarks for patient satisfaction (using 2009 Lombardy Region Patient Satisfaction Questionnaire) is proposed. PMID:22666140

Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review

PubMed Central

Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

2015-01-01

Introduction Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. Objective To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. Methods A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. Conclusions The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments. PMID:26151362

Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review.

PubMed

Cordier, Reinie; Speyer, Renée; Chen, Yu-Wei; Wilkes-Gillan, Sarah; Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

2015-01-01

Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

Uses and biases of volunteer water quality data

USGS Publications Warehouse

Loperfido, J.V.; Beyer, P.; Just, C.L.; Schnoor, J.L.

2010-01-01

State water quality monitoring has been augmented by volunteer monitoring programs throughout the United States. Although a significant effort has been put forth by volunteers, questions remain as to whether volunteer data are accurate and can be used by regulators. In this study, typical volunteer water quality measurements from laboratory and environmental samples in Iowa were analyzed for error and bias. Volunteer measurements of nitrate+nitrite were significantly lower (about 2-fold) than concentrations determined via standard methods in both laboratory-prepared and environmental samples. Total reactive phosphorus concentrations analyzed by volunteers were similar to measurements determined via standard methods in laboratory-prepared samples and environmental samples, but were statistically lower than the actual concentration in four of the five laboratory-prepared samples. Volunteer water quality measurements were successful in identifying and classifying most of the waters which violate United States Environmental Protection Agency recommended water quality criteria for total nitrogen (66%) and for total phosphorus (52%) with the accuracy improving when accounting for error and biases in the volunteer data. An understanding of the error and bias in volunteer water quality measurements can allow regulators to incorporate volunteer water quality data into total maximum daily load planning or state water quality reporting. ?? 2010 American Chemical Society.

[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.

Effects of Covariance Heterogeneity on Three Procedures for Analyzing Multivariate Repeated Measures Designs.

ERIC Educational Resources Information Center

Vallejo, Guillermo; Fidalgo, Angel; Fernandez, Paula

2001-01-01

Estimated empirical Type I error rate and power rate for three procedures for analyzing multivariate repeated measures designs: (1) the doubly multivariate model; (2) the Welch-James multivariate solution (H. Keselman, M. Carriere, a nd L. Lix, 1993); and (3) the multivariate version of the modified Brown-Forsythe procedure (M. Brown and A.…

[Quality concept in health care. Methodology for its measurement].

PubMed

Morera Guitart, J

2003-12-01

It is increasingly necessary that the neurologists achieve basic knowledgement in clinical management and medical care quality. We will review the concepts of medical care quality (MCQ). Of the definitions checked, we want to emphasize the following aspects. a) application of current scientific knowledge; b) interpersonal relationship; c) environment where the assistance is dispensed; d) results in health; e) cost of assistance; f) risks for the patient and g) patient satisfaction. For the analysis of the MCQ we could distinguish several components: scientific-technical component, efficacy, effectiveness, efficiency, accessibility, continuity, equity, appropriateness, and satisfaction of the patient and of the professional. One of the main objectives to measure the MCQ is to improve the assistance itself. For its measurement we can employ diverse methods depending on our objective: to improve the process, to do Benchmarking, to know the satisfaction of the patients or to guarantee the quality of the medical attention. The most used tools for this measurement are: establishment of criteria-indicator-standard for quality, elaboration of satisfaction questionnaires, interviews to key informant, analysis of complaints and claims of patients and professionals, and clinical audits. The role of the neurologist in the achievement of a high quality neurological attention if fundamental. Therefore, it is necessary some specific formation on: scientific and technical matter, communicative abilities, teamworking, management and organisation of tasks and pharmaco-economic evaluation, and a cultural change that involves every professional on the co-responsibility of the continuous improvement of the processes and of the results of his work, advancing gradually towards the excellence of medical assistance.

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 in the healthcare sector: new strategic measures for new challenges].

PubMed

Larroca, Norberto

2002-01-01

This article reviews the experience of the organizations representing the private healthcare industry in Argentina in their request to improve the quality of care. In it, the author highlights how their collaboration with the PAHO/WHO in the nineties led to the drafting of a Quality Accreditation Handbook, as well as its circulation in most of the countries in the area. Ten years on, the new challenges are analyzed in order to achieve better quality fro all, without limits. With these challenges in mind, the study presents the five programmes being developed at present, by the private health sector as a way of collaborating with society and the government in its progress towards the nationalization of resources and achieving a fairer system and better quality in healthcare.

Quality requirements for veterinary hematology analyzers in small animals-a survey about veterinary experts' requirements and objective evaluation of analyzer performance based on a meta-analysis of method validation studies: bench top hematology analyzer.

PubMed

Cook, Andrea M; Moritz, Andreas; Freeman, Kathleen P; Bauer, Natali

2016-09-01

Scarce information exists about quality requirements and objective evaluation of performance of large veterinary bench top hematology analyzers. The study was aimed at comparing the observed total error (TEobs ) derived from meta-analysis of published method validation data to the total allowable error (TEa ) for veterinary hematology variables in small animals based on experts' opinions. Ideally, TEobs should be < TEa . An online survey was sent to veterinary experts in clinical pathology and small animal internal medicine for providing the maximal allowable deviation from a given result for each variable. Percent of TEa = (allowable median deviation/clinical threshold) * 100%. Second, TEobs for 3 laser-based bench top hematology analyzers (ADVIA 2120; Sysmex XT2000iV, and CellDyn 3500) was calculated based on method validation studies published between 2005 and 2013 (n = 4). The percent TEobs = 2 * CV (%) + bias (%). The CV was derived from published studies except for the ADVIA 2120 (internal data), and bias was estimated from the regression equation. A total of 41 veterinary experts (19 diplomates, 8 residents, 10 postgraduate students, 4 anonymous specialists) responded. The proposed range of TEa was wide, but generally ≤ 20%. The TEobs was < TEa for all variables and analyzers except for canine and feline HGB (high bias, low CV) and platelet counts (high bias, high CV). Overall, veterinary bench top analyzers fulfilled experts' requirements except for HGB due to method-related bias, and platelet counts due to known preanalytic/analytic issues. © 2016 American Society for Veterinary Clinical Pathology.

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

Diabetes and Hypertension Quality Measurement in Four Safety-Net Sites

PubMed Central

Benkert, R.; Dennehy, P.; White, J.; Hamilton, A.; Tanner, C.

2014-01-01

Summary Background In this new era after the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, the literature on lessons learned with electronic health record (EHR) implementation needs to be revisited. Objectives Our objective was to describe what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics, specifically feasibility of data retrieval, measurements over time, quality of data, and how our teams used this data. Methods A cross-sectional study was conducted from October 2008 to October 2012 in four safety-net clinics located in the Midwest and Western United States. A data warehouse that stores data from across the U.S was utilized for data extraction from patients with diabetes or hypertension diagnoses and at least two office visits per year. Standard quality measures were collected over a period of two to four years. All sites were engaged in a partnership model with the IT staff and a shared learning process to enhance the use of the quality metrics. Results While use of the algorithms was feasible across sites, challenges occurred when attempting to use the query results for research purposes. There was wide variation of both process and outcome results by individual centers. Composite calculations balanced out the differences seen in the individual measures. Despite using consistent quality definitions, the differences across centers had an impact on numerators and denominators. All sites agreed to a partnership model of EHR implementation, and each center utilized the available resources of the partnership for Center-specific quality initiatives. Conclusions Utilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care

Financial incentives and measurement improved physicians' quality of care in the Philippines.

PubMed

Peabody, John; Shimkhada, Riti; Quimbo, Stella; Florentino, Jhiedon; Bacate, Marife; McCulloch, Charles E; Solon, Orville

2011-04-01

The merits of using financial incentives to improve clinical quality have much appeal, yet few studies have rigorously assessed the potential benefits. The uncertainty surrounding assessments of quality can lead to poor policy decisions, possibly resulting in increased cost with little or no quality improvement, or missed opportunities to improve care. We conducted an experiment involving physicians in thirty Philippine hospitals that overcomes many of the limitations of previous studies. We measured clinical performance and then examined whether modest bonuses equal to about 5 percent of a physician's salary, as well as system-level incentives that increased compensation to hospitals and across groups of physicians, led to improvements in the quality of care. We found that both the bonus and system-level incentives improved scores in a quality measurement system used in our study by ten percentage points. Our findings suggest that when careful measurement is combined with the types of incentives we studied, there may be a larger impact on quality than previously recognized.

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...

Analysis of measurement deviations for the patient-specific quality assurance using intensity-modulated spot-scanning particle beams

NASA Astrophysics Data System (ADS)

Li, Yongqiang; Hsi, Wen C.

2017-04-01

To analyze measurement deviations of patient-specific quality assurance (QA) using intensity-modulated spot-scanning particle beams, a commercial radiation dosimeter using 24 pinpoint ionization chambers was utilized. Before the clinical trial, validations of the radiation dosimeter and treatment planning system were conducted. During the clinical trial 165 measurements were performed on 36 enrolled patients. Two or three fields of particle beam were used for each patient. Measurements were typically performed with the dosimeter placed at special regions of dose distribution along depth and lateral profiles. In order to investigate the dosimeter accuracy, repeated measurements with uniform dose irradiations were also carried out. A two-step approach was proposed to analyze 24 sampling points over a 3D treatment volume. The mean value and the standard deviation of each measurement did not exceed 5% for all measurements performed on patients with various diseases. According to the defined intervention thresholds of mean deviation and the distance-to-agreement concept with a Gamma index analysis using criteria of 3.0% and 2 mm, a decision could be made regarding whether the dose distribution was acceptable for the patient. Based measurement results, deviation analysis was carried out. In this study, the dosimeter was used for dose verification and provided a safety guard to assure precise dose delivery of highly modulated particle therapy. Patient-specific QA will be investigated in future clinical operations.

Teaching Evaluation: A Critical Measure for Improving the Quality of Education

ERIC Educational Resources Information Center

Ji, Zhou

2009-01-01

In the coming period, the main task for China's higher education system is to improve the quality of education, and the key to improving the quality of education is to improve the quality of teaching. Teaching evaluations are a critical measure for improving the quality of teaching. The work of evaluating teaching at institutions of higher…

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.

Cumulative uncertainty in measured streamflow and water quality data for small watersheds

USGS Publications Warehouse

Harmel, R.D.; Cooper, R.J.; Slade, R.M.; Haney, R.L.; Arnold, J.G.

2006-01-01

The scientific community has not established an adequate understanding of the uncertainty inherent in measured water quality data, which is introduced by four procedural categories: streamflow measurement, sample collection, sample preservation/storage, and laboratory analysis. Although previous research has produced valuable information on relative differences in procedures within these categories, little information is available that compares the procedural categories or presents the cumulative uncertainty in resulting water quality data. As a result, quality control emphasis is often misdirected, and data uncertainty is typically either ignored or accounted for with an arbitrary margin of safety. Faced with the need for scientifically defensible estimates of data uncertainty to support water resource management, the objectives of this research were to: (1) compile selected published information on uncertainty related to measured streamflow and water quality data for small watersheds, (2) use a root mean square error propagation method to compare the uncertainty introduced by each procedural category, and (3) use the error propagation method to determine the cumulative probable uncertainty in measured streamflow, sediment, and nutrient data. Best case, typical, and worst case "data quality" scenarios were examined. Averaged across all constituents, the calculated cumulative probable uncertainty (??%) contributed under typical scenarios ranged from 6% to 19% for streamflow measurement, from 4% to 48% for sample collection, from 2% to 16% for sample preservation/storage, and from 5% to 21% for laboratory analysis. Under typical conditions, errors in storm loads ranged from 8% to 104% for dissolved nutrients, from 8% to 110% for total N and P, and from 7% to 53% for TSS. Results indicated that uncertainty can increase substantially under poor measurement conditions and limited quality control effort. This research provides introductory scientific estimates of

Measuring quality in maternal-newborn care: developing a clinical dashboard.

PubMed

Sprague, Ann E; Dunn, Sandra I; Fell, Deshayne B; Harrold, Joann; Walker, Mark C; Kelly, Sherrie; Smith, Graeme N

2013-01-01

Pregnancy, birth, and the early newborn period are times of high use of health care services. As well as opportunities for providing quality care, there are potential missed opportunities for health promotion, safety issues, and increased costs for the individual and the system when quality is not well defined or measured. There has been a need to identify key performance indicators (KPIs) to measure quality care within the provincial maternal-newborn system. We also wanted to provide automated audit and feedback about these KPIs to support quality improvement initiatives in a large Canadian province with approximately 140 000 births per year. We therefore worked to develop a maternal-newborn dashboard to increase awareness about selected KPIs and to inform and support hospitals and care providers about areas for quality improvement. We mapped maternal-newborn data elements to a quality domain framework, sought feedback via survey for the relevance and feasibility of change, and examined current data and the literature to assist in setting provincial benchmarks. Six clinical performance indicators of maternal-newborn quality care were identified and evidence-informed benchmarks were set. A maternal-newborn dashboard with "drill down" capacity for detailed analysis to enhance audit and feedback is now available for implementation. While audit and feedback does not guarantee individuals or institutions will make practice changes and move towards quality improvement, it is an important first step. Practice change and quality improvement will not occur without an awareness of the issues.

Measures of fidelity of delivery of, and engagement with, complex, face-to-face health behaviour change interventions: A systematic review of measure quality.

PubMed

Walton, Holly; Spector, Aimee; Tombor, Ildiko; Michie, Susan

2017-11-01

Understanding the effectiveness of complex, face-to-face health behaviour change interventions requires high-quality measures to assess fidelity of delivery and engagement. This systematic review aimed to (1) identify the types of measures used to monitor fidelity of delivery of, and engagement with, complex, face-to-face health behaviour change interventions and (2) describe the reporting of psychometric and implementation qualities. Electronic databases were searched, systematic reviews and reference lists were hand-searched, and 21 experts were contacted to identify articles. Studies that quantitatively measured fidelity of delivery of, and/or engagement with, a complex, face-to-face health behaviour change intervention for adults were included. Data on interventions, measures, and psychometric and implementation qualities were extracted and synthesized using narrative analysis. Sixty-six studies were included: 24 measured both fidelity of delivery and engagement, 20 measured fidelity of delivery, and 22 measured engagement. Measures of fidelity of delivery included observation (n = 17; 38.6%), self-report (n = 15; 34%), quantitatively rated qualitative interviews (n = 1; 2.3%), or multiple measures (n = 11; 25%). Measures of engagement included self-report (n = 18; 39.1%), intervention records (n = 11; 24%), or multiple measures (n = 17; 37%). Fifty-one studies (77%) reported at least one psychometric or implementation quality; 49 studies (74.2%) reported at least one psychometric quality, and 17 studies (25.8%) reported at least one implementation quality. Fewer than half of the reviewed studies measured both fidelity of delivery of, and engagement with complex, face-to-face health behaviour change interventions. More studies reported psychometric qualities than implementation qualities. Interpretation of intervention outcomes from fidelity of delivery and engagement measurements may be limited due to a lack of reporting of psychometric and

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 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

Behavioral System Feedback Measurement Failure: Sweeping Quality under the Rug

ERIC Educational Resources Information Center

Mihalic, Maria T.; Ludwig, Timothy D.

2009-01-01

Behavioral Systems rely on valid measurement systems to manage processes and feedback and to deliver contingencies. An examination of measurement system components designed to track customer service quality of furniture delivery drivers revealed the measurement system failed to capture information it was designed to measure. A reason for this…

Measuring ward round quality in urology.

PubMed

Darbyshire, Daniel; Barrett, Charlotte; Ross, David; Shackley, David

2015-01-01

Ward rounds are the traditional process by which clinical information is interpreted and management plans made in the inpatient setting and the only time during which patient-doctor interaction can reliably occur. Efforts to improve quality and safety have started looking at the ward round but this has mainly been in the acute medical setting. To begin the quality improvement process for Urological ward rounds. Twenty indicators thought to relate to quality were recorded for every weekday ward round by the Urology team for one month. Twenty ward rounds, 93 patient encounters, were reviewed. A consultant was present for 37% of the patient encounters. 84% of observation charts were reviewed; drug charts 28% and antibiotics 70%. Plans were communicated to the doctors, patient and nursing staff. All notes were typed directly onto the electronic system, 20% of notes were checked by the lead clinician. Mean time per patient was 6 minutes. By starting a discussion about ward rounds we aim to align the process with the broader values of the organisation. Ward rounds can be the cornerstone of delivering safe, clean and personal care and measuring this process is vital to understanding efforts to improve them.

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.

Image enhancement and quality measures for dietary assessment using mobile devices

NASA Astrophysics Data System (ADS)

Xu, Chang; Zhu, Fengqing; Khanna, Nitin; Boushey, Carol J.; Delp, Edward J.

2012-03-01

Measuring accurate dietary intake is considered to be an open research problem in the nutrition and health fields. We are developing a system, known as the mobile device food record (mdFR), to automatically identify and quantify foods and beverages consumed based on analyzing meal images captured with a mobile device. The mdFR makes use of a fiducial marker and other contextual information to calibrate the imaging system so that accurate amounts of food can be estimated from the scene. Food identification is a difficult problem since foods can dramatically vary in appearance. Such variations may arise not only from non-rigid deformations and intra-class variability in shape, texture, color and other visual properties, but also from changes in illumination and viewpoint. To address the color consistency problem, this paper describes illumination quality assessment methods implemented on a mobile device and three post color correction methods.

Image Enhancement and Quality Measures for Dietary Assessment Using Mobile Devices

PubMed Central

Xu, Chang; Zhu, Fengqing; Khanna, Nitin; Boushey, Carol J.; Delp, Edward J.

2016-01-01

Measuring accurate dietary intake is considered to be an open research problem in the nutrition and health fields. We are developing a system, known as the mobile device food record (mdFR), to automatically identify and quantify foods and beverages consumed based on analyzing meal images captured with a mobile device. The mdFR makes use of a fiducial marker and other contextual information to calibrate the imaging system so that accurate amounts of food can be estimated from the scene. Food identification is a difficult problem since foods can dramatically vary in appearance. Such variations may arise not only from non-rigid deformations and intra-class variability in shape, texture, color and other visual properties, but also from changes in illumination and viewpoint. To address the color consistency problem, this paper describes illumination quality assessment methods implemented on a mobile device and three post color correction methods. PMID:28572695

Analyzing power measurements of (d,/sup 2/He) reactions on light nuclei

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

Motobayashi, T.; Sakai, H.; Matsuoka, N.

1986-12-01

Spin-flip charge-exchange (d,/sup 2/He) reactions on /sup 12/C, /sup 13/C, and /sup 14/N were measured at E/sub d/ = 70 MeV. At forward angles, negative vector analyzing powers of -0.2 to -0.6 were observed for ..delta..L = 0 transitions for all targets studied, whereas a positive value was obtained for the transition to the 4.4 MeV excited state of /sup 12/B in the /sup 12/C(d,/sup 2/He) reaction for which ..delta..L = 1 is the main component. Distorted-wave Born-approximation calculations reproduce this ..delta..L dependence of the analyzing power. The fits to the data for ..delta..L = 0 transitions are improved ifmore » the two-step processes via d-p-/sup 2/He and d-/sup 3/He-/sup 2/He channels are taken into account.« less

Using laser-induced breakdown spectroscopy to assess preservation quality of archaeological bones by measurement of calcium-to-fluorine ratios.

PubMed

Rusak, David Alexander; Marsico, Ryan Matthew; Taroli, Brett Louis

2011-10-01

We determined calcium-to-fluorine (Ca/F) signal ratios at the surface and in the depth dimension in approximately 6000-year-old sheep and cattle bones using Ca I 671.8 and F I 685.6 emission lines. Because the bones had been previously analyzed for collagen preservation quality by measurement of C/N ratios at the Oxford Radiocarbon Accelerator Unit, we were able to examine the correlation between our ratios and quality of preservation. In the bones analyzed in this experiment, the Ca I 671.8/F I 685.6 ratio was generally lower and decreased with successive laser pulses into poorly preserved bones while the ratio was generally higher and increased with successive laser pulses into well-preserved bones. After 210 successive pulses, a discriminator value for this ratio (5.70) could be used to distinguish well-preserved and poorly preserved bones regardless of species. © 2011 Society for Applied Spectroscopy

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.

Measuring functional service quality using SERVQUAL in a high-dependence health service relationship.

PubMed

Clark, W Randy; Clark, Leigh Anne

2007-01-01

Although there is a growing concern about health care quality, little research has focused on how to measure quality in long-term care settings. In this article, we make the following observations: (1) most users of the SERVQUAL instrument reassess customers' expectations each time they measure quality perceptions; (2) long-term care relationships are likely to be ongoing, dependent relationships; (3) because of this dependence, customers in the long-term care setting are likely to reduce their expectations when faced with poor service quality; (4) by using this "settled" expectations level, service providers may make biased conclusions of quality improvements. We recommend various methods for overcoming or minimizing this "settling" effect and propose modifications to the SERVQUAL gap 5 measure to assess quality in a long-term care setting.

Characterization of Adipose Tissue Product Quality Using Measurements of Oxygen Consumption Rate.

PubMed

Suszynski, Thomas M; Sieber, David A; Mueller, Kathryn; Van Beek, Allen L; Cunningham, Bruce L; Kenkel, Jeffrey M

2018-03-14

Fat grafting is a common procedure in plastic surgery but associated with unpredictable graft retention. Adipose tissue (AT) "product" quality is affected by the methods used for harvest, processing and transfer, which vary widely amongst surgeons. Currently, there is no method available to accurately assess the quality of AT. In this study, we present a novel method for the assessment of AT product quality through direct measurements of oxygen consumption rate (OCR). OCR has exhibited potential in predicting outcomes following pancreatic islet transplant. Our study aim was to reapportion existing technology for its use with AT preparations and to confirm that these measurements are feasible. OCR was successfully measured for en bloc and postprocessed AT using a stirred microchamber system. OCR was then normalized to DNA content (OCR/DNA), which represents the AT product quality. Mean (±SE) OCR/DNA values for fresh en bloc and post-processed AT were 149.8 (± 9.1) and 61.1 (± 6.1) nmol/min/mg DNA, respectively. These preliminary data suggest that: (1) OCR and OCR/DNA measurements of AT harvested using conventional protocol are feasible; and (2) standard AT processing results in a decrease in overall AT product quality. OCR measurements of AT using existing technology can be done and enables accurate, real-time, quantitative assessment of the quality of AT product prior to transfer. The availability and further validation of this type of assay could enable optimization of fat grafting protocol by providing a tool for the more detailed study of procedural variables that affect AT product quality.

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 spanning the quality chasm: an examination of team functioning measures.

PubMed

Strasser, Dale C; Burridge, Andrea Backscheider; Falconer, Judith A; Uomoto, Jay M; Herrin, Jeph

2014-11-01

To examine the effect of 5 measures of team functioning on patient outcomes. Observational, exploratory, measurement. Team functioning surveys and patient outcomes collected 1 year apart in a clinical trial were analyzed. The findings are discussed in context of the domains of team functioning, team effectiveness, and quality improvement. 27 Veterans Affairs medical centers. Staff (t1: N=356; t2: N=273) on inpatient teams and patients (t1: N=4266; t2: N=3213) treated by the teams. Not applicable. Five measures of team functioning (Physician Engagement, Shared Leadership, Supervisor Team Support, Teamness, and Team Effectiveness scales) and 3 measures of patient outcomes (functional improvement, discharge destination, and length of stay) were assessed at 2 time points with hierarchical generalized linear models to evaluate the association between team functioning measures and changes in patient outcomes. Associations (P<.05) between team functioning measures and patient outcomes were found for 3 of the 15 analyses over the study period. Higher Physician Engagement scale score was associated with lower length of stay (P=.017), and increased scores on Teamness and Team Effectiveness scales correlated with higher rates of community discharge (P=.044 and .049, respectively). This exploratory analysis revealed trends that team functioning corresponds with patient outcomes in clinically relevant patterns. An increase in community discharge and a decrease in length of stay were associated with higher scores of team functioning. Here, we find evidence that modifiable attributes of team functioning have a measurable effect on patient outcomes. Such findings are promising and support the need for further research on team effectiveness. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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.

A preliminary quality of life questionnaire-bronchiectasis: a patient-reported outcome measure for bronchiectasis.

PubMed

Quittner, Alexandra L; Marciel, Kristen K; Salathe, Matthias A; O'Donnell, Anne E; Gotfried, Mark H; Ilowite, Jonathan S; Metersky, Mark L; Flume, Patrick A; Lewis, Sandra A; McKevitt, Matthew; Montgomery, A Bruce; O'Riordan, Thomas G; Barker, Alan F

2014-08-01

The Quality of Life Questionnaire-Bronchiectasis (QOL-B) is the first disease-specific, patient-reported outcome measure for patients with bronchiectasis. Content validity, cognitive testing, responsivity to open-label treatment, and psychometric analyses are presented. Reviews of literature, existing measures, and physician input were used to generate the initial QOL-B. Modifications following preliminary cognitive testing (N = 35 patients with bronchiectasis) generated version (V) 1.0. An open-ended patient interview study (N = 28) provided additional information and was content analyzed to derive saturation matrices, which summarized all disease-related topics mentioned by each participant. This resulted in QOL-B V2.0. Psychometric analyses were carried out using results from an open-label phase 2 trial, in which 89 patients were enrolled and treated with aztreonam for inhalation solution. Responsivity to open-label treatment was observed. Additional analyses generated QOL-B V3.0, with 37 items on eight scales: respiratory symptoms; physical, role, emotional, and social functioning; vitality; health perceptions; and treatment burden. For each scale, scores are standardized on a 0-to-100-point scale; higher scores indicate better health-related quality of life. No total score is calculated. A final cognitive testing study (N = 40) resulted in a minor change to one social functioning scale item (QOL-B V3.1). Content validity, cognitive testing, responsivity to open-label treatment, and initial psychometric analyses supported QOL-B items and structure. This interim QOL-B is a promising tool for evaluating the efficacy of new therapies for patients with bronchiectasis and for measuring symptoms, functioning, and quality of life in these patients on a routine basis. A final psychometric validation study is needed and is forthcoming. ClinicalTrials.gov; No.: NCT00805025; URL: www.clinicaltrials.gov.

Clinical quality is independently associated with favorable bond ratings.

PubMed

Haydar, Ziad; Nicewander, David; Convery, Paul; Black, Michael; Ballard, David

2010-01-01

The relation between clinical quality and bond rating for nonprofit hospitals has been proposed but never fully studied. We analyzed the relation between bond rating, clinical quality measures (The Joint Commission/Centers for Medicare and Medicaid Services [CMS] core measures), and balance sheet and income statement financial measures of 236 hospitals across the United States that are rated by Moody's Investors Service and that reported clinical quality measures to CMS during the study period. We found a statistically significant relation between higher quality measures and more favorable bond ratings. This association remained significant after controlling for traditional financial parameters.

Subjective Quality of Life Measures for Evaluating Medical Intervention.

ERIC Educational Resources Information Center

McCauley, Clark; Bremer, Barbara A.

1991-01-01

Evidence indicates that subjective quality-of-life scales developed by N. M. Bradburn (1969) and by A. Campbell, P. Converse, and W. Rodgers (1976) can be as sensitive as physiological measures in distinguishing among medical treatment groups. These scales can complement more objective measures of patient status. (SLD)

Comparing Alternative Instruments to Measure Service Quality in Higher Education

ERIC Educational Resources Information Center

Brochado, Ana

2009-01-01

Purpose: The purpose of this paper is to examine the performance of five alternative measures of service quality in the high education sector--service quality (SERVQUAL), importance-weighted SERVQUAL, service performance (SERVPERF), importance-weighted SERVPERF, and higher education performance (HEdPERF). Design/methodology/approach: Data were…

Comparison of laboratory and field remote sensing methods to measure forage quality.

PubMed

Guo, Xulin; Wilmshurst, John F; Li, Zhaoqin

2010-09-01

Recent research in range ecology has emphasized the importance of forage quality as a key indicator of rangeland condition. However, we lack tools to evaluate forage quality at scales appropriate for management. Using canopy reflectance data to measure forage quality has been conducted at both laboratory and field levels separately, but little work has been conducted to evaluate these methods simultaneously. The objective of this study is to find a reliable way of assessing grassland quality through measuring forage chemistry with reflectance. We studied a mixed grass ecosystem in Grasslands National Park of Canada and surrounding pastures, located in southern Saskatchewan. Spectral reflectance was collected at both in-situ field level and in the laboratory. Vegetation samples were collected at each site, sorted into the green grass portion, and then sent to a chemical company for measuring forage quality variables, including protein, lignin, ash, moisture at 135 °C, Neutral Detergent Fiber (NDF), Acid Detergent Fiber (ADF), Total Digestible, Digestible Energy, Net Energy for Lactation, Net Energy for Maintenance, and Net Energy for Gain. Reflectance data were processed with the first derivative transformation and continuum removal method. Correlation analysis was conducted on spectral and forage quality variables. A regression model was further built to investigate the possibility of using canopy spectral measurements to predict the grassland quality. Results indicated that field level prediction of protein of mixed grass species was possible (r² = 0.63). However, the relationship between canopy reflectance and the other forage quality variables was not strong.

Global Measurement of the Quality of Education: A Help to Developing Countries?

ERIC Educational Resources Information Center

Vedder, Paul

1994-01-01

Addresses the involvement of international interest groups in defining and determining educational quality in developing countries, suggesting that global measures of quality damage the educational systems of developing countries by creating feelings of isolation and inferiority. Suggests alternative measures which meet global standards and may be…

Measuring the quality of life in hypertension according to Item Response Theory

PubMed Central

Borges, José Wicto Pereira; Moreira, Thereza Maria Magalhães; Schmitt, Jeovani; de Andrade, Dalton Francisco; Barbetta, Pedro Alberto; de Souza, Ana Célia Caetano; Lima, Daniele Braz da Silva; Carvalho, Irialda Saboia

2017-01-01

ABSTRACT OBJECTIVE To analyze the Miniquestionário de Qualidade de Vida em Hipertensão Arterial (MINICHAL – Mini-questionnaire of Quality of Life in Hypertension) using the Item Response Theory. METHODS This is an analytical study conducted with 712 persons with hypertension treated in thirteen primary health care units of Fortaleza, State of Ceará, Brazil, in 2015. The steps of the analysis by the Item Response Theory were: evaluation of dimensionality, estimation of parameters of items, and construction of scale. The study of dimensionality was carried out on the polychoric correlation matrix and confirmatory factor analysis. To estimate the item parameters, we used the Gradual Response Model of Samejima. The analyses were conducted using the free software R with the aid of psych and mirt. RESULTS The analysis has allowed the visualization of item parameters and their individual contributions in the measurement of the latent trait, generating more information and allowing the construction of a scale with an interpretative model that demonstrates the evolution of the worsening of the quality of life in five levels. Regarding the item parameters, the items related to the somatic state have had a good performance, as they have presented better power to discriminate individuals with worse quality of life. The items related to mental state have been those which contributed with less psychometric data in the MINICHAL. CONCLUSIONS We conclude that the instrument is suitable for the identification of the worsening of the quality of life in hypertension. The analysis of the MINICHAL using the Item Response Theory has allowed us to identify new sides of this instrument that have not yet been addressed in previous studies. PMID:28492764

Analyzing the cost effectiveness of Santiago, Chile's policy of using urban forests to improve air quality.

PubMed

Escobedo, Francisco J; Wagner, John E; Nowak, David J; De la Maza, Carmen Luz; Rodriguez, Manuel; Crane, Daniel E

2008-01-01

Santiago, Chile has the distinction of having among the worst urban air pollution problems in Latin America. As part of an atmospheric pollution reduction plan, the Santiago Regional Metropolitan government defined an environmental policy goal of using urban forests to remove particulate matter less than 10 microm (PM(10)) in the Gran Santiago area. We used cost effectiveness, or the process of establishing costs and selecting least cost alternatives for obtaining a defined policy goal of PM(10) removal, to analyze this policy goal. For this study, we quantified PM(10) removal by Santiago's urban forests based on socioeconomic strata and using field and real-time pollution and climate data via a dry deposition urban forest effects model. Municipal urban forest management costs were estimated using management cost surveys and Chilean Ministry of Planning and Cooperation documents. Results indicate that managing municipal urban forests (trees, shrubs, and grass whose management is under the jurisdiction of Santiago's 36 municipalities) to remove PM(10) was a cost-effective policy for abating PM(10) based on criteria set by the World Bank. In addition, we compared the cost effectiveness of managing municipal urban forests and street trees to other control policies (e.g. alternative fuels) to abate PM(10) in Santiago and determined that municipal urban forest management efficiency was similar to these other air quality improvement measures.

Inferring random component distributions from environmental measurements for quality assurance

USDA-ARS?s Scientific Manuscript database

Environmental measurement programs can add value by providing not just accurate data, but also a measure of that accuracy. While quality assurance (QA) has been recognized as necessary since almost the beginning of automated weather measurement, it has received less attention than the data proper. M...

A Measure of Quality

ERIC Educational Resources Information Center

Environmental Science and Technology, 1976

1976-01-01

Recent national surveys conducted by the Council on Environmental Quality and others uncovered inconsistencies and confusion in the manner environmental quality parameters were used and reported. A standard air pollution index, comparative guide to water quality indicators and biological monitoring information are being developed. (BT)

Water quality parameter measurement using spectral signatures

NASA Technical Reports Server (NTRS)

White, P. E.

1973-01-01

Regression analysis is applied to the problem of measuring water quality parameters from remote sensing spectral signature data. The equations necessary to perform regression analysis are presented and methods of testing the strength and reliability of a regression are described. An efficient algorithm for selecting an optimal subset of the independent variables available for a regression is also presented.

QNOTE: an instrument for measuring the quality of EHR clinical notes.

PubMed

Burke, Harry B; Hoang, Albert; Becher, Dorothy; Fontelo, Paul; Liu, Fang; Stephens, Mark; Pangaro, Louis N; Sessums, Laura L; O'Malley, Patrick; Baxi, Nancy S; Bunt, Christopher W; Capaldi, Vincent F; Chen, Julie M; Cooper, Barbara A; Djuric, David A; Hodge, Joshua A; Kane, Shawn; Magee, Charles; Makary, Zizette R; Mallory, Renee M; Miller, Thomas; Saperstein, Adam; Servey, Jessica; Gimbel, Ronald W

2014-01-01

The outpatient clinical note documents the clinician's information collection, problem assessment, and patient management, yet there is currently no validated instrument to measure the quality of the electronic clinical note. This study evaluated the validity of the QNOTE instrument, which assesses 12 elements in the clinical note, for measuring the quality of clinical notes. It also compared its performance with a global instrument that assesses the clinical note as a whole. Retrospective multicenter blinded study of the clinical notes of 100 outpatients with type 2 diabetes mellitus who had been seen in clinic on at least three occasions. The 300 notes were rated by eight general internal medicine and eight family medicine practicing physicians. The QNOTE instrument scored the quality of the note as the sum of a set of 12 note element scores, and its inter-rater agreement was measured by the intraclass correlation coefficient. The Global instrument scored the note in its entirety, and its inter-rater agreement was measured by the Fleiss κ. The overall QNOTE inter-rater agreement was 0.82 (CI 0.80 to 0.84), and its note quality score was 65 (CI 64 to 66). The Global inter-rater agreement was 0.24 (CI 0.19 to 0.29), and its note quality score was 52 (CI 49 to 55). The QNOTE quality scores were consistent, and the overall QNOTE score was significantly higher than the overall Global score (p=0.04). We found the QNOTE to be a valid instrument for evaluating the quality of electronic clinical notes, and its performance was superior to that of the Global instrument. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

MEASUREMENT EQUIVALENCE OF NEIGHBORHOOD QUALITY MEASURES FOR EUROPEAN AMERICAN AND MEXICAN AMERICAN FAMILIES

PubMed Central

Kim, Su Yeong; Nair, Rajni; Knight, George P.; Roosa, Mark W.; Updegraff, Kimberly A.

2009-01-01

The factorial and construct equivalence of subscales assessing parents’ and children’s perceptions of the quality of their neighborhood was examined in Mexican American and European American families. All subscales (dangerous people in the neighborhood, sense of safety in the neighborhood, quality of the physical environment) demonstrated adequate partial factorial invariance across English- and Spanish-speaking Mexican American and European American families. Reports by children about dangerous people in the neighborhood was the closest to achieving strict factorial invariance, and the only one of the four dimensions to achieve invariance in the validity analyses across Mexican American and European American families. The implications of using these self-report neighborhood quality measures in studies of multiple cultural or language groups are discussed. PMID:19183709

[The measurement of data quality in censuses of population and housing].

PubMed

1980-01-01

The determination of data quality in population and housing censuses is discussed. Principal types of errors commonly found in census data are reviewed, and the parameters used to evaluate data quality are described. Various methods for measuring data quality are outlined and possible applications of the methods are illustrated using Canadian examples

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

Quality Assurance handbook for air pollution measurement systems. Volume 4, Meteorological measurements

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

Not Available

1990-08-01

The purpose of this volume of the QA Handbook is to provide information and guidance for both the meteorologist and the non-meteorologist who must make judgments about the validity of data and accuracy of measurement systems. Care has been taken to provide definitions to help those making these judgments to communicate without ambiguity. Methods are described in the handbook which will objectively define the quality of measurements so the non-meteorologist can communicate with the meteorologist or environmental scientist or engineer with precision of meaning.

Development of a coal quality analyzer for application to power plants based on laser-induced breakdown spectroscopy

NASA Astrophysics Data System (ADS)

Zhang, Lei; Gong, Yao; Li, Yufang; Wang, Xin; Fan, Juanjuan; Dong, Lei; Ma, Weiguang; Yin, Wangbao; Jia, Suotang

2015-11-01

It is vitally important for a power plant to determine the coal property rapidly to optimize the combustion process. In this work, a fully software-controlled laser-induced breakdown spectroscopy (LIBS) based coal quality analyzer comprising a LIBS apparatus, a sampling equipment, and a control module, has been designed for possible application to power plants for offering rapid and precise coal quality analysis results. A closed-loop feedback pulsed laser energy stabilization technology is proposed to stabilize the Nd: YAG laser output energy to a preset interval by using the detected laser energy signal so as to enhance the measurement stability and applied in a month-long monitoring experiment. The results show that the laser energy stability has been greatly reduced from ± 5.2% to ± 1.3%. In order to indicate the complex relationship between the concentrations of the analyte of interest and the corresponding plasma spectra, the support vector regression (SVR) is employed as a non-linear regression method. It is shown that this SVR method combined with principal component analysis (PCA) enables a significant improvement in cross-validation accuracy by using the calibration set of coal samples. The root mean square error for prediction of ash content, volatile matter content, and calorific value decreases from 2.74% to 1.82%, 1.69% to 1.22%, and 1.23 MJ/kg to 0.85 MJ/kg, respectively. Meanwhile, the corresponding average relative error of the predicted samples is reduced from 8.3% to 5.48%, 5.83% to 4.42%, and 5.4% to 3.68%, respectively. The enhanced levels of accuracy obtained with the SVR combined with PCA based calibration models open up avenues for prospective prediction in coal properties.

An evidence-based framework to measure quality of allied health care.

PubMed

Grimmer, Karen; Lizarondo, Lucylynn; Kumar, Saravana; Bell, Erica; Buist, Michael; Weinstein, Philip

2014-02-26

There is no standard way of describing the complexities of allied health (AH) care, or its quality. AH is an umbrella term which excludes medicine and nursing, and variably includes disciplines which provide therapy, diagnostic, or scientific services. This paper outlines a framework for a standard approach to evaluate the quality of AH therapy services. A realist synthesis framework describing what AH does, how it does it, and what is achieved, was developed. This was populated by the findings of a systematic review of literature published since 1980 reporting concepts of quality relevant to AH. Articles were included on quality measurement concepts, theories, debates, and/or hypothetical frameworks. Of 139 included articles, 21 reported on descriptions of quality potentially relevant to AH. From these, 24 measures of quality were identified, with 15 potentially relating to what AH does, 17 to how AH delivers care, 8 relating to short term functional outcomes, and 9 relating to longer term functional and health system outcomes. A novel evidence-based quality framework was proposed to address the complexity of AH therapies. This should assist in better evaluation of AH processes and outcomes, costs, and evidence-based engagement of AH providers in healthcare teams.

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

PubMed

Chumber, Sundeep; Huber, Jörg; Ghezzi, Pietro

2015-02-01

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

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.

The effect of sodium bicarbonate and validation of beckman coulter AU680 analyzers for measuring total carbon dioxide (TCO2) concentrations in horse serum.

PubMed

Dirikolu, Levent; Waller, Pamela; Waguespack, Mona Landry; Andrews, Frank Michael; Keowen, Michael Layne; Gaunt, Stephen David

2017-11-01

This study evaluated the usage of Beckman Coulter AU680 analyzers for measurement of TCO 2 in horse serum, and the effect of sodium bicarbonate administrations on serum TCO 2 levels in resting horses. Treatment of horses with sodium bicarbonate did not result in any adverse events. Mean TCO 2 concentration was significantly higher from 1 to 8 h in the sodium bicarbonate-treated horses compared to the untreated controls. Within an hour, administration of sodium bicarbonate increased the TCO 2 level from 31.5 ± -2.5 (SD) to 34.0 ± 2.65 (SD) mmol/L and at 2-8 h post-administration, the TCO 2 level was above the 36 mmol/L cut-off level. In all quality control analysis of Australian standard by Beckman Coulter AU680 analyzer, the instrument slightly over estimated the TCO 2 level but the values were in close agreement with mean TCO 2 level being 38.03 with ± 0.87 mmol/L (SD). Expanded uncertainty was calculated using different levels of confidence interval. Based on 99.5% confidence interval using 0.805% expanded uncertainty using mean measured concentration of 38.05 mmol/L, it was estimated that any race samples TCO 2 level higher than 38.5 mmol/L will be indicative of sodium bicarbonate administration using Beckman Coulter AU680 analyzer in Louisiana.

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…

Measurement Matters: Assessing Personal Qualities Other Than Cognitive Ability for Educational Purposes

PubMed Central

Duckworth, Angela L.; Yeager, David Scott

2016-01-01

There has been perennial interest in personal qualities other than cognitive ability that determine success, including self-control, grit, growth mindset, and many others. Attempts to measure such qualities for the purposes of educational policy and practice, however, are more recent. In this article, we identify serious challenges to doing so. We first address confusion over terminology, including the descriptor “non-cognitive.” We conclude that debate over the optimal name for this broad category of personal qualities obscures substantial agreement about the specific attributes worth measuring. Next, we discuss advantages and limitations of different measures. In particular, we compare self-report questionnaires, teacher-report questionnaires, and performance tasks, using self-control as an illustrative case study to make the general point that each approach is imperfect in its own way. Finally, we discuss how each measure’s imperfections can affect its suitability for program evaluation, accountability, individual diagnosis, and practice improvement. For example, we do not believe any available measure is suitable for between-school accountability judgments. In addition to urging caution among policymakers and practitioners, we highlight medium-term innovations that may make measures of these personal qualities more suitable for educational purposes. PMID:27134288

In-Hospital Quality-of-Care Measures for Pediatric Sepsis Syndrome.

PubMed

Odetola, Folafoluwa O; Freed, Gary; Shevrin, Caroline; Madden, Brian; McCormick, Julie; Dombkowski, Kevin

2017-07-24

Sepsis syndrome, comprising sepsis, severe sepsis, and septic shock, is a leading cause of child mortality and morbidity, for which the delivery of time-sensitive care leads to improved survival. We aimed to describe the development and testing of quality measures for in-hospital care of pediatric sepsis syndrome. Seven measures of quality of care for children hospitalized with sepsis syndrome were developed by using an iterative process including literature review, development of concepts and candidate measures, and selection of measures for feasibility and importance by 2 panels of experts. The measures were tested for reliability and validity among children 0 to 18 years of age hospitalized with sepsis syndrome from January 1, 2012, to June 30, 2013. Of 27 hospitals, 59% had no protocol for the identification and treatment of pediatric sepsis syndrome. Blood culture was performed in only 70% of patients with pediatric sepsis syndrome. Antibiotics were administered within 1 hour of diagnosis in 70% of patients with pediatric severe sepsis or septic shock, and timely fluid resuscitation was performed in 50% of patients with severe sepsis or septic shock. Documentation of heart rate during fluid resuscitation of children with severe sepsis or septic shock was observed in 18% of cases. Two measures could not be rigorously tested for validity and reliability given the rarity of septic shock and were deemed infeasible. This multisite study to develop and validate measures of the quality of hospital care of children with sepsis syndrome highlights the existence of important gaps in delivery of care. Copyright © 2017 by the American Academy of Pediatrics.

Highlights of Total Quality Management in the Department of Defense: Lessons Learned, Quality Measurements and Innovative Practices

DTIC Science & Technology

1991-09-26

Quality Management (TQM) through both quantitative and qualitative analyses. Interviews were conducted with top executives from ten exemplar organizations within the Department of Defense (DOD). Survey questionnaires on perceptions of quality practices were administered to a sample of 102 representing members of the executive steering committees at the same organizations. Research identifies lessons learned by top executives during TQM implementation, discusses measures of organization-wide quality management , specifies evaluation mechanisms to

Data Quality Assurance for Supersonic Jet Noise Measurements

NASA Technical Reports Server (NTRS)

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

2010-01-01

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

Clinical implementation of photon beam flatness measurements to verify beam quality.

PubMed

Goodall, Simon; Harding, Nicholas; Simpson, Jake; Alexander, Louise; Morgan, Steve

2015-11-08

This work describes the replacement of Tissue Phantom Ratio (TPR) measurements with beam profile flatness measurements to determine photon beam quality during routine quality assurance (QA) measurements. To achieve this, a relationship was derived between the existing TPR15/5 energy metric and beam flatness, to provide baseline values and clinically relevant tolerances. The beam quality was varied around two nominal beam energy values for four matched Elekta linear accelerators (linacs) by varying the bending magnet currents and reoptimizing the beam. For each adjusted beam quality the TPR15/5 was measured using an ionization chamber and Solid Water phantom. Two metrics of beam flatness were evaluated using two identical commercial ionization chamber arrays. A linear relationship was found between TPR15/5 and both metrics of flatness, for both nominal energies and on all linacs. Baseline diagonal flatness (FDN) values were measured to be 103.0% (ranging from 102.5% to 103.8%) for 6 MV and 102.7% (ranging from 102.6% to 102.8%) for 10 MV across all four linacs. Clinically acceptable tolerances of ± 2% for 6 MV, and ± 3% for 10 MV, were derived to equate to the current TPR15/5 clinical tolerance of ± 0.5%. Small variations in the baseline diagonal flatness values were observed between ionization chamber arrays; however, the rate of change of TPR15/5 with diagonal flatness was found to remain within experimental uncertainty. Measurements of beam flatness were shown to display an increased sensitivity to variations in the beam quality when compared to TPR measurements. This effect is amplified for higher nominal energy photons. The derivation of clinical baselines and associated tolerances has allowed this method to be incorporated into routine QA, streamlining the process whilst also increasing versatility. In addition, the effect of beam adjustment can be observed in real time, allowing increased practicality during corrective and preventive maintenance

A Nanometer Aerosol Size Analyzer (nASA) for Rapid Measurement of High-concentration Size Distributions

NASA Astrophysics Data System (ADS)

Han, Hee-Siew; Chen, Da-Ren; Pui, David Y. H.; Anderson, Bruce E.

2000-03-01

We have developed a fast-response nanometer aerosol size analyzer (nASA) that is capable of scanning 30 size channels between 3 and 100 nm in a total time of 3 s. The analyzer includes a bipolar charger (Po210), an extended-length nanometer differential mobility analyzer (Nano-DMA), and an electrometer (TSI 3068). This combination of components provides particle size spectra at a scan rate of 0.1 s per channel free of uncertainties caused by response-time-induced smearing. The nASA thus offers a fast response for aerosol size distribution measurements in high-concentration conditions and also eliminates the need for applying a de-smearing algorithm to resulting data. In addition, because of its thermodynamically stable means of particle detection, the nASA is useful for applications requiring measurements over a broad range of sample pressures and temperatures. Indeed, experimental transfer functions determined for the extended-length Nano-DMA using the tandem differential mobility analyzer (TDMA) technique indicate the nASA provides good size resolution at pressures as low as 200 Torr. Also, as was demonstrated in tests to characterize the soot emissions from the J85-GE engine of a T-38 aircraft, the broad dynamic concentration range of the nASA makes it particularly suitable for studies of combustion or particle formation processes. Further details of the nASA performance as well as results from calibrations, laboratory tests and field applications are presented below.

A Nanometer Aerosol Size Analyzer (nASA) for Rapid Measurement of High-Concentration Size Distributions

NASA Technical Reports Server (NTRS)

Han, Hee-Siew; Chen, Da-Ren; Pui, David Y. H.; Anderson, Bruce E.

2001-01-01

We have developed a fast-response Nanometer Aerosol Size Analyzer (nASA) that is capable of scanning 30 size channels between 3 and 100 nm in a total time of 3 seconds. The analyzer includes a bipolar charger (P0210), an extended-length Nanometer Differential Mobility Analyzer (Nano-DMA), and an electrometer (TSI 3068). This combination of components provides particle size spectra at a scan rate of 0.1 second per channel free of uncertainties caused by response-time-induced smearing. The nASA thus offers a fast response for aerosol size distribution measurements in high-concentration conditions and also eliminates the need for applying a de-smearing algorithm to resulting data. In addition, because of its thermodynamically stable means of particle detection, the nASA is useful for applications requiring measurements over a broad range of sample pressures and temperatures. Indeed, experimental transfer functions determined for the extended-length Nano-DMA using the Tandem Differential Mobility Analyzer (TDMA) technique indicate the nASA provides good size resolution at pressures as low as 200 Torr. Also, as was demonstrated in tests to characterize the soot emissions from the J85-GE engine of a T38 aircraft, the broad dynamic concentration range of the nASA makes it particularly suitable for studies of combustion or particle formation processes. Further details of the nASA performance as well as results from calibrations, laboratory tests and field applications are presented.

RAPIDLY MEASURED INDICATORS OF RECREATIONAL WATER QUALITY ARE PREDICTIVE OF SWIMMING ASSOCIATED GASTROINTESTINAL ILLNESS

EPA Science Inventory

Standard methods to measure recreational water quality require at least 24 hours to obtain results making it impossible to assess the quality of water within a single day. Methods to measure recreational water quality in two hours or less have been developed. Application of rapid...

Janus: Graphical Software for Analyzing In-Situ Measurements of Solar-Wind Ions

NASA Astrophysics Data System (ADS)

Maruca, B.; Stevens, M. L.; Kasper, J. C.; Korreck, K. E.

2016-12-01

In-situ observations of solar-wind ions provide tremendous insights into the physics of space plasmas. Instrument on spacecraft measure distributions of ion energies, which can be processed into scientifically useful data (e.g., values for ion densities and temperatures). This analysis requires a strong, technical understanding of the instrument, so it has traditionally been carried out by the instrument teams using automated software that they had developed for that purpose. The automated routines are optimized for typical solar-wind conditions, so they can fail to capture the complex (and scientifically interesting) microphysics of transient solar-wind - such as coronal mass ejections (CME's) and co-rotating interaction regions (CIR's) - which are often better analyzed manually.This presentation reports on the ongoing development of Janus, a new software package for processing in-situ measurement of solar-wind ions. Janus will provide user with an easy-to-use graphical user interface (GUI) for carrying out highly customized analyses. Transparent to the user, Janus will automatically handle the most technical tasks (e.g., the retrieval and calibration of measurements). For the first time, users with only limited knowledge about the instruments (e.g., non-instrumentalists and students) will be able to easily process measurements of solar-wind ions. Version 1 of Janus focuses specifically on such measurements from the Wind spacecraft's Faraday Cups and is slated for public release in time for this presentation.

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

Objective measures for quality assessment of automatic skin enhancement algorithms

NASA Astrophysics Data System (ADS)

Ciuc, Mihai; Capata, Adrian; Florea, Corneliu

2010-01-01

Automatic portrait enhancement by attenuating skin flaws (pimples, blemishes, wrinkles, etc.) has received considerable attention from digital camera manufacturers thanks to its impact on the public. Subsequently, a number of algorithms have been developed to meet this need. One central aspect to developing such an algorithm is quality assessment: having a few numbers that precisely indicate the amount of beautification brought by an algorithm (as perceived by human observers) is of great help, as it works on circumvent time-costly human evaluation. In this paper, we propose a method to numerically evaluate the quality of a skin beautification algorithm. The most important aspects we take into account and quantize to numbers are the quality of the skin detector, the amount of smoothing performed by the method, the preservation of intrinsic skin texture, and the preservation of facial features. We combine these measures into two numbers that assess the quality of skin detection and beautification. The derived measures are highly correlated with human perception, therefore they constitute a helpful tool for tuning and comparing algorithms.

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

Do Activity Level Outcome Measures Commonly Used in Neurological Practice Assess Upper-Limb Movement Quality?

PubMed

Demers, Marika; Levin, Mindy F

2017-07-01

Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.

Potential of Laser Induced Breakdown Spectroscopy for analyzing the quality of unroasted and ground coffee

NASA Astrophysics Data System (ADS)

Silva, Tiago Varão; Hubinger, Silviane Zanni; Gomes Neto, José Anchieta; Milori, Débora Marcondes Bastos Pereira; Ferreira, Ednaldo José; Ferreira, Edilene Cristina

2017-09-01

Coffee is an important commodity and a very popular beverage around the world. Its economic value as well as beverage quality are strongly dependent of the quality of beans. The presence of defective beans in coffee blends has caused a negative impact on the beverage Global Quality (GQ) assessed by cupping tests. The main defective beans observed in the productive chain has been those Blacks, Greens and Sours (BGS). Chemical composition of BGS has a damaging impact on beverage GQ. That is why analytical tools are needed for monitoring and controlling the GQ in coffee agro-industry. Near Infrared Spectroscopy (NIRS) has been successfully applied for assessment of coffee quality. Another potential technique for direct, clean and fast measurement of coffee GQ is Laser Induced Breakdown Spectroscopy (LIBS). Elements and diatomic molecules commonly present in organic compounds (structure) can be assessed by using LIBS. In this article is reported an evaluation of LIBS for the main interferents of GQ (BGS defects). Results confirm the great potential of LIBS for discriminating good beans from those with BGS defects by using emission lines of C, CN, C2 and N. Most importantly, some emission lines presented strong linear correlation (r > 0.9) with NIRS absorption bands assigned to proteins, lipids, sugar and carboxylic acids, suggesting LIBS potential to estimate these compounds in unroasted and ground coffee samples.

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.

77 FR 11119 - Request for Nominations of Children's Healthcare Quality Measures for Potential Inclusion in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

... Set of Health Care Quality Measures for Medicaid/CHIP AGENCY: Agency for Healthcare Research and... and Human Services (HHS) with improving pediatric health care quality measures. The Agency for... quality for potential inclusion in the CHIPRA 2013 Improved Core Set of Health Care Quality Measures (the...

A potential hyperspectral remote sensing imager for water quality measurements

NASA Astrophysics Data System (ADS)

Zur, Yoav; Braun, Ofer; Stavitsky, David; Blasberger, Avigdor

2003-04-01

Utilization of Pan Chromatic and Multi Spectral Remote Sensing Imagery is wide spreading and becoming an established business for commercial suppliers of such imagery like ISI and others. Some emerging technologies are being used to generate Hyper-Spectral imagery (HSI) by aircraft as well as other platforms. The commercialization of such technology for Remote Sensing from space is still questionable and depends upon several parameters including maturity, cost, market reception and many others. HSI can be used in a variety of applications in agriculture, urban mapping, geology and others. One outstanding potential usage of HSI is for water quality monitoring, a subject studied in this paper. Water quality monitoring is becoming a major area of interest in HSI due to the increase in water demand around the globe. The ability to monitor water quality in real time having both spatial and temporal resolution is one of the advantages of Remote Sensing. This ability is not limited only for measurements of oceans and inland water, but can be applied for drinking and irrigation water reservoirs as well. HSI in the UV-VNIR has the ability to measure a wide range of constituents that define water quality. Among the constituents that can be measured are the pigment concentration of various algae, chlorophyll a and c, carotenoids and phycocyanin, thus enabling to define the algal phyla. Other parameters that can be measured are TSS (Total Suspended Solids), turbidity, BOD (Biological Oxygen Demand), hydrocarbons, oxygen demand. The study specifies the properties of such a space borne device that results from the spectral signatures and the absorption bands of the constituents in question. Other parameters considered are the repetition of measurements, the spatial aspects of the sensor and the SNR of the sensor in question.

Nuclear fuel microsphere gamma analyzer

DOEpatents

Valentine, Kenneth H.; Long, Jr., Ernest L.; Willey, Melvin G.

1977-01-01

A gamma analyzer system is provided for the analysis of nuclear fuel microspheres and other radioactive particles. The system consists of an analysis turntable with means for loading, in sequence, a plurality of stations within the turntable; a gamma ray detector for determining the spectrum of a sample in one section; means for analyzing the spectrum; and a receiver turntable to collect the analyzed material in stations according to the spectrum analysis. Accordingly, particles may be sorted according to their quality; e.g., fuel particles with fractured coatings may be separated from those that are not fractured, or according to other properties.

Analyzers Measure Greenhouse Gases, Airborne Pollutants

NASA Technical Reports Server (NTRS)

2012-01-01

In complete darkness, a NASA observatory waits. When an eruption of boiling water billows from a nearby crack in the ground, the observatory s sensors seek particles in the fluid, measure shifts in carbon isotopes, and analyze samples for biological signatures. NASA has landed the observatory in this remote location, far removed from air and sunlight, to find life unlike any that scientists have ever seen. It might sound like a scene from a distant planet, but this NASA mission is actually exploring an ocean floor right here on Earth. NASA established a formal exobiology program in 1960, which expanded into the present-day Astrobiology Program. The program, which celebrated its 50th anniversary in 2010, not only explores the possibility of life elsewhere in the universe, but also examines how life begins and evolves, and what the future may hold for life on Earth and other planets. Answers to these questions may be found not only by launching rockets skyward, but by sending probes in the opposite direction. Research here on Earth can revise prevailing concepts of life and biochemistry and point to the possibilities for life on other planets, as was demonstrated in December 2010, when NASA researchers discovered microbes in Mono Lake in California that subsist and reproduce using arsenic, a toxic chemical. The Mono Lake discovery may be the first of many that could reveal possible models for extraterrestrial life. One primary area of interest for NASA astrobiologists lies with the hydrothermal vents on the ocean floor. These vents expel jets of water heated and enriched with chemicals from off-gassing magma below the Earth s crust. Also potentially within the vents: microbes that, like the Mono Lake microorganisms, defy the common characteristics of life on Earth. Basically all organisms on our planet generate energy through the Krebs Cycle, explains Mike Flynn, research scientist at NASA s Ames Research Center. This metabolic process breaks down sugars for energy

MERCURY MEASUREMENTS USING DIRECT-ANALYZER ...

EPA Pesticide Factsheets

There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact Field. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for media, responding to public inquiries. S

Investigation of ion beam space charge compensation with a 4-grid analyzer

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

Ullmann, C., E-mail: c.ullmann@gsi.de; Adonin, A.; Berezov, R.

2016-02-15

Experiments to investigate the space charge compensation of pulsed high-current heavy ion beams are performed at the GSI ion source text benches with a 4-grid analyzer provided by CEA/Saclay. The technical design of the 4-grid analyzer is revised to verify its functionality for measurements at pulsed high-current heavy ion beams. The experimental investigation of space charge compensation processes is needed to increase the performance and quality of current and future accelerator facilities. Measurements are performed directly downstream a triode extraction system mounted to a multi-cusp ion source at a high-current test bench as well as downstream the post-acceleration system ofmore » the high-current test injector (HOSTI) with ion energies up to 120 keV/u for helium and argon. At HOSTI, a cold or hot reflex discharge ion source is used to change the conditions for the measurements. The measurements were performed with helium, argon, and xenon and are presented. Results from measurements with single aperture extraction systems are shown.« less

Towards a model for the measurement of data quality in websites

NASA Astrophysics Data System (ADS)

Leite, Patrícia; Gonçalves, Joaquim; Teixeira, Paulo; Rocha, Álvaro

2014-10-01

Websites are, nowadays, the face of institutions, but they are often neglected, especially when it comes to contents. In the present paper, we put forth an investigation work whose final goal is the development of a model for the measurement of data quality in institutional websites for health units. To that end, we have carried out a bibliographic review of the available approaches for the evaluation of website content quality, in order to identify the most recurrent dimensions and the attributes, and we are currently carrying out a Delphi Method process, presently in its second stage, with the purpose of reaching an adequate set of attributes for the measurement of content quality.

The quality of veterinary in-clinic and reference laboratory biochemical testing.

PubMed

Rishniw, Mark; Pion, Paul D; Maher, Tammy

2012-03-01

Although evaluation of biochemical analytes in blood is common in veterinary practice, studies assessing the global quality of veterinary in-clinic and reference laboratory testing have not been reported. The aim of this study was to assess the quality of biochemical testing in veterinary laboratories using results obtained from analyses of 3 levels of assayed quality control materials over 5 days. Quality was assessed by comparison of calculated total error with quality requirements, determination of sigma metrics, use of a quality goal index to determine factors contributing to poor performance, and agreement between in-clinic and reference laboratory mean results. The suitability of in-clinic and reference laboratory instruments for statistical quality control was determined using adaptations from the computerized program, EZRules3. Reference laboratories were able to achieve desirable quality requirements more frequently than in-clinic laboratories. Across all 3 materials, > 50% of in-clinic analyzers achieved a sigma metric ≥ 6.0 for measurement of 2 analytes, whereas > 50% of reference laboratory analyzers achieved a sigma metric ≥ 6.0 for measurement of 6 analytes. Expanded uncertainty of measurement and ± total allowable error resulted in the highest mean percentages of analytes demonstrating agreement between in-clinic and reference laboratories. Owing to marked variation in bias and coefficient of variation between analyzers of the same and different types, the percentages of analytes suitable for statistical quality control varied widely. These findings reflect the current state-of-the-art with regard to in-clinic and reference laboratory analyzer performance and provide a baseline for future evaluations of the quality of veterinary laboratory testing. © 2012 American Society for Veterinary Clinical Pathology.

The HARM score for gastrointestinal surgery: Application and validation of a novel, reliable and simple tool to measure surgical quality and outcomes.

PubMed

Crawshaw, Benjamin P; Keller, Deborah S; Brady, Justin T; Augestad, Knut M; Schiltz, Nicholas K; Koroukian, Siran M; Navale, Suparna M; Steele, Scott R; Delaney, Conor P

2017-03-01

The HospitAl length of stay, Readmissions and Mortality (HARM) score is a simple, inexpensive quality tool, linked directly to patient outcomes. We assess the HARM score for measuring surgical quality across multiple surgical populations. Upper gastrointestinal, hepatobiliary, and colorectal surgery cases between 2005 and 2009 were identified from the Healthcare Cost and Utilization Project California State Inpatient Database. Composite and individual HARM scores were calculated from length of stay, 30-day readmission and mortality, correlated to complication rates for each hospital and stratified by operative type. 71,419 admissions were analyzed. Higher HARM scores correlated with higher complication rates for all cases after risk adjustment and stratification by operation type, elective or emergent status. The HARM score is a simple and valid quality measurement for upper gastrointestinal, hepatobiliary and colorectal surgery. The HARM score could facilitate benchmarking to improve patient outcomes and resource utilization, and may facilitate outcome improvement. Copyright © 2016 Elsevier Inc. All rights reserved.