Development and implementation of a human accuracy program in patient foodservice.

PubMed

Eden, S H; Wood, S M; Ptak, K M

1987-04-01

For many years, industry has utilized the concept of human error rates to monitor and minimize human errors in the production process. A consistent quality-controlled product increases consumer satisfaction and repeat purchase of product. Administrative dietitians have applied the concepts of using human error rates (the number of errors divided by the number of opportunities for error) at four hospitals, with a total bed capacity of 788, within a tertiary-care medical center. Human error rate was used to monitor and evaluate trayline employee performance and to evaluate layout and tasks of trayline stations, in addition to evaluating employees in patient service areas. Long-term employees initially opposed the error rate system with some hostility and resentment, while newer employees accepted the system. All employees now believe that the constant feedback given by supervisors enhances their self-esteem and productivity. Employee error rates are monitored daily and are used to counsel employees when necessary; they are also utilized during annual performance evaluation. Average daily error rates for a facility staffed by new employees decreased from 7% to an acceptable 3%. In a facility staffed by long-term employees, the error rate increased, reflecting improper error documentation. Patient satisfaction surveys reveal satisfaction, for tray accuracy increased from 88% to 92% in the facility staffed by long-term employees and has remained above the 90% standard in the facility staffed by new employees.

A Six Sigma Trial For Reduction of Error Rates in Pathology Laboratory.

PubMed

Tosuner, Zeynep; Gücin, Zühal; Kiran, Tuğçe; Büyükpinarbaşili, Nur; Turna, Seval; Taşkiran, Olcay; Arici, Dilek Sema

2016-01-01

A major target of quality assurance is the minimization of error rates in order to enhance patient safety. Six Sigma is a method targeting zero error (3.4 errors per million events) used in industry. The five main principles of Six Sigma are defining, measuring, analysis, improvement and control. Using this methodology, the causes of errors can be examined and process improvement strategies can be identified. The aim of our study was to evaluate the utility of Six Sigma methodology in error reduction in our pathology laboratory. The errors encountered between April 2014 and April 2015 were recorded by the pathology personnel. Error follow-up forms were examined by the quality control supervisor, administrative supervisor and the head of the department. Using Six Sigma methodology, the rate of errors was measured monthly and the distribution of errors at the preanalytic, analytic and postanalytical phases was analysed. Improvement strategies were reclaimed in the monthly intradepartmental meetings and the control of the units with high error rates was provided. Fifty-six (52.4%) of 107 recorded errors in total were at the pre-analytic phase. Forty-five errors (42%) were recorded as analytical and 6 errors (5.6%) as post-analytical. Two of the 45 errors were major irrevocable errors. The error rate was 6.8 per million in the first half of the year and 1.3 per million in the second half, decreasing by 79.77%. The Six Sigma trial in our pathology laboratory provided the reduction of the error rates mainly in the pre-analytic and analytic phases.

Total energy based flight control system

NASA Technical Reports Server (NTRS)

Lambregts, Antonius A. (Inventor)

1985-01-01

An integrated aircraft longitudinal flight control system uses a generalized thrust and elevator command computation (38), which accepts flight path angle, longitudinal acceleration command signals, along with associated feedback signals, to form energy rate error (20) and energy rate distribution error (18) signals. The engine thrust command is developed (22) as a function of the energy rate distribution error and the elevator position command is developed (26) as a function of the energy distribution error. For any vertical flight path and speed mode the outerloop errors are normalized (30, 34) to produce flight path angle and longitudinal acceleration commands. The system provides decoupled flight path and speed control for all control modes previously provided by the longitudinal autopilot, autothrottle and flight management systems.

Paediatric electronic infusion calculator: An intervention to eliminate infusion errors in paediatric critical care.

PubMed

Venkataraman, Aishwarya; Siu, Emily; Sadasivam, Kalaimaran

2016-11-01

Medication errors, including infusion prescription errors are a major public health concern, especially in paediatric patients. There is some evidence that electronic or web-based calculators could minimise these errors. To evaluate the impact of an electronic infusion calculator on the frequency of infusion errors in the Paediatric Critical Care Unit of The Royal London Hospital, London, United Kingdom. We devised an electronic infusion calculator that calculates the appropriate concentration, rate and dose for the selected medication based on the recorded weight and age of the child and then prints into a valid prescription chart. Electronic infusion calculator was implemented from April 2015 in Paediatric Critical Care Unit. A prospective study, five months before and five months after implementation of electronic infusion calculator, was conducted. Data on the following variables were collected onto a proforma: medication dose, infusion rate, volume, concentration, diluent, legibility, and missing or incorrect patient details. A total of 132 handwritten prescriptions were reviewed prior to electronic infusion calculator implementation and 119 electronic infusion calculator prescriptions were reviewed after electronic infusion calculator implementation. Handwritten prescriptions had higher error rate (32.6%) as compared to electronic infusion calculator prescriptions (<1%) with a p  < 0.001. Electronic infusion calculator prescriptions had no errors on dose, volume and rate calculation as compared to handwritten prescriptions, hence warranting very few pharmacy interventions. Use of electronic infusion calculator for infusion prescription significantly reduced the total number of infusion prescribing errors in Paediatric Critical Care Unit and has enabled more efficient use of medical and pharmacy time resources.

Families as Partners in Hospital Error and Adverse Event Surveillance

PubMed Central

Khan, Alisa; Coffey, Maitreya; Litterer, Katherine P.; Baird, Jennifer D.; Furtak, Stephannie L.; Garcia, Briana M.; Ashland, Michele A.; Calaman, Sharon; Kuzma, Nicholas C.; O’Toole, Jennifer K.; Patel, Aarti; Rosenbluth, Glenn; Destino, Lauren A.; Everhart, Jennifer L.; Good, Brian P.; Hepps, Jennifer H.; Dalal, Anuj K.; Lipsitz, Stuart R.; Yoon, Catherine S.; Zigmont, Katherine R.; Srivastava, Rajendu; Starmer, Amy J.; Sectish, Theodore C.; Spector, Nancy D.; West, Daniel C.; Landrigan, Christopher P.

2017-01-01

IMPORTANCE Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection. OBJECTIVE To compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports. DESIGN, SETTING, AND PARTICIPANTS We conducted a prospective cohort study including the parents/caregivers of 989 hospitalized patients 17 years and younger (total 3902 patient-days) and their clinicians from December 2014 to July 2015 in 4 US pediatric centers. Clinician abstractors identified potential errors and AEs by reviewing medical records, hospital incident reports, and clinician reports as well as weekly and discharge Family Safety Interviews (FSIs). Two physicians reviewed and independently categorized all incidents, rating severity and preventability (agreement, 68%–90%; κ, 0.50–0.68). Discordant categorizations were reconciled. Rates were generated using Poisson regression estimated via generalized estimating equations to account for repeated measures on the same patient. MAIN OUTCOMES AND MEASURES Error and AE rates. RESULTS Overall, 746 parents/caregivers consented for the study. Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26–40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%). These included 22 preventable AEs (8.6%), 17 nonharmful medical errors (6.7%), and 11 nonpreventable AEs (4.3%) on the study unit. In total, 179 errors and 113 AEs were identified from all sources. Family reports included 8 otherwise unidentified AEs, including 7 preventable AEs. Error rates with family reporting (45.9 per 1000 patient-days) were 1.2-fold (95%CI, 1.1–1.2) higher than rates without family reporting (39.7 per 1000 patient-days). Adverse event rates with family reporting (28.7 per 1000 patient-days) were 1.1-fold (95%CI, 1.0–1.2; P=.006) higher than rates without (26.1 per 1000 patient-days). Families and clinicians reported similar rates of errors (10.0 vs 12.8 per 1000 patient-days; relative rate, 0.8; 95%CI, .5–1.2) and AEs (8.5 vs 6.2 per 1000 patient-days; relative rate, 1.4; 95%CI, 0.8–2.2). Family-reported error rates were 5.0-fold (95%CI, 1.9–13.0) higher and AE rates 2.9-fold (95% CI, 1.2–6.7) higher than hospital incident report rates. CONCLUSIONS AND RELEVANCE Families provide unique information about hospital safety and should be included in hospital safety surveillance in order to facilitate better design and assessment of interventions to improve safety. PMID:28241211

In-Flight Pitot-Static Calibration

NASA Technical Reports Server (NTRS)

Foster, John V. (Inventor); Cunningham, Kevin (Inventor)

2016-01-01

A GPS-based pitot-static calibration system uses global output-error optimization. High data rate measurements of static and total pressure, ambient air conditions, and GPS-based ground speed measurements are used to compute pitot-static pressure errors over a range of airspeed. System identification methods rapidly compute optimal pressure error models with defined confidence intervals.

38 CFR 3.343 - Continuance of total disability ratings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... error, without examination showing material improvement in physical or mental condition. Examination... period during which a total rating is provided will not be able to maintain inactivity of the disease... reason thereof unless there is received evidence of marked improvement or recovery in physical or mental...

38 CFR 3.343 - Continuance of total disability ratings.

Code of Federal Regulations, 2014 CFR

2014-07-01

... error, without examination showing material improvement in physical or mental condition. Examination... period during which a total rating is provided will not be able to maintain inactivity of the disease... reason thereof unless there is received evidence of marked improvement or recovery in physical or mental...

38 CFR 3.343 - Continuance of total disability ratings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... error, without examination showing material improvement in physical or mental condition. Examination... period during which a total rating is provided will not be able to maintain inactivity of the disease... reason thereof unless there is received evidence of marked improvement or recovery in physical or mental...

38 CFR 3.343 - Continuance of total disability ratings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... error, without examination showing material improvement in physical or mental condition. Examination... period during which a total rating is provided will not be able to maintain inactivity of the disease... reason thereof unless there is received evidence of marked improvement or recovery in physical or mental...

A Comparison of Medication Histories Obtained by a Pharmacy Technician Versus Nurses in the Emergency Department.

PubMed

Markovic, Marija; Mathis, A Scott; Ghin, Hoytin Lee; Gardiner, Michelle; Fahim, Germin

2017-01-01

To compare the medication history error rate of the emergency department (ED) pharmacy technician with that of nursing staff and to describe the workflow environment. Fifty medication histories performed by an ED nurse followed by the pharmacy technician were evaluated for discrepancies (RN-PT group). A separate 50 medication histories performed by the pharmacy technician and observed with necessary intervention by the ED pharmacist were evaluated for discrepancies (PT-RPh group). Discrepancies were totaled and categorized by type of error and therapeutic category of the medication. The workflow description was obtained by observation and staff interview. A total of 474 medications in the RN-PT group and 521 in the PT-RPh group were evaluated. Nurses made at least one error in all 50 medication histories (100%), compared to 18 medication histories for the pharmacy technician (36%). In the RN-PT group, 408 medications had at least one error, corresponding to an accuracy rate of 14% for nurses. In the PT-RPh group, 30 medications had an error, corresponding to an accuracy rate of 94.4% for the pharmacy technician ( P < 0.0001). The most common error made by nurses was a missing medication (n = 109), while the most common error for the pharmacy technician was a wrong medication frequency (n = 19). The most common drug class with documented errors for ED nurses was cardiovascular medications (n = 100), while the pharmacy technician made the most errors in gastrointestinal medications (n = 11). Medication histories obtained by the pharmacy technician were significantly more accurate than those obtained by nurses in the emergency department.

A Corpus Based Study on the Preposition Error Types in Turkish EFL Learners' Essays

ERIC Educational Resources Information Center

Tunaz, Mehmet; Muyan, Emrah; Muratoglu, Nursel

2016-01-01

The purpose of this study was to investigate the categories of preposition errors made by EFL learners of elementary and intermediate proficiency levels by comparing the rate of preposition errors (addition, omission, substitution) to their total preposition uses in their essays, and by comparing the overall preposition usage of learners of both…

A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study.

PubMed

Gilmartin-Thomas, Julia Fiona-Maree; Smith, Felicity; Wolfe, Rory; Jani, Yogini

2017-07-01

No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. Prospective observational. Ten Greater London care homes. Nurses and carers administering medications. Between October 2014 and June 2015, a pharmacist researcher directly observed solid, orally administered medications in tablet or capsule form at ten purposively sampled care homes (five only used original medication packaging and five used both multi-compartment compliance aids and original medication packaging). The medication administration error rate was calculated as the number of observed doses administered (or omitted) in error according to medication administration records, compared to the opportunities for error (total number of observed doses plus omitted doses). Over 108.4h, 41 different staff (35 nurses, 6 carers) were observed to administer medications to 823 residents during 90 medication administration rounds. A total of 2452 medication doses were observed (1385 from original medication packaging, 1067 from multi-compartment compliance aids). One hundred and seventy eight medication administration errors were identified from 2493 opportunities for error (7.1% overall medication administration error rate). A greater medication administration error rate was seen for original medication packaging than multi-compartment compliance aids (9.3% and 3.1% respectively, risk ratio (RR)=3.9, 95% confidence interval (CI) 2.4 to 6.1, p<0.001). Similar differences existed when comparing medication administration error rates between original medication packaging (from original medication packaging-only care homes) and multi-compartment compliance aids (RR=2.3, 95%CI 1.1 to 4.9, p=0.03), and between original medication packaging and multi-compartment compliance aids within care homes that used a combination of both medication administration systems (RR=4.3, 95%CI 2.7 to 6.8, p<0.001). A significant difference in error rate was not observed between use of a single or combination medication administration system (p=0.44). The significant difference in, and high overall, medication administration error rate between original medication packaging and multi-compartment compliance aids supports the use of the latter in care homes, as well as local investigation of tablet and capsule impact on medication administration errors and staff training to prevent errors occurring. As a significant difference in error rate was not observed between use of a single or combination medication administration system, common practice of using both multi-compartment compliance aids (for most medications) and original packaging (for medications with stability issues) is supported. Copyright © 2017 Elsevier Ltd. All rights reserved.

Transition year labeling error characterization study. [Kansas, Minnesota, Montana, North Dakota, South Dakota, and Oklahoma

NASA Technical Reports Server (NTRS)

Clinton, N. J. (Principal Investigator)

1980-01-01

Labeling errors made in the large area crop inventory experiment transition year estimates by Earth Observation Division image analysts are identified and quantified. The analysis was made from a subset of blind sites in six U.S. Great Plains states (Oklahoma, Kansas, Montana, Minnesota, North and South Dakota). The image interpretation basically was well done, resulting in a total omission error rate of 24 percent and a commission error rate of 4 percent. The largest amount of error was caused by factors beyond the control of the analysts who were following the interpretation procedures. The odd signatures, the largest error cause group, occurred mostly in areas of moisture abnormality. Multicrop labeling was tabulated showing the distribution of labeling for all crops.

Comparison of Meropenem MICs and Susceptibilities for Carbapenemase-Producing Klebsiella pneumoniae Isolates by Various Testing Methods▿

PubMed Central

Bulik, Catharine C.; Fauntleroy, Kathy A.; Jenkins, Stephen G.; Abuali, Mayssa; LaBombardi, Vincent J.; Nicolau, David P.; Kuti, Joseph L.

2010-01-01

We describe the levels of agreement between broth microdilution, Etest, Vitek 2, Sensititre, and MicroScan methods to accurately define the meropenem MIC and categorical interpretation of susceptibility against carbapenemase-producing Klebsiella pneumoniae (KPC). A total of 46 clinical K. pneumoniae isolates with KPC genotypes, all modified Hodge test and blaKPC positive, collected from two hospitals in NY were included. Results obtained by each method were compared with those from broth microdilution (the reference method), and agreement was assessed based on MICs and Clinical Laboratory Standards Institute (CLSI) interpretative criteria using 2010 susceptibility breakpoints. Based on broth microdilution, 0%, 2.2%, and 97.8% of the KPC isolates were classified as susceptible, intermediate, and resistant to meropenem, respectively. Results from MicroScan demonstrated the most agreement with those from broth microdilution, with 95.6% agreement based on the MIC and 2.2% classified as minor errors, and no major or very major errors. Etest demonstrated 82.6% agreement with broth microdilution MICs, a very major error rate of 2.2%, and a minor error rate of 2.2%. Vitek 2 MIC agreement was 30.4%, with a 23.9% very major error rate and a 39.1% minor error rate. Sensititre demonstrated MIC agreement for 26.1% of isolates, with a 3% very major error rate and a 26.1% minor error rate. Application of FDA breakpoints had little effect on minor error rates but increased very major error rates to 58.7% for Vitek 2 and Sensititre. Meropenem MIC results and categorical interpretations for carbapenemase-producing K. pneumoniae differ by methodology. Confirmation of testing results is encouraged when an accurate MIC is required for antibiotic dosing optimization. PMID:20484603

Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error.

PubMed

Raab, Stephen S; Grzybicki, Dana Marie; Sudilovsky, Daniel; Balassanian, Ronald; Janosky, Janine E; Vrbin, Colleen M

2006-10-01

Our objective was to determine whether the Toyota Production System process redesign resulted in diagnostic error reduction for patients who underwent cytologic evaluation of thyroid nodules. In this longitudinal, nonconcurrent cohort study, we compared the diagnostic error frequency of a thyroid aspiration service before and after implementation of error reduction initiatives consisting of adoption of a standardized diagnostic terminology scheme and an immediate interpretation service. A total of 2,424 patients underwent aspiration. Following terminology standardization, the false-negative rate decreased from 41.8% to 19.1% (P = .006), the specimen nondiagnostic rate increased from 5.8% to 19.8% (P < .001), and the sensitivity increased from 70.2% to 90.6% (P < .001). Cases with an immediate interpretation had a lower noninterpretable specimen rate than those without immediate interpretation (P < .001). Toyota process change led to significantly fewer diagnostic errors for patients who underwent thyroid fine-needle aspiration.

Impact of an antiretroviral stewardship strategy on medication error rates.

PubMed

Shea, Katherine M; Hobbs, Athena Lv; Shumake, Jason D; Templet, Derek J; Padilla-Tolentino, Eimeira; Mondy, Kristin E

2018-05-02

The impact of an antiretroviral stewardship strategy on medication error rates was evaluated. This single-center, retrospective, comparative cohort study included patients at least 18 years of age infected with human immunodeficiency virus (HIV) who were receiving antiretrovirals and admitted to the hospital. A multicomponent approach was developed and implemented and included modifications to the order-entry and verification system, pharmacist education, and a pharmacist-led antiretroviral therapy checklist. Pharmacists performed prospective audits using the checklist at the time of order verification. To assess the impact of the intervention, a retrospective review was performed before and after implementation to assess antiretroviral errors. Totals of 208 and 24 errors were identified before and after the intervention, respectively, resulting in a significant reduction in the overall error rate ( p < 0.001). In the postintervention group, significantly lower medication error rates were found in both patient admissions containing at least 1 medication error ( p < 0.001) and those with 2 or more errors ( p < 0.001). Significant reductions were also identified in each error type, including incorrect/incomplete medication regimen, incorrect dosing regimen, incorrect renal dose adjustment, incorrect administration, and the presence of a major drug-drug interaction. A regression tree selected ritonavir as the only specific medication that best predicted more errors preintervention ( p < 0.001); however, no antiretrovirals reliably predicted errors postintervention. An antiretroviral stewardship strategy for hospitalized HIV patients including prospective audit by staff pharmacists through use of an antiretroviral medication therapy checklist at the time of order verification decreased error rates. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

A Comparison of Medication Histories Obtained by a Pharmacy Technician Versus Nurses in the Emergency Department

PubMed Central

Markovic, Marija; Mathis, A. Scott; Ghin, Hoytin Lee; Gardiner, Michelle; Fahim, Germin

2017-01-01

Purpose: To compare the medication history error rate of the emergency department (ED) pharmacy technician with that of nursing staff and to describe the workflow environment. Methods: Fifty medication histories performed by an ED nurse followed by the pharmacy technician were evaluated for discrepancies (RN-PT group). A separate 50 medication histories performed by the pharmacy technician and observed with necessary intervention by the ED pharmacist were evaluated for discrepancies (PT-RPh group). Discrepancies were totaled and categorized by type of error and therapeutic category of the medication. The workflow description was obtained by observation and staff interview. Results: A total of 474 medications in the RN-PT group and 521 in the PT-RPh group were evaluated. Nurses made at least one error in all 50 medication histories (100%), compared to 18 medication histories for the pharmacy technician (36%). In the RN-PT group, 408 medications had at least one error, corresponding to an accuracy rate of 14% for nurses. In the PT-RPh group, 30 medications had an error, corresponding to an accuracy rate of 94.4% for the pharmacy technician (P < 0.0001). The most common error made by nurses was a missing medication (n = 109), while the most common error for the pharmacy technician was a wrong medication frequency (n = 19). The most common drug class with documented errors for ED nurses was cardiovascular medications (n = 100), while the pharmacy technician made the most errors in gastrointestinal medications (n = 11). Conclusion: Medication histories obtained by the pharmacy technician were significantly more accurate than those obtained by nurses in the emergency department. PMID:28090164

Rate and power efficient image compressed sensing and transmission

NASA Astrophysics Data System (ADS)

Olanigan, Saheed; Cao, Lei; Viswanathan, Ramanarayanan

2016-01-01

This paper presents a suboptimal quantization and transmission scheme for multiscale block-based compressed sensing images over wireless channels. The proposed method includes two stages: dealing with quantization distortion and transmission errors. First, given the total transmission bit rate, the optimal number of quantization bits is assigned to the sensed measurements in different wavelet sub-bands so that the total quantization distortion is minimized. Second, given the total transmission power, the energy is allocated to different quantization bit layers based on their different error sensitivities. The method of Lagrange multipliers with Karush-Kuhn-Tucker conditions is used to solve both optimization problems, for which the first problem can be solved with relaxation and the second problem can be solved completely. The effectiveness of the scheme is illustrated through simulation results, which have shown up to 10 dB improvement over the method without the rate and power optimization in medium and low signal-to-noise ratio cases.

Errors in clinical laboratories or errors in laboratory medicine?

PubMed

Plebani, Mario

2006-01-01

Laboratory testing is a highly complex process and, although laboratory services are relatively safe, they are not as safe as they could or should be. Clinical laboratories have long focused their attention on quality control methods and quality assessment programs dealing with analytical aspects of testing. However, a growing body of evidence accumulated in recent decades demonstrates that quality in clinical laboratories cannot be assured by merely focusing on purely analytical aspects. The more recent surveys on errors in laboratory medicine conclude that in the delivery of laboratory testing, mistakes occur more frequently before (pre-analytical) and after (post-analytical) the test has been performed. Most errors are due to pre-analytical factors (46-68.2% of total errors), while a high error rate (18.5-47% of total errors) has also been found in the post-analytical phase. Errors due to analytical problems have been significantly reduced over time, but there is evidence that, particularly for immunoassays, interference may have a serious impact on patients. A description of the most frequent and risky pre-, intra- and post-analytical errors and advice on practical steps for measuring and reducing the risk of errors is therefore given in the present paper. Many mistakes in the Total Testing Process are called "laboratory errors", although these may be due to poor communication, action taken by others involved in the testing process (e.g., physicians, nurses and phlebotomists), or poorly designed processes, all of which are beyond the laboratory's control. Likewise, there is evidence that laboratory information is only partially utilized. A recent document from the International Organization for Standardization (ISO) recommends a new, broader definition of the term "laboratory error" and a classification of errors according to different criteria. In a modern approach to total quality, centered on patients' needs and satisfaction, the risk of errors and mistakes in pre- and post-examination steps must be minimized to guarantee the total quality of laboratory services.

Graduate Students' Administration and Scoring Errors on the WISC-IV: Reducing Inaccuracies with Training and Experience

ERIC Educational Resources Information Center

Alper, Jaclyn

2012-01-01

A total of 52 Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) protocols, administered by graduate students were examined to obtain data on the type and frequency of examiner errors, the impact of errors on resultant test scores as well as improvement rate over the course of two years in training. Findings were consistent with…

Influence of measurement error on Maxwell's demon

NASA Astrophysics Data System (ADS)

Sørdal, Vegard; Bergli, Joakim; Galperin, Y. M.

2017-06-01

In any general cycle of measurement, feedback, and erasure, the measurement will reduce the entropy of the system when information about the state is obtained, while erasure, according to Landauer's principle, is accompanied by a corresponding increase in entropy due to the compression of logical and physical phase space. The total process can in principle be fully reversible. A measurement error reduces the information obtained and the entropy decrease in the system. The erasure still gives the same increase in entropy, and the total process is irreversible. Another consequence of measurement error is that a bad feedback is applied, which further increases the entropy production if the proper protocol adapted to the expected error rate is not applied. We consider the effect of measurement error on a realistic single-electron box Szilard engine, and we find the optimal protocol for the cycle as a function of the desired power P and error ɛ .

Frequency and Severity of Parenteral Nutrition Medication Errors at a Large Children's Hospital After Implementation of Electronic Ordering and Compounding.

PubMed

MacKay, Mark; Anderson, Collin; Boehme, Sabrina; Cash, Jared; Zobell, Jeffery

2016-04-01

The Institute for Safe Medication Practices has stated that parenteral nutrition (PN) is considered a high-risk medication and has the potential of causing harm. Three organizations--American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), American Society of Health-System Pharmacists, and National Advisory Group--have published guidelines for ordering, transcribing, compounding and administering PN. These national organizations have published data on compliance to the guidelines and the risk of errors. The purpose of this article is to compare total compliance with ordering, transcription, compounding, administration, and error rate with a large pediatric institution. A computerized prescriber order entry (CPOE) program was developed that incorporates dosing with soft and hard stop recommendations and simultaneously eliminating the need for paper transcription. A CPOE team prioritized and identified issues, then developed solutions and integrated innovative CPOE and automated compounding device (ACD) technologies and practice changes to minimize opportunities for medication errors in PN prescription, transcription, preparation, and administration. Thirty developmental processes were identified and integrated in the CPOE program, resulting in practices that were compliant with A.S.P.E.N. safety consensus recommendations. Data from 7 years of development and implementation were analyzed and compared with published literature comparing error, harm rates, and cost reductions to determine if our process showed lower error rates compared with national outcomes. The CPOE program developed was in total compliance with the A.S.P.E.N. guidelines for PN. The frequency of PN medication errors at our hospital over the 7 years was 230 errors/84,503 PN prescriptions, or 0.27% compared with national data that determined that 74 of 4730 (1.6%) of prescriptions over 1.5 years were associated with a medication error. Errors were categorized by steps in the PN process: prescribing, transcription, preparation, and administration. There were no transcription errors, and most (95%) errors occurred during administration. We conclude that PN practices that conferred a meaningful cost reduction and a lower error rate (2.7/1000 PN) than reported in the literature (15.6/1000 PN) were ascribed to the development and implementation of practices that conform to national PN guidelines and recommendations. Electronic ordering and compounding programs eliminated all transcription and related opportunities for errors. © 2015 American Society for Parenteral and Enteral Nutrition.

The effects of aging on postural control and selective attention when stepping down while performing a concurrent auditory response task.

PubMed

Tsang, William W N; Lam, Nazca K Y; Lau, Kit N L; Leung, Harry C H; Tsang, Crystal M S; Lu, Xi

2013-12-01

To investigate the effects of aging on postural control and cognitive performance in single- and dual-tasking. A cross-sectional comparative design was conducted in a university motion analysis laboratory. Young adults (n = 30; age 21.9 ± 2.4 years) and older adults (n = 30; age 71.9 ± 6.4 years) were recruited. Postural control after stepping down was measured with and without performing a concurrent auditory response task. Measurement included: (1) reaction time and (2) error rate in performing the cognitive task; (3) total sway path and (4) total sway area after stepping down. Our findings showed that the older adults had significantly longer reaction times and higher error rates than the younger subjects in both the single-tasking and dual-tasking conditions. The older adults had significantly longer reaction times and higher error rates when dual-tasking compared with single-tasking, but the younger adults did not. The older adults demonstrated significantly less total sway path, but larger total sway area in single-leg stance after stepping down than the young adults. The older adults showed no significant change in total sway path and area between the dual-tasking and when compared with single-tasking conditions, while the younger adults showed significant decreases in sway. Older adults prioritize postural control by sacrificing cognitive performance when faced with dual-tasking.

Methodological variations and their effects on reported medication administration error rates.

PubMed

McLeod, Monsey Chan; Barber, Nick; Franklin, Bryony Dean

2013-04-01

Medication administration errors (MAEs) are a problem, yet methodological variation between studies presents a potential barrier to understanding how best to increase safety. Using the UK as a case-study, we systematically summarised methodological variations in MAE studies, and their effects on reported MAE rates. Nine healthcare databases were searched for quantitative observational MAE studies in UK hospitals. Methodological variations were analysed and meta-analysis of MAE rates performed using studies that used the same definitions. Odds ratios (OR) were calculated to compare MAE rates between intravenous (IV) and non-IV doses, and between paediatric and adult doses. We identified 16 unique studies reporting three MAE definitions, 44 MAE subcategories and four different denominators. Overall adult MAE rates were 5.6% of a total of 21 533 non-IV opportunities for error (OE) (95% CI 4.6% to 6.7%) and 35% of a total of 154 IV OEs (95% CI 2% to 68%). MAEs were five times more likely in IV than non-IV doses (pooled OR 5.1; 95% CI 3.5 to 7.5). Including timing errors of ±30 min increased the MAE rate from 27% to 69% of 320 IV doses in one study. Five studies were unclear as to whether the denominator included dose omissions; omissions accounted for 0%-13% of IV doses and 1.8%-5.1% of non-IV doses. Wide methodological variations exist even within one country, some with significant effects on reported MAE rates. We have made recommendations for future MAE studies; these may be applied both within and outside the UK.

Precipitation and Latent Heating Distributions from Satellite Passive Microwave Radiometry. Part 1; Improved Method and Uncertainties

NASA Technical Reports Server (NTRS)

Olson, William S.; Kummerow, Christian D.; Yang, Song; Petty, Grant W.; Tao, Wei-Kuo; Bell, Thomas L.; Braun, Scott A.; Wang, Yansen; Lang, Stephen E.; Johnson, Daniel E.;

Experimental investigation of false positive errors in auditory species occurrence surveys

USGS Publications Warehouse

Miller, David A.W.; Weir, Linda A.; McClintock, Brett T.; Grant, Evan H. Campbell; Bailey, Larissa L.; Simons, Theodore R.

2012-01-01

False positive errors are a significant component of many ecological data sets, which in combination with false negative errors, can lead to severe biases in conclusions about ecological systems. We present results of a field experiment where observers recorded observations for known combinations of electronically broadcast calling anurans under conditions mimicking field surveys to determine species occurrence. Our objectives were to characterize false positive error probabilities for auditory methods based on a large number of observers, to determine if targeted instruction could be used to reduce false positive error rates, and to establish useful predictors of among-observer and among-species differences in error rates. We recruited 31 observers, ranging in abilities from novice to expert, that recorded detections for 12 species during 180 calling trials (66,960 total observations). All observers made multiple false positive errors and on average 8.1% of recorded detections in the experiment were false positive errors. Additional instruction had only minor effects on error rates. After instruction, false positive error probabilities decreased by 16% for treatment individuals compared to controls with broad confidence interval overlap of 0 (95% CI: -46 to 30%). This coincided with an increase in false negative errors due to the treatment (26%; -3 to 61%). Differences among observers in false positive and in false negative error rates were best predicted by scores from an online test and a self-assessment of observer ability completed prior to the field experiment. In contrast, years of experience conducting call surveys was a weak predictor of error rates. False positive errors were also more common for species that were played more frequently, but were not related to the dominant spectral frequency of the call. Our results corroborate other work that demonstrates false positives are a significant component of species occurrence data collected by auditory methods. Instructing observers to only report detections they are completely certain are correct is not sufficient to eliminate errors. As a result, analytical methods that account for false positive errors will be needed, and independent testing of observer ability is a useful predictor for among-observer variation in observation error rates.

Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study.

PubMed

Fanning, Laura; Jones, Nick; Manias, Elizabeth

2016-04-01

The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADCs on medication selection and preparation error rates in EDs. Our aim was to assess the impact of ADCs on medication selection and preparation error rates in an ED of a tertiary teaching hospital. Pre intervention and post intervention study involving direct observations of nurses completing medication selection and preparation activities before and after the implementation of ADCs in the original and new emergency departments within a 377-bed tertiary teaching hospital in Australia. Medication selection and preparation error rates were calculated and compared between these two periods. Secondary end points included the impact on medication error type and severity. A total of 2087 medication selection and preparations were observed among 808 patients pre and post intervention. Implementation of ADCs in the new ED resulted in a 64.7% (1.96% versus 0.69%, respectively, P = 0.017) reduction in medication selection and preparation errors. All medication error types were reduced in the post intervention study period. There was an insignificant impact on medication error severity as all errors detected were categorised as minor. The implementation of ADCs could reduce medication selection and preparation errors and improve medication safety in an ED setting. © 2015 John Wiley & Sons, Ltd.

Does raising type 1 error rate improve power to detect interactions in linear regression models? A simulation study.

PubMed

Durand, Casey P

2013-01-01

Statistical interactions are a common component of data analysis across a broad range of scientific disciplines. However, the statistical power to detect interactions is often undesirably low. One solution is to elevate the Type 1 error rate so that important interactions are not missed in a low power situation. To date, no study has quantified the effects of this practice on power in a linear regression model. A Monte Carlo simulation study was performed. A continuous dependent variable was specified, along with three types of interactions: continuous variable by continuous variable; continuous by dichotomous; and dichotomous by dichotomous. For each of the three scenarios, the interaction effect sizes, sample sizes, and Type 1 error rate were varied, resulting in a total of 240 unique simulations. In general, power to detect the interaction effect was either so low or so high at α = 0.05 that raising the Type 1 error rate only served to increase the probability of including a spurious interaction in the model. A small number of scenarios were identified in which an elevated Type 1 error rate may be justified. Routinely elevating Type 1 error rate when testing interaction effects is not an advisable practice. Researchers are best served by positing interaction effects a priori and accounting for them when conducting sample size calculations.

Reliability of a Longitudinal Sequence of Scale Ratings

ERIC Educational Resources Information Center

Laenen, Annouschka; Alonso, Ariel; Molenberghs, Geert; Vangeneugden, Tony

2009-01-01

Reliability captures the influence of error on a measurement and, in the classical setting, is defined as one minus the ratio of the error variance to the total variance. Laenen, Alonso, and Molenberghs ("Psychometrika" 73:443-448, 2007) proposed an axiomatic definition of reliability and introduced the R[subscript T] coefficient, a measure of…

Accuracy of cited “facts” in medical research articles: A review of study methodology and recalculation of quotation error rate

PubMed Central

2017-01-01

Previous reviews estimated that approximately 20 to 25% of assertions cited from original research articles, or “facts,” are inaccurately quoted in the medical literature. These reviews noted that the original studies were dissimilar and only began to compare the methods of the original studies. The aim of this review is to examine the methods of the original studies and provide a more specific rate of incorrectly cited assertions, or quotation errors, in original research articles published in medical journals. Additionally, the estimate of quotation errors calculated here is based on the ratio of quotation errors to quotations examined (a percent) rather than the more prevalent and weighted metric of quotation errors to the references selected. Overall, this resulted in a lower estimate of the quotation error rate in original medical research articles. A total of 15 studies met the criteria for inclusion in the primary quantitative analysis. Quotation errors were divided into two categories: content ("factual") or source (improper indirect citation) errors. Content errors were further subdivided into major and minor errors depending on the degree that the assertion differed from the original source. The rate of quotation errors recalculated here is 14.5% (10.5% to 18.6% at a 95% confidence interval). These content errors are predominantly, 64.8% (56.1% to 73.5% at a 95% confidence interval), major errors or cited assertions in which the referenced source either fails to substantiate, is unrelated to, or contradicts the assertion. Minor errors, which are an oversimplification, overgeneralization, or trivial inaccuracies, are 35.2% (26.5% to 43.9% at a 95% confidence interval). Additionally, improper secondary (or indirect) citations, which are distinguished from calculations of quotation accuracy, occur at a rate of 10.4% (3.4% to 17.5% at a 95% confidence interval). PMID:28910404

Accuracy of cited "facts" in medical research articles: A review of study methodology and recalculation of quotation error rate.

PubMed

Mogull, Scott A

2017-01-01

Previous reviews estimated that approximately 20 to 25% of assertions cited from original research articles, or "facts," are inaccurately quoted in the medical literature. These reviews noted that the original studies were dissimilar and only began to compare the methods of the original studies. The aim of this review is to examine the methods of the original studies and provide a more specific rate of incorrectly cited assertions, or quotation errors, in original research articles published in medical journals. Additionally, the estimate of quotation errors calculated here is based on the ratio of quotation errors to quotations examined (a percent) rather than the more prevalent and weighted metric of quotation errors to the references selected. Overall, this resulted in a lower estimate of the quotation error rate in original medical research articles. A total of 15 studies met the criteria for inclusion in the primary quantitative analysis. Quotation errors were divided into two categories: content ("factual") or source (improper indirect citation) errors. Content errors were further subdivided into major and minor errors depending on the degree that the assertion differed from the original source. The rate of quotation errors recalculated here is 14.5% (10.5% to 18.6% at a 95% confidence interval). These content errors are predominantly, 64.8% (56.1% to 73.5% at a 95% confidence interval), major errors or cited assertions in which the referenced source either fails to substantiate, is unrelated to, or contradicts the assertion. Minor errors, which are an oversimplification, overgeneralization, or trivial inaccuracies, are 35.2% (26.5% to 43.9% at a 95% confidence interval). Additionally, improper secondary (or indirect) citations, which are distinguished from calculations of quotation accuracy, occur at a rate of 10.4% (3.4% to 17.5% at a 95% confidence interval).

Evaluation of analytical errors in a clinical chemistry laboratory: a 3 year experience.

PubMed

Sakyi, As; Laing, Ef; Ephraim, Rk; Asibey, Of; Sadique, Ok

2015-01-01

Proficient laboratory service is the cornerstone of modern healthcare systems and has an impact on over 70% of medical decisions on admission, discharge, and medications. In recent years, there is an increasing awareness of the importance of errors in laboratory practice and their possible negative impact on patient outcomes. We retrospectively analyzed data spanning a period of 3 years on analytical errors observed in our laboratory. The data covered errors over the whole testing cycle including pre-, intra-, and post-analytical phases and discussed strategies pertinent to our settings to minimize their occurrence. We described the occurrence of pre-analytical, analytical and post-analytical errors observed at the Komfo Anokye Teaching Hospital clinical biochemistry laboratory during a 3-year period from January, 2010 to December, 2012. Data were analyzed with Graph Pad Prism 5(GraphPad Software Inc. CA USA). A total of 589,510 tests was performed on 188,503 outpatients and hospitalized patients. The overall error rate for the 3 years was 4.7% (27,520/58,950). Pre-analytical, analytical and post-analytical errors contributed 3.7% (2210/58,950), 0.1% (108/58,950), and 0.9% (512/58,950), respectively. The number of tests reduced significantly over the 3-year period, but this did not correspond with a reduction in the overall error rate (P = 0.90) along with the years. Analytical errors are embedded within our total process setup especially pre-analytical and post-analytical phases. Strategic measures including quality assessment programs for staff involved in pre-analytical processes should be intensified.

Older drivers: On-road and off-road test results.

PubMed

Selander, Helena; Lee, Hoe C; Johansson, Kurt; Falkmer, Torbjörn

2011-07-01

Eighty-five volunteer drivers, 65-85 years old, without cognitive impairments impacting on their driving were examined, in order to investigate driving errors characteristic for older drivers. In addition, any relationships between cognitive off-road and on-road tests results, the latter being the gold standard, were identified. Performance measurements included Trail Making Test (TMT), Nordic Stroke Driver Screening Assessment (NorSDSA), Useful Field of View (UFOV), self-rating driving performance and the two on-road protocols P-Drive and ROA. Some of the older drivers displayed questionable driving behaviour. In total, 21% of the participants failed the on-road assessment. Some of the specific errors were more serious than others. The most common driving errors embraced speed; exceeding the speed limit or not controlling the speed. Correlations with the P-Drive protocol were established for NorSDSA total score (weak), UFOV subtest 2 (weak), and UFOV subtest 3 (moderate). Correlations with the ROA protocol were established for UFOV subtest 2 (weak) and UFOV subtest 3 (weak). P-Drive and self ratings correlated weakly, whereas no correlation between self ratings and the ROA protocol was found. The results suggest that specific problems or errors seen in an older person's driving can actually be "normal driving behaviours". Copyright © 2011 Elsevier Ltd. All rights reserved.

A comparison of acoustic montoring methods for common anurans of the northeastern United States

USGS Publications Warehouse

Brauer, Corinne; Donovan, Therese; Mickey, Ruth M.; Katz, Jonathan; Mitchell, Brian R.

2016-01-01

Many anuran monitoring programs now include autonomous recording units (ARUs). These devices collect audio data for extended periods of time with little maintenance and at sites where traditional call surveys might be difficult. Additionally, computer software programs have grown increasingly accurate at automatically identifying the calls of species. However, increased automation may cause increased error. We collected 435 min of audio data with 2 types of ARUs at 10 wetland sites in Vermont and New York, USA, from 1 May to 1 July 2010. For each minute, we determined presence or absence of 4 anuran species (Hyla versicolor, Pseudacris crucifer, Anaxyrus americanus, and Lithobates clamitans) using 1) traditional human identification versus 2) computer-mediated identification with software package, Song Scope® (Wildlife Acoustics, Concord, MA). Detections were compared with a data set consisting of verified calls in order to quantify false positive, false negative, true positive, and true negative rates. Multinomial logistic regression analysis revealed a strong (P < 0.001) 3-way interaction between the ARU recorder type, identification method, and focal species, as well as a trend in the main effect of rain (P = 0.059). Overall, human surveyors had the lowest total error rate (<2%) compared with 18–31% total errors with automated methods. Total error rates varied by species, ranging from 4% for A. americanus to 26% for L. clamitans. The presence of rain may reduce false negative rates. For survey minutes where anurans were known to be calling, the odds of a false negative were increased when fewer individuals of the same species were calling.

Computer calculated dose in paediatric prescribing.

PubMed

Kirk, Richard C; Li-Meng Goh, Denise; Packia, Jeya; Min Kam, Huey; Ong, Benjamin K C

2005-01-01

Medication errors are an important cause of hospital-based morbidity and mortality. However, only a few medication error studies have been conducted in children. These have mainly quantified errors in the inpatient setting; there is very little data available on paediatric outpatient and emergency department medication errors and none on discharge medication. This deficiency is of concern because medication errors are more common in children and it has been suggested that the risk of an adverse drug event as a consequence of a medication error is higher in children than in adults. The aims of this study were to assess the rate of medication errors in predominantly ambulatory paediatric patients and the effect of computer calculated doses on medication error rates of two commonly prescribed drugs. This was a prospective cohort study performed in a paediatric unit in a university teaching hospital between March 2003 and August 2003. The hospital's existing computer clinical decision support system was modified so that doctors could choose the traditional prescription method or the enhanced method of computer calculated dose when prescribing paracetamol (acetaminophen) or promethazine. All prescriptions issued to children (<16 years of age) at the outpatient clinic, emergency department and at discharge from the inpatient service were analysed. A medication error was defined as to have occurred if there was an underdose (below the agreed value), an overdose (above the agreed value), no frequency of administration specified, no dose given or excessive total daily dose. The medication error rates and the factors influencing medication error rates were determined using SPSS version 12. From March to August 2003, 4281 prescriptions were issued. Seven prescriptions (0.16%) were excluded, hence 4274 prescriptions were analysed. Most prescriptions were issued by paediatricians (including neonatologists and paediatric surgeons) and/or junior doctors. The error rate in the children's emergency department was 15.7%, for outpatients was 21.5% and for discharge medication was 23.6%. Most errors were the result of an underdose (64%; 536/833). The computer calculated dose error rate was 12.6% compared with the traditional prescription error rate of 28.2%. Logistical regression analysis showed that computer calculated dose was an important and independent variable influencing the error rate (adjusted relative risk = 0.436, 95% CI 0.336, 0.520, p < 0.001). Other important independent variables were seniority and paediatric training of the person prescribing and the type of drug prescribed. Medication error, especially underdose, is common in outpatient, emergency department and discharge prescriptions. Computer calculated doses can significantly reduce errors, but other risk factors have to be concurrently addressed to achieve maximum benefit.

Sampling Errors in Monthly Rainfall Totals for TRMM and SSM/I, Based on Statistics of Retrieved Rain Rates and Simple Models

NASA Technical Reports Server (NTRS)

Bell, Thomas L.; Kundu, Prasun K.; Einaudi, Franco (Technical Monitor)

2000-01-01

Estimates from TRMM satellite data of monthly total rainfall over an area are subject to substantial sampling errors due to the limited number of visits to the area by the satellite during the month. Quantitative comparisons of TRMM averages with data collected by other satellites and by ground-based systems require some estimate of the size of this sampling error. A method of estimating this sampling error based on the actual statistics of the TRMM observations and on some modeling work has been developed. "Sampling error" in TRMM monthly averages is defined here relative to the monthly total a hypothetical satellite permanently stationed above the area would have reported. "Sampling error" therefore includes contributions from the random and systematic errors introduced by the satellite remote sensing system. As part of our long-term goal of providing error estimates for each grid point accessible to the TRMM instruments, sampling error estimates for TRMM based on rain retrievals from TRMM microwave (TMI) data are compared for different times of the year and different oceanic areas (to minimize changes in the statistics due to algorithmic differences over land and ocean). Changes in sampling error estimates due to changes in rain statistics due 1) to evolution of the official algorithms used to process the data, and 2) differences from other remote sensing systems such as the Defense Meteorological Satellite Program (DMSP) Special Sensor Microwave/Imager (SSM/I), are analyzed.

Frequency and analysis of non-clinical errors made in radiology reports using the National Integrated Medical Imaging System voice recognition dictation software.

PubMed

Motyer, R E; Liddy, S; Torreggiani, W C; Buckley, O

2016-11-01

Voice recognition (VR) dictation of radiology reports has become the mainstay of reporting in many institutions worldwide. Despite benefit, such software is not without limitations, and transcription errors have been widely reported. Evaluate the frequency and nature of non-clinical transcription error using VR dictation software. Retrospective audit of 378 finalised radiology reports. Errors were counted and categorised by significance, error type and sub-type. Data regarding imaging modality, report length and dictation time was collected. 67 (17.72 %) reports contained ≥1 errors, with 7 (1.85 %) containing 'significant' and 9 (2.38 %) containing 'very significant' errors. A total of 90 errors were identified from the 378 reports analysed, with 74 (82.22 %) classified as 'insignificant', 7 (7.78 %) as 'significant', 9 (10 %) as 'very significant'. 68 (75.56 %) errors were 'spelling and grammar', 20 (22.22 %) 'missense' and 2 (2.22 %) 'nonsense'. 'Punctuation' error was most common sub-type, accounting for 27 errors (30 %). Complex imaging modalities had higher error rates per report and sentence. Computed tomography contained 0.040 errors per sentence compared to plain film with 0.030. Longer reports had a higher error rate, with reports >25 sentences containing an average of 1.23 errors per report compared to 0-5 sentences containing 0.09. These findings highlight the limitations of VR dictation software. While most error was deemed insignificant, there were occurrences of error with potential to alter report interpretation and patient management. Longer reports and reports on more complex imaging had higher error rates and this should be taken into account by the reporting radiologist.

Sleep quality, but not quantity, is associated with self-perceived minor error rates among emergency department nurses.

PubMed

Weaver, Amy L; Stutzman, Sonja E; Supnet, Charlene; Olson, DaiWai M

2016-03-01

The emergency department (ED) is demanding and high risk. The impact of sleep quantity has been hypothesized to impact patient care. This study investigated the hypothesis that fatigue and impaired mentation, due to sleep disturbance and shortened overall sleeping hours, would lead to increased nursing errors. This is a prospective observational study of 30 ED nurses using self-administered survey and sleep architecture measured by wrist actigraphy as predictors of self-reported error rates. An actigraphy device was worn prior to working a 12-hour shift and nurses completed the Pittsburgh Sleep Quality Index (PSQI). Error rates were reported on a visual analog scale at the end of a 12-hour shift. The PSQI responses indicated that 73.3% of subjects had poor sleep quality. Lower sleep quality measured by actigraphy (hours asleep/hours in bed) was associated with higher self-perceived minor errors. Sleep quantity (total hours slept) was not associated with minor, moderate, nor severe errors. Our study found that ED nurses' sleep quality, immediately prior to a working 12-hour shift, is more predictive of error than sleep quantity. These results present evidence that a "good night's sleep" prior to working a nursing shift in the ED is beneficial for reducing minor errors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients.

PubMed

Commers, Tessa; Swindells, Susan; Sayles, Harlan; Gross, Alan E; Devetten, Marcel; Sandkovsky, Uriel

2014-01-01

Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infected patients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associated costs. A retrospective review of hospitalized HIV-infected patients was carried out between 1 January 2009 and 31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrect scheduling and/or incorrect therapy. The time to error correction was recorded. Relative risks (RRs) were computed to evaluate patient characteristics and error rates. A total of 289 medication errors were identified in 146/416 admissions (35%). The most common was drug omission (69%). At an error rate of 31%, nucleoside reverse transcriptase inhibitors were associated with an increased risk of error when compared with protease inhibitors (RR 1.32; 95% CI 1.04-1.69) and co-formulated drugs (RR 1.59; 95% CI 1.19-2.09). Of the errors, 31% were corrected within the first 24 h, but over half (55%) were never remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within 24 h than were admissions without an omission. Drug interactions with ART were detected on 51 occasions. For the study population (n = 177), an increased risk of admission error was observed for black (43%) compared with white (28%) individuals (RR 1.53; 95% CI 1.16-2.03) but no significant differences were observed between white patients and other minorities or between men and women. Errors in inpatient ART were common, and the majority were never detected. The most common errors involved omission of medication, and nucleoside reverse transcriptase inhibitors had the highest rate of prescribing error. Interventions to prevent and correct errors are urgently needed.

The Constant Error of the Halo in Educational Outcomes Research. AIR 1998 Annual Forum Paper.

ERIC Educational Resources Information Center

Pike, Gary R.

This study examined whether halo error--the masking of college gains by general gains in intellectual development--influenced students' ratings of their learning and development during college. A total of 1,084 first-time freshmen at the University of Missouri-Columbia (MU) completed the College Student Experiences Questionnaire (CSEQ) during the…

Reference Accuracy among Research Articles Published in "Research on Social Work Practice"

ERIC Educational Resources Information Center

Wilks, Scott E.; Geiger, Jennifer R.; Bates, Samantha M.; Wright, Amy L.

2017-01-01

Objective: The objective was to examine reference errors in research articles published in Research on Social Work Practice. High rates of reference errors in other top social work journals have been noted in previous studies. Methods: Via a sampling frame of 22,177 total references among 464 research articles published in the previous decade, a…

Validation of prostate-specific antigen laboratory values recorded in Surveillance, Epidemiology, and End Results registries.

PubMed

Adamo, Margaret Peggy; Boten, Jessica A; Coyle, Linda M; Cronin, Kathleen A; Lam, Clara J K; Negoita, Serban; Penberthy, Lynne; Stevens, Jennifer L; Ward, Kevin C

2017-02-15

Researchers have used prostate-specific antigen (PSA) values collected by central cancer registries to evaluate tumors for potential aggressive clinical disease. An independent study collecting PSA values suggested a high error rate (18%) related to implied decimal points. To evaluate the error rate in the Surveillance, Epidemiology, and End Results (SEER) program, a comprehensive review of PSA values recorded across all SEER registries was performed. Consolidated PSA values for eligible prostate cancer cases in SEER registries were reviewed and compared with text documentation from abstracted records. Four types of classification errors were identified: implied decimal point errors, abstraction or coding implementation errors, nonsignificant errors, and changes related to "unknown" values. A total of 50,277 prostate cancer cases diagnosed in 2012 were reviewed. Approximately 94.15% of cases did not have meaningful changes (85.85% correct, 5.58% with a nonsignificant change of <1 ng/mL, and 2.80% with no clinical change). Approximately 5.70% of cases had meaningful changes (1.93% due to implied decimal point errors, 1.54% due to abstract or coding errors, and 2.23% due to errors related to unknown categories). Only 419 of the original 50,277 cases (0.83%) resulted in a change in disease stage due to a corrected PSA value. The implied decimal error rate was only 1.93% of all cases in the current validation study, with a meaningful error rate of 5.81%. The reasons for the lower error rate in SEER are likely due to ongoing and rigorous quality control and visual editing processes by the central registries. The SEER program currently is reviewing and correcting PSA values back to 2004 and will re-release these data in the public use research file. Cancer 2017;123:697-703. © 2016 American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

A prospective audit of a nurse independent prescribing within critical care.

PubMed

Carberry, Martin; Connelly, Sarah; Murphy, Jennifer

2013-05-01

To determine the prescribing activity of different staff groups within intensive care unit (ICU) and combined high dependency unit (HDU), namely trainee and consultant medical staff and advanced nurse practitioners in critical care (ANPCC); to determine the number and type of prescription errors; to compare error rates between prescribing groups and to raise awareness of prescribing activity within critical care. The introduction of government legislation has led to the development of non-medical prescribing roles in acute care. This has facilitated an opportunity for the ANPCC working in critical care to develop a prescribing role. The audit was performed over 7 days (Monday-Sunday), on rolling days over a 7-week period in September and October 2011 in three ICUs. All drug entries made on the ICU prescription by the three groups, trainee medical staff, ANPCCs and consultant anaesthetists, were audited once for errors. Data were collected by reviewing all drug entries for errors namely, patient data, drug dose, concentration, rate and frequency, legibility and prescriber signature. A paper data collection tool was used initially; data was later entered onto a Microsoft Access data base. A total of 1418 drug entries were audited from 77 patient prescription Cardexes. Error rates were reported as, 40 errors in 1418 prescriptions (2·8%): ANPCC errors, n = 2 in 388 prescriptions (0·6%); trainee medical staff errors, n = 33 in 984 (3·4%); consultant errors, n = 5 in 73 (6·8%). The error rates were significantly different for different prescribing groups (p < 0·01). This audit shows that prescribing error rates were low (2·8%). Having the lowest error rate, the nurse practitioners are at least as effective as other prescribing groups within this audit, in terms of errors only, in prescribing diligence. National data is required in order to benchmark independent nurse prescribing practice in critical care. These findings could be used to inform research and role development within the critical care. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

Corrections of clinical chemistry test results in a laboratory information system.

PubMed

Wang, Sihe; Ho, Virginia

2004-08-01

The recently released reports by the Institute of Medicine, To Err Is Human and Patient Safety, have received national attention because of their focus on the problem of medical errors. Although a small number of studies have reported on errors in general clinical laboratories, there are, to our knowledge, no reported studies that focus on errors in pediatric clinical laboratory testing. To characterize the errors that have caused corrections to have to be made in pediatric clinical chemistry results in the laboratory information system, Misys. To provide initial data on the errors detected in pediatric clinical chemistry laboratories in order to improve patient safety in pediatric health care. All clinical chemistry staff members were informed of the study and were requested to report in writing when a correction was made in the laboratory information system, Misys. Errors were detected either by the clinicians (the results did not fit the patients' clinical conditions) or by the laboratory technologists (the results were double-checked, and the worksheets were carefully examined twice a day). No incident that was discovered before or during the final validation was included. On each Monday of the study, we generated a report from Misys that listed all of the corrections made during the previous week. We then categorized the corrections according to the types and stages of the incidents that led to the corrections. A total of 187 incidents were detected during the 10-month study, representing a 0.26% error detection rate per requisition. The distribution of the detected incidents included 31 (17%) preanalytic incidents, 46 (25%) analytic incidents, and 110 (59%) postanalytic incidents. The errors related to noninterfaced tests accounted for 50% of the total incidents and for 37% of the affected tests and orderable panels, while the noninterfaced tests and panels accounted for 17% of the total test volume in our laboratory. This pilot study provided the rate and categories of errors detected in a pediatric clinical chemistry laboratory based on the corrections of results in the laboratory information system. A direct interface of the instruments to the laboratory information system showed that it had favorable effects on reducing laboratory errors.

Efficiently characterizing the total error in quantum circuits

NASA Astrophysics Data System (ADS)

Carignan-Dugas, Arnaud; Wallman, Joel J.; Emerson, Joseph

A promising technological advancement meant to enlarge our computational means is the quantum computer. Such a device would harvest the quantum complexity of the physical world in order to unfold concrete mathematical problems more efficiently. However, the errors emerging from the implementation of quantum operations are likewise quantum, and hence share a similar level of intricacy. Fortunately, randomized benchmarking protocols provide an efficient way to characterize the operational noise within quantum devices. The resulting figures of merit, like the fidelity and the unitarity, are typically attached to a set of circuit components. While important, this doesn't fulfill the main goal: determining if the error rate of the total circuit is small enough in order to trust its outcome. In this work, we fill the gap by providing an optimal bound on the total fidelity of a circuit in terms of component-wise figures of merit. Our bound smoothly interpolates between the classical regime, in which the error rate grows linearly in the circuit's length, and the quantum regime, which can naturally allow quadratic growth. Conversely, our analysis substantially improves the bounds on single circuit element fidelities obtained through techniques such as interleaved randomized benchmarking. This research was supported by the U.S. Army Research Office through Grant W911NF- 14-1-0103, CIFAR, the Government of Ontario, and the Government of Canada through NSERC and Industry Canada.

Evaluation of Analytical Errors in a Clinical Chemistry Laboratory: A 3 Year Experience

PubMed Central

Sakyi, AS; Laing, EF; Ephraim, RK; Asibey, OF; Sadique, OK

2015-01-01

Background: Proficient laboratory service is the cornerstone of modern healthcare systems and has an impact on over 70% of medical decisions on admission, discharge, and medications. In recent years, there is an increasing awareness of the importance of errors in laboratory practice and their possible negative impact on patient outcomes. Aim: We retrospectively analyzed data spanning a period of 3 years on analytical errors observed in our laboratory. The data covered errors over the whole testing cycle including pre-, intra-, and post-analytical phases and discussed strategies pertinent to our settings to minimize their occurrence. Materials and Methods: We described the occurrence of pre-analytical, analytical and post-analytical errors observed at the Komfo Anokye Teaching Hospital clinical biochemistry laboratory during a 3-year period from January, 2010 to December, 2012. Data were analyzed with Graph Pad Prism 5(GraphPad Software Inc. CA USA). Results: A total of 589,510 tests was performed on 188,503 outpatients and hospitalized patients. The overall error rate for the 3 years was 4.7% (27,520/58,950). Pre-analytical, analytical and post-analytical errors contributed 3.7% (2210/58,950), 0.1% (108/58,950), and 0.9% (512/58,950), respectively. The number of tests reduced significantly over the 3-year period, but this did not correspond with a reduction in the overall error rate (P = 0.90) along with the years. Conclusion: Analytical errors are embedded within our total process setup especially pre-analytical and post-analytical phases. Strategic measures including quality assessment programs for staff involved in pre-analytical processes should be intensified. PMID:25745569

Automated drug dispensing system reduces medication errors in an intensive care setting.

PubMed

Chapuis, Claire; Roustit, Matthieu; Bal, Gaëlle; Schwebel, Carole; Pansu, Pascal; David-Tchouda, Sandra; Foroni, Luc; Calop, Jean; Timsit, Jean-François; Allenet, Benoît; Bosson, Jean-Luc; Bedouch, Pierrick

2010-12-01

We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction. Preintervention and postintervention study involving a control and an intervention medical intensive care unit. Two medical intensive care units in the same department of a 2,000-bed university hospital. Adult medical intensive care patients. After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control. The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; p<.05); however, no significant difference was observed before automated dispensing system implementation (20.4% and 19.3%, respectively; not significant). Before-and-after comparisons in the study unit also showed a significantly reduced percentage of total opportunities for error (20.4% and 13.5%; p<.01). An analysis of detailed opportunities for error showed a significant impact of the automated dispensing system in reducing preparation errors (p<.05). Most errors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale. The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.

On the Mutual Information of Multi-hop Acoustic Sensors Network in Underwater Wireless Communication

DTIC Science & Technology

2014-05-01

DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. The University of the District of Columbia Computer Science and Informati Briana Lowe Wellman Washington...financial support throughout my Master’s study and research. Also, I would like to acknowledge the Faculty of the Electrical and Computer Engineering...received bits are in error, and then compute the bit-error-rate as the number of bit errors divided by the total number of bits in the transmitted signal

Validation Relaxation: A Quality Assurance Strategy for Electronic Data Collection

PubMed Central

Gordon, Nicholas; Griffiths, Thomas; Kraemer, John D; Siedner, Mark J

2017-01-01

Background The use of mobile devices for data collection in developing world settings is becoming increasingly common and may offer advantages in data collection quality and efficiency relative to paper-based methods. However, mobile data collection systems can hamper many standard quality assurance techniques due to the lack of a hardcopy backup of data. Consequently, mobile health data collection platforms have the potential to generate datasets that appear valid, but are susceptible to unidentified database design flaws, areas of miscomprehension by enumerators, and data recording errors. Objective We describe the design and evaluation of a strategy for estimating data error rates and assessing enumerator performance during electronic data collection, which we term “validation relaxation.” Validation relaxation involves the intentional omission of data validation features for select questions to allow for data recording errors to be committed, detected, and monitored. Methods We analyzed data collected during a cluster sample population survey in rural Liberia using an electronic data collection system (Open Data Kit). We first developed a classification scheme for types of detectable errors and validation alterations required to detect them. We then implemented the following validation relaxation techniques to enable data error conduct and detection: intentional redundancy, removal of “required” constraint, and illogical response combinations. This allowed for up to 11 identifiable errors to be made per survey. The error rate was defined as the total number of errors committed divided by the number of potential errors. We summarized crude error rates and estimated changes in error rates over time for both individuals and the entire program using logistic regression. Results The aggregate error rate was 1.60% (125/7817). Error rates did not differ significantly between enumerators (P=.51), but decreased for the cohort with increasing days of application use, from 2.3% at survey start (95% CI 1.8%-2.8%) to 0.6% at day 45 (95% CI 0.3%-0.9%; OR=0.969; P<.001). The highest error rate (84/618, 13.6%) occurred for an intentional redundancy question for a birthdate field, which was repeated in separate sections of the survey. We found low error rates (0.0% to 3.1%) for all other possible errors. Conclusions A strategy of removing validation rules on electronic data capture platforms can be used to create a set of detectable data errors, which can subsequently be used to assess group and individual enumerator error rates, their trends over time, and categories of data collection that require further training or additional quality control measures. This strategy may be particularly useful for identifying individual enumerators or systematic data errors that are responsive to enumerator training and is best applied to questions for which errors cannot be prevented through training or software design alone. Validation relaxation should be considered as a component of a holistic data quality assurance strategy. PMID:28821474

Validation Relaxation: A Quality Assurance Strategy for Electronic Data Collection.

PubMed

Kenny, Avi; Gordon, Nicholas; Griffiths, Thomas; Kraemer, John D; Siedner, Mark J

2017-08-18

The use of mobile devices for data collection in developing world settings is becoming increasingly common and may offer advantages in data collection quality and efficiency relative to paper-based methods. However, mobile data collection systems can hamper many standard quality assurance techniques due to the lack of a hardcopy backup of data. Consequently, mobile health data collection platforms have the potential to generate datasets that appear valid, but are susceptible to unidentified database design flaws, areas of miscomprehension by enumerators, and data recording errors. We describe the design and evaluation of a strategy for estimating data error rates and assessing enumerator performance during electronic data collection, which we term "validation relaxation." Validation relaxation involves the intentional omission of data validation features for select questions to allow for data recording errors to be committed, detected, and monitored. We analyzed data collected during a cluster sample population survey in rural Liberia using an electronic data collection system (Open Data Kit). We first developed a classification scheme for types of detectable errors and validation alterations required to detect them. We then implemented the following validation relaxation techniques to enable data error conduct and detection: intentional redundancy, removal of "required" constraint, and illogical response combinations. This allowed for up to 11 identifiable errors to be made per survey. The error rate was defined as the total number of errors committed divided by the number of potential errors. We summarized crude error rates and estimated changes in error rates over time for both individuals and the entire program using logistic regression. The aggregate error rate was 1.60% (125/7817). Error rates did not differ significantly between enumerators (P=.51), but decreased for the cohort with increasing days of application use, from 2.3% at survey start (95% CI 1.8%-2.8%) to 0.6% at day 45 (95% CI 0.3%-0.9%; OR=0.969; P<.001). The highest error rate (84/618, 13.6%) occurred for an intentional redundancy question for a birthdate field, which was repeated in separate sections of the survey. We found low error rates (0.0% to 3.1%) for all other possible errors. A strategy of removing validation rules on electronic data capture platforms can be used to create a set of detectable data errors, which can subsequently be used to assess group and individual enumerator error rates, their trends over time, and categories of data collection that require further training or additional quality control measures. This strategy may be particularly useful for identifying individual enumerators or systematic data errors that are responsive to enumerator training and is best applied to questions for which errors cannot be prevented through training or software design alone. Validation relaxation should be considered as a component of a holistic data quality assurance strategy. ©Avi Kenny, Nicholas Gordon, Thomas Griffiths, John D Kraemer, Mark J Siedner. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.08.2017.

Hospital-based transfusion error tracking from 2005 to 2010: identifying the key errors threatening patient transfusion safety.

PubMed

Maskens, Carolyn; Downie, Helen; Wendt, Alison; Lima, Ana; Merkley, Lisa; Lin, Yulia; Callum, Jeannie

2014-01-01

This report provides a comprehensive analysis of transfusion errors occurring at a large teaching hospital and aims to determine key errors that are threatening transfusion safety, despite implementation of safety measures. Errors were prospectively identified from 2005 to 2010. Error data were coded on a secure online database called the Transfusion Error Surveillance System. Errors were defined as any deviation from established standard operating procedures. Errors were identified by clinical and laboratory staff. Denominator data for volume of activity were used to calculate rates. A total of 15,134 errors were reported with a median number of 215 errors per month (range, 85-334). Overall, 9083 (60%) errors occurred on the transfusion service and 6051 (40%) on the clinical services. In total, 23 errors resulted in patient harm: 21 of these errors occurred on the clinical services and two in the transfusion service. Of the 23 harm events, 21 involved inappropriate use of blood. Errors with no harm were 657 times more common than events that caused harm. The most common high-severity clinical errors were sample labeling (37.5%) and inappropriate ordering of blood (28.8%). The most common high-severity error in the transfusion service was sample accepted despite not meeting acceptance criteria (18.3%). The cost of product and component loss due to errors was $593,337. Errors occurred at every point in the transfusion process, with the greatest potential risk of patient harm resulting from inappropriate ordering of blood products and errors in sample labeling. © 2013 American Association of Blood Banks (CME).

Relative dosimetrical verification in high dose rate brachytherapy using two-dimensional detector array IMatriXX

PubMed Central

Manikandan, A.; Biplab, Sarkar; David, Perianayagam A.; Holla, R.; Vivek, T. R.; Sujatha, N.

2011-01-01

For high dose rate (HDR) brachytherapy, independent treatment verification is needed to ensure that the treatment is performed as per prescription. This study demonstrates dosimetric quality assurance of the HDR brachytherapy using a commercially available two-dimensional ion chamber array called IMatriXX, which has a detector separation of 0.7619 cm. The reference isodose length, step size, and source dwell positional accuracy were verified. A total of 24 dwell positions, which were verified for positional accuracy gave a total error (systematic and random) of –0.45 mm, with a standard deviation of 1.01 mm and maximum error of 1.8 mm. Using a step size of 5 mm, reference isodose length (the length of 100% isodose line) was verified for single and multiple catheters of same and different source loadings. An error ≤1 mm was measured in 57% of tests analyzed. Step size verification for 2, 3, 4, and 5 cm was performed and 70% of the step size errors were below 1 mm, with maximum of 1.2 mm. The step size ≤1 cm could not be verified by the IMatriXX as it could not resolve the peaks in dose profile. PMID:21897562

Examining the accuracy of foodservice in a hospital setting.

PubMed

Glover, N S; Keane, T M

1984-09-01

Although a great deal of research has been conducted to determine the appropriate diets for the prevention and treatment of various illnesses, there is very little in the literature about research that directly assesses the accuracy of the prescribed diets served to patients in a hospital setting. The present study was designed to evaluate the accuracy of meals served to patients by identifying critical errors and more general errors on trays about to be served. The results indicated that the error rate was greater on weekends and holidays than during the week. Significantly, a correlational analysis revealed that error rate was inversely related to the total number of foodservice supervisors and more specifically to the number of food production supervisors and registered dietitians present. The implications of the results for possible interventions and training are discussed.

Error identification in a high-volume clinical chemistry laboratory: Five-year experience.

PubMed

Jafri, Lena; Khan, Aysha Habib; Ghani, Farooq; Shakeel, Shahid; Raheem, Ahmed; Siddiqui, Imran

2015-07-01

Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators - visible hemolysis, failure of proficiency testing and delay in stat tests - were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.

Quality of routine health data collected by health workers using smartphone at primary health care in Ethiopia.

PubMed

Medhanyie, Araya Abrha; Spigt, Mark; Yebyo, Henock; Little, Alex; Tadesse, Kidane; Dinant, Geert-Jan; Blanco, Roman

2017-05-01

Mobile phone based applications are considered by many as potentially useful for addressing challenges and improving the quality of data collection in developing countries. Yet very little evidence is available supporting or refuting the potential and widely perceived benefits on the use of electronic forms on smartphones for routine patient data collection by health workers at primary health care facilities. A facility based cross sectional study using a structured paper checklist was prepared to assess the completeness and accuracy of 408 electronic records completed and submitted to a central database server using electronic forms on smartphones by 25 health workers. The 408 electronic records were selected randomly out of a total of 1772 maternal health records submitted by the health workers to the central database over a period of six months. Descriptive frequencies and percentages of data completeness and error rates were calculated. When compared to paper records, the use of electronic forms significantly improved data completeness by 209 (8%) entries. Of a total 2622 entries checked for completeness, 2602 (99.2%) electronic record entries were complete, while 2393 (91.3%) paper record entries were complete. A very small percentage of error rates, which was easily identifiable, occurred in both electronic and paper forms although the error rate in the electronic records was more than double that of paper records (2.8% vs. 1.1%). More than half of entry errors in the electronic records related to entering a text value. With minimal training, supervision, and no incentives, health care workers were able to use electronic forms for patient assessment and routine data collection appropriately and accurately with a very small error rate. Minimising the number of questions requiring text responses in electronic forms would be helpful in minimizing data errors. Copyright © 2017 Elsevier B.V. All rights reserved.

Usefulness of biological fingerprint in magnetic resonance imaging for patient verification.

PubMed

Ueda, Yasuyuki; Morishita, Junji; Kudomi, Shohei; Ueda, Katsuhiko

2016-09-01

The purpose of our study is to investigate the feasibility of automated patient verification using multi-planar reconstruction (MPR) images generated from three-dimensional magnetic resonance (MR) imaging of the brain. Several anatomy-related MPR images generated from three-dimensional fast scout scan of each MR examination were used as biological fingerprint images in this study. The database of this study consisted of 730 temporal pairs of MR examination of the brain. We calculated the correlation value between current and prior biological fingerprint images of the same patient and also all combinations of two images for different patients to evaluate the effectiveness of our method for patient verification. The best performance of our system were as follows: a half-total error rate of 1.59 % with a false acceptance rate of 0.023 % and a false rejection rate of 3.15 %, an equal error rate of 1.37 %, and a rank-one identification rate of 98.6 %. Our method makes it possible to verify the identity of the patient using only some existing medical images without the addition of incidental equipment. Also, our method will contribute to patient misidentification error management caused by human errors.

Estimation of particulate nutrient load using turbidity meter.

PubMed

Yamamoto, K; Suetsugi, T

2006-01-01

The "Nutrient Load Hysteresis Coefficient" was proposed to evaluate the hysteresis of the nutrient loads to flow rate quantitatively. This could classify the runoff patterns of nutrient load into 15 patterns. Linear relationships between the turbidity and the concentrations of particulate nutrients were observed. It was clarified that the linearity was caused by the influence of the particle size on turbidity output and accumulation of nutrients on smaller particles (diameter < 23 microm). The L-Q-Turb method, which is a new method for the estimation of runoff loads of nutrients using a regression curve between the turbidity and the concentrations of particulate nutrients, was developed. This method could raise the precision of the estimation of nutrient loads even if they had strong hysteresis to flow rate. For example, as for the runoff load of total phosphorus load on flood events in a total of eight cases, the averaged error of estimation of total phosphorus load by the L-Q-Turb method was 11%, whereas the averaged estimation error by the regression curve between flow rate and nutrient load was 28%.

The incidence and severity of errors in pharmacist-written discharge medication orders.

PubMed

Onatade, Raliat; Sawieres, Sara; Veck, Alexandra; Smith, Lindsay; Gore, Shivani; Al-Azeib, Sumiah

2017-08-01

Background Errors in discharge prescriptions are problematic. When hospital pharmacists write discharge prescriptions improvements are seen in the quality and efficiency of discharge. There is limited information on the incidence of errors in pharmacists' medication orders. Objective To investigate the extent and clinical significance of errors in pharmacist-written discharge medication orders. Setting 1000-bed teaching hospital in London, UK. Method Pharmacists in this London hospital routinely write discharge medication orders as part of the clinical pharmacy service. Convenient days, based on researcher availability, between October 2013 and January 2014 were selected. Pre-registration pharmacists reviewed all discharge medication orders written by pharmacists on these days and identified discrepancies between the medication history, inpatient chart, patient records and discharge summary. A senior clinical pharmacist confirmed the presence of an error. Each error was assigned a potential clinical significance rating (based on the NCCMERP scale) by a physician and an independent senior clinical pharmacist, working separately. Main outcome measure Incidence of errors in pharmacist-written discharge medication orders. Results 509 prescriptions, written by 51 pharmacists, containing 4258 discharge medication orders were assessed (8.4 orders per prescription). Ten prescriptions (2%), contained a total of ten erroneous orders (order error rate-0.2%). The pharmacist considered that one error had the potential to cause temporary harm (0.02% of all orders). The physician did not rate any of the errors with the potential to cause harm. Conclusion The incidence of errors in pharmacists' discharge medication orders was low. The quality, safety and policy implications of pharmacists routinely writing discharge medication orders should be further explored.

Medication Errors in Vietnamese Hospitals: Prevalence, Potential Outcome and Associated Factors

PubMed Central

Nguyen, Huong-Thao; Nguyen, Tuan-Dung; van den Heuvel, Edwin R.; Haaijer-Ruskamp, Flora M.; Taxis, Katja

2015-01-01

Background Evidence from developed countries showed that medication errors are common and harmful. Little is known about medication errors in resource-restricted settings, including Vietnam. Objectives To determine the prevalence and potential clinical outcome of medication preparation and administration errors, and to identify factors associated with errors. Methods This was a prospective study conducted on six wards in two urban public hospitals in Vietnam. Data of preparation and administration errors of oral and intravenous medications was collected by direct observation, 12 hours per day on 7 consecutive days, on each ward. Multivariable logistic regression was applied to identify factors contributing to errors. Results In total, 2060 out of 5271 doses had at least one error. The error rate was 39.1% (95% confidence interval 37.8%- 40.4%). Experts judged potential clinical outcomes as minor, moderate, and severe in 72 (1.4%), 1806 (34.2%) and 182 (3.5%) doses. Factors associated with errors were drug characteristics (administration route, complexity of preparation, drug class; all p values < 0.001), and administration time (drug round, p = 0.023; day of the week, p = 0.024). Several interactions between these factors were also significant. Nurse experience was not significant. Higher error rates were observed for intravenous medications involving complex preparation procedures and for anti-infective drugs. Slightly lower medication error rates were observed during afternoon rounds compared to other rounds. Conclusions Potentially clinically relevant errors occurred in more than a third of all medications in this large study conducted in a resource-restricted setting. Educational interventions, focusing on intravenous medications with complex preparation procedure, particularly antibiotics, are likely to improve patient safety. PMID:26383873

Decreasing patient identification band errors by standardizing processes.

PubMed

Walley, Susan Chu; Berger, Stephanie; Harris, Yolanda; Gallizzi, Gina; Hayes, Leslie

2013-04-01

Patient identification (ID) bands are an essential component in patient ID. Quality improvement methodology has been applied as a model to reduce ID band errors although previous studies have not addressed standardization of ID bands. Our specific aim was to decrease ID band errors by 50% in a 12-month period. The Six Sigma DMAIC (define, measure, analyze, improve, and control) quality improvement model was the framework for this study. ID bands at a tertiary care pediatric hospital were audited from January 2011 to January 2012 with continued audits to June 2012 to confirm the new process was in control. After analysis, the major improvement strategy implemented was standardization of styles of ID bands and labels. Additional interventions included educational initiatives regarding the new ID band processes and disseminating institutional and nursing unit data. A total of 4556 ID bands were audited with a preimprovement ID band error average rate of 9.2%. Significant variation in the ID band process was observed, including styles of ID bands. Interventions were focused on standardization of the ID band and labels. The ID band error rate improved to 5.2% in 9 months (95% confidence interval: 2.5-5.5; P < .001) and was maintained for 8 months. Standardization of ID bands and labels in conjunction with other interventions resulted in a statistical decrease in ID band error rates. This decrease in ID band error rates was maintained over the subsequent 8 months.

A comparison of endoscopic localization error rate between operating surgeons and referring endoscopists in colorectal cancer.

PubMed

Azin, Arash; Saleh, Fady; Cleghorn, Michelle; Yuen, Andrew; Jackson, Timothy; Okrainec, Allan; Quereshy, Fayez A

2017-03-01

Colonoscopy for colorectal cancer (CRC) has a localization error rate as high as 21 %. Such errors can have substantial clinical consequences, particularly in laparoscopic surgery. The primary objective of this study was to compare accuracy of tumor localization at initial endoscopy performed by either the operating surgeon or non-operating referring endoscopist. All patients who underwent surgical resection for CRC at a large tertiary academic hospital between January 2006 and August 2014 were identified. The exposure of interest was the initial endoscopist: (1) surgeon who also performed the definitive operation (operating surgeon group); and (2) referring gastroenterologist or general surgeon (referring endoscopist group). The outcome measure was localization error, defined as a difference in at least one anatomic segment between initial endoscopy and final operative location. Multivariate logistic regression was used to explore the association between localization error rate and the initial endoscopist. A total of 557 patients were included in the study; 81 patients in the operating surgeon cohort and 476 patients in the referring endoscopist cohort. Initial diagnostic colonoscopy performed by the operating surgeon compared to referring endoscopist demonstrated statistically significant lower intraoperative localization error rate (1.2 vs. 9.0 %, P = 0.016); shorter mean time from endoscopy to surgery (52.3 vs. 76.4 days, P = 0.015); higher tattoo localization rate (32.1 vs. 21.0 %, P = 0.027); and lower preoperative repeat endoscopy rate (8.6 vs. 40.8 %, P < 0.001). Initial endoscopy performed by the operating surgeon was protective against localization error on both univariate analysis, OR 7.94 (95 % CI 1.08-58.52; P = 0.016), and multivariate analysis, OR 7.97 (95 % CI 1.07-59.38; P = 0.043). This study demonstrates that diagnostic colonoscopies performed by an operating surgeon are independently associated with a lower localization error rate. Further research exploring the factors influencing localization accuracy and why operating surgeons have lower error rates relative to non-operating endoscopists is necessary to understand differences in care.

Rain rate range profiling from a spaceborne radar

NASA Technical Reports Server (NTRS)

Meneghini, R.

1980-01-01

At certain frequencies and incidence angles the relative invariance of the surface scattering properites over land can be used to estimate the total attenuation and the integrated rain from a spaceborne attenuation-wavelength radar. The technique is generalized so that rain rate profiles along the radar beam can be estimated, i.e., rain rate determination at each range bin. This is done by modifying the standard algorithm for an attenuating-wavelength radar to include in it the measurement of the total attenuation. Simple error analyses of the estimates show that this type of profiling is possible if the total attenuation can be measured with a modest degree of accuracy.

Recovery from unusual attitudes: HUD vs. back-up display in a static F/A-18 simulator.

PubMed

Huber, Samuel W

2006-04-01

Spatial disorientation (SD) remains one of the most important causes of fatal fighter aircraft accidents. The aim of this study was to give a recommendation for the use of the head-up display (HUD) or back-up attitude directional indicator (ADI) in a state of spatial disorientation based on the respective performance in an unusual attitude recovery task. Seven fighter pilots joining a conversion course to the F/A-18 participated in this study. Flight time will be presented as range (and mean in parentheses). Total military flight experience of the subjects was 835-1759 h (1412 h). Flight time on the F/A-18 was 41-123 h (70 h). The study was performed in a fixed base F/A-18D Weapons Tactics Trainer. We tested the recovery from 11 unusual attitudes and analyzed decision time (DT), total recovery time (TRT), and error rates for the HUD or the back-up ADI. We found no differences regarding either reaction times or error rates. For the HUD we found a DT (mean +/- SD) of 1.3 +/- 0.4 s, a TRT of 9.1 +/- 4.1 s, and an error rate of 29%. For the ADI the respective values were a DT of 1.4 +/- 0.4 s, a TRT of 8.3 +/- 3.8 s, and an error rate of 27%. Unusual attitude recoveries are performed equally well using the HUD or the back-up ADI. Switching from one instrument to the other during recovery should be avoided since it would probably result in a loss of time without benefit.

Near field communications technology and the potential to reduce medication errors through multidisciplinary application

PubMed Central

Pegler, Joe; Lehane, Elaine; Livingstone, Vicki; McCarthy, Nora; Sahm, Laura J.; Tabirca, Sabin; O’Driscoll, Aoife; Corrigan, Mark

2016-01-01

Background Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems. Methods An NFC-based system was designed to facilitate prescribing, administration and review of medications commonly used on surgical wards. Final year medical, nursing, and pharmacy students were recruited to test the electronic system in a cross-over observational setting on a simulated ward. Medication errors were compared against errors recorded using a paper-based system. Results A significant difference in the commission of medication errors was seen when NFC and paper-based medication systems were compared. Paper use resulted in a mean of 4.09 errors per prescribing round while NFC prescribing resulted in a mean of 0.22 errors per simulated prescribing round (P=0.000). Likewise, medication administration errors were reduced from a mean of 2.30 per drug round with a Paper system to a mean of 0.80 errors per round using NFC (P<0.015). A mean satisfaction score of 2.30 was reported by users, (rated on seven-point scale with 1 denoting total satisfaction with system use and 7 denoting total dissatisfaction). Conclusions An NFC based medication system may be used to effectively reduce medication errors in a simulated ward environment. PMID:28293602

Near field communications technology and the potential to reduce medication errors through multidisciplinary application.

PubMed

O'Connell, Emer; Pegler, Joe; Lehane, Elaine; Livingstone, Vicki; McCarthy, Nora; Sahm, Laura J; Tabirca, Sabin; O'Driscoll, Aoife; Corrigan, Mark

2016-01-01

Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems. An NFC-based system was designed to facilitate prescribing, administration and review of medications commonly used on surgical wards. Final year medical, nursing, and pharmacy students were recruited to test the electronic system in a cross-over observational setting on a simulated ward. Medication errors were compared against errors recorded using a paper-based system. A significant difference in the commission of medication errors was seen when NFC and paper-based medication systems were compared. Paper use resulted in a mean of 4.09 errors per prescribing round while NFC prescribing resulted in a mean of 0.22 errors per simulated prescribing round (P=0.000). Likewise, medication administration errors were reduced from a mean of 2.30 per drug round with a Paper system to a mean of 0.80 errors per round using NFC (P<0.015). A mean satisfaction score of 2.30 was reported by users, (rated on seven-point scale with 1 denoting total satisfaction with system use and 7 denoting total dissatisfaction). An NFC based medication system may be used to effectively reduce medication errors in a simulated ward environment.

Evaluation of Faculty and Non-faculty Physicians’ Medication Errors in Outpatients’ Prescriptions in Shiraz, Iran

PubMed Central

Misagh, Pegah; Vazin, Afsaneh; Namazi, Soha

2018-01-01

This study was aimed at finding the occurrence rate of prescription errors in the outpatients› prescriptions written by faculty and non-faculty physicians practicing in Shiraz, Iran. In this cross-sectional study 2000 outpatient prescriptions were randomly collected from pharmacies affiliated with Shiraz University of Medical Sciences (SUMS) and social security insurance in Shiraz, Iran. Patient information including age, weight, diagnosis and chief complain were recorded. Physicians ‘characteristics were extracted from prescriptions. Prescription errors including errors in spelling, instruction, strength, dosage form and quantity as well as drug-drug interactions and contraindications were identified. The mean ± SD age of patients was 37.91 ± 21.10 years. Most of the patients were male (77.15%) and 81.50% of patients were adults. The average total number of drugs per prescription was 3.19 ± 1.60. The mean ± SD of prescription errors was 7.38 ± 4.06. Spelling error (26.4%), instruction error (21.03%), and strength error (19.18%) were the most frequent prescription errors. The mean ± SD of prescription errors was 7.83 ± 4.2 and 6.93 ± 3.88 in non-faculty and faculty physicians, respectively (P < 0.05). Number of prescription errors increased significantly as the number of prescribed drugs increased. All prescriptions had at least one error. The rate of prescription errors was higher in non-faculty physicians. Number of prescription errors related with the prescribed drugs in the prescription.

WE-H-BRC-09: Simulated Errors in Mock Radiotherapy Plans to Quantify the Effectiveness of the Physics Plan Review

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

Gopan, O; Kalet, A; Smith, W

2016-06-15

Purpose: A standard tool for ensuring the quality of radiation therapy treatments is the initial physics plan review. However, little is known about its performance in practice. The goal of this study is to measure the effectiveness of physics plan review by introducing simulated errors into “mock” treatment plans and measuring the performance of plan review by physicists. Methods: We generated six mock treatment plans containing multiple errors. These errors were based on incident learning system data both within the department and internationally (SAFRON). These errors were scored for severity and frequency. Those with the highest scores were included inmore » the simulations (13 errors total). Observer bias was minimized using a multiple co-correlated distractor approach. Eight physicists reviewed these plans for errors, with each physicist reviewing, on average, 3/6 plans. The confidence interval for the proportion of errors detected was computed using the Wilson score interval. Results: Simulated errors were detected in 65% of reviews [51–75%] (95% confidence interval [CI] in brackets). The following error scenarios had the highest detection rates: incorrect isocenter in DRRs/CBCT (91% [73–98%]) and a planned dose different from the prescribed dose (100% [61–100%]). Errors with low detection rates involved incorrect field parameters in record and verify system (38%, [18–61%]) and incorrect isocenter localization in planning system (29% [8–64%]). Though pre-treatment QA failure was reliably identified (100%), less than 20% of participants reported the error that caused the failure. Conclusion: This is one of the first quantitative studies of error detection. Although physics plan review is a key safety measure and can identify some errors with high fidelity, others errors are more challenging to detect. This data will guide future work on standardization and automation. Creating new checks or improving existing ones (i.e., via automation) will help in detecting those errors with low detection rates.« less

Correlation of patient entry rates and physician documentation errors in dictated and handwritten emergency treatment records.

PubMed

Dawdy, M R; Munter, D W; Gilmore, R A

1997-03-01

This study was designed to examine the relationship between patient entry rates (a measure of physician work load) and documentation errors/omissions in both handwritten and dictated emergency treatment records. The study was carried out in two phases. Phase I examined handwritten records and Phase II examined dictated and transcribed records. A total of 838 charts for three common chief complaints (chest pain, abdominal pain, asthma/chronic obstructive pulmonary disease) were retrospectively reviewed and scored for the presence or absence of 11 predetermined criteria. Patient entry rates were determined by reviewing the emergency department patient registration logs. The data were analyzed using simple correlation and linear regression analysis. A positive correlation was found between patient entry rates and documentation errors in handwritten charts. No such correlation was found in the dictated charts. We conclude that work load may negatively affect documentation accuracy when charts are handwritten. However, the use of dictation services may minimize or eliminate this effect.

Frozen section analysis of margins for head and neck tumor resections: reduction of sampling errors with a third histologic level.

PubMed

Olson, Stephen M; Hussaini, Mohammad; Lewis, James S

2011-05-01

Frozen section analysis is an essential tool for assessing margins intra-operatively to assure complete resection. Many institutions evaluate surgical defect edge tissue provided by the surgeon after the main lesion has been removed. With the increasing use of transoral laser microsurgery, this method is becoming even more prevalent. We sought to evaluate error rates at our large academic institution and to see if sampling errors could be reduced by the simple method change of taking an additional third section on these specimens. All head and neck tumor resection cases from January 2005 through August 2008 with margins evaluated by frozen section were identified by database search. These cases were analyzed by cutting two levels during frozen section and a third permanent section later. All resection cases from August 2008 through July 2009 were identified as well. These were analyzed by cutting three levels during frozen section (the third a 'much deeper' level) and a fourth permanent section later. Error rates for both of these periods were determined. Errors were separated into sampling and interpretation types. There were 4976 total frozen section specimens from 848 patients. The overall error rate was 2.4% for all frozen sections where just two levels were evaluated and was 2.5% when three levels were evaluated (P=0.67). The sampling error rate was 1.6% for two-level sectioning and 1.2% for three-level sectioning (P=0.42). However, when considering only the frozen section cases where tumor was ultimately identified (either at the time of frozen section or on permanent sections) the sampling error rate for two-level sectioning was 15.3 versus 7.4% for three-level sectioning. This difference was statistically significant (P=0.006). Cutting a single additional 'deeper' level at the time of frozen section identifies more tumor-bearing specimens and may reduce the number of sampling errors.

Precipitation and Latent Heating Distributions from Satellite Passive Microwave Radiometry. Part 1; Method and Uncertainties

NASA Technical Reports Server (NTRS)

Olson, William S.; Kummerow, Christian D.; Yang, Song; Petty, Grant W.; Tao, Wei-Kuo; Bell, Thomas L.; Braun, Scott A.; Wang, Yansen; Lang, Stephen E.; Johnson, Daniel E.

2004-01-01

A revised Bayesian algorithm for estimating surface rain rate, convective rain proportion, and latent heating/drying profiles from satellite-borne passive microwave radiometer observations over ocean backgrounds is described. The algorithm searches a large database of cloud-radiative model simulations to find cloud profiles that are radiatively consistent with a given set of microwave radiance measurements. The properties of these radiatively consistent profiles are then composited to obtain best estimates of the observed properties. The revised algorithm is supported by an expanded and more physically consistent database of cloud-radiative model simulations. The algorithm also features a better quantification of the convective and non-convective contributions to total rainfall, a new geographic database, and an improved representation of background radiances in rain-free regions. Bias and random error estimates are derived from applications of the algorithm to synthetic radiance data, based upon a subset of cloud resolving model simulations, and from the Bayesian formulation itself. Synthetic rain rate and latent heating estimates exhibit a trend of high (low) bias for low (high) retrieved values. The Bayesian estimates of random error are propagated to represent errors at coarser time and space resolutions, based upon applications of the algorithm to TRMM Microwave Imager (TMI) data. Errors in instantaneous rain rate estimates at 0.5 deg resolution range from approximately 50% at 1 mm/h to 20% at 14 mm/h. These errors represent about 70-90% of the mean random deviation between collocated passive microwave and spaceborne radar rain rate estimates. The cumulative algorithm error in TMI estimates at monthly, 2.5 deg resolution is relatively small (less than 6% at 5 mm/day) compared to the random error due to infrequent satellite temporal sampling (8-35% at the same rain rate).

A compact presentation of DSN array telemetry performance

NASA Technical Reports Server (NTRS)

Greenhall, C. A.

1982-01-01

The telemetry performance of an arrayed receiver system, including radio losses, is often given by a family of curves giving bit error rate vs bit SNR, with tracking loop SNR at one receiver held constant along each curve. This study shows how to process this information into a more compact, useful format in which the minimal total signal power and optimal carrier suppression, for a given fixed bit error rate, are plotted vs data rate. Examples for baseband-only combining are given. When appropriate dimensionless variables are used for plotting, receiver arrays with different numbers of antennas and different threshold tracking loop bandwidths look much alike, and a universal curve for optimal carrier suppression emerges.

Repeat analysis of intraoral digital imaging performed by undergraduate students using a complementary metal oxide semiconductor sensor: An institutional case study.

PubMed

Yusof, Mohd Yusmiaidil Putera Mohd; Rahman, Nur Liyana Abdul; Asri, Amiza Aqiela Ahmad; Othman, Noor Ilyani; Wan Mokhtar, Ilham

2017-12-01

This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor (CMOS) intraoral sensor. A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and interobserver agreement was achieved. The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients.

TID and SEE Response of an Advanced Samsung 4G NAND Flash Memory

NASA Technical Reports Server (NTRS)

Oldham, Timothy R.; Friendlich, M.; Howard, J. W.; Berg, M. D.; Kim, H. S.; Irwin, T. L.; LaBel, K. A.

2007-01-01

Initial total ionizing dose (TID) and single event heavy ion test results are presented for an unhardened commercial flash memory, fabricated with 63 nm technology. Results are that the parts survive to a TID of nearly 200 krad (SiO2), with a tractable soft error rate of about 10(exp -l2) errors/bit-day, for the Adams Ten Percent Worst Case Environment.

An observational study of drug administration errors in a Malaysian hospital (study of drug administration errors).

PubMed

Chua, S S; Tea, M H; Rahman, M H A

2009-04-01

Drug administration errors were the second most frequent type of medication errors, after prescribing errors but the latter were often intercepted hence, administration errors were more probably to reach the patients. Therefore, this study was conducted to determine the frequency and types of drug administration errors in a Malaysian hospital ward. This is a prospective study that involved direct, undisguised observations of drug administrations in a hospital ward. A researcher was stationed in the ward under study for 15 days to observe all drug administrations which were recorded in a data collection form and then compared with the drugs prescribed for the patient. A total of 1118 opportunities for errors were observed and 127 administrations had errors. This gave an error rate of 11.4 % [95% confidence interval (CI) 9.5-13.3]. If incorrect time errors were excluded, the error rate reduced to 8.7% (95% CI 7.1-10.4). The most common types of drug administration errors were incorrect time (25.2%), followed by incorrect technique of administration (16.3%) and unauthorized drug errors (14.1%). In terms of clinical significance, 10.4% of the administration errors were considered as potentially life-threatening. Intravenous routes were more likely to be associated with an administration error than oral routes (21.3% vs. 7.9%, P < 0.001). The study indicates that the frequency of drug administration errors in developing countries such as Malaysia is similar to that in the developed countries. Incorrect time errors were also the most common type of drug administration errors. A non-punitive system of reporting medication errors should be established to encourage more information to be documented so that risk management protocol could be developed and implemented.

Can an online clinical data management service help in improving data collection and data quality in a developing country setting?

PubMed

Wildeman, Maarten A; Zandbergen, Jeroen; Vincent, Andrew; Herdini, Camelia; Middeldorp, Jaap M; Fles, Renske; Dalesio, Otilia; van der Donk, Emile; Tan, I Bing

2011-08-08

Data collection by electronic medical record (EMR) systems have been proven to be helpful in data collection for scientific research and in improving healthcare. For a multi-centre trial in Indonesia and the Netherlands a web based system was selected to enable all participating centres to easily access data. This study assesses whether the introduction of a clinical trial data management service (CTDMS) composed of electronic case report forms (eCRF) can result in effective data collection and treatment monitoring. Data items entered were checked for inconsistencies automatically when submitted online. The data were divided into primary and secondary data items. We analysed both the total number of errors and the change in error rate, for both primary and secondary items, over the first five month of the trial. In the first five months 51 patients were entered. The primary data error rate was 1.6%, whilst that for secondary data was 2.7% against acceptable error rates for analysis of 1% and 2.5% respectively. The presented analysis shows that after five months since the introduction of the CTDMS the primary and secondary data error rates reflect acceptable levels of data quality. Furthermore, these error rates were decreasing over time. The digital nature of the CTDMS, as well as the online availability of that data, gives fast and easy insight in adherence to treatment protocols. As such, the CTDMS can serve as a tool to train and educate medical doctors and can improve treatment protocols.

The effect of divided attention on novices and experts in laparoscopic task performance.

PubMed

Ghazanfar, Mudassar Ali; Cook, Malcolm; Tang, Benjie; Tait, Iain; Alijani, Afshin

2015-03-01

Attention is important for the skilful execution of surgery. The surgeon's attention during surgery is divided between surgery and outside distractions. The effect of this divided attention has not been well studied previously. We aimed to compare the effect of dividing attention of novices and experts on a laparoscopic task performance. Following ethical approval, 25 novices and 9 expert surgeons performed a standardised peg transfer task in a laboratory setup under three randomly assigned conditions: silent as control condition and two standardised auditory distracting tasks requiring response (easy and difficult) as study conditions. Human reliability assessment was used for surgical task analysis. Primary outcome measures were correct auditory responses, task time, number of surgical errors and instrument movements. Secondary outcome measures included error rate, error probability and hand specific differences. Non-parametric statistics were used for data analysis. 21109 movements and 9036 total errors were analysed. Novices had increased mean task completion time (seconds) (171 ± 44SD vs. 149 ± 34, p < 0.05), number of total movements (227 ± 27 vs. 213 ± 26, p < 0.05) and number of errors (127 ± 51 vs. 96 ± 28, p < 0.05) during difficult study conditions compared to control. The correct responses to auditory stimuli were less frequent in experts (68 %) compared to novices (80 %). There was a positive correlation between error rate and error probability in novices (r (2) = 0.533, p < 0.05) but not in experts (r (2) = 0.346, p > 0.05). Divided attention conditions in theatre environment require careful consideration during surgical training as the junior surgeons are less able to focus their attention during these conditions.

A visual detection model for DCT coefficient quantization

NASA Technical Reports Server (NTRS)

Ahumada, Albert J., Jr.; Watson, Andrew B.

1994-01-01

The discrete cosine transform (DCT) is widely used in image compression and is part of the JPEG and MPEG compression standards. The degree of compression and the amount of distortion in the decompressed image are controlled by the quantization of the transform coefficients. The standards do not specify how the DCT coefficients should be quantized. One approach is to set the quantization level for each coefficient so that the quantization error is near the threshold of visibility. Results from previous work are combined to form the current best detection model for DCT coefficient quantization noise. This model predicts sensitivity as a function of display parameters, enabling quantization matrices to be designed for display situations varying in luminance, veiling light, and spatial frequency related conditions (pixel size, viewing distance, and aspect ratio). It also allows arbitrary color space directions for the representation of color. A model-based method of optimizing the quantization matrix for an individual image was developed. The model described above provides visual thresholds for each DCT frequency. These thresholds are adjusted within each block for visual light adaptation and contrast masking. For given quantization matrix, the DCT quantization errors are scaled by the adjusted thresholds to yield perceptual errors. These errors are pooled nonlinearly over the image to yield total perceptual error. With this model one may estimate the quantization matrix for a particular image that yields minimum bit rate for a given total perceptual error, or minimum perceptual error for a given bit rate. Custom matrices for a number of images show clear improvement over image-independent matrices. Custom matrices are compatible with the JPEG standard, which requires transmission of the quantization matrix.

Ultrasound transducer function: annual testing is not sufficient.

PubMed

Mårtensson, Mattias; Olsson, Mats; Brodin, Lars-Åke

2010-10-01

The objective was to follow-up the study 'High incidence of defective ultrasound transducers in use in routine clinical practice' and evaluate if annual testing is good enough to reduce the incidence of defective ultrasound transducers in routine clinical practice to an acceptable level. A total of 299 transducers were tested in 13 clinics at five hospitals in the Stockholm area. Approximately 7000-15,000 ultrasound examinations are carried out at these clinics every year. The transducers tested in the study had been tested and classified as fully operational 1 year before and since then been in normal use in the routine clinical practice. The transducers were tested with the Sonora FirstCall Test System. There were 81 (27.1%) defective transducers found; giving a 95% confidence interval ranging from 22.1 to 32.1%. The most common transducer errors were 'delamination' of the ultrasound lens and 'break in the cable' which together constituted 82.7% of all transducer errors found. The highest error rate was found at the radiological clinics with a mean error rate of 36.0%. There was a significant difference in error rate between two observed ways the clinics handled the transducers. There was no significant difference in the error rates of the transducer brands or the transducers models. Annual testing is not sufficient to reduce the incidence of defective ultrasound transducers in routine clinical practice to an acceptable level and it is strongly advisable to create a user routine that minimizes the handling of the transducers.

Prediction of error rates in dose-imprinted memories on board CRRES by two different methods. [Combined Release and Radiation Effects Satellite

NASA Technical Reports Server (NTRS)

Brucker, G. J.; Stassinopoulos, E. G.

1991-01-01

An analysis of the expected space radiation effects on the single event upset (SEU) properties of CMOS/bulk memories onboard the Combined Release and Radiation Effects Satellite (CRRES) is presented. Dose-imprint data from ground test irradiations of identical devices are applied to the predictions of cosmic-ray-induced space upset rates in the memories onboard the spacecraft. The calculations take into account the effect of total dose on the SEU sensitivity of the devices as the dose accumulates in orbit. Estimates of error rates, which involved an arbitrary selection of a single pair of threshold linear energy transfer (LET) and asymptotic cross-section values, were compared to the results of an integration over the cross-section curves versus LET. The integration gave lower upset rates than the use of the selected values of the SEU parameters. Since the integration approach is more accurate and eliminates the need for an arbitrary definition of threshold LET and asymptotic cross section, it is recommended for all error rate predictions where experimental sigma-versus-LET curves are available.

Importance of Ionospheric Gradients for error Correction

NASA Astrophysics Data System (ADS)

Ravula, Ramprasad

Importance of Ionospheric Gradients for error Correction R. Ram Prasad1, P.Nagasekhar2 1Sai Spurthi Institute of Technology-JNTU Hyderabad,2Sai Spurthi Institute of Technology-JNTU Hyderabad Email ID:rams.ravula@gmail.com In India, Indian Space Research Organization (ISRO) has established with an objective to develop space technology and its application to various national tasks. To cater to the needs of civil aviation applications, GPS Aided Geo Augmented Navigation (GAGAN) system is being jointly implemented along with Airports Authority of India (AAI) over the Indian region. The most predominant parameter affecting the navigation accuracy of GAGAN is ionospheric delay which is a function of total number of electrons present in one square meter cylindrical cross sectional area in the line of site direction between the satellite and the user on the earth i.e. Total Electron Content (TEC).The irregular distribution of electron densities i.e. rate of TEC variation, causes Ionospheric gradients such as spatial gradients (Expressed in TECu/km) and temporal gradients (Expressed in TECu /minute). Among the satellite signals arriving to the earth in multiple directions, the signals which suffer from severe ionospheric gradients can be estimated i.e. Rate of TEC Index (ROTI) and Rate of TEC (ROT). These aspects which contribute to errors can be treated for improving GAGAN positional accuracy.

Development of a scale of executive functioning for the RBANS.

PubMed

Spencer, Robert J; Kitchen Andren, Katherine A; Tolle, Kathryn A

2018-01-01

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a cognitive battery that contains scales of several cognitive abilities, but no scale in the instrument is exclusively dedicated to executive functioning. Although the subtests allow for observation of executive-type errors, each error is of fairly low base rate, and healthy and clinical normative data are lacking on the frequency of these types of errors, making their significance difficult to interpret in isolation. The aim of this project was to create an RBANS executive errors scale (RBANS EE) with items comprised of qualitatively dysexecutive errors committed throughout the test. Participants included Veterans referred for outpatient neuropsychological testing. Items were initially selected based on theoretical literature and were retained based on item-total correlations. The RBANS EE (a percentage calculated by dividing the number of dysexecutive errors by the total number of responses) was moderately related to each of seven established measures of executive functioning and was strongly predictive of dichotomous classification of executive impairment. Thus, the scale had solid concurrent validity, justifying its use as a supplementary scale. The RBANS EE requires no additional administration time and can provide a quantified measure of otherwise unmeasured aspects of executive functioning.

Evolution at increased error rate leads to the coexistence of multiple adaptive pathways in an RNA virus.

PubMed

Cabanillas, Laura; Arribas, María; Lázaro, Ester

2013-01-16

When beneficial mutations present in different genomes spread simultaneously in an asexual population, their fixation can be delayed due to competition among them. This interference among mutations is mainly determined by the rate of beneficial mutations, which in turn depends on the population size, the total error rate, and the degree of adaptation of the population. RNA viruses, with their large population sizes and high error rates, are good candidates to present a great extent of interference. To test this hypothesis, in the current study we have investigated whether competition among beneficial mutations was responsible for the prolonged presence of polymorphisms in the mutant spectrum of an RNA virus, the bacteriophage Qβ, evolved during a large number of generations in the presence of the mutagenic nucleoside analogue 5-azacytidine. The analysis of the mutant spectra of bacteriophage Qβ populations evolved at artificially increased error rate shows a large number of polymorphic mutations, some of them with demonstrated selective value. Polymorphisms distributed into several evolutionary lines that can compete among them, making it difficult the emergence of a defined consensus sequence. The presence of accompanying deleterious mutations, the high degree of recurrence of the polymorphic mutations, and the occurrence of epistatic interactions generate a highly complex interference dynamics. Interference among beneficial mutations in bacteriophage Qβ evolved at increased error rate permits the coexistence of multiple adaptive pathways that can provide selective advantages by different molecular mechanisms. In this way, interference can be seen as a positive factor that allows the exploration of the different local maxima that exist in rugged fitness landscapes.

Audit of the global carbon budget: estimate errors and their impact on uptake uncertainty

NASA Astrophysics Data System (ADS)

Ballantyne, A. P.; Andres, R.; Houghton, R.; Stocker, B. D.; Wanninkhof, R.; Anderegg, W.; Cooper, L. A.; DeGrandpre, M.; Tans, P. P.; Miller, J. B.; Alden, C.; White, J. W. C.

2015-04-01

Over the last 5 decades monitoring systems have been developed to detect changes in the accumulation of carbon (C) in the atmosphere and ocean; however, our ability to detect changes in the behavior of the global C cycle is still hindered by measurement and estimate errors. Here we present a rigorous and flexible framework for assessing the temporal and spatial components of estimate errors and their impact on uncertainty in net C uptake by the biosphere. We present a novel approach for incorporating temporally correlated random error into the error structure of emission estimates. Based on this approach, we conclude that the 2σ uncertainties of the atmospheric growth rate have decreased from 1.2 Pg C yr-1 in the 1960s to 0.3 Pg C yr-1 in the 2000s due to an expansion of the atmospheric observation network. The 2σ uncertainties in fossil fuel emissions have increased from 0.3 Pg C yr-1 in the 1960s to almost 1.0 Pg C yr-1 during the 2000s due to differences in national reporting errors and differences in energy inventories. Lastly, while land use emissions have remained fairly constant, their errors still remain high and thus their global C uptake uncertainty is not trivial. Currently, the absolute errors in fossil fuel emissions rival the total emissions from land use, highlighting the extent to which fossil fuels dominate the global C budget. Because errors in the atmospheric growth rate have decreased faster than errors in total emissions have increased, a ~20% reduction in the overall uncertainty of net C global uptake has occurred. Given all the major sources of error in the global C budget that we could identify, we are 93% confident that terrestrial C uptake has increased and 97% confident that ocean C uptake has increased over the last 5 decades. Thus, it is clear that arguably one of the most vital ecosystem services currently provided by the biosphere is the continued removal of approximately half of atmospheric CO2 emissions from the atmosphere, although there are certain environmental costs associated with this service, such as the acidification of ocean waters.

Quotation accuracy in medical journal articles-a systematic review and meta-analysis.

PubMed

Jergas, Hannah; Baethge, Christopher

2015-01-01

Background. Quotations and references are an indispensable element of scientific communication. They should support what authors claim or provide important background information for readers. Studies indicate, however, that quotations not serving their purpose-quotation errors-may be prevalent. Methods. We carried out a systematic review, meta-analysis and meta-regression of quotation errors, taking account of differences between studies in error ascertainment. Results. Out of 559 studies screened we included 28 in the main analysis, and estimated major, minor and total quotation error rates of 11,9%, 95% CI [8.4, 16.6] 11.5% [8.3, 15.7], and 25.4% [19.5, 32.4]. While heterogeneity was substantial, even the lowest estimate of total quotation errors was considerable (6.7%). Indirect references accounted for less than one sixth of all quotation problems. The findings remained robust in a number of sensitivity and subgroup analyses (including risk of bias analysis) and in meta-regression. There was no indication of publication bias. Conclusions. Readers of medical journal articles should be aware of the fact that quotation errors are common. Measures against quotation errors include spot checks by editors and reviewers, correct placement of citations in the text, and declarations by authors that they have checked cited material. Future research should elucidate if and to what degree quotation errors are detrimental to scientific progress.

A simulation study to quantify the impacts of exposure measurement error on air pollution health risk estimates in copollutant time-series models.

PubMed

Dionisio, Kathie L; Chang, Howard H; Baxter, Lisa K

2016-11-25

Exposure measurement error in copollutant epidemiologic models has the potential to introduce bias in relative risk (RR) estimates. A simulation study was conducted using empirical data to quantify the impact of correlated measurement errors in time-series analyses of air pollution and health. ZIP-code level estimates of exposure for six pollutants (CO, NO x , EC, PM 2.5 , SO 4 , O 3 ) from 1999 to 2002 in the Atlanta metropolitan area were used to calculate spatial, population (i.e. ambient versus personal), and total exposure measurement error. Empirically determined covariance of pollutant concentration pairs and the associated measurement errors were used to simulate true exposure (exposure without error) from observed exposure. Daily emergency department visits for respiratory diseases were simulated using a Poisson time-series model with a main pollutant RR = 1.05 per interquartile range, and a null association for the copollutant (RR = 1). Monte Carlo experiments were used to evaluate the impacts of correlated exposure errors of different copollutant pairs. Substantial attenuation of RRs due to exposure error was evident in nearly all copollutant pairs studied, ranging from 10 to 40% attenuation for spatial error, 3-85% for population error, and 31-85% for total error. When CO, NO x or EC is the main pollutant, we demonstrated the possibility of false positives, specifically identifying significant, positive associations for copollutants based on the estimated type I error rate. The impact of exposure error must be considered when interpreting results of copollutant epidemiologic models, due to the possibility of attenuation of main pollutant RRs and the increased probability of false positives when measurement error is present.

An empirical model for global earthquake fatality estimation

USGS Publications Warehouse

Jaiswal, Kishor; Wald, David

2010-01-01

We analyzed mortality rates of earthquakes worldwide and developed a country/region-specific empirical model for earthquake fatality estimation within the U.S. Geological Survey's Prompt Assessment of Global Earthquakes for Response (PAGER) system. The earthquake fatality rate is defined as total killed divided by total population exposed at specific shaking intensity level. The total fatalities for a given earthquake are estimated by multiplying the number of people exposed at each shaking intensity level by the fatality rates for that level and then summing them at all relevant shaking intensities. The fatality rate is expressed in terms of a two-parameter lognormal cumulative distribution function of shaking intensity. The parameters are obtained for each country or a region by minimizing the residual error in hindcasting the total shaking-related deaths from earthquakes recorded between 1973 and 2007. A new global regionalization scheme is used to combine the fatality data across different countries with similar vulnerability traits.

Controlling false-negative errors in microarray differential expression analysis: a PRIM approach.

PubMed

Cole, Steve W; Galic, Zoran; Zack, Jerome A

2003-09-22

Theoretical considerations suggest that current microarray screening algorithms may fail to detect many true differences in gene expression (Type II analytic errors). We assessed 'false negative' error rates in differential expression analyses by conventional linear statistical models (e.g. t-test), microarray-adapted variants (e.g. SAM, Cyber-T), and a novel strategy based on hold-out cross-validation. The latter approach employs the machine-learning algorithm Patient Rule Induction Method (PRIM) to infer minimum thresholds for reliable change in gene expression from Boolean conjunctions of fold-induction and raw fluorescence measurements. Monte Carlo analyses based on four empirical data sets show that conventional statistical models and their microarray-adapted variants overlook more than 50% of genes showing significant up-regulation. Conjoint PRIM prediction rules recover approximately twice as many differentially expressed transcripts while maintaining strong control over false-positive (Type I) errors. As a result, experimental replication rates increase and total analytic error rates decline. RT-PCR studies confirm that gene inductions detected by PRIM but overlooked by other methods represent true changes in mRNA levels. PRIM-based conjoint inference rules thus represent an improved strategy for high-sensitivity screening of DNA microarrays. Freestanding JAVA application at http://microarray.crump.ucla.edu/focus

Repeat analysis of intraoral digital imaging performed by undergraduate students using a complementary metal oxide semiconductor sensor: An institutional case study

PubMed Central

Rahman, Nur Liyana Abdul; Asri, Amiza Aqiela Ahmad; Othman, Noor Ilyani; Wan Mokhtar, Ilham

2017-01-01

Purpose This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor (CMOS) intraoral sensor. Materials and Methods A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and interobserver agreement was achieved. Conclusion The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients. PMID:29279822

Prescribing Errors Involving Medication Dosage Forms

PubMed Central

Lesar, Timothy S

2002-01-01

CONTEXT Prescribing errors involving medication dose formulations have been reported to occur frequently in hospitals. No systematic evaluations of the characteristics of errors related to medication dosage formulation have been performed. OBJECTIVE To quantify the characteristics, frequency, and potential adverse patient effects of prescribing errors involving medication dosage forms . DESIGN Evaluation of all detected medication prescribing errors involving or related to medication dosage forms in a 631-bed tertiary care teaching hospital. MAIN OUTCOME MEASURES Type, frequency, and potential for adverse effects of prescribing errors involving or related to medication dosage forms. RESULTS A total of 1,115 clinically significant prescribing errors involving medication dosage forms were detected during the 60-month study period. The annual number of detected errors increased throughout the study period. Detailed analysis of the 402 errors detected during the last 16 months of the study demonstrated the most common errors to be: failure to specify controlled release formulation (total of 280 cases; 69.7%) both when prescribing using the brand name (148 cases; 36.8%) and when prescribing using the generic name (132 cases; 32.8%); and prescribing controlled delivery formulations to be administered per tube (48 cases; 11.9%). The potential for adverse patient outcome was rated as potentially “fatal or severe” in 3 cases (0.7%), and “serious” in 49 cases (12.2%). Errors most commonly involved cardiovascular agents (208 cases; 51.7%). CONCLUSIONS Hospitalized patients are at risk for adverse outcomes due to prescribing errors related to inappropriate use of medication dosage forms. This information should be considered in the development of strategies to prevent adverse patient outcomes resulting from such errors. PMID:12213138

Simple Sample Preparation Method for Direct Microbial Identification and Susceptibility Testing From Positive Blood Cultures.

PubMed

Pan, Hong-Wei; Li, Wei; Li, Rong-Guo; Li, Yong; Zhang, Yi; Sun, En-Hua

2018-01-01

Rapid identification and determination of the antibiotic susceptibility profiles of the infectious agents in patients with bloodstream infections are critical steps in choosing an effective targeted antibiotic for treatment. However, there has been minimal effort focused on developing combined methods for the simultaneous direct identification and antibiotic susceptibility determination of bacteria in positive blood cultures. In this study, we constructed a lysis-centrifugation-wash procedure to prepare a bacterial pellet from positive blood cultures, which can be used directly for identification by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and antibiotic susceptibility testing by the Vitek 2 system. The method was evaluated using a total of 129 clinical bacteria-positive blood cultures. The whole sample preparation process could be completed in <15 min. The correct rate of direct MALDI-TOF MS identification was 96.49% for gram-negative bacteria and 97.22% for gram-positive bacteria. Vitek 2 antimicrobial susceptibility testing of gram-negative bacteria showed an agreement rate of antimicrobial categories of 96.89% with a minor error, major error, and very major error rate of 2.63, 0.24, and 0.24%, respectively. Category agreement of antimicrobials against gram-positive bacteria was 92.81%, with a minor error, major error, and very major error rate of 4.51, 1.22, and 1.46%, respectively. These results indicated that our direct antibiotic susceptibility analysis method worked well compared to the conventional culture-dependent laboratory method. Overall, this fast, easy, and accurate method can facilitate the direct identification and antibiotic susceptibility testing of bacteria in positive blood cultures.

Refining Field Measurements of Methane Flux Rates from Abandoned Oil and Gas Wells

NASA Astrophysics Data System (ADS)

Lagron, C. S.; Kang, M.; Riqueros, N. S.; Jackson, R. B.

2015-12-01

Recent studies in Pennsylvania demonstrate the potential for significant methane emissions from abandoned oil and gas wells. A subset of tested wells was high emitting, with methane flux rates up to seven orders of magnitude greater than natural fluxes (up to 105 mg CH4/hour, or about 2.5LPM). These wells contribute disproportionately to the total methane emissions from abandoned oil and gas wells. The principles guiding the chamber design have been developed for lower flux rates, typically found in natural environments, and chamber design modifications may reduce uncertainty in flux rates associated with high-emitting wells. Kang et al. estimate errors of a factor of two in measured values based on previous studies. We conduct controlled releases of methane to refine error estimates and improve chamber design with a focus on high-emitters. Controlled releases of methane are conducted at 0.05 LPM, 0.50 LPM, 1.0 LPM, 2.0 LPM, 3.0 LPM, and 5.0 LPM, and at two chamber dimensions typically used in field measurements studies of abandoned wells. As most sources of error tabulated by Kang et al. tend to bias the results toward underreporting of methane emissions, a flux-targeted chamber design modification can reduce error margins and/or provide grounds for a potential upward revision of emission estimates.

Medication prescribing errors in the medical intensive care unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

PubMed

Sada, Oumer; Melkie, Addisu; Shibeshi, Workineh

2015-09-16

Medication errors (MEs) are important problems in all hospitalized populations, especially in intensive care unit (ICU). Little is known about the prevalence of medication prescribing errors in the ICU of hospitals in Ethiopia. The aim of this study was to assess medication prescribing errors in the ICU of Tikur Anbessa Specialized Hospital using retrospective cross-sectional analysis of patient cards and medication charts. About 220 patient charts were reviewed with a total of 1311 patient-days, and 882 prescription episodes. 359 MEs were detected; with prevalence of 40 per 100 orders. Common prescribing errors were omission errors 154 (42.89%), 101 (28.13%) wrong combination, 48 (13.37%) wrong abbreviation, 30 (8.36%) wrong dose, wrong frequency 18 (5.01%) and wrong indications 8 (2.23%). The present study shows that medication errors are common in medical ICU of Tikur Anbessa Specialized Hospital. These results suggest future targets of prevention strategies to reduce the rate of medication error.

Incidence of speech recognition errors in the emergency department.

PubMed

Goss, Foster R; Zhou, Li; Weiner, Scott G

2016-09-01

Physician use of computerized speech recognition (SR) technology has risen in recent years due to its ease of use and efficiency at the point of care. However, error rates between 10 and 23% have been observed, raising concern about the number of errors being entered into the permanent medical record, their impact on quality of care and medical liability that may arise. Our aim was to determine the incidence and types of SR errors introduced by this technology in the emergency department (ED). Level 1 emergency department with 42,000 visits/year in a tertiary academic teaching hospital. A random sample of 100 notes dictated by attending emergency physicians (EPs) using SR software was collected from the ED electronic health record between January and June 2012. Two board-certified EPs annotated the notes and conducted error analysis independently. An existing classification schema was adopted to classify errors into eight errors types. Critical errors deemed to potentially impact patient care were identified. There were 128 errors in total or 1.3 errors per note, and 14.8% (n=19) errors were judged to be critical. 71% of notes contained errors, and 15% contained one or more critical errors. Annunciation errors were the highest at 53.9% (n=69), followed by deletions at 18.0% (n=23) and added words at 11.7% (n=15). Nonsense errors, homonyms and spelling errors were present in 10.9% (n=14), 4.7% (n=6), and 0.8% (n=1) of notes, respectively. There were no suffix or dictionary errors. Inter-annotator agreement was 97.8%. This is the first estimate at classifying speech recognition errors in dictated emergency department notes. Speech recognition errors occur commonly with annunciation errors being the most frequent. Error rates were comparable if not lower than previous studies. 15% of errors were deemed critical, potentially leading to miscommunication that could affect patient care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The introduction of an acute physiological support service for surgical patients is an effective error reduction strategy.

PubMed

Clarke, D L; Kong, V Y; Naidoo, L C; Furlong, H; Aldous, C

2013-01-01

Acute surgical patients are particularly vulnerable to human error. The Acute Physiological Support Team (APST) was created with the twin objectives of identifying high-risk acute surgical patients in the general wards and reducing both the incidence of error and impact of error on these patients. A number of error taxonomies were used to understand the causes of human error and a simple risk stratification system was adopted to identify patients who are particularly at risk of error. During the period November 2012-January 2013 a total of 101 surgical patients were cared for by the APST at Edendale Hospital. The average age was forty years. There were 36 females and 65 males. There were 66 general surgical patients and 35 trauma patients. Fifty-six patients were referred on the day of their admission. The average length of stay in the APST was four days. Eleven patients were haemo-dynamically unstable on presentation and twelve were clinically septic. The reasons for referral were sepsis,(4) respiratory distress,(3) acute kidney injury AKI (38), post-operative monitoring (39), pancreatitis,(3) ICU down-referral,(7) hypoxia,(5) low GCS,(1) coagulopathy.(1) The mortality rate was 13%. A total of thirty-six patients experienced 56 errors. A total of 143 interventions were initiated by the APST. These included institution or adjustment of intravenous fluids (101), blood transfusion,(12) antibiotics,(9) the management of neutropenic sepsis,(1) central line insertion,(3) optimization of oxygen therapy,(7) correction of electrolyte abnormality,(8) correction of coagulopathy.(2) CONCLUSION: Our intervention combined current taxonomies of error with a simple risk stratification system and is a variant of the defence in depth strategy of error reduction. We effectively identified and corrected a significant number of human errors in high-risk acute surgical patients. This audit has helped understand the common sources of error in the general surgical wards and will inform on-going error reduction initiatives. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Reducing error and improving efficiency during vascular interventional radiology: implementation of a preprocedural team rehearsal.

PubMed

Morbi, Abigail H M; Hamady, Mohamad S; Riga, Celia V; Kashef, Elika; Pearch, Ben J; Vincent, Charles; Moorthy, Krishna; Vats, Amit; Cheshire, Nicholas J W; Bicknell, Colin D

2012-08-01

To determine the type and frequency of errors during vascular interventional radiology (VIR) and design and implement an intervention to reduce error and improve efficiency in this setting. Ethical guidance was sought from the Research Services Department at Imperial College London. Informed consent was not obtained. Field notes were recorded during 55 VIR procedures by a single observer. Two blinded assessors identified failures from field notes and categorized them into one or more errors by using a 22-part classification system. The potential to cause harm, disruption to procedural flow, and preventability of each failure was determined. A preprocedural team rehearsal (PPTR) was then designed and implemented to target frequent preventable potential failures. Thirty-three procedures were observed subsequently to determine the efficacy of the PPTR. Nonparametric statistical analysis was used to determine the effect of intervention on potential failure rates, potential to cause harm and procedural flow disruption scores (Mann-Whitney U test), and number of preventable failures (Fisher exact test). Before intervention, 1197 potential failures were recorded, of which 54.6% were preventable. A total of 2040 errors were deemed to have occurred to produce these failures. Planning error (19.7%), staff absence (16.2%), equipment unavailability (12.2%), communication error (11.2%), and lack of safety consciousness (6.1%) were the most frequent errors, accounting for 65.4% of the total. After intervention, 352 potential failures were recorded. Classification resulted in 477 errors. Preventable failures decreased from 54.6% to 27.3% (P < .001) with implementation of PPTR. Potential failure rates per hour decreased from 18.8 to 9.2 (P < .001), with no increase in potential to cause harm or procedural flow disruption per failure. Failures during VIR procedures are largely because of ineffective planning, communication error, and equipment difficulties, rather than a result of technical or patient-related issues. Many of these potential failures are preventable. A PPTR is an effective means of targeting frequent preventable failures, reducing procedural delays and improving patient safety.

Adaptive data rate control TDMA systems as a rain attenuation compensation technique

NASA Technical Reports Server (NTRS)

Sato, Masaki; Wakana, Hiromitsu; Takahashi, Takashi; Takeuchi, Makoto; Yamamoto, Minoru

1993-01-01

Rainfall attenuation has a severe effect on signal strength and impairs communication links for future mobile and personal satellite communications using Ka-band and millimeter wave frequencies. As rain attenuation compensation techniques, several methods such as uplink power control, site diversity, and adaptive control of data rate or forward error correction have been proposed. In this paper, we propose a TDMA system that can compensate rain attenuation by adaptive control of transmission rates. To evaluate the performance of this TDMA terminal, we carried out three types of experiments: experiments using a Japanese CS-3 satellite with Ka-band transponders, in house IF loop-back experiments, and computer simulations. Experimental results show that this TDMA system has advantages over the conventional constant-rate TDMA systems, as resource sharing technique, in both bit error rate and total TDMA burst lengths required for transmitting given information.

On the conditions of exponential stability in active disturbance rejection control based on singular perturbation analysis

NASA Astrophysics Data System (ADS)

Shao, S.; Gao, Z.

2017-10-01

Stability of active disturbance rejection control (ADRC) is analysed in the presence of unknown, nonlinear, and time-varying dynamics. In the framework of singular perturbations, the closed-loop error dynamics are semi-decoupled into a relatively slow subsystem (the feedback loop) and a relatively fast subsystem (the extended state observer), respectively. It is shown, analytically and geometrically, that there exists a unique exponential stable solution if the size of the initial observer error is sufficiently small, i.e. in the same order of the inverse of the observer bandwidth. The process of developing the uniformly asymptotic solution of the system reveals the condition on the stability of the ADRC and the relationship between the rate of change in the total disturbance and the size of the estimation error. The differentiability of the total disturbance is the only assumption made.

Wireless visual sensor network resource allocation using cross-layer optimization

NASA Astrophysics Data System (ADS)

Bentley, Elizabeth S.; Matyjas, John D.; Medley, Michael J.; Kondi, Lisimachos P.

2009-01-01

In this paper, we propose an approach to manage network resources for a Direct Sequence Code Division Multiple Access (DS-CDMA) visual sensor network where nodes monitor scenes with varying levels of motion. It uses cross-layer optimization across the physical layer, the link layer and the application layer. Our technique simultaneously assigns a source coding rate, a channel coding rate, and a power level to all nodes in the network based on one of two criteria that maximize the quality of video of the entire network as a whole, subject to a constraint on the total chip rate. One criterion results in the minimal average end-to-end distortion amongst all nodes, while the other criterion minimizes the maximum distortion of the network. Our approach allows one to determine the capacity of the visual sensor network based on the number of nodes and the quality of video that must be transmitted. For bandwidth-limited applications, one can also determine the minimum bandwidth needed to accommodate a number of nodes with a specific target chip rate. Video captured by a sensor node camera is encoded and decoded using the H.264 video codec by a centralized control unit at the network layer. To reduce the computational complexity of the solution, Universal Rate-Distortion Characteristics (URDCs) are obtained experimentally to relate bit error probabilities to the distortion of corrupted video. Bit error rates are found first by using Viterbi's upper bounds on the bit error probability and second, by simulating nodes transmitting data spread by Total Square Correlation (TSC) codes over a Rayleigh-faded DS-CDMA channel and receiving that data using Auxiliary Vector (AV) filtering.

Analytical Assessment of Simultaneous Parallel Approach Feasibility from Total System Error

NASA Technical Reports Server (NTRS)

Madden, Michael M.

2014-01-01

In a simultaneous paired approach to closely-spaced parallel runways, a pair of aircraft flies in close proximity on parallel approach paths. The aircraft pair must maintain a longitudinal separation within a range that avoids wake encounters and, if one of the aircraft blunders, avoids collision. Wake avoidance defines the rear gate of the longitudinal separation. The lead aircraft generates a wake vortex that, with the aid of crosswinds, can travel laterally onto the path of the trail aircraft. As runway separation decreases, the wake has less distance to traverse to reach the path of the trail aircraft. The total system error of each aircraft further reduces this distance. The total system error is often modeled as a probability distribution function. Therefore, Monte-Carlo simulations are a favored tool for assessing a "safe" rear-gate. However, safety for paired approaches typically requires that a catastrophic wake encounter be a rare one-in-a-billion event during normal operation. Using a Monte-Carlo simulation to assert this event rarity with confidence requires a massive number of runs. Such large runs do not lend themselves to rapid turn-around during the early stages of investigation when the goal is to eliminate the infeasible regions of the solution space and to perform trades among the independent variables in the operational concept. One can employ statistical analysis using simplified models more efficiently to narrow the solution space and identify promising trades for more in-depth investigation using Monte-Carlo simulations. These simple, analytical models not only have to address the uncertainty of the total system error but also the uncertainty in navigation sources used to alert an abort of the procedure. This paper presents a method for integrating total system error, procedure abort rates, avionics failures, and surveillance errors into a statistical analysis that identifies the likely feasible runway separations for simultaneous paired approaches.

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department

PubMed Central

Hitti, Eveline; Tamim, Hani; Bakhti, Rinad; Zebian, Dina; Mufarrij, Afif

2017-01-01

Introduction Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%–38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions. Methods We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period. Results Overall, E-prescriptions included fewer prescription errors as compared to HW-prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p <0.0001), missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p <0.0001) and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02). Conclusion A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive. PMID:28874948

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department.

PubMed

Hitti, Eveline; Tamim, Hani; Bakhti, Rinad; Zebian, Dina; Mufarrij, Afif

2017-08-01

Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%-38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions. We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period. Overall, E-prescriptions included fewer prescription errors as compared to HW-prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p <0.0001), missing frequency (3.5% to 2.2%, p=0.04), missing strength errors (32.4% to 10.2%, p <0.0001) and legibility (0.7% to 0.2%, p=0.005). E-prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02). A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive.

A bundle with a preformatted medical order sheet and an introductory course to reduce prescription errors in neonates.

PubMed

Palmero, David; Di Paolo, Ermindo R; Beauport, Lydie; Pannatier, André; Tolsa, Jean-François

2016-01-01

The objective of this study was to assess whether the introduction of a new preformatted medical order sheet coupled with an introductory course affected prescription quality and the frequency of errors during the prescription stage in a neonatal intensive care unit (NICU). Two-phase observational study consisting of two consecutive 4-month phases: pre-intervention (phase 0) and post-intervention (phase I) conducted in an 11-bed NICU in a Swiss university hospital. Interventions consisted of the introduction of a new preformatted medical order sheet with explicit information supplied, coupled with a staff introductory course on appropriate prescription and medication errors. The main outcomes measured were formal aspects of prescription and frequency and nature of prescription errors. Eighty-three and 81 patients were included in phase 0 and phase I, respectively. A total of 505 handwritten prescriptions in phase 0 and 525 in phase I were analysed. The rate of prescription errors decreased significantly from 28.9% in phase 0 to 13.5% in phase I (p < 0.05). Compared with phase 0, dose errors, name confusion and errors in frequency and rate of drug administration decreased in phase I, from 5.4 to 2.7% (p < 0.05), 5.9 to 0.2% (p < 0.05), 3.6 to 0.2% (p < 0.05), and 4.7 to 2.1% (p < 0.05), respectively. The rate of incomplete and ambiguous prescriptions decreased from 44.2 to 25.7 and 8.5 to 3.2% (p < 0.05), respectively. Inexpensive and simple interventions can improve the intelligibility of prescriptions and reduce medication errors. Medication errors are frequent in NICUs and prescription is one of the most critical steps. CPOE reduce prescription errors, but their implementation is not available everywhere. Preformatted medical order sheet coupled with an introductory course decrease medication errors in a NICU. Preformatted medical order sheet is an inexpensive and readily implemented alternative to CPOE.

Digital Intraoral Imaging Re-Exposure Rates of Dental Students.

PubMed

Senior, Anthea; Winand, Curtis; Ganatra, Seema; Lai, Hollis; Alsulfyani, Noura; Pachêco-Pereira, Camila

2018-01-01

A guiding principle of radiation safety is ensuring that radiation dosage is as low as possible while yielding the necessary diagnostic information. Intraoral images taken with conventional dental film have a higher re-exposure rate when taken by dental students compared to experienced staff. The aim of this study was to examine the prevalence of and reasons for re-exposure of digital intraoral images taken by third- and fourth-year dental students in a dental school clinic. At one dental school in Canada, the total number of intraoral images taken by third- and fourth-year dental students, re-exposures, and error descriptions were extracted from patient clinical records for an eight-month period (September 2015 to April 2016). The data were categorized to distinguish between digital images taken with solid-state sensors or photostimulable phosphor plates (PSP). The results showed that 9,397 intraoral images were made, and 1,064 required re-exposure. The most common error requiring re-exposure for bitewing images was an error in placement of the receptor too far mesially or distally (29% for sensors and 18% for PSP). The most common error requiring re-exposure for periapical images was inadequate capture of the periapical area (37% for sensors and 6% for PSP). A retake rate of 11% was calculated, and the common technique errors causing image deficiencies were identified. Educational intervention can now be specifically designed to reduce the retake rate and radiation dose for future patients.

Quotation accuracy in medical journal articles—a systematic review and meta-analysis

PubMed Central

Jergas, Hannah

2015-01-01

Background. Quotations and references are an indispensable element of scientific communication. They should support what authors claim or provide important background information for readers. Studies indicate, however, that quotations not serving their purpose—quotation errors—may be prevalent. Methods. We carried out a systematic review, meta-analysis and meta-regression of quotation errors, taking account of differences between studies in error ascertainment. Results. Out of 559 studies screened we included 28 in the main analysis, and estimated major, minor and total quotation error rates of 11,9%, 95% CI [8.4, 16.6] 11.5% [8.3, 15.7], and 25.4% [19.5, 32.4]. While heterogeneity was substantial, even the lowest estimate of total quotation errors was considerable (6.7%). Indirect references accounted for less than one sixth of all quotation problems. The findings remained robust in a number of sensitivity and subgroup analyses (including risk of bias analysis) and in meta-regression. There was no indication of publication bias. Conclusions. Readers of medical journal articles should be aware of the fact that quotation errors are common. Measures against quotation errors include spot checks by editors and reviewers, correct placement of citations in the text, and declarations by authors that they have checked cited material. Future research should elucidate if and to what degree quotation errors are detrimental to scientific progress. PMID:26528420

A Comprehensive Quality Assurance Program for Personnel and Procedures in Radiation Oncology: Value of Voluntary Error Reporting and Checklists

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

Kalapurakal, John A., E-mail: j-kalapurakal@northwestern.edu; Zafirovski, Aleksandar; Smith, Jeffery

Purpose: This report describes the value of a voluntary error reporting system and the impact of a series of quality assurance (QA) measures including checklists and timeouts on reported error rates in patients receiving radiation therapy. Methods and Materials: A voluntary error reporting system was instituted with the goal of recording errors, analyzing their clinical impact, and guiding the implementation of targeted QA measures. In response to errors committed in relation to treatment of the wrong patient, wrong treatment site, and wrong dose, a novel initiative involving the use of checklists and timeouts for all staff was implemented. The impactmore » of these and other QA initiatives was analyzed. Results: From 2001 to 2011, a total of 256 errors in 139 patients after 284,810 external radiation treatments (0.09% per treatment) were recorded in our voluntary error database. The incidence of errors related to patient/tumor site, treatment planning/data transfer, and patient setup/treatment delivery was 9%, 40.2%, and 50.8%, respectively. The compliance rate for the checklists and timeouts initiative was 97% (P<.001). These and other QA measures resulted in a significant reduction in many categories of errors. The introduction of checklists and timeouts has been successful in eliminating errors related to wrong patient, wrong site, and wrong dose. Conclusions: A comprehensive QA program that regularly monitors staff compliance together with a robust voluntary error reporting system can reduce or eliminate errors that could result in serious patient injury. We recommend the adoption of these relatively simple QA initiatives including the use of checklists and timeouts for all staff to improve the safety of patients undergoing radiation therapy in the modern era.« less

Using snowball sampling method with nurses to understand medication administration errors.

PubMed

Sheu, Shuh-Jen; Wei, Ien-Lan; Chen, Ching-Huey; Yu, Shu; Tang, Fu-In

2009-02-01

We aimed to encourage nurses to release information about drug administration errors to increase understanding of error-related circumstances and to identify high-alert situations. Drug administration errors represent the majority of medication errors, but errors are underreported. Effective ways are lacking to encourage nurses to actively report errors. Snowball sampling was conducted to recruit participants. A semi-structured questionnaire was used to record types of error, hospital and nurse backgrounds, patient consequences, error discovery mechanisms and reporting rates. Eighty-five nurses participated, reporting 328 administration errors (259 actual, 69 near misses). Most errors occurred in medical surgical wards of teaching hospitals, during day shifts, committed by nurses working fewer than two years. Leading errors were wrong drugs and doses, each accounting for about one-third of total errors. Among 259 actual errors, 83.8% resulted in no adverse effects; among remaining 16.2%, 6.6% had mild consequences and 9.6% had serious consequences (severe reaction, coma, death). Actual errors and near misses were discovered mainly through double-check procedures by colleagues and nurses responsible for errors; reporting rates were 62.5% (162/259) vs. 50.7% (35/69) and only 3.5% (9/259) vs. 0% (0/69) were disclosed to patients and families. High-alert situations included administration of 15% KCl, insulin and Pitocin; using intravenous pumps; and implementation of cardiopulmonary resuscitation (CPR). Snowball sampling proved to be an effective way to encourage nurses to release details concerning medication errors. Using empirical data, we identified high-alert situations. Strategies for reducing drug administration errors by nurses are suggested. Survey results suggest that nurses should double check medication administration in known high-alert situations. Nursing management can use snowball sampling to gather error details from nurses in a non-reprimanding atmosphere, helping to establish standard operational procedures for known high-alert situations.

Older patients can accurately recall their preoperative health status six weeks following total hip arthroplasty.

PubMed

Marsh, Jackie; Bryant, Dianne; MacDonald, Steven J

2009-12-01

In clinical trials, use of patient recall data would be beneficial when the collection of baseline data is impossible, such as in trauma situations. We investigated the ability of older patients to accurately recall their preoperative quality of life, function, and general health status at six weeks following total hip arthroplasty. We randomized consecutive patients who were fifty-five years of age or older into two groups. At each assessment, patients completed self-report questionnaires (at four weeks preoperatively, on the day of surgery, and at six weeks and three months postoperatively for Group 1 and at six weeks and three months postoperatively for Group 2). At six weeks postoperatively, all patients completed the questionnaires on the basis of their recollection of their preoperative health status. We evaluated the validity and reliability of recall ratings, the degree of error in recall ratings, and the effects of the use of recall data on power and sample size requirements. A total of 174 patients (mean age, seventy-one years) who were undergoing either primary or revision total hip arthroplasty were randomized and included in the analysis (118 patients were in Group 1 and fifty-six were in Group 2). Agreement between actual and recalled data was excellent for disease-specific questionnaires (intraclass correlation coefficient, 0.86, 0.87, and 0.88) and moderate for generic health measures (intraclass correlation coefficient, 0.48, 0.58, and 0.60). Increased error associated with recalled ratings compared with actual ratings necessitates minimal increases in sample size or results in small decreases in power. Patients undergoing total hip arthroplasty can accurately recall their preoperative health status at six weeks postoperatively.

Application of human reliability analysis to nursing errors in hospitals.

PubMed

Inoue, Kayoko; Koizumi, Akio

2004-12-01

Adverse events in hospitals, such as in surgery, anesthesia, radiology, intensive care, internal medicine, and pharmacy, are of worldwide concern and it is important, therefore, to learn from such incidents. There are currently no appropriate tools based on state-of-the art models available for the analysis of large bodies of medical incident reports. In this study, a new model was developed to facilitate medical error analysis in combination with quantitative risk assessment. This model enables detection of the organizational factors that underlie medical errors, and the expedition of decision making in terms of necessary action. Furthermore, it determines medical tasks as module practices and uses a unique coding system to describe incidents. This coding system has seven vectors for error classification: patient category, working shift, module practice, linkage chain (error type, direct threat, and indirect threat), medication, severity, and potential hazard. Such mathematical formulation permitted us to derive two parameters: error rates for module practices and weights for the aforementioned seven elements. The error rate of each module practice was calculated by dividing the annual number of incident reports of each module practice by the annual number of the corresponding module practice. The weight of a given element was calculated by the summation of incident report error rates for an element of interest. This model was applied specifically to nursing practices in six hospitals over a year; 5,339 incident reports with a total of 63,294,144 module practices conducted were analyzed. Quality assurance (QA) of our model was introduced by checking the records of quantities of practices and reproducibility of analysis of medical incident reports. For both items, QA guaranteed legitimacy of our model. Error rates for all module practices were approximately of the order 10(-4) in all hospitals. Three major organizational factors were found to underlie medical errors: "violation of rules" with a weight of 826 x 10(-4), "failure of labor management" with a weight of 661 x 10(-4), and "defects in the standardization of nursing practices" with a weight of 495 x 10(-4).

Evaluation of quality indicators in a laboratory supporting tertiary cancer care facilities in India.

PubMed

Kumar, Savitha Anil; Jayanna, Prashanth; Prabhudesai, Shilpa; Kumar, Ajai

2014-01-01

To collect and tabulate errors and nonconformities in the preanalytical, analytical, and postanalytical process phases in a diagnostic clinical laboratory that supports a super-specialty cancer center in India, and identify areas of potential improvement in patient services. We collected data from our laboratory during a period of 24 months. Departments in the study included clinical biochemistry, hematology, clinical pathology, microbiology and serology, surgical pathology, and molecular pathology. We had initiated quality assessment based on international standards in our laboratory in 2010, with the aim of obtaining accreditation by national and international governing bodies. We followed the guidelines specified by International Organization for Standardization (ISO) 15189:2007 to identify noncompliant elements of our processes. Among a total of 144,030 specimens that our referral laboratory received during the 2-year period of our study, we uncovered an overall error rate for all 3 process phases of 1.23%; all of our error rates closely approximated the results from our peer institutions. Errors were most common in the preanalytical phase in both years of study; preanalytical- and postanalytical-phase errors constituted more than 90% of all errors. Further improvements are warranted in laboratory services and are contingent on adequate training and interdepartmental communication and cooperation. Copyright© by the American Society for Clinical Pathology (ASCP).

An improved estimator for the hydration of fat-free mass from in vivo measurements subject to additive technical errors.

PubMed

Kinnamon, Daniel D; Lipsitz, Stuart R; Ludwig, David A; Lipshultz, Steven E; Miller, Tracie L

2010-04-01

The hydration of fat-free mass, or hydration fraction (HF), is often defined as a constant body composition parameter in a two-compartment model and then estimated from in vivo measurements. We showed that the widely used estimator for the HF parameter in this model, the mean of the ratios of measured total body water (TBW) to fat-free mass (FFM) in individual subjects, can be inaccurate in the presence of additive technical errors. We then proposed a new instrumental variables estimator that accurately estimates the HF parameter in the presence of such errors. In Monte Carlo simulations, the mean of the ratios of TBW to FFM was an inaccurate estimator of the HF parameter, and inferences based on it had actual type I error rates more than 13 times the nominal 0.05 level under certain conditions. The instrumental variables estimator was accurate and maintained an actual type I error rate close to the nominal level in all simulations. When estimating and performing inference on the HF parameter, the proposed instrumental variables estimator should yield accurate estimates and correct inferences in the presence of additive technical errors, but the mean of the ratios of TBW to FFM in individual subjects may not.

Agreement Assessment of Tigecycline Susceptibilities Determined by the Disk Diffusion and Broth Microdilution Methods among Commonly Encountered Resistant Bacterial Isolates: Results from the Tigecycline In Vitro Surveillance in Taiwan (TIST) Study, 2008 to 2010

PubMed Central

Liu, Jien-Wei; Ko, Wen-Chien; Huang, Cheng-Hua; Liao, Chun-Hsing; Lu, Chin-Te; Chuang, Yin-Ching; Tsao, Shih-Ming; Chen, Yao-Shen; Liu, Yung-Ching; Chen, Wei-Yu; Jang, Tsrang-Neng; Lin, Hsiu-Chen; Chen, Chih-Ming; Shi, Zhi-Yuan; Pan, Sung-Ching; Yang, Jia-Ling; Kung, Hsiang-Chi; Liu, Chun-Eng; Cheng, Yu-Jen; Chen, Yen-Hsu; Lu, Po-Liang; Sun, Wu; Wang, Lih-Shinn; Yu, Kwok-Woon; Chiang, Ping-Cherng; Lee, Ming-Hsun; Lee, Chun-Ming; Hsu, Gwo-Jong

2012-01-01

The Tigecycline In Vitro Surveillance in Taiwan (TIST) study, initiated in 2006, is a nationwide surveillance program designed to longitudinally monitor the in vitro activity of tigecycline against commonly encountered drug-resistant bacteria. This study compared the in vitro activity of tigecycline against 3,014 isolates of clinically important drug-resistant bacteria using the standard broth microdilution and disk diffusion methods. Species studied included methicillin-resistant Staphylococcus aureus (MRSA; n = 759), vancomycin-resistant Enterococcus faecium (VRE; n = 191), extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (n = 602), ESBL-producing Klebsiella pneumoniae (n = 736), and Acinetobacter baumannii (n = 726) that had been collected from patients treated between 2008 and 2010 at 20 hospitals in Taiwan. MICs and inhibition zone diameters were interpreted according to the currently recommended U.S. Food and Drug Administration (FDA) criteria and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. The MIC90 values of tigecycline against MRSA, VRE, ESBL-producing E. coli, ESBL-producing K. pneumoniae, and A. baumannii were 0.5, 0.125, 0.5, 2, and 8 μg/ml, respectively. The total error rates between the two methods using the FDA criteria were high: 38.4% for ESBL-producing K. pneumoniae and 33.8% for A. baumannii. Using the EUCAST criteria, the total error rate was also high (54.6%) for A. baumannii isolates. The total error rates between these two methods were <5% for MRSA, VRE, and ESBL-producing E. coli. For routine susceptibility testing of ESBL-producing K. pneumoniae and A. baumannii against tigecycline, the broth microdilution method should be used because of the poor correlation of results between these two methods. PMID:22155819

Error reporting in transfusion medicine at a tertiary care centre: a patient safety initiative.

PubMed

Elhence, Priti; Shenoy, Veena; Verma, Anupam; Sachan, Deepti

2012-11-01

Errors in the transfusion process can compromise patient safety. A study was undertaken at our center to identify the errors in the transfusion process and their causes in order to reduce their occurrence by corrective and preventive actions. All near miss, no harm events and adverse events reported in the 'transfusion process' during 1 year study period were recorded, classified and analyzed at a tertiary care teaching hospital in North India. In total, 285 transfusion related events were reported during the study period. Of these, there were four adverse (1.5%), 10 no harm (3.5%) and 271 (95%) near miss events. Incorrect blood component transfusion rate was 1 in 6031 component units. ABO incompatible transfusion rate was one in 15,077 component units issued or one in 26,200 PRBC units issued and acute hemolytic transfusion reaction due to ABO incompatible transfusion was 1 in 60,309 component units issued. Fifty-three percent of the antecedent near miss events were bedside events. Patient sample handling errors were the single largest category of errors (n=94, 33%) followed by errors in labeling and blood component handling and storage in user areas. The actual and near miss event data obtained through this initiative provided us with clear evidence about latent defects and critical points in the transfusion process so that corrective and preventive actions could be taken to reduce errors and improve transfusion safety.

Audit of the global carbon budget: estimate errors and their impact on uptake uncertainty

DOE PAGES

Ballantyne, A. P.; Andres, R.; Houghton, R.; ...

2015-04-30

Over the last 5 decades monitoring systems have been developed to detect changes in the accumulation of carbon (C) in the atmosphere and ocean; however, our ability to detect changes in the behavior of the global C cycle is still hindered by measurement and estimate errors. Here we present a rigorous and flexible framework for assessing the temporal and spatial components of estimate errors and their impact on uncertainty in net C uptake by the biosphere. We present a novel approach for incorporating temporally correlated random error into the error structure of emission estimates. Based on this approach, we concludemore » that the 2σ uncertainties of the atmospheric growth rate have decreased from 1.2 Pg C yr ₋1 in the 1960s to 0.3 Pg C yr ₋1 in the 2000s due to an expansion of the atmospheric observation network. The 2σ uncertainties in fossil fuel emissions have increased from 0.3 Pg C yr ₋1 in the 1960s to almost 1.0 Pg C yr ₋1 during the 2000s due to differences in national reporting errors and differences in energy inventories. Lastly, while land use emissions have remained fairly constant, their errors still remain high and thus their global C uptake uncertainty is not trivial. Currently, the absolute errors in fossil fuel emissions rival the total emissions from land use, highlighting the extent to which fossil fuels dominate the global C budget. Because errors in the atmospheric growth rate have decreased faster than errors in total emissions have increased, a ~20% reduction in the overall uncertainty of net C global uptake has occurred. Given all the major sources of error in the global C budget that we could identify, we are 93% confident that terrestrial C uptake has increased and 97% confident that ocean C uptake has increased over the last 5 decades. Thus, it is clear that arguably one of the most vital ecosystem services currently provided by the biosphere is the continued removal of approximately half of atmospheric CO 2 emissions from the atmosphere, although there are certain environmental costs associated with this service, such as the acidification of ocean waters.« less

Precipitation and Latent Heating Distributions from Satellite Passive Microwave Radiometry. Part II: Evaluation of Estimates Using Independent Data

NASA Technical Reports Server (NTRS)

Yang, Song; Olson, William S.; Wang, Jian-Jian; Bell, Thomas L.; Smith, Eric A.; Kummerow, Christian D.

2006-01-01

Rainfall rate estimates from spaceborne microwave radiometers are generally accepted as reliable by a majority of the atmospheric science community. One of the Tropical Rainfall Measuring Mission (TRMM) facility rain-rate algorithms is based upon passive microwave observations from the TRMM Microwave Imager (TMI). In Part I of this series, improvements of the TMI algorithm that are required to introduce latent heating as an additional algorithm product are described. Here, estimates of surface rain rate, convective proportion, and latent heating are evaluated using independent ground-based estimates and satellite products. Instantaneous, 0.5 deg. -resolution estimates of surface rain rate over ocean from the improved TMI algorithm are well correlated with independent radar estimates (r approx. 0.88 over the Tropics), but bias reduction is the most significant improvement over earlier algorithms. The bias reduction is attributed to the greater breadth of cloud-resolving model simulations that support the improved algorithm and the more consistent and specific convective/stratiform rain separation method utilized. The bias of monthly 2.5 -resolution estimates is similarly reduced, with comparable correlations to radar estimates. Although the amount of independent latent heating data is limited, TMI-estimated latent heating profiles compare favorably with instantaneous estimates based upon dual-Doppler radar observations, and time series of surface rain-rate and heating profiles are generally consistent with those derived from rawinsonde analyses. Still, some biases in profile shape are evident, and these may be resolved with (a) additional contextual information brought to the estimation problem and/or (b) physically consistent and representative databases supporting the algorithm. A model of the random error in instantaneous 0.5 deg. -resolution rain-rate estimates appears to be consistent with the levels of error determined from TMI comparisons with collocated radar. Error model modifications for nonraining situations will be required, however. Sampling error represents only a portion of the total error in monthly 2.5 -resolution TMI estimates; the remaining error is attributed to random and systematic algorithm errors arising from the physical inconsistency and/or nonrepresentativeness of cloud-resolving-model-simulated profiles that support the algorithm.

The Limits of Coding with Joint Constraints on Detected and Undetected Error Rates

NASA Technical Reports Server (NTRS)

Dolinar, Sam; Andrews, Kenneth; Pollara, Fabrizio; Divsalar, Dariush

2008-01-01

We develop a remarkably tight upper bound on the performance of a parameterized family of bounded angle maximum-likelihood (BA-ML) incomplete decoders. The new bound for this class of incomplete decoders is calculated from the code's weight enumerator, and is an extension of Poltyrev-type bounds developed for complete ML decoders. This bound can also be applied to bound the average performance of random code ensembles in terms of an ensemble average weight enumerator. We also formulate conditions defining a parameterized family of optimal incomplete decoders, defined to minimize both the total codeword error probability and the undetected error probability for any fixed capability of the decoder to detect errors. We illustrate the gap between optimal and BA-ML incomplete decoding via simulation of a small code.

The Relationship Between Technical Errors and Decision Making Skills in the Junior Resident

PubMed Central

Nathwani, J. N.; Fiers, R.M.; Ray, R.D.; Witt, A.K.; Law, K. E.; DiMarco, S.M.; Pugh, C.M.

2017-01-01

Objective The purpose of this study is to co-evaluate resident technical errors and decision-making capabilities during placement of a subclavian central venous catheter (CVC). We hypothesize that there will be significant correlations between scenario based decision making skills, and technical proficiency in central line insertion. We also predict residents will have problems in anticipating common difficulties and generating solutions associated with line placement. Design Participants were asked to insert a subclavian central line on a simulator. After completion, residents were presented with a real life patient photograph depicting CVC placement and asked to anticipate difficulties and generate solutions. Error rates were analyzed using chi-square tests and a 5% expected error rate. Correlations were sought by comparing technical errors and scenario based decision making. Setting This study was carried out at seven tertiary care centers. Participants Study participants (N=46) consisted of largely first year research residents that could be followed longitudinally. Second year research and clinical residents were not excluded. Results Six checklist errors were committed more often than anticipated. Residents performed an average of 1.9 errors, significantly more than the 1 error, at most, per person expected (t(44)=3.82, p<.001). The most common error was performance of the procedure steps in the wrong order (28.5%, P<.001). Some of the residents (24%) had no errors, 30% committed one error, and 46 % committed more than one error. The number of technical errors committed negatively correlated with the total number of commonly identified difficulties and generated solutions (r(33)= −.429, p=.021, r(33)= −.383, p=.044 respectively). Conclusions Almost half of the surgical residents committed multiple errors while performing subclavian CVC placement. The correlation between technical errors and decision making skills suggests a critical need to train residents in both technique and error management. ACGME Competencies Medical Knowledge, Practice Based Learning and Improvement, Systems Based Practice PMID:27671618

Using Healthcare Failure Mode and Effect Analysis to reduce medication errors in the process of drug prescription, validation and dispensing in hospitalised patients.

PubMed

Vélez-Díaz-Pallarés, Manuel; Delgado-Silveira, Eva; Carretero-Accame, María Emilia; Bermejo-Vicedo, Teresa

2013-01-01

To identify actions to reduce medication errors in the process of drug prescription, validation and dispensing, and to evaluate the impact of their implementation. A Health Care Failure Mode and Effect Analysis (HFMEA) was supported by a before-and-after medication error study to measure the actual impact on error rate after the implementation of corrective actions in the process of drug prescription, validation and dispensing in wards equipped with computerised physician order entry (CPOE) and unit-dose distribution system (788 beds out of 1080) in a Spanish university hospital. The error study was carried out by two observers who reviewed medication orders on a daily basis to register prescription errors by physicians and validation errors by pharmacists. Drugs dispensed in the unit-dose trolleys were reviewed for dispensing errors. Error rates were expressed as the number of errors for each process divided by the total opportunities for error in that process times 100. A reduction in prescription errors was achieved by providing training for prescribers on CPOE, updating prescription procedures, improving clinical decision support and automating the software connection to the hospital census (relative risk reduction (RRR), 22.0%; 95% CI 12.1% to 31.8%). Validation errors were reduced after optimising time spent in educating pharmacy residents on patient safety, developing standardised validation procedures and improving aspects of the software's database (RRR, 19.4%; 95% CI 2.3% to 36.5%). Two actions reduced dispensing errors: reorganising the process of filling trolleys and drawing up a protocol for drug pharmacy checking before delivery (RRR, 38.5%; 95% CI 14.1% to 62.9%). HFMEA facilitated the identification of actions aimed at reducing medication errors in a healthcare setting, as the implementation of several of these led to a reduction in errors in the process of drug prescription, validation and dispensing.

Increased errors and decreased performance at night: A systematic review of the evidence concerning shift work and quality.

PubMed

de Cordova, Pamela B; Bradford, Michelle A; Stone, Patricia W

2016-02-15

Shift workers have worse health outcomes than employees who work standard business hours. However, it is unclear how this poorer health shift may be related to employee work productivity. The purpose of this systematic review is to assess the relationship between shift work and errors and performance. Searches of MEDLINE/PubMed, EBSCOhost, and CINAHL were conducted to identify articles that examined the relationship between shift work, errors, quality, productivity, and performance. All articles were assessed for study quality. A total of 435 abstracts were screened with 13 meeting inclusion criteria. Eight studies were rated to be of strong, methodological quality. Nine studies demonstrated a positive relationship that night shift workers committed more errors and had decreased performance. Night shift workers have worse health that may contribute to errors and decreased performance in the workplace.

Effect of Preoperative Warm-up Exercise Before Laparoscopic Gynecological Surgery: A Randomized Trial.

PubMed

Polterauer, Stephan; Husslein, Heinrich; Kranawetter, Marlene; Schwameis, Richard; Reinthaller, Alexander; Heinze, Georg; Grimm, Christoph

2016-01-01

Laparoscopic surgical procedures require a high level of cognitive and psychomotoric skills. Thus, effective training methods to acquire an adequate level of expertise are crucial. The aim of this study was to investigate the effect of preoperative warm up training on surgeon׳s performance during gynecologic laparoscopic surgery. In this randomized controlled trial, surgeons performed a preoperative warm up training using a virtual reality simulator before laparoscopic unilateral salpingo-oophorectomy. Serving as their own controls, each subject performed 2 pairs of laparoscopic cases, each pair consisting of 1 case with and 1 without warm up before surgery. Surgeries were videotaped and psychomotoric skills were rated using objective structured assessment of technical skills (OSATS) and the generic error rating tool by a masked observer. Perioperative complications were assessed. Statistical analysis was performed using a mixed model, and mean OSATS scores were compared between both the groups. In total, data of 10 surgeons and 17 surgeries were available for analysis. No differences between educational level and surgical experiences were observed between the groups. Mean standard error psychomotoric and task-specific OSATS scores of 19.8 (1.7) and 3.7 (0.2) were observed in the warm up group compared with 18.6 (1.7) and 3.8 (0.2) in the no warm up group, respectively (p = 0.51 and p = 0.29). Using generic error rating tool, the total number of errors was 8.75 (2.15) in the warm up group compared with 10.8 (2.18) in the no warm-up group (p = 0.53). Perioperative complications and operating time did not differ between both the groups. The present study suggests that warm-up before laparoscopic salpingo-oophorectomy does not increase psychomotoric skills during surgery. Moreover, it does not influence operating time and complication rates. (Medical University of Vienna-IRB approval number, 1072/2011, ClinicalTrials.gov number, NCT01712607). Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A biometric identification system based on eigenpalm and eigenfinger features.

PubMed

Ribaric, Slobodan; Fratric, Ivan

2005-11-01

This paper presents a multimodal biometric identification system based on the features of the human hand. We describe a new biometric approach to personal identification using eigenfinger and eigenpalm features, with fusion applied at the matching-score level. The identification process can be divided into the following phases: capturing the image; preprocessing; extracting and normalizing the palm and strip-like finger subimages; extracting the eigenpalm and eigenfinger features based on the K-L transform; matching and fusion; and, finally, a decision based on the (k, l)-NN classifier and thresholding. The system was tested on a database of 237 people (1,820 hand images). The experimental results showed the effectiveness of the system in terms of the recognition rate (100 percent), the equal error rate (EER = 0.58 percent), and the total error rate (TER = 0.72 percent).

Hesitation and error: Does product placement in an emergency department influence hand hygiene performance?

PubMed

Stackelroth, Jenny; Sinnott, Michael; Shaban, Ramon Z

2015-09-01

Existing research has consistently demonstrated poor compliance by health care workers with hand hygiene standards. This study examined the extent to which incorrect hand hygiene occurred as a result of the inability to easily distinguish between different hand hygiene solutions placed at washbasins. A direct observational method was used using ceiling-mounted, motion-activated video camera surveillance in a tertiary referral emergency department in Australia. Data from a 24-hour period on day 10 of the recordings were collected into the Hand Hygiene-Technique Observation Tool based on Feldman's criteria as modified by Larson and Lusk. A total of 459 episodes of hand hygiene were recorded by 6 video cameras in the 24-hour period. The observed overall rate of error in this study was 6.2% (27 episodes). In addition an overall rate of hesitation was 5.8% (26 episodes). There was no statistically significant difference in error rates with the 2 hand washbasin configurations. The amelioration of causes of error and hesitation by standardization of the appearance and relative positioning of hand hygiene solutions at washbasins may translate in to improved hand hygiene behaviors. Placement of moisturizer at the washbasin may not be essential. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Evaluation of Hand Written and Computerized Out-Patient Prescriptions in Urban Part of Central Gujarat.

PubMed

Joshi, Anuradha; Buch, Jatin; Kothari, Nitin; Shah, Nishal

2016-06-01

Prescription order is an important therapeutic transaction between physician and patient. A good quality prescription is an extremely important factor for minimizing errors in dispensing medication and it should be adherent to guidelines for prescription writing for benefit of the patient. To evaluate frequency and type of prescription errors in outpatient prescriptions and find whether prescription writing abides with WHO standards of prescription writing. A cross-sectional observational study was conducted at Anand city. Allopathic private practitioners practising at Anand city of different specialities were included in study. Collection of prescriptions was started a month after the consent to minimize bias in prescription writing. The prescriptions were collected from local pharmacy stores of Anand city over a period of six months. Prescriptions were analysed for errors in standard information, according to WHO guide to good prescribing. Descriptive analysis was performed to estimate frequency of errors, data were expressed as numbers and percentage. Total 749 (549 handwritten and 200 computerised) prescriptions were collected. Abundant omission errors were identified in handwritten prescriptions e.g., OPD number was mentioned in 6.19%, patient's age was mentioned in 25.50%, gender in 17.30%, address in 9.29% and weight of patient mentioned in 11.29%, while in drug items only 2.97% drugs were prescribed by generic name. Route and Dosage form was mentioned in 77.35%-78.15%, dose mentioned in 47.25%, unit in 13.91%, regimens were mentioned in 72.93% while signa (direction for drug use) in 62.35%. Total 4384 errors out of 549 handwritten prescriptions and 501 errors out of 200 computerized prescriptions were found in clinicians and patient details. While in drug item details, total number of errors identified were 5015 and 621 in handwritten and computerized prescriptions respectively. As compared to handwritten prescriptions, computerized prescriptions appeared to be associated with relatively lower rates of error. Since out-patient prescription errors are abundant and often occur in handwritten prescriptions, prescribers need to adapt themselves to computerized prescription order entry in their daily practice.

Evaluation of Hand Written and Computerized Out-Patient Prescriptions in Urban Part of Central Gujarat

PubMed Central

Buch, Jatin; Kothari, Nitin; Shah, Nishal

2016-01-01

Introduction Prescription order is an important therapeutic transaction between physician and patient. A good quality prescription is an extremely important factor for minimizing errors in dispensing medication and it should be adherent to guidelines for prescription writing for benefit of the patient. Aim To evaluate frequency and type of prescription errors in outpatient prescriptions and find whether prescription writing abides with WHO standards of prescription writing. Materials and Methods A cross-sectional observational study was conducted at Anand city. Allopathic private practitioners practising at Anand city of different specialities were included in study. Collection of prescriptions was started a month after the consent to minimize bias in prescription writing. The prescriptions were collected from local pharmacy stores of Anand city over a period of six months. Prescriptions were analysed for errors in standard information, according to WHO guide to good prescribing. Statistical Analysis Descriptive analysis was performed to estimate frequency of errors, data were expressed as numbers and percentage. Results Total 749 (549 handwritten and 200 computerised) prescriptions were collected. Abundant omission errors were identified in handwritten prescriptions e.g., OPD number was mentioned in 6.19%, patient’s age was mentioned in 25.50%, gender in 17.30%, address in 9.29% and weight of patient mentioned in 11.29%, while in drug items only 2.97% drugs were prescribed by generic name. Route and Dosage form was mentioned in 77.35%-78.15%, dose mentioned in 47.25%, unit in 13.91%, regimens were mentioned in 72.93% while signa (direction for drug use) in 62.35%. Total 4384 errors out of 549 handwritten prescriptions and 501 errors out of 200 computerized prescriptions were found in clinicians and patient details. While in drug item details, total number of errors identified were 5015 and 621 in handwritten and computerized prescriptions respectively. Conclusion As compared to handwritten prescriptions, computerized prescriptions appeared to be associated with relatively lower rates of error. Since out-patient prescription errors are abundant and often occur in handwritten prescriptions, prescribers need to adapt themselves to computerized prescription order entry in their daily practice. PMID:27504305

Some potential errors in the measurement of mercury gas exchange at the soil surface using a dynamic flux chamber.

PubMed

Gillis, A; Miller, D R

2000-10-09

A series of controlled environment experiments were conducted to examine the use of a dynamic flux chamber to measure soil emission and absorption of total gaseous mercury (TGM). Uncertainty about the appropriate airflow rates through the chamber and chamber exposure to ambient wind are shown to be major sources of potential error. Soil surface mercury flux measurements over a range of chamber airflow rates showed a positive linear relationship between flux rates and airflow rate through the chamber. Mercury flux measurements using the chamber in an environmental wind tunnel showed that exposure of the system to ambient winds decreased the measured flux rates by 40% at a wind speed of 1.0 m s(-1) and 90% at a wind speed of 2 m s(-1). Wind tunnel measurements also showed that the chamber footprint was limited to the area of soil inside the chamber and there is little uncertainty of the footprint size in dry soil.

An improved procedure for the validation of satellite-based precipitation estimates

NASA Astrophysics Data System (ADS)

Tang, Ling; Tian, Yudong; Yan, Fang; Habib, Emad

2015-09-01

The objective of this study is to propose and test a new procedure to improve the validation of remote-sensing, high-resolution precipitation estimates. Our recent studies show that many conventional validation measures do not accurately capture the unique error characteristics in precipitation estimates to better inform both data producers and users. The proposed new validation procedure has two steps: 1) an error decomposition approach to separate the total retrieval error into three independent components: hit error, false precipitation and missed precipitation; and 2) the hit error is further analyzed based on a multiplicative error model. In the multiplicative error model, the error features are captured by three model parameters. In this way, the multiplicative error model separates systematic and random errors, leading to more accurate quantification of the uncertainties. The proposed procedure is used to quantitatively evaluate the recent two versions (Version 6 and 7) of TRMM's Multi-sensor Precipitation Analysis (TMPA) real-time and research product suite (3B42 and 3B42RT) for seven years (2005-2011) over the continental United States (CONUS). The gauge-based National Centers for Environmental Prediction (NCEP) Climate Prediction Center (CPC) near-real-time daily precipitation analysis is used as the reference. In addition, the radar-based NCEP Stage IV precipitation data are also model-fitted to verify the effectiveness of the multiplicative error model. The results show that winter total bias is dominated by the missed precipitation over the west coastal areas and the Rocky Mountains, and the false precipitation over large areas in Midwest. The summer total bias is largely coming from the hit bias in Central US. Meanwhile, the new version (V7) tends to produce more rainfall in the higher rain rates, which moderates the significant underestimation exhibited in the previous V6 products. Moreover, the error analysis from the multiplicative error model provides a clear and concise picture of the systematic and random errors, with both versions of 3B42RT have higher errors in varying degrees than their research (post-real-time) counterparts. The new V7 algorithm shows obvious improvements in reducing random errors in both winter and summer seasons, compared to its predecessors V6. Stage IV, as expected, surpasses the satellite-based datasets in all the metrics over CONUS. Based on the results, we recommend the new procedure be adopted for routine validation of satellite-based precipitation datasets, and we expect the procedure will work effectively for higher resolution data to be produced in the Global Precipitation Measurement (GPM) era.

Correcting for sequencing error in maximum likelihood phylogeny inference.

PubMed

Kuhner, Mary K; McGill, James

2014-11-04

Accurate phylogenies are critical to taxonomy as well as studies of speciation processes and other evolutionary patterns. Accurate branch lengths in phylogenies are critical for dating and rate measurements. Such accuracy may be jeopardized by unacknowledged sequencing error. We use simulated data to test a correction for DNA sequencing error in maximum likelihood phylogeny inference. Over a wide range of data polymorphism and true error rate, we found that correcting for sequencing error improves recovery of the branch lengths, even if the assumed error rate is up to twice the true error rate. Low error rates have little effect on recovery of the topology. When error is high, correction improves topological inference; however, when error is extremely high, using an assumed error rate greater than the true error rate leads to poor recovery of both topology and branch lengths. The error correction approach tested here was proposed in 2004 but has not been widely used, perhaps because researchers do not want to commit to an estimate of the error rate. This study shows that correction with an approximate error rate is generally preferable to ignoring the issue. Copyright © 2014 Kuhner and McGill.

NO sub X Deposited in the Stratosphere by the Space Shuttle Solid Rocket Motors

NASA Technical Reports Server (NTRS)

Pergament, H. S.; Thorpe, R. D.; Hwang, B.

1975-01-01

The possible effects of the interaction of the plumes from the two solid rocket motors (SRM) from the space shuttles and mixing of the rocket exhaust products and ambient air in the base recirculation region on the total nitrous oxide deposition rate in the stratosphere were investigated. It was shown that these phenomena will not influence the total NOx deposition rate. It was also shown that uncertainties in the particle size of Al2O3, size distributions and particle/gas drag and heat transfer coefficients will not have a significant effect on the predicted NOx deposition rate. The final results show that the total mass flow of NOx leaving the plume at 30 km altitude is 4000 g./sec with a possible error factor of 3. For a vehicle velocity of 1140 meter/sec this yields an NOx deposition rate of about 3.5 g./meter. The corresponding HCl deposition rate at this altitude is about a factor of 500 greater than this value.

Scale-Dependent Infrared Radiative Damping Rates on Mars and Their Role in the Deposition of Gravity-Wave Momentum Flux

DTIC Science & Technology

2010-01-01

1984; Zhu and Strobel , 1991; Zhu, 1993; Bresser et al., 1995) and the resulting scale-dependent IR damping rates have been incorporated within...determining total non-LTE cooling rates over the entire band. Offline calculations by Zhu and Strobel (1990) found errors of no more than ∼1 K day−1 in...and Strobel (1991) and Zhu (1993), who provide more details and justification. If we add small temperature perturbations δT to a background

Systems Issues Pertaining to Holographic Optical Data Storage in Thick Bacteriorhodopsin Films

NASA Technical Reports Server (NTRS)

Downie, John D.; Timucin, Dogan A.; Gary, Charles K.; Oezcan, Meric; Smithey, Daniel T.; Crew, Marshall; Lau, Sonie (Technical Monitor)

1998-01-01

The optical data storage capacity and raw bit-error-rate achievable with thick photochromic bacteriorhodopsin (BR) films are investigated for sequential recording and read- out of angularly- and shift-multiplexed digital holograms inside a thick blue-membrane D85N BR film. We address the determination of an exposure schedule that produces equal diffraction efficiencies among each of the multiplexed holograms. This exposure schedule is determined by numerical simulations of the holographic recording process within the BR material, and maximizes the total grating strength. We also experimentally measure the shift selectivity and compare the results to theoretical predictions. Finally, we evaluate the bit-error-rate of a single hologram, and of multiple holograms stored within the film.

Learning time-dependent noise to reduce logical errors: real time error rate estimation in quantum error correction

NASA Astrophysics Data System (ADS)

Huo, Ming-Xia; Li, Ying

2017-12-01

Quantum error correction is important to quantum information processing, which allows us to reliably process information encoded in quantum error correction codes. Efficient quantum error correction benefits from the knowledge of error rates. We propose a protocol for monitoring error rates in real time without interrupting the quantum error correction. Any adaptation of the quantum error correction code or its implementation circuit is not required. The protocol can be directly applied to the most advanced quantum error correction techniques, e.g. surface code. A Gaussian processes algorithm is used to estimate and predict error rates based on error correction data in the past. We find that using these estimated error rates, the probability of error correction failures can be significantly reduced by a factor increasing with the code distance.

Same-Day Identification and Antimicrobial Susceptibility Testing of Bacteria in Positive Blood Culture Broths Using Short-Term Incubation on Solid Medium with the MicroFlex LT, Vitek-MS, and Vitek2 Systems

PubMed Central

Ha, Jihye; Han, Geum Hee; Kim, Myungsook; Lee, Kyungwon

2018-01-01

Background Early and appropriate antibiotic treatment improves the clinical outcome of patients with septicemia; therefore, reducing the turn-around time for identification (ID) and antimicrobial susceptibility test (AST) results is essential. We established a method for rapid ID and AST using short-term incubation of positive blood culture broth samples on solid media, and evaluated its performance relative to that of the conventional method using two rapid ID systems and a rapid AST method. Methods A total of 254 mono-microbial samples were included. Positive blood culture samples were incubated on blood agar plates for six hours and identified by the MicroFlex LT (Bruker Daltonics) and Vitek-MS (bioMeriéux) systems, followed by AST using the Vitek2 System (bioMeriéux). Results The correct species-level ID rates were 82.3% (209/254) and 78.3% (199/254) for the MicroFlex LT and Vitek-MS platforms, respectively. For the 1,174 microorganism/antimicrobial agent combinations tested, the rapid AST method showed total concordance of 97.8% (1,148/1,174) with the conventional method, with a very major error rate of 0.5%, major error rate of 0.7%, and minor error rate of 1.0%. Conclusions Routine implementation of this short-term incubation method could provide ID results on the day of blood culture-positivity detection and one day earlier than the conventional AST method. This simple method will be very useful for rapid ID and AST of bacteria from positive blood culture bottles in routine clinical practice. PMID:29401558

Liability claims and costs before and after implementation of a medical error disclosure program.

PubMed

Kachalia, Allen; Kaufman, Samuel R; Boothman, Richard; Anderson, Susan; Welch, Kathleen; Saint, Sanjay; Rogers, Mary A M

2010-08-17

Since 2001, the University of Michigan Health System (UMHS) has fully disclosed and offered compensation to patients for medical errors. To compare liability claims and costs before and after implementation of the UMHS disclosure-with-offer program. Retrospective before-after analysis from 1995 to 2007. Public academic medical center and health system. Inpatients and outpatients involved in claims made to UMHS. Number of new claims for compensation, number of claims compensated, time to claim resolution, and claims-related costs. After full implementation of a disclosure-with-offer program, the average monthly rate of new claims decreased from 7.03 to 4.52 per 100,000 patient encounters (rate ratio [RR], 0.64 [95% CI, 0.44 to 0.95]). The average monthly rate of lawsuits decreased from 2.13 to 0.75 per 100,000 patient encounters (RR, 0.35 [CI, 0.22 to 0.58]). Median time from claim reporting to resolution decreased from 1.36 to 0.95 years. Average monthly cost rates decreased for total liability (RR, 0.41 [CI, 0.26 to 0.66]), patient compensation (RR, 0.41 [CI, 0.26 to 0.67]), and non-compensation-related legal costs (RR, 0.39 [CI, 0.22 to 0.67]). The study design cannot establish causality. Malpractice claims generally declined in Michigan during the latter part of the study period. The findings might not apply to other health systems, given that UMHS has a closed staff model covered by a captive insurance company and often assumes legal responsibility. The UMHS implemented a program of full disclosure of medical errors with offers of compensation without increasing its total claims and liability costs. Blue Cross Blue Shield of Michigan Foundation.

Same-Day Identification and Antimicrobial Susceptibility Testing of Bacteria in Positive Blood Culture Broths Using Short-Term Incubation on Solid Medium with the MicroFlex LT, Vitek-MS, and Vitek2 Systems.

PubMed

Ha, Jihye; Hong, Sung Kuk; Han, Geum Hee; Kim, Myungsook; Yong, Dongeun; Lee, Kyungwon

2018-05-01

Early and appropriate antibiotic treatment improves the clinical outcome of patients with septicemia; therefore, reducing the turn-around time for identification (ID) and antimicrobial susceptibility test (AST) results is essential. We established a method for rapid ID and AST using short-term incubation of positive blood culture broth samples on solid media, and evaluated its performance relative to that of the conventional method using two rapid ID systems and a rapid AST method. A total of 254 mono-microbial samples were included. Positive blood culture samples were incubated on blood agar plates for six hours and identified by the MicroFlex LT (Bruker Daltonics) and Vitek-MS (bioMeriéux) systems, followed by AST using the Vitek2 System (bioMeriéux). The correct species-level ID rates were 82.3% (209/254) and 78.3% (199/254) for the MicroFlex LT and Vitek-MS platforms, respectively. For the 1,174 microorganism/antimicrobial agent combinations tested, the rapid AST method showed total concordance of 97.8% (1,148/1,174) with the conventional method, with a very major error rate of 0.5%, major error rate of 0.7%, and minor error rate of 1.0%. Routine implementation of this short-term incubation method could provide ID results on the day of blood culture-positivity detection and one day earlier than the conventional AST method. This simple method will be very useful for rapid ID and AST of bacteria from positive blood culture bottles in routine clinical practice. © The Korean Society for Laboratory Medicine

Comparison of medication safety effectiveness among nine critical access hospitals.

PubMed

Cochran, Gary L; Haynatzki, Gleb

2013-12-15

The rates of medication errors across three different medication dispensing and administration systems frequently used in critical access hospitals (CAHs) were analyzed. Nine CAHs agreed to participate in this prospective study and were assigned to one of three groups based on similarities in their medication-use processes: (1) less than 10 hours per week of onsite pharmacy support and no bedside barcode system, (2) onsite pharmacy support for 40 hours per week and no bedside barcode system, and (3) onsite pharmacy support for 40 or more hours per week with a bedside barcode system. Errors were characterized by severity, phase of origination, type, and cause. Characteristics of the medication being administered and a number of best practices were collected for each medication pass. Logistic regression was used to identify significant predictors of errors. A total of 3103 medication passes were observed. More medication errors originated in hospitals that had onsite pharmacy support for less than 10 hours per week and no bedside barcode system than in other types of hospitals. A bedside barcode system had the greatest impact on lowering the odds of an error reaching the patient. Wrong dose and omission were common error types. Human factors and communication were the two most frequently identified causes of error for all three systems. Medication error rates were lower in CAHs with 40 or more hours per week of onsite pharmacy support with or without a bedside barcode system compared with hospitals with less than 10 hours per week of pharmacy support and no bedside barcode system.

Determination of the precision error of the pulmonary artery thermodilution catheter using an in vitro continuous flow test rig.

PubMed

Yang, Xiao-Xing; Critchley, Lester A; Joynt, Gavin M

2011-01-01

Thermodilution cardiac output using a pulmonary artery catheter is the reference method against which all new methods of cardiac output measurement are judged. However, thermodilution lacks precision and has a quoted precision error of ± 20%. There is uncertainty about its true precision and this causes difficulty when validating new cardiac output technology. Our aim in this investigation was to determine the current precision error of thermodilution measurements. A test rig through which water circulated at different constant rates with ports to insert catheters into a flow chamber was assembled. Flow rate was measured by an externally placed transonic flowprobe and meter. The meter was calibrated by timed filling of a cylinder. Arrow and Edwards 7Fr thermodilution catheters, connected to a Siemens SC9000 cardiac output monitor, were tested. Thermodilution readings were made by injecting 5 mL of ice-cold water. Precision error was divided into random and systematic components, which were determined separately. Between-readings (random) variability was determined for each catheter by taking sets of 10 readings at different flow rates. Coefficient of variation (CV) was calculated for each set and averaged. Between-catheter systems (systematic) variability was derived by plotting calibration lines for sets of catheters. Slopes were used to estimate the systematic component. Performances of 3 cardiac output monitors were compared: Siemens SC9000, Siemens Sirecust 1261, and Philips MP50. Five Arrow and 5 Edwards catheters were tested using the Siemens SC9000 monitor. Flow rates between 0.7 and 7.0 L/min were studied. The CV (random error) for Arrow was 5.4% and for Edwards was 4.8%. The random precision error was ± 10.0% (95% confidence limits). CV (systematic error) was 5.8% and 6.0%, respectively. The systematic precision error was ± 11.6%. The total precision error of a single thermodilution reading was ± 15.3% and ± 13.0% for triplicate readings. Precision error increased by 45% when using the Sirecust monitor and 100% when using the Philips monitor. In vitro testing of pulmonary artery catheters enabled us to measure both the random and systematic error components of thermodilution cardiac output measurement, and thus calculate the precision error. Using the Siemens monitor, we established a precision error of ± 15.3% for single and ± 13.0% for triplicate reading, which was similar to the previous estimate of ± 20%. However, this precision error was significantly worsened by using the Sirecust and Philips monitors. Clinicians should recognize that the precision error of thermodilution cardiac output is dependent on the selection of catheter and monitor model.

Nondimensional parameter for conformal grinding: combining machine and process parameters

NASA Astrophysics Data System (ADS)

Funkenbusch, Paul D.; Takahashi, Toshio; Gracewski, Sheryl M.; Ruckman, Jeffrey L.

1999-11-01

Conformal grinding of optical materials with CNC (Computer Numerical Control) machining equipment can be used to achieve precise control over complex part configurations. However complications can arise due to the need to fabricate complex geometrical shapes at reasonable production rates. For example high machine stiffness is essential, but the need to grind 'inside' small or highly concave surfaces may require use of tooling with less than ideal stiffness characteristics. If grinding generates loads sufficient for significant tool deflection, the programmed removal depth will not be achieved. Moreover since grinding load is a function of the volumetric removal rate the amount of load deflection can vary with location on the part, potentially producing complex figure errors. In addition to machine/tool stiffness and removal rate, load generation is a function of the process parameters. For example by reducing the feed rate of the tool into the part, both the load and resultant deflection/removal error can be decreased. However this must be balanced against the need for part through put. In this paper a simple model which permits combination of machine stiffness and process parameters into a single non-dimensional parameter is adapted for a conformal grinding geometry. Errors in removal can be minimized by maintaining this parameter above a critical value. Moreover, since the value of this parameter depends on the local part geometry, it can be used to optimize process settings during grinding. For example it may be used to guide adjustment of the feed rate as a function of location on the part to eliminate figure errors while minimizing the total grinding time required.

Neuropsychology of selective attention and magnetic cortical stimulation.

PubMed

Sabatino, M; Di Nuovo, S; Sardo, P; Abbate, C S; La Grutta, V

1996-01-01

Informed volunteers were asked to perform different neuropsychological tests involving selective attention under control conditions and during transcranial magnetic cortical stimulation. The tests chosen involved the recognition of a specific letter among different letters (verbal test) and the search for three different spatial orientations of an appendage to a square (visuo-spatial test). For each test the total time taken and the error rate were calculated. Results showed that cortical stimulation did not cause a worsening in performance. Moreover, magnetic stimulation of the temporal lobe neither modified completion time in both verbal and visuo-spatial tests nor changed error rate. In contrast, magnetic stimulation of the pre-frontal area induced a significant reduction in the performance time of both the verbal and visuo-spatial tests always without an increase in the number of errors. The experimental findings underline the importance of the pre-frontal area in performing tasks requiring a high level of controlled attention and suggest the need to adopt an interdisciplinary approach towards the study of neurone/mind interface mechanisms.

A recent Cleanroom success story: The Redwing project

NASA Technical Reports Server (NTRS)

Hausler, Philip A.

1992-01-01

Redwing is the largest completed Cleanroom software engineering project in IBM, both in terms of lines of code and project staffing. The product provides a decision-support facility that utilizes artificial intelligence (AI) technology for predicting and preventing complex operating problems in an MVS environment. The project used the Cleanroom process for development and realized a defect rate of 2.6 errors/KLOC, measured from first execution. This represents the total amount of errors that were found in testing and installation at three field test sites. Development productivity was 486 LOC/PM, which included all development labor expended in design specification through completion of incremental testing. In short, the Redwing team produced a complex systems software product with an extraordinarily low error rate, while maintaining high productivity. All of this was accomplished by a project team using Cleanroom for the first time. An 'introductory implementation' of Cleanroom was defined and used on Redwing. This paper describes the quality and productivity results, the Redwing project, and how Cleanroom was implemented.

Precipitation and Latent Heating Distributions from Satellite Passive Microwave Radiometry. Part 2; Evaluation of Estimates Using Independent Data

NASA Technical Reports Server (NTRS)

Yang, Song; Olson, William S.; Wang, Jian-Jian; Bell, Thomas L.; Smith, Eric A.; Kummerow, Christian D.

2004-01-01

Rainfall rate estimates from space-borne k&ents are generally accepted as reliable by a majority of the atmospheric science commu&y. One-of the Tropical Rainfall Measuring Mission (TRh4M) facility rain rate algorithms is based upon passive microwave observations fiom the TRMM Microwave Imager (TMI). Part I of this study describes improvements in the TMI algorithm that are required to introduce cloud latent heating and drying as additional algorithm products. Here, estimates of surface rain rate, convective proportion, and latent heating are evaluated using independent ground-based estimates and satellite products. Instantaneous, OP5resolution estimates of surface rain rate over ocean fiom the improved TMI algorithm are well correlated with independent radar estimates (r approx. 0.88 over the Tropics), but bias reduction is the most significant improvement over forerunning algorithms. The bias reduction is attributed to the greater breadth of cloud-resolving model simulations that support the improved algorithm, and the more consistent and specific convective/stratiform rain separation method utilized. The bias of monthly, 2.5 deg. -resolution estimates is similarly reduced, with comparable correlations to radar estimates. Although the amount of independent latent heating data are limited, TMI estimated latent heating profiles compare favorably with instantaneous estimates based upon dual-Doppler radar observations, and time series of surface rain rate and heating profiles are generally consistent with those derived from rawinsonde analyses. Still, some biases in profile shape are evident, and these may be resolved with: (a) additional contextual information brought to the estimation problem, and/or; (b) physically-consistent and representative databases supporting the algorithm. A model of the random error in instantaneous, 0.5 deg-resolution rain rate estimates appears to be consistent with the levels of error determined from TMI comparisons to collocated radar. Error model modifications for non-raining situations will be required, however. Sampling error appears to represent only a fraction of the total error in monthly, 2S0-resolution TMI estimates; the remaining error is attributed to physical inconsistency or non-representativeness of cloud-resolving model simulated profiles supporting the algorithm.

Cavemen Were Better at Depicting Quadruped Walking than Modern Artists: Erroneous Walking Illustrations in the Fine Arts from Prehistory to Today

PubMed Central

Horvath, Gabor; Farkas, Etelka; Boncz, Ildiko; Blaho, Miklos; Kriska, Gyorgy

2012-01-01

The experts of animal locomotion well know the characteristics of quadruped walking since the pioneering work of Eadweard Muybridge in the 1880s. Most of the quadrupeds advance their legs in the same lateral sequence when walking, and only the timing of their supporting feet differ more or less. How did this scientific knowledge influence the correctness of quadruped walking depictions in the fine arts? Did the proportion of erroneous quadruped walking illustrations relative to their total number (i.e. error rate) decrease after Muybridge? How correctly have cavemen (upper palaeolithic Homo sapiens) illustrated the walking of their quadruped prey in prehistoric times? The aim of this work is to answer these questions. We have analyzed 1000 prehistoric and modern artistic quadruped walking depictions and determined whether they are correct or not in respect of the limb attitudes presented, assuming that the other aspects of depictions used to determine the animals gait are illustrated correctly. The error rate of modern pre-Muybridgean quadruped walking illustrations was 83.5%, much more than the error rate of 73.3% of mere chance. It decreased to 57.9% after 1887, that is in the post-Muybridgean period. Most surprisingly, the prehistoric quadruped walking depictions had the lowest error rate of 46.2%. All these differences were statistically significant. Thus, cavemen were more keenly aware of the slower motion of their prey animals and illustrated quadruped walking more precisely than later artists. PMID:23227149

Mannitol dosing error during interfacility transfer for intracranial emergencies.

PubMed

Elliott, Cameron A; MacKenzie, Mark; O'Kelly, Cian J

2015-11-01

Mannitol is commonly used to treat elevated intracranial pressure (ICP). The authors analyzed mannitol dosing errors at peripheral hospitals prior to or during transport to tertiary care facilities for intracranial emergencies. They also investigated the appropriateness of mannitol use based on the 2007 Brain Trauma Foundation guidelines for severe traumatic brain injury. The authors conducted a retrospective review of the Shock Trauma Air Rescue Society (STARS) electronic patient database of helicopter medical evacuations in Alberta, Canada, between 2004 and 2012, limited to patients receiving mannitol before transfer. They extracted data on mannitol administration and patient characteristics, including diagnosis, mechanism, Glasgow Coma Scale score, weight, age, and pupil status. A total of 120 patients with an intracranial emergency received a mannitol infusion initiated at a peripheral hospital (median Glasgow Coma Scale score 6; range 3-13). Overall, there was a 22% dosing error rate, which comprised an underdosing rate (<0.25 g/kg) of 8.3% (10 of 120 patients), an overdosing rate (>1.5 g/kg) of 7.5% (9 of 120), and a nonbolus administration rate (>1 hour) of 6.7% (8 of 120). Overall, 72% of patients had a clear indication to receive mannitol as defined by meeting at least one of the following criteria based on Brain Trauma Foundation guidelines: neurological deterioration (11%), severe traumatic brain injury (69%), or pupillary abnormality (25%). Mannitol administration at peripheral hospitals is prone to dosing error. Strategies such as a pretransport checklist may mitigate this risk.

Cavemen were better at depicting quadruped walking than modern artists: erroneous walking illustrations in the fine arts from prehistory to today.

PubMed

Horvath, Gabor; Farkas, Etelka; Boncz, Ildiko; Blaho, Miklos; Kriska, Gyorgy

2012-01-01

The experts of animal locomotion well know the characteristics of quadruped walking since the pioneering work of Eadweard Muybridge in the 1880s. Most of the quadrupeds advance their legs in the same lateral sequence when walking, and only the timing of their supporting feet differ more or less. How did this scientific knowledge influence the correctness of quadruped walking depictions in the fine arts? Did the proportion of erroneous quadruped walking illustrations relative to their total number (i.e. error rate) decrease after Muybridge? How correctly have cavemen (upper palaeolithic Homo sapiens) illustrated the walking of their quadruped prey in prehistoric times? The aim of this work is to answer these questions. We have analyzed 1000 prehistoric and modern artistic quadruped walking depictions and determined whether they are correct or not in respect of the limb attitudes presented, assuming that the other aspects of depictions used to determine the animals gait are illustrated correctly. The error rate of modern pre-Muybridgean quadruped walking illustrations was 83.5%, much more than the error rate of 73.3% of mere chance. It decreased to 57.9% after 1887, that is in the post-Muybridgean period. Most surprisingly, the prehistoric quadruped walking depictions had the lowest error rate of 46.2%. All these differences were statistically significant. Thus, cavemen were more keenly aware of the slower motion of their prey animals and illustrated quadruped walking more precisely than later artists.

Entangled quantum key distribution over two free-space optical links.

PubMed

Erven, C; Couteau, C; Laflamme, R; Weihs, G

2008-10-13

We report on the first real-time implementation of a quantum key distribution (QKD) system using entangled photon pairs that are sent over two free-space optical telescope links. The entangled photon pairs are produced with a type-II spontaneous parametric down-conversion source placed in a central, potentially untrusted, location. The two free-space links cover a distance of 435 m and 1,325 m respectively, producing a total separation of 1,575 m. The system relies on passive polarization analysis units, GPS timing receivers for synchronization, and custom written software to perform the complete QKD protocol including error correction and privacy amplification. Over 6.5 hours during the night, we observed an average raw key generation rate of 565 bits/s, an average quantum bit error rate (QBER) of 4.92%, and an average secure key generation rate of 85 bits/s.

Maintenance-free operation of WDM quantum key distribution system through a field fiber over 30 days

NASA Astrophysics Data System (ADS)

Yoshino, Ken-ichiro; Ochi, Takao; Fujiwara, Mikio; Sasaki, Masahide; Tajima, Akio

2013-12-01

Maintenance-free wavelength-division-multiplexing quantum key distribution for 30 days was achieved through a 22-km field fiber. Using polarization-independent interferometers and stabilization techniques, we attained a quantum bit error rate as low as 1.70% and a key rate as high as 229.8 kbps, making the record of total secure key of 595.6 Gbits accumulated over an uninterrupted operation period.

Daily Orthogonal Kilovoltage Imaging Using a Gantry-Mounted On-Board Imaging System Results in a Reduction in Radiation Therapy Delivery Errors

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

Russo, Gregory A., E-mail: gregory.russo@bmc.org; Qureshi, Muhammad M.; Truong, Minh-Tam

2012-11-01

Purpose: To determine whether the use of routine image guided radiation therapy (IGRT) using pretreatment on-board imaging (OBI) with orthogonal kilovoltage X-rays reduces treatment delivery errors. Methods and Materials: A retrospective review of documented treatment delivery errors from 2003 to 2009 was performed. Following implementation of IGRT in 2007, patients received daily OBI with orthogonal kV X-rays prior to treatment. The frequency of errors in the pre- and post-IGRT time frames was compared. Treatment errors (TEs) were classified as IGRT-preventable or non-IGRT-preventable. Results: A total of 71,260 treatment fractions were delivered to 2764 patients. A total of 135 (0.19%) TEsmore » occurred in 39 (1.4%) patients (3.2% in 2003, 1.1% in 2004, 2.5% in 2005, 2% in 2006, 0.86% in 2007, 0.24% in 2008, and 0.22% in 2009). In 2007, the TE rate decreased by >50% and has remained low (P = .00007, compared to before 2007). Errors were classified as being potentially preventable with IGRT (e.g., incorrect site, patient, or isocenter) vs. not. No patients had any IGRT-preventable TEs from 2007 to 2009, whereas there were 9 from 2003 to 2006 (1 in 2003, 2 in 2004, 2 in 2005, and 4 in 2006; P = .0058) before the implementation of IGRT. Conclusions: IGRT implementation has a patient safety benefit with a significant reduction in treatment delivery errors. As such, we recommend the use of IGRT in routine practice to complement existing quality assurance measures.« less

Daily orthogonal kilovoltage imaging using a gantry-mounted on-board imaging system results in a reduction in radiation therapy delivery errors.

PubMed

Russo, Gregory A; Qureshi, Muhammad M; Truong, Minh-Tam; Hirsch, Ariel E; Orlina, Lawrence; Bohrs, Harry; Clancy, Pauline; Willins, John; Kachnic, Lisa A

2012-11-01

To determine whether the use of routine image guided radiation therapy (IGRT) using pretreatment on-board imaging (OBI) with orthogonal kilovoltage X-rays reduces treatment delivery errors. A retrospective review of documented treatment delivery errors from 2003 to 2009 was performed. Following implementation of IGRT in 2007, patients received daily OBI with orthogonal kV X-rays prior to treatment. The frequency of errors in the pre- and post-IGRT time frames was compared. Treatment errors (TEs) were classified as IGRT-preventable or non-IGRT-preventable. A total of 71,260 treatment fractions were delivered to 2764 patients. A total of 135 (0.19%) TEs occurred in 39 (1.4%) patients (3.2% in 2003, 1.1% in 2004, 2.5% in 2005, 2% in 2006, 0.86% in 2007, 0.24% in 2008, and 0.22% in 2009). In 2007, the TE rate decreased by >50% and has remained low (P = .00007, compared to before 2007). Errors were classified as being potentially preventable with IGRT (e.g., incorrect site, patient, or isocenter) vs. not. No patients had any IGRT-preventable TEs from 2007 to 2009, whereas there were 9 from 2003 to 2006 (1 in 2003, 2 in 2004, 2 in 2005, and 4 in 2006; P = .0058) before the implementation of IGRT. IGRT implementation has a patient safety benefit with a significant reduction in treatment delivery errors. As such, we recommend the use of IGRT in routine practice to complement existing quality assurance measures. Copyright © 2012 Elsevier Inc. All rights reserved.

Nurses' attitudes and perceived barriers to the reporting of medication administration errors.

PubMed

Yung, Hai-Peng; Yu, Shu; Chu, Chi; Hou, I-Ching; Tang, Fu-In

2016-07-01

(1) To explore the attitudes and perceived barriers to reporting medication administration errors and (2) to understand the characteristics of - and nurses' feelings - about error reports. Under-reporting of medication administration errors is a global concern related to the safety of patient care. Understanding nurses' attitudes and perceived barriers to error reporting is the initial step to increasing the reporting rate. A cross-sectional, descriptive survey with a self-administered questionnaire was completed by the nurses of a medical centre hospital in Taiwan. A total of 306 nurses participated in the study. Nurses' attitudes towards medication administration error reporting were inclined towards positive. The major perceived barrier was fear of the consequences after reporting. The results demonstrated that 88.9% of medication administration errors were reported orally, whereas 19.0% were reported through the hospital internet system. Self-recrimination was the common feeling of nurses after the commission of an medication administration error. Even if hospital management encourages errors to be reported without recrimination, nurses' attitudes toward medication administration error reporting are not very positive and fear is the most prominent barrier contributing to underreporting. Nursing managers should establish anonymous reporting systems and counselling classes to create a secure atmosphere to reduce nurses' fear and provide incentives to encourage reporting. © 2016 John Wiley & Sons Ltd.

Bluetooth Heart Rate Monitors For Spaceflight

NASA Technical Reports Server (NTRS)

Buxton, R. E.; West, M. R.; Kalogera, K. L.; Hanson, A. M.

2016-01-01

Heart rate monitoring is required for crewmembers during exercise aboard the International Space Station (ISS) and will be for future exploration missions. The cardiovascular system must be sufficiently stressed throughout a mission to maintain the ability to perform nominal and contingency/emergency tasks. High quality heart rate data are required to accurately determine the intensity of exercise performed by the crewmembers and show maintenance of VO2max. The quality of the data collected on ISS is subject to multiple limitations and is insufficient to meet current requirements. PURPOSE: To evaluate the performance of commercially available Bluetooth heart rate monitors (BT_HRM) and their ability to provide high quality heart rate data to monitor crew health aboard the ISS and during future exploration missions. METHODS: Nineteen subjects completed 30 data collection sessions of various intensities on the treadmill and/or cycle. Subjects wore several BT_HRM technologies for each testing session. One electrode-based chest strap (CS) was worn, while one or more optical sensors (OS) were worn. Subjects were instrumented with a 12-lead ECG to compare the heart rate data from the Bluetooth sensors. Each BT_HRM data set was time matched to the ECG data and a +/-5bpm threshold was applied to the difference between the 2 data sets. Percent error was calculated based on the number of data points outside the threshold and the total number of data points. RESULTS: The electrode-based chest straps performed better than the optical sensors. The best performing CS was CS1 (1.6% error), followed by CS4 (3.3% error), CS3 (6.4% error), and CS2 (9.2% error). The OS resulted in 10.4% error for OS1 and 14.9% error for OS2. CONCLUSIONS: The highest quality data came from CS1, but unfortunately it has been discontinued by the manufacturer. The optical sensors have not been ruled out for use, but more investigation is needed to determine how to obtain the best quality data. CS2 will be used in an ISS Bluetooth validation study, because it simultaneously transmits magnetic pulse that is integrated with existing exercise hardware on ISS. The simultaneous data streams allow for beat-to-beat comparison between the current ISS standard and CS2. Upon Bluetooth validation aboard ISS, the research team will down select a new BT_HRM for operational use.

Bluetooth(Registered Trademark) Heart Rate Monitors for Spaceflight

NASA Technical Reports Server (NTRS)

Buxton, Roxanne E.; West, Michael R.; Kalogera, Kent L.; Hanson, Andrea M.

2016-01-01

Heart rate monitoring is required during exercise for crewmembers aboard the International Space Station (ISS) and will be for future exploration missions. The cardiovascular system must be sufficiently stressed throughout a mission to maintain the ability to perform nominal and contingency/emergency tasks. High quality heart rate data is required to accurately determine the intensity of exercise performed by the crewmembers and show maintenance of VO2max. The quality of the data collected on ISS is subject to multiple limitations and is insufficient to meet current requirements. PURPOSE: To evaluate the performance of commercially available Bluetooth® heart rate monitors (BT_HRM) and their ability to provide high quality heart rate data to monitor crew health on board ISS and during future exploration missions. METHODS: Nineteen subjects completed 30 data collection sessions of various intensities on the treadmill and/or cycle. Subjects wore several BT_HRM technologies for each testing session. One electrode-based chest strap (CS) was worn, while one or more optical sensors (OS) was worn. Subjects were instrumented with a 12-lead ECG to compare the heart rate data from the Bluetooth sensors. Each BT_RHM data set was time matched to the ECG data and a +/-5bpm threshold was applied to the difference between the two data sets. Percent error was calculated based on the number of data points outside the threshold and the total number of data points. REULTS: The electrode-based chest straps performed better than the optical sensors. The best performing CS was CS1 (1.6%error), followed by CS4 (3.3%error), CS3 (6.4%error), and CS2 (9.2%error). The OS resulted in 10.4% error for OS1 and 14.9% error for OS2. CONCLUSIONS: The highest quality data came from CS1, unfortunately it has been discontinued by the manufacturer. The optical sensors have not been ruled out for use, but more investigation is needed to determine how to get the best quality data. CS2 will be used in an ISS Bluetooth validation study, because it simultaneously transmits Magnetic Pulse which is integrated with existing exercise hardware on ISS. The simultaneous data streams allow for beat to beat comparison between the current ISS standard and CS2.Upon Bluetooth(Registered Trademark) validation aboard ISS, down select of a new BT_HRM for operational use will be made.

Laboratory errors and patient safety.

PubMed

Miligy, Dawlat A

2015-01-01

Laboratory data are extensively used in medical practice; consequently, laboratory errors have a tremendous impact on patient safety. Therefore, programs designed to identify and reduce laboratory errors, as well as, setting specific strategies are required to minimize these errors and improve patient safety. The purpose of this paper is to identify part of the commonly encountered laboratory errors throughout our practice in laboratory work, their hazards on patient health care and some measures and recommendations to minimize or to eliminate these errors. Recording the encountered laboratory errors during May 2008 and their statistical evaluation (using simple percent distribution) have been done in the department of laboratory of one of the private hospitals in Egypt. Errors have been classified according to the laboratory phases and according to their implication on patient health. Data obtained out of 1,600 testing procedure revealed that the total number of encountered errors is 14 tests (0.87 percent of total testing procedures). Most of the encountered errors lay in the pre- and post-analytic phases of testing cycle (representing 35.7 and 50 percent, respectively, of total errors). While the number of test errors encountered in the analytic phase represented only 14.3 percent of total errors. About 85.7 percent of total errors were of non-significant implication on patients health being detected before test reports have been submitted to the patients. On the other hand, the number of test errors that have been already submitted to patients and reach the physician represented 14.3 percent of total errors. Only 7.1 percent of the errors could have an impact on patient diagnosis. The findings of this study were concomitant with those published from the USA and other countries. This proves that laboratory problems are universal and need general standardization and bench marking measures. Original being the first data published from Arabic countries that evaluated the encountered laboratory errors and launch the great need for universal standardization and bench marking measures to control the laboratory work.

Modeling and Control of a Tailsitter with a Ducted Fan

NASA Astrophysics Data System (ADS)

Argyle, Matthew Elliott

There are two traditional aircraft categories: fixed-wing which have a long endurance and a high cruise airspeed and rotorcraft which can take-off and land vertically. The tailsitter is a type of aircraft that has the strengths of both platforms, with no additional mechanical complexity, because it takes off and lands vertically on its tail and can transition the entire aircraft horizontally into high-speed flight. In this dissertation, we develop the entire control system for a tailsitter with a ducted fan. The standard method to compute the quaternion-based attitude error does not generate ideal trajectories for a hovering tailsitter for some situations. In addition, the only approach in the literature to mitigate this breaks down for large attitude errors. We develop an alternative quaternion-based error method which generates better trajectories than the standard approach and can handle large errors. We also derive a hybrid backstepping controller with almost global asymptotic stability based on this error method. Many common altitude and airspeed control schemes for a fixed-wing airplane assume that the altitude and airspeed dynamics are decoupled which leads to errors. The Total Energy Control System (TECS) is an approach that controls the altitude and airspeed by manipulating the total energy rate and energy distribution rate, of the aircraft, in a manner which accounts for the dynamic coupling. In this dissertation, a nonlinear controller, which can handle inaccurate thrust and drag models, based on the TECS principles is derived. Simulation results show that the nonlinear controller has better performance than the standard PI TECS control schemes. Most constant altitude transitions are accomplished by generating an optimal trajectory, and potentially actuator inputs, based on a high fidelity model of the aircraft. While there are several approaches to mitigate the effects of modeling errors, these do not fully remove the accurate model requirement. In this dissertation, we develop two different approaches that can achieve near constant altitude transitions for some types of aircraft. The first method, based on multiple LQR controllers, requires a high fidelity model of the aircraft. However, the second method, based on the energy along the body axes, requires almost no aerodynamic information.

Prevalence of refractive error in malay primary school children in suburban area of Kota Bharu, Kelantan, Malaysia.

PubMed

Hashim, Syaratul-Emma; Tan, Hui-Ken; Wan-Hazabbah, W H; Ibrahim, Mohtar

2008-11-01

Refractive error remains one of the primary causes of visual impairment in children worldwide, and the prevalence of refractive error varies widely. The objective of this study was to determine the prevalence of refractive error and study the possible associated factors inducing refractive error among primary school children of Malay ethnicity in the suburban area of Kota Bharu, Kelantan, Malaysia. A school-based cross-sectional study was performed from January to July 2006 by random selection on Standard 1 to Standard 6 students of 10 primary schools in the Kota Bharu district. Visual acuity assessment was measured using logMAR ETDRS chart. Positive predictive value of uncorrected visual acuity equal or worse than 20/40, was used as a cut-off point for further evaluation by automated refraction and retinoscopic refraction. A total of 840 students were enumerated but only 705 were examined. The prevalence of uncorrected visual impairment was seen in 54 (7.7%) children. The main cause of the uncorrected visual impairment was refractive error which contributed to 90.7% of the total, and with 7.0% prevalence for the studied population. Myopia is the most common type of refractive error among children aged 6 to 12 years with prevalence of 5.4%, followed by hyperopia at 1.0% and astigmatism at 0.6%. A significant positive correlation was noted between myopia development with increasing age (P <0.005), more hours spent on reading books (P <0.005) and background history of siblings with glasses (P <0.005) and whose parents are of higher educational level (P <0.005). Malays in suburban Kelantan (5.4%) have the lowest prevalence of myopia compared with Malays in the metropolitan cities of Kuala Lumpur (9.2%) and Singapore (22.1%). The ethnicity-specific prevalence rate of myopia was the lowest among Malays in Kota Bharu, followed by Kuala Lumpur, and is the highest among Singaporean Malays. Better socio-economic factors could have contributed to higher myopia rates in the cities, since the genetic background of these ethnic Malays are similar.

Cardiopulmonary resuscitation using the cardio vent device in a resuscitation model.

PubMed

Suner, Selim; Jay, Gregory D; Kleinman, Gary J; Woolard, Robert H; Jagminas, Liudvikas; Becker, Bruce M

2002-05-01

To compare the "Bellows on Sternum Resuscitation" (BSR) device that permits simultaneous compression and ventilation by one rescuer with two person cardiopulmonary resuscitation (CPR) with bag-valve-mask (BVM) ventilation in a single blind crossover study performed in the laboratory setting. Tidal volume and compression depth were recorded continuously during 12-min CPR sessions with the BSR device and two person CPR. Six CPR instructors performed a total of 1,894 ventilations and 10,532 compressions in 3 separate 12-min sessions. Mean tidal volume (MTV) and compression rate (CR) with the BSR device differed significantly from CPR with the BVM group (1242 mL vs. 1065 mL, respectively, p = 0.0018 and 63.2 compressions per minute (cpm) vs. 81.3 cpm, respectively, p = 0.0076). Error in compression depth (ECD) rate of 9.78% was observed with the BSR device compared to 8.49% with BMV CPR (p = 0.1815). Error rate was significantly greater during the second half of CPR sessions for both BSR and BVM groups. It is concluded that one-person CPR with the BSR device is equivalent to two-person CPR with BVM in all measured parameters except for CR. Both groups exhibited greater error rate in CPR performance in the latter half of 12-min CPR sessions.

Evaluation and optimization of sampling errors for the Monte Carlo Independent Column Approximation

NASA Astrophysics Data System (ADS)

Räisänen, Petri; Barker, W. Howard

2004-07-01

The Monte Carlo Independent Column Approximation (McICA) method for computing domain-average broadband radiative fluxes is unbiased with respect to the full ICA, but its flux estimates contain conditional random noise. McICA's sampling errors are evaluated here using a global climate model (GCM) dataset and a correlated-k distribution (CKD) radiation scheme. Two approaches to reduce McICA's sampling variance are discussed. The first is to simply restrict all of McICA's samples to cloudy regions. This avoids wasting precious few samples on essentially homogeneous clear skies. Clear-sky fluxes need to be computed separately for this approach, but this is usually done in GCMs for diagnostic purposes anyway. Second, accuracy can be improved by repeated sampling, and averaging those CKD terms with large cloud radiative effects. Although this naturally increases computational costs over the standard CKD model, random errors for fluxes and heating rates are reduced by typically 50% to 60%, for the present radiation code, when the total number of samples is increased by 50%. When both variance reduction techniques are applied simultaneously, globally averaged flux and heating rate random errors are reduced by a factor of #3.

Estimation of Human Body Volume (BV) from Anthropometric Measurements Based on Three-Dimensional (3D) Scan Technique.

PubMed

Liu, Xingguo; Niu, Jianwei; Ran, Linghua; Liu, Taijie

2017-08-01

This study aimed to develop estimation formulae for the total human body volume (BV) of adult males using anthropometric measurements based on a three-dimensional (3D) scanning technique. Noninvasive and reliable methods to predict the total BV from anthropometric measurements based on a 3D scan technique were addressed in detail. A regression analysis of BV based on four key measurements was conducted for approximately 160 adult male subjects. Eight total models of human BV show that the predicted results fitted by the regression models were highly correlated with the actual BV (p < 0.001). Two metrics, the mean value of the absolute difference between the actual and predicted BV (V error ) and the mean value of the ratio between V error and actual BV (RV error ), were calculated. The linear model based on human weight was recommended as the most optimal due to its simplicity and high efficiency. The proposed estimation formulae are valuable for estimating total body volume in circumstances in which traditional underwater weighing or air displacement plethysmography is not applicable or accessible. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Helium Mass Spectrometer Leak Detection: A Method to Quantify Total Measurement Uncertainty

NASA Technical Reports Server (NTRS)

Mather, Janice L.; Taylor, Shawn C.

2015-01-01

In applications where leak rates of components or systems are evaluated against a leak rate requirement, the uncertainty of the measured leak rate must be included in the reported result. However, in the helium mass spectrometer leak detection method, the sensitivity, or resolution, of the instrument is often the only component of the total measurement uncertainty noted when reporting results. To address this shortfall, a measurement uncertainty analysis method was developed that includes the leak detector unit's resolution, repeatability, hysteresis, and drift, along with the uncertainty associated with the calibration standard. In a step-wise process, the method identifies the bias and precision components of the calibration standard, the measurement correction factor (K-factor), and the leak detector unit. Together these individual contributions to error are combined and the total measurement uncertainty is determined using the root-sum-square method. It was found that the precision component contributes more to the total uncertainty than the bias component, but the bias component is not insignificant. For helium mass spectrometer leak rate tests where unit sensitivity alone is not enough, a thorough evaluation of the measurement uncertainty such as the one presented herein should be performed and reported along with the leak rate value.

Direct measurement of the poliovirus RNA polymerase error frequency in vitro

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

Ward, C.D.; Stokes, M.A.M.; Flanegan, J.B.

1988-02-01

The fidelity of RNA replication by the poliovirus-RNA-dependent RNA polymerase was examined by copying homopolymeric RNA templates in vitro. The poliovirus RNA polymerase was extensively purified and used to copy poly(A), poly(C), or poly(I) templates with equimolar concentrations of noncomplementary and complementary ribonucleotides. The error frequency was expressed as the amount of a noncomplementary nucleotide incorporated divided by the total amount of complementary and noncomplementary nucleotide incorporated. The polymerase error frequencies were very high, depending on the specific reaction conditions. The activity of the polymerase on poly(U) and poly(G) was too low to measure error frequencies on these templates. Amore » fivefold increase in the error frequency was observed when the reaction conditions were changed from 3.0 mM Mg{sup 2+} (pH 7.0) to 7.0 mM Mg{sup 2+} (pH 8.0). This increase in the error frequency correlates with an eightfold increase in the elongation rate that was observed under the same conditions in a previous study.« less

Iterative random vs. Kennard-Stone sampling for IR spectrum-based classification task using PLS2-DA

NASA Astrophysics Data System (ADS)

Lee, Loong Chuen; Liong, Choong-Yeun; Jemain, Abdul Aziz

2018-04-01

External testing (ET) is preferred over auto-prediction (AP) or k-fold-cross-validation in estimating more realistic predictive ability of a statistical model. With IR spectra, Kennard-stone (KS) sampling algorithm is often used to split the data into training and test sets, i.e. respectively for model construction and for model testing. On the other hand, iterative random sampling (IRS) has not been the favored choice though it is theoretically more likely to produce reliable estimation. The aim of this preliminary work is to compare performances of KS and IRS in sampling a representative training set from an attenuated total reflectance - Fourier transform infrared spectral dataset (of four varieties of blue gel pen inks) for PLS2-DA modeling. The `best' performance achievable from the dataset is estimated with AP on the full dataset (APF, error). Both IRS (n = 200) and KS were used to split the dataset in the ratio of 7:3. The classic decision rule (i.e. maximum value-based) is employed for new sample prediction via partial least squares - discriminant analysis (PLS2-DA). Error rate of each model was estimated repeatedly via: (a) AP on full data (APF, error); (b) AP on training set (APS, error); and (c) ET on the respective test set (ETS, error). A good PLS2-DA model is expected to produce APS, error and EVS, error that is similar to the APF, error. Bearing that in mind, the similarities between (a) APS, error vs. APF, error; (b) ETS, error vs. APF, error and; (c) APS, error vs. ETS, error were evaluated using correlation tests (i.e. Pearson and Spearman's rank test), using series of PLS2-DA models computed from KS-set and IRS-set, respectively. Overall, models constructed from IRS-set exhibits more similarities between the internal and external error rates than the respective KS-set, i.e. less risk of overfitting. In conclusion, IRS is more reliable than KS in sampling representative training set.

Rate constant for the fraction of atomic chlorine with formaldehyde from 200 to 500K

NASA Technical Reports Server (NTRS)

Michael, J. V.; Nava, D. F.; Payne, W. A.; Stief, L. J.

1978-01-01

A flash photolysis - resonance fluorescence technique was used to measure rate constant. The results were independent of substantial variations in H2CO, total pressure (Ar), and flash intensity (i.e., initial Cl). The rate constant was shown to be invariant with temperature, the best representation for this temperature range being K = (7.48 + or - 0.50) x 10 to the minus 11 power cu cm molecule-1 s-1 where the error is one standard deviation. The rate constant is theoretically discussed and the potential importance of the reaction in stratospheric chemistry is considered.

Errors in radiation oncology: A study in pathways and dosimetric impact

PubMed Central

Drzymala, Robert E.; Purdy, James A.; Michalski, Jeff

2005-01-01

As complexity for treating patients increases, so does the risk of error. Some publications have suggested that record and verify (R&V) systems may contribute in propagating errors. Direct data transfer has the potential to eliminate most, but not all, errors. And although the dosimetric consequences may be obvious in some cases, a detailed study does not exist. In this effort, we examined potential errors in terms of scenarios, pathways of occurrence, and dosimetry. Our goal was to prioritize error prevention according to likelihood of event and dosimetric impact. For conventional photon treatments, we investigated errors of incorrect source‐to‐surface distance (SSD), energy, omitted wedge (physical, dynamic, or universal) or compensating filter, incorrect wedge or compensating filter orientation, improper rotational rate for arc therapy, and geometrical misses due to incorrect gantry, collimator or table angle, reversed field settings, and setup errors. For electron beam therapy, errors investigated included incorrect energy, incorrect SSD, along with geometric misses. For special procedures we examined errors for total body irradiation (TBI, incorrect field size, dose rate, treatment distance) and LINAC radiosurgery (incorrect collimation setting, incorrect rotational parameters). Likelihood of error was determined and subsequently rated according to our history of detecting such errors. Dosimetric evaluation was conducted by using dosimetric data, treatment plans, or measurements. We found geometric misses to have the highest error probability. They most often occurred due to improper setup via coordinate shift errors or incorrect field shaping. The dosimetric impact is unique for each case and depends on the proportion of fields in error and volume mistreated. These errors were short‐lived due to rapid detection via port films. The most significant dosimetric error was related to a reversed wedge direction. This may occur due to incorrect collimator angle or wedge orientation. For parallel‐opposed 60° wedge fields, this error could be as high as 80% to a point off‐axis. Other examples of dosimetric impact included the following: SSD, ~2%/cm for photons or electrons; photon energy (6 MV vs. 18 MV), on average 16% depending on depth, electron energy, ~0.5cm of depth coverage per MeV (mega‐electron volt). Of these examples, incorrect distances were most likely but rapidly detected by in vivo dosimetry. Errors were categorized by occurrence rate, methods and timing of detection, longevity, and dosimetric impact. Solutions were devised according to these criteria. To date, no one has studied the dosimetric impact of global errors in radiation oncology. Although there is heightened awareness that with increased use of ancillary devices and automation, there must be a parallel increase in quality check systems and processes, errors do and will continue to occur. This study has helped us identify and prioritize potential errors in our clinic according to frequency and dosimetric impact. For example, to reduce the use of an incorrect wedge direction, our clinic employs off‐axis in vivo dosimetry. To avoid a treatment distance setup error, we use both vertical table settings and optical distance indicator (ODI) values to properly set up fields. As R&V systems become more automated, more accurate and efficient data transfer will occur. This will require further analysis. Finally, we have begun examining potential intensity‐modulated radiation therapy (IMRT) errors according to the same criteria. PACS numbers: 87.53.Xd, 87.53.St PMID:16143793

Effects of sharing information on drug administration errors in pediatric wards: a pre–post intervention study

PubMed Central

Chua, Siew-Siang; Choo, Sim-Mei; Sulaiman, Che Zuraini; Omar, Asma; Thong, Meow-Keong

2017-01-01

Background and purpose Drug administration errors are more likely to reach the patient than other medication errors. The main aim of this study was to determine whether the sharing of information on drug administration errors among health care providers would reduce such problems. Patients and methods This study involved direct, undisguised observations of drug administrations in two pediatric wards of a major teaching hospital in Kuala Lumpur, Malaysia. This study consisted of two phases: Phase 1 (pre-intervention) and Phase 2 (post-intervention). Data were collected by two observers over a 40-day period in both Phase 1 and Phase 2 of the study. Both observers were pharmacy graduates: Observer 1 just completed her undergraduate pharmacy degree, whereas Observer 2 was doing her one-year internship as a provisionally registered pharmacist in the hospital under study. A drug administration error was defined as a discrepancy between the drug regimen received by the patient and that intended by the prescriber and also drug administration procedures that did not follow standard hospital policies and procedures. Results from Phase 1 of the study were analyzed, presented and discussed with the ward staff before commencement of data collection in Phase 2. Results A total of 1,284 and 1,401 doses of drugs were administered in Phase 1 and Phase 2, respectively. The rate of drug administration errors reduced significantly from Phase 1 to Phase 2 (44.3% versus 28.6%, respectively; P<0.001). Logistic regression analysis showed that the adjusted odds of drug administration errors in Phase 1 of the study were almost three times that in Phase 2 (P<0.001). The most common types of errors were incorrect administration technique and incorrect drug preparation. Nasogastric and intravenous routes of drug administration contributed significantly to the rate of drug administration errors. Conclusion This study showed that sharing of the types of errors that had occurred was significantly associated with a reduction in drug administration errors. PMID:28356748

Evaluation of Bayesian Sequential Proportion Estimation Using Analyst Labels

NASA Technical Reports Server (NTRS)

Lennington, R. K.; Abotteen, K. M. (Principal Investigator)

1980-01-01

The author has identified the following significant results. A total of ten Large Area Crop Inventory Experiment Phase 3 blind sites and analyst-interpreter labels were used in a study to compare proportional estimates obtained by the Bayes sequential procedure with estimates obtained from simple random sampling and from Procedure 1. The analyst error rate using the Bayes technique was shown to be no greater than that for the simple random sampling. Also, the segment proportion estimates produced using this technique had smaller bias and mean squared errors than the estimates produced using either simple random sampling or Procedure 1.

Electrodermal lability as an indicator for subjective sleepiness during total sleep deprivation.

PubMed

Michael, Lars; Passmann, Sven; Becker, Ruth

2012-08-01

The present study addresses the suitability of electrodermal lability as an indicator of individual vulnerability to the effects of total sleep deprivation. During two complete circadian cycles, the effects of 48h of total sleep deprivation on physiological measures (electrodermal activity and body temperature), subjective sleepiness (measured by visual analogue scale and tiredness symptom scale) and task performance (reaction time and errors in a go/no go task) were investigated. Analyses of variance with repeated measures revealed substantial decreases of the number of skin conductance responses, body temperature, and increases for subjective sleepiness, reaction time and error rates. For all changes, strong circadian oscillations could be observed as well. The electrodermal more labile subgroup reported higher subjective sleepiness compared with electrodermal more stable participants, but showed no differences in the time courses of body temperature and task performance. Therefore, electrodermal lability seems to be a specific indicator for the changes in subjective sleepiness due to total sleep deprivation and circadian oscillations, but not a suitable indicator for vulnerability to the effects of sleep deprivation per se. © 2011 European Sleep Research Society.

SU-F-T-251: The Quality Assurance for the Heavy Patient Load Department in the Developing Country: The Primary Experience of An Entire Workflow QA Process Management in Radiotherapy

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

Xie, J; Wang, J; Peng, J

Purpose: To implement an entire workflow quality assurance (QA) process in the radiotherapy department and to reduce the error rates of radiotherapy based on the entire workflow management in the developing country. Methods: The entire workflow QA process management starts from patient registration to the end of last treatment including all steps through the entire radiotherapy process. Error rate of chartcheck is used to evaluate the the entire workflow QA process. Two to three qualified senior medical physicists checked the documents before the first treatment fraction of every patient. Random check of the treatment history during treatment was also performed.more » A total of around 6000 patients treatment data before and after implementing the entire workflow QA process were compared from May, 2014 to December, 2015. Results: A systemic checklist was established. It mainly includes patient’s registration, treatment plan QA, information exporting to OIS(Oncology Information System), documents of treatment QAand QA of the treatment history. The error rate derived from the chart check decreases from 1.7% to 0.9% after our the entire workflow QA process. All checked errors before the first treatment fraction were corrected as soon as oncologist re-confirmed them and reinforce staff training was accordingly followed to prevent those errors. Conclusion: The entire workflow QA process improved the safety, quality of radiotherapy in our department and we consider that our QA experience can be applicable for the heavily-loaded radiotherapy departments in developing country.« less

Evaluating causes of error in landmark-based data collection using scanners

PubMed Central

Shearer, Brian M.; Cooke, Siobhán B.; Halenar, Lauren B.; Reber, Samantha L.; Plummer, Jeannette E.; Delson, Eric

2017-01-01

In this study, we assess the precision, accuracy, and repeatability of craniodental landmarks (Types I, II, and III, plus curves of semilandmarks) on a single macaque cranium digitally reconstructed with three different surface scanners and a microCT scanner. Nine researchers with varying degrees of osteological and geometric morphometric knowledge landmarked ten iterations of each scan (40 total) to test the effects of scan quality, researcher experience, and landmark type on levels of intra- and interobserver error. Two researchers additionally landmarked ten specimens from seven different macaque species using the same landmark protocol to test the effects of the previously listed variables relative to species-level morphological differences (i.e., observer variance versus real biological variance). Error rates within and among researchers by scan type were calculated to determine whether or not data collected by different individuals or on different digitally rendered crania are consistent enough to be used in a single dataset. Results indicate that scan type does not impact rate of intra- or interobserver error. Interobserver error is far greater than intraobserver error among all individuals, and is similar in variance to that found among different macaque species. Additionally, experience with osteology and morphometrics both positively contribute to precision in multiple landmarking sessions, even where less experienced researchers have been trained in point acquisition. Individual training increases precision (although not necessarily accuracy), and is highly recommended in any situation where multiple researchers will be collecting data for a single project. PMID:29099867

Performance factors of mobile rich media job aids for community health workers

PubMed Central

Florez-Arango, Jose F; Dunn, Kim; Zhang, Jiajie

2011-01-01

Objective To study and analyze the possible benefits on performance of community health workers using point-of-care clinical guidelines implemented as interactive rich media job aids on small-format mobile platforms. Design A crossover study with one intervention (rich media job aids) and one control (traditional job aids), two periods, with 50 community health workers, each subject solving a total 15 standardized cases per period per period (30 cases in total per subject). Measurements Error rate per case and task, protocol compliance. Results A total of 1394 cases were evaluated. Intervention reduces errors by an average of 33.15% (p=0.001) and increases protocol compliance 30.18% (p<0.001). Limitations Medical cases were presented on human patient simulators in a laboratory setting, not on real patients. Conclusion These results indicate encouraging prospects for mHealth technologies in general, and the use of rich media clinical guidelines on cell phones in particular, for the improvement of community health worker performance in developing countries. PMID:21292702

Performance factors of mobile rich media job aids for community health workers.

PubMed

Florez-Arango, Jose F; Iyengar, M Sriram; Dunn, Kim; Zhang, Jiajie

2011-01-01

To study and analyze the possible benefits on performance of community health workers using point-of-care clinical guidelines implemented as interactive rich media job aids on small-format mobile platforms. A crossover study with one intervention (rich media job aids) and one control (traditional job aids), two periods, with 50 community health workers, each subject solving a total 15 standardized cases per period per period (30 cases in total per subject). Error rate per case and task, protocol compliance. A total of 1394 cases were evaluated. Intervention reduces errors by an average of 33.15% (p = 0.001) and increases protocol compliance 30.18% (p < 0.001). Limitations Medical cases were presented on human patient simulators in a laboratory setting, not on real patients. These results indicate encouraging prospects for mHealth technologies in general, and the use of rich media clinical guidelines on cell phones in particular, for the improvement of community health worker performance in developing countries.

Frequency of dosage prescribing medication errors associated with manual prescriptions for very preterm infants.

PubMed

Horri, J; Cransac, A; Quantin, C; Abrahamowicz, M; Ferdynus, C; Sgro, C; Robillard, P-Y; Iacobelli, S; Gouyon, J-B

2014-12-01

The risk of dosage Prescription Medication Error (PME) among manually written prescriptions within 'mixed' prescribing system (computerized physician order entry (CPOE) + manual prescriptions) has not been previously assessed in neonatology. This study aimed to evaluate the rate of dosage PME related to manual prescriptions in the high-risk population of very preterm infants (GA < 33 weeks) in a mixed prescription system. The study was based on a retrospective review of a random sample of manual daily prescriptions in two neonatal intensive care units (NICU) A and B, located in different French University hospitals (Dijon and La Reunion island). Daily prescription was defined as the set of all drugs manually prescribed on a single day for one patient. Dosage error was defined as a deviation of at least ±10% from the weight-appropriate recommended dose. The analyses were based on the assessment of 676 manually prescribed drugs from NICU A (58 different drugs from 93 newborns and 240 daily prescriptions) and 354 manually prescribed drugs from NICU B (73 different drugs from 131 newborns and 241 daily prescriptions). The dosage error rate per 100 manually prescribed drugs was similar in both NICU: 3·8% (95% CI: 2·5-5·6%) in NICU A and 3·1% (95% CI: 1·6-5·5%) in NICU B (P = 0·54). Among all the 37 identified dosage errors, the over-dosing was almost as frequent as the under-dosing (17 and 20 errors, respectively). Potentially severe dosage errors occurred in a total of seven drug prescriptions. None of the dosage PME was recorded in the corresponding medical files and information on clinical outcome was not sufficient to identify clinical conditions related to dosage PME. Overall, 46·8% of manually prescribed drugs were off label or unlicensed, with no significant differences between prescriptions with or without dosage error. The risk of a dosage PME increased significantly if the drug was included in the CPOE system but was manually prescribed (OR = 3·3; 95% CI: 1·6-7·0, P < 0·001). The presence of dosage PME in the manual prescriptions written within mixed prescription systems suggests that manual prescriptions should be totally avoided in neonatal units. © 2014 John Wiley & Sons Ltd.

Development and content validation of performance assessments for endoscopic third ventriculostomy.

PubMed

Breimer, Gerben E; Haji, Faizal A; Hoving, Eelco W; Drake, James M

2015-08-01

This study aims to develop and establish the content validity of multiple expert rating instruments to assess performance in endoscopic third ventriculostomy (ETV), collectively called the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT). The important aspects of ETV were identified through a review of current literature, ETV videos, and discussion with neurosurgeons, fellows, and residents. Three assessment measures were subsequently developed: a procedure-specific checklist (CL), a CL of surgical errors, and a global rating scale (GRS). Neurosurgeons from various countries, all identified as experts in ETV, were then invited to participate in a modified Delphi survey to establish the content validity of these instruments. In each Delphi round, experts rated their agreement including each procedural step, error, and GRS item in the respective instruments on a 5-point Likert scale. Seventeen experts agreed to participate in the study and completed all Delphi rounds. After item generation, a total of 27 procedural CL items, 26 error CL items, and 9 GRS items were posed to Delphi panelists for rating. An additional 17 procedural CL items, 12 error CL items, and 1 GRS item were added by panelists. After three rounds, strong consensus (>80% agreement) was achieved on 35 procedural CL items, 29 error CL items, and 10 GRS items. Moderate consensus (50-80% agreement) was achieved on an additional 7 procedural CL items and 1 error CL item. The final procedural and error checklist contained 42 and 30 items, respectively (divided into setup, exposure, navigation, ventriculostomy, and closure). The final GRS contained 10 items. We have established the content validity of three ETV assessment measures by iterative consensus of an international expert panel. Each measure provides unique assessment information and thus can be used individually or in combination, depending on the characteristics of the learner and the purpose of the assessment. These instruments must now be evaluated in both the simulated and operative settings, to determine their construct validity and reliability. Ultimately, the measures contained in the NEVAT may prove suitable for formative assessment during ETV training and potentially as summative assessment measures during certification.

Impact of Uncertainty in the Drop Size Distribution on Oceanic Rainfall Retrievals From Passive Microwave Observations

NASA Technical Reports Server (NTRS)

Wilheit, Thomas T.; Chandrasekar, V.; Li, Wanyu

2007-01-01

The variability of the drop size distribution (DSD) is one of the factors that must be considered in understanding the uncertainties in the retrieval of oceanic precipitation from passive microwave observations. Here, we have used observations from the Precipitation Radar on the Tropical Rainfall Measuring Mission spacecraft to infer the relationship between the DSD and the rain rate and the variability in this relationship. The impact on passive microwave rain rate retrievals varies with the frequency and rain rate. The total uncertainty for a given pixel can be slightly larger than 10% at the low end (ca. 10 GHz) of frequencies commonly used for this purpose and smaller at higher frequencies (up to 37 GHz). Since the error is not totally random, averaging many pixels, as in a monthly rainfall total, should roughly halve this uncertainty. The uncertainty may be lower at rain rates less than about 30 mm/h, but the lack of sensitivity of the surface reference technique to low rain rates makes it impossible to tell from the present data set.

National Incidence of Medication Error in Surgical Patients Before and After Accreditation Council for Graduate Medical Education Duty-Hour Reform.

PubMed

Vadera, Sumeet; Griffith, Sandra D; Rosenbaum, Benjamin P; Chan, Alvin Y; Thompson, Nicolas R; Kshettry, Varun R; Kelly, Michael L; Weil, Robert J; Bingaman, William; Jehi, Lara

2015-01-01

The Accreditation Council for Graduate Medical Education (ACGME) established duty-hour regulations for accredited residency programs on July 1, 2003. It is unclear what changes occurred in the national incidence of medication errors in surgical patients before and after ACGME regulations. Patient and hospital characteristics for pre- and post-duty-hour reform were evaluated, comparing teaching and nonteaching hospitals. A difference-in-differences study design was used to assess the association between duty-hour reform and medication errors in teaching hospitals. We used the Nationwide Inpatient Sample database, which consists of approximately annual 20% stratified sample of all the United States nonfederal hospital inpatient admissions. A query of the database, including 4 years before (2000-2003) and 8 years after (2003-2011) the ACGME duty-hour reform of July 2003, was performed to extract surgical inpatient hospitalizations (N = 13,933,326). The years 2003 and 2004 were discarded in the analysis to allow for a wash-out period during duty-hour reform (though we still provide medication error rates). The Nationwide Inpatient Sample estimated the total national surgical inpatients (N = 135,092,013) in nonfederal hospitals during these time periods with 68,736,863 patients in teaching hospitals and 66,355,150 in nonteaching hospitals. Shortly after duty-hour reform (2004 and 2006), teaching hospitals had a statistically significant increase in rate of medication error (p = 0.019 and 0.006, respectively) when compared with nonteaching hospitals even after accounting for trends across all hospitals during this period. After 2007, no further statistically significant difference was noted. After ACGME duty-hour reform, medication error rates increased in teaching hospitals, which diminished over time. This decrease in errors may be related to changes in training program structure to accommodate duty-hour reform. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

F-16 Class A mishaps in the U.S. Air Force, 1975-93.

PubMed

Knapp, C J; Johnson, R

1996-08-01

All USAF F-16 fighter Class A (major) aircraft mishaps from 1975-93 were analyzed, using records from the U.S. Air Force Safety Agency (AFSA). There were 190 Class A mishaps involving 204 F-16's and 217 aircrew during this 19-yr period. The overall Class A rate was 5.09 per 100,000 flight hours, more than double the overall USAF rate. The mishaps are categorized by year, month, time of day and model of aircraft in relation to mishap causes as determined and reported by AFSA. Formation position, phase of flight and primary cause of the mishap indicate that maneuvering, cruise and low-level phases account for the majority of the mishaps (71%), with air-to-air engagements associated with a higher proportion of pilot error (71%) than was air-to-ground (49%). Engine failure was the number one cause of mishaps (35%), and collision with the ground the next most frequent (24%). Pilot error was determined as causative in 55% of all the mishaps. Pilot error was often associated with other non-pilot related causes. Channelized attention, loss of situational awareness, and spatial disorientation accounted for approximately 30% of the total pilot error causes found. Pilot demographics, flight hour/sortie profiles, and aircrew injuries are also listed. Fatalities occurred in 27% of the mishaps, with 97% of those involving pilot errors.

Managing the Pre- and Post-analytical Phases of the Total Testing Process

PubMed Central

2012-01-01

For many years, the clinical laboratory's focus on analytical quality has resulted in an error rate of 4-5 sigma, which surpasses most other areas in healthcare. However, greater appreciation of the prevalence of errors in the pre- and post-analytical phases and their potential for patient harm has led to increasing requirements for laboratories to take greater responsibility for activities outside their immediate control. Accreditation bodies such as the Joint Commission International (JCI) and the College of American Pathologists (CAP) now require clear and effective procedures for patient/sample identification and communication of critical results. There are a variety of free on-line resources available to aid in managing the extra-analytical phase and the recent publication of quality indicators and proposed performance levels by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) working group on laboratory errors and patient safety provides particularly useful benchmarking data. Managing the extra-laboratory phase of the total testing cycle is the next challenge for laboratory medicine. By building on its existing quality management expertise, quantitative scientific background and familiarity with information technology, the clinical laboratory is well suited to play a greater role in reducing errors and improving patient safety outside the confines of the laboratory. PMID:22259773

Skylab water balance error analysis

NASA Technical Reports Server (NTRS)

Leonard, J. I.

1977-01-01

Estimates of the precision of the net water balance were obtained for the entire Skylab preflight and inflight phases as well as for the first two weeks of flight. Quantitative estimates of both total sampling errors and instrumentation errors were obtained. It was shown that measurement error is minimal in comparison to biological variability and little can be gained from improvement in analytical accuracy. In addition, a propagation of error analysis demonstrated that total water balance error could be accounted for almost entirely by the errors associated with body mass changes. Errors due to interaction between terms in the water balance equation (covariances) represented less than 10% of the total error. Overall, the analysis provides evidence that daily measurements of body water changes obtained from the indirect balance technique are reasonable, precise, and relaible. The method is not biased toward net retention or loss.

Simultaneous Control of Error Rates in fMRI Data Analysis

PubMed Central

Kang, Hakmook; Blume, Jeffrey; Ombao, Hernando; Badre, David

2015-01-01

The key idea of statistical hypothesis testing is to fix, and thereby control, the Type I error (false positive) rate across samples of any size. Multiple comparisons inflate the global (family-wise) Type I error rate and the traditional solution to maintaining control of the error rate is to increase the local (comparison-wise) Type II error (false negative) rates. However, in the analysis of human brain imaging data, the number of comparisons is so large that this solution breaks down: the local Type II error rate ends up being so large that scientifically meaningful analysis is precluded. Here we propose a novel solution to this problem: allow the Type I error rate to converge to zero along with the Type II error rate. It works because when the Type I error rate per comparison is very small, the accumulation (or global) Type I error rate is also small. This solution is achieved by employing the Likelihood paradigm, which uses likelihood ratios to measure the strength of evidence on a voxel-by-voxel basis. In this paper, we provide theoretical and empirical justification for a likelihood approach to the analysis of human brain imaging data. In addition, we present extensive simulations that show the likelihood approach is viable, leading to ‘cleaner’ looking brain maps and operationally superiority (lower average error rate). Finally, we include a case study on cognitive control related activation in the prefrontal cortex of the human brain. PMID:26272730

Detecting small-study effects and funnel plot asymmetry in meta-analysis of survival data: A comparison of new and existing tests.

PubMed

Debray, Thomas P A; Moons, Karel G M; Riley, Richard D

2018-03-01

Small-study effects are a common threat in systematic reviews and may indicate publication bias. Their existence is often verified by visual inspection of the funnel plot. Formal tests to assess the presence of funnel plot asymmetry typically estimate the association between the reported effect size and their standard error, the total sample size, or the inverse of the total sample size. In this paper, we demonstrate that the application of these tests may be less appropriate in meta-analysis of survival data, where censoring influences statistical significance of the hazard ratio. We subsequently propose 2 new tests that are based on the total number of observed events and adopt a multiplicative variance component. We compare the performance of the various funnel plot asymmetry tests in an extensive simulation study where we varied the true hazard ratio (0.5 to 1), the number of published trials (N=10 to 100), the degree of censoring within trials (0% to 90%), and the mechanism leading to participant dropout (noninformative versus informative). Results demonstrate that previous well-known tests for detecting funnel plot asymmetry suffer from low power or excessive type-I error rates in meta-analysis of survival data, particularly when trials are affected by participant dropout. Because our novel test (adopting estimates of the asymptotic precision as study weights) yields reasonable power and maintains appropriate type-I error rates, we recommend its use to evaluate funnel plot asymmetry in meta-analysis of survival data. The use of funnel plot asymmetry tests should, however, be avoided when there are few trials available for any meta-analysis. © 2017 The Authors. Research Synthesis Methods Published by John Wiley & Sons, Ltd.

Development and Assessment of a Medication Safety Measurement Program in a Long-Term Care Pharmacy.

PubMed

Hertig, John B; Hultgren, Kyle E; Parks, Scott; Rondinelli, Rick

2016-02-01

Medication errors continue to be a major issue in the health care system, including in long-term care facilities. While many hospitals and health systems have developed methods to identify, track, and prevent these errors, long-term care facilities historically have not invested in these error-prevention strategies. The objective of this study was two-fold: 1) to develop a set of medication-safety process measures for dispensing in a long-term care pharmacy, and 2) to analyze the data from those measures to determine the relative safety of the process. The study was conducted at In Touch Pharmaceuticals in Valparaiso, Indiana. To assess the safety of the medication-use system, each step was documented using a comprehensive flowchart (process flow map) tool. Once completed and validated, the flowchart was used to complete a "failure modes and effects analysis" (FMEA) identifying ways a process may fail. Operational gaps found during FMEA were used to identify points of measurement. The research identified a set of eight measures as potential areas of failure; data were then collected on each one of these. More than 133,000 medication doses (opportunities for errors) were included in the study during the research time frame (April 1, 2014, and ended on June 4, 2014). Overall, there was an approximate order-entry error rate of 15.26%, with intravenous errors at 0.37%. A total of 21 errors migrated through the entire medication-use system. These 21 errors in 133,000 opportunities resulted in a final check error rate of 0.015%. A comprehensive medication-safety measurement program was designed and assessed. This study demonstrated the ability to detect medication errors in a long-term pharmacy setting, thereby making process improvements measureable. Future, larger, multi-site studies should be completed to test this measurement program.

The relationship between facial emotion recognition and executive functions in first-episode patients with schizophrenia and their siblings.

PubMed

Yang, Chengqing; Zhang, Tianhong; Li, Zezhi; Heeramun-Aubeeluck, Anisha; Liu, Na; Huang, Nan; Zhang, Jie; He, Leiying; Li, Hui; Tang, Yingying; Chen, Fazhan; Liu, Fei; Wang, Jijun; Lu, Zheng

2015-10-08

Although many studies have examined executive functions and facial emotion recognition in people with schizophrenia, few of them focused on the correlation between them. Furthermore, their relationship in the siblings of patients also remains unclear. The aim of the present study is to examine the correlation between executive functions and facial emotion recognition in patients with first-episode schizophrenia and their siblings. Thirty patients with first-episode schizophrenia, their twenty-six siblings, and thirty healthy controls were enrolled. They completed facial emotion recognition tasks using the Ekman Standard Faces Database, and executive functioning was measured by Wisconsin Card Sorting Test (WCST). Hierarchical regression analysis was applied to assess the correlation between executive functions and facial emotion recognition. Our study found that in siblings, the accuracy in recognizing low degree 'disgust' emotion was negatively correlated with the total correct rate in WCST (r = -0.614, p = 0.023), but was positively correlated with the total error in WCST (r = 0.623, p = 0.020); the accuracy in recognizing 'neutral' emotion was positively correlated with the total error rate in WCST (r = 0.683, p = 0.014) while negatively correlated with the total correct rate in WCST (r = -0.677, p = 0.017). People with schizophrenia showed an impairment in facial emotion recognition when identifying moderate 'happy' facial emotion, the accuracy of which was significantly correlated with the number of completed categories of WCST (R(2) = 0.432, P < .05). There were no correlations between executive functions and facial emotion recognition in the healthy control group. Our study demonstrated that facial emotion recognition impairment correlated with executive function impairment in people with schizophrenia and their unaffected siblings but not in healthy controls.

Accelerated Brain DCE-MRI Using Iterative Reconstruction With Total Generalized Variation Penalty for Quantitative Pharmacokinetic Analysis: A Feasibility Study.

PubMed

Wang, Chunhao; Yin, Fang-Fang; Kirkpatrick, John P; Chang, Zheng

2017-08-01

To investigate the feasibility of using undersampled k-space data and an iterative image reconstruction method with total generalized variation penalty in the quantitative pharmacokinetic analysis for clinical brain dynamic contrast-enhanced magnetic resonance imaging. Eight brain dynamic contrast-enhanced magnetic resonance imaging scans were retrospectively studied. Two k-space sparse sampling strategies were designed to achieve a simulated image acquisition acceleration factor of 4. They are (1) a golden ratio-optimized 32-ray radial sampling profile and (2) a Cartesian-based random sampling profile with spatiotemporal-regularized sampling density constraints. The undersampled data were reconstructed to yield images using the investigated reconstruction technique. In quantitative pharmacokinetic analysis on a voxel-by-voxel basis, the rate constant K trans in the extended Tofts model and blood flow F B and blood volume V B from the 2-compartment exchange model were analyzed. Finally, the quantitative pharmacokinetic parameters calculated from the undersampled data were compared with the corresponding calculated values from the fully sampled data. To quantify each parameter's accuracy calculated using the undersampled data, error in volume mean, total relative error, and cross-correlation were calculated. The pharmacokinetic parameter maps generated from the undersampled data appeared comparable to the ones generated from the original full sampling data. Within the region of interest, most derived error in volume mean values in the region of interest was about 5% or lower, and the average error in volume mean of all parameter maps generated through either sampling strategy was about 3.54%. The average total relative error value of all parameter maps in region of interest was about 0.115, and the average cross-correlation of all parameter maps in region of interest was about 0.962. All investigated pharmacokinetic parameters had no significant differences between the result from original data and the reduced sampling data. With sparsely sampled k-space data in simulation of accelerated acquisition by a factor of 4, the investigated dynamic contrast-enhanced magnetic resonance imaging pharmacokinetic parameters can accurately estimate the total generalized variation-based iterative image reconstruction method for reliable clinical application.

The impact of using an intravenous workflow management system (IVWMS) on cost and patient safety.

PubMed

Lin, Alex C; Deng, Yihong; Thaibah, Hilal; Hingl, John; Penm, Jonathan; Ivey, Marianne F; Thomas, Mark

2018-07-01

The aim of this study was to determine the financial costs associated with wasted and missing doses before and after the implementation of an intravenous workflow management system (IVWMS) and to quantify the number and the rate of detected intravenous (IV) preparation errors. A retrospective analysis of the sample hospital information system database was conducted using three months of data before and after the implementation of an IVWMS System (DoseEdge ® ) which uses barcode scanning and photographic technologies to track and verify each step of the preparation process. The financial impact associated with wasted and missing >IV doses was determined by combining drug acquisition, labor, accessory, and disposal costs. The intercepted error reports and pharmacist detected error reports were drawn from the IVWMS to quantify the number of errors by defined error categories. The total number of IV doses prepared before and after the implementation of the IVWMS system were 110,963 and 101,765 doses, respectively. The adoption of the IVWMS significantly reduced the amount of wasted and missing IV doses by 14,176 and 2268 doses, respectively (p < 0.001). The overall cost savings of using the system was $144,019 over 3 months. The total number of errors detected was 1160 (1.14%) after using the IVWMS. The implementation of the IVWMS facilitated workflow changes that led to a positive impact on cost and patient safety. The implementation of the IVWMS increased patient safety by enforcing standard operating procedures and bar code verifications. Published by Elsevier B.V.

Knowledge of healthcare professionals about medication errors in hospitals

PubMed Central

Abdel-Latif, Mohamed M. M.

2016-01-01

Context: Medication errors are the most common types of medical errors in hospitals and leading cause of morbidity and mortality among patients. Aims: The aim of the present study was to assess the knowledge of healthcare professionals about medication errors in hospitals. Settings and Design: A self-administered questionnaire was distributed to randomly selected healthcare professionals in eight hospitals in Madinah, Saudi Arabia. Subjects and Methods: An 18-item survey was designed and comprised questions on demographic data, knowledge of medication errors, availability of reporting systems in hospitals, attitudes toward error reporting, causes of medication errors. Statistical Analysis Used: Data were analyzed with Statistical Package for the Social Sciences software Version 17. Results: A total of 323 of healthcare professionals completed the questionnaire with 64.6% response rate of 138 (42.72%) physicians, 34 (10.53%) pharmacists, and 151 (46.75%) nurses. A majority of the participants had a good knowledge about medication errors concept and their dangers on patients. Only 68.7% of them were aware of reporting systems in hospitals. Healthcare professionals revealed that there was no clear mechanism available for reporting of errors in most hospitals. Prescribing (46.5%) and administration (29%) errors were the main causes of errors. The most frequently encountered medication errors were anti-hypertensives, antidiabetics, antibiotics, digoxin, and insulin. Conclusions: This study revealed differences in the awareness among healthcare professionals toward medication errors in hospitals. The poor knowledge about medication errors emphasized the urgent necessity to adopt appropriate measures to raise awareness about medication errors in Saudi hospitals. PMID:27330261

A global perspective of the limits of prediction skill based on the ECMWF ensemble

NASA Astrophysics Data System (ADS)

Zagar, Nedjeljka

2016-04-01

In this talk presents a new model of the global forecast error growth applied to the forecast errors simulated by the ensemble prediction system (ENS) of the ECMWF. The proxy for forecast errors is the total spread of the ECMWF operational ensemble forecasts obtained by the decomposition of the wind and geopotential fields in the normal-mode functions. In this way, the ensemble spread can be quantified separately for the balanced and inertio-gravity (IG) modes for every forecast range. Ensemble reliability is defined for the balanced and IG modes comparing the ensemble spread with the control analysis in each scale. The results show that initial uncertainties in the ECMWF ENS are largest in the tropical large-scale modes and their spatial distribution is similar to the distribution of the short-range forecast errors. Initially the ensemble spread grows most in the smallest scales and in the synoptic range of the IG modes but the overall growth is dominated by the increase of spread in balanced modes in synoptic and planetary scales in the midlatitudes. During the forecasts, the distribution of spread in the balanced and IG modes grows towards the climatological spread distribution characteristic of the analyses. The ENS system is found to be somewhat under-dispersive which is associated with the lack of tropical variability, primarily the Kelvin waves. The new model of the forecast error growth has three fitting parameters to parameterize the initial fast growth and a more slow exponential error growth later on. The asymptotic values of forecast errors are independent of the exponential growth rate. It is found that the asymptotic values of the errors due to unbalanced dynamics are around 10 days while the balanced and total errors saturate in 3 to 4 weeks. Reference: Žagar, N., R. Buizza, and J. Tribbia, 2015: A three-dimensional multivariate modal analysis of atmospheric predictability with application to the ECMWF ensemble. J. Atmos. Sci., 72, 4423-4444.

Hope Modified the Association between Distress and Incidence of Self-Perceived Medical Errors among Practicing Physicians: Prospective Cohort Study

PubMed Central

Hayashino, Yasuaki; Utsugi-Ozaki, Makiko; Feldman, Mitchell D.; Fukuhara, Shunichi

2012-01-01

The presence of hope has been found to influence an individual's ability to cope with stressful situations. The objective of this study is to evaluate the relationship between medical errors, hope and burnout among practicing physicians using validated metrics. Prospective cohort study was conducted among hospital based physicians practicing in Japan (N = 836). Measures included the validated Burnout Scale, self-assessment of medical errors and Herth Hope Index (HHI). The main outcome measure was the frequency of self-perceived medical errors, and Poisson regression analysis was used to evaluate the association between hope and medical error. A total of 361 errors were reported in 836 physician-years. We observed a significant association between hope and self-report of medical errors. Compared with the lowest tertile category of HHI, incidence rate ratios (IRRs) of self-perceived medical errors of physicians in the highest category were 0.44 (95%CI, 0.34 to 0.58) and 0.54 (95%CI, 0.42 to 0.70) respectively, for the 2nd and 3rd tertile. In stratified analysis by hope score, among physicians with a low hope score, those who experienced higher burnout reported higher incidence of errors; physicians with high hope scores did not report high incidences of errors, even if they experienced high burnout. Self-perceived medical errors showed a strong association with physicians' hope, and hope modified the association between physicians' burnout and self-perceived medical errors. PMID:22530055

VLSI for High-Speed Digital Signal Processing

DTIC Science & Technology

1994-09-30

particular, the design, layout and fab - rication of integrated circuits. The primary project for this grant has been the design and implementation of a...targeted at 33.36 dB, and PSNR (dB) Rate ( bpp ) the FRSBC algorithm, targeted at 0.5 bits/pixel, respec- Filter FDSBC FRSBC FDSBC FRSBC tively. The filter...to mean square error d by as shown in Fig. 6, is used, yielding a total of 16 subbands. 255’ The rates, in bits per pixel ( bpp ), and the peak signal

A cascaded coding scheme for error control and its performance analysis

NASA Technical Reports Server (NTRS)

Lin, Shu; Kasami, Tadao; Fujiwara, Tohru; Takata, Toyoo

1986-01-01

A coding scheme is investigated for error control in data communication systems. The scheme is obtained by cascading two error correcting codes, called the inner and outer codes. The error performance of the scheme is analyzed for a binary symmetric channel with bit error rate epsilon <1/2. It is shown that if the inner and outer codes are chosen properly, extremely high reliability can be attained even for a high channel bit error rate. Various specific example schemes with inner codes ranging form high rates to very low rates and Reed-Solomon codes as inner codes are considered, and their error probabilities are evaluated. They all provide extremely high reliability even for very high bit error rates. Several example schemes are being considered by NASA for satellite and spacecraft down link error control.

Statistical analysis of modeling error in structural dynamic systems

NASA Technical Reports Server (NTRS)

Hasselman, T. K.; Chrostowski, J. D.

1990-01-01

The paper presents a generic statistical model of the (total) modeling error for conventional space structures in their launch configuration. Modeling error is defined as the difference between analytical prediction and experimental measurement. It is represented by the differences between predicted and measured real eigenvalues and eigenvectors. Comparisons are made between pre-test and post-test models. Total modeling error is then subdivided into measurement error, experimental error and 'pure' modeling error, and comparisons made between measurement error and total modeling error. The generic statistical model presented in this paper is based on the first four global (primary structure) modes of four different structures belonging to the generic category of Conventional Space Structures (specifically excluding large truss-type space structures). As such, it may be used to evaluate the uncertainty of predicted mode shapes and frequencies, sinusoidal response, or the transient response of other structures belonging to the same generic category.

A Quality Improvement Project to Decrease Human Milk Errors in the NICU.

PubMed

Oza-Frank, Reena; Kachoria, Rashmi; Dail, James; Green, Jasmine; Walls, Krista; McClead, Richard E

2017-02-01

Ensuring safe human milk in the NICU is a complex process with many potential points for error, of which one of the most serious is administration of the wrong milk to the wrong infant. Our objective was to describe a quality improvement initiative that was associated with a reduction in human milk administration errors identified over a 6-year period in a typical, large NICU setting. We employed a quasi-experimental time series quality improvement initiative by using tools from the model for improvement, Six Sigma methodology, and evidence-based interventions. Scanned errors were identified from the human milk barcode medication administration system. Scanned errors of interest were wrong-milk-to-wrong-infant, expired-milk, or preparation errors. The scanned error rate and the impact of additional improvement interventions from 2009 to 2015 were monitored by using statistical process control charts. From 2009 to 2015, the total number of errors scanned declined from 97.1 per 1000 bottles to 10.8. Specifically, the number of expired milk error scans declined from 84.0 per 1000 bottles to 8.9. The number of preparation errors (4.8 per 1000 bottles to 2.2) and wrong-milk-to-wrong-infant errors scanned (8.3 per 1000 bottles to 2.0) also declined. By reducing the number of errors scanned, the number of opportunities for errors also decreased. Interventions that likely had the greatest impact on reducing the number of scanned errors included installation of bedside (versus centralized) scanners and dedicated staff to handle milk. Copyright © 2017 by the American Academy of Pediatrics.

45 CFR 98.100 - Error Rate Report.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Error Rate Report. 98.100 Section 98.100 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.100 Error Rate Report. (a) Applicability—The requirements of this subpart...

45 CFR 98.100 - Error Rate Report.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Error Rate Report. 98.100 Section 98.100 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.100 Error Rate Report. (a) Applicability—The requirements of this subpart...

45 CFR 98.100 - Error Rate Report.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Error Rate Report. 98.100 Section 98.100 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.100 Error Rate Report. (a) Applicability—The requirements of this subpart...

45 CFR 98.100 - Error Rate Report.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Error Rate Report. 98.100 Section 98.100 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.100 Error Rate Report. (a) Applicability—The requirements of this subpart...

Human Factors Risk Analyses of a Doffing Protocol for Ebola-Level Personal Protective Equipment: Mapping Errors to Contamination.

PubMed

Mumma, Joel M; Durso, Francis T; Ferguson, Ashley N; Gipson, Christina L; Casanova, Lisa; Erukunuakpor, Kimberly; Kraft, Colleen S; Walsh, Victoria L; Zimring, Craig; DuBose, Jennifer; Jacob, Jesse T

2018-03-05

Doffing protocols for personal protective equipment (PPE) are critical for keeping healthcare workers (HCWs) safe during care of patients with Ebola virus disease. We assessed the relationship between errors and self-contamination during doffing. Eleven HCWs experienced with doffing Ebola-level PPE participated in simulations in which HCWs donned PPE marked with surrogate viruses (ɸ6 and MS2), completed a clinical task, and were assessed for contamination after doffing. Simulations were video recorded, and a failure modes and effects analysis and fault tree analyses were performed to identify errors during doffing, quantify their risk (risk index), and predict contamination data. Fifty-one types of errors were identified, many having the potential to spread contamination. Hand hygiene and removing the powered air purifying respirator (PAPR) hood had the highest total risk indexes (111 and 70, respectively) and number of types of errors (9 and 13, respectively). ɸ6 was detected on 10% of scrubs and the fault tree predicted a 10.4% contamination rate, likely occurring when the PAPR hood inadvertently contacted scrubs during removal. MS2 was detected on 10% of hands, 20% of scrubs, and 70% of inner gloves and the predicted rates were 7.3%, 19.4%, 73.4%, respectively. Fault trees for MS2 and ɸ6 contamination suggested similar pathways. Ebola-level PPE can both protect and put HCWs at risk for self-contamination throughout the doffing process, even among experienced HCWs doffing with a trained observer. Human factors methodologies can identify error-prone steps, delineate the relationship between errors and self-contamination, and suggest remediation strategies.

Quality of Impressions and Work Authorizations Submitted by Dental Students Supervised by Prosthodontists and General Dentists.

PubMed

Imbery, Terence A; Diaz, Nicholas; Greenfield, Kristy; Janus, Charles; Best, Al M

2016-10-01

Preclinical fixed prosthodontics is taught by Department of Prosthodontics faculty members at Virginia Commonwealth University School of Dentistry; however, 86% of all clinical cases in academic year 2012 were staffed by faculty members from the Department of General Practice. The aims of this retrospective study were to quantify the quality of impressions, accuracy of laboratory work authorizations, and most common errors and to determine if there were differences between the rate of errors in cases supervised by the prosthodontists and the general dentists. A total of 346 Fixed Prosthodontic Laboratory Tracking Sheets for the 2012 academic year were reviewed. The results showed that, overall, 73% of submitted impressions were acceptable at initial evaluation, 16% had to be poured first and re-evaluated for quality prior to pindexing, 7% had multiple impressions submitted for transfer dies, and 4% were rejected for poor quality. There were higher acceptance rates for impressions and work authorizations for cases staffed by prosthodontists than by general dentists, but the differences were not statistically significant (p=0.0584 and p=0.0666, respectively). Regarding the work authorizations, 43% overall did not provide sufficient information or had technical errors that delayed prosthesis fabrication. The most common errors were incorrect mountings, absence of solid casts, inadequate description of margins for porcelain fused to metal crowns, inaccurate die trimming, and margin marking. The percentages of errors in cases supervised by general dentists and prosthodontists were similar for 17 of the 18 types of errors identified; only for margin description was the percentage of errors statistically significantly higher for general dentist-supervised than prosthodontist-supervised cases. These results highlighted the ongoing need for faculty development and calibration to ensure students receive the highest quality education from all faculty members teaching fixed prosthodontics.

Data Analysis & Statistical Methods for Command File Errors

NASA Technical Reports Server (NTRS)

Meshkat, Leila; Waggoner, Bruce; Bryant, Larry

2014-01-01

This paper explains current work on modeling for managing the risk of command file errors. It is focused on analyzing actual data from a JPL spaceflight mission to build models for evaluating and predicting error rates as a function of several key variables. We constructed a rich dataset by considering the number of errors, the number of files radiated, including the number commands and blocks in each file, as well as subjective estimates of workload and operational novelty. We have assessed these data using different curve fitting and distribution fitting techniques, such as multiple regression analysis, and maximum likelihood estimation to see how much of the variability in the error rates can be explained with these. We have also used goodness of fit testing strategies and principal component analysis to further assess our data. Finally, we constructed a model of expected error rates based on the what these statistics bore out as critical drivers to the error rate. This model allows project management to evaluate the error rate against a theoretically expected rate as well as anticipate future error rates.

Detecting Signatures of GRACE Sensor Errors in Range-Rate Residuals

NASA Astrophysics Data System (ADS)

Goswami, S.; Flury, J.

2016-12-01

In order to reach the accuracy of the GRACE baseline, predicted earlier from the design simulations, efforts are ongoing since a decade. GRACE error budget is highly dominated by noise from sensors, dealiasing models and modeling errors. GRACE range-rate residuals contain these errors. Thus, their analysis provides an insight to understand the individual contribution to the error budget. Hence, we analyze the range-rate residuals with focus on contribution of sensor errors due to mis-pointing and bad ranging performance in GRACE solutions. For the analysis of pointing errors, we consider two different reprocessed attitude datasets with differences in pointing performance. Then range-rate residuals are computed from these two datasetsrespectively and analysed. We further compare the system noise of four K-and Ka- band frequencies of the two spacecrafts, with range-rate residuals. Strong signatures of mis-pointing errors can be seen in the range-rate residuals. Also, correlation between range frequency noise and range-rate residuals are seen.

Temperature variation and distribution of living cells within tree stems: implications for stem respiration modeling and scale-up.

PubMed

Stockfors, J

2000-09-01

Few studies have examined variation in respiration rates within trees, and even fewer studies have focused on variation caused by within-stem temperature differences. In this study, stem temperatures at 40 positions in the stem of one 30-year-old Norway spruce (Picea abies (L.) Karst.) were measured during 40 days between July 1994 and June 1995. The temperature data were used to simulate variations in respiration rate within the stem. The simulations assumed that the temperature-respiration relationship was constant (Q10 = 2) for all days and all stem positions. Total respiration for the whole stem was calculated by interpolating the temperature between the thermocouples and integrating the respiration rates in three dimensions. Total respiration rate of the stem was then compared to respiration rate scaled up from horizontal planes at the thermocouple heights (40, 140, 240 and 340 cm) on a surface area and on a sapwood volume basis. Simulations were made for three distributions of living cells in the stems: one with a constant 5% fraction of living cells, disregarding depth into the stem; one with a living cell fraction decreasing linearly with depth into the stem; and one with an exponentially decreasing fraction of living cells. Mean temperature variation within the stem was 3.7 degrees C, and was more than 10 degrees C for 8% of the time. The maximum measured temperature difference was 21.5 degrees C. The corresponding mean variation in respiration was 35% and was more than 50% for 24% of the time. Scaling up respiration rates from different heights between 40 and 240 cm to the whole stem produced an error of 2 to 58% for the whole year. For a single sunny day, the error was between 2 and 72%. Thus, within-stem variations in temperature may significantly affect the accuracy of scaling respiration data obtained from small samples to whole trees. A careful choice of chamber position and basis for scaling is necessary to minimize errors from variation in temperature.

A meta-analysis of inhibitory-control deficits in patients diagnosed with Alzheimer's dementia.

PubMed

Kaiser, Anna; Kuhlmann, Beatrice G; Bosnjak, Michael

2018-05-10

The authors conducted meta-analyses to determine the magnitude of performance impairments in patients diagnosed with Alzheimer's dementia (AD) compared with healthy aging (HA) controls on eight tasks commonly used to measure inhibitory control. Response time (RT) and error rates from a total of 64 studies were analyzed with random-effects models (overall effects) and mixed-effects models (moderator analyses). Large differences between AD patients and HA controls emerged in the basic inhibition conditions of many of the tasks with AD patients often performing slower, overall d = 1.17, 95% CI [0.88-1.45], and making more errors, d = 0.83 [0.63-1.03]. However, comparably large differences were also present in performance on many of the baseline control-conditions, d = 1.01 [0.83-1.19] for RTs and d = 0.44 [0.19-0.69] for error rates. A standardized derived inhibition score (i.e., control-condition score - inhibition-condition score) suggested no significant mean group difference for RTs, d = -0.07 [-0.22-0.08], and only a small difference for errors, d = 0.24 [-0.12-0.60]. Effects systematically varied across tasks and with AD severity. Although the error rate results suggest a specific deterioration of inhibitory-control abilities in AD, further processes beyond inhibitory control (e.g., a general reduction in processing speed and other, task-specific attentional processes) appear to contribute to AD patients' performance deficits observed on a variety of inhibitory-control tasks. Nonetheless, the inhibition conditions of many of these tasks well discriminate between AD patients and HA controls. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Multicenter Assessment of Gram Stain Error Rates.

PubMed

Samuel, Linoj P; Balada-Llasat, Joan-Miquel; Harrington, Amanda; Cavagnolo, Robert

2016-06-01

Gram stains remain the cornerstone of diagnostic testing in the microbiology laboratory for the guidance of empirical treatment prior to availability of culture results. Incorrectly interpreted Gram stains may adversely impact patient care, and yet there are no comprehensive studies that have evaluated the reliability of the technique and there are no established standards for performance. In this study, clinical microbiology laboratories at four major tertiary medical care centers evaluated Gram stain error rates across all nonblood specimen types by using standardized criteria. The study focused on several factors that primarily contribute to errors in the process, including poor specimen quality, smear preparation, and interpretation of the smears. The number of specimens during the evaluation period ranged from 976 to 1,864 specimens per site, and there were a total of 6,115 specimens. Gram stain results were discrepant from culture for 5% of all specimens. Fifty-eight percent of discrepant results were specimens with no organisms reported on Gram stain but significant growth on culture, while 42% of discrepant results had reported organisms on Gram stain that were not recovered in culture. Upon review of available slides, 24% (63/263) of discrepant results were due to reader error, which varied significantly based on site (9% to 45%). The Gram stain error rate also varied between sites, ranging from 0.4% to 2.7%. The data demonstrate a significant variability between laboratories in Gram stain performance and affirm the need for ongoing quality assessment by laboratories. Standardized monitoring of Gram stains is an essential quality control tool for laboratories and is necessary for the establishment of a quality benchmark across laboratories. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Multicenter Assessment of Gram Stain Error Rates

PubMed Central

Balada-Llasat, Joan-Miquel; Harrington, Amanda; Cavagnolo, Robert

2016-01-01

Gram stains remain the cornerstone of diagnostic testing in the microbiology laboratory for the guidance of empirical treatment prior to availability of culture results. Incorrectly interpreted Gram stains may adversely impact patient care, and yet there are no comprehensive studies that have evaluated the reliability of the technique and there are no established standards for performance. In this study, clinical microbiology laboratories at four major tertiary medical care centers evaluated Gram stain error rates across all nonblood specimen types by using standardized criteria. The study focused on several factors that primarily contribute to errors in the process, including poor specimen quality, smear preparation, and interpretation of the smears. The number of specimens during the evaluation period ranged from 976 to 1,864 specimens per site, and there were a total of 6,115 specimens. Gram stain results were discrepant from culture for 5% of all specimens. Fifty-eight percent of discrepant results were specimens with no organisms reported on Gram stain but significant growth on culture, while 42% of discrepant results had reported organisms on Gram stain that were not recovered in culture. Upon review of available slides, 24% (63/263) of discrepant results were due to reader error, which varied significantly based on site (9% to 45%). The Gram stain error rate also varied between sites, ranging from 0.4% to 2.7%. The data demonstrate a significant variability between laboratories in Gram stain performance and affirm the need for ongoing quality assessment by laboratories. Standardized monitoring of Gram stains is an essential quality control tool for laboratories and is necessary for the establishment of a quality benchmark across laboratories. PMID:26888900

Chemotherapy Order Entry by a Clinical Support Pharmacy Technician in an Outpatient Medical Day Unit

PubMed Central

Neville, Heather; Broadfield, Larry; Harding, Claudia; Heukshorst, Shelley; Sweetapple, Jennifer; Rolle, Megan

2016-01-01

Background: Pharmacy technicians are expanding their scope of practice, often in partnership with pharmacists. In oncology, such a shift in responsibilities may lead to workflow efficiencies, but may also cause concerns about patient risk and medication errors. Objectives: The primary objective was to compare the time spent on order entry and order-entry checking before and after training of a clinical support pharmacy technician (CSPT) to perform chemotherapy order entry. The secondary objectives were to document workflow interruptions and to assess medication errors. Methods: This before-and-after observational study investigated chemotherapy order entry for ambulatory oncology patients. Order entry was performed by pharmacists before the process change (phase 1) and by 1 CSPT after the change (phase 2); order-entry checking was performed by a pharmacist during both phases. The tasks were timed by an independent observer using a personal digital assistant. A convenience sample of 125 orders was targeted for each phase. Data were exported to Microsoft Excel software, and timing differences for each task were tested with an unpaired t test. Results: Totals of 143 and 128 individual orders were timed for order entry during phase 1 (pharmacist) and phase 2 (CSPT), respectively. The mean total time to perform order entry was greater during phase 1 (1:37 min versus 1:20 min; p = 0.044). Totals of 144 and 122 individual orders were timed for order-entry checking (by a pharmacist) in phases 1 and 2, respectively, and there was no difference in mean total time for order-entry checking (1:21 min versus 1:20 min; p = 0.69). There were 33 interruptions not related to order entry (totalling 39:38 min) during phase 1 and 25 interruptions (totalling 30:08 min) during phase 2. Three errors were observed during order entry in phase 1 and one error during order-entry checking in phase 2; the errors were rated as having no effect on patient care. Conclusions: Chemotherapy order entry by a trained CSPT appeared to be just as safe and efficient as order entry by a pharmacist. Changes in pharmacy technicians’ scope of practice could increase the amount of time available for pharmacists to provide direct patient care in the oncology setting. PMID:27402999

Chemotherapy Order Entry by a Clinical Support Pharmacy Technician in an Outpatient Medical Day Unit.

PubMed

Neville, Heather; Broadfield, Larry; Harding, Claudia; Heukshorst, Shelley; Sweetapple, Jennifer; Rolle, Megan

2016-01-01

Pharmacy technicians are expanding their scope of practice, often in partnership with pharmacists. In oncology, such a shift in responsibilities may lead to workflow efficiencies, but may also cause concerns about patient risk and medication errors. The primary objective was to compare the time spent on order entry and order-entry checking before and after training of a clinical support pharmacy technician (CSPT) to perform chemotherapy order entry. The secondary objectives were to document workflow interruptions and to assess medication errors. This before-and-after observational study investigated chemotherapy order entry for ambulatory oncology patients. Order entry was performed by pharmacists before the process change (phase 1) and by 1 CSPT after the change (phase 2); order-entry checking was performed by a pharmacist during both phases. The tasks were timed by an independent observer using a personal digital assistant. A convenience sample of 125 orders was targeted for each phase. Data were exported to Microsoft Excel software, and timing differences for each task were tested with an unpaired t test. Totals of 143 and 128 individual orders were timed for order entry during phase 1 (pharmacist) and phase 2 (CSPT), respectively. The mean total time to perform order entry was greater during phase 1 (1:37 min versus 1:20 min; p = 0.044). Totals of 144 and 122 individual orders were timed for order-entry checking (by a pharmacist) in phases 1 and 2, respectively, and there was no difference in mean total time for order-entry checking (1:21 min versus 1:20 min; p = 0.69). There were 33 interruptions not related to order entry (totalling 39:38 min) during phase 1 and 25 interruptions (totalling 30:08 min) during phase 2. Three errors were observed during order entry in phase 1 and one error during order-entry checking in phase 2; the errors were rated as having no effect on patient care. Chemotherapy order entry by a trained CSPT appeared to be just as safe and efficient as order entry by a pharmacist. Changes in pharmacy technicians' scope of practice could increase the amount of time available for pharmacists to provide direct patient care in the oncology setting.

Voidage correction algorithm for unresolved Euler-Lagrange simulations

NASA Astrophysics Data System (ADS)

Askarishahi, Maryam; Salehi, Mohammad-Sadegh; Radl, Stefan

2018-04-01

The effect of grid coarsening on the predicted total drag force and heat exchange rate in dense gas-particle flows is investigated using Euler-Lagrange (EL) approach. We demonstrate that grid coarsening may reduce the predicted total drag force and exchange rate. Surprisingly, exchange coefficients predicted by the EL approach deviate more significantly from the exact value compared to results of Euler-Euler (EE)-based calculations. The voidage gradient is identified as the root cause of this peculiar behavior. Consequently, we propose a correction algorithm based on a sigmoidal function to predict the voidage experienced by individual particles. Our correction algorithm can significantly improve the prediction of exchange coefficients in EL models, which is tested for simulations involving Euler grid cell sizes between 2d_p and 12d_p . It is most relevant in simulations of dense polydisperse particle suspensions featuring steep voidage profiles. For these suspensions, classical approaches may result in an error of the total exchange rate of up to 30%.

Exploring the Relationship of Task Performance and Physical and Cognitive Fatigue During a Daylong Light Precision Task.

PubMed

Yung, Marcus; Manji, Rahim; Wells, Richard P

2017-11-01

Our aim was to explore the relationship between fatigue and operation system performance during a simulated light precision task over an 8-hr period using a battery of physical (central and peripheral) and cognitive measures. Fatigue may play an important role in the relationship between poor ergonomics and deficits in quality and productivity. However, well-controlled laboratory studies in this area have several limitations, including the lack of work relevance of fatigue exposures and lack of both physical and cognitive measures. There remains a need to understand the relationship between physical and cognitive fatigue and task performance at exposure levels relevant to realistic production or light precision work. Errors and fatigue measures were tracked over the course of a micropipetting task. Fatigue responses from 10 measures and errors in pipetting technique, precision, and targeting were submitted to principal component analysis to descriptively analyze features and patterns. Fatigue responses and error rates contributed to three principal components (PCs), accounting for 50.9% of total variance. Fatigue responses grouped within the three PCs reflected central and peripheral upper extremity fatigue, postural sway, and changes in oculomotor behavior. In an 8-hr light precision task, error rates shared similar patterns to both physical and cognitive fatigue responses, and/or increases in arousal level. The findings provide insight toward the relationship between fatigue and operation system performance (e.g., errors). This study contributes to a body of literature documenting task errors and fatigue, reflecting physical (both central and peripheral) and cognitive processes.

Autosophy: an alternative vision for satellite communication, compression, and archiving

NASA Astrophysics Data System (ADS)

Holtz, Klaus; Holtz, Eric; Kalienky, Diana

2006-08-01

Satellite communication and archiving systems are now designed according to an outdated Shannon information theory where all data is transmitted in meaningless bit streams. Video bit rates, for example, are determined by screen size, color resolution, and scanning rates. The video "content" is irrelevant so that totally random images require the same bit rates as blank images. An alternative system design, based on the newer Autosophy information theory, is now evolving, which transmits data "contend" or "meaning" in a universally compatible 64bit format. This would allow mixing all multimedia transmissions in the Internet's packet stream. The new systems design uses self-assembling data structures, which grow like data crystals or data trees in electronic memories, for both communication and archiving. The advantages for satellite communication and archiving may include: very high lossless image and video compression, unbreakable encryption, resistance to transmission errors, universally compatible data formats, self-organizing error-proof mass memories, immunity to the Internet's Quality of Service problems, and error-proof secure communication protocols. Legacy data transmission formats can be converted by simple software patches or integrated chipsets to be forwarded through any media - satellites, radio, Internet, cable - without needing to be reformatted. This may result in orders of magnitude improvements for all communication and archiving systems.

The Differential Effects of Two Self-Managed Math Instruction Procedures: Cover, Copy, and Compare versus Copy, Cover, and Compare

ERIC Educational Resources Information Center

Grafman, Joel M.; Cates, Gary L.

2010-01-01

This study compared the fluency and error rates produced when using the Cover, Copy, and Compare (CCC) and a modified CCC procedure (MCCC) called Copy, Cover, and Compare to complete subtraction math problems. Two second-grade classrooms consisting of 47 total students participated in the study. The following items were administered to…

A cascaded coding scheme for error control and its performance analysis

NASA Technical Reports Server (NTRS)

Lin, S.

1986-01-01

A coding scheme for error control in data communication systems is investigated. The scheme is obtained by cascading two error correcting codes, called the inner and the outer codes. The error performance of the scheme is analyzed for a binary symmetric channel with bit error rate epsilon < 1/2. It is shown that, if the inner and outer codes are chosen properly, extremely high reliability can be attained even for a high channel bit error rate. Various specific example schemes with inner codes ranging from high rates to very low rates and Reed-Solomon codes are considered, and their probabilities are evaluated. They all provide extremely high reliability even for very high bit error rates, say 0.1 to 0.01. Several example schemes are being considered by NASA for satellite and spacecraft down link error control.

ADEOS Total Ozone Mapping Spectrometer (TOMS) Data Products User's Guide

NASA Technical Reports Server (NTRS)

Krueger, A.; Bhartia, P. K.; McPeters, R.; Herman, J.; Wellemeyer, C.; Jaross, G.; Seftor, C.; Torres, O.; Labow, G.; Byerly, W.;

Earth Probe Total Ozone Mapping Spectrometer (TOMS) Data Product User's Guide

NASA Technical Reports Server (NTRS)

McPeters, R.; Bhartia, P. K.; Krueger, A.; Herman, J.; Wellemeyer, C.; Seftor, C.; Jaross, G.; Torres, O.; Moy, L.; Labow, G.;

Comparison of athlete-coach perceptions of internal and external load markers for elite junior tennis training.

PubMed

Murphy, Alistair P; Duffield, Rob; Kellett, Aaron; Reid, Machar

2014-09-01

To investigate the discrepancy between coach and athlete perceptions of internal load and notational analysis of external load in elite junior tennis. Fourteen elite junior tennis players and 6 international coaches were recruited. Ratings of perceived exertion (RPEs) were recorded for individual drills and whole sessions, along with a rating of mental exertion, coach rating of intended session exertion, and athlete heart rate (HR). Furthermore, total stroke count and unforced-error count were notated using video coding after each session, alongside coach and athlete estimations of shots and errors made. Finally, regression analyses explained the variance in the criterion variables of athlete and coach RPE. Repeated-measures analyses of variance and interclass correlation coefficients revealed that coaches significantly (P < .01) underestimated athlete session RPE, with only moderate correlation (r = .59) demonstrated between coach and athlete. However, athlete drill RPE (P = .14; r = .71) and mental exertion (P = .44; r = .68) were comparable and substantially correlated. No significant differences in estimated stroke count were evident between athlete and coach (P = .21), athlete notational analysis (P = .06), or coach notational analysis (P = .49). Coaches estimated significantly greater unforced errors than either athletes or notational analysis (P < .01). Regression analyses found that 54.5% of variance in coach RPE was explained by intended session exertion and coach drill RPE, while drill RPE and peak HR explained 45.3% of the variance in athlete session RPE. Coaches misinterpreted session RPE but not drill RPE, while inaccurately monitoring error counts. Improved understanding of external- and internal-load monitoring may help coach-athlete relationships in individual sports like tennis avoid maladaptive training.

A Simple Exact Error Rate Analysis for DS-CDMA with Arbitrary Pulse Shape in Flat Nakagami Fading

NASA Astrophysics Data System (ADS)

Rahman, Mohammad Azizur; Sasaki, Shigenobu; Kikuchi, Hisakazu; Harada, Hiroshi; Kato, Shuzo

A simple exact error rate analysis is presented for random binary direct sequence code division multiple access (DS-CDMA) considering a general pulse shape and flat Nakagami fading channel. First of all, a simple model is developed for the multiple access interference (MAI). Based on this, a simple exact expression of the characteristic function (CF) of MAI is developed in a straight forward manner. Finally, an exact expression of error rate is obtained following the CF method of error rate analysis. The exact error rate so obtained can be much easily evaluated as compared to the only reliable approximate error rate expression currently available, which is based on the Improved Gaussian Approximation (IGA).

Cortical regions involved in semantic processing investigated by repetitive navigated transcranial magnetic stimulation and object naming.

PubMed

Sollmann, Nico; Tanigawa, Noriko; Tussis, Lorena; Hauck, Theresa; Ille, Sebastian; Maurer, Stefanie; Negwer, Chiara; Zimmer, Claus; Ringel, Florian; Meyer, Bernhard; Krieg, Sandro M

2015-04-01

Knowledge about the cortical representation of semantic processing is mainly derived from functional magnetic resonance imaging (fMRI) or direct cortical stimulation (DCS) studies. Because DCS is regarded as the gold standard in terms of language mapping but can only be used during awake surgery due to its invasive character, repetitive navigated transcranial magnetic stimulation (rTMS)—a non-invasive modality that uses a similar technique as DCS—seems highly feasible for use in the investigation of semantic processing in the healthy human brain. A total number of 100 (50 left-hemispheric and 50 right-hemispheric) rTMS-based language mappings were performed in 50 purely right-handed, healthy volunteers during an object-naming task. All rTMS-induced semantic naming errors were then counted and evaluated systematically. Furthermore, since the distribution of stimulations within both hemispheres varied between individuals and cortical regions stimulated, all elicited errors were standardized and subsequently related to their cortical sites by projecting the mapping results into the cortical parcellation system (CPS). Overall, the most left-hemispheric semantic errors were observed after targeting the rTMS to the posterior middle frontal gyrus (pMFG; standardized error rate: 7.3‰), anterior supramarginal gyrus (aSMG; 5.6‰), and ventral postcentral gyrus (vPoG; 5.0‰). In contrast to that, the highest right-hemispheric error rates occurred after stimulation of the posterior superior temporal gyrus (pSTG; 12.4‰), middle superior temporal gyrus (mSTG; 6.2‰), and anterior supramarginal gyrus (aSMG; 6.2‰). Although error rates were low, the rTMS-based approach of investigating semantic processing during object naming shows convincing results compared to the current literature. Therefore, rTMS seems a valuable, safe, and reliable tool for the investigation of semantic processing within the healthy human brain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of bar-code technology on the safety of medication administration.

PubMed

Poon, Eric G; Keohane, Carol A; Yoon, Catherine S; Ditmore, Matthew; Bane, Anne; Levtzion-Korach, Osnat; Moniz, Thomas; Rothschild, Jeffrey M; Kachalia, Allen B; Hayes, Judy; Churchill, William W; Lipsitz, Stuart; Whittemore, Anthony D; Bates, David W; Gandhi, Tejal K

2010-05-06

Serious medication errors are common in hospitals and often occur during order transcription or administration of medication. To help prevent such errors, technology has been developed to verify medications by incorporating bar-code verification technology within an electronic medication-administration system (bar-code eMAR). We conducted a before-and-after, quasi-experimental study in an academic medical center that was implementing the bar-code eMAR. We assessed rates of errors in order transcription and medication administration on units before and after implementation of the bar-code eMAR. Errors that involved early or late administration of medications were classified as timing errors and all others as nontiming errors. Two clinicians reviewed the errors to determine their potential to harm patients and classified those that could be harmful as potential adverse drug events. We observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate)--a 41.4% relative reduction in errors (P<0.001). The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001). The rate of timing errors in medication administration fell by 27.3% (P<0.001), but the rate of potential adverse drug events associated with timing errors did not change significantly. Transcription errors occurred at a rate of 6.1% on units that did not use the bar-code eMAR but were completely eliminated on units that did use it. Use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show that the bar-code eMAR is an important intervention to improve medication safety. (ClinicalTrials.gov number, NCT00243373.) 2010 Massachusetts Medical Society

Feedback controlled optics with wavefront compensation

NASA Technical Reports Server (NTRS)

Breckenridge, William G. (Inventor); Redding, David C. (Inventor)

1993-01-01

The sensitivity model of a complex optical system obtained by linear ray tracing is used to compute a control gain matrix by imposing the mathematical condition for minimizing the total wavefront error at the optical system's exit pupil. The most recent deformations or error states of the controlled segments or optical surfaces of the system are then assembled as an error vector, and the error vector is transformed by the control gain matrix to produce the exact control variables which will minimize the total wavefront error at the exit pupil of the optical system. These exact control variables are then applied to the actuators controlling the various optical surfaces in the system causing the immediate reduction in total wavefront error observed at the exit pupil of the optical system.

TH-AB-202-04: Auto-Adaptive Margin Generation for MLC-Tracked Radiotherapy

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

Glitzner, M; Lagendijk, J; Raaymakers, B

Purpose: To develop an auto-adaptive margin generator for MLC tracking. The generator is able to estimate errors arising in image guided radiotherapy, particularly on an MR-Linac, which depend on the latencies of machine and image processing, as well as on patient motion characteristics. From the estimated error distribution, a segment margin is generated, able to compensate errors up to a user-defined confidence. Method: In every tracking control cycle (TCC, 40ms), the desired aperture D(t) is compared to the actual aperture A(t), a delayed and imperfect representation of D(t). Thus an error e(t)=A(T)-D(T) is measured every TCC. Applying kernel-density-estimation (KDE), themore » cumulative distribution (CDF) of e(t) is estimated. With CDF-confidence limits, upper and lower error limits are extracted for motion axes along and perpendicular leaf-travel direction and applied as margins. To test the dosimetric impact, two representative motion traces were extracted from fast liver-MRI (10Hz). The traces were applied onto a 4D-motion platform and continuously tracked by an Elekta Agility 160 MLC using an artificially imposed tracking delay. Gafchromic film was used to detect dose exposition for static, tracked, and error-compensated tracking cases. The margin generator was parameterized to cover 90% of all tracking errors. Dosimetric impact was rated by calculating the ratio between underexposed points (>5% underdosage) to the total number of points inside FWHM of static exposure. Results: Without imposing adaptive margins, tracking experiments showed a ratio of underexposed points of 17.5% and 14.3% for two motion cases with imaging delays of 200ms and 300ms, respectively. Activating the margin generated yielded total suppression (<1%) of underdosed points. Conclusion: We showed that auto-adaptive error compensation using machine error statistics is possible for MLC tracking. The error compensation margins are calculated on-line, without the need of assuming motion or machine models. Further strategies to reduce consequential overdosages are currently under investigation. This work was funded by the SoRTS consortium, which includes the industry partners Elekta, Philips and Technolution.« less

Optical phase-locked loop (OPLL) for free-space laser communications with heterodyne detection

NASA Technical Reports Server (NTRS)

Win, Moe Z.; Chen, Chien-Chung; Scholtz, Robert A.

1991-01-01

Several advantages of coherent free-space optical communications are outlined. Theoretical analysis is formulated for an OPLL disturbed by shot noise, modulation noise, and frequency noise consisting of a white component, a 1/f component, and a 1/f-squared component. Each of the noise components is characterized by its associated power spectral density. It is shown that the effect of modulation depends only on the ratio of loop bandwidth and data rate, and is negligible for an OPLL with loop bandwidth smaller than one fourth the data rate. Total phase error variance as a function of loop bandwidth is displayed for several values of carrier signal to noise ratio. Optimal loop bandwidth is also calculated as a function of carrier signal to noise ratio. An OPLL experiment is performed, where it is shown that the measured phase error variance closely matches the theoretical predictions.

High data rate Reed-Solomon encoding and decoding using VLSI technology

NASA Technical Reports Server (NTRS)

Miller, Warner; Morakis, James

1987-01-01

Presented as an implementation of a Reed-Solomon encode and decoder, which is 16-symbol error correcting, each symbol is 8 bits. This Reed-Solomon (RS) code is an efficient error correcting code that the National Aeronautics and Space Administration (NASA) will use in future space communications missions. A Very Large Scale Integration (VLSI) implementation of the encoder and decoder accepts data rates up 80 Mbps. A total of seven chips are needed for the decoder (four of the seven decoding chips are customized using 3-micron Complementary Metal Oxide Semiconduction (CMOS) technology) and one chip is required for the encoder. The decoder operates with the symbol clock being the system clock for the chip set. Approximately 1.65 billion Galois Field (GF) operations per second are achieved with the decoder chip set and 640 MOPS are achieved with the encoder chip.

Participation and performance in INSTAND multi-analyte molecular genetics external quality assessment schemes from 2006 to 2012.

PubMed

Maly, Friedrich E; Fried, Roman; Spannagl, Michael

2014-01-01

INSTAND e.V. has provided Molecular Genetics Multi-Analyte EQA schemes since 2006. EQA participation and performance were assessed from 2006 - 2012. From 2006 to 2012, the number of analytes in the Multi-Analyte EQA schemes rose from 17 to 53. Total number of results returned rose from 168 in January 2006 to 824 in August 2012. The overall error rate was 1.40 +/- 0.84% (mean +/- SD, N = 24 EQA dates). From 2006 to 2012, no analyte was reported 100% correctly. Individual participant performance was analysed for one common analyte, Lactase (LCT) T-13910C. From 2006 to 2012, 114 laboratories participated in this EQA. Of these, 10 laboratories (8.8%) reported at least one wrong result during the whole observation period. All laboratories reported correct results after their failure incident. In spite of the low overall error rate, EQA will continue to be important for Molecular Genetics.

Total Survey Error & Institutional Research: A Case Study of the University Experience Survey

ERIC Educational Resources Information Center

Whiteley, Sonia

2014-01-01

Total Survey Error (TSE) is a component of Total Survey Quality (TSQ) that supports the assessment of the extent to which a survey is "fit-for-purpose". While TSQ looks at a number of dimensions, such as relevance, credibility and accessibility, TSE is has a more operational focus on accuracy and minimising errors. Mitigating survey…

45 CFR 265.7 - How will we determine if the State is meeting the quarterly reporting requirements?

Code of Federal Regulations, 2012 CFR

2012-10-01

... computational errors and are internally consistent (e.g., items that should add to totals do so); (3) The State... from computational errors and are internally consistent (e.g., items that should add to totals do so... from computational errors and are internally consistent (e.g., items that should add to totals do so...

Feasibility of the capnogram to monitor ventilation rate during cardiopulmonary resuscitation.

PubMed

Aramendi, Elisabete; Elola, Andoni; Alonso, Erik; Irusta, Unai; Daya, Mohamud; Russell, James K; Hubner, Pia; Sterz, Fritz

2017-01-01

The rates of chest compressions (CCs) and ventilations are both important metrics to monitor the quality of cardiopulmonary resuscitation (CPR). Capnography permits monitoring ventilation, but the CCs provided during CPR corrupt the capnogram and compromise the accuracy of automatic ventilation detectors. The aim of this study was to evaluate the feasibility of an automatic algorithm based on the capnogram to detect ventilations and provide feedback on ventilation rate during CPR, specifically addressing intervals where CCs are delivered. The dataset used to develop and test the algorithm contained in-hospital and out-of-hospital cardiac arrest episodes. The method relies on adaptive thresholding to detect ventilations in the first derivative of the capnogram. The performance of the detector was reported in terms of sensitivity (SE) and Positive Predictive Value (PPV). The overall performance was reported in terms of the rate error and errors in the hyperventilation alarms. Results were given separately for the intervals with CCs. A total of 83 episodes were considered, resulting in 4880min and 46,740 ventilations (8741 during CCs). The method showed an overall SE/PPV above 99% and 97% respectively, even in intervals with CCs. The error for the ventilation rate was below 1.8min -1 in any group, and >99% of the ventilation alarms were correctly detected. A method to provide accurate feedback on ventilation rate using only the capnogram is proposed. Its accuracy was proven even in intervals where canpography signal was severely corrupted by CCs. This algorithm could be integrated into monitor/defibrillators to provide reliable feedback on ventilation rate during CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Time-gated scintillator imaging for real-time optical surface dosimetry in total skin electron therapy.

PubMed

Bruza, Petr; Gollub, Sarah L; Andreozzi, Jacqueline M; Tendler, Irwin I; Williams, Benjamin B; Jarvis, Lesley A; Gladstone, David J; Pogue, Brian W

2018-05-02

The purpose of this study was to measure surface dose by remote time-gated imaging of plastic scintillators. A novel technique for time-gated, intensified camera imaging of scintillator emission was demonstrated, and key parameters influencing the signal were analyzed, including distance, angle and thickness. A set of scintillator samples was calibrated by using thermo-luminescence detector response as reference. Examples of use in total skin electron therapy are described. The data showed excellent room light rejection (signal-to-noise ratio of scintillation SNR  ≈  470), ideal scintillation dose response linearity, and 2% dose rate error. Individual sample scintillation response varied by 7% due to sample preparation. Inverse square distance dependence correction and lens throughput error (8% per meter) correction were needed. At scintillator-to-source angle and observation angle  <50°, the radiant energy fluence error was smaller than 1%. The achieved standard error of the scintillator cumulative dose measurement compared to the TLD dose was 5%. The results from this proof-of-concept study documented the first use of small scintillator targets for remote surface dosimetry in ambient room lighting. The measured dose accuracy renders our method to be comparable to thermo-luminescent detector dosimetry, with the ultimate realization of accuracy likely to be better than shown here. Once optimized, this approach to remote dosimetry may substantially reduce the time and effort required for surface dosimetry.

Time-gated scintillator imaging for real-time optical surface dosimetry in total skin electron therapy

NASA Astrophysics Data System (ADS)

Bruza, Petr; Gollub, Sarah L.; Andreozzi, Jacqueline M.; Tendler, Irwin I.; Williams, Benjamin B.; Jarvis, Lesley A.; Gladstone, David J.; Pogue, Brian W.

2018-05-01

The purpose of this study was to measure surface dose by remote time-gated imaging of plastic scintillators. A novel technique for time-gated, intensified camera imaging of scintillator emission was demonstrated, and key parameters influencing the signal were analyzed, including distance, angle and thickness. A set of scintillator samples was calibrated by using thermo-luminescence detector response as reference. Examples of use in total skin electron therapy are described. The data showed excellent room light rejection (signal-to-noise ratio of scintillation SNR  ≈  470), ideal scintillation dose response linearity, and 2% dose rate error. Individual sample scintillation response varied by 7% due to sample preparation. Inverse square distance dependence correction and lens throughput error (8% per meter) correction were needed. At scintillator-to-source angle and observation angle  <50°, the radiant energy fluence error was smaller than 1%. The achieved standard error of the scintillator cumulative dose measurement compared to the TLD dose was 5%. The results from this proof-of-concept study documented the first use of small scintillator targets for remote surface dosimetry in ambient room lighting. The measured dose accuracy renders our method to be comparable to thermo-luminescent detector dosimetry, with the ultimate realization of accuracy likely to be better than shown here. Once optimized, this approach to remote dosimetry may substantially reduce the time and effort required for surface dosimetry.

Integrating Six Sigma with total quality management: a case example for measuring medication errors.

PubMed

Revere, Lee; Black, Ken

2003-01-01

Six Sigma is a new management philosophy that seeks a nonexistent error rate. It is ripe for healthcare because many healthcare processes require a near-zero tolerance for mistakes. For most organizations, establishing a Six Sigma program requires significant resources and produces considerable stress. However, in healthcare, management can piggyback Six Sigma onto current total quality management (TQM) efforts so that minimal disruption occurs in the organization. Six Sigma is an extension of the Failure Mode and Effects Analysis that is required by JCAHO; it can easily be integrated into existing quality management efforts. Integrating Six Sigma into the existing TQM program facilitates process improvement through detailed data analysis. A drilled-down approach to root-cause analysis greatly enhances the existing TQM approach. Using the Six Sigma metrics, internal project comparisons facilitate resource allocation while external project comparisons allow for benchmarking. Thus, the application of Six Sigma makes TQM efforts more successful. This article presents a framework for including Six Sigma in an organization's TQM plan while providing a concrete example using medication errors. Using the process defined in this article, healthcare executives can integrate Six Sigma into all of their TQM projects.

The influence of the structure and culture of medical group practices on prescription drug errors.

PubMed

Kralewski, John E; Dowd, Bryan E; Heaton, Alan; Kaissi, Amer

2005-08-01

This project was designed to identify the magnitude of prescription drug errors in medical group practices and to explore the influence of the practice structure and culture on those error rates. Seventy-eight practices serving an upper Midwest managed care (Care Plus) plan during 2001 were included in the study. Using Care Plus claims data, prescription drug error rates were calculated at the enrollee level and then were aggregated to the group practice that each enrollee selected to provide and manage their care. Practice structure and culture data were obtained from surveys of the practices. Data were analyzed using multivariate regression. Both the culture and the structure of these group practices appear to influence prescription drug error rates. Seeing more patients per clinic hour, more prescriptions per patient, and being cared for in a rural clinic were all strongly associated with more errors. Conversely, having a case manager program is strongly related to fewer errors in all of our analyses. The culture of the practices clearly influences error rates, but the findings are mixed. Practices with cohesive cultures have lower error rates but, contrary to our hypothesis, cultures that value physician autonomy and individuality also have lower error rates than those with a more organizational orientation. Our study supports the contention that there are a substantial number of prescription drug errors in the ambulatory care sector. Even by the strictest definition, there were about 13 errors per 100 prescriptions for Care Plus patients in these group practices during 2001. Our study demonstrates that the structure of medical group practices influences prescription drug error rates. In some cases, this appears to be a direct relationship, such as the effects of having a case manager program on fewer drug errors, but in other cases the effect appears to be indirect through the improvement of drug prescribing practices. An important aspect of this study is that it provides insights into the relationships of the structure and culture of medical group practices and prescription drug errors and provides direction for future research. Research focused on the factors influencing the high error rates in rural areas and how the interaction of practice structural and cultural attributes influence error rates would add important insights into our findings. For medical practice directors, our data show that they should focus on patient care coordination to reduce errors.

Advanced error-prediction LDPC with temperature compensation for highly reliable SSDs

NASA Astrophysics Data System (ADS)

Tokutomi, Tsukasa; Tanakamaru, Shuhei; Iwasaki, Tomoko Ogura; Takeuchi, Ken

2015-09-01

To improve the reliability of NAND Flash memory based solid-state drives (SSDs), error-prediction LDPC (EP-LDPC) has been proposed for multi-level-cell (MLC) NAND Flash memory (Tanakamaru et al., 2012, 2013), which is effective for long retention times. However, EP-LDPC is not as effective for triple-level cell (TLC) NAND Flash memory, because TLC NAND Flash has higher error rates and is more sensitive to program-disturb error. Therefore, advanced error-prediction LDPC (AEP-LDPC) has been proposed for TLC NAND Flash memory (Tokutomi et al., 2014). AEP-LDPC can correct errors more accurately by precisely describing the error phenomena. In this paper, the effects of AEP-LDPC are investigated in a 2×nm TLC NAND Flash memory with temperature characterization. Compared with LDPC-with-BER-only, the SSD's data-retention time is increased by 3.4× and 9.5× at room-temperature (RT) and 85 °C, respectively. Similarly, the acceptable BER is increased by 1.8× and 2.3×, respectively. Moreover, AEP-LDPC can correct errors with pre-determined tables made at higher temperatures to shorten the measurement time before shipping. Furthermore, it is found that one table can cover behavior over a range of temperatures in AEP-LDPC. As a result, the total table size can be reduced to 777 kBytes, which makes this approach more practical.

Emergency department discharge prescription errors in an academic medical center

PubMed Central

Belanger, April; Devine, Lauren T.; Lane, Aaron; Condren, Michelle E.

2017-01-01

This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule. Descriptive statistics were used to address the study objective. Categories evaluated were patient age, provider type, drug class, and type and time of error. The discharge prescription error rate out of 1000 prescriptions was 13.4%, with “incomplete or inadequate prescription” being the most commonly detected error (58.2%). The adult and pediatric error rates were 11.7% and 22.7%, respectively. The antibiotics reviewed had the highest number of errors. The highest within-class error rates were with antianginal medications, antiparasitic medications, antacids, appetite stimulants, and probiotics. Emergency medicine residents wrote the highest percentage of prescriptions (46.7%) and had an error rate of 9.2%. Residents of other specialties wrote 340 prescriptions and had an error rate of 20.9%. Errors occurred most often between 10:00 am and 6:00 pm. PMID:28405061

Poster - 49: Assessment of Synchrony respiratory compensation error for CyberKnife liver treatment

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

Liu, Ming; Cygler,

The goal of this work is to quantify respiratory motion compensation errors for liver tumor patients treated by the CyberKnife system with Synchrony tracking, to identify patients with the smallest tracking errors and to eventually help coach patient’s breathing patterns to minimize dose delivery errors. The accuracy of CyberKnife Synchrony respiratory motion compensation was assessed for 37 patients treated for liver lesions by analyzing data from system logfiles. A predictive model is used to modulate the direction of individual beams during dose delivery based on the positions of internally implanted fiducials determined using an orthogonal x-ray imaging system and themore » current location of LED external markers. For each x-ray pair acquired, system logfiles report the prediction error, the difference between the measured and predicted fiducial positions, and the delivery error, which is an estimate of the statistical error in the model overcoming the latency between x-ray acquisition and robotic repositioning. The total error was calculated at the time of each x-ray pair, for the number of treatment fractions and the number of patients, giving the average respiratory motion compensation error in three dimensions. The 99{sup th} percentile for the total radial error is 3.85 mm, with the highest contribution of 2.79 mm in superior/inferior (S/I) direction. The absolute mean compensation error is 1.78 mm radially with a 1.27 mm contribution in the S/I direction. Regions of high total error may provide insight into features predicting groups of patients with larger or smaller total errors.« less

Effect of survey design and catch rate estimation on total catch estimates in Chinook salmon fisheries

USGS Publications Warehouse

McCormick, Joshua L.; Quist, Michael C.; Schill, Daniel J.

2012-01-01

Roving–roving and roving–access creel surveys are the primary techniques used to obtain information on harvest of Chinook salmon Oncorhynchus tshawytscha in Idaho sport fisheries. Once interviews are conducted using roving–roving or roving–access survey designs, mean catch rate can be estimated with the ratio-of-means (ROM) estimator, the mean-of-ratios (MOR) estimator, or the MOR estimator with exclusion of short-duration (≤0.5 h) trips. Our objective was to examine the relative bias and precision of total catch estimates obtained from use of the two survey designs and three catch rate estimators for Idaho Chinook salmon fisheries. Information on angling populations was obtained by direct visual observation of portions of Chinook salmon fisheries in three Idaho river systems over an 18-d period. Based on data from the angling populations, Monte Carlo simulations were performed to evaluate the properties of the catch rate estimators and survey designs. Among the three estimators, the ROM estimator provided the most accurate and precise estimates of mean catch rate and total catch for both roving–roving and roving–access surveys. On average, the root mean square error of simulated total catch estimates was 1.42 times greater and relative bias was 160.13 times greater for roving–roving surveys than for roving–access surveys. Length-of-stay bias and nonstationary catch rates in roving–roving surveys both appeared to affect catch rate and total catch estimates. Our results suggest that use of the ROM estimator in combination with an estimate of angler effort provided the least biased and most precise estimates of total catch for both survey designs. However, roving–access surveys were more accurate than roving–roving surveys for Chinook salmon fisheries in Idaho.

Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains

PubMed Central

Schroeder, Scott R; Salomon, Meghan M; Galanter, William L; Schiff, Gordon D; Vaida, Allen J; Gaunt, Michael J; Bryson, Michelle L; Rash, Christine; Falck, Suzanne; Lambert, Bruce L

2017-01-01

Background Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. Objectives We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Methods Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Results Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Conclusions Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors. PMID:27193033

Frequency and types of the medication errors in an academic emergency department in Iran: The emergent need for clinical pharmacy services in emergency departments.

PubMed

Zeraatchi, Alireza; Talebian, Mohammad-Taghi; Nejati, Amir; Dashti-Khavidaki, Simin

2013-07-01

Emergency departments (EDs) are characterized by simultaneous care of multiple patients with various medical conditions. Due to a large number of patients with complex diseases, speed and complexity of medication use, working in under-staffing and crowded environment, medication errors are commonly perpetrated by emergency care providers. This study was designed to evaluate the incidence of medication errors among patients attending to an ED in a teaching hospital in Iran. In this cross-sectional study, a total of 500 patients attending to ED were randomly assessed for incidence and types of medication errors. Some factors related to medication errors such as working shift, weekdays and schedule of the educational program of trainee were also evaluated. Nearly, 22% of patients experienced at least one medication error. The rate of medication errors were 0.41 errors per patient and 0.16 errors per ordered medication. The frequency of medication errors was higher in men, middle age patients, first weekdays, night-time work schedules and the first semester of educational year of new junior emergency medicine residents. More than 60% of errors were prescription errors by physicians and the remaining were transcription or administration errors by nurses. More than 35% of the prescribing errors happened during the selection of drug dose and frequency. The most common medication errors by nurses during the administration were omission error (16.2%) followed by unauthorized drug (6.4%). Most of the medication errors happened for anticoagulants and thrombolytics (41.2%) followed by antimicrobial agents (37.7%) and insulin (7.4%). In this study, at least one-fifth of the patients attending to ED experienced medication errors resulting from multiple factors. More common prescription errors happened during ordering drug dose and frequency. More common administration errors included dug omission or unauthorized drug.

Effect of a health system's medical error disclosure program on gastroenterology-related claims rates and costs.

PubMed

Adams, Megan A; Elmunzer, B Joseph; Scheiman, James M

2014-04-01

In 2001, the University of Michigan Health System (UMHS) implemented a novel medical error disclosure program. This study analyzes the effect of this program on gastroenterology (GI)-related claims and costs. This was a review of claims in the UMHS Risk Management Database (1990-2010), naming a gastroenterologist. Claims were classified according to pre-determined categories. Claims data, including incident date, date of resolution, and total liability dollars, were reviewed. Mean total liability incurred per claim in the pre- and post-implementation eras was compared. Patient encounter data from the Division of Gastroenterology was also reviewed in order to benchmark claims data with changes in clinical volume. There were 238,911 GI encounters in the pre-implementation era and 411,944 in the post-implementation era. A total of 66 encounters resulted in claims: 38 in the pre-implementation era and 28 in the post-implementation era. Of the total number of claims, 15.2% alleged delay in diagnosis/misdiagnosis, 42.4% related to a procedure, and 42.4% involved improper management, treatment, or monitoring. The reduction in the proportion of encounters resulting in claims was statistically significant (P=0.001), as was the reduction in time to claim resolution (1,000 vs. 460 days) (P<0.0001). There was also a reduction in the mean total liability per claim ($167,309 pre vs. $81,107 post, 95% confidence interval: 33682.5-300936.2 pre vs. 1687.8-160526.7 post). Implementation of a novel medical error disclosure program, promoting transparency and quality improvement, not only decreased the number of GI-related claims per patient encounter, but also dramatically shortened the time to claim resolution.

Height-Error Analysis for the FAA-Air Force Replacement Radar Program (FARR)

DTIC Science & Technology

1991-08-01

7719 Figure 1-7 CLIMATOLOGY ERRORS BY MONWTH PERCENT FREQUENCY TABLE OF ERROR BY MONTH ERROR MONTH Col Pc IJAl IFEB )MA IA R IAY JJ’N IJUL JAUG (SEP...MONTH Col Pct IJAN IFEB IMPJ JAPR 1 MM IJUN IJUL JAUG ISEP J--T IN~ IDEC I Total ----- -- - - --------------------------.. . -.. 4...MONTH ERROR MONTH Col Pct IJAN IFEB IM4AR IAPR IMAY jJum IJU JAUG ISEP JOCT IN JDEC I Total . .- 4

Dispensing error rate after implementation of an automated pharmacy carousel system.

PubMed

Oswald, Scott; Caldwell, Richard

2007-07-01

A study was conducted to determine filling and dispensing error rates before and after the implementation of an automated pharmacy carousel system (APCS). The study was conducted in a 613-bed acute and tertiary care university hospital. Before the implementation of the APCS, filling and dispensing rates were recorded during October through November 2004 and January 2005. Postimplementation data were collected during May through June 2006. Errors were recorded in three areas of pharmacy operations: first-dose or missing medication fill, automated dispensing cabinet fill, and interdepartmental request fill. A filling error was defined as an error caught by a pharmacist during the verification step. A dispensing error was defined as an error caught by a pharmacist observer after verification by the pharmacist. Before implementation of the APCS, 422 first-dose or missing medication orders were observed between October 2004 and January 2005. Independent data collected in December 2005, approximately six weeks after the introduction of the APCS, found that filling and error rates had increased. The filling rate for automated dispensing cabinets was associated with the largest decrease in errors. Filling and dispensing error rates had decreased by December 2005. In terms of interdepartmental request fill, no dispensing errors were noted in 123 clinic orders dispensed before the implementation of the APCS. One dispensing error out of 85 clinic orders was identified after implementation of the APCS. The implementation of an APCS at a university hospital decreased medication filling errors related to automated cabinets only and did not affect other filling and dispensing errors.

Cirrus Cloud Retrieval Using Infrared Sounding Data: Multilevel Cloud Errors.

NASA Astrophysics Data System (ADS)

Baum, Bryan A.; Wielicki, Bruce A.

1994-01-01

In this study we perform an error analysis for cloud-top pressure retrieval using the High-Resolution Infrared Radiometric Sounder (HIRS/2) 15-µm CO2 channels for the two-layer case of transmissive cirrus overlying an overcast, opaque stratiform cloud. This analysis includes standard deviation and bias error due to instrument noise and the presence of two cloud layers, the lower of which is opaque. Instantaneous cloud pressure retrieval errors are determined for a range of cloud amounts (0.1 1.0) and cloud-top pressures (850250 mb). Large cloud-top pressure retrieval errors are found to occur when a lower opaque layer is present underneath an upper transmissive cloud layer in the satellite field of view (FOV). Errors tend to increase with decreasing upper-cloud elective cloud amount and with decreasing cloud height (increasing pressure). Errors in retrieved upper-cloud pressure result in corresponding errors in derived effective cloud amount. For the case in which a HIRS FOV has two distinct cloud layers, the difference between the retrieved and actual cloud-top pressure is positive in all casts, meaning that the retrieved upper-cloud height is lower than the actual upper-cloud height. In addition, errors in retrieved cloud pressure are found to depend upon the lapse rate between the low-level cloud top and the surface. We examined which sounder channel combinations would minimize the total errors in derived cirrus cloud height caused by instrument noise and by the presence of a lower-level cloud. We find that while the sounding channels that peak between 700 and 1000 mb minimize random errors, the sounding channels that peak at 300—500 mb minimize bias errors. For a cloud climatology, the bias errors are most critical.

[Fire behavior of Mongolian oak leaves fuel-bed under no-wind and zero-slope conditions. I. Factors affecting fire spread rate and modeling].

PubMed

Jin, Sen; Liu, Bo-Fei; Di, Xue-Ying; Chu, Teng-Fei; Zhang, Ji-Li

2012-01-01

Aimed to understand the fire behavior of Mongolian oak leaves fuel-bed under field condition, the leaves of a secondary Mongolian oak forest in Northeast Forestry University experimental forest farm were collected and brought into laboratory to construct fuel-beds with varied loading, height, and moisture content, and a total of 100 experimental fires were burned under no-wind and zero-slope conditions. It was observed that the fire spread rate of the fuel-beds was less than 0.5 m x min(-1). Fuel-bed loading, height, and moisture contents all had significant effects on the fire spread rate. The effect of fuel-bed moisture content on the fire spread had no significant correlations with fuel-bed loading and height, but the effect of fuel-bed height was related to the fuel-bed loading. The packing ratio of fuel-beds had less effect on the fire spread rate. Taking the fuel-bed loading, height, and moisture content as predictive variables, a prediction model for the fire spread rate of Mongolian oak leaves fuel-bed was established, which could explain 83% of the variance of the fire spread rate, with a mean absolute error 0.04 m x min(-1) and a mean relative error less than 17%.

Joint Transmitter and Receiver Power Allocation under Minimax MSE Criterion with Perfect and Imperfect CSI for MC-CDMA Transmissions

NASA Astrophysics Data System (ADS)

Kotchasarn, Chirawat; Saengudomlert, Poompat

We investigate the problem of joint transmitter and receiver power allocation with the minimax mean square error (MSE) criterion for uplink transmissions in a multi-carrier code division multiple access (MC-CDMA) system. The objective of power allocation is to minimize the maximum MSE among all users each of which has limited transmit power. This problem is a nonlinear optimization problem. Using the Lagrange multiplier method, we derive the Karush-Kuhn-Tucker (KKT) conditions which are necessary for a power allocation to be optimal. Numerical results indicate that, compared to the minimum total MSE criterion, the minimax MSE criterion yields a higher total MSE but provides a fairer treatment across the users. The advantages of the minimax MSE criterion are more evident when we consider the bit error rate (BER) estimates. Numerical results show that the minimax MSE criterion yields a lower maximum BER and a lower average BER. We also observe that, with the minimax MSE criterion, some users do not transmit at full power. For comparison, with the minimum total MSE criterion, all users transmit at full power. In addition, we investigate robust joint transmitter and receiver power allocation where the channel state information (CSI) is not perfect. The CSI error is assumed to be unknown but bounded by a deterministic value. This problem is formulated as a semidefinite programming (SDP) problem with bilinear matrix inequality (BMI) constraints. Numerical results show that, with imperfect CSI, the minimax MSE criterion also outperforms the minimum total MSE criterion in terms of the maximum and average BERs.

Evaluating an educational intervention to improve the accuracy of death certification among trainees from various specialties

PubMed Central

Villar, Jesús; Pérez-Méndez, Lina

2007-01-01

Background The inaccuracy of death certification can lead to the misallocation of resources in health care programs and research. We evaluated the rate of errors in the completion of death certificates among medical residents from various specialties, before and after an educational intervention which was designed to improve the accuracy in the certification of the cause of death. Methods A 90-min seminar was delivered to seven mixed groups of medical trainees (n = 166) from several health care institutions in Spain. Physicians were asked to read and anonymously complete a same case-scenario of death certification before and after the seminar. We compared the rates of errors and the impact of the educational intervention before and after the seminar. Results A total of 332 death certificates (166 completed before and 166 completed after the intervention) were audited. Death certificates were completed with errors by 71.1% of the physicians before the educational intervention. Following the seminar, the proportion of death certificates with errors decreased to 9% (p < 0.0001). The most common error in the completion of death certificates was the listing of the mechanism of death instead of the cause of death. Before the seminar, 56.8% listed respiratory or cardiac arrest as the immediate cause of death. None of the participants listed any mechanism of death after the educational intervention (p < 0.0001). Conclusion Major errors in the completion of the correct cause of death on death certificates are common among medical residents. A simple educational intervention can dramatically improve the accuracy in the completion of death certificates by physicians. PMID:18005414

Objective Assessment of Patient Inhaler User Technique Using an Audio-Based Classification Approach.

PubMed

Taylor, Terence E; Zigel, Yaniv; Egan, Clarice; Hughes, Fintan; Costello, Richard W; Reilly, Richard B

2018-02-01

Many patients make critical user technique errors when using pressurised metered dose inhalers (pMDIs) which reduce the clinical efficacy of respiratory medication. Such critical errors include poor actuation coordination (poor timing of medication release during inhalation) and inhaling too fast (peak inspiratory flow rate over 90 L/min). Here, we present a novel audio-based method that objectively assesses patient pMDI user technique. The Inhaler Compliance Assessment device was employed to record inhaler audio signals from 62 respiratory patients as they used a pMDI with an In-Check Flo-Tone device attached to the inhaler mouthpiece. Using a quadratic discriminant analysis approach, the audio-based method generated a total frame-by-frame accuracy of 88.2% in classifying sound events (actuation, inhalation and exhalation). The audio-based method estimated the peak inspiratory flow rate and volume of inhalations with an accuracy of 88.2% and 83.94% respectively. It was detected that 89% of patients made at least one critical user technique error even after tuition from an expert clinical reviewer. This method provides a more clinically accurate assessment of patient inhaler user technique than standard checklist methods.

Factors associated with aberrant imprint methylation and oligozoospermia

PubMed Central

Kobayashi, Norio; Miyauchi, Naoko; Tatsuta, Nozomi; Kitamura, Akane; Okae, Hiroaki; Hiura, Hitoshi; Sato, Akiko; Utsunomiya, Takafumi; Yaegashi, Nobuo; Nakai, Kunihiko; Arima, Takahiro

2017-01-01

Disturbingly, the number of patients with oligozoospermia (low sperm count) has been gradually increasing in industrialized countries. Epigenetic alterations are believed to be involved in this condition. Recent studies have clarified that intrinsic and extrinsic factors can induce epigenetic transgenerational phenotypes through apparent reprogramming of the male germ line. Here we examined DNA methylation levels of 22 human imprinted loci in a total of 221 purified sperm samples from infertile couples and found methylation alterations in 24.8% of the patients. Structural equation model suggested that the cause of imprint methylation errors in sperm might have been environmental factors. More specifically, aberrant methylation and a particular lifestyle (current smoking, excess consumption of carbonated drinks) were associated with severe oligozoospermia, while aging probably affected this pathology indirectly through the accumulation of PCB in the patients. Next we examined the pregnancy outcomes for patients when the sperm had abnormal imprint methylation. The live-birth rate decreased and the miscarriage rate increased with the methylation errors. Our research will be useful for the prevention of methylation errors in sperm from infertile men, and sperm with normal imprint methylation might increase the safety of assisted reproduction technology (ART) by reducing methylation-induced diseases of children conceived via ART. PMID:28186187

Simulating Memory Impairment for Child Sexual Abuse.

PubMed

Newton, Jeremy W; Hobbs, Sue D

2015-08-01

The current study investigated effects of simulated memory impairment on recall of child sexual abuse (CSA) information. A total of 144 adults were tested for memory of a written CSA scenario in which they role-played as the victim. There were four experimental groups and two testing sessions. During Session 1, participants read a CSA story and recalled it truthfully (Genuine group), omitted CSA information (Omission group), exaggerated CSA information (Commission group), or did not recall the story at all (No Rehearsal group). One week later, at Session 2, all participants were told to recount the scenario truthfully, and their memory was then tested using free recall and cued recall questions. The Session 1 manipulation affected memory accuracy during Session 2. Specifically, compared with the Genuine group's performance, the Omission, Commission, or No Rehearsal groups' performance was characterized by increased omission and commission errors and decreased reporting of correct details. Victim blame ratings (i.e., victim responsibility and provocativeness) and participant gender predicted increased error and decreased accuracy, whereas perpetrator blame ratings predicted decreased error and increased accuracy. Findings are discussed in relation to factors that may affect memory for CSA information. Copyright © 2015 John Wiley & Sons, Ltd.

Automated Classification of Selected Data Elements from Free-text Diagnostic Reports for Clinical Research.

PubMed

Löpprich, Martin; Krauss, Felix; Ganzinger, Matthias; Senghas, Karsten; Riezler, Stefan; Knaup, Petra

2016-08-05

In the Multiple Myeloma clinical registry at Heidelberg University Hospital, most data are extracted from discharge letters. Our aim was to analyze if it is possible to make the manual documentation process more efficient by using methods of natural language processing for multiclass classification of free-text diagnostic reports to automatically document the diagnosis and state of disease of myeloma patients. The first objective was to create a corpus consisting of free-text diagnosis paragraphs of patients with multiple myeloma from German diagnostic reports, and its manual annotation of relevant data elements by documentation specialists. The second objective was to construct and evaluate a framework using different NLP methods to enable automatic multiclass classification of relevant data elements from free-text diagnostic reports. The main diagnoses paragraph was extracted from the clinical report of one third randomly selected patients of the multiple myeloma research database from Heidelberg University Hospital (in total 737 selected patients). An EDC system was setup and two data entry specialists performed independently a manual documentation of at least nine specific data elements for multiple myeloma characterization. Both data entries were compared and assessed by a third specialist and an annotated text corpus was created. A framework was constructed, consisting of a self-developed package to split multiple diagnosis sequences into several subsequences, four different preprocessing steps to normalize the input data and two classifiers: a maximum entropy classifier (MEC) and a support vector machine (SVM). In total 15 different pipelines were examined and assessed by a ten-fold cross-validation, reiterated 100 times. For quality indication the average error rate and the average F1-score were conducted. For significance testing the approximate randomization test was used. The created annotated corpus consists of 737 different diagnoses paragraphs with a total number of 865 coded diagnosis. The dataset is publicly available in the supplementary online files for training and testing of further NLP methods. Both classifiers showed low average error rates (MEC: 1.05; SVM: 0.84) and high F1-scores (MEC: 0.89; SVM: 0.92). However the results varied widely depending on the classified data element. Preprocessing methods increased this effect and had significant impact on the classification, both positive and negative. The automatic diagnosis splitter increased the average error rate significantly, even if the F1-score decreased only slightly. The low average error rates and high average F1-scores of each pipeline demonstrate the suitability of the investigated NPL methods. However, it was also shown that there is no best practice for an automatic classification of data elements from free-text diagnostic reports.

The effects of induced oblique astigmatism on symptoms and reading performance while viewing a computer screen.

PubMed

Rosenfield, Mark; Hue, Jennifer E; Huang, Rae R; Bababekova, Yuliya

2012-03-01

Computer vision syndrome (CVS) is a complex of eye and vision problems related to computer use which has been reported in up to 90% of computer users. Ocular symptoms may include asthenopia, accommodative and vergence difficulties and dry eye. Previous studies have reported that uncorrected astigmatism may have a significant impact on symptoms of CVS. However, its effect on task performance is unclear. This study recorded symptoms after a 10 min period of reading from a computer monitor either through the habitual distance refractive correction or with a supplementary -1.00 or -2.00D oblique cylinder added over these lenses in 12 young, visually-normal subjects. Additionally, the distance correction condition was repeated to assess the repeatability of the symptom questionnaire. Subjects' reading speed and accuracy were monitored during the course of the 10 min trial. There was no significant difference in reading rate or the number of errors between the three astigmatic conditions. However, a significant change in symptoms was reported with the median total symptom scores for the 0, 1 and 2D astigmatic conditions being 2.0, 6.5 and 40.0, respectively (p < 0.0001). Further, the repeatability coefficient of the total symptom score following the repeated zero astigmatism condition was ± 13.46. The presence of induced astigmatism produced a significant increase in post-task symptoms but did not affect reading rate or the number of reading errors. The correction of small astigmatic refractive errors may be important in optimizing patient comfort during computer operation. Ophthalmic & Physiological Optics © 2011 The College of Optometrists.

Uncorrected refractive errors and spectacle utilisation rate in Tehran: the unmet need

PubMed Central

Fotouhi, A; Hashemi, H; Raissi, B; Mohammad, K

2006-01-01

Aim To determine the prevalence of the met and unmet need for spectacles and their associated factors in the population of Tehran. Methods 6497 Tehran citizens were enrolled through random cluster sampling and were invited to a clinic for an interview and ophthalmic examination. 4354 (70.3%) participated in the survey, and refraction measurement results of 4353 people aged 5 years and over are presented. The unmet need for spectacles was defined as the proportion of people who did not use spectacles despite a correctable visual acuity of worse than 20/40 in the better eye. Results The need for spectacles in the studied population, standardised for age and sex, was 14.1% (95% confidence interval (CI), 12.8% to 15.4%). This need was met with appropriate spectacles in 416 people (9.3% of the total sample), while it was unmet in 230 people, representing 4.8% of the total sample population (95% CI, 4.1% to 5.4%). The spectacle coverage rate (met need/(met need + unmet need)) was 66.0%. Multivariate logistic regression showed that variables of age, education, and type of refractive error were associated with lack of spectacle correction. There was an increase in the unmet need with older age, lesser education, and myopia. Conclusion This survey determined the met and unmet need for spectacles in a Tehran population. It also identified high risk groups with uncorrected refractive errors to guide intervention programmes for the society. While the study showed the unmet need for spectacles and its determinants, more extensive studies towards the causes of unmet need are recommended. PMID:16488929

Measurement of the Total Cross Section of Uranium-Uranium Collisions at √{sNN} = 192 . 8 GeV

NASA Astrophysics Data System (ADS)

Baltz, A. J.; Fischer, W.; Blaskiewicz, M.; Gassner, D.; Drees, K. A.; Luo, Y.; Minty, M.; Thieberger, P.; Wilinski, M.; Pshenichnov, I. A.

2014-03-01

The total cross section of Uranium-Uranium at √{sNN} = 192 . 8 GeV has been measured to be 515 +/-13stat +/-22sys barn, which agrees with the calculated theoretical value of 487.3 barn within experimental error. That this total cross section is more than an order of magnitude larger than the geometric ion-ion cross section is primarily due to Bound-Free Pair Production (BFPP) and Electro-Magnetic Dissociation (EMD). Nearly all beam losses were due to geometric, BFPP and EMD collisions. This allowed the determination of the total cross section from the measured beam loss rates and luminosity. The beam loss rate is calculated from a time-dependent measurement of the total beam intensity. The luminosity is measured via the detection of neutron pairs in time-coincidence in the Zero Degree Calorimeters. Apart from a general interest in verifying the calculations experimentally, an accurate prediction of the losses created in the heavy ion collisions is of practical interest for the LHC, where collision products have the potential to quench cryogenically cooled magnets.

Differential detection in quadrature-quadrature phase shift keying (Q2PSK) systems

NASA Astrophysics Data System (ADS)

El-Ghandour, Osama M.; Saha, Debabrata

1991-05-01

A generalized quadrature-quadrature phase shift keying (Q2PSK) signaling format is considered for differential encoding and differential detection. Performance in the presence of additive white Gaussian noise (AWGN) is analyzed. Symbol error rate is found to be approximately twice the symbol error rate in a quaternary DPSK system operating at the same Eb/N0. However, the bandwidth efficiency of differential Q2PSK is substantially higher than that of quaternary DPSK. When the error is due to AWGN, the ratio of double error rate to single error rate can be very high, and the ratio may approach zero at high SNR. To improve error rate, differential detection through maximum-likelihood decoding based on multiple or N symbol observations is considered. If N and SNR are large this decoding gives a 3-dB advantage in error rate over conventional N = 2 differential detection, fully recovering the energy loss (as compared to coherent detection) if the observation is extended to a large number of symbol durations.

Error Correction using Quantum Quasi-Cyclic Low-Density Parity-Check(LDPC) Codes

NASA Astrophysics Data System (ADS)

Jing, Lin; Brun, Todd; Quantum Research Team

Quasi-cyclic LDPC codes can approach the Shannon capacity and have efficient decoders. Manabu Hagiwara et al., 2007 presented a method to calculate parity check matrices with high girth. Two distinct, orthogonal matrices Hc and Hd are used. Using submatrices obtained from Hc and Hd by deleting rows, we can alter the code rate. The submatrix of Hc is used to correct Pauli X errors, and the submatrix of Hd to correct Pauli Z errors. We simulated this system for depolarizing noise on USC's High Performance Computing Cluster, and obtained the block error rate (BER) as a function of the error weight and code rate. From the rates of uncorrectable errors under different error weights we can extrapolate the BER to any small error probability. Our results show that this code family can perform reasonably well even at high code rates, thus considerably reducing the overhead compared to concatenated and surface codes. This makes these codes promising as storage blocks in fault-tolerant quantum computation. Error Correction using Quantum Quasi-Cyclic Low-Density Parity-Check(LDPC) Codes.

IMRT QA: Selecting gamma criteria based on error detection sensitivity.

PubMed

Steers, Jennifer M; Fraass, Benedick A

2016-04-01

The gamma comparison is widely used to evaluate the agreement between measurements and treatment planning system calculations in patient-specific intensity modulated radiation therapy (IMRT) quality assurance (QA). However, recent publications have raised concerns about the lack of sensitivity when employing commonly used gamma criteria. Understanding the actual sensitivity of a wide range of different gamma criteria may allow the definition of more meaningful gamma criteria and tolerance limits in IMRT QA. We present a method that allows the quantitative determination of gamma criteria sensitivity to induced errors which can be applied to any unique combination of device, delivery technique, and software utilized in a specific clinic. A total of 21 DMLC IMRT QA measurements (ArcCHECK®, Sun Nuclear) were compared to QA plan calculations with induced errors. Three scenarios were studied: MU errors, multi-leaf collimator (MLC) errors, and the sensitivity of the gamma comparison to changes in penumbra width. Gamma comparisons were performed between measurements and error-induced calculations using a wide range of gamma criteria, resulting in a total of over 20 000 gamma comparisons. Gamma passing rates for each error class and case were graphed against error magnitude to create error curves in order to represent the range of missed errors in routine IMRT QA using 36 different gamma criteria. This study demonstrates that systematic errors and case-specific errors can be detected by the error curve analysis. Depending on the location of the error curve peak (e.g., not centered about zero), 3%/3 mm threshold = 10% at 90% pixels passing may miss errors as large as 15% MU errors and ±1 cm random MLC errors for some cases. As the dose threshold parameter was increased for a given %Diff/distance-to-agreement (DTA) setting, error sensitivity was increased by up to a factor of two for select cases. This increased sensitivity with increasing dose threshold was consistent across all studied combinations of %Diff/DTA. Criteria such as 2%/3 mm and 3%/2 mm with a 50% threshold at 90% pixels passing are shown to be more appropriately sensitive without being overly strict. However, a broadening of the penumbra by as much as 5 mm in the beam configuration was difficult to detect with commonly used criteria, as well as with the previously mentioned criteria utilizing a threshold of 50%. We have introduced the error curve method, an analysis technique which allows the quantitative determination of gamma criteria sensitivity to induced errors. The application of the error curve method using DMLC IMRT plans measured on the ArcCHECK® device demonstrated that large errors can potentially be missed in IMRT QA with commonly used gamma criteria (e.g., 3%/3 mm, threshold = 10%, 90% pixels passing). Additionally, increasing the dose threshold value can offer dramatic increases in error sensitivity. This approach may allow the selection of more meaningful gamma criteria for IMRT QA and is straightforward to apply to other combinations of devices and treatment techniques.

Executive Council lists and general practitioner files

PubMed Central

Farmer, R. D. T.; Knox, E. G.; Cross, K. W.; Crombie, D. L.

1974-01-01

An investigation of the accuracy of general practitioner and Executive Council files was approached by a comparison of the two. High error rates were found, including both file errors and record errors. On analysis it emerged that file error rates could not be satisfactorily expressed except in a time-dimensioned way, and we were unable to do this within the context of our study. Record error rates and field error rates were expressible as proportions of the number of records on both the lists; 79·2% of all records exhibited non-congruencies and particular information fields had error rates ranging from 0·8% (assignation of sex) to 68·6% (assignation of civil state). Many of the errors, both field errors and record errors, were attributable to delayed updating of mutable information. It is concluded that the simple transfer of Executive Council lists to a computer filing system would not solve all the inaccuracies and would not in itself permit Executive Council registers to be used for any health care applications requiring high accuracy. For this it would be necessary to design and implement a purpose designed health care record system which would include, rather than depend upon, the general practitioner remuneration system. PMID:4816588

Quality Indicators for the Total Testing Process.

PubMed

Plebani, Mario; Sciacovelli, Laura; Aita, Ada

2017-03-01

ISO 15189:2012 requires the use of quality indicators (QIs) to monitor and evaluate all steps of the total testing process, but several difficulties dissuade laboratories from effective and continuous use of QIs in routine practice. An International Federation of Clinical Chemistry and Laboratory Medicine working group addressed this problem and implemented a project to develop a model of QIs to be used in clinical laboratories worldwide to monitor and evaluate all steps of the total testing process, and decrease error rates and improve patient services in laboratory testing. All laboratories are invited, at no cost, to enroll in the project and contribute to harmonized management at the international level. Copyright © 2016 Elsevier Inc. All rights reserved.

Satellite Sampling and Retrieval Errors in Regional Monthly Rain Estimates from TMI AMSR-E, SSM/I, AMSU-B and the TRMM PR

NASA Technical Reports Server (NTRS)

Fisher, Brad; Wolff, David B.

2010-01-01

Passive and active microwave rain sensors onboard earth-orbiting satellites estimate monthly rainfall from the instantaneous rain statistics collected during satellite overpasses. It is well known that climate-scale rain estimates from meteorological satellites incur sampling errors resulting from the process of discrete temporal sampling and statistical averaging. Sampling and retrieval errors ultimately become entangled in the estimation of the mean monthly rain rate. The sampling component of the error budget effectively introduces statistical noise into climate-scale rain estimates that obscure the error component associated with the instantaneous rain retrieval. Estimating the accuracy of the retrievals on monthly scales therefore necessitates a decomposition of the total error budget into sampling and retrieval error quantities. This paper presents results from a statistical evaluation of the sampling and retrieval errors for five different space-borne rain sensors on board nine orbiting satellites. Using an error decomposition methodology developed by one of the authors, sampling and retrieval errors were estimated at 0.25 resolution within 150 km of ground-based weather radars located at Kwajalein, Marshall Islands and Melbourne, Florida. Error and bias statistics were calculated according to the land, ocean and coast classifications of the surface terrain mask developed for the Goddard Profiling (GPROF) rain algorithm. Variations in the comparative error statistics are attributed to various factors related to differences in the swath geometry of each rain sensor, the orbital and instrument characteristics of the satellite and the regional climatology. The most significant result from this study found that each of the satellites incurred negative longterm oceanic retrieval biases of 10 to 30%.

Hybrid and concatenated coding applications.

NASA Technical Reports Server (NTRS)

Hofman, L. B.; Odenwalder, J. P.

1972-01-01

Results of a study to evaluate the performance and implementation complexity of a concatenated and a hybrid coding system for moderate-speed deep-space applications. It is shown that with a total complexity of less than three times that of the basic Viterbi decoder, concatenated coding improves a constraint length 8 rate 1/3 Viterbi decoding system by 1.1 and 2.6 dB at bit error probabilities of 0.0001 and one hundred millionth, respectively. With a somewhat greater total complexity, the hybrid coding system is shown to obtain a 0.9-dB computational performance improvement over the basic rate 1/3 sequential decoding system. Although substantial, these complexities are much less than those required to achieve the same performances with more complex Viterbi or sequential decoder systems.

Medical errors and uncertainty in primary healthcare: A comparative study of coping strategies among young and experienced GPs

PubMed Central

Kuikka, Liisa; Pitkälä, Kaisu

2014-01-01

Abstract Objective. To study coping differences between young and experienced GPs in primary care who experience medical errors and uncertainty. Design. Questionnaire-based survey (self-assessment) conducted in 2011. Setting. Finnish primary practice offices in Southern Finland. Subjects. Finnish GPs engaged in primary health care from two different respondent groups: young (working experience ≤ 5years, n = 85) and experienced (working experience > 5 years, n = 80). Main outcome measures. Outcome measures included experiences and attitudes expressed by the included participants towards medical errors and tolerance of uncertainty, their coping strategies, and factors that may influence (positively or negatively) sources of errors. Results. In total, 165/244 GPs responded (response rate: 68%). Young GPs expressed significantly more often fear of committing a medical error (70.2% vs. 48.1%, p = 0.004) and admitted more often than experienced GPs that they had committed a medical error during the past year (83.5% vs. 68.8%, p = 0.026). Young GPs were less prone to apologize to a patient for an error (44.7% vs. 65.0%, p = 0.009) and found, more often than their more experienced colleagues, on-site consultations and electronic databases useful for avoiding mistakes. Conclusion. Experienced GPs seem to better tolerate uncertainty and also seem to fear medical errors less than their young colleagues. Young and more experienced GPs use different coping strategies for dealing with medical errors. Implications. When GPs become more experienced, they seem to get better at coping with medical errors. Means to support these skills should be studied in future research. PMID:24914458

Joint Denoising/Compression of Image Contours via Shape Prior and Context Tree

NASA Astrophysics Data System (ADS)

Zheng, Amin; Cheung, Gene; Florencio, Dinei

2018-07-01

With the advent of depth sensing technologies, the extraction of object contours in images---a common and important pre-processing step for later higher-level computer vision tasks like object detection and human action recognition---has become easier. However, acquisition noise in captured depth images means that detected contours suffer from unavoidable errors. In this paper, we propose to jointly denoise and compress detected contours in an image for bandwidth-constrained transmission to a client, who can then carry out aforementioned application-specific tasks using the decoded contours as input. We first prove theoretically that in general a joint denoising / compression approach can outperform a separate two-stage approach that first denoises then encodes contours lossily. Adopting a joint approach, we first propose a burst error model that models typical errors encountered in an observed string y of directional edges. We then formulate a rate-constrained maximum a posteriori (MAP) problem that trades off the posterior probability p(x'|y) of an estimated string x' given y with its code rate R(x'). We design a dynamic programming (DP) algorithm that solves the posed problem optimally, and propose a compact context representation called total suffix tree (TST) that can reduce complexity of the algorithm dramatically. Experimental results show that our joint denoising / compression scheme outperformed a competing separate scheme in rate-distortion performance noticeably.

Adherence to the Australian National Inpatient Medication Chart: the efficacy of a uniform national drug chart on improving prescription error.

PubMed

Atik, Alp

2013-10-01

In 2006, the National Inpatient Medication Chart (NIMC) was introduced as a uniform medication chart in Australian public hospitals with the aim of reducing prescription error. The rate of regular medication prescription error in the NIMC was assessed. Data was collected using the NIMC Audit Tool and analyzed with respect to causes of error per medication prescription and per medication chart. The following prescription requirements were assessed: date, generic drug name, route of administration, dose, frequency, administration time, indication, signature, name and contact details. A total of 1877 medication prescriptions were reviewed. 1653 prescriptions (88.07%) had no contact number, 1630 (86.84%) did not have an indication, 1230 and 675 (35.96%) used a drug's trade name. Within 261 medication charts, all had at least one entry, which did not include an indication, 258 (98.85%) had at least one entry, which did not have a contact number and 200 (76.63%) had at least one entry, which used a trade name. The introduction of a uniform national medication chart is a positive step, but more needs to be done to address the root causes of prescription error. © 2012 John Wiley & Sons Ltd.

Pedigree and genotyping quality analyses of over 10,000 DNA samples from the Generation Scotland: Scottish Family Health Study.

PubMed

Kerr, Shona M; Campbell, Archie; Murphy, Lee; Hayward, Caroline; Jackson, Cathy; Wain, Louise V; Tobin, Martin D; Dominiczak, Anna; Morris, Andrew; Smith, Blair H; Porteous, David J

2013-03-22

Generation Scotland: Scottish Family Health Study (GS:SFHS) is a family-based biobank of 24,000 participants with rich phenotype and DNA available for genetic research. This paper describes the laboratory results from genotyping 32 single nucleotide polymorphisms (SNPs) on DNA from over 10,000 participants who attended GS:SFHS research clinics. The analysis described here was undertaken to test the quality of genetic information available to researchers. The success rate of each marker genotyped (call rate), minor allele frequency and adherence to Mendelian inheritance are presented. The few deviations in marker transmission in the 925 parent-child trios analysed were assessed as to whether they were likely to be miscalled genotypes, data or sample handling errors, or pedigree inaccuracies including non-paternity. The first 10,450 GS:SFHS clinic participants who had spirometry and smoking data available and DNA extracted were selected. 32 SNPs were assayed, chosen as part of a replication experiment from a Genome-Wide Association Study meta-analysis of lung function. In total 325,336 genotypes were returned. The overall project pass rate (32 SNPs on 10,450 samples) was 97.29%. A total of 925 parent-child trios were assessed for transmission of the SNP markers, with 16 trios indicating evidence of inconsistency in the recorded pedigrees. The Generation Scotland: Scottish Family Health Study used well-validated study methods and can produce good quality genetic data, with a low error rate. The GS:SFHS DNA samples are of high quality and the family groups were recorded and processed with accuracy during collection of the cohort.

Sex differences in the shoulder joint position sense acuity: a cross-sectional study.

PubMed

Vafadar, Amir K; Côté, Julie N; Archambault, Philippe S

2015-09-30

Work-related musculoskeletal disorders (WMSD) is the most expensive form of work disability. Female sex has been considered as an individual risk factor for the development of WMSD, specifically in the neck and shoulder region. One of the factors that might contribute to the higher injury rate in women is possible differences in neuromuscular control. Accordingly the purpose of this study was to estimate the effect of sex on shoulder joint position sense acuity (as a part of shoulder neuromuscular control) in healthy individuals. Twenty-eight healthy participants, 14 females and 14 males were recruited for this study. To test position sense acuity, subjects were asked to flex their dominant shoulder to one of the three pre-defined angle ranges (low, mid and high-ranges) with eyes closed, hold their arm in that position for three seconds, go back to the starting position and then immediately replicate the same joint flexion angle, while the difference between the reproduced and original angle was taken as the measure of position sense error. The errors were measured using Vicon motion capture system. Subjects reproduced nine positions in total (3 ranges × 3 trials each). Calculation of absolute repositioning error (magnitude of error) showed no significant difference between men and women (p-value ≥ 0.05). However, the analysis of the direction of error (constant error) showed a significant difference between the sexes, as women tended to mostly overestimate the target, whereas men tended to both overestimate and underestimate the target (p-value ≤ 0.01, observed power = 0.79). The results also showed that men had a significantly more variable error, indicating more variability in their position sense, compared to women (p-value ≤ 0.05, observed power = 0.78). Differences observed in the constant JPS error suggest that men and women might use different neuromuscular control strategies in the upper limb. In addition, higher JPS variability observed in men might be one of the factors that could contribute to their lower rate of musculoskeletal disorders, compared to women. The result of this study showed that shoulder position sense, as part of the neuromuscular control system, differs between men and women. This finding can help us better understand the reasons behind the higher rate of musculoskeletal disorders in women, especially in the working environments.

Personal protective equipment for the Ebola virus disease: A comparison of 2 training programs.

PubMed

Casalino, Enrique; Astocondor, Eugenio; Sanchez, Juan Carlos; Díaz-Santana, David Enrique; Del Aguila, Carlos; Carrillo, Juan Pablo

2015-12-01

Personal protective equipment (PPE) for preventing Ebola virus disease (EVD) includes basic PPE (B-PPE) and enhanced PPE (E-PPE). Our aim was to compare conventional training programs (CTPs) and reinforced training programs (RTPs) on the use of B-PPE and E-PPE. Four groups were created, designated CTP-B, CTP-E, RTP-B, and RTP-E. All groups received the same theoretical training, followed by 3 practical training sessions. A total of 120 students were included (30 per group). In all 4 groups, the frequency and number of total errors and critical errors decreased significantly over the course of the training sessions (P < .01). The RTP was associated with a greater reduction in the number of total errors and critical errors (P < .0001). During the third training session, we noted an error frequency of 7%-43%, a critical error frequency of 3%-40%, 0.3-1.5 total errors, and 0.1-0.8 critical errors per student. The B-PPE groups had the fewest errors and critical errors (P < .0001). Our results indicate that both training methods improved the student's proficiency, that B-PPE appears to be easier to use than E-PPE, that the RTP achieved better proficiency for both PPE types, and that a number of students are still potentially at risk for EVD contamination despite the improvements observed during the training. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Hardness assurance for proton direct ionization-induced SEEs using a high-energy proton beam

DOE PAGES

Dodds, Nathaniel Anson; Schwank, James R.; Shaneyfelt, Marty R.; ...

2014-11-06

The low-energy proton energy spectra of all shielded space environments have the same shape. This shape is easily reproduced in the laboratory by degrading a high-energy proton beam, producing a high-fidelity test environment. We use this test environment to dramatically simplify rate prediction for proton direct ionization effects, allowing the work to be done at high-energy proton facilities, on encapsulated parts, without knowledge of the IC design, and with little or no computer simulations required. Proton direct ionization (PDI) is predicted to significantly contribute to the total error rate under the conditions investigated. Scaling effects are discussed using data frommore » 65-nm, 45-nm, and 32-nm SOI SRAMs. These data also show that grazing-angle protons will dominate the PDI-induced error rate due to their higher effective LET, so PDI hardness assurance methods must account for angular effects to be conservative. As a result, we show that this angular dependence can be exploited to quickly assess whether an IC is susceptible to PDI.« less

Cost Estimation for Surface Navy Investment in Arctic-capable Platform to Maintain National Security Interests

DTIC Science & Technology

2014-12-01

Approx) A N OVA R~gresslon R esidual Total d.f. ss 1 . 0 .00018 1. 0 .00518 2. 0 .00536 Coefficients Standard Error Intercept 0.04 234 0...150.3230 + 27.9237 • "Mission" Rating (1-10) AN OVA Regression Residual To Cal d.f. 1 . 1 . 2 . ss 2,469.15829 1,630.59238 4 .099.75068...per Foot ($M) =· 1.8590 + 0.0091 • Length (ft) AN OVA d . fc ss Regres sion 1 . 4.22352 Residual 4 . 7.26194 Total 5 . 11.48546 Coefficients

Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.

PubMed

Schroeder, Scott R; Salomon, Meghan M; Galanter, William L; Schiff, Gordon D; Vaida, Allen J; Gaunt, Michael J; Bryson, Michelle L; Rash, Christine; Falck, Suzanne; Lambert, Bruce L

2017-05-01

Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Classification based upon gene expression data: bias and precision of error rates.

PubMed

Wood, Ian A; Visscher, Peter M; Mengersen, Kerrie L

2007-06-01

Gene expression data offer a large number of potentially useful predictors for the classification of tissue samples into classes, such as diseased and non-diseased. The predictive error rate of classifiers can be estimated using methods such as cross-validation. We have investigated issues of interpretation and potential bias in the reporting of error rate estimates. The issues considered here are optimization and selection biases, sampling effects, measures of misclassification rate, baseline error rates, two-level external cross-validation and a novel proposal for detection of bias using the permutation mean. Reporting an optimal estimated error rate incurs an optimization bias. Downward bias of 3-5% was found in an existing study of classification based on gene expression data and may be endemic in similar studies. Using a simulated non-informative dataset and two example datasets from existing studies, we show how bias can be detected through the use of label permutations and avoided using two-level external cross-validation. Some studies avoid optimization bias by using single-level cross-validation and a test set, but error rates can be more accurately estimated via two-level cross-validation. In addition to estimating the simple overall error rate, we recommend reporting class error rates plus where possible the conditional risk incorporating prior class probabilities and a misclassification cost matrix. We also describe baseline error rates derived from three trivial classifiers which ignore the predictors. R code which implements two-level external cross-validation with the PAMR package, experiment code, dataset details and additional figures are freely available for non-commercial use from http://www.maths.qut.edu.au/profiles/wood/permr.jsp

Interobserver Reliability of the Total Body Score System for Quantifying Human Decomposition.

PubMed

Dabbs, Gretchen R; Connor, Melissa; Bytheway, Joan A

2016-03-01

Several authors have tested the accuracy of the Total Body Score (TBS) method for quantifying decomposition, but none have examined the reliability of the method as a scoring system by testing interobserver error rates. Sixteen participants used the TBS system to score 59 observation packets including photographs and written descriptions of 13 human cadavers in different stages of decomposition (postmortem interval: 2-186 days). Data analysis used a two-way random model intraclass correlation in SPSS (v. 17.0). The TBS method showed "almost perfect" agreement between observers, with average absolute correlation coefficients of 0.990 and average consistency correlation coefficients of 0.991. While the TBS method may have sources of error, scoring reliability is not one of them. Individual component scores were examined, and the influences of education and experience levels were investigated. Overall, the trunk component scores were the least concordant. Suggestions are made to improve the reliability of the TBS method. © 2016 American Academy of Forensic Sciences.

A comparison of exact tests for trend with binary endpoints using Bartholomew's statistic.

PubMed

Consiglio, J D; Shan, G; Wilding, G E

2014-01-01

Tests for trend are important in a number of scientific fields when trends associated with binary variables are of interest. Implementing the standard Cochran-Armitage trend test requires an arbitrary choice of scores assigned to represent the grouping variable. Bartholomew proposed a test for qualitatively ordered samples using asymptotic critical values, but type I error control can be problematic in finite samples. To our knowledge, use of the exact probability distribution has not been explored, and we study its use in the present paper. Specifically we consider an approach based on conditioning on both sets of marginal totals and three unconditional approaches where only the marginal totals corresponding to the group sample sizes are treated as fixed. While slightly conservative, all four tests are guaranteed to have actual type I error rates below the nominal level. The unconditional tests are found to exhibit far less conservatism than the conditional test and thereby gain a power advantage.

Do Errors on Classroom Reading Tasks Slow Growth in Reading? Technical Report No. 404.

ERIC Educational Resources Information Center

Anderson, Richard C.; And Others

A pervasive finding from research on teaching and classroom learning is that a low rate of error on classroom tasks is associated with large year to year gains in achievement, particularly for reading in the primary grades. The finding of a negative relationship between error rate, especially rate of oral reading errors, and gains in reading…

Accuracy of Patient Specific Cutting Blocks in Total Knee Arthroplasty

PubMed Central

Helmy, Naeder; Kühnel, Stefanie P.

2014-01-01

Background. Long-term survival of total knee arthroplasty (TKA) is mainly determined by optimal positioning of the components and prosthesis alignment. Implant positioning can be optimized by computer assisted surgery (CAS). Patient specific cutting blocks (PSCB) seem to have the potential to improve component alignment compared to the conventional technique and to be comparable to CAS. Methods. 113 knees were selected for PSI and included in this study. Pre- and postoperative mechanical axis, represented by the hip-knee-angle (HKA), the proximal tibial angle (PTA), the distal femoral angle (DFA), and the tibial slope (TS) were measured and the deviation from expected ideal values was calculated. Results. With a margin of error of ±3°, success rates were 81.4% for HKA, 92.0% for TPA, and 94.7% for DFA. With the margin of error for alignments extended to ±4°, we obtained a success rate of 92.9% for the HKA, 98.2% for the PTA, and 99.1% for the DFA. The TS showed postoperative results of 2.86 ± 2.02° (mean change 1.76 ± 2.85°). Conclusion. PSCBs for TKA seem to restore the overall leg alignment. Our data suggest that each individual component can be implanted accurately and the results are comparable to the ones in CAS. PMID:25254210

Estimating genotype error rates from high-coverage next-generation sequence data.

PubMed

Wall, Jeffrey D; Tang, Ling Fung; Zerbe, Brandon; Kvale, Mark N; Kwok, Pui-Yan; Schaefer, Catherine; Risch, Neil

2014-11-01

Exome and whole-genome sequencing studies are becoming increasingly common, but little is known about the accuracy of the genotype calls made by the commonly used platforms. Here we use replicate high-coverage sequencing of blood and saliva DNA samples from four European-American individuals to estimate lower bounds on the error rates of Complete Genomics and Illumina HiSeq whole-genome and whole-exome sequencing. Error rates for nonreference genotype calls range from 0.1% to 0.6%, depending on the platform and the depth of coverage. Additionally, we found (1) no difference in the error profiles or rates between blood and saliva samples; (2) Complete Genomics sequences had substantially higher error rates than Illumina sequences had; (3) error rates were higher (up to 6%) for rare or unique variants; (4) error rates generally declined with genotype quality (GQ) score, but in a nonlinear fashion for the Illumina data, likely due to loss of specificity of GQ scores greater than 60; and (5) error rates increased with increasing depth of coverage for the Illumina data. These findings, especially (3)-(5), suggest that caution should be taken in interpreting the results of next-generation sequencing-based association studies, and even more so in clinical application of this technology in the absence of validation by other more robust sequencing or genotyping methods. © 2014 Wall et al.; Published by Cold Spring Harbor Laboratory Press.

Seasonal variability of stratospheric methane: implications for constraining tropospheric methane budgets using total column observations

NASA Astrophysics Data System (ADS)

Saad, Katherine M.; Wunch, Debra; Deutscher, Nicholas M.; Griffith, David W. T.; Hase, Frank; De Mazière, Martine; Notholt, Justus; Pollard, David F.; Roehl, Coleen M.; Schneider, Matthias; Sussmann, Ralf; Warneke, Thorsten; Wennberg, Paul O.

2016-11-01

Global and regional methane budgets are markedly uncertain. Conventionally, estimates of methane sources are derived by bridging emissions inventories with atmospheric observations employing chemical transport models. The accuracy of this approach requires correctly simulating advection and chemical loss such that modeled methane concentrations scale with surface fluxes. When total column measurements are assimilated into this framework, modeled stratospheric methane introduces additional potential for error. To evaluate the impact of such errors, we compare Total Carbon Column Observing Network (TCCON) and GEOS-Chem total and tropospheric column-averaged dry-air mole fractions of methane. We find that the model's stratospheric contribution to the total column is insensitive to perturbations to the seasonality or distribution of tropospheric emissions or loss. In the Northern Hemisphere, we identify disagreement between the measured and modeled stratospheric contribution, which increases as the tropopause altitude decreases, and a temporal phase lag in the model's tropospheric seasonality driven by transport errors. Within the context of GEOS-Chem, we find that the errors in tropospheric advection partially compensate for the stratospheric methane errors, masking inconsistencies between the modeled and measured tropospheric methane. These seasonally varying errors alias into source attributions resulting from model inversions. In particular, we suggest that the tropospheric phase lag error leads to large misdiagnoses of wetland emissions in the high latitudes of the Northern Hemisphere.

Speech Errors across the Lifespan

ERIC Educational Resources Information Center

Vousden, Janet I.; Maylor, Elizabeth A.

2006-01-01

Dell, Burger, and Svec (1997) proposed that the proportion of speech errors classified as anticipations (e.g., "moot and mouth") can be predicted solely from the overall error rate, such that the greater the error rate, the lower the anticipatory proportion (AP) of errors. We report a study examining whether this effect applies to changes in error…

Prevalence of refractive errors in Tibetan adolescents.

PubMed

Qian, Xuehan; Liu, Beihong; Wang, Jing; Wei, Nan; Qi, Xiaoli; Li, Xue; Li, Jing; Zhang, Ying; Hua, Ning; Ning, Yuxian; Ding, Gang; Ma, Xu; Wang, Binbin

2018-05-11

The prevalence of adolescent eye disease in remote areas of the Qinghai-Tibet Plateau has rarely been reported. To understand the prevalence of common eye diseases in Tibet, we performed ocular-disease screening on students from primary and secondary schools in Tibet, and compared the prevalence to that in the Central China Plain (referred to here as the "plains area"). The refractive status of students was evaluated with a Spot™ vision screener. The test was conducted three or fewer times for both eyes of each student and results with best correction were recorded. A total of 3246 students from primary and secondary schools in the Tibet Naidong district were screened, yielding a refractive error rate of 28.51%, which was significantly lower than that of the plains group (28.51% vs. 56.92%, p < 0.001). In both groups, the prevalence of refractive errors among females was higher than that among males. We found that Tibetan adolescents had a lower prevalence of refractive errors than did adolescents in the plains area, which may be related to less intensive schooling and greater exposure to sunlight.

Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting.

PubMed

Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

[Adverse events in general surgery. A prospective analysis of 13,950 consecutive patients].

PubMed

Rebasa, Pere; Mora, Laura; Vallverdú, Helena; Luna, Alexis; Montmany, Sandra; Romaguera, Andreu; Navarro, Salvador

2011-11-01

Adverse event (AE) rates in General Surgery vary, according to different authors and recording methods, between 2% and 30%. Six years ago we designed a prospective AE recording system to change patient safety culture in our Department. We present the results of this work after a 6 year follow-up. The AE, sequelae and health care errors in a University Hospital surgery department were recorded. An analysis of each incident recorded was performed by a reviewer. The data was entered into data base for rapid access and consultation. The results were routinely presented in Departmental morbidity-mortality sessions. A total of 13,950 patients had suffered 11,254 AE, which affected 5142 of them (36.9% of admissions). A total of 920 patients were subjected to at least one health care error (6.6% of admissions). This meant that 6.6% of our patients suffered an avoidable AE. The overall mortality at 5 years in our department was 2.72% (380 deaths). An adverse event was implicated in the death of the patient in 180 cases (1.29% of admissions). In 49 cases (0.35% of admissions), mortality could be attributed to an avoidable AE. After 6 years there tends to be an increasingly lower incidence of errors. The exhaustive and prospective recording of AE leads to changes in patient safety culture in a Surgery Department and helps decrease the incidence of health care errors. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

Angular rate optimal design for the rotary strapdown inertial navigation system.

PubMed

Yu, Fei; Sun, Qian

2014-04-22

Due to the characteristics of high precision for a long duration, the rotary strapdown inertial navigation system (RSINS) has been widely used in submarines and surface ships. Nowadays, the core technology, the rotating scheme, has been studied by numerous researchers. It is well known that as one of the key technologies, the rotating angular rate seriously influences the effectiveness of the error modulating. In order to design the optimal rotating angular rate of the RSINS, the relationship between the rotating angular rate and the velocity error of the RSINS was analyzed in detail based on the Laplace transform and the inverse Laplace transform in this paper. The analysis results showed that the velocity error of the RSINS depends on not only the sensor error, but also the rotating angular rate. In order to minimize the velocity error, the rotating angular rate of the RSINS should match the sensor error. One optimal design method for the rotating rate of the RSINS was also proposed in this paper. Simulation and experimental results verified the validity and superiority of this optimal design method for the rotating rate of the RSINS.

The Error in Total Error Reduction

PubMed Central

Witnauer, James E.; Urcelay, Gonzalo P.; Miller, Ralph R.

2013-01-01

Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modelling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. PMID:23891930

The effectiveness of the error reporting promoting program on the nursing error incidence rate in Korean operating rooms.

PubMed

Kim, Myoung-Soo; Kim, Jung-Soon; Jung, In Sook; Kim, Young Hae; Kim, Ho Jung

2007-03-01

The purpose of this study was to develop and evaluate an error reporting promoting program(ERPP) to systematically reduce the incidence rate of nursing errors in operating room. A non-equivalent control group non-synchronized design was used. Twenty-six operating room nurses who were in one university hospital in Busan participated in this study. They were stratified into four groups according to their operating room experience and were allocated to the experimental and control groups using a matching method. Mann-Whitney U Test was used to analyze the differences pre and post incidence rates of nursing errors between the two groups. The incidence rate of nursing errors decreased significantly in the experimental group compared to the pre-test score from 28.4% to 15.7%. The incidence rate by domains, it decreased significantly in the 3 domains-"compliance of aseptic technique", "management of document", "environmental management" in the experimental group while it decreased in the control group which was applied ordinary error-reporting method. Error-reporting system can make possible to hold the errors in common and to learn from them. ERPP was effective to reduce the errors of recognition-related nursing activities. For the wake of more effective error-prevention, we will be better to apply effort of risk management along the whole health care system with this program.

Inaccurate Language Interpretation and its Clinical Significance in the Medical Encounters of Spanish-speaking Latinos

PubMed Central

Nápoles, Anna M.; Santoyo-Olsson, Jasmine; Karliner, Leah S.; Gregorich, Steven E.; Pérez-Stable, Eliseo J.

2015-01-01

Background Limited English-proficient (LEP) patients suffer poorer quality of care and outcomes. Interpreters can ameliorate these disparities; however, evidence is lacking on the quality of different interpretation modes. Objective Compare accuracy of interpretation for in-person professional (IP), professional videoconferencing (VC), and ad hoc interpretation (AH). Design Cross-sectional study of transcribed audiotaped primary care visits Subjects 32 Spanish-speaking Latino patients; 14 clinicians Measures Independent coding of transcripts by four coders (two were internists) for accurate and inaccurate interpretation instances. Unit of analysis was a segment of continuous speech or text unit (TU). Two internists independently verified inaccurate interpretation instances and rated their clinical significance as clinically insignificant, mildly, moderately or highly clinically significant. Results Accurate interpretation made up 70% of total coded TUs and inaccurate interpretation (errors) made up 30%. Inaccurate interpretation occurred at twice the rate for AH (54% of coded TUs) versus IP (25%) and VC (23%) interpretation, due to more errors of omission (p<0.001) and answers for patient or clinician (p<0.001). Mean number of errors per visit was 27, with 7.1% of errors rated as moderately/highly clinically significant. In adjusted models, the odds of inaccurate interpretation were lower for IP (OR = −1.25, 95% CI −1.56, −0.95) and VC (OR = −1.05; 95% CI −1.26, −0.84) than for AH interpreted visits; the odds of a moderately/highly clinically significant error were lower for IP (OR = −0.06; 95% CI −1.05, 0.92) than for AH interpreted visits. Conclusions Inaccurate language interpretation in medical encounters is common and more frequent when untrained interpreters are used compared to professional in-person or via videoconferencing. Professional video conferencing interpretation may increase access to higher quality medical interpretation services. PMID:26465121

Sleep quality, posttraumatic stress, depression, and human errors in train drivers: a population-based nationwide study in South Korea.

PubMed

Jeon, Hong Jin; Kim, Ji-Hae; Kim, Bin-Na; Park, Seung Jin; Fava, Maurizio; Mischoulon, David; Kang, Eun-Ho; Roh, Sungwon; Lee, Dongsoo

2014-12-01

Human error is defined as an unintended error that is attributable to humans rather than machines, and that is important to avoid to prevent accidents. We aimed to investigate the association between sleep quality and human errors among train drivers. Cross-sectional. Population-based. A sample of 5,480 subjects who were actively working as train drivers were recruited in South Korea. The participants were 4,634 drivers who completed all questionnaires (response rate 84.6%). None. The Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), the Impact of Event Scale-Revised (IES-R), the State-Trait Anxiety Inventory (STAI), and the Korean Occupational Stress Scale (KOSS). Of 4,634 train drivers, 349 (7.5%) showed more than one human error per 5 y. Human errors were associated with poor sleep quality, higher PSQI total scores, short sleep duration at night, and longer sleep latency. Among train drivers with poor sleep quality, those who experienced severe posttraumatic stress showed a significantly higher number of human errors than those without. Multiple logistic regression analysis showed that human errors were significantly associated with poor sleep quality and posttraumatic stress, whereas there were no significant associations with depression, trait and state anxiety, and work stress after adjusting for age, sex, education years, marital status, and career duration. Poor sleep quality was found to be associated with more human errors in train drivers, especially in those who experienced severe posttraumatic stress. © 2014 Associated Professional Sleep Societies, LLC.

Reduction in Hospital-Wide Clinical Laboratory Specimen Identification Errors following Process Interventions: A 10-Year Retrospective Observational Study

PubMed Central

Ning, Hsiao-Chen; Lin, Chia-Ni; Chiu, Daniel Tsun-Yee; Chang, Yung-Ta; Wen, Chiao-Ni; Peng, Shu-Yu; Chu, Tsung-Lan; Yu, Hsin-Ming; Wu, Tsu-Lan

2016-01-01

Background Accurate patient identification and specimen labeling at the time of collection are crucial steps in the prevention of medical errors, thereby improving patient safety. Methods All patient specimen identification errors that occurred in the outpatient department (OPD), emergency department (ED), and inpatient department (IPD) of a 3,800-bed academic medical center in Taiwan were documented and analyzed retrospectively from 2005 to 2014. To reduce such errors, the following series of strategies were implemented: a restrictive specimen acceptance policy for the ED and IPD in 2006; a computer-assisted barcode positive patient identification system for the ED and IPD in 2007 and 2010, and automated sample labeling combined with electronic identification systems introduced to the OPD in 2009. Results Of the 2000345 specimens collected in 2005, 1023 (0.0511%) were identified as having patient identification errors, compared with 58 errors (0.0015%) among 3761238 specimens collected in 2014, after serial interventions; this represents a 97% relative reduction. The total number (rate) of institutional identification errors contributed from the ED, IPD, and OPD over a 10-year period were 423 (0.1058%), 556 (0.0587%), and 44 (0.0067%) errors before the interventions, and 3 (0.0007%), 52 (0.0045%) and 3 (0.0001%) after interventions, representing relative 99%, 92% and 98% reductions, respectively. Conclusions Accurate patient identification is a challenge of patient safety in different health settings. The data collected in our study indicate that a restrictive specimen acceptance policy, computer-generated positive identification systems, and interdisciplinary cooperation can significantly reduce patient identification errors. PMID:27494020

[Prospective study in 2 hospitals].

PubMed

Jiménez-Buñuales, M T; Martínez-Sáenz, M S; González-Diego, P; Vallejo-García, M; Gallardo-Anciano, J; Cestafe-Martínez, A

2016-06-01

The purpose of this study is to know the incidence rate of medication reconciliation at admission and discharge in patients of La Rioja and to improve the patient safety on medication reconciliation. An observational prospective study, part of the Joint Action PaSQ, Work Package 5, European Union Network for Patient Safety and Quality of Care. The study has taken into account the definitions of the Institute for Safe Medication Practices. Any unintended discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a reconciliation error. A total of 750 patients were included, 9 (1.2%) of whom showed at least one discrepancy. The patients had a total of 3,156 mediations registered: 2,313 prescriptions (73.4%) showed no differences, while 821 prescriptions (26%) were intended discrepancies and 21 prescriptions (0.6%) unintended discrepancies were considered by the physician as reconciliation errors. A percentage of 1.2 of the patients, which represents 0.6% of the medicines (one in 166 medications registered) had reconciliation errors during their hospital stay. A proceeding has been implemented by means of the physician doing the medication reconciliation and reviewing it with the help of a medication reconciliation form. The medication reconciliation is a priority strategic objective to improve the safety of patients. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

Impact of patient-specific factors, irradiated left ventricular volume, and treatment set-up errors on the development of myocardial perfusion defects after radiation therapy for left-sided breast cancer

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

Evans, Elizabeth S.; Prosnitz, Robert G.; Yu Xiaoli

2006-11-15

Purpose: The aim of this study was to assess the impact of patient-specific factors, left ventricle (LV) volume, and treatment set-up errors on the rate of perfusion defects 6 to 60 months post-radiation therapy (RT) in patients receiving tangential RT for left-sided breast cancer. Methods and Materials: Between 1998 and 2005, a total of 153 patients were enrolled onto an institutional review board-approved prospective study and had pre- and serial post-RT (6-60 months) cardiac perfusion scans to assess for perfusion defects. Of the patients, 108 had normal pre-RT perfusion scans and available follow-up data. The impact of patient-specific factors onmore » the rate of perfusion defects was assessed at various time points using univariate and multivariate analysis. The impact of set-up errors on the rate of perfusion defects was also analyzed using a one-tailed Fisher's Exact test. Results: Consistent with our prior results, the volume of LV in the RT field was the most significant predictor of perfusion defects on both univariate (p = 0.0005 to 0.0058) and multivariate analysis (p = 0.0026 to 0.0029). Body mass index (BMI) was the only significant patient-specific factor on both univariate (p = 0.0005 to 0.022) and multivariate analysis (p = 0.0091 to 0.05). In patients with very small volumes of LV in the planned RT fields, the rate of perfusion defects was significantly higher when the fields set-up 'too deep' (83% vs. 30%, p = 0.059). The frequency of deep set-up errors was significantly higher among patients with BMI {>=}25 kg/m{sup 2} compared with patients of normal weight (47% vs. 28%, p = 0.068). Conclusions: BMI {>=}25 kg/m{sup 2} may be a significant risk factor for cardiac toxicity after RT for left-sided breast cancer, possibly because of more frequent deep set-up errors resulting in the inclusion of additional heart in the RT fields. Further study is necessary to better understand the impact of patient-specific factors and set-up errors on the development of RT-induced perfusion defects.« less

An error criterion for determining sampling rates in closed-loop control systems

NASA Technical Reports Server (NTRS)

Brecher, S. M.

1972-01-01

The determination of an error criterion which will give a sampling rate for adequate performance of linear, time-invariant closed-loop, discrete-data control systems was studied. The proper modelling of the closed-loop control system for characterization of the error behavior, and the determination of an absolute error definition for performance of the two commonly used holding devices are discussed. The definition of an adequate relative error criterion as a function of the sampling rate and the parameters characterizing the system is established along with the determination of sampling rates. The validity of the expressions for the sampling interval was confirmed by computer simulations. Their application solves the problem of making a first choice in the selection of sampling rates.

Unacceptably High Error Rates in Vitek 2 Testing of Cefepime Susceptibility in Extended-Spectrum-β-Lactamase-Producing Escherichia coli

PubMed Central

Rhodes, Nathaniel J.; Richardson, Chad L.; Heraty, Ryan; Liu, Jiajun; Malczynski, Michael; Qi, Chao

2014-01-01

While a lack of concordance is known between gold standard MIC determinations and Vitek 2, the magnitude of the discrepancy and its impact on treatment decisions for extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli are not. Clinical isolates of ESBL-producing E. coli were collected from blood, tissue, and body fluid samples from January 2003 to July 2009. Resistance genotypes were identified by PCR. Primary analyses evaluated the discordance between Vitek 2 and gold standard methods using cefepime susceptibility breakpoint cutoff values of 8, 4, and 2 μg/ml. The discrepancies in MICs between the methods were classified per convention as very major, major, and minor errors. Sensitivity, specificity, and positive and negative predictive values for susceptibility classifications were calculated. A total of 304 isolates were identified; 59% (179) of the isolates carried blaCTX-M, 47% (143) carried blaTEM, and 4% (12) carried blaSHV. At a breakpoint MIC of 8 μg/ml, Vitek 2 produced a categorical agreement of 66.8% and exhibited very major, major, and minor error rates of 23% (20/87 isolates), 5.1% (8/157 isolates), and 24% (73/304), respectively. The sensitivity, specificity, and positive and negative predictive values for a susceptibility breakpoint of 8 μg/ml were 94.9%, 61.2%, 72.3%, and 91.8%, respectively. The sensitivity, specificity, and positive and negative predictive values for a susceptibility breakpoint of 2 μg/ml were 83.8%, 65.3%, 41%, and 93.3%, respectively. Vitek 2 results in unacceptably high error rates for cefepime compared to those of agar dilution for ESBL-producing E. coli. Clinicians should be wary of making treatment decisions on the basis of Vitek 2 susceptibility results for ESBL-producing E. coli. PMID:24752253

PROTECTED-UK - Clinical pharmacist interventions in the UK critical care unit: exploration of relationship between intervention, service characteristics and experience level.

PubMed

Rudall, Nicola; McKenzie, Catherine; Landa, June; Bourne, Richard S; Bates, Ian; Shulman, Rob

2017-08-01

Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort, a multi-site critical care interventions study, were further analysed to assess effects of: time on critical care, number of interventions, CP expertise and days of week, on impact of intervention and ultimately contribution to patient care. Intervention data were collected from 21 adult critical care units over 14 days. Interventions could be error, optimisation or consults, and were blind-coded to ensure consistency, prior to bivariate analysis. Pharmacy service demographics were further collated by investigator survey. Of the 20 758 prescriptions reviewed, 3375 interventions were made (intervention rate 16.1%). CPs spent 3.5 h per day (mean, ±SD 1.7) on direct patient care, reviewed 10.3 patients per day (±SD 4.2) and required 22.5 min (±SD 9.5) per review. Intervention rate had a moderate inverse correlation with the time the pharmacist spent on critical care (P = 0.05; r = 0.4). Optimisation rate had a strong inverse association with total number of prescriptions reviewed per day (P = 0.001; r = 0.7). A consultant CP had a moderate inverse correlation with number of errors identified (P = 0.008; r = 0.6). No correlation existed between the presence of electronic prescribing in critical care and any intervention rate. Few centres provided weekend services, although the intervention rate was significantly higher on weekends than weekdays. A CP is essential for safe and optimised patient medication therapy; an extended and developed pharmacy service is expected to reduce errors. CP services should be adequately staffed to enable adequate time for prescription review and maximal therapy optimisation. © 2016 Royal Pharmaceutical Society.

Technological Advancements and Error Rates in Radiation Therapy Delivery

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

Margalit, Danielle N., E-mail: dmargalit@partners.org; Harvard Cancer Consortium and Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA; Chen, Yu-Hui

2011-11-15

Purpose: Technological advances in radiation therapy (RT) delivery have the potential to reduce errors via increased automation and built-in quality assurance (QA) safeguards, yet may also introduce new types of errors. Intensity-modulated RT (IMRT) is an increasingly used technology that is more technically complex than three-dimensional (3D)-conformal RT and conventional RT. We determined the rate of reported errors in RT delivery among IMRT and 3D/conventional RT treatments and characterized the errors associated with the respective techniques to improve existing QA processes. Methods and Materials: All errors in external beam RT delivery were prospectively recorded via a nonpunitive error-reporting system atmore » Brigham and Women's Hospital/Dana Farber Cancer Institute. Errors are defined as any unplanned deviation from the intended RT treatment and are reviewed during monthly departmental quality improvement meetings. We analyzed all reported errors since the routine use of IMRT in our department, from January 2004 to July 2009. Fisher's exact test was used to determine the association between treatment technique (IMRT vs. 3D/conventional) and specific error types. Effect estimates were computed using logistic regression. Results: There were 155 errors in RT delivery among 241,546 fractions (0.06%), and none were clinically significant. IMRT was commonly associated with errors in machine parameters (nine of 19 errors) and data entry and interpretation (six of 19 errors). IMRT was associated with a lower rate of reported errors compared with 3D/conventional RT (0.03% vs. 0.07%, p = 0.001) and specifically fewer accessory errors (odds ratio, 0.11; 95% confidence interval, 0.01-0.78) and setup errors (odds ratio, 0.24; 95% confidence interval, 0.08-0.79). Conclusions: The rate of errors in RT delivery is low. The types of errors differ significantly between IMRT and 3D/conventional RT, suggesting that QA processes must be uniquely adapted for each technique. There was a lower error rate with IMRT compared with 3D/conventional RT, highlighting the need for sustained vigilance against errors common to more traditional treatment techniques.« less

Error Rate Comparison during Polymerase Chain Reaction by DNA Polymerase

DOE PAGES

McInerney, Peter; Adams, Paul; Hadi, Masood Z.

2014-01-01

As larger-scale cloning projects become more prevalent, there is an increasing need for comparisons among high fidelity DNA polymerases used for PCR amplification. All polymerases marketed for PCR applications are tested for fidelity properties (i.e., error rate determination) by vendors, and numerous literature reports have addressed PCR enzyme fidelity. Nonetheless, it is often difficult to make direct comparisons among different enzymes due to numerous methodological and analytical differences from study to study. We have measured the error rates for 6 DNA polymerases commonly used in PCR applications, including 3 polymerases typically used for cloning applications requiring high fidelity. Error ratemore » measurement values reported here were obtained by direct sequencing of cloned PCR products. The strategy employed here allows interrogation of error rate across a very large DNA sequence space, since 94 unique DNA targets were used as templates for PCR cloning. The six enzymes included in the study, Taq polymerase, AccuPrime-Taq High Fidelity, KOD Hot Start, cloned Pfu polymerase, Phusion Hot Start, and Pwo polymerase, we find the lowest error rates with Pfu , Phusion, and Pwo polymerases. Error rates are comparable for these 3 enzymes and are >10x lower than the error rate observed with Taq polymerase. Mutation spectra are reported, with the 3 high fidelity enzymes displaying broadly similar types of mutations. For these enzymes, transition mutations predominate, with little bias observed for type of transition.« less

Implementation of bayesian model averaging on the weather data forecasting applications utilizing open weather map

NASA Astrophysics Data System (ADS)

Rahmat, R. F.; Nasution, F. R.; Seniman; Syahputra, M. F.; Sitompul, O. S.

2018-02-01

Weather is condition of air in a certain region at a relatively short period of time, measured with various parameters such as; temperature, air preasure, wind velocity, humidity and another phenomenons in the atmosphere. In fact, extreme weather due to global warming would lead to drought, flood, hurricane and other forms of weather occasion, which directly affects social andeconomic activities. Hence, a forecasting technique is to predict weather with distinctive output, particullary mapping process based on GIS with information about current weather status in certain cordinates of each region with capability to forecast for seven days afterward. Data used in this research are retrieved in real time from the server openweathermap and BMKG. In order to obtain a low error rate and high accuracy of forecasting, the authors use Bayesian Model Averaging (BMA) method. The result shows that the BMA method has good accuracy. Forecasting error value is calculated by mean square error shows (MSE). The error value emerges at minumum temperature rated at 0.28 and maximum temperature rated at 0.15. Meanwhile, the error value of minimum humidity rates at 0.38 and the error value of maximum humidity rates at 0.04. Afterall, the forecasting error rate of wind speed is at 0.076. The lower the forecasting error rate, the more optimized the accuracy is.

Type I error rates of rare single nucleotide variants are inflated in tests of association with non-normally distributed traits using simple linear regression methods.

PubMed

Schwantes-An, Tae-Hwi; Sung, Heejong; Sabourin, Jeremy A; Justice, Cristina M; Sorant, Alexa J M; Wilson, Alexander F

2016-01-01

In this study, the effects of (a) the minor allele frequency of the single nucleotide variant (SNV), (b) the degree of departure from normality of the trait, and (c) the position of the SNVs on type I error rates were investigated in the Genetic Analysis Workshop (GAW) 19 whole exome sequence data. To test the distribution of the type I error rate, 5 simulated traits were considered: standard normal and gamma distributed traits; 2 transformed versions of the gamma trait (log 10 and rank-based inverse normal transformations); and trait Q1 provided by GAW 19. Each trait was tested with 313,340 SNVs. Tests of association were performed with simple linear regression and average type I error rates were determined for minor allele frequency classes. Rare SNVs (minor allele frequency < 0.05) showed inflated type I error rates for non-normally distributed traits that increased as the minor allele frequency decreased. The inflation of average type I error rates increased as the significance threshold decreased. Normally distributed traits did not show inflated type I error rates with respect to the minor allele frequency for rare SNVs. There was no consistent effect of transformation on the uniformity of the distribution of the location of SNVs with a type I error.

Comparison of water production rates from UV spectroscopy and visual magnitudes for some recent comets

NASA Technical Reports Server (NTRS)

Roettger, E. E.; Feldman, P. D.; A'Hearn, M. F.; Festou, M. C.

1990-01-01

IUE data on the UV and visible coma emissions of the comets Bradfield, P/Tempel 2, Wilson, and P/Halley, are presently compared with the visual lightcurves from magnitudes reported in the IAU circulars to consider the temporal evolution of these comets. While the water-production rates obtainable from visual magnitudes on the basis of Newburn's (1984) method are consistent with OH-derived rates to first order, they are sometimes either displaced or unable to exhibit the same pre/postperihelion asymmetry. The best agreement is obtained for the relatively dust-free Comet P/Tempel 2. IUE Fine Error Sensor lightcurves are generally in agreement with curves based on total visual magnitude.

Total ozone trend significance from space time variability of daily Dobson data

NASA Technical Reports Server (NTRS)

Wilcox, R. W.

1981-01-01

Estimates of standard errors of total ozone time and area means, as derived from ozone's natural temporal and spatial variability and autocorrelation in middle latitudes determined from daily Dobson data are presented. Assessing the significance of apparent total ozone trends is equivalent to assessing the standard error of the means. Standard errors of time averages depend on the temporal variability and correlation of the averaged parameter. Trend detectability is discussed, both for the present network and for satellite measurements.

How many mailouts? Could attempts to increase the response rate in the Iraq war cohort study be counterproductive?

PubMed Central

Tate, A Rosemary; Jones, Margaret; Hull, Lisa; Fear, Nicola T; Rona, Roberto; Wessely, Simon; Hotopf, Matthew

2007-01-01

Background Low response and reporting errors are major concerns for survey epidemiologists. However, while nonresponse is commonly investigated, the effects of misclassification are often ignored, possibly because they are hard to quantify. We investigate both sources of bias in a recent study of the effects of deployment to the 2003 Iraq war on the health of UK military personnel, and attempt to determine whether improving response rates by multiple mailouts was associated with increased misclassification error and hence increased bias in the results. Methods Data for 17,162 UK military personnel were used to determine factors related to response and inverse probability weights were used to assess nonresponse bias. The percentages of inconsistent and missing answers to health questions from the 10,234 responders were used as measures of misclassification in a simulation of the 'true' relative risks that would have been observed if misclassification had not been present. Simulated and observed relative risks of multiple physical symptoms and post-traumatic stress disorder (PTSD) were compared across response waves (number of contact attempts). Results Age, rank, gender, ethnic group, enlistment type (regular/reservist) and contact address (military or civilian), but not fitness, were significantly related to response. Weighting for nonresponse had little effect on the relative risks. Of the respondents, 88% had responded by wave 2. Missing answers (total 3%) increased significantly (p < 0.001) between waves 1 and 4 from 2.4% to 7.3%, and the percentage with discrepant answers (total 14%) increased from 12.8% to 16.3% (p = 0.007). However, the adjusted relative risks decreased only slightly from 1.24 to 1.22 for multiple physical symptoms and from 1.12 to 1.09 for PTSD, and showed a similar pattern to those simulated. Conclusion Bias due to nonresponse appears to be small in this study, and increasing the response rates had little effect on the results. Although misclassification is difficult to assess, the results suggest that bias due to reporting errors could be greater than bias caused by nonresponse. Resources might be better spent on improving and validating the data, rather than on increasing the response rate. PMID:18045472

IMRT QA: Selecting gamma criteria based on error detection sensitivity

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

Steers, Jennifer M.; Fraass, Benedick A., E-mail: benedick.fraass@cshs.org

Purpose: The gamma comparison is widely used to evaluate the agreement between measurements and treatment planning system calculations in patient-specific intensity modulated radiation therapy (IMRT) quality assurance (QA). However, recent publications have raised concerns about the lack of sensitivity when employing commonly used gamma criteria. Understanding the actual sensitivity of a wide range of different gamma criteria may allow the definition of more meaningful gamma criteria and tolerance limits in IMRT QA. We present a method that allows the quantitative determination of gamma criteria sensitivity to induced errors which can be applied to any unique combination of device, delivery technique,more » and software utilized in a specific clinic. Methods: A total of 21 DMLC IMRT QA measurements (ArcCHECK®, Sun Nuclear) were compared to QA plan calculations with induced errors. Three scenarios were studied: MU errors, multi-leaf collimator (MLC) errors, and the sensitivity of the gamma comparison to changes in penumbra width. Gamma comparisons were performed between measurements and error-induced calculations using a wide range of gamma criteria, resulting in a total of over 20 000 gamma comparisons. Gamma passing rates for each error class and case were graphed against error magnitude to create error curves in order to represent the range of missed errors in routine IMRT QA using 36 different gamma criteria. Results: This study demonstrates that systematic errors and case-specific errors can be detected by the error curve analysis. Depending on the location of the error curve peak (e.g., not centered about zero), 3%/3 mm threshold = 10% at 90% pixels passing may miss errors as large as 15% MU errors and ±1 cm random MLC errors for some cases. As the dose threshold parameter was increased for a given %Diff/distance-to-agreement (DTA) setting, error sensitivity was increased by up to a factor of two for select cases. This increased sensitivity with increasing dose threshold was consistent across all studied combinations of %Diff/DTA. Criteria such as 2%/3 mm and 3%/2 mm with a 50% threshold at 90% pixels passing are shown to be more appropriately sensitive without being overly strict. However, a broadening of the penumbra by as much as 5 mm in the beam configuration was difficult to detect with commonly used criteria, as well as with the previously mentioned criteria utilizing a threshold of 50%. Conclusions: We have introduced the error curve method, an analysis technique which allows the quantitative determination of gamma criteria sensitivity to induced errors. The application of the error curve method using DMLC IMRT plans measured on the ArcCHECK® device demonstrated that large errors can potentially be missed in IMRT QA with commonly used gamma criteria (e.g., 3%/3 mm, threshold = 10%, 90% pixels passing). Additionally, increasing the dose threshold value can offer dramatic increases in error sensitivity. This approach may allow the selection of more meaningful gamma criteria for IMRT QA and is straightforward to apply to other combinations of devices and treatment techniques.« less

Authentication of the botanical and geographical origin of honey by mid-infrared spectroscopy.

PubMed

Ruoff, Kaspar; Luginbühl, Werner; Künzli, Raphael; Iglesias, María Teresa; Bogdanov, Stefan; Bosset, Jacques Olivier; von der Ohe, Katharina; von der Ohe, Werner; Amado, Renato

2006-09-06

The potential of Fourier transform mid-infrared spectroscopy (FT-MIR) using an attenuated total reflectance (ATR) cell was evaluated for the authentication of 11 unifloral (acacia, alpine rose, chestnut, dandelion, heather, lime, rape, fir honeydew, metcalfa honeydew, oak honeydew) and polyfloral honey types (n = 411 samples) previously classified with traditional methods such as chemical, pollen, and sensory analysis. Chemometric evaluation of the spectra was carried out by applying principal component analysis and linear discriminant analysis, the error rates of the discriminant models being calculated by using Bayes' theorem. The error rates ranged from <0.1% (polyfloral and heather honeys as well as honeydew honeys from metcalfa, oak, and fir) to 8.3% (alpine rose honey) in both jackknife classification and validation, depending on the honey type considered. This study indicates that ATR-MIR spectroscopy is a valuable tool for the authentication of the botanical origin and quality control and may also be useful for the determination of the geographical origin of honey.

On the error in crop acreage estimation using satellite (LANDSAT) data

NASA Technical Reports Server (NTRS)

Chhikara, R. (Principal Investigator)

1983-01-01

The problem of crop acreage estimation using satellite data is discussed. Bias and variance of a crop proportion estimate in an area segment obtained from the classification of its multispectral sensor data are derived as functions of the means, variances, and covariance of error rates. The linear discriminant analysis and the class proportion estimation for the two class case are extended to include a third class of measurement units, where these units are mixed on ground. Special attention is given to the investigation of mislabeling in training samples and its effect on crop proportion estimation. It is shown that the bias and variance of the estimate of a specific crop acreage proportion increase as the disparity in mislabeling rates between two classes increases. Some interaction is shown to take place, causing the bias and the variance to decrease at first and then to increase, as the mixed unit class varies in size from 0 to 50 percent of the total area segment.

Approximation of Bit Error Rates in Digital Communications

DTIC Science & Technology

2007-06-01

and Technology Organisation DSTO—TN—0761 ABSTRACT This report investigates the estimation of bit error rates in digital communi- cations, motivated by...recent work in [6]. In the latter, bounds are used to construct estimates for bit error rates in the case of differentially coherent quadrature phase

A novel color vision test for detection of diabetic macular edema.

PubMed

Shin, Young Joo; Park, Kyu Hyung; Hwang, Jeong-Min; Wee, Won Ryang; Lee, Jin Hak; Lee, In Bum; Hyon, Joon Young

2014-01-02

To determine the sensitivity of the Seoul National University (SNU) computerized color vision test for detecting diabetic macular edema. From May to September 2003, a total of 73 eyes of 73 patients with diabetes mellitus were examined using the SNU computerized color vision test and optical coherence tomography (OCT). Color deficiency was quantified as the total error score on the SNU test and as error scores for each of four color quadrants corresponding to yellows (Q1), greens (Q2), blues (Q3), and reds (Q4). SNU error scores were assessed as a function of OCT foveal thickness and total macular volume (TMV). The error scores in Q1, Q2, Q3, and Q4 measured by the SNU color vision test increased with foveal thickness (P < 0.05), whereas they were not correlated with TMV. Total error scores, the summation of Q1 and Q3, the summation of Q2 and Q4, and blue-yellow (B-Y) error scores were significantly correlated with foveal thickness (P < 0.05), but not with TMV. The observed correlation between SNU color test error scores and foveal thickness indicates that the SNU test may be useful for detection and monitoring of diabetic macular edema.

An intercomparison of multidecadal observational and reanalysis data sets for global total ozone trends and variability analysis

NASA Astrophysics Data System (ADS)

Bai, Kaixu; Chang, Ni-Bin; Shi, Runhe; Yu, Huijia; Gao, Wei

2017-07-01

A four-step adaptive ozone trend estimation scheme is proposed by integrating multivariate linear regression (MLR) and ensemble empirical mode decomposition (EEMD) to analyze the long-term variability of total column ozone from a set of four observational and reanalysis total ozone data sets, including the rarely explored ERA-Interim total ozone reanalysis, from 1979 to 2009. Consistency among the four data sets was first assessed, indicating a mean relative difference of 1% and root-mean-square error around 2% on average, with respect to collocated ground-based total ozone observations. Nevertheless, large drifts with significant spatiotemporal inhomogeneity were diagnosed in ERA-Interim after 1995. To emphasize long-term trends, natural ozone variations associated with the solar cycle, quasi-biennial oscillation, volcanic aerosols, and El Niño-Southern Oscillation were modeled with MLR and then removed from each total ozone record, respectively, before performing EEMD analyses. The resulting rates of change estimated from the proposed scheme captured the long-term ozone variability well, with an inflection time of 2000 clearly detected. The positive rates of change after 2000 suggest that the ozone layer seems to be on a healing path, but the results are still inadequate to conclude an actual recovery of the ozone layer, and more observational evidence is needed. Further investigations suggest that biases embedded in total ozone records may significantly impact ozone trend estimations by resulting in large uncertainty or even negative rates of change after 2000.

Restrictions on surgical resident shift length does not impact type of medical errors.

PubMed

Anderson, Jamie E; Goodman, Laura F; Jensen, Guy W; Salcedo, Edgardo S; Galante, Joseph M

2017-05-15

In 2011, resident duty hours were restricted in an attempt to improve patient safety and resident education. With the goal of reducing fatigue, shorter shift length leads to more patient handoffs, raising concerns about adverse effects on patient safety. This study seeks to determine whether differences in duty-hour restrictions influence types of errors made by residents. This is a nested retrospective cohort study at a surgery department in an academic medical center. During 2013-14, standard 2011 duty hours were in place for residents. In 2014-15, duty-hour restrictions at the study site were relaxed ("flexible") with no restrictions on shift length. We reviewed all morbidity and mortality submissions from July 1, 2013-June 30, 2015 and compared differences in types of errors between these periods. A total of 383 patients experienced adverse events, including 59 deaths (15.4%). Comparing standard versus flexible periods, there was no difference in mortality (15.7% versus 12.6%, P = 0.479) or complication rates (2.6% versus 2.5%, P = 0.696). There was no difference in types of errors between periods (P = 0.050-0.808). The most number of errors were due to cognitive failures (229, 59.6%), whereas the fewest number of errors were due to team failure (127, 33.2%). By subset, technical errors resulted in the highest number of errors (169, 44.1%). There were no differences between types of errors of cases that were nonelective, at night, or involving residents. Among adverse events reported in this departmental surgical morbidity and mortality, there were no differences in types of errors when resident duty hours were less restrictive. Copyright © 2017 Elsevier Inc. All rights reserved.

Analysis of the effects of Eye-Tracker performance on the pulse positioning errors during refractive surgery☆

PubMed Central

Arba-Mosquera, Samuel; Aslanides, Ioannis M.

2012-01-01

Purpose To analyze the effects of Eye-Tracker performance on the pulse positioning errors during refractive surgery. Methods A comprehensive model, which directly considers eye movements, including saccades, vestibular, optokinetic, vergence, and miniature, as well as, eye-tracker acquisition rate, eye-tracker latency time, scanner positioning time, laser firing rate, and laser trigger delay have been developed. Results Eye-tracker acquisition rates below 100 Hz correspond to pulse positioning errors above 1.5 mm. Eye-tracker latency times to about 15 ms correspond to pulse positioning errors of up to 3.5 mm. Scanner positioning times to about 9 ms correspond to pulse positioning errors of up to 2 mm. Laser firing rates faster than eye-tracker acquisition rates basically duplicate pulse-positioning errors. Laser trigger delays to about 300 μs have minor to no impact on pulse-positioning errors. Conclusions The proposed model can be used for comparison of laser systems used for ablation processes. Due to the pseudo-random nature of eye movements, positioning errors of single pulses are much larger than observed decentrations in the clinical settings. There is no single parameter that ‘alone’ minimizes the positioning error. It is the optimal combination of the several parameters that minimizes the error. The results of this analysis are important to understand the limitations of correcting very irregular ablation patterns.

Failure analysis and modeling of a multicomputer system. M.S. Thesis

NASA Technical Reports Server (NTRS)

Subramani, Sujatha Srinivasan

1990-01-01

This thesis describes the results of an extensive measurement-based analysis of real error data collected from a 7-machine DEC VaxCluster multicomputer system. In addition to evaluating basic system error and failure characteristics, we develop reward models to analyze the impact of failures and errors on the system. The results show that, although 98 percent of errors in the shared resources recover, they result in 48 percent of all system failures. The analysis of rewards shows that the expected reward rate for the VaxCluster decreases to 0.5 in 100 days for a 3 out of 7 model, which is well over a 100 times that for a 7-out-of-7 model. A comparison of the reward rates for a range of k-out-of-n models indicates that the maximum increase in reward rate (0.25) occurs in going from the 6-out-of-7 model to the 5-out-of-7 model. The analysis also shows that software errors have the lowest reward (0.2 vs. 0.91 for network errors). The large loss in reward rate for software errors is due to the fact that a large proportion (94 percent) of software errors lead to failure. In comparison, the high reward rate for network errors is due to fast recovery from a majority of these errors (median recovery duration is 0 seconds).

Energy-Efficient Querying of Wireless Sensor Networks

DTIC Science & Technology

2007-09-01

will fail to locate the desired information. Depending on the rate of node movement , this data exchange will be costly in terms of total network...nodes is best accomplished using a small time window to reduce errors introduced by the node’s movement (i.e., older measurements are less likely to...embedded processor or input from upper layer applications,” nodes which detect their own movement transmit an alert signal over a “wake-up” channel

Forensic comparison and matching of fingerprints: using quantitative image measures for estimating error rates through understanding and predicting difficulty.

PubMed

Kellman, Philip J; Mnookin, Jennifer L; Erlikhman, Gennady; Garrigan, Patrick; Ghose, Tandra; Mettler, Everett; Charlton, David; Dror, Itiel E

2014-01-01

Latent fingerprint examination is a complex task that, despite advances in image processing, still fundamentally depends on the visual judgments of highly trained human examiners. Fingerprints collected from crime scenes typically contain less information than fingerprints collected under controlled conditions. Specifically, they are often noisy and distorted and may contain only a portion of the total fingerprint area. Expertise in fingerprint comparison, like other forms of perceptual expertise, such as face recognition or aircraft identification, depends on perceptual learning processes that lead to the discovery of features and relations that matter in comparing prints. Relatively little is known about the perceptual processes involved in making comparisons, and even less is known about what characteristics of fingerprint pairs make particular comparisons easy or difficult. We measured expert examiner performance and judgments of difficulty and confidence on a new fingerprint database. We developed a number of quantitative measures of image characteristics and used multiple regression techniques to discover objective predictors of error as well as perceived difficulty and confidence. A number of useful predictors emerged, and these included variables related to image quality metrics, such as intensity and contrast information, as well as measures of information quantity, such as the total fingerprint area. Also included were configural features that fingerprint experts have noted, such as the presence and clarity of global features and fingerprint ridges. Within the constraints of the overall low error rates of experts, a regression model incorporating the derived predictors demonstrated reasonable success in predicting objective difficulty for print pairs, as shown both in goodness of fit measures to the original data set and in a cross validation test. The results indicate the plausibility of using objective image metrics to predict expert performance and subjective assessment of difficulty in fingerprint comparisons.

Convergence behavior of the random phase approximation renormalized correlation energy

NASA Astrophysics Data System (ADS)

Bates, Jefferson E.; Sensenig, Jonathon; Ruzsinszky, Adrienn

2017-05-01

Based on the random phase approximation (RPA), RPA renormalization [J. E. Bates and F. Furche, J. Chem. Phys. 139, 171103 (2013), 10.1063/1.4827254] is a robust many-body perturbation theory that works for molecules and materials because it does not diverge as the Kohn-Sham gap approaches zero. Additionally, RPA renormalization enables the simultaneous calculation of RPA and beyond-RPA correlation energies since the total correlation energy is the sum of a series of independent contributions. The first-order approximation (RPAr1) yields the dominant beyond-RPA contribution to the correlation energy for a given exchange-correlation kernel, but systematically underestimates the total beyond-RPA correction. For both the homogeneous electron gas model and real systems, we demonstrate numerically that RPA renormalization beyond first order converges monotonically to the infinite-order beyond-RPA correlation energy for several model exchange-correlation kernels and that the rate of convergence is principally determined by the choice of the kernel and spin polarization of the ground state. The monotonic convergence is rationalized from an analysis of the RPA renormalized correlation energy corrections, assuming the exchange-correlation kernel and response functions satisfy some reasonable conditions. For spin-unpolarized atoms, molecules, and bulk solids, we find that RPA renormalization is typically converged to 1 meV error or less by fourth order regardless of the band gap or dimensionality. Most spin-polarized systems converge at a slightly slower rate, with errors on the order of 10 meV at fourth order and typically requiring up to sixth order to reach 1 meV error or less. Slowest to converge, however, open-shell atoms present the most challenging case and require many higher orders to converge.

Total error shift patterns for daily CT on rails image-guided radiotherapy to the prostate bed

PubMed Central

2011-01-01

Background To evaluate the daily total error shift patterns on post-prostatectomy patients undergoing image guided radiotherapy (IGRT) with a diagnostic quality computer tomography (CT) on rails system. Methods A total of 17 consecutive post-prostatectomy patients receiving adjuvant or salvage IMRT using CT-on-rails IGRT were analyzed. The prostate bed's daily total error shifts were evaluated for a total of 661 CT scans. Results In the right-left, cranial-caudal, and posterior-anterior directions, 11.5%, 9.2%, and 6.5% of the 661 scans required no position adjustments; 75.3%, 66.1%, and 56.8% required a shift of 1 - 5 mm; 11.5%, 20.9%, and 31.2% required a shift of 6 - 10 mm; and 1.7%, 3.8%, and 5.5% required a shift of more than 10 mm, respectively. There was evidence of correlation between the x and y, x and z, and y and z axes in 3, 3, and 3 of 17 patients, respectively. Univariate (ANOVA) analysis showed that the total error pattern was random in the x, y, and z axis for 10, 5, and 2 of 17 patients, respectively, and systematic for the rest. Multivariate (MANOVA) analysis showed that the (x,y), (x,z), (y,z), and (x, y, z) total error pattern was random in 5, 1, 1, and 1 of 17 patients, respectively, and systematic for the rest. Conclusions The overall daily total error shift pattern for these 17 patients simulated with an empty bladder, and treated with CT on rails IGRT was predominantly systematic. Despite this, the temporal vector trends showed complex behaviors and unpredictable changes in magnitude and direction. These findings highlight the importance of using daily IGRT in post-prostatectomy patients. PMID:22024279

Angular Rate Optimal Design for the Rotary Strapdown Inertial Navigation System

PubMed Central

Yu, Fei; Sun, Qian

2014-01-01

Due to the characteristics of high precision for a long duration, the rotary strapdown inertial navigation system (RSINS) has been widely used in submarines and surface ships. Nowadays, the core technology, the rotating scheme, has been studied by numerous researchers. It is well known that as one of the key technologies, the rotating angular rate seriously influences the effectiveness of the error modulating. In order to design the optimal rotating angular rate of the RSINS, the relationship between the rotating angular rate and the velocity error of the RSINS was analyzed in detail based on the Laplace transform and the inverse Laplace transform in this paper. The analysis results showed that the velocity error of the RSINS depends on not only the sensor error, but also the rotating angular rate. In order to minimize the velocity error, the rotating angular rate of the RSINS should match the sensor error. One optimal design method for the rotating rate of the RSINS was also proposed in this paper. Simulation and experimental results verified the validity and superiority of this optimal design method for the rotating rate of the RSINS. PMID:24759115

Reverse Transcription Errors and RNA-DNA Differences at Short Tandem Repeats.

PubMed

Fungtammasan, Arkarachai; Tomaszkiewicz, Marta; Campos-Sánchez, Rebeca; Eckert, Kristin A; DeGiorgio, Michael; Makova, Kateryna D

2016-10-01

Transcript variation has important implications for organismal function in health and disease. Most transcriptome studies focus on assessing variation in gene expression levels and isoform representation. Variation at the level of transcript sequence is caused by RNA editing and transcription errors, and leads to nongenetically encoded transcript variants, or RNA-DNA differences (RDDs). Such variation has been understudied, in part because its detection is obscured by reverse transcription (RT) and sequencing errors. It has only been evaluated for intertranscript base substitution differences. Here, we investigated transcript sequence variation for short tandem repeats (STRs). We developed the first maximum-likelihood estimator (MLE) to infer RT error and RDD rates, taking next generation sequencing error rates into account. Using the MLE, we empirically evaluated RT error and RDD rates for STRs in a large-scale DNA and RNA replicated sequencing experiment conducted in a primate species. The RT error rates increased exponentially with STR length and were biased toward expansions. The RDD rates were approximately 1 order of magnitude lower than the RT error rates. The RT error rates estimated with the MLE from a primate data set were concordant with those estimated with an independent method, barcoded RNA sequencing, from a Caenorhabditis elegans data set. Our results have important implications for medical genomics, as STR allelic variation is associated with >40 diseases. STR nonallelic transcript variation can also contribute to disease phenotype. The MLE and empirical rates presented here can be used to evaluate the probability of disease-associated transcripts arising due to RDD. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Analysis and Compensation of Modulation Angular Rate Error Based on Missile-Borne Rotation Semi-Strapdown Inertial Navigation System.

PubMed

Zhang, Jiayu; Li, Jie; Zhang, Xi; Che, Xiaorui; Huang, Yugang; Feng, Kaiqiang

2018-05-04

The Semi-Strapdown Inertial Navigation System (SSINS) provides a new solution to attitude measurement of a high-speed rotating missile. However, micro-electro-mechanical-systems (MEMS) inertial measurement unit (MIMU) outputs are corrupted by significant sensor errors. In order to improve the navigation precision, a rotation modulation technology method called Rotation Semi-Strapdown Inertial Navigation System (RSSINS) is introduced into SINS. In fact, the stability of the modulation angular rate is difficult to achieve in a high-speed rotation environment. The changing rotary angular rate has an impact on the inertial sensor error self-compensation. In this paper, the influence of modulation angular rate error, including acceleration-deceleration process, and instability of the angular rate on the navigation accuracy of RSSINS is deduced and the error characteristics of the reciprocating rotation scheme are analyzed. A new compensation method is proposed to remove or reduce sensor errors so as to make it possible to maintain high precision autonomous navigation performance by MIMU when there is no external aid. Experiments have been carried out to validate the performance of the method. In addition, the proposed method is applicable for modulation angular rate error compensation under various dynamic conditions.

Measuring Data Quality Through a Source Data Verification Audit in a Clinical Research Setting.

PubMed

Houston, Lauren; Probst, Yasmine; Humphries, Allison

2015-01-01

Health data has long been scrutinised in relation to data quality and integrity problems. Currently, no internationally accepted or "gold standard" method exists measuring data quality and error rates within datasets. We conducted a source data verification (SDV) audit on a prospective clinical trial dataset. An audit plan was applied to conduct 100% manual verification checks on a 10% random sample of participant files. A quality assurance rule was developed, whereby if >5% of data variables were incorrect a second 10% random sample would be extracted from the trial data set. Error was coded: correct, incorrect (valid or invalid), not recorded or not entered. Audit-1 had a total error of 33% and audit-2 36%. The physiological section was the only audit section to have <5% error. Data not recorded to case report forms had the greatest impact on error calculations. A significant association (p=0.00) was found between audit-1 and audit-2 and whether or not data was deemed correct or incorrect. Our study developed a straightforward method to perform a SDV audit. An audit rule was identified and error coding was implemented. Findings demonstrate that monitoring data quality by a SDV audit can identify data quality and integrity issues within clinical research settings allowing quality improvement to be made. The authors suggest this approach be implemented for future research.

Effects of model error on control of large flexible space antenna with comparisons of decoupled and linear quadratic regulator control procedures

NASA Technical Reports Server (NTRS)

Hamer, H. A.; Johnson, K. G.

1986-01-01

An analysis was performed to determine the effects of model error on the control of a large flexible space antenna. Control was achieved by employing two three-axis control-moment gyros (CMG's) located on the antenna column. State variables were estimated by including an observer in the control loop that used attitude and attitude-rate sensors on the column. Errors were assumed to exist in the individual model parameters: modal frequency, modal damping, mode slope (control-influence coefficients), and moment of inertia. Their effects on control-system performance were analyzed either for (1) nulling initial disturbances in the rigid-body modes, or (2) nulling initial disturbances in the first three flexible modes. The study includes the effects on stability, time to null, and control requirements (defined as maximum torque and total momentum), as well as on the accuracy of obtaining initial estimates of the disturbances. The effects on the transients of the undisturbed modes are also included. The results, which are compared for decoupled and linear quadratic regulator (LQR) control procedures, are shown in tabular form, parametric plots, and as sample time histories of modal-amplitude and control responses. Results of the analysis showed that the effects of model errors on the control-system performance were generally comparable for both control procedures. The effect of mode-slope error was the most serious of all model errors.

Impact of an electronic medication administration record on medication administration efficiency and errors.

PubMed

McComas, Jeffery; Riingen, Michelle; Chae Kim, Son

2014-12-01

The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.

The development and validation of the clinicians' awareness towards cognitive errors (CATChES) in clinical decision making questionnaire tool.

PubMed

Chew, Keng Sheng; Kueh, Yee Cheng; Abdul Aziz, Adlihafizi

2017-03-21

Despite their importance on diagnostic accuracy, there is a paucity of literature on questionnaire tools to assess clinicians' awareness toward cognitive errors. A validation study was conducted to develop a questionnaire tool to evaluate the Clinician's Awareness Towards Cognitive Errors (CATChES) in clinical decision making. This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors. Content validation for both parts was first determined followed by construct validation for Part A. Construct validation for Part B was not determined as the responses were set in a dichotomous format. For content validation, all items in both Part A and Part B were rated as "excellent" in terms of their relevance in clinical settings. For construct validation using exploratory factor analysis (EFA) for Part A, a two-factor model with total variance extraction of 60% was determined. Two items were deleted. Then, the EFA was repeated showing that all factor loadings are above the cut-off value of >0.5. The Cronbach's alpha for both factors are above 0.6. The CATChES questionnaire tool is a valid questionnaire tool aimed to evaluate the awareness among clinicians toward cognitive errors in clinical decision making.

When do latent class models overstate accuracy for diagnostic and other classifiers in the absence of a gold standard?

PubMed

Spencer, Bruce D

2012-06-01

Latent class models are increasingly used to assess the accuracy of medical diagnostic tests and other classifications when no gold standard is available and the true state is unknown. When the latent class is treated as the true class, the latent class models provide measures of components of accuracy including specificity and sensitivity and their complements, type I and type II error rates. The error rates according to the latent class model differ from the true error rates, however, and empirical comparisons with a gold standard suggest the true error rates often are larger. We investigate conditions under which the true type I and type II error rates are larger than those provided by the latent class models. Results from Uebersax (1988, Psychological Bulletin 104, 405-416) are extended to accommodate random effects and covariates affecting the responses. The results are important for interpreting the results of latent class analyses. An error decomposition is presented that incorporates an error component from invalidity of the latent class model. © 2011, The International Biometric Society.

Estimating gene gain and loss rates in the presence of error in genome assembly and annotation using CAFE 3.

PubMed

Han, Mira V; Thomas, Gregg W C; Lugo-Martinez, Jose; Hahn, Matthew W

2013-08-01

Current sequencing methods produce large amounts of data, but genome assemblies constructed from these data are often fragmented and incomplete. Incomplete and error-filled assemblies result in many annotation errors, especially in the number of genes present in a genome. This means that methods attempting to estimate rates of gene duplication and loss often will be misled by such errors and that rates of gene family evolution will be consistently overestimated. Here, we present a method that takes these errors into account, allowing one to accurately infer rates of gene gain and loss among genomes even with low assembly and annotation quality. The method is implemented in the newest version of the software package CAFE, along with several other novel features. We demonstrate the accuracy of the method with extensive simulations and reanalyze several previously published data sets. Our results show that errors in genome annotation do lead to higher inferred rates of gene gain and loss but that CAFE 3 sufficiently accounts for these errors to provide accurate estimates of important evolutionary parameters.

The error in total error reduction.

PubMed

Witnauer, James E; Urcelay, Gonzalo P; Miller, Ralph R

2014-02-01

Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modeling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. Copyright © 2013 Elsevier Inc. All rights reserved.

Derivation of an analytic expression for the error associated with the noise reduction rating

NASA Astrophysics Data System (ADS)

Murphy, William J.

2005-04-01

Hearing protection devices are assessed using the Real Ear Attenuation at Threshold (REAT) measurement procedure for the purpose of estimating the amount of noise reduction provided when worn by a subject. The rating number provided on the protector label is a function of the mean and standard deviation of the REAT results achieved by the test subjects. If a group of subjects have a large variance, then it follows that the certainty of the rating should be correspondingly lower. No estimate of the error of a protector's rating is given by existing standards or regulations. Propagation of errors was applied to the Noise Reduction Rating to develop an analytic expression for the hearing protector rating error term. Comparison of the analytic expression for the error to the standard deviation estimated from Monte Carlo simulation of subject attenuations yielded a linear relationship across several protector types and assumptions for the variance of the attenuations.

Comparison of students from private and public schools on the spelling performance.

PubMed

Silva, Nathane Sanches Marques; Crenitte, Patrícia Abreu Pinheiro

2015-01-01

To compare the spelling ability of schoolchildren from the fourth to sixth grades of the elementary schools in the private and public schools of Bauru, São Paulo, and to verify whether errors are overcome as studies progress and the hierarchy of errors as to how often they occur. A dictation was applied to 384 schoolchildren: 206 from the private schools: 74 were at the fourth grade, 65 at the fifth grade, and 67 at the sixth grade; and 178 from the public schools; 56 at the fourth grade, 63 at the fifth grade, and 59 at the sixth grade of elementary school. Student's t test was used. In comparison of total spelling errors score, difference was found among the fourth and sixth grades of the private and public schools. Spelling errors decreased as education progressed, and those related to language irregularities were more common. Spelling ability and performance of students from the private and public schools are not similar in the fourth and sixth grades, but it is in the fifth grade. Spelling errors are gradually overcome as education progresses; however, this overcome rate was considerable between the fourth and fifth grades in the public schools. Decrease in the types of spelling errors follows a hierarchy of categories: phoneme/grapheme conversion, simple contextual rules, complex contextual rules, and language irregularities. Finally, the most common type of spelling error found was that related to language irregularities.

Errors in laboratory medicine: practical lessons to improve patient safety.

PubMed

Howanitz, Peter J

2005-10-01

Patient safety is influenced by the frequency and seriousness of errors that occur in the health care system. Error rates in laboratory practices are collected routinely for a variety of performance measures in all clinical pathology laboratories in the United States, but a list of critical performance measures has not yet been recommended. The most extensive databases describing error rates in pathology were developed and are maintained by the College of American Pathologists (CAP). These databases include the CAP's Q-Probes and Q-Tracks programs, which provide information on error rates from more than 130 interlaboratory studies. To define critical performance measures in laboratory medicine, describe error rates of these measures, and provide suggestions to decrease these errors, thereby ultimately improving patient safety. A review of experiences from Q-Probes and Q-Tracks studies supplemented with other studies cited in the literature. Q-Probes studies are carried out as time-limited studies lasting 1 to 4 months and have been conducted since 1989. In contrast, Q-Tracks investigations are ongoing studies performed on a yearly basis and have been conducted only since 1998. Participants from institutions throughout the world simultaneously conducted these studies according to specified scientific designs. The CAP has collected and summarized data for participants about these performance measures, including the significance of errors, the magnitude of error rates, tactics for error reduction, and willingness to implement each of these performance measures. A list of recommended performance measures, the frequency of errors when these performance measures were studied, and suggestions to improve patient safety by reducing these errors. Error rates for preanalytic and postanalytic performance measures were higher than for analytic measures. Eight performance measures were identified, including customer satisfaction, test turnaround times, patient identification, specimen acceptability, proficiency testing, critical value reporting, blood product wastage, and blood culture contamination. Error rate benchmarks for these performance measures were cited and recommendations for improving patient safety presented. Not only has each of the 8 performance measures proven practical, useful, and important for patient care, taken together, they also fulfill regulatory requirements. All laboratories should consider implementing these performance measures and standardizing their own scientific designs, data analysis, and error reduction strategies according to findings from these published studies.

Use of CCSDS and OSI Protocols on the Advanced Communications Technology Satellite

NASA Technical Reports Server (NTRS)

Chirieleison, Don

1996-01-01

Although ACTS (Advanced Communications Technology Satellite) provides an almost error-free channel during much of the day and under most conditions, there are times when it is not suitable for reliably error-free data communications when operating in the uncoded mode. Because coded operation is not always available to every earth station, measures must be taken in the end system to maintain adequate throughput when transferring data under adverse conditions. The most effective approach that we tested to improve performance was the addition of an 'outer' Reed-Solomon code through use of CCSDS (Consultative Committee for Space Data Systems) GOS 2 (a forward error correcting code). This addition can benefit all users of an ACTS channel including those applications that do not require totally reliable transport, but it is somewhat expensive because additional hardware is needed. Although we could not characterize the link noise statistically (it appeared to resemble uncorrelated white noise, the type that block codes are least effective in correcting), we did find that CCSDS GOS 2 gave an essentially error-free link at BER's (bit error rate) as high as 6x10(exp -4). For users that demand reliable transport, an ARQ (Automatic Repeat Queuing) protocol such as TCP (Transmission Control Protocol) or TP4 (Transport Protocol, Class 4) will probably be used. In this category, it comes as no surprise that the best choice of the protocol suites tested over ACTS was TP4 using CCSDS GOS 2. TP4 behaves very well over an error-free link which GOS 2 provides up to a point. Without forward error correction, however, TP4 service begins to degrade in the 10(exp -7)-10(exp -6) range and by 4x10(exp -6), it barely gives any throughput at all. If Congestion Avoidance is used in TP4, the degradation is even more pronounced. Fortunately, as demonstrated here, this effect can be more than compensated for by choosing the Selective Acknowledgment option. In fact, this option can enable TP4 to deliver some throughput at error rates as high as 10(exp -5).

An 802.11 n wireless local area network transmission scheme for wireless telemedicine applications.

PubMed

Lin, C F; Hung, S I; Chiang, I H

2010-10-01

In this paper, an 802.11 n transmission scheme is proposed for wireless telemedicine applications. IEEE 802.11n standards, a power assignment strategy, space-time block coding (STBC), and an object composition Petri net (OCPN) model are adopted. With the proposed wireless system, G.729 audio bit streams, Joint Photographic Experts Group 2000 (JPEG 2000) clinical images, and Moving Picture Experts Group 4 (MPEG-4) video bit streams achieve a transmission bit error rate (BER) of 10-7, 10-4, and 103 simultaneously. The proposed system meets the requirements prescribed for wireless telemedicine applications. An essential feature of this proposed transmission scheme is that clinical information that requires a high quality of service (QoS) is transmitted at a high power transmission rate with significant error protection. For maximizing resource utilization and minimizing the total transmission power, STBC and adaptive modulation techniques are used in the proposed 802.11 n wireless telemedicine system. Further, low power, direct mapping (DM), low-error protection scheme, and high-level modulation are adopted for messages that can tolerate a high BER. With the proposed transmission scheme, the required reliability of communication can be achieved. Our simulation results have shown that the proposed 802.11 n transmission scheme can be used for developing effective wireless telemedicine systems.

Single-sample method for the estimation of glomerular filtration rate in children

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

Tauxe, W.N.; Bagchi, A.; Tepe, P.G.

1987-03-01

A method for the determination of the glomerular filtration rate (GFR) in children which involves the use of a single-plasma sample (SPS) after the injection of a radioactive indicator such as radioiodine labeled diatrizoate (Hypaque) has been developed. This is analogous to previously published SPS techniques of effective renal plasma flow (ERPF) in adults and children and GFR SPS techniques in adults. As a reference standard, GFR has been calculated from compartment analysis of injected radiopharmaceuticals (Sapirstein Method). Theoretical volumes of distribution were calculated at various times after injection (Vt) by dividing the total injected counts (I) by the plasmamore » concentration (Ct) expressed in liters, determined by counting an aliquot of plasma in a well type scintillation counter. Errors of predicting GFR from the various Vt values were determined as the standard error of estimate (Sy.x) in ml/min. They were found to be relatively high early after injection and to fall to a nadir of 3.9 ml/min at 91 min. The Sy.x Vt relationship was examined in linear, quadratic, and exponential form, but the simpler linear relationship was found to yield the lowest error. Other data calculated from the compartment analysis of the reference plasma disappearance curves are presented, but at this time have apparently little clinical relevance.« less

Bit error rate performance of Image Processing Facility high density tape recorders

NASA Technical Reports Server (NTRS)

Heffner, P.

1981-01-01

The Image Processing Facility at the NASA/Goddard Space Flight Center uses High Density Tape Recorders (HDTR's) to transfer high volume image data and ancillary information from one system to another. For ancillary information, it is required that very low bit error rates (BER's) accompany the transfers. The facility processes about 10 to the 11th bits of image data per day from many sensors, involving 15 independent processing systems requiring the use of HDTR's. When acquired, the 16 HDTR's offered state-of-the-art performance of 1 x 10 to the -6th BER as specified. The BER requirement was later upgraded in two steps: (1) incorporating data randomizing circuitry to yield a BER of 2 x 10 to the -7th and (2) further modifying to include a bit error correction capability to attain a BER of 2 x 10 to the -9th. The total improvement factor was 500 to 1. Attention is given here to the background, technical approach, and final results of these modifications. Also discussed are the format of the data recorded by the HDTR, the magnetic tape format, the magnetic tape dropout characteristics as experienced in the Image Processing Facility, the head life history, and the reliability of the HDTR's.

Death Certification Errors and the Effect on Mortality Statistics.

PubMed

McGivern, Lauri; Shulman, Leanne; Carney, Jan K; Shapiro, Steven; Bundock, Elizabeth

Errors in cause and manner of death on death certificates are common and affect families, mortality statistics, and public health research. The primary objective of this study was to characterize errors in the cause and manner of death on death certificates completed by non-Medical Examiners. A secondary objective was to determine the effects of errors on national mortality statistics. We retrospectively compared 601 death certificates completed between July 1, 2015, and January 31, 2016, from the Vermont Electronic Death Registration System with clinical summaries from medical records. Medical Examiners, blinded to original certificates, reviewed summaries, generated mock certificates, and compared mock certificates with original certificates. They then graded errors using a scale from 1 to 4 (higher numbers indicated increased impact on interpretation of the cause) to determine the prevalence of minor and major errors. They also compared International Classification of Diseases, 10th Revision (ICD-10) codes on original certificates with those on mock certificates. Of 601 original death certificates, 319 (53%) had errors; 305 (51%) had major errors; and 59 (10%) had minor errors. We found no significant differences by certifier type (physician vs nonphysician). We did find significant differences in major errors in place of death ( P < .001). Certificates for deaths occurring in hospitals were more likely to have major errors than certificates for deaths occurring at a private residence (59% vs 39%, P < .001). A total of 580 (93%) death certificates had a change in ICD-10 codes between the original and mock certificates, of which 348 (60%) had a change in the underlying cause-of-death code. Error rates on death certificates in Vermont are high and extend to ICD-10 coding, thereby affecting national mortality statistics. Surveillance and certifier education must expand beyond local and state efforts. Simplifying and standardizing underlying literal text for cause of death may improve accuracy, decrease coding errors, and improve national mortality statistics.

Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing.

PubMed

Matheny, Michael E; Normand, Sharon-Lise T; Gross, Thomas P; Marinac-Dabic, Danica; Loyo-Berrios, Nilsa; Vidi, Venkatesan D; Donnelly, Sharon; Resnic, Frederic S

2011-12-14

Automated adverse outcome surveillance tools and methods have potential utility in quality improvement and medical product surveillance activities. Their use for assessing hospital performance on the basis of patient outcomes has received little attention. We compared risk-adjusted sequential probability ratio testing (RA-SPRT) implemented in an automated tool to Massachusetts public reports of 30-day mortality after isolated coronary artery bypass graft surgery. A total of 23,020 isolated adult coronary artery bypass surgery admissions performed in Massachusetts hospitals between January 1, 2002 and September 30, 2007 were retrospectively re-evaluated. The RA-SPRT method was implemented within an automated surveillance tool to identify hospital outliers in yearly increments. We used an overall type I error rate of 0.05, an overall type II error rate of 0.10, and a threshold that signaled if the odds of dying 30-days after surgery was at least twice than expected. Annual hospital outlier status, based on the state-reported classification, was considered the gold standard. An event was defined as at least one occurrence of a higher-than-expected hospital mortality rate during a given year. We examined a total of 83 hospital-year observations. The RA-SPRT method alerted 6 events among three hospitals for 30-day mortality compared with 5 events among two hospitals using the state public reports, yielding a sensitivity of 100% (5/5) and specificity of 98.8% (79/80). The automated RA-SPRT method performed well, detecting all of the true institutional outliers with a small false positive alerting rate. Such a system could provide confidential automated notification to local institutions in advance of public reporting providing opportunities for earlier quality improvement interventions.

Effect of therapeutic interchange on medication reconciliation during hospitalization and upon discharge in a geriatric population

PubMed Central

Wang, Jessica S.; Fogerty, Robert L.

2017-01-01

Background Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange. Methods and findings Secondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009–2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs), histamine H2-receptor antagonists (H2 blockers), hydroxymethylglutaryl CoA reductase inhibitors (statins), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and inhaled corticosteroids (ICS). There was limited electronic medication reconciliation support available. Main measures were presence and accuracy of therapeutic interchange during hospitalization, and rate of medication reconciliation errors on discharge. We examined charts of 303 patients taking 555 medications at time of admission in the six medication classes of interest. A total of 244 (44.0%) of medications were therapeutically interchanged to an approved formulary drug at admission, affecting 64% of the study patients. Among the therapeutically interchanged drugs, we identified 78 (32.0%) suspected medication conversion errors. The discharge medication reconciliation error rate was 11.5% among the 244 therapeutically interchanged medications, compared with 4.2% among the 311 unchanged medications (relative risk [RR] 2.75, 95% confidence interval [CI] 1.45–5.19). Conclusions Therapeutic interchange was prevalent among hospitalized patients in this study and elevates the risk for potential medication errors during and after hospitalization. Improved electronic systems for managing therapeutic interchange and medication reconciliation may be valuable. PMID:29049325

Developing and Validating a Tablet Version of an Illness Explanatory Model Interview for a Public Health Survey in Pune, India

PubMed Central

Giduthuri, Joseph G.; Maire, Nicolas; Joseph, Saju; Kudale, Abhay; Schaetti, Christian; Sundaram, Neisha; Schindler, Christian; Weiss, Mitchell G.

2014-01-01

Background Mobile electronic devices are replacing paper-based instruments and questionnaires for epidemiological and public health research. The elimination of a data-entry step after an interview is a notable advantage over paper, saving investigator time, decreasing the time lags in managing and analyzing data, and potentially improving the data quality by removing the error-prone data-entry step. Research has not yet provided adequate evidence, however, to substantiate the claim of fewer errors for computerized interviews. Methodology We developed an Android-based illness explanatory interview for influenza vaccine acceptance and tested the instrument in a field study in Pune, India, for feasibility and acceptability. Error rates for tablet and paper were compared with reference to the voice recording of the interview as gold standard to assess discrepancies. We also examined the preference of interviewers for the classical paper-based or the electronic version of the interview and compared the costs of research with both data collection devices. Results In 95 interviews with household respondents, total error rates with paper and tablet devices were nearly the same (2.01% and 1.99% respectively). Most interviewers indicated no preference for a particular device; but those with a preference opted for tablets. The initial investment in tablet-based interviews was higher compared to paper, while the recurring costs per interview were lower with the use of tablets. Conclusion An Android-based tablet version of a complex interview was developed and successfully validated. Advantages were not compromised by increased errors, and field research assistants with a preference preferred the Android device. Use of tablets may be more costly than paper for small samples and less costly for large studies. PMID:25233212

The statistical validity of nursing home survey findings.

PubMed

Woolley, Douglas C

2011-11-01

The Medicare nursing home survey is a high-stakes process whose findings greatly affect nursing homes, their current and potential residents, and the communities they serve. Therefore, survey findings must achieve high validity. This study looked at the validity of one key assessment made during a nursing home survey: the observation of the rate of errors in administration of medications to residents (med-pass). Statistical analysis of the case under study and of alternative hypothetical cases. A skilled nursing home affiliated with a local medical school. The nursing home administrators and the medical director. Observational study. The probability that state nursing home surveyors make a Type I or Type II error in observing med-pass error rates, based on the current case and on a series of postulated med-pass error rates. In the common situation such as our case, where med-pass errors occur at slightly above a 5% rate after 50 observations, and therefore trigger a citation, the chance that the true rate remains above 5% after a large number of observations is just above 50%. If the true med-pass error rate were as high as 10%, and the survey team wished to achieve 75% accuracy in determining that a citation was appropriate, they would have to make more than 200 med-pass observations. In the more common situation where med pass errors are closer to 5%, the team would have to observe more than 2000 med-passes to achieve even a modest 75% accuracy in their determinations. In settings where error rates are low, large numbers of observations of an activity must be made to reach acceptable validity of estimates for the true rates of errors. In observing key nursing home functions with current methodology, the State Medicare nursing home survey process does not adhere to well-known principles of valid error determination. Alternate approaches in survey methodology are discussed. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

How does aging affect the types of error made in a visual short-term memory ‘object-recall’ task?

PubMed Central

Sapkota, Raju P.; van der Linde, Ian; Pardhan, Shahina

2015-01-01

This study examines how normal aging affects the occurrence of different types of incorrect responses in a visual short-term memory (VSTM) object-recall task. Seventeen young (Mean = 23.3 years, SD = 3.76), and 17 normally aging older (Mean = 66.5 years, SD = 6.30) adults participated. Memory stimuli comprised two or four real world objects (the memory load) presented sequentially, each for 650 ms, at random locations on a computer screen. After a 1000 ms retention interval, a test display was presented, comprising an empty box at one of the previously presented two or four memory stimulus locations. Participants were asked to report the name of the object presented at the cued location. Errors rates wherein participants reported the names of objects that had been presented in the memory display but not at the cued location (non-target errors) vs. objects that had not been presented at all in the memory display (non-memory errors) were compared. Significant effects of aging, memory load and target recency on error type and absolute error rates were found. Non-target error rate was higher than non-memory error rate in both age groups, indicating that VSTM may have been more often than not populated with partial traces of previously presented items. At high memory load, non-memory error rate was higher in young participants (compared to older participants) when the memory target had been presented at the earliest temporal position. However, non-target error rates exhibited a reversed trend, i.e., greater error rates were found in older participants when the memory target had been presented at the two most recent temporal positions. Data are interpreted in terms of proactive interference (earlier examined non-target items interfering with more recent items), false memories (non-memory items which have a categorical relationship to presented items, interfering with memory targets), slot and flexible resource models, and spatial coding deficits. PMID:25653615

How does aging affect the types of error made in a visual short-term memory 'object-recall' task?

PubMed

Sapkota, Raju P; van der Linde, Ian; Pardhan, Shahina

2014-01-01

This study examines how normal aging affects the occurrence of different types of incorrect responses in a visual short-term memory (VSTM) object-recall task. Seventeen young (Mean = 23.3 years, SD = 3.76), and 17 normally aging older (Mean = 66.5 years, SD = 6.30) adults participated. Memory stimuli comprised two or four real world objects (the memory load) presented sequentially, each for 650 ms, at random locations on a computer screen. After a 1000 ms retention interval, a test display was presented, comprising an empty box at one of the previously presented two or four memory stimulus locations. Participants were asked to report the name of the object presented at the cued location. Errors rates wherein participants reported the names of objects that had been presented in the memory display but not at the cued location (non-target errors) vs. objects that had not been presented at all in the memory display (non-memory errors) were compared. Significant effects of aging, memory load and target recency on error type and absolute error rates were found. Non-target error rate was higher than non-memory error rate in both age groups, indicating that VSTM may have been more often than not populated with partial traces of previously presented items. At high memory load, non-memory error rate was higher in young participants (compared to older participants) when the memory target had been presented at the earliest temporal position. However, non-target error rates exhibited a reversed trend, i.e., greater error rates were found in older participants when the memory target had been presented at the two most recent temporal positions. Data are interpreted in terms of proactive interference (earlier examined non-target items interfering with more recent items), false memories (non-memory items which have a categorical relationship to presented items, interfering with memory targets), slot and flexible resource models, and spatial coding deficits.

Improved assessment of multiple sclerosis lesion segmentation agreement via detection and outline error estimates

PubMed Central

2012-01-01

Background Presented is the method “Detection and Outline Error Estimates” (DOEE) for assessing rater agreement in the delineation of multiple sclerosis (MS) lesions. The DOEE method divides operator or rater assessment into two parts: 1) Detection Error (DE) -- rater agreement in detecting the same regions to mark, and 2) Outline Error (OE) -- agreement of the raters in outlining of the same lesion. Methods DE, OE and Similarity Index (SI) values were calculated for two raters tested on a set of 17 fluid-attenuated inversion-recovery (FLAIR) images of patients with MS. DE, OE, and SI values were tested for dependence with mean total area (MTA) of the raters' Region of Interests (ROIs). Results When correlated with MTA, neither DE (ρ = .056, p=.83) nor the ratio of OE to MTA (ρ = .23, p=.37), referred to as Outline Error Rate (OER), exhibited significant correlation. In contrast, SI is found to be strongly correlated with MTA (ρ = .75, p < .001). Furthermore, DE and OER values can be used to model the variation in SI with MTA. Conclusions The DE and OER indices are proposed as a better method than SI for comparing rater agreement of ROIs, which also provide specific information for raters to improve their agreement. PMID:22812697

A vignette study to examine health care professionals' attitudes towards patient involvement in error prevention.

PubMed

Schwappach, David L B; Frank, Olga; Davis, Rachel E

2013-10-01

Various authorities recommend the participation of patients in promoting patient safety, but little is known about health care professionals' (HCPs') attitudes towards patients' involvement in safety-related behaviours. To investigate how HCPs evaluate patients' behaviours and HCP responses to patient involvement in the behaviour, relative to different aspects of the patient, the involved HCP and the potential error. Cross-sectional fractional factorial survey with seven factors embedded in two error scenarios (missed hand hygiene, medication error). Each survey included two randomized vignettes that described the potential error, a patient's reaction to that error and the HCP response to the patient. Twelve hospitals in Switzerland. A total of 1141 HCPs (response rate 45%). Approval of patients' behaviour, HCP response to the patient, anticipated effects on the patient-HCP relationship, HCPs' support for being asked the question, affective response to the vignettes. Outcomes were measured on 7-point scales. Approval of patients' safety-related interventions was generally high and largely affected by patients' behaviour and correct identification of error. Anticipated effects on the patient-HCP relationship were much less positive, little correlated with approval of patients' behaviour and were mainly determined by the HCP response to intervening patients. HCPs expressed more favourable attitudes towards patients intervening about a medication error than about hand sanitation. This study provides the first insights into predictors of HCPs' attitudes towards patient engagement in safety. Future research is however required to assess the generalizability of the findings into practice before training can be designed to address critical issues. © 2012 John Wiley & Sons Ltd.

Adaptive error detection for HDR/PDR brachytherapy: Guidance for decision making during real-time in vivo point dosimetry

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

Kertzscher, Gustavo, E-mail: guke@dtu.dk; Andersen, Claus E., E-mail: clan@dtu.dk; Tanderup, Kari, E-mail: karitand@rm.dk

Purpose: This study presents an adaptive error detection algorithm (AEDA) for real-timein vivo point dosimetry during high dose rate (HDR) or pulsed dose rate (PDR) brachytherapy (BT) where the error identification, in contrast to existing approaches, does not depend on an a priori reconstruction of the dosimeter position. Instead, the treatment is judged based on dose rate comparisons between measurements and calculations of the most viable dosimeter position provided by the AEDA in a data driven approach. As a result, the AEDA compensates for false error cases related to systematic effects of the dosimeter position reconstruction. Given its nearly exclusivemore » dependence on stable dosimeter positioning, the AEDA allows for a substantially simplified and time efficient real-time in vivo BT dosimetry implementation. Methods: In the event of a measured potential treatment error, the AEDA proposes the most viable dosimeter position out of alternatives to the original reconstruction by means of a data driven matching procedure between dose rate distributions. If measured dose rates do not differ significantly from the most viable alternative, the initial error indication may be attributed to a mispositioned or misreconstructed dosimeter (false error). However, if the error declaration persists, no viable dosimeter position can be found to explain the error, hence the discrepancy is more likely to originate from a misplaced or misreconstructed source applicator or from erroneously connected source guide tubes (true error). Results: The AEDA applied on twoin vivo dosimetry implementations for pulsed dose rate BT demonstrated that the AEDA correctly described effects responsible for initial error indications. The AEDA was able to correctly identify the major part of all permutations of simulated guide tube swap errors and simulated shifts of individual needles from the original reconstruction. Unidentified errors corresponded to scenarios where the dosimeter position was sufficiently symmetric with respect to error and no-error source position constellations. The AEDA was able to correctly identify all false errors represented by mispositioned dosimeters contrary to an error detection algorithm relying on the original reconstruction. Conclusions: The study demonstrates that the AEDA error identification during HDR/PDR BT relies on a stable dosimeter position rather than on an accurate dosimeter reconstruction, and the AEDA’s capacity to distinguish between true and false error scenarios. The study further shows that the AEDA can offer guidance in decision making in the event of potential errors detected with real-timein vivo point dosimetry.« less

Error rate information in attention allocation pilot models

NASA Technical Reports Server (NTRS)

Faulkner, W. H.; Onstott, E. D.

1977-01-01

The Northrop urgency decision pilot model was used in a command tracking task to compare the optimized performance of multiaxis attention allocation pilot models whose urgency functions were (1) based on tracking error alone, and (2) based on both tracking error and error rate. A matrix of system dynamics and command inputs was employed, to create both symmetric and asymmetric two axis compensatory tracking tasks. All tasks were single loop on each axis. Analysis showed that a model that allocates control attention through nonlinear urgency functions using only error information could not achieve performance of the full model whose attention shifting algorithm included both error and error rate terms. Subsequent to this analysis, tracking performance predictions for the full model were verified by piloted flight simulation. Complete model and simulation data are presented.

Personal identification based on prescription eyewear.

PubMed

Berg, Gregory E; Collins, Randall S

2007-03-01

This study presents a web-based tool that can be used to assist in identification of unknown individuals using spectacle prescriptions. Currently, when lens prescriptions are used in forensic identifications, investigators are constrained to a simple "match" or "no-match" judgment with an antemortem prescription. It is not possible to evaluate the strength of the conclusion, or rather, the potential or real error rates associated with the conclusion. Three databases totaling over 385,000 individual prescriptions are utilized in this study to allow forensic analysts to easily determine the strength of individuation of a spectacle match to antemortem records by calculating the frequency at which the observed prescription occurs in various U.S. populations. Optical refractive errors are explained, potential states and combinations of refractive errors are described, measuring lens corrections is discussed, and a detailed description of the databases is presented. The practical application of this system is demonstrated using two recent forensic identifications. This research provides a valuable personal identification tool that can be used in cases where eyeglass portions are recovered in forensic contexts.

7 CFR 275.23 - Determination of State agency program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING... section, the adjusted regressed payment error rate shall be calculated to yield the State agency's payment error rate. The adjusted regressed payment error rate is given by r 1″ + r 2″. (ii) If FNS determines...

The Relation Between Inflation in Type-I and Type-II Error Rate and Population Divergence in Genome-Wide Association Analysis of Multi-Ethnic Populations.

PubMed

Derks, E M; Zwinderman, A H; Gamazon, E R

2017-05-01

Population divergence impacts the degree of population stratification in Genome Wide Association Studies. We aim to: (i) investigate type-I error rate as a function of population divergence (F ST ) in multi-ethnic (admixed) populations; (ii) evaluate the statistical power and effect size estimates; and (iii) investigate the impact of population stratification on the results of gene-based analyses. Quantitative phenotypes were simulated. Type-I error rate was investigated for Single Nucleotide Polymorphisms (SNPs) with varying levels of F ST between the ancestral European and African populations. Type-II error rate was investigated for a SNP characterized by a high value of F ST . In all tests, genomic MDS components were included to correct for population stratification. Type-I and type-II error rate was adequately controlled in a population that included two distinct ethnic populations but not in admixed samples. Statistical power was reduced in the admixed samples. Gene-based tests showed no residual inflation in type-I error rate.

Time-series-based hybrid mathematical modelling method adapted to forecast automotive and medical waste generation: Case study of Lithuania.

PubMed

Karpušenkaitė, Aistė; Ruzgas, Tomas; Denafas, Gintaras

2018-05-01

The aim of the study was to create a hybrid forecasting method that could produce higher accuracy forecasts than previously used 'pure' time series methods. Mentioned methods were already tested with total automotive waste, hazardous automotive waste, and total medical waste generation, but demonstrated at least a 6% error rate in different cases and efforts were made to decrease it even more. Newly developed hybrid models used a random start generation method to incorporate different time-series advantages and it helped to increase the accuracy of forecasts by 3%-4% in hazardous automotive waste and total medical waste generation cases; the new model did not increase the accuracy of total automotive waste generation forecasts. Developed models' abilities to forecast short- and mid-term forecasts were tested using prediction horizon.

Performance Bounds on Two Concatenated, Interleaved Codes

NASA Technical Reports Server (NTRS)

Moision, Bruce; Dolinar, Samuel

2010-01-01

A method has been developed of computing bounds on the performance of a code comprised of two linear binary codes generated by two encoders serially concatenated through an interleaver. Originally intended for use in evaluating the performances of some codes proposed for deep-space communication links, the method can also be used in evaluating the performances of short-block-length codes in other applications. The method applies, more specifically, to a communication system in which following processes take place: At the transmitter, the original binary information that one seeks to transmit is first processed by an encoder into an outer code (Co) characterized by, among other things, a pair of numbers (n,k), where n (n > k)is the total number of code bits associated with k information bits and n k bits are used for correcting or at least detecting errors. Next, the outer code is processed through either a block or a convolutional interleaver. In the block interleaver, the words of the outer code are processed in blocks of I words. In the convolutional interleaver, the interleaving operation is performed bit-wise in N rows with delays that are multiples of B bits. The output of the interleaver is processed through a second encoder to obtain an inner code (Ci) characterized by (ni,ki). The output of the inner code is transmitted over an additive-white-Gaussian- noise channel characterized by a symbol signal-to-noise ratio (SNR) Es/No and a bit SNR Eb/No. At the receiver, an inner decoder generates estimates of bits. Depending on whether a block or a convolutional interleaver is used at the transmitter, the sequence of estimated bits is processed through a block or a convolutional de-interleaver, respectively, to obtain estimates of code words. Then the estimates of the code words are processed through an outer decoder, which generates estimates of the original information along with flags indicating which estimates are presumed to be correct and which are found to be erroneous. From the perspective of the present method, the topic of major interest is the performance of the communication system as quantified in the word-error rate and the undetected-error rate as functions of the SNRs and the total latency of the interleaver and inner code. The method is embodied in equations that describe bounds on these functions. Throughout the derivation of the equations that embody the method, it is assumed that the decoder for the outer code corrects any error pattern of t or fewer errors, detects any error pattern of s or fewer errors, may detect some error patterns of more than s errors, and does not correct any patterns of more than t errors. Because a mathematically complete description of the equations that embody the method and of the derivation of the equations would greatly exceed the space available for this article, it must suffice to summarize by reporting that the derivation includes consideration of several complex issues, including relationships between latency and memory requirements for block and convolutional codes, burst error statistics, enumeration of error-event intersections, and effects of different interleaving depths. In a demonstration, the method was used to calculate bounds on the performances of several communication systems, each based on serial concatenation of a (63,56) expurgated Hamming code with a convolutional inner code through a convolutional interleaver. The bounds calculated by use of the method were compared with results of numerical simulations of performances of the systems to show the regions where the bounds are tight (see figure).

Error decomposition and estimation of inherent optical properties.

PubMed

Salama, Mhd Suhyb; Stein, Alfred

2009-09-10

We describe a methodology to quantify and separate the errors of inherent optical properties (IOPs) derived from ocean-color model inversion. Their total error is decomposed into three different sources, namely, model approximations and inversion, sensor noise, and atmospheric correction. Prior information on plausible ranges of observation, sensor noise, and inversion goodness-of-fit are employed to derive the posterior probability distribution of the IOPs. The relative contribution of each error component to the total error budget of the IOPs, all being of stochastic nature, is then quantified. The method is validated with the International Ocean Colour Coordinating Group (IOCCG) data set and the NASA bio-Optical Marine Algorithm Data set (NOMAD). The derived errors are close to the known values with correlation coefficients of 60-90% and 67-90% for IOCCG and NOMAD data sets, respectively. Model-induced errors inherent to the derived IOPs are between 10% and 57% of the total error, whereas atmospheric-induced errors are in general above 43% and up to 90% for both data sets. The proposed method is applied to synthesized and in situ measured populations of IOPs. The mean relative errors of the derived values are between 2% and 20%. A specific error table to the Medium Resolution Imaging Spectrometer (MERIS) sensor is constructed. It serves as a benchmark to evaluate the performance of the atmospheric correction method and to compute atmospheric-induced errors. Our method has a better performance and is more appropriate to estimate actual errors of ocean-color derived products than the previously suggested methods. Moreover, it is generic and can be applied to quantify the error of any derived biogeophysical parameter regardless of the used derivation.

Improving the quality of cognitive screening assessments: ACEmobile, an iPad-based version of the Addenbrooke's Cognitive Examination-III.

PubMed

Newman, Craig G J; Bevins, Adam D; Zajicek, John P; Hodges, John R; Vuillermoz, Emil; Dickenson, Jennifer M; Kelly, Denise S; Brown, Simona; Noad, Rupert F

2018-01-01

Ensuring reliable administration and reporting of cognitive screening tests are fundamental in establishing good clinical practice and research. This study captured the rate and type of errors in clinical practice, using the Addenbrooke's Cognitive Examination-III (ACE-III), and then the reduction in error rate using a computerized alternative, the ACEmobile app. In study 1, we evaluated ACE-III assessments completed in National Health Service (NHS) clinics ( n  = 87) for administrator error. In study 2, ACEmobile and ACE-III were then evaluated for their ability to capture accurate measurement. In study 1, 78% of clinically administered ACE-IIIs were either scored incorrectly or had arithmetical errors. In study 2, error rates seen in the ACE-III were reduced by 85%-93% using ACEmobile. Error rates are ubiquitous in routine clinical use of cognitive screening tests and the ACE-III. ACEmobile provides a framework for supporting reduced administration, scoring, and arithmetical error during cognitive screening.

Predictors of laparoscopic simulation performance among practicing obstetrician gynecologists.

PubMed

Mathews, Shyama; Brodman, Michael; D'Angelo, Debra; Chudnoff, Scott; McGovern, Peter; Kolev, Tamara; Bensinger, Giti; Mudiraj, Santosh; Nemes, Andreea; Feldman, David; Kischak, Patricia; Ascher-Walsh, Charles

2017-11-01

While simulation training has been established as an effective method for improving laparoscopic surgical performance in surgical residents, few studies have focused on its use for attending surgeons, particularly in obstetrics and gynecology. Surgical simulation may have a role in improving and maintaining proficiency in the operating room for practicing obstetrician gynecologists. We sought to determine if parameters of performance for validated laparoscopic virtual simulation tasks correlate with surgical volume and characteristics of practicing obstetricians and gynecologists. All gynecologists with laparoscopic privileges (n = 347) from 5 academic medical centers in New York City were required to complete a laparoscopic surgery simulation assessment. The physicians took a presimulation survey gathering physician self-reported characteristics and then performed 3 basic skills tasks (enforced peg transfer, lifting/grasping, and cutting) on the LapSim virtual reality laparoscopic simulator (Surgical Science Ltd, Gothenburg, Sweden). The association between simulation outcome scores (time, efficiency, and errors) and self-rated clinical skills measures (self-rated laparoscopic skill score or surgical volume category) were examined with regression models. The average number of laparoscopic procedures per month was a significant predictor of total time on all 3 tasks (P = .001 for peg transfer; P = .041 for lifting and grasping; P < .001 for cutting). Average monthly laparoscopic surgical volume was a significant predictor of 2 efficiency scores in peg transfer, and all 4 efficiency scores in cutting (P = .001 to P = .015). Surgical volume was a significant predictor of errors in lifting/grasping and cutting (P < .001 for both). Self-rated laparoscopic skill level was a significant predictor of total time in all 3 tasks (P < .0001 for peg transfer; P = .009 for lifting and grasping; P < .001 for cutting) and a significant predictor of nearly all efficiency scores and errors scores in all 3 tasks. In addition to total time, there was at least 1 other objective performance measure that significantly correlated with surgical volume for each of the 3 tasks. Higher-volume physicians and those with fellowship training were more confident in their laparoscopic skills. By determining simulation performance as it correlates to active physician practice, further studies may help assess skill and individualize training to maintain skill levels as case volumes fluctuate. Copyright © 2017 Elsevier Inc. All rights reserved.

Fast and memory efficient text image compression with JBIG2.

PubMed

Ye, Yan; Cosman, Pamela

2003-01-01

In this paper, we investigate ways to reduce encoding time, memory consumption and substitution errors for text image compression with JBIG2. We first look at page striping where the encoder splits the input image into horizontal stripes and processes one stripe at a time. We propose dynamic dictionary updating procedures for page striping to reduce the bit rate penalty it incurs. Experiments show that splitting the image into two stripes can save 30% of encoding time and 40% of physical memory with a small coding loss of about 1.5%. Using more stripes brings further savings in time and memory but the return diminishes. We also propose an adaptive way to update the dictionary only when it has become out-of-date. The adaptive updating scheme can resolve the time versus bit rate tradeoff and the memory versus bit rate tradeoff well simultaneously. We then propose three speedup techniques for pattern matching, the most time-consuming encoding activity in JBIG2. When combined together, these speedup techniques can save up to 75% of the total encoding time with at most 1.7% of bit rate penalty. Finally, we look at improving reconstructed image quality for lossy compression. We propose enhanced prescreening and feature monitored shape unifying to significantly reduce substitution errors in the reconstructed images.

Documentation of study medication dispensing in a prospective large randomized clinical trial: experiences from the ARISTOTLE Trial.

PubMed

Alexander, John H; Levy, Elliott; Lawrence, Jack; Hanna, Michael; Waclawski, Anthony P; Wang, Junyuan; Califf, Robert M; Wallentin, Lars; Granger, Christopher B

2013-09-01

In ARISTOTLE, apixaban resulted in a 21% reduction in stroke, a 31% reduction in major bleeding, and an 11% reduction in death. However, approval of apixaban was delayed to investigate a statement in the clinical study report that "7.3% of subjects in the apixaban group and 1.2% of subjects in the warfarin group received, at some point during the study, a container of the wrong type." Rates of study medication dispensing error were characterized through reviews of study medication container tear-off labels in 6,520 participants from randomly selected study sites. The potential effect of dispensing errors on study outcomes was statistically simulated in sensitivity analyses in the overall population. The rate of medication dispensing error resulting in treatment error was 0.04%. Rates of participants receiving at least 1 incorrect container were 1.04% (34/3,273) in the apixaban group and 0.77% (25/3,247) in the warfarin group. Most of the originally reported errors were data entry errors in which the correct medication container was dispensed but the wrong container number was entered into the case report form. Sensitivity simulations in the overall trial population showed no meaningful effect of medication dispensing error on the main efficacy and safety outcomes. Rates of medication dispensing error were low and balanced between treatment groups. The initially reported dispensing error rate was the result of data recording and data management errors and not true medication dispensing errors. These analyses confirm the previously reported results of ARISTOTLE. © 2013.

Propagation of stage measurement uncertainties to streamflow time series

NASA Astrophysics Data System (ADS)

Horner, Ivan; Le Coz, Jérôme; Renard, Benjamin; Branger, Flora; McMillan, Hilary

2016-04-01

Streamflow uncertainties due to stage measurements errors are generally overlooked in the promising probabilistic approaches that have emerged in the last decade. We introduce an original error model for propagating stage uncertainties through a stage-discharge rating curve within a Bayesian probabilistic framework. The method takes into account both rating curve (parametric errors and structural errors) and stage uncertainty (systematic and non-systematic errors). Practical ways to estimate the different types of stage errors are also presented: (1) non-systematic errors due to instrument resolution and precision and non-stationary waves and (2) systematic errors due to gauge calibration against the staff gauge. The method is illustrated at a site where the rating-curve-derived streamflow can be compared with an accurate streamflow reference. The agreement between the two time series is overall satisfying. Moreover, the quantification of uncertainty is also satisfying since the streamflow reference is compatible with the streamflow uncertainty intervals derived from the rating curve and the stage uncertainties. Illustrations from other sites are also presented. Results are much contrasted depending on the site features. In some cases, streamflow uncertainty is mainly due to stage measurement errors. The results also show the importance of discriminating systematic and non-systematic stage errors, especially for long term flow averages. Perspectives for improving and validating the streamflow uncertainty estimates are eventually discussed.

Spot measurement of heart rate based on morphology of PhotoPlethysmoGraphic (PPG) signals.

PubMed

Madhan Mohan, P; Nagarajan, V; Vignesh, J C

2017-02-01

Due to increasing health consciousness among people, it is imperative to have low-cost health care devices to measure the vital parameters like heart rate and arterial oxygen saturation (SpO 2 ). In this paper, an efficient heart rate monitoring algorithm based on the morphology of photoplethysmography (PPG) signals to measure the spot heart rate (HR) and its real-time implementation is proposed. The algorithm does pre-processing and detects the onsets and systolic peaks of the PPG signal to estimate the heart rate of the subject. Since the algorithm is based on the morphology of the signal, it works well when the subject is not moving, which is a typical test case. So, this algorithm is developed mainly to measure the heart rate at on-demand applications. Real-time experimental results indicate the heart rate accuracy of 99.5%, mean absolute percentage error (MAPE) of 1.65%, mean absolute error (MAE) of 1.18 BPM and reference closeness factor (RCF) of 0.988. The results further show that the average response time of the algorithm to give the spot HR is 6.85 s, so that the users need not wait longer to see their HR. The hardware implementation results show that the algorithm only requires 18 KBytes of total memory and runs at high speed with 0.85 MIPS. So, this algorithm can be targeted to low-cost embedded platforms.

Large-scale retrospective evaluation of regulated liquid chromatography-mass spectrometry bioanalysis projects using different total error approaches.

PubMed

Tan, Aimin; Saffaj, Taoufiq; Musuku, Adrien; Awaiye, Kayode; Ihssane, Bouchaib; Jhilal, Fayçal; Sosse, Saad Alaoui; Trabelsi, Fethi

2015-03-01

The current approach in regulated LC-MS bioanalysis, which evaluates the precision and trueness of an assay separately, has long been criticized for inadequate balancing of lab-customer risks. Accordingly, different total error approaches have been proposed. The aims of this research were to evaluate the aforementioned risks in reality and the difference among four common total error approaches (β-expectation, β-content, uncertainty, and risk profile) through retrospective analysis of regulated LC-MS projects. Twenty-eight projects (14 validations and 14 productions) were randomly selected from two GLP bioanalytical laboratories, which represent a wide variety of assays. The results show that the risk of accepting unacceptable batches did exist with the current approach (9% and 4% of the evaluated QC levels failed for validation and production, respectively). The fact that the risk was not wide-spread was only because the precision and bias of modern LC-MS assays are usually much better than the minimum regulatory requirements. Despite minor differences in magnitude, very similar accuracy profiles and/or conclusions were obtained from the four different total error approaches. High correlation was even observed in the width of bias intervals. For example, the mean width of SFSTP's β-expectation is 1.10-fold (CV=7.6%) of that of Saffaj-Ihssane's uncertainty approach, while the latter is 1.13-fold (CV=6.0%) of that of Hoffman-Kringle's β-content approach. To conclude, the risk of accepting unacceptable batches was real with the current approach, suggesting that total error approaches should be used instead. Moreover, any of the four total error approaches may be used because of their overall similarity. Lastly, the difficulties/obstacles associated with the application of total error approaches in routine analysis and their desirable future improvements are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Prescribing errors during hospital inpatient care: factors influencing identification by pharmacists.

PubMed

Tully, Mary P; Buchan, Iain E

2009-12-01

To investigate the prevalence of prescribing errors identified by pharmacists in hospital inpatients and the factors influencing error identification rates by pharmacists throughout hospital admission. 880-bed university teaching hospital in North-west England. Data about prescribing errors identified by pharmacists (median: 9 (range 4-17) collecting data per day) when conducting routine work were prospectively recorded on 38 randomly selected days over 18 months. Proportion of new medication orders in which an error was identified; predictors of error identification rate, adjusted for workload and seniority of pharmacist, day of week, type of ward or stage of patient admission. 33,012 new medication orders were reviewed for 5,199 patients; 3,455 errors (in 10.5% of orders) were identified for 2,040 patients (39.2%; median 1, range 1-12). Most were problem orders (1,456, 42.1%) or potentially significant errors (1,748, 50.6%); 197 (5.7%) were potentially serious; 1.6% (n = 54) were potentially severe or fatal. Errors were 41% (CI: 28-56%) more likely to be identified at patient's admission than at other times, independent of confounders. Workload was the strongest predictor of error identification rates, with 40% (33-46%) less errors identified on the busiest days than at other times. Errors identified fell by 1.9% (1.5-2.3%) for every additional chart checked, independent of confounders. Pharmacists routinely identify errors but increasing workload may reduce identification rates. Where resources are limited, they may be better spent on identifying and addressing errors immediately after admission to hospital.

Insights from Synthetic Star-forming Regions. II. Verifying Dust Surface Density, Dust Temperature, and Gas Mass Measurements With Modified Blackbody Fitting

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

Koepferl, Christine M.; Robitaille, Thomas P.; Dale, James E., E-mail: koepferl@usm.lmu.de

We use a large data set of realistic synthetic observations (produced in Paper I of this series) to assess how observational techniques affect the measurement physical properties of star-forming regions. In this part of the series (Paper II), we explore the reliability of the measured total gas mass, dust surface density and dust temperature maps derived from modified blackbody fitting of synthetic Herschel observations. We find from our pixel-by-pixel analysis of the measured dust surface density and dust temperature a worrisome error spread especially close to star formation sites and low-density regions, where for those “contaminated” pixels the surface densitiesmore » can be under/overestimated by up to three orders of magnitude. In light of this, we recommend to treat the pixel-based results from this technique with caution in regions with active star formation. In regions of high background typical in the inner Galactic plane, we are not able to recover reliable surface density maps of individual synthetic regions, since low-mass regions are lost in the far-infrared background. When measuring the total gas mass of regions in moderate background, we find that modified blackbody fitting works well (absolute error: + 9%; −13%) up to 10 kpc distance (errors increase with distance). Commonly, the initial images are convolved to the largest common beam-size, which smears contaminated pixels over large areas. The resulting information loss makes this commonly used technique less verifiable as now χ {sup 2} values cannot be used as a quality indicator of a fitted pixel. Our control measurements of the total gas mass (without the step of convolution to the largest common beam size) produce similar results (absolute error: +20%; −7%) while having much lower median errors especially for the high-mass stellar feedback phase. In upcoming papers (Paper III; Paper IV) of this series we test the reliability of measured star formation rate with direct and indirect techniques.« less

Alternative Methods of Accounting for Underreporting and Overreporting When Measuring Dietary Intake-Obesity Relations

PubMed Central

Mendez, Michelle A.; Popkin, Barry M.; Buckland, Genevieve; Schroder, Helmut; Amiano, Pilar; Barricarte, Aurelio; Huerta, José-María; Quirós, José R.; Sánchez, María-José; González, Carlos A

2011-01-01

Misreporting characterized by the reporting of implausible energy intakes may undermine the valid estimation of diet-disease relations, but the methods to best identify and account for misreporting are unknown. The present study compared how alternate approaches affected associations between selected dietary factors and body mass index (BMI) by using data from the European Prospective Investigation Into Cancer and Nutrition-Spain. A total of 24,332 women and 15,061 men 29–65 years of age recruited from 1992 to 1996 for whom measured height and weight and validated diet history data were available were included. Misreporters were identified on the basis of disparities between reported energy intakes and estimated requirements calculated using the original Goldberg method and 2 alternatives: one that substituted basal metabolic rate equations that are more valid at higher BMIs and another that used doubly labeled water-predicted total energy expenditure equations. Compared with results obtained using the original method, underreporting was considerably lower and overreporting higher with alternative methods, which were highly concordant. Accounting for misreporters with all methods yielded diet-BMI relations that were more consistent with expectations; alternative methods often strengthened associations. For example, among women, multivariable-adjusted differences in BMI for the highest versus lowest vegetable intake tertile (β = 0.37 (standard error, 0.07)) were neutral after adjusting with the original method (β = 0.01 (standard error, 07)) and negative using the predicted total energy expenditure method with stringent cutoffs (β = −0.15 (standard error, 0.07)). Alternative methods may yield more valid associations between diet and obesity-related outcomes. PMID:21242302

Overcoming pitfalls: Results from a mandatory peer review process for written examinations.

PubMed

Wilby, Kyle John; El Hajj, Maguy S; El-Bashir, Marwa; Mraiche, Fatima

2018-04-01

Written assessments are essential components of higher education practices. However, faculty members encounter common pitfalls when designing questions intended to evaluate student-learning outcomes. The objective of this project was to determine the impact of a mandatory examination peer review process on question accuracy, alignment with learning objectives, use of best practices in question design, and language/grammar. A mandatory peer review process was implemented for all midterm (before phase) and final (after phase) examinations. Peer review occurred by two reviewers and followed a pre-defined guidance document. Non-punitive feedback given to faculty members served as the intervention. Frequencies of flagged questions according to guidance categories were compared between phases. A total of 21 midterm and 21 final exam reviews were included in the analysis. A total of 637 questions were reviewed across all midterms and 1003 questions were reviewed across all finals. Few questions were flagged for accuracy and alignment with learning outcomes. The median total proportion of questions flagged for best practices was significantly lower for final exams versus midterm exams (15.8 vs. 6.45%, p = 0.014). The intervention did not influence language and grammar errors (9.68 vs. 10.0% of questions flagged before and after, respectively, p = 0.305). A non-punitive peer review process for written examinations can overcome pitfalls in exam creation and improve best practices in question writing. The peer-review process had a substantial effect at flagging language/grammar errors but error rate did not differ between midterm and final exams. Copyright © 2017 Elsevier Inc. All rights reserved.

Alternative methods of accounting for underreporting and overreporting when measuring dietary intake-obesity relations.

PubMed

Mendez, Michelle A; Popkin, Barry M; Buckland, Genevieve; Schroder, Helmut; Amiano, Pilar; Barricarte, Aurelio; Huerta, José-María; Quirós, José R; Sánchez, María-José; González, Carlos A

2011-02-15

Misreporting characterized by the reporting of implausible energy intakes may undermine the valid estimation of diet-disease relations, but the methods to best identify and account for misreporting are unknown. The present study compared how alternate approaches affected associations between selected dietary factors and body mass index (BMI) by using data from the European Prospective Investigation Into Cancer and Nutrition-Spain. A total of 24,332 women and 15,061 men 29-65 years of age recruited from 1992 to 1996 for whom measured height and weight and validated diet history data were available were included. Misreporters were identified on the basis of disparities between reported energy intakes and estimated requirements calculated using the original Goldberg method and 2 alternatives: one that substituted basal metabolic rate equations that are more valid at higher BMIs and another that used doubly labeled water-predicted total energy expenditure equations. Compared with results obtained using the original method, underreporting was considerably lower and overreporting higher with alternative methods, which were highly concordant. Accounting for misreporters with all methods yielded diet-BMI relations that were more consistent with expectations; alternative methods often strengthened associations. For example, among women, multivariable-adjusted differences in BMI for the highest versus lowest vegetable intake tertile (β = 0.37 (standard error, 0.07)) were neutral after adjusting with the original method (β = 0.01 (standard error, 07)) and negative using the predicted total energy expenditure method with stringent cutoffs (β = -0.15 (standard error, 0.07)). Alternative methods may yield more valid associations between diet and obesity-related outcomes.

A comparison of registration errors with imageless computer navigation during MIS total knee arthroplasty versus standard incision total knee arthroplasty: a cadaveric study.

PubMed

Davis, Edward T; Pagkalos, Joseph; Gallie, Price A M; Macgroarty, Kelly; Waddell, James P; Schemitsch, Emil H

2015-01-01

Optimal component alignment in total knee arthroplasty has been associated with better functional outcome as well as improved implant longevity. The ability to align components optimally during minimally invasive (MIS) total knee replacement (TKR) has been a cause of concern. Computer navigation is a useful aid in achieving the desired alignment although it is limited by the error during the manual registration of landmarks. Our study aims to compare the registration process error between a standard and a MIS surgical approach. We hypothesized that performing the registration error via an MIS approach would increase the registration process error. Five fresh frozen lower limbs were routinely prepared and draped. The registration process was performed through an MIS approach. This was then extended to the standard approach and the registration was performed again. Two surgeons performed the registration process five times with each approach. Performing the registration process through the MIS approach was not associated with higher error compared to the standard approach in the alignment parameters of interest. This rejects our hypothesis. Image-free navigated MIS TKR does not appear to carry higher risk of component malalignment due to the registration process error. Navigation can be used during MIS TKR to improve alignment without reduced accuracy due to the approach.

Resampling-Based Empirical Bayes Multiple Testing Procedures for Controlling Generalized Tail Probability and Expected Value Error Rates: Focus on the False Discovery Rate and Simulation Study

PubMed Central

Dudoit, Sandrine; Gilbert, Houston N.; van der Laan, Mark J.

2014-01-01

Summary This article proposes resampling-based empirical Bayes multiple testing procedures for controlling a broad class of Type I error rates, defined as generalized tail probability (gTP) error rates, gTP(q, g) = Pr(g(Vn, Sn) > q), and generalized expected value (gEV) error rates, gEV(g) = E[g(Vn, Sn)], for arbitrary functions g(Vn, Sn) of the numbers of false positives Vn and true positives Sn. Of particular interest are error rates based on the proportion g(Vn, Sn) = Vn/(Vn + Sn) of Type I errors among the rejected hypotheses, such as the false discovery rate (FDR), FDR = E[Vn/(Vn + Sn)]. The proposed procedures offer several advantages over existing methods. They provide Type I error control for general data generating distributions, with arbitrary dependence structures among variables. Gains in power are achieved by deriving rejection regions based on guessed sets of true null hypotheses and null test statistics randomly sampled from joint distributions that account for the dependence structure of the data. The Type I error and power properties of an FDR-controlling version of the resampling-based empirical Bayes approach are investigated and compared to those of widely-used FDR-controlling linear step-up procedures in a simulation study. The Type I error and power trade-off achieved by the empirical Bayes procedures under a variety of testing scenarios allows this approach to be competitive with or outperform the Storey and Tibshirani (2003) linear step-up procedure, as an alternative to the classical Benjamini and Hochberg (1995) procedure. PMID:18932138

Effects of vertical distribution of water vapor and temperature on total column water vapor retrieval error

NASA Technical Reports Server (NTRS)

Sun, Jielun

1993-01-01

Results are presented of a test of the physically based total column water vapor retrieval algorithm of Wentz (1992) for sensitivity to realistic vertical distributions of temperature and water vapor. The ECMWF monthly averaged temperature and humidity fields are used to simulate the spatial pattern of systematic retrieval error of total column water vapor due to this sensitivity. The estimated systematic error is within 0.1 g/sq cm over about 70 percent of the global ocean area; systematic errors greater than 0.3 g/sq cm are expected to exist only over a few well-defined regions, about 3 percent of the global oceans, assuming that the global mean value is unbiased.

Topological quantum computing with a very noisy network and local error rates approaching one percent.

PubMed

Nickerson, Naomi H; Li, Ying; Benjamin, Simon C

2013-01-01

A scalable quantum computer could be built by networking together many simple processor cells, thus avoiding the need to create a single complex structure. The difficulty is that realistic quantum links are very error prone. A solution is for cells to repeatedly communicate with each other and so purify any imperfections; however prior studies suggest that the cells themselves must then have prohibitively low internal error rates. Here we describe a method by which even error-prone cells can perform purification: groups of cells generate shared resource states, which then enable stabilization of topologically encoded data. Given a realistically noisy network (≥10% error rate) we find that our protocol can succeed provided that intra-cell error rates for initialisation, state manipulation and measurement are below 0.82%. This level of fidelity is already achievable in several laboratory systems.

Data entry errors and design for model-based tight glycemic control in critical care.

PubMed

Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

2012-01-01

Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. Model-based methods and computerized protocols offer the opportunity to improve TGC quality but require human data entry, particularly of blood glucose (BG) values, which can be significantly prone to error. This study presents the design and optimization of data entry methods to minimize error for a computerized and model-based TGC method prior to pilot clinical trials. To minimize data entry error, two tests were carried out to optimize a method with errors less than the 5%-plus reported in other studies. Four initial methods were tested on 40 subjects in random order, and the best two were tested more rigorously on 34 subjects. The tests measured entry speed and accuracy. Errors were reported as corrected and uncorrected errors, with the sum comprising a total error rate. The first set of tests used randomly selected values, while the second set used the same values for all subjects to allow comparisons across users and direct assessment of the magnitude of errors. These research tests were approved by the University of Canterbury Ethics Committee. The final data entry method tested reduced errors to less than 1-2%, a 60-80% reduction from reported values. The magnitude of errors was clinically significant and was typically by 10.0 mmol/liter or an order of magnitude but only for extreme values of BG < 2.0 mmol/liter or BG > 15.0-20.0 mmol/liter, both of which could be easily corrected with automated checking of extreme values for safety. The data entry method selected significantly reduced data entry errors in the limited design tests presented, and is in use on a clinical pilot TGC study. The overall approach and testing methods are easily performed and generalizable to other applications and protocols. © 2012 Diabetes Technology Society.

Analysis and Compensation of Modulation Angular Rate Error Based on Missile-Borne Rotation Semi-Strapdown Inertial Navigation System

PubMed Central

Zhang, Jiayu; Li, Jie; Zhang, Xi; Che, Xiaorui; Huang, Yugang; Feng, Kaiqiang

2018-01-01

The Semi-Strapdown Inertial Navigation System (SSINS) provides a new solution to attitude measurement of a high-speed rotating missile. However, micro-electro-mechanical-systems (MEMS) inertial measurement unit (MIMU) outputs are corrupted by significant sensor errors. In order to improve the navigation precision, a rotation modulation technology method called Rotation Semi-Strapdown Inertial Navigation System (RSSINS) is introduced into SINS. In fact, the stability of the modulation angular rate is difficult to achieve in a high-speed rotation environment. The changing rotary angular rate has an impact on the inertial sensor error self-compensation. In this paper, the influence of modulation angular rate error, including acceleration-deceleration process, and instability of the angular rate on the navigation accuracy of RSSINS is deduced and the error characteristics of the reciprocating rotation scheme are analyzed. A new compensation method is proposed to remove or reduce sensor errors so as to make it possible to maintain high precision autonomous navigation performance by MIMU when there is no external aid. Experiments have been carried out to validate the performance of the method. In addition, the proposed method is applicable for modulation angular rate error compensation under various dynamic conditions. PMID:29734707

The Relationship between Occurrence Timing of Dispensing Errors and Subsequent Danger to Patients under the Situation According to the Classification of Drugs by Efficacy.

PubMed

Tsuji, Toshikazu; Nagata, Kenichiro; Kawashiri, Takehiro; Yamada, Takaaki; Irisa, Toshihiro; Murakami, Yuko; Kanaya, Akiko; Egashira, Nobuaki; Masuda, Satohiro

2016-01-01

There are many reports regarding various medical institutions' attempts at the prevention of dispensing errors. However, the relationship between occurrence timing of dispensing errors and subsequent danger to patients has not been studied under the situation according to the classification of drugs by efficacy. Therefore, we analyzed the relationship between position and time regarding the occurrence of dispensing errors. Furthermore, we investigated the relationship between occurrence timing of them and danger to patients. In this study, dispensing errors and incidents in three categories (drug name errors, drug strength errors, drug count errors) were classified into two groups in terms of its drug efficacy (efficacy similarity (-) group, efficacy similarity (+) group), into three classes in terms of the occurrence timing of dispensing errors (initial phase errors, middle phase errors, final phase errors). Then, the rates of damage shifting from "dispensing errors" to "damage to patients" were compared as an index of danger between two groups and among three classes. Consequently, the rate of damage in "efficacy similarity (-) group" was significantly higher than that in "efficacy similarity (+) group". Furthermore, the rate of damage is the highest in "initial phase errors", the lowest in "final phase errors" among three classes. From the results of this study, it became clear that the earlier the timing of dispensing errors occurs, the more severe the damage to patients becomes.

Agreeableness and Conscientiousness as Predictors of University Students' Self/Peer-Assessment Rating Error

ERIC Educational Resources Information Center

Birjandi, Parviz; Siyyari, Masood

2016-01-01

This paper presents the results of an investigation into the role of two personality traits (i.e. Agreeableness and Conscientiousness from the Big Five personality traits) in predicting rating error in the self-assessment and peer-assessment of composition writing. The average self/peer-rating errors of 136 Iranian English major undergraduates…

National Suicide Rates a Century after Durkheim: Do We Know Enough to Estimate Error?

ERIC Educational Resources Information Center

Claassen, Cynthia A.; Yip, Paul S.; Corcoran, Paul; Bossarte, Robert M.; Lawrence, Bruce A.; Currier, Glenn W.

2010-01-01

Durkheim's nineteenth-century analysis of national suicide rates dismissed prior concerns about mortality data fidelity. Over the intervening century, however, evidence documenting various types of error in suicide data has only mounted, and surprising levels of such error continue to be routinely uncovered. Yet the annual suicide rate remains the…

The Relationship of Error Rate and Comprehension in Second and Third Grade Oral Reading Fluency

ERIC Educational Resources Information Center

Abbott, Mary; Wills, Howard; Miller, Angela; Kaufman, Journ

2012-01-01

This study explored the relationships of oral reading speed and error rate on comprehension with second and third grade students with identified reading risk. The study included 920 second and 974 third graders. Results found a significant relationship between error rate, oral reading fluency, and reading comprehension performance, and…

What Are Error Rates for Classifying Teacher and School Performance Using Value-Added Models?

ERIC Educational Resources Information Center

Schochet, Peter Z.; Chiang, Hanley S.

2013-01-01

This article addresses likely error rates for measuring teacher and school performance in the upper elementary grades using value-added models applied to student test score gain data. Using a realistic performance measurement system scheme based on hypothesis testing, the authors develop error rate formulas based on ordinary least squares and…

Small Scale Mass Flow Plug Calibration

NASA Technical Reports Server (NTRS)

Sasson, Jonathan

2015-01-01

A simple control volume model has been developed to calculate the discharge coefficient through a mass flow plug (MFP) and validated with a calibration experiment. The maximum error of the model in the operating region of the MFP is 0.54%. The model uses the MFP geometry and operating pressure and temperature to couple continuity, momentum, energy, an equation of state, and wall shear. Effects of boundary layer growth and the reduction in cross-sectional flow area are calculated using an in- integral method. A CFD calibration is shown to be of lower accuracy with a maximum error of 1.35%, and slower by a factor of 100. Effects of total pressure distortion are taken into account in the experiment. Distortion creates a loss in flow rate and can be characterized by two different distortion descriptors.

False Positives in Multiple Regression: Unanticipated Consequences of Measurement Error in the Predictor Variables

ERIC Educational Resources Information Center

Shear, Benjamin R.; Zumbo, Bruno D.

2013-01-01

Type I error rates in multiple regression, and hence the chance for false positive research findings, can be drastically inflated when multiple regression models are used to analyze data that contain random measurement error. This article shows the potential for inflated Type I error rates in commonly encountered scenarios and provides new…

Decrease in medical command errors with use of a "standing orders" protocol system.

PubMed

Holliman, C J; Wuerz, R C; Meador, S A

1994-05-01

The purpose of this study was to determine the physician medical command error rates and paramedic error rates after implementation of a "standing orders" protocol system for medical command. These patient-care error rates were compared with the previously reported rates for a "required call-in" medical command system (Ann Emerg Med 1992; 21(4):347-350). A secondary aim of the study was to determine if the on-scene time interval was increased by the standing orders system. Prospectively conducted audit of prehospital advanced life support (ALS) trip sheets was made at an urban ALS paramedic service with on-line physician medical command from three local hospitals. All ALS run sheets from the start time of the standing orders system (April 1, 1991) for a 1-year period ending on March 30, 1992 were reviewed as part of an ongoing quality assurance program. Cases were identified as nonjustifiably deviating from regional emergency medical services (EMS) protocols as judged by agreement of three physician reviewers (the same methodology as a previously reported command error study in the same ALS system). Medical command and paramedic errors were identified from the prehospital ALS run sheets and categorized. Two thousand one ALS runs were reviewed; 24 physician errors (1.2% of the 1,928 "command" runs) and eight paramedic errors (0.4% of runs) were identified. The physician error rate was decreased from the 2.6% rate in the previous study (P < .0001 by chi 2 analysis). The on-scene time interval did not increase with the "standing orders" system.(ABSTRACT TRUNCATED AT 250 WORDS)

Quantifying Data Quality for Clinical Trials Using Electronic Data Capture

PubMed Central

Nahm, Meredith L.; Pieper, Carl F.; Cunningham, Maureen M.

2008-01-01

Background Historically, only partial assessments of data quality have been performed in clinical trials, for which the most common method of measuring database error rates has been to compare the case report form (CRF) to database entries and count discrepancies. Importantly, errors arising from medical record abstraction and transcription are rarely evaluated as part of such quality assessments. Electronic Data Capture (EDC) technology has had a further impact, as paper CRFs typically leveraged for quality measurement are not used in EDC processes. Methods and Principal Findings The National Institute on Drug Abuse Treatment Clinical Trials Network has developed, implemented, and evaluated methodology for holistically assessing data quality on EDC trials. We characterize the average source-to-database error rate (14.3 errors per 10,000 fields) for the first year of use of the new evaluation method. This error rate was significantly lower than the average of published error rates for source-to-database audits, and was similar to CRF-to-database error rates reported in the published literature. We attribute this largely to an absence of medical record abstraction on the trials we examined, and to an outpatient setting characterized by less acute patient conditions. Conclusions Historically, medical record abstraction is the most significant source of error by an order of magnitude, and should be measured and managed during the course of clinical trials. Source-to-database error rates are highly dependent on the amount of structured data collection in the clinical setting and on the complexity of the medical record, dependencies that should be considered when developing data quality benchmarks. PMID:18725958

Neutrino masses and cosmological parameters from a Euclid-like survey: Markov Chain Monte Carlo forecasts including theoretical errors

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

Audren, Benjamin; Lesgourgues, Julien; Bird, Simeon

2013-01-01

We present forecasts for the accuracy of determining the parameters of a minimal cosmological model and the total neutrino mass based on combined mock data for a future Euclid-like galaxy survey and Planck. We consider two different galaxy surveys: a spectroscopic redshift survey and a cosmic shear survey. We make use of the Monte Carlo Markov Chains (MCMC) technique and assume two sets of theoretical errors. The first error is meant to account for uncertainties in the modelling of the effect of neutrinos on the non-linear galaxy power spectrum and we assume this error to be fully correlated in Fouriermore » space. The second error is meant to parametrize the overall residual uncertainties in modelling the non-linear galaxy power spectrum at small scales, and is conservatively assumed to be uncorrelated and to increase with the ratio of a given scale to the scale of non-linearity. It hence increases with wavenumber and decreases with redshift. With these two assumptions for the errors and assuming further conservatively that the uncorrelated error rises above 2% at k = 0.4 h/Mpc and z = 0.5, we find that a future Euclid-like cosmic shear/galaxy survey achieves a 1-σ error on M{sub ν} close to 32 meV/25 meV, sufficient for detecting the total neutrino mass with good significance. If the residual uncorrelated errors indeed rises rapidly towards smaller scales in the non-linear regime as we have assumed here then the data on non-linear scales does not increase the sensitivity to the total neutrino mass. Assuming instead a ten times smaller theoretical error with the same scale dependence, the error on the total neutrino mass decreases moderately from σ(M{sub ν}) = 18 meV to 14 meV when mildly non-linear scales with 0.1 h/Mpc < k < 0.6 h/Mpc are included in the analysis of the galaxy survey data.« less

Effect of atmospheric turbulence on the bit error probability of a space to ground near infrared laser communications link using binary pulse position modulation and an avalanche photodiode detector

NASA Technical Reports Server (NTRS)

Safren, H. G.

1987-01-01

The effect of atmospheric turbulence on the bit error rate of a space-to-ground near infrared laser communications link is investigated, for a link using binary pulse position modulation and an avalanche photodiode detector. Formulas are presented for the mean and variance of the bit error rate as a function of signal strength. Because these formulas require numerical integration, they are of limited practical use. Approximate formulas are derived which are easy to compute and sufficiently accurate for system feasibility studies, as shown by numerical comparison with the exact formulas. A very simple formula is derived for the bit error rate as a function of signal strength, which requires only the evaluation of an error function. It is shown by numerical calculations that, for realistic values of the system parameters, the increase in the bit error rate due to turbulence does not exceed about thirty percent for signal strengths of four hundred photons per bit or less. The increase in signal strength required to maintain an error rate of one in 10 million is about one or two tenths of a db.

Evaluation of process errors in bed load sampling using a Dune Model

USGS Publications Warehouse

Gomez, Basil; Troutman, Brent M.

1997-01-01

Reliable estimates of the streamwide bed load discharge obtained using sampling devices are dependent upon good at-a-point knowledge across the full width of the channel. Using field data and information derived from a model that describes the geometric features of a dune train in terms of a spatial process observed at a fixed point in time, we show that sampling errors decrease as the number of samples collected increases, and the number of traverses of the channel over which the samples are collected increases. It also is preferable that bed load sampling be conducted at a pace which allows a number of bed forms to pass through the sampling cross section. The situations we analyze and simulate pertain to moderate transport conditions in small rivers. In such circumstances, bed load sampling schemes typically should involve four or five traverses of a river, and the collection of 20–40 samples at a rate of five or six samples per hour. By ensuring that spatial and temporal variability in the transport process is accounted for, such a sampling design reduces both random and systematic errors and hence minimizes the total error involved in the sampling process.

Error in total ozone measurements arising from aerosol attenuation

NASA Technical Reports Server (NTRS)

Thomas, R. W. L.; Basher, R. E.

1979-01-01

A generalized least squares method for deducing both total ozone and aerosol extinction spectrum parameters from Dobson spectrophotometer measurements was developed. An error analysis applied to this system indicates that there is little advantage to additional measurements once a sufficient number of line pairs have been employed to solve for the selected detail in the attenuation model. It is shown that when there is a predominance of small particles (less than about 0.35 microns in diameter) the total ozone from the standard AD system is too high by about one percent. When larger particles are present the derived total ozone may be an overestimate or an underestimate but serious errors occur only for narrow polydispersions.

Beyond Rating Curves: Time Series Models for in-Stream Turbidity Prediction

NASA Astrophysics Data System (ADS)

Wang, L.; Mukundan, R.; Zion, M.; Pierson, D. C.

2012-12-01

The New York City Department of Environmental Protection (DEP) manages New York City's water supply, which is comprised of over 20 reservoirs and supplies over 1 billion gallons of water per day to more than 9 million customers. DEP's "West of Hudson" reservoirs located in the Catskill Mountains are unfiltered per a renewable filtration avoidance determination granted by the EPA. While water quality is usually pristine, high volume storm events occasionally cause the reservoirs to become highly turbid. A logical strategy for turbidity control is to temporarily remove the turbid reservoirs from service. While effective in limiting delivery of turbid water and reducing the need for in-reservoir alum flocculation, this strategy runs the risk of negatively impacting water supply reliability. Thus, it is advantageous for DEP to understand how long a particular turbidity event will affect their system. In order to understand the duration, intensity and total load of a turbidity event, predictions of future in-stream turbidity values are important. Traditionally, turbidity predictions have been carried out by applying streamflow observations/forecasts to a flow-turbidity rating curve. However, predictions from rating curves are often inaccurate due to inter- and intra-event variability in flow-turbidity relationships. Predictions can be improved by applying an autoregressive moving average (ARMA) time series model in combination with a traditional rating curve. Since 2003, DEP and the Upstate Freshwater Institute have compiled a relatively consistent set of 15-minute turbidity observations at various locations on Esopus Creek above Ashokan Reservoir. Using daily averages of this data and streamflow observations at nearby USGS gauges, flow-turbidity rating curves were developed via linear regression. Time series analysis revealed that the linear regression residuals may be represented using an ARMA(1,2) process. Based on this information, flow-turbidity regressions with ARMA(1,2) errors were fit to the observations. Preliminary model validation exercises at a 30-day forecast horizon show that the ARMA error models generally improve the predictive skill of the linear regression rating curves. Skill seems to vary based on the ambient hydrologic conditions at the onset of the forecast. For example, ARMA error model forecasts issued before a high flow/turbidity event do not show significant improvements over the rating curve approach. However, ARMA error model forecasts issued during the "falling limb" of the hydrograph are significantly more accurate than rating curves for both single day and accumulated event predictions. In order to assist in reservoir operations decisions associated with turbidity events and general water supply reliability, DEP has initiated design of an Operations Support Tool (OST). OST integrates a reservoir operations model with 2D hydrodynamic water quality models and a database compiling near-real-time data sources and hydrologic forecasts. Currently, OST uses conventional flow-turbidity rating curves and hydrologic forecasts for predictive turbidity inputs. Given the improvements in predictive skill over traditional rating curves, the ARMA error models are currently being evaluated as an addition to DEP's Operations Support Tool.

Comparing mean high water and high water line shorelines: Should prosy-datum offsets be incorporated into shoreline change analysis?

USGS Publications Warehouse

Moore, L.J.; Ruggiero, P.; List, J.H.

2006-01-01

More than one type of shoreline indicator can be used in shoreline change analyses, and quantifying the effects of this practice on the resulting shoreline change rates is important. Comparison of three high water line (proxy-based) shorelines and a mean high water intercept (datum-based) shoreline collected from simultaneous aerial photographic and lidar surveys of a relatively steep reflective beach (tan ?? = 0.07), which experiences a moderately energetic wave climate (annual average Hs = 1.2 m), reveals an average horizontal offset of 18.8 m between the two types of shoreline indicators. Vertical offsets are also substantial and are correlated with foreshore beach slope and corresponding variations in wave runup. Incorporating the average horizontal offset into both a short-term, endpoint shoreline change analysis and a long-term, linear regression analysis causes rates to be shifted an average of -0.5 m/y and -0.1 m/y, respectively. The rate shift increases with increasing horizontal offset and decreasing measurement intervals and, depending on the rapidity of shoreline change rates, is responsible for varying degrees of analysis error. Our results demonstrate that under many circumstances, the error attributable to proxy-datum offsets is small relative to shoreline change rates and thus not important. Furthermore, we find that when the error associated with proxy-datum offsets is large enough to be important, the shoreline change rates themselves are not likely to be significant. A total water level model reveals that the high water line digitized by three independent coastal labs for this study was generated by a combination of large waves and a high tide several days before the collection of aerial photography. This illustrates the complexity of the high water line as a shoreline indicator and calls into question traditional definitions, which consider the high water line a wetted bound or "marks left by the previous high tide.".

The random coding bound is tight for the average code.

NASA Technical Reports Server (NTRS)

Gallager, R. G.

1973-01-01

The random coding bound of information theory provides a well-known upper bound to the probability of decoding error for the best code of a given rate and block length. The bound is constructed by upperbounding the average error probability over an ensemble of codes. The bound is known to give the correct exponential dependence of error probability on block length for transmission rates above the critical rate, but it gives an incorrect exponential dependence at rates below a second lower critical rate. Here we derive an asymptotic expression for the average error probability over the ensemble of codes used in the random coding bound. The result shows that the weakness of the random coding bound at rates below the second critical rate is due not to upperbounding the ensemble average, but rather to the fact that the best codes are much better than the average at low rates.

Empirically Defined Patterns of Executive Function Deficits in Schizophrenia and Their Relation to Everyday Functioning: A Person-Centered Approach

PubMed Central

Iampietro, Mary; Giovannetti, Tania; Drabick, Deborah A. G.; Kessler, Rachel K.

2013-01-01

Executive function (EF) deficits in schizophrenia (SZ) are well documented, although much less is known about patterns of EF deficits and their association to differential impairments in everyday functioning. The present study empirically defined SZ groups based on measures of various EF abilities and then compared these EF groups on everyday action errors. Participants (n=45) completed various subtests from the Delis–Kaplan Executive Function System (D-KEFS) and the Naturalistic Action Test (NAT), a performance-based measure of everyday action that yields scores reflecting total errors and a range of different error types (e.g., omission, perseveration). Results of a latent class analysis revealed three distinct EF groups, characterized by (a) multiple EF deficits, (b) relatively spared EF, and (c) perseverative responding. Follow-up analyses revealed that the classes differed significantly on NAT total errors, total commission errors, and total perseveration errors; the two classes with EF impairment performed comparably on the NAT but performed worse than the class with relatively spared EF. In sum, people with SZ demonstrate variable patterns of EF deficits, and distinct aspects of these EF deficit patterns (i.e., poor mental control abilities) may be associated with everyday functioning capabilities. PMID:23035705

Single event upset susceptibilities of latchup immune CMOS process programmable gate arrays

NASA Astrophysics Data System (ADS)

Koga, R.; Crain, W. R.; Crawford, K. B.; Hansel, S. J.; Lau, D. D.; Tsubota, T. K.

Single event upsets (SEU) and latchup susceptibilities of complementary metal oxide semiconductor programmable gate arrays (CMOS PPGA's) were measured at the Lawrence Berkeley Laboratory 88-in. cyclotron facility with Xe (603 MeV), Cu (290 MeV), and Ar (180 MeV) ion beams. The PPGA devices tested were those which may be used in space. Most of the SEU measurements were taken with a newly constructed tester called the Bus Access Storage and Comparison System (BASACS) operating via a Macintosh II computer. When BASACS finds that an output does not match a prerecorded pattern, the state of all outputs, position in the test cycle, and other necessary information is transmitted and stored in the Macintosh. The upset rate was kept between 1 and 3 per second. After a sufficient number of errors are stored, the test is stopped and the total fluence of particles and total errors are recorded. The device power supply current was closely monitored to check for occurrence of latchup. Results of the tests are presented, indicating that some of the PPGA's are good candidates for selected space applications.

Separate Medication Preparation Rooms Reduce Interruptions and Medication Errors in the Hospital Setting: A Prospective Observational Study.

PubMed

Huckels-Baumgart, Saskia; Baumgart, André; Buschmann, Ute; Schüpfer, Guido; Manser, Tanja

2016-12-21

Interruptions and errors during the medication process are common, but published literature shows no evidence supporting whether separate medication rooms are an effective single intervention in reducing interruptions and errors during medication preparation in hospitals. We tested the hypothesis that the rate of interruptions and reported medication errors would decrease as a result of the introduction of separate medication rooms. Our aim was to evaluate the effect of separate medication rooms on interruptions during medication preparation and on self-reported medication error rates. We performed a preintervention and postintervention study using direct structured observation of nurses during medication preparation and daily structured medication error self-reporting of nurses by questionnaires in 2 wards at a major teaching hospital in Switzerland. A volunteer sample of 42 nurses was observed preparing 1498 medications for 366 patients over 17 hours preintervention and postintervention on both wards. During 122 days, nurses completed 694 reporting sheets containing 208 medication errors. After the introduction of the separate medication room, the mean interruption rate decreased significantly from 51.8 to 30 interruptions per hour (P < 0.01), and the interruption-free preparation time increased significantly from 1.4 to 2.5 minutes (P < 0.05). Overall, the mean medication error rate per day was also significantly reduced after implementation of the separate medication room from 1.3 to 0.9 errors per day (P < 0.05). The present study showed the positive effect of a hospital-based intervention; after the introduction of the separate medication room, the interruption and medication error rates decreased significantly.

Evaluation of genomic high-throughput sequencing data generated on Illumina HiSeq and Genome Analyzer systems

PubMed Central

2011-01-01

Background The generation and analysis of high-throughput sequencing data are becoming a major component of many studies in molecular biology and medical research. Illumina's Genome Analyzer (GA) and HiSeq instruments are currently the most widely used sequencing devices. Here, we comprehensively evaluate properties of genomic HiSeq and GAIIx data derived from two plant genomes and one virus, with read lengths of 95 to 150 bases. Results We provide quantifications and evidence for GC bias, error rates, error sequence context, effects of quality filtering, and the reliability of quality values. By combining different filtering criteria we reduced error rates 7-fold at the expense of discarding 12.5% of alignable bases. While overall error rates are low in HiSeq data we observed regions of accumulated wrong base calls. Only 3% of all error positions accounted for 24.7% of all substitution errors. Analyzing the forward and reverse strands separately revealed error rates of up to 18.7%. Insertions and deletions occurred at very low rates on average but increased to up to 2% in homopolymers. A positive correlation between read coverage and GC content was found depending on the GC content range. Conclusions The errors and biases we report have implications for the use and the interpretation of Illumina sequencing data. GAIIx and HiSeq data sets show slightly different error profiles. Quality filtering is essential to minimize downstream analysis artifacts. Supporting previous recommendations, the strand-specificity provides a criterion to distinguish sequencing errors from low abundance polymorphisms. PMID:22067484

Error Rates in Measuring Teacher and School Performance Based on Student Test Score Gains. NCEE 2010-4004

ERIC Educational Resources Information Center

Schochet, Peter Z.; Chiang, Hanley S.

2010-01-01

This paper addresses likely error rates for measuring teacher and school performance in the upper elementary grades using value-added models applied to student test score gain data. Using realistic performance measurement system schemes based on hypothesis testing, we develop error rate formulas based on OLS and Empirical Bayes estimators.…

Improving the prediction of going concern of Taiwanese listed companies using a hybrid of LASSO with data mining techniques.

PubMed

Goo, Yeung-Ja James; Chi, Der-Jang; Shen, Zong-De

2016-01-01

The purpose of this study is to establish rigorous and reliable going concern doubt (GCD) prediction models. This study first uses the least absolute shrinkage and selection operator (LASSO) to select variables and then applies data mining techniques to establish prediction models, such as neural network (NN), classification and regression tree (CART), and support vector machine (SVM). The samples of this study include 48 GCD listed companies and 124 NGCD (non-GCD) listed companies from 2002 to 2013 in the TEJ database. We conduct fivefold cross validation in order to identify the prediction accuracy. According to the empirical results, the prediction accuracy of the LASSO-NN model is 88.96 % (Type I error rate is 12.22 %; Type II error rate is 7.50 %), the prediction accuracy of the LASSO-CART model is 88.75 % (Type I error rate is 13.61 %; Type II error rate is 14.17 %), and the prediction accuracy of the LASSO-SVM model is 89.79 % (Type I error rate is 10.00 %; Type II error rate is 15.83 %).

Prescription errors before and after introduction of electronic medication alert system in a pediatric emergency department.

PubMed

Sethuraman, Usha; Kannikeswaran, Nirupama; Murray, Kyle P; Zidan, Marwan A; Chamberlain, James M

2015-06-01

Prescription errors occur frequently in pediatric emergency departments (PEDs).The effect of computerized physician order entry (CPOE) with electronic medication alert system (EMAS) on these is unknown. The objective was to compare prescription errors rates before and after introduction of CPOE with EMAS in a PED. The hypothesis was that CPOE with EMAS would significantly reduce the rate and severity of prescription errors in the PED. A prospective comparison of a sample of outpatient, medication prescriptions 5 months before and after CPOE with EMAS implementation (7,268 before and 7,292 after) was performed. Error types and rates, alert types and significance, and physician response were noted. Medication errors were deemed significant if there was a potential to cause life-threatening injury, failure of therapy, or an adverse drug effect. There was a significant reduction in the errors per 100 prescriptions (10.4 before vs. 7.3 after; absolute risk reduction = 3.1, 95% confidence interval [CI] = 2.2 to 4.0). Drug dosing error rates decreased from 8 to 5.4 per 100 (absolute risk reduction = 2.6, 95% CI = 1.8 to 3.4). Alerts were generated for 29.6% of prescriptions, with 45% involving drug dose range checking. The sensitivity of CPOE with EMAS in identifying errors in prescriptions was 45.1% (95% CI = 40.8% to 49.6%), and the specificity was 57% (95% CI = 55.6% to 58.5%). Prescribers modified 20% of the dosing alerts, resulting in the error not reaching the patient. Conversely, 11% of true dosing alerts for medication errors were overridden by the prescribers: 88 (11.3%) resulted in medication errors, and 684 (88.6%) were false-positive alerts. A CPOE with EMAS was associated with a decrease in overall prescription errors in our PED. Further system refinements are required to reduce the high false-positive alert rates. © 2015 by the Society for Academic Emergency Medicine.

Performance improvement of robots using a learning control scheme

NASA Technical Reports Server (NTRS)

Krishna, Ramuhalli; Chiang, Pen-Tai; Yang, Jackson C. S.

1987-01-01

Many applications of robots require that the same task be repeated a number of times. In such applications, the errors associated with one cycle are also repeated every cycle of the operation. An off-line learning control scheme is used here to modify the command function which would result in smaller errors in the next operation. The learning scheme is based on a knowledge of the errors and error rates associated with each cycle. Necessary conditions for the iterative scheme to converge to zero errors are derived analytically considering a second order servosystem model. Computer simulations show that the errors are reduced at a faster rate if the error rate is included in the iteration scheme. The results also indicate that the scheme may increase the magnitude of errors if the rate information is not included in the iteration scheme. Modification of the command input using a phase and gain adjustment is also proposed to reduce the errors with one attempt. The scheme is then applied to a computer model of a robot system similar to PUMA 560. Improved performance of the robot is shown by considering various cases of trajectory tracing. The scheme can be successfully used to improve the performance of actual robots within the limitations of the repeatability and noise characteristics of the robot.

Citation Help in Databases: The More Things Change, the More They Stay the Same

ERIC Educational Resources Information Center

Van Ullen, Mary; Kessler, Jane

2012-01-01

In 2005, the authors reviewed citation help in databases and found an error rate of 4.4 errors per citation. This article describes a follow-up study that revealed a modest improvement in the error rate to 3.4 errors per citation, still unacceptably high. The most problematic area was retrieval statements. The authors conclude that librarians…

Mimicking Aphasic Semantic Errors in Normal Speech Production: Evidence from a Novel Experimental Paradigm

ERIC Educational Resources Information Center

Hodgson, Catherine; Lambon Ralph, Matthew A.

2008-01-01

Semantic errors are commonly found in semantic dementia (SD) and some forms of stroke aphasia and provide insights into semantic processing and speech production. Low error rates are found in standard picture naming tasks in normal controls. In order to increase error rates and thus provide an experimental model of aphasic performance, this study…

Physical fault tolerance of nanoelectronics.

PubMed

Szkopek, Thomas; Roychowdhury, Vwani P; Antoniadis, Dimitri A; Damoulakis, John N

2011-04-29

The error rate in complementary transistor circuits is suppressed exponentially in electron number, arising from an intrinsic physical implementation of fault-tolerant error correction. Contrariwise, explicit assembly of gates into the most efficient known fault-tolerant architecture is characterized by a subexponential suppression of error rate with electron number, and incurs significant overhead in wiring and complexity. We conclude that it is more efficient to prevent logical errors with physical fault tolerance than to correct logical errors with fault-tolerant architecture.

Comparison of Agar Dilution, Disk Diffusion, MicroScan, and Vitek Antimicrobial Susceptibility Testing Methods to Broth Microdilution for Detection of Fluoroquinolone-Resistant Isolates of the Family Enterobacteriaceae

PubMed Central

Steward, Christine D.; Stocker, Sheila A.; Swenson, Jana M.; O’Hara, Caroline M.; Edwards, Jonathan R.; Gaynes, Robert P.; McGowan, John E.; Tenover, Fred C.

1999-01-01

Fluoroquinolone resistance appears to be increasing in many species of bacteria, particularly in those causing nosocomial infections. However, the accuracy of some antimicrobial susceptibility testing methods for detecting fluoroquinolone resistance remains uncertain. Therefore, we compared the accuracy of the results of agar dilution, disk diffusion, MicroScan Walk Away Neg Combo 15 conventional panels, and Vitek GNS-F7 cards to the accuracy of the results of the broth microdilution reference method for detection of ciprofloxacin and ofloxacin resistance in 195 clinical isolates of the family Enterobacteriaceae collected from six U.S. hospitals for a national surveillance project (Project ICARE [Intensive Care Antimicrobial Resistance Epidemiology]). For ciprofloxacin, very major error rates were 0% (disk diffusion and MicroScan), 0.9% (agar dilution), and 2.7% (Vitek), while major error rates ranged from 0% (agar dilution) to 3.7% (MicroScan and Vitek). Minor error rates ranged from 12.3% (agar dilution) to 20.5% (MicroScan). For ofloxacin, no very major errors were observed, and major errors were noted only with MicroScan (3.7% major error rate). Minor error rates ranged from 8.2% (agar dilution) to 18.5% (Vitek). Minor errors for all methods were substantially reduced when results with MICs within ±1 dilution of the broth microdilution reference MIC were excluded from analysis. However, the high number of minor errors by all test systems remains a concern. PMID:9986809

A method of treating the non-grey error in total emittance measurements

NASA Technical Reports Server (NTRS)

Heaney, J. B.; Henninger, J. H.

1971-01-01

In techniques for the rapid determination of total emittance, the sample is generally exposed to surroundings that are at a different temperature than the sample's surface. When the infrared spectral reflectance of the surface is spectrally selective, these techniques introduce an error into the total emittance values. Surfaces of aluminum overcoated with oxides of various thicknesses fall into this class. Because they are often used as temperature control coatings on satellites, their emittances must be accurately known. The magnitude of the error was calculated for Alzak and silicon oxide-coated aluminum and was shown to be dependent on the thickness of the oxide coating. The results demonstrate that, because the magnitude of the error is thickness-dependent, it is generally impossible or impractical to eliminate it by calibrating the measuring device.

Quantizing and sampling considerations in digital phased-locked loops

NASA Technical Reports Server (NTRS)

Hurst, G. T.; Gupta, S. C.

1974-01-01

The quantizer problem is first considered. The conditions under which the uniform white sequence model for the quantizer error is valid are established independent of the sampling rate. An equivalent spectral density is defined for the quantizer error resulting in an effective SNR value. This effective SNR may be used to determine quantized performance from infinitely fine quantized results. Attention is given to sampling rate considerations. Sampling rate characteristics of the digital phase-locked loop (DPLL) structure are investigated for the infinitely fine quantized system. The predicted phase error variance equation is examined as a function of the sampling rate. Simulation results are presented and a method is described which enables the minimum required sampling rate to be determined from the predicted phase error variance equations.

Organizational safety culture and medical error reporting by Israeli nurses.

PubMed

Kagan, Ilya; Barnoy, Sivia

2013-09-01

To investigate the association between patient safety culture (PSC) and the incidence and reporting rate of medical errors by Israeli nurses. Self-administered structured questionnaires were distributed to a convenience sample of 247 registered nurses enrolled in training programs at Tel Aviv University (response rate = 91%). The questionnaire's three sections examined the incidence of medication mistakes in clinical practice, the reporting rate for these errors, and the participants' views and perceptions of the safety culture in their workplace at three levels (organizational, departmental, and individual performance). Pearson correlation coefficients, t tests, and multiple regression analysis were used to analyze the data. Most nurses encountered medical errors from a daily to a weekly basis. Six percent of the sample never reported their own errors, while half reported their own errors "rarely or sometimes." The level of PSC was positively and significantly correlated with the error reporting rate. PSC, place of birth, error incidence, and not having an academic nursing degree were significant predictors of error reporting, together explaining 28% of variance. This study confirms the influence of an organizational safety climate on readiness to report errors. Senior healthcare executives and managers can make a major impact on safety culture development by creating and promoting a vision and strategy for quality and safety and fostering their employees' motivation to implement improvement programs at the departmental and individual level. A positive, carefully designed organizational safety culture can encourage error reporting by staff and so improve patient safety. © 2013 Sigma Theta Tau International.

Software for Quantifying and Simulating Microsatellite Genotyping Error

PubMed Central

Johnson, Paul C.D.; Haydon, Daniel T.

2007-01-01

Microsatellite genetic marker data are exploited in a variety of fields, including forensics, gene mapping, kinship inference and population genetics. In all of these fields, inference can be thwarted by failure to quantify and account for data errors, and kinship inference in particular can benefit from separating errors into two distinct classes: allelic dropout and false alleles. Pedant is MS Windows software for estimating locus-specific maximum likelihood rates of these two classes of error. Estimation is based on comparison of duplicate error-prone genotypes: neither reference genotypes nor pedigree data are required. Other functions include: plotting of error rate estimates and confidence intervals; simulations for performing power analysis and for testing the robustness of error rate estimates to violation of the underlying assumptions; and estimation of expected heterozygosity, which is a required input. The program, documentation and source code are available from http://www.stats.gla.ac.uk/~paulj/pedant.html. PMID:20066126

Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study.

PubMed

Westbrook, Johanna I; Raban, Magdalena Z; Walter, Scott R; Douglas, Heather

2018-01-09

Interruptions and multitasking have been demonstrated in experimental studies to reduce individuals' task performance. These behaviours are frequently used by clinicians in high-workload, dynamic clinical environments, yet their effects have rarely been studied. To assess the relative contributions of interruptions and multitasking by emergency physicians to prescribing errors. 36 emergency physicians were shadowed over 120 hours. All tasks, interruptions and instances of multitasking were recorded. Physicians' working memory capacity (WMC) and preference for multitasking were assessed using the Operation Span Task (OSPAN) and Inventory of Polychronic Values. Following observation, physicians were asked about their sleep in the previous 24 hours. Prescribing errors were used as a measure of task performance. We performed multivariate analysis of prescribing error rates to determine associations with interruptions and multitasking, also considering physician seniority, age, psychometric measures, workload and sleep. Physicians experienced 7.9 interruptions/hour. 28 clinicians were observed prescribing 239 medication orders which contained 208 prescribing errors. While prescribing, clinicians were interrupted 9.4 times/hour. Error rates increased significantly if physicians were interrupted (rate ratio (RR) 2.82; 95% CI 1.23 to 6.49) or multitasked (RR 1.86; 95% CI 1.35 to 2.56) while prescribing. Having below-average sleep showed a >15-fold increase in clinical error rate (RR 16.44; 95% CI 4.84 to 55.81). WMC was protective against errors; for every 10-point increase on the 75-point OSPAN, a 19% decrease in prescribing errors was observed. There was no effect of polychronicity, workload, physician gender or above-average sleep on error rates. Interruptions, multitasking and poor sleep were associated with significantly increased rates of prescribing errors among emergency physicians. WMC mitigated the negative influence of these factors to an extent. These results confirm experimental findings in other fields and raise questions about the acceptability of the high rates of multitasking and interruption in clinical environments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluating Micrometeorological Estimates of Groundwater Discharge from Great Basin Desert Playas.

PubMed

Jackson, Tracie R; Halford, Keith J; Gardner, Philip M

2018-03-06

Groundwater availability studies in the arid southwestern United States traditionally have assumed that groundwater discharge by evapotranspiration (ET g ) from desert playas is a significant component of the groundwater budget. However, desert playa ET g rates are poorly constrained by Bowen ratio energy budget (BREB) and eddy-covariance (EC) micrometeorological measurement approaches. Best attempts by previous studies to constrain ET g from desert playas have resulted in ET g rates that are within the measurement error of micrometeorological approaches. This study uses numerical models to further constrain desert playa ET g rates that are within the measurement error of BREB and EC approaches, and to evaluate the effect of hydraulic properties and salinity-based groundwater density contrasts on desert playa ET g rates. Numerical models simulated ET g rates from desert playas in Death Valley, California and Dixie Valley, Nevada. Results indicate that actual ET g rates from desert playas are significantly below the uncertainty thresholds of BREB- and EC-based micrometeorological measurements. Discharge from desert playas likely contributes less than 2% of total groundwater discharge from Dixie and Death Valleys, which suggests discharge from desert playas also is negligible in other basins. Simulation results also show that ET g from desert playas primarily is limited by differences in hydraulic properties between alluvial fan and playa sediments and, to a lesser extent, by salinity-based groundwater density contrasts. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Stabilization of the total force in multi-finger pressing tasks studied with the ‘inverse piano’ technique

PubMed Central

Martin, J.R.; Budgeon, M.K.; Zatsiorsky, V.M.; Latash, M.L.

2010-01-01

When one finger changes its force, other fingers of the hand can show unintended force changes in the same direction (enslaving) and in the opposite direction (error compensation). We tested a hypothesis that externally imposed changes in finger force predominantly lead to error compensation effects in other fingers thus stabilizing the total force. A novel device, the “inverse piano”, was used to impose controlled displacements to one of the fingers over different magnitudes and at different rates. Subjects (n =10) pressed with four fingers at a constant force level and then one of the fingers was unexpectedly raised. The subjects were instructed not to interfere with possible changes in the finger forces. Raising a finger caused an increase in its force and a drop in the force of the other three fingers. Overall, total force showed a small increase. Larger force drops were seen in neighbors of the raised finger (proximity effect). The results show that multi-finger force stabilizing synergies dominate during involuntary reactions to externally imposed finger force changes. Within the referent configuration hypothesis, the data suggest that the instruction “not to interfere” leads to adjustments of the referent coordinates of all the individual fingers. PMID:21450360

Model studies of the beam-filling error for rain-rate retrieval with microwave radiometers

NASA Technical Reports Server (NTRS)

Ha, Eunho; North, Gerald R.

1995-01-01

Low-frequency (less than 20 GHz) single-channel microwave retrievals of rain rate encounter the problem of beam-filling error. This error stems from the fact that the relationship between microwave brightness temperature and rain rate is nonlinear, coupled with the fact that the field of view is large or comparable to important scales of variability of the rain field. This means that one may not simply insert the area average of the brightness temperature into the formula for rain rate without incurring both bias and random error. The statistical heterogeneity of the rain-rate field in the footprint of the instrument is key to determining the nature of these errors. This paper makes use of a series of random rain-rate fields to study the size of the bias and random error associated with beam filling. A number of examples are analyzed in detail: the binomially distributed field, the gamma, the Gaussian, the mixed gamma, the lognormal, and the mixed lognormal ('mixed' here means there is a finite probability of no rain rate at a point of space-time). Of particular interest are the applicability of a simple error formula due to Chiu and collaborators and a formula that might hold in the large field of view limit. It is found that the simple formula holds for Gaussian rain-rate fields but begins to fail for highly skewed fields such as the mixed lognormal. While not conclusively demonstrated here, it is suggested that the notionof climatologically adjusting the retrievals to remove the beam-filling bias is a reasonable proposition.

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

McInerney, Peter; Adams, Paul; Hadi, Masood Z.

As larger-scale cloning projects become more prevalent, there is an increasing need for comparisons among high fidelity DNA polymerases used for PCR amplification. All polymerases marketed for PCR applications are tested for fidelity properties (i.e., error rate determination) by vendors, and numerous literature reports have addressed PCR enzyme fidelity. Nonetheless, it is often difficult to make direct comparisons among different enzymes due to numerous methodological and analytical differences from study to study. We have measured the error rates for 6 DNA polymerases commonly used in PCR applications, including 3 polymerases typically used for cloning applications requiring high fidelity. Error ratemore » measurement values reported here were obtained by direct sequencing of cloned PCR products. The strategy employed here allows interrogation of error rate across a very large DNA sequence space, since 94 unique DNA targets were used as templates for PCR cloning. The six enzymes included in the study, Taq polymerase, AccuPrime-Taq High Fidelity, KOD Hot Start, cloned Pfu polymerase, Phusion Hot Start, and Pwo polymerase, we find the lowest error rates with Pfu , Phusion, and Pwo polymerases. Error rates are comparable for these 3 enzymes and are >10x lower than the error rate observed with Taq polymerase. Mutation spectra are reported, with the 3 high fidelity enzymes displaying broadly similar types of mutations. For these enzymes, transition mutations predominate, with little bias observed for type of transition.« less

Decision support system for determining the contact lens for refractive errors patients with classification ID3

NASA Astrophysics Data System (ADS)

Situmorang, B. H.; Setiawan, M. P.; Tosida, E. T.

2017-01-01

Refractive errors are abnormalities of the refraction of light so that the shadows do not focus precisely on the retina resulting in blurred vision [1]. Refractive errors causing the patient should wear glasses or contact lenses in order eyesight returned to normal. The use of glasses or contact lenses in a person will be different from others, it is influenced by patient age, the amount of tear production, vision prescription, and astigmatic. Because the eye is one organ of the human body is very important to see, then the accuracy in determining glasses or contact lenses which will be used is required. This research aims to develop a decision support system that can produce output on the right contact lenses for refractive errors patients with a value of 100% accuracy. Iterative Dichotomize Three (ID3) classification methods will generate gain and entropy values of attributes that include code sample data, age of the patient, astigmatic, the ratio of tear production, vision prescription, and classes that will affect the outcome of the decision tree. The eye specialist test result for the training data obtained the accuracy rate of 96.7% and an error rate of 3.3%, the result test using confusion matrix obtained the accuracy rate of 96.1% and an error rate of 3.1%; for the data testing obtained accuracy rate of 100% and an error rate of 0.

Using failure mode and effects analysis to improve the safety of neonatal parenteral nutrition.

PubMed

Arenas Villafranca, Jose Javier; Gómez Sánchez, Araceli; Nieto Guindo, Miriam; Faus Felipe, Vicente

2014-07-15

Failure mode and effects analysis (FMEA) was used to identify potential errors and to enable the implementation of measures to improve the safety of neonatal parenteral nutrition (PN). FMEA was used to analyze the preparation and dispensing of neonatal PN from the perspective of the pharmacy service in a general hospital. A process diagram was drafted, illustrating the different phases of the neonatal PN process. Next, the failures that could occur in each of these phases were compiled and cataloged, and a questionnaire was developed in which respondents were asked to rate the following aspects of each error: incidence, detectability, and severity. The highest scoring failures were considered high risk and identified as priority areas for improvements to be made. The evaluation process detected a total of 82 possible failures. Among the phases with the highest number of possible errors were transcription of the medical order, formulation of the PN, and preparation of material for the formulation. After the classification of these 82 possible failures and of their relative importance, a checklist was developed to achieve greater control in the error-detection process. FMEA demonstrated that use of the checklist reduced the level of risk and improved the detectability of errors. FMEA was useful for detecting medication errors in the PN preparation process and enabling corrective measures to be taken. A checklist was developed to reduce errors in the most critical aspects of the process. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Beyond the Total Score: A Preliminary Investigation into the Types of Phonological Awareness Errors Made by First Graders

ERIC Educational Resources Information Center

Hayward, Denyse V.; Annable, Caitlin D.; Fung, Jennifer E.; Williamson, Robert D.; Lovell-Johnston, Meridith A.; Phillips, Linda M.

2017-01-01

Current phonological awareness assessment procedures consider only the total score a child achieves. Such an approach may result in children who achieve the same total score receiving the same instruction even though the configuration of their errors represent fundamental knowledge differences. The purpose of this study was to develop a tool for…

Racial Variations in the Prevalence of Refractive Errors in the United States: The Multi-Ethnic Study of Atherosclerosis

PubMed Central

PAN, CHEN-WEI; KLEIN, BARBARA E.K.; COTCH, MARY FRANCES; SHRAGER, SANDI; KLEIN, RONALD; FOLSOM, AARON; KRONMAL, RICHARD; SHEA, STEVEN J.; BURKE, GREGORY L.; SAW, SEANG-MEI; WONG, TIEN Y.

2013-01-01

PURPOSE To describe racial variations in the prevalence of refractive errors among adult white, Chinese, Hispanic, and black subjects in the United States. DESIGN Cross-sectional data from a prospective cohort study—the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS A total of 6000 adults aged 45 to 84 years living in the United States participated in the study. Refractive error was assessed, without cycloplegia, in both eyes of all participants using an autorefractor. After excluding eyes with cataract, cataract surgery, or previous refractive surgery, the eye with the larger absolute spherical equivalent (SE) value for each participant was used to classify refractive error. Any myopia was defined as SE of −1.0 diopters (D) or less; high myopia was defined as SE of −5.0 D or less; any hyperopia was defined as SE of +1.0 D or more; clinically significant hyperopia was defined as SE of +3.0 D or more. Astigmatism was defined as a cylinder value of +1.0 D or more. RESULTS After excluding 508 participants with cataracts in both eyes, 838 participants with cataract surgery, 90 participants with laser refractive surgery, and 134 participants who refused to remove their contact lenses for the refraction measurement, 4430 adults with refractive error assessment in at least 1 eye contributed to the analysis. The prevalence of myopia among MESA participants was 25.1%, with lowest rates in Hispanic participants (14.2%), followed by black (21.5%) and white participants (31.0%), and highest rates in Chinese participants (37.2%). The overall rates of high myopia and astigmatism were 4.6% and 45.0%, respectively, with Chinese subjects also having the highest rates of high myopia (11.8%) and astigmatism (53.4%). The overall prevalence of any hyperopia was 38.2% and clinically significant hyperopia was 6.1%, with Hispanic participants having the highest rates of hyperopia (50.2%) and clinically significant hyperopia (8.8%). In multivariate analyses adjusting for age, sex, race, and study site, higher education level, being employed, and being taller were associated with a higher prevalence of myopia. In contrast, lower educational level and being shorter were associated with a higher prevalence of hyperopia. CONCLUSIONS Myopia and astigmatism were most prevalent in the Chinese population, with Chinese subjects having 3 times the prevalence of myopia as Hispanic subjects. Hyperopia was most common in Hispanic subjects. These findings provide further insights into variations in refractive errors among different racial groups and have important implications for the eye care services in the United States. PMID:23453694

Racial variations in the prevalence of refractive errors in the United States: the multi-ethnic study of atherosclerosis.

PubMed

Pan, Chen-Wei; Klein, Barbara E K; Cotch, Mary Frances; Shrager, Sandi; Klein, Ronald; Folsom, Aaron; Kronmal, Richard; Shea, Steven J; Burke, Gregory L; Saw, Seang-Mei; Wong, Tien Y

2013-06-01

To describe racial variations in the prevalence of refractive errors among adult white, Chinese, Hispanic, and black subjects in the United States. Cross-sectional data from a prospective cohort study-the Multi-Ethnic Study of Atherosclerosis (MESA). A total of 6000 adults aged 45 to 84 years living in the United States participated in the study. Refractive error was assessed, without cycloplegia, in both eyes of all participants using an autorefractor. After excluding eyes with cataract, cataract surgery, or previous refractive surgery, the eye with the larger absolute spherical equivalent (SE) value for each participant was used to classify refractive error. Any myopia was defined as SE of -1.0 diopters (D) or less; high myopia was defined as SE of -5.0 D or less; any hyperopia was defined as SE of +1.0 D or more; clinically significant hyperopia was defined as SE of +3.0 D or more. Astigmatism was defined as a cylinder value of +1.0 D or more. After excluding 508 participants with cataracts in both eyes, 838 participants with cataract surgery, 90 participants with laser refractive surgery, and 134 participants who refused to remove their contact lenses for the refraction measurement, 4430 adults with refractive error assessment in at least 1 eye contributed to the analysis. The prevalence of myopia among MESA participants was 25.1%, with lowest rates in Hispanic participants (14.2%), followed by black (21.5%) and white participants (31.0%), and highest rates in Chinese participants (37.2%). The overall rates of high myopia and astigmatism were 4.6% and 45.0%, respectively, with Chinese subjects also having the highest rates of high myopia (11.8%) and astigmatism (53.4%). The overall prevalence of any hyperopia was 38.2% and clinically significant hyperopia was 6.1%, with Hispanic participants having the highest rates of hyperopia (50.2%) and clinically significant hyperopia (8.8%). In multivariate analyses adjusting for age, sex, race, and study site, higher education level, being employed, and being taller were associated with a higher prevalence of myopia. In contrast, lower educational level and being shorter were associated with a higher prevalence of hyperopia. Myopia and astigmatism were most prevalent in the Chinese population, with Chinese subjects having 3 times the prevalence of myopia as Hispanic subjects. Hyperopia was most common in Hispanic subjects. These findings provide further insights into variations in refractive errors among different racial groups and have important implications for the eye care services in the United States. Copyright © 2013 Elsevier Inc. All rights reserved.

Fourth-Grade Children are Less Accurate in Reporting School Breakfast than School Lunch during 24-Hour Dietary Recalls

PubMed Central

Baxter, Suzanne Domel; Royer, Julie A.; Hardin, James W.; Guinn, Caroline H.; Smith, Albert F.

2008-01-01

Objective To compare reporting accuracy for breakfast and lunch in two studies. Design Children were observed eating school meals and interviewed the following morning about the previous day. Study 1 – 104 children were each interviewed one to three times with ≥25 days separating any two interviews. Study 2 – 121 children were each interviewed once in forward (morning-to-evening) and once in reverse (evening-to-morning) order, separated by ≥29 days. Setting 12 schools. Participants Fourth-grade children. Main Outcome Measures For each meal: food-item variables – observed number, reported number, omission rate, intrusion rate, total inaccuracy; kilocalorie variables – observed, reported, correspondence rate, inflation ratio. Analysis General linear mixed-models. Results For each study, observed and reported numbers of items and kilocalories, and correspondence rate (reporting accuracy), were greater for lunch than breakfast; omission rate, intrusion rate, and inflation ratio (measures of reporting error) were greater for breakfast than lunch. Study 1 – for each meal over interviews, total inaccuracy decreased and correspondence rate increased. Study 2 – for each meal for boys for reverse and girls for forward order, omission rate was lower and correspondence rate was higher. Conclusions and Implications Breakfast was reported less accurately than lunch. Despite improvement over interviews (Study 1) and differences for order × sex (Study 2), reporting accuracy was low for breakfast and lunch. PMID:17493562

Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting

PubMed Central

Westerik, Janine A. M.; Carter, Victoria; Chrystyn, Henry; Burden, Anne; Thompson, Samantha L.; Ryan, Dermot; Gruffydd-Jones, Kevin; Haughney, John; Roche, Nicolas; Lavorini, Federico; Papi, Alberto; Infantino, Antonio; Roman-Rodriguez, Miguel; Bosnic-Anticevich, Sinthia; Lisspers, Karin; Ställberg, Björn; Henrichsen, Svein Høegh; van der Molen, Thys; Hutton, Catherine; Price, David B.

2016-01-01

Abstract Objective: Correct inhaler technique is central to effective delivery of asthma therapy. The study aim was to identify factors associated with serious inhaler technique errors and their prevalence among primary care patients with asthma using the Diskus dry powder inhaler (DPI). Methods: This was a historical, multinational, cross-sectional study (2011–2013) using the iHARP database, an international initiative that includes patient- and healthcare provider-reported questionnaires from eight countries. Patients with asthma were observed for serious inhaler errors by trained healthcare providers as predefined by the iHARP steering committee. Multivariable logistic regression, stepwise reduced, was used to identify clinical characteristics and asthma-related outcomes associated with ≥1 serious errors. Results: Of 3681 patients with asthma, 623 (17%) were using a Diskus (mean [SD] age, 51 [14]; 61% women). A total of 341 (55%) patients made ≥1 serious errors. The most common errors were the failure to exhale before inhalation, insufficient breath-hold at the end of inhalation, and inhalation that was not forceful from the start. Factors significantly associated with ≥1 serious errors included asthma-related hospitalization the previous year (odds ratio [OR] 2.07; 95% confidence interval [CI], 1.26–3.40); obesity (OR 1.75; 1.17–2.63); poor asthma control the previous 4 weeks (OR 1.57; 1.04–2.36); female sex (OR 1.51; 1.08–2.10); and no inhaler technique review during the previous year (OR 1.45; 1.04–2.02). Conclusions: Patients with evidence of poor asthma control should be targeted for a review of their inhaler technique even when using a device thought to have a low error rate. PMID:26810934

Medication errors room: a simulation to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system.

PubMed

Daupin, Johanne; Atkinson, Suzanne; Bédard, Pascal; Pelchat, Véronique; Lebel, Denis; Bussières, Jean-François

2016-12-01

The medication-use system in hospitals is very complex. To improve the health professionals' awareness of the risks of errors related to the medication-use system, a simulation of medication errors was created. The main objective was to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system using a simulation. The secondary objective was to assess their level of satisfaction. This descriptive cross-sectional study was conducted in a 500-bed mother-and-child university hospital. A multidisciplinary group set up 30 situations and replicated a patient room and a care unit pharmacy. All hospital staff, including nurses, physicians, pharmacists and pharmacy technicians, was invited. Participants had to detect if a situation contained an error and fill out a response grid. They also answered a satisfaction survey. The simulation was held during 100 hours. A total of 230 professionals visited the simulation, 207 handed in a response grid and 136 answered the satisfaction survey. The participants' overall rate of correct answers was 67.5% ± 13.3% (4073/6036). Among the least detected errors were situations involving a Y-site infusion incompatibility, an oral syringe preparation and the patient's identification. Participants mainly considered the simulation as effective in identifying incorrect practices (132/136, 97.8%) and relevant to their practice (129/136, 95.6%). Most of them (114/136; 84.4%) intended to change their practices in view of their exposure to the simulation. We implemented a realistic medication-use system errors simulation in a mother-child hospital, with a wide audience. This simulation was an effective, relevant and innovative tool to raise the health care professionals' awareness of critical processes. © 2016 John Wiley & Sons, Ltd.

Error reporting from the da Vinci surgical system in robotic surgery: A Canadian multispecialty experience at a single academic centre

PubMed Central

Rajih, Emad; Tholomier, Côme; Cormier, Beatrice; Samouëlian, Vanessa; Warkus, Thomas; Liberman, Moishe; Widmer, Hugues; Lattouf, Jean-Baptiste; Alenizi, Abdullah M.; Meskawi, Malek; Valdivieso, Roger; Hueber, Pierre-Alain; Karakewicz, Pierre I.; El-Hakim, Assaad; Zorn, Kevin C.

2017-01-01

Introduction The goal of the study is to evaluate and report on the third-generation da Vinci surgical (Si) system malfunctions. Methods A total of 1228 robotic surgeries were performed between January 2012 and December 2015 at our academic centre. All cases were performed by using a single, dual console, four-arm, da Vinci Si robot system. The three specialties included urology, gynecology, and thoracic surgery. Studied outcomes included the robotic surgical error types, immediate consequences, and operative side effects. Error rate trend with time was also examined. Results Overall robotic malfunctions were documented on the da Vinci Si systems event log in 4.97% (61/1228) of the cases. The most common error was related to pressure sensors in the robotic arms indicating out of limit output. This recoverable fault was noted in 2.04% (25/1228) of cases. Other errors included unrecoverable electronic communication-related in 1.06% (13/1228) of cases, failed encoder error in 0.57% (7/1228), illuminator-related in 0.33% (4/1228), faulty switch in 0.24% (3/1228), battery-related failures in 0.24% (3/1228), and software/hardware error in 0.08% (1/1228) of cases. Surgical delay was reported only in one patient. No conversion to either open or laparoscopic occurred secondary to robotic malfunctions. In 2015, the incidence of robotic error rose to 1.71% (21/1228) from 0.81% (10/1228) in 2014. Conclusions Robotic malfunction is not infrequent in the current era of robotic surgery in various surgical subspecialties, but rarely consequential. Their seldom occurrence does not seem to affect patient safety or surgical outcome. PMID:28503234

Error reporting from the da Vinci surgical system in robotic surgery: A Canadian multispecialty experience at a single academic centre.

PubMed

Rajih, Emad; Tholomier, Côme; Cormier, Beatrice; Samouëlian, Vanessa; Warkus, Thomas; Liberman, Moishe; Widmer, Hugues; Lattouf, Jean-Baptiste; Alenizi, Abdullah M; Meskawi, Malek; Valdivieso, Roger; Hueber, Pierre-Alain; Karakewicz, Pierre I; El-Hakim, Assaad; Zorn, Kevin C

2017-05-01

The goal of the study is to evaluate and report on the third-generation da Vinci surgical (Si) system malfunctions. A total of 1228 robotic surgeries were performed between January 2012 and December 2015 at our academic centre. All cases were performed by using a single, dual console, four-arm, da Vinci Si robot system. The three specialties included urology, gynecology, and thoracic surgery. Studied outcomes included the robotic surgical error types, immediate consequences, and operative side effects. Error rate trend with time was also examined. Overall robotic malfunctions were documented on the da Vinci Si systems event log in 4.97% (61/1228) of the cases. The most common error was related to pressure sensors in the robotic arms indicating out of limit output. This recoverable fault was noted in 2.04% (25/1228) of cases. Other errors included unrecoverable electronic communication-related in 1.06% (13/1228) of cases, failed encoder error in 0.57% (7/1228), illuminator-related in 0.33% (4/1228), faulty switch in 0.24% (3/1228), battery-related failures in 0.24% (3/1228), and software/hardware error in 0.08% (1/1228) of cases. Surgical delay was reported only in one patient. No conversion to either open or laparoscopic occurred secondary to robotic malfunctions. In 2015, the incidence of robotic error rose to 1.71% (21/1228) from 0.81% (10/1228) in 2014. Robotic malfunction is not infrequent in the current era of robotic surgery in various surgical subspecialties, but rarely consequential. Their seldom occurrence does not seem to affect patient safety or surgical outcome.

Tilt Error in Cryospheric Surface Radiation Measurements at High Latitudes: A Model Study

NASA Astrophysics Data System (ADS)

Bogren, W.; Kylling, A.; Burkhart, J. F.

2015-12-01

We have evaluated the magnitude and makeup of error in cryospheric radiation observations due to small sensor misalignment in in-situ measurements of solar irradiance. This error is examined through simulation of diffuse and direct irradiance arriving at a detector with a cosine-response foreoptic. Emphasis is placed on assessing total error over the solar shortwave spectrum from 250nm to 4500nm, as well as supporting investigation over other relevant shortwave spectral ranges. The total measurement error introduced by sensor tilt is dominated by the direct component. For a typical high latitude albedo measurement with a solar zenith angle of 60◦, a sensor tilted by 1, 3, and 5◦ can respectively introduce up to 2.6, 7.7, and 12.8% error into the measured irradiance and similar errors in the derived albedo. Depending on the daily range of solar azimuth and zenith angles, significant measurement error can persist also in integrated daily irradiance and albedo.

Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting.

PubMed

Prakash, Varuna; Koczmara, Christine; Savage, Pamela; Trip, Katherine; Stewart, Janice; McCurdie, Tara; Cafazzo, Joseph A; Trbovich, Patricia

2014-11-01

Nurses are frequently interrupted during medication verification and administration; however, few interventions exist to mitigate resulting errors, and the impact of these interventions on medication safety is poorly understood. The study objectives were to (A) assess the effects of interruptions on medication verification and administration errors, and (B) design and test the effectiveness of targeted interventions at reducing these errors. The study focused on medication verification and administration in an ambulatory chemotherapy setting. A simulation laboratory experiment was conducted to determine interruption-related error rates during specific medication verification and administration tasks. Interventions to reduce these errors were developed through a participatory design process, and their error reduction effectiveness was assessed through a postintervention experiment. Significantly more nurses committed medication errors when interrupted than when uninterrupted. With use of interventions when interrupted, significantly fewer nurses made errors in verifying medication volumes contained in syringes (16/18; 89% preintervention error rate vs 11/19; 58% postintervention error rate; p=0.038; Fisher's exact test) and programmed in ambulatory pumps (17/18; 94% preintervention vs 11/19; 58% postintervention; p=0.012). The rate of error commission significantly decreased with use of interventions when interrupted during intravenous push (16/18; 89% preintervention vs 6/19; 32% postintervention; p=0.017) and pump programming (7/18; 39% preintervention vs 1/19; 5% postintervention; p=0.017). No statistically significant differences were observed for other medication verification tasks. Interruptions can lead to medication verification and administration errors. Interventions were highly effective at reducing unanticipated errors of commission in medication administration tasks, but showed mixed effectiveness at reducing predictable errors of detection in medication verification tasks. These findings can be generalised and adapted to mitigate interruption-related errors in other settings where medication verification and administration are required. 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.

Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting

PubMed Central

Prakash, Varuna; Koczmara, Christine; Savage, Pamela; Trip, Katherine; Stewart, Janice; McCurdie, Tara; Cafazzo, Joseph A; Trbovich, Patricia

2014-01-01

Background Nurses are frequently interrupted during medication verification and administration; however, few interventions exist to mitigate resulting errors, and the impact of these interventions on medication safety is poorly understood. Objective The study objectives were to (A) assess the effects of interruptions on medication verification and administration errors, and (B) design and test the effectiveness of targeted interventions at reducing these errors. Methods The study focused on medication verification and administration in an ambulatory chemotherapy setting. A simulation laboratory experiment was conducted to determine interruption-related error rates during specific medication verification and administration tasks. Interventions to reduce these errors were developed through a participatory design process, and their error reduction effectiveness was assessed through a postintervention experiment. Results Significantly more nurses committed medication errors when interrupted than when uninterrupted. With use of interventions when interrupted, significantly fewer nurses made errors in verifying medication volumes contained in syringes (16/18; 89% preintervention error rate vs 11/19; 58% postintervention error rate; p=0.038; Fisher's exact test) and programmed in ambulatory pumps (17/18; 94% preintervention vs 11/19; 58% postintervention; p=0.012). The rate of error commission significantly decreased with use of interventions when interrupted during intravenous push (16/18; 89% preintervention vs 6/19; 32% postintervention; p=0.017) and pump programming (7/18; 39% preintervention vs 1/19; 5% postintervention; p=0.017). No statistically significant differences were observed for other medication verification tasks. Conclusions Interruptions can lead to medication verification and administration errors. Interventions were highly effective at reducing unanticipated errors of commission in medication administration tasks, but showed mixed effectiveness at reducing predictable errors of detection in medication verification tasks. These findings can be generalised and adapted to mitigate interruption-related errors in other settings where medication verification and administration are required. PMID:24906806

TECHNICAL ADVANCES: Effects of genotyping protocols on success and errors in identifying individual river otters (Lontra canadensis) from their faeces.

PubMed

Hansen, Heidi; Ben-David, Merav; McDonald, David B

2008-03-01

In noninvasive genetic sampling, when genotyping error rates are high and recapture rates are low, misidentification of individuals can lead to overestimation of population size. Thus, estimating genotyping errors is imperative. Nonetheless, conducting multiple polymerase chain reactions (PCRs) at multiple loci is time-consuming and costly. To address the controversy regarding the minimum number of PCRs required for obtaining a consensus genotype, we compared consumer-style the performance of two genotyping protocols (multiple-tubes and 'comparative method') in respect to genotyping success and error rates. Our results from 48 faecal samples of river otters (Lontra canadensis) collected in Wyoming in 2003, and from blood samples of five captive river otters amplified with four different primers, suggest that use of the comparative genotyping protocol can minimize the number of PCRs per locus. For all but five samples at one locus, the same consensus genotypes were reached with fewer PCRs and with reduced error rates with this protocol compared to the multiple-tubes method. This finding is reassuring because genotyping errors can occur at relatively high rates even in tissues such as blood and hair. In addition, we found that loci that amplify readily and yield consensus genotypes, may still exhibit high error rates (7-32%) and that amplification with different primers resulted in different types and rates of error. Thus, assigning a genotype based on a single PCR for several loci could result in misidentification of individuals. We recommend that programs designed to statistically assign consensus genotypes should be modified to allow the different treatment of heterozygotes and homozygotes intrinsic to the comparative method. © 2007 The Authors.

National suicide rates a century after Durkheim: do we know enough to estimate error?

PubMed

Claassen, Cynthia A; Yip, Paul S; Corcoran, Paul; Bossarte, Robert M; Lawrence, Bruce A; Currier, Glenn W

2010-06-01

Durkheim's nineteenth-century analysis of national suicide rates dismissed prior concerns about mortality data fidelity. Over the intervening century, however, evidence documenting various types of error in suicide data has only mounted, and surprising levels of such error continue to be routinely uncovered. Yet the annual suicide rate remains the most widely used population-level suicide metric today. After reviewing the unique sources of bias incurred during stages of suicide data collection and concatenation, we propose a model designed to uniformly estimate error in future studies. A standardized method of error estimation uniformly applied to mortality data could produce data capable of promoting high quality analyses of cross-national research questions.

Does Mckuer's Law Hold for Heart Rate Control via Biofeedback Display?

NASA Technical Reports Server (NTRS)

Courter, B. J.; Jex, H. R.

1984-01-01

Some persons can control their pulse rate with the aid of a biofeedback display. If the biofeedback display is modified to show the error between a command pulse-rate and the measured rate, a compensatory (error correcting) heart rate tracking control loop can be created. The dynamic response characteristics of this control loop when subjected to step and quasi-random disturbances were measured. The control loop includes a beat-to-beat cardiotachmeter differenced with a forcing function from a quasi-random input generator; the resulting error pulse-rate is displayed as feedback. The subject acts to null the displayed pulse-rate error, thereby closing a compensatory control loop. McRuer's Law should hold for this case. A few subjects already skilled in voluntary pulse-rate control were tested for heart-rate control response. Control-law properties are derived, such as: crossover frequency, stability margins, and closed-loop bandwidth. These are evaluated for a range of forcing functions and for step as well as random disturbances.

Online automatic tuning and control for fed-batch cultivation

PubMed Central

van Straten, Gerrit; van der Pol, Leo A.; van Boxtel, Anton J. B.

2007-01-01

Performance of controllers applied in biotechnological production is often below expectation. Online automatic tuning has the capability to improve control performance by adjusting control parameters. This work presents automatic tuning approaches for model reference specific growth rate control during fed-batch cultivation. The approaches are direct methods that use the error between observed specific growth rate and its set point; systematic perturbations of the cultivation are not necessary. Two automatic tuning methods proved to be efficient, in which the adaptation rate is based on a combination of the error, squared error and integral error. These methods are relatively simple and robust against disturbances, parameter uncertainties, and initialization errors. Application of the specific growth rate controller yields a stable system. The controller and automatic tuning methods are qualified by simulations and laboratory experiments with Bordetella pertussis. PMID:18157554

High-density marker imputation accuracy in sixteen French cattle breeds.

PubMed

Hozé, Chris; Fouilloux, Marie-Noëlle; Venot, Eric; Guillaume, François; Dassonneville, Romain; Fritz, Sébastien; Ducrocq, Vincent; Phocas, Florence; Boichard, Didier; Croiseau, Pascal

2013-09-03

Genotyping with the medium-density Bovine SNP50 BeadChip® (50K) is now standard in cattle. The high-density BovineHD BeadChip®, which contains 777,609 single nucleotide polymorphisms (SNPs), was developed in 2010. Increasing marker density increases the level of linkage disequilibrium between quantitative trait loci (QTL) and SNPs and the accuracy of QTL localization and genomic selection. However, re-genotyping all animals with the high-density chip is not economically feasible. An alternative strategy is to genotype part of the animals with the high-density chip and to impute high-density genotypes for animals already genotyped with the 50K chip. Thus, it is necessary to investigate the error rate when imputing from the 50K to the high-density chip. Five thousand one hundred and fifty three animals from 16 breeds (89 to 788 per breed) were genotyped with the high-density chip. Imputation error rates from the 50K to the high-density chip were computed for each breed with a validation set that included the 20% youngest animals. Marker genotypes were masked for animals in the validation population in order to mimic 50K genotypes. Imputation was carried out using the Beagle 3.3.0 software. Mean allele imputation error rates ranged from 0.31% to 2.41% depending on the breed. In total, 1980 SNPs had high imputation error rates in several breeds, which is probably due to genome assembly errors, and we recommend to discard these in future studies. Differences in imputation accuracy between breeds were related to the high-density-genotyped sample size and to the genetic relationship between reference and validation populations, whereas differences in effective population size and level of linkage disequilibrium showed limited effects. Accordingly, imputation accuracy was higher in breeds with large populations and in dairy breeds than in beef breeds. More than 99% of the alleles were correctly imputed if more than 300 animals were genotyped at high-density. No improvement was observed when multi-breed imputation was performed. In all breeds, imputation accuracy was higher than 97%, which indicates that imputation to the high-density chip was accurate. Imputation accuracy depends mainly on the size of the reference population and the relationship between reference and target populations.

High-density marker imputation accuracy in sixteen French cattle breeds

PubMed Central

2013-01-01

Background Genotyping with the medium-density Bovine SNP50 BeadChip® (50K) is now standard in cattle. The high-density BovineHD BeadChip®, which contains 777 609 single nucleotide polymorphisms (SNPs), was developed in 2010. Increasing marker density increases the level of linkage disequilibrium between quantitative trait loci (QTL) and SNPs and the accuracy of QTL localization and genomic selection. However, re-genotyping all animals with the high-density chip is not economically feasible. An alternative strategy is to genotype part of the animals with the high-density chip and to impute high-density genotypes for animals already genotyped with the 50K chip. Thus, it is necessary to investigate the error rate when imputing from the 50K to the high-density chip. Methods Five thousand one hundred and fifty three animals from 16 breeds (89 to 788 per breed) were genotyped with the high-density chip. Imputation error rates from the 50K to the high-density chip were computed for each breed with a validation set that included the 20% youngest animals. Marker genotypes were masked for animals in the validation population in order to mimic 50K genotypes. Imputation was carried out using the Beagle 3.3.0 software. Results Mean allele imputation error rates ranged from 0.31% to 2.41% depending on the breed. In total, 1980 SNPs had high imputation error rates in several breeds, which is probably due to genome assembly errors, and we recommend to discard these in future studies. Differences in imputation accuracy between breeds were related to the high-density-genotyped sample size and to the genetic relationship between reference and validation populations, whereas differences in effective population size and level of linkage disequilibrium showed limited effects. Accordingly, imputation accuracy was higher in breeds with large populations and in dairy breeds than in beef breeds. More than 99% of the alleles were correctly imputed if more than 300 animals were genotyped at high-density. No improvement was observed when multi-breed imputation was performed. Conclusion In all breeds, imputation accuracy was higher than 97%, which indicates that imputation to the high-density chip was accurate. Imputation accuracy depends mainly on the size of the reference population and the relationship between reference and target populations. PMID:24004563

Time-resolved in vivo luminescence dosimetry for online error detection in pulsed dose-rate brachytherapy.

PubMed

Andersen, Claus E; Nielsen, Søren Kynde; Lindegaard, Jacob Christian; Tanderup, Kari

2009-11-01

The purpose of this study is to present and evaluate a dose-verification protocol for pulsed dose-rate (PDR) brachytherapy based on in vivo time-resolved (1 s time resolution) fiber-coupled luminescence dosimetry. Five cervix cancer patients undergoing PDR brachytherapy (Varian GammaMed Plus with 192Ir) were monitored. The treatments comprised from 10 to 50 pulses (1 pulse/h) delivered by intracavitary/interstitial applicators (tandem-ring systems and/or needles). For each patient, one or two dosimetry probes were placed directly in or close to the tumor region using stainless steel or titanium needles. Each dosimeter probe consisted of a small aluminum oxide crystal attached to an optical fiber cable (1 mm outer diameter) that could guide radioluminescence (RL) and optically stimulated luminescence (OSL) from the crystal to special readout instrumentation. Positioning uncertainty and hypothetical dose-delivery errors (interchanged guide tubes or applicator movements from +/-5 to +/-15 mm) were simulated in software in order to assess the ability of the system to detect errors. For three of the patients, the authors found no significant differences (P>0.01) for comparisons between in vivo measurements and calculated reference values at the level of dose per dwell position, dose per applicator, or total dose per pulse. The standard deviations of the dose per pulse were less than 3%, indicating a stable dose delivery and a highly stable geometry of applicators and dosimeter probes during the treatments. For the two other patients, the authors noted significant deviations for three individual pulses and for one dosimeter probe. These deviations could have been due to applicator movement during the treatment and one incorrectly positioned dosimeter probe, respectively. Computer simulations showed that the likelihood of detecting a pair of interchanged guide tubes increased by a factor of 10 or more for the considered patients when going from integrating to time-resolved dose verification. The likelihood of detecting a +/-15 mm displacement error increased by a factor of 1.5 or more. In vivo fiber-coupled RL/OSL dosimetry based on detectors placed in standard brachytherapy needles was demonstrated. The time-resolved dose-rate measurements were found to provide a good way to visualize the progression and stability of PDR brachytherapy dose delivery, and time-resolved dose-rate measurements provided an increased sensitivity for detection of dose-delivery errors compared with time-integrated dosimetry.

Performance analysis of a cascaded coding scheme with interleaved outer code

NASA Technical Reports Server (NTRS)

Lin, S.

1986-01-01

A cascaded coding scheme for a random error channel with a bit-error rate is analyzed. In this scheme, the inner code C sub 1 is an (n sub 1, m sub 1l) binary linear block code which is designed for simultaneous error correction and detection. The outer code C sub 2 is a linear block code with symbols from the Galois field GF (2 sup l) which is designed for correcting both symbol errors and erasures, and is interleaved with a degree m sub 1. A procedure for computing the probability of a correct decoding is presented and an upper bound on the probability of a decoding error is derived. The bound provides much better results than the previous bound for a cascaded coding scheme with an interleaved outer code. Example schemes with inner codes ranging from high rates to very low rates are evaluated. Several schemes provide extremely high reliability even for very high bit-error rates say 10 to the -1 to 10 to the -2 power.

Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital.

PubMed

Sánchez-Margalet, Víctor; Rodriguez-Oliva, Manuel; Sánchez-Pozo, Cristina; Fernández-Gallardo, María Francisca; Goberna, Raimundo

2005-01-01

Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach <5% analytical error and <7.9% total error. We studied 80 meters throughout the Virgen Macarena Hospital and we found most devices with performance error higher than 10%. The aim of the present study was to establish a new system to control portable glucose meters together with an educational program for nurses in a 1200-bed University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/l) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (<7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

The effect of speaking rate on serial-order sound-level errors in normal healthy controls and persons with aphasia.

PubMed

Fossett, Tepanta R D; McNeil, Malcolm R; Pratt, Sheila R; Tompkins, Connie A; Shuster, Linda I

Although many speech errors can be generated at either a linguistic or motoric level of production, phonetically well-formed sound-level serial-order errors are generally assumed to result from disruption of phonologic encoding (PE) processes. An influential model of PE (Dell, 1986; Dell, Burger & Svec, 1997) predicts that speaking rate should affect the relative proportion of these serial-order sound errors (anticipations, perseverations, exchanges). These predictions have been extended to, and have special relevance for persons with aphasia (PWA) because of the increased frequency with which speech errors occur and because their localization within the functional linguistic architecture may help in diagnosis and treatment. Supporting evidence regarding the effect of speaking rate on phonological encoding has been provided by studies using young normal language (NL) speakers and computer simulations. Limited data exist for older NL users and no group data exist for PWA. This study tested the phonologic encoding properties of Dell's model of speech production (Dell, 1986; Dell,et al., 1997), which predicts that increasing speaking rate affects the relative proportion of serial-order sound errors (i.e., anticipations, perseverations, and exchanges). The effects of speech rate on the error ratios of anticipation/exchange (AE), anticipation/perseveration (AP) and vocal reaction time (VRT) were examined in 16 normal healthy controls (NHC) and 16 PWA without concomitant motor speech disorders. The participants were recorded performing a phonologically challenging (tongue twister) speech production task at their typical and two faster speaking rates. A significant effect of increased rate was obtained for the AP but not the AE ratio. Significant effects of group and rate were obtained for VRT. Although the significant effect of rate for the AP ratio provided evidence that changes in speaking rate did affect PE, the results failed to support the model derived predictions regarding the direction of change for error type proportions. The current findings argued for an alternative concept of the role of activation and decay in influencing types of serial-order sound errors. Rather than a slow activation decay rate (Dell, 1986), the results of the current study were more compatible with an alternative explanation of rapid activation decay or slow build-up of residual activation.

Evaluation of TRMM Ground-Validation Radar-Rain Errors Using Rain Gauge Measurements

NASA Technical Reports Server (NTRS)

Wang, Jianxin; Wolff, David B.

2009-01-01

Ground-validation (GV) radar-rain products are often utilized for validation of the Tropical Rainfall Measuring Mission (TRMM) spaced-based rain estimates, and hence, quantitative evaluation of the GV radar-rain product error characteristics is vital. This study uses quality-controlled gauge data to compare with TRMM GV radar rain rates in an effort to provide such error characteristics. The results show that significant differences of concurrent radar-gauge rain rates exist at various time scales ranging from 5 min to 1 day, despite lower overall long-term bias. However, the differences between the radar area-averaged rain rates and gauge point rain rates cannot be explained as due to radar error only. The error variance separation method is adapted to partition the variance of radar-gauge differences into the gauge area-point error variance and radar rain estimation error variance. The results provide relatively reliable quantitative uncertainty evaluation of TRMM GV radar rain estimates at various times scales, and are helpful to better understand the differences between measured radar and gauge rain rates. It is envisaged that this study will contribute to better utilization of GV radar rain products to validate versatile spaced-based rain estimates from TRMM, as well as the proposed Global Precipitation Measurement, and other satellites.

Errors Affect Hypothetical Intertemporal Food Choice in Women

PubMed Central

Sellitto, Manuela; di Pellegrino, Giuseppe

2014-01-01

Growing evidence suggests that the ability to control behavior is enhanced in contexts in which errors are more frequent. Here we investigated whether pairing desirable food with errors could decrease impulsive choice during hypothetical temporal decisions about food. To this end, healthy women performed a Stop-signal task in which one food cue predicted high-error rate, and another food cue predicted low-error rate. Afterwards, we measured participants’ intertemporal preferences during decisions between smaller-immediate and larger-delayed amounts of food. We expected reduced sensitivity to smaller-immediate amounts of food associated with high-error rate. Moreover, taking into account that deprivational states affect sensitivity for food, we controlled for participants’ hunger. Results showed that pairing food with high-error likelihood decreased temporal discounting. This effect was modulated by hunger, indicating that, the lower the hunger level, the more participants showed reduced impulsive preference for the food previously associated with a high number of errors as compared with the other food. These findings reveal that errors, which are motivationally salient events that recruit cognitive control and drive avoidance learning against error-prone behavior, are effective in reducing impulsive choice for edible outcomes. PMID:25244534

Fresh Fuel Measurements With the Differential Die-Away Self-Interrogation Instrument

NASA Astrophysics Data System (ADS)

Trahan, Alexis C.; Belian, Anthony P.; Swinhoe, Martyn T.; Menlove, Howard O.; Flaska, Marek; Pozzi, Sara A.

2017-07-01

The purpose of the Next Generation Safeguards Initiative (NGSI)-Spent Fuel (SF) Project is to strengthen the technical toolkit of safeguards inspectors and/or other interested parties. The NGSI-SF team is working to achieve the following technical goals more easily and efficiently than in the past using nondestructive assay measurements of spent fuel assemblies: 1) verify the initial enrichment, burnup, and cooling time of facility declaration; 2) detect the diversion or replacement of pins; 3) estimate the plutonium mass; 4) estimate decay heat; and 5) determine the reactivity of spent fuel assemblies. The differential die-away self-interrogation (DDSI) instrument is one instrument that was assessed for years regarding its feasibility for robust, timely verification of spent fuel assemblies. The instrument was recently built and was tested using fresh fuel assemblies in a variety of configurations, including varying enrichment, neutron absorber content, and symmetry. The early die-away method, a multiplication determination method developed in simulation space, was successfully tested on the fresh fuel assembly data and determined multiplication with a root-mean-square (RMS) error of 2.9%. The experimental results were compared with MCNP simulations of the instrument as well. Low multiplication assemblies had agreement with an average RMS error of 0.2% in the singles count rate (i.e., total neutrons detected per second) and 3.4% in the doubles count rates (i.e., neutrons detected in coincidence per second). High-multiplication assemblies had agreement with an average RMS error of 4.1% in the singles and 13.3% in the doubles count rates.

Fresh Fuel Measurements With the Differential Die-Away Self-Interrogation Instrument

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

Trahan, Alexis C.; Belian, Anthony P.; Swinhoe, Martyn T.

The purpose of the Next Generation Safeguards Initiative (NGSI)-Spent Fuel (SF) Project is to strengthen the technical toolkit of safeguards inspectors and/or other interested parties. Thus the NGSI-SF team is working to achieve the following technical goals more easily and efficiently than in the past using nondestructive assay measurements of spent fuel assemblies: 1) verify the initial enrichment, burnup, and cooling time of facility declaration; 2) detect the diversion or replacement of pins; 3) estimate the plutonium mass; 4) estimate decay heat; and 5) determine the reactivity of spent fuel assemblies. The differential die-away self-interrogation (DDSI) instrument is one instrumentmore » that was assessed for years regarding its feasibility for robust, timely verification of spent fuel assemblies. The instrument was recently built and was tested using fresh fuel assemblies in a variety of configurations, including varying enrichment, neutron absorber content, and symmetry. The early die-away method, a multiplication determination method developed in simulation space, was successfully tested on the fresh fuel assembly data and determined multiplication with a root-mean-square (RMS) error of 2.9%. The experimental results were compared with MCNP simulations of the instrument as well. Low multiplication assemblies had agreement with an average RMS error of 0.2% in the singles count rate (i.e., total neutrons detected per second) and 3.4% in the doubles count rates (i.e., neutrons detected in coincidence per second). High-multiplication assemblies had agreement with an average RMS error of 4.1% in the singles and 13.3% in the doubles count rates.« less

Dynamic Sensorimotor Planning during Long-Term Sequence Learning: The Role of Variability, Response Chunking and Planning Errors

PubMed Central

Verstynen, Timothy; Phillips, Jeff; Braun, Emily; Workman, Brett; Schunn, Christian; Schneider, Walter

2012-01-01

Many everyday skills are learned by binding otherwise independent actions into a unified sequence of responses across days or weeks of practice. Here we looked at how the dynamics of action planning and response binding change across such long timescales. Subjects (N = 23) were trained on a bimanual version of the serial reaction time task (32-item sequence) for two weeks (10 days total). Response times and accuracy both showed improvement with time, but appeared to be learned at different rates. Changes in response speed across training were associated with dynamic changes in response time variability, with faster learners expanding their variability during the early training days and then contracting response variability late in training. Using a novel measure of response chunking, we found that individual responses became temporally correlated across trials and asymptoted to set sizes of approximately 7 bound responses at the end of the first week of training. Finally, we used a state-space model of the response planning process to look at how predictive (i.e., response anticipation) and error-corrective (i.e., post-error slowing) processes correlated with learning rates for speed, accuracy and chunking. This analysis yielded non-monotonic association patterns between the state-space model parameters and learning rates, suggesting that different parts of the response planning process are relevant at different stages of long-term learning. These findings highlight the dynamic modulation of response speed, variability, accuracy and chunking as multiple movements become bound together into a larger set of responses during sequence learning. PMID:23056630

Fresh Fuel Measurements With the Differential Die-Away Self-Interrogation Instrument

DOE PAGES

Trahan, Alexis C.; Belian, Anthony P.; Swinhoe, Martyn T.; ...

2017-01-05

The purpose of the Next Generation Safeguards Initiative (NGSI)-Spent Fuel (SF) Project is to strengthen the technical toolkit of safeguards inspectors and/or other interested parties. Thus the NGSI-SF team is working to achieve the following technical goals more easily and efficiently than in the past using nondestructive assay measurements of spent fuel assemblies: 1) verify the initial enrichment, burnup, and cooling time of facility declaration; 2) detect the diversion or replacement of pins; 3) estimate the plutonium mass; 4) estimate decay heat; and 5) determine the reactivity of spent fuel assemblies. The differential die-away self-interrogation (DDSI) instrument is one instrumentmore » that was assessed for years regarding its feasibility for robust, timely verification of spent fuel assemblies. The instrument was recently built and was tested using fresh fuel assemblies in a variety of configurations, including varying enrichment, neutron absorber content, and symmetry. The early die-away method, a multiplication determination method developed in simulation space, was successfully tested on the fresh fuel assembly data and determined multiplication with a root-mean-square (RMS) error of 2.9%. The experimental results were compared with MCNP simulations of the instrument as well. Low multiplication assemblies had agreement with an average RMS error of 0.2% in the singles count rate (i.e., total neutrons detected per second) and 3.4% in the doubles count rates (i.e., neutrons detected in coincidence per second). High-multiplication assemblies had agreement with an average RMS error of 4.1% in the singles and 13.3% in the doubles count rates.« less

The impact of physical and mental tasks on pilot mental workoad

NASA Technical Reports Server (NTRS)

Berg, S. L.; Sheridan, T. B.

1986-01-01

Seven instrument-rated pilots with a wide range of backgrounds and experience levels flew four different scenarios on a fixed-base simulator. The Baseline scenario was the simplest of the four and had few mental and physical tasks. An activity scenario had many physical but few mental tasks. The Planning scenario had few physical and many mental taks. A Combined scenario had high mental and physical task loads. The magnitude of each pilot's altitude and airspeed deviations was measured, subjective workload ratings were recorded, and the degree of pilot compliance with assigned memory/planning tasks was noted. Mental and physical performance was a strong function of the manual activity level, but not influenced by the mental task load. High manual task loads resulted in a large percentage of mental errors even under low mental task loads. Although all the pilots gave similar subjective ratings when the manual task load was high, subjective ratings showed greater individual differences with high mental task loads. Altitude or airspeed deviations and subjective ratings were most correlated when the total task load was very high. Although airspeed deviations, altitude deviations, and subjective workload ratings were similar for both low experience and high experience pilots, at very high total task loads, mental performance was much lower for the low experience pilots.

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

Barbee, D; McCarthy, A; Galavis, P

Purpose: Errors found during initial physics plan checks frequently require replanning and reprinting, resulting decreased departmental efficiency. Additionally, errors may be missed during physics checks, resulting in potential treatment errors or interruption. This work presents a process control created using the Eclipse Scripting API (ESAPI) enabling dosimetrists and physicists to detect potential errors in the Eclipse treatment planning system prior to performing any plan approvals or printing. Methods: Potential failure modes for five categories were generated based on available ESAPI (v11) patient object properties: Images, Contours, Plans, Beams, and Dose. An Eclipse script plugin (PlanCheck) was written in C# tomore » check errors most frequently observed clinically in each of the categories. The PlanCheck algorithms were devised to check technical aspects of plans, such as deliverability (e.g. minimum EDW MUs), in addition to ensuring that policy and procedures relating to planning were being followed. The effect on clinical workflow efficiency was measured by tracking the plan document error rate and plan revision/retirement rates in the Aria database over monthly intervals. Results: The number of potential failure modes the PlanCheck script is currently capable of checking for in the following categories: Images (6), Contours (7), Plans (8), Beams (17), and Dose (4). Prior to implementation of the PlanCheck plugin, the observed error rates in errored plan documents and revised/retired plans in the Aria database was 20% and 22%, respectively. Error rates were seen to decrease gradually over time as adoption of the script improved. Conclusion: A process control created using the Eclipse scripting API enabled plan checks to occur within the planning system, resulting in reduction in error rates and improved efficiency. Future work includes: initiating full FMEA for planning workflow, extending categories to include additional checks outside of ESAPI via Aria database queries, and eventual automated plan checks.« less

An Empirical State Error Covariance Matrix Orbit Determination Example

NASA Technical Reports Server (NTRS)

Frisbee, Joseph H., Jr.

2015-01-01

State estimation techniques serve effectively to provide mean state estimates. However, the state error covariance matrices provided as part of these techniques suffer from some degree of lack of confidence in their ability to adequately describe the uncertainty in the estimated states. A specific problem with the traditional form of state error covariance matrices is that they represent only a mapping of the assumed observation error characteristics into the state space. Any errors that arise from other sources (environment modeling, precision, etc.) are not directly represented in a traditional, theoretical state error covariance matrix. First, consider that an actual observation contains only measurement error and that an estimated observation contains all other errors, known and unknown. Then it follows that a measurement residual (the difference between expected and observed measurements) contains all errors for that measurement. Therefore, a direct and appropriate inclusion of the actual measurement residuals in the state error covariance matrix of the estimate will result in an empirical state error covariance matrix. This empirical state error covariance matrix will fully include all of the errors in the state estimate. The empirical error covariance matrix is determined from a literal reinterpretation of the equations involved in the weighted least squares estimation algorithm. It is a formally correct, empirical state error covariance matrix obtained through use of the average form of the weighted measurement residual variance performance index rather than the usual total weighted residual form. Based on its formulation, this matrix will contain the total uncertainty in the state estimate, regardless as to the source of the uncertainty and whether the source is anticipated or not. It is expected that the empirical error covariance matrix will give a better, statistical representation of the state error in poorly modeled systems or when sensor performance is suspect. In its most straight forward form, the technique only requires supplemental calculations to be added to existing batch estimation algorithms. In the current problem being studied a truth model making use of gravity with spherical, J2 and J4 terms plus a standard exponential type atmosphere with simple diurnal and random walk components is used. The ability of the empirical state error covariance matrix to account for errors is investigated under four scenarios during orbit estimation. These scenarios are: exact modeling under known measurement errors, exact modeling under corrupted measurement errors, inexact modeling under known measurement errors, and inexact modeling under corrupted measurement errors. For this problem a simple analog of a distributed space surveillance network is used. The sensors in this network make only range measurements and with simple normally distributed measurement errors. The sensors are assumed to have full horizon to horizon viewing at any azimuth. For definiteness, an orbit at the approximate altitude and inclination of the International Space Station is used for the study. The comparison analyses of the data involve only total vectors. No investigation of specific orbital elements is undertaken. The total vector analyses will look at the chisquare values of the error in the difference between the estimated state and the true modeled state using both the empirical and theoretical error covariance matrices for each of scenario.

A five-year experience with throat cultures.

PubMed

Shank, J C; Powell, T A

1984-06-01

This study addresses the usefulness of the throat culture in a family practice residency setting and explores the following questions: (1) Do faculty physicians clinically identify streptococcal pharyngitis better than residents? (2) With time, will residents and faculty physicians improve in their diagnostic accuracy? (3) Should the throat culture be used always, selectively, or never? A total of 3,982 throat cultures were obtained over a five-year study period with 16 percent positive for beta-hemolytic streptococci. The results were compared with the physician's clinical diagnosis of either "nonstreptococcal" (category A) or "streptococcal" (category B). Within category A, 363 of 3,023 patients had positive cultures (12 percent clinical diagnostic error rate). Within category B, 665 of 959 patients had negative cultures (69 percent clinical diagnostic error rate). Faculty were significantly better than residents in diagnosing streptococcal pharyngitis, but not in diagnosing nonstreptococcal sore throats. Neither faculty nor residents improved their diagnostic accuracy over time. Regarding age-specific recommendations, the findings support utilizing a throat culture in all children aged 2 to 15 years with sore throat, but in adults only when the physician suspects streptococcal pharyngitis.

Experimental and Computational Studies of the Kinetics of the Reaction of Atomic Hydrogen with Methanethiol.

PubMed

Kerr, Katherine E; Alecu, Ionut M; Thompson, Kristopher M; Gao, Yide; Marshall, Paul

2015-07-16

The overall rate constant for H + CH3SH has been studied over 296-1007 K in an Ar bath gas using the laser flash photolysis method at 193 nm. H atoms were generated from CH3SH and in some cases NH3. They were detected via time-resolved resonance fluorescence. The results are summarized as k = (3.45 ± 0.19) × 10(-11) cm(3) molecule(-1) s(-1) exp(-6.92 ± 0.16 kJ mol(-1)/RT) where the errors in the Arrhenius parameters are the statistical uncertainties at the 2σ level. Overall error limits of ±9% for k are proposed. In the overlapping temperature range there is very good agreement with the resonance fluorescence measurements of Wine et al. Ab initio data and transition state theory yield moderate accord with the total rate constant, but not with prior mass spectrometry measurements of the main product channels leading to CH3S + H2 and CH3 + H2S by Amano et al.

Bit-error rate for free-space adaptive optics laser communications.

PubMed

Tyson, Robert K

2002-04-01

An analysis of adaptive optics compensation for atmospheric-turbulence-induced scintillation is presented with the figure of merit being the laser communications bit-error rate. The formulation covers weak, moderate, and strong turbulence; on-off keying; and amplitude-shift keying, over horizontal propagation paths or on a ground-to-space uplink or downlink. The theory shows that under some circumstances the bit-error rate can be improved by a few orders of magnitude with the addition of adaptive optics to compensate for the scintillation. Low-order compensation (less than 40 Zernike modes) appears to be feasible as well as beneficial for reducing the bit-error rate and increasing the throughput of the communication link.

Derivation of formulas for root-mean-square errors in location, orientation, and shape in triangulation solution of an elongated object in space

NASA Technical Reports Server (NTRS)

Long, S. A. T.

1974-01-01

Formulas are derived for the root-mean-square (rms) displacement, slope, and curvature errors in an azimuth-elevation image trace of an elongated object in space, as functions of the number and spacing of the input data points and the rms elevation error in the individual input data points from a single observation station. Also, formulas are derived for the total rms displacement, slope, and curvature error vectors in the triangulation solution of an elongated object in space due to the rms displacement, slope, and curvature errors, respectively, in the azimuth-elevation image traces from different observation stations. The total rms displacement, slope, and curvature error vectors provide useful measure numbers for determining the relative merits of two or more different triangulation procedures applicable to elongated objects in space.

Transcriptional fidelities of human mitochondrial POLRMT, yeast mitochondrial Rpo41, and phage T7 single-subunit RNA polymerases.

PubMed

Sultana, Shemaila; Solotchi, Mihai; Ramachandran, Aparna; Patel, Smita S

2017-11-03

Single-subunit RNA polymerases (RNAPs) are present in phage T7 and in mitochondria of all eukaryotes. This RNAP class plays important roles in biotechnology and cellular energy production, but we know little about its fidelity and error rates. Herein, we report the error rates of three single-subunit RNAPs measured from the catalytic efficiencies of correct and all possible incorrect nucleotides. The average error rates of T7 RNAP (2 × 10 -6 ), yeast mitochondrial Rpo41 (6 × 10 -6 ), and human mitochondrial POLRMT (RNA polymerase mitochondrial) (2 × 10 -5 ) indicate high accuracy/fidelity of RNA synthesis resembling those of replicative DNA polymerases. All three RNAPs exhibit a distinctly high propensity for GTP misincorporation opposite dT, predicting frequent A→G errors in RNA with rates of ∼10 -4 The A→C, G→A, A→U, C→U, G→U, U→C, and U→G errors mostly due to pyrimidine-purine mismatches were relatively frequent (10 -5 -10 -6 ), whereas C→G, U→A, G→C, and C→A errors from purine-purine and pyrimidine-pyrimidine mismatches were rare (10 -7 -10 -10 ). POLRMT also shows a high C→A error rate on 8-oxo-dG templates (∼10 -4 ). Strikingly, POLRMT shows a high mutagenic bypass rate, which is exacerbated by TEFM (transcription elongation factor mitochondrial). The lifetime of POLRMT on terminally mismatched elongation substrate is increased in the presence of TEFM, which allows POLRMT to efficiently bypass the error and continue with transcription. This investigation of nucleotide selectivity on normal and oxidatively damaged DNA by three single-subunit RNAPs provides the basic information to understand the error rates in mitochondria and, in the case of T7 RNAP, to assess the quality of in vitro transcribed RNAs. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

Tilt error in cryospheric surface radiation measurements at high latitudes: a model study

NASA Astrophysics Data System (ADS)

Bogren, Wiley Steven; Faulkner Burkhart, John; Kylling, Arve

2016-03-01

We have evaluated the magnitude and makeup of error in cryospheric radiation observations due to small sensor misalignment in in situ measurements of solar irradiance. This error is examined through simulation of diffuse and direct irradiance arriving at a detector with a cosine-response fore optic. Emphasis is placed on assessing total error over the solar shortwave spectrum from 250 to 4500 nm, as well as supporting investigation over other relevant shortwave spectral ranges. The total measurement error introduced by sensor tilt is dominated by the direct component. For a typical high-latitude albedo measurement with a solar zenith angle of 60°, a sensor tilted by 1, 3, and 5° can, respectively introduce up to 2.7, 8.1, and 13.5 % error into the measured irradiance and similar errors in the derived albedo. Depending on the daily range of solar azimuth and zenith angles, significant measurement error can persist also in integrated daily irradiance and albedo. Simulations including a cloud layer demonstrate decreasing tilt error with increasing cloud optical depth.

Concomitant prescribing and dispensing errors at a Brazilian hospital: a descriptive study

PubMed Central

Silva, Maria das Dores Graciano; Rosa, Mário Borges; Franklin, Bryony Dean; Reis, Adriano Max Moreira; Anchieta, Lêni Márcia; Mota, Joaquim Antônio César

2011-01-01

OBJECTIVE: To analyze the prevalence and types of prescribing and dispensing errors occurring with high-alert medications and to propose preventive measures to avoid errors with these medications. INTRODUCTION: The prevalence of adverse events in health care has increased, and medication errors are probably the most common cause of these events. Pediatric patients are known to be a high-risk group and are an important target in medication error prevention. METHODS: Observers collected data on prescribing and dispensing errors occurring with high-alert medications for pediatric inpatients in a university hospital. In addition to classifying the types of error that occurred, we identified cases of concomitant prescribing and dispensing errors. RESULTS: One or more prescribing errors, totaling 1,632 errors, were found in 632 (89.6%) of the 705 high-alert medications that were prescribed and dispensed. We also identified at least one dispensing error in each high-alert medication dispensed, totaling 1,707 errors. Among these dispensing errors, 723 (42.4%) content errors occurred concomitantly with the prescribing errors. A subset of dispensing errors may have occurred because of poor prescription quality. The observed concomitancy should be examined carefully because improvements in the prescribing process could potentially prevent these problems. CONCLUSION: The system of drug prescribing and dispensing at the hospital investigated in this study should be improved by incorporating the best practices of medication safety and preventing medication errors. High-alert medications may be used as triggers for improving the safety of the drug-utilization system. PMID:22012039

Austrian firearm legislation and its effects on suicide and homicide mortality: A natural quasi-experiment amidst the global economic crisis.

PubMed

König, Daniel; Swoboda, Patrick; Cramer, Robert J; Krall, Christoph; Postuvan, Vita; Kapusta, Nestor D

2018-08-01

Restriction of access to suicide methods has been shown to effectively reduce suicide mortality rates. To examine how the global economic crisis of 2008 and the firearm legislation reform of 1997 affected suicide and homicide mortality rate within Austria. Official data for the years 1985-2016 for firearm certificates, suicide, homicide, unemployment rates and alcohol consumption were examined using auto regressive error and Poisson regression models. Firearm certificates, total suicide mortality rate, suicide and homicides by firearms, and the fraction of firearm suicides/homicides among all suicides/homicides decreased after the firearm legislation reform in 1997. However, significant trend changes can be observed after 2008. The availability of firearm certificates significantly increased and was accompanied by significant changes in trends of firearm suicide and homicide rates. Concurrently, the total suicide mortality rate in 2008, for the first time since 1985, stopped its decreasing trend. While the total homicide rate further decreased, the fraction of firearm homicides among all homicides significantly increased. The initially preventative effect of the firearm legislation reform in Austria in 1997 seems to have been counteracted by the global economic downturn of 2008. Increased firearm availability was associated with corresponding increases in both firearm suicide and firearm homicide mortality. Restrictive firearm legislation should be an imperative part of a country's suicide prevention programme. Although firearm legislation reform may have long-lasting effects, societal changes may facilitate compensatory firearm acquisitions and thus counteract preventive efforts, calling in turn again for adapted counter-measures. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Resolution-Adaptive Hybrid MIMO Architectures for Millimeter Wave Communications

NASA Astrophysics Data System (ADS)

Choi, Jinseok; Evans, Brian L.; Gatherer, Alan

2017-12-01

In this paper, we propose a hybrid analog-digital beamforming architecture with resolution-adaptive ADCs for millimeter wave (mmWave) receivers with large antenna arrays. We adopt array response vectors for the analog combiners and derive ADC bit-allocation (BA) solutions in closed form. The BA solutions reveal that the optimal number of ADC bits is logarithmically proportional to the RF chain's signal-to-noise ratio raised to the 1/3 power. Using the solutions, two proposed BA algorithms minimize the mean square quantization error of received analog signals under a total ADC power constraint. Contributions of this paper include 1) ADC bit-allocation algorithms to improve communication performance of a hybrid MIMO receiver, 2) approximation of the capacity with the BA algorithm as a function of channels, and 3) a worst-case analysis of the ergodic rate of the proposed MIMO receiver that quantifies system tradeoffs and serves as the lower bound. Simulation results demonstrate that the BA algorithms outperform a fixed-ADC approach in both spectral and energy efficiency, and validate the capacity and ergodic rate formula. For a power constraint equivalent to that of fixed 4-bit ADCs, the revised BA algorithm makes the quantization error negligible while achieving 22% better energy efficiency. Having negligible quantization error allows existing state-of-the-art digital beamformers to be readily applied to the proposed system.

Optimization of multimagnetometer systems on a spacecraft

NASA Technical Reports Server (NTRS)

Neubauer, F. M.

1975-01-01

The problem of optimizing the position of magnetometers along a boom of given length to yield a minimized total error is investigated. The discussion is limited to at most four magnetometers, which seems to be a practical limit due to weight, power, and financial considerations. The outlined error analysis is applied to some illustrative cases. The optimal magnetometer locations, for which the total error is minimum, are computed for given boom length, instrument errors, and very conservative magnetic field models characteristic for spacecraft with only a restricted or ineffective magnetic cleanliness program. It is shown that the error contribution by the magnetometer inaccuracy is increased as the number of magnetometers is increased, whereas the spacecraft field uncertainty is diminished by an appreciably larger amount.

The threshold vs LNT showdown: Dose rate findings exposed flaws in the LNT model part 2. How a mistake led BEIR I to adopt LNT

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

Calabrese, Edward J., E-mail: edwardc@schoolph.uma

This paper reveals that nearly 25 years after the used Russell's dose-rate data to support the adoption of the linear-no-threshold (LNT) dose response model for genetic and cancer risk assessment, Russell acknowledged a significant under-reporting of the mutation rate of the historical control group. This error, which was unknown to BEIR I, had profound implications, leading it to incorrectly adopt the LNT model, which was a decision that profoundly changed the course of risk assessment for radiation and chemicals to the present. -- Highlights: • The BEAR I Genetics Panel made an error in denying dose rate for mutation. •more » The BEIR I Genetics Subcommittee attempted to correct this dose rate error. • The control group used for risk assessment by BEIR I is now known to be in error. • Correcting this error contradicts the LNT, supporting a threshold model.« less

Outcome Assessments and Cost Avoidance of an Oral Chemotherapy Management Clinic.

PubMed

Wong, Siu-Fun; Bounthavong, Mark; Nguyen, Cham P; Chen, Timothy

2016-03-01

Increasing use of oral chemotherapy drugs increases the challenges for drug and patient management. An oral chemotherapy management clinic was developed to provide patients with oral chemotherapy management, concurrent medication (CM) education, and symptom management services. This evaluation aims to measure the need and effectiveness of this practice model due to scarce published data. This is a case series report of all patients referred to the oral chemotherapy management clinic. Data collected included patient demographics, depression scores, CMs, and types of intervention, including detection and management outcomes collected at baseline, 3-day, 7-day, and 3-month follow-ups. Persistence rate was monitored. Secondary analysis assessed potential cost avoidance. A total of 86 evaluated patients (32 men and 54 women, mean age of 63.4 years) did not show a high risk for medication nonadherence. The 3 most common cancer diagnoses were rectal, pancreatic, and breast, with capecitabine most prescribed. Patients had an average of 13.7 CMs. A total of 125 interventions (detection and management of adverse drug event detection, compliance, drug interactions, medication error, and symptom management) occurred in 201 visits, with more than 75% of interventions occurring within the first 14 days. A persistence rate was observed in 78% of 41 evaluable patients. The total estimated annual cost avoidance per 1.0 full time employee (FTE) was $125,761.93. This evaluation demonstrated the need for additional support for patients receiving oral chemotherapy within standard of care medical service. A comprehensive oral chemotherapy management referral service can optimize patient care delivery via early interventions for adverse drug events, drug interactions, and medication errors up to 3 months after initiation of treatment. Copyright © 2016 by the National Comprehensive Cancer Network.

Teamwork and clinical error reporting among nurses in Korean hospitals.

PubMed

Hwang, Jee-In; Ahn, Jeonghoon

2015-03-01

To examine levels of teamwork and its relationships with clinical error reporting among Korean hospital nurses. The study employed a cross-sectional survey design. We distributed a questionnaire to 674 nurses in two teaching hospitals in Korea. The questionnaire included items on teamwork and the reporting of clinical errors. We measured teamwork using the Teamwork Perceptions Questionnaire, which has five subscales including team structure, leadership, situation monitoring, mutual support, and communication. Using logistic regression analysis, we determined the relationships between teamwork and error reporting. The response rate was 85.5%. The mean score of teamwork was 3.5 out of 5. At the subscale level, mutual support was rated highest, while leadership was rated lowest. Of the participating nurses, 522 responded that they had experienced at least one clinical error in the last 6 months. Among those, only 53.0% responded that they always or usually reported clinical errors to their managers and/or the patient safety department. Teamwork was significantly associated with better error reporting. Specifically, nurses with a higher team communication score were more likely to report clinical errors to their managers and the patient safety department (odds ratio = 1.82, 95% confidence intervals [1.05, 3.14]). Teamwork was rated as moderate and was positively associated with nurses' error reporting performance. Hospital executives and nurse managers should make substantial efforts to enhance teamwork, which will contribute to encouraging the reporting of errors and improving patient safety. Copyright © 2015. Published by Elsevier B.V.

Assessment of the knowledge and attitudes of intern doctors to medication prescribing errors in a Nigeria tertiary hospital

PubMed Central

Ajemigbitse, Adetutu A.; Omole, Moses Kayode; Ezike, Nnamdi Chika; Erhun, Wilson O.

2013-01-01

Context: Junior doctors are reported to make most of the prescribing errors in the hospital setting. Aims: The aim of the following study is to determine the knowledge intern doctors have about prescribing errors and circumstances contributing to making them. Settings and Design: A structured questionnaire was distributed to intern doctors in National Hospital Abuja Nigeria. Subjects and Methods: Respondents gave information about their experience with prescribing medicines, the extent to which they agreed with the definition of a clinically meaningful prescribing error and events that constituted such. Their experience with prescribing certain categories of medicines was also sought. Statistical Analysis Used: Data was analyzed with Statistical Package for the Social Sciences (SPSS) software version 17 (SPSS Inc Chicago, Ill, USA). Chi-squared analysis contrasted differences in proportions; P < 0.05 was considered to be statistically significant. Results: The response rate was 90.9% and 27 (90%) had <1 year of prescribing experience. 17 (56.7%) respondents totally agreed with the definition of a clinically meaningful prescribing error. Most common reasons for prescribing mistakes were a failure to check prescriptions with a reference source (14, 25.5%) and failure to check for adverse drug interactions (14, 25.5%). Omitting some essential information such as duration of therapy (13, 20%), patient age (14, 21.5%) and dosage errors (14, 21.5%) were the most common types of prescribing errors made. Respondents considered workload (23, 76.7%), multitasking (19, 63.3%), rushing (18, 60.0%) and tiredness/stress (16, 53.3%) as important factors contributing to prescribing errors. Interns were least confident prescribing antibiotics (12, 25.5%), opioid analgesics (12, 25.5%) cytotoxics (10, 21.3%) and antipsychotics (9, 19.1%) unsupervised. Conclusions: Respondents seemed to have a low awareness of making prescribing errors. Principles of rational prescribing and events that constitute prescribing errors should be taught in the practice setting. PMID:24808682

Assessment of the knowledge and attitudes of intern doctors to medication prescribing errors in a Nigeria tertiary hospital.

PubMed

Ajemigbitse, Adetutu A; Omole, Moses Kayode; Ezike, Nnamdi Chika; Erhun, Wilson O

2013-12-01

Junior doctors are reported to make most of the prescribing errors in the hospital setting. The aim of the following study is to determine the knowledge intern doctors have about prescribing errors and circumstances contributing to making them. A structured questionnaire was distributed to intern doctors in National Hospital Abuja Nigeria. Respondents gave information about their experience with prescribing medicines, the extent to which they agreed with the definition of a clinically meaningful prescribing error and events that constituted such. Their experience with prescribing certain categories of medicines was also sought. Data was analyzed with Statistical Package for the Social Sciences (SPSS) software version 17 (SPSS Inc Chicago, Ill, USA). Chi-squared analysis contrasted differences in proportions; P < 0.05 was considered to be statistically significant. The response rate was 90.9% and 27 (90%) had <1 year of prescribing experience. 17 (56.7%) respondents totally agreed with the definition of a clinically meaningful prescribing error. Most common reasons for prescribing mistakes were a failure to check prescriptions with a reference source (14, 25.5%) and failure to check for adverse drug interactions (14, 25.5%). Omitting some essential information such as duration of therapy (13, 20%), patient age (14, 21.5%) and dosage errors (14, 21.5%) were the most common types of prescribing errors made. Respondents considered workload (23, 76.7%), multitasking (19, 63.3%), rushing (18, 60.0%) and tiredness/stress (16, 53.3%) as important factors contributing to prescribing errors. Interns were least confident prescribing antibiotics (12, 25.5%), opioid analgesics (12, 25.5%) cytotoxics (10, 21.3%) and antipsychotics (9, 19.1%) unsupervised. Respondents seemed to have a low awareness of making prescribing errors. Principles of rational prescribing and events that constitute prescribing errors should be taught in the practice setting.

Determination of Type I Error Rates and Power of Answer Copying Indices under Various Conditions

ERIC Educational Resources Information Center

Yormaz, Seha; Sünbül, Önder

2017-01-01

This study aims to determine the Type I error rates and power of S[subscript 1] , S[subscript 2] indices and kappa statistic at detecting copying on multiple-choice tests under various conditions. It also aims to determine how copying groups are created in order to calculate how kappa statistics affect Type I error rates and power. In this study,…

Can a two-hour lecture by a pharmacist improve the quality of prescriptions in a pediatric hospital? A retrospective cohort study.

PubMed

Vairy, Stephanie; Corny, Jennifer; Jamoulle, Olivier; Levy, Arielle; Lebel, Denis; Carceller, Ana

2017-12-01

A high rate of prescription errors exists in pediatric teaching hospitals, especially during initial training. To determine the effectiveness of a two-hour lecture by a pharmacist on rates of prescription errors and quality of prescriptions. A two-hour lecture led by a pharmacist was provided to 11 junior pediatric residents (PGY-1) as part of a one-month immersion program. A control group included 15 residents without the intervention. We reviewed charts to analyze the first 50 prescriptions of each resident. Data were collected from 1300 prescriptions involving 451 patients, 550 in the intervention group and 750 in the control group. The rate of prescription errors in the intervention group was 9.6% compared to 11.3% in the control group (p=0.32), affecting 106 patients. Statistically significant differences between both groups were prescriptions with unwritten doses (p=0.01) and errors involving overdosing (p=0.04). We identified many errors as well as issues surrounding quality of prescriptions. We found a 10.6% prescription error rate. This two-hour lecture seems insufficient to reduce prescription errors among junior pediatric residents. This study highlights the most frequent types of errors and prescription quality issues that should be targeted by future educational interventions.

Zero tolerance prescribing: a strategy to reduce prescribing errors on the paediatric intensive care unit.

PubMed

Booth, Rachelle; Sturgess, Emma; Taberner-Stokes, Alison; Peters, Mark

2012-11-01

To establish the baseline prescribing error rate in a tertiary paediatric intensive care unit (PICU) and to determine the impact of a zero tolerance prescribing (ZTP) policy incorporating a dedicated prescribing area and daily feedback of prescribing errors. A prospective, non-blinded, observational study was undertaken in a 12-bed tertiary PICU over a period of 134 weeks. Baseline prescribing error data were collected on weekdays for all patients for a period of 32 weeks, following which the ZTP policy was introduced. Daily error feedback was introduced after a further 12 months. Errors were sub-classified as 'clinical', 'non-clinical' and 'infusion prescription' errors and the effects of interventions considered separately. The baseline combined prescribing error rate was 892 (95 % confidence interval (CI) 765-1,019) errors per 1,000 PICU occupied bed days (OBDs), comprising 25.6 % clinical, 44 % non-clinical and 30.4 % infusion prescription errors. The combined interventions of ZTP plus daily error feedback were associated with a reduction in the combined prescribing error rate to 447 (95 % CI 389-504) errors per 1,000 OBDs (p < 0.0001), an absolute risk reduction of 44.5 % (95 % CI 40.8-48.0 %). Introduction of the ZTP policy was associated with a significant decrease in clinical and infusion prescription errors, while the introduction of daily error feedback was associated with a significant reduction in non-clinical prescribing errors. The combined interventions of ZTP and daily error feedback were associated with a significant reduction in prescribing errors in the PICU, in line with Department of Health requirements of a 40 % reduction within 5 years.

Determination of vigabatrin in plasma by reversed-phase high-performance liquid chromatography.

PubMed

Tsanaclis, L M; Wicks, J; Williams, J; Richens, A

1991-05-01

A method is described for the determination of vigabatrin in 50 microliters of plasma by isocratic high-performance liquid chromatography using fluorescence detection. The procedure involves protein precipitation with methanol followed by precolumn derivatisation with o-phthaldialdehyde reagent. Separation of the derivatised vigabatrin was achieved on a Microsorb C18 column using a mobile phase of 10 mM orthophosphoric acid:acetonitrile:methanol (6:3:1) at a flow rate of 2.0 ml/min. Assay time is 15 min and chromatograms show no interference from commonly coadministered anticonvulsant drugs. The total analytical error within the range of 0.85-85 micrograms/ml was found to be 7.6% with the within-replicates error of 2.76%. The minimum detection limit was 0.08 micrograms/ml and the minimum quantitation limit was 0.54 micrograms/ml.

Trueness verification of actual creatinine assays in the European market demonstrates a disappointing variability that needs substantial improvement. An international study in the framework of the EC4 creatinine standardization working group.

PubMed

Delanghe, Joris R; Cobbaert, Christa; Galteau, Marie-Madeleine; Harmoinen, Aimo; Jansen, Rob; Kruse, Rolf; Laitinen, Päivi; Thienpont, Linda M; Wuyts, Birgitte; Weykamp, Cas; Panteghini, Mauro

2008-01-01

The European In Vitro Diagnostics (IVD) directive requires traceability to reference methods and materials of analytes. It is a task of the profession to verify the trueness of results and IVD compatibility. The results of a trueness verification study by the European Communities Confederation of Clinical Chemistry (EC4) working group on creatinine standardization are described, in which 189 European laboratories analyzed serum creatinine in a commutable serum-based material, using analytical systems from seven companies. Values were targeted using isotope dilution gas chromatography/mass spectrometry. Results were tested on their compliance to a set of three criteria: trueness, i.e., no significant bias relative to the target value, between-laboratory variation and within-laboratory variation relative to the maximum allowable error. For the lower and intermediate level, values differed significantly from the target value in the Jaffe and the dry chemistry methods. At the high level, dry chemistry yielded higher results. Between-laboratory coefficients of variation ranged from 4.37% to 8.74%. Total error budget was mainly consumed by the bias. Non-compensated Jaffe methods largely exceeded the total error budget. Best results were obtained for the enzymatic method. The dry chemistry method consumed a large part of its error budget due to calibration bias. Despite the European IVD directive and the growing needs for creatinine standardization, an unacceptable inter-laboratory variation was observed, which was mainly due to calibration differences. The calibration variation has major clinical consequences, in particular in pediatrics, where reference ranges for serum and plasma creatinine are low, and in the estimation of glomerular filtration rate.

Addressing Angular Single-Event Effects in the Estimation of On-Orbit Error Rates

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

Lee, David S.; Swift, Gary M.; Wirthlin, Michael J.

2015-12-01

Our study describes complications introduced by angular direct ionization events on space error rate predictions. In particular, prevalence of multiple-cell upsets and a breakdown in the application of effective linear energy transfer in modern-scale devices can skew error rates approximated from currently available estimation models. Moreover, this paper highlights the importance of angular testing and proposes a methodology to extend existing error estimation tools to properly consider angular strikes in modern-scale devices. Finally, these techniques are illustrated with test data provided from a modern 28 nm SRAM-based device.

Reducing the Familiarity of Conjunction Lures with Pictures

ERIC Educational Resources Information Center

Lloyd, Marianne E.

2013-01-01

Four experiments were conducted to test whether conjunction errors were reduced after pictorial encoding and whether the semantic overlap between study and conjunction items would impact error rates. Across 4 experiments, compound words studied with a single-picture had lower conjunction error rates during a recognition test than those words…

Effect of Missing Inter-Beat Interval Data on Heart Rate Variability Analysis Using Wrist-Worn Wearables.

PubMed

Baek, Hyun Jae; Shin, JaeWook

2017-08-15

Most of the wrist-worn devices on the market provide a continuous heart rate measurement function using photoplethysmography, but have not yet provided a function to measure the continuous heart rate variability (HRV) using beat-to-beat pulse interval. The reason for such is the difficulty of measuring a continuous pulse interval during movement using a wearable device because of the nature of photoplethysmography, which is susceptible to motion noise. This study investigated the effect of missing heart beat interval data on the HRV analysis in cases where pulse interval cannot be measured because of movement noise. First, we performed simulations by randomly removing data from the RR interval of the electrocardiogram measured from 39 subjects and observed the changes of the relative and normalized errors for the HRV parameters according to the total length of the missing heart beat interval data. Second, we measured the pulse interval from 20 subjects using a wrist-worn device for 24 h and observed the error value for the missing pulse interval data caused by the movement during actual daily life. The experimental results showed that mean NN and RMSSD were the most robust for the missing heart beat interval data among all the parameters in the time and frequency domains. Most of the pulse interval data could not be obtained during daily life. In other words, the sample number was too small for spectral analysis because of the long missing duration. Therefore, the frequency domain parameters often could not be calculated, except for the sleep state with little motion. The errors of the HRV parameters were proportional to the missing data duration in the presence of missing heart beat interval data. Based on the results of this study, the maximum missing duration for acceptable errors for each parameter is recommended for use when the HRV analysis is performed on a wrist-worn device.

Vectorization of optically sectioned brain microvasculature: learning aids completion of vascular graphs by connecting gaps and deleting open-ended segments.

PubMed

Kaufhold, John P; Tsai, Philbert S; Blinder, Pablo; Kleinfeld, David

2012-08-01

A graph of tissue vasculature is an essential requirement to model the exchange of gasses and nutriments between the blood and cells in the brain. Such a graph is derived from a vectorized representation of anatomical data, provides a map of all vessels as vertices and segments, and may include the location of nonvascular components, such as neuronal and glial somata. Yet vectorized data sets typically contain erroneous gaps, spurious endpoints, and spuriously merged strands. Current methods to correct such defects only address the issue of connecting gaps and further require manual tuning of parameters in a high dimensional algorithm. To address these shortcomings, we introduce a supervised machine learning method that (1) connects vessel gaps by "learned threshold relaxation"; (2) removes spurious segments by "learning to eliminate deletion candidate strands"; and (3) enforces consistency in the joint space of learned vascular graph corrections through "consistency learning." Human operators are only required to label individual objects they recognize in a training set and are not burdened with tuning parameters. The supervised learning procedure examines the geometry and topology of features in the neighborhood of each vessel segment under consideration. We demonstrate the effectiveness of these methods on four sets of microvascular data, each with >800(3) voxels, obtained with all optical histology of mouse tissue and vectorization by state-of-the-art techniques in image segmentation. Through statistically validated sampling and analysis in terms of precision recall curves, we find that learning with bagged boosted decision trees reduces equal-error error rates for threshold relaxation by 5-21% and strand elimination performance by 18-57%. We benchmark generalization performance across datasets; while improvements vary between data sets, learning always leads to a useful reduction in error rates. Overall, learning is shown to more than halve the total error rate, and therefore, human time spent manually correcting such vectorizations. Copyright © 2012 Elsevier B.V. All rights reserved.

Vectorization of optically sectioned brain microvasculature: Learning aids completion of vascular graphs by connecting gaps and deleting open-ended segments

PubMed Central

Kaufhold, John P.; Tsai, Philbert S.; Blinder, Pablo; Kleinfeld, David

2012-01-01

A graph of tissue vasculature is an essential requirement to model the exchange of gasses and nutriments between the blood and cells in the brain. Such a graph is derived from a vectorized representation of anatomical data, provides a map of all vessels as vertices and segments, and may include the location of nonvascular components, such as neuronal and glial somata. Yet vectorized data sets typically contain erroneous gaps, spurious endpoints, and spuriously merged strands. Current methods to correct such defects only address the issue of connecting gaps and further require manual tuning of parameters in a high dimensional algorithm. To address these shortcomings, we introduce a supervised machine learning method that (1) connects vessel gaps by “learned threshold relaxation”; (2) removes spurious segments by “learning to eliminate deletion candidate strands”; and (3) enforces consistency in the joint space of learned vascular graph corrections through “consistency learning.” Human operators are only required to label individual objects they recognize in a training set and are not burdened with tuning parameters. The supervised learning procedure examines the geometry and topology of features in the neighborhood of each vessel segment under consideration. We demonstrate the effectiveness of these methods on four sets of microvascular data, each with > 8003 voxels, obtained with all optical histology of mouse tissue and vectorization by state-of-the-art techniques in image segmentation. Through statistically validated sampling and analysis in terms of precision recall curves, we find that learning with bagged boosted decision trees reduces equal-error error rates for threshold relaxation by 5 to 21 % and strand elimination performance by 18 to 57 %. We benchmark generalization performance across datasets; while improvements vary between data sets, learning always leads to a useful reduction in error rates. Overall, learning is shown to more than halve the total error rate, and therefore, human time spent manually correcting such vectorizations. PMID:22854035

Review of medication errors that are new or likely to occur more frequently with electronic medication management systems.

PubMed

Van de Vreede, Melita; McGrath, Anne; de Clifford, Jan

2018-05-14

Objective. The aim of the present study was to identify and quantify medication errors reportedly related to electronic medication management systems (eMMS) and those considered likely to occur more frequently with eMMS. This included developing a new classification system relevant to eMMS errors. Methods. Eight Victorian hospitals with eMMS participated in a retrospective audit of reported medication incidents from their incident reporting databases between May and July 2014. Site-appointed project officers submitted deidentified incidents they deemed new or likely to occur more frequently due to eMMS, together with the Incident Severity Rating (ISR). The authors reviewed and classified incidents. Results. There were 5826 medication-related incidents reported. In total, 93 (47 prescribing errors, 46 administration errors) were identified as new or potentially related to eMMS. Only one ISR2 (moderate) and no ISR1 (severe or death) errors were reported, so harm to patients in this 3-month period was minimal. The most commonly reported error types were 'human factors' and 'unfamiliarity or training' (70%) and 'cross-encounter or hybrid system errors' (22%). Conclusions. Although the results suggest that the errors reported were of low severity, organisations must remain vigilant to the risk of new errors and avoid the assumption that eMMS is the panacea to all medication error issues. What is known about the topic? eMMS have been shown to reduce some types of medication errors, but it has been reported that some new medication errors have been identified and some are likely to occur more frequently with eMMS. There are few published Australian studies that have reported on medication error types that are likely to occur more frequently with eMMS in more than one organisation and that include administration and prescribing errors. What does this paper add? This paper includes a new simple classification system for eMMS that is useful and outlines the most commonly reported incident types and can inform organisations and vendors on possible eMMS improvements. The paper suggests a new classification system for eMMS medication errors. What are the implications for practitioners? The results of the present study will highlight to organisations the need for ongoing review of system design, refinement of workflow issues, staff education and training and reporting and monitoring of errors.

Certification of ICI 1012 optical data storage tape

NASA Technical Reports Server (NTRS)

Howell, J. M.

1993-01-01

ICI has developed a unique and novel method of certifying a Terabyte optical tape. The tape quality is guaranteed as a statistical upper limit on the probability of uncorrectable errors. This is called the Corrected Byte Error Rate or CBER. We developed this probabilistic method because of two reasons why error rate cannot be measured directly. Firstly, written data is indelible, so one cannot employ write/read tests such as used for magnetic tape. Secondly, the anticipated error rates need impractically large samples to measure accurately. For example, a rate of 1E-12 implies only one byte in error per tape. The archivability of ICI 1012 Data Storage Tape in general is well characterized and understood. Nevertheless, customers expect performance guarantees to be supported by test results on individual tapes. In particular, they need assurance that data is retrievable after decades in archive. This paper describes the mathematical basis, measurement apparatus and applicability of the certification method.

The dependence of crowding on flanker complexity and target-flanker similarity

PubMed Central

Bernard, Jean-Baptiste; Chung, Susana T.L.

2013-01-01

We examined the effects of the spatial complexity of flankers and target-flanker similarity on the performance of identifying crowded letters. On each trial, observers identified the middle character of random strings of three characters (“trigrams”) briefly presented at 10° below fixation. We tested the 26 lowercase letters of the Times-Roman and Courier fonts, a set of 79 characters (letters and non-letters) of the Times-Roman font, and the uppercase letters of two highly complex ornamental fonts, Edwardian and Aristocrat. Spatial complexity of characters was quantified by the length of the morphological skeleton of each character, and target-flanker similarity was defined based on a psychometric similarity matrix. Our results showed that (1) letter identification error rate increases with flanker complexity up to a certain value, beyond which error rate becomes independent of flanker complexity; (2) the increase of error rate is slower for high-complexity target letters; (3) error rate increases with target-flanker similarity; and (4) mislocation error rate increases with target-flanker similarity. These findings, combined with the current understanding of the faulty feature integration account of crowding, provide some constraints of how the feature integration process could cause perceptual errors. PMID:21730225

Evaluation of Preanalytical Quality Indicators by Six Sigma and Pareto`s Principle.

PubMed

Kulkarni, Sweta; Ramesh, R; Srinivasan, A R; Silvia, C R Wilma Delphine

2018-01-01

Preanalytical steps are the major sources of error in clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in preanalytical area as these processes are done outside the laboratory. Sigma value depicts the performance of laboratory and its quality measures. Hence in the present study six sigma and Pareto principle was applied to preanalytical quality indicators to evaluate the clinical biochemistry laboratory performance. This observational study was carried out for a period of 1 year from November 2015-2016. A total of 1,44,208 samples and 54,265 test requisition forms were screened for preanalytical errors like missing patient information, sample collection details in forms and hemolysed, lipemic, inappropriate, insufficient samples and total number of errors were calculated and converted into defects per million and sigma scale. Pareto`s chart was drawn using total number of errors and cumulative percentage. In 75% test requisition forms diagnosis was not mentioned and sigma value of 0.9 was obtained and for other errors like sample receiving time, stat and type of sample sigma values were 2.9, 2.6, and 2.8 respectively. For insufficient sample and improper ratio of blood to anticoagulant sigma value was 4.3. Pareto`s chart depicts out of 80% of errors in requisition forms, 20% is contributed by missing information like diagnosis. The development of quality indicators, application of six sigma and Pareto`s principle are quality measures by which not only preanalytical, the total testing process can be improved.

Frequency of data extraction errors and methods to increase data extraction quality: a methodological review.

PubMed

Mathes, Tim; Klaßen, Pauline; Pieper, Dawid

2017-11-28

Our objective was to assess the frequency of data extraction errors and its potential impact on results in systematic reviews. Furthermore, we evaluated the effect of different extraction methods, reviewer characteristics and reviewer training on error rates and results. We performed a systematic review of methodological literature in PubMed, Cochrane methodological registry, and by manual searches (12/2016). Studies were selected by two reviewers independently. Data were extracted in standardized tables by one reviewer and verified by a second. The analysis included six studies; four studies on extraction error frequency, one study comparing different reviewer extraction methods and two studies comparing different reviewer characteristics. We did not find a study on reviewer training. There was a high rate of extraction errors (up to 50%). Errors often had an influence on effect estimates. Different data extraction methods and reviewer characteristics had moderate effect on extraction error rates and effect estimates. The evidence base for established standards of data extraction seems weak despite the high prevalence of extraction errors. More comparative studies are needed to get deeper insights into the influence of different extraction methods.

PRESAGE: Protecting Structured Address Generation against Soft Errors

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

Sharma, Vishal C.; Gopalakrishnan, Ganesh; Krishnamoorthy, Sriram

Modern computer scaling trends in pursuit of larger component counts and power efficiency have, unfortunately, lead to less reliable hardware and consequently soft errors escaping into application data ("silent data corruptions"). Techniques to enhance system resilience hinge on the availability of efficient error detectors that have high detection rates, low false positive rates, and lower computational overhead. Unfortunately, efficient detectors to detect faults during address generation (to index large arrays) have not been widely researched. We present a novel lightweight compiler-driven technique called PRESAGE for detecting bit-flips affecting structured address computations. A key insight underlying PRESAGE is that any addressmore » computation scheme that flows an already incurred error is better than a scheme that corrupts one particular array access but otherwise (falsely) appears to compute perfectly. Enabling the flow of errors allows one to situate detectors at loop exit points, and helps turn silent corruptions into easily detectable error situations. Our experiments using PolyBench benchmark suite indicate that PRESAGE-based error detectors have a high error-detection rate while incurring low overheads.« less

PRESAGE: Protecting Structured Address Generation against Soft Errors

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

Sharma, Vishal C.; Gopalakrishnan, Ganesh; Krishnamoorthy, Sriram

Modern computer scaling trends in pursuit of larger component counts and power efficiency have, unfortunately, lead to less reliable hardware and consequently soft errors escaping into application data ("silent data corruptions"). Techniques to enhance system resilience hinge on the availability of efficient error detectors that have high detection rates, low false positive rates, and lower computational overhead. Unfortunately, efficient detectors to detect faults during address generation have not been widely researched (especially in the context of indexing large arrays). We present a novel lightweight compiler-driven technique called PRESAGE for detecting bit-flips affecting structured address computations. A key insight underlying PRESAGEmore » is that any address computation scheme that propagates an already incurred error is better than a scheme that corrupts one particular array access but otherwise (falsely) appears to compute perfectly. Ensuring the propagation of errors allows one to place detectors at loop exit points and helps turn silent corruptions into easily detectable error situations. Our experiments using the PolyBench benchmark suite indicate that PRESAGE-based error detectors have a high error-detection rate while incurring low overheads.« less

Instructions to "put the phone down" do not improve the quality of bystander initiated dispatcher-assisted cardiopulmonary resuscitation.

PubMed

Brown, Todd B; Saini, Devashish; Pepper, Tracy; Mirza, Muzna; Nandigam, Hari Krishna; Kaza, Niroop; Cofield, Stacey S

2008-02-01

The quality of early bystander CPR appears important in maximizing survival. This trial tests whether explicit instructions to "put the phone down" improve the quality of bystander initiated dispatch-assisted CPR. In a randomized, double-blinded, controlled trial, subjects were randomized to a modified version of the Medical Priority Dispatch System (MPDS) version 11.2 protocol or a simplified protocol, each with or without instruction to "put the phone down" during CPR. Data were recorded from a Laerdal Resusci Anne Skillreporter manikin. A simulated emergency medical dispatcher, contacted by cell phone, delivered standardized instructions. Primary outcome measures included chest compression rate, depth, and the proportion of compressions without error, with correct hand position, adequate depth, and total release. Time was measured in two distinct ways: time required for initiation of CPR and total amount of time hands were off the chest during CPR. Proportions were analyzed by Wilcoxon rank sum tests and time variables with ANOVA. All tests used a two-sided alpha-level of 0.05. Two hundred and fifteen subjects were randomized-107 in the "put the phone down" instruction group and 108 in the group without "put the phone down" instructions. The groups were comparable across demographic and experiential variables. The additional instruction to "put the phone down" had no effect on the proportion of compressions administered without error, with the correct depth, and with the correct hand position. Likewise, "put the phone down" did not affect the average compression depth, the average compression rate, the total hands-off-chest time, or the time to initiate chest compressions. A statistically significant, yet trivial, effect was found in the proportion of compressions with total release of the chest wall. Instructions to "put the phone down" had no effect on the quality of bystander initiated dispatcher-assisted CPR in this trial.

Online Error Reporting for Managing Quality Control Within Radiology.

PubMed

Golnari, Pedram; Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L

2016-06-01

Information technology systems within health care, such as picture archiving and communication system (PACS) in radiology, can have a positive impact on production but can also risk compromising quality. The widespread use of PACS has removed the previous feedback loop between radiologists and technologists. Instead of direct communication of quality discrepancies found for an examination, the radiologist submitted a paper-based quality-control report. A web-based issue-reporting tool can help restore some of the feedback loop and also provide possibilities for more detailed analysis of submitted errors. The purpose of this study was to evaluate the hypothesis that data from use of an online error reporting software for quality control can focus our efforts within our department. For the 372,258 radiologic examinations conducted during the 6-month period study, 930 errors (390 exam protocol, 390 exam validation, and 150 exam technique) were submitted, corresponding to an error rate of 0.25 %. Within the category exam protocol, technologist documentation had the highest number of submitted errors in ultrasonography (77 errors [44 %]), while imaging protocol errors were the highest subtype error for computed tomography modality (35 errors [18 %]). Positioning and incorrect accession had the highest errors in the exam technique and exam validation error category, respectively, for nearly all of the modalities. An error rate less than 1 % could signify a system with a very high quality; however, a more likely explanation is that not all errors were detected or reported. Furthermore, staff reception of the error reporting system could also affect the reporting rate.

Biometric recognition using 3D ear shape.

PubMed

Yan, Ping; Bowyer, Kevin W

2007-08-01

Previous works have shown that the ear is a promising candidate for biometric identification. However, in prior work, the preprocessing of ear images has had manual steps and algorithms have not necessarily handled problems caused by hair and earrings. We present a complete system for ear biometrics, including automated segmentation of the ear in a profile view image and 3D shape matching for recognition. We evaluated this system with the largest experimental study to date in ear biometrics, achieving a rank-one recognition rate of 97.8 percent for an identification scenario and an equal error rate of 1.2 percent for a verification scenario on a database of 415 subjects and 1,386 total probes.

Toward a More Usable Home-Based Video Telemedicine System: A Heuristic Evaluation of the Clinician User Interfaces of Home-Based Video Telemedicine Systems

PubMed Central

Welch, Brandon; Brinda, FNU

2017-01-01

Background Telemedicine is the use of technology to provide and support health care when distance separates the clinical service and the patient. Home-based telemedicine systems involve the use of such technology for medical support and care connecting the patient from the comfort of their homes with the clinician. In order for such a system to be used extensively, it is necessary to understand not only the issues faced by the patients in using them but also the clinician. Objectives The aim of this study was to conduct a heuristic evaluation of 4 telemedicine software platforms—Doxy.me, Polycom, Vidyo, and VSee—to assess possible problems and limitations that could affect the usability of the system from the clinician’s perspective. Methods It was found that 5 experts individually evaluated all four systems using Nielsen’s list of heuristics, classifying the issues based on a severity rating scale. Results A total of 46 unique problems were identified by the experts. The heuristics most frequently violated were visibility of system status and Error prevention amounting to 24% (11/46 issues) each. Esthetic and minimalist design was second contributing to 13% (6/46 issues) of the total errors. Conclusions Heuristic evaluation coupled with a severity rating scale was found to be an effective method for identifying problems with the systems. Prioritization of these problems based on the rating provides a good starting point for resolving the issues affecting these platforms. There is a need for better transparency and a more streamlined approach for how physicians use telemedicine systems. Visibility of the system status and speaking the users’ language are keys for achieving this. PMID:28438724

Hybrid optical CDMA-FSO communications network under spatially correlated gamma-gamma scintillation.

PubMed

Jurado-Navas, Antonio; Raddo, Thiago R; Garrido-Balsells, José María; Borges, Ben-Hur V; Olmos, Juan José Vegas; Monroy, Idelfonso Tafur

2016-07-25

In this paper, we propose a new hybrid network solution based on asynchronous optical code-division multiple-access (OCDMA) and free-space optical (FSO) technologies for last-mile access networks, where fiber deployment is impractical. The architecture of the proposed hybrid OCDMA-FSO network is thoroughly described. The users access the network in a fully asynchronous manner by means of assigned fast frequency hopping (FFH)-based codes. In the FSO receiver, an equal gain-combining technique is employed along with intensity modulation and direct detection. New analytical formalisms for evaluating the average bit error rate (ABER) performance are also proposed. These formalisms, based on the spatially correlated gamma-gamma statistical model, are derived considering three distinct scenarios, namely, uncorrelated, totally correlated, and partially correlated channels. Numerical results show that users can successfully achieve error-free ABER levels for the three scenarios considered as long as forward error correction (FEC) algorithms are employed. Therefore, OCDMA-FSO networks can be a prospective alternative to deliver high-speed communication services to access networks with deficient fiber infrastructure.

Global carbon - nitrogen - phosphorus cycle interactions: A key to solving the atmospheric CO2 balance problem?

NASA Technical Reports Server (NTRS)

Peterson, B. J.; Mellillo, J. M.

1984-01-01

If all biotic sinks of atmospheric CO2 reported were added a value of about 0.4 Gt C/yr would be found. For each category, a very high (non-conservative) estimate was used. This still does not provide a sufficient basis for achieving a balance between the sources and sinks of atmospheric CO2. The bulk of the discrepancy lies in a combination of errors in the major terms, the greatest being in a combination of errors in the major terms, the greatest being in the net biotic release and ocean uptake segments, but smaller errors or biases may exist in calculations of the rate of atmospheric CO2 increase and total fossil fuel use as well. The reason why biotic sinks are not capable of balancing the CO2 increase via nutrient-matching in the short-term is apparent from a comparison of the stoichiometry of the sources and sinks. The burning of fossil fuels and forest biomass releases much more CO2-carbon than is sequestered as organic carbon.

Quality Indicators in Laboratory Medicine: the status of the progress of IFCC Working Group "Laboratory Errors and Patient Safety" project.

PubMed

Sciacovelli, Laura; Lippi, Giuseppe; Sumarac, Zorica; West, Jamie; Garcia Del Pino Castro, Isabel; Furtado Vieira, Keila; Ivanov, Agnes; Plebani, Mario

2017-03-01

The knowledge of error rates is essential in all clinical laboratories as it enables them to accurately identify their risk level, and compare it with those of other laboratories in order to evaluate their performance in relation to the State-of-the-Art (i.e. benchmarking) and define priorities for improvement actions. Although no activity is risk free, it is widely accepted that the risk of error is minimized by the use of Quality Indicators (QIs) managed as a part of laboratory improvement strategy and proven to be suitable monitoring and improvement tools. The purpose of QIs is to keep the error risk at a level that minimizes the likelihood of patients. However, identifying a suitable State-of-the-Art is challenging, because it calls for the knowledge of error rates measured in a variety of laboratories throughout world that differ in their organization and management, context, and the population they serve. Moreover, it also depends on the choice of the events to keep under control and the individual procedure for measurement. Although many laboratory professionals believe that the systemic use of QIs in Laboratory Medicine may be effective in decreasing errors occurring throughout the total testing process (TTP), to improve patient safety as well as to satisfy the requirements of International Standard ISO 15189, they find it difficult to maintain standardized and systematic data collection, and to promote continued high level of interest, commitment and dedication in the entire staff. Although many laboratories worldwide express a willingness to participate to the Model of QIs (MQI) project of IFCC Working Group "Laboratory Errors and Patient Safety", few systematically enter/record their own results and/or use a number of QIs designed to cover all phases of the TTP. Many laboratories justify their inadequate participation in data collection of QIs by claiming that the number of QIs included in the MQI is excessive. However, an analysis of results suggests that QIs need to be split into further measurements. As the International Standard on Laboratory Accreditation and approved guidelines do not specify the appropriate number of QIs to be used in the laboratory, and the MQI project does not compel laboratories to use all the QIs proposed, it appears appropriate to include in the MQI all the indicators of apparent utility in monitoring critical activities. The individual laboratory should also be able to decide how many and which QIs can be adopted. In conclusion, the MQI project is proving to be an important tool that, besides providing the TTP error rate and spreading the importance of the use of QIs in enhancing patient safety, highlights critical aspects compromising the widespread and appropriate use of QIs.

Mental workload measurement for emergency operating procedures in digital nuclear power plants.

PubMed

Gao, Qin; Wang, Yang; Song, Fei; Li, Zhizhong; Dong, Xiaolu

2013-01-01

Mental workload is a major consideration for the design of emergency operation procedures (EOPs) in nuclear power plants. Continuous and objective measures are desired. This paper compares seven mental workload measurement methods (pupil size, blink rate, blink duration, heart rate variability, parasympathetic/sympathetic ratio, total power and (Goals, Operations, Methods, and Section Rules)-(Keystroke Level Model) GOMS-KLM-based workload index) with regard to sensitivity, validity and intrusiveness. Eighteen participants performed two computerised EOPs of different complexity levels, and mental workload measures were collected during the experiment. The results show that the blink rate is sensitive to both the difference in the overall task complexity and changes in peak complexity within EOPs, that the error rate is sensitive to the level of arousal and correlate to the step error rate and that blink duration increases over the task period in both low and high complexity EOPs. Cardiac measures were able to distinguish tasks with different overall complexity. The intrusiveness of the physiological instruments is acceptable. Finally, the six physiological measures were integrated using group method of data handling to predict perceived overall mental workload. The study compared seven measures for evaluating the mental workload with emergency operation procedure in nuclear power plants. An experiment with simulated procedures was carried out, and the results show that eye response measures are useful for assessing temporal changes of workload whereas cardiac measures are useful for evaluating the overall workload.

Ozone Trend Detectability

NASA Technical Reports Server (NTRS)

Campbell, J. W. (Editor)

1981-01-01

The detection of anthropogenic disturbances in the Earth's ozone layer was studied. Two topics were addressed: (1) the level at which a trend in total ozoning is detected by existing data sources; and (2) empirical evidence in the prediction of the depletion in total ozone. Error sources are identified. The predictability of climatological series, whether empirical models can be trusted, and how errors in the Dobson total ozone data impact trend detectability, are discussed.

High Precision Ranging and Range-Rate Measurements over Free-Space-Laser Communication Link

NASA Technical Reports Server (NTRS)

Yang, Guangning; Lu, Wei; Krainak, Michael; Sun, Xiaoli

2016-01-01

We present a high-precision ranging and range-rate measurement system via an optical-ranging or combined ranging-communication link. A complete bench-top optical communication system was built. It included a ground terminal and a space terminal. Ranging and range rate tests were conducted in two configurations. In the communication configuration with 622 data rate, we achieved a two-way range-rate error of 2 microns/s, or a modified Allan deviation of 9 x 10 (exp -15) with 10 second averaging time. Ranging and range-rate as a function of Bit Error Rate of the communication link is reported. They are not sensitive to the link error rate. In the single-frequency amplitude modulation mode, we report a two-way range rate error of 0.8 microns/s, or a modified Allan deviation of 2.6 x 10 (exp -15) with 10 second averaging time. We identified the major noise sources in the current system as the transmitter modulation injected noise and receiver electronics generated noise. A new improved system will be constructed to further improve the system performance for both operating modes.

Autonomic Cardiovascular Control and Executive Function in Chronic Hypotension.

PubMed

Duschek, Stefan; Hoffmann, Alexandra; Reyes Del Paso, Gustavo A; Ettinger, Ulrich

2017-06-01

Chronic low blood pressure (hypotension) is characterized by complaints such as fatigue, reduced drive, dizziness, and cold limbs. Additionally, deficits in attention and memory have been observed. Autonomic dysregulation is considered to be involved in the origin of this condition. The study explored autonomic cardiovascular control in the context of higher cognitive processing (executive function) in hypotension. Hemodynamic recordings were performed in 40 hypotensive and 40 normotensive participants during execution of four classical executive function tasks (number-letter task, n-back task, continuous performance test, and flanker task). Parameters of cardiac sympathetic control, i.e., stroke volume, cardiac output, pre-ejection period, total peripheral resistance, and parasympathetic control, i.e., respiratory sinus arrhythmia and baroreflex sensitivity, were obtained. The hypotensive group exhibited lower stroke volume and cardiac output, as well as higher pre-ejection period and baroreflex sensitivity during task execution. Increased error rates in hypotensive individuals were observed in the n-back and flanker tasks. In the total sample, there were positive correlations of error rates with pre-ejection period, baroreflex sensitivity and respiratory sinus arrhythmia, and negative correlations with cardiac output. Group differences in stroke volume, cardiac output, and pre-ejection period suggest diminished beta-adrenergic myocardial drive during executive function processing in hypotension, in addition to increased baroreflex function. Although further research is warranted to quantify the extent of executive function impairment in hypotension, the results from correlation analysis add evidence to the notion that higher sympathetic inotropic influences and reduced parasympathetic cardiac influences are accompanied by better cognitive performance.

Performance of electrolyte measurements assessed by a trueness verification program.

PubMed

Ge, Menglei; Zhao, Haijian; Yan, Ying; Zhang, Tianjiao; Zeng, Jie; Zhou, Weiyan; Wang, Yufei; Meng, Qinghui; Zhang, Chuanbao

2016-08-01

In this study, we analyzed frozen sera with known commutabilities for standardization of serum electrolyte measurements in China. Fresh frozen sera were sent to 187 clinical laboratories in China for measurement of four electrolytes (sodium, potassium, calcium, and magnesium). Target values were assigned by two reference laboratories. Precision (CV), trueness (bias), and accuracy [total error (TEa)] were used to evaluate measurement performance, and the tolerance limit derived from the biological variation was used as the evaluation criterion. About half of the laboratories used a homogeneous system (same manufacturer for instrument, reagent and calibrator) for calcium and magnesium measurement, and more than 80% of laboratories used a homogeneous system for sodium and potassium measurement. More laboratories met the tolerance limit of imprecision (coefficient of variation [CVa]) than the tolerance limits of trueness (biasa) and TEa. For sodium, calcium, and magnesium, the minimal performance criterion derived from biological variation was used, and the pass rates for total error were approximately equal to the bias (<50%). For potassium, the pass rates for CV and TE were more than 90%. Compared with the non homogeneous system, the homogeneous system was superior for all three quality specifications. The use of commutable proficiency testing/external quality assessment (PT/EQA) samples with values assigned by reference methods can monitor performance and provide reliable data for improving the performance of laboratory electrolyte measurement. The homogeneous systems were superior to the non homogeneous systems, whereas accuracy of assigned values of calibrators and assay stability remained challenges.

Sagnac secret sharing over telecom fiber networks.

PubMed

Bogdanski, Jan; Ahrens, Johan; Bourennane, Mohamed

2009-01-19

We report the first Sagnac quantum secret sharing (in three-and four-party implementations) over 1550 nm single mode fiber (SMF) networks, using a single qubit protocol with phase encoding. Our secret sharing experiment has been based on a single qubit protocol, which has opened the door to practical secret sharing implementation over fiber telecom channels and in free-space. The previous quantum secret sharing proposals were based on multiparticle entangled states, difficult in the practical implementation and not scalable. Our experimental data in the three-party implementation show stable (in regards to birefringence drift) quantum secret sharing transmissions at the total Sagnac transmission loop distances of 55-75 km with the quantum bit error rates (QBER) of 2.3-2.4% for the mean photon number micro?= 0.1 and 1.7-2.1% for micro= 0.3. In the four-party case we have achieved quantum secret sharing transmissions at the total Sagnac transmission loop distances of 45-55 km with the quantum bit error rates (QBER) of 3.0-3.7% for the mean photon number micro= 0.1 and 1.8-3.0% for micro?= 0.3. The stability of quantum transmission has been achieved thanks to our new concept for compensation of SMF birefringence effects in Sagnac, based on a polarization control system and a polarization insensitive phase modulator. The measurement results have showed feasibility of quantum secret sharing over telecom fiber networks in Sagnac configuration, using standard fiber telecom components.

Utility of functional status for classifying community versus institutional discharges after inpatient rehabilitation for stroke.

PubMed

Reistetter, Timothy A; Graham, James E; Deutsch, Anne; Granger, Carl V; Markello, Samuel; Ottenbacher, Kenneth J

2010-03-01

To evaluate the ability of patient functional status to differentiate between community and institutional discharges after rehabilitation for stroke. Retrospective cross-sectional design. Inpatient rehabilitation facilities contributing to the Uniform Data System for Medical Rehabilitation. Patients (N=157,066) receiving inpatient rehabilitation for stroke from 2006 and 2007. Not applicable. Discharge FIM rating and discharge setting (community vs institutional). Approximately 71% of the sample was discharged to the community. Receiver operating characteristic curve analyses revealed that FIM total performed as well as or better than FIM motor and FIM cognition subscales in differentiating discharge settings. Area under the curve for FIM total was .85, indicating very good ability to identify persons discharged to the community. A FIM total rating of 78 was identified as the optimal cut point for distinguishing between positive (community) and negative (institution) tests. This cut point yielded balanced sensitivity and specificity (both=.77). Discharge planning is complex, involving many factors. Identifying a functional threshold for classifying discharge settings can provide important information to assist in this process. Additional research is needed to determine if the risks and benefits of classification errors justify shifting the cut point to weight either sensitivity or specificity of FIM ratings. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Lava effusion rate definition and measurement: a review

USGS Publications Warehouse

Calvari, Sonia; Dehn, Jonathan; Harris, A.

2007-01-01

Measurement of effusion rate is a primary objective for studies that model lava flow and magma system dynamics, as well as for monitoring efforts during on-going eruptions. However, its exact definition remains a source of confusion, and problems occur when comparing volume flux values that are averaged over different time periods or spatial scales, or measured using different approaches. Thus our aims are to: (1) define effusion rate terminology; and (2) assess the various measurement methods and their results. We first distinguish between instantaneous effusion rate, and time-averaged discharge rate. Eruption rate is next defined as the total volume of lava emplaced since the beginning of the eruption divided by the time since the eruption began. The ultimate extension of this is mean output rate, this being the final volume of erupted lava divided by total eruption duration. Whether these values are total values, i.e. the flux feeding all flow units across the entire flow field, or local, i.e. the flux feeding a single active unit within a flow field across which many units are active, also needs to be specified. No approach is without its problems, and all can have large error (up to ∼50%). However, good agreement between diverse approaches shows that reliable estimates can be made if each approach is applied carefully and takes into account the caveats we detail here. There are three important factors to consider and state when measuring, giving or using an effusion rate. First, the time-period over which the value was averaged; second, whether the measurement applies to the entire active flow field, or a single lava flow within that field; and third, the measurement technique and its accompanying assumptions.

Estimating population genetic parameters and comparing model goodness-of-fit using DNA sequences with error

PubMed Central

Liu, Xiaoming; Fu, Yun-Xin; Maxwell, Taylor J.; Boerwinkle, Eric

2010-01-01

It is known that sequencing error can bias estimation of evolutionary or population genetic parameters. This problem is more prominent in deep resequencing studies because of their large sample size n, and a higher probability of error at each nucleotide site. We propose a new method based on the composite likelihood of the observed SNP configurations to infer population mutation rate θ = 4Neμ, population exponential growth rate R, and error rate ɛ, simultaneously. Using simulation, we show the combined effects of the parameters, θ, n, ɛ, and R on the accuracy of parameter estimation. We compared our maximum composite likelihood estimator (MCLE) of θ with other θ estimators that take into account the error. The results show the MCLE performs well when the sample size is large or the error rate is high. Using parametric bootstrap, composite likelihood can also be used as a statistic for testing the model goodness-of-fit of the observed DNA sequences. The MCLE method is applied to sequence data on the ANGPTL4 gene in 1832 African American and 1045 European American individuals. PMID:19952140

A long-term follow-up evaluation of electronic health record prescribing safety

PubMed Central

Abramson, Erika L; Malhotra, Sameer; Osorio, S Nena; Edwards, Alison; Cheriff, Adam; Cole, Curtis; Kaushal, Rainu

2013-01-01

Objective To be eligible for incentives through the Electronic Health Record (EHR) Incentive Program, many providers using older or locally developed EHRs will be transitioning to new, commercial EHRs. We previously evaluated prescribing errors made by providers in the first year following transition from a locally developed EHR with minimal prescribing clinical decision support (CDS) to a commercial EHR with robust CDS. Following system refinements, we conducted this study to assess the rates and types of errors 2 years after transition and determine the evolution of errors. Materials and methods We conducted a mixed methods cross-sectional case study of 16 physicians at an academic-affiliated ambulatory clinic from April to June 2010. We utilized standardized prescription and chart review to identify errors. Fourteen providers also participated in interviews. Results We analyzed 1905 prescriptions. The overall prescribing error rate was 3.8 per 100 prescriptions (95% CI 2.8 to 5.1). Error rates were significantly lower 2 years after transition (p<0.001 compared to pre-implementation, 12 weeks and 1 year after transition). Rates of near misses remained unchanged. Providers positively appreciated most system refinements, particularly reduced alert firing. Discussion Our study suggests that over time and with system refinements, use of a commercial EHR with advanced CDS can lead to low prescribing error rates, although more serious errors may require targeted interventions to eliminate them. Reducing alert firing frequency appears particularly important. Our results provide support for federal efforts promoting meaningful use of EHRs. Conclusions Ongoing error monitoring can allow CDS to be optimally tailored and help achieve maximal safety benefits. Clinical Trials Registration ClinicalTrials.gov, Identifier: NCT00603070. PMID:23578816

An error covariance model for sea surface topography and velocity derived from TOPEX/POSEIDON altimetry

NASA Technical Reports Server (NTRS)

Tsaoussi, Lucia S.; Koblinsky, Chester J.

1994-01-01

In order to facilitate the use of satellite-derived sea surface topography and velocity oceanographic models, methodology is presented for deriving the total error covariance and its geographic distribution from TOPEX/POSEIDON measurements. The model is formulated using a parametric model fit to the altimeter range observations. The topography and velocity modeled with spherical harmonic expansions whose coefficients are found through optimal adjustment to the altimeter range residuals using Bayesian statistics. All other parameters, including the orbit, geoid, surface models, and range corrections are provided as unadjusted parameters. The maximum likelihood estimates and errors are derived from the probability density function of the altimeter range residuals conditioned with a priori information. Estimates of model errors for the unadjusted parameters are obtained from the TOPEX/POSEIDON postlaunch verification results and the error covariances for the orbit and the geoid, except for the ocean tides. The error in the ocean tides is modeled, first, as the difference between two global tide models and, second, as the correction to the present tide model, the correction derived from the TOPEX/POSEIDON data. A formal error covariance propagation scheme is used to derive the total error. Our global total error estimate for the TOPEX/POSEIDON topography relative to the geoid for one 10-day period is found tio be 11 cm RMS. When the error in the geoid is removed, thereby providing an estimate of the time dependent error, the uncertainty in the topography is 3.5 cm root mean square (RMS). This level of accuracy is consistent with direct comparisons of TOPEX/POSEIDON altimeter heights with tide gauge measurements at 28 stations. In addition, the error correlation length scales are derived globally in both east-west and north-south directions, which should prove useful for data assimilation. The largest error correlation length scales are found in the tropics. Errors in the velocity field are smallest in midlatitude regions. For both variables the largest errors caused by uncertainty in the geoid. More accurate representations of the geoid await a dedicated geopotential satellite mission. Substantial improvements in the accuracy of ocean tide models are expected in the very near future from research with TOPEX/POSEIDON data.

Fully Convolutional Networks for Ground Classification from LIDAR Point Clouds

NASA Astrophysics Data System (ADS)

Rizaldy, A.; Persello, C.; Gevaert, C. M.; Oude Elberink, S. J.

2018-05-01

Deep Learning has been massively used for image classification in recent years. The use of deep learning for ground classification from LIDAR point clouds has also been recently studied. However, point clouds need to be converted into an image in order to use Convolutional Neural Networks (CNNs). In state-of-the-art techniques, this conversion is slow because each point is converted into a separate image. This approach leads to highly redundant computation during conversion and classification. The goal of this study is to design a more efficient data conversion and ground classification. This goal is achieved by first converting the whole point cloud into a single image. The classification is then performed by a Fully Convolutional Network (FCN), a modified version of CNN designed for pixel-wise image classification. The proposed method is significantly faster than state-of-the-art techniques. On the ISPRS Filter Test dataset, it is 78 times faster for conversion and 16 times faster for classification. Our experimental analysis on the same dataset shows that the proposed method results in 5.22 % of total error, 4.10 % of type I error, and 15.07 % of type II error. Compared to the previous CNN-based technique and LAStools software, the proposed method reduces the total error and type I error (while type II error is slightly higher). The method was also tested on a very high point density LIDAR point clouds resulting in 4.02 % of total error, 2.15 % of type I error and 6.14 % of type II error.

The effectiveness of risk management program on pediatric nurses' medication error.

PubMed

Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat

2013-09-01

Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses' medication error rate. This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P < 0.001) and the error-reporting rate was higher (P < 0.007) compared to before the intervention and also in comparison to the nurses of the control hospital. Based on the results of this study and taking into account the high-risk nature of the medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses' cooperation.

FMLRC: Hybrid long read error correction using an FM-index.

PubMed

Wang, Jeremy R; Holt, James; McMillan, Leonard; Jones, Corbin D

2018-02-09

Long read sequencing is changing the landscape of genomic research, especially de novo assembly. Despite the high error rate inherent to long read technologies, increased read lengths dramatically improve the continuity and accuracy of genome assemblies. However, the cost and throughput of these technologies limits their application to complex genomes. One solution is to decrease the cost and time to assemble novel genomes by leveraging "hybrid" assemblies that use long reads for scaffolding and short reads for accuracy. We describe a novel method leveraging a multi-string Burrows-Wheeler Transform with auxiliary FM-index to correct errors in long read sequences using a set of complementary short reads. We demonstrate that our method efficiently produces significantly more high quality corrected sequence than existing hybrid error-correction methods. We also show that our method produces more contiguous assemblies, in many cases, than existing state-of-the-art hybrid and long-read only de novo assembly methods. Our method accurately corrects long read sequence data using complementary short reads. We demonstrate higher total throughput of corrected long reads and a corresponding increase in contiguity of the resulting de novo assemblies. Improved throughput and computational efficiency than existing methods will help better economically utilize emerging long read sequencing technologies.

Impact of Flow-Dependent Error Correlations and Tropospheric Chemistry on Assimilated Ozone

NASA Technical Reports Server (NTRS)

Wargan, K.; Stajner, I.; Hayashi, H.; Pawson, S.; Jones, D. B. A.

2003-01-01

The presentation compares different versions of a global three-dimensional ozone data assimilation system developed at NASA's Data Assimilation Office. The Solar Backscatter Ultraviolet/2 (SBUV/2) total and partial ozone column retrievals are the sole data assimilated in all of the experiments presented. We study the impact of changing the forecast error covariance model from a version assuming static correlations with a one that captures a short-term Lagrangian evolution of those correlations. This is further combined with a study of the impact of neglecting the tropospheric ozone production, loss and dry deposition rates, which are obtained from the Harvard GEOS-CHEM model. We compare statistical characteristics of the assimilated data and the results of validation against independent observations, obtained from WMO balloon-borne sondes and the Polar Ozone and Aerosol Measurement (POAM) III instrument. Experiments show that allowing forecast error correlations to evolve with the flow results in positive impact on assimilated ozone within the regions where data were not assimilated, particularly at high latitudes in both hemispheres. On the other hand, the main sensitivity to tropospheric chemistry is in the Tropics and sub-Tropics. The best agreement between the assimilated ozone and the in-situ sonde data is in the experiment using both flow-dependent error covariances and tropospheric chemistry.

Population-based survey of refractive error among school-aged children in rural northern China: the Heilongjiang eye study.

PubMed

Li, Zhijian; Xu, Keke; Wu, Shubin; Lv, Jia; Jin, Di; Song, Zhen; Wang, Zhongliang; Liu, Ping

2014-01-01

The prevalence of refractive error in the north of China is unknown. The study aimed to estimate the prevalence and associated factors of refractive error in school-aged children in a rural area of northern China. Cross-sectional study. The cluster random sampling method was used to select the sample. A total of 1700 subjects of 5 to 18 years of age were examined. All participants underwent ophthalmic evaluation. Refraction was performed under cycloplegia. Association of refractive errors with age, sex, and education was analysed. The main outcome measure was prevalence rates of refractive error among school-aged children. Of the 1700 responders, 1675 were eligible. The prevalence of uncorrected, presenting, and best-corrected visual acuity of 20/40 or worse in the better eye was 6.3%, 3.0% and 1.2%, respectively. The prevalence of myopia was 5.0% (84/1675, 95% CI, 4.8%-5.4%) and of hyperopia was 1.6% (27/1675, 95% CI, 1.0%-2.2%). Astigmatism was evident in 2.0% of the subjects. Myopia increased with increasing age, whereas hyperopia and astigmatism were associated with younger age. Myopia, hyperopia and astigmatism were more common in females. We also found that prevalence of refractive error were associated with education. Myopia and astigmatism were more common in those with higher degrees of education. This report has provided details of the refractive status in a rural school-aged population. Although the prevalence of refractive errors is lower in the population, the unmet need for spectacle correction remains a significant challenge for refractive eye-care services. © 2013 Royal Australian and New Zealand College of Ophthalmologists.

Error Analysis of Deep Sequencing of Phage Libraries: Peptides Censored in Sequencing

PubMed Central

Matochko, Wadim L.; Derda, Ratmir

2013-01-01

Next-generation sequencing techniques empower selection of ligands from phage-display libraries because they can detect low abundant clones and quantify changes in the copy numbers of clones without excessive selection rounds. Identification of errors in deep sequencing data is the most critical step in this process because these techniques have error rates >1%. Mechanisms that yield errors in Illumina and other techniques have been proposed, but no reports to date describe error analysis in phage libraries. Our paper focuses on error analysis of 7-mer peptide libraries sequenced by Illumina method. Low theoretical complexity of this phage library, as compared to complexity of long genetic reads and genomes, allowed us to describe this library using convenient linear vector and operator framework. We describe a phage library as N × 1 frequency vector n = ||ni||, where ni is the copy number of the ith sequence and N is the theoretical diversity, that is, the total number of all possible sequences. Any manipulation to the library is an operator acting on n. Selection, amplification, or sequencing could be described as a product of a N × N matrix and a stochastic sampling operator (S a). The latter is a random diagonal matrix that describes sampling of a library. In this paper, we focus on the properties of S a and use them to define the sequencing operator (S e q). Sequencing without any bias and errors is S e q = S a IN, where IN is a N × N unity matrix. Any bias in sequencing changes IN to a nonunity matrix. We identified a diagonal censorship matrix (C E N), which describes elimination or statistically significant downsampling, of specific reads during the sequencing process. PMID:24416071