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Quality metrics

Michelle M Valdez, Maureen Liwanag, Charles Mount, Rechell Rodriguez, Elisea Avalos-Reyes, Andrew Smith, David Collette, Michael Starsiak, Richard Green
Introduction: Inefficiencies in the command approval process for publications and/or presentations negatively impact DoD Graduate Medical Education (GME) residency programs' ability to meet ACGME scholarly activity requirements. A preliminary review of the authored works approval process at Naval Medical Center San Diego (NMCSD) disclosed significant inefficiency, variation in process, and a low level of customer satisfaction. In order to facilitate and encourage scholarly activity at NMCSD, and meet ACGME requirements, the Executive Steering Council (ESC) chartered an interprofessional team to lead a Lean Six Sigma (LSS) Rapid Improvement Event (RIE) project...
March 14, 2018: Military Medicine
Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
J Russell Hoverman, Marcus A Neubauer, Melissa Jameson, Jad E Hayes, Kathryn J Eagye, Mitra Abdullahpour, Wendy J Haydon, Maria Sipala, Amy Supraner, Michael A Kolodziej, Diana K Verrilli
PURPOSE: Reform of cancer care delivery seeks to control costs while improving quality. Texas Oncology collaborated with Aetna to conduct a payer-sponsored program that used evidence-based treatment pathways, a disease management call center, and an introduction to advance care planning to improve patient care and reduce total costs. METHODS: From June 1, 2013, to May 31, 2016, 746 Medicare Advantage patients with nine common cancer diagnoses were enrolled. Patients electing for patient support services were telephoned by oncology nurses who assessed symptoms and quality of life and introduced advance care planning...
March 16, 2018: Journal of Oncology Practice
Sara Moccia, Elena De Momi, Sara El Hadji, Leonardo S Mattos
BACKGROUND: Blood vessel segmentation is a topic of high interest in medical image analysis since the analysis of vessels is crucial for diagnosis, treatment planning and execution, and evaluation of clinical outcomes in different fields, including laryngology, neurosurgery and ophthalmology. Automatic or semi-automatic vessel segmentation can support clinicians in performing these tasks. Different medical imaging techniques are currently used in clinical practice and an appropriate choice of the segmentation algorithm is mandatory to deal with the adopted imaging technique characteristics (e...
May 2018: Computer Methods and Programs in Biomedicine
Jenifer E Clapp, Sarah A Niederman, Elizabeth Leonard, Christine J Curtis
INTRODUCTION: Approximately 60% of the American diet comes from processed foods, which makes improving their nutritional quality important for Americans' health. The objective of this study was to measure changes in serving sizes, calories, and sodium in top-selling processed foods that were on the market in 2009 and 2015. METHODS: We analyzed products in the top 80% of sales in the 54 processed food categories with consistent serving sizes and sales metrics that were on the market in both 2009 and 2015...
March 15, 2018: Preventing Chronic Disease
Patric Schmitz, Julian Hildebrandt, Andre Calero Valdez, Leif Kobbelt, Martina Ziefle
In virtual environments, the space that can be explored by real walking is limited by the size of the tracked area. To enable unimpeded walking through large virtual spaces in small real-world surroundings, redirection techniques are used. These unnoticeably manipulate the user's virtual walking trajectory. It is important to know how strongly such techniques can be applied without the user noticing the manipulation-or getting cybersick. Previously, this was estimated by measuring a detection threshold (DT) in highly-controlled psychophysical studies, which experimentally isolate the effect but do not aim for perceived immersion in the context of VR applications...
April 2018: IEEE Transactions on Visualization and Computer Graphics
Ethan Leng, Benjamin Spilseth, Lin Zhang, Jin Jin, Joseph S Koopmeiners, Gregory J Metzger
PURPOSE: Computer-aided detection/diagnosis (CAD) of prostate cancer (PCa) on multipara-metric MRI (mpMRI) is an active area of research. In the literature, the performance of predictive models trained to detect PCa on mpMRI has typically been reported in terms of voxel-wise mea-sures such as sensitivity and specificity and/or area under the receiver operating curve (AUC).However, it is unclear whether models that score higher by these measures are actually superior.Here, we propose a novel method for lesion identification as well as novel measures that assess the quality of the detected lesions...
March 15, 2018: Medical Physics
E Laurin, K K Thakur, I A Gardner, P Hick, N J G Moody, M S J Crane, I Ernst
Design and reporting quality of diagnostic accuracy studies (DAS) are important metrics for assessing utility of tests used in animal and human health. Following standards for designing DAS will assist in appropriate test selection for specific testing purposes and minimize the risk of reporting biased sensitivity and specificity estimates. To examine the benefits of recommending standards, design information from published DAS literature was assessed for 10 finfish, seven mollusc, nine crustacean and two amphibian diseases listed in the 2017 OIE Manual of Diagnostic Tests for Aquatic Animals...
March 15, 2018: Journal of Fish Diseases
Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Thomas K F Foo, Evangelos Laskaris, Mark Vermilyea, Minfeng Xu, Paul Thompson, Gene Conte, Christopher Van Epps, Christopher Immer, Seung-Kyun Lee, Ek T Tan, Dominic Graziani, Jean-Baptise Mathieu, Christopher J Hardy, John F Schenck, Eric Fiveland, Wolfgang Stautner, Justin Ricci, Joseph Piel, Keith Park, Yihe Hua, Ye Bai, Alex Kagan, David Stanley, Paul T Weavers, Erin Gray, Yunhong Shu, Matthew A Frick, Norbert G Campeau, Joshua Trzasko, John Huston, Matt A Bernstein
PURPOSE: To build and evaluate a small-footprint, lightweight, high-performance 3T MRI scanner for advanced brain imaging with image quality that is equal to or better than conventional whole-body clinical 3T MRI scanners, while achieving substantial reductions in installation costs. METHODS: A conduction-cooled magnet was developed that uses less than 12 liters of liquid helium in a gas-charged sealed system, and standard NbTi wire, and weighs approximately 2000 kg...
March 13, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
L M Oliver, W S Fisher, L Fore, A Smith, P Bradley
Coral reef condition on the south shore of St. Thomas, U.S. Virgin Islands, was assessed at various distances from Charlotte Amalie, the most densely populated city on the island. Human influence in the area includes industrial activity, wastewater discharge, cruise ship docks, and impervious surfaces throughout the watershed. Anthropogenic activity was characterized using a landscape development intensity (LDI) index, sedimentation threat (ST) estimates, and water quality (WQ) impairments in the near-coastal zone...
March 13, 2018: Environmental Monitoring and Assessment
Laurel J Gabard-Durnam, Adriana S Mendez Leal, Carol L Wilkinson, April R Levin
Electroenchephalography (EEG) recordings collected with developmental populations present particular challenges from a data processing perspective. These EEGs have a high degree of artifact contamination and often short recording lengths. As both sample sizes and EEG channel densities increase, traditional processing approaches like manual data rejection are becoming unsustainable. Moreover, such subjective approaches preclude standardized metrics of data quality, despite the heightened importance of such measures for EEGs with high rates of initial artifact contamination...
2018: Frontiers in Neuroscience
Chandrasekaran Jayaraman, Chaithanya Krishna Mummidisetty, Alannah Mannix-Slobig, Lori McGee Koch, Arun Jayaraman
BACKGROUND: Monitoring physical activity and leveraging wearable sensor technologies to facilitate active living in individuals with neurological impairment has been shown to yield benefits in terms of health and quality of living. In this context, accurate measurement of physical activity estimates from these sensors are vital. However, wearable sensor manufacturers generally only provide standard proprietary algorithms based off of healthy individuals to estimate physical activity metrics which may lead to inaccurate estimates in population with neurological impairment like stroke and incomplete spinal cord injury (iSCI)...
March 13, 2018: Journal of Neuroengineering and Rehabilitation
Dana E Niles, Jordan Duval-Arnould, Sophie Skellett, Lynda Knight, Felice Su, Tia T Raymond, Todd Sweberg, Anita I Sen, Dianne L Atkins, Stuart H Friess, Allan R de Caen, Hiroshi Kurosawa, Robert M Sutton, Heather Wolfe, Robert A Berg, Annemarie Silver, Elizabeth A Hunt, Vinay M Nadkarni
OBJECTIVES: Pediatric in-hospital cardiac arrest cardiopulmonary resuscitation quality metrics have been reported in few children less than 8 years. Our objective was to characterize chest compression fraction, rate, depth, and compliance with 2015 American Heart Association guidelines across multiple pediatric hospitals. DESIGN: Retrospective observational study of data from a multicenter resuscitation quality collaborative from October 2015 to April 2017. SETTING: Twelve pediatric hospitals across United States, Canada, and Europe...
March 10, 2018: Pediatric Critical Care Medicine
Oliver S Smart, Vladimír Horský, Swanand Gore, Radka Svobodová Vařeková, Veronika Bendová, Gerard J Kleywegt, Sameer Velankar
Realising the importance of assessing the quality of the biomolecular structures deposited in the Protein Data Bank (PDB), the Worldwide Protein Data Bank (wwPDB) partners established Validation Task Forces to obtain advice on the methods and standards to be used to validate structures determined by X-ray crystallography, nuclear magnetic resonance spectroscopy and three-dimensional electron cryo-microscopy. The resulting wwPDB validation pipeline is an integral part of the wwPDB OneDep deposition, biocuration and validation system...
March 1, 2018: Acta Crystallographica. Section D, Structural Biology
Oliver S Smart, Vladimír Horský, Swanand Gore, Radka Svobodová Vařeková, Veronika Bendová, Gerard J Kleywegt, Sameer Velankar
Crystallographic studies of ligands bound to biological macromolecules (proteins and nucleic acids) play a crucial role in structure-guided drug discovery and design, and also provide atomic level insights into the physical chemistry of complex formation between macromolecules and ligands. The quality with which small-molecule ligands have been modelled in Protein Data Bank (PDB) entries has been, and continues to be, a matter of concern for many investigators. Correctly interpreting whether electron density found in a binding site is compatible with the soaked or co-crystallized ligand or represents water or buffer molecules is often far from trivial...
March 1, 2018: Acta Crystallographica. Section D, Structural Biology
Satomi Shiraishi, Michael P Grams, Luis E Fong de Los Santos
PURPOSE: To demonstrate an objective quality control framework for the image review process. METHODS AND MATERIALS: 927 cone-beam computed tomography (CBCT) registrations were retrospectively analyzed for 33 bilateral head and neck cancer patients who received definitive radiotherapy. Two registration tracking volumes (RTVs) - cervical spine (C-spine) and mandible - were defined, within which a similarity metric was calculated and used as a registration quality tracking metric over the course of treatment...
March 12, 2018: Medical Physics
John W Hayes, Daniel Gomez-Cardona, Ran Zhang, Ke Li, Juan Pablo Cruz-Bastida, Guang-Hong Chen
PURPOSE: Low signal correction (LSC) in the raw counts domain has been shown to effectively reduce noise streaks in CT because the data inconsistency associated with photon-starved regions may be mitigated prior to the log transformation step. However, a systematic study of the performance of these raw data correction methods is still missing in literature. The purpose of this work was to provide such a systematic study for two well-known low signal correction schemes using either the adaptive trimmed mean (ATM) filter or the anisotropic diffusion (AD) filter in the raw counts domain...
March 12, 2018: Medical Physics
Etienne W Henn, Hennie S Cronje
INTRODUCTION AND HYPOTHESIS: A rectocele is the bulging of the anterior rectal wall into the posterior vaginal compartment. The route of surgical repair can be transvaginal, transrectal or abdominal. The aim of this retrospective study is to describe a novel transvaginal surgical procedure and investigate the associated subjective and objective clinical outcomes. METHODS: Database records were retrieved for all women who underwent a rectocele plication for the period from January 2010 until December 2015 in a referral urogynecology unit with a minimum follow-up period of 12 months...
March 12, 2018: International Urogynecology Journal
Ambarish Pandey, Kershaw V Patel, Li Liang, Adam D DeVore, Roland Matsouaka, Deepak L Bhatt, Clyde W Yancy, Adrian F Hernandez, Paul A Heidenreich, James A de Lemos, Gregg C Fonarow
Importance: Among patients hospitalized with heart failure (HF), the long-term clinical implications of hospitalization at hospitals based on 30-day risk-standardized mortality rates (RSMRs) is not known. Objective: To evaluate the association of hospital-specific 30-day RSMR with long-term survival among patients hospitalized with HF in the American Heart Association Get With The Guidelines-HF registry. Design, Setting, and Participants: The longitudinal observational study included 106 304 patients with HF who were admitted to 317 centers participating in the Get With The Guidelines-HF registry from January 1, 2005, to December 31, 2013, and had Medicare-linked follow-up data...
March 12, 2018: JAMA Cardiology
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