WorldWideScience

Sample records for account outcome measurements

  1. Distance Education in a Cost Accounting Course: Instruction, Interaction, and Multiple Measures of Learning Outcomes

    Directory of Open Access Journals (Sweden)

    Clement C. Chen

    2010-07-01

    Full Text Available Students in online and traditional classroom sections of an intermediate-level cost accounting course responded to a survey about their experiences in the course. Specifically, several items related to the instruction and learning outcomes were addressed. Additionally, student examination performance in the two types of sections was compared. The results suggest that students in both learning environments generally rated the instruction, professor/student interaction, and learning outcomes at a high level. However, where differences in satisfaction levels exist, the ratings generally were higher among students in the traditional classroom. Examination performance was comparable on 14 of 18 topic areas with the traditional method producing better comprehension in three of the remaining four areas. While student learning, instruction, and interaction between students and with the instructor were good in the online sections, the results suggest that the traditional learning approach provided a level of richness to the student learning experience that was not matched in the online approach. Overall, the survey results have implications for course design going forward, regardless of course delivery method.

  2. FINANCIAL OUTCOME BETWEEN ACCOUNTING AND FISCALITY

    Directory of Open Access Journals (Sweden)

    Florentina Moisescu

    2015-05-01

    Full Text Available The tax result does not reflect the real financial performance of a company but rather shows a result of taxation which is to determine the size of tax for a company. Therefore, in Romanian accounting there are a lot of different ways which are used to obtain an `embellished` accounting result due to a large variety of accounting policies and methods which allows the company to choose the desired outcome. In our county, the main goal of an enterprise seems to be either the decrease of the financial result in order to avoid payment of a bigger tax to the state tax authority or the postponement of it, while companies from other countries want a financial result as big as possible so that they can attract investors.

  3. Education Funding and Student Outcomes: A Conceptual Framework for Measurement of the Alignment of State Education Finance and Academic Accountability Policies

    Science.gov (United States)

    Knoeppel, Robert C.; Della Sala, Matthew R.

    2015-01-01

    The conceptualization and measurement of education finance equity and adequacy has engaged researchers for more than three decades. At the same time, calls for increased academic accountability and higher student achievement in K-12 public education have reached new levels at both the national and state levels. Aligning these represents an…

  4. Risks factoring business: accounting measurement

    Directory of Open Access Journals (Sweden)

    Z.V. Gutsaylyuk

    2015-06-01

    Full Text Available The paper carried out the identification of risk factors for the development of possible accounting software management. Studied theoretical and methodological aspects of the risk classification of factoring operations in the part of the risk assessment factors. It is proposed to consider the risks factors as the risk that is acceptable controlled by accounting instruments and the risks that can not be taken into account in the accounting records. To minimize the risk factor, accounting-driven tools, a method of self-insurance, which is a factor in the creation of provision for factoring transactions designed to cover unexpected expenses and losses. Provision for factoring factor will establish more stable conditions of financial activity and avoid the fluctuations of profit factor in relation to the writing off of losses on factoring operatsіyam.Developed proposals allow for further research to improve the organizational and methodological basis of accounting and analysis of information as a basis for providing risk management factor, particularly in terms of improving the evaluation questions such risks and their qualitative and quantitative analysis.

  5. Understanding and measuring child welfare outcomes.

    Science.gov (United States)

    D'Andrade, Amy; Osterling, Kathy Lemon; Austin, Michael J

    2008-01-01

    The new "Children's and Family Services Reviews" (CFSR) process focuses on the effectiveness of services to children and families by measuring client outcomes. This article reviews the research literature related to child welfare outcomes in order to provide a context for federal accountability efforts. It also summarizes the 2001 federal mandate to hold states accountable for child welfare outcomes and describes California's response to this mandate. Implications of the outcomes literature review and measurement problems in the CFSR process suggest CSFR measures do not always capture meaningful outcomes. Recommendations for change are made.

  6. 50 CFR 648.323 - Accountability measures.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Accountability measures. 648.323 Section 648.323 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... Skate Complex Fisheries § 648.323 Accountability measures. (a) TAL overages. If the skate wing...

  7. 50 CFR 622.49 - Accountability measures.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Accountability measures. 622.49 Section 622.49 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... § 622.49 Accountability measures. (a) Gulf reef fish—(1) Greater amberjack—(i) Commercial fishery....

  8. Measuring Learning Outcomes in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    2003-01-01

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes...... is a complex matter requiring sensible measures for both declarative knowledge (ability to verbalize pertinent facts or processes) and procedural knowledge (intellectual skills). The study uses a multitude of measures based on a hierarchical separation of intellectual skills originally suggested by Gagné (1984...

  9. Could Learning Outcomes of the First Course in Accounting Predict Overall Academic Performance?

    Science.gov (United States)

    Alanzi, Khalid A.; Alfraih, Mishari M.

    2017-01-01

    Purpose: This study aims to question whether learning outcomes of the first course in accounting could predict the overall academic performance of accounting students as measured by their graduating grade point average (GPA). Design/methodology/approach The sample of the present study was drawn from accounting students who were graduated during…

  10. Educational Testing as an Accountability Measure

    DEFF Research Database (Denmark)

    Ydesen, Christian

    2013-01-01

    analysis of the origins and impacts of test-based accountability measures applying both top-down and bottom-up perspectives. These historical perspectives offer the opportunity to gain a fuller understanding of this contemporary accountability concept and its potential, appeal, and implications...... for continued use in contemporary educational settings. Accountability measures and practices serve as a way to govern schools; by analysing the history of accountability as the concept has been practised in the education sphere, the article will discuss both pros and cons of such a methodology, particularly......This article reveals perspectives based on experiences from twentieth-century Danish educational history by outlining contemporary, test-based accountability regime characteristics and their implications for education policy. The article introduces one such characteristic, followed by an empirical...

  11. Educational Testing as an Accountability Measure

    DEFF Research Database (Denmark)

    Ydesen, Christian

    2013-01-01

    analysis of the origins and impacts of test-based accountability measures applying both top-down and bottom-up perspectives. These historical perspectives offer the opportunity to gain a fuller understanding of this contemporary accountability concept and its potential, appeal, and implications...... for continued use in contemporary educational settings. Accountability measures and practices serve as a way to govern schools; by analysing the history of accountability as the concept has been practised in the education sphere, the article will discuss both pros and cons of such a methodology, particularly......This article reveals perspectives based on experiences from twentieth-century Danish educational history by outlining contemporary, test-based accountability regime characteristics and their implications for education policy. The article introduces one such characteristic, followed by an empirical...

  12. Measuring Learning Outcomes in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. Sensible measures are needed by educators in order to (1) chose teaching methods matching prerequisite skills among a heterogeneous student body......-order-rules. This paper presents data collected in 1999-2000 including 75 graduate students representing both types of schema. The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing. The hypotheses are tested by traditional ANOVAs, and have been confirmed...

  13. Outcome measures of antidepressive therapy.

    Science.gov (United States)

    Rosenberg, R

    2000-01-01

    A variety of outcome measures assessing antidepressive therapy are available. However, in randomized clinical trials, the Hamilton Rating Scale for Depression (HAM-D) is often the primary outcome measure. Results from factor analysis and Rasch item analysis indicate that the HAM-D is heterogeneous and that the sum of items scores may not be an adequate measure of the severity of depression. A Melancholia Scale of 11 items has been suggested as a more valid measure of the core symptoms of affective syndrome. Other global outcome measures, focusing on health-related quality of life issues and on social functioning as well as macro-economic analyses are also used in depression. Applying stringent and well-documented outcome measures in randomized clinical trials of antidepressants may give the clinician a better indication of the most appropriate drug for treatment of the individual patient.

  14. MEASUREMENT: ACCOUNTING FOR RELIABILITY IN PERFORMANCE ESTIMATES.

    Science.gov (United States)

    Waterman, Brian; Sutter, Robert; Burroughs, Thomas; Dunagan, W Claiborne

    2014-01-01

    When evaluating physician performance measures, physician leaders are faced with the quandary of determining whether departures from expected physician performance measurements represent a true signal or random error. This uncertainty impedes the physician leader's ability and confidence to take appropriate performance improvement actions based on physician performance measurements. Incorporating reliability adjustment into physician performance measurement is a valuable way of reducing the impact of random error in the measurements, such as those caused by small sample sizes. Consequently, the physician executive has more confidence that the results represent true performance and is positioned to make better physician performance improvement decisions. Applying reliability adjustment to physician-level performance data is relatively new. As others have noted previously, it's important to keep in mind that reliability adjustment adds significant complexity to the production, interpretation and utilization of results. Furthermore, the methods explored in this case study only scratch the surface of the range of available Bayesian methods that can be used for reliability adjustment; further study is needed to test and compare these methods in practice and to examine important extensions for handling specialty-specific concerns (e.g., average case volumes, which have been shown to be important in cardiac surgery outcomes). Moreover, it's important to note that the provider group average as a basis for shrinkage is one of several possible choices that could be employed in practice and deserves further exploration in future research. With these caveats, our results demonstrate that incorporating reliability adjustment into physician performance measurements is feasible and can notably reduce the incidence of "real" signals relative to what one would expect to see using more traditional approaches. A physician leader who is interested in catalyzing performance improvement

  15. Responsiveness of Clinical Outcome Measures

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    to condition alterations in PrS patients and should be added as an outcome measure to standard questionnaires used serially. The prospective acceptable outcome method offers a benchmark by which clinicians can balance any mismatch between what are acceptable outcomes to the patient with what is realistically......, the most commonly used retrospective method to establish the MCID has inherent methodological flaws. Perhaps it would be more prudent to ask LBP patients what is an acceptable result of the treatment before it begins? Objectives The overall objective was to establish the responsiveness and MCID in specific...... subgroups of patients with LBP. In addition, we explored whether low back pain patients were able to determine an acceptable treatment outcome before it began. Methods The responsiveness in subgroups study. An extensive cross-cultural adaptation and validation of the ODI was carried out on patients seen...

  16. Social Prerequisites and Outcomes of Accountable Curriculum in Higher

    Directory of Open Access Journals (Sweden)

    Mohammadreza Nili

    2010-07-01

    Full Text Available AbstractHigher education system(HES is a social institution that has long been set up to accomplish threemissions education, research and service, but during recent years entrepreneurship has been added to itsmissions. Curriculum is the most important component and subsystem of HES and has been thought of as theheart of higher education (HE, because it is the most fundamental means that provides students withknowledge, experience and skills to supply services to the society. The curriculum which can accomplishideals and missions of universities, organizational (of the university and social (of the employers and thesociety is called accountable curriculum (AC. The main goal of this research was explanation ofprerequisites and social outcomes of higher education accountable curriculum (HEAC. To do the researchdescriptive survey method was used and in order to collect the needed data interview and questionnaireinstruments were utilized.The sample of the study which the questionnaire was distributed in, included faculty members and graduatestudents of university of Isfahan, Technical University of Isfahan, and Medical University of Isfahan andalso employers and administrators of the companies of Isfahan city. The participants of the sample wereal1ocated using stratified random sampling. The questionnaire surveyed the sample's viewpoints aboutprerequisites and outcomes of the AC in the field of social services. The collected data were analyzed atdescriptive and inferential levels using SPSS. The findings of T-test revealed that the mean of the sample'sviewpoints about the explained prerequisites and outcomes had been more than the hypothetical (theoreticalmean of the population (p≤0/001. The multivariate variance analysis( MANOVA of the data showed thatthere hadn't been significant difference among viewpoints of faculties, and employers in respect ofprerequisites of HEAC, but there had been significant difference between their views about expected

  17. Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures.

    Science.gov (United States)

    Valuck, Tom; Blaisdell, David; Dugan, Donna P; Westrich, Kimberly; Dubois, Robert W; Miller, Robert S; McClellan, Mark

    2017-02-01

    Payment for health care services, including oncology services, is shifting from volume-based fee-for-service to value-based accountable care. The objective of accountable care is to support providers with flexibility and resources to reform care delivery, accompanied by accountability for maintaining or improving outcomes while lowering costs. These changes depend on health care payers, systems, physicians, and patients having meaningful measures to assess care delivery and outcomes and to balance financial incentives for lowering costs while providing greater value. Gaps in accountable care measure sets may cause missed signals of problems in care and missed opportunities for improvement. Measures to balance financial incentives may be particularly important for oncology, where high cost and increasingly targeted diagnostics and therapeutics intersect with the highly complex and heterogeneous needs and preferences of cancer patients. Moreover, the concept of value in cancer care, defined as the measure of outcomes achieved per costs incurred, is rarely incorporated into performance measurement. This article analyzes gaps in oncology measures in accountable care, discusses challenging measurement issues, and offers strategies for improving oncology measurement. Discern Health analyzed gaps in accountable care measure sets for 10 cancer conditions that were selected based on incidence and prevalence; impact on cost and mortality; a diverse range of high-cost diagnostic procedures and treatment modalities (e.g., genomic tumor testing, molecularly targeted therapies, and stereotactic radiotherapy); and disparities or performance gaps in patient care. We identified gaps by comparing accountable care set measures with high-priority measurement opportunities derived from practice guidelines developed by the National Comprehensive Cancer Network and other oncology specialty societies. We found significant gaps in accountable care measure sets across all 10 conditions. For

  18. Accounting System and Financial Performance Measurements

    OpenAIRE

    Halíř, Zbyněk

    2011-01-01

    The paper concerns measuring and reporting of financial performance of an enterprise. Currently increasing emphasis is placed on performance measurement and management. Within performance measurement and management in general the role of financial performance is becoming increasingly important. The paper is concerned with measuring and reporting of financial performance of an enterprise primarily from manager’s point of view. In its first part it deals primarily with the connection between th...

  19. Clinical outcome measures in juvenile idiopathic arthritis.

    Science.gov (United States)

    Consolaro, Alessandro; Giancane, Gabriella; Schiappapietra, Benedetta; Davì, Sergio; Calandra, Serena; Lanni, Stefano; Ravelli, Angelo

    2016-04-18

    Juvenile idiopathic arthritis (JIA), as a chronic condition, is associated with significant disease- and treatment-related morbidity, thus impacting children's quality of life. In order to optimize JIA management, the paediatric rheumatologist has begun to regularly use measurements of disease activity developed, validated and endorsed by international paediatric rheumatology professional societies in an effort to monitor the disease course over time and assess the efficacy of therapeutic interventions in JIA patients.A literature review was performed to describe the main outcome measures currently used in JIA patients to determine disease activity status.The Juvenile Disease Activity Score (JADAS), in its different versions (classic JADAS, JADAS-CRP and cJADAS) and the validated definitions of disease activity and response to treatment represent an important tool for the assessment of clinically relevant changes in disease activity, leading more and more to a treat-to-target strategy, based on a tight and thorough control of the patient condition. Moreover, in recent years, increasing attention on the incorporation of patient-reported or parent-reported outcomes (PRCOs), when measuring the health state of patients with paediatric rheumatic diseases has emerged.We think that the care of JIA patients cannot be possible without taking into account clinical outcome measures and, in this regard, further work is required.

  20. [Patient-reported outcomes: definition and measurement].

    Science.gov (United States)

    Botturi, Davide; Rodella, Stefania

    2014-06-01

    The concept of "patient-reported outcomes" have been proposed by the Food and Drug Administration in the year 2000, in order to describe one of the different and potential sources of information on the drug's safety and effectiveness. It represents an "umbrella" term, which covers a multiplicity of meanings and primarily identifies a conceptual approach and a methodology specifically oriented to the patients' point of view on outcomes, instead of the traditional clinical and professional perspective. The patient-reported outcomes measures are frequently self-completed questionnaires. The measures can be classified in general and specific. The first one, general, relates to the assessment of the quality of life or the health status, in the general population or in subgroups with particular health problems (eg. SF-36 Health Survey, EQ-5D). The second one, specific, mainly relates to the assessment of particular types of symptoms (eg. pain, anxiety, fear, depression) and functions (eg. daily living activities), in population's subgroups with definite health problems, undergoing or not to a healthcare procedure (eg. Adult Asthma Quality of Life Questionnaire, Kidney Disease Quality of Life Instrument, Oxford Hip Score, Oxford Knee Score). For the selection of an instrument a series of criteria needs to be taken into account, among which the psychometric properties, the expert judgement, the interpretability, the acceptability, and the feasibility of the entire process.

  1. Measuring and Assessing the Quality and Usefulness of Accounting Information

    OpenAIRE

    Gergana Tsoncheva

    2014-01-01

    High quality accounting information is of key importance for a large number of users, as it influences the quality of the decisions made. Providing high quality and useful accounting information is a prerequisite for the efficiency of the enterprise. Usefulness is determined by the quality of accounting information. Measuring and assessing the quality and usefulness of accounting information are of particular importance, as these activities will not only enhance the quality of economic decisi...

  2. [Patient evaluation and outcome measures].

    Science.gov (United States)

    Nieto Pol, Enrique

    2014-01-01

    Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey). Copyright © 2014 Elsevier España, S.L. All rights reserved.

  3. [Measuring outcome in spasticity rehabilitation].

    Science.gov (United States)

    Fheodoroff, K; Wissel, J; Entner, T; Freimüller, M

    2001-01-01

    Spasticity is a frequent consequence of upper motor neuron lesion and is associated with a variety of symptoms such as pain, muscle stiffness and reflex patterns that interfere with activities of daily living, dexterity and gait. As therapy strategies in managing spasticity-associated problems have been evolving there is an increasing need for a practicable documentation system which describes spasticity and related symptoms on different levels in order to evaluate especially the level of functioning. In daily routine the single-case-design reflects a useful technique to evaluate the status in terms of technical, functional and individual goals for treatment. However, there is no single tool to measure the different types of changes due to treatment, therefore a variety of selecting tests, based on the functional changes expected from the selected treatment, is recommended. The sensitivity of the selected tests should match the range of expected improvements related to the specific treatment. Technical goals should be evaluated by validated spasticity rating scales. As changes in technical measures of spasticity such as muscle tone, muscle length, range of motion or repetitive voluntary movements may not correlate with clinical improvements, individual functional goals should be defined. Those functional goals should reflect the patients' and care-givers' individual perception of the actual problem. A treatment diary is a useful tool to document subjective perception of changes over time. Some practical issues are adressed below. Reliable outcome measures enable patients and doctors to select further treatment strategies and gives health care providers information on treatment expectations in return for their investments.

  4. Clinical Outcome Measures in Chiari I Malformation.

    Science.gov (United States)

    Yarbrough, Chester K; Greenberg, Jacob K; Park, Tae Sung

    2015-10-01

    Chiari malformation type 1 (CM-I) is a common and often debilitating neurologic disease. Reliable evaluation of treatments has been hampered by inconsistent use of clinical outcome measures. A variety of outcome measurement tools are available, although few have been validated in CM-I. The recent development of the Chicago Chiari Outcome Scale and the Chiari Symptom Profile provides CM-I-specific instruments to measure outcomes in adults and children, although validation and refinement may be necessary.

  5. Hospital Quality Initiative - Outcome Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  6. Effect size for dichotomous outcome measures

    Institute of Scientific and Technical Information of China (English)

    Yuanjia WANG; Naihua DUAN

    2011-01-01

    @@ Effect size for continuous outcome measures was discussed in our previous column[1].In this column we discuss several widely used effect size measures for dichotomous (Yes/No) outcome measures such as mortality,relapse,cure,discontinuation of treatment,and so forth.

  7. Measuring Learning Outcomes. A Learner Perspective in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    2000-01-01

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. Sensible measures are needed by educators in order to (1) chose teaching methods matching prerequisite skills among a heterogenous student body, (2......-order-rules. This paper presents data collected in September 1999 including 34 graduate students representing both types of schema. The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing. The findings suggest that the student-mass, to some extent, is able...

  8. Measuring Learning Outcomes. A Learner Perspective in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. Sensible measures are needed by educators in order to (1) chose teaching methods matching prerequisite skills among a heterogenous student body, (2......-order-rules. This paper presents data collected in September 1999 including 34 graduate students representing both types of schema. The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing. The findings suggest that the student-mass, to some extent, is able...

  9. Accounting in Agriculture: Measurement practices of listed firms

    OpenAIRE

    Rute Gonçalves; Patrícia Lopes

    2015-01-01

    Based on the International Accounting Standard (IAS) 41 – Agriculture, this paper examines measurement practices of biological assets and their drivers, under accounting choice theory, given data from 2012. Taking into consideration 324 listed firms worldwide that have adopted International Financial Reporting Standards (IFRS) until 2011, the empirical evidence supports that while a large number of firms measures biological assets at fair value, there are others that refute the presumption of...

  10. Prevention validation and accounting platform: a framework for establishing accountability and performance measures of substance abuse prevention programs.

    Science.gov (United States)

    Kim, S; McLeod, J H; Williams, C; Hepler, N

    2000-01-01

    The field of substance abuse prevention has neither an overarching conceptual framework nor a set of shared terminologies for establishing the accountability and performance outcome measures of substance abuse prevention services rendered. Hence, there is a wide gap between what we currently have as data on one hand and information that are required to meet the performance goals and accountability measures set by the Government Performance and Results Act of 1993 on the other. The task before us is: How can we establish the accountability and performance measures of substance abuse prevention programs and transform the field of prevention into prevention science? The intent of this volume is to serve that purpose and accelerate the processes of this transformation by identifying the requisite components of the transformation (i.e., theory, methodology, convention on terms, and data) and by introducing an open forum called, Prevention Validation and Accounting (PREVA) Platform. The entire PREVA Platform (for short, the Platform) is designed as an analytic framework, which is formulated by a collectivity of common concepts, terminologies, accounting units, protocols for counting the units, data elements, and operationalizations of various constructs, and other summary measures intended to bring about an efficient and effective measurement of process input, program capacity, process output, performance outcome, and societal impact of substance abuse prevention programs. The measurement units and summary data elements are designed to be measured across time and across jurisdictions, i.e., from local to regional to state to national levels. In the Platform, the process input is captured by two dimensions of time and capital. Time is conceptualized in terms of service delivery time and time spent for research and development. Capital is measured by the monies expended for the delivery of program activities during a fiscal or reporting period. Program capacity is captured

  11. International Target Values for Measurement Uncertainties in Nuclear Material Accountancy

    Institute of Scientific and Technical Information of China (English)

    LIU; Hong-bin; GAO; Qiang

    2012-01-01

    <正>The IAEA has published a revised version International Target Values (ITVs) 2010 for Measurement Uncertainties in Safeguarding Nuclear Materials in 2010. The report proposes the international target values of measurement uncertainties of the routine measurement methods for the nuclear material accountancy.

  12. Historical Costs versus Fair Value Measurement in Financial Accounting

    OpenAIRE

    Dvořáková, Dana

    2009-01-01

    There are two important points in which in which we need assets and liabilities measured in financial accounting: on initial recognition and at a balance sheet day. Many International Financial Reporting Standards (IFRS) used the fair value measurement concept. But most of these standards use the fair value measurement method only at a balance sheet day. On initial recognition assets and liabilities are measured usually at costs. The IASB presented the discussion paper “Measurement Bases for ...

  13. Contracts, Performance Measurement and Accountability in the Public Sector

    DEFF Research Database (Denmark)

    Drewry, Gavin; Greve, Carsten; Tanquerel, Thierry

    This book addresses issues to do with public accountability, audit and performance measurement that are both highly topical and of crucial importance to the theory and practice of public administration in an era of contractualized public management. The literature on public sector contracting...... of audit and accountability in a variety of countries and contexts; the third part offers some wider, cross-cutting perspectives. Based on the work of the EGPA permanent study group on the history of contractualization, Contracts, Performance Measurement and Accountability in the Public Sector draws upon...... - covering both 'hard' agreements (ones that are legally enforceable) and 'soft' agreements (enforced by negotiation and mutual trust) - has been growing for some time and the present book adds a primarily European perspective on contracting, performance-based management and accountability. One important...

  14. A new approach for measuring human resource accounting

    Directory of Open Access Journals (Sweden)

    Esmat Bavali

    2014-06-01

    Full Text Available Significance of identifying human resource competency in organizations and the necessity for valuating human resource in accounting persuade many researchers to design a conceptual model for measuring human resource accounting. This study, first, examines dimensions of various valuation models of human resource and then they are compared with Goleman individual and social competency indicators. Next, individual, organizational and social competency indicators are designed through developing Goleman model. Finally, Analytical Hierarchy Process (AHP and experts’ ideas in human resource accounting in superior universities of the world are used to classify the indicators; and the conceptual model of measuring human resource accounting is designed based on guidelines of management and human capital development vice-presidency and inspiring effort rate of return method.

  15. Personal Accountability in Education: Measure Development and Validation

    Science.gov (United States)

    Rosenblatt, Zehava

    2017-01-01

    Purpose: The purpose of this paper, three-study research project, is to establish and validate a two-dimensional scale to measure teachers' and school administrators' accountability disposition. Design/methodology/approach: The scale items were developed in focus groups, and the final measure was tested on various samples of Israeli teachers and…

  16. A new approach for measuring human resource accounting

    OpenAIRE

    2014-01-01

    Significance of identifying human resource competency in organizations and the necessity for valuating human resource in accounting persuade many researchers to design a conceptual model for measuring human resource accounting. This study, first, examines dimensions of various valuation models of human resource and then they are compared with Goleman individual and social competency indicators. Next, individual, organizational and social competency indicators are designed through developing G...

  17. Un-"Chartered" Waters: Balancing Montessori Curriculum and Accountability Measures in a Charter School

    Science.gov (United States)

    Scott, Catherine M.

    2017-01-01

    More than 6,000 charter schools exist in the United States, and of these 120 are Montessori charter schools. When studying charter school practices, researchers often examine issues such as performance accountability measures and effectiveness of charter school curricula. In doing so, the outcomes often overlook the challenges for teachers as they…

  18. Un-"Chartered" Waters: Balancing Montessori Curriculum and Accountability Measures in a Charter School

    Science.gov (United States)

    Scott, Catherine M.

    2017-01-01

    More than 6,000 charter schools exist in the United States, and of these 120 are Montessori charter schools. When studying charter school practices, researchers often examine issues such as performance accountability measures and effectiveness of charter school curricula. In doing so, the outcomes often overlook the challenges for teachers as they…

  19. Electrochemically-Modulated Separations for Material Accountability Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Arrigo, Leah M.; Liezers, Martin; Douglas, Matthew; Green, Michael A.; Farmer, Orville T.; Schwantes, Jon M.; Peper, Shane M.; Duckworth, Douglas C.

    2010-05-07

    The Safeguards community recognizes that an accurate and timely measurement of accountable material mass at the head-end of the facility is critical to a modern materials control and accountability program at fuel reprocessing plants. For material accountancy, it is critical to detect both acute and chronic diversions of nuclear materials. Therefore, both on-line nondestructive (NDA) and destructive analysis (DA) approaches are desirable. Current methods for DA involve grab sampling and laboratory based column extractions that are costly, hazardous, and time consuming. Direct on-line gamma measurements of Pu, while desirable, are not possible due to contributions from other actinide and fission products. A technology for simple, online separation of targeted materials would benefit both DA and NDA measurements.

  20. Measuring Inclusive Education Outcomes in Alberta, Canada

    Science.gov (United States)

    Loreman, Tim

    2014-01-01

    This study details the results of a review of the academic and public sector literature on measuring inclusive education in large systems. It highlights some outcomes drawn from the international literature on inclusion that might be indicative of the presence and quality of inclusive education in an effort to develop a set of outcomes for…

  1. Volunteers in Circles of Support and Accountability Job Demands, Job Resources, and Outcome.

    Science.gov (United States)

    Höing, Mechtild; Bogaerts, Stefan; Vogelvang, Bas

    2015-10-21

    In Circles of Support and Accountability (CoSA), volunteers support a medium- to high-risk sex offender in his process toward desistance by developing a long-term empathic relationship. More knowledge is needed about the impact of this work on volunteers themselves. In a sample of 40 Dutch CoSA volunteers-at the time constituting 37% of the national population of 108 then active CoSA volunteers-we measured outcome in terms of volunteer satisfaction, determination to continue, compassion satisfaction, burnout and secondary stress, vicarious growth, civic capacities, and professional skills. We explored theoretically derived predictors of positive and negative outcome, and conceptualized them within the Job Demands-Resources model (JD-R). Volunteers reported mainly positive effects, especially high levels of volunteer satisfaction, compassion satisfaction, and determination to continue. Results indicated that job demands and most of the internal job resources were of minor importance. External job resources, especially social support and connectedness, were associated with positive outcome. Connectedness mediated the effect of social support on compassion satisfaction.

  2. Measuring outcomes and efficiency in medicare value-based purchasing.

    Science.gov (United States)

    Tompkins, Christopher P; Higgins, Aparna R; Ritter, Grant A

    2009-01-01

    The Medicare program may soon adopt value-based purchasing (VBP), in which hospitals could receive incentives that are conditional on meeting specified performance objectives. The authors advocate for a market-oriented framework and direct measures of system-level value that are focused on better outcomes and lower total cost of care. They present a multidimensional framework for measuring outcomes of care and a method to adjust incentive payments based on efficiency. Incremental reforms based on VBP could provoke transformational changes in total patient care by linking payments to value related to the whole patient experience, recognizing shared accountability among providers.

  3. Financial accounting effects of tax aggressiveness : Contracting and measurement

    NARCIS (Netherlands)

    De Waegenaere, A.M.B.; Sansing, R.; Wielhouwer, J.L.

    2015-01-01

    This study examines a setting in which a tax-reporting decision is delegated to a firm's tax manager. Using financial accounting measures of tax expense to evaluate the tax manager allows the firm to efficiently attain the level of tax avoidance it prefers, despite the fact that the consequences of

  4. Financial accounting effects of tax aggressiveness : Contracting and measurement

    NARCIS (Netherlands)

    De Waegenaere, A.M.B.; Sansing, R.; Wielhouwer, J.L.

    2015-01-01

    This study examines a setting in which a tax-reporting decision is delegated to a firm's tax manager. Using financial accounting measures of tax expense to evaluate the tax manager allows the firm to efficiently attain the level of tax avoidance it prefers, despite the fact that the consequences of

  5. Performance Measurement and Accountability of WAQF Institutions in Malaysia

    Directory of Open Access Journals (Sweden)

    Arshad Roshayani

    2017-01-01

    Full Text Available It has been seen for the past few years that the revival of waqf institutions has been an upsurge interest of Muslim communities around the world. In line with the revitalization, the issues of measuring and managing waqf performance are growingly being discussed and concerned by the academicians and constituents. Waqf institutions need to demonstrate their performance as whether they have effectively and efficiently managed in order to discharge their accountability to various waqf stakeholders. There are many studies conducted to measure the performance of various organizations in the private, public and third sector. However, studies on the performance measurement of waqf institution are still limited, and financial ratios become the dominant measurement in those studies. Being a non-profit in nature and religious entity, managing the entrusted waqf assets for social and economic development of the society, the performance measurement of waqf institutions should also focus on realizing their missions. Therefore, the aim of this paper is to discuss both financial and non-financial measurement that can be adapted by waqf institutions to assess their performance in discharging their accountability. Drawing from the experience on performance measurement discussed in the non-profit organizations literatures, this conceptual paper is hoped to provide significant insight on how waqf institutions performance may be measured and provide a tool to benchmark the best practices that can guide them to achieve their goals and missions.

  6. Measuring participation outcomes in rehabilitation medicine

    NARCIS (Netherlands)

    van der Zee, C.H.

    2013-01-01

    We developed the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) to fulfill the need for a generic measurement instrument to assess outcomes of outpatient rehabilitation programmes. The USER-Participation assesses three aspects of participation, thereby measuring bo

  7. Accounting for choice of measurement scale in extreme value modeling

    OpenAIRE

    Wadsworth, J. L.; Tawn, J. A.; Jonathan, P.

    2010-01-01

    We investigate the effect that the choice of measurement scale has upon inference and extrapolation in extreme value analysis. Separate analyses of variables from a single process on scales which are linked by a nonlinear transformation may lead to discrepant conclusions concerning the tail behavior of the process. We propose the use of a Box--Cox power transformation incorporated as part of the inference procedure to account parametrically for the uncertainty surrounding the scale of extrapo...

  8. International Accounting Convergence in the Field of Fair Value Measurement

    OpenAIRE

    Diana Cozma Ighian

    2015-01-01

    The investors’ desire for high-quality, internationally comparable financial information that is useful for decision-making in increasingly global capital markets imposed an international convergence, the ultimate goal of which is a single set of international accounting standards that companies worldwide would use for both domestic and cross-border financial reporting. The guidance, set out in IFRS 13 Fair Value Measurement and the update to Topic 820 (formerly referred to as SFAS 157), comp...

  9. The International Dermatology Outcome Measures Group

    DEFF Research Database (Denmark)

    Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W;

    2015-01-01

    As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis......, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project....

  10. International Accounting Convergence in the Field of Fair Value Measurement

    Directory of Open Access Journals (Sweden)

    Diana Cozma Ighian

    2015-09-01

    Full Text Available The investors’ desire for high-quality, internationally comparable financial information that is useful for decision-making in increasingly global capital markets imposed an international convergence, the ultimate goal of which is a single set of international accounting standards that companies worldwide would use for both domestic and cross-border financial reporting. The guidance, set out in IFRS 13 Fair Value Measurement and the update to Topic 820 (formerly referred to as SFAS 157, completes a major project of the boards’ joint work to improve IFRSs and US GAAP and to bring about their convergence. This article describes the controversial history of fair value measurement and the main novelties in the field of fair value measurement, arising from the international convergence process.

  11. 77 FR 32914 - Snapper-Grouper Fishery of the South Atlantic; 2012 Recreational Accountability Measure and...

    Science.gov (United States)

    2012-06-04

    ... the South Atlantic; 2012 Recreational Accountability Measure and Closure for South Atlantic Golden... (NOAA), Commerce. ACTION: Temporary rule; closure. SUMMARY: NMFS implements accountability measures...

  12. 78 FR 32995 - Snapper-Grouper Fishery of the South Atlantic; 2013 Recreational Accountability Measure and...

    Science.gov (United States)

    2013-06-03

    ... the South Atlantic; 2013 Recreational Accountability Measure and Closure for South Atlantic Golden... (NOAA), Commerce. ACTION: Temporary rule; closure. SUMMARY: NMFS implements accountability measures...

  13. 78 FR 30779 - Snapper-Grouper Fishery of the South Atlantic; 2013 Recreational Accountability Measure and...

    Science.gov (United States)

    2013-05-23

    ... the South Atlantic; 2013 Recreational Accountability Measure and Closure for South Atlantic Snowy... (NOAA), Commerce. ACTION: Temporary rule; closure. SUMMARY: NMFS implements accountability measures...

  14. 78 FR 48075 - Western Pacific Fisheries; 2013 Annual Catch Limits and Accountability Measures; Correcting...

    Science.gov (United States)

    2013-08-07

    ... Catch Limits and Accountability Measures; Correcting Amendment AGENCY: National Marine Fisheries Service...- season accountability measures upon attainment of the annual catch limit. Accordingly, in the...

  15. Technology development for nuclear material measurement and accountability

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jong Sook; Lee, Byung Doo; Cha, Hong Ryul; Lee, Yong Duk; Choi, Hyung Nae; Nah, Won Woo; Park, Hoh Joon; Lee, Yung Kil [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-12-01

    The measurement techniques for Pu samples and spent fuel assembly were developed in support of the implementation of national inspection responsibility under the Atomic Energy Act promulgated in 1994 and a computer program was also developed to assess the total nuclear material balance by facility declared records. The results of plutonium isotopic determination by gamma-ray spectrometry with high resolution germanium detector with peak analysis codes (FRAM and MGA codes) were approached to within 1% {approx} 2% of error from chemical analysis values by mass spectrometry. A gamma-ray measurement system for underwater spent nuclear fuels was developed and tested successfully. The falsification of facility and state records can be traced with the help of the developed computer code against declared reports submitted by the concerned state. This activity eventually resulted in finding the discrepancy of accountability records. 18 figs, 20 tabs, 27 refs. (Author).

  16. Biobehavioral Measures as Outcomes: A Cautionary Tale

    Science.gov (United States)

    Kovach, Christine R.; Woods, Diana Lynn; Devine, Elizabeth C.; Logan, Brent R.; Raff, Hershel

    2013-01-01

    This article discusses the use of biobehavioral measures as outcomes for healthcare intervention studies. Effect size (ES) values for salivary cortisol, and observation-based measures of pain and agitation are examined. Effects pre to post treatment were assessed separately for nursing home (NH) residents with and without acute psychotic symptoms. This study revealed large positive effects on both pain and agitation measures in the group with acute psychotic symptoms and small-to-medium positive effects on these same measures in the group without acute psychotic symptoms. In both of these groups the ES values were not consistently positive on the cortisol measures. Prior to determining if a measure can be used to estimate minimum clinically important differences, it is essential to consider if the biomarker will be responsive to therapy in the populations and contexts being studied. PMID:24158972

  17. Online versus Face-to-Face Accounting Education: A Comparison of CPA Exam Outcomes across Matched Institutions

    Science.gov (United States)

    Morgan, John Daniel

    2015-01-01

    Programmatic-level comparisons are made between the certified public accountant (CPA) exam outcomes of two types of accounting programs: online or distance accounting programs and face-to-face or classroom accounting programs. After matching programs from each group on student selectivity at admission, the two types of programs are compared on CPA…

  18. Online versus Face-to-Face Accounting Education: A Comparison of CPA Exam Outcomes across Matched Institutions

    Science.gov (United States)

    Morgan, John Daniel

    2015-01-01

    Programmatic-level comparisons are made between the certified public accountant (CPA) exam outcomes of two types of accounting programs: online or distance accounting programs and face-to-face or classroom accounting programs. After matching programs from each group on student selectivity at admission, the two types of programs are compared on CPA…

  19. American College of Rheumatology White Paper on Performance Outcome Measures in Rheumatology.

    Science.gov (United States)

    Suter, Lisa G; Barber, Claire E; Herrin, Jeph; Leong, Amye; Losina, Elena; Miller, Amy; Newman, Eric; Robbins, Mark; Tory, Heather; Yazdany, Jinoos

    2016-10-01

    To highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes. We constructed a hypothetical performance outcome measure to demonstrate the benefits and challenges of designing quality measures that assess patient outcomes. We defined the data source, measure cohort, reporting period, period at risk, measure outcome, outcome attribution, risk adjustment, reliability and validity, and reporting approach. We discussed outcome measure challenges specific to rheumatology and to fields where patients have predominantly chronic, complex, ambulatory care-sensitive conditions. Our hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. We summarized the components, benefits, challenges, and tradeoffs between feasibility and usability. We highlighted how different measure applications, such as for rapid cycle quality improvement efforts versus pay for performance programs, require different approaches to measure development and testing. We provided a summary table of key take-home points for clinicians and policymakers. Performance outcome measures are coming to rheumatology, and the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers. This study provides an overview of key issues and is intended to stimulate a productive dialogue between patients, practitioners, insurers, and government agencies regarding optimal performance outcome measure development. © 2016, American College of Rheumatology.

  20. Measuring Learning Outcomes. Evolution of Cognitive Skills among Graduate Students in Auditing

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    ) being able to set up challenging yet fair exams for the total student body. Assessing learning outcomes for the purpose of knowledge management plays a major role in accounting firms too. Knowledge transfer among auditors is a part of dayly life within most accounting firms. Developing a sound on......The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. Students taking accounting classes are often also provided with on-the-job training in accounting firms. Hence knowledge about learning outcomes for different groups of students...... is essential information for educators as well as the accounting profession. Sensible measures is needed by educators in order to (1) chose teaching methods matching prerequisite skills among a heterogenous student body, (2) assess the need for de-learning existing knowledge (i.e., cleaning the slate), and (3...

  1. Korean Clinic Based Outcome Measure Studies

    Directory of Open Access Journals (Sweden)

    Jongbae Park

    2003-02-01

    Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

  2. Theoretical conditions for validity in accounting performance measurement

    DEFF Research Database (Denmark)

    Nørreklit, Hanne; Nørreklit, Lennart; Mitchell, Falconer

    2007-01-01

    The concept of truth is a foundation upon which the accounting profession has built its reputation. The need for truth in accounting is enshrined in ethical codes, accounting regulations, authoritative texts and, of course, the auditor's assignation of a "true and fair view"....

  3. Implementing Outcomes-Based Accountability in Children's Services: An Overview of the Process and Impact. LG Group Research Report

    Science.gov (United States)

    Chamberlain, Tamsin; Golden, Sarah; Walker, Fiona

    2010-01-01

    Is your local authority using outcomes based accountability for planning and managing the performance of services? If yes, does it lead to an improvement? The Outcomes Based Accountability (OBA) approach uses performance management categories that distinguish between "How much did we do?", "How well did we do it?" and "Is anyone better off?" Based…

  4. Patient reported outcome measures in neurogenic bladder

    Science.gov (United States)

    Clark, Roderick

    2016-01-01

    Many interventions for neurogenic bladder patients are directed towards improving quality of life (QOL). Patient reported outcome measures (PROMs) are the primary method of evaluating QOL, and they provide an important quantification of symptoms which can’t be measured objectively. Our goal was to review general measurement principles, and identify and discuss PROMs relevant to neurogenic bladder patients. We identify two recent reviews of the state of the literature and updated the results with an additional Medline search up to September 1, 2015. Using the previous identified reviews, and our updated literature review, we identified 16 PROMs which are used for the assessment of QOL and symptoms in neurogenic bladder patients. Several are specifically designed for neurogenic bladder patients, such as the Qualiveen (for neurogenic bladder related QOL), and the Neurogenic Bladder Symptom Score (NBSS) (for neurogenic bladder symptoms). We also highlight general QOL measures for patients with multiple sclerosis (MS) and spinal cord injury (SCI) which include questions about bladder symptoms, and incontinence PROMs which are commonly used, but not specifically designed for neurogenic bladder patients. It is essential for clinicians and researchers with an interest in neurogenic bladder to be aware of the current PROMs, and to have a basic understanding of the principals of measurement in order to select the most appropriate one for their purpose. PMID:26904409

  5. Patient reported outcome measures in neurogenic bladder.

    Science.gov (United States)

    Clark, Roderick; Welk, Blayne

    2016-02-01

    Many interventions for neurogenic bladder patients are directed towards improving quality of life (QOL). Patient reported outcome measures (PROMs) are the primary method of evaluating QOL, and they provide an important quantification of symptoms which can't be measured objectively. Our goal was to review general measurement principles, and identify and discuss PROMs relevant to neurogenic bladder patients. We identify two recent reviews of the state of the literature and updated the results with an additional Medline search up to September 1, 2015. Using the previous identified reviews, and our updated literature review, we identified 16 PROMs which are used for the assessment of QOL and symptoms in neurogenic bladder patients. Several are specifically designed for neurogenic bladder patients, such as the Qualiveen (for neurogenic bladder related QOL), and the Neurogenic Bladder Symptom Score (NBSS) (for neurogenic bladder symptoms). We also highlight general QOL measures for patients with multiple sclerosis (MS) and spinal cord injury (SCI) which include questions about bladder symptoms, and incontinence PROMs which are commonly used, but not specifically designed for neurogenic bladder patients. It is essential for clinicians and researchers with an interest in neurogenic bladder to be aware of the current PROMs, and to have a basic understanding of the principals of measurement in order to select the most appropriate one for their purpose.

  6. A General Approach to Welfare Measurement through National Income Accounting

    OpenAIRE

    Geir B. Asheim; Buchholz, Wolfgang

    2003-01-01

    We develop a framework for analyzing national income accounting using a revealed welfare approach that is sufficiently general to cover, e.g., both the standard discounted utilitarian and maximin criteria as special cases. We show that the basic welfare properties of comprehensive national income accounting, which were previously ascribed only to the discounted utilitarian case, in fact extend to this more general framework. In particular, it holds under a wide range of circumstances that rea...

  7. Thriving in the 21st century: outcome assessment, practice parameters, and accountability.

    Science.gov (United States)

    Bergman, D A

    1995-10-01

    The past two decades have brought about major health care changes that have been driven by an ever-increasing cost of health care, practice variability, and medical malpractice litigation. These changes pose a challenge to pediatricians to contain costs, to reduce inappropriate use of health care services, and to demonstrate improved health care outcomes. To meet this challenge, a new "clinical tool kit" is required, one that will allow the pediatrician to analyze current practices and to document effective interventions. Two of the major tools in this kit are practice guidelines and outcomes assessment instruments. Practice guidelines are optimal care specifications that provide an analytic framework for defining high-quality care and measuring health care outcomes. Ideally, these guidelines should be developed from scientific evidence. In practice, however, scientific evidence to support the majority of recommendations made in guidelines is insufficient. Consequently, these recommendations are instead developed by expert consensus. Measurement of health outcomes includes clinical outcomes, patient satisfaction, cost and use, and quality of life. Health care organizations have become very sophisticated in measuring cost and use, but considerably less work has been done in the patient-centered areas of satisfaction and quality of life. This is particularly true for children, because measures are dependent on the viewpoint chosen (parent, child, or teacher), the age of the child, and the adjustment for severity of illness. Analyzing practice patterns and improving health outcomes will not be easy tasks to accomplish. For the pediatrician to use these tools in an efficient and effective manner, a new research agenda and new skills will be required.

  8. Outcome Measures in Functional Urology : Towards evaluation through patient reported outcome measures?

    NARCIS (Netherlands)

    L.A. 't Hoen (Lisette)

    2015-01-01

    markdownabstractAbstract Pelvic floor disorders are characterized by four domains: urinary symptoms, anorectal symptoms, pelvic organ prolapse and sexual dysfunction. The symptoms of the different domains have a significant impact on patient’s quality of life. Traditional outcome measures, such a

  9. 76 FR 61284 - Accountability Measures and Reduced Season for the South Atlantic Recreational Sector of Golden...

    Science.gov (United States)

    2011-10-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 RIN 0648-XA701 Accountability Measures and...), Commerce. ACTION: Temporary rule. SUMMARY: NMFS implements accountability measures (AMs) for...

  10. ibadan knee/hip osteoarthritis outcome measure: process of ...

    African Journals Online (AJOL)

    results of care and its effect upon the health of the patient and society.1 ... centeredness to customer centeredness in outcomes assessment. ... only meet accountability but patient satisfaction. ..... Price DD, McGrath PA, Raffi A, Buckingham B.

  11. Partnership Versus Public Ownership of Accounting Firms: Exploring RelativePerformance, Performance Measurement and Measurement Issues

    Directory of Open Access Journals (Sweden)

    Mark E Pickering

    2012-09-01

    Full Text Available Despite theoretical arguments that partnerships are the most efficient ownership form for professional service firms (PSFs, PSFs are increasingly moving to other ownership structures, such as publicly listed companies (PLCs. Research on the comparative performance of PSF, PLCs and partnerships is sparse with conflicting results suggesting that some segments of PSFs are moving to a less efficient form. This study explores the performance of two Australian accounting PLCs compared to a sample of similar sized mid tier accounting firms. The accounting PLCs achieved substantially higher revenue growth rates but lower productivity than the partnership sample. Measurement issues were identified in the use of closing resource numbers and different treatment of reporting merger and acquisition revenues which may partially explain the underperformance of publicly owned PSFs in prior studies. The need for research at a more detailed level exploring the market and service focus, organisational structures, resources utilised and resource costs across different PSF ownership forms is suggested.

  12. Intangible assets and national income accounting: measuring a scientific revolution

    OpenAIRE

    Leonard I. Nakamura

    2009-01-01

    In this paper the author relates the measurement of intangibles to the project of measuring the sources of growth. He focuses on three related and difficult areas of the measurement of national income: the measurement of new goods, the deflation of intangible investment, and the divergence between the social and private valuations of intangible assets. The author argues that the economic theory and practice underlying measurement of these items is currently controversial and incomplete, and h...

  13. The importance of measuring and accounting for potential biases in respondent-driven samples.

    Science.gov (United States)

    Rudolph, Abby E; Fuller, Crystal M; Latkin, Carl

    2013-07-01

    Respondent-driven sampling (RDS) is often viewed as a superior method for recruiting hard-to-reach populations disproportionately burdened with poor health outcomes. As an analytic approach, it has been praised for its ability to generate unbiased population estimates via post-stratified weights which account for non-random recruitment. However, population estimates generated with RDSAT (RDS Analysis Tool) are sensitive to variations in degree weights. Several assumptions are implicit in the degree weight and are not routinely assessed. Failure to meet these assumptions could result in inaccurate degree measures and consequently result in biased population estimates. We highlight potential biases associated with violating the assumptions implicit in degree weights for the RDSAT estimator and propose strategies to measure and possibly correct for biases in the analysis.

  14. Debate Regarding Measuring Accounting Value: Historical Cost against Fair Value

    Directory of Open Access Journals (Sweden)

    Victor Munteanu

    2015-12-01

    Full Text Available The transition from historical cost to fair value represents an option with major implications in accounting, because it is a complex process that requires tuning to today’s trends of national and global economy. We can state that with all the advantages of using historical cost it has its limitations and it is” getting old”. That doesn’t mean that will be abandoned but substituted when it is needed with another value. At present, the lack of historical value is inconceivable; many practitioners consider it to be the best method to evaluate assets.

  15. A Simple Regression-based Approach to Account for Survival Bias in Birth Outcomes Research.

    Science.gov (United States)

    Tchetgen Tchetgen, Eric J; Phiri, Kelesitse; Shapiro, Roger

    2015-07-01

    In perinatal epidemiology, birth outcomes such as small for gestational age (SGA) may not be observed for a pregnancy ending with a stillbirth. It is then said that SGA is truncated by stillbirth, which may give rise to survival bias when evaluating the effects on SGA of an exposure known also to influence the risk of a stillbirth. In this article, we consider the causal effects of maternal infection with human immunodeficiency virus (HIV) on the risk of SGA, in a sample of pregnant women in Botswana. We hypothesize that previously estimated effects of HIV on SGA may be understated because they fail to appropriately account for the over-representation of live births among HIV negative mothers, relative to HIV positive mothers. A simple yet novel regression-based approach is proposed to adjust effect estimates for survival bias for an outcome that is either continuous or binary. Under certain straightforward assumptions, the approach produces an estimate that may be interpreted as the survivor average causal effect of maternal HIV, which is, the average effect of maternal HIV on SGA among births that would be live irrespective of maternal HIV status. The approach is particularly appealing, because it recovers an exposure effect which is robust to survival bias, even if the association between the risk of SGA and that of a stillbirth cannot be completely explained by adjusting for observed shared risk factors. The approach also gives a formal statistical test of the null hypothesis of no survival bias in the regression framework.

  16. Adjusting for outcome misclassification: the importance of accounting for case-control sampling and other forms of outcome-related selection.

    Science.gov (United States)

    Jurek, Anne M; Maldonado, George; Greenland, Sander

    2013-03-01

    Special care must be taken when adjusting for outcome misclassification in case-control data. Basic adjustment formulas using either sensitivity and specificity or predictive values (as with external validation data) do not account for the fact that controls are sampled from a much larger pool of potential controls. A parallel problem arises in surveys and cohort studies in which participation or loss is outcome related. We review this problem and provide simple methods to adjust for outcome misclassification in case-control studies, and illustrate the methods in a case-control birth certificate study of cleft lip/palate and maternal cigarette smoking during pregnancy. Adjustment formulas for outcome misclassification that ignore case-control sampling can yield severely biased results. In the data we examined, the magnitude of error caused by not accounting for sampling is small when population sensitivity and specificity are high, but increases as (1) population sensitivity decreases, (2) population specificity decreases, and (3) the magnitude of the differentiality increases. Failing to account for case-control sampling can result in an odds ratio adjusted for outcome misclassification that is either too high or too low. One needs to account for outcome-related selection (such as case-control sampling) when adjusting for outcome misclassification using external information. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Distinctive research patterns on public sector performance measurement of public administration and accounting disciplines

    NARCIS (Netherlands)

    van Helden, G. Jan; Johnsen, Age; Vakkuri, Jarmo

    2008-01-01

    This article explores distinctive research patterns of public administration and accounting disciplines concerning public sector performance measurement (PSPM). Our review shows that accounting researchers from Europe investigate reasons for limited PM use and factors explaining a rational or symbol

  18. Health outcome after major trauma: what are we measuring?

    Directory of Open Access Journals (Sweden)

    Karen Hoffman

    Full Text Available Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.MEDLINE, EMBASE, and CINAHL (from 2006-2012 were searched for studies evaluating health outcome after traumatic injuries.Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF were used to evaluate to what extent outcome measures captured health impacts.34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%, functional activities (11% and environmental factors (2%.Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

  19. Personal Outcomes as Measures of Quality.

    Science.gov (United States)

    Gardner, James F.; Nudler, Sylvia; Chapman, Michael S.

    1997-01-01

    The Council on Quality and Leadership in Supports for People with Disabilities conducted interviews with 447 people with disabilities to identify priority outcomes they expect from service and supports. An analysis resulted in 24 variables loading onto 7 major factors: identity, autonomy, affiliation, attainment, rights, health, and safeguards.…

  20. Impact/outcome measures for libraries

    Directory of Open Access Journals (Sweden)

    Roswitha Poll

    2003-12-01

    Full Text Available Libraries today document their performance for the most part only in data of input and output (e.g. size of the collection, number of issues, of reference answers etc.. If they do more, they evaluate the quality and user-orientation of their services by applying performance indicators or user satisfaction surveys. Data of high use or high user satisfaction seem to indicate that users benefit from the library's services. But in demonstrating the library's value to the financing authorities or the public it would be much more effective if libraries could show a direct impact/outcome of their services on their users. Such outcome might be either a monetary value attributed to one case of use, or the impact on the users' skills and knowledge, their information literacy. Quite a number of projects in different countries have tested methods to catch this 'outcome'. They have tried to assess the value assigned by the population to certain library services, to find a connection between success in studies or research and library use, to assess the library's impact on students' information literacy, to explore the information behaviour of groups in order to specify the library's role in information research and information delivery. The paper describes the different starting points for assessing outcome of library services.

  1. A Kernel-based Account of Bibliometric Measures

    Science.gov (United States)

    Ito, Takahiko; Shimbo, Masashi; Kudo, Taku; Matsumoto, Yuji

    The application of kernel methods to citation analysis is explored. We show that a family of kernels on graphs provides a unified perspective on the three bibliometric measures that have been discussed independently: relatedness between documents, global importance of individual documents, and importance of documents relative to one or more (root) documents (relative importance). The framework provided by the kernels establishes relative importance as an intermediate between relatedness and global importance, in which the degree of `relativity,' or the bias between relatedness and importance, is naturally controlled by a parameter characterizing individual kernels in the family.

  2. Stakeholders' views on measuring outcomes for people with learning disabilities.

    Science.gov (United States)

    Young, Anita F; Chesson, Rosemary A

    2006-01-01

    What works and how do we know? These are recurring questions for health and social care professionals, although mediated through differing philosophies and historical perspectives. The aims of the study reported here were to discover views of managers and commissioners of services for people with learning disabilities in Scotland regarding (a) current approaches to service evaluation (as an indication of what is to be measured) and (b) healthcare outcome measurement (as an indication of preferences regarding how this should be measured). A postal questionnaire was used to survey 94 stakeholders from the NHS, Local Authorities, and non-statutory organisations across Scotland. Respondents' views were sought on current approaches to service evaluation within learning disabilities; outcome measurement; appropriateness of specified methods of measuring health outcomes; desired future methods of outcome measurement within learning disabilities; and service user involvement in care. A 77% (73/94) response rate to the questionnaire was achieved. Different methods of service evaluation were used by different stakeholders. Staff appraisal was the most frequently identified method (used by 85% of respondents). Specific outcome measures were used by 32% of respondents although there were differences of opinion as to what constitutes specific outcome measures. Overall there was strong support for goal-setting and reviewing (83%) and individualised outcome measures (75%) as appropriate methods for use with people with learning disabilities. The hypothetical question asking what outcome measures should be introduced for this client group had by far the lowest response rate (51/73). The overwhelming majority of all respondents, 68 (92%), reported user involvement in their service. Staff ambivalence to outcome measurement was evident in the research and respondents highlighted the complexity and multidimensional nature of outcomes for this service user group. Managers recognised

  3. THE PERFORMANCE OF THE ECONOMIC ENTITY MEASURED THROUGH ACCOUNTING INFORMATION

    Directory of Open Access Journals (Sweden)

    Marius Cristian Milos

    2012-01-01

    Full Text Available The users of financial statements need information regarding the resources of an economic entity and also data regarding the way in which the entity’s management is using resources. This information helps users to quantify efficiency and performance within an entity. There are many stakeholders who do show interest in an entity’s financial reports, including existing and potential investors, employees, lenders, suppliers, customers, regulators and other government agencies and not the least the common citizens. The main purpose of this paper is to highlight the importance of the performance measurement and to discuss possible reporting methods. Performance is a concept that raises many questions regarding the most accurate way or the best method for quantifying and reporting performance at the company level .So if financial performance indicators are considered to offer an accurate image of the situation of a company, the modern approach which focuses also on non-financial indicators offers new perspectives upon performance measurement, which may be really expressive and also based on simplicity.

  4. Practical considerations for the implementation of health outcome measures.

    Science.gov (United States)

    Carriere, Robin S

    2009-01-01

    The collection of health outcomes information is important for effective management of the health care system. The Health Outcomes for Better Information and Care (HOBIC) program is implementing a set of nurse-sensitive health outcome measures across the province of Ontario. This paper examines some of the opportunities and challenges of implementing measures across multiple organizations and multiple sectors of the health care system.

  5. Patient-Reported Outcome Measures in Systemic Sclerosis (Scleroderma).

    Science.gov (United States)

    Pellar, Russell E; Tingey, Theresa M; Pope, Janet Elizabeth

    2016-05-01

    Scleroderma (systemic sclerosis) is a rare autoimmune connective tissue disease that can damage multiple organs and reduce quality of life. Patient-reported outcome measures capture the patient's perspective. Some measures are specific to systemic sclerosis and others are general. Patient-reported outcomes in systemic sclerosis are important to aid in understanding the impact of systemic sclerosis on patients.

  6. Patient-reported outcome measures for asthma : a systematic review

    NARCIS (Netherlands)

    Worth, Allison; Hammersley, Victoria; Knibb, Rebecca; Flokstra-de-Blok, Bertine; DunnGalvin, Audrey; Walker, Samantha; Dubois, Anthony EJ; Sheikh, Aziz

    2014-01-01

    BACKGROUND: Patient-reported outcome measures (PROMs) are measures of the outcome of treatment(s) reported directly by the patient or carer. There is increasing international policy interest in using these to assess the impact of clinical care. AIMS: To identify suitably validated PROMs for asthma a

  7. [Outcomes count: the importance of measuring the outcomes of hospital care].

    Science.gov (United States)

    Sangha, Oliver; Schneeweiss, Sebastian

    2002-01-01

    A century ago the Boston surgeon Earnest A. Codman described in detail the requirements for monitoring quality of care and emphasized the importance of outcomes in evaluating care. At the time the medical societies were disconcerted by his ideas, which were perceived as revolutionary. After several decade of focusing on the structures and processes of care we are now witnessing a renaissance of measuring outcomes. This paper emphasizes the need for outcomes measurement monitor quality of care. The introduction of diagnosis-related groups in Germany is the most recent development that underlines the importance of outcomes measurement and benchmarking.

  8. Toward defining and measuring social accountability in graduate medical education: a stakeholder study.

    Science.gov (United States)

    Reddy, Anjani T; Lazreg, Sonia A; Phillips, Robert L; Bazemore, Andrew W; Lucan, Sean C

    2013-09-01

    Since 1965, Medicare has publically financed graduate medical education (GME) in the United States. Given public financing, various advisory groups have argued that GME should be more socially accountable. Several efforts are underway to develop accountability measures for GME that could be tied to Medicare payments, but it is not clear how to measure or even define social accountability. We explored how GME stakeholders perceive, define, and measure social accountability. Through purposive and snowball sampling, we completed semistructured interviews with 18 GME stakeholders from GME training sites, government agencies, and health care organizations. We analyzed interview field notes and audiorecordings using a flexible, iterative, qualitative group process to identify themes. THREE THEMES EMERGED IN REGARDS TO DEFINING SOCIAL ACCOUNTABILITY: (1) creating a diverse physician workforce to address regional needs and primary care and specialty shortages; (2) ensuring quality in training and care to best serve patients; and (3) providing service to surrounding communities and the general public. All but 1 stakeholder believed GME institutions have a responsibility to be socially accountable. Reported barriers to achieving social accountability included training time constraints, financial limitations, and institutional resistance. Suggestions for measuring social accountability included reviewing graduates' specialties and practice locations, evaluating curricular content, and reviewing program services to surrounding communities. Most stakeholders endorsed the concept of social accountability in GME, suggesting definitions and possible measures that could inform policy makers calls for increased accountability despite recognized barriers.

  9. Correlations between outcomes of random measurements

    Science.gov (United States)

    Tran, Minh Cong; Dakić, Borivoje; Laskowski, Wiesław; Paterek, Tomasz

    2016-10-01

    We recently showed that multipartite correlations between outcomes of random observables detect quantum entanglement in all pure and some mixed states. In this followup article we further develop this approach, derive a maximal amount of such correlations, and show that they are not monotonous under local operations and classical communication. Nevertheless, we demonstrate their usefulness in entanglement detection with a single random observable per party. Finally we study convex-roof extension of the correlations and provide a closed-form necessary and sufficient condition for entanglement in rank-2 mixed states and a witness in general.

  10. 77 FR 74119 - Snapper-Grouper Fishery of the South Atlantic; 2012 Commercial Accountability Measure and Closure...

    Science.gov (United States)

    2012-12-13

    ... the South Atlantic; 2012 Commercial Accountability Measure and Closure for South Atlantic Snowy... (NOAA), Commerce. ACTION: Temporary rule; closure. SUMMARY: NMFS implements accountability measures...

  11. A Multilevel Analysis of Patient Engagement and Patient-Reported Outcomes in Primary Care Practices of Accountable Care Organizations.

    Science.gov (United States)

    Shortell, Stephen M; Poon, Bing Ying; Ramsay, Patricia P; Rodriguez, Hector P; Ivey, Susan L; Huber, Thomas; Rich, Jeremy; Summerfelt, Tom

    2017-06-01

    The growing movement toward more accountable care delivery and the increasing number of people with chronic illnesses underscores the need for primary care practices to engage patients in their own care. For adult primary care practices seeing patients with diabetes and/or cardiovascular disease, we examined the relationship between selected practice characteristics, patient engagement, and patient-reported outcomes of care. Cross-sectional multilevel observational study of 16 randomly selected practices in two large accountable care organizations (ACOs). Patients with diabetes and/or cardiovascular disease (CVD) who met study eligibility criteria (n = 4368) and received care in 2014 were randomly selected to complete a patient activation and PRO survey (51% response rate; n = 2176). Primary care team members of the 16 practices completed surveys that assessed practice culture, relational coordination, and teamwork (86% response rate; n = 411). Patient-reported outcomes included depression (PHQ-4), physical functioning (PROMIS SF12a), and social functioning (PROMIS SF8a), the Patient Assessment of Chronic Illness Care instrument (PACIC-11), and the Patient Activation Measure instrument (PAM-13). Patient-level covariates included patient age, gender, education, insurance coverage, limited English language proficiency, blood pressure, HbA1c, LDL-cholesterol, and disease comorbidity burden. For each of the 16 practices, patient-centered culture and the degree of relational coordination among team members were measured using a clinician and staff survey. The implementation of shared decision-making activities in each practice was assessed using an operational leader survey. Having a patient-centered culture was positively associated with fewer depression symptoms (odds ratio [OR] = 1.51; confidence interval [CI] 1.04, 2.19) and better physical function scores (OR = 1.85; CI 1.25, 2.73). Patient activation was positively associated with fewer

  12. Observer bias in randomized clinical trials with measurement scale outcomes

    DEFF Research Database (Denmark)

    Hróbjartsson, Asbjørn; Thomsen, Ann Sofia Skou; Emanuelsson, Frida;

    2013-01-01

    BACKGROUND:Clinical trials are commonly done without blinded outcome assessors despite the risk of bias. We wanted to evaluate the effect of nonblinded outcome assessment on estimated effects in randomized clinical trials with outcomes that involved subjective measurement scales. METHODS......:We conducted a systematic review of randomized clinical trials with both blinded and nonblinded assessment of the same measurement scale outcome. We searched PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, HighWire Press and Google Scholar for relevant studies. Two......%). Heterogeneity was moderate (I(2) = 46%, p = 0.02) and unexplained by metaregression. INTERPRETATION:We provide empirical evidence for observer bias in randomized clinical trials with subjective measurement scale outcomes. A failure to blind assessors of outcomes in such trials results in a high risk...

  13. 48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard for composition and measurement of pension cost. 9904.412 Section 9904.412 Federal Acquisition... accounting standard for composition and measurement of pension cost....

  14. Current status of outcome measure development in vasculitis.

    Science.gov (United States)

    Merkel, Peter A; Aydin, Sibel Z; Boers, Maarten; Cornell, Christina; Direskeneli, Haner; Gebhart, Don; Hatemi, Gulen; Luqmani, Raashid; Matteson, Eric L; Milman, Nataliya; Robson, Joanna; Seo, Philip; Tomasson, Gunnar

    2014-03-01

    The conduct of randomized controlled trials for vasculitis, especially for the antineutrophil cytoplasmic antibody-associated vasculitides [AAV, granulomatosis with polyangiitis (Wegener's) and microscopic polyangiitis], has been greatly advanced by the development, use, and acceptance of validated outcome measures. Trials have subsequently provided the opportunity to validate and refine reliable, valid outcome measures for these multisystemic and relapsing rare diseases. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group was formed in 2004 to foster development of validated and widely accepted outcomes in vasculitis using data-driven analyses, a dedication to building consensus, and adherence to, and guidance by, the principles of the OMERACT approach. This work led to the endorsement by OMERACT of the core set of domains and associated outcome measures for AAV. Next steps for the study of existing outcome tools in AAV include better definition of response criteria through development of more data-driven weighting of the elements of activity and damage assessment. The Working Group is now also embarking on a series of linked projects to develop validated patient-reported outcomes for use in clinical research in vasculitis. Additionally, the Working Group is studying how current methods of disease assessment and plans for new outcomes can be informed by the conceptual framework of the International Classification of Function of the World Health Organization. The success of the Group's work in AAV has also led to a formal process for developing outcomes for the large vessel vasculitides (Takayasu arteritis and giant cell arteritis) and Behçet disease.

  15. Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

    DEFF Research Database (Denmark)

    1998-01-01

    There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

  16. Improving Outcome Measures Other Than Achievement

    Directory of Open Access Journals (Sweden)

    Kristin Anderson Moore

    2015-05-01

    Full Text Available Research indicates that educational, economic, and life success reflect children’s nonacademic as well as academic competencies. Therefore, longitudinal surveys that assess educational progress and success need to incorporate nonacademic measures to avoid omitted variable bias, inform development of new intervention strategies, and support mediating and moderating analyses. Based on a life course model and a whole child perspective, this article suggests constructs in the domains of child health, emotional/psychological development, educational achievement/attainment, social behavior, and social relationships. Four critical constructs are highlighted: self-regulation, agency/motivation, persistence/diligence, and executive functioning. Other constructs that are currently measured need to be retained, including social skills, positive relationships, activities, positive behaviors, academic self-efficacy, educational engagement, and internalizing/emotional well-being. Examples of measures that are substantively and psychometrically robust are provided.

  17. Does public reporting measure up? Federalism, accountability and child-care policy in Canada.

    Science.gov (United States)

    Anderson, Lynell; Findlay, Tammy

    2010-01-01

    Governments in Canada have recently been exploring new accountability measures within intergovernmental relations. Public reporting has become the preferred mechanism in a range of policy areas, including early learning and child-care, and the authors assess its effectiveness as an accountability measure. The article is based on their experience with a community capacity-building project that considers the relationship between the public policy, funding and accountability mechanisms under the federal/provincial/territorial agreements related to child-care. The authors argue that in its current form, public reporting has not lived up to its promise of accountability to citizens. This evaluation is based on the standards that governments have set for themselves under the federal/provincial/territorial agreements, as well as guidelines set by the Public Sector Accounting Board, an independent body that develops accounting standards over time through consultation with governments.

  18. Measurement Bases for Acquisitions and Mergers in Financial Accounting and in Commercial Law

    OpenAIRE

    Vomáčková, Hana

    2011-01-01

    In association with transactions involving businesses, acquisitions and mergers, etc., commercial law stipulates the new measurement of business assets and thus also net business assets. Similarly, financial accounting stipulates the new measurement of assets, liabilities and net assets with an impact on the amount and structure of equity. It is a principal question as to whether the new measurement bases required by both commercial law and financial accounting are in principal identical. Pra...

  19. Demonstrating high reliability on accountability measures at the Johns Hopkins Hospital.

    Science.gov (United States)

    Pronovost, Peter J; Demski, Renee; Callender, Tiffany; Winner, Laura; Miller, Marlene R; Austin, J Matthew; Berenholtz, Sean M

    2013-12-01

    Patients continue to suffer preventable harm from the omission of evidence-based therapies. To remedy this, The Joint Commission developed core measures for therapies with strong evidence and, through the Top Performer on Key Quality Measures program, recognize hospitals that deliver those therapies to 95% of patients. The Johns Hopkins Medicine board of trustees committed to high reliability and to providing > or = 96% of patients with the recommended therapies. The Armstrong Institute for Patient Safety and Quality coordinated the core measures initiative, which targeted nine process measures for the 96% performance goal: eight Joint Commission accountability measures and one Delmarva Foundation core measure. A conceptual model for this initiative included communicating goals, building capacity with Lean Sigma methods, transparently reporting performance and establishing an accountability plan, and developing a sustainability plan. Clinicians and quality improvement staff formed one team for each targeted process measure, and Armstrong Institute staff supported the teams work. The primary performance measure was the percentage of patients who received the recommended process of care, as defined by the specifications for each of The Joint Commission's accountability measures. The > or = 96% performance goal was achieved for 82% of the measures in 2011 and 95% of the measures in 2012. With support from leadership and a conceptual model to communicate goals, use robust improvement methods, and ensure accountability, The Johns Hopkins Hospital achieved high reliability for The Joint Commission accountability measures.

  20. Water Accounting Plus (WA+ – a water accounting procedure for complex river basins based on satellite measurements

    Directory of Open Access Journals (Sweden)

    D. Molden

    2012-11-01

    Full Text Available Coping with the issue of water scarcity and growing competition for water among different sectors requires proper water management strategies and decision processes. A pre-requisite is a clear understanding of the basin hydrological processes, manageable and unmanageable water flows, the interaction with land use and opportunities to mitigate the negative effects and increase the benefits of water depletion on society. Currently, water professionals do not have a common framework that links hydrological flows to user groups of water and their benefits. The absence of a standard hydrological and water management summary is causing confusion and wrong decisions. The non-availability of water flow data is one of the underpinning reasons for not having operational water accounting systems for river basins in place. In this paper we introduce Water Accounting Plus (WA+, which is a new framework designed to provide explicit spatial information on water depletion and net withdrawal processes in complex river basins. The influence of land use on the water cycle is described explicitly by defining land use groups with common characteristics. Analogous to financial accounting, WA+ presents four sheets including (i a resource base sheet, (ii a consumption sheet, (iii a productivity sheet, and (iv a withdrawal sheet. Every sheet encompasses a set of indicators that summarize the overall water resources situation. The impact of external (e.g. climate change and internal influences (e.g. infrastructure building can be estimated by studying the changes in these WA+ indicators. Satellite measurements can be used for 3 out of the 4 sheets, but is not a precondition for implementing WA+ framework. Data from hydrological models and water allocation models can also be used as inputs to WA+.

  1. The Development of NOAA Education Common Outcome Performance Measures (Invited)

    Science.gov (United States)

    Baek, J.

    2013-12-01

    The National Oceanic and Atmospheric Administration (NOAA) Education Council has embarked on an ambitious Monitoring and Evaluation (M&E) project that will allow it to assess education program outcomes and impacts across the agency, line offices, and programs. The purpose of this internal effort is to link outcome measures to program efforts and to evaluate the success of the agency's education programs in meeting the strategic goals. Using an outcome-based evaluation approach, the NOAA Education Council is developing two sets of common outcome performance measures, environmental stewardship and professional development. This presentation will examine the benefits and tradeoffs of common outcome performance measures that collect program results across a portfolio of education programs focused on common outcomes. Common outcome performance measures have a few benefits to our agency and to the climate education field at large. The primary benefit is shared understanding, which comes from our process for writing common outcome performance measures. Without a shared and agreed upon set of definitions for the measure of an outcome, the reported results may not be measuring the same things and would incorrectly indicate levels of performance. Therefore, our writing process relies on a commitment to developing a shared set of definitions based on consensus. We hope that by taking the time to debate and coming to agreement across a diverse set of programs, the strength of our common measures can indicate real progress towards outcomes we care about. An additional benefit is that these common measures can be adopted and adapted by other agencies and organizations that share similar theories of change. The measures are not without their drawbacks, and we do make tradeoffs as part of our process in order to continue making progress. We know that any measure is necessarily a narrow slice of performance. A slice that may not best represent the unique and remarkable contribution

  2. Outcome Measures in Clinical Trials for Multiple Sclerosis.

    Science.gov (United States)

    van Munster, Caspar E P; Uitdehaag, Bernard M J

    2017-02-09

    Due to the heterogeneous nature of the disease, it is a challenge to capture disease activity of multiple sclerosis (MS) in a reliable and valid way. Therefore, it can be difficult to assess the true efficacy of interventions in clinical trials. In phase III trials in MS, the traditionally used primary clinical outcome measures are the Expanded Disability Status Scale and the relapse rate. Secondary outcome measures in these trials are the number or volume of T2 hyperintense lesions and gadolinium-enhancing T1 lesions on magnetic resonance imaging (MRI) of the brain. These secondary outcome measures are often primary outcome measures in phase II trials in MS. Despite several limitations, the traditional clinical measures are still the mainstay for assessing treatment efficacy. Newer and potentially valuable outcome measures increasingly used or explored in MS trials are, clinically, the MS Functional Composite and patient-reported outcome measures, and on MRI, brain atrophy and the formation of persisting black holes. Several limitations of these measures have been addressed and further improvements will probably be proposed. Major improvements are the coverage of additional functional domains such as cognitive functioning and assessment of the ability to carry out activities of daily living. The development of multidimensional measures is promising because these measures have the potential to cover the full extent of MS activity and progression. In this review, we provide an overview of the historical background and recent developments of outcome measures in MS trials. We discuss the advantages and limitations of various measures, including newer assessments such as optical coherence tomography, biomarkers in body fluids and the concept of 'no evidence of disease activity'.

  3. The Impact of Merit Pay on Teaching and Research Outcomes of Accounting Programs

    Science.gov (United States)

    Lindsay, David H.; Campbell, Annhenrie; Tan, Kim B.

    2012-01-01

    Basing the compensation of accounting professors on merit pay in order to encourage better teaching, research and service is controversial. This study uses data from a survey of the 852 accounting programs in the United States to empirically examine the influence of merit-based salary plans. Findings indicate a strong positive association between…

  4. Made to Measure: College Leaders Come Together to Strengthen Institutional Accountability

    Science.gov (United States)

    Boerner, Heather

    2015-01-01

    Since the American Association of Community Colleges (AACC) launched the Voluntary Framework of Accountability (VFA) in 2011, accountability measures have sprung up in just about every corner of higher education. There is the Integrated Postsecondary Education Data System (IPEDS), the National Governors Association's Complete to Compete program,…

  5. Identifying meaningful outcome measures for the intensive care unit.

    Science.gov (United States)

    Martinez, Elizabeth A; Donelan, Karen; Henneman, Justin P; Berenholtz, Sean M; Miralles, Paola D; Krug, Allison E; Iezzoni, Lisa I; Charnin, Jonathan E; Pronovost, Peter J

    2014-01-01

    Despite important progress in measuring the safety of health care delivery in a variety of health care settings, a comprehensive set of metrics for benchmarking is still lacking, especially for patient outcomes. Even in high-risk settings where similar procedures are performed daily, such as hospital intensive care units (ICUs), these measures largely do not exist. Yet we cannot compare safety or quality across institutions or regions, nor can we track whether safety is improving over time. To a large extent, ICU outcome measures deemed valid, important, and preventable by clinicians are unavailable, and abstracting clinical data from the medical record is excessively burdensome. Even if a set of outcomes garnered consensus, ensuring adequate risk adjustment to facilitate fair comparisons across institutions presents another challenge. This study reports on a consensus process to build 5 outcome measures for broad use to evaluate the quality of ICU care and inform quality improvement efforts.

  6. Culturally Sensitive and Environment-Friendly Outcome Measures in ...

    African Journals Online (AJOL)

    Dr Olaleye

    2Department of Medical Rehabilitation, Nnamdi Azikwe University, Nigeria. 3 School of Research ..... Gibbon B (1991): Measuring stroke recovery. Nursing Times .... Yoemans S. G. (2000): The Clinical Application of Outcomes. Assessment ...

  7. A Bayesian framework to account for uncertainty due to missing binary outcome data in pairwise meta-analysis.

    Science.gov (United States)

    Turner, N L; Dias, S; Ades, A E; Welton, N J

    2015-05-30

    Missing outcome data are a common threat to the validity of the results from randomised controlled trials (RCTs), which, if not analysed appropriately, can lead to misleading treatment effect estimates. Studies with missing outcome data also threaten the validity of any meta-analysis that includes them. A conceptually simple Bayesian framework is proposed, to account for uncertainty due to missing binary outcome data in meta-analysis. A pattern-mixture model is fitted, which allows the incorporation of prior information on a parameter describing the missingness mechanism. We describe several alternative parameterisations, with the simplest being a prior on the probability of an event in the missing individuals. We describe a series of structural assumptions that can be made concerning the missingness parameters. We use some artificial data scenarios to demonstrate the ability of the model to produce a bias-adjusted estimate of treatment effect that accounts for uncertainty. A meta-analysis of haloperidol versus placebo for schizophrenia is used to illustrate the model. We end with a discussion of elicitation of priors, issues with poor reporting and potential extensions of the framework. Our framework allows one to make the best use of evidence produced from RCTs with missing outcome data in a meta-analysis, accounts for any uncertainty induced by missing data and fits easily into a wider evidence synthesis framework for medical decision making.

  8. Recognition and Measurement Obstacles of the Conceptual Framework of Financial Accounting Underlying E-commerce Business

    Directory of Open Access Journals (Sweden)

    Sana’a NM

    2016-04-01

    Full Text Available The remarkable growth in electronic commerce constitutes another new challenge for the accounting profession in its effort to meet the rapid and continuing revolution of information changes. Therefore, the objective of this study is to investigate the important obstacles facing corporations working in the business of E-commerce. This study also aims to investigate the production of accounting information as related to level three (recognition and measurements of the conceptual framework underlying financial accounting. Therefore, to achieve the primary objectives of this study the researcher has developed a questionnaire that has been distributed to Jordanian external auditors. A total of 77 questionnaires were distributed; however, only 71 questionnaires were suitable for the analysis. A sample t- test was used to test the hypotheses of the study. The main results of the study revealed high arithmetic mean related to the obstacles of the accounting concepts (principles, assumptions, and constraints at level three of the conceptual framework that underlies financial accounting. This requires attention in the preparation of the financial reports of a corporation operating in E-commerce Business. Moreover, the research concludes that the obstacles are connected, interdependent and interrelated with each other. Therefore, the accounting principle obstacles have implications over the application of accounting assumptions and constraints. Consequently, the researcher recommends the need to make changes in the concepts of recognition and measurements in the conceptual framework that underlies financial accounting. This is to ensure the qualitative characteristics of accounting information for E-commerce business corporations.

  9. Measuring behavioral outcomes in cardiopulmonary rehabilitation: AN AACVPR STATEMENT.

    Science.gov (United States)

    Verrill, David; Graham, Helen; Vitcenda, Mark; Peno-Green, Laura; Kramer, Valerie; Corbisiero, Teresa

    2009-01-01

    Outcome measurement in cardiopulmonary rehabilitation is required for optimal assessment of program quality, effectiveness of treatments, and evaluation of patient progress. Recent position statements from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of Cardiology, American Heart Association, American Thoracic Society, and American College of Chest Physicians have provided state-of-the-art information on the importance of assessing performance and outcome measures for optimal program effectiveness. Such measures are also required for AACVPR program certification. To meet current standards of practice, the AACVPR developed an Outcomes Matrix that includes 4 domains: Health, Clinical, Behavioral, and Service. Although the Clinical and Health domains have been most commonly used in outcome reporting (eg, 6-minute walk test, quality-of-life survey scores), behavioral measures have received less attention, primarily because they have been perceived as being more difficult to measure and quantify over time. This statement describes 5 common behavioral outcome measures: smoking cessation, medication use, supplemental oxygen use, exercise habits, and nutritional behaviors. Sample questions and calculations for each of these behavioral measures are also provided. By using these measures at program entry and completion, cardiac and pulmonary rehabilitation practitioners can effectively track and document behavioral changes over time for physicians, third-party insurance providers, or hospital administrators and thus demonstrate the effectiveness of exercise and educational interventions on patient overall health and well-being.

  10. The International Dermatology Outcome Measures initiative as applied to psoriatic disease outcomes

    DEFF Research Database (Denmark)

    Gottlieb, Alice B; Armstrong, April W; Christensen, Robin

    2014-01-01

    In the United States, access to care is the number one issue facing our patients with dermatological conditions. In part, this is because we do not have outcome measures that are useful in clinical practice and available in databases where payers and governmental agencies can compare the performa......, payers, and pharmaceutical scientists. As reported herein, the group's goal is to develop outcome measures in dermatology that address the needs of all involved....

  11. Comparability of Accounting Choices in Subsequent Measurement of Fixed Assets, Intangible Assets, and Investment Property in South American Companies

    National Research Council Canada - National Science Library

    Flaida Êmine Alves de Souza; Sirlei Lemes

    2016-01-01

    ... Accounting Standards Board (IASB). In this article, we identified the comparability degree of accounting choices in the subsequent measurement of fixed assets, intangible assets, and investment property (IP...

  12. Water Accounting Plus (WA+ – a water accounting procedure for complex river basins based on satellite measurements

    Directory of Open Access Journals (Sweden)

    P. Karimi

    2013-07-01

    Full Text Available Coping with water scarcity and growing competition for water among different sectors requires proper water management strategies and decision processes. A pre-requisite is a clear understanding of the basin hydrological processes, manageable and unmanageable water flows, the interaction with land use and opportunities to mitigate the negative effects and increase the benefits of water depletion on society. Currently, water professionals do not have a common framework that links depletion to user groups of water and their benefits. The absence of a standard hydrological and water management summary is causing confusion and wrong decisions. The non-availability of water flow data is one of the underpinning reasons for not having operational water accounting systems for river basins in place. In this paper, we introduce Water Accounting Plus (WA+, which is a new framework designed to provide explicit spatial information on water depletion and net withdrawal processes in complex river basins. The influence of land use and landscape evapotranspiration on the water cycle is described explicitly by defining land use groups with common characteristics. WA+ presents four sheets including (i a resource base sheet, (ii an evapotranspiration sheet, (iii a productivity sheet, and (iv a withdrawal sheet. Every sheet encompasses a set of indicators that summarise the overall water resources situation. The impact of external (e.g., climate change and internal influences (e.g., infrastructure building can be estimated by studying the changes in these WA+ indicators. Satellite measurements can be used to acquire a vast amount of required data but is not a precondition for implementing WA+ framework. Data from hydrological models and water allocation models can also be used as inputs to WA+.

  13. Routine outcome measures in Norway: Only partly implemented.

    Science.gov (United States)

    Ruud, Torleif

    2015-01-01

    Norway has not had any strategy exclusively for the implementation of routine outcome measurement in the mental health services, but some efforts have been made as part of strategies for a national patient register and quality indicators. Fifteen years after the decision to make the rating of the Global Assessment of Functioning scale (GAF) mandatory at admission and discharge of each treatment episode in adult mental health services, this is still not fully implemented. An unknown and probably very low proportion of mental health services use GAF as a routine outcome measure in everyday clinical practice. Well-established electronic patient records in the mental health services and established procedures for reporting routine data to the National Patient Register should make it possible to collect and use routine outcome data. Implementation of routine outcome measurement in mental health services must be done with due emphasis on the critical steps in the various phases of the implementation process. The regional health authorities have a key role in establishing electronic systems that make relevant outcome measurements available in a seamless way for clinicians as well as for patients, and by contributing to a culture where quality and outcome are valued and given priority.

  14. Outcome measures in amyotrophic lateral sclerosis clinical trials

    Science.gov (United States)

    Paganoni, Sabrina; Cudkowicz, Merit; Berry, James D

    2017-01-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with an average survival of 3–5 years. While therapies for ALS remain limited, basic and translational ALS research has been host to numerous influential discoveries in recent years. These discoveries have led to a large pipeline of potential therapies that await testing in clinical trials. Until recently, ALS clinical trials have relied on a limited cadre of ‘traditional’ outcome measures, including survival and measures of function. These measures have proven useful, although imperfect, in Phase III ALS trials. However, their utility in early-phase ALS trials is limited. For these early trials, outcome measures focused on target engagement or biological pathway analysis might improve trial outcomes and better support the drug development process.

  15. Entanglement-assisted guessing of complementary measurement outcomes

    NARCIS (Netherlands)

    Berta, M.; Coles, P.J.; Wehner, S.D.C.

    2014-01-01

    Heisenberg's uncertainty principle implies that if one party (Alice) prepares a system and randomly measures one of two incompatible observables, then another party (Bob) cannot perfectly predict the measurement outcomes. This implication assumes that Bob does not possess an additional system that i

  16. Volunteers in Circles of Support and Accountability : Job demands, job resources, and outcome

    NARCIS (Netherlands)

    Höing, M.A.; Vogelvang, B.; Bogaerts, Stefan

    2016-01-01

    In Circles of Support and Accountability (CoSA), volunteers support a medium- to high-risk sex offender in his process toward desistance by developing a long-term empathic relationship. More knowledge is needed about the impact of this work on volunteers themselves. In a sample of 40 Dutch CoSA volu

  17. Volunteers in circles of support and accountability : Job demands, job resources, and outcome

    NARCIS (Netherlands)

    Höing, M.A.; Vogelvang, B.; Bogaerts, Stefan

    2017-01-01

    In Circles of Support and Accountability (CoSA), volunteers support a medium- to high-risk sex offender in his process toward desistance by developing a long-term empathic relationship. More knowledge is needed about the impact of this work on volunteers themselves. In a sample of 40 Dutch CoSA volu

  18. Wind power deployment outcomes: How can we account for the differences?

    NARCIS (Netherlands)

    Toke, D.; Breukers, S.; Wolsink, M.

    2008-01-01

    This paper aims to understand different outcomes of implementation of wind power deployment programmes. Geographical variables such as quantity of wind resources are in themselves insufficient to explain patterns of implementation of wind power. To enhance the review of the factors affecting wind

  19. Does confined placental mosaicism account for adverse perinatal outcomes in IVF pregnancies?

    NARCIS (Netherlands)

    B.C. Jacod; K.D. Lichtenbelt (Klaske); G.H. Schuring-Blom (Heleen); J.S.E. Laven (Joop); D. van Opstal (Diane); M.J.C. Eijkemans (René); N.S. Macklon (Nick)

    2008-01-01

    textabstractBACKGROUND: IVF singletons have poorer perinatal outcomes than singletons from spontaneous conceptions. This may be due to the influence of ovarian stimulation on the chromosomal constitution of the embryos which could be translated into localized chromosomal anomalies in the placenta.

  20. Does confined placental mosaicism account for adverse perinatal outcomes in IVF pregnancies?

    NARCIS (Netherlands)

    Jacod, B. C.; Lichtenbelt, K. D.; Schuring-Blom, G. H.; Laven, J. S. E.; van Opstal, D.; Eijkemans, M. J. C.; Macklon, N. S.

    BACKGROUND: IVF singletons have poorer perinatal outcomes than singletons from spontaneous conceptions. This may be due to the influence of ovarian stimulation on the chromosomal constitution of the embryos which could be translated into localized chromosomal anomalies in the placenta. The aim of

  1. Wind power deployment outcomes: How can we account for the differences?

    NARCIS (Netherlands)

    D. Toke; S. Breukers; M. Wolsink

    2008-01-01

    This paper aims to understand different outcomes of implementation of wind power deployment programmes. Geographical variables such as quantity of wind resources are in themselves insufficient to explain patterns of implementation of wind power. To enhance the review of the factors affecting wind po

  2. Accounting for the speed shear in wind turbine power performance measurement

    DEFF Research Database (Denmark)

    Wagner, Rozenn

    in the power curve. A power curve defined in terms of this equivalent wind speed would be less dependant on the shear than the standard power curve. The equivalent wind speed method was then experimentally validated with lidar measurements. Two equivalent wind speed definitions were considered both resulting...... ways of accounting for the turbulence were tested with the experimental data: an adaptation of the equivalent wind speed so that it also accounts for the turbulence intensity and the combination of the equivalent wind speed accounting for the wind shear only with the turbulence normalising method...... the vertical wind shear and the turbulence intensity. The work presented in this thesis consists of the description and the investigation of a simple method to account for the wind speed shear in the power performance measurement. Ignoring this effect was shown to result in a power curve dependant on the shear...

  3. Patient Reported Outcomes Measurement Information System (PROMIS) in the upper extremity: the future of outcomes reporting?

    Science.gov (United States)

    Makhni, Eric C; Meadows, Molly; Hamamoto, Jason T; Higgins, John D; Romeo, Anthony A; Verma, Nikhil N

    2017-02-01

    Patient reported outcomes (PROs) serve an integral role in clinical research by helping to determine the impact of clinical care as experienced by the patient. With recent initiatives in health care policy and pay for performance, outcome reporting is now recognized as a policy-driven requirement in addition to a clinical research tool. For outcome measures to satisfy these regulatory requirements and provide value in understanding disease outcomes, they must be responsive and efficient. Recent research has uncovered certain concerns regarding traditional PROs in patients with upper extremity disability and injury. These include lack of consensus regarding selection of PROs for a given diagnoses, inconsistent techniques of administration of the same PROs, and the administrative burden to patients and providers of completing these forms. To address these limitations, emphasis has been placed on streamlining the outcomes reporting process, and, as a result, the National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Information System (PROMIS). PROMIS forms were created to comprehensively and efficiently measure outcomes across multiple disease states, including orthopedics. These tools exist in computer adaptive testing and short forms with the intention of more efficiently measuring outcomes compared with legacy PROs. The goals of this review are to highlight the main components of PROMIS reporting tools and identify recent use of the scores in the upper extremity literature. The review will also highlight the research and health policy potentials and limitations of implementing PROMIS into everyday orthopedic practice. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. Accounting for covariate measurement error in a Cox model analysis of recurrence of depression.

    Science.gov (United States)

    Liu, K; Mazumdar, S; Stone, R A; Dew, M A; Houck, P R; Reynolds, C F

    2001-01-01

    When a covariate measured with error is used as a predictor in a survival analysis using the Cox model, the parameter estimate is usually biased. In clinical research, covariates measured without error such as treatment procedure or sex are often used in conjunction with a covariate measured with error. In a randomized clinical trial of two types of treatments, we account for the measurement error in the covariate, log-transformed total rapid eye movement (REM) activity counts, in a Cox model analysis of the time to recurrence of major depression in an elderly population. Regression calibration and two variants of a likelihood-based approach are used to account for measurement error. The likelihood-based approach is extended to account for the correlation between replicate measures of the covariate. Using the replicate data decreases the standard error of the parameter estimate for log(total REM) counts while maintaining the bias reduction of the estimate. We conclude that covariate measurement error and the correlation between replicates can affect results in a Cox model analysis and should be accounted for. In the depression data, these methods render comparable results that have less bias than the results when measurement error is ignored.

  5. Failing Tests: Commentary on "Adapting Educational Measurement to the Demands of Test-Based Accountability"

    Science.gov (United States)

    Thissen, David

    2015-01-01

    In "Adapting Educational Measurement to the Demands of Test-Based Accountability" Koretz takes the time-honored engineering approach to educational measurement, identifying specific problems with current practice and proposing minimal modifications of the system to alleviate those problems. In response to that article, David Thissen…

  6. Measuring outcomes of communication partner training of health care professionals:

    DEFF Research Database (Denmark)

    Isaksen, Jytte; Jensen, Lise Randrup

    are best measured in research and in clinical practice in a valid, reliable and feasible manner. Rationale: Research studies have used a variety of outcome measures, including blind ratings of videotaped interactions or self-rating questionnaires for staff [8]. Video rating does not seem feasible...... different needs? Implications for clinical practice: There is a need to develop different types of outcome measures for communication partner training in the health care context, including questionnaires for health care staff, which address generally agreed-upon problem areas in patient...... of the available questionnaires. However, it is important in order to lay the groundwork for future studies, which compare the efficacy and outcome of different methods of implementing conversation partner training in clinical practice. Aims: The overall purpose of this round table is to: 1. provide an overview...

  7. Outcome Measures for Clinical Drug Trials in Autism

    OpenAIRE

    Aman, Michael G; Novotny, Sherie; Samango-Sprouse, Carole; Lecavalier, Luc; Leonard, Elizabeth; Gadow, Kenneth D.; King, Bryan H; Pearson, Deborah A.; Gernsbacher, Morton Ann; Chez, Michael

    2004-01-01

    This paper identifies instruments and measures that may be appropriate for randomized clinical trials in participants with autism spectrum disorders (ASDs). The Clinical Global Impressions scale was recommended for all randomized clinical trials. At this point, however, there is no “perfect” choice of outcome measure for core features of autism, although we will discuss five measures of potential utility. Several communication instruments are recommended, based in part on suitability across t...

  8. Disability outcome measures in multiple sclerosis clinical trials

    DEFF Research Database (Denmark)

    Cohen, Jeffrey A; Reingold, Stephen C; Polman, Chris H;

    2012-01-01

    recommend practical refinements. Conversely, although substantial data support the multiple sclerosis functional composite as an alternative measure, changes to its component tests and scoring method are needed. Novel approaches, including the use of composite endpoints, patient-reported outcomes......, and measurement of biomarkers, show promise as adjuncts to the current disability measures, but are insufficiently validated to serve as substitutes. A collaborative approach that involves academic experts, regulators, industry representitives, and funding agencies is needed to most effectively develop disability...

  9. Accounting for health-care outcomes: implications for intensive care unit practice and performance.

    Science.gov (United States)

    Sorensen, Roslyn; Iedema, Rick

    2010-08-01

    The aim of this study was to understand the environment of health care, and how clinicians and managers respond in terms of performance accountability. A qualitative method was used in a tertiary metropolitan teaching intensive care unit (ICU) in Sydney, Australia, including interviews with 15 clinical managers and focus groups with 29 nurses of differing experience. The study found that a managerial focus on abstract goals, such as budgets detracted from managing the core business of clinical work. Fractures were evident within clinical units, between clinical units and between clinical and managerial domains. These fractures reinforced the status quo where seemingly unconnected patient care activities were undertaken by loosely connected individual clinicians with personalized concepts of accountability. Managers must conceptualize health services as an interconnected entity within which self-directed teams negotiate and agree objectives, collect and review performance data and define collective practice. Organically developing regimens of care within and across specialist clinical units, such as in ICUs, directly impact upon health service performance and accountability.

  10. Wealth and the Accounting Period in the Measurement of Means. The Measure of Poverty, Technical Paper VI.

    Science.gov (United States)

    Steuerle, Eugene; McClung, Nelson

    This technical study is concerned with both the statistical and policy effects of alternative definitions of poverty which result when the definition of means is altered by varying the time period (accounting period) over which income is measured or by including in the measure of means not only realized income, but also unrealized income and…

  11. Measures of language outcomes using the Aboriginal Children's Survey.

    Science.gov (United States)

    Findlay, Leanne C; Kohen, Dafna E

    2013-01-01

    Speech and language skills are an important developmental milestone for all children, and one of the most prevalent forms of developmental delay among Aboriginal children. However, population-based indicators of Aboriginal children's language outcomes are limited. Data from the Aboriginal Children's Survey (ACS) were used to examine measures of language for Aboriginal children who were 2 to 5 years of age. Responses to ACS questions on ability in any language were examined in exploratory factor analyses to determine possible language indicators. Construct validity was examined by regressing language outcomes onto socio-demographic characteristics known to be associated with children's language. Four language outcomes were identified and labelled: expressive language, mutual understanding, story-telling, and speech and language difficulties. The conceptualization of items from the ACS into separate language indicators can be used by researchers examining young Aboriginal children's language outcomes.

  12. THE EFFECTS OF THE MEASURES REGARDING SEQUESTRATION OF CASH IN TAX DEBTORS’ BANK ACCOUNTS

    Directory of Open Access Journals (Sweden)

    DELIMAN EUGEN

    2010-07-01

    Full Text Available Fiscal administration seeks rapid intervention in the action of preventing the formation of budgetary arrears and accomplishing public financial resources at the time scheduled by the fiscal authorities to collect public financial resources. The establishing of the immediate measure blocking of bank accounts of economic agents who recorded debt to the consolidated general budget of the state, is an essential measure necessary to avoid the forvard slip of other creditors, debt recovery actions, having as consequence the preventing of taxpayers as state debtors to organize their insolvency. The present study aims to draw attention upon the effects of blocking the bank accounts on the evolution of budgetary revenues through enforcement measures during 2006-2009, and the registering of more favorable results regarding collection should take into account the immediate legitimate interest of the budgeted creditor, but should also make sure that the rights of taxpayers are observed.

  13. Responsiveness of outcome measures for upper limb prosthetic rehabilitation.

    Science.gov (United States)

    Resnik, Linda; Borgia, Matthew

    2016-02-01

    There is limited research on responsiveness of prosthetic rehabilitation outcome measures. To examine responsiveness of the Box and Block test, Jebsen-Taylor Hand Function tests, Upper Extremity Functional Scale, University of New Brunswick skill and spontaneity tests, Activity Measure for Upper Limb Amputation, and the Patient-Specific Functional Scale. This was a quasi-experimental study with repeated measurements in a convenience sample of upper limb amputees. Measures were collected before, during, and after training with the DEKA Arm. Largest effect sizes were observed for Patient-Specific Functional Scale (effect size: 1.59, confidence interval: 1.00, 2.14), Activity Measure for Upper Limb Amputation (effect size: 1.33, confidence interval: 0.73, 1.90), and University of New Brunswick skill test (effect size: 1.18, confidence interval: 0.61, 1.73). Other measures that were responsive to change were Box and Block test, Jebsen-Taylor Hand Function light and heavy can tests, and University of New Brunswick spontaneity test. Responsiveness and pattern of responsiveness varied by prosthetic level. The Box and Block test, Jebsen-Taylor Hand Function light and heavy can tests, University of New Brunswick skill and spontaneity tests, Activities Measure for Upper Limb Amputation, and the Patient-Specific Functional Scale were responsive to change during prosthetic training. These findings have implications for choice of measures for research and practice and inform clinicians about the amount of training necessary to maximize outcomes with the DEKA Arm. Findings on responsiveness of outcome measures have implications for the choice of measures for clinical trials and practice. Findings regarding the responsiveness to change over the course of training can inform clinicians about the amount of training that may be necessary to maximize specific outcomes with the DEKA Arm. © The International Society for Prosthetics and Orthotics 2014.

  14. 78 FR 59626 - Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2013-14

    Science.gov (United States)

    2013-09-27

    ... Bottomfish Annual Catch Limits and Accountability Measures for 2013-14 AGENCY: National Marine Fisheries..., as an associated accountability measure (AM) close the non-commercial and commercial fisheries...

  15. 77 FR 32913 - Accountability Measures for the Recreational Sector of Gray Triggerfish in the Gulf of Mexico for...

    Science.gov (United States)

    2012-06-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 RIN 0648-XCO36 Accountability Measures for.... ACTION: Temporary rule; closure. SUMMARY: NMFS implements accountability measures (AMs) for...

  16. A clinically meaningful theory of outcome measures in rehabilitation medicine.

    Science.gov (United States)

    Massof, Robert W

    2010-01-01

    Comparative effectiveness research in rehabilitation medicine requires the development and validation of clinically meaningful and scientifically rigorous measurements of patient states and theories that explain and predict outcomes of intervention. Patient traits are latent (unobservable) variables that can be measured only by inference from observations of surrogate manifest (observable) variables. In the behavioral sciences, latent variables are analogous to intensive physical variables such as temperature and manifest variables are analogous to extensive physical variables such as distance. Although only one variable at a time can be measured, the variable can have a multidimensional structure that must be understood in order to explain disagreements among different measures of the same variable. The use of Rasch theory to measure latent trait variables can be illustrated with a balance scale metaphor that has randomly added variability in the weights of the objects being measured. Knowledge of the distribution of the randomly added variability provides the theoretical structure for estimating measures from ordinal observation scores (e.g., performance measures or rating scales) using statistical inference. In rehabilitation medicine, the latent variable of primary interest is the patient's functional ability. Functional ability can be estimated from observations of surrogate performance measures (e.g., speed and accuracy) or self-report of the difficulty the patient experiences performing specific activities. A theoretical framework borrowed from project management, called the Activity Breakdown Structure (ABS), guides the choice of activities for assessment, based on the patient's value judgments, to make the observations clinically meaningful. In the case of low vision, the functional ability measure estimated from Rasch analysis of activity difficulty ratings was discovered to be a two-dimensional variable. The two visual function dimensions are independent

  17. Accounting for posttraumatic stress disorder symptom severity with pre- and posttrauma measures

    DEFF Research Database (Denmark)

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2016-01-01

    Using data from a longitudinal study of community-dwelling older adults, we analyzed the most extensive set of known correlates of posttraumatic stress disorder (PTSD) symptoms obtained from a single sample to examine the measures’ independent and combined utility in accounting for PTSD symptom...... attachment and factors related to the current trauma memory, such as self-rated severity, event centrality, frequency of involuntary recall, and physical reactions to the memory, accounted for symptom severity better than did measures of pretrauma factors. In an analysis restricted to prospective measures...... severity. Fifteen measures identified as PTSD risk factors in published meta-analyses as well as 12 theoretically and empirically supported individual difference and health-related measures were included in our analysis. Individual difference measures assessed after the trauma, including insecure...

  18. Accounting- versus economic-based rates of return: implications for profitability measures in the pharmaceutical industry.

    Science.gov (United States)

    Skrepnek, Grant H

    2004-01-01

    Accounting-based profits have indicated that pharmaceutical firms have achieved greater returns relative to other sectors. However, partially due to the theoretically inappropriate reporting of research and development (R&D) expenditures according to generally accepted accounting principles, evidence suggests that a substantial and upward bias is present in accounting-based rates of return for corporations with high levels of intangible assets. Given the intensity of R&D in pharmaceutical firms, accounting-based profit metrics in the drug sector may be affected to a greater extent than other industries. The aim of this work was to address measurement issues associated with corporate performance and factors that contribute to the bias within accounting-based rates of return. Seminal and broadly cited works on the subject of accounting- versus economic-based rates of return were reviewed from the economic and finance literature, with an emphasis placed on issues and scientific evidence directly related to the drug development process and pharmaceutical industry. With international convergence and harmonization of accounting standards being imminent, stricter adherence to theoretically sound economic principles is advocated, particularly those based on discounted cash-flow methods. Researchers, financial analysts, and policy makers must be cognizant of the biases and limitations present within numerous corporate performance measures. Furthermore, the development of more robust and valid economic models of the pharmaceutical industry is required to capture the unique dimensions of risk and return of the drug development process. Empiric work has illustrated that estimates of economic-based rates of return range from approximately 2 to approximately 11 percentage points below various accounting-based rates of return for drug companies. Because differences in the nature of risk and uncertainty borne by drug manufacturers versus other sectors make comparative assessments

  19. Outcome Measures for Clinical Trials in Down Syndrome.

    Science.gov (United States)

    Esbensen, Anna J; Hooper, Stephen R; Fidler, Deborah; Hartley, Sigan L; Edgin, Jamie; d'Ardhuy, Xavier Liogier; Capone, George; Conners, Frances A; Mervis, Carolyn B; Abbeduto, Leonard; Rafii, Michael; Krinsky-McHale, Sharon J; Urv, Tiina; Group, Outcome Measures Working

    2017-05-01

    Increasingly individuals with intellectual and developmental disabilities, including Down syndrome, are being targeted for clinical trials. However, a challenge exists in effectively evaluating the outcomes of these new pharmacological interventions. Few empirically evaluated, psychometrically sound outcome measures appropriate for use in clinical trials with individuals with Down syndrome have been identified. To address this challenge, the National Institutes of Health (NIH) assembled leading clinicians and scientists to review existing measures and identify those that currently are appropriate for trials; those that may be appropriate after expansion of age range addition of easier items, and/or downward extension of psychometric norms; and areas where new measures need to be developed. This article focuses on measures in the areas of cognition and behavior.

  20. Use of Outcome Measurement by Paediatric AHPs in Northern Ireland

    Science.gov (United States)

    Harron, Anita; Titterington, Jill

    2016-01-01

    Background: Professional standards advocate routine use of outcome measurement (OM) in the practice of allied health professionals (AHPs). Historically, OM has focused on impairment and its immediate constraints on activity, while current policy encourages the development and addition of impact-based OM. There appears to be an assumption at this…

  1. Patient-reported outcome measures in arthroplasty registries

    DEFF Research Database (Denmark)

    Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric

    2016-01-01

    The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and u...

  2. 78 FR 52125 - Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2013-14

    Science.gov (United States)

    2013-08-22

    ... Bottomfish Annual Catch Limits and Accountability Measures for 2013-14 AGENCY: National Marine Fisheries... catch limit is projected to be reached, NMFS, as an accountability measure, would close the commercial... annual catch limit and accountability measure, and anticipates announcing the final specifications...

  3. OMERACT: An international initiative to improve outcome measurement in rheumatology

    Directory of Open Access Journals (Sweden)

    Simon Lee

    2007-11-01

    Full Text Available Abstract OMERACT is the acronym for an international, informally organized network initiated in 1992 aimed at improving outcome measurement in rheumatology. Chaired by an executive committee, it organizes consensus conferences in a 2-yearly cycle that circles the globe. Data driven recommendations are prepared and updated by expert working groups. Recommendations include core sets of measures for most of the major rheumatologic conditions. Since 2002 patients have been actively engaged in the process.

  4. Measuring patient satisfaction for the Quality and Outcomes Framework

    OpenAIRE

    Hankins, Matthew; Fraser, Alice; Hodson, Andrew; Hooley, Claire; Smith, Helen

    2007-01-01

    The general medical services (GMS) contract Quality and Outcomes Framework (QOF) awards up to 70 points for measuring patient satisfaction with either the Improving Practices Questionnaire (IPQ) or the General Practice Assessment Questionnaire (GPAQ). The usefulness of data collected depends crucially on the validity and reliability of the measurement instrument. The literature was reviewed to assess the validity and reliability of these questionnaires. The literature was searched for peer-re...

  5. Analysis of repeated outcome measures from longitudinal studies

    Institute of Scientific and Technical Information of China (English)

    Yuanjia WANG; Naihua DUAN

    2011-01-01

    @@ In many clinical studies repeated measurements of an outcome are collected over time.For example,in an 8-week study of treatment for obsessive compulsive disorder,the severity of the disorder may be measured weekly using the Yale-Brown-Obsessive-Compulsive-Disorder-Scale (YBOCS).For each study participant who completes the study,there will be nine repeated measures of YBOCS (a baseline assessment plus eight assessments during the course of treatment).Such a study in which participants are followed and measured repeatedly over time is called a longitudinal study and the resulting data are called longitudinal data.

  6. Unconditionally secure bit commitment by transmitting measurement outcomes.

    Science.gov (United States)

    Kent, Adrian

    2012-09-28

    We propose a new unconditionally secure bit commitment scheme based on Minkowski causality and the properties of quantum information. The receiving party sends a number of randomly chosen Bennett-Brassard 1984 (BB84) qubits to the committer at a given point in space-time. The committer carries out measurements in one of the two BB84 bases, depending on the committed bit value, and transmits the outcomes securely at (or near) light speed in opposite directions to remote agents. These agents unveil the bit by returning the outcomes to adjacent agents of the receiver. The protocol's security relies only on simple properties of quantum information and the impossibility of superluminal signalling.

  7. Unconditionally Secure Bit Commitment by Transmitting Measurement Outcomes

    CERN Document Server

    ,

    2011-01-01

    We propose a new unconditionally secure bit commitment scheme based on Minkowski causality and the properties of quantum information. The receiving party sends a number of randomly chosen BB84 qubits to the committer at a given point in space-time. The committer carries out measurements in one of the two BB84 bases, depending on the committed bit value, and transmits the outcomes securely at light speed in opposite directions to remote agents. These agents unveil the bit by returning the outcomes to adjacent agents of the receiver. The security proofs rely only on simple properties of quantum information and the impossibility of superluminal signalling.

  8. A generalized maximum entropy stochastic frontier measuring productivity accounting for spatial dependency

    NARCIS (Netherlands)

    Tonini, A.; Pede, V.

    2011-01-01

    In this paper, a stochastic frontier model accounting for spatial dependency is developed using generalized maximum entropy estimation. An application is made for measuring total factor productivity in European agriculture. The empirical results show that agricultural productivity growth in Europe i

  9. Measuring the Academic Self-Efficacy of First-Year Accounting Students

    Science.gov (United States)

    Byrne, Marann; Flood, Barbara; Griffin, Julie

    2014-01-01

    This study measured the levels of academic self-efficacy of first-year accounting students. It also investigated whether there were any gender differences and the extent to which efficacy levels explained variation in academic performance. Overall the analysis revealed that many students lacked the confidence to participate fully in the academic…

  10. Nuclear Material Accountancy Assessment Technical Measures in Nuclear Centrifuge Enrichment Facility

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Nuclear material accountancy assessment is the main technical measures for nuclear materials regulatory. It is an important basis to detect theft, loss and the illegal diversion of nuclear material. In order to implement the control of nuclear materials for nuclear facilities,

  11. 77 FR 53776 - Snapper-Grouper Fishery of the South Atlantic; Accountability Measures and Commercial Closures...

    Science.gov (United States)

    2012-09-04

    ... Region FMP published March 16, 2010 (77 FR 15916). In part, the final rule for the Comprehensive ACL... National Oceanic and Atmospheric Administration 50 CFR Part 622 RIN 0648-XC132 Snapper-Grouper Fishery of the South Atlantic; Accountability Measures and Commercial Closures for Two Snapper-Grouper...

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

    Science.gov (United States)

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

    2000-01-01

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

  13. Evaluating psychological debriefing: are we measuring the right outcomes?

    Science.gov (United States)

    Deahl, M P; Srinivasan, M; Jones, N; Neblett, C; Jolly, A

    2001-07-01

    The efficacy of critical incident stress debriefing (CISD) and psychological debriefing (PD) following potentially traumatising events has recently been challenged after a number of recent randomised controlled trials (RCTs) failed to demonstrate that CISD or PD prevents or reduces the incidence of posttraumatic stress disorder (PTSD). These studies have used measures of PTSD as the principal outcome and have generally not measured comorbid psychopathology, behavioral or social dysfunction. In a recent RCT of group debriefing amongst British soldiers returning from peacekeeping operations in Bosnia, PD had a significant effect in reducing a worrying level of alcohol misuse in the sample. The findings of this study suggest that that it is premature to conclude that debriefing is ineffective and that a broader range of outcome measures should be employed in future trials of debriefing.

  14. Do sex and atopy influence cough outcome measurements in children?

    Science.gov (United States)

    Chang, Anne B; Gibson, Peter G; Willis, Carol; Petsky, Helen L; Widdicombe, John G; Masters, I Brent; Robertson, Colin F

    2011-08-01

    Despite the commonality of cough and its burden, there are no published data on the relationship between atopy or sex on objectively measured cough frequency or subjective cough scores in children. In 202 children with and without cough, we determined the effect of sex and atopy on validated cough outcome measurements (cough receptor sensitivity [CRS], objective cough counts, and cough scores). We hypothesized that in contrast to adult data, sex does not influence cough outcome measures, and atopy is not a determinant of these cough measurements. We combined data from four previous studies. Atopy (skin prick test), the concentration of capsaicin causing two and five or more coughs (C2 and C5, respectively), objectively measured cough frequency, and cough scores were determined and their relationship explored. The children's (93 girls, 109 boys) mean age was 10.6 years (SD 2.9), and 56% had atopy. In multivariate analysis, CRS was influenced by age (C2 coefficient, 5.9; P = .034; C5 coefficient, 29.1; P = .0001). Atopy and sex did not significantly influence any of the cough outcomes (cough counts, C2, C5, cough score) in control subjects and children with cough. Atopy does not influence important cough outcome measures in children with and without chronic cough. However, age, but not sex, influences CRS in children. Unlike adult data, sex does not affect objective counts or cough score in children with and without chronic cough. Studies on cough in children should be age matched, but matching for atopic status and sex is less important.

  15. Retail price as an outcome measure for the effectiveness of drug law enforcement.

    Science.gov (United States)

    Bright, David A; Ritter, Alison

    2010-09-01

    One outcome measure of law enforcement effectiveness is the reduction in drug consumption which occurs as a result of law enforcement interventions. A theoretical relationship between drug consumption and retail price has promoted the use of retail price as a surrogate measure for consumption. In the current article, retail price is examined as a potential outcome measure for the effectiveness of law enforcement. The predictions regarding the relationship between law enforcement intensity and price are only partially supported by research. Explanations for the disconnect between the drug law enforcement activity and retail price include: rapid adaptation by market players, enforcement swamping, assumptions of rational actors, short-run versus long-run effects, structure of the illicit market, simultaneous changes that affect price in perverse ways, the role of violence in markets, and data limitations. Researchers who use retail price as an outcome measure need to take into account the complex relationship between drug law enforcement interventions and the retail price of illicit drugs. Viable outcome measures which can be used as complements to retail price are worth investigation. Copyright 2009 Elsevier B.V. All rights reserved.

  16. Guest Editorial: Implementing outcome measures- The military physical therapists perspective

    Directory of Open Access Journals (Sweden)

    COL (Ret Paul D. Stoneman, PhD, MPT, DPT, OCS, SCS

    2013-10-01

    Full Text Available Outcome measures are a necessary part of rehabilitation. Various methods and measures have been used to assess patient progress and as criteria for discharge from inpatient care, routine outpatient care, and long-term rehabilitation in a variety of patient populations for many years. In the sports medicine setting, outcome measures become especially important in determining when injured athletes are able to return to the playing field. In a military setting, similar to sports medicine, the use of outcome measures is necessary to help determine when the patient is able to return to duty or deploy. In the case of servicemembers with traumatic limb loss, the ultimate goal for many is to return to Active Duty as a "tactical athlete" and member of today's Army, Navy, Air Force, Marine Corps, or Coast Guard. Determining the functional level and ability to meet the demands they may face is a challenge for the military healthcare system (MHCS and more specifically for the providers rehabilitating servicemembers with major limb loss.

  17. Unseeded Large Scale PIV measurements accounting for capillary-gravity waves phase speed

    CERN Document Server

    Benetazzo,; Gamba,; M.,; Barbariol,; F,

    2016-01-01

    Large Scale Particle Image Velocimetry (LSPIV) is widely recognized as a reliable method to measure water surface velocity field in open channels and rivers. LSPIV technique is based on a camera view that frames the water surface in a sequence, and image-processing methods to compute water surface displacements between consecutive frames. Using LSPIV, high flow velocities, as for example flood conditions, were accurately measured, whereas determinations of low flow velocities is more challenging, especially in absence of floating seeding transported by the flow velocity. In fact, in unseeded conditions, typical surface features dynamics must be taken into account: besides surface structures convected by the current, capillary-gravity waves travel in all directions, with their own dynamics. Discrimination between all these phenomena is here discussed, providing a new method to distinguish and to correct unseeded LSPIV measurements associated with wavy structures, accounting for their phase speed magnitude and ...

  18. Accounting for uncertainty due to 'last observation carried forward' outcome imputation in a meta-analysis model.

    Science.gov (United States)

    Dimitrakopoulou, Vasiliki; Efthimiou, Orestis; Leucht, Stefan; Salanti, Georgia

    2015-02-28

    Missing outcome data are a problem commonly observed in randomized control trials that occurs as a result of participants leaving the study before its end. Missing such important information can bias the study estimates of the relative treatment effect and consequently affect the meta-analytic results. Therefore, methods on manipulating data sets with missing participants, with regard to incorporating the missing information in the analysis so as to avoid the loss of power and minimize the bias, are of interest. We propose a meta-analytic model that accounts for possible error in the effect sizes estimated in studies with last observation carried forward (LOCF) imputed patients. Assuming a dichotomous outcome, we decompose the probability of a successful unobserved outcome taking into account the sensitivity and specificity of the LOCF imputation process for the missing participants. We fit the proposed model within a Bayesian framework, exploring different prior formulations for sensitivity and specificity. We illustrate our methods by performing a meta-analysis of five studies comparing the efficacy of amisulpride versus conventional drugs (flupenthixol and haloperidol) on patients diagnosed with schizophrenia. Our meta-analytic models yield estimates similar to meta-analysis with LOCF-imputed patients. Allowing for uncertainty in the imputation process, precision is decreased depending on the priors used for sensitivity and specificity. Results on the significance of amisulpride versus conventional drugs differ between the standard LOCF approach and our model depending on prior beliefs on the imputation process. Our method can be regarded as a useful sensitivity analysis that can be used in the presence of concerns about the LOCF process.

  19. Measuring the Outcome of Biomedical Research: A Systematic Literature Review

    OpenAIRE

    Frédérique Thonon; Rym Boulkedid; Tristan Delory; Sophie Rousseau; Mahasti Saghatchian; Wim van Harten; Claire O'Neill; Corinne Alberti

    2015-01-01

    Background There is an increasing need to evaluate the production and impact of medical research produced by institutions. Many indicators exist, yet we do not have enough information about their relevance. The objective of this systematic review was (1) to identify all the indicators that could be used to measure the output and outcome of medical research carried out in institutions and (2) enlist their methodology, use, positive and negative points. Methodology We have searched 3 databases ...

  20. Measuring and accounting for the intensity of nursing care: is it worthwhile?

    Science.gov (United States)

    Finkler, Steven A

    2008-05-01

    In June 2007, the Robert Wood Johnson Foundation sponsored a conference titled "The Economics of Nursing: Paying for Quality Nursing Care." The second topic at the conference was "the appropriateness and feasibility of measuring and accounting for the intensity of nursing care." Drs. Welton and Sermeus presented papers on that topic. This response to those papers focuses on why the hospital industry has not always accounted for and measured nursing intensity. Then it asks, "Why do we want more accurate information about nursing resources used by different patients?" It is not sufficient to say the data regarding nursing costs are not accurate. Nor is it sufficient to say that we now can improve the accuracy of the data. To move forward in this area, we need to develop compelling evidence and arguments that indicate that nursing-cost data of greater accuracy have a benefit that will exceed the costs of that data collection.

  1. Pelvic Floor Disorders Registry: Study Design and Outcome Measures.

    Science.gov (United States)

    Weber LeBrun, Emily; Adam, Rony A; Barber, Matthew D; Boyles, Sarah Hamilton; Iglesia, Cheryl B; Lukacz, Emily S; Moalli, Pamela; Moen, Michael D; Richter, Holly E; Subak, Leslee L; Sung, Vivian W; Visco, Anthony G; Bradley, Catherine S

    2016-01-01

    Pelvic floor disorders affect up to 24% of adult women in the United States, and many patients with pelvic organ prolapse (POP) choose to undergo surgical repair to improve their quality of life. While a variety of surgical repair approaches and techniques are utilized, including mesh augmentation, there is limited comparative effectiveness and safety outcome data guiding best practice. In conjunction with device manufacturers, federal regulatory organizations, and professional societies, the American Urogynecologic Society developed the Pelvic Floor Disorders Registry (PFDR) designed to improve the quality of POP surgery by facilitating quality improvement and research on POP treatments. The PFDR will serve as a resource for surgeons interested in benchmarking and outcomes data and as a data repository for Food and Drug Administration-mandated POP surgical device studies. Provider-reported clinical data and patient-reported outcomes will be collected prospectively at baseline and for up to 3 years after treatment. All data elements including measures of success, adverse events, and surgeon characteristics were identified and defined within the context of the anticipated multifunctionality of the registry, and with collaboration from multiple stakeholders. The PFDR will provide a platform to collect high-quality, standardized patient-level data from a variety of nonsurgical (pessary) and surgical treatments of POP and other pelvic floor disorders. Data from this registry may be used to evaluate short- and longer-term treatment outcomes, patient-reported outcomes, and complications, as well as to identify factors associated with treatment success and failure with the overall goal of improving the quality of care for women with these conditions.

  2. Goal setting as an outcome measure: A systematic review.

    Science.gov (United States)

    Hurn, Jane; Kneebone, Ian; Cropley, Mark

    2006-09-01

    Goal achievement has been considered to be an important measure of outcome by clinicians working with patients in physical and neurological rehabilitation settings. This systematic review was undertaken to examine the reliability, validity and sensitivity of goal setting and goal attainment scaling approaches when used with working age and older people. To review the reliability, validity and sensitivity of both goal setting and goal attainment scaling when employed as an outcome measure within a physical and neurological working age and older person rehabilitation environment, by examining the research literature covering the 36 years since goal-setting theory was proposed. Data sources included a computer-aided literature search of published studies examining the reliability, validity and sensitivity of goal setting/goal attainment scaling, with further references sourced from articles obtained through this process. There is strong evidence for the reliability, validity and sensitivity of goal attainment scaling. Empirical support was found for the validity of goal setting but research demonstrating its reliability and sensitivity is limited. Goal attainment scaling appears to be a sound measure for use in physical rehabilitation settings with working age and older people. Further work needs to be carried out with goal setting to establish its reliability and sensitivity as a measurement tool.

  3. Indicators as an Instrument of Measurement in Management Accounting in Logistics Enterprises in Poland

    Directory of Open Access Journals (Sweden)

    Justyna Dobroszek

    2015-12-01

    Full Text Available Purpose: The purpose of this study was to present the extent to which indicators applied by logistics providers in Poland measure logistics-related processes and performance in the context of implementing the concept of management accounting in the enterprises that were researched. Methodology: The research methods used by the authors included a literature review of mainly German and Polish publications and survey research conducted in 2011–2013 among logistics enterprises in Poland. This study served as the basis for verifying four hypotheses and formulating conclusions. Findings: The main results of this study showed that management accounting systems are implemented in about half of then logistics providers in Poland covered by the survey. 75% of all enterprises conducted indicator analysis to evaluate logistics processes, costs and performance, and 90% of the indicators used by these enterprises were of a financial nature. Research limitations: The main limitation of the research was associated with conducting the survey. The low return rate of completed questionnaires did not allow for a detailed analysis of the undertaken subject to be conducted. Moreover, the research results cannot be generalized to all logistics companies in Poland. Originality: The study was the first review of the application of indicators in logistics companies in Poland in relation to the implementation of the management accounting concept. The study provides knowledge about how Polish logistics enterprises use indicators as an important management accounting instrument.

  4. Patient population management: taking the leap from variance analysis to outcomes measurement.

    Science.gov (United States)

    Allen, K M

    1998-01-01

    Case managers today at BCHS have a somewhat different role than at the onset of the Collaborative Practice Model. They are seen throughout the organization as: Leaders/participants on cross-functional teams. Systems change agents. Integrating/merging with quality services and utilization management. Outcomes managers. One of the major cross-functional teams is in the process of designing a Care Coordinator role. These individuals will, as one of their functions, assume responsibility for daily patient care management activities. A variance tracking program has come into the Utilization Management (UM) department as part of a software package purchased to automate UM work activities. This variance program could potentially be used by the new care coordinators as the role develops. The case managers are beginning to use a Decision Support software, (Transition Systems Inc.) in the collection of data that is based on a cost accounting system and linked to clinical events. Other clinical outcomes data bases are now being used by the case manager to help with the collection and measurement of outcomes information. Hoshin planning will continue to be a framework for defining and setting the targets for clinical and financial improvements throughout the organization. Case managers will continue to be involved in many of these system-wide initiatives. In the words of Galileo, 1579, "You need to count what's countable, measure what's measurable, and what's not measurable, make measurable."

  5. Measurement properties of patient-reported outcome measures (PROMS) in Patellofemoral Pain Syndrome: a systematic review.

    Science.gov (United States)

    Green, Andrew; Liles, Clive; Rushton, Alison; Kyte, Derek G

    2014-12-01

    This systematic review investigated the measurement properties of disease-specific patient-reported outcome measures used in Patellofemoral Pain Syndrome. Two independent reviewers conducted a systematic search of key databases (MEDLINE, EMBASE, AMED, CINHAL+ and the Cochrane Library from inception to August 2013) to identify relevant studies. A third reviewer mediated in the event of disagreement. Methodological quality was evaluated using the validated COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool. Data synthesis across studies determined the level of evidence for each patient-reported outcome measure. The search strategy returned 2177 citations. Following the eligibility review phase, seven studies, evaluating twelve different patient-reported outcome measures, met inclusion criteria. A 'moderate' level of evidence supported the structural validity of several measures: the Flandry Questionnaire, Anterior Knee Pain Scale, Functional Index Questionnaire, Eng and Pierrynowski Questionnaire and Visual Analogue Scales for 'usual' and 'worst' pain. In addition, there was a 'Limited' level of evidence supporting the test-retest reliability and validity (cross-cultural, hypothesis testing) of the Persian version of the Anterior Knee Pain Scale. Other measurement properties were evaluated with poor methodological quality, and many properties were not evaluated in any of the included papers. Current disease-specific outcome measures for Patellofemoral Pain Syndrome require further investigation. Future studies should evaluate all important measurement properties, utilising an appropriate framework such as COSMIN to guide study design, to facilitate optimal methodological quality.

  6. Accounting for Outcome Misclassification in Estimates of the Effect of Occupational Asbestos Exposure on Lung Cancer Death

    Science.gov (United States)

    Edwards, Jessie K.; Cole, Stephen R.; Chu, Haitao; Olshan, Andrew F.; Richardson, David B.

    2014-01-01

    In studies of the health effects of asbestos, lung cancer death is subject to misclassification. We used modified maximum likelihood to explore the effects of outcome misclassification on the rate ratio of lung cancer death per 100 fiber-years per milliliter of cumulative asbestos exposure in a cohort study of textile workers in Charleston, South Carolina, followed from 1940 to 2001. The standard covariate-adjusted estimate of the rate ratio was 1.94 (95% confidence interval: 1.55, 2.44), and modified maximum likelihood produced similar results when we assumed that the specificity of outcome classification was 0.98. With sensitivity assumed to be 0.80 and specificity assumed to be 0.95, estimated rate ratios were further from the null and less precise (rate ratio = 2.17; 95% confidence interval: 1.59, 2.98). In the present context, standard estimates for the effect of asbestos on lung cancer death were similar to estimates accounting for the limited misclassification. However, sensitivity analysis using modified maximum likelihood was needed to verify the robustness of standard estimates, and this approach will provide unbiased estimates in settings with more misclassification. PMID:24352593

  7. Outcomes 'out of africa': the selection and implementation of outcome measures for palliative care in Africa

    Directory of Open Access Journals (Sweden)

    Downing Julia

    2012-01-01

    Full Text Available Abstract Background End-of-life care research across Africa is under-resourced and under-developed. A central issue in research in end-of-life care is the measurement of effects and outcomes of care on patients and families. Little is known about the experiences of health professionals' selection and implementation of outcome measures (OM in clinical care, research, audit, or teaching in Africa. Methods An online survey was undertaken of those using outcome measures across the region, as part of the PRISMA project. A questionnaire addressing the use of OMs was developed for a similar survey in Europe and adapted for Africa. Participants were sampled through the contacts database of APCA. Invitation emails were sent out in January 2010 and reminders in February 2010. Results 168/301 invited contacts (56% from 24 countries responded, with 78 respondents having previously used OM (65% in clinical practice, 12% in research and 23% for both. Main reasons for not using OM were a lack of guidance/training on using and analysing OM, with 49% saying that they would use the tools if this was provided. 40% of those using OM in clinical practice used POS, and 80% used them to assess, evaluate and monitor change. The POS was also the main tool used in research, with the principle criteria for use being validation in Africa, access to the tool and time needed to complete it. Challenges to the use of tools were shortage of time and resources, lack of guidance and training for the professionals, poor health status of patients and complexity of OM. Researchers also have problems analysing OM data. The APCA African POS was the most common version of the POS used, and was reported as a valuable tool for measuring outcomes. Respondents indicated the ideal outcome tool should be short, multi-dimensional and easy to use. Conclusion This was the first survey on professionals' views on OM in Africa. It showed that the APCA African POS was the most frequently OM used

  8. Accounting for the speed shear in wind turbine power performance measurement

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, R.

    2010-04-15

    The power curve of a wind turbine is the primary characteristic of the machine as it is the basis of the warranty for it power production. The current IEC standard for power performance measurement only requires the measurement of the wind speed at hub height and the air density to characterise the wind field in front of the turbine. However, with the growing size of the turbine rotors during the last years, the effect of the variations of the wind speed within the swept rotor area, and therefore of the power output, cannot be ignored any longer. Primary effects on the power performance are from the vertical wind shear and the turbulence intensity. The work presented in this thesis consists of the description and the investigation of a simple method to account for the wind speed shear in the power performance measurement. Ignoring this effect was shown to result in a power curve dependant on the shear condition, therefore on the season and the site. It was then proposed to use an equivalent wind speed accounting for the whole speed profile in front of the turbine. The method was first tested with aerodynamic simulations of a multi-megawatt wind turbine which demonstrated the decrease of the scatter in the power curve. A power curve defined in terms of this equivalent wind speed would be less dependant on the shear than the standard power curve. The equivalent wind speed method was then experimentally validated with lidar measurements. Two equivalent wind speed definitions were considered both resulting in the reduction of the scatter in the power curve. As a lidar wind profiler can measure the wind speed at several heights within the rotor span, the wind speed profile is described with more accuracy than with the power law model. The equivalent wind speed derived from measurements, including at least one measurement above hub height, resulted in a smaller scatter in the power curve than the equivalent wind speed derived from profiles extrapolated from measurements

  9. Outcome measures based on classification performance fail to predict the intelligibility of binary-masked speech

    DEFF Research Database (Denmark)

    Kressner, Abigail Anne; May, Tobias; Rozell, Christopher J.

    2016-01-01

    To date, the most commonly used outcome measure for assessing ideal binary mask estimation algorithms is based on the difference between the hit rate and the false alarm rate (H-FA). Recently, the error distribution has been shown to substantially affect intelligibility. However, H-FA treats each...... mask unit independently and does not take into account how errors are distributed. Alternatively, algorithms can be evaluated with the short-time objective intelligibility (STOI) metric using the reconstructed speech. This study investigates the ability of H-FA and STOI to predict intelligibility...

  10. Accounting for External Turbulence of Logistics Organizations via Performance Measurement Systems

    DEFF Research Database (Denmark)

    Bühler, Andreas; Wallenburg, Carl Marcus; Wieland, Andreas

    2016-01-01

    Purpose: This paper aims to investigate the role of upper management in designing performance measurement systems (PMS) that account for external turbulence of the organization and to show how this PMS design for turbulence impacts organizational resilience and distribution service performance...... distribution service performance. Originality/value: This paper is the first to introduce the concept of PMS design for turbulence to the literature and to show that it is relevant for supply chain risk management by fostering the capabilities and the performance of logistics organizations. Further....... Design/methodology/approach: Hypotheses are developed by integrating management accounting and strategic management perspectives into supply chain management and subsequently tested based on data from 431 logistics organizations (i.e. both logistics companies and internal logistics departments...

  11. Accounting for the effect of horizontal gradients in limb measurements of scattered sunlight

    Directory of Open Access Journals (Sweden)

    J. Puķīte

    2007-11-01

    Full Text Available Limb measurements provided by the SCanning Imaging Absorption spectrometer for Atmospheric CHartographY (SCIAMACHY on the ENVISAT satellite allow retrieving stratospheric profiles of various trace gases on a global scale, among them BrO for the first time. For limb observations in the UV/VIS spectral region the instrument measures scattered light with a complex distribution of light paths: the light is measured at different elevation angles and can be scattered or absorbed in the atmosphere or reflected by the ground. By means of spectroscopy and radiative transfer modelling the measurements can be inverted to retrieve the vertical distribution of stratospheric trace gases.

    A full spherical 3-D Monte Carlo radiative transfer model "Tracy-II" is applied in this study. The Monte Carlo method benefits from conceptual simplicity and allows realizing the concept of full spherical geometry of the atmosphere and also its 3-D properties, which is important for a realistic description of the limb geometry. Furthermore it allows accounting for horizontal gradients in the distribution of trace gases.

    In this study the effect ofhorizontal inhomogeneous distributions of trace gases on the retrieval of profiles from limb measurements of scattered UV/VIS light is investigated. We introduce a method to correct for this effect by combining consecutive limb scanning sequences and utilizing the overlap in their measurement sensitivity regions. It is found that if horizontal inhomogenity is not properly accounted for, typical errors of 20% for NO2 and up to 50% for OClO around the altitude of the profile peak can arise for measurements close to the Arctic polar vortex boundary in boreal winter.

  12. Directly measured secondhand smoke exposure and COPD health outcomes

    Directory of Open Access Journals (Sweden)

    Balmes John

    2006-06-01

    Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

  13. Making Health System Performance Measurement Useful to Policy Makers: Aligning Strategies, Measurement and Local Health System Accountability in Ontario

    Science.gov (United States)

    Veillard, Jeremy; Huynh, Tai; Ardal, Sten; Kadandale, Sowmya; Klazinga, Niek S.; Brown, Adalsteinn D.

    2010-01-01

    This study examined the experience of the Ontario Ministry of Health and Long-Term Care in enhancing its stewardship and performance management role by developing a health system strategy map and a strategy-based scorecard through a process of policy reviews and expert consultations, and linking them to accountability agreements. An evaluation of the implementation and of the effects of the policy intervention has been carried out through direct policy observation over three years, document analysis, interviews with decision-makers and systematic discussion of findings with other authors and external reviewers. Cascading strategies at health and local health system levels were identified, and a core set of health system and local health system performance indicators was selected and incorporated into accountability agreements with the Local Health Integration Networks. despite the persistence of such challenges as measurement limitations and lack of systematic linkage to decision-making processes, these activities helped to strengthen substantially the ministry's performance management function. PMID:21286268

  14. Accounting for the effect of horizontal gradients in limb measurements of scattered sunlight

    Directory of Open Access Journals (Sweden)

    J. Puķīte

    2008-06-01

    Full Text Available Limb measurements provided by the SCanning Imaging Absorption spectrometer for Atmospheric CHartographY (SCIAMACHY on the ENVISAT satellite allow retrieving stratospheric profiles of various trace gases on a global scale, among them BrO for the first time. For limb observations in the UV/VIS spectral region the instrument measures scattered light with a complex distribution of light paths: the light is measured at different tangent heights and can be scattered or absorbed in the atmosphere or reflected by the ground. By means of spectroscopy and radiative transfer modelling these measurements can be inverted to retrieve the vertical distribution of stratospheric trace gases.

    The fully spherical 3-D Monte Carlo radiative transfer model "Tracy-II" is applied in this study. The Monte Carlo method benefits from conceptual simplicity and allows realizing the concept of full spherical geometry of the atmosphere and also its 3-D properties, which is important for a realistic description of the limb geometry. Furthermore it allows accounting for horizontal gradients in the distribution of trace gases.

    In this study the effect of horizontally inhomogeneous distributions of trace gases along flight/viewing direction on the retrieval of profiles is investigated. We introduce a tomographic method to correct for this effect by combining consecutive limb scanning sequences and utilizing the overlap in their measurement sensitivity regions. It is found that if horizontal inhomogenity is not properly accounted for, typical errors of 20% for NO2 and up to 50% for OClO around the altitude of the profile peak can arise for measurements close to the Arctic polar vortex boundary in boreal winter.

  15. Issues for the selection of wheelchair-specific activity and participation outcome measures: a review.

    Science.gov (United States)

    Mortenson, William B; Miller, William C; Auger, Claudine

    2008-06-01

    To use the World Health Organization's International Classification of Functioning, Disability and Health as a framework to identify and to evaluate wheelchair-specific outcome instruments that are useful for measuring activity and participation. CINHAL, PsychInfo, EMBASE, Google Scholar, Dissertation Abstracts Medline databases, and conference proceedings. Activity and participation measures that were specifically intended for adults who use wheelchairs and that were published in English in a peer-reviewed journal were included in this review. Based on electronic database searches using a variety of search terms, articles were identified by title, and appropriate abstracts were retrieved. Articles were obtained for all relevant abstracts. For peer-reviewed measures included in the review, we obtained any instruction manuals and related publications, frequently published in conference proceedings and theses or available electronically, on the development and testing of the measure. Tools included in the review were evaluated based on their conceptual coverage, reliability, validity, responsiveness, usefulness, and wheelchair contribution, which indicated how well the tool isolated the effect of the wheelchair on activity and participation outcomes. A number of conceptual, psychometric, and applicability issues were identified with the 11 wheelchair-specific measures included in the review. A majority of the measures were mobility focused. No single tool received excellent ratings in all areas of the review. Some of the most frequent issues identified included a failure to account for differences attributable to different wheelchairs and wheelchair seating, limited psychometric testing, and high administrative and respondent burden. Good reliability evidence was reported for most of the measures, but validity information was only available for 6 of the 11 measures, and responsiveness information for 3. This review suggests that these measures could be improved with

  16. Transactional stress and coping theory in accounting for psychological states measures

    Directory of Open Access Journals (Sweden)

    V. Buško

    2007-08-01

    Full Text Available The paper examines a relative predictive value of some stable individual attributes and the processes of cognitive appraisals and coping with stress in accounting for specific components of anxiety state measures. Self-report instruments for the measurement of selected psychological constructs, i.e. perceived incompetence, externality, stress intensity and duration, situation-specific coping strategies, and the two anxiety state components, were taken in a sample of 449 male military basics trainees, ranging in age from 18-27. Hierarchical multiple regression analyses showed that the set of predictors employed could account for statistically, as well as theoretically and practically a significant part of variance in cognitive anxiety component (45,5%, and in visceral-emotional component (32,2% of the anxiety state. The extent of anxiety reactions assessed by both scales could primarily be explained by general perception of personal incompetence, as a relatively stable dimension of general self-concept. Of the ways of coping examined, reinterpretation of stressful events was the only strategy contributing to low level, whereas passivization, wishful thinking, and seeking social support contributed to higher levels of anxiety measured by both scales. The results give partial support to the basic hypotheses on the mediating role of coping in the relationships among particular components of the stress and coping models.

  17. Measuring the outcome of biomedical research: a systematic literature review.

    Directory of Open Access Journals (Sweden)

    Frédérique Thonon

    Full Text Available There is an increasing need to evaluate the production and impact of medical research produced by institutions. Many indicators exist, yet we do not have enough information about their relevance. The objective of this systematic review was (1 to identify all the indicators that could be used to measure the output and outcome of medical research carried out in institutions and (2 enlist their methodology, use, positive and negative points.We have searched 3 databases (Pubmed, Scopus, Web of Science using the following keywords: [Research outcome* OR research output* OR bibliometric* OR scientometric* OR scientific production] AND [indicator* OR index* OR evaluation OR metrics]. We included articles presenting, discussing or evaluating indicators measuring the scientific production of an institution. The search was conducted by two independent authors using a standardised data extraction form. For each indicator we extracted its definition, calculation, its rationale and its positive and negative points. In order to reduce bias, data extraction and analysis was performed by two independent authors.We included 76 articles. A total of 57 indicators were identified. We have classified those indicators into 6 categories: 9 indicators of research activity, 24 indicators of scientific production and impact, 5 indicators of collaboration, 7 indicators of industrial production, 4 indicators of dissemination, 8 indicators of health service impact. The most widely discussed and described is the h-index with 31 articles discussing it.The majority of indicators found are bibliometric indicators of scientific production and impact. Several indicators have been developed to improve the h-index. This indicator has also inspired the creation of two indicators to measure industrial production and collaboration. Several articles propose indicators measuring research impact without detailing a methodology for calculating them. Many bibliometric indicators identified

  18. The gross motor function measure is a valid and sensitive outcome measure for spinal muscular atrophy.

    Science.gov (United States)

    Nelson, Leslie; Owens, Hollis; Hynan, Linda S; Iannaccone, Susan T

    2006-06-01

    Spinal muscular atrophy is a genetic disease of the anterior horn cell with high morbidity rate in childhood. Certain drugs may be of benefit and are in or under consideration for Phase II trials. Outcome measures that are age appropriate and representative of disease activity remain under study. Several have not yet been validated for spinal muscular atrophy. The Gross Motor Function Measure is a measure of motor function. We showed previously that the Gross Motor Function Measure is a reliable outcome measure to assess motor function in children with spinal muscular atrophy. By collating our data from 40 spinal muscular atrophy patients, ages 5 through 17 years, we now show the validity of the Gross Motor Function Measure when compared to Quantitative Muscle Testing and ambulatory status in children with spinal muscular atrophy. The median for Gross Motor Function Measure total scores for walkers was 237 (range: 197-261) and for non-walkers, 64 (range: 4-177; PGross Motor Function Measure is valid and sensitive as an outcome measure for clinical trials in pediatric spinal muscular atrophy.

  19. The Relationship between Market and Accounting Determined Risk Measures: Reviewing and Updating the Beaver, Kettler, Scholes (1970) Study

    Science.gov (United States)

    Jarvela, Michael; Kozyra, James; Potter, Carla

    2009-01-01

    The association between market-determined risk measures and accounting-determined risk measures was originally explored in the 1970s by Beaver, Kettler, and Scholes (BKS). The results of the BKS (1970) study suggest that accounting information is usefulness in assessing firm specific risk. Since BKS, there have been few studies conducted to…

  20. Whose Accountability Is It? Conceptual Metaphor and Affinity for Learning Outcomes Based Accountability: Comparisons between California PreK-12 and Higher Education Leaders

    Science.gov (United States)

    Blizzard, Devin Dag

    2010-01-01

    The strength of leaders' identification with education accountability language framed by Conceptual Metaphor (Lakoff & Johnson, 2002) was evaluated across California PreK-12 and Higher Education groups. Survey and short-answer data from 549 California college deans, college presidents, PreK-12 superintendents, and PreK-12 school principals…

  1. Refining estimates of public health spending as measured in national health expenditure accounts: the Canadian experience.

    Science.gov (United States)

    Ballinger, Geoff

    2007-01-01

    The recent focus on public health stemming from, among other things, severe acute respiratory syndrome and avian flu has created an imperative to refine health-spending estimates in the Canadian Health Accounts. This article presents the Canadian experience in attempting to address the challenges associated with developing the needed taxonomies for systematically capturing, measuring, and analyzing the national investment in the Canadian public health system. The first phase of this process was completed in 2005, which was a 2-year project to estimate public health spending based on a more classic definition by removing the administration component of the previously combined public health and administration category. Comparing the refined public health estimate with recent data from the Organization for Economic Cooperation and Development still positions Canada with the highest share of total health expenditure devoted to public health than any other country reporting. The article also provides an analysis of the comparability of public health estimates across jurisdictions within Canada as well as a discussion of the recommendations for ongoing improvement of public health spending estimates. The Canadian Institute for Health Information is an independent, not-for-profit organization that provides Canadians with essential statistics and analysis on the performance of the Canadian health system, the delivery of healthcare, and the health status of Canadians. The Canadian Institute for Health Information administers more than 20 databases and registries, including Canada's Health Accounts, which tracks historically 40 categories of health spending by 5 sources of finance for 13 provincial and territorial jurisdictions. Until 2005, expenditure on public health services in the Canadian Health Accounts included measures to prevent the spread of communicable disease, food and drug safety, health inspections, health promotion, community mental health programs, public

  2. Material accountancy measurement techniques in dry-powdered processing of nuclear spent fuels.

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, S. F.

    1999-03-24

    The paper addresses the development of inductively coupled plasma-mass spectrometry (ICPMS), thermal ionization-mass spectrometry (TIMS), alpha-spectrometry, and gamma spectrometry techniques for in-line analysis of highly irradiated (18 to 64 GWD/T) PWR spent fuels in a dry-powdered processing cycle. The dry-powdered technique for direct elemental and isotopic accountancy assay measurements was implemented without the need for separation of the plutonium, uranium and fission product elements in the bulk powdered process. The analyses allow the determination of fuel burn-up based on the isotopic composition of neodymium and/or cesium. An objective of the program is to develop the ICPMS method for direct fissile nuclear materials accountancy in the dry-powdered processing of spent fuel. The ICPMS measurement system may be applied to the KAERI DUPIC (direct use of spent PWR fuel in CANDU reactors) experiment, and in a near-real-time mode for international safeguards verification and non-proliferation policy concerns.

  3. Measure of Information Content of Remotely Sensed Images Accounting for Spatial Correlation

    Directory of Open Access Journals (Sweden)

    ZHANG Ying

    2015-10-01

    Full Text Available A measure is proposed based on the information theory and geostatistics to evaluate information content in remotely sensed images. The method is based on the additive noise model and maximum mutual information.These factors affecting the information content have been taken into account, such as noise, spatial correlation and so on. It is suitable for measuring the information content in optical images that have robust spatial correlation with different land cover types. An experiment was performed on a Landsat TM image with three different kinds of land cover types (city, farmland and mountain. The result shows that city has the most information content. It also proves that there is a log positive correlation between information content and the variance of the images.

  4. Measuring cognitive outcomes in a pre-clinical bioethics course.

    Science.gov (United States)

    Fernandes, Ashley K; Borges, Nicole; Rodabaugh, Heather

    2012-05-01

    Medical schools universally accept the idea that bioethics courses are essential components of education, but few studies which measure outcomes (i.e., knowledge or retention) have demonstrated their educational value in the literature. The goal of this study was to examine whether core concepts of a pre-clinical bioethics course were learned and retained. Over the course of 2 years, a pre-test comprising 25 multiple-choice questions was administered to two classes (2008-2010) of first-year medical students prior to the start of a 15-week ethics course, and an identical post-test was administered at the end of the course. A total of 189 students participated. Paired t tests showed a significant difference between pre-test scores and post-test scores. The pre-test average score was 69.8 %, and the post-test average was 82.6 %, an increase of 12.9 % after the ethics course. The pre- and post-test results also suggested a shift in difficulty level of the questions, with students finding identical questions easier after the intervention. Given the increase in post-test scores after the 15-week intervention, the study suggests that core concepts in medical ethics were learned and retained. These results demonstrate that an introductory bioethics course can improve short-term outcomes in knowledge and comprehension, and should provide impetus to educators to demonstrate improved educational outcomes in ethics at higher levels of B.S. Bloom's Taxonomy of Learning.

  5. Vision and vision-related outcome measures in multiple sclerosis.

    Science.gov (United States)

    Balcer, Laura J; Miller, David H; Reingold, Stephen C; Cohen, Jeffrey A

    2015-01-01

    Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis.

  6. SEIZURE SEVERITY AS AN ALTERNATIVE MEASURE OF OUTCOME IN EPILEPSY

    Directory of Open Access Journals (Sweden)

    Koraliya S. Todorova

    2013-07-01

    Full Text Available Seizure severity emerges as an important aspect of epilepsy. This is most relevant in refractory patients in whom complete remission of seizures is unlikely and reduced seizure severity may be a significant determinant of psychosocial well-being with a consequent improvement in quality of life (QOL. Thus a valid measure of seizure severity can serve both as an indicator of clinical outcome and as an evaluation tool of the interaction between seizures and the psychosocial complications of epilepsy.After a brief review of the most frequently used scales measuring seizure severity in adults with epilepsy we have explored the relationship between seizure severity and QOL in a set of 103 patients. Two self-evaluation questionnaires were applied: the Seizure Severity Questionnaire (SSQ and the Quality of Life in Epilepsy Inventory (QOLIE-31. The severity of the coexisting depression, an important confounder in the relationship between seizure severity and QOL, was assessed by the Hamilton Depression Rating Scale (HAMD-17.All domains of the Quality-of-Life in Epilepsy Inventory (QOLIE-31 correlated highly significantly with seizure severity (p≤0.01. The correlation was strong for the Overall score (r=-0.70; p≤0.001 and the Seizure worry domain (r=-0.71; p≤0.001. When the potentially confounding effect of depression was controlled for, the regression of seizure severity with the QOLIE-31 Overall score (P=0.001; R²=0.56 and the Seizure worry domain (P=0.001; R²=0.50 remained significant. These findings indicate that seizure severity is strongly associated with QOL in epilepsy and could be used as an alternative indicator of outcome in clinical research.

  7. Outcome Measures for Clinical Drug Trials in Autism

    Science.gov (United States)

    Aman, Michael G.; Novotny, Sherie; Samango-Sprouse, Carole; Lecavalier, Luc; Leonard, Elizabeth; Gadow, Kenneth D.; King, Bryan H.; Pearson, Deborah A.; Gernsbacher, Morton Ann; Chez, Michael

    2015-01-01

    This paper identifies instruments and measures that may be appropriate for randomized clinical trials in participants with autism spectrum disorders (ASDs). The Clinical Global Impressions scale was recommended for all randomized clinical trials. At this point, however, there is no “perfect” choice of outcome measure for core features of autism, although we will discuss five measures of potential utility. Several communication instruments are recommended, based in part on suitability across the age range. In trials where the intention is to alter core features of ASDs, adaptive behavior scales are also worthy of consideration. Several “behavior complexes” common to ASDs are identified, and instruments are recommended for assessment of these. Given the prevalence of cognitive impairment in ASDs, it is important to assess any cognitive effects, although cognitive data from ASD randomized clinical trials, thus far, are minimal. Guidance from trials in related pharmacologic areas and behavioral pharmacology may be helpful. We recommend routine elicitation of side effects, height and weight, vital signs, and (in the case of antipsychotics) extrapyramidal side-effects assessment. It is often appropriate to include laboratory tests and assessments for continence and sleep pattern. PMID:14999174

  8. Objective versus subjective outcome measures of biofeedback: what really matters?

    Science.gov (United States)

    Berry, Amanda; Rudick, Kristen; Richter, Meg; Zderic, Stephen

    2014-08-01

    Clinical epidemiologic studies suggest that once established, voiding dysfunction can become a lifelong condition if not treated correctly early on in life. Biofeedback is one component of a voiding retraining program to help children with voiding dysfunction. Our goal was to compare objective non-invasive urodynamic data obtained during office biofeedback sessions with patient reported voiding symptom scores. Charts of 55 children referred in 2010 for pelvic floor muscle biofeedback therapy for urinary incontinence were retrospectively reviewed. Patients with any anatomic diagnoses were excluded. Forty-seven (86%) females and eight males (14%) with a mean age of 8.2 years made up the cohort. Uroflow curves, voided volumes, and post-void residuals were recorded at each visit and served as objective data. Volumes were normalized as a percentage of expected bladder capacity according to age. The patient reported symptom score and patient reported outcome (improved, no change or worse) served as subjective measures of intervention. The primary referral diagnoses were day and night wetting in 37 (67%) and daytime incontinence in 18 (33%) children. A history of urinary tract infection (UTI) was noted in 32 (64%) patients, and 25% were maintained on antibiotic prophylaxis during the study period. Twenty-nine percent were maintained on anticholinergic medication. Patients attended an average of 2.5 biofeedback sessions. Voided volumes and post void residual volumes were unchanged, 50% of the abnormal uroflow curves normalized over the course of treatment (p biofeedback were rated an improved in 26 (47%), no change in 15 (27%), worse in three (5%) patients, and not rated in 11 patients (21%). Pelvic floor muscle biofeedback is associated with patient-reported improvement in symptoms, reduction in voiding symptom score, and normalization of uroflow curves, but these improvements are not correlated with objective parameters of voided volumes and post-void residual urine

  9. Use of calorimetric assay for operational and accountability measurements of pure plutonium metal

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Teresa L [Los Alamos National Laboratory; Sampson, Thomas E [Los Alamos National Laboratory

    2010-01-01

    Plutonium pure metal products (PMP) are high purity plutonium metal items produced by electrorefining. The plutonium metal is produced as an approximately 3-kg ring. Accountability measurements for the electro-refining runs are typically balance/weight factor (incoming impure metal), chemistry (pure metal rings), and calorimetric assay or neutron counting of the crucibles and other wastes. The PMP items are qualified for their end use by extensive chemical assay. After PMP materials are made they are often sent to the vault for storage before being sent to the casting process, the next step in the production chain. The chemical assay of PMP items often takes a few weeks; however, before the metal items are allowed into the vault they must be measured. Non-destructive assay personnel measure the metals either by multiplicity neutron counting or calorimetric assay, depending on which instrument is available, thus generating comparisons between non-destructive assay and chemical assay. The suite of measurements, calorimetric assay, chemical assay, and neutron mUltiplicity counting is compared for a large group of PMP items.

  10. A psychometric analysis of outcome measures in peripheral spondyloarthritis

    Science.gov (United States)

    Turina, Maureen C; Baeten, Dominique L; Mease, Philip; Paramarta, Jacqueline E; Song, In-Ho; Pangan, Aileen L; Landewé, Robert

    2016-01-01

    Objectives To assess the discriminatory capacity of various outcome measures and response criteria in patients with peripheral spondyloarthritis (pSpA). Methods Data originated from two randomised controlled trials, ABILITY-2 and Tnf Inhibition in PEripheral SpondyloArthritis (TIPES). Continuous outcome measures included patient's global assessment (PGA)/physician's global assessment of disease (PhGA), C-reactive protein (CRP), tender joint counts (TJC)/swollen joint counts (SJC), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Ankylosing Spondylitis Disease Activity Score (ASDAS). Dichotomous response criteria included Peripheral SpondyloArthritis Response Criteria (PSpARC), American College of Rheumatology (ACR), ASDAS and BASDAI response criteria. The capacity to discriminate between adalimumab and placebo groups was assessed by standardised mean differences (SMD) for continuous variables, and Pearson's χ2 for dichotomous response criteria. Results Within each trial, the composite indices for axial SpA assessment, ASDAS-CRP (SMD: −0.63 and −0.89 in ABILITY-2 and the TIPES trial, respectively) and BASDAI (SMD: −0.50 and −0.73), and the single-item measures PGA (SMD: −0.47 and −1.12) and PhGA (SMD: −0.64 and −0.87) performed better than other single-item measures, such as CRP (SMD: −0.18 and −0.53), SJC or TJC. In general, the PSpARC and ACR response criteria discriminated better than ASDAS and BASDAI response criteria. Conclusions The axial SpA-specific ASDAS-CRP and BASDAI, but also PGA and PhGA, demonstrated good discriminatory ability in patients with pSpA. The pSpA-specific pSpARC response criteria and the rheumatoid arthritis-specific ACR response criteria also discriminated well. To fully capture typical pSpA manifestations, it may be worth developing new pSpA-specific indices with better performance and face validity. Trial registration numbers ABILITY-2: NCT01064856; TIPES: EUDRACT 2008-006885-27. PMID:26245756

  11. Selection effects may account for better outcomes of the German Disease Management Program for type 2 diabetes

    Directory of Open Access Journals (Sweden)

    van den Bussche Hendrik

    2010-12-01

    Full Text Available Abstract Background The nationwide German disease management program (DMP for type 2 diabetes was introduced in 2003. Meanwhile, results from evaluation studies were published, but possible baseline differences between DMP and usual-care patients have not been examined. The objective of our study was therefore to find out if patient characteristics as socio-demographic variables, cardiovascular risk profile or motivation for life style changes influence the chance of being enrolled in the German DMP for type 2 diabetes and may therefore account for outcome differences between DMP and usual-care patients. Methods Case control study comparing DMP patients with usual-care patients at baseline and follow up; mean follow-up period of 36 ± 14 months. We used chart review data from 51 GP surgeries. Participants were 586 DMP and 250 usual-care patients with type 2 diabetes randomly selected by chart registry. Data were analysed by multivariate logistic and linear regression analyses. Significance levels were p ≤ 0.05. Results There was a better chance for enrolment if patients a had a lower risk status for diabetes complications, i.e. non-smoking (odds ratio of 1.97, 95% confidence interval of 1.11 to 3.48 and lower systolic blood pressure (1.79 for 120 mmHg vs. 160 mmHg, 1.15 to 2.81; b had higher activity rates, i.e. were practicing blood glucose self-monitoring (1.67, 1.03 to 2.76 and had been prescribed a diabetes patient education before enrolment (2.32, 1.29 to 4.19 c were treated with oral medication (2.17, 1.35 to 3.49 and d had a higher GP-rated motivation for diabetes education (4.55 for high motivation vs. low motivation, 2.21 to 9.36. Conclusions At baseline, future DMP patients had a lower risk for diabetes complications, were treated more intensively and were more active and motivated in managing their disease than usual-care patients. This finding a points to the problem that the German DMP may not reach the higher risk patients and b

  12. Estimating the acute health effects of coarse particulate matter accounting for exposure measurement error.

    Science.gov (United States)

    Chang, Howard H; Peng, Roger D; Dominici, Francesca

    2011-10-01

    In air pollution epidemiology, there is a growing interest in estimating the health effects of coarse particulate matter (PM) with aerodynamic diameter between 2.5 and 10 μm. Coarse PM concentrations can exhibit considerable spatial heterogeneity because the particles travel shorter distances and do not remain suspended in the atmosphere for an extended period of time. In this paper, we develop a modeling approach for estimating the short-term effects of air pollution in time series analysis when the ambient concentrations vary spatially within the study region. Specifically, our approach quantifies the error in the exposure variable by characterizing, on any given day, the disagreement in ambient concentrations measured across monitoring stations. This is accomplished by viewing monitor-level measurements as error-prone repeated measurements of the unobserved population average exposure. Inference is carried out in a Bayesian framework to fully account for uncertainty in the estimation of model parameters. Finally, by using different exposure indicators, we investigate the sensitivity of the association between coarse PM and daily hospital admissions based on a recent national multisite time series analysis. Among Medicare enrollees from 59 US counties between the period 1999 and 2005, we find a consistent positive association between coarse PM and same-day admission for cardiovascular diseases.

  13. Accounting for baseline differences and measurement error in the analysis of change over time.

    Science.gov (United States)

    Braun, Julia; Held, Leonhard; Ledergerber, Bruno

    2014-01-15

    If change over time is compared in several groups, it is important to take into account baseline values so that the comparison is carried out under the same preconditions. As the observed baseline measurements are distorted by measurement error, it may not be sufficient to include them as covariate. By fitting a longitudinal mixed-effects model to all data including the baseline observations and subsequently calculating the expected change conditional on the underlying baseline value, a solution to this problem has been provided recently so that groups with the same baseline characteristics can be compared. In this article, we present an extended approach where a broader set of models can be used. Specifically, it is possible to include any desired set of interactions between the time variable and the other covariates, and also, time-dependent covariates can be included. Additionally, we extend the method to adjust for baseline measurement error of other time-varying covariates. We apply the methodology to data from the Swiss HIV Cohort Study to address the question if a joint infection with HIV-1 and hepatitis C virus leads to a slower increase of CD4 lymphocyte counts over time after the start of antiretroviral therapy.

  14. Novel mechanisms, treatments and outcome measures in childhood sleep

    Directory of Open Access Journals (Sweden)

    Annalisa eColonna

    2015-05-01

    Full Text Available Sleep disorders and sleep of insufficient duration and quality are on the increase due to changes in our lifestyle, particularly in children and adolescents. Sleep disruption is also more common in children with medical conditions, compounding their difficulties. Recent studies have focused on new mechanisms that explain how learning and cognitive performance depend on a good night’s sleep. Growing alongside this latest understanding is an innovative new field of non-drug interventions that improve sleep architecture, with resulting cognitive improvements. However, we need to rigorously evaluate such potentially popular and self-administered sleep interventions with equally state-of-the-art outcome measurement tools. Animated hand-held games, that incorporate embedded sleep-dependent learning tasks, promise to offer new robust methods of measuring changes in overnight learning. Portable computing technology has the potential to offer practical, inexpensive and reliable tools to indirectly assess the quality of sleep. They may be adopted in both clinical and educational settings, providing a unique way of monitoring the effect of sleep disruption on learning, leading also to a radical rethink of how we manage chronic diseases.

  15. Quantifying prosthetic gait deviation using simple outcome measures

    Science.gov (United States)

    Kark, Lauren; Odell, Ross; McIntosh, Andrew S; Simmons, Anne

    2016-01-01

    AIM: To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis (3DGA). METHODS: Eight unilateral, transfemoral amputees and 12 unilateral, transtibial amputees were recruited. Twenty-eight able-bodied controls were recruited. All participants underwent 3DGA, the timed-up-and-go test and the six-minute walk test (6MWT). The lower-limb amputees also completed the Prosthesis Evaluation Questionnaire. Results from 3DGA were summarised using the gait deviation index (GDI), which was subsequently regressed, using stepwise regression, against the other measures. RESULTS: Step-length (SL), self-selected walking speed (SSWS) and the distance walked during the 6MWT (6MWD) were significantly correlated with GDI. The 6MWD was the strongest, single predictor of the GDI, followed by SL and SSWS. The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility. CONCLUSION: This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA. PMID:27335814

  16. Outcome measures for primary Sjögren's syndrome.

    Science.gov (United States)

    Seror, Raphaèle; Bootsma, Hendrika; Bowman, Simon J; Dörner, Thomas; Gottenberg, Jacques-Eric; Mariette, Xavier; Ramos-Casals, Manel; Ravaud, Philippe; Theander, Elke; Tzioufas, Athanasios; Vitali, Claudio

    2012-08-01

    Lymphocytic infiltration of different exocrine and non-exocrine epithelia is the pathological hallmark of primary Sjögren's syndrome, whereas involvement of salivary and lachrymal glands with the clinical counterpart of dry eye and dry mouth are the predominant features of the disease, together with fatigue and musculoskeletal pain. In addition, systemic manifestations, like arthritis, skin vasculitis, peripheral neuropathy, glomerulonephritis, may also be present in a consistent number of patients. As result, clinical features in SS can be divided into two facets: the benign subjective but disabling manifestations such as dryness, pain and fatigue, and the systemic manifestations. In the past decades, a core set of domains, which included sicca symptoms, objective measurements of tear and saliva production, fatigue, quality of life, disease activity and damage was indicated as essential for outcome assessment in this disorder. Afterwards, great efforts have been made to develop valid tools for the assessment of different domains. Specific questionnaires such as the Profile of Fatigue and Discomfort (PROFAD) and Sicca Symptoms Inventory (SSI) have been proposed as dedicated tools for the evaluation of patients symptoms, whereas different composite indexes have been suggested for the assessment of disease activity and damage. Some of these preliminary studies served as bases of an international project supported by EULAR, aimed at developing two consensus disease activity indexes: the EULAR Sjögren's Syndrome Patients Reported Index (ESSPRI), and the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), a systemic activity index to assess systemic manifestations. A detailed and critical review of all these indexes is provided in this article. Both EULAR indexes showed, in recent studies, to be feasible, valid, and reliable instruments. After their final validation, which is currently in process, they could be used as consensus outcome criteria in therapeutic

  17. ACCOUNTING POLICIES AND OPTIONS ON THE RECOGNITION, MEASUREMENT AND DERECOGNITION OF INVENTORIES IN PUBLIC SECTOR ENTITIES

    Directory of Open Access Journals (Sweden)

    CRISTINA OTILIA ȚENOVICI

    2012-11-01

    Full Text Available International accounting harmonization focuses on improving and reducing the differences between national accounting regulations concerning accounting rules and principles, of general interest, likely to determine the comparability of information in financial statements of institutions, respectively to reduce differences among accounting regulations of different countries. The reference system for drafting accounting policies allows alternatives for accounting registration and assessment, respectively different methods of assessing the patrimony, the result and financial position. The choice of an accounting option is determined by the need to provide a clear financial image on the position and performance of the institution. Thus, for stock assessment they choose the accounting policy likely to provide relevant, reliable, neutral, prudent and complete information in all significant respects by means of with the financial statements.

  18. 77 FR 60945 - 2012-2013 Accountability Measure and Closure for Commercial Black Sea Bass in the South Atlantic

    Science.gov (United States)

    2012-10-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 RIN 0648-XC152 2012-2013 Accountability...; closure. SUMMARY: NMFS implements an accountability measure (AM) for the commercial sector of black...

  19. Routine outcome measurement in the Netherlands - A focus on benchmarking.

    Science.gov (United States)

    Delespaul, Philippe A E G

    2015-01-01

    Routine outcome measurement (ROM) is a 'hot' topic in the Netherlands. Over recent years the Netherlands have developed a centralized monitoring system for all reimbursed mental health interventions, in an attempt to improve the quality of care. The Foundation for Benchmarking Mental Health (SBG) is an independent knowledge centre for mental health providers and insurance companies. It was founded to organize and manage the countrywide ROM initiative. A Dutch countrywide ROM initiative is appealing, and the procedures in the Netherlands are described. However, the national ROM system was oversold. Arguments are discussed. It would have been a far better strategy if insurance companies and authorities had not focused on a national system but stimulated local data collection and requested a managerial plan-do-check-act (PDCA) cycle to stimulate service improvements from year to year. Within the same service, chances are higher that the same kind of clientele is served from year to year and therefore it will be easier to interpret the data. The ROM should regain its clinical focus. Mobile ROM systems using smartphones that collect sampled experiences could be an interesting future solution.

  20. Sensitivity as outcome measure of androgen replacement: the AMS scale

    Directory of Open Access Journals (Sweden)

    Dinger Juergen C

    2006-03-01

    Full Text Available Abstract Background The capacity of the AMS scale as clinical utility and as outcome measure still needs validation. Methods An open post-marketing study was performed by office-based physicians in Germany in 2004. We analysed data of 1670 androgen-deficient males who were treated with testosterone gel. The AMS scale was applied prior to and after 3 months treatment. Results The improvement of complaints under treatment relative to the baseline score was 30.7% (total score, 27.3% (psychological domain, 30.5% (somatic domain, and 30.7% (sexual domain, respectively. Patients with little or no symptoms before therapy improved by 9%, those with mild complaints at entry by 24%, with moderate by 32%, and with severe symptoms by 39% – compared with the baseline score. We showed that the distribution of complaints of testosterone deficient men before therapy almost returned to norm values after 12 weeks of testosterone treatment. Age, BMI, and total testosterone level at baseline did not modify the positive effect of androgen therapy. We also demonstrated that the AMS results can predict the independent (physician's opinion about the individual treatment effect. Both, sensitivity (correct prediction of a positive assessment by the physician and specificity (correct prediction of a negative assessment by the physician were over 70%, if about 22% improvement of the AMS total score was used as cut-off point. Conclusion The AMS scale showed a convincing ability to measure treatment effects on quality of life across the full range of severity of complaints. Effect modification by other variables at baseline was not observed. In addition, results of the scale can predict the subjective clinical expert opinion on the treatment efficiency.

  1. Materials accounting in a fast-breeder-reactor fuels-reprocessing facility: optimal allocation of measurement uncertainties

    Energy Technology Data Exchange (ETDEWEB)

    Dayem, H.A.; Ostenak, C.A.; Gutmacher, R.G.; Kern, E.A.; Markin, J.T.; Martinez, D.P.; Thomas, C.C. Jr.

    1982-07-01

    This report describes the conceptual design of a materials accounting system for the feed preparation and chemical separations processes of a fast breeder reactor spent-fuel reprocessing facility. For the proposed accounting system, optimization techniques are used to calculate instrument measurement uncertainties that meet four different accounting performance goals while minimizing the total development cost of instrument systems. We identify instruments that require development to meet performance goals and measurement uncertainty components that dominate the materials balance variance. Materials accounting in the feed preparation process is complicated by large in-process inventories and spent-fuel assembly inputs that are difficult to measure. To meet 8 kg of plutonium abrupt and 40 kg of plutonium protracted loss-detection goals, materials accounting in the chemical separations process requires: process tank volume and concentration measurements having a precision less than or equal to 1%; accountability and plutonium sample tank volume measurements having a precision less than or equal to 0.3%, a shortterm correlated error less than or equal to 0.04%, and a long-term correlated error less than or equal to 0.04%; and accountability and plutonium sample tank concentration measurements having a precision less than or equal to 0.4%, a short-term correlated error less than or equal to 0.1%, and a long-term correlated error less than or equal to 0.05%. The effects of process design on materials accounting are identified. Major areas of concern include the voloxidizer, the continuous dissolver, and the accountability tank.

  2. Materials accounting in a fast-breeder-reactor fuels-reprocessing facility: optimal allocation of measurement uncertainties

    Energy Technology Data Exchange (ETDEWEB)

    Dayem, H.A.; Ostenak, C.A.; Gutmacher, R.G.; Kern, E.A.; Markin, J.T.; Martinez, D.P.; Thomas, C.C. Jr.

    1982-07-01

    This report describes the conceptual design of a materials accounting system for the feed preparation and chemical separations processes of a fast breeder reactor spent-fuel reprocessing facility. For the proposed accounting system, optimization techniques are used to calculate instrument measurement uncertainties that meet four different accounting performance goals while minimizing the total development cost of instrument systems. We identify instruments that require development to meet performance goals and measurement uncertainty components that dominate the materials balance variance. Materials accounting in the feed preparation process is complicated by large in-process inventories and spent-fuel assembly inputs that are difficult to measure. To meet 8 kg of plutonium abrupt and 40 kg of plutonium protracted loss-detection goals, materials accounting in the chemical separations process requires: process tank volume and concentration measurements having a precision less than or equal to 1%; accountability and plutonium sample tank volume measurements having a precision less than or equal to 0.3%, a shortterm correlated error less than or equal to 0.04%, and a long-term correlated error less than or equal to 0.04%; and accountability and plutonium sample tank concentration measurements having a precision less than or equal to 0.4%, a short-term correlated error less than or equal to 0.1%, and a long-term correlated error less than or equal to 0.05%. The effects of process design on materials accounting are identified. Major areas of concern include the voloxidizer, the continuous dissolver, and the accountability tank.

  3. Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

    DEFF Research Database (Denmark)

    Terslev, Lene; Gutierrez, Marwin; Schmidt, Wolfgang A

    2015-01-01

    OBJECTIVE: To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout. METHODS: Based on the lack of definitions, highlighted in a recent literature review on US as an outcome tool...

  4. Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

    Science.gov (United States)

    Zainuba, Mohamed; Rahal, Ahmad

    2012-01-01

    This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures…

  5. Measuring, comparing and improving clinical outcomes in gastrointestinal cancer surgery

    NARCIS (Netherlands)

    Henneman, D.

    2016-01-01

    In this thesis, hospital variation concerning various surgical outcomes is illustrated, thereby exploring the usability of these outcomes for hospital comparisons, both from a clinical and methodological point of view. Moreover, the studies provide insight in risk factors for adverse events in color

  6. Measuring, comparing and improving clinical outcomes in gastrointestinal cancer surgery

    OpenAIRE

    Henneman, D.

    2016-01-01

    In this thesis, hospital variation concerning various surgical outcomes is illustrated, thereby exploring the usability of these outcomes for hospital comparisons, both from a clinical and methodological point of view. Moreover, the studies provide insight in risk factors for adverse events in colorectal and oesophageal cancer surgery, focusing on the mechanism behind postoperative complications leading to mortality or not.

  7. Material control in nuclear fuel fabrication facilities. Part II. Accountability, instrumentation and measurement techniques in fuel fabrication facilities

    Energy Technology Data Exchange (ETDEWEB)

    Borgonovi, G.M.; McCartin, T.J.; McDaniel, T.; Miller, C.L.; Nguyen, T.

    1978-01-01

    This report describes the measurement techniques, the instrumentation, and the procedures used in accountability and control of nuclear materials, as they apply to fuel fabrication facilities. A general discussion is given of instrumentation and measurement techniques which are presently used being considered for fuel fabrication facilities. Those aspects which are most significant from the point of view of satisfying regulatory constraints have been emphasized. Sensors and measurement devices have been discussed, together with their interfacing into a computerized system designed to permit real-time data collection and analysis. Estimates of accuracy and precision of measurement techniques have been given, and, where applicable, estimates of associated costs have been presented. A general description of material control and accounting is also included. In this section, the general principles of nuclear material accounting have been reviewed first (closure of material balance). After a discussion of the most current techniques used to calculate the limit of error on inventory difference, a number of advanced statistical techniques are reviewed. The rest of the section deals with some regulatory aspects of data collection and analysis, for accountability purposes, and with the overall effectiveness of accountability in detecting diversion attempts in fuel fabrication facilities. A specific example of application of the accountability methods to a model fuel fabrication facility is given. The effect of random and systematic errors on the total material uncertainty has been discussed, together with the effect on uncertainty of the length of the accounting period.

  8. Reliability assessment of a hospital quality measure based on rates of adverse outcomes on nursing units.

    Science.gov (United States)

    Staggs, Vincent S

    2015-12-31

    The purpose of this study was to develop methods for assessing the reliability of scores on a widely disseminated hospital quality measure based on nursing unit fall rates. Poisson regression interactive multilevel modeling was adapted to account for clustering of units within hospitals. Three signal-noise reliability measures were computed. Squared correlations between the hospital score and true hospital fall rate averaged 0.52 ± 0.18 for total falls (0.68 ± 0.18 for injurious falls). Reliabilities on the other two measures averaged at least 0.70 but varied widely across hospitals. Parametric bootstrap data reflecting within-unit noise in falls were generated to evaluate percentile-ranked hospital scores as estimators of true hospital fall rate ranks. Spearman correlations between bootstrap hospital scores and true fall rates averaged 0.81 ± 0.01 (0.79 ± 0.01). Bias was negligible, but ranked hospital scores were imprecise, varying across bootstrap samples with average SD 11.8 (14.9) percentiles. Across bootstrap samples, hospital-measure scores fell in the same decile as the true fall rate in about 30% of cases. Findings underscore the importance of thoroughly assessing reliability of quality measurements before deciding how they will be used. Both the hospital measure and the reliability methods described can be adapted to other contexts involving clustered rates of adverse patient outcomes. © The Author(s) 2015.

  9. The role of cost accounting in the university performance measurement in Portugal

    OpenAIRE

    Marques,Maria da Conceição da Costa

    2010-01-01

    Cost accounting is aimed at emphasising those elements of costs and profits of original importance to the management board of an organizational unit. Therefore, cost accounting was initially understood as mere collector of costs and profits, using the traditional system of costing everything, a budget with a limited base. Originally, it was designed to calculate real costs with the aim to determine the results. In public organizations, the aim of cost accounting, costs or management, c...

  10. Measuring outcomes in orthopaedics: implementation of an outcomes program in an outpatient orthopaedic practice.

    Science.gov (United States)

    Rodts, Mary F; Glanzman, Renée; Gray, Adam; Johnson, Randal; Viellieu, Dennis; Hachem, Fadi

    2014-01-01

    With increased demand to provide quality care for patients, orthopaedic practices will need to develop ways to efficiently collect and manage data to support the care that they provide. An outcomes management program must be efficient and consistent to provide good data. This article describes the implementation of an outcomes program at one large private orthopaedic practice within an academic medical setting.

  11. Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures

    Directory of Open Access Journals (Sweden)

    Mallory Devon

    2006-11-01

    Full Text Available Abstract Background Central to the development of a sound evidence base for Complementary and Alternative Medicine (CAM interventions is the need for valid, reliable and relevant outcome measures to assess whether the interventions work. We assessed the specific needs for a database that would cover a wide range of outcomes measures for CAM research and considered a framework for such a database. Methods The study was a survey of CAM researchers, practitioners and students. An online questionnaire was emailed to the members of the Canadian Interdisciplinary Network for CAM Research (IN-CAM and the CAM Education and Research Network of Alberta (CAMera. The majority of survey questions were open-ended and asked about outcome measures currently used, outcome measures' assessment criteria, sources of information, perceived barriers to finding outcome measures and outcome domains of importance. Descriptive quantitative analysis and qualitative content analysis were used. Results One hundred and sixty-four completed surveys were received. Of these, 62 respondents reported using outcome measures in their CAM research and identified 92 different specific outcomes. The most important barriers were the fact that, for many health concepts, outcome measures do not yet exist, as well as issues related to accessibility of instruments. Important outcome domains identified included physical, psychological, social, spiritual, quality of life and holistic measures. Participants also mentioned the importance of individualized measures that assess unique patient-centered outcomes for each research participant, and measures to assess the context of healing and the process of healing. Conclusion We have developed a preliminary framework that includes all components of health-related outcomes. The framework provides a foundation for a larger, comprehensive collection of CAM outcomes. It fits very well in a whole systems perspective, which requires an expanded set of

  12. Measuring Networking as an Outcome Variable in Undergraduate Research Experiences.

    Science.gov (United States)

    Hanauer, David I; Hatfull, Graham

    2015-01-01

    The aim of this paper is to propose, present, and validate a simple survey instrument to measure student conversational networking. The tool consists of five items that cover personal and professional social networks, and its basic principle is the self-reporting of degrees of conversation, with a range of specific discussion partners. The networking instrument was validated in three studies. The basic psychometric characteristics of the scales were established by conducting a factor analysis and evaluating internal consistency using Cronbach's alpha. The second study used a known-groups comparison and involved comparing outcomes for networking scales between two different undergraduate laboratory courses (one involving a specific effort to enhance networking). The final study looked at potential relationships between specific networking items and the established psychosocial variable of project ownership through a series of binary logistic regressions. Overall, the data from the three studies indicate that the networking scales have high internal consistency (α = 0.88), consist of a unitary dimension, can significantly differentiate between research experiences with low and high networking designs, and are related to project ownership scales. The ramifications of the networking instrument for student retention, the enhancement of public scientific literacy, and the differentiation of laboratory courses are discussed. © 2015 D. I. Hanauer and G. Hatfull. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  13. Effects of a social accountability approach, CARE’s Community Score Card, on reproductive health-related outcomes in Malawi: A cluster-randomized controlled evaluation

    Science.gov (United States)

    Galavotti, Christine; Sebert Kuhlmann, Anne; Msiska, Thumbiko; Hastings, Phil; Marti, C. Nathan

    2017-01-01

    Background Social accountability approaches, which emphasize mutual responsibility and accountability by community members, health care workers, and local health officials for improving health outcomes in the community, are increasingly being employed in low-resource settings. We evaluated the effects of a social accountability approach, CARE’s Community Score Card (CSC), on reproductive health outcomes in Ntcheu district, Malawi using a cluster-randomized control design. Methods We matched 10 pairs of communities, randomly assigning one from each pair to intervention and control arms. We conducted two independent cross-sectional surveys of women who had given birth in the last 12 months, at baseline and at two years post-baseline. Using difference-in-difference (DiD) and local average treatment effect (LATE) estimates, we evaluated the effects on outcomes including modern contraceptive use, antenatal and postnatal care service utilization, and service satisfaction. We also evaluated changes in indicators developed by community members and service providers in the intervention areas. Results DiD analyses showed significantly greater improvements in the proportion of women receiving a home visit during pregnancy (B = 0.20, P accountability, and ensures that solutions to problems are locally-relevant, locally-supported and feasible to implement. PMID:28187159

  14. Hepatology may have problems with putative surrogate outcome measures

    DEFF Research Database (Denmark)

    Gluud, Christian; Brok, Jesper; Gong, Yan;

    2007-01-01

    hepatitis C, serum bilirubin concentration following ursodeoxycholic acid or immunosuppressants for patients with primary biliary cirrhosis, and nutritional outcomes following artificial nutrition for liver patients may not be valid surrogates for morbidity or mortality. The challenge is to develop reliable...

  15. A method to account for the temperature sensitivity of TCCON total column measurements

    Science.gov (United States)

    Niebling, Sabrina G.; Wunch, Debra; Toon, Geoffrey C.; Wennberg, Paul O.; Feist, Dietrich G.

    2014-05-01

    The Total Carbon Column Observing Network (TCCON) consists of ground-based Fourier Transform Spectrometer (FTS) systems all around the world. It achieves better than 0.25% precision and accuracy for total column measurements of CO2 [Wunch et al. (2011)]. In recent years, the TCCON data processing and retrieval software (GGG) has been improved to achieve better and better results (e. g. ghost correction, improved a priori profiles, more accurate spectroscopy). However, a small error is also introduced by the insufficent knowledge of the true temperature profile in the atmosphere above the individual instruments. This knowledge is crucial to retrieve highly precise gas concentrations. In the current version of the retrieval software, we use six-hourly NCEP reanalysis data to produce one temperature profile at local noon for each measurement day. For sites in the mid latitudes which can have a large diurnal variation of the temperature in the lowermost kilometers of the atmosphere, this approach can lead to small errors in the final gas concentration of the total column. Here, we present and describe a method to account for the temperature sensitivity of the total column measurements. We exploit the fact that H2O is most abundant in the lowermost kilometers of the atmosphere where the largest diurnal temperature variations occur. We use single H2O absorption lines with different temperature sensitivities to gain information about the temperature variations over the course of the day. This information is used to apply a posteriori correction of the retrieved gas concentration of total column. In addition, we show that the a posteriori temperature correction is effective by applying it to data from Lamont, Oklahoma, USA (36,6°N and 97,5°W). We chose this site because regular radiosonde launches with a time resolution of six hours provide detailed information of the real temperature in the atmosphere and allow us to test the effectiveness of our correction. References

  16. Accounting for uncertainty in volumes of seabed change measured with repeat multibeam sonar surveys

    Science.gov (United States)

    Schimel, Alexandre C. G.; Ierodiaconou, Daniel; Hulands, Lachlan; Kennedy, David M.

    2015-12-01

    Seafloors of unconsolidated sediment are highly dynamic features; eroding or accumulating under the action of tides, waves and currents. Assessing which areas of the seafloor experienced change and measuring the corresponding volumes involved provide insights into these important active sedimentation processes. Computing the difference between Digital Elevation Models (DEMs) obtained from repeat Multibeam Echosounders (MBES) surveys has become a common technique to identify these areas, but the uncertainty in these datasets considerably affects the estimation of the volumes displaced. The two main techniques used to take into account uncertainty in volume estimations are the limitation of calculations to areas experiencing a change in depth beyond a chosen threshold, and the computation of volumetric confidence intervals. However, these techniques are still in their infancy and, as a result, are often crude, seldom used or poorly understood. In this article, we explored a number of possible methodological advances to address this issue, including: (1) using the uncertainty information provided by the MBES data processing algorithm CUBE, (2) adapting fluvial geomorphology techniques for volume calculations using spatially variable thresholds and (3) volumetric histograms. The nearshore seabed off Warrnambool harbour - located in the highly energetic southwest Victorian coast, Australia - was used as a test site. Four consecutive MBES surveys were carried out over a four-months period. The difference between consecutive DEMs revealed an area near the beach experiencing large sediment transfers - mostly erosion - and an area of reef experiencing increasing deposition from the advance of a nearby sediment sheet. The volumes of sediment displaced in these two areas were calculated using the techniques described above, both traditionally and using the suggested improvements. We compared the results and discussed the applicability of the new methodological improvements

  17. Indicators as an Instrument of Measurement in Management Accounting in Logistics Enterprises in Poland

    National Research Council Canada - National Science Library

    Justyna Dobroszek; Anna Szychta

    2015-01-01

    ... the concept of management accounting in the enterprises that were researched. Methodology: The research methods used by the authors included a literature review of mainly German and Polish publications and survey research conducted in 2011...

  18. Connecting Stuttering Management and Measurement: V. Deduction and Induction in the Development of Stuttering Treatment Outcome Measures and Stuttering Treatments

    Science.gov (United States)

    Onslow, Mark

    2006-01-01

    Background: The development of evidence-based practice, which is increasingly popular in stuttering treatment, is closely linked to the development of outcome measures. Aims: Two approaches to the development of stuttering treatment outcome measures are outlined. The first is the deductive, top-down approach, where the development of specific…

  19. Objective measures of subjective experience: the use of therapist notes in process-outcome research.

    Science.gov (United States)

    Bucci, Wilma; Maskit, Bernard; Hoffman, Leon

    2012-06-01

    Computerized linguistic measures of emotional engagement, and reflective and affective language, previously applied to session transcripts, were applied to notes of 14 treatments by candidates under supervision at the New York Psychoanalytic Society and Institute, covering the five decades from the 1950s to the 1990s. The findings indicate a strong relationship between candidates' subjective experience as represented unintentionally in the linguistic style of their case notes and the effectiveness of their clinical work. The treatments were evaluated for effectiveness by experienced clinicians using the Global Assessment of Functioning (GAF) and the Psychodynamic Functioning Scales of Høglend and colleagues; a Composite Clinical Effectiveness (CCE) measure was constructed based on level and change in these measures. The Mean High Weighted Referential Activity Dictionary (MHW), a computerized measure of emotional engagement developed in the framework of Bucci's theory of multiple coding and the referential process, showed a positive correlation of .73 with CCE. The Hostility subcategory of the Negative Affect Dictionary (ANH) showed a negative correlation, -.48, with CCE. In a multiple regression analysis, these two variables accounted for over three-quarters of the variance in the CCE. Implications of the findings for process/outcome research and supervision and evaluation of trainees are discussed.

  20. Management guidelines and outcome measures in polymyalgia rheumatica (PMR).

    Science.gov (United States)

    Dasgupta, B; Matteson, E L; Maradit-Kremers, H

    2007-01-01

    Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease of the elderly that is subject to wide variations in clinical practice and is managed both in the primary and secondary care settings by general practitioners, rheumatologists and non-rheumatologists. Considerable uncertainty exists relating to diagnosis, management and outcome in patients with PMR. The guidelines presented here seek to improve outcomes for PMR patients by outlining a process to ensure more accurate diagnosis and timely specialist referral. The guidelines are directed to promote more conservative treatment and to ensure early bone protection in order to reduce the common morbidity of osteoporotic fractures. Furthermore, these guidelines specify the goals of treatment, including clinical and patient-based outcomes, and provide advice concerning monitoring for disease activity and complications.

  1. Outcomes measurement in patients with head and neck cancer.

    Science.gov (United States)

    Gourin, Christine G

    2014-03-01

    Outcomes research is defined as clinical and population-based research that investigates the results of healthcare practices or interventions through the filter of the benefit to the patient and other stakeholders. Outcomes research is an increasingly important field or research, because of the pressing need for evidence-based information that can be used to make better informed health and healthcare decisions, and define desired health care practices in the current era of healthcare reform. This article will review the head and neck cancer (HNCA) outcomes literature published in the past year, with a focus on studies evaluating treatment and survival, short-term and long-term complications, and quality of life (QOL).

  2. A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials

    DEFF Research Database (Denmark)

    Juhl, Carsten Bogh; Lund, Hans; Guyatt, GH

    2010-01-01

    Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta-analyses ......Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta...

  3. Longitudinal evaluation of patient-reported outcomes measurement information systems measures in pediatric chronic pain.

    Science.gov (United States)

    Kashikar-Zuck, Susmita; Carle, Adam; Barnett, Kimberly; Goldschneider, Kenneth R; Sherry, David D; Mara, Constance A; Cunningham, Natoshia; Farrell, Jennifer; Tress, Jenna; DeWitt, Esi Morgan

    2016-02-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS) initiative is a comprehensive strategy by the National Institutes of Health to support the development and validation of precise instruments to assess self-reported health domains across healthy and disease-specific populations. Much progress has been made in instrument development, but there remains a gap in the validation of PROMIS measures for pediatric chronic pain. The purpose of this study was to investigate the construct validity and responsiveness to change of 7 PROMIS domains for the assessment of children (ages: 8-18) with chronic pain--Pain Interference, Fatigue, Anxiety, Depression, Mobility, Upper Extremity Function, and Peer Relationships. The PROMIS measures were administered at the initial visit and 2 follow-up visits at an outpatient chronic pain clinic (CPC; N = 82) and at an intensive amplified musculoskeletal pain day-treatment program (N = 63). Aim 1 examined construct validity of PROMIS measures by comparing them with corresponding "legacy" measures administered as part of usual care in the CPC sample. Aim 2 examined sensitivity to change in both CPC and amplified musculoskeletal pain samples. Longitudinal growth models showed that PROMIS' Pain Interference, Anxiety, Depression, Mobility, Upper Extremity, and Peer Relationship measures and legacy instruments generally performed similarly with slightly steeper slopes of improvement in legacy measures. All 7 PROMIS domains showed responsiveness to change. Results offered initial support for the validity of PROMIS measures in pediatric chronic pain. Further validation with larger and more diverse pediatric pain samples and additional legacy measures would broaden the scope of use of PROMIS in clinical research.

  4. Quality of life as an outcome measure in surgical oncology

    NARCIS (Netherlands)

    Langenhoff, B S; Krabbe, P F; Wobbes, T; Ruers, T J

    2001-01-01

    BACKGROUND: There is a growing interest in assessing the impact of a disease and the effect of a treatment on a patient's life, expressed as health-related quality of life (HRQoL). HRQoL assessment can provide essential outcome information for cancer surgery. METHODS: The core of this review is deri

  5. Outcome Measures of Triple Board Graduates, 1991-2003

    Science.gov (United States)

    Warren, Marla J.; Dunn, David W.; Rushton, Jerry

    2006-01-01

    Objective: To describe program outcomes for the Combined Training Program in Child and Adolescent Psychiatry, Pediatrics, and Psychiatry (Triple Board Program). Method: All Triple Board Program graduates to date (1991-2003) were asked to participate in a 37-item written survey from February to April 2004. Results: The response rate was 80.7%. Most…

  6. Quality of care in systemic lupus erythematosus: the association between process and outcome measures in the Lupus Outcomes Study.

    Science.gov (United States)

    Yazdany, Jinoos; Trupin, Laura; Schmajuk, Gabriela; Katz, Patricia P; Yelin, Edward H

    2014-08-01

    Although process measures to assess quality of care in systemic lupus erythematosus (SLE) are available, their relationship to long-term outcomes has not been studied. Using a prospective, longitudinal cohort study, we examined the associations between high-quality care and two important SLE outcomes, disease activity and damage. Data were derived from the University of California, San Francisco Lupus Outcomes Study. Participants were followed from 2009 through 2013, responding to yearly surveys. Primary outcomes in this study were clinically meaningful increases in disease activity and damage, assessed by the Systemic Lupus Activity Questionnaire (SLAQ) and the Brief Index of Lupus Damage (BILD), respectively. Using multivariable regression, we examined the relationship between high performance on 13 validated quality measures (receipt of ≥85% of quality measures), and disease outcomes, adjusting for disease status, sociodemographic characteristics, healthcare services and follow-up time. The 737 participants were eligible for a mean of five quality measures (SD 2, range 2-12). There were 155 and 162 participants who had clinically meaningful increases in SLAQ and BILD, respectively. In our models, we found no statistically significant relationship between performance on quality measures and changes in SLAQ. However, receiving higher-quality SLE care was significantly protective against increased disease damage (adjusted OR 0.4, 95% CI 0.4 to 0.7), even after adjusting for covariates. In this community-based cohort, we illustrate for the first time a strong link between processes of care, defined by SLE quality measures, and the subsequent accumulation of disease damage, an important outcome. 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.

  7. Fair value or cost-based measurement for PPE and IP: evidence from accounting practice under IFRS

    OpenAIRE

    Fonseca, Maria

    2007-01-01

    Some standards permit a choice between different measurement bases. IAS 16 and IAS 40 allow entities to choose between fair value and cost-based measurement for property, plant and equipment (PPE) and investment property (IP), respectively. This study analyzes the accounting practice concerning measurement of PPE and IP after recognition, under IFRS. The sample was extracted from stock exchange listed European companies included in the S&P Europe 350 Index. Data was hand collec...

  8. Measuring Performance for Accountability of a Small Social Economy Organization: The Case of an Independent School

    Directory of Open Access Journals (Sweden)

    Steven M. Smith

    2011-01-01

    Full Text Available This article is a result of a joint project in social economy research between a community partner-an independent school-and academic partners. The school is a democratic organization, run by teachers and parents. The goal of the project was to find ways to improve communication and reporting about general performance of the school as part of the school's accountability to its members. Starting from lessons of the balanced scorecard approach for non-profits, we describe the process of development of survey-based measures for the particular organization. The direction of the tool development and subsequent organizational changes were carried out in a participatory process between the school's staff, the parents, and the board. We identify the limitations and challenges of this process, and outline its successes to draw lessons for other similar democratic organizations. / Cet article est le produit d'un projet conjoint de recherche sur l'économie sociale entre un partenaire communautaire-une école privée-et des partenaires académiques. L'école est une organisation démocratique dirigée par des enseignants et des parents. Le but de ce projet était de trouver des façons d'améliorer la communication et la reddition de compte en ce qui a trait au rendement général de l'école comme faisant partie de la responsabilité de l'école envers ses membres. En commençant par des leçons sur l'approche de tableau de bord équilibré pour les organismes sans but lucratif, nous abordons le processus de l'élaboration de mesures fondées sur des enquêtes pour l'organisation particulière. L'orientation du développement d'outils et des changements organisationnels subséquents ont été déterminés lors d'un processus participatif entre le personnel de l'école, les parents et la direction. Nous établissons les limites et les défis de cette façon de procéder et en soulignons les réussites pour tirer des leçons qui serviront à d

  9. A Novel Socioeconomic Measure Using Individual Housing Data in Cardiovascular Outcome Research

    Directory of Open Access Journals (Sweden)

    Duk Won Bang

    2014-11-01

    Full Text Available Background: To assess whether the individual housing-based socioeconomic status (SES measure termed HOUSES was associated with post-myocardial infarction (MI mortality. Methods: The study was designed as a population-based cohort study, which compared post-MI mortality among Olmsted County, Minnesota, USA, residents with different SES as measured by HOUSES using Cox proportional hazards models. Subjects’ addresses at index date of MI were geocoded to real property data to formulate HOUSES (a z-score for housing value, square footage, and numbers of bedrooms and bathrooms. Educational levels were used as a comparison for the HOUSES index. Results: 637 of the 696 eligible patients with MI (92% were successfully geocoded to real property data. Post-MI survival rates were 60% (50–72, 78% (71–85, 72% (60–87, and 87% (81–93 at 2 years for patients in the first (the lowest SES, second, third, and fourth quartiles of HOUSES, respectively (p < 0.001. HOUSES was associated with post-MI all-cause mortality, controlling for all variables except age and comorbidity (p = 0.036 but was not significant after adjusting for age and comorbidity (p = 0.24. Conclusions: Although HOUSES is associated with post-MI mortality, the differential mortality rates by HOUSES were primarily accounted for by age and comorbid conditions. HOUSES may be useful for health disparities research concerning cardiovascular outcomes, especially in overcoming the paucity of conventional SES measures in commonly used datasets.

  10. Predicting stroke outcome using DCE-CT measured blood velocity

    Science.gov (United States)

    Oosterbroek, Jaap; Bennink, Edwin; Dankbaar, Jan Willem; Horsch, Alexander D.; Viergever, Max A.; Velthuis, Birgitta K.; de Jong, Hugo W. A. M.

    2015-03-01

    CT plays an important role in the diagnosis of acute stroke patients. Dynamic contrast enhanced CT (DCE-CT) can estimate local tissue perfusion and extent of ischemia. However, hemodynamic information of the large intracranial vessels may also be obtained from DCE-CT data and may contain valuable diagnostic information. We describe a novel method to estimate intravascular blood velocity (IBV) in large cerebral vessels using DCE-CT data, which may be useful to help predict stroke outcome. DCE-CT scans from 34 patients with isolated M1 occlusions were included from a large prospective multi-center cohort study of patients with acute ischemic stroke. Gaussians fitted to the intravascular data yielded the time-to-peak (TTP) and cerebral-blood-volume (CBV). IBV was computed by taking the inverse of the TTP gradient magnitude. Voxels with a CBV of at least 10% of the CBV found in the arterial input function were considered part of a vessel. Mid-sagittal planes were drawn manually and averages of the IBV over all vessel-voxels (arterial and venous) were computed for each hemisphere. Mean-hemisphere IBV differences, mean-hemisphere TTP differences, and hemisphere vessel volume differences were used to differentiate between patients with good and bad outcome (modified Rankin Scale score <3 versus ≥3 at 90 days) using ROC analysis. AUCs from the ROC for IBV, TTP, and vessel volume were 0.80, 0.67 and 0.62 respectively. In conclusion, IBV was found to be a better predictor of patient outcome than the parameters used to compute it and may be a promising new parameter for stroke outcome prediction.

  11. Measuring management success for protected species: Looking beyond biological outcomes

    Directory of Open Access Journals (Sweden)

    Kathryn D Bisack

    2016-05-01

    Full Text Available The complexity of the ocean ecosystem, including the human component, is such that a single fishery may require multiple policy instruments to support recovery and conservation of protected species, in addition to those for fisheries management. As regulations multiply, the need for retrospective analysis and evaluation grows in order to inform future policy. To accurately evaluate policy instruments, clear objectives and their link to outcomes are necessary, as well as identifying criteria to evaluate outcomes. The Northeast United States sink gillnet groundfish fishery provides a case study of the complexity of regulations and policy instruments implemented under the Marine Mammal Protection Act and the Endangered Species Act to address bycatch of marine mammals. The case study illustrates a range of possible objectives for the policy instruments including biological, economic, social-normative and longevity factors. We highlight links between possible objectives, outcomes and criteria for the four factors, as well as areas for consideration when undertaking ex-post analyses. To support learning from past actions, we call for a coordinated effort involving multiple disciplines and jurisdictions to undertake retrospective analyses and evaluations of key groups of policy instruments used for protected species.

  12. Educational Testing as an Accountability Measure: Drawing on Twentieth-Century Danish History of Education Experiences

    Science.gov (United States)

    Ydesen, Christian

    2013-01-01

    This article reveals perspectives based on experiences from twentieth-century Danish educational history by outlining contemporary, test-based accountability regime characteristics and their implications for education policy. The article introduces one such characteristic, followed by an empirical analysis of the origins and impacts of test-based…

  13. Accounting for posttraumatic stress disorder symptom severity with pre- and posttrauma measures

    DEFF Research Database (Denmark)

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2016-01-01

    Using data from a longitudinal study of community-dwelling older adults, we analyzed the most extensive set of known correlates of posttraumatic stress disorder (PTSD) symptoms obtained from a single sample to examine the measures’ independent and combined utility in accounting for PTSD symptom...

  14. 77 FR 18298 - Improvements to the Compliance, Safety, Accountability (CSA) Motor Carrier Safety Measurement...

    Science.gov (United States)

    2012-03-27

    ...) regulations; 4. Aligning violations that are included in SMS with the Commercial Vehicle Safety Alliance (CVSA... configuration better identified carriers with a high risk of future HM safety violations. The analysis found... Federal Motor Carrier Safety Administration Improvements to the Compliance, Safety, Accountability (CSA...

  15. The tools of disability outcomes research functional status measures.

    Science.gov (United States)

    Cohen, M E; Marino, R J

    2000-12-01

    To review the major functional status measures currently used in rehabilitation research, including the domains and scope of functional status measures, as well as the psychometric properties of selected functional status measures and their use in adult rehabilitation populations. Measures of physical functioning widely used in rehabilitation research. Major generic measures included the following activities of daily living and instrumental activities of daily living: the FIM instrument, the Katz Activities of Daily Living Scale, the Level of Rehabilitation Scale, the Barthel index, and the Patient Evaluation and Conference System. Measures were evaluated based on published evidence of validity, reliability, and sensitivity. Measures were chosen on the basis of the amount and quality of published research on the functional measures widely used in rehabilitation medicine. Independent research of computer databases and reviews of functional measures were conducted to determine suitability for inclusion. The quality and validity of the measures were assessed using standard psychometric guidelines. Measures were evaluated based on published evidence of validity, reliability, sensitivity response and administrative burdens and instrument bias. Each criterion was graded on a 3-point scale reflecting the level of evidence. Researchers in the field of disabilities research need to consider carefully study objectives when measuring physical functioning in people with disabilities.

  16. Process and outcome measures of quality of care at the diabetes ...

    African Journals Online (AJOL)

    2016-05-16

    May 16, 2016 ... services such as blood pressure and weight measurement, it performed suboptimally for foot examinations. Performance indicators that .... Table 4: Frequency distribution of outcome measures. Parameter n (%). HbA1c (%).

  17. Establishing construct validity for the thyroid-specific patient reported outcome measure (ThyPRO)

    DEFF Research Database (Denmark)

    Watt, Torquil; Bjorner, Jakob Bue; Groenvold, Mogens;

    2009-01-01

    To establish a reliable and valid scale structure of a patient-reported outcome measuring thyroid-specific quality of life.......To establish a reliable and valid scale structure of a patient-reported outcome measuring thyroid-specific quality of life....

  18. Discrepancies between patient-reported outcome measures when assessing urinary incontinence or pelvic-prolapse surgery

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Lose, Gunnar; Guldberg, Rikke

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation...

  19. Nonprofit Organizations and Outcome Measurement: From Tracking Program Activities to Focusing on Frontline Work

    Science.gov (United States)

    Benjamin, Lehn M.

    2012-01-01

    Why do we continue to see evidence that nonprofit staff feel like outcome measurement is missing important aspects of their work? Based on an analysis of over 1,000 pages of material in 10 outcome measurement guides and a focused literature review of frontline work in three types of nonprofit organizations, this article shows that existing outcome…

  20. Thurstone scaling as a measurement method to quantify subjective health outcomes

    NARCIS (Netherlands)

    Krabbe, Paul F M

    BACKGROUND: Many objective health outcome measures are used to monitor patients or evaluate health interventions, but there are also subjective measures. For the latter, it is difficult to derive metric data, which are needed to quantify health outcomes such as functional disability, severity of

  1. Thurstone scaling as a measurement method to quantify subjective health outcomes.

    NARCIS (Netherlands)

    Krabbe, P.F.M.

    2008-01-01

    BACKGROUND: Many objective health outcome measures are used to monitor patients or evaluate health interventions, but there are also subjective measures. For the latter, it is difficult to derive metric data, which are needed to quantify health outcomes such as functional disability, severity of

  2. Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis

    DEFF Research Database (Denmark)

    Heiligenhaus, Arnd; Foeldvari, Ivan; Edelsten, Clive

    2012-01-01

    To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis.......To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis....

  3. Neighbourhood social capital: measurement issues and associations with health outcomes.

    Science.gov (United States)

    Mackenbach, J D; Lakerveld, J; van Lenthe, F J; Kawachi, I; McKee, M; Rutter, H; Glonti, K; Compernolle, S; De Bourdeaudhuij, I; Feuillet, T; Oppert, J-M; Nijpels, G; Brug, J

    2016-01-01

    We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes.

  4. What Can States Learn about College and Career Readiness Accountability Measures from Alternative Education? Ask the CCRS Center

    Science.gov (United States)

    Deeds, Carinne; Malter, Zachary

    2016-01-01

    This "Ask the CCRS Center Brief" provides an overview of the accountability measures used by states and districts to assess the college and career readiness of students who are educated in alternative programs and schools (defined hereafter as "alternative settings"). Alternative settings are designed to serve at-risk students…

  5. Transparency and Accountability: What if the Federal Gainful Employment-Debt Measures Regulations Applied to Law Schools?

    Science.gov (United States)

    Mattox, Kari Ann

    2013-01-01

    The purpose of this analysis is to compare current guidelines of the American Bar Association (ABA) for law schools to those of the U.S. Department of Education's Gainful Employment-Debt Measures regulations in order to assess their transparency and accountability. This analysis is relevant in a time of increasing tuition costs and record…

  6. Materials measurement and accounting in an operating plutonium conversion and purification process. Phase I. Process modeling and simulation. [PUCSF code

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, C.C. Jr.; Ostenak, C.A.; Gutmacher, R.G.; Dayem, H.A.; Kern, E.A.

    1981-04-01

    A model of an operating conversion and purification process for the production of reactor-grade plutonium dioxide was developed as the first component in the design and evaluation of a nuclear materials measurement and accountability system. The model accurately simulates process operation and can be used to identify process problems and to predict the effect of process modifications.

  7. Quantum Correlations Are Stronger Than All Nonsignaling Correlations Produced by n-Outcome Measurements.

    Science.gov (United States)

    Kleinmann, Matthias; Cabello, Adán

    2016-10-07

    We show that, for any n, there are m-outcome quantum correlations, with m>n, which are stronger than any nonsignaling correlation produced from selecting among n-outcome measurements. As a consequence, for any n, there are m-outcome quantum measurements that cannot be constructed by selecting locally from the set of n-outcome measurements. This is a property of the set of measurements in quantum theory that is not mandatory for general probabilistic theories. We also show that this prediction can be tested through high-precision Bell-type experiments and identify past experiments providing evidence that some of these strong correlations exist in nature. Finally, we provide a modified version of quantum theory restricted to having at most n-outcome quantum measurements.

  8. Health outcomes in diabetics measured with Minnesota Community Measurement quality metrics

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2014-12-01

    Full Text Available Paul Y Takahashi,1 Jennifer L St Sauver,2 Lila J Finney Rutten,2 Robert M Jacobson,3 Debra J Jacobson,2 Michaela E McGree,2 Jon O Ebbert1 1Department of Internal Medicine, Division of Primary Care Internal Medicine, 2Department of Health Sciences Research, Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, 3Department of Pediatric and Adolescent Medicine, Division of Community Pediatrics, Mayo Clinic, Rochester, MN, USA Objective: Our objective was to understand the relationship between optimal diabetes control, as defined by Minnesota Community Measurement (MCM, and adverse health outcomes including emergency department (ED visits, hospitalizations, 30-day rehospitalization, intensive care unit (ICU stay, and mortality. Patients and methods: In 2009, we conducted a retrospective cohort study of empaneled Employee and Community Health patients with diabetes mellitus. We followed patients from 1 September 2009 until 30 June 2011 for hospitalization and until 5 January 2014 for mortality. Optimal control of diabetes mellitus was defined as achieving the following three measures: low-density lipoprotein (LDL cholesterol <100 mg/mL, blood pressure <140/90 mmHg, and hemoglobin A1c <8%. Using the electronic medical record, we assessed hospitalizations, ED visits, ICU stays, 30-day rehospitalizations, and mortality. The chi-square or Wilcoxon rank-sum tests were used to compare those with and without optimal control. We used Cox proportional hazard models to estimate the associations between optimal diabetes mellitus status and each outcome. Results: We identified 5,731 empaneled patients with diabetes mellitus; 2,842 (49.6% were in the optimal control category. After adjustment, we observed that non-optimally controlled patients had higher risks for hospitalization (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.00–1.23, ED visits (HR 1.15; 95% CI 1.06–1.25, and mortality (HR 1.29; 95% CI 1.09–1

  9. Prospective evaluation of outcome measures in free-flap surgery.

    LENUS (Irish Health Repository)

    Kelly, John L

    2004-08-01

    Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +\\/- 29 min) and in those that survived (92 +\\/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.

  10. An Analysis of State Data Collection Protocols for Measuring Postschool Outcomes for Students with Disabilities

    Science.gov (United States)

    Gerber, Paul J.; Batalo, Cecilia G.; De Arment, Serra T.

    2014-01-01

    Indicator 14 is a federal accountability initiative that attempts to generate data on the outcomes of students with disabilities 1 year after leaving high school. Currently, there are only two areas, postsecondary education/training and employment, mandated for examination. Ultimately, the data are used to develop specific goals for 6-year State…

  11. Validation of the Italian version of the SBMA Functional Rating Scale as outcome measure.

    Science.gov (United States)

    Querin, Giorgia; DaRe, Elisa; Martinelli, Ilaria; Bello, Luca; Bertolin, Cinzia; Pareyson, Davide; Mariotti, Caterina; Pegoraro, Elena; Sorarù, Gianni

    2016-11-01

    The Spinal and Bulbar Muscular Atrophy Functional Rating Scale (SBMAFRS) is an established rating instrument used to assess the functional status of patients with Spinal and Bulbar Muscular Atrophy (SBMA). Our aim was to validate an Italian version of the scale. We administered the SBMAFRS to sixty SBMA patients during routine follow-up of clinical evaluations. To estimate the test stability, the scale was re-administered to a subset of 39 randomly selected patients after 8 weeks. The patients underwent clinical evaluation including 6-min walk. Psychometric analysis included reliability assessment and factorial analysis. To evaluate convergent validity, correlations between SBMAFRS items and muscular force assessed by manual testing, ALSFRS total score and subscales scores, and forced vital capacity, were performed. Internal consistency as measured by Cronbach's alpha (total scale 0.85) was high. Test-retest reliability assessed by Spearman's rho was also high. Principal component analysis with varimax rotation yielded a four-factor solution accounting for approximately 79 % of the variance. The scale total score and subscales score were strongly correlated with respective items and subscores of the ALSFRS, with respiratory function and with the 6-min walk test. In conclusion, we performed an Italian validation of the only existing disease-specific Functional Rating Scale for SBMA patients. This scale will be a useful tool not only in the clinical practice but also as an outcome measure in upcoming clinical trials.

  12. Core Outcome Sets and Multidimensional Assessment Tools for Harmonizing Outcome Measure in Chronic Pain and Back Pain

    Directory of Open Access Journals (Sweden)

    Ulrike Kaiser

    2016-08-01

    Full Text Available Core Outcome Sets (COSs are a set of domains and measurement instruments recommended for application in any clinical trial to ensure comparable outcome assessment (both domains and instruments. COSs are not exclusively recommended for clinical trials, but also for daily record keeping in routine care. There are several COS recommendations considering clinical trials as well as multidimensional assessment tools to support daily record keeping in low back pain. In this article, relevant initiatives will be described, and implications for research in COS development in chronic pain and back pain will be discussed.

  13. Core Outcome Sets and Multidimensional Assessment Tools for Harmonizing Outcome Measure in Chronic Pain and Back Pain

    Science.gov (United States)

    Kaiser, Ulrike; Neustadt, Katrin; Kopkow, Christian; Schmitt, Jochen; Sabatowski, Rainer

    2016-01-01

    Core Outcome Sets (COSs) are a set of domains and measurement instruments recommended for application in any clinical trial to ensure comparable outcome assessment (both domains and instruments). COSs are not exclusively recommended for clinical trials, but also for daily record keeping in routine care. There are several COS recommendations considering clinical trials as well as multidimensional assessment tools to support daily record keeping in low back pain. In this article, relevant initiatives will be described, and implications for research in COS development in chronic pain and back pain will be discussed. PMID:27589816

  14. On the Measurement of Food Insecurity: How to Account for Risk?

    NARCIS (Netherlands)

    Weikard, H.P.; Gabbert, S.G.M.

    2010-01-01

    This article offers a measure of food insecurity. Its purpose is to capture the idea that the concept of food insecurity is inherently forward-looking. We apply our measure to construct a refinement of the measures of undernourishment used by the Food and Agriculture Organization of the United Natio

  15. 会计计量的十大“硬伤”%The Top Ten Flaws of Accounting Measurement

    Institute of Scientific and Technical Information of China (English)

    尉然

    2011-01-01

    会计这门经济学科是社会经济发展产物,并随着社会经济发展而发展。2008年金融危机已暴露出现行会计计量弊端,因此,在后金融危机时代,如何进一步完善、推动会计理论发展,以适应社会经济发展需要,是会计界必然面对的问题。%in 2008 the financial crisis has exposed presents good accountant the measurement malpractice.Therefore,after the financial crisis time,how to further consummate,promote the accounting theory development,meets the socio-economic development need,is question which accountant faces inevitably.

  16. Is it worth it to consider videogames in accounting education? A comparison of a simulation and a videogame in attributes, motivation and learning outcomes

    Directory of Open Access Journals (Sweden)

    Jordi Carenys

    2017-07-01

    Full Text Available The objective of this study is to assess the effectiveness of videogames in comparison to simulations in a higher education environment and with regard to their attributes, motivation, and learning outcomes, as three of the main dimensions that play a role in the effectiveness of digital game-based learning. Results demonstrate significant differences between the attributes and motivation dimensions, while no significant differences were found for the learning outcomes. This would imply that although both instructional tools lead students to the desired level of knowledge acquisition, the motivation generated, together with the set of features provided by the games complement each other, leading to a superior learning experience. These results support the inclusion of videogames as a complement to simulations in higher education accounting and business environments and allow us to propose a blended approach that provides the learner with the ‘best of both worlds’.

  17. Which measures of time preference best predict outcomes? Evidence from a large-scale field experiment

    OpenAIRE

    Burks, Stephen V.; Carpenter, Jeffrey P.; Goette, Lorenz; Rustichini, Aldo

    2011-01-01

    Economists and psychologists have devised numerous instruments to measure time preferences and have generated a rich literature examining the extent to which time preferences predict important outcomes; however, we still do not know which measures work best. With the help of a large sample of non-student participants (truck driver trainees) and administrative data on outcomes, we gather four different time preference measures and test the extent to which they predict both on their own and whe...

  18. Relationship outcomes as measurement criteria to assist communication strategists to manage organisational relationships

    Directory of Open Access Journals (Sweden)

    E. Botha

    2011-06-01

    Full Text Available Nonfinancial assets like relationships are increasingly important to managers. Communication managers in particular are focusing on measuring and managing organisational relationships as a means to quantify the return on investment (ROI of public relations and communication strategies. Measuring relationships offers communication managers a way to evaluate its contribution to the organisation. A commonly agreed upon definition of these relationships, however, does not exist. If we consider communication management is a managerial function, it must first refine its instruments of measurement. This study looks at the three-stage model of organisational relationships (relationship antecedents, maintenance strategies and relationship outcomes proposed by Grunig & Huang (2000 to firstly review the development of the model. Secondly, the study takes an in-depth look at each relationship outcomes of trust, commitment, satisfaction and control mutuality. Lastly, we assess the reliability and validity of the use of current relationship outcome measures through a survey of 154 organisational relationships. Previous studies that have utilized these outcomes in the measurement of organisational relationships do not discuss the possible interaction (or relationship among these outcomes. This study contributes to current literature by both providing an improved framework for the measurement of relationship outcomes and hypothesizing about how these outcomes interact with one another. It also discusses the managerial implications of managing relationships through the constant measurement of trust, commitment, satisfaction and control mutuality

  19. Identifying best practice through benchmarking and outcome measurement.

    Science.gov (United States)

    Lanier, Lynne

    2004-01-01

    Collecting and analyzing various types of data are essential to identifying areas for improvement. Data collection and analysis are routinely performed in hospitals and are even required by some regulatory agencies. Realization of the full benefits, which may be achieved through collection and analysis of data, should be actively pursued to prevent a meaningless exercise in paperwork. Internal historical comparison of data may be helpful but does not achieve the ultimate goal of identifying external benchmarks in order to determine best practice. External benchmarks provide a means of comparison with similar facilities, allowing the identification of processes needing improvement. The specialty of ophthalmology presents unique practice situations that are not comparable with other specialties, making it imperative to benchmark against other facilities where quick surgical case time, efficient surgical turnover times, low infection rates, and cost containment are essential and standard operations. Important data to benchmark include efficiency data, financial data, and quality or patient outcome data. After identifying facilities that excel in certain aspects of performance, it is necessary to analyze how their procedures help them achieve these favorable results. Careful data collection and analysis lead to improved practice and patient care.

  20. Comparing measures of racial/ethnic discrimination, coping, and associations with health-related outcomes in a diverse sample.

    Science.gov (United States)

    Benjamins, Maureen R

    2013-10-01

    Discrimination is detrimental to health behaviors and outcomes, but little is known about which measures of discrimination are most strongly related to health, if relationships with health outcomes vary by race/ethnicity, and if coping responses moderate these associations. To explore these issues, the current study assessed race/ethnic differences in five measures of race/ethnic discrimination, as well as emotional and behavioral coping responses, within a population-based sample of Whites, African Americans, Mexicans, and Puerto Ricans (n = 1,699). Stratified adjusted logistic regression models were run to examine associations between the discrimination measures and mental, physical, and health behavior outcomes and to test the role of coping. Overall, 86 % of the sample reported discrimination. Puerto Ricans were more likely than Mexicans and Whites to report most types of discrimination but less likely than Blacks. Discrimination was most strongly related to depression and was less consistently (or not) associated with physical health and health behaviors. Differences by measure of discrimination and respondent race/ethnicity were apparent. No support was found to suggest that coping responses moderate the association between discrimination and health. More work is needed to understand the health effects of this widespread social problem. In addition, interventions attempting to reduce health disparities need to take into account the influence of discrimination.

  1. Measuring Social Capital as an Outcome of Service Learning

    Science.gov (United States)

    D'Agostino, Maria J.

    2010-01-01

    Service-learning has been put forth as one of the proposed solutions to increasing social capital. However, service-learning research has not significantly addressed the impact of service learning on social capital. Unlike most previous studies, this research used quantitative analysis to measure the effect of university service-learning programs…

  2. Measuring Social Capital as an Outcome of Service Learning

    Science.gov (United States)

    D'Agostino, Maria J.

    2010-01-01

    Service-learning has been put forth as one of the proposed solutions to increasing social capital. However, service-learning research has not significantly addressed the impact of service learning on social capital. Unlike most previous studies, this research used quantitative analysis to measure the effect of university service-learning programs…

  3. A comparison of Graham and Piotroski investment models using accounting information and efficacy measurement

    Directory of Open Access Journals (Sweden)

    Nusrat Jahan

    2016-03-01

    Full Text Available We examine the investment models of Benjamin Graham and Joseph Piotroski and compare the efficacy of these two models by running backtest, using screening rules and ranking systems built in Portfolio 123. Using different combinations of screening rules and ranking systems, we also examine the performance of Piotroski and Graham investment models. We find that the combination of Piotroski and Graham investment models performs better than S&P 500. We also find that the Piotroski screening with Graham ranking generates the highest average annualized return among different combinations of screening rules and ranking systems analyzed in this paper. Overall, our results show a profound impact of accounting information on investor’s decision making.

  4. Accounting for quality in the measurement of hospital performance: evidence from Costa Rica.

    Science.gov (United States)

    Arocena, Pablo; García-Prado, Ariadna

    2007-07-01

    This paper provides insights into how Costa Rican public hospitals responded to the pressure for increased efficiency and quality introduced by the reforms carried out over the period 1997-2001. To that purpose we compute a generalized output distance function by means of non-parametric mathematical programming to construct a productivity index, which accounts for productivity changes while controlling for quality of care. Our results show an improvement in hospital performance mainly driven by quality increases. The adoption of management contracts seems to have contributed to such enhancement, more notably for small hospitals. Further, productivity growth is primarily due to technical and scale efficiency change rather than technological change. A number of policy implications are drawn from these results.

  5. A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials

    DEFF Research Database (Denmark)

    Juhl, Carsten Bogh; Lund, Hans; Guyatt, GH

    2010-01-01

    Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta-analyses ......Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta......-analyses in knee osteoarthritis (OA). Methods A systematic literature search was conducted in high impact factor journals. Eligible were randomized controlled trials, using two or more PROs measuring pain or disability. A prioritized list was developed based on the capacity to discriminate between intervention...

  6. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review.

    Directory of Open Access Journals (Sweden)

    Leire Santisteban

    Full Text Available Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians.In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time.Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included.In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMTwas the most commonly used measure (in 36% of studies. Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72% combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL, the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus.The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke.

  7. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

    Science.gov (United States)

    Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

    2016-01-01

    Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

  8. Recommendations for Self-Report Outcome Measures in Vulvodynia Clinical Trials.

    Science.gov (United States)

    Pukall, Caroline F; Bergeron, Sophie; Brown, Candace; Bachmann, Gloria; Wesselmann, Ursula

    2017-08-01

    Vulvodynia (idiopathic chronic vulvar pain) is a prevalent condition associated with significant and negative impacts in many areas of function. Despite the increased research interest in vulvodynia in recent years, recommendations for outcome measures for use in clinical trials are missing. The purpose of this paper, therefore, was to provide recommendations for outcome measures for vulvodynia clinical trials so that consistent measures are used across trials to facilitate between-study comparisons and the conduct of large multicenter trials, and to improve measurement of the multiple dimensions of vulvodynia. Given that provoked vestibulodynia (PVD)-characterized by provoked pain localized to the vaginal opening-is the most common subtype of vulvodynia and the current main focus of clinical trials, this paper focused on recommended outcome measures in PVD clinical trials. The framework used to guide the selection of outcome measures was based on the one proposed by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). The IMMPACT framework provided a well-suited guideline for outcome measure recommendations in PVD clinical trials. However, given the provoked presentation of PVD and the significant impact it has on sexuality, modifications to some of the IMMPACT recommendations were made and specific additional measures were suggested. Measures that are specific to vulvovaginal pain are ideal for adoption in PVD clinical trials, and many such measures currently exist that allow the relevant IMMPACT domains to be captured.

  9. Accounting for the speed shear in wind turbine power performance measurement

    DEFF Research Database (Denmark)

    Wagner, Rozenn; Courtney, Michael; Gottschall, Julia

    2011-01-01

    The current IEC standard for wind turbine power performance measurement only requires measurement of the wind speed at hub height assuming this wind speed to be representative for the whole rotor swept area. However, the power output of a wind turbine depends on the kinetic energy flux, which...... itself depends on the wind speed profile, especially for large turbines. Therefore, it is important to characterize the wind profile in front of the turbine, and this should be preferably achieved by measuring the wind speed over the vertical range between lower and higher rotor tips. In this paper, we...... describe an experiment in which wind speed profiles were measured in front of a multimegawatt turbine using a ground–based pulsed lidar. Ignoring the vertical shear was shown to overestimate the kinetic energy flux of these profiles, in particular for those deviating significantly from a power law profile...

  10. Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

    NARCIS (Netherlands)

    Marks, Miriam

    2014-01-01

    The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in

  11. The National Outcomes Measurement System for Pediatric Speech-Language Pathology

    Science.gov (United States)

    Mullen, Robert; Schooling, Tracy

    2010-01-01

    Purpose: The American Speech-Language-Hearing Association's (ASHA's) National Outcomes Measurement System (NOMS) was developed in the late 1990s. The primary purpose was to serve as a source of data for speech-language pathologists (SLPs) who found themselves called on to provide empirical evidence of the functional outcomes associated with their…

  12. Consensus for tinnitus patient assessment and treatment outcome measurement : Tinnitus Research Initiative meeting, Regensburg, July 2006

    NARCIS (Netherlands)

    Langguth, B.; Goodey, R.; Azevedo, A.; Bjorne, A.; Cacace, A.; Crocetti, A.; Del Bo, L.; De Ridder, D.; Diges, I.; Elbert, T.; Flor, H.; Herraiz, C.; Ganz Sanchez, T.; Eichhammer, P.; Figueiredo, R.; Hajak, G.; Kleinjung, T.; Landgrebe, M.; Londero, A.; Lainez, M. J. A.; Mazzoli, M.; Meikle, M. B.; Melcher, J.; Rauschecker, J. P.; Sand, P. G.; Struve, M.; Van de Heyning, P.; Van Dijk, P.; Vergara, R.; Langguth, B; Hajak, G; Kleinjung, T; Cacace, A; Moller, AR

    2007-01-01

    There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinn

  13. Demonstrating marketing accountability.

    Science.gov (United States)

    Gombeski, William R; Britt, Jason; Taylor, Jan; Riggs, Karen; Wray, Tanya; Adkins, Wanda; Springate, Suzanne

    2008-01-01

    Pressure on health care marketers to demonstrate effectiveness of their strategies and show their contribution to organizational goals is growing. A seven-tiered model based on the concepts of structure (having the right people, systems), process (doing the right things in the right way), and outcomes (results) is discussed. Examples of measures for each tier are provided and the benefits of using the model as a tool for measuring, organizing, tracking, and communicating appropriate information are provided. The model also provides a framework for helping management understand marketing's value and can serve as a vehicle for demonstrating marketing accountability.

  14. Vision and vision-related outcome measures in multiple sclerosis

    DEFF Research Database (Denmark)

    Balcer, Laura J; Miller, David H; Reingold, Stephen C

    2015-01-01

    sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique...... to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting...

  15. Accounting for randomness in measurement and sampling in studying cancer cell population dynamics.

    Science.gov (United States)

    Ghavami, Siavash; Wolkenhauer, Olaf; Lahouti, Farshad; Ullah, Mukhtar; Linnebacher, Michael

    2014-10-01

    Knowing the expected temporal evolution of the proportion of different cell types in sample tissues gives an indication about the progression of the disease and its possible response to drugs. Such systems have been modelled using Markov processes. We here consider an experimentally realistic scenario in which transition probabilities are estimated from noisy cell population size measurements. Using aggregated data of FACS measurements, we develop MMSE and ML estimators and formulate two problems to find the minimum number of required samples and measurements to guarantee the accuracy of predicted population sizes. Our numerical results show that the convergence mechanism of transition probabilities and steady states differ widely from the real values if one uses the standard deterministic approach for noisy measurements. This provides support for our argument that for the analysis of FACS data one should consider the observed state as a random variable. The second problem we address is about the consequences of estimating the probability of a cell being in a particular state from measurements of small population of cells. We show how the uncertainty arising from small sample sizes can be captured by a distribution for the state probability.

  16. MRI as outcome measure in facioscapulohumeral muscular dystrophy

    DEFF Research Database (Denmark)

    Andersen, Grete; Dahlqvist, Julia R; Vissing, Christoffer R

    2017-01-01

    muscles. Changes were compared with those in FSHD score, muscle strength (hand-held dynamometry), 6-minute-walk-distance, 14-step-stair-test, and 5-time-sit-to-stand-test. Composite absolute fat fraction of all assessed muscles increased by 0.036 (CI 0.026-0.046, P increases in all measured...... disease progression in patients with FSHD1. Ambulatory patients with confirmed diagnosis of FSHD1 (25/20 men/women, age 20-75 years, FSHD score: 0-12) were tested with 359-560-day interval between tests. Using the MRI Dixon technique, muscle fat replacement was evaluated in paraspinal, thigh, and calf...... muscle groups. The clinical severity FSHD score worsened (10%, P muscle strength decreased over the hip (8%), neck (8%), and back (17%) (P muscle strength...

  17. Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

    Science.gov (United States)

    Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

    2015-12-01

    Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Study on Measurement of Human Resource Accounting%关于人力资源会计计量的研究

    Institute of Scientific and Technical Information of China (English)

    林春玉

    2013-01-01

      Human resource accounting includes the measurement of human resources and human resources value measurement. Purpose is to provide the enterprise human resources change information to the enterprise and the outside world.%  人力资源会计包括人力资源的计量和人力资源价值的计量。目的是将企业人力资源变化的信息提供给企业和外界有关人士使用。

  19. Measurement properties of patient-reported outcome measures (PROMs) in adults with obstructive sleep apnea (OSA): A systematic review

    NARCIS (Netherlands)

    Abma, I.L.; Wees, P.J. van der; Veer, V.; Westert, G.P.; Rovers, M.M.

    2016-01-01

    This systematic review summarizes the evidence regarding the quality of patient-reported outcome measures (PROMs) validated in patients with obstructive sleep apnea (OSA). We performed a systematic literature search of all PROMs validated in patients with OSA, and found 22 measures meeting our

  20. Conservation covenants on private land: issues with measuring and achieving biodiversity outcomes in Australia.

    Science.gov (United States)

    Fitzsimons, James A; Carr, C Ben

    2014-09-01

    Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants.

  1. Conservation Covenants on Private Land: Issues with Measuring and Achieving Biodiversity Outcomes in Australia

    Science.gov (United States)

    Fitzsimons, James A.; Carr, C. Ben

    2014-09-01

    Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants.

  2. Methods for measuring, enhancing, and accounting for medication adherence in clinical trials.

    Science.gov (United States)

    Vrijens, B; Urquhart, J

    2014-06-01

    Adherence to rationally prescribed medications is essential for effective pharmacotherapy. However, widely variable adherence to protocol-specified dosing regimens is prevalent among participants in ambulatory drug trials, mostly manifested in the form of underdosing. Drug actions are inherently dose and time dependent, and as a result, variable underdosing diminishes the actions of trial medications by various degrees. The ensuing combination of increased variability and decreased magnitude of trial drug actions reduces statistical power to discern between-group differences in drug actions. Variable underdosing has many adverse consequences, some of which can be mitigated by the combination of reliable measurements of ambulatory patients' adherence to trial and nontrial medications, measurement-guided management of adherence, statistically and pharmacometrically sound analyses, and modifications in trial design. Although nonadherence is prevalent across all therapeutic areas in which the patients are responsible for treatment administration, the significance of the adverse consequences depends on the characteristics of both the disease and the medications.

  3. Outcomes of bone density measurements in coeliac disease.

    Science.gov (United States)

    Bolland, Mark J; Grey, Andrew; Rowbotham, David S

    2016-01-29

    Some guidelines recommend that patients with newly diagnosed coeliac disease undergo bone density scanning. We assessed the bone density results in a cohort of patients with coeliac disease. We searched bone density reports over two 5-year periods in all patients from Auckland District Health Board (2008-12) and in patients under 65 years from Counties Manukau District Health Board (2009-13) for the term 'coeliac.' Reports for 137 adults listed coeliac disease as an indication for bone densitometry. The average age was 47 years, body mass index (BMI) 25 kg/m(2), and 77% were female. The median time between coeliac disease diagnosis and bone densitometry was 261 days. The average bone density Z-score was slightly lower than expected (Z-score -0.3 to 0.4) at the lumbar spine, total hip and femoral neck, but 88-93% of Z-scores at each site lay within the normal range. Low bone density was strongly related to BMI: the proportions with Z-score 30 kg/m(2) were 28%, 15%, 6% and 0% respectively. Average bone density was normal, suggesting that bone density measurement is not indicated routinely in coeliac disease, but could be considered on a case-by-case basis for individuals with strong risk factors for fracture.

  4. THE ACCOUNTING PROFIT – A MEASURE OF THE PERFORMANCE OF THE BUSINESS ENTITY

    OpenAIRE

    Mihaela TULVINSCHI

    2013-01-01

    Profit is believed to be the main indicator for measuring the performance of the business entity, but performance cannot come down to the mere identification of the economic profit. Profit is a value that has been created for the business entity while performance is a reference term used by the managers and employees of a company. Economic performance means that the attained results should exceed the defined objectives, the competition and the results arrived at during the previous years. The...

  5. Use of the measure your medical outcome profile (MYMOP2 and W-BQ12 (Well-Being outcomes measures to evaluate chiropractic treatment: an observational study

    Directory of Open Access Journals (Sweden)

    Polus Barbara I

    2011-03-01

    Full Text Available Abstract Background The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2 and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods Chiropractic care of the patients involved spinal manipulative therapy (SMT, mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12. Results Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions.

  6. Accounting for sensor calibration, data validation, measurement and sampling uncertainties in monitoring urban drainage systems.

    Science.gov (United States)

    Bertrand-Krajewski, J L; Bardin, J P; Mourad, M; Béranger, Y

    2003-01-01

    Assessing the functioning and the performance of urban drainage systems on both rainfall event and yearly time scales is usually based on online measurements of flow rates and on samples of influent effluent for some rainfall events per year. In order to draw pertinent scientific and operational conclusions from the measurement results, it is absolutely necessary to use appropriate methods and techniques in order to i) calibrate sensors and analytical methods, ii) validate raw data, iii) evaluate measurement uncertainties, iv) evaluate the number of rainfall events to sample per year in order to determine performance indicator with a given uncertainty. Based an previous work, the paper gives a synthetic review of required and techniques, and illustrates their application to storage and settling tanks. Experiments show that, controlled and careful experimental conditions, relative uncertainties are about 20% for flow rates in sewer pipes, 6-10% for volumes, 25-35% for TSS concentrations and loads, and 18-276% for TSS removal rates. In order to evaluate the annual pollutant interception efficiency of storage and settling tanks with a given uncertainty, efforts should first be devoted to decrease the sampling uncertainty by increasing the number of sampled events.

  7. The challenges of translating the clinical outcomes in Routine Evaluation-Outcome Measure (CORE-OM) into British Sign Language.

    Science.gov (United States)

    Rogers, Katherine D; Young, Alys; Lovell, Karina; Evans, Chris

    2013-01-01

    This article discusses translation issues arising during the production of a British Sign Language (BSL) version of the psychological outcome measure "Clinical Outcomes in Routine Evaluation-Outcome Measure" (CORE-OM). The process included forward translation, meeting with a team of translators, producing a second draft of the BSL version and back translating into English. Further modifications were made to the BSL version before piloting it with d/Deaf populations. Details of the translation process are addressed, including (a) the implications of translating between modalities (written text to visual language); (b) clarity of frequency anchors: analog versus digital encoding; (c) pronouns and the direction of signing; and (iv) the influence of the on-screen format. The discussion of item-specific issues encountered when producing a BSL version of the CORE-OM includes the expression of precise emotional states in a language that uses visual modifiers, problems associated with iconic signs, and the influence of Deaf world knowledge when interpreting specific statements. Finally, it addresses the extent to which lessons learned through this translation process are generalizable to other signed languages and spoken language translations of standardized instruments. Despite the challenges, a BSL version of the CORE-OM has been produced and found to be reliable.

  8. Feedback from Outcome Measures and Treatment Effectiveness, Treatment Efficiency, and Collaborative Practice: A Systematic Review.

    Science.gov (United States)

    Gondek, Dawid; Edbrooke-Childs, Julian; Fink, Elian; Deighton, Jessica; Wolpert, Miranda

    2016-05-01

    Due to recent increases in the use of feedback from outcome measures in mental health settings, we systematically reviewed evidence regarding the impact of feedback from outcome measures on treatment effectiveness, treatment efficiency, and collaborative practice. In over half of 32 studies reviewed, the feedback condition had significantly higher levels of treatment effectiveness on at least one treatment outcome variable. Feedback was particularly effective for not-on-track patients or when it was provided to both clinicians and patients. The findings for treatment efficiency and collaborative practice were less consistent. Given the heterogeneity of studies, more research is needed to determine when and for whom feedback is most effective.

  9. Use of the extended therapy outcome measure for children with dysarthria.

    Science.gov (United States)

    Enderby, Pam

    2014-08-01

    Increasing demand on healthcare resources has led to a greater emphasis on the examination of the impact of service delivery on outcomes. Clinical assessments frequently do not cover all aspects of change associated with interventions for those with complex conditions. This paper reviews the need for more comprehensive outcome measurement suitable for clinical practice and benchmarking. It describes an extension of the Therapy Outcome Measure for specific use in reflecting the impact of the broad range of interventions commonly required when managing children with dysarthria. Three case histories are used to illustrate the approach, and data from four speech-language pathology services are used to illustrate the value of benchmarking.

  10. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure

    Directory of Open Access Journals (Sweden)

    Trujillo A

    2016-06-01

    Full Text Available Adriana Trujillo,1,2 Guillem Feixas,1,2 Arturo Bados,1 Eugeni García-Grau,1 Marta Salla,1 Joan Carles Medina,1 Adrián Montesano,1,2 José Soriano,3 Leticia Medeiros-Ferreira,4 Josep Cañete,5 Sergi Corbella,6 Antoni Grau,7 Fernando Lana,8 Chris Evans9 1Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, 2Institute for Brain, Cognition and Behaviour, University of Barcelona, 3Hospital of the Holy Cross and Saint Paul, 4Nou Barris Mental Health Center, Barcelona, 5Hospital of Mataró, Sanitary Consortium of Maresme, Mataró, 6FPCEE, Blanquerna, Universitat Ramon Llull, 7Institute of Eating Disorders, Barcelona, 8MAR Health Park, CAEMIL, Santa Coloma de Gramenet, Spain; 9East London NHS Foundation Trust, NPDDNet, London, UK Objective: The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk.Method: Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192 from different mental health and primary care centers; and the nonclinical sample (n=452, which included a student and a community sample.Results: The questionnaire showed good acceptability and internal consistency, appropriate test–retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment.Conclusion: The Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure showed acceptable psychometric properties, providing support for using the

  11. Multiple Overimputation to Address Missing Data and Measurement Error: Application to HIV Treatment During Pregnancy and Pregnancy Outcomes.

    Science.gov (United States)

    Bengtson, Angela M; Westreich, Daniel; Musonda, Patrick; Pettifor, Audrey; Chibwesha, Carla; Chi, Benjamin H; Vwalika, Bellington; Pence, Brian W; Stringer, Jeffrey S A; Miller, William C

    2016-09-01

    Investigations of the association of combination antiretroviral therapy (ART) with pregnancy outcomes often rely on routinely collected clinical data, which are prone to missing data and measurement error. Measurement error in gestational age may bias the relation between combination ART and gestational age-based outcomes. We demonstrate the use of multiple overimputation to address missing data and measurement error in gestational age. Using routinely collected clinical data from public health facilities in Lusaka, Zambia, we multiply imputed missing data and multiply overimputed observed values of gestational age. Poisson models with robust variance estimators were used to estimate risk ratios (RRs) for the associations of duration of combination ART with small for gestational age (SGA) and preterm birth. We compared results from a complete-case analysis, using multiple imputation to address missing data only and using multiple overimputation to address missing data and measurement error. In the complete-case analysis, there was no evidence of an association between duration of combination ART and SGA or preterm birth. When we performed multiple overimputation, RRs for SGA moved past the null, but remained imprecise. For preterm birth, RRs for 9-32 weeks of combination ART moved away from the null as the variance due to measurement error increased. When we used multiple overimputation to account for measurement error and missing data, we observed an increased risk of preterm birth with longer duration of combination ART. Future analyses examining associations between combination ART and pregnancy outcomes should consider using multiple overimputation to address measurement error in gestational age.

  12. Optimized Clustering Estimators for BAO Measurements Accounting for Significant Redshift Uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Ashley J. [Portsmouth U., ICG; Banik, Nilanjan [Fermilab; Avila, Santiago [Madrid, IFT; Percival, Will J. [Portsmouth U., ICG; Dodelson, Scott [Fermilab; Garcia-Bellido, Juan [Madrid, IFT; Crocce, Martin [ICE, Bellaterra; Elvin-Poole, Jack [Jodrell Bank; Giannantonio, Tommaso [Cambridge U., KICC; Manera, Marc [Cambridge U., DAMTP; Sevilla-Noarbe, Ignacio [Madrid, CIEMAT

    2017-05-15

    We determine an optimized clustering statistic to be used for galaxy samples with significant redshift uncertainty, such as those that rely on photometric redshifts. To do so, we study the BAO information content as a function of the orientation of galaxy clustering modes with respect to their angle to the line-of-sight (LOS). The clustering along the LOS, as observed in a redshift-space with significant redshift uncertainty, has contributions from clustering modes with a range of orientations with respect to the true LOS. For redshift uncertainty $\\sigma_z \\geq 0.02(1+z)$ we find that while the BAO information is confined to transverse clustering modes in the true space, it is spread nearly evenly in the observed space. Thus, measuring clustering in terms of the projected separation (regardless of the LOS) is an efficient and nearly lossless compression of the signal for $\\sigma_z \\geq 0.02(1+z)$. For reduced redshift uncertainty, a more careful consideration is required. We then use more than 1700 realizations of galaxy simulations mimicking the Dark Energy Survey Year 1 sample to validate our analytic results and optimized analysis procedure. We find that using the correlation function binned in projected separation, we can achieve uncertainties that are within 10 per cent of of those predicted by Fisher matrix forecasts. We predict that DES Y1 should achieve a 5 per cent distance measurement using our optimized methods. We expect the results presented here to be important for any future BAO measurements made using photometric redshift data.

  13. Associations between nine family dinner frequency measures and child weight, dietary and psychosocial outcomes

    Science.gov (United States)

    Fulkerson, Jayne A.; Friend, Sarah E.; Neumark-Sztainer, Dianne

    2015-01-01

    Background Family meal frequency has been consistently and significantly associated with positive youth dietary and psychosocial outcomes but less consistently associated with weight outcomes. Family meal frequency measurement has varied widely and it is unclear how this variation may impact relationships with youth weight, dietary, and psychosocial outcomes. Objective This study assesses how five parent/caregiver-reported and four child-reported family dinner frequency measures correlate with each other and are associated with health-related outcomes. Design/Participants This secondary, cross-sectional analysis uses baseline, parent/caregiver (n=160) and 8–12 year old child (n=160) data from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus trial (collected 2011–2012). Data were obtained from objective measurements, dietary recall interviews, and psychosocial surveys. Outcome measures Outcomes included child body mass index z-scores (BMIz), fruit, vegetable and sugar-sweetened beverage intake, dietary quality (Healthy Eating Index-2010 [HEI-2010]), family connectedness, and meal conversations. Statistical analyses performed Pearson correlations and general linear models were used to assess associations between family dinner frequency measures and outcomes. Results All family dinner frequency measures had comparable means and were correlated within and across parent/caregiver- and child-reporters (r=0.17–0.94, pfamily dinner frequency measures were significantly associated with BMIz scores and 100% were significantly associated with fruit/vegetable intake and HEI-2010. In adjusted models, most significant associations with dietary and psychosocial outcomes remained but associations with child BMIz remained significant only for parent/caregiver- (β±SE= −0.07±0.03; pfamily dinner frequency measures asking about ‘sitting and eating’ dinner. Conclusions In spite of phrasing variations in family dinner frequency measures (e.g., which

  14. Capturing Psychologists' Work in Integrated Care: Measuring and Documenting Administrative Outcomes.

    Science.gov (United States)

    Kearney, Lisa K; Smith, Clifford A; Pomerantz, Andrew S

    2015-12-01

    With the expansion of integrated primary care and the increased focus on fiscal sustainability, it is critical for clinical managers of these innovative systems to have practical methods for measuring administrative outcomes. Administrative outcomes will assist leadership in the development of efficient, streamlined clinics to provide services to the primary care population. Additionally, administrative measures can be utilized to provide information to assist in guiding resource utilization and management decisions. Several administrative outcomes are suggested for integrated primary care managers to consider for application, including: clinic utilization measures, integrated care administrative measures, wait time and access metrics, and productivity monitors. Effective utilization of these measures can help office managers and clinic leadership not only to maximize patient care, but also to enhance essential business operations, which increase the long-term sustainability of integrated primary care programs.

  15. Scoping review of outcome measures used in telerehabilitation and virtual reality for post-stroke rehabilitation.

    Science.gov (United States)

    Veras, Mirella; Kairy, Dahlia; Rogante, Marco; Giacomozzi, Claudia; Saraiva, Silvia

    2017-07-01

    Introduction Despite the increased interest in telerehabilitation (TR), virtual reality (VR) and outcome measures for stroke rehabilitation, surprisingly little research has been done to map and identify the most common outcome measures used in TR. For this review, we conducted a systematic search of the literature that reports outcome measures used in TR or VR for stroke rehabilitation. Our specific objectives included: 1) to identify the outcome measures used in TR and VR studies; and 2) to describe which parts of the International Classification of Functioning are measured in the studies. Methods We conducted a comprehensive search of relevant electronic databases (e.g. PubMed, the Cumulative Index to Nursing and Allied Health Literature, Embase, PSYCOINFO, The Cochrane Central Register of Controlled Trial and the Physiotherapy Evidence Database). The scoping review included all study designs. Two reviewers conducted pilot testing of the data extraction forms and independently screened all the studies and extracted the data. Disagreements about inclusion or exclusion were resolved by consensus or by consulting a third reviewer. Results In total, 28 studies were included in this scoping review. The results were synthesized and reported considering the implications of the findings within the clinical practice and policy context. Discussion This scoping review identified a wide range of outcome measures used in VR and TR studies and helped identify gaps in current use of outcome measures in the literature. The review also informs researchers and end users (i.e. clinicians, policymakers and researchers) regarding the most appropriate outcome measures for TR or VR.

  16. Trainee-associated outcomes in laparoscopic colectomy for cancer: propensity score analysis accounting for operative time, procedure complexity and patient comorbidity.

    Science.gov (United States)

    Kasten, Kevin R; Celio, Adam C; Trakimas, Lauren; Manwaring, Mark L; Spaniolas, Konstantinos

    2017-07-19

    Surgical trainee association with operative outcomes is controversial. Studies are conflicting, possibly due to insufficient control of confounding variables such as operative time, case complexity, and heterogeneous patient populations. As operative complications worsen long-term outcomes in oncologic patients, understanding effect of trainee involvement during laparoscopic colectomy for cancer is of utmost importance. Here, we hypothesized that resident involvement was associated with worsened 30-day mortality and 30-day overall morbidity in this patient population. Patients undergoing laparoscopic colectomy for oncologic diagnosis from 2005 to 2012 were assessed using the American College of Surgeons National Surgical Quality Improvement Program dataset. Propensity score matching accounted for demographics, comorbidities, case complexity, and operative time. Attending only cases were compared to junior, middle, chief resident, and fellow level cohorts to assess primary outcomes of 30-day mortality and 30-day overall morbidity. A total of 13,211 patients met inclusion criteria, with 4075 (30.8%) cases lacking trainee involvement and 9136 (69.2%) involving a trainee. Following propensity matching, junior (PGY 1-2) and middle level (PGY 3-4) resident involvement was not associated with worsened outcomes. Chief (PGY 5) resident involvement was associated with worsened 30-day overall morbidity (15.5 vs. 18.6%, p = 0.01). Fellow (PGY > 5) involvement was associated with worsened 30-day overall morbidity (16.0 vs. 21.0%, p < 0.001), serious morbidity (9.3 vs. 13.5%, p < 0.001), minor morbidity (9.8 vs. 13.1%, p = 0.002), and surgical site infection (7.9 vs. 10.5%, p = 0.006). No differences were seen in 30-day mortality for any resident level. Following propensity-matched analysis of cancer patients undergoing laparoscopic colectomy, chief residents, and fellows were associated with worsened operative outcomes compared to attending along cases, while junior

  17. Disease-specific quality indicators, guidelines, and outcome measures in systemic lupus erythematosus (SLE).

    Science.gov (United States)

    Mosca, M; Bombardieri, S

    2007-01-01

    The assessment of quality of care is becoming increasingly important, but as yet no standard set of measures to assess quality has been developed. The ACR Quality Measures Committee has selected the following areas of study to develop quality indicators: diagnostic/classification criteria, outcome measures/response criteria, treatment guidelines/management recommendations, definition of quality indicators, and definition of data collection systems. The aim of the present review is to evaluate existing guidelines and outcome measures concerning disease/activity monitoring, autoantibody and laboratory assessment, outcomes, and therapy in systemic lupus erythematosus (SLE) that could be used to define disease-specific quality indicators. Much data is available in the literature that could serve to define a starter set of quality indicators for SLE. Monitoring issues are discussed in the ACR and EULAR recommendations. As far as therapy is concerned, the ACR has provided indicators for rheumatoid arthritis that could also be applied to SLE, as well as indications for anti-malarial monitoring. The outcomes measures most frequently used in SLE are damage and death, but organ-specific definitions of outcome and response are being evaluated. The development of quality measures for SLE is just beginning; existing information could serve to construct a starter set of indicators such as the one proposed here. Certainly much progress will be made in the near future. A practical, user-friendly tool for physicians that will help them deliver high quality care to populations is also needed.

  18. Measuring and accounting for the Hawthorne effect during a direct overt observational study of intensive care unit nurses.

    Science.gov (United States)

    Kurtz, Sharon Lea

    2017-09-01

    Because suspecting nurses could alter hand hygiene (HH) behavior when observed, the goal of this article was to describe how the Hawthorne effect (HE) was measured and accounted for in a direct observational prospective study. Observations were made 8 h/d for 3-5 days in 5 intensive care units (ICUs) (4 hospitals) on a convenience sample of 64 ICU nurses in Texas. The HE was measured so if hand hygiene adherence rates of the first 2 hours were 20% higher than the last 6 hours, the first 2 hours would be dropped and an additional 2 hours would be added at the end of the observation period. Hourly rates were recorded during the observation period, using room entry and room exit. The difference between aggregated rates of the first 2 hours and last 6 hours was 0.56% (range, 0.02%-15.74%) and not significant. On 12 observation days, higher rates were observed during the first 2 hours. On 6 days, higher rates were observed in the last 6 hours, with difference in rates of 1.43% (day 1), 2.97% (day 2), and 1.42% (day 3). The attempt at measuring and accounting for the HE showed little difference in HH rates throughout the observation period. Based on these results, necessity of the observer moving locations during HH surveillance after 10-20 minutes, because of a feared HE, might not be necessary. Copyright © 2017. Published by Elsevier Inc.

  19. Comparisons of clinically based outcome measures and laboratory-based outcome measure for balance in patients following total hip and knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Jogi P

    2017-04-01

    Full Text Available Pankaj Jogi, Tom Overend, John Kramer School of Physical Therapy, University of Western Ontario, London, ON, Canada Background: Information available in the literature on clinically based and laboratory-based outcome measures of balance is limited. How much information is provided by clinically based outcome measures compared to laboratory-based measure in patients with total hip (THA and knee arthroplasty (TKA is not known. Aim: The purpose of this study was to determine the relationship between selected clinically based outcome measures and laboratory-based force platform measure in patients following THA and TKA. Methods: Patients who underwent THA (n = 26 and TKA (n = 28 were evaluated at about 5–7 weeks following surgery. Participants were assessed using four clinically based outcome measures – 1 the Berg Balance Scale (BBS, 2 the Timed Up and Go test (TUG, 3 the Activities-specific Balance Confidence Scale (ABC, and 4 the Western Ontario McMaster Universities Osteoarthritis Index-function subscale (WOMAC-function – and one laboratory-based force plate measure (95% ellipse area. Results: Moderate correlations were observed between the BBS and the 95% ellipse area of force plate (r = 0.46–0.51 for the two-legged stance, the anterior lean stance, and the posterior lean stance. Fair correlations were observed between TUG and the 95% ellipse area of force plate (r = 0.31–0.37 for all the three test conditions. Low correlations were observed for the ABC and the WOMAC-function with the 95% ellipse area of force plate (r = 0.11–0.25 for all the three test conditions. Conclusion: The BBS demonstrated the greatest correlations with the 95% ellipse area of the force plate measure and should be preferred by physical therapists over the TUG, the ABC, and the WOMAC-function to assess balance in patients with THA and TKA. Keywords: total knee arthroplasty, total hip arthroplasty, force plate, clinical measures, balance

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

    Directory of Open Access Journals (Sweden)

    Lidwine B. Mokkink

    2016-01-01

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

  1. Realization of a Binary-Outcome Projection Measurement of a Three-Level Superconducting Quantum System

    Science.gov (United States)

    Jerger, Markus; Macha, Pascal; Hamann, Andrés Rosario; Reshitnyk, Yarema; Juliusson, Kristinn; Fedorov, Arkady

    2016-07-01

    Binary-outcome measurements allow one to determine whether a multilevel quantum system is in a certain state while preserving quantum coherence between all orthogonal states. In this paper, we explore different regimes of the dispersive readout of a three-level superconducting quantum system coupled to a microwave cavity in order to implement binary-outcome measurements. By designing identical cavity-frequency shifts for the first and second excited states of the system, we realize strong projective binary-outcome measurements onto its ground state with a fidelity of 94.3%. Complemented with standard microwave control and low-noise parametric amplification, this scheme enables the quantum nondemolition detection of leakage errors and can be used to create sets of compatible measurements to reveal the contextual nature of superconducting circuits.

  2. Measurement of lactate in a prehospital setting is related to outcome

    NARCIS (Netherlands)

    van Beest, Paul A.; Mulder, Peter Jan; Oetomo, Suparto Bambang; van den Broek, Bert; Kuiper, Michael A.; Spronk, Peter E.

    2009-01-01

    Objective We evaluated the relationship of lactate measured in a preclinical setting with outcome. Simultaneously, we evaluated the feasibility of implementing blood lactate measurement in a prehospital setting as part of a quality improvement project Methods Chart review of patients from whom serum

  3. The Benchmarking Capacity of a General Outcome Measure of Academic Language in Science and Social Studies

    Science.gov (United States)

    Mooney, Paul; Lastrapes, Renée E.

    2016-01-01

    The amount of research evaluating the technical merits of general outcome measures of science and social studies achievement is growing. This study targeted criterion validity for critical content monitoring. Questions addressed the concurrent criterion validity of alternate presentation formats of critical content monitoring and the measure's…

  4. Test-Retest Reliability of Dual-Task Outcome Measures in People With Parkinson Disease

    NARCIS (Netherlands)

    Strouwen, C.; Molenaar, E.A.; Keus, S.H.; Munks, L.; Bloem, B.R.; Nieuwboer, A.

    2016-01-01

    BACKGROUND: Dual-task (DT) training is gaining ground as a physical therapy intervention in people with Parkinson disease (PD). Future studies evaluating the effect of such interventions need reliable outcome measures. To date, the test-retest reliability of DT measures in patients with PD remains l

  5. Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation

    Science.gov (United States)

    Francis, David O.; Daniero, James J.; Hovis, Kristen L.; Sathe, Nila; Jacobson, Barbara; Penson, David F.; Feurer, Irene D.; McPheeters, Melissa L.

    2017-01-01

    Purpose: The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties. Method: MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and the Health…

  6. Proof in the Pudding: Implications of Measure Selection in Academic Outcomes Assessment

    Science.gov (United States)

    Priniski, Stacy J.; Winterrowd, Erin

    2017-01-01

    Academic outcomes assessment in student affairs is integral for both service improvement and demonstrating the unit's value to the university's academic mission. However, identifying the right measures is challenging. We implemented three common measures (pre-post self-reported academic functioning, retrospective perceptions of service impact, and…

  7. Fatigue is a reliable, sensitive and unique outcome measure in rheumatoid arthritis.

    LENUS (Irish Health Repository)

    Minnock, Patricia

    2009-12-01

    Fatigue is an important symptom in patients with RA. Measurement of fatigue in clinical trials and in clinical practice requires scales that are reproducible, sensitive to change and practical. This study examined the reliability and sensitivity to change of fatigue and its relative independence as an outcome measure in RA.

  8. How measurement artifacts affect cerebral autoregulation outcomes: A technical note on transfer function analysis.

    Science.gov (United States)

    Meel-van den Abeelen, Aisha S S; de Jong, Daan L K; Lagro, Joep; Panerai, Ronney B; Claassen, Jurgen A H R

    2016-05-01

    Cerebral autoregulation (CA) is the mechanism that aims to maintain adequate cerebral perfusion during changes in blood pressure (BP). Transfer function analysis (TFA), the most reported method in literature to quantify CA, shows large between-study variability in outcomes. The aim of this study is to investigate the role of measurement artifacts in this variation. Specifically, the role of distortion in the BP and/or CBFV measurementon TFA outcomes was investigated. The influence of three types of artifacts on TFA outcomes was studied: loss of signal, motion artifacts, and baseline drifts. TFA metrics of signals without the simulated artifacts were compared with those of signals with artifacts. TFA outcomes scattered highly when more than 10% of BP signal or over 8% of the CBFV signal was lost, or when measurements contained one or more artifacts resulting from head movement. Furthermore, baseline drift affected interpretation of TFA outcomes when the power in the BP signal was 5 times the power in the LF band. In conclusion, loss of signal in BP and loss in CBFV, affects interpretation of TFA outcomes. Therefore, it is vital to validate signal quality to the defined standards before interpreting TFA outcomes.

  9. Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire.

    Science.gov (United States)

    Sutton, Anna

    2016-11-01

    Dispositional self-awareness is conceptualized in several different ways, including insight, reflection, rumination and mindfulness, with the latter in particular attracting extensive attention in recent research. While self-awareness is generally associated with positive psychological well-being, these different conceptualizations are also each associated with a range of unique outcomes. This two part, mixed methods study aimed to advance understanding of dispositional self-awareness by developing a questionnaire to measure its outcomes. In Study 1, expert focus groups categorized and extended an initial pool of potential items from previous research. In Study 2, these items were reduced to a 38 item self-report questionnaire with four factors representing three beneficial outcomes (reflective self-development, acceptance and proactivity) and one negative outcome (costs). Regression of these outcomes against self-awareness measures revealed that self-reflection and insight predicted beneficial outcomes, rumination predicted reduced benefits and increased costs, and mindfulness predicted both increased proactivity and costs. These studies help to refine the self-awareness concept by identifying the unique outcomes associated with the concepts of self-reflection, insight, reflection, rumination and mindfulness. It can be used in future studies to evaluate and develop awareness-raising techniques to maximize self-awareness benefits while minimizing related costs.

  10. Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire

    Directory of Open Access Journals (Sweden)

    Anna Sutton

    2016-11-01

    Full Text Available Dispositional self-awareness is conceptualized in several different ways, including insight, reflection, rumination and mindfulness, with the latter in particular attracting extensive attention in recent research. While self-awareness is generally associated with positive psychological well-being, these different conceptualizations are also each associated with a range of unique outcomes. This two part, mixed methods study aimed to advance understanding of dispositional self-awareness by developing a questionnaire to measure its outcomes. In Study 1, expert focus groups categorized and extended an initial pool of potential items from previous research. In Study 2, these items were reduced to a 38 item self-report questionnaire with four factors representing three beneficial outcomes (reflective self-development, acceptance and proactivity and one negative outcome (costs. Regression of these outcomes against self-awareness measures revealed that self-reflection and insight predicted beneficial outcomes, rumination predicted reduced benefits and increased costs, and mindfulness predicted both increased proactivity and costs. These studies help to refine the self-awareness concept by identifying the unique outcomes associated with the concepts of self-reflection, insight, reflection, rumination and mindfulness. It can be used in future studies to evaluate and develop awareness-raising techniques to maximize self-awareness benefits while minimizing related costs.

  11. Associations among Nine Family Dinner Frequency Measures and Child Weight, Dietary, and Psychosocial Outcomes.

    Science.gov (United States)

    Horning, Melissa L; Fulkerson, Jayne A; Friend, Sarah E; Neumark-Sztainer, Dianne

    2016-06-01

    Family meal frequency has been consistently and significantly associated with positive youth dietary and psychosocial outcomes, but less consistently associated with weight outcomes. Family meal frequency measurement has varied widely and it is unclear how this variation might impact relationships with youth weight, dietary, and psychosocial outcomes. This study assesses how five parent/caregiver-reported and four child-reported family dinner frequency measures correlate with each other and are associated with health-related outcomes. This secondary, cross-sectional analysis uses baseline, parent/caregiver (n=160) and 8- to 12-year-old child (n=160) data from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus trial (collected 2011 to 2012). Data were obtained from objective measurements, dietary recall interviews, and psychosocial surveys. Outcomes included child body mass index z scores (BMIz); fruit, vegetable, and sugar-sweetened beverage intake; dietary quality (Healthy Eating Index-2010); family connectedness; and meal conversations. Pearson correlations and general linear models were used to assess associations between family dinner frequency measures and outcomes. All family dinner frequency measures had comparable means and were correlated within and across parent/caregiver and child reporters (r=0.17 to 0.94; Pfamily dinner frequency measures were significantly associated with BMIz and 100% were significantly associated with fruit and vegetable intake and Healthy Eating Index-2010. In adjusted models, most significant associations with dietary and psychosocial outcomes remained, but associations with child BMIz remained significant only for parent/caregiver- (β±standard error=-.07±.03; Pfamily dinner frequency measures asking about "sitting and eating" dinner. Despite phrasing variations in family dinner frequency measures (eg, which family members were present and how meals were occurring), few differences were found in associations

  12. Accelerometer thresholds: Accounting for body mass reduces discrepancies between measures of physical activity for individuals with overweight and obesity.

    Science.gov (United States)

    Raiber, Lilian; Christensen, Rebecca A G; Jamnik, Veronica K; Kuk, Jennifer L

    2017-01-01

    The objective of this study was to explore whether accelerometer thresholds that are adjusted to account for differences in body mass influence discrepancies between self-report and accelerometer-measured physical activity (PA) volume for individuals with overweight and obesity. We analyzed 6164 adults from the National Health and Nutrition Examination Survey between 2003-2006. Established accelerometer thresholds were adjusted to account for differences in body mass to produce a similar energy expenditure (EE) rate as individuals with normal weight. Moderate-, vigorous-, and moderate- to vigorous-intensity PA (MVPA) durations were measured using established and adjusted accelerometer thresholds and compared with self-report. Durations of self-report were longer than accelerometer-measured MVPA using established thresholds (normal weight: 57.8 ± 2.4 vs 9.0 ± 0.5 min/day, overweight: 56.1 ± 2.7 vs 7.4 ± 0.5 min/day, and obesity: 46.5 ± 2.2 vs 3.7 ± 0.3 min/day). Durations of subjective and objective PA were negatively associated with body mass index (BMI) (P overweight and obese groups by 6.0 ± 0.3 min/day and 17.7 ± 0.8 min/day, respectively (P overweight and obese groups. However, accelerometer-measured PA generally remained shorter than durations of self-report within all BMI categories. Further research may be necessary to improve analytical approaches when using objective measures of PA for individuals with overweight or obesity.

  13. Translating patient reported outcome measures: methodological issues explored using cognitive interviewing with three rheumatoid arthritis measures in six European languages

    NARCIS (Netherlands)

    Hewlett, Sarah E.; Nicklin, Joanna; Bode, Christina; Carmona, Loretto; Dures, Emma; Engelbrecht, Matthias; Hagel, Sofia; Kirwan, John R.; Molto, Anna; Redondo, Marta; Gossec, Laure

    2016-01-01

    Objective. Cross-cultural translation of patient-reported outcome measures (PROMs) is a lengthy process, often performed professionally. Cognitive interviewing assesses patient comprehension of PROMs. The objective was to evaluate the usefulness of cognitive interviewing to assess translations and c

  14. Patient reported outcomes measures in neurogenic bladder and bowel: A systematic review of the current literature.

    Science.gov (United States)

    Patel, Darshan P; Elliott, Sean P; Stoffel, John T; Brant, William O; Hotaling, James M; Myers, Jeremy B

    2016-01-01

    To describe existing bladder and bowel specific quality of life (QoL) measurement tools, QoL in patients with multiple sclerosis (MS), spinal cord injury (SCI), Parkinson's Disease (PD), stroke, or spina bifida (SB) affected by bladder or bowel dysfunction, and the impact of specific bladder and bowel management on QoL. We performed a systematic review in PubMed/Medline databases in accordance with the PRISMA statement for English publications between January 1, 2000 and January 1, 2014. Articles were first screened based on their abstract and select full-text articles were then reviewed for eligibility. Articles with no QoL or PROM assessing urinary or bowel dysfunction were excluded. Risk of bias assessment included randomization, incomplete outcomes data, selective outcomes reporting, and other biases. All articles were graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system as per the Cochrane Handbook for Systematic Reviews of Interventions. The most common QoL measurement tool for urinary and bowel dysfunction was the Medical Outcomes Study SF-36. Twelve (24%) studies used only non-validated QoL questionnaires. Only three urinary or bowel specific QoL measures were found: the Qualiveen questionnaire, the FICQoL, and the QoL-BM. Several studies identified instances were clinical and patient-reported outcomes were inconsistent particularly with indwelling urinary catheter usage and reconstructive surgery. Additionally, certain clinical outcomes surrogates commonly used as primary outcomes measures may not correlate with the patient reported outcomes (PRO). Current PRO measures (PROM) and QoL assessments are heterogeneous and several inconsistencies in clinical and PRO for various management options exist. Standardized PROM will help identify optimal bladder and bowel management for patients with neurologic conditions. © 2014 Wiley Periodicals, Inc.

  15. Improving the Accuracy of Satellite Sea Surface Temperature Measurements by Explicitly Accounting for the Bulk-Skin Temperature Difference

    Science.gov (United States)

    Castro, Sandra L.; Emery, William J.

    2002-01-01

    The focus of this research was to determine whether the accuracy of satellite measurements of sea surface temperature (SST) could be improved by explicitly accounting for the complex temperature gradients at the surface of the ocean associated with the cool skin and diurnal warm layers. To achieve this goal, work centered on the development and deployment of low-cost infrared radiometers to enable the direct validation of satellite measurements of skin temperature. During this one year grant, design and construction of an improved infrared radiometer was completed and testing was initiated. In addition, development of an improved parametric model for the bulk-skin temperature difference was completed using data from the previous version of the radiometer. This model will comprise a key component of an improved procedure for estimating the bulk SST from satellites. The results comprised a significant portion of the Ph.D. thesis completed by one graduate student and they are currently being converted into a journal publication.

  16. Developing measures of community-relevant outcomes for violence prevention programs: a community-based participatory research approach to measurement.

    Science.gov (United States)

    Hausman, Alice J; Baker, Courtney N; Komaroff, Eugene; Thomas, Nicole; Guerra, Terry; Hohl, Bernadette C; Leff, Stephen S

    2013-12-01

    Community-Based Participatory Research is a research paradigm that encourages community participation in designing and implementing evaluation research, though the actual outcome measures usually reflect the "external" academic researchers' view of program effect and the policy-makers' needs for decision-making. This paper describes a replicable process by which existing standardized psychometric scales commonly used in youth-related intervention programs were modified to measure indicators of program success defined by community partners. This study utilizes a secondary analysis of data gathered in the context of a community-based youth violence prevention program. Data were retooled into new measures developed using items from the Alabama Parenting Questionnaire, the Hare Area Specific Self-Esteem Scale, and the Youth Asset Survey. These measures evaluated two community-defined outcome indicators, "More Parental Involvement" and "Showing Kids Love." Results showed that existing scale items can be re-organized to create measures of community-defined outcomes that are psychometrically reliable and valid. Results also show that the community definitions of parent or parenting caregivers exemplified by the two indicators are similar to how these constructs have been defined in previous research, but they are not synonymous. There are nuanced differences that are important and worthy of better understanding, in part through better measurement.

  17. TSS concentration in sewers estimated from turbidity measurements by means of linear regression accounting for uncertainties in both variables.

    Science.gov (United States)

    Bertrand-Krajewski, J L

    2004-01-01

    In order to replace traditional sampling and analysis techniques, turbidimeters can be used to estimate TSS concentration in sewers, by means of sensor and site specific empirical equations established by linear regression of on-site turbidity Tvalues with TSS concentrations C measured in corresponding samples. As the ordinary least-squares method is not able to account for measurement uncertainties in both T and C variables, an appropriate regression method is used to solve this difficulty and to evaluate correctly the uncertainty in TSS concentrations estimated from measured turbidity. The regression method is described, including detailed calculations of variances and covariance in the regression parameters. An example of application is given for a calibrated turbidimeter used in a combined sewer system, with data collected during three dry weather days. In order to show how the established regression could be used, an independent 24 hours long dry weather turbidity data series recorded at 2 min time interval is used, transformed into estimated TSS concentrations, and compared to TSS concentrations measured in samples. The comparison appears as satisfactory and suggests that turbidity measurements could replace traditional samples. Further developments, including wet weather periods and other types of sensors, are suggested.

  18. Measuring stress before and during pregnancy: a review of population-based studies of obstetric outcomes.

    Science.gov (United States)

    Witt, Whitney P; Litzelman, Kristin; Cheng, Erika R; Wakeel, Fathima; Barker, Emily S

    2014-01-01

    Mounting evidence from clinic and convenience samples suggests that stress is an important predictor of adverse obstetric outcomes. Using a proposed theoretical framework, this review identified and synthesized the population-based literature on the measurement of stress prior to and during pregnancy in relation to obstetric outcomes. Population-based, peer-reviewed empirical articles that examined stress prior to or during pregnancy in relation to obstetric outcomes were identified in the PubMed and PsycInfo databases. Articles were evaluated to determine the domain(s) of stress (environmental, psychological, and/or biological), period(s) of stress (preconception and/or pregnancy), and strength of the association between stress and obstetric outcomes. Thirteen studies were evaluated. The identified studies were all conducted in developed countries. The majority of studies examined stress only during pregnancy (n = 10); three examined stress during both the preconception and pregnancy periods (n = 3). Most studies examined the environmental domain (e.g. life events) only (n = 9), two studies examined the psychological domain only, and two studies examined both. No study incorporated a biological measure of stress. Environmental stressors before and during pregnancy were associated with worse obstetric outcomes, although some conflicting findings exist. Few population-based studies have examined stress before or during pregnancy in relation to obstetric outcomes. Although considerable variation exists in the measurement of stress across studies, environmental stress increased the risk for poor obstetric outcomes. Additional work using a lifecourse approach is needed to fill the existing gaps in the literature and to develop a more comprehensive understanding of the mechanisms by which stress impacts obstetric outcomes.

  19. The importance of quality of survival as an outcome measure for an integrated trauma system.

    Science.gov (United States)

    Cameron, Peter A; Gabbe, Belinda J; McNeil, John J

    2006-12-01

    Risk-adjusted survival rates have been the principle mode of comparison between trauma systems. In mature trauma systems, it is possible that there will be further improvements in survival but these are likely to be small. In the future, the largest gains will come from quality of life and improved function of the survivors. The issues related to measuring quality of survival for trauma systems are reviewed, including feasibility, ethical considerations, risk adjustment of outcomes of survivors, and challenges for selection of instruments and administration. In addition, the preliminary experiences of measuring outcomes in survivors through the Victorian State Trauma Registry are discussed. Although function and quality of life have been identified as important factors to measure in trauma populations, a standardised protocol has not been established. The experience in Victoria suggests that monitoring of population-based outcomes in survivors is feasible and may create the basis for benchmarking the level of morbidity in survivors.

  20. A scoping review of outcomes related to orthodontic treatment measured in cleft lip and palate.

    Science.gov (United States)

    Tsichlaki, A; O'Brien, K; Johal, A; Fleming, P S

    2017-05-01

    The aim of this study was to identify and summarize the outcomes measured in orthodontic studies of children with cleft lip and/or palate. The objectives were to categorize the outcomes into pre-determined domains and to explore whether any domains were under-represented. Electronic databases and grey literature were searched until December 2016 to identify all studies of orthodontic treatment interventions in children and adolescents with cleft lip and palate. Abstracts and subsequently eligible full-text articles were screened independently and in duplicate by two reviewers. All reported outcome measures were identified and categorized into six predetermined outcome domains. The search identified 833 abstracts. The majority of studies did not assess orthodontic interventions and were therefore not eligible for inclusion. Consequently, following screening 71 eligible articles were retrieved in full, of which 40 met the inclusion criteria. Morphological features of malocclusion were measured in 27 studies (68%) and adverse effects of orthodontic treatment in 10 (25%). Functional status (n=4; 10%), physical consequences of malocclusion (n=3; 7.5%), quality of life (n=3; 7.5%) and health resource utilization (n=2; 5%) were rarely considered. Relatively few studies concerning patients with cleft lip and palate focused on orthodontic interventions. Most of the identified outcomes were concerned with measuring morphological treatment-related changes and do not reflect patient perspectives. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Measure of functional independence dominates discharge outcome prediction after inpatient rehabilitation for stroke.

    Science.gov (United States)

    Brown, Allen W; Therneau, Terry M; Schultz, Billie A; Niewczyk, Paulette M; Granger, Carl V

    2015-04-01

    Identifying clinical data acquired at inpatient rehabilitation admission for stroke that accurately predict key outcomes at discharge could inform the development of customized plans of care to achieve favorable outcomes. The purpose of this analysis was to use a large comprehensive national data set to consider a wide range of clinical elements known at admission to identify those that predict key outcomes at rehabilitation discharge. Sample data were obtained from the Uniform Data System for Medical Rehabilitation data set with the diagnosis of stroke for the years 2005 through 2007. This data set includes demographic, administrative, and medical variables collected at admission and discharge and uses the FIM (functional independence measure) instrument to assess functional independence. Primary outcomes of interest were functional independence measure gain, length of stay, and discharge to home. The sample included 148,367 people (75% white; mean age, 70.6±13.1 years; 97% with ischemic stroke) admitted to inpatient rehabilitation a mean of 8.2±12 days after symptom onset. The total functional independence measure score, the functional independence measure motor subscore, and the case-mix group were equally the strongest predictors for any of the primary outcomes. The most clinically relevant 3-variable model used the functional independence measure motor subscore, age, and walking distance at admission (r(2)=0.107). No important additional effect for any other variable was detected when added to this model. This analysis shows that a measure of functional independence in motor performance and age at rehabilitation hospital admission for stroke are predominant predictors of outcome at discharge in a uniquely large US national data set. © 2015 American Heart Association, Inc.

  2. Rethinking exploitation: a process-centered account.

    Science.gov (United States)

    Jansen, Lynn A; Wall, Steven

    2013-12-01

    Exploitation has become an important topic in recent discussions of biomedical and research ethics. This is due in no small measure to the influence of Alan Wertheimer's path-breaking work on the subject. This paper presents some objections to Wertheimer's account of the concept. The objections attempt to show that his account places too much emphasis on outcome-based considerations and too little on process-based considerations. Building on these objections, the paper develops an alternative process-centered account of the concept. This alternative account of exploitation takes as its point of departure the broadly Kantian notion that it is wrong to use another as an instrument for the advancement of one's own ends. It sharpens this slippery notion and adds a number of refinements to it. The paper concludes by arguing that process-centered accounts of exploitation better illuminate the ethical challenges posed by research on human subjects than outcome-centered accounts.

  3. A Critical Review of Audiological Outcome Measures for Infants and Children

    Science.gov (United States)

    Moodie, Sheila T.; Seewald, Richard C.; Bartlett, Doreen J.; Scollie, Susan D.

    2011-01-01

    Outcome evaluation is an important stage in the pediatric hearing aid fitting process, however a systematic way of evaluating outcome in the pediatric audiology population is lacking. This is in part due to the need for an evidence-based outcome evaluation guideline for infants and children with hearing loss who wear hearing aids. As part of the development of a guideline, a critical review of the existing pediatric audiology outcome evaluation tools was conducted. Subjective outcome evaluation tools that measure auditory-related behaviors in children from birth to 6 years of age were critically appraised using a published grading system (Andresen, 2000). Of the tools that exist, 12 were appraised because they met initial criteria outlined by the Network of Pediatric Audiologists of Canada as being appropriate for children birth to 6 years of age who wear hearing aids. Tools that were considered for the guideline scored high in both statistical and feasibility criteria. The subjective outcome evaluation tools that were ultimately chosen to be included in the guideline were the LittlEARS Auditory Questionnaire (Tsiakpini et al., 2004) and the Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) Rating Scale (Ching & Hill, 2005b) due to the high grades they received in the critical review and their target age ranges. Following this critical review of pediatric outcome evaluation tools, the next step was for the Network Clinicians to evaluate the guideline (Moodie et al., 2011b). PMID:21873343

  4. Challenges encountered in measuring outcome for a rural psychiatric residential program.

    Science.gov (United States)

    Arfken, C L; Wilson, J G; Hegedus, A M

    2002-06-01

    Evaluation of outcome measures can provide policymakers with valuable information on the effectiveness of psychiatric rehabilitation. Two specific challenges in collecting outcome measures for psychiatric rehabilitation programs are heterogeneity of outcomes and difficulty with follow-up. These two challenges were illustrated in the process of evaluating Rose Hill Center, a rural residential psychiatric rehabilitation program. The original design was to conduct interviews with former residents and family members and verify healthcare utilization. The difficulty of locating people and their reluctance to participate conspired to lower the follow-up rates. The design was modified to improve the follow-up rate but decrease the details of specific outcomes. The results showed a high but biased follow-up rate, with more information obtained for people who graduated from the program. The residents with planned discharge showed excellent outcomes in terms of living situation, working situation, healthcare utilization, and low severity of current symptoms. High compliance with medication spoke to the program's philosophy of including the residents in the decision-making process. The dual challenges of heterogeneity of outcomes and difficulty in follow-up that limit efforts to document the value of psychiatric rehabilitation are discussed.

  5. Evaluating health visitor parenting support: validating outcome measures for parental self-efficacy.

    Science.gov (United States)

    Whittaker, Karen A; Cowley, Sarah

    2006-12-01

    Parenting support has become an increasing feature of child health services within the United Kingdom but typically, outcome measures available for testing the effectiveness of parenting interventions have been developed and validated elsewhere. This article reports the results of a feasibility study testing the Parenting Self-Agency Measure (PSAM) and subscales from the Self-Efficacy for Parenting Tasks Index (SEPTI) as outcome measures for UK-based parenting support programmes. Forty-six mothers and 10 fathers accessing routine health visitor and school nurse services participated in the test-re-test of the scales and commented separately on the acceptability of scale questions. Very large intra-class correlation results indicated good repeatability but alpha coefficient scores and factor analysis results suggest that UK respondents may not recognize SEPTI subscales items as measuring single dimensions. The PSAM was a more stable measure of parenting self-beliefs than the SEPTI subscales when tested with a UK sample of parents.

  6. Measurement of Educational Progress in the Context of Local Demographics: Using General Outcome Measurement as a Basis for the Development and Use of Local Norms

    Science.gov (United States)

    Koehler-Hak, Kathrine M.

    2014-01-01

    General outcome measurement, a specific type of formative evaluation, can be used to assess progress toward long-term academic goals. Curriculum-based measurement is a widely used type of general outcome measurement. When used to develop local norms, curriculum-based measurement data are helpful in making individual student and systems-level…

  7. Methods for Developing Patient-Reported Outcome-Based Performance Measures (PRO-PMs).

    Science.gov (United States)

    Basch, Ethan; Spertus, John; Dudley, R Adams; Wu, Albert; Chuahan, Cynthia; Cohen, Perry; Smith, Mary Lou; Black, Nick; Crawford, Amaris; Christensen, Keri; Blake, Kathleen; Goertz, Christine

    2015-06-01

    To recommend methods for assessing quality of care via patient-reported outcome-based performance measures (PRO-PMs) of symptoms, functional status, and quality of life. A Technical Expert Panel was assembled by the American Medical Association-convened Physician Consortium for Performance Improvement. An environmental scan and structured literature review were conducted to identify quality programs that integrate PRO-PMs. Key methodological considerations in the design, implementation, and analysis of these PRO-PM data were systematically identified. Recommended methods for addressing each identified consideration were developed on the basis of published patient-reported outcome (PRO) standards and refined through public comment. Literature review focused on programs using PROs to assess performance and on PRO guidance documents. Thirteen PRO programs and 10 guidance documents were identified. Nine best practices were developed, including the following: provide a rationale for measuring the outcome and for using a PRO-PM; describe the context of use; select a measure that is meaningful to patients with adequate psychometric properties; provide evidence of the measure's sensitivity to differences in care; address missing data and risk adjustment; and provide a framework for implementation, interpretation, dissemination, and continuous refinement. Methods for integrating PROs into performance measurement are available. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Psychometric properties of carer-reported outcome measures in palliative care: A systematic review.

    Science.gov (United States)

    Michels, Charlotte T J; Boulton, Mary; Adams, Astrid; Wee, Bee; Peters, Michele

    2016-01-01

    Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers' outcomes is a common problem. To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures' psychometric properties. A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required. © The Author(s) 2015.

  9. CONSIDER - Core Outcome Set in IAD Research: study protocol for establishing a core set of outcomes and measurements in incontinence-associated dermatitis research.

    Science.gov (United States)

    Van den Bussche, Karen; De Meyer, Dorien; Van Damme, Nele; Kottner, Jan; Beeckman, Dimitri

    2017-10-01

    This study protocol describes the methodology for the development of a core set of outcomes and a core set of measurements for incontinence-associated dermatitis. Incontinence is a widespread disorder with an important impact on quality of life. One of the most common complications is incontinence-associated dermatitis, resulting from chemical and physical irritation of the skin barrier, triggering inflammation and skin damage. Managing incontinence-associated dermatitis is an important challenge for nurses. Several interventions have been assessed in clinical trials, but heterogeneity in study outcomes complicates the comparability and standardization. To overcome this challenge, the development of a core outcome set, a minimum set of outcomes and measurements to be assessed in clinical research, is needed. A project team, International Steering Committee and panelists will be involved to guide the development of the core outcome set. The framework of the Harmonizing Outcomes Measures for Eczema roadmap endorsed by Cochrane Skin Group Core Outcomes Set Initiative, is used to inform the project design. A systematic literature review, interviews to integrate the patients' perspective and a consensus study with healthcare researchers and providers using the Delphi procedure will be performed. The project was approved by the Ethics review Committee (April 2016). This is the first project that will identify a core outcome set of outcomes and measurements for incontinence-associated dermatitis research. A core outcome set will reduce possible reporting bias, allow results comparisons and statistical pooling across trials and strengthen evidence-based practice and decision-making. This project has been registered in the Core Outcome Measures in Effectiveness Trials (COMET) database and is part of the Cochrane Skin Group Core Outcomes Set Initiative (CSG-COUSIN). © 2016 John Wiley & Sons Ltd.

  10. Goal specificity: a proxy measure for improvements in environmental outcomes in collaborative governance.

    Science.gov (United States)

    Biddle, Jennifer C; Koontz, Tomas M

    2014-12-01

    Collaborative governance critics continually call for evidence to support its prevalent use. As is often the case in environmental policy, environmental outcomes occur at a rate incompatible with political agendas. In addition, a multitude of possibly confounding variables makes it difficult to correlate collaborative governance processes with environmental outcomes. The findings of this study offer empirical evidence that collaborative processes have a measurable, beneficial effect on environmental outcomes. Through the use of a unique paired-waterbody design, our dataset reduced the potential for confounding variables to impact our environmental outcome measurements. The results of a path analysis indicate that the output of setting specific pollutant reduction goals is significantly related to watershed partnerships' level of attainment of their environmental improvement goals. The action of setting specific goals (e.g. percentage of load reductions in pollutant levels) is fostered by sustained participation from partnership members throughout the lifecycle of the collaborative. In addition, this study demonstrates the utility of logic modeling for environmental planning and management, and suggests that the process of setting specific pollutant reduction goals is a useful proxy measure for reporting progress towards improvements in environmental outcomes when long-term environmental data are not available.

  11. DTI measures track and predict motor function outcomes in stroke rehabilitation utilizing BCI technology.

    Science.gov (United States)

    Song, Jie; Nair, Veena A; Young, Brittany M; Walton, Leo M; Nigogosyan, Zack; Remsik, Alexander; Tyler, Mitchell E; Farrar-Edwards, Dorothy; Caldera, Kristin E; Sattin, Justin A; Williams, Justin C; Prabhakaran, Vivek

    2015-01-01

    Tracking and predicting motor outcomes is important in determining effective stroke rehabilitation strategies. Diffusion tensor imaging (DTI) allows for evaluation of the underlying structural integrity of brain white matter tracts and may serve as a potential biomarker for tracking and predicting motor recovery. In this study, we examined the longitudinal relationship between DTI measures of the posterior limb of the internal capsule (PLIC) and upper-limb motor outcomes in 13 stroke patients (median 20-month post-stroke) who completed up to 15 sessions of intervention using brain-computer interface (BCI) technology. Patients' upper-limb motor outcomes and PLIC DTI measures including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were assessed longitudinally at four time points: pre-, mid-, immediately post- and 1-month-post intervention. DTI measures and ratios of each DTI measure comparing the ipsilesional and contralesional PLIC were correlated with patients' motor outcomes to examine the relationship between structural integrity of the PLIC and patients' motor recovery. We found that lower diffusivity and higher FA values of the ipsilesional PLIC were significantly correlated with better upper-limb motor function. Baseline DTI ratios were significantly correlated with motor outcomes measured immediately post and 1-month-post BCI interventions. A few patients achieved improvements in motor recovery meeting the minimum clinically important difference (MCID). These findings suggest that upper-limb motor recovery in stroke patients receiving BCI interventions relates to the microstructural status of the PLIC. Lower diffusivity and higher FA measures of the ipsilesional PLIC contribute toward better motor recovery in the stroke-affected upper-limb. DTI-derived measures may be a clinically useful biomarker in tracking and predicting motor recovery in stroke patients receiving BCI interventions.

  12. Minimal Clinically Important Difference of Patient Reported Outcome Measures of Lower Extremity Injuries in Orthopedics

    Science.gov (United States)

    Çelik, Derya; Çoban, Özge; Kılıçoğlu, Önder

    2017-01-01

    Purpose: MCID scores for outcome measures are frequently used evidence-based guides to gage meaningful changes. To conduct a systematic review of the quality and content of the the minimal clinically important difference (MCID) relating to 16 patient-rated outcome measures (PROM) used in lower extremity. Methods: We conducted a systematic literature review on articles reporting MCID in lower extremity outcome measures and orthopedics from January 1, 1980, to May 10, 2016. We evaluated MCID of the 16 patient reported outcome measures (PROM) which were Harris Hip Score (HHS), Oxford Hip Score (OHS), Hip Outcome Score (HOS), Hip Disability and Osteoarthritis Outcome Score (HOOS), The International Knee Documentation Committee Subjective Knee Form (IKDC), The Lysholm Scale, The Western Ontario Meniscal Evaluation Tool (WOMET), The Anterior Cruciate Ligament Quality of Life Questionnaire (ACL-QOL), The Lower Extremity Functional Scale (LEFS), The Western Ontario and Mcmaster Universities Index (WOMAC), Knee İnjury And Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Kujala Anterior Knee Pain Scale, The Victorian Institute of Sports Assessment Patellar Tendinosis (Jumper’s Knee) (VİSA-P), Tegner Activity Rating Scale, Marx Activity Rating Scale, Foot And Ankle Outcome Score (FAOS), The Foot Function Index (FFI), Foot And Ankle Ability Measure (FAAM), The Foot And Ankle Disability Index Score and Sports Module, Achill Tendon Total Rupture Score(ATRS), The Victorian İnstitute Of Sports Assesment Achilles Questionnaire(VİSA-A), American Orthopaedic Foot and Ankle Society (AOFAS). A search of the PubMed/MEDLINE, PEDro and Cochrane Cen¬tral Register of Controlled Trials and Web of Science databases from the date of inception to May 1, 2016 was conducted. The terms “minimal clinically important difference,” “minimal clinically important change”, “minimal clinically important improvement” “were combined with one of the PROM as mentioned above

  13. Process Accounting

    OpenAIRE

    Gilbertson, Keith

    2002-01-01

    Standard utilities can help you collect and interpret your Linux system's process accounting data. Describes the uses of process accounting, standard process accounting commands, and example code that makes use of process accounting utilities.

  14. Using the analytic hierarchy process to elicit patient preferences: prioritizing multiple outcome measures of antidepressant drug treatment

    NARCIS (Netherlands)

    Hummel, M.J.M.; Volz, F.; Manen, van J.G.; Danner, M.; Dintsios, C.-M.; IJzerman, M.J.; Gerber, A.

    2012-01-01

    Background and Objective: In health technology assessment, the evidence obtained from clinical trials regarding multiple clinical outcomes is used to support reimbursement claims. At present, the relevance of these outcome measures for patients is, however, not systematically assessed, and judgments

  15. Patient-reported Outcome Measurement for Patients With Total Knee Arthroplasty.

    Science.gov (United States)

    Lyman, Stephen; Yin, Kaitlyn L

    2017-02-01

    Total knee arthroplasty is a large contributor to Medicare costs. In an effort to lower costs and improve outcomes, the Centers for Medicaid and Medicare Services has implemented the Comprehensive Care for Joint Replacement model, which incentivizes surgeons to submit both general health and joint-specific patient-reported outcome measures (PROMs). However, in addition to using PROMs for reporting purposes, surgeons should also consider incorporating PROMs into clinical practice. Currently, PROMs are not widely implemented in the clinical setting despite their value in measuring factors such as patients' expectations and mental state, which impact outcomes. Furthermore, as technology improves, PROM collection will become faster and more efficient. The information collected by PROMs can inform treatment decisions and facilitate communication between the surgeon and the patient.

  16. A systematic review of mental health outcome measures for young people aged 12 to 25 years

    OpenAIRE

    Kwan, Benjamin; Rickwood, Debra J.

    2015-01-01

    Background Mental health outcome measures are used to monitor the quality and effectiveness of mental health services. There is also a growing expectation for implementation of routine measurement and measures being used by clinicians as a feedback monitoring system to improve client outcomes. The recent focus in Australia and elsewhere targeting mental health services to young people aged 12–25 years has meant that outcome measures relevant to this age range are now needed. This is a shift f...

  17. Measurement of social participation outcomes in rehabilitation of veterans with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    William Stiers, PhD

    2012-02-01

    Full Text Available Traumatic brain injury (TBI is a significant concern in the veteran population, and the Department of Veteran Affairs (VA has devoted substantial healthcare resources to the rehabilitation of veterans with TBI. Evaluating the outcomes of these rehabilitation activities requires measuring whether they meaningfully improve veterans’ lives, especially with regard to community and vocational participation, which are strongly linked to perceived quality of life. In January 2010, the VA Rehabilitation Research and Development Service convened an invitational conference focused on outcome measurement in rehabilitation with a specific focus on veterans’ community and vocational participation. This article reports on the working group, addressing the issues of conceptualizing and operationalizing such participation outcome measures for veterans with TBI; we discuss conceptual models of participation, review participation subdomains and their instruments of measurement, and identify current research issues and needs. Two avenues are identified for advancing participation measurement in veterans with TBI. First, we describe suggestions to facilitate the immediate implementation of participation measurement into TBI clinical practice and rehabilitation research within the VA healthcare system. Second, we describe recommendations for future VA research funding initiatives specific to improving the measurement of participation in veterans with TBI.

  18. Measuring social inclusion--a key outcome in global mental health.

    Science.gov (United States)

    Baumgartner, Joy Noel; Burns, Jonathan K

    2014-04-01

    Social inclusion is increasingly recognized as a key outcome for evaluating global mental health programmes and interventions. Whereas social inclusion as an outcome is not a new concept in the field of mental health, its measurement has been hampered by varying definitions, concepts and instruments. To move the field forward, this paper reviews the currently available instruments which measure social inclusion and are reported in the literature, realizing that no single measure will be appropriate for all studies or contexts. A systematic literature search of English language peer-reviewed articles published through February 2013 was undertaken to identify scales specifically developed to measure social inclusion or social/community integration among populations with mental disorders. Five instruments were identified through the search criteria. The scales are discussed in terms of their theoretical underpinnings, domains and/or key items and their potential for use in global settings. Whereas numerous reviewed abstracts discussed mental health and social inclusion or social integration, very few were concerned with direct measurement of the construct. All identified scales were developed in high-income countries with limited attention paid to how the scale could be adapted for cross-cultural use. Social inclusion is increasingly highlighted as a key outcome for global mental health policies and programmes, yet its measurement is underdeveloped. There is need for a global cross-cultural measure that has been developed and tested in diverse settings. However, until that need is met, some of the scales presented here may be amenable to adaptation.

  19. Measuring Outcomes in Adult Weight Loss Studies That Include Diet and Physical Activity: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rachel A. Millstein

    2014-01-01

    Full Text Available Background. Measuring success of obesity interventions is critical. Several methods measure weight loss outcomes but there is no consensus on best practices. This systematic review evaluates relevant outcomes (weight loss, BMI, % body fat, and fat mass to determine which might be the best indicator(s of success. Methods. Eligible articles described adult weight loss interventions that included diet and physical activity and a measure of weight or BMI change and body composition change. Results. 28 full-text articles met inclusion criteria. Subjects, settings, intervention lengths, and intensities varied. All studies measured body weight (−2.9 to −17.3 kg, 9 studies measured BMI (−1.1 to −5.1 kg/m2, 20 studies measured % body fat (−0.7 to −10.2%, and 22 studies measured fat mass (−0.9 to −14.9 kg. All studies found agreement between weight or BMI and body fat mass or body fat % decreases, though there were discrepancies in degree of significance between measures. Conclusions. Nearly all weight or BMI and body composition measures agreed. Since body fat is the most metabolically harmful tissue type, it may be a more meaningful measure of health change. Future studies should consider primarily measuring % body fat, rather than or in addition to weight or BMI.

  20. Accounting for graduate medical education production of primary care physicians and general surgeons: timing of measurement matters.

    Science.gov (United States)

    Petterson, Stephen; Burke, Matthew; Phillips, Robert; Teevan, Bridget

    2011-05-01

    Legislation proposed in 2009 to expand GME set institutional primary care and general surgery production eligibility thresholds at 25% at entry into training. The authors measured institutions' production of primary care physicians and general surgeons on completion of first residency versus two to four years after graduation to inform debate and explore residency expansion and physician workforce implications. Production of primary care physicians and general surgeons was assessed by retrospective analysis of the 2009 American Medical Association Masterfile, which includes physicians' training institution, residency specialty, and year of completion for up to six training experiences. The authors measured production rates for each institution based on physicians completing their first residency during 2005-2007 in family or internal medicine, pediatrics, or general surgery. They then reassessed rates to account for those who completed additional training. They compared these rates with proposed expansion eligibility thresholds and current workforce needs. Of 116,004 physicians completing their first residency, 54,245 (46.8%) were in primary care and general surgery. Of 683 training institutions, 586 met the 25% threshold for expansion eligibility. At two to four years out, only 29,963 physicians (25.8%) remained in primary care or general surgery, and 135 institutions lost eligibility. A 35% threshold eliminated 314 institutions collectively training 93,774 residents (80.8%). Residency expansion thresholds that do not account for production at least two to four years after completion of first residency overestimate eligibility. The overall primary care production rate from GME will not sustain the current physician workforce composition. Copyright © by the Association of American medical Colleges.

  1. Refining estimates of public health spending as measured in national health expenditures accounts: the United States experience.

    Science.gov (United States)

    Sensenig, Arthur L

    2007-01-01

    Providing for the delivery of public health services and understanding the funding mechanisms for these services are topics of great currency in the United States. In 2002, the Department of Homeland Security was created and the responsibility for providing public health services was realigned among federal agencies. State and local public health agencies are under increased financial pressures even as they shoulder more responsibilities as the vital first link in the provision of public health services. Recent events, such as hurricanes Katrina and Rita, served to highlight the need to accurately access the public health delivery system at all levels of government. The National Health Expenditure Accounts (NHEA), prepared by the National Health Statistics Group, measure expenditures on healthcare goods and services in the United States. Government public health activity constitutes an important service category in the NHEA. In the most recent set of estimates, Government Public Health Activity expenditures totaled $56.1 billion in 2004, or 3.0 percent of total US health spending. Accurately measuring expenditures for public health services in the United States presents many challenges. Among these challenges is the difficult task of defining what types of government activity constitute public health services. There is no clear-cut, universally accepted definition of government public health care services, and the definitions in the proposed International Classification for Health Accounts are difficult to apply to an individual country's unique delivery systems. Other challenges include the definitional issues associated with the boundaries of healthcare as well as the requirement that census and survey data collected from government(s) be compliant with the Classification of Functions of Government (COFOG), an internationally recognized classification system developed by the United Nations.

  2. Accounting for vegetation height and wind direction to correct eddy covariance measurements of energy fluxes over hilly crop fields

    Science.gov (United States)

    Zitouna-Chebbi, Rim; Prévot, Laurent; Jacob, Frédéric; Voltz, Marc

    2015-05-01

    As agricultural hilly watersheds are widespread throughout the world, there is a strong need for reliable estimates of land surface fluxes, especially evapotranspiration, over crop fields on hilly slopes. In order to obtain reliable estimates from eddy covariance (EC) measurements in such conditions, the current study aimed at proposing adequate planar fit tilt corrections that account for the combined effects of topography, wind direction, and vegetation height on airflow inclinations. EC measurements were collected within an agricultural hilly watershed in northeastern Tunisia, throughout the growth cycles of cereals, legumes, and pasture. The wind had two dominant directions that induced upslope and downslope winds. For upslope winds, the airflows were parallel to the slopes and slightly came closer to the horizontal plane when vegetation grew. For downslope winds, over fields located in the lee of the rim top, the airflows were almost horizontal over bare soil and came closer to the topographical slope when vegetation grew. We therefore adjusted the planar fit tilt correction on EC measurements according to vegetation height and by discriminating between upslope and downslope winds. This adjusted tilt correction improved the energy balance closure in most cases, and the obtained energy balance closures were similar to that reported in the literature for flat conditions. We conclude that EC data collected within crop fields on hilly slopes can be used for monitoring land surface fluxes, provided planar fit tilt corrections are applied in an appropriate manner.

  3. An International Standard Set of Patient-Centered Outcome Measures After Stroke

    NARCIS (Netherlands)

    Salinas, J. (Joel); Sprinkhuizen, S.M. (Sara M.); Ackerson, T. (Teri); Bernhardt, J. (Julie); Davie, C. (Charlie); George, M.G. (Mary G.); Gething, S. (Stephanie); Kelly, A.G. (Adam G.); Lindsay, P. (Patrice); Liu, L. (Liping); Martins, S.C.O. (Sheila C.O.); Morgan, L. (Louise); B. Norrving (Bo); Ribbers, G.M. (Gerard M.); Silver, F.L. (Frank L.); Smith, E.E. (Eric E.); Williams, L.S. (Linda S.); Schwamm, L.H. (Lee H.)

    2015-01-01

    markdownabstract__BACKGROUND AND PURPOSE:__ Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures

  4. Recent advances in outcome measures in IgM-anti-MAG+ neuropathies

    NARCIS (Netherlands)

    Pruppers, Mariëlle H J; Merkies, Ingemar S J; Notermans, Nicolette C

    2015-01-01

    PURPOSE OF REVIEW: This review aims to provide an overview of all randomized trials performed in IgM Anti-Myelin Associated Glycoprotein related peripheral neuropathy (MGUSP) with emphasis on the applied outcome measures including the rationale for their choice and possible limitations, emphasizing

  5. Anastomotic leakage as an outcome measure for quality of colorectal cancer surgery

    NARCIS (Netherlands)

    Snijders, H. S.; Henneman, D.; van Leersum, N. L.; ten Berge, M.; Fiocco, M.; Karsten, T. M.; Havenga, K.; Wiggers, T.; Dekker, J. W.; Tollenaar, R. A. E. M.; Wouters, M. W. J. M.

    2013-01-01

    Introduction When comparing mortality rates between hospitals to explore hospital performance, there is an important role for adjustment for differences in case-mix. Identifying outcome measures that are less influenced by differences in case-mix may be valuable. The main goal of this study was to e

  6. Clinical Utility of the Modified Stroop Task as a Treatment Outcome Measure: Questions Raised

    Science.gov (United States)

    Ball, Jillian R.; Mitchell, Philip B.; Touyz, Stephen W.; Griffiths, Rosalyn A.; Beumont, Pierre J. V.

    2004-01-01

    Data from an outpatient treatment trial for anorexia nervosa were examined to gain preliminary insights as to whether the modified Stroop colour-naming task might offer a useful measure of treatment outcome. It was hypothesised that interference for eating-, weight- and shape-related words on a modified version on the Stroop colour-naming task…

  7. Combining Clinical Information and Patient Reported Outcome Measures in Orthopaedic Surgery and Sports Medicine

    NARCIS (Netherlands)

    Kampen, D.A. van

    2013-01-01

    In this thesis we investigated the use of clinical information and Patient Reported Outcome Measures (PROMs) for patient evaluation in orthopaedic surgery and sports medicine. In the first part, we showed that the Dutch version of the Simple Shoulder Test (SST) is a valid and reliable

  8. Combining Clinical Information and Patient Reported Outcome Measures in Orthopaedic Surgery and Sports Medicine

    NARCIS (Netherlands)

    Kampen, D.A. van

    2013-01-01

    In this thesis we investigated the use of clinical information and Patient Reported Outcome Measures (PROMs) for patient evaluation in orthopaedic surgery and sports medicine. In the first part, we showed that the Dutch version of the Simple Shoulder Test (SST) is a valid and reliable instrumen

  9. A "Learning Platform" Approach to Outcome Measurement in Fragile X Syndrome: A Preliminary Psychometric Study

    Science.gov (United States)

    Hall, S. S.; Hammond, J. L.; Hirt, M.; Reiss, A. L.

    2012-01-01

    Background: Clinical trials of medications to alleviate the cognitive and behavioural symptoms of individuals with fragile X syndrome (FXS) are now underway. However, there are few reliable, valid and/or sensitive outcome measures available that can be directly administered to individuals with FXS. The majority of assessments employed in clinical…

  10. Outcome measures of spiritual care in palliative home care: a qualitative study

    NARCIS (Netherlands)

    Vermandere, M.; Lepeleire, J. De; Mechelen, W. van; Warmenhoven, F.C.; Thoonsen, B.A.; Aertgeerts, B.

    2013-01-01

    The purpose of this study was to identify key outcome measures of spiritual care in palliative home care. A qualitative study was conducted with experts from 3 stakeholder groups (physicians, professional spiritual caregivers, and researchers) representing 2 countries (Belgium and The Netherlands).

  11. Student Identification with Business Education Models: Measurement and Relationship to Educational Outcomes

    Science.gov (United States)

    Halbesleben, Jonathon R. B.; Wheeler, Anthony R.

    2009-01-01

    Although management scholars have provided a variety of metaphors to describe the role of students in management courses, researchers have yet to explore students' identification with the models and how they are linked to educational outcomes. This article develops a measurement tool for students' identification with business education models and…

  12. Measuring the Outcomes of Vocational Education and Training. Review of Research.

    Science.gov (United States)

    Dumbrell, Tom

    Outcome measures are one of three key dimensions of the performance of Australia's vocational education and training (VET) system. The government, employers, students, and the broader community all share an interest in ensuring that Australia's VET system produces skills needed in the labor market. However, each group's views of what constitutes a…

  13. Population-based studies on trauma care: models and measurements of adverse outcome

    NARCIS (Netherlands)

    Jongh, M.A.C. de

    2011-01-01

    In this thesis we investigated whether population-based studies with routinely collected data are eligible to assess (adverse) outcome after trauma. We used the Dutch trauma registry which was designed in order to get insight into the magnitude of trauma victims in the Netherlands and to measure,

  14. Goal Attainment Scaling as an Outcome Measure in Randomized Controlled Trials of Psychosocial Interventions in Autism

    Science.gov (United States)

    Ruble, Lisa; McGrew, John H.; Toland, Michael D.

    2012-01-01

    Goal attainment scaling (GAS) holds promise as an idiographic approach for measuring outcomes of psychosocial interventions in community settings. GAS has been criticized for untested assumptions of scaling level (i.e., interval or ordinal), inter-individual equivalence and comparability, and reliability of coding across different behavioral…

  15. Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baker, Joshua F; Conaghan, Philip G; Emery, Paul;

    2017-01-01

    PURPOSE: We assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA). METHODS: This longitudinal cohort of 291 patients with RA was derived from...... across treatment groups. CONCLUSIONS: MRI measures of inflammation and structural damage correlate independently with physical function, pain and patient global assessments. These observations support the validity of MRI biomarkers. TRIAL REGISTRATION NUMBER: NCT00264537; Post-results....

  16. Training clinicians in how to use patient-reported outcome measures in routine clinical practice

    OpenAIRE

    Santana, MJ; Haverman, L; Absolom, K; Takeuchi, E.; Feeny, D; Grootenhuis, M; Velikova, G

    2015-01-01

    Introduction: Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs data. However, as the experience in using those measures increased, it became obvious the clinical value in using individual patient PROs profiles in daily practice to identify/monitor ...

  17. Simple measures of progress and outcome in the evaluation of mental health services.

    Science.gov (United States)

    Newman, F L; Hunter, R H; Irving, D

    1987-01-01

    There is a tautology regarding the use of progress and outcome measures. Such measures are easy to use in a reliable and valid fashion if the language of the measures is used as an integral part of (a) treatment planning and progress review, (b) clinical supervision, and (c) program management. The paper describes example guidelines and uses of measures in each of these functions. Also included are listings of scales with documented reliability and validity (by target population) and some sources for finding computer software for scoring some of the scales.

  18. Treatment effects model for assessing disease management: measuring outcomes and strengthening program management.

    Science.gov (United States)

    Wendel, Jeanne; Dumitras, Diana

    2005-06-01

    This paper describes an analytical methodology for obtaining statistically unbiased outcomes estimates for programs in which participation decisions may be correlated with variables that impact outcomes. This methodology is particularly useful for intraorganizational program evaluations conducted for business purposes. In this situation, data is likely to be available for a population of managed care members who are eligible to participate in a disease management (DM) program, with some electing to participate while others eschew the opportunity. The most pragmatic analytical strategy for in-house evaluation of such programs is likely to be the pre-intervention/post-intervention design in which the control group consists of people who were invited to participate in the DM program, but declined the invitation. Regression estimates of program impacts may be statistically biased if factors that impact participation decisions are correlated with outcomes measures. This paper describes an econometric procedure, the Treatment Effects model, developed to produce statistically unbiased estimates of program impacts in this type of situation. Two equations are estimated to (a) estimate the impacts of patient characteristics on decisions to participate in the program, and then (b) use this information to produce a statistically unbiased estimate of the impact of program participation on outcomes. This methodology is well-established in economics and econometrics, but has not been widely applied in the DM outcomes measurement literature; hence, this paper focuses on one illustrative application.

  19. Outcome measures and scar aesthetics in minimally invasive video-assisted parathyroidectomy.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2012-02-01

    OBJECTIVES: To compare the scar outcome of video-assisted parathyroidectomy (VAP) with traditional bilateral cervical exploration (BCE) using previously validated scar assessment scales, and to examine the feasibility of introducing VAP into a general otolaryngology-head and neck practice. DESIGN: A retrospective review of medical records from a prospectively obtained database of patients and long-term follow-up of scar analysis. PATIENTS: The records of 60 patients undergoing parathyroidectomy were reviewed: 29 patients underwent VAP and 31 patients underwent an open procedure with BCE. The groups were matched for age and sex. A total of 46 patients were followed up to assess scar outcome. MAIN OUTCOME MEASURES: The primary outcome was a comparison of patient and observer scar satisfaction between VAP and traditional BCE using validated scar assessment tools: the Patient Scar Assessment Scale and the Manchester Scar Scale. The secondary outcomes were to retrospectively evaluate our results with VAP and to assess the suitability of introducing this technique into a general otolaryngology-head and neck practice. RESULTS: The average scar length in the VAP group was 1.7 cm, and the average scar length in the BCE group was 4.3 cm. The patients in the BCE group scored higher than the patients in the VAP group on the Manchester Scar Scale (P < .01) and on the Patient and Observer Scar Scales (P = .02), indicating a worse scar outcome. The mean operative time in the VAP group was 41 minutes compared with 115 minutes in the open procedure BCE group. There was no difference between the 2 groups in terms of postoperative complications. CONCLUSIONS: Video-assisted parathyroidectomy is a safe and feasible procedure in the setting of a general otolaryngology-head and neck practice, with outcomes and complication rates that are comparable to those of traditional bilateral neck exploration. Both patient and observer analysis demonstrated that VAP was associated with a more

  20. Cognitive, neurophysiological, neurological and psychosocial outcomes in early-treated PKU-patients : A start toward standardized outcome measurement across development

    NARCIS (Netherlands)

    van Spronsen, F. J.; Huijbregts, S. C. J.; Bosch, A. M.; Leuzzi, V.

    2011-01-01

    The aim of this paper is to provide a concise summary of findings from outcome studies in early-treated phenylketonuria (PKU). The paper should not be considered as an extensive review of the many different outcome measures that have been used in PKU-research, but as an attempt to integrate such

  1. A tool for evaluating the potential for cost-effective outcomes measurement

    Directory of Open Access Journals (Sweden)

    Somasekhar MM

    2012-04-01

    Full Text Available Melinda M Somasekhar1, Alfred Bove2, Chris Rausch1, James Degnan3, Cathy T King1, Arnold Meyer11The Albert J Finestone, MD, Office for Continuing Medical Education, 2Section of Cardiology, Temple University School of Medicine, Philadelphia, PA, USA; 3Measurement and Research Center, Temple University, Philadelphia, PA, USAAbstract: Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine’s Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a the intended change(s will have a substantial impact on current practice; (b the intended practice change(s are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c the potential change(s affects a large population; (d external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e there is a strong motivation on the part of physicians to implement the intended change(s; and (f the intended change(s is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood

  2. ACCRUAL ACCOUNTING BETWEEN DYNAMISM AND PRUDENCE

    Directory of Open Access Journals (Sweden)

    Mihaela TULVINSCHI

    2016-08-01

    Full Text Available Economic environment and the behavior of the economic entity is in continuous transformation. A determined value today may be outdated tomorrow. Consequently, maintaining a balance in the activity of the economic entity requires corrective actions. The purpose of this article is to highlight the connection between the accrual accounting, the dynamic accounting theory and the accounting prudence. Establishing the optimal timing for recognition of expenses, revenues and outcome, dynamic accounting theory gives managers quality information in order to make the best decisions. Adopting a prudent behavior is necessary in a reasonable measure in order to avoid serious repercussions caused by an exaggerated optimism.

  3. Validation of GAITRite and PROMIS as high-throughput physical function outcome measures following ACL reconstruction.

    Science.gov (United States)

    Papuga, M Owen; Beck, Christopher A; Kates, Stephen L; Schwarz, Edward M; Maloney, Michael D

    2014-06-01

    New healthcare demands for quality measures of elective procedures, such as anterior cruciate ligament (ACL) reconstructive surgery, warrant the establishment of high throughput outcomes for high volume clinics. To this end, we evaluated the PROMIS and GAITRite as physical function outcome measures to quantify early healing and post-operative complications in 106 patients at pre-operative and 3, 10, 20 and 52 weeks post-ACL reconstruction with bone-tendon-bone autograft, and compared the results to the current IKDC validated outcome measure. The results showed that both PROMIS and GAITRite were significantly quicker to administer versus IKDC (pPROMIS and GAITRite detected a significant decrease in physical function at 3 weeks post-operative, and a significant improvement at 10 weeks post-operative versus pre-operative (pPROMIS and IKDC detected significant improvement out to 52 weeks post-operative (pPROMIS, with a combined correlation value of 0.8954 (pPROMIS is a diagnostic test for poor outcomes.

  4. Current measures of metabolic heterogeneity within cervical cancer do not predict disease outcome

    Directory of Open Access Journals (Sweden)

    Brooks Frank J

    2011-06-01

    Full Text Available Abstract Background A previous study evaluated the intra-tumoral heterogeneity observed in the uptake of F-18 fluorodeoxyglucose (FDG in pre-treatment positron emission tomography (PET scans of cancers of the uterine cervix as an indicator of disease outcome. This was done via a novel statistic which ostensibly measured the spatial variations in intra-tumoral metabolic activity. In this work, we argue that statistic is intrinsically non-spatial, and that the apparent delineation between unsuccessfully- and successfully-treated patient groups via that statistic is spurious. Methods We first offer a straightforward mathematical demonstration of our argument. Next, we recapitulate an assiduous re-analysis of the originally published data which was derived from FDG-PET imagery. Finally, we present the results of a principal component analysis of FDG-PET images similar to those previously analyzed. Results We find that the previously published measure of intra-tumoral heterogeneity is intrinsically non-spatial, and actually is only a surrogate for tumor volume. We also find that an optimized linear combination of more canonical heterogeneity quantifiers does not predict disease outcome. Conclusions Current measures of intra-tumoral metabolic activity are not predictive of disease outcome as has been claimed previously. The implications of this finding are: clinical categorization of patients based upon these statistics is invalid; more sophisticated, and perhaps innately-geometric, quantifications of metabolic activity are required for predicting disease outcome.

  5. Thurstone scaling as a measurement method to quantify subjective health outcomes.

    Science.gov (United States)

    Krabbe, Paul F M

    2008-04-01

    Many objective health outcome measures are used to monitor patients or evaluate health interventions, but there are also subjective measures. For the latter, it is difficult to derive metric data, which are needed to quantify health outcomes such as functional disability, severity of side effects, and health status. Thurstone's Law of Comparative Judgment is presented as an alternative means to derive metric values for subjective health outcomes. The appeal of Thurstone's scaling model is that it can transform subjective individual rank order data or comparative preference data to a single group composite interval scale. To demonstrate its contribution, an empirical study was conducted, focusing on the valuation of health states. Rank order data were collected for 18 health states and were then used as input for Thurstone scaling. Visual analogue scale (VAS) values were also collected for the same states. An agency for market research recruited 212 Dutch respondents aged 18-75 years. The derived Thurstone values showed a strong relationship with the VAS values. The positions of the 2 worst states were almost identical on the VAS and the Thurstone scale. Intermediate states were scaled somewhat differently by the 2 methods. For many subjective health outcomes, Thurstone scaling and its derivatives may be an attractive methodology to arrive at quantitative measures.

  6. Validity of behavioral measures as proxies for HIV-related outcomes.

    Science.gov (United States)

    Zimmerman, Rick S; Morisky, Donald E; Harrison, Lana; Mark, Hayley D

    2014-08-15

    Over the last 30 years, expectations for the quality, validity, and objectivity of the outcome measures used to assess the impact of behavior change interventions related to HIV have steadily increased. At this point (mid-2014 at this writing), biologic evidence or biomarkers of the incidence of HIV and other sexually transmitted infections in a target population is clearly preferable to self-reports of behavior. This kind of evidence is, however, much more expensive to collect than participants' reports of behavior change (eg, increased condom use, reduced substance use or abstinence from substance use, and high levels of medication adherence). In addition, although potentially less subject to reporting bias, biomarkers and biologic outcomes have their own flaws. In this article, we review the literature on the validity of self-reports of outcomes most relevant to HIV behavior change interventions, sexual behavior (ever having had sex and condom use), substance use, and medication adherence. We note the extent to which they may be adequate outcome measures without biologic data, and the conditions under which they may be most likely to be sufficient. We also argue, like many others, that where possible, both self-report and biologic measures should be collected.

  7. The Relationship Between Implementation of School-Wide Positive Behavior Intervention and Supports and Performance on State Accountability Measures

    Directory of Open Access Journals (Sweden)

    Adriana M. Marin

    2013-10-01

    Full Text Available This study examined data from 96 schools in a Southeastern U.S. state participating in training and/or coaching on School-Wide Positive Behavioral Interventions and Supports (SWPBIS provided by the State Personnel Development Grant (SPDG in their state. Schools studied either received training only (“non-intensive” sites or training and on-site coaching (“intensive” sites. Fidelity of implementation was self-evaluated by both types of schools using the Benchmarks of Quality (BOQ. Some schools were also externally evaluated using the School-Wide Evaluation Tool (SET, with those scoring 80% or higher determined “model sites.” Using an independent sample t-test, analyses revealed statistically significant differences between intensive and nonintensive schools’ Quality of Distribution Index (QDI scores and between model sites and nonmodel sites on QDI scores. Correlations were performed to determine whether the fidelity of implementation of SWPBIS as measured by the BOQ was related to any of the state’s accountability measures: performance classification, QDI, or growth.

  8. Accounting for measurement error in biomarker data and misclassification of subtypes in the analysis of tumor data.

    Science.gov (United States)

    Nevo, Daniel; Zucker, David M; Tamimi, Rulla M; Wang, Molin

    2016-12-30

    A common paradigm in dealing with heterogeneity across tumors in cancer analysis is to cluster the tumors into subtypes using marker data on the tumor, and then to analyze each of the clusters separately. A more specific target is to investigate the association between risk factors and specific subtypes and to use the results for personalized preventive treatment. This task is usually carried out in two steps-clustering and risk factor assessment. However, two sources of measurement error arise in these problems. The first is the measurement error in the biomarker values. The second is the misclassification error when assigning observations to clusters. We consider the case with a specified set of relevant markers and propose a unified single-likelihood approach for normally distributed biomarkers. As an alternative, we consider a two-step procedure with the tumor type misclassification error taken into account in the second-step risk factor analysis. We describe our method for binary data and also for survival analysis data using a modified version of the Cox model. We present asymptotic theory for the proposed estimators. Simulation results indicate that our methods significantly lower the bias with a small price being paid in terms of variance. We present an analysis of breast cancer data from the Nurses' Health Study to demonstrate the utility of our method. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Quantum Superpositions and the Representation of Physical Reality Beyond Measurement Outcomes and Mathematical Structures

    CERN Document Server

    de Ronde, Christian

    2016-01-01

    In this paper we intend to discuss the importance of providing a physical representation of quantum superpositions which goes beyond the mere reference to mathematical structures and measurement outcomes. This proposal goes in the opposite direction of the orthodox project which attempts to "bridge the gap" between the quantum formalism and common sense "classical reality" --precluding, right from the start, the possibility of interpreting quantum superpositions through non-classical notions. We will argue that in order to restate the problem of interpretation of quantum mechanics in truly ontological terms we require a radical revision of the problems and definitions addressed within the orthodox literature. On the one hand, we will discuss the need of providing a formal redefinition of superpositions which captures their contextual character. On the other hand, we attempt to replace the focus on the measurement problem, which concentrates on the justification of measurement outcomes from "weird" superposed ...

  10. Content validity of patient-reported outcome measures: perspectives from a PROMIS meeting.

    Science.gov (United States)

    Magasi, Susan; Ryan, Gery; Revicki, Dennis; Lenderking, William; Hays, Ron D; Brod, Meryl; Snyder, Claire; Boers, Maarten; Cella, David

    2012-06-01

    Content validity of patient-reported outcome measures (PROs) has been a focus of debate since the 2006 publication of the U.S. FDA Draft Guidance for Industry in Patient Reported Outcome Measurement. Under the auspices of the Patient Reported Outcomes Measurement Information System (PROMIS) initiative, a working meeting on content validity was convened with leading PRO measurement experts. Platform presentations and participant discussion highlighted key issues in the content validity debate, including inconsistency in the definition and evaluation of content validity, the need for empirical research to support methodological approaches to the evaluation of content validity, and concerns that continual re-evaluation of content validity slows the pace of science and leads to the proliferation of study-specific PROs. We advocate an approach to the evaluation of content validity, which includes meticulously documented qualitative and advanced quantitative methods. To advance the science of content validity in PROs, we recommend (1) development of a consensus definition of content validity; (2) development of content validity guidelines that delineate the role of qualitative and quantitative methods and the integration of multiple perspectives; (3) empirical evaluation of generalizability of content validity across applications; and (4) use of generic measures as the foundation for PROs assessment.

  11. Development and initial validation of the ibadan knee/hip osteoarthritis outcome measure

    Directory of Open Access Journals (Sweden)

    A. O. Akinpelu

    2007-02-01

    Full Text Available Background and Aim: Development of outcome measures remains a focus of health research in the 21st century. Outcome measures originally developed for the Nigerian environment are very rare. The aims of this study were to develop an outcome measure for management of hip and knee arthritic conditions, and to investigate the validity and responsiveness of it. Methods: The Ibadan Knee/Hip Osteoarthritis Measure (IKHOAMwas developed from other measures found in literature, as well as complaints of attending patients. Forty nine patients with pain from knee and/or hip osteoarthritis, the OA group (OAG and 49 individuals without knee or hip pain, the pain-free group (PFG were assessed, using the IKHOAM. The OAG was assessed on IKHOAM and the Visual Analogue Scale (VAS before and after a 6-week physiotherapy programme. Results: Significant differences between IKHOAM scores of the OAG and PFG and between IKHOAM scores of OAG pre and post 6-week physiotherapy programme, as well as the significant negative correlations between changes in IKHOAM and VAS scores of OAG before and after the 6-week physiotherapy programme were demonstrated. Conclusion: IKHOAM demonstrated initial criteria towards validity and responsiveness and may be used in a Nigerian population of OA knee/hip individuals and similar environments.

  12. Efficacy Outcome Measures for Procedural Sedation Clinical Trials in Adults: An ACTTION Systematic Review.

    Science.gov (United States)

    Williams, Mark R; McKeown, Andrew; Dexter, Franklin; Miner, James R; Sessler, Daniel I; Vargo, John; Turk, Dennis C; Dworkin, Robert H

    2016-01-01

    Successful procedural sedation represents a spectrum of patient- and clinician-related goals. The absence of a gold-standard measure of the efficacy of procedural sedation has led to a variety of outcomes being used in clinical trials, with the consequent lack of consistency among measures, making comparisons among trials and meta-analyses challenging. We evaluated which existing measures have undergone psychometric analysis in a procedural sedation setting and whether the validity of any of these measures support their use across the range of procedures for which sedation is indicated. Numerous measures were found to have been used in clinical research on procedural sedation across a wide range of procedures. However, reliability and validity have been evaluated for only a limited number of sedation scales, observer-rated pain/discomfort scales, and satisfaction measures in only a few categories of procedures. Typically, studies only examined 1 or 2 aspects of scale validity. The results are likely unique to the specific clinical settings they were tested in. Certain scales, for example, those requiring motor stimulation, are unsuitable to evaluate sedation for procedures where movement is prohibited (e.g., magnetic resonance imaging scans). Further work is required to evaluate existing measures for procedures for which they were not developed. Depending on the outcomes of these efforts, it might ultimately be necessary to consider measures of sedation efficacy to be procedure specific.

  13. Methodological issues in examining measurement equivalence in patient reported outcomes measures: Methods overview to the two-part series, “Measurement equivalence of the Patient Reported Outcomes Measurement Information System® (PROMIS® short forms”

    Directory of Open Access Journals (Sweden)

    Jeanne A. Teresi

    2016-03-01

    Full Text Available The purpose of this article is to introduce the methods used and challenges confronted by the authors of this two-part series of articles describing the results of analyses of measurement equivalence of the short form scales from the Patient Reported Outcomes Measurement Information System® (PROMIS®. Qualitative and quantitative approaches used to examine differential item functioning (DIF are reviewed briefly. Qualitative methods focused on generation of DIF hypotheses. The basic quantitative approaches used all rely on a latent variable model, and examine parameters either derived directly from item response theory (IRT or from structural equation models (SEM. A key methods focus of these articles is to describe state-of-the art approaches to examination of measurement equivalence in eight domains: physical health, pain, fatigue, sleep, depression, anxiety, cognition, and social function. These articles represent the first time that DIF has been examined systematically in the PROMIS short form measures, particularly among ethnically diverse groups. This is also the first set of analyses to examine the performance of PROMIS short forms in patients with cancer. Latent variable model state-of-the-art methods for examining measurement equivalence are introduced briefly in this paper to orient readers to the approaches adopted in this set of papers. Several methodological challenges underlying (DIF-free anchor item selection and model assumption violations are presented as a backdrop for the articles in this two-part series on measurement equivalence of PROMIS measures.

  14. A systematic review of ultrasonography as an outcome measure of skin involvement in systemic sclerosis.

    Science.gov (United States)

    Ch'ng, Shereen S; Roddy, Janet; Keen, Helen I

    2013-06-01

    The modified Rodnan skin score is widely accepted as a validated tool to assess skin involvement in systemic sclerosis, which is a hallmark of this heterogeneous disease. Ultrasonography is increasingly being utilized in the study of other rheumatic diseases. The utility of ultrasonography to measure skin thickness in systemic sclerosis has been explored since three decades ago. The aim of this review was to examine the validity of ultrasonography as an outcome measure of skin involvement in systemic sclerosis. Original articles in English, published before December 2010, pertaining to the use of B mode ultrasound assessing skin involvement in systemic sclerosis were reviewed. Data were extracted with a focus on criterion and construct validity, reproducibility and responsiveness to change. Seventeen papers were analyzed. Skin thickness was most commonly studied, although skin echogenicity has also been examined. There was heterogeneity with regards to subjects, definitions used and sites imaged. Although there was limited information regarding reliability, when reported, the results showed excellent reproducibility. There was also a lack of construct and criterion validity and evidence for sensitivity to change. Ultrasound has potential as an outcome measure in systemic sclerosis. However, more work needs to be done in order to prove that it is a feasible outcome measure with proven validity.

  15. Reporting outcome measures of functional constipation in children from 0 to 4 years of age.

    Science.gov (United States)

    Kuizenga-Wessel, Sophie; Benninga, Marc A; Tabbers, Merit M

    2015-04-01

    Functional constipation (FC) often begins in the first year of life. Although standard definitions and criteria have been formulated to describe FC, these are rarely used in research and clinical practice. The aim of the study is to systematically assess how definitions and outcome measures are defined in therapeutic randomized controlled trials (RCTs) of infants with FC. PubMed, EMBASE, and Cochrane databases were searched. Studies were included if it was a (systematic review of) therapeutic RCT, children ≤4 years old, they had FC, a clear definition of constipation was provided, and were written in English. Quality was assessed using the Delphi list. A total of 1115 articles were found; only 5 studies fulfilled the inclusion criteria. Four different definitions were used, of which only 2 used the internationally accepted Rome III criteria. Defecation frequency was used as primary outcome in all included trials and stool consistency in 3 trials. Two trials involving infants investigated new infant formulas, whereas the third RCT evaluated the efficacy of a probiotic strain. The 2 trials including infants up to 4 years of age compared polyethylene glycol without electrolytes (PEG4000) with lactulose and milk of magnesia. All of the trials used nonvalidated parental diaries. Different definitions and outcome measures for FC in infants are used in RCTs. Disappointingly, there is a lack of well-designed therapeutic trials in infants with constipation. To make comparison between future trials possible, standard definitions, core outcomes, and validated instruments are needed.

  16. Tests examining skill outcomes in sport: a systematic review of measurement properties and feasibility.

    Science.gov (United States)

    Robertson, Samuel J; Burnett, Angus F; Cochrane, Jodie

    2014-04-01

    A high level of participant skill is influential in determining the outcome of many sports. Thus, tests assessing skill outcomes in sport are commonly used by coaches and researchers to estimate an athlete's ability level, to evaluate the effectiveness of interventions or for the purpose of talent identification. The objective of this systematic review was to examine the methodological quality, measurement properties and feasibility characteristics of sporting skill outcome tests reported in the peer-reviewed literature. A search of both SPORTDiscus and MEDLINE databases was undertaken. Studies that examined tests of sporting skill outcomes were reviewed. Only studies that investigated measurement properties of the test (reliability or validity) were included. A total of 22 studies met the inclusion/exclusion criteria. A customised checklist of assessment criteria, based on previous research, was utilised for the purpose of this review. A range of sports were the subject of the 22 studies included in this review, with considerations relating to methodological quality being generally well addressed by authors. A range of methods and statistical procedures were used by researchers to determine the measurement properties of their skill outcome tests. The majority (95%) of the reviewed studies investigated test-retest reliability, and where relevant, inter and intra-rater reliability was also determined. Content validity was examined in 68% of the studies, with most tests investigating multiple skill domains relevant to the sport. Only 18% of studies assessed all three reviewed forms of validity (content, construct and criterion), with just 14% investigating the predictive validity of the test. Test responsiveness was reported in only 9% of studies, whilst feasibility received varying levels of attention. In organised sport, further tests may exist which have not been investigated in this review. This could be due to such tests firstly not being published in the peer

  17. Patient-reported outcome measures in pediatric epilepsy: a content analysis using World Health Organization definitions.

    Science.gov (United States)

    Sadeghi, Salva; Fayed, Nora; Ronen, Gabriel M

    2014-09-01

    Patient-reported outcome (PRO) measures that assess the effect of epilepsy on children's lives include the concepts of health, health-related quality of life (HRQOL), and quality of life (QOL). They also contain varied health and health-related content. Our objectives were to identify what generic and epilepsy-specific PRO instruments are used in childhood epilepsy research and to make explicit their conceptual approach and biopsychosocial content. MEDLINE, EMBASE, and PsycINFO were searched from 2001 to 2011 for PRO measures used in pediatric epilepsy. Measures were analyzed on an item-by-item basis according to World Health Organization (WHO) definitions of QOL and the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) biopsychosocial health framework to distinguish the conceptual approach within each measure. The health content analysis coded each item according to specific ICF-CY components of body function, activity and participation, environment, or personal factors to determine the health content for each measure. Three generic and 13 epilepsy-specific PRO measures were identified; 10 of 16 measures utilized a biopsychosocial health approach rather than an HRQOL or QOL approach. Content analysis showed that in 11 of 16 measures, >25% of the items represented participation and activity components of the ICF-CY, whereas a high proportion of environment items were found in only one epilepsy-specific measure. This comprehensive review provides information aiding clinicians and researchers in the selection of the appropriate PRO instruments for children with epilepsy on the basis of content. Most epilepsy-specific and generic PROs use a biopsychosocial health approach as opposed to a subjective HRQOL/QOL approach to measurement. Clinicians and researchers must be aware of these concepts and content when intending to measure outcomes validly. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  18. The Adjective Check List as an outcome measure: assessment of personality change in psychotherapy.

    Science.gov (United States)

    Itzhar-Nabarro, Zohar; Silberschatz, George; Curtis, John T

    2009-11-01

    To investigate the value of the Adjective Check List (ACL) as a psychotherapy outcome measure, the ACL and Symptom Checklist-90-Revised (SCL-90-R) were administered at four times (before therapy, immediately after therapy, and at 6-month and 1-year follow-ups) to 38 patients in brief dynamic psychotherapy. High correlations between selected ACL scales and SCL-90-R Global Severity Index scores (GSI) were found. GSI change from before to after therapy correlated with change on the ACL scales. Changes from before to after therapy were detected for ACL scales at both the mean group and the individual levels. Because the ACL provides valuable information on personality dimensions as well as concurrent levels of distress, it is a particularly promising psychotherapy outcome measure.

  19. Measurement of cardiorespiratory fitness in children from two commonly used field tests after accounting for body fatness and maturity.

    Science.gov (United States)

    Hamlin, Michael J; Fraser, Meegan; Lizamore, Catherine A; Draper, Nick; Shearman, Jeremy P; Kimber, Nicholas E

    2014-03-27

    Body fat and maturation both influence cardiorespiratory fitness, however few studies have taken these variables into account when using field tests to predict children's fitness levels. The purpose of this study was to determine the relationship between two field tests of cardiorespiratory fitness (20 m Maximal Multistage Shuttle Run [20-MST], 550 m distance run [550-m]) and direct measurement of VO2max after adjustment for body fatness and maturity levels. Fifty-three participants (25 boys, 28 girls, age 10.6 ± 1.2 y, mean ± SD) had their body fat levels estimated using bioelectrical impedance (16.6% ± 6.0% and 20.0% ± 5.8% for boys and girls, respectively). Participants performed in random order, the 20-MST and 550-m run followed by a progressive treadmill test to exhaustion during which gas exchange measures were taken. Pearson correlation coefficient analysis revealed that the participants' performance in the 20-MST and 550-m run were highly correlated to VO2max obtained during the treadmill test to exhaustion (r = 0.70 and 0.59 for 20-MST and 550-m run, respectively). Adjusting for body fatness and maturity levels in a multivariate regression analysis increased the associations between the field tests and VO2max (r = 0.73 for 20-MST and 0.65 for 550-m). We may conclude that both the 20-MST and the 550-m distance run are valid field tests of cardiorespiratory fitness in New Zealand 8-13 year old children and incorporating body fatness and maturity levels explains an additional 5-7% of the variance.

  20. Goals and Psychological Accounting

    DEFF Research Database (Denmark)

    Koch, Alexander Karl; Nafziger, Julia

    -induced reference points make substandard performance psychologically painful and motivate the individual to stick to his goals. How strong the commitment to goals is depends on the type of psychological account. We provide conditions when it is optimal to evaluate goals in narrow accounts. The key intuition......We model how people formulate and evaluate goals to overcome self-control problems. People often attempt to regulate their behavior by evaluating goal-related outcomes separately (in narrow psychological accounts) rather than jointly (in a broad account). To explain this evidence, our theory...... of endogenous narrow or broad psychological accounts combines insights from the literatures on goals and mental accounting with models of expectations-based reference-dependent preferences. By formulating goals the individual creates expectations that induce reference points for task outcomes. These goal...

  1. Training working memory and fluid intelligence in older adults: developing measures and exploring outcomes

    OpenAIRE

    Hynes, Sinéad

    2013-01-01

    This thesis investigates computerised cognitive training in older adults, with a focus on training working memory and fluid intelligence. A series of studies is reported, with two broad aims. The first was to develop and validate outcome measures appropriate for use in this population, and the second was to examine whether established gains in cognitive functioning generalised to everyday life. In relation to the first aim, two studies were conducted which concerned the development of a se...

  2. A Comparison of Comorbidity Measurements to Control for Confounding in Health Outcomes Studies

    Science.gov (United States)

    2005-08-01

    OF PHARMACY [ 006 A Comparison of Comorbidity Measurements to Control for Confounding in Health Outcomes Studies JOEL F. FARLEY, B.S. PHARMACYA D•.;h... Joel F. Farley, R.Ph., University of Minnesota, College of Pharmacy, 7-174 Weaver-Densford Hall, 308 Harvard St. S.E., Minneapolis, MN 55455 Email...Hall RE, Rosen AK, Ash AS, Moskowitz MA. Searching for an improved clinical comorbidity index for use with ICD-9-CM administrative data. J Clin Epidemiol

  3. A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (ICHOM) Initiative.

    Science.gov (United States)

    Ong, Wee Loon; Schouwenburg, Maartje G; van Bommel, Annelotte C M; Stowell, Caleb; Allison, Kim H; Benn, Karen E; Browne, John P; Cooter, Rodney D; Delaney, Geoff P; Duhoux, Francois P; Ganz, Patricia A; Hancock, Patricia; Jagsi, Reshma; Knaul, Felicia M; Knip, Anne M; Koppert, Linetta B; Kuerer, Henry M; McLaughin, Sarah; Mureau, Marc A M; Partridge, Ann H; Reid, Dereesa Purtell; Sheeran, Lisa; Smith, Thomas J; Stoutjesdijk, Mark J; Vrancken Peeters, Marie Jeanne T F D; Wengström, Yvonne; Yip, Cheng-Har; Saunders, Christobel

    2016-12-29

    A major challenge in value-based health care is the lack of standardized health outcomes measurements, hindering optimal monitoring and comparison of the quality of health care across different settings globally. The International Consortium for Health Outcomes Measurement (ICHOM) assembled a multidisciplinary international working group, comprised of 26 health care providers and patient advocates, to develop a standard set of value-based patient-centered outcomes for breast cancer (BC). The working group convened via 8 teleconferences and completed a follow-up survey after each meeting. A modified 2-round Delphi method was used to achieve consensus on the outcomes and case-mix variables to be included. Patient focus group meetings (8 early or metastatic BC patients) and online anonymized surveys of 1225 multinational BC patients and survivors were also conducted to obtain patients' input. The standard set encompasses survival and cancer control, and disutility of care (eg, acute treatment complications) outcomes, to be collected through administrative data and/or clinical records. A combination of multiple patient-reported outcomes measurement (PROM) tools is recommended to capture long-term degree of health outcomes. Selected case-mix factors were recommended to be collected at baseline. The ICHOM will endeavor to achieve wide buy-in of this set and facilitate its implementation in routine clinical practice in various settings and institutions worldwide.

  4. Capturing the True Value of Assistive Technologies to Consumers in Routine Outcome Measurement

    Directory of Open Access Journals (Sweden)

    Desleigh de Jonge

    2016-10-01

    Full Text Available (1 Background: Recent reforms in Australia, providing people with disability and older people with choice and control over allocated funding, have altered consumer expectations and transformed the landscape of assistive technology (AT service provision. The purpose of this study is to report on the routine AT outcomes of people who accessed an AT consultation service and examine how well these capture the impact of AT on their lives; (2 Methods: This study, which uses mixed methods for concurrent triangulation of the data, reports on the outcomes for 127 people who acquired a range of assistive technology in 2015 and examines the adequacy of an existing service outcome framework in capturing the true value of these technologies to AT users. Outcome data was routinely collected by a community service 2–4 months following an AT consultation. A telephone or face-to-face interview gathered demographic information as well as AT outcomes, using two standardized tools, the Individualized Prioritised Problem Assessment (IPPA and the EATS 6D. Qualitative comments relating to the impact of the AT on the person’s life were also documented; (3 Results: The acquired AT generally met or exceeded expectations of the person using the AT and the attending health professional. Overall, people experienced decreased difficulty and increased feelings of autonomy, with most of the reported improvements identified in mobility and usual activities; (4 Conclusion: Routine outcome data provide some evidence of the value of AT in addressing concerns as identified by clients. Qualitative data, which captured the impact of AT on people’s lives, suggest that the empowering and transformative aspects of AT are not currently being captured by existing measures.

  5. Patient-Reported Outcome Measures-What Data Do We Really Need?

    Science.gov (United States)

    Lyman, Stephen; Hidaka, Chisa

    2016-06-01

    The Center for Medicaid and Medicare Services has recently announced the inclusion of several patient-reported outcome measures (PROMs), including the abbreviated Hip Disability and Osteoarthritis Outcome Score and Knee Injury and Osteoarthritis Outcome Score for joint replacement (HOOS, JR and KOOS, JR) for the purpose of quality assessment in total hip and total knee replacement (THR and TKR). Historically, Center for Medicaid and Medicare Services and other agencies have used measures of process (eg, % vaccinated) or adverse events (eg, infection rates, readmission rates) for quality assessment. However, the use of PROMs has become a priority based on stated goals by the National Quality Strategy and Institute of Medicine for a more patient-centered approach. Here, we review several general health and joint-specific PROMs, which have been extensively used in research to assess treatment efficacy and discuss their relevance to the new criteria for quality assessment, particularly for THR and TKR. Although we expect HOOS, JR and KOOS, JR to yield much useful information in the near term, these surveys are likely an interim solution. In the future, we anticipate that novel measurement platforms, such as wearable technologies or patient-specific surveys, may open new and exciting avenues of research to discover which types of data-perhaps not previously available-best represent patient quality of life and satisfaction after THR, TKR, or other orthopedic procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Fair value accounting

    OpenAIRE

    Shamkuts, Volha, 1977-

    2010-01-01

    The thesis is devoted to fair value accounting. Fair value accounting implies that assets and liabilities get measured and reported in firm´s financial statements at their market value. The purpose of the thesis is to analyze the conceptual foundations of fair value accounting. The thesis is organized in the following way. First, origins and development of fair value accounting are discussed. Second, overview of fair value accounting is presented. The overview includes de...

  7. Internet Accounting

    NARCIS (Netherlands)

    Pras, Aiko; Beijnum, van Bert-Jan; Sprenkels, Ron; Párhonyi, Robert

    2001-01-01

    This article provides an introduction to Internet accounting and discusses the status of related work within the IETF and IRTF, as well as certain research projects. Internet accounting is different from accounting in POTS. To understand Internet accounting, it is important to answer questions like

  8. Psychometric validation of patient-reported outcome measures assessing chronic constipation

    Directory of Open Access Journals (Sweden)

    Nelson LM

    2014-09-01

    Full Text Available Lauren M Nelson,1 Valerie SL Williams,1 Sheri E Fehnel,1 Robyn T Carson,2 James MacDougall,3 Mollie J Baird,3 Stavros Tourkodimitris,2 Caroline B Kurtz,3 Jeffrey M Johnston31RTI Health Solutions, Durham, NC, USA; 2Forest Research Institute, Jersey City, NJ, USA; 3Ironwood Pharmaceuticals, Cambridge, MA, USABackground: Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration's guidance on patient-reported outcomes.Aim: Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures.Study methods: Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307 and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272. The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed.Results: The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change.Conclusion: In large studies of CC patients, linaclotide significantly improved abdominal and

  9. Psychometric properties of outcome measures for children and adolescents with brachial plexus birth palsy: a systematic review.

    Science.gov (United States)

    Bialocerkowski, Andrea; O'shea, Kate; Pin, Tamis W

    2013-12-01

    The aim of this review was to evaluate the psychometric properties of outcome measures used to quantify upper limb function in children and adolescents with brachial plexus birth palsy (BPBP). Eleven electronic databases were searched to identify studies on the effects of conservative management to improve upper limb function in young people with BPBP. Outcome measures used in these studies were extracted and used in a subsequent search to identify studies that evaluated the psychometric properties of these measures. The methodological quality of these studies was rated using a standardized critical appraisal tool. Thirty-three outcome measures and 12 psychometric studies were identified. Nine outcome measures had some psychometric evidence, which was variable in quality. The outcome measures which seem to have the most robust psychometric properties include the Active Movement Scale, Assisting Hand Assessment, Pediatric Evaluation of Disability Index, and the Pediatric Outcomes Data Collection Instrument. Further research is required to determine the psychometric properties of outcome measures used for children and adolescents with BPBP. Caution is required when interpreting the results of commonly used outcome measures in this population owing to their relatively unknown psychometric properties. © 2013 Mac Keith Press.

  10. Outcome measures in studies on the use of oxytocin for the treatment of delay in labour: A systematic review.

    LENUS (Irish Health Repository)

    Begley, Cecily M

    2014-07-01

    to identify primary and secondary outcome measures in randomised trials, and systematic reviews of randomised trials, measuring effectiveness of oxytocin for treatment of delay in the first and second stages of labour, and to identify any positive health-focussed outcomes used.

  11. Accounting Automation

    OpenAIRE

    Laynebaril1

    2017-01-01

    Accounting Automation   Click Link Below To Buy:   http://hwcampus.com/shop/accounting-automation/  Or Visit www.hwcampus.com Accounting Automation” Please respond to the following: Imagine you are a consultant hired to convert a manual accounting system to an automated system. Suggest the key advantages and disadvantages of automating a manual accounting system. Identify the most important step in the conversion process. Provide a rationale for your response. ...

  12. Cerebral atrophy as outcome measure in short-term phase 2 clinical trials in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Elskamp, I.J. van den; Boden, B.; Barkhof, F. [VU University Medical Center, Department of Radiology, MS Center Amsterdam, Amsterdam (Netherlands); Dattola, V. [VU University Medical Center, Department of Radiology, MS Center Amsterdam, Amsterdam (Netherlands); University of Messina, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, Messina (Italy); Knol, D.L. [VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands); Filippi, M. [Scientific Institute and University Ospedale San Raffaele, Neuroimaging Research Unit, Milan (Italy); Kappos, L. [University Hospital, University of Basel, Department of Neurology, Basel (Switzerland); Fazekas, F. [Medical University of Graz, Department of Neurology, Graz (Austria); Wagner, K. [Bayer-Schering Pharma, Berlin (Germany); Pohl, C. [Bayer-Schering Pharma, Berlin (Germany); University Hospital Bonn, Department of Neurology, Bonn (Germany); Sandbrink, R. [Bayer-Schering Pharma, Berlin (Germany); Heinrich-Heine-University Dusseldorf, Department of Neurology, Dusseldorf (Germany); Polman, C.H. [VU University Medical Center, Department of Neurology, MS Center Amsterdam, Amsterdam (Netherlands); Uitdehaag, B.M.J. [VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands); VU University Medical Center, Department of Neurology, MS Center Amsterdam, Amsterdam (Netherlands)

    2010-10-15

    Cerebral atrophy is a compound measure of the neurodegenerative component of multiple sclerosis (MS) and a conceivable outcome measure for clinical trials monitoring the effect of neuroprotective agents. In this study, we evaluate the rate of cerebral atrophy in a 6-month period, investigate the predictive and explanatory value of other magnetic resonance imaging (MRI) measures in relation to cerebral atrophy, and determine sample sizes for future short-term clinical trials using cerebral atrophy as primary outcome measure. One hundred thirty-five relapsing-remitting multiple sclerosis patients underwent six monthly MRI scans from which the percentage brain volume change (PBVC) and the number and volume of gadolinium (Gd)-enhancing lesions, T2 lesions, and persistent black holes (PBH) were determined. By means of multiple linear regression analysis, the relationship between focal MRI variables and PBVC was assessed. Sample size calculations were performed for all patients and subgroups selected for enhancement or a high T2 lesion load at baseline. A significant atrophy occurred over 6 months (PBVC = -0.33%, SE = 0.061, p < 0.0001). The number of baseline T2 lesions (p = 0.024), the on-study Gd-enhancing lesion volume (p = 0.044), and the number of on-study PBHs (p = 0.003) were associated with an increased rate of atrophy. For a 50% decrease in rate of atrophy, the sample size calculations showed that approximately 283 patients per arm are required in an unselected sampled population and 185 patients per arm are required in a selected population. Within a 6-month period, significant atrophy can be detected and on-study associations of PBVC and PBHs emphasizes axonal loss to be a driving mechanism. Application as primary outcome measure in short-term clinical trials with feasible sample size requires a potent drug to obtain sufficient power. (orig.)

  13. Instrumentos de avaliação em espondilite anquilosante Outcome measures in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Themis Mizerkowski Torres

    2006-06-01

    Full Text Available A espondilite anquilosante (EA é uma doença inflamatória crônica caracterizada por acometimento predominante do esqueleto axial. Ocorre de forma insidiosa e é potencialmente debilitante, levando à redução na qualidade de vida dos indivíduos acometidos. A sua etiopatogenia ainda não está totalmente esclarecida, dificultando estratégias no seu diagnóstico e manejo. O avanço da terapia com agentes biológicos veio reforçar discussões sobre a melhor forma de avaliação destes pacientes. Nesta revisão, discutimos os principais instrumentos utilizados para avaliar pacientes com EA e o consenso do grupo internacional (ASAS working group - Assessments in Ankylosing Spondylitis Working Group determinado no OMERACT IV (Outcome Measures in Rheumatology.Ankylosing spondylitis is a chronic and progressive disease involving predominantly the axial skeleton. It is insidious and potentially debilitating, compromising the quality of life of patients suffering from the disease. The etiopathogenesis is still uncertain, which difficult strategies in its diagnosis and treatment. Advances in biological therapies are reforcing discussions in the best way of managing the disease. In this paper, we revise the outcome instruments available for ankylosing spondylitis and the consensus from the ASAS working group (Assessments in Ankylosing Spondylitis Working Group established at the OMERACT IV (Outcome Measures in Rheumatology.

  14. Preoperative Patient-Recorded Outcome Measures Predict Patient Discharge Location Following Unicondylar Knee Arthroplasty.

    Science.gov (United States)

    Ayala, Alfonso E; Lawson, Kevin A; Gruessner, Angelika C; Dohm, Michael P

    2017-02-01

    Advantages of unicondylar knee arthroplasty (UKA) over total knee arthroplasty include rapid recovery and shorter lengths of stay following surgery. Patients requiring extended postoperative care fail to recognize these benefits. Patient-reported outcome measures have proved useful in predicting outcomes following joint arthroplasty. The purpose of this study was to identify and report preoperative patient-reported outcome measures and clinical variables that predict discharge to skilled nursing facilities following UKA. A prospective cohort of 174 patients was used to collect 36-Item Short Form scores and objective clinical data. Univariate and multivariate analysis with backward elimination were conducted to find a predictive risk model. The predictive model reported (78.7% concordance, receiver operating characteristic curve c-statistic 0.719, P = .0016) demonstrates that risk factors for discharge to skilled nursing facilities are: older age (odds ratio 4.18; 95% confidence interval [CI] 1.256-13.911, P = .019), bilateral UKA procedures (odds ratio 1.887; 95% CI 1.054-3.378, P = .0326) and lower patient-reported preoperative 36-Item Short Form physical function scores (odds ratio 0.968; CI 0.938-1, P = .0488). The information presented here regarding possible patient disposition following UKA could aid informed decision-making regarding patients' short-term needs following surgery and help streamline preoperative planning. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. The use of collaboration science to define consensus outcome measures: a telemental health case study.

    Science.gov (United States)

    Mishkind, Matthew C; Doarn, Charles R; Bernard, Jordana; Shore, Jay H

    2013-06-01

    The purpose of this document is to provide an overview of a collaboration science process used to develop recommendations for the field of telemental health (TMH) in the selection of outcome measures that best reflect programmatic impacts. A common use of group development techniques in medicine is the development of clinical guidelines, which typically occurs using one of two methods: the nominal group or the Delphi method. Both processes have been faulted for limited transparency, reliability, and sustainability. Recommendations to improve the traditional process include making goals explicit, making disagreements transparent, and publicly displaying levels of agreement. A group of 26 TMH experts convened during the American Telemedicine Association's 2012 Fall Forum in New Orleans, LA to participate in a 1-day, interactive, consensus-building workshop to initiate the development of a shared lexicon of outcomes. The workshop method was designed to improve on traditional methods of guideline development by focusing on clarity of expectations, transparency, and timeliness of group development work. Results suggest that, compared with other traditional methods, the current process involved more people, occurred more rapidly, was more transparent, and resulted in a comparable deliverable. Recommendations for further process development, both within and external to TMH, as well as an initial overview of defined outcome measures are discussed.

  16. Prediction of responders for outcome measures of Locomotor Experience Applied Post Stroke trial

    Directory of Open Access Journals (Sweden)

    Bruce H. K. Dobkin, MD

    2014-03-01

    Full Text Available The Locomotor Experience Applied Post Stroke rehabilitation trial found equivalent walking outcomes for body weight-supported treadmill plus overground walking practice versus home-based exercise that did not emphasize walking. From this large database, we examined several clinically important questions that provide insights into recovery of walking that may affect future trial designs. Using logistic regression analyses, we examined predictors of response based on a variety of walking speed-related outcomes and measures that captured disability, physical impairment, and quality of life. The most robust predictor was being closer at baseline to the primary outcome measure, which was the functional walking speed thresholds of 0.4 m/s (household walking and 0.8 m/s (community walking. Regardless of baseline walking speed, a younger age and higher Berg Balance Scale score were relative predictors of responding, whether operationally defined by transitioning beyond each speed boundary or by a continuous change or a greater than median increase in walking speed. Of note, the cutoff values of 0.4 and 0.8 m/s had no particular significance compared with other walking speed changes despite their general use as descriptors of functional levels of walking. No evidence was found for any difference in predictors based on treatment group.

  17. Material control in nuclear fuel fabrication facilities. Part II. Accountability, instrumntation, and measurement techniques in fuel fabrication facilities, P. O. 1236909. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Borgonovi, G.M.; McCartin, T.J.; McDaniel, T.; Miller, C.L.; Nguyen, T.

    1978-12-01

    This report describes the measurement techniques, the instrumentation, and the procedures used in accountability and control of nuclear materials, as they apply to fuel fabrication facilities. Some of the material included has appeared elswhere and it has been summarized. An extensive bibliography is included. A spcific example of application of the accountability methods to a model fuel fabrication facility which is based on the Westinghouse Anderson design.

  18. Influence of stroke infarct location on functional outcome measured by the modified rankin scale.

    Science.gov (United States)

    Cheng, Bastian; Forkert, Nils Daniel; Zavaglia, Melissa; Hilgetag, Claus C; Golsari, Amir; Siemonsen, Susanne; Fiehler, Jens; Pedraza, Salvador; Puig, Josep; Cho, Tae-Hee; Alawneh, Josef; Baron, Jean-Claude; Ostergaard, Leif; Gerloff, Christian; Thomalla, Götz

    2014-06-01

    In the early days after ischemic stroke, information on structural brain damage from MRI supports prognosis of functional outcome. It is rated widely by the modified Rankin Scale that correlates only moderately with lesion volume. We therefore aimed to elucidate the influence of lesion location from early MRI (days 2-3) on functional outcome after 1 month using voxel-based lesion symptom mapping. We analyzed clinical and MRI data of patients from a prospective European multicenter stroke imaging study (I-KNOW). Lesions were delineated on fluid-attenuated inversion recovery images on days 2 to 3 after stroke onset. We generated statistic maps of lesion contribution related to clinical outcome (modified Rankin Scale) after 1 month using voxel-based lesion symptom mapping. Lesion maps of 101 patients with middle cerebral artery infarctions were included for analysis (right-sided stroke, 47%). Mean age was 67 years, median admission National Institutes of Health Stroke Scale was 11. Mean infarct volumes were comparable between both sides (left, 37.5 mL; right, 43.7 mL). Voxel-based lesion symptom mapping revealed areas with high influence on higher modified Rankin Scale in regions involving the corona radiata, internal capsule, and insula. In addition, asymmetrically distributed impact patterns were found involving the right inferior temporal gyrus and left superior temporal gyrus. In this group of patients with stroke, characteristic lesion patterns in areas of motor control and areas involved in lateralized brain functions on early MRI were found to influence functional outcome. Our data provide a novel map of the impact of lesion localization on functional stroke outcome as measured by the modified Rankin Scale. © 2014 American Heart Association, Inc.

  19. Outcome Measures of an Intracanal, Endoscopic Transforaminal Decompression Technique: Initial Findings from the MIS Prospective Registry.

    Science.gov (United States)

    Sclafani, Joseph A; Raiszadeh, Kamshad; Laich, Dan; Shen, Jian; Bennett, Matthew; Blok, Robert; Liang, Kevin; Kim, Choll W

    2015-01-01

    Minimally invasive transforaminal endoscopic procedures can achieve spinal decompression through either direct or indirect techniques. Subtle variations in trajectory of the surgical corridor can dictate access to the pathologic tissue. Two general strategies exist: the intradiscal "inside-out" technique and the extradiscal, intracanal (IC) technique. The IC technique utilizes a more lateral transforaminal approach than the intradiscal technique, which allows for a more direct decompression of the spinal canal. This study is an assessment of IC patient outcome data obtained through analysis of a previously validated MIS Prospective Registry. Post-hoc analysis was performed on the MIS Prospective Registry database containing 1032 patients. A subgroup of patients treated with the endoscopic IC technique was identified. Patient outcome measures after treatment of symptomatic disk herniation and neuroforaminal stenosis were evaluated. A total of 86 IC patients were analyzed. Overall, there was significant improvement in employment and walking tolerance as soon as 6 weeks post-op as well as significant one year VAS and ODI score improvement. Subanalysis of IC patients with two distinct primary diagnoses was performed. Group IC-1 (disc herniation) showed improvement in ODI and VAS back and leg outcomes at 1 year post-op. Group IC-2 (foraminal stenosis) showed VAS back and leg score improvement at one year post-op but did not demonstrate significant improvement in overall ODI outcome at any time point. The one year re-operation rate was 2% (1/40) for group IC-1 and 28% (5/18) for group IC-2. The initial results of the MIS Registry IC subgroup show a significant clinical improvement when the technique is employed to treat patients with lumbar disc herniation. The treatment of foraminal stenosis can lead to improved short-term clinical outcome but is associated with a high re-operation rate at 1 year post-op.

  20. In vivo electrical conductivity measurements during and after tumor electroporation: conductivity changes reflect the treatment outcome.

    Science.gov (United States)

    Ivorra, Antoni; Al-Sakere, Bassim; Rubinsky, Boris; Mir, Lluis M

    2009-10-01

    Electroporation is the phenomenon in which cell membrane permeability is increased by exposing the cell to short high-electric-field pulses. Reversible electroporation treatments are used in vivo for gene therapy and drug therapy while irreversible electroporation is used for tissue ablation. Tissue conductivity changes induced by electroporation could provide real-time feedback of the treatment outcome. Here we describe the results from a study in which fibrosarcomas (n = 39) inoculated in mice were treated according to different electroporation protocols, some of them known to cause irreversible damage. Conductivity was measured before, within the pulses, in between the pulses and for up to 30 min after treatment. Conductivity increased pulse after pulse. Depending on the applied electroporation protocol, the conductivity increase after treatment ranged from 10% to 180%. The most significant conclusion from this study is the fact that post-treatment conductivity seems to be correlated with treatment outcome in terms of reversibility.

  1. Number of patients needed to discriminate between subgroups in patient reported outcome measures

    DEFF Research Database (Denmark)

    Paulsen, Aksel

    2011-01-01

    Background: Patient reported outcome-measures (PROs) are increasingly used in orthopedics. Information on number of patients needed in different settings is warranted. Aim: To assess the number of patients needed for different PROs to discriminate between subgroups of age, gender, and diagnosis...... with sample size calculations or by power calculations and simulated ANOVA F tests, depending on the number of groups. Results: To discriminate between gender, the least number needed to find a statistically significant difference in mean sum score in each group was 298 (OHS) while HOOS QoL required the most....... Methods: 5777 primary THA patients, operated 1‐2, 5‐6, and 10‐11 years ago. SF‐12 Health Survey (SF-12), EQ-5D, Oxford 12‐item Hip Score (OHS), and Hip dysfunction and Osteoarthritis Outcome Score (HOOS) were included. The different PRO subscales abilities to discriminate between groups were studied using...

  2. Strategies for assessment and outcome measurement in physical and rehabilitation medicine: an educational review.

    Science.gov (United States)

    Küçükdeveci, Ayşe A; Tennant, Alan; Grimby, Gunnar; Franchignoni, Franco

    2011-07-01

    The aim of this educational review, which is based upon expert opinion, is to describe to clinicians training in Physical and Rehabilitation Medicine and research students training to work in the field, the appropriate attributes and standards required for assessment and outcome measurement. "What to assess" is discussed in the context of the conceptual framework provided by the International Classification of Functioning, Disability and Health, supplemented with quality of life as an additional construct. The reasons for making the assessment, and the context in which the assessment will be used, are then considered. Examples of recommendations of some international organizations regarding what and how to assess are presented. Suggestions are made about the selection of assessment tools, including examples from two diagnostic groups: stroke and rheumatoid arthritis. Finally, the basic psychometric standards required for any assessment tool, and additional requirements for outcome assessment, are explained.

  3. Manual function outcome measures in children with developmental coordination disorder (DCD): Systematic review.

    Science.gov (United States)

    Bieber, Eleonora; Smits-Engelsman, Bouwien C M; Sgandurra, Giuseppina; Cioni, Giovanni; Feys, Hilde; Guzzetta, Andrea; Klingels, Katrijn

    2016-08-01

    This study systematically reviewed the clinical and psychometric properties of manual function outcome measures for children with developmental coordination disorder (DCD) aged 3-18 years. Three electronic databases were searched to identify manual function tools at the ICF-CY body function, activity and participation level used in children with DCD. Study selection and data extraction was conducted by two blind assessors according to the CanChild Outcome Measures Rating Form. Nineteen clinical tests (seven fine hand use tools and 12 handwriting measures), three naturalistic observations and six questionnaires were identified. The fine-motor subdomain of the Movement Assessment Battery for Children, the Bruininks-Oseretsky Test of Motor Proficiency-2 and the Functional Strength Measurement, with adequate reliability and validity properties, might be useful for manual function capacity assessment. The Systematic Detection of Writing Problems (SOS) and the Detailed Assessment of Speed of Handwriting (DASH) could be adopted for handwriting assessment, respectively from 6 and 9 years old. Naturalistic observations and questionnaires, whose psychometric properties have been investigated into limited extent, offer an assessment of the daily performances. This review shows that a combination of different tools is needed for a comprehensive assessment of manual function in children with DCD including the three levels of the ICF-CY. Further investigation of psychometric properties of those tools in children with DCD is warranted. Tests validated in other populations should be explored for their applicability for assessing manual function in children with DCD.

  4. Development and Validation of the Keele Musculoskeletal Patient Reported Outcome Measure (MSK-PROM.

    Directory of Open Access Journals (Sweden)

    Jonathan C Hill

    Full Text Available To develop and validate a patient report outcome measure (PROM for clinical practice that can monitor health status of patients with a range of musculoskeletal (MSK disorders.Constructs for inclusion in the MSK-PROM were identified from a consensus process involving patients with musculoskeletal conditions, clinicians, purchasers of healthcare services, and primary care researchers. Psychometric properties of the brief tool, including face and construct validity, repeatability and responsiveness were assessed in a sample of patients with musculoskeletal pain consulting physiotherapy services in the United Kingdom (n=425.The consensus process identified 10 prioritised domains for monitoring musculoskeletal health status: pain intensity, quality of life, physical capacity, interference with social/leisure activities, emotional well-being, severity of most difficult thing, activities and roles, understanding independence, and overall impact. As the EuroQol (EQ-5D-5L is a widely adopted PROMs tool and covers the first four domains listed, to reduce patient burden to a minimum the MSK-PROM was designed to capture the remaining six prioritised domains which are not measured by the EQ-5D-5L. The tool demonstrated excellent reliability, construct validity, responsiveness and acceptability to patients and clinicians for use in clinical practice.We have validated a brief patient reported outcome measure (MSK-PROM for use in clinical practice to measure musculoskeletal health status and monitor outcomes over time using domains that are meaningful to patients and sensitive to change. Further work will establish whether the MSK-PROM is useful in other musculoskeletal healthcare settings.

  5. Repeated heart rate measurement and cardiovascular outcomes in left ventricular systolic dysfunction.

    Science.gov (United States)

    Hamill, Victoria; Ford, Ian; Fox, Kim; Böhm, Michael; Borer, Jeffrey S; Ferrari, Roberto; Komajda, Michel; Steg, Philippe Gabriel; Tavazzi, Luigi; Tendera, Michal; Swedberg, Karl

    2015-10-01

    Elevated resting heart rate is associated with increased cardiovascular risk, particularly in patients with left ventricular systolic dysfunction. Heart rate is not monitored routinely in these patients. We hypothesized that routine monitoring of heart rate would increase its prognostic value in patients with left ventricular systolic dysfunction. We analyzed the relationship between heart rate measurements and a range of adverse cardiovascular outcomes, including hospitalization for worsening heart failure, in the pooled placebo-treated patients from the morBidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction (BEAUTIFUL) trial and Systolic Heart failure treatment with the If inhibitor ivabradine (SHIFT) Trial, using standard and time-varying covariate Cox proportional hazards models. By adjusting for other prognostic factors, models were fitted for baseline heart rate alone or for time-updated heart rate (latest heart rate) alone or corrected for baseline heart rate or for immediate previous time-updated heart rate. Baseline heart rate was strongly associated with all outcomes apart from hospitalization for myocardial infarction. Time-updated heart rate increased the strengths of associations for all outcomes. Adjustment for baseline heart rate or immediate previous time-updated heart rate modestly reduced the prognostic importance of time-updated heart rate. For hospitalization for worsening heart failure, each 5 beats/min increase in baseline heart rate and time-updated heart rate was associated with a 15% (95% confidence interval, 12-18) and 22% (confidence interval, 19-40) increase in risk, respectively. Even after correction, the prognostic value of time-updated heart rate remained greater. In patients with left ventricular systolic dysfunction, time-updated heart rate is more strongly related with adverse cardiovascular outcomes than baseline heart rate. Heart rate should be measured to

  6. Evaluating the use of gas discharge visualization to measure massage therapy outcomes

    Science.gov (United States)

    Haun, Jolie; Patel, Nitin; Schwartz, Gary; Ritenbaugh, Cheryl

    2017-01-01

    Background The purpose of this study was to evaluate the short-term effects of massage therapy using gas discharge visualization (GDV), a computerized biophysical electrophoton capture (EPC), in tandem with traditional self-report measures to evaluate the use of GDV measurement to assess the bioenergetic whole-person effects of massage therapy. Methods This study used a single treatment group, pre–post-repeated measures design with a sample of 23 healthy adults. This study utilized a single 50-min full-body relaxation massage with participants. GDV measurement method, an EPC, and traditional paper-based measures evaluating pain, stress, muscle tension, and well-being were used to assess intervention outcomes. Results Significant differences were found between pre- and post-measures of well-being, pain, stress, muscle tension, and GDV parameters. Pearson correlations indicate the GDV measure is correlated with pain and stress, variables that impact the whole person. Conclusions This study demonstrates that GDV parameters may be used to indicate significant bioenergetic change from pre- to post-massage. Findings warrant further investigation with a larger diverse sample size and control group to further explore GDV as a measure of whole-person bioenergetic effects associated with massage. PMID:26087069

  7. Measuring dosage: a key factor when assessing the relationship between prenatal case management and birth outcomes.

    Science.gov (United States)

    Slaughter, Jaime C; Issel, L Michele; Handler, Arden S; Rosenberg, Deborah; Kane, Debra J; Stayner, Leslie T

    2013-10-01

    To assess whether a measure of prenatal case management (PCM) dosage is more sensitive than a dichotomous PCM exposure measure when evaluating the effect of PCM on low birthweight (LBW) and preterm birth (PTB). We constructed a retrospective cohort study (N = 16,657) of Iowa Medicaid-insured women who had a singleton live birth from October 2005 to December 2006; 28 % of women received PCM. A PCM dosage measure was created to capture duration of enrollment, total time with a case manager, and intervention breadth. Propensity score (PS)-adjusted odds ratios (ORs), and 95 % confidence intervals (95 % CIs) were calculated to assess the risk of each outcome by PCM dosage and the dichotomous PCM exposure measure. PS-adjusted ORs of PTB were 0.88 (95 % CI 0.70-1.11), 0.58 (95 % CI 0.47-0.72), and 1.43 (95 % CI 1.23-1.67) for high, medium, and low PCM dosage, respectively. For LBW, the PS-adjusted ORs were 0.76 (95 % CI 0.57-1.00), 0.64 (95 % CI 0.50-0.82), and 1.36 (95 % CI 1.14-1.63), for high, medium, and low PCM dosage, respectively. The PCM dichotomous participation measure was not significantly associated with LBW (OR = 0.95, 95 % CI 0.82-1.09) or PTB (0.97, 95 % CI 0.87-1.10). The reference group in each analysis is No PCM. PCM was associated with a reduced risk of adverse pregnancy outcomes for Medicaid-insured women in Iowa. PCM dosage appeared to be a more sensitive measure than the dichotomous measure of PCM participation.

  8. Systematic review: patient-reported outcome measures in coeliac disease for regulatory submissions.

    Science.gov (United States)

    Canestaro, W J; Edwards, T C; Patrick, D L

    2016-08-01

    New therapeutics are moving into phase 3 clinical trials for the treatment of coeliac disease, a condition with no established therapies other than gluten-free diet. These trials will require a meaningful, validated and fit for purpose patient-reported outcome measure (PROM) to quantify the symptomatic improvement of patients. To evaluate existing PROMs for suitability in a Food and Drug Administration (FDA) approval trial for a coeliac disease therapeutic. We performed a systematic search in five online databases (MedLine, EmBase, Web of Science, CENTRAL, CINAHL) for studies that enrolled patients with coeliac disease and used PROMs. Studies included in this review had to measure some PROM concept, be patient administered and based upon a previously validated instrument with published measurement properties. Our literature search identified 2706 unique records of which 199 ultimately qualified for abstraction. The majority of PROMs used in studies of coeliac disease was generic and did not measure numerous symptoms or concerns of interest to patients. Four PROMs were found to contain appropriate content for use in an FDA trial: the coeliac disease-specific modification of the Gastrointestinal Symptoms Rating Scale (CeD-GSRS), Psychological General Well-Being Index (PGWB), the Celiac Disease Symptom Diary (CDSD) and the Celiac Disease Patient Reported Outcome (CeD-PRO). The GSRS and PGWB are most often used together and are two of the most extensively used measures in coeliac disease. The CDSD and CeD-PRO were developed exclusively for trials in coeliac disease but have much less published information on their measurement properties. While we did not find PROMs that currently meet the stated expectations of the FDA for regulatory purposes, four PROMs (CeD-GSRS, PGWB, CDSD and CeD-PRO) appear to contain appropriate content and with modest additional validation work could meet scientific standards for valid and sensitive measures of disease and treatment outcome

  9. Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation: Qualitative Classification and Quantitative Measurement.

    Science.gov (United States)

    Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

    2016-03-01

    The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement.This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China.Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I-capsule with mild opacification but no invasion into the capsule opening; Type II-capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III-capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed.The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I-120 eyes (38.1%); Type II-157 eyes (49.8%); Type III-38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = -0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = -0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type II, and the PCOO increased

  10. Educational Accountability

    Science.gov (United States)

    Pincoffs, Edmund L.

    1973-01-01

    Discusses educational accountability as the paradigm of performance contracting, presents some arguments for and against accountability, and discusses the goals of education and the responsibility of the teacher. (Author/PG)

  11. Are process performance measures associated with clinical outcomes among patients with hip fractures?

    DEFF Research Database (Denmark)

    Kristensen, Pia Kjaer; Thillemann, Theis Muncholm; Søballe, Kjeld;

    2016-01-01

    OBJECTIVES: To examine the association between process performance measures and clinical outcome among patients with hip fracture. DESIGN: Nationwide, population-based follow-up study. SETTING: Public Danish hospitals. PARTICIPANTS: A total of 25 354 patients 65 years or older who were admitted...... and length of stay (LOS). RESULTS: Fulfilling 75-100% of the relevant process performance measures was associated with lower 30-day mortality (22.6% vs. 8.5%, adjusted odds ratio (OR) 0.31 (95% CI: 0.28-0.35)) and lower odds for readmission (21.7% vs. 17.4%, adjusted OR 0.78 (95% CI: 0.70-0.87)). The overall...... with a hip fracture in Denmark between 2010 and 2013. INTERVENTION: The process performance measures, including systematic pain assessment, early mobilization, basic mobility assessment at arrival and at discharge, post-discharge rehabilitation program, anti-osteoporotic medication and prevention of future...

  12. Predicting Outcomes on the Liver Transplant Waiting List in the United States: Accounting for Large Regional Variation in Organ Availability and Priority Allocation Points.

    Science.gov (United States)

    Hart, Allyson; Schladt, David P; Zeglin, Jessica; Pyke, Joshua; Kim, W Ray; Lake, John R; Roberts, John P; Hirose, Ryutaro; Mulligan, David C; Kasiske, Bertram L; Snyder, Jon J; Israni, Ajay K

    2016-10-01

    The probability of liver transplant and death on the waiting list in the United States varies greatly by donation service area (DSA) due to geographic differences in availability of organs and allocation of priority points, making it difficult for providers to predict likely outcomes after listing. We aimed to develop an online calculator to report outcomes by region and patient characteristics. Using the Scientific Registry of Transplant Recipients database, we included all prevalent US adults aged 18 years or older waitlisted for liver transplant, examined on 24 days at least 30 days apart over a 2-year period. Outcomes were determined at intervals of 30 to 365 days. Outcomes are reported by transplant program, DSA, region, and the nation for comparison, and can be shown by allocation or by laboratory model for end-stage liver disease (MELD) score (6-14, 15-24, 25-29, 30-34, 35-40), age, and blood type. Outcomes varied greatly by DSA; for candidates with allocation MELD 25-29, the 25th and 75th percentiles of liver transplant probability were 30% and 67%, respectively, at 90 days. Corresponding percentiles for death or becoming too sick to undergo transplant were 5% and 9%. Outcomes also varied greatly for candidates with and without MELD exception points. The waitlist outcome calculator highlights ongoing disparities in access to liver transplant and may assist providers in understanding and counseling their patients about likely outcomes on the waiting list.

  13. Accounting outsourcing

    OpenAIRE

    Richtáriková, Paulína

    2012-01-01

    The thesis deals with accounting outsourcing and provides a comprehensive explanation of the topic. At first the thesis defines basic concepts (outsourcing, insourcing, offshoring and outplacement) and describes differences between the accounting outsourcing and outsourcing of other business activities. The emphasis is put on a decision whether or not to implement the accounting outsourcing. Thus the thesis describes main reasons why to implement the accounting outsourcing and risks that are ...

  14. Accounting outsourcing

    OpenAIRE

    Klečacká, Tereza

    2009-01-01

    This thesis gives a complex view on accounting outsourcing, deals with the outsourcing process from its beginning (condition of collaboration, making of contract), through collaboration to its possible ending. This work defines outsourcing, indicates the main advatages, disadvatages and arguments for its using. The main object of thesis is mainly practical side of accounting outsourcing and providing of first quality accounting services.

  15. Accounting standards

    NARCIS (Netherlands)

    Stellinga, B.; Mügge, D.

    2014-01-01

    The European and global regulation of accounting standards have witnessed remarkable changes over the past twenty years. In the early 1990s, EU accounting practices were fragmented along national lines and US accounting standards were the de facto global standards. Since 2005, all EU listed companie

  16. 森林自然资本会计计量体系及方法%System and Method of Accounting Measurement for Forest Natural Capital

    Institute of Scientific and Technical Information of China (English)

    刘梅娟; 温作民

    2011-01-01

    Forest is a typical example of natural capital. The difficulty of its fair value measurement is the key of the forest natural capital accounting application. Based on analysing the problem of the accounting measurement for the forest natural capital, this paper discusses the reality and possibility of transforming the economic measurement of the forest natural capital into the accounting measurement. Furthermore, the measurement framework is constructed from an accounting standpoint. At the same time, it explores the accounting measurement of the forest natural capital from three aspects: physical measurement, monetary measurement and application of monetary measurement approach in financial accounting system. Currently, the value appraisal methods should take from those applied in current mature economics as reference. However, economic measurement method for forest natural capital valuation is different from its accounting measurement method. Afterwards, the valuation result would be considered as fair value only if it satisfied the definition and restriction of fair value.%针对森林自然资本价值会计计量中存在的问题,探索森林自然资本经济学计量问题向其会计学计量问题转变的现实性与可能性,从会计视角构建森林自然资本价值计量构架,以此为基础从微观层面对森林自然资本的实物计量、货币计量、货币计量方法在财务会计系统中的应用3个环节的计量理论及方法进行分析,并进一步指出森林自然资本公允价值计量应更多地借鉴现行成熟的经济学计量方法,但森林自然资本价值经济学计量方法有别于其会计学计量方法,只有符合公允价值定义和条件的评价结果才是其公允价值.

  17. Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.

    Science.gov (United States)

    Snowden, Austyn; Telfer, Iain

    2017-01-01

    Chaplains are employed by health organizations around the world to support patients in recognizing and addressing their spiritual needs. There is currently no generalizable measure of the impact of these interventions and so the clinical and strategic worth of chaplaincy is difficult to articulate. This article introduces the Scottish PROM, an original five-item patient reported outcome measure constructed specifically to address this gap. It describes the validation process from its conceptual grounding in the spiritual care literature through face and content validity cycles. It shows that the Scottish PROM is internally consistent and unidimensional. Responses to the Scottish PROM show strong convergent validity with responses to the Warwick and Edinburgh Mental Well-Being Scale, a generic well-being scale often used as a proxy for spiritual well-being. In summary, the Scottish PROM is fit for purpose. It measures the outcomes of spiritual care as delivered by chaplains in this study. This novel project introduces an essential and original breakthrough; the possibility of generalizable international chaplaincy research.

  18. Moving beyond Mindfulness: Defining Equanimity as an Outcome Measure in Meditation and Contemplative Research.

    Science.gov (United States)

    Desbordes, Gaëlle; Gard, Tim; Hoge, Elizabeth A; Hölzel, Britta K; Kerr, Catherine; Lazar, Sara W; Olendzki, Andrew; Vago, David R

    2014-01-21

    In light of a growing interest in contemplative practices such as meditation, the emerging field of contemplative science has been challenged to describe and objectively measure how these practices affect health and well-being. While "mindfulness" itself has been proposed as a measurable outcome of contemplative practices, this concept encompasses multiple components, some of which, as we review here, may be better characterized as equanimity. Equanimity can be defined as an even-minded mental state or dispositional tendency toward all experiences or objects, regardless of their origin or their affective valence (pleasant, unpleasant, or neutral). In this article we propose that equanimity be used as an outcome measure in contemplative research. We first define and discuss the inter-relationship between mindfulness and equanimity from the perspectives of both classical Buddhism and modern psychology and present existing meditation techniques for cultivating equanimity. We then review psychological, physiological, and neuroimaging methods that have been used to assess equanimity, either directly or indirectly. In conclusion, we propose that equanimity captures potentially the most important psychological element in the improvement of well-being, and therefore should be a focus in future research studies.

  19. Periodontal research: Basics and beyond - Part II (ethical issues, sampling, outcome measures and bias

    Directory of Open Access Journals (Sweden)

    Haritha Avula

    2013-01-01

    Full Text Available A good research beginning refers to formulating a well-defined research question, developing a hypothesis and choosing an appropriate study design. The first part of the review series has discussed these issues in depth and this paper intends to throw light on other issues pertaining to the implementation of research. These include the various ethical norms and standards in human experimentation, the eligibility criteria for the participants, sampling methods and sample size calculation, various outcome measures that need to be defined and the biases that can be introduced in research.

  20. Total Knee Arthroplasty in Younger Patients Evaluated by Alternative Outcome Measures

    DEFF Research Database (Denmark)

    Klit, Jakob; Jacobsen, Steffen; Rosenlund, Signe

    2014-01-01

    of sexual life. Questionnaires including Oxford Knee Score (OKS) and SF-36 were evaluated preoperatively and three, six, and twelve months postoperatively. OKS and SF-36 showed significant improvements. However, patient satisfaction and fulfillment of personal expectations did not reflect these scores....... Overall, TKA did not affect the patients’ socioeconomic status, and overall, patients did not experience impairment of sexual life, but decreased frequency and negative affection of sexual practice should be anticipated. Alternative outcome measurements of TKA surgery not focusing on implants and surgical...... techniques shed new light on important consequences of replacement surgery....

  1. Measuring patient outcomes in breast augmentation: introducing the BREAST-Q Augmentation module.

    Science.gov (United States)

    Pusic, Andrea L; Reavey, Patrick L; Klassen, Anne F; Scott, Amie; McCarthy, Colleen; Cano, Stefan J

    2009-01-01

    The Breast-Q Augmentation module is a new and unique questionnaire for measuring patient-reported outcomes following breast augmentation. It has undergone a rigorous development and validation process and is currently the only questionnaire for breast augmentation that meets international and federal standards for questionnaire development. The Breast-Q Augmentation module covers a comprehensive set of concerns of breast augmentation patients, including satisfaction with breasts and impact on quality of life. With its excellent psychometric properties, the Breast-Q Augmentation module can provide clinicians and researchers with a wealth of essential data to improve the field of breast augmentation from the perspectives of both surgeons and patients.

  2. General job stress: a unidimensional measure and its non-linear relations with outcome variables.

    Science.gov (United States)

    Yankelevich, Maya; Broadfoot, Alison; Gillespie, Jennifer Z; Gillespie, Michael A; Guidroz, Ashley

    2012-04-01

    This article aims to examine the non-linear relations between a general measure of job stress [Stress in General (SIG)] and two outcome variables: intentions to quit and job satisfaction. In so doing, we also re-examine the factor structure of the SIG and determine that, as a two-factor scale, it obscures non-linear relations with outcomes. Thus, in this research, we not only test for non-linear relations between stress and outcome variables but also present an updated version of the SIG scale. Using two distinct samples of working adults (sample 1, N = 589; sample 2, N = 4322), results indicate that a more parsimonious eight-item SIG has better model-data fit than the 15-item two-factor SIG and that the eight-item SIG has non-linear relations with job satisfaction and intentions to quit. Specifically, the revised SIG has an inverted curvilinear J-shaped relation with job satisfaction such that job satisfaction drops precipitously after a certain level of stress; the SIG has a J-shaped curvilinear relation with intentions to quit such that turnover intentions increase exponentially after a certain level of stress.

  3. Diffuse optical measurements of head and neck tumor hemodynamics for early prediction of chemoradiation therapy outcomes

    Science.gov (United States)

    Dong, Lixin; Kudrimoti, Mahesh; Irwin, Daniel; Chen, Li; Kumar, Sameera; Shang, Yu; Huang, Chong; Johnson, Ellis L.; Stevens, Scott D.; Shelton, Brent J.; Yu, Guoqiang

    2016-08-01

    This study used a hybrid near-infrared diffuse optical instrument to monitor tumor hemodynamic responses to chemoradiation therapy for early prediction of treatment outcomes in patients with head and neck cancer. Forty-seven patients were measured once per week to evaluate the hemodynamic status of clinically involved cervical lymph nodes as surrogates for the primary tumor response. Patients were classified into two groups: complete response (CR) (n=29) and incomplete response (IR) (n=18). Tumor hemodynamic responses were found to be associated with clinical outcomes (CR/IR), wherein the associations differed depending on human papillomavirus (HPV-16) status. In HPV-16 positive patients, significantly lower levels in tumor oxygenated hemoglobin concentration ([HbO2]) at weeks 1 to 3, total hemoglobin concentration at week 3, and blood oxygen saturation (StO2) at week 3 were found in the IR group. In HPV-16 negative patients, significantly higher levels in tumor blood flow index and reduced scattering coefficient (μs‧) at week 3 were observed in the IR group. These hemodynamic parameters exhibited significantly high accuracy for early prediction of clinical outcomes, within the first three weeks of therapy, with the areas under the receiver operating characteristic curves (AUCs) ranging from 0.83 to 0.96.

  4. Fatigue, patient reported outcomes, and objective measurement of physical activity in systemic lupus erythematosus.

    Science.gov (United States)

    Mahieu, M A; Ahn, G E; Chmiel, J S; Dunlop, D D; Helenowski, I B; Semanik, P; Song, J; Yount, S; Chang, R W; Ramsey-Goldman, R

    2016-10-01

    Fatigue is a common symptom in systemic lupus erythematosus (SLE), and engaging in physical activity may reduce fatigue. We aimed to characterize relationships between fatigue, other health status measures assessed with the Patient Reported Outcomes Measurement Information System (PROMIS) instruments, and accelerometer-based physical activity measurements in patients with SLE. The internal consistency of each PROMIS measure in our SLE sample was also evaluated. This cross-sectional study analyzed 123 adults with SLE. The primary fatigue outcome was Fatigue Severity Scale score. Secondary outcomes were PROMIS standardized T-scores in seven health status domains. Accelerometers were worn for seven days, and mean daily minutes of light, moderate/vigorous, and bouted (10 minutes) moderate/vigorous physical activity were estimated. Cronbach's alpha was determined for each PROMIS measure to assess internal consistency. Relationships between Fatigue Severity Scale, PROMIS, and physical activity were summarized with Spearman partial correlation coefficients (r), adjusted for average daily accelerometer wear time. Mean Fatigue Severity Scale score (4.3, SD 1.6) was consistent with clinically relevant levels of fatigue. Greater daily and bouted moderate/vigorous physical activity minutes correlated with lower Mean Fatigue Severity Scale score (r = -0.20, p = 0.03 and r = -0.30, p = 0.0007, respectively). For PROMIS, bouted moderate/vigorous physical activity minutes correlated with less fatigue (r = -0.20, p = 0.03). PROMIS internal consistency was excellent, with Cronbach's alpha > 0.90 for each domain. Mean PROMIS T-scores for fatigue, pain interference, anxiety, sleep disturbance, sleep-related impairment, and physical function were worse than reported for the general US population. More moderate/vigorous physical activity minutes were associated with less pain interference (r = -0.22, p = 0.01). Both light physical activity and

  5. MEASURES TO IMPROVE THE OUTCOME OF ABRUPTIO PLACENTA IN A TERTIARY REFERRAL CENTRE

    Directory of Open Access Journals (Sweden)

    Vijaya

    2015-12-01

    Full Text Available AIM To analyze the outcome of 135 patients admitted with Abruptio Placenta during a period of 9 months managed at Tertiary Referral Centre, Modern Govt. Maternity Hospital, Petalburz, Hyderabad, Telangana State. MATERIALS AND METHODS A study of 135 cases of Abruptio Placenta over a period of 9 months at a tertiary level referral centre. They were analyzed regarding age, parity, socio economic status, period of gestation, antenatal care, management of Abruption and maternal and fetal outcome, and the measures to improve the condition were analyzed. RESULTS Abruptio placenta is a dreadful threat to maternal and fetal life. In our study unbooked cases were 110(81.48%, Hypertension is the main risk factor almost in 90(66.66% cases, 65% of them were between 28-36 weeks of GA, and 6 were grandmultis, 6 cases ended up with HELLP syndrome with DIC. All these 6 cases were near misses, 5 unbooked cases had eclampsia. One case of unbooked eclampsia had abruption DIC and could not be saved as it was the late referral. Total number of vaginal deliveries were 66(48.88% and total no. of abdominal deliveries were 67(49.62% in this LSCS 66 and one hysterotomy. IUD at the time of admission total were 100(74%. CONCLUSION To improve the outcome in Abruptio Placentae Good antenatal care, Educating the patient, Strengthening the Primary Health Centers in identifying the risk factors like Pre-eclampsia thereby avoiding eclampsia. Regular antenatal checkups timely delivery and availability of blood and blood products with good Neonatal care unit will help in improving the outcome of Abruptio.

  6. Modeling Verdict Outcomes Using Social Network Measures: The Watergate and Caviar Network Cases.

    Directory of Open Access Journals (Sweden)

    Víctor Hugo Masías

    Full Text Available Modelling criminal trial verdict outcomes using social network measures is an emerging research area in quantitative criminology. Few studies have yet analyzed which of these measures are the most important for verdict modelling or which data classification techniques perform best for this application. To compare the performance of different techniques in classifying members of a criminal network, this article applies three different machine learning classifiers-Logistic Regression, Naïve Bayes and Random Forest-with a range of social network measures and the necessary databases to model the verdicts in two real-world cases: the U.S. Watergate Conspiracy of the 1970's and the now-defunct Canada-based international drug trafficking ring known as the Caviar Network. In both cases it was found that the Random Forest classifier did better than either Logistic Regression or Naïve Bayes, and its superior performance was statistically significant. This being so, Random Forest was used not only for classification but also to assess the importance of the measures. For the Watergate case, the most important one proved to be betweenness centrality while for the Caviar Network, it was the effective size of the network. These results are significant because they show that an approach combining machine learning with social network analysis not only can generate accurate classification models but also helps quantify the importance social network variables in modelling verdict outcomes. We conclude our analysis with a discussion and some suggestions for future work in verdict modelling using social network measures.

  7. 76 FR 81295 - Cost Accounting Standards: Cost Accounting Standards 412 and 413-Cost Accounting Standards...

    Science.gov (United States)

    2011-12-27

    ... cost on a current mark-to-market basis better aligns the CAS measurement with current accounting and... 9904 Cost Accounting Standards: Cost Accounting Standards 412 and 413--Cost Accounting Standards... Policy 48 CFR Part 9904 Cost Accounting Standards: Cost Accounting Standards 412 and......

  8. Measuring and reporting quality of life outcomes in clinical trials in cystic fibrosis: a critical review

    Directory of Open Access Journals (Sweden)

    Hart Anna

    2005-03-01

    Full Text Available Abstract Good quality clinical trials are essential to inform the best cystic fibrosis (CF management and care, by determining and comparing the effectiveness of new and existing therapies and drug delivery systems. The formal inclusion of quality of life (QoL as an outcome measure in CF clinical trials is becoming more common. Both an appropriate QoL measure and sound methodology are required in order to draw valid inferences about treatments and QoL. A review was undertaken of randomised controlled trials in cystic fibrosis where QoL was measured. EMBASE, MEDLINE and ISI Web of Science were searched to locate all full papers in the English language reporting randomised controlled trials in cystic fibrosis, published between January 1991 and December 2004. All Cochrane reviews published before December 2004 were hand searched. Papers were included if the authors had reported that they had measured QoL or well being in the trial. 16 trials were identified. The interventions investigated were: antibiotics (4; home versus hospital administration of antibiotics (1; steroids (1; mucolytic therapies (6; exercise (3 and pancreatic enzymes (1. Not one trial evaluated in this review provided conclusive results concerning QoL. This review highlights many of the pitfalls of QoL measurement in CF clinical trials and provides constructive information concerning the design and reporting of trials measuring QoL.

  9. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Directory of Open Access Journals (Sweden)

    Alexander Ross

    2013-11-01

    Full Text Available Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH, and 98.7% at Norfolk and Norwich Hospital (NNUH, whilst 95% (n = 18 of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study. The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care.

  10. An introduction to patient-reported outcome measures (PROMs) in physiotherapy.

    Science.gov (United States)

    Kyte, D G; Calvert, M; van der Wees, P J; ten Hove, R; Tolan, S; Hill, J C

    2015-06-01

    The use of patient-reported outcome measures (PROMs) is set to rise in physiotherapy. PROMs provide additional 'patient-centred' data which is unique in capturing the patient's own opinion on the impact of their disease or disorder, and its treatment, on their life. Thus, PROMs are increasingly used by clinicians to guide routine patient care, or for the purposes of audit, and are already firmly embedded in clinical research. This article seeks to summarise the key aspects of PROM use for physiotherapists, both in routine clinical practice and in the research setting, and highlights recent developments in the field. Generic and condition-specific PROMs are defined and examples of commonly used measures are provided. The selection of appropriate PROMs, and their effective use in the clinical and research settings is discussed. Finally, existing barriers to PROM use in practice are identified and recent physiotherapy PROM initiatives, led by the Royal Dutch Society for Physical Therapy are explored.

  11. [Psychometric properties of Q-DIO, an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes].

    NARCIS (Netherlands)

    Muller-Staub, M.; Lunney, M.; Lavin, M.A.; Needham, I.; Odenbreit, M.; Achterberg, T. van

    2010-01-01

    The instrument Q-DIO was developed in the years 2005 till 2006 to measure the quality of documented nursing diagnoses, interventions, and nursing sensitive patient outcomes. Testing psychometric properties of the Q-DIO (Quality of nursing Diagnoses, Interventions and Outcomes.) was the study aim. In

  12. Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures

    Science.gov (United States)

    Campbell, Alistair; Hemsley, Samantha

    2009-01-01

    The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures…

  13. Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures

    Science.gov (United States)

    Campbell, Alistair; Hemsley, Samantha

    2009-01-01

    The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures…

  14. The importance of patient-reported outcome measures in reconstructive urology.

    Science.gov (United States)

    Jackson, Matthew J; N'Dow, James; Pickard, Rob

    2010-11-01

    Patient-reported outcome measures (PROMs) are now recognised as the most appropriate instruments to assess the effectiveness of healthcare interventions from the patient's perspective. The purpose of this review was to identify recent publications describing the use of PROMs following reconstructive urological surgery. A wide systematic search identified only three original articles published in the last 2 years that prospectively assessed effectiveness using a patient-completed condition-specific or generic health-related quality of life (HRQoL) instrument. These publications illustrate the need to administer PROMs at a postoperative interval relevant to the anticipated recovery phase of individual procedures. They also highlight the difference in responsiveness of generic HRQoL instruments to symptomatic improvement between straightforward conditions such as pelviureteric junction obstruction and complex multidimensional conditions such as meningomyelocele. PROMs uptake and awareness is increasing in reconstructive urology but more work is required to demonstrate the effectiveness of surgical procedures for patients and healthcare funders alike. Healthcare policy-makers now rely on these measures to determine whether specific treatments are worth financing and to compare outcomes between institutions.

  15. Measuring patients' perceptions of the outcomes of treatment for early prostate cancer.

    Science.gov (United States)

    Clark, Jack A; Bokhour, Barbara G; Inui, Thomas S; Silliman, Rebecca A; Talcott, James A

    2003-08-01

    Compared with careful attention to the physical (eg, urinary, bowel, sexual) dysfunction that may follow treatment, little attention has been given to the behavioral, emotional, and interpersonal changes that the diagnosis of early prostate cancer and subsequent physical dysfunction may bring. To construct patient-centered measures of the outcomes of treatment for early prostate cancer. Qualitative study followed by survey of early prostate cancer patients and group of comparable patients with no history of prostate cancer. Analysis of focus groups identified relevant domains of quality of life, which were represented by Likert scale items included in survey questionnaires. Psychometric analyses of survey data defined scales evaluated with respect to internal consistency and validity. Qualitative analysis identified three domains: urinary control, sexuality, and uncertainty about the cancer and its treatment. Psychometric analysis defined 11 scales. Seven were generically relevant to most older men: urinary control (eg, embarrassment with leakage), sexual intimacy (eg, anxiety about completing intercourse), sexual confidence (eg, comfort with sexuality), marital affection (eg, emotional distance from spouse/partner), masculine self esteem (eg, feeling oneself a whole man), health worry (eg, apprehensiveness about health changes), and PSA concern (eg, closely attending to one's PSA). Four scales were specific to the treatment experience: perceived cancer control, quality of treatment decision making, regret of treatment choice, and cancer-related outlook. The scales provide definition and metrics for patient-centered research in this area. They complement measures of physical dysfunction and bring into resolution outcomes of treatment that have gone unnoticed in previous studies.

  16. ACCOUNTING POLICIES AND FINANCIAL ANALYSIS INTERDEPENDENCES - EMPIRICAL EVIDENCE

    Directory of Open Access Journals (Sweden)

    Nino Serdarević

    2011-06-01

    Full Text Available This paper presents empirical evidence on applied analysis interdependences with created accounting policies and estimates within Bosnia and Herzegovina (BIH private commercial entities, in specific, targeting practice oriented relevance of financial indicators, non-financial indicators, enterprise resource planning and management account-ting insight frequencies. Recently, standard setters (International Accounting Standards Board and International Federation of Accountants have published outcomes of an internationally organized research on financial reports usefulness, recommending enforced usage of enterprise relevant information, non-financial indicators and risks implications in assets and liabilities positions. These imply litigation and possible income smoothening. In regard to financial reporting reliability, many authors suggest accounting conservatism as a measure to compose risk assessment and earnings response ratio. Author argues that recently suggested financial management measures involving cash and assets management, liquidity ratios and turns do not directly imply accounting information quality, prior computed within applied accounting conservatism.

  17. The STarT Back Screening Tool and Individual Psychological Measures: Evaluation of Prognostic Capabilities for Low Back Pain Clinical Outcomes in Outpatient Physical Therapy Settings

    Science.gov (United States)

    Bishop, Mark D.; Fritz, Julie M.; Robinson, Michael E.; Asal, Nabih R.; Nisenzon, Anne N.

    2013-01-01

    disability at 6 months. Limitations Physical therapy treatment was not standardized or accounted for in the analysis. Conclusions Prediction of clinical outcomes by psychology-based measures was dependent upon the clinical outcome domain of interest. Similar to studies from the primary care setting, initial screening with the SBT provided additional prognostic information for 6-month disability and changes in SBT overall scores may provide important clinical decision-making information for treatment monitoring. PMID:23125279

  18. Development of a new patient-reported outcome measure in sarcopenia.

    Science.gov (United States)

    Evans, Christopher J; Chiou, Chiun-Fang; Fitzgerald, Kristina A; Evans, William J; Ferrell, Betty R; Dale, William; Fried, Linda P; Gandra, Shravanthi R; Dennee-Sommers, Brooke; Patrick, Donald L

    2011-03-01

    The objective of this study was to develop a patient-reported outcome (PRO) to assess reduced muscle strength in sarcopenia. Qualitative research study. University of Arkansas for Medical Sciences. Subjects with sarcopenia. Adults aged 55 years and older with sarcopenia (n = 12) attended open-ended, concept elicitation interviews to characterize the functional effects of reduced muscle strength on their lives. The resulting qualitative data were analyzed using a qualitative analysis software program (Atlas.ti [Atlas.ti GmbH, Berlin, Germany]) and a common set of codes was developed to summarize the data. Subsequently, the initial PRO measure was drafted. Cognitive interviews were then conducted with additional sarcopenia subjects (n = 12) to refine the measure. Qualitative interviews identified key concepts (eg, impacts) in the areas of activities of daily living, emotions, social activities, energy, balance, coordination, sleep, and strength. Based on data from the cognitive debriefing interviews (eg, understandability, relevance, suggestions to reword items), the PRO measure development team came to consensus on which items or parts of the instructions to retain, revise, or delete. The final measure included 14 items. The final PRO measure, the Age-Related Muscle Loss Questionnaire, can be used in both clinical practice and clinical trial settings to assess functional impacts of reduced muscle strength in sarcopenia. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  19. Measuring Outcomes in Mental Health Services for Older People: An Evaluation of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+)

    Science.gov (United States)

    Gee, Susan B.; Croucher, Matthew J.; Beveridge, John

    2010-01-01

    The Health of the Nation Outcome Scales (HoNOS) family of measures is routinely used in mental health services in the New Zealand, Australia, and the United Kingdom. However, the psychometric properties of the HoNOS65+ for elderly people have not been extensively evaluated. The aim of the present study was to examine the validity, reliability, and…

  20. Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error - Reply ( letter to the editor

    NARCIS (Netherlands)

    Boshuizen, H.C.; Lanti, M.; Menotti, A.; Moschandreas, J.; Tolonen, H.; Nissinen, A.; Nedeljkovic, S.; Kafatos, A.; Kromhout, D.

    2008-01-01

    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality d

  1. Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error

    NARCIS (Netherlands)

    Boshuizen, H.C.; Lanti, M.; Menotti, A.; Moschandreas, J.; Tolonen, H.; Nissinen, A.; Nedeljkovic, S.; Kafatos, A.; Kromhout, D.

    2007-01-01

    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality d

  2. Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error - Reply ( letter to the editor

    NARCIS (Netherlands)

    Boshuizen, H.C.; Lanti, M.; Menotti, A.; Moschandreas, J.; Tolonen, H.; Nissinen, A.; Nedeljkovic, S.; Kafatos, A.; Kromhout, D.

    2008-01-01

    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality

  3. Do School Incentives and Accountability Measures Improve Skills in the Middle East and North Africa? The Cases of Jordan and Tunisia

    Science.gov (United States)

    Shafiq, M. Najeeb

    2011-01-01

    There is general agreement that skill-enhancing school reforms in the Middle East and North Africa (MENA) region are necessary for economic, political and social reasons. Using student-level data from Jordan and Tunisia, this study assesses the relationship between skills and the following school incentive and accountability measures: pedagogical…

  4. Seeking Truth from Facts: the Theoretical Conerstone of the Accounting Measurement%实事求是:会计计量的理论基石

    Institute of Scientific and Technical Information of China (English)

    尉然

    2012-01-01

    随着社会经济的发展,现行会计计量存在脱离现实等诸多缺陷和弊端,如:现行会计计量使资产价值缺乏判断的标准;计量方法与资产价值属性之间逻辑混乱;不考虑资产计量的时点性;等等。会计计量应遵循实事求是原则,其科学性、真实性应该在实践中得到检验、发展。%With the social and economic development, the current accounting measurement exist many defects and shortcomings, such as divorced from reality and so on. For example, the current lack of accounting measures to determine the asset value of the standards, measurement methods and logical confusion between property asset value, difficult to coordinate the accounting objective, not a true reflection of their overall asset value, without considering the point in time, and so on. The accounting measurement scientific truth should be tested in practice and development.

  5. Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error

    NARCIS (Netherlands)

    Boshuizen, H.C.; Lanti, M.; Menotti, A.; Moschandreas, J.; Tolonen, H.; Nissinen, A.; Nedeljkovic, S.; Kafatos, A.; Kromhout, D.

    2007-01-01

    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality d

  6. Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error - Reply ( letter to the editor

    NARCIS (Netherlands)

    Boshuizen, H.C.; Lanti, M.; Menotti, A.; Moschandreas, J.; Tolonen, H.; Nissinen, A.; Nedeljkovic, S.; Kafatos, A.; Kromhout, D.

    2008-01-01

    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality d

  7. Negative priming 1985 to 2015: a measure of inhibition, the emergence of alternative accounts, and the multiple process challenge.

    Science.gov (United States)

    D'Angelo, Maria C; Thomson, David R; Tipper, Steven P; Milliken, Bruce

    2016-10-01

    In this article, three generations of authors describe the background to the original article; the subsequent emergence of vigorous debates concerning what negative priming actually reflects, where radically different accounts based on memory retrieval were proposed; and a re-casting of the conceptual issues underlying studies of negative priming. What started as a simple observation (slowed reaction times) and mechanism (distractor inhibition) appears now to be best explained by a multiple mechanism account involving both episodic binding and retrieval processes as well as an inhibitory process. Emerging evidence from converging techniques such as functional magnetic resonance imaging (fMRI), and especially electroencephalography (EEG), is beginning to identify these different processes. The past 30 years of negative priming experiments has revealed the dynamic and complex cognitive processes that mediate what appear to be apparently simple behavioural effects.

  8. Analysing the sustainability of the entities quoted on the B.S.E. using accounting sustainability measures

    Directory of Open Access Journals (Sweden)

    Florentin Caloian

    2013-11-01

    Full Text Available In order to ensure a sustainable development of an entity, a sustainability accounting report, trustfulness and proper made is mandatory for financial users. As a fact, the entities have to reveal social and environment information in order to increase the creditworthiness in the activity they realized. The purpose of this research is to point out how the sustainability accounting report influences the financial performance of the companies, by quantifying the social and environment elements in a score variable. The analysis is done upon the societies that are listed on the first category of Bucharest Stock of Exchange and tries to identity the way through which sustainable development can be ensured. The results are based on a linear regression model and find a direct positive correlation between the score variable and the financial performance of the companies

  9. Progress Towards a Core Set of Outcome Measures in Small-vessel Vasculitis. Report from OMERACT 9

    Science.gov (United States)

    MERKEL, PETER A.; HERLYN, KAREN; MAHR, ALFRED D.; NEOGI, TUHINA; SEO, PHILIP; WALSH, MICHAEL; BOERS, MAARTEN; LUQMANI, RAASHID

    2011-01-01

    The past decade has seen a substantial increase in the number and quality of clinical trials of new therapies for vasculitis, including randomized, controlled, multicenter trials that have successfully incorporated measures of disease activity and toxicity. However, because current treatment regimens for severe disease effectively induce initial remission and reduce mortality, future trials will focus on any of several goals including: (a) treatment of mild—moderate disease; (b) prevention of chronic damage; (c) reduction in treatment toxicity; or (d) more subtle differences in remission induction or maintenance. Thus, new trials will require outcome measure instruments that are more precise and are better able to detect effective treatments for different disease states and measure chronic manifestations of disease. The OMERACT Vasculitis Working Group comprises international clinical investigators with expertise in vasculitis who, since 2002, have worked collaboratively to advance the refinement of outcome measures in vasculitis, create new measures to address domains of illness not covered by current research approaches, and harmonize outcome assessment in vasculitis. The focus of the OMERACT group to date has been on outcome measures in small-vessel vasculitis with an overall goal of creating a core set of outcome measures for vasculitis, each of which fulfills the OMERACT filter of truth, discrimination, feasibility, and identifying additional domains requiring further research. This process has been informed by several ongoing projects providing data on outcomes of disease activity, disease-related damage, multidimensional health-related quality of life, and patient-reported ratings of the burden of vasculitis. PMID:19820226

  10. Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients?

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Andersen, Christina W.; Pedersen, Sigrid F

    2014-01-01

    OBJECTIVE: To evaluate the effect of progressive resistance strength training as additional training measured on functional outcomes in older hospitalized patients. DESIGN: A single-blinded randomized controlled trial. SETTING: Department of Geriatric Rehabilitation in university hospital...

  11. Core domain and outcome measurement sets for shoulder pain trials are needed: Systematic review of physical therapy trials

    NARCIS (Netherlands)

    M.J. Page (Matthew J.); J.E. McKenzie (Joanne E.); S.E. Green (Sally E.); D.E. Beaton (Dorcas E.); N.B. Jain (Nitin B.); M. Lenza (Mario); A.P. Verhagen (Arianne P.); S. Surace (Stephen); J. Deitch (Jessica); R. Buchbinder (Rachelle)

    2015-01-01

    textabstractObjectives To explore the outcome domains and measurement instruments reported in published randomized controlled trials of physical therapy interventions for shoulder pain (rotator cuff disease, adhesive capsulitis, or nonspecific shoulder pain). Study Design and Setting We included tri

  12. Investigation of the effects of correlated measurement errors in time series analysis techniques applied to nuclear material accountancy data. [Program COVAR

    Energy Technology Data Exchange (ETDEWEB)

    Pike, D.H.; Morrison, G.W.; Downing, D.J.

    1982-04-01

    It has been shown in previous work that the Kalman Filter and Linear Smoother produces optimal estimates of inventory and loss from a material balance area. The assumptions of the Kalman Filter/Linear Smoother approach assume no correlation between inventory measurement error nor does it allow for serial correlation in these measurement errors. The purpose of this report is to extend the previous results by relaxing these assumptions to allow for correlation of measurement errors. The results show how to account for correlated measurement errors in the linear system model of the Kalman Filter/Linear Smoother. An algorithm is also included for calculating the required error covariance matrices.

  13. Enhancing rigour in the validation of patient reported outcome measures (PROMs: bridging linguistic and psychometric testing

    Directory of Open Access Journals (Sweden)

    Roberts Gwerfyl

    2012-06-01

    Full Text Available Abstract Background A strong consensus exists for a systematic approach to linguistic validation of patient reported outcome measures (PROMs and discrete methods for assessing their psychometric properties. Despite the need for robust evidence of the appropriateness of measures, transition from linguistic to psychometric validation is poorly documented or evidenced. This paper demonstrates the importance of linking linguistic and psychometric testing through a purposeful stage which bridges the gap between translation and large-scale validation. Findings Evidence is drawn from a study to develop a Welsh language version of the Beck Depression Inventory-II (BDI-II and investigate its psychometric properties. The BDI-II was translated into Welsh then administered to Welsh-speaking university students (n = 115 and patients with depression (n = 37 concurrent with the English BDI-II, and alongside other established depression and quality of life measures. A Welsh version of the BDI-II was produced that, on administration, showed conceptual equivalence with the original measure; high internal consistency reliability (Cronbach’s alpha = 0.90; 0.96; item homogeneity; adequate correlation with the English BDI-II (r = 0.96; 0.94 and additional measures; and a two-factor structure with one overriding dimension. Nevertheless, in the student sample, the Welsh version showed a significantly lower overall mean than the English (p = 0.002; and significant differences in six mean item scores. This prompted a review and refinement of the translated measure. Conclusions Exploring potential sources of bias in translated measures represents a critical step in the translation-validation process, which until now has been largely underutilised. This paper offers important findings that inform advanced methods of cross-cultural validation of PROMs.

  14. Validation of a core outcome measure for palliative care in Africa: the APCA African Palliative Outcome Scale

    Directory of Open Access Journals (Sweden)

    Moll Tony

    2010-01-01

    Full Text Available Abstract Background Despite the burden of progressive incurable disease in Africa, there is almost no evidence on patient care or outcomes. A primary reason has been the lack of appropriate locally-validated outcome tools. This study aimed to validate a multidimensional scale (the APCA African Palliative Outcome Scale in a multi-centred international study. Methods Validation was conducted across 5 African services and in 3 phases: Phase 1. Face validity: content analysis of qualitative interviews and cognitive interviewing of POS; Phase 2. Construct validity: correlation of POS with Missoula-Vitas Quality of Life Index (Spearman's rank tests; Phase 3. Internal consistency (Cronbach's alpha calculated twice using 2 datasets, test-retest reliability (intraclass correlation coefficients calculated for 2 time points and time to complete (calculated twice using 2 datasets. Results The validation involved 682 patients and 437 family carers, interviewed in 8 different languages. Phase 1. Qualitative interviews (N = 90 patients; N = 38 carers showed POS items mapped well onto identified needs; cognitive interviews (N = 73 patients; N = 29 carers demonstrated good interpretation; Phase 2. POS-MVQoLI Spearman's rank correlations were low-moderate as expected (N = 285; Phase 3. (N = 307, 2nd assessment mean 21.2 hours after first, SD 7.2 Cronbach's Alpha was 0.6 on both datasets, indicating expected moderate internal consistency; test-retest found high intra-class correlation coefficients for all items (0.78-0.89; median time to complete 7 mins, reducing to 5 mins at second visit. Conclusions The APCA African POS has sound psychometric properties, is well comprehended and brief to use. Application of this tool offers the opportunity to at last address the omissions of palliative care research in Africa.

  15. A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS family of measures

    Directory of Open Access Journals (Sweden)

    Dodson Sarity

    2005-11-01

    Full Text Available Abstract Background The Health of the Nation Outcome Scales was developed to routinely measure outcomes for adults with mental illness. Comparable instruments were also developed for children and adolescents (the Health of the Nation Outcome Scales for Children and Adolescents and older people (the Health of the Nation Outcome Scales 65+. All three are being widely used as outcome measures in the United Kingdom, Australia and New Zealand. There is, however, no comprehensive review of these instruments. This paper fills this gap by reviewing the psychometric properties of each. Method Articles and reports relating to the instruments were retrieved, and their findings synthesised to assess the instruments' validity (content, construct, concurrent, predictive, reliability (test-retest, inter-rater, sensitivity to change, and feasibility/utility. Results Mostly, the instruments perform adequately or better on most dimensions, although some of their psychometric properties warrant closer examination. Conclusion Collectively, the Health of the Nation Outcome Scales family of measures can assess outcomes for different groups on a range of mental health-related constructs, and can be regarded as appropriate for routinely monitoring outcomes.

  16. Assessment of patient-reported outcome measures in the surgical treatment of patients with gastric cancer.

    Science.gov (United States)

    Straatman, Jennifer; van der Wielen, Nicole; Joosten, Pieter J; Terwee, Caroline B; Cuesta, Miguel A; Jansma, Elise P; van der Peet, Donald L

    2016-05-01

    Gastric cancer is responsible for 10 % of all cancer-related deaths worldwide. With improved operative techniques and neo-adjuvant therapy, survival rates are increasing. Outcomes of interest are shifting to quality of life (QOL), with many different tools available. The aim of this study was to assess which patient-reported outcome measures (PROMs) are used to measure QOL after a gastrectomy for cancer. A comprehensive search was conducted for original articles investigating QOL after gastrectomy. Two authors independently selected relevant articles, conducted clinical appraisal and extracted data (P.J. and J.S.). Out of 3414 articles, 26 studies were included, including a total of 4690 patients. These studies included ten different PROMs, which could be divided into generic, symptom-specific and disease-specific questionnaires. The EORTC and the FACT questionnaires use an oncological overall QOL module and an organ-specific module. Only one validation study regarding the use of the EORTC after surgery for gastric cancer was available, demonstrating good psychometric properties and clinical validity. A great variety of PROMs are being used in the measurement of QOL after surgery for gastric cancer. A questionnaire with a general module along with a disease-specific module for the assessment of QOL seems most desirable, such as the EORTC and the FACT with their specific modules. Both are developed in different treatment modalities, such as in surgical patients. EORTC is the most widely used questionnaire and therefore allows for comparison of new studies to existing data. Future studies are needed to assess content validity in surgical gastric cancer patients.

  17. The importance of rating scales in measuring patient-reported outcomes

    Directory of Open Access Journals (Sweden)

    Khadka Jyoti

    2012-07-01

    Full Text Available Abstract Background A critical component that influences the measurement properties of a patient-reported outcome (PRO instrument is the rating scale. Yet, there is a lack of general consensus regarding optimal rating scale format, including aspects of question structure, the number and the labels of response categories. This study aims to explore the characteristics of rating scales that function well and those that do not, and thereby develop guidelines for formulating rating scales. Methods Seventeen existing PROs designed to measure vision-related quality of life dimensions were mailed for self-administration, in sets of 10, to patients who were on a waiting list for cataract extraction. These PROs included questions with ratings of difficulty, frequency, severity, and global ratings. Using Rasch analysis, performance of rating scales were assessed by examining hierarchical ordering (indicating categories are distinct from each other and follow a logical transition from lower to higher value, evenness (indicating relative utilization of categories, and range (indicating coverage of the attribute by the rating scale. Results The rating scales with complicated question format, a large number of response categories, or unlabelled categories, tended to be dysfunctional. Rating scales with five or fewer response categories tended to be functional. Most of the rating scales measuring difficulty performed well. The rating scales measuring frequency and severity demonstrated hierarchical ordering but the categories lacked even utilization. Conclusion Developers of PRO instruments should use a simple question format, fewer (four to five and labelled response categories.

  18. Measuring situation awareness in emergency settings: a systematic review of tools and outcomes.

    Science.gov (United States)

    Cooper, Simon; Porter, Joanne; Peach, Linda

    2014-01-01

    Nontechnical skills have an impact on health care outcomes and improve patient safety. Situation awareness is core with the view that an understanding of the environment will influence decision-making and performance. This paper reviews and describes indirect and direct measures of situation awareness applicable for emergency settings. Electronic databases and search engines were searched from 1980 to 2010, including CINAHL, Ovid Medline, Pro-Quest, Cochrane, and the search engine, Google Scholar. Access strategies included keyword, author, and journal searches. Publications identified were assessed for relevance, and analyzed and synthesized using Oxford evidence levels and the Critical Appraisal Skills Programme guidelines in order to assess their quality and rigor. One hundred and thirteen papers were initially identified, and reduced to 55 following title and abstract review. The final selection included 14 papers drawn from the fields of emergency medicine, intensive care, anesthetics, and surgery. Ten of these discussed four general nontechnical skill measures (including situation awareness) and four incorporated the Situation Awareness Global Assessment Technique. A range of direct and indirect techniques for measuring situation awareness is available. In the medical literature, indirect approaches are the most common, with situation awareness measured as part of a nontechnical skills assessment. In simulation-based studies, situation awareness in emergencies tends to be suboptimal, indicating the need for improved training techniques to enhance awareness and improve decision-making.

  19. Research on accounting recognition and measurement of forest ecological assets%森林生态资产的特征、会计确认与计量

    Institute of Scientific and Technical Information of China (English)

    刘梅娟; 温作民; 魏远竹

    2012-01-01

    现行的会计准则及制度从未涉及森林生态资产的核算规定.随着当今人们对森林生态问题前所未有的关注及其会计信息披露的需要,其核算问题也成为会计界研究的前沿与热点问题,有关它的特殊性及会计确认与计量等深层次问题都亟待解决.在阐述森林生态资产特殊性及其对会计确认与计量影响的基础上,分析认为森林生态资产的会计确认应该在评估的基础上进行,森林生态资产的初始及后续的会计计量均比较适合采用公允价值计量模式,其公允价值的获取途径应更多地考虑非市场价值的评估技术,而其估价技术方法应充分采纳现行成熟的生态经济学或环境经济学价值评价方法.%Current accounting standards and systems do not include the accounting of forest ecological assets. With the increasing attention that people pay to forest ecological issues and the needs for accounting information disclosure, its value accounting has become a forefront issue and hot topic in the accounting profession. The profound issues about its particularities, accounting recognition and measurements are to be solved. Based on the analysis of the features of forest ecological assets and its impacts on accounting recognition and measurement, this paper proposes that accounting recognition should be based on the appraisal and a fair value model is suggested for initial and further measurement of forest ecological assets. For the fair value measurement, the appraisal techniques of non-market values should be given more consideration. And its value appraisal methods should refer to the existing mature ecological economic or environmental economic appraisal methods.

  20. Beyond FEV1 in COPD: a review of patient-reported outcomes and their measurement

    Directory of Open Access Journals (Sweden)

    Jones P

    2012-10-01

    Full Text Available Paul Jones,1 Marc Miravitlles,2 Thys van der Molen,3 Karoly Kulich41Division of Clinical Science, University of London, London, UK; 2Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Ciber de Enfermedades Respiratorias, Barcelona, Spain; 3Department of Primary Care, University Medical Centre Groningen, Groningen, The Netherlands; 4Novartis Pharma AG, Basel, SwitzerlandAbstract: Patients with chronic obstructive pulmonary disease (COPD present with a variety of symptoms and pathological consequences. Although primarily viewed as a respiratory disease, COPD has both pulmonary and extrapulmonary effects, which have an impact on many aspects of physical, emotional, and mental well-being. Traditional assessment of COPD relies heavily on measuring lung function, specifically forced expiratory volume in 1 second (FEV1. However, the evidence suggests that FEV1 is a relatively poor correlate of symptoms such as breathlessness and the impact of COPD on daily life. Furthermore, many consequences of the disease, including anxiety and depression and the ability to perform daily activities, can only be described and reported reliably by the patient. Thus, in order to provide a comprehensive view of the effects of interventions in clinical trials, it is essential that spirometry is accompanied by assessments using patient-reported outcome (PRO instruments. We provide an overview of patient-reported outcome concepts in COPD, such as breathlessness, physical functioning, and health status, and evaluate the tools used for measuring these concepts. Particular attention is given to the newly developed instruments emerging in response to recent regulatory guidelines for the development and use of PROs in clinical trials. We conclude that although data from the development and validation of these new PRO instruments are emerging, to build the body of evidence that supports the use of a new instrument takes many years. Furthermore, new

  1. How "accountable" are accountable care organizations?

    Science.gov (United States)

    Addicott, Rachael; Shortell, Stephen M

    2014-01-01

    The establishment of accountable care organizations (ACOs) in the Affordable Care Act (ACA) was intended to support both cost savings and high-quality care. However, a key challenge will be to ensure that governance and accountability mechanisms are sufficient to support those twin ambitions. This exploratory study considers how recently developed ACOs have established governance structures and accountability mechanisms, particularly focusing on attempts at collaborative accountability and shared governance arrangements. Four case studies of ACOs across the United States were undertaken, with data collected throughout 2012. These involved 34 semistructured interviews with ACO administrative and clinical leaders, observation of nine meetings, and a review of documentary materials from each ACO. We identified very few examples of physicians being held to account as a collective and therefore only limited evidence of collaborative accountability impacting on behavior change. However, ACO leaders do have many mechanisms available to stimulate change across physicians. The challenge is to determine governance structure(s) and accountability mechanisms that facilitate the most effective combination of approaches, measures, incentives, and sanctions to achieve the goals of more accountable care. Accountability structures and processes will need to be tailored to local membership composition, historical evolution, and current stage of development. There are also some common lessons to be drawn. Shared goals and incentives should be reflected through performance criteria. It is important to align measures and thresholds across payers to ensure ACOs are not unnecessarily burdened or compromised by reporting on different and potentially disjointed measures. Finally, emphasis needs to be placed on the importance of credible, transparent data. This exploratory study provides early evidence regarding how ACOs are establishing their governance and accountability arrangements and

  2. Numerical Electric Field Analysis of Power Status Sensor Observing Power Distribution System Taking into Account Voltage Divider Measurement Circuit

    Science.gov (United States)

    Kubo, Takuro; Furukawa, Tatsuya; Itoh, Hideaki; Fukumoto, Hisao; Wakuya, Hiroshi; Ohchi, Masashi

    We have proposed and preproducted the voltage-current waveform sensor of resin molded type for measuring the power factor and harmonics in power distribution systems. We have executed numerical electromagnetic analyses using the finite element method to estimate the characteristics and behaviours of the sensor. Although the magnetic field analyses for the current sensor have involved the measurement circuit, the electric field analyses have not included the measurement circuit for measuring voltage waveforms of power lines. In this paper, we describe the electric field analyses with the measurement circuit and prove the insulating strength of the proposed sensor permissible to the use in 22kV power distribution systems.

  3. How magnetic are Finnish hospitals measured by transformational leadership and empirical quality outcomes?

    Science.gov (United States)

    Kvist, Tarja; Mäntynen, Raija; Turunen, Hannele; Partanen, Pirjo; Miettinen, Merja; Wolf, Gail A; Vehviläinen-Julkunen, Katri

    2013-01-01

      The overall aim of this study was to examine nurses' and patients' perceptions of the Magnet model components of transformational leadership and empirical quality outcomes in four Finnish hospitals and to determine if the evidence for transformational leadership and empirical quality outcomes is the same or different in the four hospitals.   This report presents baseline measurements for a longitudinal study of the adaptation of the Magnet model in Finnish hospitals.   Web-based surveys and mailed questionnaires were used in 2008-2009 to collect data from patients (n = 2566) about their satisfaction with care, and from nursing staff about transformational leadership (n = 1151), job satisfaction (n = 2707) and patient safety culture (n = 925) in the selected hospitals.   Awareness of the work of nursing leaders was low. Nurses reported a high level of job satisfaction. Patient safety culture varied considerably between the four hospitals. Patients believed they generally received excellent quality care.   Leadership systems are in transition at the hospitals. Patient safety culture is a complex phenomenon that may be unfamiliar to respondents. The results of the study provide a baseline description to guide the journey toward development of Magnet standards.   Finnish nursing leaders, especially nursing directors, should increase their visibility by working more closely with their staff. They should also pay attention to giving direct feedback about work generally and patient safety issues in particular. © 2012 Blackwell Publishing Ltd.

  4. Modeling strategy to identify patients with primary immunodeficiency utilizing risk management and outcome measurement.

    Science.gov (United States)

    Modell, Vicki; Quinn, Jessica; Ginsberg, Grant; Gladue, Ron; Orange, Jordan; Modell, Fred

    2017-06-01

    This study seeks to generate analytic insights into risk management and probability of an identifiable primary immunodeficiency defect. The Jeffrey Modell Centers Network database, Jeffrey Modell Foundation's 10 Warning Signs, the 4 Stages of Testing Algorithm, physician-reported clinical outcomes, programs of physician education and public awareness, the SPIRIT® Analyzer, and newborn screening, taken together, generates P values of less than 0.05%. This indicates that the data results do not occur by chance, and that there is a better than 95% probability that the data are valid. The objectives are to improve patients' quality of life, while generating significant reduction of costs. The advances of the world's experts aligned with these JMF programs can generate analytic insights as to risk management and probability of an identifiable primary immunodeficiency defect. This strategy reduces the uncertainties related to primary immunodeficiency risks, as we can screen, test, identify, and treat undiagnosed patients. We can also address regional differences and prevalence, age, gender, treatment modalities, and sites of care, as well as economic benefits. These tools support high net benefits, substantial financial savings, and significant reduction of costs. All stakeholders, including patients, clinicians, pharmaceutical companies, third party payers, and government healthcare agencies, must address the earliest possible precise diagnosis, appropriate intervention and treatment, as well as stringent control of healthcare costs through risk assessment and outcome measurement. An affected patient is entitled to nothing less, and stakeholders are responsible to utilize tools currently available. Implementation offers a significant challenge to the entire primary immunodeficiency community.

  5. A systematic review of patient-reported outcome measures for chronic suppurative otitis media.

    Science.gov (United States)

    Phillips, John S; Yung, Matthew W

    2016-06-01

    The purpose of this review was to systematically appraise the world literature to identify existing patient-reported outcome measures (PROMs) for the assessment of outcomes in patients with chronic suppurative otitis media, to verify the diversity of the individual questionnaire items, to report the methods employed to evaluate the questionnaires, and to identify areas for development in the future. Embase (January 1980-November 2014), MEDLINE (January 1946-November 2014), Cumulative Index to Nursing and Allied Health Literature (January 1981-November 2014), and PsycINFO (January 1806-November 2014). A systematic literature search was independently undertaken by the two authors according to predefined inclusion and exclusion criteria. Nine original articles were identified, which overall outlined the evaluation of four different questionnaires. This systematic appraisal of the world literature has identified four PROM questionnaires for use in patients with chronic suppurative otitis media. All four questionnaires evaluate reliability and validity using different psychometric methods. The Chronic Ear Survey questionnaire has been most broadly evaluated and disseminated. All four questionnaires assess static health status. There are many advantages to developing a dynamic one-hit questionnaire to assess the health status of patients having undergone an intervention for chronic suppurative otitis media. NA Laryngoscope, 126:1458-1463, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  6. New language outcome measures for Mandarin speaking children with hearing loss

    Institute of Scientific and Technical Information of China (English)

    Xueman Liu; Jill de Villiers; Wendy Lee; Chunyan Ning; Eric Rolfhus; Teresa Hutchings; Fan Jiang; Yiwen Zhang

    2016-01-01

    Objective:The paper discusses recent evidence on the assessment of language outcomes in children with hearing loss acquiring oral language. Methods: Research emphasizes that language tests must be specific enough to capture subtle deficits in vocabulary and grammar learning at different developmental ages. The Diagnostic Receptive and Expressive Assessment of Mandarin (DREAM) was carefully designed to be a comprehensive standardized Mandarin assessment normed in Mainland China. Results:This paper summarizes the evidence-based item design process and validity and reliability results of DREAM. A pilot study reported here shows that DREAM provided detailed information about hearing impaired children's language abilities and can be used to aid intervention planning to maximize progress. Conclusion: DREAM represents an example of translational science, transferring methods from empirical studies of language acquisition in research environments into applied domains such as assessment and intervention. Research on outcomes in China will advance significantly with the availability of evidence-based comprehensive language tests that measure a sufficient age range of skills, are normed on Mandarin speaking children in mainland China, and are designed to capture features central to Mandarin language acquisition.

  7. Patient reported outcome measures of quality of end-of-life care: A systematic review.

    Science.gov (United States)

    Kearns, Tara; Cornally, Nicola; Molloy, William

    2017-02-01

    End-of-life (EoL) care(1) is increasingly used as a generic term in preference to palliative care or terminal care, particularly with reference to individuals with chronic disease, who are resident in community and long-term care (LTC) settings. This review evaluates studies based on patient reported outcome measures (PROMS) of quality of EoL care across all health-care settings. From 1041 citations, 12 studies were extracted by searches conducted in EBSCO, Scopus, Web of Science, PubMed, Cochrane, Open Grey and Google Scholar databases. At present, the evidence base for EoL care is founded on cancer care. This review highlights the paucity of studies that evaluate quality of EoL care for patients with chronic disease outside the established cancer-acute care paradigm, particularly in LTC. This review highlights the absence of any PROMs for the estimated 60% of patients in LTC with cognitive impairment. Patient-reported outcomes (PROs) are critical to understanding how EoL care services and practices affect patients' health and EoL experience. PROMs describe the quality of care from the patient's perspective and add balance to existing clinical or proxy-derived knowledge on the quality of care and services provided.

  8. Validation of two generic patient-reported outcome measures in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Boye Kristina S

    2007-07-01

    Full Text Available Abstract Background Prior to using a generic patient-reported outcome measure (PRO, the measure should be validated within the target population. The purpose of the current study was to validate two generic measures in patients with type 2 diabetes. Methods Patients with type 2 diabetes in Scotland and England completed two generic measures: EQ-5D and Psychological General Well-Being Index (PGWB. Two diabetes-specific measures were administered: ADS and DSC-R. Analyses assessed reliability and validity. Results There were 130 participants (53 Scotland; 77 England; 64% male; mean age = 55.7 years. Responses on the EQ-5D and PGWB reflected moderate impairment consistent with previous diabetes samples: mean EQ-5D Index score, 0.75; EQ-5D VAS, 68.8; PGWB global score, 67.9. All scales of the PGWB demonstrated good internal consistency reliability (Cronbach's alpha = 0.77 to 0.97. The EQ-5D and PGWB demonstrated convergent validity through significant correlations with the ADS (r = 0.48 to 0.61, DSC-R scales (r = 0.33 to 0.81 except ophthalmology subscale, and Body Mass Index (r = 0.15 to 0.38. The EQ-5D and PGWB discriminated between groups of patients known to differ in diabetes-related characteristics (e.g., history of hypoglycemia. Conclusion Results support the use of the EQ-5D and PGWB among patients with type 2 diabetes, possibly in combination with condition-specific measures.

  9. Patient-reported outcome measures in psoriasis: the good, the bad and the missing!

    Science.gov (United States)

    Kitchen, H; Cordingley, L; Young, H; Griffiths, C E M; Bundy, C

    2015-01-01

    As a long-term condition, psoriasis demands significant personal and professional input for optimal self-management. Low levels of well-being and high levels of psychological distress in patients with psoriasis are associated with reduced resources for self-care. Patient-reported outcome (PRO) measures can be used to assess physical, social and psychological functioning in order to guide treatment. In this article, we systematically reviewed the development and validation of existing PRO measures. PubMed (Medline), PsycINFO and CINAHL were searched systematically using predefined search terms. The search was limited to articles in the English language relating to human subjects. Articles were selected for full review through explicit inclusion/exclusion criteria. PRO measures were critically reviewed in accordance with the published guidelines and theory on the development and validation of PROs. The search identified 967 abstracts; 71 of these articles met the criteria for full review. In these 71 articles, 45 PRO measures were found: 16 were specific to psoriasis, 21 assessed other dermatological conditions and eight were developed for generic nondermatological health conditions. The review revealed several limitations of the existing measures, including: (i) a composite structure assessing multiple, poorly-defined concepts; (ii) a lack of evidence for face and content validity; (iii) a failure to include both patient and clinician perspectives and requirements and (iv) a lack of evidence regarding the feasibility and acceptability for patients and physicians. No single PRO measure with adequate evidence of validity, reliability and sensitivity to change captures patient well-being in psoriasis. A valid, sensitive, specific and acceptable PRO that assesses the full impact of psoriasis on well-being is needed for the comprehensive clinical management of psoriasis.

  10. Accountability for Services for Young Children with Disabilities and the Assessment of Meaningful Outcomes: The Role of the Speech-Language Pathologist

    Science.gov (United States)

    Hebbeler, Kathleen; Rooney, Robin

    2009-01-01

    Purpose: This article describes the federal accountability requirements related to young children with disabilities and the contribution of the speech-language pathologist (SLP) to provide these data through the use of authentic, functional assessments. Method: The article summarizes recent state and federal developments related to assessment for…

  11. Bayesian latent variable models for hierarchical clustered count outcomes with repeated measures in microbiome studies.

    Science.gov (United States)

    Xu, Lizhen; Paterson, Andrew D; Xu, Wei

    2017-04-01

    Motivated by the multivariate nature of microbiome data with hierarchical taxonomic clusters, counts that are often skewed and zero inflated, and repeated measures, we propose a Bayesian latent variable methodology to jointly model multiple operational taxonomic units within a single taxonomic cluster. This novel method can incorporate both negative binomial and zero-inflated negative binomial responses, and can account for serial and familial correlations. We develop a Markov chain Monte Carlo algorithm that is built on a data augmentation scheme using Pólya-Gamma random variables. Hierarchical centering and parameter expansion techniques are also used to improve the convergence of the Markov chain. We evaluate the performance of our proposed method through extensive simulations. We also apply our method to a human microbiome study.

  12. Behavioral, Brain Imaging and Genomic Measures to Predict Functional Outcomes Post - Bed Rest and Spaceflight

    Science.gov (United States)

    Mulavara, A. P.; DeDios, Y. E.; Gadd, N. E.; Caldwell, E. E.; Batson, C. D.; Goel, R.; Seidler, R. D.; Oddsson, L.; Zanello, S.; Clarke, T.; Peters, B.; Cohen, H. S.; Reschke, M.; Wood, S.; Bloomberg, J. J.

    2016-01-01

    retrospective study, leveraging data already collected from relevant ongoing or completed bed rest and spaceflight studies. These data will be combined with predictor metrics that will be collected prospectively (as described for behavioral, brain imaging and genomic measures) from these returning subjects to build models for predicting post-mission (bed rest - non-astronauts or space flight - astronauts) adaptive capability as manifested in their outcome measures. To date we have completed a study on 15 normal subjects with all of the above measures. In this presentation we will discuss the optimized set of tests for predictive metrics to be used for evaluating post mission adaptive capability as manifested in their outcome measures. Comparisons of model performance will allow us to better design and implement sensorimotor adaptability training countermeasures against decrements in post-mission adaptive capability that are customized for each crewmember's sensory biases, adaptive capacity, brain structure and functional capacities, and genetic predispositions. The ability to customize adaptability training will allow more efficient use of crew time during training and will optimize training prescriptions for astronauts to ensure expected outcomes.

  13. Accountability: new challenges, new forms

    NARCIS (Netherlands)

    C. van Woerkum; N. Aarts

    2012-01-01

    The general call for more accountability, affecting all western institutions, has reached the communication professionals as well. How can they cope with this new challenge? The danger is that they focus mainly on outcomes, so on performative accountability, whereas decisional accountability, meanin

  14. Accountability: new challenges, new forms

    NARCIS (Netherlands)

    van Woerkum, C.; Aarts, N.

    2012-01-01

    The general call for more accountability, affecting all western institutions, has reached the communication professionals as well. How can they cope with this new challenge? The danger is that they focus mainly on outcomes, so on performative accountability, whereas decisional accountability,

  15. Accountability: New challenges, new forms

    NARCIS (Netherlands)

    Woerkum, van C.; Aarts, N.

    2012-01-01

    The general call for more accountability, affecting all western institutions, has reached the communication professionals as well. How can they cope with this new challenge? The danger is that they focus mainly on outcomes, so on performative accountability, whereas decisional accountability,

  16. Preferred reporting items for studies mapping onto preference-based outcome measures: The MAPS statement.

    Science.gov (United States)

    Petrou, Stavros; Rivero-Arias, Oliver; Dakin, Helen; Longworth, Louise; Oppe, Mark; Froud, Robert; Gray, Alastair

    2015-08-01

    'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. The primary audiences for the MAPS statement are researchers reporting mapping studies, the funders of the research, and peer reviewers and editors involved in assessing mapping studies for publication.A de novo list of 29 candidate reporting items and accompanying explanations was created by a working group comprised of six health economists and one Delphi methodologist. Following a two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, a final set of 23 items deemed essential for transparent reporting, and accompanying explanations, was developed. The items are contained in a user friendly 23 item checklist. They are presented numerically and categorised within six sections, namely: (i) title and abstract; (ii) introduction; (iii) methods; (iv) results; (v) discussion; and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document.It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by eight health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in five years' time.This statement was published jointly in Applied Health Economics

  17. Outcome Measures of Chinese Herbal Medicine for Coronary Heart Disease: An Overview of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Jing Luo

    2012-01-01

    Full Text Available Objective. The aim of this overview was to summarize the outcome measures of Chinese herbal medicine (CHM as the treatment of coronary heart disease (CHD based on available systematic reviews (SRs, so as to display the current situation and evaluate the potential benefits and advantages of CHM on CHD. Methods. An extensive search included the Cochrane Database of Systematic Reviews, MEDLINE, and 4 databases in Chinese. SRs of CHM for CHD were included. Besides evaluating and summarizing the outcome measures, we also estimated the quality of the included reviews by PRISMA (preferred reporting items for systematic reviews and meta-analyses. Data were extracted according to predefined inclusion criteria by two independent reviewers. Results. 46 articles were included. 20 kinds of CHM were reviewed. 7 SRs were concerned with myocardial infarction (MI, 38 SRs were related to angina pectoris. 11 SRs had primary endpoints, while others focused on secondary endpoints to evaluate CHM for CHD such as angina pectoris and electrocardiogram (ECG. One SR reported more adverse effects of CHM for CHD and of the SRs analyzed quality of life. Many CHM appeared to have significant effect on improving symptoms, ECG, biomarkers and so on. However, most SRs failed to make a definite conclusion for the effectiveness of CHM in CHD patients due specifically to the poor evidence. And according to PRISMA we found most of the trials in the SRs were of low quality. Conclusion. Primary endpoints were not used widely. The benefits of CHM for CHD need to be confirmed in the future with RCTs of more persuasive primary endpoints and high-quality SRs.

  18. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN

    Directory of Open Access Journals (Sweden)

    Burgess Philip

    2012-05-01

    Full Text Available Abstract Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services.

  19. Improving the Rank Precision of Population Health Measures for Small Areas with Longitudinal and Joint Outcome Models.

    Directory of Open Access Journals (Sweden)

    Jessica K Athens

    Full Text Available The University of Wisconsin Population Health Institute has published the County Health Rankings since 2010. These rankings use population-based data to highlight health outcomes and the multiple determinants of these outcomes and to encourage in-depth health assessment for all United States counties. A significant methodological limitation, however, is the uncertainty of rank estimates, particularly for small counties. To address this challenge, we explore the use of longitudinal and pooled outcome data in hierarchical Bayesian models to generate county ranks with greater precision.In our models we used pooled outcome data for three measure groups: (1 Poor physical and poor mental health days; (2 percent of births with low birth weight and fair or poor health prevalence; and (3 age-specific mortality rates for nine age groups. We used the fixed and random effects components of these models to generate posterior samples of rates for each measure. We also used time-series data in longitudinal random effects models for age-specific mortality. Based on the posterior samples from these models, we estimate ranks and rank quartiles for each measure, as well as the probability of a county ranking in its assigned quartile. Rank quartile probabilities for univariate, joint outcome, and/or longitudinal models were compared to assess improvements in rank precision.The joint outcome model for poor physical and poor mental health days resulted in improved rank precision, as did the longitudinal model for age-specific mortality rates. Rank precision for low birth weight births and fair/poor health prevalence based on the univariate and joint outcome models were equivalent.Incorporating longitudinal or pooled outcome data may improve rank certainty, depending on characteristics of the measures selected. For measures with different determinants, joint modeling neither improved nor degraded rank precision. This approach suggests a simple way to use existing

  20. Accounting and strategising

    DEFF Research Database (Denmark)

    Jørgensen, Brian; Messner, Martin

    2010-01-01

    This paper explores the relationship between accounting and strategy in a context that is characterised by pluralistic demands and high uncertainty about outcomes. By way of an ethnographic field study in an R&D intensive company, we analyse new product development (NPD) projects and the way...... in which decisions and practices concerning these projects are accounted for. Building upon a practice theory perspective, we find that actors account for the appropriateness of NPD practices not only or primarily on the basis of accounting information, but also by "strategising", i.e. by mobilising...... different strategic objectives to which these practices are supposed to contribute. We argue that this has to do with the ambiguous demands on NPD and the limits of calculability inherent in NPD design decisions. At the same time, accounting information is not necessarily irrelevant in such a case; it can...

  1. Operationalising the capability approach for outcome measurement in mental health research.

    Science.gov (United States)

    Simon, Judit; Anand, Paul; Gray, Alastair; Rugkåsa, Jorun; Yeeles, Ksenija; Burns, Tom

    2013-12-01

    Amartya Sen's multidimensional capability approach focuses on the importance of freedoms to be or do things people have reason to value. It is an alternative to standard utilitarian welfarism, the theoretical approach to quality-adjusted life years (QALYs) and cost-utility analyses. Despite the limitations of the utility approach in capturing non-health benefits and broader welfare inequalities, there have been very limited applications of the capability approach in the mental health context where these issues are imperative. We report the development and application of a multidimensional instrument, the OxCAP-MH, which aims to operationalise the capability approach for outcome measurement in mental health research. The study was carried out as part of an ongoing programme on community coercion experienced by service users with severe and enduring mental illness being treated using Community Treatment Orders. Capabilities data were collected at baseline in the OCTET RCT for 333 'revolving door' mental health service users who were in involuntary hospital treatment at the time of recruitment in England (2008-2011). The research focused on the identification of capabilities domains most affected by mental illness and their association with socio-demographic and clinical factors and other measures of well-being such as the EQ-5D and Global Assessment of Functioning (GAF) scales. The OxCAP-MH item response rate was 90%-68%. There were significant correlations between service users' overall capability scores and the GAF, EQ-5D VAS and EQ-5D-3L utilities (corr = 0.249, 0.514, 0.415, respectively). The most affected capability domains were: 'Daily activities', 'Influencing local decisions', 'Enjoying recreation', 'Planning one's life' and 'Discrimination'. Age had a mixed effect, while female service users and those with a primary diagnosis of schizophrenia or longer illness duration reported significantly lower capability scores. The results support the feasibility and

  2. Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living

    Directory of Open Access Journals (Sweden)

    Hogan David B

    2012-09-01

    Full Text Available Abstract Background Few studies have directly compared the competing approaches to identifying frailty in more vulnerable older populations. We examined the ability of two versions of a frailty index (43 vs. 83 items, the Cardiovascular Health Study (CHS frailty criteria, and the CHESS scale to accurately predict the occurrence of three outcomes among Assisted Living (AL residents followed over one year. Methods The three frailty measures and the CHESS scale were derived from assessment items completed among 1,066 AL residents (aged 65+ participating in the Alberta Continuing Care Epidemiological Studies (ACCES. Adjusted risks of one-year mortality, hospitalization and long-term care placement were estimated for those categorized as frail or pre-frail compared with non-frail (or at high/intermediate vs. low risk on CHESS. The area under the ROC curve (AUC was calculated for select models to assess the predictive accuracy of the different frailty measures and CHESS scale in relation to the three outcomes examined. Results Frail subjects defined by the three approaches and those at high risk for decline on CHESS showed a statistically significant increased risk for death and long-term care placement compared with those categorized as either not frail or at low risk for decline. The risk estimates for hospitalization associated with the frailty measures and CHESS were generally weaker with one of the frailty indices (43 items showing no significant association. For death and long-term care placement, the addition of frailty (however derived or CHESS significantly improved on the AUC obtained with a model including only age, sex and co-morbidity, though the magnitude of improvement was sometimes small. The different frailty/risk models did not differ significantly from each other in predicting mortality or hospitalization; however, one of the frailty indices (83 items showed significantly better performance over the other measures in predicting long

  3. The Accountability Bind

    Directory of Open Access Journals (Sweden)

    Katrina Bulkley

    2001-10-01

    Full Text Available Charter schools involve a trading of autonomy for accountability. This accountability comes through two forces—markets through the choices of parents and students, and accountability to government through the writing of contracts that must be renewed for schools to continue to operate. Charter schools are supposed to be more accountable for educational performance than traditional public schools because authorizers have the ability to revoke charter contracts. Here, I focus on one central component of accountability to government: performance accountability or accountability for educational outcomes to charter school authorizers through the revocation or non-renewal of charter contracts. In this paper, I suggest that contract-based accountability for educational performance in charter schools may not be working as proponents argued it would. This article explores some explanations for why there are very few examples of charter schools that have been closed primarily because of failure to demonstrate educational performance or improvement. Future work will need to test if these challenges for authorizers hold in a variety of contexts. The conclusion examines the implications of these findings for the future of charter school accountability.

  4. Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery

    DEFF Research Database (Denmark)

    Kemp, Joanne L; Collins, Natalie J; Roos, Ewa M.

    2013-01-01

    Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown.......Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown....

  5. 论公允价值对会计计量理论的影响%The Impact of Fair Value on Accounting Measurement Theory

    Institute of Scientific and Technical Information of China (English)

    马妮

    2014-01-01

    计量属性是会计计量的核心组成部分,其发展直接影响着整个会计计量理论的发展。公允价值计量属性,是伴随着经济社会的发展尤其是衍生金融工具的发展逐渐发展起来的,作为一个与其他计量属性相比应用较晚的计量属性,公允价值的发展对传统会计计量理论各方面都有直接影响。通过回顾和总结公允价值产生的背景,阐述公允价值的概念,从公允价值的优势和缺陷两个方面分析公允价值对会计计量理论的影响。目的在于探究公允价值对会计计量理论的影响程度和它的未来发展趋势,以便更好地理解和运用公允价值。%Measurement attribute is the core of accounting measurement. The development of measurement attribute has direct impact on the development of the whole theories of accounting measurement. Fair value has been developed with the development of the economy and the society,especially the derivative instruments.As a later applied measurement attribute compared with the other ones,the development of fair value would directly affect the traditional theories of accounting measurement. Through reviewing and summarizing the emerging background of fair value,the paper addresses the definition of fair value. Then,it introduces the impact of fair value on the theories of accounting measurement from aspects of advantage and disadvantage. The aim was to discuss the extent of influence of fair value on accounting measurement theories and the developmental trends and application of fair value.

  6. Macular SD-OCT Outcome Measures: Comparison of Local Structure-Function Relationships and Dynamic Range

    Science.gov (United States)

    Miraftabi, Arezoo; Amini, Navid; Morales, Esteban; Henry, Sharon; Yu, Fei; Afifi, Abdolmonem; Coleman, Anne L.; Caprioli, Joseph; Nouri-Mahdavi, Kouros

    2016-01-01

    Purpose We tested the hypothesis that the macular ganglion cell layer (GCL) thickness demonstrates a stronger structure-function (SF) relationship and extends the useful range of macular measurements compared with combined macular inner layer or full thickness. Methods Ninety-eight glaucomatous eyes and eight normal eyes with macular spectral domain optical coherence tomography (SD-OCT) volume scans and 10-2 visual fields were enrolled. Inner plexiform layer (IPL), GCL, macular retinal nerve fiber layer (mRNFL), ganglion cell-inner plexiform layer (GCIPL), ganglion cell complex (GCC), and full thickness (FT) measurements were calculated for 8 × 8 arrays of 3° superpixels. Main outcome measures were local structure-function relationships between macular superpixels and corresponding sensitivities on 10-2 fields after adjusting for ganglion cell displacement, dynamic range of measurements, and the change point (total deviation value where macular parameters reached measurement floor). Results Median (interquartile range [IQR]) mean deviation was −7.2 (−11.6 to −3.2) dB in glaucoma eyes. Strength of SF relationships was highest for GCIPL, GCL, GCC, and IPL (ρ = 0.635, 0.627, 0.621, and 0.577, respectively; P ≤ 0.046 for comparisons against GCIPL). Highest SF correlations coincided with the peak of GCL thickness, where the dynamic range was widest for FT (81.1 μm), followed by GCC (65.7 μm), GCIPL (54.9 μm), GCL (35.2 μm), mRNFL (27.5 μm), and IPL (20.9 μm). Change points were similar for all macular parameters (−7.8 to −8.9 dB). Conclusions GCIPL, GCL, and GCC demonstrated comparable SF relationships while FT, GCC, and GCIPL had the widest dynamic range. Measurement of GCL did not extend the range of useful structural measurements. Measuring GCL does not provide any advantage for detection of progression with current SD-OCT technology. PMID:27623336

  7. A Portfolio Analysis Tool for Measuring NASAs Aeronautics Research Progress toward Planned Strategic Outcomes

    Science.gov (United States)

    Tahmasebi, Farhad; Pearce, Robert

    2016-01-01

    Description of a tool for portfolio analysis of NASA's Aeronautics research progress toward planned community strategic Outcomes is presented. The strategic planning process for determining the community Outcomes is also briefly described. Stakeholder buy-in, partnership performance, progress of supporting Technical Challenges, and enablement forecast are used as the criteria for evaluating progress toward Outcomes. A few illustrative examples are also presented.

  8. Accounting assessment

    Directory of Open Access Journals (Sweden)

    Kafka S.М.

    2017-03-01

    Full Text Available The proper evaluation of accounting objects influences essentially upon the reliability of assessing the financial situation of a company. Thus, the problem in accounting estimate is quite relevant. The works of home and foreign scholars on the issues of assessment of accounting objects, regulatory and legal acts of Ukraine controlling the accounting and compiling financial reporting are a methodological basis for the research. The author uses the theoretical methods of cognition (abstraction and generalization, analysis and synthesis, induction and deduction and other methods producing conceptual knowledge for the synthesis of theoretical and methodological principles in the evaluation of assets accounting, liabilities and equity. The tabular presentation and information comparison methods are used for analytical researches. The article considers the modern approaches to the issue of evaluation of accounting objects and financial statements items. The expedience to keep records under historical value is proved and the articles of financial statements are to be presented according to the evaluation on the reporting date. In connection with the evaluation the depreciation of fixed assets is considered as a process of systematic return into circulation of the before advanced funds on the purchase (production, improvement of fixed assets and intangible assets by means of including the amount of wear in production costs. Therefore it is proposed to amortize only the actual costs incurred, i.e. not to depreciate the fixed assets received free of charge and surplus valuation of different kinds.

  9. Comments on 'Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support labeling Claims'.

    OpenAIRE

    Bradley, Clare

    2006-01-01

    I have a particular interest in the FDA's guidance on patient-reported outcome (PRO measures as I specialize in the design, development and use of such measures and license them to pharmaceutical companies, research organizations, academics and clinicians for use in clinical trials, other research and routine clinical practice. My measures include: the Diabetes Treatment Satisfaction Questionnaire (DTSQ) in it's status (DTSQs) and change (DTSQc) forms and related measures for other conditions...

  10. Renal masses measuring under 2 cm: Pathologic outcomes and associations with MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Rosenkrantz, Andrew B., E-mail: Andrew.Rosenkrantz@nyumc.org [Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016 (United States); Wehrli, Natasha E. [Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016 (United States); Melamed, Jonathan [Department of Pathology, 550 First Avenue, New York, NY 10016 (United States); Taneja, Samir S. [Department of Urology, Division of Urologic Oncology, 550 First Avenue, New York, NY 10016 (United States); Shaikh, Mohammed B. [Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016 (United States)

    2014-08-15

    Purpose: To evaluate pathologic outcomes and associations with MRI features in small renal masses measuring up to 20 mm Methods: 86 patients (61 ± 13 years; 45 M/41F) with 92 renal masses measuring up to 20 mm that underwent MRI prior to tissue diagnosis were included. Two radiologists independently evaluated all masses for microscopic lipid, hemorrhage, T2-hyperintensity, T2-homogeneity, cystic/necrotic areas, hypervascularity, enhancement homogeneity, circumscribed margins, and predominantly exophytic location. These MRI features, as well as patient age, gender, and history of RCC, were compared with pathologic findings using Fisher's exact test, unpaired t-test, and multivariate logistic regression. Results: 26.1% (24/92) of masses under 2 cm were benign, only 32.6% (30/92) were clear-cell RCC, and only 7.6% (7/92) were high-grade. Among 16 masses measuring up to 1 cm, only 12.5% (2/16) were clear-cell RCC, and none was high-grade. Within the entire cohort, no MRI or clinical feature showed a significant difference between benign and malignant lesions (p ≥ 0.053). However, for both readers, clear-cell RCC exhibited a significantly higher frequency of T2-hyperintensity, cystic/necrotic areas, and hypervascularity, and a significantly lower frequency of hemorrhage, T2-homogeneity, and enhancement homogeneity (p < 0.001–0.036). Hypervascularity was a significant independent predictor of clear-cell RCC for both readers (p = 0.002–0.007), as was T2-hyperintensity for reader 2 (p = 0.007). Conclusion: A substantial fraction of small renal masses were benign, and when malignant, largely exhibited indolent pathologic characteristics, particularly when measuring under 1 cm Although small benign and malignant masses could not be differentiated on MRI, hypervascularity showed a significant independent association with clear-cell RCC in comparison with other lesions.

  11. Measurement-based Treatment of Residual Symptoms Using Clinically Useful Depression Outcome Scale: Korean Validation Study

    Science.gov (United States)

    Jeon, Sang Won; Han, Changsu; Ko, Young-Hoon; Yoon, Seo Young; Pae, Chi-Un; Choi, Joonho; Park, Yong Chon; Kim, Jong-Woo; Yoon, Ho-Kyoung; Ko, Seung-Duk; Patkar, Ashwin A.; Zimmerman, Mark

    2017-01-01

    Objective This study was aimed at evaluating the diagnostic validity of the Korean version of the Clinically Useful Depression Outcome Scale (CUDOS) with varying follow-up in a typical clinical setting in multiple centers. Methods In total, 891 psychiatric outpatients were enrolled at the time of their intake appointment. Current diagnostic characteristics were examined using the Structured Clinical Interview for DSM-IV (41% major depressive disorder). The CUDOS was measured and compared with three clinician rating scales and four self-report scales. Results The CUDOS showed excellent results for internal consistency (Cronbach’s α, 0.91), test-retest reliability (patients at intake, r=0.81; depressed patients in ongoing treatment, r=0.89), and convergent and discriminant validity (measures of depression, r=0.80; measures of anxiety and somatization, r=0.42). The CUDOS had a high ability to discriminate between different levels of depression severity based on the rating of Clinical Global Impression for depression severity and the diagnostic classification of major depression, minor depression, and non-depression. The ability of the CUDOS to identify patients with major depression was high (area under the receiver operating characteristic curve=0.867). A score of 20 as the optimal cutoff point was suggested when screening for major depression using the CUDOS (sensitivity=89.9%, specificity=69.5%). The CUDOS was sensitive to change after antidepressant treatment: patients with greater improvement showed a greater decrease in CUDOS scores (pKorean version of the CUDOS is a very useful measurement for research and for clinical practice. PMID:28138107

  12. Measuring situation awareness in emergency settings: a systematic review of tools and outcomes

    Directory of Open Access Journals (Sweden)

    Cooper S

    2013-12-01

    Full Text Available Simon Cooper,1,2 Joanne Porter,3 Linda Peach41School of Nursing and Midwifery, Monash University, Berwick, Victoria, Australia; 2School of Nursing and Midwifery, University of Brighton, Brighton, UK; 3School of Nursing and Midwifery Monash University, Gippsland, VIC, 4School of Nursing and Midwifery, Monash University, Melbourne, VIC, AustraliaBackground: Nontechnical skills have an impact on health care outcomes and improve patient safety. Situation awareness is core with the view that an understanding of the environment will influence decision-making and performance. This paper reviews and describes indirect and direct measures of situation awareness applicable for emergency settings.Methods: Electronic databases and search engines were searched from 1980 to 2010, including CINAHL, Ovid Medline, Pro-Quest, Cochrane, and the search engine, Google Scholar. Access strategies included keyword, author, and journal searches. Publications identified were assessed for relevance, and analyzed and synthesized using Oxford evidence levels and the Critical Appraisal Skills Programme guidelines in order to assess their quality and rigor.Results: One hundred and thirteen papers were initially identified, and reduced to 55 following title and abstract review. The final selection included 14 papers drawn from the fields of emergency medicine, intensive care, anesthetics, and surgery. Ten of these discussed four general nontechnical skill measures (including situation awareness and four incorporated the Situation Awareness Global Assessment Technique.Conclusion: A range of direct and indirect techniques for measuring situation awareness is available. In the medical literature, indirect approaches are the most common, with situation awareness measured as part of a nontechnical skills assessment. In simulation-based studies, situation awareness in emergencies tends to be suboptimal, indicating the need for improved training techniques to enhance awareness and

  13. Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT).

    Science.gov (United States)

    Grieve, Sharon; Perez, Roberto Sgm; Birklein, Frank; Brunner, Florian; Bruehl, Stephen; Harden, R Norman; Packham, Tara; Gobeil, Francois; Haigh, Richard; Holly, Janet; Terkelsen, Astrid; Davies, Lindsay; Lewis, Jennifer; Thomassen, Ilona; Connett, Robyn; Worth, Tina; Vatine, Jean-Jacques; McCabe, Candida S

    2017-02-04

    Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS.In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populationsThe development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. 'What is the clinical presentation and course of CRPS, and what factors influence it?' was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as: pain, disease severity, participation and physical function, emotional and psychological function, self efficacy, catastrophizing and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and one clinician reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally.

  14. The case for an international patient-reported outcomes measurement information system (PROMIS®) initiative.

    Science.gov (United States)

    Alonso, Jordi; Bartlett, Susan J; Rose, Matthias; Aaronson, Neil K; Chaplin, John E; Efficace, Fabio; Leplège, Alain; Lu, Aiping; Tulsky, David S; Raat, Hein; Ravens-Sieberer, Ulrike; Revicki, Dennis; Terwee, Caroline B; Valderas, Jose M; Cella, David; Forrest, Christopher B

    2013-12-20

    Patient-reported outcomes (PROs) play an increasingly important role in clinical practice and research. Modern psychometric methods such as item response theory (IRT) enable the creation of item banks that support fixed-length forms as well as computerized adaptive testing (CAT), often resulting in improved measurement precision and responsiveness. Here we describe and discuss the case for developing an international core set of PROs building from the US PROMIS® network.PROMIS is a U.S.-based cooperative group of research sites and centers of excellence convened to develop and standardize PRO measures across studies and settings. If extended to a global collaboration, PROMIS has the potential to transform PRO measurement by creating a shared, unifying terminology and metric for reporting of common symptoms and functional life domains. Extending a common set of standardized PRO measures to the international community offers great potential for improving patient-centered research, clinical trials reporting, population monitoring, and health care worldwide. Benefits of such standardization include the possibility of: international syntheses (such as meta-analyses) of research findings; international population monitoring and policy development; health services administrators and planners access to relevant information on the populations they serve; better assessment and monitoring of patients by providers; and improved shared decision making.The goal of the current PROMIS International initiative is to ensure that item banks are translated and culturally adapted for use in adults and children in as many countries as possible. The process includes 3 key steps: translation/cultural adaptation, calibration, and validation. A universal translation, an approach focusing on commonalities, rather than differences across versions developed in regions or countries speaking the same language, is proposed to ensure conceptual equivalence for all items. International item

  15. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment.

    Science.gov (United States)

    Mease, Philip

    2005-08-01

    Fibromyalgia syndrome (FM) is a common chronic pain condition that affects at least 2% of the adult population in the USA and other regions in the world where FM is studied. Prevalence rates in some regions have not been ascertained and may be influenced by differences in cultural norms regarding the definition and attribution of chronic pain states. Chronic, widespread pain is the defining feature of FM, but patients may also exhibit a range of other symptoms, including sleep disturbance, fatigue, irritable bowel syndrome, headache, and mood disorders. Although the etiology of FM is not completely understood, the syndrome is thought to arise from influencing factors such as stress, medical illness, and a variety of pain conditions in some, but not all patients, in conjunction with a variety of neurotransmitter and neuroendocrine disturbances. These include reduced levels of biogenic amines, increased concentrations of excitatory neurotransmitters, including substance P, and dysregulation of the hypothalamic-pituitary-adrenal axis. A unifying hypothesis is that FM results from sensitization of the central nervous system. Establishing diagnosis and evaluating effects of therapy in patients with FM may be difficult because of the multifaceted nature of the syndrome and overlap with other chronically painful conditions. Diagnostic criteria, originally developed for research purposes, have aided our understanding of this patient population in both research and clinical settings, but need further refinement as our knowledge about chronic widespread pain evolves. Outcome measures, borrowed from clinical research in pain, rheumatology, neurology, and psychiatry, are able to distinguish treatment response in specific symptom domains. Further work is necessary to validate these measures in FM. In addition, work is under way to develop composite response criteria, intended to address the multidimensional nature of this syndrome. A range of medical treatments, including

  16. The Myotonic Dystrophy Health Index: Italian validation of a disease-specific outcome measure.

    Science.gov (United States)

    Sansone, Valeria A; Lizio, Andrea; Greco, Lucia; Gragnano, Gaia; Zanolini, Alice; Gualandris, Marco; Iatomasi, Marino; Heatwole, Chad

    2017-07-10

    The Myotonic Dystrophy Health Index (MDHI) is a disease-specific, self-reported outcome measure that assesses total disease burden and 17 areas of Myotonic Dystrophy type 1 (DM1) specific health. This study translated the MDHI into Italian and validated the instrument using a cohort of Italian DM1 patients. Italian DM1 patients were interviewed regarding the form and content of the instrument. Thirty-eight DM1 patients were subsequently recruited to test the reliability and concurrent validity of the instrument by serially completing the MDHI and a battery of clinical tests. Lastly, we determined the internal consistency of the Italian MDHI and each of its subscales. The internal consistency was excellent in the total Italian MDHI score and acceptable in all of its subscales; the test-retest reliability was high (intraclass correlation coefficient = 0.95); Italian MDHI total scores and subscales were associated with neuromuscular function, cognitive and social health, respiratory function, and quality of life. Overall, the Italian MDHI is valid and well suited to measure the multi-dimensional aspects of disease burden in Myotonic Dystrophy clinical trials. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Measuring the value of treatment to patients: patient-reported outcomes in drug development.

    Science.gov (United States)

    Willke, Richard J

    2008-02-01

    Patient-reported outcomes (PROs) can be important measures of the impact and value of new drug treatments to patients. Recently, both multisector stakeholder groups and the U.S. Food and Drug Administration have carefully considered and issued guidance on best practices for the use of PROs in measuring treatment impact. When best practices are followed and PRO data are appropriately included in drug development strategy and clinical trials, these data can be part of the evidence submitted for drug approval and included in drug labeling. One study showed that PRO data were included in 30% of a sample of new drug labels and were more concentrated in certain therapeutic areas, such as anti-inflammatory agents, vaccines, gastrointestinal agents, and respiratory and urologic agents. PRO data included in labeling, or generated in a similar scientific manner, may often then be used in other communication vehicles, such as formulary submission dossiers, journal or direct-to-consumer advertisements, publications, or continuing medical education. Meaningful and reliable PRO results regarding the effects of new treatments on how patients feel and function provide useful information to those who must make decisions about the availability and utilization of such treatments.

  18. The Role of Clinical and Instrumented Outcome Measures in Balance Control of Individuals with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Neeta Kanekar

    2013-01-01

    Full Text Available Purpose. The aim of the study was to investigate differences in balance control between individuals with multiple sclerosis (MS and healthy control subjects using clinical scales and instrumented measures of balance and determine relationships between balance measures, fatigue, and disability levels in individuals with MS with and without a history of falls. Method. Twelve individuals with MS and twelve healthy controls were evaluated using the Berg Balance and Activities-specific Balance Confidence Scales, Modified Clinical Test of Sensory Interaction on Balance, and Limits of Stability Tests as well as Fatigue Severity Scale and Barthel Index. Results. Mildly affected individuals with MS had significant balance performance deficits and poor balance confidence levels (P<0.05. MS group had higher sway velocities and diminished stability limits (P<0.05, significant sensory impairments, high fatigue and disability levels (P<0.05. Sway velocity was a significant predictor of balance performance and the ability to move towards stability limits for the MS group. For the MS-fallers group, those with lower disability levels had faster movement velocities and better balance performance. Conclusion. Implementation of both clinical and instrumented tests of balance is important for the planning and evaluation of treatment outcomes in balance rehabilitation of people with MS.

  19. Accounting for Quality

    DEFF Research Database (Denmark)

    Pflueger, Dane

    2015-01-01

    Background Accounting-that is, standardized measurement, public reporting, performance evaluation and managerial control-is commonly seen to provide the core infrastructure for quality improvement in healthcare. Yet, accounting successfully for quality has been a problematic endeavor, often......, but that it would need to be understood and operationalized in new ways in order to contribute to this end. Proposals for this new way of advancing accounting are discussed. They include the cultivation of overlapping and even conflicting measures of quality, the evaluation of accounting regimes in terms of what...... producing dysfunctional effects. This has raised questions about the appropriate role for accounting in achieving quality improvement. This paper contributes to this debate by contrasting the specific way in which accounting is understood and operationalized for quality improvement in the UK National Health...

  20. Measurement Properties of the Brief Michigan Hand Outcomes Questionnaire in Patients With Dupuytren Contracture.

    Science.gov (United States)

    Wehrli, Martina; Hensler, Stefanie; Schindele, Stephan; Herren, Daniel B; Marks, Miriam

    2016-09-01

    The brief Michigan Hand Outcomes Questionnaire (briefMHQ) was developed as a shorter version of the Michigan Hand Outcomes Questionnaire (MHQ), but its measurement properties have not been investigated in patients with Dupuytren contracture. The objective of the study was to investigate the reliability, validity, responsiveness, and interpretability of the briefMHQ. Fifty-seven patients diagnosed with Dupuytren contracture completed the briefMHQ as well as the full-length MHQ and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at baseline. Two to 14 days after baseline and 1 year after collagenase injection or surgery, patients again filled out the briefMHQ. Reliability was determined using the intraclass correlation coefficient and by calculating internal consistency (Cronbach alpha). Validity was tested by quantifying correlations with the full-length MHQ and QuickDASH. Responsiveness, based on the standardized response mean and the minimally clinically important change, was also determined. The briefMHQ had an intraclass correlation coefficient of 0.87, Cronbach alpha of 0.88, and correlations of r = 0.88 and -0.82 with the original MHQ and QuickDASH, respectively. The standardized response mean was 0.9 and the minimally clinically important change was 7 points. Overall, the briefMHQ demonstrates excellent reliability, good validity, and high responsiveness in patients with Dupuytren contracture. The briefMHQ is an accurate and time-saving tool to evaluate patients with Dupuytren contracture and the effect of a corresponding treatment. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.