Search PubMed⌕ Search

PubMed · 9157928

Evaluating a successful coroner protocol.

Abstract

The coroner release rates for the service of a particular organ procurement organization were evaluated through a retrospective analysis, which included the year before (1991), the year during (1992), and the year after (1993) the adoption of a formal protocol for coroner's cases. In 1991, 22 of 55 (40%) coroner cases were denied for donation by the coroner. In 1992 and 1993, 12 of 55 (22%) and 9 of 56 (16%) coroner cases, respectively, were denied for donation. More significantly, in 1991, 4 of 6 (67%) cases of homicidal gunshot wound to the head were denied for donation by the coroner, whereas only 1 of 13 (8%) such cases were denied in 1993. Also in 1991 all closed head injuries (two) from falls were denied for donation by the coroner, whereas in 1993 1 of 8 (12%) closed head injuries was denied for donation. Finally, all 4 of 4 nonaccidental traumas (ie, child abuse) were denied in 1991, but 1 of 2 were released in both 1992 and 1993. Further education and awareness efforts could reduce the rates of coroner denial even more significantly.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

C L Jaynes, J W Springer. 1996. Evaluating a successful coroner protocol.. https://doi.org/10.7182/prtr.1.6.1.r657v83338l16957

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Considerations for the implementation of target volume protocols in radiation therapy.

PURPOSE: Uncertainties in patient repositioning and organ motion are accounted for by defining a planning target volume (PTV). We make recommendations on issues not explicitly discussed in existing protocols for PTV design. METHODS: A quantity called "coverage" is defined to quantify how effectively a PTV encompasses the clinical target volume, and is applied to examine the impact of several factors. A stochastic simulation is used to determine the coverage required for a desirable balance between tumor control probability (TCP) and the irradiated volume. Using a sample anatomy, we assess the importance of the method used to add uncertainties, the shape of the uncertainty distribution, the effect of systematic uncertainties, and the use of nonuniform margins. Additionally, we examine the benefit of patient immobilization techniques. RESULTS: Our example indicates that 95% coverage is a reasonable goal for treatment planning. Using this as a comparison value, our example indicates quadrature addition of uncertainties predicts smaller margins (7 mm) than linear addition (11 mm), Gaussian distribution of uncertainties (7 mm) require the same margin as a uniform distribution (7 mm), systematic uncertainties have a small effect on TCP below a threshold value (4 mm), and nonuniform margins allow only a slight reduction of irradiated volume. CONCLUSION: We recommend that uncertainties should generally be added in quadrature, the exact shape of the uncertainty distribution is not critical, systematic uncertainties should be maintained below some threshold value, and nonuniform margins may be effective when uncertainties are anisotropic.

Clinical Protocols↗