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At least 361 records · Page 20Linked to original sources
PubMed2004

Collection and retrieval of structured clinical data from electronic patient records in general practice. A first-phase study to create a health care database for research and quality assessment.

OBJECTIVE: To evaluate prerequisites, practicalities, attitudes and limitations related to the collection of structured clinical data in everyday general practice for use in the future establishment of a national registration network. DESIGN: Prospective study. SETTING: Primary health care centres in south-western Sweden. SUBJECTS: Fourteen participating general practitioners in five primary health care centres. MAIN OUTCOME MEASURES: Feasibility and workload involved in structured data entry and in the retrieval of data from different record systems. The accuracy of clinical data in terms of clinical variables, correctness and representativeness. RESULTS: All four record systems could deliver basic data on the patient population. One centre had to be excluded from further data retrieval because of limitations in the data retrieval export format. Collecting data in everyday practice was feasible with acceptable data accuracy and moderate workload. CONCLUSION: It was feasible to collect, retrieve and store structured clinical data with respect to accuracy and extra workload. Interest in a national registration network and an increasing demand for information about primary health care in order to optimise clinical practices and support research, creates prerequisites for establishing a valid and reliable database. However, developmental work focusing on classification limitations, coding tools and routines for data retrieval is necessary.

Data Collection↗
PubMedDate not supplied

The accuracy of tooth loss data collected by nurses.

This paper reports on the accuracy of tooth counts conducted in 22 subjects by 10 trained nurses as part of a large longitudinal study of a pharmacological agent. These nurses participated in a training course consisting of seminars, discussion, demonstrations, and practice examinations. Each of the nurses then counted the teeth of 22 subjects and recorded their findings independently. The counts of the nurses were compared with those of the dentists to assess the accuracy of the nurses' counts. We found that nurses and dentists were in perfect agreement for 86% of the patient counts conducted. Individual nurses' levels of agreement with dentists ranged from 73% to 100%, with pairwise kappa statistic values ranging from 0.70 to 1.00. In addition, both Pearson correlation and interclass correlation measures exceeded 0.98 for every comparison of dentist and nurse counts. The results of this study suggest that training nondental health care workers may be an accurate and low-cost way of obtaining tooth loss data and other oral health measures, particularly when oral health data are collected as part of larger, multi-disciplinary studies.

Aged↗
PubMed2006

Managing data for integrity: policies and procedures for ensuring the accuracy and quality of the data in the laboratory.

Management of the research data is an extremely important responsibility of the Principal Investigator (PI) and other members of the research team. Without accurate data, no worthwhile conclusions can be drawn from the research study. Integrity in data management is critical to the success of the research group and to public trust in the research outcomes. One of the primary responsibilities of the PI is to provide proper training to the junior members of the lab. This effort can be buttressed by institutional data policies that are implemented at the group level. Extensive and frequent guidance in good research practices by the PI and other senior research staff is critical to the proper training of new scientists.

Data Collection↗
PubMed1981

Determination of pressure gradient in the Hancock mitral valve from noninvasive ultrasound Doppler data.

The accuracy with which the pressure gradient in the Hancock mitral valve can be determined from noninvasive ultrasound Doppler data was explored in a study of eight adult patients. The mean manometric pressure gradient (delta PM) was determined by performing simultaneous left atrial and left ventricular catheterization. The mean diastolic pressure gradient was also determined from noninvasive ultrasound data (delta PU). Identical cardiac cycles were used to compare delta PM and delta PU. In the eight patients delta PM ranged from 3.0 to 9.0 mmHg and cardiac output from 3.7 to 5.5 l/min. The difference delta PM-delta PU was 0.3 +/- 0.9 mmHg (mean +/- SD). The results thus indicated that noninvasive ultrasound can determine the mean diastolic gradient in the Hancock mitral valve with an accuracy which approaches that attained with conventional manometric methods.

Blood Pressure↗
PubMedDate not supplied

Accuracy of on-site data entry in a rural primary care research network.

OBJECTIVE: This study examined how accurately research data can be entered into a database by rural research network members with little computer training and no data-entry experience. METHODS: A rural primary care research network in the Upper Peninsula of Michigan collected data from a study, and each practice entered its data on a standard database. The data were then sent electronically to the main research center where they were downloaded and analyzed. Accuracy of data entry was evaluated by comparing data received at the center with data on the original questionnaire. RESULTS: Accuracy of the data, entered by practice coordinators (nurses) with little or no computer experience, was completed with an error rate of one error per 220 keystrokes or .22 errors per 1,000 keystrokes. CONCLUSIONS: Results indicate that remote data entry in research networks can be accomplished accurately and reliably with little training.

Electronic Data Processing↗
PubMedDate not supplied

Predictive accuracy of cell kinetics data in glial tumors investigated by serial stereotactic biopsy.

The prognostic accuracy of cell kinetics investigations in patients affected from glial tumors, submitted to serial stereotactic biopsy is reported. The methodology is described and the results obtained in 103 patients are discussed with particular regard to mature and anaplastic astrocytoma series. In conclusion the value of the procedure has been clearly demonstrated in glial tumors different form glioblastoma.

Adolescent↗
PubMed1984

The accuracy of occupation and industry data on death certificates.

To assess the accuracy of occupation and industry data on death certificates, we compared the known occupation and industry of 3,789 individuals with information on their death certificates. All individuals were members of the National Institute for Occupational Safety and Health cohort studies and their occupation and industry were known from personnel or union records. We focused our analysis on 2,198 long-term workers who had 10 or more years of work experience (average, 18 years). Our principal finding was that for the long-term workers in our sample, the probability of the known occupation being listed on their death certificates was 64.7% (SE = 1.1) (for white workers this figure was 73.5% (SE = 1.2). Furthermore, for the long-term workers the probability of the plant or industry being named on their death certificates was 70.1% (SE = 1.2). Women and non-whites had lower matching rates. For women the probability of a matched listing was 45.1% for occupation and 60.4% for industry. For nonwhites, it was only 30.1% for occupation and 49.2% for industry. Our results for white long-term workers generally agree with the results of previous investigators who have used different methods.

Black or African American↗
PubMedDate not supplied

Accuracy of plastic replica of aortic aneurysm using 3D-CT data for transluminal stent-grafting: experimental and clinical evaluation.

PURPOSE: To plan stent-grafting for aortic aneurysms with complicated morphology, we prepared life-sized aortic replicas by laser stereolithography using helical 3D--CT data. The accuracy of the replica was evaluated by measurement of vessel phantoms and clinical 3D--CT data. METHOD: An imaginary aortic wall was created from helical CT images of the aorta, and a hollow plastic replica was produced by laser stereolithography. The accuracy of the replica was evaluated in five abdominal aortic aneurysms by experimental phantom studies and measurements of the replicas. RESULTS: The mean difference in measurements between 3D--CT images and model vessels and between 3D--CT images and aortic replicas was 0.2 mm each. Therefore, the difference in measurements between real aortic aneurysms and the replicas was at most 0.4 mm. CONCLUSION: The accuracy of the replica is satisfactory, making it useful for preoperative evaluation and simulation for stent-grafting.

Aortic Aneurysm, Abdominal↗
PubMedDate not supplied

The development of a comprehensive, institution-based patient risk evaluation program: II. Validity and reliability of questionnaire data.

The accuracy of historical information derived from self-administered questionnaires must be confirmed. We report the results of studies conducted to assess the reliability and validity of data collected from a comprehensive cancer risk factor questionnaire developed at The University of Texas M.D. Anderson Cancer Center. A comparison of the basic demographic data of a randomly selected sample of 80 respondents and 70 nonrespondents revealed no fundamental ethnic or socioeconomic differences. We verified self-reported past illnesses, surgical procedures, and cancers by reviewing 72 patient charts, using stringent diagnostic criteria for verification. We noted substantial agreement between self-reported and documented illnesses and operations. With the exception of nine patients who misclassified metastatic disease, the verification of primary cancers was excellent. We determined reliability by interviewing 50 of these patients by telephone. Questions with a dichotomous outcome (e.g., smoking status) were reliably answered; however, those requiring quantification (e.g., amount of alcohol consumed) were less accurately reported on interview. While we recognize the limitations of self-administered questionnaires, we believe this program will develop into a comprehensive, standardized, easily accessible patient risk factor data base.

Cancer Care Facilities↗
PubMed2004

Spatial correlations of laminar BOLD and CBV responses to rat whisker stimulation with neuronal activity localized by Fos expression.

The spatial relationship between a measured fMRI signal and its underlying neuronal activity remains unclear. One obstacle is the localization of neuronal activity; another is the spatial resolution of fMRI. In the present study, high-resolution BOLD and CBV fMRI experiments (voxel size: 156 x 156 x 2000 microm3) were conducted in the rat whisker barrel cortex at 3 T; neuronal activity across cortical layers was mapped using the Fos expression technique. Results show that BOLD response is weighted by blood volume and that pixels with high BOLD response can be located at the cortical surface or in deep layers, depending on local vasculature. In contrast to BOLD response, the pixels with high CBV response were consistently clustered in the deep cortical layers. Percentage-CBV change in cortical layers IV-V was 7.3 +/- 1.5%, which was significantly higher than in layers I-III (4.1 +/- 0.9%) and VI (4.3 +/- 0.7%) (mean +/- SEM). The laminar distribution of CBV response correlates well with neuronal activity localized by Fos expression. We conclude that neuronal activity can be inferred from CBV fMRI data with high spatial accuracy. The data indicate that both intracolumn functional connectivity and neurovascular coupling can be studied using CBV fMRI.

Animals↗
PubMed1999

Identifying problems with data collection at a local level: survey of NHS maternity units in England.

OBJECTIVES: To document the extent to which maternity data are collected and how they are recorded, and to identify problems that may affect their availability throughout the NHS. METHODS: Postal survey in September 1997 with structured questionnaires. SETTING: 207 NHS trusts with maternity units in England. PARTICIPANTS: Heads of midwifery in maternity units. MAIN OUTCOME MEASURES: Extent to which maternity data were routinely recorded, how they were recorded and evaluated, and to whom they were made available. RESULTS: 167 (81%) of questionnaires were returned, representing 166 trusts. Of these trusts, 165 collected >/=17 of the 19 data items in HES maternity tail, and 158 collected >/=40 of the 45 items selected from Körner dataset. Only 18 collected all five items selected from the "indicators of success," and 17 did not collect any. In 58 of trusts data were primarily recorded on paper. A computerised maternity information system was used by 106 (63%) of trusts, but many recorded data on paper first. Thirty four did not audit data for accuracy. Most trusts analysed data not routinely collected at national level, but 18 did not analyse HES maternity tail and 17 did not analyse Körner data. CONCLUSIONS: Improvement is needed in quality, completeness, and availability of maternity data at a national level, particularly if the NHS information strategy is to be successfully implemented. Although most of the data items in national datasets are recorded locally, variations in the way data are defined, recorded, and analysed and lack of linkage between computer systems restrict their access, availability, and use at local, district, and national levels.

Data Collection↗
PubMed1988

Examination of the uncertainty in air concentration predictions using Hanford field data.

The accuracy of an environmental transport model is best determined by comparing model predictions with environmental measurements made under conditions similar to those assumed by the model, a process commonly referred to as model validation. Over the past several years, we have done a variety of validation studies with the popular Gaussian plume atmospheric dispersion model using data from tests conducted on the Hanford site. Data for short-term releases of small particles for a range of release heights from surface level to 111 m have been used. Downwind distances examined have ranged from a few hundred meters to 12.8 km, depending on the particular data used. Measured and predicted ground-level centerline, crosswind-integrated, and 22.5 degrees sector-averaged air concentrations have been compared. Up to six different sets of atmospheric dispersion parameters and three different atmospheric stability class specification schemes have been examined. Overall, dispersion parameters based on measurements made near Jülich, Federal Republic of Germany, give the best comparisons between observed and predicted air concentrations. The commonly used vertical temperature gradient method for determining atmospheric stability class consistently gives poor results. The accuracy of air concentration predictions improves when dry deposition processes are included in the model. Further validation studies using various Hanford data sets are planned.

Air Pollutants↗
PubMed1996

A template-matching pandemonium recognizes unconstrained handwritten characters with high accuracy.

Psychological data suggest that internal representations such as mental images can be used as templates in visual pattern recognition. But computational studies suggest that traditional template matching is insufficient for high-accuracy recognition of real-life patterns such as handwritten characters. Here we explore a model for visual pattern recognition that combines a template-matching and a feature-analysis approach: Character classification is based on weighted evidence from a number of analyzers (demons), each of which computes the degree of match between the input character and a stored template (a copy of a previously presented character). The template-matching pandemonium was trained to recognize totally unconstrained handwritten digits. With a mean of 37 templates per type of digit, the system has attained a recognition rate of 95.3%, which falls short of human performance by only 2%-3%.

Algorithms↗
PubMed1999

Coding accuracy of hospital discharge data for elderly survivors of myocardial infarction.

OBJECTIVE: To assess the coding accuracy of primary and secondary discharge diagnoses in the Quebec hospital discharge database for elderly persons with myocardial infarction (MI). DESIGN: Retrospective chart review in a convenience sample of six Montreal hospitals. The diagnoses listed in the medical chart were compared with those listed in the hospital discharge database. For each subject, the Charlson comorbidity index was calculated twice, once based on the medical chart and again based on the hospital discharge database. PATIENTS: Subjects aged 65 years and over who had an MI coded as the primary discharge diagnosis in the hospital discharge database and who were discharged alive. MAIN RESULTS: For 234 MI survivors, the positive predictive value (ie, probability that a patient with MI reported in the hospital discharge database had an MI diagnosed by the discharging physician) for coding MI was 0.96 (95% CI 0.94, 0.98). Comorbid medical conditions and complications of the MI were under-reported in the hospital discharge database, which meant that the Charlson index based on the hospital discharge database was an average of 0.71 units lower than the Charlson index based on the medical chart. CONCLUSIONS: When studying survivors of MI by using hospital discharge databases, the advantages must be weighed against potential drawbacks in the quality of the information. Hospital discharge databases are almost as reliable as medical charts for identifying MI patients, but there is substantial under-reporting of comorbid medical conditions.

Aged↗
PubMedDate not supplied

Automated image registration: I. General methods and intrasubject, intramodality validation.

PURPOSE: We sought to describe and validate an automated image registration method (AIR 3.0) based on matching of voxel intensities. METHOD: Different cost functions, different minimization methods, and various sampling, smoothing, and editing strategies were compared. Internal consistency measures were used to place limits on registration accuracy for MRI data, and absolute accuracy was measured using a brain phantom for PET data. RESULTS: All strategies were consistent with subvoxel accuracy for intrasubject, intramodality registration. Estimated accuracy of registration of structural MRI images was in the 75 to 150 microns range. Sparse data sampling strategies reduced registration times to minutes with only modest loss of accuracy. CONCLUSION: The registration algorithm described is a robust and flexible tool that can be used to address a variety of image registration problems. Registration strategies can be tailored to meet different needs by optimizing tradeoffs between speed and accuracy.

Algorithms↗
PubMed1992

Quality of data in the Manchester orthopaedic database.

OBJECTIVE: To determine the completeness and accuracy of data in a computerised clinical information system (Manchester orthopaedic database) in comparison with the data available through the Hospital Activity Analysis. DESIGN: Retrospective review of case notes, computer data, and Hospital Activity Analysis data. SETTING: Orthopaedic unit in a district general hospital in Manchester. SUBJECTS: 200 random patient records distributed through the period of use of the computer system (1 October 1988 to 31 March 1990) and 121 records for random admissions between 1 April 1989 and 31 March 1990, 71 of which were included in the previous sample. MAIN OUTCOME MEASURES: Conformity of the computer record key words and Hospital Activity Analysis codes to an ideal key word record and ideal code record drawn up by one investigator from the clinical notes; overall quality (completeness times accuracy). RESULTS: Overall completeness of the data in the orthopaedic database was 62% and the accuracy was 96%. Completeness improved after feedback to doctors on the use of key words in regular audit meetings. Completeness was higher in inpatient than outpatient records (69.9% v 53.7%, p less than 0.001) and when a new key word was required compared with missing and incorrect key words (both p less than 0.001). Completeness was lower when the key word was required of a senior registrar (p less than 0.05). Accuracy was not significantly different. The completeness of Hospital Activity Analysis data was 90.5% and accuracy 69.5%. Thus the overall data quality was similar in both systems. CONCLUSIONS: Even in a system designed for simple and efficient data capture, compliance by users was poor. Accuracy was high, suggesting that users understood the principles of data entry. Completeness of data capture can be improved by providing feedback to users on use of the system and performance. Improvements in future versions of the software should improve performance.

Abstracting and Indexing↗
PubMed1995

Accuracy of emergency physician data collection in automobile collisions.

OBJECTIVE: Triage decisions must be based on accurate information with a valid understanding of injury patterns and their sources. Only a data base that includes both medical and collision factors can best provide the breadth of information required to achieve this goal. In the study reported here we assessed the accuracy of automobile collision data collected by emergency physicians compared with Police Accident Reports. DESIGN: Prospective study in which emergency medicine attending physicians completed questionnaires placed near the entrance to the trauma rooms in the emergency department. MATERIALS AND METHODS: During a two-month period the emergency medicine attending physicians obtained data concerning vehicle collision factors for all automobile collisions resulting in major trauma to patients over 18 years of age who were triaged to the Emergency Department at Stanford University Hospital, a level-I trauma center. These data were then compared by one of the investigators with the data contained in Police Accident Reports, which were available for 50 of the 64 patients who met the study eligibility criteria. MEASUREMENTS AND MAIN RESULTS: For each automobile collision, the attending physician was asked to collect the following data: direction of impact; extrication required; ejection; type and use of restraints; deployment of an airbag; type of vehicle; reported severity (minor, moderate, or major) of impact; presence and degree of steering wheel deformation; presence and degree of intrusion into occupant compartment; estimated speed and collision type (i.e., vehicle to vehicle, to fixed object, etc.) Nearly three-fourths (74%) of all cases had at least one discrepancy when compared with the Police Accident Reports, while 46% of these had multiple discrepancies. CONCLUSIONS: When data obtained by emergency physicians are compared with the information in Police Accident Reports, there are notable differences on several collision factors. Triage decisions must be based on accurate information with a valid understanding of injury patterns and their sources. Only a data base that includes both medical and collision factors can best provide the breadth of information required to achieve this goal.

Accidents, Traffic↗
PubMed1997

Automated entry of hospital infection surveillance data.

OBJECTIVE: To assess the accuracy of an automated data entry system employing optical scanning technology and to provide an analysis of its costs as compared to manual data entry. DESIGN: The accuracy and cost of automated data entry of 100 surgical-wound infection surveillance questionnaires was compared to manual entry. SETTING: The Surgical Directorate, The Royal Hospitals, Belfast, Northern Ireland. RESULTS: The use of optical scanning technology greatly improved the speed and accuracy of data entry. The time spent by the keyboard operator on data entry was reduced substantially. For each surgical-wound infection questionnaire automatically processed, there was a saving in clerical time equivalent to $0.63. The automated data entry process resulted in a 22-fold productivity increase compared to manual data entry with validation. After validation, an error rate of < 0.2 errors per 1,000 responses was detected in automatically entered data compared to a rate of 12.4 errors per 1,000 responses for manually entered data. The automated system, including validation, provided a seven-fold productivity increase compared to "quick-and-dirty" manual data entry without validation. CONCLUSION: Hospital information technology systems may achieve total integration of data management, but realistically this would appear to be very much in the future. Until then, in view of the accuracy and substantial savings in time and money, we recommend the use of automated data entry technology. This system would be especially useful where data are transported from outlying hospitals to a central receiving center for collation and analysis.

Cost-Benefit Analysis↗