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Health care fraud and abuse data collection program: reporting of final adverse actions--Office of Inspector General (OIG), HHS. Notice of proposed rulemaking.

This proposed rule would establish a new 45 CFR part 61 to implement the statutory requirements of section 1128E of the Social Security Act, as added by section 221(a) of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Section 221(a) of HIPAA specifically directed the Secretary to establish a national health care fraud and abuse data collection program for the reporting and disclosing of certain final adverse actions taken against health care providers, suppliers, or practitioners, and maintain a data base of final adverse actions taken against health care providers, suppliers and practitioners.

Data Collection↗

Data collecting in grounded theory--some practical issues.

In this paper, Kathleen Duffy, Colette Ferguson and Hazel Watson discuss the challenges of using grounded theory methodology in research, particularly when used for the first time. With reference to a study of the factors influencing mentors' decisions when student nurses' clinical performance is unsatisfactory, they highlight some of the practical issues relevant to the data collection phase of the research process.

Attitude of Health Personnel↗

Using vignettes to collect data for nursing research studies: how valid are the findings?

Vignettes are simulations of real events which can be used in research studies to elicit subject's knowledge, attitudes or opinions according to how they state they would behave in the hypothetical situation depicted. Advantages associated with the use of vignettes as research tools include: the ability to collect information simultaneously from large numbers of subjects, to manipulate a number of variables at once in a manner that would not be possible in observation studies, absence of observer effect and avoidance of the ethical dilemmas commonly encountered during observation. Difficulties include problems establishing reliability and validity, especially external validity. This paper considers the advantages and disadvantages associated with the use of vignettes as data collection tools, concluding with a check-list to help critique vignettes studies.

Bias↗

Indicators of impact of services on persons with developmental disabilities: issues concerning data-collection mandates in P.L. 100-146.

Public Law 100-146 requires the Administration on Developmental Disabilities to report to the Congress in 1990 on the status of services to persons with developmental disabilities. Considerable effort has been devoted by the National Association of Developmental Disabilities Councils to providing a national methodology for characterizing state services and for surveying consumer satisfaction with these services; but these data alone will not be sufficient to adequately characterize all variables required by the 1990 report. Definitional, conceptual, and methodological issues related to measurement of scope and extent of services, documenting eligibility and accessibility, and estimating the effectiveness of services was reviewed. A framework was suggested for integrating data-collection with consumer satisfaction survey efforts already underway.

Consumer Behavior↗

The human capital study 2002-04: tracking, data collection, coverage, and attrition.

Between 2002 and 2004, the Institute of Nutrition of Central America and Panama (INCAP), in collaboration with Emory University, the International Food Policy Research Institute (IFPRI), and the University of Pennsylvania, re-surveyed young Guatemalan adults who had, as children, been participants in a nutrition supplementation trial conducted by INCAP between 1969 and 1977. This "Human Capital Study 2002-04" complements and extends data obtained in previous studies by collecting new information on measures of physical health and well-being, schooling and cognitive ability, wealth, consumption and economic productivity, and marriage and fertility histories. This paper describes the study domains and data collection procedures. Among 2,393 members of the original sample, 1,856 (77%) were targets for enrollment. Response rates varied by gender, current place of residence, and domain of data collection, with 80% of males and 89% of females completing at least one data collection instrument. Attrition was not random and appears to be associated with a number of initial characteristics of individuals and their households that should be controlled for in future analyses. We conclude that data collection was successful and data quality is high, facilitating the successful undertaking of our planned investigation of important study hypotheses.

Adult↗

Survey data collection using Audio Computer Assisted Self-Interview.

The Audio Computer Assisted Self-Interview (ACASI) is a computer application that allows a research participant to hear survey interview items over a computer headset and read the corresponding items on a computer monitor. The ACASI automates progression from one item to the next, skipping irrelevant items. The research participant responds by pressing a number keypad, sending the data directly into a database. The ACASI was used to enhance participants' sense of privacy. A convenience sample of 257 young urban women, ages 18 to 29 years, were interviewed in neighborhood settings concerning human immune deficiency virus (HIV) sexual risk behaviors. Notebook computers were used to facilitate mobility. The overwhelming majority rated their experience with ACASI as easy to use. This article will focus on the use of ACASI in HIV behavioral research, its benefits, and approaches to resolve some identified problems with this method of data collection.

Adolescent↗

Qualitative methods in arthritis research: overview and data collection.

The intent of this paper has been to introduce qualitative methods to arthritis researchers and provide them with basic skills to critically evaluate results of qualitative research. Qualitative research provides the arthritis researcher with the opportunity to look at the meaning that the subject places on his or her behavior, their knowledge of their condition and of its treatment, and the meaning they infer from the actions of those around them, including their care providers and social supports. If carefully conducted, qualitative research methods can produce rich and insightful findings. We have limited our discussion to an overview of qualitative research and data collection methods. We will discuss issues related to how participants are selected and methods of data analysis in a subsequent paper.

Anthropology, Cultural↗

[Data collection about the case management of end-stage renal insufficiency. Feasibility study. Nephrology Epidemiologic and information Network (REIN)].

End-stage renal failure (ESRD) is an important public health issue, because of both the increasing number of patients requiring renal replacement therapy and the cost of treatment. The need for a reliable data system, capable of describing the patient care network as a whole, including dialysis or transplantation, has often been reiterated. The Direction Générale de la Santé (the French Department of Health) commissioned INSERM (the National Institute of Health and Medical Research) to "study the feasibility of different scenarios of data collection about ESRD patient care in order to meet the priority needs of health care administration, physicians, and researchers". Analysis of these needs allowed the goals to be defined: to provide an accurate picture of ESRD patient care in order to guide and evaluate health care policy, to inform clinicians, and to provide a tool for more focused special studies in renal research issues. Three scenarios were studied: the first would use data systems of both the government and the National Health Insurance system for planning health care services, upon EfG (The French Transplant Agency) network to evaluate transplantation, and upon a few regional registries for epidemiology and research; the second is based on repeated cross-sectional surveys; the third would rely upon the organization of an information system, the Renal Epidemiology and Information Network (REIN). Regional centers and a national coordinating office would register and follow-up ESRD patients, principally to evaluate health care supply and quality. The REIN database would also be a resource for research. The advantage of the first scenario is its low cost; its principal drawback is that evaluations will not be possible in the regions without registries. The second suggestion is inadequate. The last project would fulfil the goals that were defined. The REIN data system would be a true public health project of interest to all the participants and institutions in this field.

Case Management↗

Summary and conclusions of the report on the second data collection period and longitudinal analyses of the SENECA Study.

In 1988 SENECA (Survey in Europe on Nutrition and the Elderly, a Concerted Action) was initiated to study cross cultural differences in nutritional issues and life style factors affecting health and performance of elderly Europeans. Nine of the original 19 participating towns in 12 European countries decided to conduct a longitudinal study. This supplement presents the findings of the second data collection period and the first longitudinal analyses of these nine towns. In addition, cross-sectional results are discussed for two towns from which few baseline data were collected, and for two towns which were only involved in the 1993 survey: one from the United Kingdom and one from the United States. Ethical permission for the studies was obtained from local ethical committees.

Aged↗

Benchmarking for hospital evacuation: a critical data collection tool.

In events such as earthquakes or terrorist attacks, hospitals may be victims of disasters. They may need to transfer patients to outside facilities rather than continue to provide on-site care. Following the Northridge earthquake, eight hospitals in the damaged area were the foci of a United States National Science Foundation study that examined the status of the hospitals' pre-event planning, post-event evacuation decision-making, and internal and external evacuation processes. Building on this experience, this paper offers a standardized data collection tool, which will enable researchers to record hospital evacuation information in a systematic manner so that comparable data can be accumulated, evacuation research methods can be improved, and consensus on methods can be reached. The study's principal subjects include: (1) hospital demographics; (2) description of existing disaster response plans; (3) an event's impacts on hospital operations; (4) decision-making and incident command; (5) movement of patients within the facility; (6) movement of patients to off-site institutions; and (7) hospital recovery.

Benchmarking↗

Effect of data collection method on results of serum digoxin concentration audit.

The appropriateness of serum digoxin concentration (SDC) orders was evaluated with respect to indication for use, sampling time, and action taken by physicians when the reported SDC was out of the normal therapeutic range; the effect of the two data-collection methods used (retrospective and concurrent audits) on the results was studied. Criteria for the appropriate use of SDCs were approved by the medical staff through the pharmacy and therapeutics committee. Patients on adult medicine services were entered into the study as daily SDC determinations were reported by the clinical laboratory. Most of the SDCs were evaluated using approved criteria by primary pharmacist clinicians who were concurrently monitoring drug therapy and participating with the treatment team. A retrospective audit of the same patients was conducted, using only chart review. A total of 134 SDCs involving 78 patients were evaluated. Concurrent-audit results indicated that 18.7% of the SDCs were ordered without an appropriate indication, 16.4% were sampled incorrectly with respect to proper timing, and 8.2% did not result in dosage adjustments when indicated. With respect to appropriate sampling time and overall use of SDCs, significantly more SDCs met the standards under concurrent audit than under retrospective audit. The retrospective chart review method of auditing may not detect as much pertinent information as is desirable.

Concurrent Review↗

"Thinking aloud": data collection in the natural setting.

Knowledge of how nurses make decisions is a desirable outcome of research. However, there currently exists an inadequacy in the techniques used to examine such decision making. In this article, the authors describe the techniques used in two studies incorporating "thinking aloud" to successfully examine the decision making of expert critical care practitioners in the natural setting. Both techniques of thinking aloud were found to provide useful information regarding decision making in the natural setting. No ethical implications were experienced in conducting these studies in the natural setting. In conclusion, the use of thinking aloud in the natural setting is an effective means of data collection.

Australia↗

Time-resolved protein crystallography with large-angle oscillations: an application of a protein data-collection system using the Weissenberg technique and a large-format imaging plate.

A diffraction-intensity data-collection system with synchrotron radiation X-rays utilizing the screenless Weissenberg technique and incorporating a large-format imaging plate is one of the most suitable apparatus for time-resolved protein crystallography with larger angle oscillations than hitherto described. The time resolution and data quality of the system have been tested using a tetragonal lysozyme crystal as a test sample in a flow-cell experiment at the bending-magnet beamline 18B at the Photon Factory, and a time resolution of 15 min is confirmed.

Journal Article↗

A descriptive survey of data collection in breastfeeding services at Victorian maternity hospitals.

An increasing number of breastfeeding clinics have been established in Victoria, Australia since 1994. The aim of this study was to identify hospital breastfeeding clinics in the state of Victoria and to examine their methods of data collection. A further aim was to investigate the feasibility of developing a standard, minimum data-set or attendance registration form for breastfeeding clinics. A postal questionnaire was sent to 82 Victorian maternity hospitals in September 2000. The response rate was 93% (76/82); 81% (62/76) indicated a need for a standard form. The 37 hospitals (49%) that provide a breastfeeding clinic collect a variable amount of information from their clients. Thirteen breastfeeding clinics are provided by maternity hospitals with over 1000 births annually, and they see an average of nine women per week (range 2-18). The collection of standard information would enable a comprehensive description of individual breastfeeding clinic services and comparison between service providers. This could act as the starting point for evaluating breastfeeding clinic service accessibility, profile of usage and the impact on breastfeeding outcomes.

Adult↗

Diagnosis of dyspepsia from data collected by a physician's assistant.

This paper presents a study of the diagnosis of "dyspepsia" in 154 patients based on data collected at their initial outpatient attendance via an interview with a non-medically qualified physician's assistant. The reactions of patients to this type of interview were favourable, and the data recorded were as reliable as those recorded by clinicians. We conclude (1) that the data recorded by the physician's assistant are valuable diagnostically; (2) where these cannot be collected by a qualified physician, this task may be delegated to a non-medically qualified person; but (3) this interview should augment and not replace the traditional clinical interview.

Diagnosis, Computer-Assisted↗

Crystallization of the F41 fragment of flagellin and data collection from extremely thin crystals.

Flagellin, which constructs supercoiled filaments of the bacterial flagellum, is very difficult to crystallize because of its strong tendency to polymerize. We therefore crystallized the F41 fragment of flagellin, which does not polymerize because terminal regions that play important roles in polymerization are cleaved off. F41 was crystallized by the hanging drop vapor diffusion method in a mixture of polyethylene glycol, glycerol, and isopropanol, with a reservoir solution covered with silicon oil. The two key factors for success in growing sufficiently large crystals were isopropanol and silicon oil, which worked well to reduce the otherwise very high nucleation rate that resulted in hundreds of tiny crystals. The crystals were grown to very thin plates with thickness less than 10 microm, which made the collection of diffraction data very difficult. Freezing and annealing of the crystals and irradiation at synchrotron beamlines had to be carried out by specific methods and under specific conditions for its structure analysis at 2.0-A resolution.

Antigens, Bacterial↗