Reliability, validity and data collection.
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Data Collection↗
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Quality of data collected for severity of illness scores in the Dutch National Intensive Care Evaluation (NICE) registry.
OBJECTIVE: To analyse the quality of data used to measure severity of illness in the Dutch National Intensive Care Evaluation (NICE) registry, after implementation of quality improving procedures. DESIGN: Data were re-abstracted from the paper records of patients or the Patient Data Management System and compared to the data contained in the registry. The re-abstracted data were considered to be the gold standard. SETTING: ICUs of nine Dutch hospitals that had been collecting data for the NICE registry for at least 1 year. MEASUREMENT AND RESULTS: The mean percentages of inaccurate and incomplete data, per hospital, over all variables, were 6.1%+/-4.4 (SD) and 2.7%+/-4.4 (SD), respectively. The mean difference in severity of illness scores between registry data and re-abstracted data was 0.2 points for APACHE II and 0.4 points for SAPS II. The mean difference in predicted mortality according to APACHE II and SAPS II between registry data and re-abstracted data was 0.4% and 0.02%, respectively. CONCLUSIONS: The current data quality of the NICE registry is good and justifies evaluative research. These positive results might be explained by the implementation of several quality assurance procedures in the NICE registry, such as training and automatic data checks. Electronic supplementary material to this paper can be obtained by using the Springer LINK server located at http://dx.doi.org/10.1007/s00134-002-1272-z
APACHE↗
A quantitative approach to data-collection strategies.
Statistical descriptors of the X-ray diffraction data set for a macromolecular crystal can be modelled using the information present in the initial diffraction images. Quantitative relationships between the crystal quality, beam apertures, oscillation width, resolution limit, redundancy and the data statistics are presented. They are analysed in terms of the radiation-dose requirements based on modelling in program the BEST. The influence of radiation damage on the data statistics is discussed.
Anions↗
The effectiveness of a first-year clinical preceptorship on the data collection and communication skills of second-year medical students.
BACKGROUND: Evidence suggests that effective physician communication strongly correlates with patient satisfaction and treatment outcome. Unfortunately, teaching these skills has been challenging because of 2 major barriers: (a) medical students are often too preoccupied with the technical and scientific aspects of their curriculum, and (b) it is difficult to expand curricular time. DESCRIPTION: To overcome these barriers, an educational intervention that has not required additional classroom time was implemented. This first-year preceptorship focused on improving data gathering and interpersonal/communication skills. EVALUATION: Analysis of the data for the 2 test groups revealed that interpersonal and communication skills were modestly higher in the preceptorship group. There was no significant difference in data collection in each of the two groups. CONCLUSIONS: Combining formal communication skills instruction with an early clinical experience may prove to be the most effective approach to improving interpersonal, communication, and data gathering skills.
Communication↗
Sport biomechanics: data collection, modelling, and implementation stages of development.
This paper discusses three stages of research development that form an integral part of the total process necessary to attain the biomechanist's goal in sport research. The paper is not intended as a comprehensive review of the areas contained within the three stages but rather as a focusing implement that draws the attention of the reader to selected aspects in the following three stages of sport research development: (a) data collection, (b) mathematical modelling, and (c) implementation. The basic contents of this paper were presented at the annual CASS Conference held in Ottawa in 1986.
Biomechanical Phenomena↗
Methodology for data collection to study prehospital cardiac arrest in New York City: the PHASE methodology. PreHospital Arrest Survival Evaluation Group.
STUDY OBJECTIVE: To describe an effective methodology for the investigation of prehospital cardiac arrest in large cities. DESIGN: Observational cohort study. SETTING: New York City emergency medical services system. PARTICIPANTS: All cardiac arrests dispatched by the 911 system between October 1, 1990, and March 31, 1991. INTERVENTIONS: Trained paramedics performed immediate postarrest interviews with prehospital and hospital care providers using a standardized data collection instrument. RESULTS: Of 3,239 consecutive, confirmed cardiac arrests in which resuscitation was attempted, 2,329 (72%) were of cardiac etiology. Information was sought for 15 of the 17 core events and times recommended by the Utstein Consensus Conference Data were obtained in more than 98% of cases for all except one of these core events and times. One core time yielded data in 96% of cases. All patients were followed until death or discharge home. None were lost to follow-up. CONCLUSION: Concurrent, interactive acquisition of prehospital cardiac arrest data in a large urban setting captured over 98% of the core data recommended for completion of the Utstein template. This methodology may be a suitable means of investigating prehospital cardiac arrest in large cities.
Adult↗
Determining the appropriate level of care. An analysis of factors affecting the staff's overall needs assessments, using data collected through the ASIM monitoring system.
For the purpose of evaluating the validity of the staff's overall needs assessment in terms of the 'appropriate level of care' as a measurement of resource needs--with particular emphasis on the need for institutional resources--an analysis was made concerning the relation of the assessment to various other factors. In the analysis, we used data collected in a survey undertaken in Solna municipality on November 1, 1991 according to the ASIM monitoring system. It was found by multiple regression analysis, that the 'appropriate level of care' was closely related to the client's degree of disability, age, and actual level of care. On the other hand, variables describing the client's social situation--marital status, single-living, informal social support, standard and accessibility of housing--bore no relation to the assessment of need for institutional care. Chiefly because of the close relation to the actual level of care it was concluded that the staff's overall assessment of 'appropriate level of care' should be used with a degree of caution as measure of the need for institutional resources, since it would tend to overrate that need. A more systematic needs assessment procedure is required in order to provide the municipal authorities with unbiased estimates of institutional resource needs.
Aged↗
The evaluation of the data collection process for a multicenter, population-based, case-control design.
This report details the methods the authors used to conduct the Cancer and Steroid Hormone Study, a multicenter, population-based, case-control study of oral contraceptive use in relation to breast, endometrial, and ovarian cancer diagnosed during 1980-1982. The authors have documented their methods and rationale, and the results of their data collection efforts as a practical guide for the planning and conduct of large case-control studies. They observed the following: 1) the Surveillance, Epidemiology, and End Results program is a useful epidemiologic resource for identifying cases from which to evaluate risk factors for cancer in the United States; 2) random digit dialing is an effective and efficient method for screening for eligible controls for a population-based study; 3) with the cooperation of community pathologists, histologic specimen slides can be retrieved and reviewed for diagnostic confirmation and histologic subclassification of cancer for greater than 95% of the cases interviewed; and 4) data reported during personal interviews of study participants can be validated by reviewing medical records for more than 75% of study participants who reported medical events that occurred during the 10 years before the beginning of the study.
Adult↗
How to make mapping images of biological specimens--data collection and image processing.
To make high-quality elemental mapping images of biological specimens, the conditions of data collection were optimized, and image-processing methods were examined. The most important step was to obtain a sufficient number of electrons to make the images. The exposure time was limited by the characteristics of the CCD camera. Obtaining a long exposure time exceeded the limitations of the camera, so exposures of the same area were performed many times and recorded in many images. The divided images were merged after observation. To merge images, a new software, 'Rotate & Merge' (R&M), was developed. Because of the characteristics of biological specimens, R&M must have several functions. Picture-zoom and image rotation are necessary because of shrinkage of the specimens due to irradiation during exposure, since even cryo techniques, including low-dose techniques, do not prevent shrinkage of specimens. Merged phosphorus-mapping images of ultra-thin slices of yeast cells were made. In these images, ribosome particles and DNA in the nucleus were observed clearly. The merging was very useful for improving the quality of mapping images.
Cyanobacteria↗
[Cornea procurement and grafts and number of patients on waiting lists. Data collection in France between 1990 and 1994].
OBJECTIVES: Analyze annual corneal graft procurement and transplantation in France. METHODS: Data collected from all public and private health centers in France in a survey conducted in August 1994 by the general health directory were analyzed by the French Graft authorities. RESULTS: Between 1990 and the first semester 1994, an annual mean of 3205 corneal grafts were performed in France. The annual number of grafts fell by 27% between 1991 and 1992 then stabilized at 2700 grafts per year. Eighty percent of the grafts were performed in public institutions. Less than 4% of the patients were foreigners. The number of patients on waiting lists on June 30, 1994 was 7129, i.e. 2.7 times the number of transplantations in 1993. Mean annual cornea procurement between 1991 and the first semester 1994 was 2930. Corneas were removed at the morgue in 78% of the cases or in the operating room in 19% (multiple organ procurement) and 1.5% (cornea alone). Grafted corneas came from public hospitals in 72% of the cases. Fifty-seven percent of the grafts used in private institutions were imported. The mean annual number of imported corneas can be estimated at 280. This number has increased by 127% since 1990 and corresponds to 8% of the grafted corneas. CONCLUSION: The number of corneal grafts in France is similar to that in other European countries, but the number of patients on waiting lists is high and French eye banks had a restricted role.
Cornea↗
Building measurement and data collection into medical practice.
Clinicians can use data to improve daily clinical practice. This paper offers eight principles for using data to support improvement in busy clinical settings: 1) seek usefulness, not perfection, in the measurement; 2) use a balanced set of process, outcome, and cost measures; 3) keep measurement simple (think big, but start small); 4) use qualitative and quantitative data; 5) write down the operational definitions of measures; 6) measure small, representative samples; 7) build measurement into daily work; and 8) develop a measurement team. The following approaches to using data for improvement are recommended. First, begin with curiosity about outcomes or a need to improve results. Second, try to avoid knee-jerk, obstructive criticism of proposed measurements. Instead, propose solutions that are practical, goal-oriented, and good enough to start with. Third, gather baseline data on a small sample and check the findings. Fourth, try to change and improve the delivery process while gathering data. Fifth, plot results over time and analyze them by using a control chart or other graphical method. Sixth, refine your understanding of variation in processes and outcomes by dividing patients into clinically homogeneous subgroups (stratification) and analyzing the results separately for each subgroup. Finally, make further changes while measuring key outcomes over time. Measurement and improvement are intertwined; it is impossible to make improvements without measurement. Measuring and learning from each patient and using the information gleaned to test improvements can become part of daily medical practice in local settings.
Blood Glucose Self-Monitoring↗
Trauma data collection using a customised trauma registry: a New Zealand experience.
AIM: To describe the process of selection and adaptation of a trauma registry and the initial experience with its use. METHOD: The decision-making processes involved in selection of a data set and computer software are described. The problems associated with collection of data, recording and analysis are outlined. RESULTS: In the 6 months from 1 January to 30 June 1995, 615 patients were entered on the Auckland Hospital trauma registry. 590 patients were discharged or transferred alive and 25 (4.1%) died in hospital. Median length of stay of survivors was 6 days (mean 9.03 days) with median ICU stay being 0 days (mean 0.81 days). A range of difficulties including data collection, recording and analysis were experienced. CONCLUSION: Despite some teething problems, establishment of a trauma registry has proven to be an achievable task within the trauma service. Recording of data which allows assessment of the quality of care, resource use and outcome has been possible. Effectiveness of the trauma service has been enhanced by the availability of this data.
Data Collection↗
The incidence and risk factors for hypotension after spinal anesthesia induction: an analysis with automated data collection.
UNLABELLED: We sought to identify factors that are associated with hypotension after the induction of spinal anesthesia (SpA) by using an anesthesia information management system. Hypotension was defined as a decrease of mean arterial blood pressure of more than 30% within a 10-min interval, and relevance was defined as a therapeutic intervention with fluids or pressors within 20 min. From January 1, 1997, to August 5, 2000, data sets from 3315 patients receiving SpA were recorded on-line by using the automatic anesthesia record keeping system NarkoData. Hypotension meeting the predefined criteria occurred in 166 (5.4%) patients. Twenty-nine patient-, surgery-, and anesthesia-related variables were studied by using univariate analysis for a possible association with the occurrence of hypotension after SpA. Logistic regression with a forward stepwise algorithm was performed to identify independent variables (P < 0.05). The discriminative power of the logistic regression model was checked with a receiver operating characteristic curve. Calibration was tested with the Hosmer-Lemeshow goodness-of-fit test. The univariate analysis identified the following variables to be associated with hypotension after SpA: age, weight, height, body mass index, amount of plain bupivacaine 0.5% used for SpA, amount of colloid infusion before puncture, chronic alcohol consumption, ASA physical status, history of hypertension, urgency of surgery, surgical department, sensory block height of anesthesia, and frequency of puncture. In the multivariate analysis, independent factors for relevant hypotension after SpA consisted of three patient-related variables ("chronic alcohol consumption," odds ratio [OR] = 3.05; "history of hypertension," OR = 2.21; and the metric variable "body mass index," OR = 1.08) and two anesthesia-related variables ("sensory block height," OR = 2.32; and "urgency of surgery," OR = 2.84). The area of 0.68 (95% confidence interval, 0.63-0.72) below the receiver operating characteristic curve was significantly greater than 0.5 (P < 0.01). The goodness-of-fit test showed a good calibration of the model (H = 4.3, df = 7, P = 0.7; C = 7.3, df = 8, P = 0.51). This study contributes to the identification of patients with a high risk for hypotension after SpA induction, with the risk increasing two- or threefold with each additional risk factor. IMPLICATIONS: By using automated data collection, 5 (chronic alcohol consumption, history of hypertension, body mass index, sensory block height, and urgency of surgery) of 29 variables could be detected as having an association with hypotension after spinal anesthesia induction. The knowledge of these risk factors should be useful in increasing vigilance in those patients most at risk for hypotension, in allowing a more timely therapeutic intervention, or even in suggesting the use of alternative methods of spinal anesthesia, such as titrated continuous or small-dose spinal anesthesia.
Aged↗
Can data collection during the grieving process be justifiable?
Research has shown that there are a number of competing theories regarding the use of bereaved people for research purposes. One view emphasizes their vulnerability, weakness and inability to take part in decision-making. Another is that there is an infringement of rights if people are denied the freedom of choice to take part in research. This article considers issues concerned with data collection from recently bereaved relatives who were at some stage of the grieving process. The participants were interviewed as part of the OXMIS study which aimed to identify the incidence of myocardial infarction in Oxfordshire. A total of 142 interviews took place (59 home visits and 83 telephone interviews). Of the cases not interviewed, sufficient information was gained in 94% from other sources to fulfil the required criteria. The perceived benefit or apparent risk of vulnerable groups participating in research is discussed in light of the study results.
Bereavement↗
Maximizing the efficiency of a study on alcohol-related birth defects by means of data collection and analytic strategy dissociation.
Application of the terms "prospective" and "retrospective" to quasi/experimental research designs used in clinical investigations is often ambiguous; they often lack specification as to whether they apply to data acquisition, analytic strategy, or both. Data may be collected prospectively by preplanned protocol or retrospectively by chart review. In addition, the direction of analysis may be prospective--comparing differential outcomes for at-risk and not at-risk (exposed/not exposed) groups--or retrospective--comparing differential preceding risks for affected and nonaffected groups. Prospective data collection is advantageous in assuring the availability of crucial variables for an entire sample, but prospective analytic strategies may be inefficient, underestimating effect sizes, particularly when the outcome of interest is rare or the effect, even if large, is seen in only a small proportion of cases. In a prospective multilinear regression model of risks for lowered birthweight for gestational age, 2% of the variance was explained by alcohol variables after adjustment for confounding. In comparison, a similar multilinear regression of case-control sample, in which the frequency of the abnormal outcome is raised, showed 18% of the variance explained by alcohol variables. Data collection and analytic strategies may be dissociated. Although some statistical power may be lost because of reduced sample size, synthetic case-control analysis is efficient in examining small effects. It also has the advantage of decreasing the size of the database to be managed and the time required for analysis. Using this approach, it is feasible to perform virtually any analysis that can be done on a mainframe on medium-sized departmental computer system.
Birth Weight↗
Dose-ranging trials: guidelines for data collection and standardized descriptions.
Protocols for dose ranging trials in healthy volunteers or patients can be described by the combination of an experimental design and one or more decision rules. Generally, the doses are chosen on the basis of an up-and-down method, until the maximum tolerated (affecting one or more physiological parameters) and the minimum effective doses are found. Despite the large number of possible protocols there is no standard for the description of the experimental design or the decision rule(s). We propose a series of variables that can be used to facilitate data collection and that can adequately and uniquely characterize most dose ranging protocols.
Clinical Protocols↗
[Identification of acute geriatric patients in the city of Hamburg ("direct data collection")].
In the past the calculation for an in-patient special offer (quantity of beds needed) was mainly carried out by diagnosis-based statistics of hospital cases. The decision for an in-patient care within a geriatric unit is however influenced by factors as "status of self-help abilities", "social situation" and "co-morbidity". Those factors are investigated either directly by the help of the patient himself or by questioning the nurses and/or the medical staff. A new way of measuring will be introduced for this questioning. The crucial element is the Barthel-Index (BI). Supporting measures are done by the inclusion of main data concerning the social situation as well as recording the modified screening according Lachs. From the 6th of September until 14th of December 1997 the three-part measuring technique was used at seven hospitals in Hamburg (amongst them one University hospital and one hospital with a geriatric unit) within the framework of a representative sample survey. These collected data register 18 admission days of all patients of sixty or over who at the time of questioning stayed for five days in one of those acute hospitals. In some hospitals some additional data were collected at the third or 6th day after admission. Altogether a whole "virtual day-admission" of the 60 years old or older patients was collected for the City of Hamburg at the 5th day after admission. Out of 425 patients 137 were moved or exmitted before questioning, 4 had already died. Out of the rest of 284 patients two of them refused the questioning, whilst the data of 6 patients were not feasible for evaluating. Finally 276 patients were questioned. Out of them 231 patients are "not potential candidates for a geriatric hospital or a geriatric day-care unit", 8 are "candidates for a geriatric day-care unit directly after discharge of primary care" and 37 are "candidates for an in-patient geriatric hospital". The presented three-part question-sheet shows a sensitivity of 89.2% and a specification of 92.2%. This measuring technique in the hands of a trained examiner appears to be a valid and manageable tool in the framework of geriatric consultation as well as for the investigation of own directly ascertained statistic datas for "potential candidates for an in-patient geriatric hospital".
Activities of Daily Living↗
Review of the literature on survey instruments used to collect data on hospital patients' perceptions of care.
OBJECTIVE: To review the existing literature (1980-2003) on survey instruments used to collect data on patients' perceptions of hospital care. STUDY DESIGN: Eight literature databases were searched (PubMED, MEDLINE Pro, MEDSCAPE, MEDLINEplus, MDX Health, CINAHL, ERIC, and JSTOR). We undertook 51 searches with each of the eight databases, for a total of 408 searches. The abstracts for each of the identified publications were examined to determine their applicability for review. METHODS OF ANALYSIS: For each instrument used to collect information on patient perceptions of hospital care we provide descriptive information, instrument content, implementation characteristics, and psychometric performance characteristics. PRINCIPAL FINDINGS: The number of institutional settings and patients used in evaluating patient perceptions of hospital care varied greatly. The majority of survey instruments were administered by mail. Response rates varied widely from very low to relatively high. Most studies provided limited information on the psychometric properties of the instruments. CONCLUSIONS: Our review reveals a diversity of survey instruments used in assessing patient perceptions of hospital care. We conclude that it would be beneficial to use a standardized survey instrument, along with standardization of the sampling, administration protocol, and mode of administration.
Health Care Surveys↗