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Practical experience with a quality control procedure using retained patient specimens on Technicon H1 and COULTER S 880.

External quality assessment and internal quality control in hematology is complicated by the lack of good control materials. Commercial materials do not always behave as patient blood and they are expensive. Patient specimens are unstable, but may be used either within certain time limits or as in Bull's moving average for red cell indices. We have used retained patient specimens for internal quality control supplemented by a commercial control material. Three patient-specimens were run alternatively on a Technicon H1 and a Coulter 880 at regular intervals. The variations for each instrument and between instrument were computed. We used the 2 of 3 (2s) control rule. Our conclusion is that the Coulter 880 had an overall better performance than the Technicon H1 when using retained patient specimens. But both instruments practically met suggested analytical goals.

Goals↗

Automated quality control in computed radiography.

PURPOSE: The purpose of this paper is to describe the automation of quality control procedures on photo-stimulable imaging plates by means of an image-processing tool providing automatic reading of the images and automatic calculation of the quality parameters monitored. MATERIALS AND METHODS: Quality-control procedures were performed according to the main available guidelines. The quality assurance programme was applied to several Kodak and Philips devices in four radiological departments. The automatic image-processing tool was developed using public domain software (Java-based ImageJ software) and contains both reading and computation procedures. RESULTS: The quality checks and algorithms described were successfully applied, proving useful for identification of defective plates and for implementation of the quality assurance programme. The use of automation allowed significant savings in the time required for quality checks. CONCLUSIONS: Completely automated image reading allows substantial economic and human resources savings, as it eliminates much of the transfer, reproduction, processing and filing procedures.

Algorithms↗

A miniaturized rapid paper chromatographic procedure for quality control of technetium-99m sestamibi.

A miniaturized rapid paper chromatographic technique (MRPC) for quality control of a technetium-99m sestamibi preparation was developed and compared with the manufacturer's and Hung et al. techniques. The MRPC system involves the use of 6.0x0.5cm Whatman 3MM paper strip developed in ethyl acetate. The procedure was completed within 3min while that of the manufacturer and Hung techniques took 30-35 and 4min respectively. The Rf range of 99mTc-sestamibi using MRPC was 0.55-0.75 while that of the other two techniques was 0.9-1.0. The results indicate that MRPC can be used to separate 99mTc-sestamibi from any 99mTc contaminant that migrates with the solvent front. The MRPC is a fast and effective chromatographic technique for routine quality control testing of 99mTc-sestamibi preparation.

Chromatography, Paper↗

The use of an electronic portal imaging device for exit dosimetry and quality control measurements.

PURPOSE: To determine ways in which electronic portal imaging devices (EPIDs) could be used to (a) measure exit doses for external beam radiotherapy and (b) perform quality control checks on linear accelerators. METHODS AND MATERIALS: When imaging, our fluoroscopic EPID adjusts the gain, offset, and frame acquisition time of the charge coupled device (CCD) camera automatically, to allow for the range of photon transmissions through the patient, and to optimize the signal-to-noise ratio. However, our EPID can be programmed to act as an integrating dosemeter. EPID dosemeter measurements were made for 20 MV photons, for different field sizes and thicknesses of unit density phantom material placed at varying exit surface to detector distances. These were compared with simultaneous Silicon diode exit dose measurements. Our exit dosimetry technique was verified using an anthropomorphic type phantom, and some initial measurements have been made for patients treated with irregularly shaped 20 MV x-ray fields. In this dosimetry mode, our EPID was also used to measure certain quality control parameters, x-ray field flatness, and the verification of segmented intensity modulated field prescriptions. RESULTS: Configured for dosimetry, our EPID exhibited a highly linear response, capable of resolving individual monitor units. Exit doses could be measured to within about 3% of that measured using Silicon diodes. Field flatness was determined to within 1.5% of Farmer dosemeter measurements. Segmented intensity modulated fields can be easily verified. CONCLUSIONS: Our EPID has the versatility to assess a range of parameters pertinent to the delivery of high quality, high precision radiotherapy. When configured appropriately, it can measure exit doses in vivo, with reasonable accuracy, perform certain quick quality control checks, and analyze segmented intensity modulated treatment fields.

Humans↗

Quality control of messenger ribonucleoprotein particles in the nucleus and at the pore.

The spatial separation of nuclear transcription and cytoplasmic translation in eukaryotic cells implies that mRNAs have to travel. On their journey, proteins involved in the various steps of transcript formation, processing and transport dynamically interact with mRNAs to form diverse messenger ribonucleoprotein complexes (mRNPs). Increasing evidence indicates that the protein complexes involved in distinct phases of manufacturing a bona fide mRNA in the nucleus are tightly coupled. Moreover, the recent demonstration that active genes migrate into preassembled, shared nuclear sub-compartments suggests that mRNAs are churned out in large 'transcription factories' with distinct but interconnected divisions. Nuclear factors have now been identified that specifically control the quality of mRNAs without affecting mRNP biogenesis or export.

Active Transport, Cell Nucleus↗

[Logistical function and quality control in a hospital service].

The characteristics of Logistical Function are studied, and are applied to controlling the quality of attention in a Medical service of a Hospital. Three variables were studied: number of annual admissions, average stay and DRG coefficients. The unit of time employed was the period of one year. Within the parameters that define this Function, the value K denotes the maximum capacity of yield of the Service in relation to the studied variable. The exponential factor b is the indicator of the ascending or descending course of the variable, which is qualified by the absolute value of the same, as much in one sense as in the other. It is essential, to be able to apply this procedure, that the human and material resources of the service under study do not vary during the entire period of observation.

English Abstract↗

[International survey of the status of dosimetry for controlling quality assurance in radiotherapy (WHO)].

The results of an IAEA/WHO 14-year survey on the precision of irradiation at a preset dose (2 Gy) in radiotherapy departments in different countries have shown that nearly in 40% of cases deviations from a preset dose exceeded the tolerant rate (+/- 5%). A conclusion has been made of the necessity to develop a program of quality guarantee in radiotherapy at national and international levels.

International Cooperation↗

Controlling quality.

Explore the source record for details and available documents.

Laboratories, Dental↗

Information theory applied to chromatographic fingerprint of herbal medicine for quality control.

At present, the construction of chromatographic fingerprints plays an important role in the quality control of complex herbal medicines. In this work, information theory was applied to obtain chromatographic fingerprints with good performance. Moreover, according to the characteristics of the chromatographic fingerprints obtained, some modifications of the calculation of the information content were conducted. In comparison with the information content from several chromatographic fingerprints obtained, reliable chromatographic fingerprints with a high separation degree and uniform concentration distribution of chemical components could be determined. The successful application of information theory with modification to simulated chromatographic fingerprints together with real herbal medicines such as Rhizoma chuanxiong and Ginkgo biloba from different sources demonstrated clearly that the proposed method to determine chromatographic fingerprints was reasonable and reliable and it was user-friendly. Chromatographic fingerprints determined with high separation degrees and uniform concentration distribution of chemical ingredients might also chemically represent characteristic components of herbal medicines for quality control.

Chromatography↗

Quality control procedure for 6-[18F]fluoro-L-DOPA: a presynaptic PET imaging ligand for brain dopamine neurons.

The goal of the current study was to establish a quality control procedure for clinical use of 6-[18F]fluoro-L-DOPA (6-[18F]-DOPA) as a selective presynaptic positron emission tomographic (PET) imaging ligand for brain dopamine neurons. A high performance liquid chromatographic procedure using a 5-mu C-18 reverse phase column and ion-pairing mobile phase was used for the quantification of 6-[18F]-DOPA. The radiochemical purity of 6-[18F]-DOPA was measured by 18F radioactivity in HPLC fractions while the chemical purity was determined by an amperometric electrochemical detector with a sensitivity of 25 pg. Quality control of eight consecutive batches of highly purified 6-[18F]-DOPA sample used in a pre-clinical trial revealed that the chemical and/or radiochemical purity of the PET imaging ligand, 6-[18F]-DOPA was greater than 97 +/- 0.5% with a specific activity of 365 +/- 31 mCi/mmol. The knowledge and assurance of radiochemical purity of PET ligands are essential for the interpretation of clinical PET imaging results. The assurance of such quality control would enable comparisons of 6-[18F]-DOPA/PET data obtained from various medical centers using different radiopharmaceutical procedures.

Brain↗

Quality control in intravenous additive service.

The elements which are necessary for a co-ordinated system of quality control of intravenous additive services are reviewed. It is argued that, with the use of advanced equipment, such a system can be established, even for this type of very divergent preparations. Major emphasis is placed upon in-process control, where the use of computerized systems creates the opportunity for an integrated quality control system.

Costs and Cost Analysis↗

A predictive value model for quality control: effects of the prevalence of errors on the performance of control procedures.

A predictive value model has been developed to describe the usefulness of results from quality control tests or procedures. The model shows that the critical parameters are the probability for false rejection, probability for error detection, and prevalence or frequency of occurrence of analytical errors. When prevalence is low, control procedures should have a low probability for false rejection. When prevalence is high, control procedures should have a high probability for error detection. The predictive value model for a quality control (QC) test is analogous to the predictive value model for a diagnostic test, thus suggesting new strategies for optimizing the performance of QC tests.

Diagnostic Errors↗

External quality control of direct antigen tests to detect group A streptococcal antigen.

Presented here are the results of an external quality control survey organized by the Swiss Center for Quality Control (CSCQ) to evaluate the performance of direct antigen tests (DATs) widely used in Swiss medical practices and laboratories for the diagnosis of group A streptococcal pharyngitis. Twice yearly over a 4-year period, just over 100 participants were requested to analyze positive, weakly positive and negative samples provided to them by the CSCQ with their routinely used DATs and to send the results to the CSCQ. For 1,620 samples distributed, the CSCQ received 1,484 (91.6%) results obtained with 17 different DATs. The specificity of all DATs for negative samples was >91%. For samples containing abundant group A streptococcal antigen, sensitivities ranged from 59.1% to 95.5%; however, for samples containing low levels of antigen, the sensitivity was much lower for all DATs, ranging from 8.7% to 69.8%. Therefore, negative DAT results should be verified with well-performed cultures in order to assure the optimal care of patients with pharyngitis.

Agglutination Tests↗

DNA profiling: a valuable tool for quality control of sample logistics including occurrences of suspected sample confusion in a blood donation centre.

BACKGROUND AND OBJECTIVES: A molecular method for analysing whole-blood samples should be established for quality control of plasma sample logistics. MATERIALS AND METHODS: DNA profiles of retention samples (plasma) were compared to profiles of recent donations (whole blood). DNA extraction, amplification and detection were performed using the Qiagen DNA Blood Mini kit, the AmpFFISTR Profiler Plus Kit and capillary electrophoresis, respectively. RESULTS: Matched pairs of full profiles were obtained for all samples investigated, therefore no deviation from the standardized procedures was detected. CONCLUSIONS: Modified extraction and amplification protocols enabled DNA profiling to be used for the quality control of plasma samples. Hence, DNA profiling can be used in the blood bank as a safe and easy method for quality control of sample logistics.

Blood Banks↗

Medicaid program; relations with other agencies, miscellaneous Medicaid definitions, third party liability quality control, and limitations on federal funds for abortions--HCFA. Final rule.

These final regulations (1) revise Medicaid rules to reflect current policy on State payment of cost sharing amounts under Medicare Part B "buy-in" agreements; (2) revise and clarify certain Medicaid definitions; (3) remove the requirement that State plans include third party liability quality control reviews as part of the State's Medicaid quality control systems; and (4) provide for limitations on the use of Federal funds for abortion. These final regulations allow States with Medicare Part B buy-in agreements the option of paying cost sharing amounts for Medicaid beneficiaries for those Medicare services that States do not cover in their Medicaid plans. States may pay cost sharing amounts under Medicare Part B buy-in agreements on all, some or none of the Part B Medicare services that are covered in the Medicaid plan. We are revising definitions and clarifying ambiguities in several existing Medicaid regulations. The revisions are to the definitions of private duty nursing services, inpatient and outpatient, inpatient and outpatient hospital services, and other laboratory and x-ray services. We are removing the requirement in our quality assurance regulations that States monitor third party liability errors as a part of their quality control system. Instead, we plan to issue regulations which encourage improved third party liability (TPL) operations by making them an integral component of State Medicaid Management Information System subject to periodic evaluation through systems performance reviews. We are revising the Medicaid regulations to provide for limitations on the use of Federal funds for abortion, in accordance with previously enacted laws.

Abortion, Induced↗

Computerization of plateletpheresis quality control records with a commercially available spreadsheet program.

Many apheresis units lack the resources to acquire customized computer software for record keeping. We have adapted a commercially available "spreadsheet" program (Lotus 1-2-3) to aid in quality control activities for plateletpheresis. Data are entered in a grid pattern wherein each donation occupies one row and successive columns contain numerical data derived from the donation. The last two columns contain formulas that calculate yield and collection efficiency from values entered in preceding columns. The program runs on an IBM PC or equivalent with 512 K RAM; the combined cost of a computer and software is currently under $2,000.00. Data entry requires fewer keystrokes per record than computation of yield and efficiency with a calculator, and creates an inclusive permanent record for future analysis. Data sorting and statistical functions allow rapid identification of incomplete records, and derivation of average platelet yield and/or collection efficiency for any time period of interest. The program also facilitates determining the proportion of donations that fall below any chosen cutoff. Performance characteristics of a particular instrument or operator can be assessed easily by isolating the pertinent records and analyzing them separately. The system will thus accomplish a variety of quality control activities, including those mandated by licensing agencies. It can be implemented by apheresis personnel with limited "computer literacy" and is superior to manual tabulation of quality control data in both ease of data entry and facility of analysis.

Data Interpretation, Statistical↗