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PubMed2002

Benchmark dose calculations for methylmercury-associated delays on evoked potential latencies in two cohorts of children.

Delays in evoked potential latencies were observed at increased exposures to methylmercury from seafood in two cohorts of children. Because this outcome parameter appeared to be virtually independent of confounders, including cultural differences, a joint analysis of benchmark doses was carried out. Comparable cohort members included 382 Faroese and 113 Madeiran children without middle ear infection or neurological disease at age seven years. Maternal hair-mercury concentrations at parturition in the Faroese cohort ranged from 0.6 to 39.1 microg/g (geometric average, 4.49 microg/g). In Madeira, mothers who had not changed their diet since pregnancy had current hair-mercury concentrations ranging from 1.1 to 54.4 microg/g (geometric average 10.14 microg/g). The mercury-associated delay in peak III latencies at two frequencies (20 and 40 Hz) showed similar regression equations in the two groups of children, and benchmark dose calculations were therefore carried out for the two groups separately and jointly. For a doubling of a 5% prevalence of abnormal results of the peak III latencies at 40 Hz in a linear dose-response model, the benchmark dose for the maternal hair-mercury concentration was 8.79 microg/g for the Faroese children; 8.04 microg/g for the Madeiran children; and 9.46 microg/g for both groups. Results were similar for the 20 Hz condition. Benchmark dose results were substantially lower using a logarithmic or square root curve function, although the difference in fit between the curves was far from statistically significant. The benchmark results using evoked potential latencies are in close agreement with results based on neuropsychological test performance.

Adult↗
PubMed2001

Benchmark dose calculation from epidemiological data.

A threshold for dose-dependent toxicity is crucial for standards setting but may not be possible to specify from empirical studies. Crump (1984) instead proposed calculating the lower statistical confidence bound of the benchmark dose, which he defined as the dose that causes a small excess risk. This concept has several advantages and has been adopted by regulatory agencies for establishing safe exposure limits for toxic substances such as mercury. We have examined the validity of this method as applied to an epidemiological study of continuous response data associated with mercury exposure. For models that are linear in the parameters, we derived an approximative expression for the lower confidence bound of the benchmark dose. We find that the benchmark calculations are highly dependent on the choice of the dose-effect function and the definition of the benchmark dose. We therefore recommend that several sets of biologically relevant default settings be used to illustrate the effect on the benchmark results and to stimulate research that will guide an a priori choice of proper default settings.

Animals↗
PubMedDate not supplied

The use of quality benchmarking in assessing web resources for the dermatology virtual branch library of the National electronic Library for Health (NeLH).

BACKGROUND: In 1998, the U.K. National Health Service Information for Health Strategy proposed the implementation of a National electronic Library for Health to provide clinicians, healthcare managers and planners, patients and the public with easy, round the clock access to high quality, up-to-date electronic information on health and healthcare. The Virtual Branch Libraries are among the most important components of the National electronic Library for Health. They aim at creating online knowledge based communities, each concerned with some specific clinical and other health-related topics. OBJECTIVES: This study is about the envisaged Dermatology Virtual Branch Libraries of the National electronic Library for Health. It aims at selecting suitable dermatology Web resources for inclusion in the forthcoming Virtual Branch Libraries after establishing preliminary quality benchmarking rules for this task. Psoriasis, being a common dermatological condition, has been chosen as a starting point. METHODS: Because quality is a principal concern of the National electronic Library for Health, the study includes a review of the major quality benchmarking systems available today for assessing health-related Web sites. The methodology of developing a quality benchmarking system has been also reviewed. Aided by metasearch Web tools, candidate resources were hand-selected in light of the reviewed benchmarking systems and specific criteria set by the authors. RESULTS: Over 90 professional and patient-oriented Web resources on psoriasis and dermatology in general are suggested for inclusion in the forthcoming Dermatology Virtual Branch Libraries. The idea of an all-in knowledge-hallmarking instrument for the National electronic Library for Health is also proposed based on the reviewed quality benchmarking systems. CONCLUSIONS: Skilled, methodical, organized human reviewing, selection and filtering based on well-defined quality appraisal criteria seems likely to be the key ingredient in the envisaged National electronic Library for Health service. Furthermore, by promoting the application of agreed quality guidelines and codes of ethics by all health information providers and not just within the National electronic Library for Health, the overall quality of the Web will improve with time and the Web will ultimately become a reliable and integral part of the care space.

Dermatology↗
PubMed1994

Experts discuss how benchmarking improves the healthcare industry. Roundtable discussion.

Healthcare Financial Management engaged four benchmarking experts in a discussion about benchmarking and its role in the healthcare industry. The experts agree that benchmarking by itself does not create change unless it is part of a larger continuous quality improvement program; that benchmarking works best when senior management supports it enthusiastically and when the "appropriate" people are involved; and that benchmarking, when implemented correctly, is one of the best tools available to help healthcare organizations improve their internal processes.

Efficiency, Organizational↗
PubMed1996

Benchmarks and performance indicators: two tools for evaluating organizational results and continuous quality improvement efforts.

Benchmarks are tools that can be compared across companies and industries to measure process output. The key to benchmarking is understanding the composition of the benchmark and whether the benchmarks consist of homogeneous groupings. Performance measures expand the concept of benchmarking and cross organizational boundaries to include factors that are strategically important to organizational success. Incorporating performance measures into a balanced score card will provide a comprehensive tool to evaluate organizational results.

Consumer Behavior↗
PubMedDate not supplied

Flow chart to benchmark.

BACKGROUND: Benchmarking is the process used to search for best-in-class, compare results, discover the enablers of superior process performance, and take action to achieve quantum process improvement. It sounds simple, but all too often benchmarking efforts fail. The first obstacle often is failing to understand how work is currently being performed. METHODS: Through linear flow charts, connection charts, and cross-functional flow charts, teams identify each step in a process, see how the people in the process interact, follow the work flow, and label the type of a step. When this is accompanied by supporting documentation, this method provides teams a way to visually see the work flow and know where there are glitches and where things are going well. RESULTS: Through flow charting, benchmarking teams can understand what they are doing so they know what to look for in a benchmarking partner and how to identify the enablers of a superior performance. CONCLUSIONS: Without flow charting, teams will not get the maximum benefit from benchmarking.

Appointments and Schedules↗
PubMed1999

The philosophy of benchmark testing a standards-based picture archiving and communications system.

The Department of Defense issued its requirements for a Digital Imaging Network-Picture Archiving and Communications System (DIN-PACS) in a Request for Proposals (RFP) to industry in January 1997, with subsequent contracts being awarded in November 1997 to the Agfa Division of Bayer and IBM Global Government Industry. The Government's technical evaluation process consisted of evaluating a written technical proposal as well as conducting a benchmark test of each proposed system at the vendor's test facility. The purpose of benchmark testing was to evaluate the performance of the fully integrated system in a simulated operational environment. The benchmark test procedures and test equipment were developed through a joint effort between the Government, academic institutions, and private consultants. Herein the authors discuss the resources required and the methods used to benchmark test a standards-based PACS.

Benchmarking↗
PubMed2002

A combination of an extrapolation method and a benchmark method to develop quantitative health targets for Japan.

The aim of the present study was to propose a methodology to formulate quantitative health targets which combined an extrapolation method and a benchmark method, and to estimate the targets for mortality rates (Mb) for selected causes of death by the year 2010 in Japan. Using the extrapolation method, based on the nationwide Mt from 1988 to 1997, the Mt in 2010 was predicted using a regression model. Using the benchmark method, the paired-mean of the age-adjusted mortality rates (Mts) of the top five prefectures among 47 prefectures was calculated as the benchmark. Combining the predicted mortality and the benchmark mortality, year 2010 targets were determined. As a results year 2010 targets as percentages compared with Mt in 1997 for cancer at all sites, stomach cancer, lung cancer, colo-rectal cancer, liver cancer and stroke were estimated to be 93, 52, 94, 102, 53 and 52% for males, and 84, 43, 86, 82, 60, and 45%, for females, respectively. The methodology presented in this article could be used as a standard procedure to formulate realistic quantified health targets, which can be adopted to develop health policies in nations, regions and communities.

Benchmarking↗
PubMed2003

Comparison of available benchmark dose softwares and models using trichloroethylene as a model substance.

By using trichloroethylene as a model substance the U.S. EPA benchmark dose software was compared to the software by Crump and the software by Kalliomaa. Dose-response and dose-effect data on the liver, kidneys, central nervous system (CNS), and tumours were selected for the evaluation. Based on the present study the U.S. EPA software is preferable to the other softwares for dichotomous data. A wider range in benchmark doses was often observed for dichotomous data when the numbers of dose levels were limited. The log-logistic model in most cases gave the best fit when ranking the dichotomous models. In addition, the log-logistic model often implied a more conservative benchmark dose. For continuous data it was more difficult to find a model describing the data. The softwares by Kalliomaa and by the U.S. EPA offered the best opportunities for benchmark dose modelling of continuous data. Flexible models, like the Hill- and the Mult model, are needed for S-shaped continuous data but these models demand more dose levels in order to describe the data. Since the number of dose levels are important for model selection study design is important and should be further evaluated.

Benchmarking↗
PubMed1999

A national day only surgery benchmarking basket.

The efficient management of day surgery facilities benefits both patients and health administrators. Patients can benefit through minimisation of hospital stay while day surgery has the potential to increase elective surgery throughput and to reduce waiting times. This paper explores whether routinely collected morbidity data from Queensland public hospitals can be used to benchmark levels of day only surgery between hospitals. Thirteen procedures were identified that met criteria for inclusion in a day only surgery benchmarking basket. Queensland public hospitals and individual procedures were benchmarked against one another and analysed to determine whether hospitals performing the 13 procedures demonstrate the same rates of day only surgery. With the development of a clinically meaningful and administratively simple tool for comparing hospital day surgery rates using routinely collected morbidity data, the opportunity now exists for health services to compare the performance of clinical services both within and between hospitals. It is also suggested that the basket of procedures identified in this study could form the basis of a national day only surgery benchmarking process.

Ambulatory Surgical Procedures↗
PubMed2000

Benchmarking in health-system pharmacy: experience at Glens Falls Hospital.

The experience of Glens Falls Hospital (GFH) with the Benchmarking Program coordinated by The Clinical Pharmacokinetics Laboratory at Millard Fillmore Hospital is described. GFH, a community hospital in upstate New York with 442 licensed beds, serves a patient population drawn from a five-county area. In 1998, GFH developed a multidisciplinary pharmacy task force charged with generating strategic initiatives for curtailing drug costs. Proposals for various programs, including specific goals, were developed with the aid of trends reported in the individual hospital reports provided by the Benchmarking Program. The data obtained through these reports helped GFH's pharmacy staff establish goals for the appropriate use of many agents, including vancomycin, and allowed GFH to assess the impact of its initiatives through comparisons with similar hospitals across the United States. In 1995, vancomycin expenditures at GFH substantially exceeded those for benchmark hospitals of similar types, but, with the implementation of new vancomycin guidelines aimed at reducing inappropriate use in 1996, the difference was eliminated. The individual hospital reports generated by the Benchmarking Program provide valuable data that can be used to assess pharmacy performance, set drug expenditure goals, and design programs to reduce antimicrobial resistance.

Benchmarking↗
PubMed2000

Benchmarking in health-system pharmacy: experience at MeritCare Medical Center.

The experience of MeritCare Medical Center (MMC) with the Benchmarking Program coordinated by The Clinical Pharmacokinetics Laboratory at Millard Fillmore Hospital is described. MMC is a community-based teaching institution in Fargo, North Dakota, that serves patients in North Dakota, South Dakota, and Minnesota. MeritCare began participating in the Benchmarking Program in 1997. Data from the individual hospital report raised concern about the high cost of antimicrobials at MMC relative to peer-group institutions. The staff conducted an evaluation of antimicrobial prophylaxis for noncardiovascular surgery, concluded that cefazolin use was suboptimal, and attempted to encourage more cost-effective utilization. MMC's participation in the Benchmarking Program also prompted more appropriate use of various other antimicrobial agents, including i.v. and oral ciprofloxacin. An i.v.-to-oral switching program was begun for various agents. Preliminary analysis after 15 months demonstrated direct cost savings for drug acquisition of $60,000 to $80,000 per year and a reduced length of stay. Initiatives undertaken by MeritCare on the basis of data obtained through the Benchmarking Program resulted in substantial estimated savings in drug acquisition costs.

Anti-Bacterial Agents↗
PubMed2025

DARKIN: a zero-shot benchmark for phosphosite-dark kinase association using protein language models.

MOTIVATION: Protein language models (pLMs) have emerged as powerful tools for capturing the intricate information encoded in protein sequences, facilitating various downstream protein prediction tasks. With numerous pLMs available, there is a critical need for diverse benchmarks to systematically evaluate their performance across biologically relevant tasks. Here, we introduce DARKIN, a zero-shot classification benchmark designed to assign phosphosites to understudied kinases, termed dark kinases. Kinases, which catalyze phosphorylation, are central to cellular signaling pathways. While phosphoproteomics enables the large-scale identification of phosphosites, determining the cognate kinase responsible for the phosphorylation event remains an experimental challenge. RESULTS: In DARKIN, we prepared training, validation, and test folds that respect the zero-shot nature of this classification problem, incorporating stratification based on kinase groups and sequence similarity. We evaluated multiple pLMs using two zero-shot classifiers: a novel, training-free k-NN-based method, and a bilinear classifier. Our findings indicate that ESM, ProtT5-XL, and SaProt exhibit superior performance on this task. DARKIN provides a challenging benchmark for assessing pLM efficacy and fosters deeper exploration of under-characterized (dark) kinases by offering a biologically relevant test bed. AVAILABILITY AND IMPLEMENTATION: The DARKIN benchmark data and the scripts for generating additional splits are publicly available at: https://github.com/tastanlab/darkin.

Protein Kinases↗
PubMedDate not supplied

Benchmarking: your performance measurement and improvement tool.

Many respected professional healthcare organizations and societies today are seeking to establish data-driven performance measurement strategies such as benchmarking. Clinicians are, however, resistant to "benchmarking" that is based on financial data alone, concerned that it may be adverse to the patients' best interests. Benchmarking of clinical procedures that uses physician's codes such as Current Procedural Terminology (CPTs) has greater credibility with practitioners. Better Performers, organizations that can perform procedures successfully at lower cost and in less time, become the "benchmark" against which other organizations can measure themselves. The Better Performers' strategies can be adopted by other facilities to save time or money while maintaining quality patient care.

Benchmarking↗
PubMedDate not supplied

The development of a benchmarking system for a cancer patient population.

Benchmarking, while a useful way to compare outcomes among health care institutions, has been less useful for institutions dealing with specialty patient populations such as cancer, rehabilitation, or psychiatry. Because of regulatory requirements mandating the use of benchmarking for accreditation and performance improvement purposes, a group of comprehensive cancer centers developed a specialized database for benchmarking outcomes for cancer patients. This article describes the development of the database and some of the obstacles encountered by the group. It also outlines solutions to the obstacles. Key words: benchmarking, cancer, quality

Benchmarking↗
PubMed1998

Using videotaped benchmarks to improve the self-assessment ability of family practice residents.

PURPOSE: To address methodologic and statistical problems of previous studies of self-assessment by exposing participants to relevant standards, anchoring rating scales, and providing practice in the use of the assessment tool. METHOD: Fifty first- and second-year family practice residents performed a ten-minute patient interview with a difficult communication problem. Following each interview, the resident and two experts independently evaluated the resident's communication skills. The resident was then shown a videotape of four performances (ranging in quality from poor to good) of the same scenario. The resident evaluated the communication skills displayed in each performance and then reevaluated his or her own performance. RESULTS: The correlation between experts' evaluations and residents' self-evaluations was moderate immediately after the interview (r = 0.38) but increased significantly after the residents viewed the videotape (r = 0.52). This effect was more pronounced for first-year residents (0.22 to 0.45) than for second-year residents (0.53 to 0.65), although the difference was not significant. Post-hoc analysis revealed that neither initial nor post-benchmark self-assessment ability was related to the ability to accurately evaluate the benchmarks in a manner consistent with the experts. CONCLUSIONS: The ability to self-assess does not seem strongly tied to the ability to assess the performances of others on the same task. Nonetheless, providing a set of benchmarks against which trainees can compare their own performances improves their ability to self-evaluate even if the qualities of the benchmarks are not explicitly identified.

Adult↗
PubMedDate not supplied

The 1999 National Pressure Ulcer Prevalence Survey: a benchmarking approach.

OBJECTIVE: Health care professionals are faced with the ongoing challenge of improving performance. From physicians and nurses to process improvement experts, health care professionals are discovering new approaches to increasing the overall effectiveness of procedures used in clinical areas. One way to collect data useful for benchmarking specific clinical practices is through the use of prevalence studies. DESIGN: A 1-day pressure ulcer prevalence survey was performed in March 1999. Acute care facilities across the United States volunteered to participate in the data collection process. Patients' demographic information, pressure ulcer stages, locations, and support surfaces were noted. SETTING: 356 acute care facilities. PARTICIPANTS: 42,817 patients. RESULTS: The overall pressure ulcer prevalence was 14.8%, with a nosocomial pressure ulcer prevalence of 7.1%. CONCLUSIONS: Benchmarking is one of the tools that enables health care professionals to measure and identify inconsistencies in patient care practices. Understanding these inconsistencies enables the health care team to develop processes that are innovative and efficient. National pressure ulcer prevalence surveys provide a benchmark to evaluate an individual facility's care and treatment of patients at risk for pressure ulcer development. Success, however, lies in the health care professional's ability to take the information and apply it to clinical practice. Through the use of a benchmarking approach, performance gaps can be identified, processes can be put into place, and improved patient outcomes can be monitored and maintained.

Adolescent↗
PubMed2001

The ICCD benchmarks for clubhouses: a practical approach to quality improvement in psychiatric rehabilitation.

OBJECTIVE: The study evaluated whether the average performance of clubhouses certified by the International Center for Clubhouse Development (ICCD) should be considered valid benchmarks for clubhouse programs. METHODS: A representative sample of clubhouses more than three years old that were based on the Fountain House model participated in a 1998 mail survey. To verify that ICCD certification is a valid indicator of program quality for use in setting benchmark performance rates, 71 certified and 48 noncertified programs were compared on a variety of organizational variables. RESULTS: Even though certified and noncertified clubhouses were similar in organizational structure and resources, findings from a logistic regression analysis confirmed that certified clubhouses provided a wider array of rehabilitation services and achieved higher rates of employment. CONCLUSIONS: The findings suggest that ICCD certification is a valid indicator of program quality. The ICCD has therefore proposed that the average performance of certified U.S. clubhouses in specific domains be adopted as benchmarks for organizational performance. When tailored for programs in particular regions and with specific levels of funding, the ICCD benchmarks for clubhouse performance set fair and reasonable expectations for clubhouse programs and for the design of performance contracts between departments of mental health and ICCD clubhouses.

Benchmarking↗