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PubMed2000

Regional variation in varicose vein operations in England 1989-1996.

AIM: To determine accuracy of Office of Population Censuses and Surveys (OPCS) codes for varicose vein (VV) operations and differences in regional activity over 7 years. METHODS: OPCS codes were obtained for VV operations (L85, L87) for the 8 English regions 1989/90-1995/96. Data were also obtained for the 4 districts of the old Oxford Region. Centrally collected codes for one hospital were compared with audit data from the same hospital. RESULTS: There was a marked inter-regional variation in VV activity, e.g. in 1995/96 the range of operations/100,000 population was 102 (Anglia & Oxford) to 138 (West Midlands). There was a gradual increase in the number of operations carried out nationally from 98/100,000 in 1989/90 to 121/100,000 in 1995/96. The numbers peaked in 1991/92, coinciding with a 'waiting list initiative'. When compared with audit data, accuracy of coding improved throughout the study period. There was a 55% inaccuracy in 1989/90 compared with 2% in 1995/96. In each year, codes overestimated the volume of work actually carried out. CONCLUSION: OPCS codes broadly reflect VV activity. Difference in VV activity in different parts of the country are apparent.

Documentation↗
PubMed2006

Evidence for electronic health record systems in physical therapy.

With increasing pressures to better manage clinical information, we investigated the role of electronic health record (EHR) systems in physical therapist practice through a critical review of the literature. We reviewed studies that met our predefined criteria after independent review by 3 authors. The investigators in all of the reviewed studies reported benefits, including improved reporting, operational efficiency, interdepartmental communication, data accuracy, and capability for future research. In 7 studies, the investigators reported barriers, including challenges with behavior modification, equipment inadequacy, and training. The investigators in all studies reported key success factors, including end-user participation, adequate training, workflow analysis, and data standardization. This review suggests that EHRs have potential benefits for physical therapists. The authors formed the following recommendations based on the studies' themes: (1) incorporate workflow analysis into system design and implementation; (2) include end users, especially clinicians, in system development; (3) devote significant resources for training; (4) plan and test carefully to ensure adequate software and hardware performance; and (5) commit to data standards.

Data Collection↗
PubMed2004

Collection and integration of clinical data for surveillance.

OBJECTIVE: The syndromic surveillance project at Public Health-Seattle & King County incorporates several data sources, including emergency department and primary care visit data collected and normalized through an automated mechanism. We describe significant changes made in this "second generation" of our system to improve data quality while complying with privacy and state public health reporting regulations. METHODS/RESULTS: The system uses de-identified visit and patient numbers to assure data accuracy, while shielding patient identity. Presently, we have 124,000 basic visit records (used to generate stratified denominators), and 29,000 surveillance records, from four emergency departments and a primary care clinic network. The system is capable of producing syndrome-clustered data sets for analysis. DISCUSSION: We have incorporated data collection techniques such as automated querying, report parsing, and HL7 electronic data interchange. We are expanding the system to include greater population coverage, and developing an understanding how to implement data collections more rapidly at individual hospital sites, as well as how best to prepare the data for analysis.

Bioterrorism↗
PubMed2001

Perceptual interactions of facial dimensions in speeded classification and identification.

The representation underlying the identification and classification of semirealistic line drawings taken from a computer model of the face was investigated by using a speeded classification task and an identification task. These data were analyzed by using a multidimensional extension of signal detection theory, within which varieties of perceptual interactions between dimensions within and across stimuli can be characterized. The dimensions of interest here were eye separation, nose length, and mouth width. The response time and accuracy data from the speeded classification task suggest that processing of a given feature did depend on whether other features were present or absent, but given that other features were present, the results strongly support separability (a macrolevel, across-stimulus form of invariance) for all pairs of facial dimensions used. This separability was confirmed by the subsequent identification task. Owing to its greater resolution, the identification task can reveal interactions that might exist at more microlevels of processing. In fact, the identification data did indicate the presence of perceptual dependence between facial dimensions within a stimulus when the dimensions that were varied were close in spatial proximity (i.e., eye separation and nose length). Within the theoretical framework, perceptual dependence can be interpreted as correlated noise between otherwise separate channels (and hence, is logically distinct from separability). This dependence was greatly reduced for dimensions that were more distant (eyes and mouth). The relation between these results and the configural effects that have been observed with faces as stimuli in other studies is discussed.

Adult↗
PubMed2026

The application of artificial intelligence in healthcare practice: A mapping review of systematic reviews.

Artificial intelligence (AI) is rapidly transforming healthcare practice, with growing evidence supporting its use in diagnosis, prognosis, treatment planning, and operational decision-making. The proliferation of systematic reviews in recent years underscores the need for an updated synthesis of the literature to inform research, policy, and practice. We searched PubMed, Web of Science, Scopus, IEEE Xplore, and CINAHL for systematic reviews and meta-analyses published between 2019 and February 2026. Eligible reviews focused on AI applications in healthcare practice, were peer-reviewed, and written in English. A total of 368 reviews met the inclusion criteria. Publication volume increased steadily, peaking in 2025. AI research was concentrated in high-density domains, such as radiology, oncology, and critical care. Across reviews, diagnostic imaging, electronic health record (EHR) data, and biomarkers/laboratory results accounted for 68% of training data sources, though newer data types, such as wearable device and sensor data, emerged from 2022 onward. Diagnosis, prognosis, and treatment comprised over 80% of AI applications, with novel uses emerging in recent years, such as AI-assisted clinical documentation (e.g., ambient documentation tools) and patient education. Ethical concerns were reported in 78.5% of reviews, with privacy, model accuracy, data and algorithmic bias, and explainability as recurrent themes. The proportion of reviews reporting ethical concerns increased from 2021 to 2025. AI applications in healthcare are expanding in scope, diversifying in data sources, and evolving toward novel clinical and operational uses. The human-centered AI or augmented intelligence paradigm, integrating computational precision with clinical expertise, holds significant promise but will require parallel advances in governance, regulatory frameworks, and ethical oversight to ensure safe adoption.

Artificial Intelligence↗
PubMed1999

How OASIS data quality affects you!

In general, each of these methods require time and energy from staff members and therefore affect both clinicians and the home health agency. Because the assessor is usually a field nurse or therapist, field staff are very vulnerable to a top down audit approach unless staff are included in the development cycle to achieve a non-threatening quality improvement process. Furthermore, an understanding of the research concepts provides agencies with a creative opportunity to develop their own audit processes. In addition, these concepts offer an awareness as to why HCFA may have chosen the specific areas and methods they have recommended to use when identifying errors. HCFA encourages agencies to consider different methodologies and approaches and to use what works best in order to ensure data accuracy. This is one of the first times in which HCFA has given so much latitude to agencies and their staff. It is hoped that this article fosters interest and insight as to why field staff should actively become involved in audit processes that check their skills and accuracy, which directly correlates to such a huge impact on all involved. In order to improve reliability, an agency should try to minimize external sources of variation and standardize the conditions under which measurement occurs. Initial and ongoing training sessions for staff on each of the OASIS data elements can establish higher reliability and can be streamlined and targeted on areas that staff have the most questions and areas that audits indicate high error rates with data inaccuracies. It is important to remember that each OASIS question has been proven to be valid and reliable; therefore, the only variable left is the source, i.e., those who use the instrument to determine where data inaccuracies could be generated (the field assessor, data entry staff, vendor transmitters, etc.). Agencies should develop the audit functions that will best meet their needs, and minimize the workload for all involved in finding these data inaccuracies.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2005

The relationship between vocal pitch-matching skills and pitch discrimination skills in untrained accurate and inaccurate singers.

Few studies have compared the relationship between pitch discrimination accuracy and the accuracy of fundamental frequency (F(o)) control. This study investigated the relationship between vocal pitch-matching skills, which is one method of testing F(o) control, and pitch discrimination skills in untrained accurate and inaccurate singers, and the effect of timbre on their pitch discrimination accuracy. Data showed that accurate singers had more precise discrimination and pitch-matching abilities compared with their inaccurate counterparts. Pitch discrimination was differentially affected by the timbre (eg, spectral differences) of comparison tones. In addition, results showed a significant relationship between pitch discrimination abilities and pitch-matching accuracy. The results suggest that accurate F(o) control is at least partially dependent on pitch discrimination abilities, which are important for accurate singing.

Adult↗
PubMed1999

Use of bar code readers and programmable keypads to improve the speed and accuracy of manual data entry in the clinical microbiology laboratory: experience of two laboratories.

AIM: To assess the effect of the use of bar code readers and programmable keypads for entry of specimen details and results in two microbiology laboratories. METHODS: The solutions selected in each laboratory are described. The benefits resulting from the implementation were measured in two ways. The speed of data entry and error reduction were measured by observation. A questionnaire was completed by users of bar codes. RESULTS: There were savings in time and in reduced data entry errors. Average time to enter a report by keyboard was 21.1 s v 14.1 s for bar coded results entry. There were no observed errors with the bar code readers but 55 errors with keystroke entries. The laboratory staff of all grades found the system fast, easy to use, and less stressful than conventional keyboard entry. CONCLUSIONS: Indirect time savings should accrue from the observed reduction in incorrectly entered data. Any microbiology laboratory seeking to improve the accuracy and efficiency of data entry into their laboratory information systems should consider the adoption of this technology which can be readily interfaced to existing terminals.

Consumer Behavior↗
PubMedDate not supplied

Development of a three-dimensional color Doppler system.

An unprecedented assembly of a three-dimensional (3D) color Doppler system was arranged for the purpose of producing and displaying precisely calculated and recorded 3D color flow mapping images of fetal and umbilical vessels. Data accuracy and quality were enhanced by a computer controlled probe positioner. Scanning was across any of three perpendicular planes to collect serial slice images in any position and interval width. The series of parallel images was digitized in a color imaging processor by a 3D reconstruction program. Analyzed data were transferred to work stations for immediate processing into 3D form and display. The resulting 3D display was a solid model image of umbilical vessels which could be rotated in real time. In addition to the clear information about the vessel's structure, hemodynamics were apparent.

Female↗
PubMed1981

Evaluation of two electronic respiratory rate monitoring systems.

Two electronic systems for monitoring respiratory rates in critical care patients were evaluated--one a system using impedance sensors and the other a system using thermistor sensors. The thermistor sensor, attached to a nasal cannula or air-entrainment mask, was connected to a sensitivity calibrating control and a digital display module. The impedance system consisted of three electrocardiogram chest leads connected to an identical digital display module. Each of 10 patients was simultaneously monitored by both systems; indicated rates from the two systems were then compared to a counted control rate to determine accuracy. Data were collected at 17 successive half-hour intervals. Analysis of variance of the data gave a significant F ratio for differences among the three methods of rate monitoring. The impedance system gave readings progressively higher and the thermistor system gave readings progressively lower than the counted control rates. This study indicates that this configuration for both impedance and thermistor sensing lacks the desired accuracy for respiratory rate monitoring but may be suitable for apnea alarms.

Evaluation Studies as Topic↗
PubMed2006

Quality assurance in a large clinical trials consortium: the experience of the Tuberculosis Trials Consortium.

Quality assurance (QA) is essential for data accuracy and proper evaluation of study objectives in clinical trials. The Tuberculosis Trials Consortium (TBTC)-a collaboration of 28 clinical sites and the Centers for Disease Control and Prevention-has developed a comprehensive QA program that provides quantitative assessments of performance based on clearly defined standards that are communicated to data collectors through a feedback process. The Implementation and Quality Committee of the TBTC developed a Site Evaluation Report (SER) that assesses performance measures (PMs) critical to the accomplishment of study objectives. PMs are defined, quantified, and evaluated, and goals and minimum acceptable scores are specified. Sites not meeting a PM minimum must provide an explanation and develop a plan to meet the goal. Site-specific and system-wide problems can be readily identified through this process. The SER is used prospectively for all TBTC treatment trials, and a Web site has been developed to maximize the availability and usefulness of performance data. The TBTC's comprehensive QA program is an example of a successful method for ensuring high quality, evaluable data.

Antitubercular Agents↗
PubMed1989

Kinetic depth effect and identification of shape.

We introduce an objective shape-identification task for measuring the kinetic depth effect (KDE). A rigidly rotating surface consisting of hills and valleys on an otherwise flat ground was defined by 300 randomly positioned dots. On each trial, 1 of 53 shapes was presented; the observer's task was to identify the shape and its overall direction of rotation. Identification accuracy was an objective measure, with a low guessing base rate of the observer's perceptual ability to extract 3D structure from 2D motion via KDE. (1) Objective accuracy data were consistent with previously obtained subjective rating judgments of depth and coherence. (2) Along with motion cues, rotating real 3D dot-defined shapes inevitably produced a cue of changing dot density. By shortening dot lifetimes to control dot density, we showed that changing density was neither necessary nor sufficient to account for accuracy; motion alone sufficed. (3) Our shape task was solvable with motion cues from the 6 most relevant locations. We extracted the dots from these locations and used them in a simplified 2D direction-labeling motion task with 6 perceptually flat flow fields. Subjects' performance in the 2D and 3D tasks was equivalent, indicating that the information processing capacity of KDE is not unique. (4) Our proposed structure-from-motion algorithm for the shape task first finds relative minima and maxima of local velocity and then assigns 3D depths proportional to velocity.

Adult↗
PubMed2001

"You ate all that!?": caretaker-child interaction during children's assisted dietary recall interviews.

Young children's dietary recalls generally are conducted with a guardian present, but how this contributes to data accuracy is unclear. Furthermore, some assumptions underlying the preference for guardian presence may be unfounded. To investigate the range of guardian-child interactions within the diet recall setting, we examined transcriptions of guardian-assisted recalls conducted with 34 children aged 7-11 whose households were enrolled with the San Diego site of the Olestra Post-Marketing Surveillance Study (OPMSS). Although guardians did add to the breadth of data collected, children were quite knowledgeable about their diets. Moreover, they sometimes rejected guardian suggestions, and guardians generally could not provide assistance when children requested it. Guardian-child negotiations reflected cultural understandings regarding children, caretaking, and guardian-child power structures as well as food, and sometimes interviewers had to make very subjective data classification decisions. Suggestions for improving dietary recall methods are provided. Findings are relevant for other research methods involving children.

Adult↗
PubMed2004

Development and validation of methods for assessing the quality of diagnostic accuracy studies.

OBJECTIVES: To develop a quality assessment tool which will be used in systematic reviews to assess the quality of primary studies of diagnostic accuracy. DATA SOURCES: Electronic databases including MEDLINE, EMBASE, BIOSIS and the methodological databases of both CRD and the Cochrane Collaboration. REVIEW METHODS: Three systematic reviews were conducted to provide an evidence base for the development of the quality assessment tool. A Delphi procedure was used to develop the quality assessment tool and the information provided by the reviews was incorporated into this. A panel of nine experts in the area of diagnostic accuracy studies took part in the Delphi procedure to agree on the items to be included in the tool. Panel members were also asked to provide feedback on various other items and whether they would like to see the development of additional topic and design specific items. The Delphi procedure produced the quality assessment tool, named the QUADAS tool, which consisted of 14 items. A background document was produced describing each item included in the tool and how each of the items should be scored. RESULTS: The reviews produced 28 possible items for inclusion in the quality assessment tool. It was found that the sources of bias supported by the most empirical evidence were variation by clinical and demographic subgroups, disease prevalence/severity, partial verification bias, clinical review bias and observer/instrument variation. There was also some evidence of bias for the effects of distorted selection of participants, absent or inappropriate reference standard, differential verification bias and review bias. The evidence for the effects of other sources of bias was insufficient to draw conclusions. The third review found that only one item, the avoidance of review bias, was included in more than 75% of tools. Spectrum composition, population recruitment, absent or inappropriate reference standard and verification bias were each included in 50-75% of tools. Other items were included in less than 50% of tools. The second review found that the quality assessment tool should have the potential to be discussed narratively, reported in a tabular summary, used as recommendations for future research, used to conduct sensitivity or regression analyses and used as criteria for inclusion in the review or a primary analysis. This suggested that some distinction is needed between high- and low-quality studies. Component analysis was considered the best approach to incorporate quality into systematic reviews of diagnostic studies and this was taken into consideration when developing the tool. CONCLUSIONS: This project produced an evidence-based quality assessment tool to be used in systematic reviews of diagnostic accuracy studies. Through the various stages of the project the current lack of such a tool and the need for a systematically developed validated tool were demonstrated. Further work to validate the tool continues beyond the scope of this project. The further development of the tool by the addition of design- and topic-specific criteria is proposed.

Delphi Technique↗
PubMed2004

Accurate identification of adverse outcomes after cervical spine surgery.

BACKGROUND: Retrospective clinical studies frequently utilize surgeon records as a source of outcomes data. The accuracy of data derived from surgeon records, however, is unknown. The purpose of the present study was to evaluate the accuracy of surgeon records in documenting the prevalence of subjective adverse outcomes. METHODS: Consecutive patients who had undergone anterior cervical arthrodesis by four spine surgeons during a ten-month period were included. Surgeon records from the routine six-week, three-month, and six-month postoperative visits were examined for documentation of persistent dysphagia and dysphonia. Patients completed surveys inquiring about the presence and magnitude of symptoms at these three time-points. Agreement between the surgeon records and the patient surveys was analyzed with use of the kappa coefficient. RESULTS: One hundred and sixty-six patients had 342 postoperative visits. Dysphagia was documented twenty-six times in the surgeon records, compared with 107 times on the patient surveys. Dysphagia was thus underreported in 80% of cases. Similarly, dysphonia was documented ten times in the surgeon records, compared with seventy-two times on the patient surveys. Poor correlation between the surgeon records and the patient surveys was observed regardless of symptom severity, previous anterior cervical surgery, anterior arthrodesis of three motion segments or more, arthrodesis cephalad to the fifth cervical level, and anterior cervical plate use. Poor correlation between the surgeon records and the patient surveys also was observed for each surgeon, regardless of subspecialty or institution. CONCLUSIONS: Correlation between the surgeon records and the patient surveys was consistently poor, regardless of the specific patient and surgeon factor analyzed. While we chose to study dysphonia and dysphagia, it is conceivable that the results may be generalizable to many situations in which office notes are utilized to ascertain the prevalence of subjective adverse outcomes. These results suggest that the prevalence of such outcomes may be seriously underreported in studies that rely on the retrospective analysis of surgeon records.

Adolescent↗
PubMed1990

Determination of volatile organics in drinking water with USEPA method 524.2 and the ion trap detector.

New drinking water regulations require the monitoring of eight volatile organic compounds that have established maximum contaminant levels (MCLs) and 51 other volatile organics for which MCLs are not established. A laboratory analytical method (Method 524.2) for the determination of 58 of these compounds is investigated, and precision and accuracy data are obtained. The method uses a standard inert gas purge extraction, isolation of the volatile organics on a three-stage solid-phase trap, thermal desorption into a gas chromatograph, separation with a fused-silica capillary column, and identification and measurement with a relatively low cost, benchtop ion trap detector that functions as a mass spectrometer. At a concentration of 2 micrograms/L (2 parts per billion), the grand mean measurement accuracy for 54 compounds was 95% of the true value with a mean relative standard deviation (RSD) of 4%. At 0.2 micrograms/L (200 parts per trillion), the grand mean measurement accuracy for 52 compounds was 95% of the true value with a mean RSD of 3%.

Gas Chromatography-Mass Spectrometry↗
PubMed1998

Validation of an electronic, population-based prescription database.

BACKGROUND: The Drug Programs Information Network (DPIN), Manitoba's (Canada) new electronic prescription database, is a valuable data source for pharmacoepidemiologic research. Pharmacies are required to submit to the DPIN all prescriptions for Pharmacare, the province's drug insurance plan, but submission of prescriptions for social assistance recipients and treaty status Indians is discretionary. OBJECTIVE: The completeness of the DPIN prescription database was assessed to determine whether treaty status Indians and social assistance recipients were underrepresented. DESIGN: Prescriptions dispensed during March 13-17, 1995, in a stratified sample of Manitoba pharmacies were linked to DPIN by prescription number to determine the proportions submitted for Indian Affairs, Social Services, and Pharmacare recipients. Pharmacare records in the DPIN were compared with original pharmacy records to evaluate data accuracy. RESULTS: Of 2196 Indian Affairs and 1879 Social Services prescriptions dispensed in 58 pharmacies, a corresponding prescription was found in the DPIN for 79.7% (98% CI 78.0% to 81.4%) and 90.1% (98% CI 88.8% to 91.4%) of prescriptions, respectively. These proportions were significantly lower than the estimated proportion of Pharmacare prescriptions submitted (93%, 98% CI 92.4% to 93.6%). Ninety-two percent of 8012 DPIN Pharmacare prescriptions matched the original prescription on the drug name, quantity, and days' supply. CONCLUSIONS: This study established that the DPIN is a valid and reliable data source for studying prescription use among the majority of Manitoban residents. However, the DPIN database has differential validity and underrepresents prescriptions dispensed for the aboriginal population.

Databases, Factual↗
PubMed1992

Visual field differences for clockwise and counterclockwise mental rotation.

Geometric line drawings were presented to normal subjects in the left visual field (LVF) or right visual field (RVF) at various degrees of rotation from a centrally presented vertical standard. The task of the subject was to indicate with a reaction time (RT) response whether the laterally presented stimulus could be rotated into the vertical standard or if it was a rotated mirror image of the standard. In Study 1, an overall right hemisphere superiority was found for RT and accuracy on match trials. Most interestingly, interactions between Visual Field and Rotation Angle for the match accuracy data and between Visual Field and Direction of Rotation (clockwise or counterclockwise) for the match RT slopes were found. These interactions suggested that clockwise rotations were more readily performed in the LVF and counterclockwise rotations in the RVF, consistent with other literature for mental rotation. The purpose of Study 2 was to replicate this finding of visual field differences for rotation direction using a design in which direction and degree of rotation were varied orthogonally. No main effect of Visual Field was found. However, significant interactions between Visual Field and Rotation Angle were found for both RT and accuracy, confirming the presence of visual field differences for rotation direction in a new sample of subjects. These differences were discussed in terms of the possibly greater relevance of medially directed stimuli and a possible hemispheric bias for rotation direction, and in terms of interhemispheric transmission factors.

Adolescent↗