Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Error Sources”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,459 records · Page 81Linked to original sources

A critical analysis of some thyroid function tests.

The results of a comparative study of thyroid function tests are reported, the assay for PBI having been used for reference. The merits and sources of error of the Bio-Rad column test, Thyopac-4 test and T3-RIA test are discussed with reference to PBI. The correlation coefficients and the sources of error being taken into consideration, PBI represents a fairly reliable indicator of T4 values and recommends itself on these grounds as a basic routine procedure, the more so as it is simple, cheap and suited for automated analysis. In case of iodine contamination or of the necessity for a selective identification of the T4 factor, the T4 column test is equally reliable. The T3-RIA test will be valuable in special diagnostic problems.

Humans↗

Assuring the quality of high-stakes undergraduate assessments of clinical competence.

In the UK, and in many Commonwealth countries, a university degree is accepted by registration bodies as an indication of competence to practice as a PRHO or intern. Concerns have been raised that the quality of university examinations may not always be sufficient for such high-stakes decision-making. Assessments of clinical competence are subject to many potential sources of error. The search for standardization, and high validity and reliability, demands the identification and reduction of measurement errors and biases due to poor test design or variation in test items, judges, patients or examination procedures. Generalizability and other research studies have identified where the likely sources of error might arise and have been taken into account in the development of published guidelines on international best practice, which institutions should strive to follow. The purpose of this paper is to describe the development of the integrated final-year assessment of clinical competence at the University of Sheffield. The aim was to introduce a range of strategies to ensure the examination met the best practice guidelines. These included blueprinting the assessment to achieve a high degree of content validity; lengthening the examination by adding a written component to the OSCE component to ensure an adequate level of reliability; providing training and feedback for examiners and simulated patients; paying attention to item development; and providing statistical information to assist the examination committee in standard setting and decision-making. This evidence-based approach should be readily achievable by all medical schools.

Clinical Competence↗

Aflatoxin B1 in peanut meal reference materials: intercomparisons of methods.

The Community Bureau of Reference (BCR) is preparing a series of animal feed reference materials to provide a basis for analytical quality assurance for aflatoxin B1 analysis, a problem of particular importance in view of Community legislation. Before reference values can be assigned to the reference materials the major errors in the underlying measurements must be identified and reduced. This paper presents the results of two intercomparison exercises involving some 20 European laboratories who applied a wide variety of analytical methods. It is shown that the major source of error and discrepancy is connected with incomplete extraction and/or losses during clean-up and that, provided correction for recovery/background interference is made, many methods can achieve acceptable accuracy. Sources of error and their control are discussed, and essential details of the methods used are presented. It is concluded that analytical QA is more important than the use of standardized methods when a high degree of accuracy and comparability are required.

Aflatoxin B1↗

Cervical smears prepared by an automated device versus the conventional method. A comparative analysis.

An automated, fluid-based method for the preparation of cervical Papanicolaou smears/slides was compared to the conventional Papanicolaou smear (CPS) method used for the screening of neoplasia. We determined diagnostic agreement and sources of error for diagnostic disagreement. For 665 patients, one cervical sample was collected to make one CPS. The collection devices, a wooden Ayre spatula and endocervical brush, were rinsed into a vial with fluid medium to be processed in the automated device. All slides were distributed among five cytotechnologists in a blind fashion. Exact diagnostic agreement was 94.6%. The results were not statistically significant (P > or = .70, McNemar's test) but were clinically important, as evidenced by the detection of low grade lesions (LGL), during initial screening, on three slides prepared by the automated device but not on their matched-pair CPSs (0.5% of all specimens). After reevaluation, the three matched CPSs demonstrated LGL. Sources of diagnostic error on the CPSs were: air-drying artifact, obscuring blood/inflammation, crowding/overlapping of cells and/or absence of diagnostic cells. The only source of error in the automated-method smears was absence of diagnostic cells.

Adolescent↗

Errors in measuring sagittal arch kinematics of the human foot with digital fluoroscopy.

Although fluoroscopy has been used to evaluate motion of the foot during gait, the accuracy and precision of fluoroscopic measures of osseous structures of the foot has not been reported in the literature. This study reports on a series of experiments that quantify the magnitude and sources of error involved in digital fluoroscopic measurements of the medial longitudinal arch. The findings indicate that with a global distortion correction procedure, errors arising from image distortion can be reduced threefold to 0.2 degrees for angular measurements and to 0.1 mm for linear measures. The limits of agreement for repeated angular measures of the calcaneus and first metatarsal were +/-0.5 degrees and +/-0.6 degrees , indicating that measurement error was primarily associated with the manual process of digitisation. While the magnitude of the residual error constitutes about +/-2.5% of the expected 20 degrees of movement of the calcaneus and first metatarsal, out-of-plane rotation may potentially contribute the greatest source of error in fluoroscopic measures of the foot. However, even at the extremes of angular displacement (15 degrees ) reported for the calcaneum during running gait, the root mean square (RMS) error was only about 1 degrees . Thus, errors associated with fluoroscopic imaging of the foot appear to be negligible when compared to those arising from skin movement artefact, which typically range between 1.5 and 4 mm (equating to errors of 2 degrees to 17 degrees for angular measures). Fluoroscopy, therefore, may be a useful technique for analysing the sagittal movement of the medial longitudinal arch during the contact phase of walking.

Biomechanical Phenomena↗

Comparison of the microdosimetric event-size method and the twin-chamber method of separating dose into neutron and gamma components.

Microdosimetric measurements of event-size spectra, made with a proportional counter, are being used increasingly for separation of dose components in mixed n-gamma fields. Measurements in fields produced by 8.3 MeV deuteron bombardment of thick beryllium and deuterium targets were made in air and at 6 and 12 cm depth in water with a spherical tissue-equivalent (TE) proportional counter and with a pair of calibrated ion chambers (TE-TE and Mg-Ar). The dose results obtained with the two methods agree well for the neutron components, but the gamma components do not demonstrate consistent agreement. An important source of error in the microdosimetric method is the matching of the spectra measured at different gain settings to cover the large range of event sizes. The effect of this and other sources of error is analysed.

Gamma Rays↗

A framework for classifying factors that contribute to error in the emergency department.

The Institute of Medicine report in 1999 spurred a national movement in patient safety and focused attention on medical error as a significant cause of preventable injury and death. Throughout the past decade, the medical community has gradually acknowledged the fallibility of medical science and imperfections of our health care organizations. Before significant progress can be made to improve safety in health care, we must better understand the sources of error. This article is presented as one step in the process of change. A framework for classifying factors that contributed to errors identified in the emergency department (ED) is presented. The framework is, in its most basic form, a comprehensive checklist of all the sources of error uncovered in the course of investigating hundreds of cases referred to Stroger Hospital's emergency medicine quality assurance committee throughout the past decade. It begins with a look at error in the ED and then looks beyond the ED to examine error in the context of the wider health care system. It incorporates ideas found in safety engineering, transportation safety, human factors engineering, and our own experience in an urban, public, teaching hospital ED.

Clinical Competence↗

The variation in user drawn outlines on digital images: effects on quantitative autoradiography.

Variation in user outlines drawn to delineate neural regions is the only source of error added to autoradiographic images after the images have been digitized. By analyzing data compiled from many outlines drawn by several different investigators, it was demonstrated that this variation constitutes a major source of error affecting quantitative autoradiography. Both the gray level variation and average within a region, as well as the specific pixels included in an outline, were affected. However, using the intersection of multiple outlining attempts surrounding any given region and a consistent set of outlining criteria, it was possible to delineate a region which remained consistent from user to user. A technique for automating the consistent outlining process is discussed.

Animals↗

Identifying systematic errors in quantitative dynamic-susceptibility contrast perfusion imaging by high-resolution multi-echo parallel EPI.

Several obstacles usually confound a straightforward perfusion analysis using dynamic-susceptibility contrast-based magnetic resonance imaging (DSC-MRI). In this work, it became possible to eliminate some of these sources of error by combining a multiple gradient-echo technique with parallel imaging (PI): first, the large dynamic range of tracer concentrations could be covered satisfactorily with multiple echo times (TE) which would otherwise result in overestimation of image magnitude in the presence of noise. Second, any bias from T(1) relaxation could be avoided by fitting to the signal magnitude of multiple TEs. Finally, with PI, a good tradeoff can be achieved between number of echoes, brain coverage, temporal resolution and spatial resolution. The latter reduces partial voluming, which could distort calculation of the arterial input function. Having ruled out these sources of error, a 4-fold overestimation of cerebral blood volume and flow remained, which was most likely due to the completely different relaxation mechanisms that are effective in arterial voxels compared with tissue. Hence, the uniform tissue-independent linear dependency of relaxation rate upon tracer concentration, which is usually assumed, must be questioned. Therefore, DSC-MRI requires knowledge of the exact dependency of transverse relaxation rate upon tracer concentration in order to calculate truly quantitative perfusion maps.

Brain↗

Error propagation and scaling for tropical forest biomass estimates.

The above-ground biomass (AGB) of tropical forests is a crucial variable for ecologists, biogeochemists, foresters and policymakers. Tree inventories are an efficient way of assessing forest carbon stocks and emissions to the atmosphere during deforestation. To make correct inferences about long-term changes in biomass stocks, it is essential to know the uncertainty associated with AGB estimates, yet this uncertainty is rarely evaluated carefully. Here, we quantify four types of uncertainty that could lead to statistical error in AGB estimates: (i) error due to tree measurement; (ii) error due to the choice of an allometric model relating AGB to other tree dimensions; (iii) sampling uncertainty, related to the size of the study plot; (iv) representativeness of a network of small plots across a vast forest landscape. In previous studies, these sources of error were reported but rarely integrated into a consistent framework. We estimate all four terms in a 50 hectare (ha, where 1 ha = 10(4) m2) plot on Barro Colorado Island, Panama, and in a network of 1 ha plots scattered across central Panama. We find that the most important source of error is currently related to the choice of the allometric model. More work should be devoted to improving the predictive power of allometric models for biomass.

Biomass↗

Continuous registration of blood velocity and cardiac output with a hot-film anemometer probe, mounted on a Swan-Ganz thermodilution catheter.

In order to construct a catheter, capable of monitoring cardiac output, a specially designed double-conical hot-film anemometer probe was fastened at the tip of a Swan-Ganz thermodilution catheter. Common sources of error for most catheter velocity probes include difficult calibration, unknown velocity profile at the point of measurement and unknown position of the probe in this profile. By using mongrel dogs and in order to exclude these sources of error, the intermittent thermodilution method was used to in vitro calibrate the hot-film anemometer, which registered velocity continuously. A mean correlation coefficient between these two methods was found to be 0.886. A mean line of regression between thermodilution (abscissa) and anemometer (ordinate) had a slope of 0.796 +/- 0.223 (+/- SD) and a y-intercept of 24 +/- 14 ml/min/kg. The slope was significantly lower than one (t test, p less than 0.05) and the y-intercept significantly larger than zero (t test, p less than 0.02). As a control of the thermodilution method, electromagnetic flow in the ascending aorta was registered and a mean correlation coefficient of 0.967 found. The hot-film sensor itself can be used as thermodilution method with the hot-film anemometer's continuous registration of velocity.

Animals↗

Matrix effects in blood gas proficiency testing.

Materials currently used for blood gas proficiency testing are unlike whole blood in several obvious respects, which by definition introduces matrix effects as possible sources of error that can affect proficiency testing results. Data from recent College of American Pathologists surveys are reviewed and aqueous and fluorocarbon matrices for PO2 and PCO2 testing are compared. Closely related to matrix effects are other sources of error unique to proficiency testing samples, such as sample temperature and sample packaging. Proficiency testing programs are seriously hampered by not being able to use either whole blood or a better surrogate than is currently available. In particular, the use of aqueous materials has the potential to penalize participant laboratories unfairly in some cases and to turn proficiency testing into a meaningless exercise in others.

Bias↗

Real-time continuous measurement of right ventricular volume using a conductance catheter.

The authors propose using a multi-electrode conductance catheter to measure continuous right ventricular volume. True ventricular volume measurements are affected by four main sources of error. 1) field non-uniformity, 2) catheter curvature, 3) blood conductivity changes, and 4) leakage of current through surrounding tissues. Three-dimensional finite-element models were developed to investigate the effects of these sources of error and to devise schemes for correcting them. The models include an axisymmetric cylindrical model, a rectangular block model, and a heart model with left and right ventricular chambers. The heart model is built from conical primitives, with major dimensions derived from the literature. Finite-element simulations showed that volume measurements were underestimated due to field nonuniformity to as much as 1/25th actual volume in segments near the exciting electrodes. The extent of underestimation in a segment decreased with increasing distance of the segment from the exciting electrodes and increased for larger segmental volumes. Catheter curvature overestimated measured volume by as much as 4.5 times when the curvature was increased from 0.0 to 1.25 (from a straight catheter to a very curved one). The leakage of current through surrounding tissues overestimated volume by nearly 30%. The sensitivity of volume measurement to blood resistivity changes was found to be very high, at 70%. Correction factors established with the computer models compensate for field nonuniformity. Mathematical mapping of the curved catheter onto a fictitious straight catheter corrects for the catheter curvature error. Correction for both nonuniform field and catheter curvature allowed measurement of total ventricular volume with an error of 7%. Leakage current is determined by using different frequencies to build the catheter electric field and to separate tissue and blood resistance paths. Using this scheme, the percentage overestimation in volume measurement due to leakage could be determined with an accuracy of 85%. The proposed correction scheme for blood conductivity changes involves the in-vivo measurement of blood conductivity with the catheter itself. It was found that blood conductivity could be determined with insignificant error (< 0.5%) so long as the blood volume around the exciting electrodes had a radius of more than the electrode spacing.

Animals↗

An investigation of laser scanning techniques for quantifying changes in facial soft-tissue volume.

This paper describes a laser scanning technique to measure accurately changes in facial volume. Three potential sources of error were identified: the registration algorithm, the inherent accuracy of the scanner, and the natural minute-to-minute variability of the human face. In experiments performed to discover the relative magnitude and significance of each source of error, the performance of the registration algorithm was found to be limited by the accuracy of the data, being 1.6 cc, on average, measured over the entire face of a plaster model. Scan-to-scan variability in the shape of the human face was measured at 3.3 cc on average. We conclude that laser scanning is a simple, non-invasive, accurate, and reproducible means of assessing changes in facial volume.

Adult↗

Force from cat soleus muscle during imposed locomotor-like movements: experimental data versus Hill-type model predictions.

Muscle is usually studied under nonphysiological conditions, such as tetanic stimulation or isovelocity movements, conditions selected to isolate specific properties or mechanisms in muscle. The purpose of this study was to measure the function of cat soleus muscle during physiological conditions, specifically a simulation of a single speed of slow walking, to determine whether the resulting force could be accurately represented by a Hill-type model. Because Hill-type models do not include history-dependent muscle properties or interactions among properties, the magnitudes of errors in predicted forces were expected to reveal whether these phenomena play important roles in the physiological conditions of this locomotor pattern. The natural locomotor length pattern during slow walking, and the action potential train for a low-threshold motor unit during slow walking, were obtained from the literature. The whole soleus muscle was synchronously stimulated with the locomotor pulse train while a muscle puller imposed the locomotor movement. The experimental results were similar to force measured via buckle transducer in freely walking animals. A Hill-type model was used to simulate the locomotor force. In a separate set of experiments, the parameters needed for a Hill-type model (force-velocity, length-tension, and stiffness of the series elastic element) were measured from the same muscle. Activation was determined by inverse computation of an isometric contraction with the use of the same locomotor stimulus pattern. During the stimulus train, the Hill-type model fit the locomotor data fairly well, with errors < 10% of maximal tetanic tension. A substantial error occurred during the relaxation phase. The model overestimated force by approximately 30% of maximal tetanic tension. A nonlinear series elastic element had little influence on the force predicted by a Hill model, yet dramatically altered the predicted muscle fiber lengths. Further experiments and modeling were performed to determine the source of errors in the Hill-type model. Isovelocity ramps were constructed to pass through a selected point in the locomotor movement with the same velocity and muscle length. The muscle was stimulated with the same locomotor pulse train. The largest errors again occurred during the relaxation phase following completion of the stimulus. Stretch during stimulation caused the Hill model to underestimate the relaxation force. Shortening movements during stimulation caused the Hill model to overestimate the relaxation force. These errors may be attributed to the effects of movement on crossbridge persistence, and/or the changing affinity of troponin for calcium between bound and unbound crossbridges, neither of which is well represented in a Hill model. Other sources of error are discussed. The model presented represents the limit of accuracy of a basic Hill-type model applied to cat soleus. The model had every advantage: the parameters were measured from the same muscle for which the locomotion was simulated and errors that could arise in the estimation of activation dynamics were avoided by inverse calculation. The accuracy might be improved by compensating for the apparent effects of velocity and length on activation. Further studies are required to determine to what degree these conclusions can be generalized to other movements and muscles.

Animals↗

A spectral approach to analyzing slice selection in planar imaging: optimization for through-plane interpolation.

Interpolation between slices is necessary whenever reslicing a volume of data into a different coordinate frame. This may be done to view the data from different perspectives, to align data from different sessions, or to remove the effects of head movement in functional imaging studies. In this paper, issues surrounding slice-selection in two-dimensional imaging are examined in the context of through-plane interpolation and a spectral framework is introduced to describe the sources of error when interpolating between slices. This framework suggests that there is a trade-off between precision in localization, which requires high spatial frequencies, and interpolation, which requires a narrow spectrum of spatial frequencies. An analysis of the sources of error has lead to several approaches to reducing interpolation error including elimination of interslice gaps or making slices overlap, use of a slice profile with a narrower spatial frequency bandwidth such as a Gaussian profile, and use of high-order interpolation. The simulation and experimental data demonstrate significant reductions in interpolation error for these approaches.

Head↗

Hemocue, an accurate bedside method of hemoglobin measurement?

OBJECTIVE: Evaluate the accuracy of this bedside method to determine hemoglobin (Hb) concentration in general surgery over a wide range of Hb values and to determine potential sources of error. METHODS: Accuracy of Hb measurement using HemoCue (AB Leo Diagnostics, Helsinborg, Sweden) was assessed in 140 surgical blood samples using 7 HemoCue devices in comparison with a CO-Oximeter (IL 482, Instrumentation Laboratory, Lexington, MA). To analyze potential sources of error, packed red cells and fresh frozen plasma were reconstituted to randomized Hb levels of 2-18 g/dL. RESULTS: In the surgical blood samples, the Hb concentration determined by the CO-Oximeter (HbCOOX) ranged from 5.1 to 16.7 g/dL and the Hb concentration measured by HemoCue (HbHC) from 4.7 to 16.0 g/dL. Bias (HbCOOX - HbHC) between HbCOOX and HbHC was 0.6+/-0.6 g/dL (mean +/- SD) or 5.4+/-5.0% (p < 0.001). Also in the reconstituted blood, the bias between HbCOOX and HbHC was significant (0.2+/-0.3 g/dL or 2.1+/-3.2%; p < 0.001). The microcuvette explained 68% of the variability between HbCOOX and HbHC. HemoCue thus underestimates the Hb concentration by 2-5% and exhibits a 8-10 times higher variability with only 86.4% of HbHC being within +/- 10% of HbCOOX. CONCLUSION. Although the mean bias between HbCOOX and HbHC was relatively low, Hb measurement by HemoCue exhibited a significant variability. Loading multiple microcuvettes and averaging the results may increase the accuracy of Hb measurement by HemoCue.

Evaluation Studies as Topic↗

Variability of FVC and FEV1 due to technician, team, device and subject in an eight centre study: three quality control studies in SAPALDIA. Swiss Study on Air Pollution and Lung Disease in Adults.

Lung function testing of a random population sample in the eight SAPALDIA (Swiss study on air pollution and lung diseases in adults) centres had to be performed simultaneously, within one year, by eight teams and 23 technicians. We conducted quality control studies to test for technician, team and device related systematic measurement errors. To assess technician effects, each centre conducted a study involving 12-19 subjects. Two studies with 13 participants each addressed team and device effects. In all studies, volunteers repeatedly performed spirometry with different technicians or devices. Effects due to technician, team or device were estimated (analysis of variance). Neither "technician" within any of eight teams nor "team" accounted for significant differences of forced vital capacity (FVC) or forced expiratory volume in one second (FEV1). The Device Effect Study revealed 10% lower FVC values for device No. 1 due to a technical problem occurring during the test day but not in the main SAPALDIA study. Further investigations revealed potential hardware and software sources of error which are not recognizable by trained technicians. These studies gave no evidence for systematic errors due to technician, team or device during the main SAPALDIA study. However, they revealed potential sources of error in modern devices, which function as "black boxes". Manufacturers should improve spirometry software to further enhance the technicians' attempts at accurate assessment.

Adult↗