A Consensus-based Data Quality Assessment Model for Patient Reported Outcome Information in Digital Quality Measurement Programs

Quality measurement has been evolving to become more patient-focused and more meaningful in supporting quality improvement. Recent advancements in digital data and measurement standards have made this evolution possible, but this move to digital measurement presents several challenges despite its many benefits. Digital quality measures (dQMs) substantially reduce the computational burden of generating “quality” knowledge and improve the reliability of the measure scores they generate, however they rely on a very specific presentation of the electronic data to achieve the aforementioned benefits. Newer dQMs based on patient-reported outcomes (PROs) measured using patient-reported outcome measures (PROMs) have been gaining attention as they generate valuable insight into a person’s perception of their own health status. Reliably capturing these insights is challenging however, as the information does not often exist in a format that can be processed by a dQM. This lack of standardization has resulted in the formation of clinical data repositories (CDRs) for the explicit purpose of extracting, transforming, and loading (ETL) PROM data from patients’ medical records into a format that can support digital quality measurement. These ETL processes are subject to rigorous evaluation to ensure that, as the information is being transformed, the integrity of the original information is being preserved. These evaluations inform decisions regarding data fitness for the specific purpose of using the data to measure quality of care. These “fit for purpose” decisions are not guided by a uniform set of expectations or requirements to assure consistency in decision-making, rather they frequently rely upon a variety of statistical and operational test results that can often present seemingly inconsistent information that requires substantial expertise to interpret and reconcile. A uniform, well-defined list of data quality concepts pertinent to using patient-reported outcome measures for the purpose of quality measurement would provide much needed guidance and enhance the consistency and reliability of data fitness decision-making. This research confirmed the scarcity of access to effective guidance for assessing fitness of PROM data and that there is a desire for a standard PROM-based data quality assessment (DQA) model to support decision making

Proactive and Integrated Management and Empowerment in Parkinson’s Disease:designing a new model of care

Contains fulltext : 218585.pdf (publisher's version ) (Open Access

Pediatric immunization-related safety incidents in primary care: A mixed methods analysis of a national database.

Background: Children are scheduled to receive 18–20 immunizations before their 18th birthday in England and Wales; this approximates to 13 million vaccines administered per annum. Each immunization represents a potential opportunity for immunization-related error and effective immunization is imperative to maintain the public health benefit from immunization. Using data from a national reporting system, this study aimed to characterize pediatric immunization-related safety incident reports from primary care in England and Wales between 2002 and 2013. Methods: A cross-sectional mixed methods study was undertaken. This comprised reading the free-text of incident reports and applying codes to describe incident type, potential contributory factors, harm severity, and incident outcomes. A subsequent thematic analysis was undertaken to interpret the most commonly occurring codes, such as those describing the incident, events leading up to it and reported contributory factors, within the contexts they were described. Results: We identified 1745 reports and most (n = 1077, 61.7%) described harm outcomes including three deaths, 67 reports of moderate harm and 1007 reports of low harm. Failure of timely vaccination was the potential cause of three child deaths from meningitis and pneumonia, and described in a further 113 reports. Vaccine administration incidents included the wrong number of doses (n = 476, 27.3%), wrong timing (n = 294, 16.8%), and wrong vaccine (n = 249, 14.3%). Documentation failures were frequently implicated. Socially and medically vulnerable children were commonly described. Conclusion: This is the largest examination of reported contributory factors for immunization-related patient safety incidents in children. Our findings suggest investments in IT infrastructure to support data linkage and identification of risk predictors, development of consultation models that promote the role of parents in mitigating safety incidents, and improvement efforts to adapt and adopt best practices from elsewhere, are needed to mitigate future immunization-related patient safety incidents. These priorities are particularly pressing for vulnerable patient groups.8 page(s

A Consensus-based Data Quality Assessment Model for Patient Reported Outcome Information in Digital Quality Measurement Programs

Quality measurement has been evolving to become more patient-focused and more meaningful in supporting quality improvement. Recent advancements in digital data and measurement standards have made this evolution possible, but this move to digital measurement presents several challenges despite its many benefits. Digital quality measures (dQMs) substantially reduce the computational burden of generating “quality” knowledge and improve the reliability of the measure scores they generate, however they rely on a very specific presentation of the electronic data to achieve the aforementioned benefits. Newer dQMs based on patient-reported outcomes (PROs) measured using patient-reported outcome measures (PROMs) have been gaining attention as they generate valuable insight into a person’s perception of their own health status. Reliably capturing these insights is challenging however, as the information does not often exist in a format that can be processed by a dQM. This lack of standardization has resulted in the formation of clinical data repositories (CDRs) for the explicit purpose of extracting, transforming, and loading (ETL) PROM data from patients’ medical records into a format that can support digital quality measurement. These ETL processes are subject to rigorous evaluation to ensure that, as the information is being transformed, the integrity of the original information is being preserved. These evaluations inform decisions regarding data fitness for the specific purpose of using the data to measure quality of care. These “fit for purpose” decisions are not guided by a uniform set of expectations or requirements to assure consistency in decision-making, rather they frequently rely upon a variety of statistical and operational test results that can often present seemingly inconsistent information that requires substantial expertise to interpret and reconcile. A uniform, well-defined list of data quality concepts pertinent to using patient-reported outcome measures for the purpose of quality measurement would provide much needed guidance and enhance the consistency and reliability of data fitness decision-making. This research confirmed the scarcity of access to effective guidance for assessing fitness of PROM data and that there is a desire for a standard PROM-based data quality assessment (DQA) model to support decision making

Pharmacological intervention of the reward system in the laying hen has an impact on anticipatory behaviour

Valid reliable indicators of positive affective state are a critical component of welfare assessments, however, these are currently lacking for laying hens. Pharmacological interventions that disrupt specific neural pathways have shown to be a useful tool when validating indicators of affective states. As such, we utilised and validated the μ-opioid receptor antagonist nalmefene to block the reward pathway in laying hens

Towards a Formal Treatment of Logic Locking

Logic locking aims to protect the intellectual property of a circuit from a fabricator by modifying the original logic of the circuit into a new “locked” circuit such that an entity without the key should not be able to learn anything about the original circuit. While logic locking provides a promising solution to outsourcing the fabrication of chips, unfortunately, several of the proposed logic locking systems have been broken. The lack of established secure techniques stems in part from the absence of a rigorous treatment toward a notion of security for logic locking, and the disconnection between practice and formalisms. We seek to address this gap by introducing formal definitions to capture the desired security of logic locking schemes. In doing so, we investigate prior definitional efforts in this space, and show that these notions either incorrectly model the desired security goals or fail to capture a natural “compositional” property that would be desirable in a logic locking system. Finally we move to constructions. First, we show that universal circuits satisfy our security notions. Second, we show that, in order to do better than universal circuits, cryptographic assumptions are necessary

Trail-makers of the middle border /

1st ed. Cf. Johnson.Johnson, M. de V. First editions (4th ed.),Mode of access: Internet.spec: On half-title: "Inscribed for B.R. Donaldson with the holiday greetings of the author, Hamlin Garland. Sincerely yours, Constance H. Garland." With ink illustration by C. Garland. Bookplate laid in: "Ex libris Ben R. Donaldson," with motto: "Tradition fades but the written record remains ever fresh.