Setting quality improvement priorities for women receiving systemic therapy (ST) for early stage breast cancer (EBC) using population level administrative data.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 299-299
Author(s):  
Katherine Enright ◽  
Lingsong Yun ◽  
Alejandro Gonzalez ◽  
Melanie Powis ◽  
Nathan Taback ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Administrative Data ◽  
Early Stage ◽  
Population Level ◽  
Secondary Prophylaxis ◽  
Absolute Difference ◽  
Ontario Cancer Registry ◽  
Institutional Variation ◽  
The Individual

299 Background: Routine evaluation of evidence informed quality measures (QM) can drive improvement in cancer systems by highlighting potential gaps in care. Targeting quality improvement at QMs that demonstrate substantial variation has the potential to make the largest impact on quality at a population level. We aimed to use variation in performance to set priorities for improving the quality of ST for women with EBC. Methods: EBC cases diagnosed 2006 – 2010 in Ontario, Canada were identified in the Ontario Cancer Registry and linked deterministically to multiple health care databases. A panel of QMs, previously developed to be operationalized for administrative data, was applied to reflect the quality of ST. Each QM was evaluated in all patients who met the inclusion criteria for the individual measure. QMs were ranked based on institutional variation in performance using the mean absolute difference (MAD). Results: We identified 28,303 patients, treated at 84 institutions. The performance of each QM is listed in Table 1. Timely receipt of ST, febrile neutropenia (FN) secondary prophylaxis, emergency room visits or hospitalizations, receipt of hormonal therapy (HT) and the use of surveillance imaging represented the 5 QM that demonstrated the greatest variation. Conclusions: Considerable institutional-level variation highlights potentially actionable areas of improvement [Table: see text]

Setting Quality Improvement Priorities for Women Receiving Systemic Therapy for Early-Stage Breast Cancer by Using Population-Level Administrative Data

2017 ◽  
Vol 35 (28) ◽  
pp. 3207-3214 ◽  
Author(s):  
Katherine A. Enright ◽  
Nathan Taback ◽  
Melanie Lynn Powis ◽  
Alejandro Gonzalez ◽  
Lingsong Yun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Quality Improvement ◽  
Systemic Therapy ◽  
Early Stage ◽  
Population Level ◽  
Early Stage Breast Cancer ◽  
System Level ◽  
Number Of Patients

Purpose Routine evaluation of quality measures (QMs) can drive improvement in cancer systems by highlighting gaps in care. Targeting quality improvement at QMs that demonstrate substantial variation has the potential to make the largest impact at the population level. We developed an approach that uses both variation in performance and number of patients affected by the QM to set priorities for improving the quality of systemic therapy for women with early-stage breast cancer (EBC). Patients and Methods Patients with EBC diagnosed from 2006 to 2010 in Ontario, Canada, were identified in the Ontario Cancer Registry and linked deterministically to multiple health care databases. Individual QMs within a panel of 15 QMs previously developed to assess the quality of systemic therapy across four domains (access, treatment delivery, toxicity, and safety) were ranked on interinstitutional variation in performance (using interquartile range) and the number of patients who were affected; then the two rankings were averaged for a summative priority ranking. Results We identified 28,427 patients with EBC who were treated at 84 institutions. The use of computerized physician electronic order entry for chemotherapy, emergency room visits or hospitalizations during chemotherapy, and timely receipt of chemotherapy were identified as the QMs that had the largest potential to improve quality of care at a system level within this cohort. Conclusion A simple ranking system based on interinstitutional variation in performance and patient volume can be used to identify high-priority areas for quality improvement from a population perspective. This approach is generalizable to other health care systems that use QMs to drive improvement.

scholarly journals Use of Electronic Administrative Databases to Measure Quality Indicators of Breast Cancer Care: Experience of Five Regional Oncology Networks in Italy

2020 ◽  
Vol 16 (2) ◽  
pp. e211-e220 ◽  
Author(s):  
Valentina Guarneri ◽  
Paolo Pronzato ◽  
Oscar Bertetto ◽  
Fausto Roila ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Indicators ◽  
Administrative Data ◽  
Population Level ◽  
Administrative Databases ◽  
Regional Variability ◽  
Care Experience ◽  
Italian Regions ◽  
Incident Cases

PURPOSE: Assuring quality of care, while maintaining sustainability, in complex conditions such as breast cancer (BC) is an important challenge for health systems. Here, we describe a methodology to define a set of quality indicators, assess their computability from administrative data, and apply them to a large cohort of BC cases. MATERIALS AND METHODS: Clinical professionals from the Italian Regional Oncology Networks identified 46 clinically relevant indicators of BC care; 22 were potentially computable using administrative data. Incident cases of BC diagnosed in 2016 in five Italian regions were identified using administrative databases from regional repositories. Each indicator was calculated through record linkage of anonymized individual data. RESULTS: A total of 15,342 incident BC cases were identified. Nine indicators were actually computable from administrative data (two structure and seven process indicators). Although most indicators were consistent with guidelines, for one indicator (blood tumor markers in the year after surgery, 44.2% to 64.5%; benchmark ≤ 20%), deviation was evident throughout the five regions, highlighting systematic overlooking of clinical recommendations. Two indicators (radiotherapy within 4 months after surgery if no adjuvant chemotherapy; 42% to 83.8%; benchmark ≥ 90%; and mammography 6 to 18 months after surgery, 55.1% to 72.6%; benchmark ≥ 90%) showed great regional variability and were lower than expected, possibly as result of an underestimation in indicator calculation by administrative data. CONCLUSION: Despite highlighting some limitations in the use of administrative data to measure health care performance, this study shows that evaluating the quality of BC care at a population level is possible and potentially useful for guiding quality improvement interventions.

Establishing achievable benchmarks for quality improvement in systemic therapy for early-stage breast cancer.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 263-263
Author(s):  
Melanie Powis ◽  
Alejandro Gonzalez ◽  
Rinku Sutradhar ◽  
Katherine Enright ◽  
Nathan Taback ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Improvement ◽  
Systemic Therapy ◽  
Early Stage ◽  
Quality Care ◽  
Early Stage Breast Cancer ◽  
High Quality ◽  
Eligibility Criteria ◽  
High Performing ◽  
The Individual

263 Background: Setting realistic targets for performance on quality indicators (QI) is a consistent challenge in quality improvement. The purpose of this study was to utilize administrative data to define achievable targets for QI in the early stage breast cancer (EBC) population in relation to systemic therapy (ST) delivery based on best performers. Methods: Deterministically linked administrative healthcare databases were used to identify EBC cases diagnosed 2006 – 2010 in Ontario, Canada. Panel of previously established QIs for systemic therapy was applied to patients who met eligibility criteria for the individual indicators. Institutions with less than 10 eligible patients for a specific indicator were excluded. An empiric benchmark was defined as the proportion of patients meeting the indicator from institutions accounting for the top decile of eligible patients. Results: We identified 28,303 EBC patients who received surgery of which 12,252 received adjuvant chemotherapy. Benchmark results are summarized in Table. Conclusions: Many institutions fell considerably below the benchmark. Further analysis of institution-level drivers of high quality care is required to help characterize high performing institutions. [Table: see text]

Reliability of administrative data for evaluating the quality of systemic treatment for cancer.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 208-208 ◽  
Author(s):  
Melanie Lynn Powis ◽  
Nathan Taback ◽  
Christina Diong ◽  
Katherine Enright ◽  
Christopher M. Booth ◽  
...  
Keyword(s):  
Administrative Data ◽  
Gold Standard ◽  
Validation Cohort ◽  
Systemic Treatment ◽  
Early Stage ◽  
Quality Measures ◽  
Administrative Databases ◽  
Study Cohort ◽  
Reliability Characteristics

208 Background: There is ongoing interest in leveraging administrative data to examine quality but methodological concerns persist. We evaluated the reliability of a previously established panel of administrative data derived quality measures for systemic cancer treatment. Methods: The study cohort consisted of women diagnosed with early stage (stage I-III) breast cancer (ESBC) in Ontario, Canada, in 2010. Performance on 11 quality indicators evaluated using deterministically linked healthcare administrative databases has been reported previously. The sensitivity and specificity of these 11 indicators were examined using the chart as the gold standard. Results: The administrative cohort consisted of 6,795 women with ESBC from which a validation cohort of 705 patients was randomly selected from among patients who underwent cancer surgery at one of five hospitals chosen to balance feasibility and institutional characteristics.Sensitivity and specificity varied by indicator (Table). Reliability of some indicators may have been affected by suboptimal chart documentation in instances where care spanned multiple settings or the medical record was fragmented, or where the number of eligible patients for that indicator was low. Conclusions: Administrative data can be used to evaluate quality of systemic cancer therapy but understanding the reliability characteristics of individual indicators is essential to inform their appropriate use and interpretation. [Table: see text]

scholarly journals Severity Estimation of Depression Using Convolutional Neural Network

2021 ◽  
Author(s):  
Attila Zoltán Jenei ◽  
Gábor Kiss
Keyword(s):  
Neural Network ◽  
Convolutional Neural Network ◽  
Early Stage ◽  
Correlation Structure ◽  
Acoustic Features ◽  
Convolutional Network ◽  
Severity Estimation ◽  
Severity Of Depression ◽  
The Individual

In the present study, we attempt to estimate the severity of depression using a Convolutional Neural Network (CNN). The method is special because an auto- and cross-correlation structure has been crafted rather than using an actual image for the input of the network. The importance to investigate the possibility of this research is that depression has become one of the leading mental disorders in the world. With its appearance, it can significantly reduce an individual's quality of life even at an early stage, and in severe cases, it may threaten with suicide. It is therefore important that the disorder be recognized as early as possible. Furthermore, it is also important to determine the disorder severity of the individual, so that a treatment order can be established. During the examination, speech acoustic features were obtained from recordings. Among the features, MFCC coefficients and formant frequencies were used based on preliminary studies. From its subsets, correlation structure was created. We applied this quadratic structure to the input of a convolutional network. Two models were crafted: single and double input versions. Altogether, the lowest RMSE value (10.797) was achieved using the two features, which has a moderate strength correlation of 0.61 (between estimated and original).

Reliability of administrative data for evaluating quality of systemic cancer treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18269-e18269
Author(s):  
Monika K. Krzyzanowska ◽  
Melanie Lynn Powis ◽  
Nathan Taback ◽  
Christina Diong ◽  
Katherine Enright ◽  
...  
Keyword(s):  
Administrative Data ◽  
Gold Standard ◽  
Validation Cohort ◽  
Systemic Treatment ◽  
Early Stage ◽  
Quality Measures ◽  
Administrative Databases ◽  
Appropriate Use ◽  
Reliability Characteristics

e18269 Background: There is ongoing interest in leveraging administrative data to examine quality but methodological concerns persist. We evaluated the reliability of a previously established panel of administrative data derived quality measures for systemic treatment. Methods: The cohort consisted of women diagnosed with early stage (stage I-III) breast cancer (ESBC) in Ontario, Canada, in 2010. Performance on 11 quality indicators evaluated using deterministically linked healthcare administrative databases has been reported previously. Sensitivity and specificity were examined using the chart as the gold standard. Results: The administrative cohort consisted of 6,795 women with ESBC from which a validation cohort of 705 patients was randomly selected from among patients who underwent cancer surgery at one of five hospitals chosen to balance feasibility and institutional characteristics.Sensitivity and specificity varied by indicator (Table 1). Reliability of some indicators may have been affected by suboptimal chart documentation in instances where care spanned multiple settings or the medical record was fragmented, or where the number of eligible patients for that indicator was low. Conclusions: Administrative data can be used to evaluate quality of systemic cancer therapy but understanding the reliability characteristics of individual indicators is essential to inform their appropriate use and interpretation. [Table: see text]

Possibilities design and implementation of quality improvement of self-realization and individual cooperation in the sports and educational environment

2019 ◽  
pp. 91-101
Author(s):  
Natalya Logacheva ◽  
Nikolay Kozyrev ◽  
Olga Kozyreva
Keyword(s):  
Quality Improvement ◽  
Educational Environment ◽  
Environment Design ◽  
Design And Implementation ◽  
Basic Concepts ◽  
Definition Of ◽  
The Individual ◽  
Goals And Objectives ◽  
Productive Solution

We identify features of the design and implementation of opportunities to improve the quality of self-realization and cooperation of the individual in the sports and educational environment. The sports and educational environment is determined by the model of realization of the productive solution of the tasks of development, self-realization and cooperation of the individual through “sports”, “education”, and “science”. We define the basic concepts and models that are connected with the functioning of the sports and educational environment, i. e. definition of the concepts of “sports educational environment”, “design and implementation of opportunities for quality improvement of self-realization and individual cooperation in the sports educational envi-ronment”, “models for quality improvement of self-realization and individual cooperation in the sports educational environment”, “functions for quality improvement of self-realization and indi-vidual cooperation in the sports and educational environment”, “principles of quality improvement of self-realization and individual cooperation in the sports and educational environment”, “technology to quality improve of self-realization and cooperation of the individual in the sports and educational environment”, “pedagogical conditions for quality improvement of self-realization and cooperation of the person in the sports and educational environment”; the models, functions, principles, goals and objectives of quality improvement of self-realization and individual cooperation in the sports and educational environment. We detail the practice of theorizing the quality improvement of self-realization and individual cooperation in the sports and educational environment. We highlight the pedagogical conditions for improvement the quality of self-realization and individual cooperation in the sports and educational environment. We prove the perspectives of studying and measuring the quality of the theorization of self-realization and individual cooperation in the sports and educational environment.

scholarly journals Assessing the Quality of Ideas From Prolific, Early-Stage Product Ideation

2010 ◽  
Author(s):  
Barry Matthew Kudrowitz ◽  
David R. Wallace
Keyword(s):  
Strong Correlation ◽  
Early Stage ◽  
Idea Generation ◽  
Innovative Product ◽  
Subjective Ratings ◽  
Test Bed ◽  
Practical Applications ◽  
The Individual ◽  
Product Idea

The goal of many idea generation techniques, such as brainstorming, is to generate a large quantity of ideas with the hopes of having a few outstanding novel ideas that are worth pursuing. The output of such sessions is a large number of rough concept sketches, which require a rapid means of screening to select a manageable set of promising ideas. In this study we develop and test metrics for evaluating large quantities of early-stage product idea sketches. In total, 1767 ideas for three different product themes were used as a test bed. With our findings, we suggest three independent qualities that fully describe an innovative product idea: creative (as a subjective judgment), useful (as defined as having practical applications), and feasible (as determined by experts). Reviewers’ subjective ratings of idea creativity had a strong correlation with ratings of idea novelty (r2 = .80), but negligible correlation with idea usefulness (r2 = .16). The clarity of sketch positively influenced ratings of idea creativity. Another interesting finding is that the quantity of ideas generated by the individual subjects had a strong correlation with that subject’s overall creativity scores (r2 = .82) and novelty scores (r2 = .85), but had weak correlations with that subject’s usefulness scores (r2 = .38).

Densité et largeur des cernes des populations d'Épinettes blanches de la région forestière des Grands Lacs et du Saint-Laurent

1990 ◽  
Vol 20 (2) ◽  
pp. 121-129 ◽  
Author(s):  
A. Corriveau ◽  
J. Beaulieu ◽  
F. Mothe ◽  
J. Poliquin ◽  
J. Doucet
Keyword(s):  
Relative Density ◽  
Population Level ◽  
White Spruce ◽  
Growth Rings ◽  
X Ray ◽  
Forest Region ◽  
Annual Growth Rings ◽  
Density Analysis ◽  
The Individual

Twenty years after planting, X-ray densitometry and immersion were used to determine the relative density of wood from 28 white spruce populations of the Great Lakes – St. Lawrence forest region. The results showed the same pattern of radial variation in all populations. Wood density decreases for the first few years of growth, then stabilizes for a time, then increases slowly, but steadily. The relative density of wood from white spruce has a slight, negative correlation with the width of the annual growth rings, at either the individual or the population level. However, some populations and individuals do deviate from this trend. Though the populations showed some statistically significant differences in relative density, analysis of variance showed that 85 to 90% was attributable to differences among trees within the same population. This study confirmed the desirability of using relative density as the basis for making mass selections within fast-growing white spruce populations to genetically improve the genetic quality of wood.

scholarly journals Analysis and generalization of competitive activity results of handball clubs in the game development aspect

2020 ◽  
Vol 24 (1) ◽  
pp. 36-43 ◽  
Author(s):  
O. M. Solovey ◽  
O.O. Mitova ◽  
D.O. Solovey ◽  
V.V. Boguslavskyi ◽  
O.M. Ivchenko
Keyword(s):  
Early Stage ◽  
Scientific Quality ◽  
Policy And Practice ◽  
Competitive Activity ◽  
Main Components ◽  
The Individual ◽  
Evidence For Policy ◽  
Scientific Periodicals ◽  
The Given

Purpose: an analysis of the competitive activity of men's club handball teams in the final tournament of the European Champions and Champions League Cup gives you the opportunity to determine the rating of the teams on the continent and the development tendencies of the game. Material: the best men's handball clubs from 52 national federations in Europe which competed in the qualifying tournament and the group stages of the draw and were the winners and prize winners of the European Champions and Champions League Cup of 1956/1957-2017/2018. A systematic review of the available qualitative literature was conducted according to Preferred Reporting Items for Systematic reviews. The “Web of Science”, “Physical Education Index (ProQuest)”, “Google Scholar” and “Scientific Periodicals Ukraine” databases were used in order to ensure, from an early stage, the scientific quality of the revised studies. The research was conducted based on ‘any field’ (e.g. title, abstract, text) and no restrictions were made regarding the language of publication. The terms used in the research were “teams scoring performance”, “elite handball”, “game location”, “players exclusions”, “home advantage”, “quality”, “opposition”, and “indicators”. The quality of the articles was assessed by a set of criteria developed by members of the Evidence for Policy and Practice Information and other specialists. The initial search found 132 journal articles; for a final list of 52 publications. Results: The article covers the organizational aspects of the competitive activity of men's handball clubs in Europe at the European Champions and Champions League tournaments from 1956 to 2018. The given analysis of the highest achievements of the leading handball clubs which are not only winners and prize winners, but also the countries that they represented. The winners and prize winners are marked both between teams of different countries and teams of one country. Conclusions: Achievements and rankings of the leading handball clubs in the international arena are the main components of preparing them for official competitions: new approaches to planning the preparation of players and teams for higher sports achievements and maximum realization of individual opportunities; the integration of the individual readiness of highly skilled handball players into leading handball clubs; to the important aspects of the new rules of the game, which are developed in the theory and implemented in practice; the main tendencies in the international and European handball that systematically develop and apply to a core of players as well as the next reserve.

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