Image and report quality in non-obstetric ultrasound examinations undertaken by sonographers: Results of an audit of 3731 cases

Introduction This paper reports the results of a rolling audit of sonographer-performed non-obstetric ultrasound examinations undertaken between 2010 and 2020 in a large University Teaching Hospital Ultrasound Department in the United Kingdom. We believe that this represents the largest published audit of sonographer non-obstetric ultrasound examination quality. Methods Random samples of sonographer ultrasound examinations were regularly and systematically audited by consultant-level ultrasound practitioners through review of soft copy images and reports. Examination and report quality were assessed against an internal audit standard in 3731 patients over an 11-year period and also against externally set audit standards in 3186 patients over a nine-year period. Results Both image and report quality exceeded externally set audit standards in all nine years of audit. In the internal audit, the quality standard just failed to be met for the first five years of audit but was achieved in all the subsequent six years. Conclusion This audit provides further information on the quality and safety of sonographer-led ultrasound service delivery within a service that has quality safeguards, readily available support and an active education programme. It is used not only to provide assurance to patients, clinicians, managers and commissioners of this service but also to direct individual professional development and drive an iterative process of quality improvement.

Evaluation of the Effect of Items’ Format and Type on Psychometric Properties of Sixth Year Pharmacy Students Clinical Clerkship Assessment Tools

Background Examination is the traditional assessment tool, and are used to guide the improvement of academic programs. Accreditation committees’ emphasis on the implementation of standardized examinations. The aims of the current study are to evaluate the quality of assessment tools of sixth year PharmD students as a function of assessment item format and type/structure and to assess the effect of the number of response choices on the characteristics of MCQs as assessment items. Methods. A total of 173 assessment items used in the examinations of sixth year rotations of PharmD program were included. Items were classified as case based or non-case based and as MCQs or open-ended. The psychometric characteristics of examinations were studied as a function of the level of the Bloom’s levels addressed by an item, item format, and number of choices in MCQs. Results. Items addressing intellectual and analysis skills were more difficult, while items associated with multiple cognitive levels were more discriminative. No differences were found between case based and noncase based items in terms of their difficulty, with a slightly better discrimination in the letter. Open-ended items were easier, yet more discriminative. MCQs with higher number of options were easier and more discriminative. Open-ended questions were significantly easier and more discriminative in comparison to MCQs as case based items while they were more difficult and more discriminative as non-case based items. Conclusion. Item formats, structure, and number of options in MCQs, affected students’ performance and overall examination quality. The discrimination of items associated with multiple Bloom’s levels was significantly higher than those associated with a single level. Noncase based items and open-ended items were easier and more discriminative than case based items and MCQs, respectively.

Investigation of Statistical Distribution of C/C-SiC Composite’s Mechanical Properties

Because of the excellent fracture toughness and oxidation resistance, carbon fiber reinforced silicon carbide (C/C-SiC or C/SiC) exhibits a sound potential in various application areas such as aerospace technology and high-performance braking systems. For the composite’s reliable design, production, examination, quality assurance and verification, however, the statistical distribution of mechanical properties is of crucial interest and has not been investigated in detail yet. In this work, the strength values of C/C-SiC composite, which was developed via Liquid Silicon Infiltration at the Institute of Structures and Design of German Aerospace Center (DLR), were measured under tensile, bending and compression load. The results were analyzed by normal and Weibull distribution statistics and verified by Kolmogorov–Smirnov-test (KS-test) and Anderson–Darling-test (AD-test). Based on the statistical analysis, the 4PB-strength of C/C-SiC composite can be better described by Weibull distribution. In comparison, normal distribution is more suitable for the compression strength. The influence of different numbers of coupons on the mechanical properties has been identified. A scanning electron microscope (SEM) was employed to analyze the fracture surface, which confirmed that the different statistical distribution of strength values was caused by various failure mechanisms.

Anti-angiogenic therapy for diabetic macular edema

Diabetic retinopathy remains one of the greatest challenges for healthcare system worldwide despite the fact that the incidence of visual acuity impairment in diabetic population has decreased due to examination quality improvement and dynamic observation of patients. Visual acuity impairment in diabetic patients is often related to diabetic macular edema. Until recently, laser photocoagulation of the retina was regarded as gold standard for diabetic macular edema treatment. Laser photocoagulation of the retina provides visual acuity stabilization rather than improvement. Since early 2000s, pharmacological approach to this severe disease has been established. As vascular endothelial growth factor (VEGF) is one of the crucial factors involved in the pathogenesis of diabetic retinal disorders, VEGF inhibitors are now recognized as a treatment of choice for diabetic macular edema. This article considers results of different clinical trials investigating anti-VEGF therapy efficacy in DME treatment.