PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “data auditing”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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

At least 1,063 records · Page 59Linked to original sources
PubMed2004

Prediction of tracheostomy tube size for paediatric long-term ventilation: an audit of children with spinal cord injury.

BACKGROUND: There are no published data to predict tracheostomy tube size as growth proceeds in children requiring long-term ventilation. METHODS: A retrospective audit was undertaken of children having long-term ventilation, managed from the Southport spinal injuries unit. The dates of step-up in size of tracheostomy tube were noted together with the tube inside and outside diameters (ID and OD) and the lateral tracheal diameter. The data were aggregated for each increment in tube size to calculate the Pearson correlation coefficients for age and weight of the children. Linear regression was then used to generate predictive equations based on age and weight. RESULTS: Out of 12 children, data from seven boys and two girls, with a mean age of 5.9 (range 1.5-13.75) yr, were obtained. Average length of follow-up was 7 yr, with an average of 3.5 tube changes per patient equating to a larger tube every 2 yr. The inside and outside tracheal tube diameters, as well as the lateral tracheal diameter, correlated significantly with age and weight (P<0.01). The appropriate tracheostomy tube internal diameter is conveniently expressed by the formula: ID mm=age yr/3 + 3.5 CONCLUSIONS: The step-up in size of the tracheostomy tube as growth proceeds should be undertaken as a planned procedure at least every 2 yr to avoid nocturnal desaturation. Age appears to be a convenient and reliable predictor.

Adolescent↗
PubMed2005

Tobacco use among adolescents enrolled in Wisconsin Medicaid program.

PROBLEM: There has been very little study done on tobacco use and cessation among the adolescent Medicaid population. Study objectives included determining the prevalence of tobacco use among adolescents enrolled in Medicaid, and identifying subgroups within this population. METHODS: To determine tobacco use among adolescents enrolled in the Wisconsin Medicaid program, we analyzed data from a medical chart-audit of health care visits by 11-21 year olds from January 1997 to January 1999. RESULTS: Tobacco use status was noted in 55% of adolescent charts. Of these, 24% were current smokers, while 38% of adolescents in the general Wisconsin population were current smokers. Females had higher rates of tobacco use than males (28% versus 11%), and those from rural areas had higher rates than those from urban areas (41% versus 17%). Of pregnant adolescents with tobacco use status documented, 31.6% were current tobacco users. CONCLUSIONS: Based on the data reported, adolescents in the Wisconsin Medicaid program who were pregnant, female, or rural residents may benefit from targeted smoking prevention and cessation intervention by health care professionals, community coalitions, and state programs.

Adolescent↗
PubMedDate not supplied

Dermatology outpatients in the West Midlands: their nature and management.

There is a lack of routinely available information about dermatology outpatient consultations which form the majority of the clinical work of this specialty. This survey was undertaken to prepare for clinical audit and assist in planning future developments of the service. Data were recorded from 2,940 outpatient consultations held during one week by 20 consultant dermatologists and their staff in the West Midlands Health Region in November 1988. The results show that collection and analysis of Regionwide data for a small specialty is feasible, and have indicated future areas of study for clinical audit.

Data Collection↗
PubMed2006

Laparoscopic versus open gastric bypass for morbid obesity: a multicenter, prospective, risk-adjusted analysis from the National Surgical Quality Improvement Program.

OBJECTIVE: To compare laparoscopic versus open gastric bypass procedures with respect to 30-day morbidity and mortality rates, using multi-institutional, prospective, risk-adjusted data. SUMMARY BACKGROUND DATA: Laparoscopic Roux-en-Y gastric bypass for weight loss is being performed with increasing frequency, partly driven by consumer demand. However, there are no multi-institutional, risk-adjusted, prospective studies comparing laparoscopic and open gastric bypass outcomes. METHODS: A multi-institutional, prospective, risk-adjusted cohort study of patients undergoing laparoscopic and open gastric bypass procedures was performed from hospitals (n = 15) involved in the Private Sector Study of the National Surgical Quality Improvement Program (NSQIP). Data points have been extensively validated, are based on standardized definitions, and were collected by nurse reviewers who are audited for accuracy. RESULTS: From 2000 to 2003, data from 1356 gastric bypass procedures was collected. The 30-day mortality rate was zero in the laparoscopic group (n = 401), and 0.6% in the open group (n = 955) (P = not significant). The 30-day complication rate was significantly lower in the laparoscopic group as compared with the open group: 7% versus 14.5% (P < 0.0001). Multivariate logistic regression analysis was performed to control for potential confounding variables and showed that patients undergoing an open procedure were more likely to develop a complication, as compared with patients undergoing an laparoscopic procedure (odds ratio = 2.08; 95% confidence interval, 1.33-3.25). Propensity score modeling revealed similar results. A prediction model was derived, and variables that significantly predict higher complication rates after gastric bypass included an open procedure, a high ASA class (III, IV, V), functionally dependent patient, and hypertension as a comorbid illness. CONCLUSIONS: Multicenter, prospective, risk-adjusted data show that laparoscopic gastric bypass is safer than open gastric bypass, with respect to 30-day complication rate.

Adult↗
PubMed2006

Does telephone triage of emergency (999) calls using Advanced Medical Priority Dispatch (AMPDS) with Department of Health (DH) call prioritisation effectively identify patients with an acute coronary syndrome? An audit of 42,657 emergency calls to Hampshire Ambulance Service NHS Trust.

INTRODUCTION: The National Service Framework for Coronary Heart Disease requires identification of patients with an acute coronary syndrome (ACS) to enable prompt identification of those who may subsequently require pre-hospital thrombolysis. The Advanced Medical Priority Dispatch System (AMPDS) with Department of Health (DH) call prioritisation is now the common triage tool for emergency ('999') calls in the UK. We retrospectively examined patients with ACS to identify whether this triage tool had been able to allocate an appropriate emergency response. METHODS: All emergency calls to Hampshire Ambulance Service NHS Trust (HAST) from the Southampton area over an 8 month period (January to August 2004) were analysed. The classification allocated to the patient by AMPDS (version 10.4) was specifically identified. Data from the Myocardial Infarct National Audit Project) were obtained from the receiving hospital in Southampton to identify the actual number of patients with a true ACS. RESULTS: In total, 42 657 emergency calls were made to HAST from the Southampton area. Of these, 263 patients were subsequently diagnosed in hospital as having an ACS. Of these 263 patients, 76 presented without chest pain. Sensitivity of AMPDS for detecting ACS in this sample was 71.1% and specificity 92.5%. Positive predictive value was 5.6% (95% confidence interval 4.8 to 6.4%), and 12.5% (33/263) of patients with confirmed ACS were classified as non-life threatening (category B) incidents. CONCLUSION: Only one of approximately every 18 patients with chest pain has an ACS. AMPDS with DH call prioritisation is not a tool designed for clinical diagnosis, and its extension into this field does not enable accurate identification of patients with ACS.

Chest Pain↗
PubMed1992

Perceptions of new AICPA (American Institute of Certified Public Accountants) audit guide.

A survey was conducted by authors Bitter and Cassidy to assess hospital providers' and auditors' perceptions of the reporting requirements of the new Audits of Providers of Health Care Services guide published by the American Institute of Certified Public Accountants. Responses indicated that there is still much dissent in the healthcare community as to what is useful information and what the effects of the new guide will be on hospital providers, auditors, and users.

Accounting↗
PubMed2003

The Scottish home parenteral nutrition managed clinical network: one year on.

The purpose of home parenteral nutrition (HPN) is to allow patients with intestinal failure a reasonable quality of life and to facilitate independence from hospital. A managed clinical network (MCN) has been established for the organisation of HPN. This multi-professional group works towards optimal patient management by adoption of nationally agreed, evidence standards and protocols, to allow equity of access to quality care. A coordinator has identified patients and practice. A MCN exists to ensure that quality care can be delivered near to the patient's home. An audit of the organisation of HPN has been completed. The aims of this study were to identify the numbers of patients receiving this treatment and to assess management practices. Data was collected from 16 centres between July 2000 and August 2001. This paper discusses the practicalities of setting up the network and presents data from the first full year of audit. This will act as the baseline for continuous audit and a basis for revision of documentation.

Adult↗
PubMed2001

Clinical use of Infliximab in Crohn's disease: the Edinburgh experience.

UNLABELLED: Infliximab is an established treatment for steroid-resistant and fistulating Crohn's disease. Although efficacy has been shown in clinical trials, financial implications often limit its use and limited data exist regarding clinical practice. AIMS: To audit the clinical effectiveness of Infliximab. METHODS: We prospectively audited 50 consecutive patients [28 females; median age, 34 years (17-70 years)]. Disease activity and response rates were assessed by the Harvey-Bradshaw index. Clinical and disease data were collected and blood was taken for inflammatory markers, complement and double-stranded DNA antibodies. Patients received Infliximab at 5 mg/kg and were followed for 12 weeks. RESULTS: Indications for Infliximab were refractory Crohn's disease in 39 patients, fistulating Crohn's disease in six, pyoderma gangrenosum in one, pouchitis in two and coeliac disease in two. Thirty-one (79%) of the refractory Crohn's disease patients and four (66%) of the fistulating patients responded at 4 weeks. Twenty-one (54%) of the refractory Crohn's disease patients had a continued response at 12 weeks. Perianal disease was more prevalent in non-responders (7/8 vs. 12/31, P < 0.02). CONCLUSIONS: Response rates to Infliximab in our group are comparable to those of clinical trials. Despite the expense, it remains a useful adjunct to treatment in this otherwise difficult group of patients. Patients with perianal disease responded less well in our cohort.

Adolescent↗
PubMed1977

Development of a medical record audit for continuing medical education.

A self-instructional audit package for the identification and management of hypertensive patients was developed. The materials were field tested in the clinics of seven institutions to assess their clarity and collect data to illustrate the usefulness of an audit as an educational tool.

Ambulatory Care↗
PubMed1999

Trends in cytogenetic prenatal diagnosis in the UK: results from UKNEQAS external audit, 1987-1998.

The aim of this audit was to evaluate trends in mean reporting time, culture success rate and abnormality rate for conventional cytogenetic prenatal diagnoses for amniotic fluid samples (AFS) and chorionic villus samples (CVS) in the UK. Anonymized data in the form of retrospective external audits were obtained from UKNEQAS in Clinical Cytogenetics annual reports, for AFS (1987-1997/98) and CVS (1988-1997/98). UK laboratories providing a prenatal service by referral criteria applicable at local level participated in the scheme. Over the period the number of AFS processed per annum increased from 28 639 to 36 817 (29 per cent) and for CVS from 2294 to 7918 (245 per cent). CVS made up 17.6 per cent of the total sample numbers in 1997/98 compared with 7.4 per cent in 1988. Reporting times and culture success rates have improved, notably overall reporting time means have fallen from 20.2 to 13.8 days for AFS and 21.3 to 14.5 days for CVS. Data submitted by individual laboratories suggest that further reductions in mean reporting times for both sample types are feasible. Such a potential improvement, if achieved by all laboratories, may question the value of a supplementary FISH or PCR-based 'rapid' aneuploidy screening test prior to karyotyping.

Amniocentesis↗
PubMed2000

Single foetal death in twin pregnancies: review of the maternal and neonatal outcomes and management.

OBJECTIVE: To review the maternal and neonatal outcomes, and management of single foetal death in twin pregnancies. DATA SOURCES: Medline literature search (1950 to 1999) and hospital audit of single antepartum foetal deaths in twin pregnancy from 1993 through 1997. DATA SELECTION: Key words for literature search: twin pregnancy/pregnancies; single fetal death/demise. DATA EXTRACTION: Data were extracted and reviewed independently by the authors. DATA SYNTHESIS: During the study period, 182 (0.76%) of 23,804 deliveries involved twin pregnancies. Seven (3.8%) of the twin pregnancies were complicated by the death of one foetus. Single foetal death in a twin pregnancy in the late second and third trimesters is associated with significant morbidity and mortality in the surviving co-twin, especially in a pregnancy involving monochorionic twins. Management should be individualised; conservative management is preferred by most obstetricians. CONCLUSION: Single foetal death in twin pregnancies should be managed in a tertiary referral centre, where intensive foetal surveillance and adequate neonatal support are available. A multidisciplinary approach should be adopted.

Female↗
PubMed2005

Pain: a review of three commonly used pain rating scales.

AIMS AND OBJECTIVES: This review aims to explore the research available relating to three commonly used pain rating scales, the Visual Analogue Scale, the Verbal Rating Scale and the Numerical Rating Scale. The review provides information needed to understand the main properties of the scales. BACKGROUND: Data generated from pain-rating scales can be easily misunderstood. This review can help clinicians to understand the main features of these tools and thus use them effectively. METHOD: A MedLine review via PubMed was carried out with no restriction of age of papers retrieved. Papers were examined for methodological soundness before being included. The search terms initially included pain rating scales, pain measurement, Visual Analogue Scale, VAS, Verbal Rating Scale, VRS, Numerical/numeric Rating Scale, NRS. The reference lists of retrieved articles were used to generate more papers and search terms. Only English Language papers were examined. CONCLUSIONS: All three pain-rating scales are valid, reliable and appropriate for use in clinical practice, although the Visual Analogue Scale has more practical difficulties than the Verbal Rating Scale or the Numerical Rating Scale. For general purposes the Numerical Rating Scale has good sensitivity and generates data that can be statistically analysed for audit purposes. Patients who seek a sensitive pain-rating scale would probably choose this one. For simplicity patients prefer the Verbal Rating Scale, but it lacks sensitivity and the data it produces can be misunderstood. RELEVANCE TO CLINICAL PRACTICE: In order to use pain-rating scales well clinicians need to appreciate the potential for error within the tools, and the potential they have to provide the required information. Interpretation of the data from a pain-rating scale is not as straightforward as it might first appear.

Humans↗
PubMed2003

National guidance on gynaecological cancer management: an audit of gynaecological cancer services and management in the South East of England.

OBJECTIVE: To evaluate the appropriateness of the structure and the process of care for gynaecological cancer against national guidelines. SETTING & SAMPLE: Incident cases of ovarian and cervical cancer managed between 1 January, 1999 and 31 December, 2000 in the South East of England. METHODS: Completion of an audit form, by a researcher, using the clinical record. Qualitative interviews with gynaecologists at each hospital. MAIN OUTCOME MEASURES: Whether hospitals meet the requirements for being a 'centre' or a 'unit' for gynaecological cancer and whether gynaecologists manage ovarian or cervical cancer according to the guidelines. RESULTS: Stage was recorded in the notes of 53% (262/492) of women with ovarian cancer but information to assist in determining stage was recorded in 86%. Of women who had a stage recorded by the consultant, who should have had a laparotomy and be referred for chemotherapy, 81% (169/209) were managed according to the guidelines, ignoring whether there was removal of disease to nodules of less than 1 cm. Stage was recorded in the notes of 60% (188/315) of women with cervical cancer, although information relevant to staging the patient was recorded in 66%. Overall 76% (142/188) of women with stage recorded in the notes were managed according to the guidelines but 40% (127/315) of women audited were not assessable. Only one site met the criteria for being a cancer centre. Of the remaining sites, most striking was the inability to assemble a team of professionals, including a radiologist, a pathologist and an oncology nurse to discuss individual patient care. CONCLUSIONS: Retrospective note audits will be hampered by missing data in the clinical record until systems are developed to improve the quality of notes. This research suggests that guidelines based on FIGO staging for the management of ovarian and cervical cancer are not followed and that this may be associated with incomplete cancer management teams.

Adult↗
PubMed1999

Population-based study of infants born at less than 28 weeks' gestation in New South Wales, Australia, in 1992-3. New South Wales Neonatal Intensive Care Unit Study Group.

The aims of the study were to use the population base of New South Wales (NSW) to study all births from 20 to 27 weeks' gestation in 1992-3 and to compare two data sources for perinatal deaths. The prospective population-based statewide audit (NICUS) of infants admitted to tertiary neonatal intensive care units (NICUs) in NSW was used to collect data on infants less than 28 weeks' gestation registered in 1992-3. This audit also surveyed the 160 obstetric hospitals in NSW to ascertain information on stillbirths and early neonatal deaths in the study period. The NSW midwives data collection (MDC) was the other source of information on stillbirths and labour ward deaths. Data were analysed using SAS. In 1992-3 in NSW 1170 infants were born at 20-27 weeks' gestation. There were 556 stillbirths and 614 live births, of whom 180 (29.3%) died in the labour ward and 434 (70.7%) were admitted to a tertiary NICU. Sixty-six per cent of stillbirths were identified by both data collections, 16.5% by the MDC only and 17% by NICUS only. There was a high major congenital anomaly rate (18.5%) among the stillbirths. Two-thirds of the infants admitted to NICUs survived to 1 year. Information was available on at least one follow-up parameter for 89% (255/288) of the survivors to 12 months (corrected age). Of the 244 infants who had a neurological assessment by a paediatrician, 17% were diagnosed to have cerebral palsy. Eleven per cent of the 239 who had a formal Griffiths developmental assessment had a major intellectual disability. Five (2% of 255) of the 1-year-olds were blind, and 12 (4.7% of 255) had bilateral hearing aids. Seventy-one per cent of the infants examined at 1 year did not have a major disability. For accurate perinatal death data, collection from more than one source is recommended. Infants born at 20-27 weeks' gestation contribute 40% of all stillbirths in NSW, most of the costs of neonatal intensive care as well as the costs of long-term morbidity. In Australia in the early 1990s, the survival of infants born at less than 28 weeks' gestation was best from 26 weeks gestational age onwards. Long-term morbidity did not change from that of earlier cohorts. The most common major disability was cerebral palsy.

Cerebral Palsy↗
PubMed1988

Computerized accounting for the dental office. Using horizontal applications general ledger software.

Remember that computer software is designed for accrual accounting, whereas your business operates and reports income on a cash basis. The rules of tax law stipulate that professional practices may use the cash method of accounting, but if accrual accounting is ever used to report taxable income the government may not permit a switch back to cash accounting. Therefore, always consider the computer as a bookkeeper, not a substitute for a qualified accountant. (Your accountant will have readily accessible payroll and general ledger data available for analysis and tax reports, thanks to the magic of computer processing.) Accounts Payable reports are interfaced with the general ledger and are of interest for transaction detail, open invoice and cash flow analysis, and for a record of payments by vendor. Payroll reports, including check register and withholding detail are provided and interfaced with the general ledger. The use of accounting software expands the use of in-office computers to areas beyond professional billing and insurance form generation. It simplifies payroll recordkeeping; maintains payables details; integrates payables, receivables, and payroll with general ledger files; provides instantaneous information on all aspects of the business office; and creates a continuous "audit-trail" following the entering of data. The availability of packaged accounting software allows the professional business office an array of choices. The person(s) responsible for bookkeeping and accounting should choose carefully, ensuring that any system is easy to use, has been thoroughly tested, and provides at least as much control over office records as has been outlined in this article.

Accounting↗