SEARCH · PubMed Health

Results for “Performance benchmarking”

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 1,711 records · Page 95Linked to original sources

PubMedDate not supplied

Strategic positioning for nursing excellence in health systems: insights from chief nursing executives.

The emergence of health systems as a dominant structure for organizing healthcare has stimulated the development of health system chief nursing executive (CNE) positions. These positions have large spans of control, requiring CNEs to balance a wide range of responsibilities, making them accountable for fiscal management, quality of care, compliance, and contributing to organizational growth. As such the CNE is required to use principles of distributive justice to guide priority setting and decision making. This review addresses important questions about CNE system integration strategies, strategic priorities, and organizational positioning as they attempt to fulfill their ethical responsibilities to patients and the nurses they serve.

Benchmarking↗

PubMed2025

Evaluating Language Models for Biomedical Fact-Checking: A Benchmark Dataset for Cancer Variant Interpretation Verification.

Accurate interpretation of genomic variants is critical for precision oncology but remains slow and dependent on specialized expertise. Public knowledgebases such as the Clinical Interpretation of Variants in Cancer (CIViC) help by curating literature-backed variant interpretations in a structured form, yet verification and review have become major bottlenecks. To address this, we developed CIViC-Fact, a benchmark dataset and pipeline for testing automated systems that verify the accuracy of cancer variant claims. CIViC-Fact links structured claims to sentence-level supporting or refuting evidence from full-text articles, and includes expert annotations and explanations. We evaluated multiple language models. Proprietary models performed well without training, but a smaller open-source model, fine-tuned on CIViC-Fact, achieved the highest accuracy (89%). Applying our fact-checking pipeline to real CIViC entries showed that reviewing less than 20% of content, focusing on flagged entries, would be sufficient to catch over half of all errors. This AI-assisted triage greatly accelerates the review process without replacing or reducing expert insight, ensuring that existing careful oversight remains in place while curators can work more efficiently. CIViC-Fact provides a realistic, high-consequence framework for biomedical fact-checking and a path toward more rigorous and efficient knowledgebase curation.

Journal Article↗

PubMedDate not supplied

A comparison of Bayesian methods for profiling hospital performance.

There is a growing interest in the use of Bayesian methods for profiling institutional performance. In the literature, several studies have compared different frequentist methods for classifying hospitals as performance outliers. The purpose of this study was to compare 4 different Bayesian methods for classifying hospitals as outcomes outliers, using 30-day hospital-level mortality rates for a cohort of acute myocardial infarction patients as a test case. The 1st Bayesian method involved determining the probability that a hospital's mortality rare for an average patient exceeded a specified threshold. The 2nd method involved ranking hospitals according to their mortality rate for an average patient. The 3rd method involved determining the probability that a hospital's standardized mortality ratio exceeded a specified threshold. The 4th method involved ranking hospitals according to their standardized mortality ratio. In most of the scenarios examined, there was only marginal agreement between the different methods. In only 4 of 19 comparisons, was there good agreement between the different methods (0.40 < or = kappa < or = 0.75). Methods based on ranking institutions were relatively insensitive to differences between hospitals. These inconsistencies raise questions about the choice of methods for classifying hospital performance, and they suggest a need for urgent research into which methods are best able to discriminate between institutions and which are most meaningful to decision makers.

Bayes Theorem↗

PubMed2005

Quantitative spectroscopy of superficial turbid media.

We report a novel diffuse optical spectroscopy probe design for determining optical properties of superficial volumes of turbid samples. The fiber-based probe employs a highly scattering layer placed in contact with the sample of interest. This layer diffuses photons from a collimated light source before they enter the sample and provides a basis for describing light transported in superficial media by the diffusion approximation. We compare the performance of this modified two-layer diffusion model with Monte Carlo simulations. A set of experiments that demonstrate the feasibility of this method in turbid tissue phantoms is also presented. Optical properties deduced by this approach are in good agreement with those derived by use of a benchmark method for determining optical properties. The average interrogation depth of the probe design investigated here is estimated to be less than 1 mm.

Equipment Design↗

PubMed1985

Determination of bovine retinal melatonin with HPLC-EC.

UNLABELLED: Bovine retinae, devoid of pigment epithelium, were assayed for endogenous melatonin using high-performance liquid chromatography with electrochemical detection (HPLC-EC). A method of extracting the more polar biogenic amines and metabolites was employed, allowing for direct injection of retinal supernatants into the chromatographic column. THE RESULTS: 1) confirm the presence of melatonin in the bovine retina; 2) provide a "benchmark" of 3.01 ng/retina for normal adult retinae collected during photophase; and 3) indicate that HPLC-EC represents an adequately sensitive instrument for the detection and quantification of melatonin in a single bovine retina.

Animals↗

PubMedDate not supplied

Local health department effectiveness in addressing the core functions of public health.

Objective 8.14 of the Year 2000 National Health Objectives calls for 90 percent of the population to be served by a local health department effectively carrying out the three core functions of public health--assessment, policy development, and assurance. To provide a benchmark of local health department effectiveness in addressing the core functions and to assess implications for achieving the year 2000 target, a random national sample (stratified by jurisdiction and population base) of local health departments was surveyed to determine self-reported compliance with 10 public health practice performance measures that operationalize the core functions. Overall compliance with the 10 performance measures was 50 percent, based on weighted responses of 208 responding health departments. Compliance was highest for the practices related to the assurance function and least for practices related to the policy development function. Compliance was also high for departments serving a population of 50,000 or more and those smaller departments organized at the city and city-county levels. Using two different definitions developed by the investigators, 19 and 31 percent of the health departments were judged to be effective in addressing the core functions of public health. These data suggest that less than 40 percent of the U.S. population was served by a health department effectively addressing the core functions of public health in 1993. It appears that considerable capacity building within the public health system will be needed to achieve the year 2000 target of 90 percent.

Community Health Services↗

PubMed1998

Neurocognitive deficit in fronto-temporal dementia.

Meta-analytic principles were used to formulate a neurocognitive profile of fronto-temporal dementia (FTD). The neurocognitive test results from a total of 88 patients with FTD and 100 health controls were synthesized using effect size analyses. The results indicate that patients with FTD are most deficient on tests of cognitive flexibility and abstraction, followed by performance on measures of performance skill, memory acquisition, attention/concentration, delayed recall, and, finally, verbal skill. A rank-order profile of specific neurocognitive tasks and test variables in order of sensitivity of FTD is also provided to help interpret the quantitative results. On the basis of the profile, neurocognitive markers meeting heuristic benchmark criteria were identified that can aid in the differentiation of FTD from other disorders with prominent features of dementia.

Attention↗

PubMedDate not supplied

Do we practice what we teach about childhood immunization in New Jersey?

BACKGROUND AND OBJECTIVES: Although childhood immunization is a benchmark for preventive service delivery in family practices, no data have been reported on childhood immunization in New Jersey family practice residencies. This study assesses immunization coverage among 2-year-olds in nine residencies and evaluates childhood immunization knowledge and barriers in 10 residency programs. METHODS: We performed a retrospective review of immunization records of 2-year-olds, using the Centers for Disease Control's Clinic Assessment Software Application, and analyzed a survey of knowledge and barriers to immunization completed by residents, nurses, and faculty. RESULTS: Among 726 children with four or more office visits, the mean percent of children immunized with the combination of four diphtheria-tetanus-pertussis, three polio, and one measles-mumps-rubella was 53% (range 31%-69%). The age-appropriate immunization rate was highest at 3 months (78%) and lowest at 16 months (29%). Among the 294 survey respondents, the mean knowledge score was 75% overall and 82% for faculty, 77% for nurses, and 71% for residents. There was moderate to good correlation of audit levels with knowledge, with 49% of the variation in immunization coverage explained by variation in knowledge. Lack of immunization records was reported by 47% as the most important office-related barrier. CONCLUSIONS: Immunization rates of 2-year-olds in nine New Jersey family practice residencies are below Healthy People 2000 goals. Low immunization rates in residency programs may improve with increased knowledge, an area for future study. Research into removing immunization-related barriers is also needed.

Adult↗

PubMed2002

Consumer assessments of care for children and adults in health plans: how do they compare?

OBJECTIVES: The Consumer Assessment of Health Plans Survey (CAHPS) includes an adult version and also a child version for parents or caretakers to rate children's care in health plans. This study examined how adult and child assessments differed in ranking health plans and explored whether the differences justified the additional cost and respondent burden in administering both surveys. METHODS: Data were from 136 commercial health plans participating in the National CAHPS Benchmarking Database, with 80,539 adults and 40,003 children. We compared mean assessments for adults and children on four global ratings and five composites, and determined respondent characteristics predictive of these assessments using regression analysis. We calculated correlations of plan mean scores for adults and children and kappa statistics for agreement when health plans are ranked as above average, average, or below average performers based on adult and child scores. RESULTS: CAHPS scores for children were significantly (P <0.001) higher than those for adults, except for customer service (lower for children) and specialist ratings. Similar respondent characteristics predicted adult and child scores. Plan-level correlations between corresponding adult and child mean scores were moderate to high (r = 0.60-0.85), which translate into fair to moderate agreement (kappa = 0.27-0.61) in ranking health plans. CONCLUSIONS: Adult and child CAHPS provide similar scores and plan rankings on many aspects of care. Child reports include information that may be useful for consumer choice and to health plans for targeting quality improvement. Methods should be developed for assessing health care for children that minimize cost and respondent burden.

Adolescent↗

PubMed2004

A survey assessment of the level of preparedness for domestic terrorism and mass casualty incidents among Eastern Association for the Surgery of Trauma members.

OBJECTIVE: The goal of this survey was to establish a benchmark for trauma surgeons' level of operational understanding of the command structure for a pre-hospital incident, a mass casualty incident (MCI), and weapons of mass destruction (WMD). The survey was distributed before the World Trade Center destruction on September 11, 2001. METHODS: The survey was developed by the authors and reviewed by a statistician for clarity and performance. The survey was sent to the membership of the 2000 Eastern Association for the Surgery of Trauma spring mailing, with two subsequent mailings and a final sampling at the Eastern Association for the Surgery of Trauma 2001 meeting. Of 723 surveys mailed, 243 were returned and statistically analyzed (significance indicated by p < 0.05). RESULTS: No statistical difference existed between level of designation of a trauma center (state or American College of Surgeons) and a facility's level of pre-paredness for MCIs or WMD. Physicians in communities with chemical plants, railways, and waterway traffic were statistically more likely to work at facilities with internal disaster plans addressing chemical and biological threats. Across all variables, physicians with military training were significantly better prepared for response to catastrophic events. With the exception of cyanide (50%), less than 30% of the membership was prepared to manage exposure to a nerve agent, less than 50% was prepared to manage illness from intentional biological exposure, and only 73% understood and were prepared to manage blast injury. Mobile medical response teams were present in 46% of the respondents' facilities, but only 30% of those teams deployed a trauma surgeon. Approximately 70% of the membership had been involved in an MCI, although only 60% understood the command structure for a prehospital incident. Only 33% of the membership had training regarding hazardous materials. Of interest, 76% and 65%, respectively, felt that education about MCIs and WMD should be included in residency training. CONCLUSION: A facility's level of pre-paredness for MCIs or WMD was not related to level of designation as a trauma center, but may be positively influenced by local physicians with prior military background. Benchmark information from this survey will provide the architecture for the development and implementation of further training in these areas for trauma surgeons.

Attitude of Health Personnel↗

PubMed1993

Effects of a protective foam on scrubbing and gloving.

OBJECTIVE: To test the effects of a skin protectant on surgical scrub and glove integrity. DESIGN: Forty-nine healthy adult volunteers were assigned (12 subjects per group) to apply a protective foam (DermaMed; Benchmark Enterprises, Salt Lake City, Utah) in conjunction with surgical scrub in one of the following formulations: 70% isopropyl alcohol, a liquid detergent base containing 4% chlorhexidine gluconate, a liquid detergent base containing 7.5% povidone-iodine, or a nonantimicrobial liquid soap (control). According to a standard protocol, subjects performed a surgical scrub on 3 days (every other day). Foam was applied after surgical scrub on day 1 and before surgical scrub on day 3. No foam was applied on day 2. Subjects were gloved for 2 hours after surgical scrub. SETTING: Laboratory setting. RESULTS: On all test days, there were significant differences in bacterial reduction by products (chlorhexidine gluconate or alcohol > povidone-iodine > control). When controlling for baseline counts and products used, there were no significant differences in colony-forming unit counts on hands with or without foam immediately after scrubbing or at 2 hours after scrub on gloved or ungloved hands, nor were there differences in glove leakage rates when foam was on hands. CONCLUSIONS: Such protectants can be used without detrimental effects to scrub effectiveness or glove integrity.

1-Propanol↗

PubMed2006

Learning curves and reliability measures for virtual reality simulation in the performance assessment of carotid angiography.

OBJECTIVES: Improvement in performance as measured by metric-based procedural errors must be demonstrated if virtual reality (VR) simulation is to be used as a valid means of proficiency assessment and improvement in procedural-based medical skills. BACKGROUND: The Food and Drug Administration requires completion of VR simulation training for physicians learning to perform carotid stenting. METHODS: Interventional cardiologists (n = 20) participating in the Emory NeuroAnatomy Carotid Training program underwent an instructional course on carotid angiography and then performed five serial simulated carotid angiograms on the Vascular Interventional System Trainer (VIST) VR simulator (Mentice AB, Gothenburg, Sweden). Of the subjects, 90% completed the full assessment. Procedure time (PT), fluoroscopy time (FT), contrast volume, and composite catheter handling errors (CE) were recorded by the simulator. RESULTS: An improvement was noted in PT, contrast volume, FT, and CE when comparing the subjects' first and last simulations (all p < 0.05). The internal consistency of the VIST VR simulator as assessed with standardized coefficient alpha was high (range 0.81 to 0.93), except for FT (alpha = 0.36). Test-retest reliability was high for CE (r = 0.9, p = 0.0001). CONCLUSIONS: A learning curve with improved performance was demonstrated on the VIST simulator. This study represents the largest collection of such data to date in carotid VR simulation and is the first report to establish the internal consistency of the VIST simulator and its test-retest reliability across several metrics. These metrics are fundamental benchmarks in the validation of any measurement device. Composite catheter handling errors represent measurable dynamic metrics with high test-retest reliability that are required for the high-stakes assessment of procedural skills.

Cardiology↗

PubMed2026

Measuring economic efficiency in adult intensive care units: A systematic review of methods, metrics, and evidence.

OBJECTIVES: Intensive care units (ICUs) consume substantial hospital resources, yet "efficiency" is inconsistently defined and measured. This study systematically reviewed how economic efficiency has been conceptualised and quantified in adult ICUs and appraised the quality of evidence. METHODS: Following PRISMA 2020 and a PROSPERO-registered protocol (CRD420251107866), we searched MEDLINE, Embase, CINAHL, Cochrane Library and Web of Science (2000-August 2025), plus global grey sources. Eligible studies explicitly defined efficiency and reported an efficiency metric/model linking ICU inputs (e.g., staff, beds/capacity, time, consumables, or costs) to outputs/outcomes (e.g., throughput/discharges, length of stay/resource use, risk-adjusted mortality). Dual independent screening and extraction were performed. Study quality was appraised using MMAT, and findings were synthesised narratively (SWiM), given heterogeneity. RESULTS: 39 studies (2001-2025) from 17 countries were included, all from high-income or upper-middle-income settings. Four methodological families were identified: (1) frontier modelling (predominantly DEA; occasional SFA/RFDH), (2) benchmarking indicators (risk-adjusted mortality and LOS/resource-use ratios; "efficiency matrix" quadrant classification), (3) cost-outcome evaluations, and (4) operational/process metrics. Across families, variation in decision-making units, input/output selection, and risk adjustment limited comparability; long-term and patient-reported outcomes were absent, and equity considerations were uncommon. CONCLUSIONS: ICU efficiency research is feasible but fragmented and often methodologically limited. Standardised definitions, validated risk adjustment, uncertainty quantification, and inclusion of patient-centred and equity-relevant outcomes are needed before efficiency metrics can reliably inform value-based decision making.

Intensive Care Units↗

PubMed2000

Simulation of electrophoretic separations by the flux-corrected transport method.

Electrophoretic separations at typical experimental electric field strengths have been simulated by applying the flux-corrected transport (FCT) finite difference method to the transient, one-dimensional electrophoresis model. The performance of FCT on simulations of zone electrophoresis (ZE), isotachophoresis (ITP), and isoelectric focusing (IEF) has been evaluated. An FCT algorithm, with a three-point, central spatial discretization, yields numerical solutions without numerical oscillations or spurious peaks, which have plagued previously-published second-order solutions to benchmark ZE and ITP problems. Moreover, the FCT technique captures sharp zone boundaries and IEF peaks more accurately than previously-published, first-order upwind schemes.

Algorithms↗

PubMed2005

Rapid assessment of protein structural stability and fold validation via NMR.

In structural proteomics, it is necessary to efficiently screen in a high-throughput manner for the presence of stable structures in proteins that can be subjected to subsequent structure determination by X-ray or NMR spectroscopy. Here we illustrate that the (1)H chemical distribution in a protein as detected by (1)H NMR spectroscopy can be used to probe protein structural stability (e.g., the presence of stable protein structures) of proteins in solution. Based on experimental data obtained on well-structured proteins and proteins that exist in a molten globule state or a partially folded alpha-helical state, a well-defined threshold exists that can be used as a quantitative benchmark for protein structural stability (e.g., foldedness) in solution. Additionally, in this chapter we describe a largely automated strategy for rapid fold validation and structure-based backbone signal assignment. Our methodology is based on a limited number of NMR experiments (e.g., HNCA and 3D NOESY-HSQC) and performs a Monte Carlo-type optimization. The novel feature of the method is the opportunity to screen for structural fragments (e.g., template scanning). The performance of this new validation tool is demonstrated with applications to a diverse set of proteins.

Calcium↗

PubMed2004

Can randomized trial outcomes for carotid endarterectomy be achieved in community-wide practice?

The benefit of carotid endarterectomy (CEA) is dependent upon achieving procedural outcomes comparable to those observed in randomized trials. We have extensively examined outcomes of the procedure in the community with a complete medical record (hospital chart) review of over 20,000 Medicare patients undergoing CEA in 10 states. In patients with comparable indications, overall risk of stroke or death of 6.9% in our Medicare studies was comparable to the 6.5% combined event rate in the North American Symptomatic Carotid Endarterectomy Trial. In asymptomatic patients, however, the overall Medicare study result of 3.8% was inferior to the benchmark perioperative combined event rate of 1.5% achieved in the Asymptomatic Carotid Atherosclerosis Study. Our data demonstrated that the randomized trial benchmarks could be achieved or even exceeded at a statewide level. Our studies also documented that evidence-based processes that can reduce perioperative stroke and death (eg, perioperative antiplatelet therapy, patching) are underutilized in the community. Overall process and outcomes assessment show considerable room for improvement. All surgeons performing CEA should use a system-based approach to ensure that all evidence-based processes are employed for patients undergoing CEA and should use indication stratification to document their own outcomes for the procedure.

Aged↗

PubMed2006

Assessing proficiency in adult basic life support: student and expert assessment and the impact of video recording.

Self-assessment is an important aspect in the development of lifelong learning skills for medical students, crucial to maintaining a high level of competence in practice. Basic Life Support (BLS) is a skill that all health professionals must acquire and maintain competence in. This paper reports data from a study of 95 first-year graduate entry medical students at Flinders University in Australia, determining how well the students could assess their own BLS performance. These students were videotaped performing a short CPR scenario using a Resusci Anne with SkillReporter (Laerdal, Norway). Using a six-point descriptive ratings scale, students graded themselves twice: once immediately after completing the task, and again after viewing a video of their performance. A single expert assessor viewed all the video recordings and, based on International Liaison Committee on Resuscitation (ILCOR) Guidelines, graded the students using the same scale. The hypothesis was that the intervention of viewing their performance on video would improve the correlation of their ratings with the expert assessor. The results showed that the students' assessments did not agree with the expert assessor either before (weighted kappa = 0.03) or after seeing the video (weighted kappa = 0.002). Possible reasons, including student attitudes and lack of benchmarking, are discussed. Self-assessment skills of students warrant further attention.

Cardiopulmonary Resuscitation↗

PubMed2026

ALPINE: a scalable pipeline for comprehensive classification of gene-editing outcomes from long-read amplicon sequencing.

SUMMARY: CRISPR genome editing has enabled precise genetic modification for gene and cell therapies, but edits often produce heterogeneous on-target outcomes, including homology-directed repair (HDR) knock-ins, DNA repair template integrations, and structural variants. Existing tools are frequently limited to short reads or lack viral vector-specific integration categories needed for therapeutic development. Here, we present ALPINE (Amplicon Long-read Pipeline for INtegration Evaluation), a scalable and reproducible pipeline for classifying and quantifying gene-editing outcomes from long-read amplicon sequencing supporting both PacBio HiFi and Oxford Nanopore platforms. ALPINE classifies reads into 10+ categories, including DNA repair vector integration subtypes, and performs variant calling near the gene-edited site with batch, multi-sample reporting. Uniquely, ALPINE can distinguish between cells treated with multiple DNA repair vectors and identify distinct molecular features, such as inverted terminal repeats (ITRs), enabling comprehensive characterization of complex gene editing outcomes. Dual-target benchmarking on simulated datasets demonstrated high accuracy for transgene integration events. Independent validation on public crosslinked-HDR dataset confirmed ALPINE's integration detection capabilities, and application to edited T cell samples demonstrated comprehensive gene-editing outcome profiling. AVAILABILITY: ALPINE is available under MIT license at https://github.com/Maggi-Chen/ALPINE and https://doi.org/10.5281/zenodo.20272510. All analysis scripts and visualization code used in this manuscript are available at https://github.com/Maggi-Chen/ALPINE-manuscript-analysis. Simulated datasets are deposited at Zenodo (https://doi.org/10.5281/zenodo.20260865). Public dataset PRJNA913199 is available through NCBI SRA.

Gene Editing↗