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Results for “Evaluation Methodology”

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At least 19 recordsLinked to original sources

PubMed1991

Fast track evaluation methodology.

Evaluating hospital information systems has taken a variety of forms since the initial development and use of automation. The process itself has moved from a hardware-based orientation controlled by data processing professionals to systems solutions and a user-driven process overseen by management. At Harbor Hospital Center in Baltimore, a fast track methodology has been introduced to shorten system evaluation time to meet the rapid changes that constantly affect the healthcare industry.

Baltimore↗

PubMed2002

ASV determination of cadmium complexation in seawater. Methodology evaluation.

The methodology for using DPASV to study cadmium complexation in seawater is evaluated using EDTA as a model ligand and by analysing natural samples. The results show that the methodology gives an accurate evaluation of metal complexation when inert complexes are studied, both as regards the ligand concentration and the conditional stability constant; the error for both the parameters is lower than 10% at a ligand concentration of about 10(-8) M and a conditional stability constant of 10(9) M-1. Cadmium complexes with ligands present in natural seawater show an evident kinetic lability that may lead to underestimation of the conditional stability constant when a working electrode characterised by a very thick diffusion layer is used. The conditional stability constant in one water sample of the Adriatic coast ranged between 0.14 and 1.4 l/nmol using a rotating disk electrode at rotation rates of 300 and 6000 rpm. The results of cadmium complexation obtained for samples collected in coastal seawater show that the ligands present low specificity for the metal.

Cadmium↗

PubMed1999

Helping children adjust--a Tri-Ministry Study: I. Evaluation methodology.

This report describes the evaluation methodology of the Tri-Ministry Study--a school-based trial evaluating the effectiveness of three universal programs: (a) a classwide social skills program (SS), (b) a partner reading program (RE); and, (c) a combination of both (SS & RE), to reduce and prevent behavioural maladjustment among children in the primary division (up to grade 3) of Ontario schools. The trial was done between 1991 and 1995. Sixty schools in 11 boards of education took part and were assigned randomly to program(s) during the study. Contributing to the evaluation database are detailed follow-up assessments (observations, ratings, and standard tests) on 2439 children. Three-level growth trajectory models are used to evaluate program effects. The analysis presented for illustration in this report focuses on reading achievement measured by the Wide Range Achievement Test. A companion paper presents the results of the study and discusses important methodological and programmatic issues applicable to this and other prevention studies in the field.

Child↗

PubMed1997

Methodologic evaluation of the radiology cost-effectiveness literature.

PURPOSE: To evaluate the methodologic quality of cost-effectiveness and cost-benefit analyses reported in the radiology literature. MATERIALS AND METHODS: Original investigations of cost-effectiveness and cost-benefit analysis were identified from an on-line search of the radiology literature from 1989 to 1995. The articles were evaluated for adherence to minimum methodologic standards for economic analysis research. Major criteria assessed were (a) provision of comparative options, (b) statement of perspective of analysis, (c) presentation of cost data, (d) measurement of outcomes, (e) use of a summary measure of economic efficiency, and (f) performance of sensitivity analysis. Minor criteria assessed were inclusion of (a) source of cost data, (b) long-term costs, (c) discounting, and (d) incremental computation of the summary measure. RESULTS: Forty-four economic analysis articles were identified. The median numbers of major and minor principles adhered to were three and one, respectively. Five studies used all six major criteria, and three used all 10 criteria. The median number of criteria adhered to did not increase during the study period. CONCLUSION: Adherence to methodologic standards in the radiology cost-effectiveness literature is not optimal. There are several examples from radiology journals, however, where such standards are met.

Bibliometrics↗

PubMed1998

Economic analyses of radiological procedures: a methodological evaluation of the medical literature.

OBJECTIVE: Increasing pressure to curb health care costs has led to considerable interest in economic analyses, including both cost-effectiveness and cost-benefit analyses. Numerous economic analyses of radiological procedures have appeared in both the radiology and non-radiology literature. The objective of this study was to evaluate the methodological quality of economic analyses of radiological procedures published in the non-radiology medical literature during the years 1990 1995. METHODS: Original investigations from the medical (non-radiological) literature that include economic analyses of radiological interventions were identified from a computerized literature search. Each economic analysis article was evaluated by two independent reviewers for adherence to ten methodological criteria. The criteria were derived from review of the medical and radiological economic analysis methodology literature and consisted of the following: (1) Comparative options stated; (2) perspective of analysis defined; (3) outcome measure identified; (4) cost data included; (5) source of cost data stated; (6) long term costs included; (7) discounting employed; (8) summary measure provided; (9) incremental computation method used; and (10) sensitivity analysis performed. The results were compared to a previous study that evaluated the radiological literature. RESULTS: Of the 56 articles in the medical literature that included economic analyses of radiological procedures, only eight (14%) conformed to all ten methodological criteria. The cost data (98%) and comparative options (89%) criteria exhibited high compliance, while the perspective of analysis (25%) and discounting (32%) criteria had relatively low compliance. Agreement between the reviewers was excellent (kappa = 0.88). CONCLUSIONS: Published economic analyses of radiology procedures usually do not meet accepted methodological standards.

Bibliometrics↗

PubMed1998

Economic analyses in obstetrics and gynecology: a methodologic evaluation of the literature.

OBJECTIVE: To evaluate the methodology of the cost-effectiveness and cost-benefit literature in obstetrics and gynecology. DATA SOURCES: We performed a MEDLINE search of the general and subspecialty obstetrics and gynecology journals for the years 1990 through 1996. METHODS OF STUDY SELECTION: Original investigations including cost-effectiveness or cost-benefit were evaluated by two reviewers for adherence to ten minimum methodologic standards derived by a review of guidelines for medical economic analyses. The major criteria considered included: 1) provision of comparative options, 2) statement of analytic perspective, 3) presentation of cost data, 4) identification of outcome measure, 5) use of summary measure of economic effectiveness or benefit, and 6) performance of a sensitivity analysis. The minor criteria evaluated included: 1) statement of source of cost data, 2) inclusion of long-term costs, 3) use of discounting, and 4) calculation of an incremental summary measure. TABULATION, INTEGRATION, AND RESULTS: Ninety-eight articles that included cost-benefit or cost-effectiveness analyses were identified. The mean number of major and minor principles adhered to were 3.6 and 1.0, respectively. Five publications (5.1%) conformed to all ten major and minor criteria, whereas nine (9.2%) articles used all six major criteria. The provision of cost data (94.8%) and statement of comparative options (96.9%) were the major principles most frequently adhered to, whereas the use of discounting (10.2%) and statement of analytic perspective (19.3%) showed the lowest compliance. Agreement between the reviewers was excellent (kappa .87). CONCLUSION: Published economic analyses in the obstetrics and gynecology literature seldom adhere to all recommended methodologic guidelines. Further training in the methodology of cost-effectiveness analysis is needed within the specialty.

Cost-Benefit Analysis↗

PubMed2003

Standard outcome metrics and evaluation methodology for disease management programs. American Healthways and Johns Hopkins Consensus Conference.

Disease management is conceptually recognized as being a significant approach for closing the gaps in care identified by the Institute of Medicine as contributing to poor outcomes from our health care system. That conceptual credibility has been bolstered by the disease management industry through the adoption of an industry-standard definition of disease management and through the development and implementation of disease management accreditation programs by the National Committee for Quality Assurance, Utilization Review Accreditation Commission, and Joint Commission on Accreditation of Healthcare Organizations. The clinical and financial outcomes of disease management programs continue to be suspect, however, due to the lack of an industry standard set of outcomes metrics and a uniform methodology for evaluating those metrics. As a result, the ability to evaluate the effectiveness of any individual program is compromised, and the ability to effectively compare results across programs of different delivery designs is non-existent. To address this issue, American Healthways and Johns Hopkins convened a consensus conference of nearly 150 health care professionals representing health plans, hospitals, practicing physicians (both primary care and specialty), and other health care professionals. The conference purpose was to develop a "first-step" set of metrics and a uniform methodology that could be applied industry-wide to enable meaningful comparisons between programs and to allow evaluation of individual programs whether "homegrown" or "outsourced." The consensus conferees recognized that there were many paths to this objective, but that they had to land on a set of metrics and a methodology that was "doable" in light of today's technology and data availability. The results of their consensus effort follow.

Disease Management↗

PubMed1997

The Danish approach to standards for economic evaluation methodologies.

Standards for economic evaluation have now been proposed in several countries. The background for this article is a report commissioned in 1994 by the Danish health authorities (the National Board of Health and the Danish Ministry of Health) on the state of the art of economic evaluation: are the methods ready to be used for systematic decision-making in the Danish healthcare sector? The themes of this article are the attitude towards economic evaluation of medical technologies and healthcare services in Denmark, the areas for application and the desirability and feasibility of a standard set of methods for conducting economic evaluations. In addition, the current state of methodologies in economic evaluation is briefly outlined. On the background of a roundtable discussion of interested parties, the Danish health authorities have decided to introduce economic evaluation of new pharmaceutical products, on a voluntary basis for 2 to 3 years, when application has been made for public reimbursement.

Denmark↗

PubMed2003

Evaluation methodology for a medical e-education patient-oriented information system.

This paper describes an evaluation methodology designed for the IMSA (Interactive Multimedia System for Auto-medication) system. IMSA stands in the multidisciplinary field of medical informatics and aims at providing a health care Internet tool for the general public. As far as a medical information system is patient-oriented, issues in understanding content and of human - computer interface usability are key factors to achieve success. The team developing IMSA concentrated part of its work on designing an evaluation methodology to ensure that the system is user-friendly and responds in a way that can be easily understood by the general public. This methodology is built on a three-tier architecture with the user, the evaluator and a set of medical case descriptions. The testing protocol is based on a user trying to run scenarios related to mild clinical signs on the IMSA prototype under the passive presence of an evaluator.

Evaluation Studies as Topic↗

PubMed2005

Standardized evaluation methodology for 2-D-3-D registration.

In the past few years, a number of two-dimensional (2-D) to three-dimensional (3-D) (2-D-3-D) registration algorithms have been introduced. However, these methods have been developed and evaluated for specific applications, and have not been directly compared. Understanding and evaluating their performance is therefore an open and important issue. To address this challenge we introduce a standardized evaluation methodology, which can be used for all types of 2-D-3-D registration methods and for different applications and anatomies. Our evaluation methodology uses the calibrated geometry of a 3-D rotational X-ray (3DRX) imaging system (Philips Medical Systems, Best, The Netherlands) in combination with image-based 3-D-3-D registration for attaining a highly accurate gold standard for 2-D X-ray to 3-D MR/CT/3DRX registration. Furthermore, we propose standardized starting positions and failure criteria to allow future researchers to directly compare their methods. As an illustration, the proposed methodology has been used to evaluate the performance of two 2-D-3-D registration techniques, viz. a gradient-based and an intensity-based method, for images of the spine. The data and gold standard transformations are available on the internet (http://www.isi.uu.nl/Research/Databases/).

Algorithms↗

PubMed1985

A methodological evaluation of 14 controlled clinical trials in myelomatosis.

A methodological evaluation of the 14 randomized clinical controlled trials so far published on myelomatosis was performed. A quite large heterogeneity was observed among the trials, especially in their presentation of patients included and in the criteria applied for therapeutic response. Additionally, none of the studies accounted for the randomization procedure - and particularly whether the randomizations were performed consecutively. 19 comparisons of the effectiveness of various drugs or drug combinations were performed and in 12 of these an insignificant result was obtained. 2 of these with more than 25% probability have overlooked a beneficial effect of one of the regimens of more than 50% and 6 trials of more than 25%. It is stressed that these situations will arise when sample sizes that are too small are applied in clinical trials. It is concluded that internationally accepted criteria for diagnosis and therapy response are needed. Additionally, a more thorough statistical planning, prior to initiation of a trial, and a more extensive analysis of the results would be helpful.

Adult↗

PubMed1983

Prostaglandin E1 in normal human skin: methodological evaluation, topographical distribution and data related to sex and age.

A methodological evaluation of a radioimmunoassay technique for PGE1 measurement was applied to normal human skin. The detection limit of the assay was 15 pg and recovery (mean +/- SD) was 90 +/- 6%. The mean value of PGE1 (+/- SEM) in nine punch biopsy specimens (4 mm in diameter) from a piece of skin surgically removed from one person was 117 +/- 14 pg/mg dry weight. The individual variation of PGE1 activity in biopsy specimens from the same topographical area in ten persons belonging to the same sex and age group was 33 +/- 4 pg/mg dry weight. The influence has been elucidated of temperature and tissue processing, local anaesthesia, sex, age and topographical distribution on endogenous PGE1 activity.

Adult↗

PubMed1996

Evaluating methodologies for assessing the value of information: sifting the evidence.

The article evaluates methodologies for studying the clinical benefits of information provision and use, particularly the impact on clinical decision making (and hence on patient care). The problems of replication of research are discussed, and the ways in which the Value Project consolidated and extended previous studies are considered. Comparisons among studies demonstrate that some of the impact findings are qualitatively and quantitatively similar, but there are also some contradictory findings. Methodological variations and differences in health care cultures account for some of the differences. Implications for the reliability and validity of these methods for assessing the value of information to clinicians are considered.

Attitude of Health Personnel↗

PubMed2004

A quality evaluation methodology of health web-pages for non-professionals.

PRIMARY OBJECTIVE: The proposal of an evaluation methodology for determining the quality of healthcare web sites for the dissemination of medical information to non-professionals. METHODS AND PROCEDURES: Three (macro) factors are considered for the quality evaluation: medical contents, accountability of the authors, and usability of the web site. Starting from two results in the literature the problem of whether or not to introduce a weighting function has been investigated. This methodology has been validated on a specialized information content, i.e., sore throats, due to the large interest such a topic enjoys with target users. The World Wide Web was accessed using a meta-search system merging several search engines. A statistical analysis was made to compare the proposed methodology with the obtained ranks of the sample web pages. MAIN OUTCOME AND RESULTS: The statistical analysis confirms that the variables examined (per item and sub factor) show substantially similar ranks and are capable of contributing to the evaluation of the main quality macro factors. A comparison between the aggregation functions in the proposed methodology (non-weighted averages) and the weighting functions, derived from the literature, allowed us to verify the suitability of the method. CONCLUSIONS: The proposed methodology suggests a simple approach which can quickly award an overall quality score for medical web sites oriented to non-professionals.

Attitude to Computers↗

PubMed1980

Field application of evaluated methodology for determining 1,2-dibromoethane, EDB, in ambient air.

EDB (ethylene dibromide) is of regulatory interest because it has cancer inducing properties and is a causative agent of aspermia. Previously evaluated methodology was used to determine the extent of exposure of workers to EDB in citrus fumigation stations and a warehouse used as a holding site before shipment. The purpose of this effort was to carry out environmental sampling, and to determine the exposure level of workers and related administrative personnel at two citrus fumigation centers and at a warehouse.

Air↗

PubMed1997

Determining if shared leadership is being practiced: evaluation methodology.

This article explores the use of a cognitive information-processing structure, mental models, to assess an organizational management change to shared leadership (SL). The purpose of this study was to describe the mental models of critical care nurses after the implementation of an SL management model. Scenarios based on daily clinical situations and measuring three SL concepts (empowerment, accountability, and partnership in decision making) were posed to critical care nurses in personal interviews. By using this evaluation methodology, nurse administrators can determine to what extent a new management change has been incorporated into daily nursing practice and in what areas to target further education and resources.

Critical Care↗

PubMed1982

Evaluation methodology for ambulatory care information systems.

The central purpose of an ambulatory care information system is to communicate information to the practitioner to facilitate clinical decision making. The clinical decision can be considered the dependent output variable in a process in which the information system, the patient, clinician characteristics and the environment are the independent input variables. Evaluation methodologies must consider there relationships. Approaches using patients outcomes are problematic because of indirect relationship between the information system and patient outcomes, which limits both sensitivity and validity. A process measure technique that focuses on the clinical decision directly as the measure of output could be appropriate if the represented a generic sampling of clinical decisions made in ambulatory care. A new method under development based on an information theory concept may be more widely applicable than currently available methods.

Ambulatory Care↗

PubMed1996

Urethral obstruction after anti-incontinence surgery in women: evaluation, methodology, and surgical results.

OBJECTIVES: To evaluate a group of women with voiding dysfunction and a low maximum flow rate (MFR) (less than or equal to 12 mL/s) after surgery for stress urinary incontinence (SUI); to establish diagnostic parameters indicating obstruction in an attempt to determine treatment selection; and to evaluate preliminary surgical results. METHODS: Eighteen women who underwent anti-incontinence surgery for SUI were diagnosed as having infravesical obstruction (IO). Thirteen women (group A [72%]) presented with clinically predominant symptoms of urgency, frequency, intermittency, and a variable vesical residual volume (RV), and five (group B [28%]) had as their most significant symptoms a high vesical RV and urinary tract infection that had been managed with intermittent catheterization (IC). The diagnosis of IO, suspected after clinical history, was established after physical examination and cystoscopic, cystographic and urodynamic investigations. RESULTS: Bladder instability was demonstrated in 6 group A patients (46%) and 1 group B patient (20%) (P = NS). Mean MFRs were 8.07 and 7.2 mL/s, respectively, in both groups (P = NS). Mean maximal voiding pressures (MVPs) were 20.23 and 5 cm H20, and mean RVs were 57.46 and 174 mL, respectively; both differences were statistically very significant (P <0.01 and P <0.001, respectively). High to normal MVPs occurred in 2 patients overall (11%). Bladder neck overcorrection, midurethral distortion, and postsurgical cystocele were demonstrated in both groups in 11 (85%), 0, and 2 (15%) patients in group A and 3 (60%), 2 (40%), and 3 (60%) patients in group B, respectively (P = NS). Patients in group A were treated surgically with cystourethrolysis and a repeated, less obstructive anti-incontinence operation. In group B 2 women (40%) had a similar surgical procedure; 1 (20%) underwent isolated urethrolysis; and 2 (40%) are currently maintained with IC. CONCLUSIONS: Among these 18 patients with voiding dysfunction after anti-incontinence surgery, a primary diagnosis of IO was established clinically. Only patients with a low MFR were selected for this study. Cytographic and endoscopic investigation as well as the presence of postsurgical cystocele assisted in establishing the diagnosis. The success rate with urethrolysis and resuspension was 60% for the 13 women with predominantly urgency, frequency, and the highest MVPs (20.23 +/- 9.67 cm H20 [group A) and 33% for the 5 women with urinary retention presenting the lowest MVPs (5.00 +/- 7.07 cm H20 [group A]) and 33% for the 5 women with urinary retention presenting the lowest MVPs (5.00 +/- 7.07 cm H20 [group B]). An added resuspension procedure is probably unnecessary in the latter group of patients and requires careful individual selection in the former group.

Adult↗