scholarly journals Kidney Perfusion as an Organ Quality Assessment Tool—Are We Counting Our Chickens Before They Have Hatched?

2020 ◽  
Vol 9 (3) ◽  
pp. 879 ◽  
Author(s):  
Julie De Beule ◽  
Ina Jochmans
Keyword(s):  
Quality Assessment ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Ex Situ ◽  
Risk Scores ◽  
Final Decision ◽  
Kidney Graft ◽  
Viability Assessment ◽  
Organ Quality ◽  
Kidney Perfusion

The final decision to accept an organ for transplantation remains a subjective one. With “poor organ quality” commonly cited as a major reason for kidney discard, accurate, objective, and reliable quality assessment is essential. In an era of increasingly higher-risk deceased donor kidneys, the catch is to accept those where the risk–benefit scale will tip in the right direction. Currently available assessment tools, such as risk-scores predicting outcome and zero-time biopsy, perform unsatisfactory, and assessment options during static cold storage are limited. Kidney perfusion technologies are finding their way into clinical practice, and they bring a new opportunity to assess kidney graft viability and quality, both in hypothermic and normothermic conditions. We give an overview of the current understanding of kidney viability assessment during ex situ kidney perfusion. A pragmatic framework to approach viability assessment is proposed as an interplay of three different compartments: the nephron, the vascular compartment, and the immune compartment. Although many interesting ways to assess kidney injury and function during perfusion have been proposed, none have reached the stage where they can reliably predict posttransplant outcome. Larger well-designed studies and validation cohorts are needed to provide better guidance.

Complications following volar locking plate fixation for distal radial fractures: a systematic review

2013 ◽  
Vol 39 (7) ◽  
pp. 745-754 ◽  
Author(s):  
A. Bentohami ◽  
K. de Burlet ◽  
N. de Korte ◽  
M. P. J. van den Bekerom ◽  
J. C. Goslings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Locking Plate ◽  
Assessment Tool ◽  
Plate Fixation ◽  
Assessment Tools ◽  
Volar Locking Plate ◽  
Locking Plate Fixation ◽  
Distal Radial Fractures ◽  
Level Of Evidence

The purpose of this systematic review is to assess the prevalence of complications following volar locking plate fixation of distal radial fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Only prospective comparative and prospective cohort studies that presented data concerning complications after treatment of distal radial fractures with a volar locking plate in human adults with a minimal follow-up of 6 months were included. Two quality assessment tools were used to assess the methodological quality of the studies (level of evidence rating according to the Oxford Centre of Evidence Based Medicine and the modified version of the Cochrane Bone, Joint and Muscle Trauma Group’s former quality assessment tool). Thirty three studies were eligible for final assessment. Most complications were problems with nerve and tendon function as well as complex regional pain syndrome. With an overall complication rate of 16.5%, most of which were ‘minor’ complications and low rates of nonunion and malunion, volar locking plate fixation can be considered a reasonably safe treatment option for patients with distal radial fractures.

scholarly journals Development of a Multidimensional App-Quality Assessment Tool for Health-Related Apps (AQUA)

2020 ◽  
Vol 1 (2) ◽  
pp. 13-23
Author(s):  
Teresa O'Rourke ◽  
Rüdiger Pryss ◽  
Winfried Schlee ◽  
Thomas Probst
Keyword(s):  
Quality Assessment ◽  
Mobile Applications ◽  
Assessment Tool ◽  
Cognitive Testing ◽  
Assessment Tools ◽  
German Language ◽  
User Engagement ◽  
Quality Assessment Tool ◽  
The Public ◽  
Health Related

Background A multitude of health-related mobile applications is available to the public in app stores. Many of these apps were not developed by health professionals and do not keep what they promise. To facilitate a safe handling and use of such apps, it is important to assess their quality in a standardized way. Some instruments for app quality assessment exist, although they have some limitations, which we want to improve on with this new assessment tool. Objectives The objective of this paper is to introduce a new multidimensional criteria-based tool for the quality assessment of health-related apps. Method Based on existing app-quality assessment tools and guidelines for evaluating health-related app-quality, items were constructed to assess objective and subjective app-quality. A pretest in form of cognitive testing was conducted with six participants and some items were optimized. Results An expert and a user version of AQUA were developed in English and German language. The expert version consists of 31 items in the seven dimensions Usability, User Engagement, Content, Visual Design, Therapeutic Quality, Security and Information. The user version consists of 34 items and additionally includes the dimension Impact. Conclusion AQUA is a brief multidimensional app-quality assessment tool that can be used for the quality assessment of health-related and mental health-related apps by experts and app-users.

scholarly journals Using smartphone-based virtual patients to assess the quality of primary healthcare in rural China: protocol for a prospective multicentre study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020943 ◽  
Author(s):  
Jing Liao ◽  
Yaolong Chen ◽  
Yiyuan Cai ◽  
Nan Zhan ◽  
Sean Sylvia ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Low Income ◽  
Rural Areas ◽  
Assessment Tool ◽  
Low Cost ◽  
Care Quality ◽  
Assessment Tools ◽  
Face Validity ◽  
Virtual Patients ◽  
Health Centres

IntroductionValid and low-cost quality assessment tools examining care quality are not readily available. The unannounced standardised patient (USP), the gold standard for assessing quality, is costly to implement while the validity of clinical vignettes, as a low-cost alternative, has been challenged. Computerised virtual patients (VPs) create high-fidelity and interactive simulations of doctor-patient encounters which can be easily implemented via smartphone at low marginal cost. Our study aims to develop and validate smartphone-based VP as a quality assessment tool for primary care, compared with USP.Methods and analysisThe study will be implemented in primary health centres (PHCs) in rural areas of seven Chinese provinces, and physicians practicing at township health centres and village clinics will be our study population. The development of VPs involves three steps: (1) identifying 10 VP cases that can best represent rural PHCs’ work, (2) designing each case by a case-specific development team and (3) developing corresponding quality scoring criteria. After being externally reviewed for content validity, these VP cases will be implemented on a smartphone-based platform and will be tested for feasibility and face validity. This smartphone-based VP tool will then be validated for its criterion validity against USP and its reliability (ie, internal consistency and stability), with 1260 VP/USP-clinician encounters across the seven study provinces for all 10 VP cases.Ethics and disseminationSun Yat-sen University: No. 2017-007. Study findings will be published and tools developed will be freely available to low-income and middle-income countries for research purposes.

scholarly journals Validation of a multiple criteria tool for healthcare facilities quality evaluation

Facilities ◽  
2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrea Brambilla ◽  
Göran Lindahl ◽  
Marta Dell'Ovo ◽  
Stefano Capolongo
Keyword(s):  
Quality Assessment ◽  
Design Research ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Structured Interviews ◽  
Patient Centeredness ◽  
Content Type ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Social Environmental

Purpose Several healthcare quality assessment tools measure the processes and outcomes of the care system. The actual physical infrastructure (buildings and organizational) aspects are, however, rarely considered. The purpose of this paper is to describe the process of validation and weighting of an evidence-informed framework for the quality assessment of hospital facilities from social, environmental and organizational perspectives to complement other assessments. Design/methodology/approach Sustainable High-quality Healthcare version 2 (SustHealth v2) is the updated version of an existing framework composed of three domains (social, environmental and organizational quality). To validate and establish a relevant weighting, interviews were conducted with 15 professionals within the field of healthcare planning, design, research and management. The study has been conducted through semi-structured interviews and the application of the Simon Roy Figueras (SRF) procedure for the elicitation of weights criteria. The data collected have been processed through the DecSpace web platform. Findings Among the three domains, the organizational qualities appear to be the most important (W = 49%), followed by the environmental (W = 29%) and social aspects (W = 22%). Relevant indicators such as future-proofing, wayfinding and users’ space control emerged as the most important within each macro-area. Those results are confirmed by the outcome of the interviews that highlight user/patient-centeredness, wayfinding strategies and space functionality as the most important concepts to foster in existing healthcare facilities improvement. Practical implications The study highlights important structural and organizational aspects that hospital managers and planners can consider when dealing with healthcare facilities’ quality improvement. Originality/value The use of the SRF multicriteria method is novel in this context when used to weight an assessment tool with a focus on hospital built environment.

scholarly journals Assessing Kidney Graft Viability and Its Cells Metabolism during Machine Perfusion

2021 ◽  
Vol 22 (3) ◽  
pp. 1121 ◽  
Author(s):  
Maria Irene Bellini ◽  
Francesco Tortorici ◽  
Maria Ida Amabile ◽  
Vito D’Andrea
Keyword(s):  
Graft Function ◽  
Kidney Graft ◽  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Viability Assessment ◽  
Organ Quality ◽  
Dynamic Techniques ◽  
Stage Renal Disease ◽  
End Stage ◽  
Circulatory Death

Kidney transplantation is the golden treatment for end-stage renal disease. Static cold storage is currently considered the standard method of preservation, but dynamic techniques, such as machine perfusion (MP), have been shown to improve graft function, especially in kidneys donated by extended criteria donors and donation after circulatory death. With poor organ quality being a major reason for kidneys not being transplanted, an accurate, objective and reliable quality assessment during preservation could add value and support to clinicians’ decisions. MPs are emerging technologies with the potential to assess kidney graft viability and quality, both in the hypothermic and normothermic scenarios. The aim of this review is to summarize current tools for graft viability assessment using MP prior to implantation in relation to the ischemic damage.

scholarly journals QUALITY ASSESSMENT OF ETHICS ANALYSES FOR HEALTH TECHNOLOGY ASSSESSMENT

2016 ◽  
Vol 32 (5) ◽  
pp. 362-369 ◽  
Author(s):  
Anna Mae Scott ◽  
Kenneth Bond ◽  
Iñaki Gutiérrez-Ibarluzea ◽  
Björn Hofmann ◽  
Lars Sandman
Keyword(s):  
Quality Assessment ◽  
Web Sites ◽  
Assessment Tool ◽  
Ethical Issues ◽  
Health Technology ◽  
Assessment Tools ◽  
Quality Assessment Tool ◽  
Key Characteristics ◽  
Crucial Part

Objectives: Although consideration of ethical issues is recognized as a crucial part of health technology assessment, ethics analysis for HTA is generally perceived as methodologically underdeveloped in comparison to other HTA domains. The aim of our study is (i) to verify existing tools for quality assessment of ethics analyses for HTA, (ii) to consider some arguments for and against the need for quality assessment tools for ethics analyses for HTA, and (iii) to propose a preliminary set of criteria that could be used for assessing the quality of ethics analyses for HTA.Methods: We systematically reviewed the literature, reviewed HTA organizations’ Web sites, and solicited views from thirty-two experts in the field of ethics for HTA.Results: The database and HTA agency Web site searches yielded 420 references (413 from databases, seven from HTA Web sites). No formal instruments for assessing the quality of ethics analyses for HTA purposes were identified. Thirty-two experts in the field of ethics for HTA from ten countries, who were brought together at two workshops held in Edmonton (Canada) and Cologne (Germany) confirmed the findings from the literature.Conclusions: Generating a quality assessment tool for ethics analyses in HTA would confer considerable benefits, including methodological alignment with other areas of HTA, increase in transparency and transferability of ethics analyses, and provision of common language between the various participants in the HTA process. We propose key characteristics of quality assessment tools for this purpose, which can be applied to ethics analyses for HTA purposes.

Assessing Medical Evidence

2018 ◽  
Author(s):  
Jacob Stegenga
Keyword(s):  
Quality Assessment ◽  
Randomized Trials ◽  
Empirical Studies ◽  
Allocation Concealment ◽  
Assessment Tools ◽  
Medical Evidence ◽  
Empirical Methods ◽  
First Order ◽  
First Order Methods

Medical scientists employ ‘quality assessment tools’ to assess evidence from medical research, especially from randomized trials. These tools are designed to take into account methodological details of studies, including randomization, subject allocation concealment, and other features of studies deemed relevant to minimizing bias. There are dozens of such tools available. They differ widely from each other, and empirical studies show that they have low inter-rater reliability and low inter-tool reliability. This is an instance of a more general problem called here the underdetermination of evidential significance. Disagreements about the quality of evidence can be due to different—but in principle equally good—weightings of the methodological features that constitute quality assessment tools. Thus, the malleability of empirical research in medicine is deep: in addition to the malleability of first-order empirical methods, such as randomized trials, there is malleability in the tools used to evaluate first-order methods.

scholarly journals Concussion in para sport: the first position statement of the Concussion in Para Sport (CIPS) Group

2021 ◽  
pp. bjsports-2020-103696
Author(s):  
Richard Weiler ◽  
Cheri Blauwet ◽  
David Clarke ◽  
Kristine Dalton ◽  
Wayne Derman ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Assessment Tool ◽  
Return To Sport ◽  
Position Statement ◽  
Assessment Tools ◽  
Future Research ◽  
Concussion Management ◽  
Rule Changes ◽  
Specific Rule ◽  
And Performance

Concussion is a frequent injury in many sports and is also common in para athletes. However, there is a paucity of concussion research related to para sport, and prior International Concussion in Sport (CIS) consensus papers have not substantively addressed this population. To remedy this and to improve concussion care provided to para athletes, the concussion in para sport (CIPS) multidisciplinary expert group was created. This group analysed and discussed in-depth para athlete-specific issues within the established key clinical domains of the current (2017) consensus statement on CIS. Due to the onset of the COVID-19 pandemic, the group held all meetings by video conferencing. The existing Sport Concussion Assessment Tool 5 (SCAT5) for the immediate on-field and office-based off-field assessment of concussion was evaluated as part of this process, to identify any para athlete-specific concerns. Regular preparticipation and periodic health examinations are essential to determine a baseline reference point for concussion symptoms but pose additional challenges for the interpreting clinician. Further considerations for concussion management for the para athlete are required within the remove, rest, reconsider and refer consensus statement framework. Considering return to sport (RTS), the 2017 CIS consensus statement has limitations when considering the RTS of the para athlete. Case-by-case decision making related to RTS following concussion is imperative for para athletes. Additional challenges exist for the evaluation and management of concussion in para athletes. There is a need for greater understanding of existing knowledge gaps and attitudes towards concussion among athlete medical staff, coaches and para athletes. Future research should investigate the use and performance of common assessment tools in the para athlete population to better guide their clinical application and inform potential modifications. Concussion prevention strategies and sport-specific rule changes, such as in Para Alpine Skiing and Cerebral Palsy Football, also should be carefully considered to reduce the occurrence of concussion in para athletes.

scholarly journals The Role of Digital Maturity Assessment in Technology Interventions with Industrial Internet Playground

Electronics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1134
Author(s):  
Annabeth Aagaard ◽  
Mirko Presser ◽  
Tom Collins ◽  
Michail Beliatis ◽  
Anita Krogsøe Skou ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Digital Transformation ◽  
Assessment Tools ◽  
Manufacturing Companies ◽  
Digital Interventions ◽  
Maturity Assessment ◽  
Industrial Internet ◽  
Digital Development ◽  
Key Dimensions ◽  
The Impact

The use of digital technologies such as Internet of Things and advanced data analytics are central in digitally transforming manufacturing companies towards Industry 4.0. Success cases are frequently reported, and there is clear evidence of technology interventions conducted by industry. However, measuring the impact and effect of such interventions on digital maturity and on the organizational adoption can be challenging. Therefore, the research aim of this paper is to explore how the combination of the different methods of Industrial Internet Playground (IIP) pilots, Shadow Infrastructure (SI) and digital maturity assessment can assist in conducting and documenting the technical, as well as organisational, impact of digital interventions. Through an elaborate literature review of existing digital maturity assessment tools and key dimensions in digital transformation, we have developed a digital maturity assessment tool (DMAT), which is presented and applied in the paper to identify digital development areas and to evaluate and document the effects of digital interventions. Thus, the paper contributes with new knowledge of how the IIP pilot and SI combined with digital maturity assessment can support effective, transparent and documented digital transformation throughout an organisation, as explored through theory and a practice case.

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