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Background Maternal and child health are internationally considered to be among the best measures for assessing health-care quality. The study was carried out with the following aims: 1) to assess the quality of perinatal care (PC) by measuring the frequencies of the five PC indicators developed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and comparing results with international standards; 2) to examine whether maternal, pregnancy care and neonatal characteristics could be factors associated with the quality of perinatal care hospital performance, measured through these indicators. Methods We retrospectively reviewed medical charts of women over the age of 18 who experienced delivery in Gynecology/obstetrics wards between January–December 2016, and those of their newborns hospitalized in the Neonatology or Neonatal Intensive Care Unit (NICU) of a public non-teaching hospital in Catanzaro (Italy). Indicators were calculated according to the methodology specified in the manual for JCAHO measures. Univariate and multivariate analyses were performed to test the independent association of maternal, pregnancy care and neonatal characteristics on the adherence to JCAHO PC indicators. Results The records of 1943 women and 1974 newborns were identified and reviewed in order to be included in at least one of the PC indicators. Elective/early-term delivery, was performed in 27.6% of eligible women, far from the recommended goal (0%); cesarean section in nulliparous women with a term, singleton baby in a vertex position exceeded the suggested target of

Objective The study was done to evaluate levels of missing and invalid values in the Michigan (MI) National Emergency Medical Services Information System (NEMSIS) (MI-EMSIS) and explore possible causes to inform improvement in data reporting and prehospital care quality. Methods We used a mixed-methods approach to study trends in data reporting. The proportion of missing or invalid values for 18 key reported variables in the MI-EMSIS (2010–2015) dataset was assessed overall, then stratified by EMS agency, software platform, and Medical Control Authorities (MCA)—regional EMS oversight entities in MI. We also conducted 4 focus groups and 10 key-informant interviews with EMS participants to understand the root causes of data missingness in MI-EMSIS. Results Only five variables of the 18 studied exhibited less than 10% missingness, and there was apparent variation in the rate of missingness across all stratifying variables under study. No consistent trends over time regarding the levels of missing or invalid values from 2010 to 2015 were identified. Qualitative findings indicated possible causes for this missingness including data-mapping issues, unclear variable definitions, and lack of infrastructure or training for data collection. Conclusions The adoption of electronic data collection in the prehospital setting can only support quality improvement if its entry is complete. The data suggest that there are many EMS agencies and MCAs with very high levels of missingness, and they do not appear to be improving over time, demonstrating a need for investment in efforts in improving data collection and reporting.

The use of quality measures to adjust health care payments and to rank providers is growing rapidly, but there are many problems with the quality measures that are currently being used. This article discusses some of these problems and then lays out some principles and procedures that should be used in the development and combination of quality measures. Many of the problems with existing quality measures would have been avoided had these principles been applied as they were developed.

Equivalent mutants are usually seen as an inconvenience in mutation analysis.We claim that equivalent mutants can be useful to detect and remove static anomalies.A process for detecting static anomalies is proposed.The process is based on mutation, equivalence checking, and quality measurement.The process is applicable to different kinds of software artifacts. Context: In mutation analysis, a mutant of a software artifact, either a program or a model, is said equivalent if it leaves the artifact meaning unchanged. Equivalent mutants are usually seen as an inconvenience and they reduce the applicability of mutation analysis.Objective: Instead, we here claim that equivalent mutants can be useful to define, detect, and remove static anomalies, i.e., deficiencies of given qualities: If an equivalent mutant has a better quality value than the original artifact, then an anomaly has been found and removed.Method: We present a process for detecting static anomalies based on mutation, equivalence checking, and quality measurement.Results: Our proposal and the originating technique are applicable to different kinds of software artifacts. We present anomalies and conduct several experiments in different contexts, at specification, design, and implementation level.Conclusion: We claim that in mutation analysis a new research direction should be followed, in which equivalent mutants and operators generating them are welcome.

In automotive industry, market demands shorter life cycles and individualized products. For manual assembly, this trend leads to more frequent planning of an ever increasing number of process variants. In order to ensure planning quality, virtual verification of manual production is crucial for efficient process optimization. However, virtual verification is not established in practice because available simulation tools require prohibitive manual modeling effort for human motions of acceptable quality. For automating the modeling process, data driven motion synthesis approaches are promising candidates that –however– require high quality input data for acceptable synthesis results. Therefore, objective motion capture data quality measures for data driven human motion synthesis are sought. This work proposes and tests a principal component analysis (PCA) and a Shannon entropy based quality measure. Both measures evaluate post-processed data and thus consider motion capture hardware in combination with a post-processing tool chain. The measures are tested for selectivity and validity using two low cost and two high cost motion capture systems. They differ in selectivity for high and low cost motion capture systems. Both measures correctly predict motion synthesis quality in tests with treadmill walking. Therefore, they can be employed for testing if a motion capture system is suitable for data driven motion synthesis that relies on PCA for input dimension reduction. Further research on robustness of the measures against motion variation is proposed.

Techniques for generating multichannel audio from stereo audio signals are supposed to enhance and extend the listening experience of the listener. To assess the quality of such upmix algorithms, subjective evaluations have been carried out. In this paper, we propose an objective evaluation test for stereo-to-multichannel upmix algorithms. Based on defined objective criteria and special test signals, an objective comparative evaluation is enabled in order to obtain a quantifiable measure for the quality of stereo-to-multichannel upmix algorithms. Therefore, the basic functional principle of the evaluation test is demonstrated, and it is illustrated how possible results can be visualized. In addition, the proposed issues are introduced for the optimization of upmix algorithms and also for the clarification and illustration of the impacts and influences of different modes and parameters.

ObjectiveTo develop a longlist of healthcare quality indicators for the care of hospitalised adults of all ages with (or at risk of) low physical activity during the hospital stay.DesignA modified RAND/UCLA Appropriateness Method Delphi study.Setting and participantsParticipants were physical therapists, nurses and managers working in Dutch university medical centres.MethodsThe current study consisted of three phases. Phase I was a systematic literature search for quality indicators and relevant domains. Phase II was a survey among healthcare professionals to collect additional data. Phase III consisted of three consensus rounds. In round 1, experts rated the relevance of the potential indicators online (Delphi). The second round was a face-to-face expert panel meeting managed by an experienced moderator. Acceptability, feasibility and validity of the quality indicators were discussed by the panel members. In round 3, the panel members rated the relevance of the potential indicators that were still under discussion.ResultsThe search retrieved 1556 studies of which 53 studies were assessed full text. Data from 17 studies were included in a first draft longlist of indicators. Eighteen nurses and one physical therapist responded to the survey and added data for a second draft of the longlist. Experts constructed the final longlist of 23 indicators in three consensus rounds. Seven domains were identified: ‘Policy’, ‘Attitude and education’, ‘Equipment and support’, ‘Evaluation’, ‘Information’, ‘Patient-tailored physical activity plan’ and ‘Outcome measure’.Conclusion and implicationsThe healthcare quality indicators developed in this study could help to grade, monitor and improve healthcare for hospitalised adults of all ages with (or at risk of) low physical activity during the hospital stay. Future research will focus on the psychometric quality of the indicators and selection of key performance indicators.

Methodologies for defining standard quality indicators are important to assess service quality in public transport. The article proposes a method to integrate EU service quality standards in the transport planning process. It also investigates the effects of a set of large-scale transport policies in Campania region, Italy, in terms of service quality and ridership variations. Results of 10 years-long transport policies (€3,115 million invested) shows an impressive increase in both service quality and ridership. The article also compares perceived and measured service quality indicators for a new high quality metro line. Results point to new perspectives in modelling users’ travel behavior and related quality measures.

BackgroundImprovement in survival of patients with colon cancer is reduced in elderly patients compared to younger patients. The aim of this study was to investigate whether the removal of >= 12 lymph nodes can explain differences in survival rates between elderly and younger patients diagnosed with colon cancer.MethodsIn a population-based cohort study, all patients (N = 41,074) diagnosed with colon cancer stage I to III from 2003 through 2010 from the Netherlands Cancer Registry were included. Age groups were defined as 75 years of age. Main outcome measures were overall and relative survival, the latter as a proxy for disease specific survival.ResultsOver an eight years time period there was a 41.2% increase in patients with >= 12 lymph nodes removed, whereas the percentage of patients with the presence of lymph node metastases remained stable (35.7% to 37.5%). After adjustment for patient and tumour characteristics and adjuvant chemotherapy, it was found that for patients in which >= 12 lymph nodes were removed compared to patients with 75: HR: 0.734 (95% CI, 0.700-0.771)) and relative survival ( 75: RER: 0.621 (95% CI, 0.567-0.681)) in all three age groups.ConclusionsThe removal of >= 12 lymph nodes is associated with an improvement in both overall and relative survival in all patients. This association was stronger in the elderly patient. The biology of this association needs further clarification.

This paper proposes a new criterion, called absolute transparency, to design control schemes applied to bilateral teleoperation of mobile robots with time-varying delay. The absolute transparency measures how and how fast the human operator and the remote system interact with each other through a teleoperation system. The absolute transparency of different control schemes is analyzed and tested through teleoperation experiments where a human operator drives a mobile robot and receives both visual and force feedback.

OBJECTIVE: To evaluate the performance of the newest version of the Pediatric Index of Mortality 3 score and compare it with the Pediatric Index of Mortality 2 in a multicenter national cohort of children admitted to PICU. DESIGN: Retrospective, prospective cohort study. SETTING: Seventeen Italian PICUs. PATIENTS: All children 0 to 15 years old admitted in PICU from January 2010 to October 2014. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Eleven thousand one hundred nine children were enrolled in the study. The mean Pediatric Index of Mortality 2 and 3 values of 4.9 and 3.9, respectively, differed significantly (p < 0.05). Overall mortality rate was 3.9%, and the standardized mortality ratio was 0.80 for Pediatric Index of Mortality 2 and 0.98 for Pediatric Index of Mortality 3 (p < 0.05). The area under the curve of the receiver operating characteristic curves was similar for Pediatric Index of Mortality 2 and Pediatric Index of Mortality 3. The Hosmer-Lemeshow test was not significant for Pediatric Index of Mortality 3 (p = 0.21) but was highly significant for Pediatric Index of Mortality 2 (p < 0.001), which overestimated death mainly in high-risk categories. CONCLUSIONS: Mortality indices require validation in each country where it is used. The new Pediatric Index of Mortality 3 score performed well in an Italian population. Both calibration and discrimination were appropriate, and the score more accurately predicted the mortality risk than Pediatric Index of Mortality 2.

Publication à la conférence Discovery Science 2016; International audience; From a molecule to the brain perception, olfaction is a complex phenomenon that remains to be fully understood in neuroscience. A challenge is to establish comprehensive rules between the physicochem-ical properties of the molecules (e.g., weight, atom counts) and specific and small subsets of olfactory qualities (e.g., fruity, woody). This problem is particularly difficult as the current knowledge states that molecular properties only account for 30% of the identity of an odor: predictive models are found lacking in providing universal rules. However, descriptive approaches enable to elicit local hypotheses, validated by domain experts, to understand the olfactory percept. Based on a new quality measure tailored for multi-labeled data with skewed distributions, our approach extracts the top-k unredundant subgroups interpreted as descriptive rules description → {subset of labels}. Our experiments on benchmark and olfaction datasets demonstrate the capabilities of our approach with direct applications for the perfume and flavor industries.

Background In 2013, Danish policy-makers on a nationwide level decided to set up a national quality of care database for hospital-based emergency care in Denmark including the selection of quality indicators. The aim of the study was to describe the Delphi process that contributed to the selection of quality indicators for a new national database of hospital-based emergency care in Denmark. Methods The process comprised a literature review followed by a modified-Delphi survey process, involving a panel of 54 experts (senior clinicians, researchers and administrators from the emergency area and collaborating specialties). Based on the literature review, we identified 43 potential indicators, of which eight were time-critical conditions. We then consulted the Expert panel in two consecutive rounds. The Expert panel was asked to what extent each indicator would be a good measure of hospital-based emergency care in Denmark. In each round, the Expert panel participants scored each indicator on a Likert scale ranging from one (=disagree completely) through to six (=agree completely). Consensus for a quality indicator was reached if the median was greater than or equal to five (=agree). The Delphi process was followed by final selection by the steering group for the new database. Results Following round two of the Expert panel, consensus was reached on 32 quality indicators, including three time-critical conditions. Subsequently, the database steering group chose a set of nine quality indicators for the initial version of the national database for hospital-based emergency care. Conclusions The two-round modified Delphi process contributed to the selection of an initial set of nine quality indicators for a new a national database for hospital-based emergency care in Denmark. Final selection was made by the database steering group informed by the Delphi process. Electronic supplementary material The online version of this article (doi:10.1186/s13049-016-0203-x) contains supplementary material, which is available to authorized users.

International audience; Many studies use community detection algorithms in order to understand complex networks. Most papers study node communities, i.e. groups of nodes, which may or may not overlap. A widely used measure to evaluate the quality of a community structure is the modularity. However, sometimes it is also relevant to study link partitions rather than node partitions. In order to evaluate a link partition, we propose a new quality function: Expected Nodes. Our function is based on the same inspiration as the modularity and compares, for a given link group, the number of incident nodes to the expected one. In this short note, we discuss the advantages and drawbacks of our quality function compared to other ones on synthetics graphs. We show that Expected Nodes is able to pass some fundamental sanity criteria and is the one that best identifies the most relevant partition in a more realistic context.

© 2014 by Lippincott Williams & Wilkins. OBJECTIVES:: To examine the validity of hybrid quality measures that use both clinical registry and administrative claims data, capitalizing on the strengths of each data source. BACKGROUND:: Previous studies demonstrate substantial disagreement between clinical registry and administrative claims data on the occurrence of postoperative complications. Clinical data have greater validity than claims data for quality measurement but can be burdensome for hospitals to collect. METHODS:: American College of Surgeons National Surgical Quality Improvement Program records were linked to Medicare inpatient claims (2005–2008). National Quality Forum–endorsed risk-adjusted measures of 30-day postoperative complications or death assessed hospital quality for patients undergoing colectomy, lower extremity bypass, or all surgical procedures. Measures use hierarchical multivariable logistic regression to identify statistical outliers. Measures were applied using clinical data, claims data, or a hybrid of both data sources. Kappa statistics assessed agreement on determinations of hospital quality. RESULTS:: A total of 111,984 patients participated from 206 hospitals. Agreement on hospital quality between clinical and claims data was poor. Hybrid models using claims data to risk-adjust complications identified by clinical data had moderate agreement with all clinical data models, whereas hybrid models using clinical data to risk-adjust complications identified by claims data had routinely poor agreement with all clinical data models. CONCLUSIONS:: Assessments of hospital quality differ substantially when using clinical registry versus administrative claims data. A hybrid approach using claims data for risk adjustment and clinical data for complications may be a valid alternative with lower data collection burden. For quality measures focused on postoperative complications to be meaningful, such policies should require, at a minimum, collection of clinical outcomes data.

Background The sensitivity of a mammography program is normally evaluated by comparing the interval cancer rate to the expected breast cancer incidence without screening, i.e. the proportional interval cancer rate (PICR). The expected breast cancer incidence in absence of screening is, however, difficult to estimate when a program has been running for some time. As an alternative to the PICR we propose the interval cancer ratio . We validated this simple measure by comparing it with the traditionally used PICR. Method We undertook a systematic review and included studies: 1) covering a service screening program, 2) women aged 50-69 years, 3) observed data, 4) interval cancers, women screened, or interval cancer rate, screen detected cases, or screen detection rate, and 5) estimated breast cancer incidence rate of background population. This resulted in 5 papers describing 12 mammography screening programs. Results Covering initial screens only, the ICR varied from 0.10 to 0.28 while the PICR varied from 0.22 to 0.51. For subsequent screens only, the ICR varied from 0.22 to 0.37 and the PICR from 0.28 to 0.51. There was a strong positive correlation between the ICR and the PICR for initial screens (r = 0.81), but less so for subsequent screens (r = 0.65). Conclusion This alternate measure seems to capture the burden of interval cancers just as well as the traditional PICR, without need for the increasingly difficult estimation of background incidence, making it a more accessible tool when evaluating mammography screening program performance. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-782) contains supplementary material, which is available to authorized users.

The quality of pan-sharpened image is usually quantified separately by various spectral and spatial quality measures mostly originating from image processing. This quantity and diversity of quality measures makes it quite difficult to rank different image fusion methods. A new Joint Quality Measure (JQM) is proposed which is based on the combination of two Structural SIMilarity (SSIM) indices (one for spectral quality and another one for spatial quality) allowing comparison of different methods using a sole measure. Quality assessment of four fusion methods: Component Substitution (CS), General Fusion Filtering (GFF), variant of GFF and ATWT (one of ARSIS implementations) is performed for IKONOS and WorldView-2 satellite optical remote sensing data. Experiments and results showed the superiority of the proposed JQM when compared with already known joint measure - Quality with No Reference (QNR) index. Moreover, the results are fully supported by a visual analysis of imagery.

This paper presents a new comparative objective method for image quality evaluation. This method relies on two keys points: a local objective evaluation and a perceptual gathering. The local evaluation concerns the dissimilarities between the degraded image and the reference image; it is based on a gray-level local Hausdorff distance. This local Hausdorff distance uses a generalized distance transform which is studied here. The evaluation result is a local dissimilarity map (LDMap). In order to include perceptual information, a perceptual map based on the image properties is then proposed. The coefficients of this map are used to weight and to gather the LDMap measures into a single quality measure. The perceptual map is tunable and it gives encouraging quality measures even with naive parameters.

Regular decompositions are necessary for most superpixel-based object recognition or tracking applications. So far in the literature, the regularity or compactness of a superpixel shape is mainly measured by its circularity. In this work, we first demonstrate that such measure is not adapted for superpixel evaluation, since it does not directly express regularity but circular appearance. Then, we propose a new metric that considers several shape regularity aspects: convexity, balanced repartition, and contour smoothness. Finally, we demonstrate that our measure is robust to scale and noise and enables to more relevantly compare superpixel methods., International Conference on Image Processing 2017