Electronic Data Management System Research Articles

Design of Electronic Data Management System in Web-Based CAD Environment

Based on the enterprise demand for data management in the networked environment of the CAD, this paper designs a data management system, gives the systems structure, analyses the main problems in system development, introduces the main functional modules. The results show that the system can improve the design productivity of enterprises, and it also has good practical value and potential marketing value.

효율성 측정지표를 활용한 전자적 임상시험프로세스 효과분석

본 연구의 목적은 전자적 임상시험 데이터 관리를 위한 설계 시 시간적 요인에 주목하여 시스템의 효율성을 검증해 보고자 함이다. 임상시험 데이터 관리에 대한 관심이 커지고 있고 시스템 도입이 활발한 데 반해, 실제 효율성 측정에 관한 실증연구는 많지 않다. 특히 국내의 경우 임상시험 데이터 관리를 위한 전산화 도입률 조차 낮은 실정이다. 본 연구는 전자적 임상시험 데이터 관리에 대한 중요성 인식 확산을 위하여 전자적 시스템의 효과에 대한 실증연구를 시도하였으며, 시간효율성 측정지표를 활용하여 다기관 임상시험 사례의 자료를 분석하였다. 연구결과로서 전자적 시스템으로의 전환이 임상시험 전체 프로세스에 제공할 수 있는 시간 측면에서의 효율성을 검증하였으며 전자적 임상시험 데이터 관리 시스템의 활용 효과를 분석하기 위한 국내 첫 실증연구의 시도라는 의미가 있다. 나아가 전략적 데이터 관리 수립 및 임상단계 별 비교연구 등 향후 다양한 비교 연구들의 초석이 될 것이다. The purpose of this study is to empirically examine how much the electronic clinical trial data management system actually enhances its efficiency. While the development of clinical trial markets highlights the significance of data management with increasing rate of adoption of electronic systems, its effects have not been fully supported with rigorous evidences. Particularly, the adoption rate of electronic clinical trial systems is low in domestic clinical trials markets. This study attempts to analyze the effect of the systems for reminding the importance of e-data management in clinical trials. The measurement indicator is experimented with the time related data collected from a multi-center clinical trial case. The result showed that the speed of the electronic clinical trial processes can be improved. The implication of this study lies in its first attempt to empirically analyze the effect of electronic clinical data management systems. Furthermore, application of the indicator in conjunction with electronic clinical trial processes is expected to facilitate strategic data management.

COINS: An Innovative Informatics and Neuroimaging Tool Suite Built for Large Heterogeneous Datasets

The availability of well-characterized neuroimaging data with large numbers of subjects, especially for clinical populations, is critical to advancing our understanding of the healthy and diseased brain. Such data enables questions to be answered in a much more generalizable manner and also has the potential to yield solutions derived from novel methods that were conceived after the original studies’ implementation. Though there is currently growing interest in data sharing, the neuroimaging community has been struggling for years with how to best encourage sharing data across brain imaging studies. With the advent of studies that are much more consistent across sites (e.g., resting functional magnetic resonance imaging, diffusion tensor imaging, and structural imaging) the potential of pooling data across studies continues to gain momentum. At the mind research network, we have developed the collaborative informatics and neuroimaging suite (COINS; http://coins.mrn.org) to provide researchers with an information system based on an open-source model that includes web-based tools to manage studies, subjects, imaging, clinical data, and other assessments. The system currently hosts data from nine institutions, over 300 studies, over 14,000 subjects, and over 19,000 MRI, MEG, and EEG scan sessions in addition to more than 180,000 clinical assessments. In this paper we provide a description of COINS with comparison to a valuable and popular system known as XNAT. Although there are many similarities between COINS and other electronic data management systems, the differences that may concern researchers in the context of multi-site, multi-organizational data sharing environments with intuitive ease of use and PHI security are emphasized as important attributes.

Electronic Synoptic Operative Reporting for Thyroid Surgery using an Electronic Data Management System: Potential for Prospective Multicenter Data Collection

Electronic synoptic operative reports ensure systematic documentation of all critical components and findings during complex surgical procedures. Thyroid surgery lends itself to synoptic reporting, because there are a predefined number of essential intraoperative events and findings that every endocrine surgeon invariably records. An electronic web-based form (e-form) was designed and implemented to record operative data in a synoptic structure for thyroid surgery. The e-form was implemented as a pilot study from January 2008 to October 2009 for use by three attending surgeons. During this period, 514 e-forms were completed with 100% compliance, which recorded data from 384 total thyroidectomies and 130 thyroid lobectomies. All users found the e-form to be easy to use, comprehensive, and took less than 5min to complete. The main advantages of a web-based e-form for synoptic recording of thyroid surgery are that it is user-friendly and easy to complete, yet comprehensive. Because it is based on a system available across institutions, it can be used as a minimum dataset and could be considered a national and international standard for wider use, especially if endorsed by the American or International Association for Endocrine Surgeons.

Heterogeneity prevails: the state of clinical trial data management in Europe - results of a survey of ECRIN centres

BackgroundThe use of Clinical Data Management Systems (CDMS) has become essential in clinical trials to handle the increasing amount of data that must be collected and analyzed. With a CDMS trial data are captured at investigator sites with "electronic Case Report Forms". Although more and more of these electronic data management systems are used in academic research centres an overview of CDMS products and of available data management and quality management resources for academic clinical trials in Europe is missing.MethodsThe ECRIN (European Clinical Research Infrastructure Network) data management working group conducted a two-part standardized survey on data management, software tools, and quality management for clinical trials. The questionnaires were answered by nearly 80 centres/units (with an overall response rate of 47% and 43%) from 12 European countries and EORTC.ResultsOur survey shows that about 90% of centres have a CDMS in routine use. Of these CDMS nearly 50% are commercial systems; Open Source solutions don't play a major role. In general, solutions used for clinical data management are very heterogeneous: 20 different commercial CDMS products (7 Open Source solutions) in addition to 17/18 proprietary systems are in use. The most widely employed CDMS products are MACRO™ and Capture System™, followed by solutions that are used in at least 3 centres: eResearch Network™, CleanWeb™, GCP Base™ and SAS™. Although quality management systems for data management are in place in most centres/units, there exist some deficits in the area of system validation.ConclusionsBecause the considerable heterogeneity of data management software solutions may be a hindrance to cooperation based on trial data exchange, standards like CDISC (Clinical Data Interchange Standard Consortium) should be implemented more widely. In a heterogeneous environment the use of data standards can simplify data exchange, increase the quality of data and prepare centres for new developments (e.g. the use of EHR for clinical research). Because data management and the use of electronic data capture systems in clinical trials are characterized by the impact of regulations and guidelines, ethical concerns are discussed. In this context quality management becomes an important part of compliant data management. To address these issues ECRIN will establish certified data centres to support electronic data management and associated compliance needs of clinical trial centres in Europe.

How a Data-Driven Quality Management System Can Manage Compliance Risk in Clinical Trials

A majority of data presented to global regulatory agencies during the approval stage of an investigational product is collected during its clinical development. Any concern or doubt about the integrity or quality of clinical data, compliance with GCP, or ethical standards during regulatory review can lead to costly delays in the granting of a marketing authorization. This risk can be minimized if accurate metrics are used to continually monitor the quality of the contributing research operations. As highly cost-effective tools, metrics can be used to monitor operations throughout this phase of development. With continuous monitoring, proactive measures can be implemented to prevent issues from escalating into regulatory concerns. This article describes the development of a quality management system based on a data- and metrics-driven compliance strategy. Combined with an electronic information management system, the aim of this system is to monitor and manage cost and timelines while ensuring the quality of clinical research operations.

Mindfulness Research Guide: a New Paradigm for Managing Empirical Health Information.

Scientific knowledge of human health continues to grow substantially through publication in empirical journals. These journals, which serve as the warehouses of scientific knowledge, continue to publish vast amounts of empirical information. This abundance of information, which promotes an understanding of and advances in human health, is also a precursor of information overload that can result in unintended and negative effects in both empirical and applied fields. Researchers and practitioners also struggle with this abundance as they are often pressured by an inability to stay abreast with the vast influx of current information. I offer a brief discussion of a new paradigm to manage empirical health information. The Mindfulness Research Guide serves as a case example for use as a publicly available specialized electronic information management system that endeavors to manage, organize, centralize, and deliver a wide range of information on a specific health construct-mindfulness. As empirical information continues to accumulate and guide our knowledge of human health at an unprecedented pace, new information management paradigms such as the Mindfulness Research Guide will be needed to organize, maintain, and deliver information in an easily accessible and timely fashion.

Cultural and associated enablers of, and barriers to, adverse incident reporting

AimFollowing the introduction of an electronic Incident Information Management System (IIMS) in New South Wales, Australia, the authors investigated enablers and barriers to the use of IIMS and factors associated...

Metabolic Risk Factors Among Medicaid Outpatients With Schizophrenia Receiving Second-Generation Antipsychotics

Metabolic Risk Factors Among Medicaid Outpatients With Schizophrenia Receiving Second-Generation Antipsychotics

CAPACITY BUILDING OF ETHICS REVIEW COMMITTEES ACROSS AFRICA BASED ON THE RESULTS OF A COMPREHENSIVE NEEDS ASSESSMENT SURVEY

A needs assessment survey of ethics review committees (ERCs) across Africa was conducted in order to establish their major needs and areas of weaknesses in terms of ethical review capacity. The response rate was 84% (31 of 37 targeted committees), and committees surveyed were located in 18 African countries. The majority of the responding committees (61%) have been in existence between 5 and 10 years; approximately 74% of the respondents were institutional committees, with the remainder being either national (6/31) or regional (2/31). In terms of the ethical review process, nine of the 31 committees that responded did not have standard operating procedures (SOPs), and seven of the 22 that did have SOPs had never revised them after their initial development (an average period of three years). Of the 31 committees, 10 operated without any ethical guidelines. Many of the committees (13/30) met once per month, and the number of proposals reviewed annually varied, ranging from five to over 100. All respondents relied on paper-based data management and archiving systems. Overall, the survey identified the major constraints on ERCs as lack of office equipment, outdated or lack of SOPs, lack of electronic data management systems, inadequate resources, lack of or insufficient expertise on the committees, and poor recognition of the importance of the role of the committees. Consequently, the authors are addressing the identified needs and weaknesses through the Bill and Melinda Gates Foundation-funded capacity building project. The impact of the intervention project will be assessed during and at the end of the four-year longitudinal project.

Improving Teacher Preparation Through an Electronic Data Management System

The focus of this article is how technology, specifically, the utilization of an electronic data management system, can be integrated into the college classroom as a lens for reflective practice on teacher preparation. In addition to using a traditional Teacher Evaluation Questionnaire (TEQ) for feedback, the instructor documented the impact of instructional practices by entering assessment rubrics as fields in the electronic data management system. Teacher candidate scores were collected and analyzed over multiple semesters in order to make improvements to instruction. The changes to instructional practices were evidenced in higher scores on assessment rubrics following course revisions. Using an electronic data management system offers the instructor an additional resource to engage in reflective practice.

Information literacy in the workplace

Although increasingly recognized as a future skills issue, the use of information in the workplace is a little studied area within library and information research. A substantial `pedagogic' literature of learning in the workplace exists, however, and this was critically reviewed to generate a repertoire of issues which could in turn be used to inform a research project. This repertoire was supplemented by advice from the Scottish Information Literacy Project's partners and contacts including those working in Adult Literacies. These issues were used to generate research questions for an interview-based project which, it was hoped, would generate both action points and further research questions. With the help of partners a range of interviewees was identified, mainly in the public sector. Information usage in the workplace, as the pedagogic literature predicted, proved to be a form of social interaction with people, both within and outside the organization, being generally the prime source of information. Other sources included intranets, electronic resource data management systems, a limited range of Internet sites and a small number of printed sources. Recommendations include the need to establish contacts with chambers of commerce, skills agencies and trade unions. Public libraries should explore the possibility of developing information literacy training programmes.

A means to an end: a web-based client management system in palliative care

Home-based palliative care (hospice) services require comprehensive and fully integrated information systems to develop and manage the various aspects of their business, incorporating client data and management information. These systems assist in maintaining the quality of client care as well as improved management efficiencies. This article reports on a large not-for-profit home-based palliative care service in Australia, which embarked on a project to develop an electronic data management system specifically designed to meet the needs of the palliative care sector. This web-based client information management system represents a joint venture between the organization and a commercial company and has been a very successful project.

Autologous Hematopoietic Stem Cell Transplantation (HSCT) for Autoimmune Diseases: 10 Years Experience from the European Group for Blood and Marrow Transplantation (EBMT) Working Party on Autoimmune Diseases

Introduction Since 1996 a joint collaborative effort from the European Group for Blood and Marrow Transplantation (EBMT) and League against Rheumatism (EULAR) collected cases of Autologous Hematopoietic Stem Cell Transplantation (AHSCT) for patients (pts) with severe autoimmune diseases (AD). This retrospective observational study was designed to assess patients outcome and analyse the determinants of treatment responses after AHSCT.Methods All consecutive AD pts treated by AHSCT from 1996 to 2007 according to the EBMT-EULAR consensus statement with ethics committee approved protocol were included. Data were reported yearly via the electronic EBMT data management system PROMISE and outcomes updated as December 2007. Standard AHSCT techniques used either bone marrow (BM), peripheral blood stem cells (PBSC) or both. PBSC were collected with cyclophosphamide CY (CY 4 g/m2) + granulocyte-colony stimulating factor (G-CSF), or with G-CSF alone if cardiac function prevented CY.Cell selection used either CD34+ selection with or without monoclonal antibodies, particularly anti-CD52, anti-CD3, anti- CD19 or anti-CD20. Conditioning regimen used either Total Body Irradiation (TBI) or chemotherapy alone, with various combinations of CY, Busulfan, BEAM ± Antithymocyte Globulins (ATG), which were then subgrouped arbitrarily intohigh intensity regimen, including Busulfan or TBI,low intensity restricted to CY alone, Melphalan alone and Fludarabine-based regimens, orintermediate regimen with all the other combinations.Primary outcome measure was Progression Free Survival (PFS) defined as survival without evidence of relapse or progression. Secondary outcomes were the Overall Survival (OS) defined as time to death, irrespective of the cause and Transplant Related Mortality (TRM) at day 100, defined as death without ADs relapse or progression. Cumulative incidence curves were used for TRM, considering relapse or progression within 100 days as a competing event and compared using the Gray's test. Kaplan-Meier estimate was used to calculate PFS Probabilities and the log-rank test for univariate comparisons. For all pronostic analyses, continuous variables were categorised and the median was used as a cut-off point. Associations of patient, disease and graft characteristics with outcomes were evaluated in multivariate analyses, using Cox proportional hazards for PFS, and proportional hazard regression model of Fine and Gray for NRM. Results: From 1996 to December 2007, 900 AD pts (64 % female, median 35 years) from 171 teams in 27 countries treated by AHSCT were reported to the EBMT data base, mainly multiple sclerosis (MS, n=345), systemic sclerosis (SSc, n=175), systemic lupus erythematosus (SLE, n=85), rheumatoid arthritis (RA, n=89), juvenile idiopathic arthritis (JIA, n=65), vasculitis (VASC, n=26) and hematological immune cytopenia (HIC, n=37). PSC were used as stem cell source for 92% of the pts; 42 % of the pts had in vitro cell selection, mostly with CD34+ selection. All types of conditioning regimens were used in all disease categories with very few patients (7%) with TBI. On the overall population, the 5 years PFS was 43 ± 2 % and OS was 85 ± 1 %. Three years after AHSCT:PFS was 61±5 % for SSc, 55±3 % for MS, 54±6 % for SLE, 52±7 % for JIA, 53±15 % for PMDM, 47±11 % for VASC, 34±9 % for HIC and 23±5 % for RA,);OS was 98 ± 2 % for RA, 93 ± 2 % for MS, 82 ± 5 % for JIA, 83 ± 5 % for SLE and 77 ± 4 % for SSc, depending primarily on AD type (p<0.001).By multivariate analysis, the age > 35 yrs (HR 0.73, 95%CI (0.59–0.89), p=0.002), AHSCT performed before December 2000 (HR 0.69, 95%CI (0.55–0.85), p=0.008) and number of AHSCT for ADs per centre £ 13 (HR 0.82, 95%CI (0.67–0.99, p=0.05) were associated with a lower PFS. The day 100 TRM was 5 ± 1% overall and appeared significantly lower for a number of patients per centre > 13 (HR 0.45, 95% CI (0.21–0.99), p=0.05).ConclusionThe EBMT registry allowed to collect 900 ADs pts with AHSCT after 10 years of collaborative effort. Although retrospective, this largest cohort studied worldwide so far showed that patient age, AD type and number of AHSCT per centre are important determinants of the response. AHSCT appeared a good therapeutic alternative for severe Ads unresponsive to conventional treatment, supporting the ongoing European and north American phase 3 trials comparing AHSCT to standard therapies in SSc, MS, SLE and Crohn's disease.

Attitudes toward the large-scale implementation of an incident reporting system

An electronic Incident Information Management System implemented system-wide by the Department of Health, New South Wales, Australia was evaluated. We hypothesized that health professionals (i) would support the system via utilization and favourable attitudes and (ii) that their usage and attitudes would vary according to profession with nurses being most, and doctors least, favourably disposed. An online, anonymous questionnaire survey of 2185 health practitioners. Undertaking system training, satisfaction with training, reporting incidents, incident reporting rates since system introduction and attitude questions focusing on use, security and evaluation of the system and workplace safety cultures. The first hypothesis received partial support. The majority of respondents had undertaken training and rated it highly. Most had reported incidents and maintained their previous reporting levels. Most attitudes regarding using the system and its security were favourable. Mixed attitudes were held about workplace safety cultures and the value of the system. Deficiencies in quality of reporting, feedback on incident reports and resources to analyse incident data were problems identified. The second hypothesis was confirmed. Nurses were most, and doctors least, likely to undertake training, report incidents and express favourable attitudes. Allied health responses were intermediate to those of the other professions. The system implementation was relatively successful, but more so with some professions. Problems identified indicated that expectations as to the goals achievable in the short term were optimistic, but these are amenable to planned interventions.

Intensity-Modulated Radiation Therapy Dose Prescription, Recording, and Delivery: Patterns of Variability Among Institutions and Treatment Planning Systems

Intensity-modulated radiation therapy (IMRT) is a widely accepted method for radiation treatment to provide a prescribed and uniform dose to the target volume and a minimum dose to normal tissues that is dependent on the IMRT software and the treatment machine. We examined the variation in IMRT dose prescription, treatment planning, dose recording, and dose delivery among cancer patients who were treated with different treatment planning systems at different medical institutions to assess variability in patient care. We conducted a retrospective analysis of 803 patients who were treated with IMRT between October 2004 and July 2006 for brain, head and neck, or prostate cancer at five medical institutions that used different treatment planning systems. The prescribed dose to the target volume, as recorded in the chart or as noted in the electronic data management system, was extracted for each patient. The planned dose that was delivered to the patient, as represented in the dose-volume histogram, was acquired from each treatment planning system. The actual minimum, maximum, median, and isocenter doses to the target volume were normalized to the prescribed dose and analyzed for each disease site and institution. Of the 803 patients, 12% were treated for brain cancer, 26% for head and neck cancer, and 62% for prostate cancer. The recorded dose variability from prescription was widespread for the minimum, maximum, and isocenter doses. A total of 46% of the patients received a maximum dose that was more than 10% higher than the prescribed dose, and 63% of the patients received a dose that was more than 10% lower than the prescribed dose. At all five institutions, the prostate cancer cases had the smallest dosimetric variation and the head and neck cancer cases had the largest variation. The median dose to the target varied from the prescribed dose by +/-2% in 68% of the patients, by +/-5% in 88% of the patients, and by +/-10% in 96% of the patients. The recorded isocenter dose varied from prescription for all disease sites and treatment planning systems. Substantial variation in the prescribed and delivered doses exists among medical institutions, raising concerns about the validity of comparing clinical outcomes for IMRT. The isocenter dose in IMRT is simply a point dose and often does not reflect the prescription dose that is specified by a selected isodose line encompassing the target volume. This study suggests the need for national and/or international guidelines for dose prescription, planning, and reporting for a meaningful clinical trial in IMRT.

Open source electronic health record and patient data management system for intensive care.

In Intensive Care Units, the amount of data to be processed for patients care, the turn over of the patients, the necessity for reliability and for review processes indicate the use of Patient Data Management Systems (PDMS) and electronic health records (EHR). To respond to the needs of an Intensive Care Unit and not to be locked with proprietary software, we developed a PDMS and EHR based on open source software and components. The software was designed as a client-server architecture running on the Linux operating system and powered by the PostgreSQL data base system. The client software was developed in C using GTK interface library. The application offers to the users the following functions: medical notes captures, observations and treatments, nursing charts with administration of medications, scoring systems for classification, and possibilities to encode medical activities for billing processes. Since his deployment in February 2004, the PDMS was used to care more than three thousands patients with the expected software reliability and facilitated data management and review processes. Communications with other medical software were not developed from the start, and are realized by the use of the Mirth HL7 communication engine. Further upgrade of the system will include multi-platform support, use of typed language with static analysis, and configurable interface. The developed system based on open source software components was able to respond to the medical needs of the local ICU environment. The use of OSS for development allowed us to customize the software to the preexisting organization and contributed to the acceptability of the whole system.

Development of an electronic radiation oncology patient information management system

The quality of patient care is critically influenced by the availability of accurate information and its efficient management. Radiation oncology consists of many information components, for example there may be information related to the patient (e.g., profile, disease site, stage, etc.), to people (radiation oncologists, radiological physicists, technologists, etc.), and to equipment (diagnostic, planning, treatment, etc.). These different data must be integrated. A comprehensive information management system is essential for efficient storage and retrieval of the enormous amounts of information. A radiation therapy patient information system (RTPIS) has been developed using open source software. PHP and JAVA script was used as the programming languages, MySQL as the database, and HTML and CSF as the design tool. This system utilizes typical web browsing technology using a WAMP5 server. Any user having a unique user ID and password can access this RTPIS. The user ID and password is issued separately to each individual according to the person's job responsibilities and accountability, so that users will be able to only access data that is related to their job responsibilities. With this system authentic users will be able to use a simple web browsing procedure to gain instant access. All types of users in the radiation oncology department should find it user-friendly. The maintenance of the system will not require large human resources or space. The file storage and retrieval process would be be satisfactory, unique, uniform, and easily accessible with adequate data protection. There will be very little possibility of unauthorized handling with this system. There will also be minimal risk of loss or accidental destruction of information.

Obesity at diagnosis increases relapse rate and shortens time to relapse in breast cancer patients

21123 Objective: Breast cancer is the most common cancer in US women. One in eight women will develop breast cancer in their lifetime. Obesity, one of the 10 leading US health indicators, is associated with breast cancer risk and outcome in various studies. Louisiana is one of the three states with obesity prevalence above 30%. Feist-Weiller Cancer Center (FWCC) in Shreveport serves a large area of Louisiana as far as Baton Rouge. There is a large population of African American patients who are followed in FWCC. The objective of this study is to examine the association of obesity with breast cancer in our patient population. Study Design: A retrospective study from single institution. Medical records of the breast cancer patients in FWCC electronic data management system are reviewed. National Institutes of Health criteria are used to stratify patients: normal or underweight (NW, body mass index or BMI &lt; 25kg/m2, overweight (OW, BMI 25–29.9), and obese (OB, BMI &gt; = 30). Relapse and time to relapsed are compared among three groups. Result: In analysis using multivariant Cox proportional regression model, BMI at diagnosis is a statistical significant predictor of time to relapse. In univariant analysis, increased BMI at diagnosis is associated with 3.3% risk of disease relapse per year. The results demonstrates a positive association of obesity and disease course in breast cancer patients treated at FWCC. No significant financial relationships to disclose.

Implementation of Web-Based Electronic Data Management System

A case study of the implementation of a web-based electronic data management system (EDMS) for the construction material quality assurance program of the State Highway 130 Turnpike project, a 49-mi design–build highway megaproject in Texas, is presented. EDMS consists of a set of web-enabled data management and engineering analysis tools that support the independent construction quality assurance firm's (CQAF's) functions in managing, reporting, and analyzing materials test data. The system currently supports 43 field and laboratory test procedures and enables CQAF staff to process effectively a large volume of test reports. Substantial efforts were extended to develop online information delivery functions to disseminate consistent test information among a broad constituency of users, including engineers, managers, technicians and inspectors, construction superintendents, material vendors, and designers, in a virtual real-time fashion. The system automatically tracks and monitors material-related deficiencies and summarizes out-of-specification test results accepted by CQAF engineers on the basis of engineering judgment. To facilitate the oversight roles of federal and state transportation agencies, the system electronically transmits test data to the state transportation agency within hours of test completion. Using statistical analysis functions embedded in the system, engineers are able to monitor material quality trends and deficiencies effectively. Through EDMS, the quality and efficiency of the CQAF in making acceptance decisions, tracking deficiencies and corrective actions, and ensuring that the materials and workmanship incorporated into the project are in compliance with the requirements of the project specifications are greatly enhanced.