Inform Quality Research Articles

Candidate Quality Measures for Hand Surgery

Quality measures are tools used by physicians, health care systems, and payers to evaluate performance, monitor the outcomes of interventions, and inform quality improvement efforts. A paucity of quality measures exist that address hand surgery care. We completed a RAND/UCLA (University of California Los Angeles) Delphi Appropriateness process with the goal of developing and evaluating candidate hand surgery quality measures to be used for national quality measure development efforts. A consortium of 9 academic upper limb surgeons completed a RAND/UCLA Delphi Appropriateness process to evaluate the importance, scientific acceptability, usability, and feasibility of 44 candidate quality measures. These addressed hand problems the panelists felt were most appropriate for quality measure development. Panelists rated the measures on an ordinal scale between 1 (definitely not valid) and 9 (definitely valid) in 2 rounds (preliminary round and final round) with an intervening face-to-face discussion. Ratings from 1 to 3 were considered not valid, 4 to 6 as equivocal or uncertain, and 7 to 9 as valid. If no more than 2 of the 9 ratings were outside the 3-point range that included the median (1-3, 4-6, or 7-9), the panelists were considered to be in agreement. If 3 or more of the panelists' ratings of a measure were within the 1 to 3 range and 3 or more ratings were in the 7 to 9 range, the panelists were considered to be in disagreement. There was agreement on 43% (19) of the measures as important, 27% (12) as scientifically sound, 48% (21) as usable, and 59% (26) as feasible to complete. Ten measures metall 4 of these criteria and were, therefore, considered valid measurements of quality. Quality measures that were developed address outcomes (patient-reported outcomes for assessment and improvement of function) and processes of care (utilization rates of imaging, antibiotics, occupational therapy, ultrasound, and operative treatment). The consortium developed 10 measures of hand surgery quality using a validated methodology. These measures merit further development. Quality measures can be used to evaluate the quality of care provided byphysicians and health systems and can inform quality and value-based reimbursement models.

Hospital safety among neurologic patients: A population-based cohort study of adverse events.

To examine the frequency and type of adverse events (AEs) experienced by neurologic patients in hospital. This population-based, retrospective cohort study used hospital discharge abstract data for children and adults admitted to hospital from 2009 to 2015 with 1 of 9 neurologic conditions (Alzheimer disease and related dementia, brain tumor, epilepsy, motor neuron disease, multiple sclerosis, parkinsonism/Parkinson disease, spinal cord injury, traumatic brain injury, and stroke). Neurologic conditions were identified with ICD-10-CA codes. Eighteen AEs were examined with ICD-10-CA codes. The proportion of AEs was calculated, and regression analysis was used to examine factors and outcomes associated with AEs (age, sex, comorbidity, length of stay, and mortality). The overall proportion of admissions associated with an AE among those with a neurologic condition was 11 per 100 admissions. Those with a spinal cord injury had the highest proportion of AEs (39.4 per 100 admissions). The most common AEs were infections and respiratory complications (32.0% and 16.7%, respectively). Age and the presence of comorbidities were associated with higher odds of an AE, while readmission was associated with lower odds of an AE. Having an AE was associated with increased length of stay and higher odds of mortality. This study demonstrates that neurologic patients have a high proportion of AEs in hospital. The findings provide information on the quality and safety of care for people with neurologic conditions in hospital, which can help inform future quality improvement initiatives.

Explaining resistance to system usage in the PharmaCloud: A view of the dual-factor model

Use of the PharmaCloud can improve the quality of healthcare, but improvements are likely to be thwarted if physicians resist using the system. This study uses the dual-factor model to explain physicians’ resistance behaviors to system usage. The results of a field survey conducted in Taiwan showed that physicians’ resistance to using the PharmaCloud stemmed from regret avoidance, inertia, perceived value, and perceived threat. These results also indicate that system, information, and service qualities are the key determinants of the behavioral intention to use. This research advances the theoretical understanding of user acceptance and resistance to technology post-implementation and offers practical implications.

Evaluation of 'SAEFVIC', A Pharmacovigilance Surveillance Scheme for the Spontaneous Reporting of Adverse Events Following Immunisation in Victoria, Australia.

Australia is traditionally an early adopter of vaccines, therefore comprehensive and effective post-licensure vaccine pharmacovigilance is critical to maintain confidence in immunisation, both nationally and internationally. With adverse event following immunisation (AEFI) surveillance the responsibility of Australian jurisdictions, Victoria operates an enhanced passive AEFI surveillance system integrated with clinical services, called 'SAEFVIC' (Surveillance of Adverse Events Following Vaccination In the Community). The aim of this study was to evaluate Victoria's current AEFI surveillance system 'SAEFVIC' and inform ongoing quality improvement of vaccine pharmacovigilance in Victoria and Australia. We conducted a retrospective structured desktop evaluation of AEFI reporting received by SAEFVIC from 2007 to 2014, to evaluate the system according to its stated objectives, i.e. to improve AEFI reporting; provide AEFI signal detection; and to maintain consumer confidence in vaccination. AEFI reporting has tripled since SAEFVIC commenced (incidence risk ratio [IRR] 3.04, 95% confidence interval [CI] 2.35-3.93), raising Victoria to be the lead jurisdiction by AEFI reporting volume and to rank third by population reporting rate nationally. The largest increase was observed in children. Data were utilised to investigate potential signal events and inform vaccine policy. Signal detection required clinical suspicion by surveillance nurses, or prior vaccine-specific concerns. Subsequent vaccination post-AEFI was documented for 56.2% (95% CI 54.1-58.4)of reports, and the proportion of children due or overdue for vaccination was 2.3% higher for those reporting AEFI compared with the general population. SAEFVIC has improved AEFI surveillance, facilitates signal investigation and validation, and supports consumer confidence in immunisation. Expansion of the system nationally has the potential to improve capacity and capability of vaccine pharmacovigilance, particularly through data consistency and jurisdictional comparability in Australia.

High‐Resolution NMR Spectroscopy for the Classification of Beer

High‐resolution Nuclear Magnetic Resonance (NMR) spectroscopy has many applications in the analysis of food and beverage products, especially in combination with multivariate analysis. Most studies have focused on the composition, raw materials, geographical origin, and quality control of these products. Since the 1H NMR spectrum of beer contains huge water and ethanol resonances with higher signal intensities of them than those of the compounds of interest, it becomes problematic to assign a spectrum. So, these obstacles must be overcome in order to define chemical components in beer and to analyze or obtain meaningful data. In this paper, we will analyze the 1H NMR spectra of different lagers and ales with principal component analysis (PCA) and partial least squares (PLS) methods. The results of multivariate analysis of 1H NMR spectra of lyophilized and raw samples obtained using a standard solvent suppression pulse program are compared and discussed for more exact technique as an informative quality control tool.

Relating Ediacaran Fronds

AbstractEdiacaran fronds are key components of terminal-Proterozoic ecosystems. They represent one of the most widespread and common body forms ranging across all major Ediacaran fossil localities and time slices postdating the Gaskiers glaciation, but uncertainty over their phylogenetic affinities has led to uncertainty over issues of homology and functional morphology between and within organisms displaying this ecomorphology. Here we present the first large-scale, multigroup cladistic analysis of Ediacaran organisms, sampling 20 ingroup taxa with previously asserted affinities to the Arboreomorpha, Erniettomorpha, and Rangeomorpha. Using a newly derived morphological character matrix that incorporates multiple axes of potential phylogenetically informative data, including architectural, developmental, and structural qualities, we seek to illuminate the evolutionary history of these organisms. We find strong support for existing classification schema and devise apomorphy-based definitions for each of the three frondose clades examined here. Through a rigorous cladistic framework it is possible to discern the pattern of evolution within and between these clades, including the identification of homoplasies and functional constraints. This work both validates earlier studies of Ediacaran groups and accentuates instances in which previous assumptions of their natural history are uninformative.

Abstract TMP76: Stroke Quality-of-care Metrics in Comprehensive and Primary Stroke Centers and Non-stroke Centers

Introduction: Measuring the quality of stroke care has become increasingly important, but real-world data are limited, especially because many hospitals do not track their own statistics. We sought to determine differences in quality-of-care metrics for ischemic stroke (IS) among non-stroke centers, primary stroke centers (PSC), and comprehensive stroke centers (CSC). Methods: The Greater Cincinnati/Northern Kentucky (GCNK) Stroke Study measures temporal trends in the incidence of stroke in a biracial population of 1.3 million. Adult IS cases in 2010 from the GCNK region were ascertained from all local hospitals via ICD-9 codes 430-436 using retrospective chart review. Hospitals included 10 non-stroke centers, 2 PSCs, and 1 PSC that earned CSC status in 2013. Differences in IS patients’ demographics, medical histories, and quality measures were evaluated among hospital categories using chi-square, Fisher’s exact, and Kruskal-Wallis tests. Quality measures were matched to Get With The Guidelines-Stroke (GWTG-S) when possible, although data regarding the appropriateness for non-treatment were not available. Results: In 2010, there were 1,981 IS patients in our population (55% female, 21% black) with a median age of 71 years. Of these, 83 were transferred to a different hospital type. There were significant differences in the demographics and medical histories of IS patients, as well as the majority of quality measures, with the CSC and PSCs demonstrating greater compliance with most metrics. (Table) Conclusions: We found significant hospital-level differences in both premorbid patient characteristics and quality-of-care metrics depending on the hospital stroke certification status. To our knowledge, this is the first measurement of best-practice care specifically involving hospitals not participating in national quality improvement programs, such as GWTG-S. These differences may help inform quality improvement efforts across hospital types.

Perioperative Outcomes and Management in Pediatric Complex Cranial Vault Reconstruction: A Multicenter Study from the Pediatric Craniofacial Collaborative Group.

The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determine perioperative management, outcomes, and complications in children undergoing complex cranial vault reconstruction across North America and to delineate salient features of current practices. Thirty-one institutions contributed data from June 2012 to September 2015. Data extracted included demographics, perioperative management, length of stay, laboratory results, and blood management techniques employed. Complications and outlier events were described. Outcomes analyzed included total blood donor exposures, intraoperative and perioperative transfusion volumes, and length of stay outcomes. One thousand two hundred twenty-three cases were analyzed: 935 children aged less than or equal to 24 months and 288 children aged more than 24 months. Ninety-five percent of children aged less than or equal to 24 months and 79% of children aged more than 24 months received at least one transfusion. There were no deaths. Notable complications included cardiac arrest, postoperative seizures, unplanned postoperative mechanical ventilation, large-volume transfusion, and unplanned second surgeries. Utilization of blood conservation techniques was highly variable. The authors present a comprehensive description of perioperative management, outcomes, and complications from a large group of North American children undergoing complex cranial vault reconstruction. Transfusion remains the rule for the vast majority of patients. The occurrence of numerous significant complications together with large variability in perioperative management and outcomes suggest targets for improvement.

Caves Sacred Objects Images (19th – Early 20th Ct.) as the Sources for History of Social Interactions in the Dormition Kyiv-Caves Lavra

Near and Far caves of the Dormition Kyiv-Caves Lavra belonged to Kyivan symbolic focal area in the symbolic core of the Orthodox territory. The sacred objects keepers interacted with numerous visitors there. Highly detailed images of the 19 th – early 20 th cc. need to be examined , as far as they may reflect these social interactions. The aim of this article is to evaluate an informative value of the Caves sacred objects’ images for the research of the social interactions, which were taking their place near these sacred objects. Due to quick eyes, discernment and technical skill of painters as well as the usage of the high quality photographic equipment the examined visual sources help us to verify and even complement some data from the verbal sources. First of all this concerns the details, which are important for social interactions history, but either too obvious or too negligible for their beholders. These sources are worthwhile because they rise some new research questions and help to systematize the search of an information on the problem. If carefully matched with the verbal sources, these images have a high informative value. They could be helpful in the research of general approaches of Lavra inhabitants to the communicative space near the sacred objects (from a perspective of its aesthetic and informative qualities, serviceability and accessibility for believers); concepts of the votives’ place near the sacred objects; traditional prayer practices and the monks’ role in them. However, these visual sources are useful only for study of the social interactions in the Near and Far caves with the participation of Lavra inhabitants. The author sees a hopeful prospect in the informative value estimation of the photographic report depicting the St. Euphrosyne’s holy relics translocation from the Lavra Far Caves to the monastery of the Saviour and St. Euphrosyne in Polotsk. Key words : Dormition Kyiv-Caves Lavra, 19 th – early 20 th ct., social interactions, visual source, sacred object, Near caves, Far caves, sacred object keeper, visitor, painter, photographer, informative value.

Infographics as a mnemonic structure: analysis of the informative and identity components of infographic online compositions in Iberic newspapers

Infographics as a transdisciplinary component that permits to objectify depth that amplifies and potentiates time and space, is the proper structure for the reading characteristics of Net Generation and outputs the dynamic skills of visual intelligence, creating mnemonic frameworks. This article analyses the use of its Informative content, and its appliance to the qualities of Online Information (accurate, timely, complete and concise), its components of Identity (periodicity, animation, stateness, interactivity, image, multimedia and typology) and its Informative components (structure, clarity, content and readability) through revision, over two weeks (2014 and 2015), of the six daily general online newspapers of Iberian Peninsula that, according to the Asociación para la Investigación de Medios de Comunicación and Marktest, have more views: El País, 20minutos, Público, Correio da Manhã, Jornal de Notícias and Diário de Notícias. Is also registered in this analysis, the vision of content producers through a survey of members of the Infographic Society (the only professional association of this particular profession established in the Iberian environment) and the results of the study are contrasted with an in-depth interview with structured questionnaire relating to four global infographic designers working for The Guardian, The Times and National Geographic. Although the results reflect a low Multimediality and Interactivity, the analysis finds that there is a sensory and affective effort Permanence and Narrative in the mnemonic meshing of skills in Journalistic Online Infographics limited by a poor Visibility of the Infographic compound given by the media, either by failure of Production, of Continuity, Informative, of Usability and/or integration.

Оценка качества вод и «здоровья» экосистем с позиций экологической парадигмы

Methodological approach to the water quality and ecosystem health from the ecological paradigm position has been vindicated. Critical analysis of the currently existing methods of water quality assessment has been performed. It has been shown that biological criteria of the ecosystems’ status diagnostics (in-situ) based on studying of laws of aquatic organisms and communities organization levels variability adequately reflect water quality and ecosystem health. New methodical solutions on hydro/chemical information compression to the unified indicator of the impact doze and vindication of informative biological water quality assessment criteria are depicted. Results of practical testing of the developed methods on a number of water bodies of Russia are presented. The methods are based on revealing of the cause-effect relations that are developed on the basis of doze-effect dependencies between the water quality chemical composition integral indicator and fish physiological status indicators.

Index for comparative assessment of municipal websites

Municipal corporations are important components of urban local governance. In India, these are responsible for many services including tax payments by citizens. In today's digital age, e-governance is a step towards effective utilisation of information and communication technology (ICT) for the flow of information between government and its stakeholders, delivery of public e-services and e-participation implementation. The present study proposes a detailed three-level framework municipal website quality assessment index (MWQAI) for assessment of municipal websites of India which may also be used for other developing countries. As a prototype of its use, qualities of seven municipal websites in the state of Madhya Pradesh in India are studied using MWQAI and other assessment instruments. Such a study enables comparative assessment of the websites to appraise their sophistication levels. More importantly, it provides suggestions for up-gradation of websites in the context of qualities of information provided, interactions, transactions and citizen-oriented services.

Index for Comparative Assessment of Municipal Websites

Municipal corporations are important components of urban local governance. In India, these are responsible for many services including tax payments by citizens. In today's digital age, e-governance is a step towards effective utilisation of information and communication technology (ICT) for the flow of information between government and its stakeholders, delivery of public e-services and e-participation implementation. The present study proposes a detailed three-level framework municipal website quality assessment index (MWQAI) for assessment of municipal websites of India which may also be used for other developing countries. As a prototype of its use, qualities of seven municipal websites in the state of Madhya Pradesh in India are studied using MWQAI and other assessment instruments. Such a study enables comparative assessment of the websites to appraise their sophistication levels. More importantly, it provides suggestions for up-gradation of websites in the context of qualities of information provided, interactions, transactions and citizen-oriented services.

Hygiene on maternity units: lessons from a needs assessment in Bangladesh and India

BackgroundAs the proportion of deliveries in health institutions increases in low- and middle-income countries, so do the challenges of maintaining standards of hygiene and preventing healthcare-associated infections (HCAIs) in mothers and babies. Adequate water, sanitation, and hygiene (WASH) and infection prevention and control (IPC) in these settings should be seen as integral parts of the broader domain of quality care. Assessment approaches are needed which capture standards for both WASH and IPC, and so inform quality improvement processes.DesignA needs assessment was conducted in seven maternity units in Gujarat, India, and eight in Dhaka Division, Bangladesh in 2014. The WASH & CLEAN study developed and applied a suite of tools – a ‘walkthrough checklist’ which included the collection of swab samples, a facility needs assessment tool and document review, and qualitative interviews with staff and recently delivered women – to establish the state of hygiene as measured by visual cleanliness and the presence of potential pathogens, and individual and contextual determinants or drivers.ResultsNo clear relationship was found between visually assessed cleanliness and the presence of pathogens; findings from qualitative interviews and the facility questionnaire found inadequacies in IPC training for healthcare providers and no formal training at all for ward cleaners. Lack of written policies and protocols, and poor monitoring and supervision also contributed to suboptimal IPC standards.ConclusionsVisual assessment of cleanliness and hygiene is an inadequate marker for ‘safety’ in terms of the presence of potential pathogens and associated risk of infection. Routine environmental screening of high-risk touch sites using simple microbiology could improve detection and control of pathogens. IPC training for both healthcare providers and ward cleaners represents an important opportunity for quality improvement. This should occur in conjunction with broader systems changes, including the establishment of functioning IPC committees, implementing standard policies and protocols, and improving health management information systems to capture information on maternal and newborn HCAIs.

Surveillance of infection associated with external ventricular drains: proposed methodology and results from a pilot study

The insertion of external ventricular drains (EVDs) is necessary in some neurosurgical patients, but increases the risk of meningitis/ventriculitis. While there are well-recognized risk factors, the proportion of patients who develop meningitis/ventriculitis varies partly due to differences in definitions. A multi-disciplinary working group was established to agree definitions for EVD-associated meningitis/ventriculitis, and a surveillance system was piloted in four centres in the UK and Ireland. Definitions were agreed based on those published previously and on clinical and microbiological criteria. An agreed dataset was developed to monitor patients after the insertion of an EVD and until the EVD was removed and the microbial aetiology was recorded. Four neurosurgical centres participated, with 61-564 patients surveyed in each unit. The vast majority of drains were cranial. Intracranial haemorrhage was the most common indication for the EVD insertion. Between 6% and 35% of EVDs were inserted by consultants rather than junior doctors. The proportion of patients who developed meningitis/ventriculitis varied from 3% to 18% and from 4.8 to 12.7/1000 EVD-days. Coagulase-negative staphylococci were the most common microbial causes. Routine and ongoing monitoring of patients with an EVD in situ to detect meningitis/ventriculitis presents logistical difficulties, and few units do so. This pilot study suggests that a national system of surveillance with agreed definitions and a methodology to enable unit-to-unit comparisons of EVD meningitis/ventriculitis is both necessary and feasible. This will, in turn, inform quality improvement processes leading to the minimization of infection.

Pictorial metaphors for information

Purpose Arts-informed, visual research was conducted to document the pictorial metaphors that appear among original drawings of information. The purpose of this paper is to report the diversity of these pictorial metaphors, delineate their formal qualities as drawings, and provide a fresh perspective on the concept of information. Design/methodology/approach The project utilized pre-existing iSquare drawings of information that were produced by iSchool graduate students during a draw-and-write activity. From a data set of 417 images, 125 of the strongest pictorial metaphors were identified and subjected to cognitive metaphor theory. Findings Overwhelmingly, the favored source domain for envisioning information was nature. The most common pictorial metaphors were: Earth, web, tree, light bulb, box, cloud, and fishing/mining, and each brings different qualities of information into focus. The drawings were often canonical versions of objects in the world, leading to arrays of pictorial metaphors marked by their similarity. Research limitations/implications Less than 30 percent of the data set qualified as pictorial metaphors, making them a minority strategy for representing information as an image. The process to identify and interpret pictorial metaphors was highly subjective. The arts-informed methodology generated tensions between artistic and social scientific paradigms. Practical implications The pictorial metaphors for information can enhance information science education and fortify professional identity among information professionals. Originality/value This is the first arts-informed, visual study of information that utilizes cognitive metaphor theory to explore the nature of information. It strengthens a sense of history, humanity, nature, and beauty in our understanding of information today, and contributes to metaphor research at large.

Análise de livros didáticos sobre o tema "morcegos"

Resumo: Morcegos provocam medo, são considerados pouco carismáticos para a população em geral e são raras as divulgações de seus benefícios ecológicos. Os livros didáticos podem acrescentar ou reforçar alguns equívocos, estereótipos e mitificações, além de falhas conceituais, informações incorretas ou de cunho discriminatório. Esta pesquisa teve como objetivo analisar o conteúdo sobre quirópteros dos livros didáticos, disponíveis na biblioteca municipal e em escolas públicas de Assis, São Paulo, além de avaliar como são veiculadas as informações pelas editoras com influência educacional. Dos 33 livros avaliados, apenas 26 continham informações sobre morcegos. Havia poucos erros conceituais ou informações distorcidas, mas, a qualidade informativa foi considerada insatisfatória e os discursos, superficiais. Constatou-se a necessidade de enfatizar as informações sobre os diversos papéis ecológicos dos morcegos e da inclusão de informações médico-sanitárias e profiláticas como forma de contribuição à saúde pública brasileira.

American Thoracic Society and Marron Institute Report. Estimated Excess Morbidity and Mortality Caused by Air Pollution above American Thoracic Society–Recommended Standards, 2011–2013

Estimates of the health impacts of air pollution are needed to make informed air quality management decisions at both the national and local levels. Using design values of ambient pollution concentrations from 2011-2013 as a baseline, the American Thoracic Society (ATS) and the Marron Institute of Urban Management estimated excess morbidity and mortality in the United States attributable to exposure to ambient ozone (O3) and fine particulate matter (PM2.5) at levels above the American Thoracic Society-recommended standards. Within the subset of counties with valid design values for each pollutant, 14% had PM2.5 concentrations greater than the ATS recommendation, whereas 91% had O3 concentrations greater than the ATS recommendation. Approximately 9,320 excess deaths (69% from O3; 31% from PM2.5), 21,400 excess morbidities (74% from O3; 26% from PM2.5), and 19,300,000 adversely impacted days (88% from O3; 12% from PM2.5) in the United States each year are attributable to pollution exceeding the ATS-recommended standards. California alone is responsible for 37% of the total estimated health impacts, and the next three states (Pennsylvania, Texas, and Ohio) together contributed to 20% of the total estimates. City-specific health estimates are provided in this report and through an accompanying online tool to help inform air quality management decisions made at the local level. Riverside and Los Angeles, California have the most to gain by attaining the ATS recommendations for O3 and PM2.5. This report will be revised and updated regularly to help cities track their progress.

Acute Gastroenteritis and Recreational Water: Highest Burden Among Young US Children.

To provide summary estimates of gastroenteritis risks and illness burden associated with recreational water exposure and determine whether children have higher risks and burden. We combined individual participant data from 13 prospective cohorts at marine and freshwater beaches throughout the United States (n = 84 411). We measured incident outcomes within 10 days of exposure: diarrhea, gastrointestinal illness, missed daily activity (work, school, vacation), and medical visits. We estimated the relationship between outcomes and 2 exposures: body immersion swimming and Enterococcus spp. fecal indicator bacteria levels in the water. We also estimated the population-attributable risk associated with these exposures. Water exposure accounted for 21% of diarrhea episodes and 9% of missed daily activities but was unassociated with gastroenteritis leading to medical consultation. Children aged 0 to 4 and 5 to 10 years had the most water exposure, exhibited stronger associations between levels of water quality and illness, and accounted for the largest attributable illness burden. The higher gastroenteritis risk and associated burden in young children presents important new information to inform future recreational water quality guidelines designed to protect public health.

Multi-agent-based modeling for extracting relevant association rules using a multi-criteria analysis approach

Recently, association rule mining plays a vital role in knowledge discovery in database. In fact, in most cases, the real datasets lead to a very large number of rules, which do not allow users to make their own selection of the most relevant. The difficult task is mining useful and non-redundant rules. Several approaches have been proposed, such as rule clustering, informative cover method and quality measurements. Another way to selecting relevant association rules, we believe that it is necessary to integrate a decisional approach within the knowledge discovery process. Therefore, in this paper, we propose an approach to discover a category of relevant association rules based on multi-criteria analysis. In other side, the general process of association rules extraction becomes more and more complex, to solve such problem, we also proposed a multi-agent system for modeling the different process of our proposed approach. Therefore, we conclude our work by an empirical study applied to a set of banking data to illustrate the performance of our approach.