Quality Assurance Research Articles

Causal reasoning in Software Quality Assurance: A systematic review

Context:Software Quality Assurance (SQA) is a fundamental part of software engineering to ensure stakeholders that software products work as expected after release in operation. Machine Learning (ML) has proven to be able to boost SQA activities and contribute to the development of quality software systems. In this context, Causal Reasoning is gaining increasing interest as a methodology to go beyond a purely data-driven approach by exploiting the use of causality for more effective SQA strategies. Objective:Provide a broad and detailed overview of the use of causal reasoning for SQA activities, in order to support researchers to access this research field, identifying room for application, main challenges and research opportunities. Methods:A systematic review of the scientific literature on causal reasoning for SQA. The study has found, classified, and analyzed 86 articles, according to established guidelines for software engineering secondary studies. Results:Results highlight the primary areas within SQA where causal reasoning has been applied, the predominant methodologies used, and the level of maturity of the proposed solutions. Fault localization is the activity where causal reasoning is more exploited, especially in the web services/microservices domain, but other tasks like testing are rapidly gaining popularity. Both causal inference and causal discovery are exploited, with the Pearl’s graphical formulation of causality being preferred, likely due to its intuitiveness. Tools to favour their application are appearing at a fast pace – most of them after 2021. Conclusions:The findings show that causal reasoning is a valuable means for SQA tasks with respect to multiple quality attributes, especially during V&V, evolution and maintenance to ensure reliability, while it is not yet fully exploited for phases like requirements engineering and design. We give a picture of the current landscape, pointing out exciting possibilities for future research.

Explainable AI based Predictions for Workpiece Quality

It is well known that sound emissions of drilling and milling machines can be used to predict process and work piece quality. Deep Learning models have successfully been applied for that task. However, artificial neural networks are perceived as black boxes as the inference mechanisms of the network are not transparent. In this paper we present a Convolutional Neural Network trained on audio data with which process and product quality of a milling process can be controlled. The model was trained on 10-second audio snippets recorded from a milling machine that were converted into spectrograms. The trained model classifies the drilling process and predicts the expected workpiece quality. Additionally, rough estimates of the center rough and average roughness depth values are predicted. Moreover, we apply the Explainable AI methods that produce explanations by highlighting sections of the spectrogram that were relevant for the prediction. The spectrograms enriched with the explanations provide insights into the decision making process of the deep learning model in a human interpretable form. Patterns of how and why of a prediction become visible. Areas considered relevant by the model can be compared to the expectations of the human user. Through this explanation component, the model is not only able to make predictions but also to increase trust in the system which is an important aspect of acceptance of AI based quality assurance.

Pharmacy stakeholders' views and experiences of the credentialing of advanced or specialist pharmacist practice: A mixed methods systematic review

BackgroundCredentialing of advanced and specialist pharmacist practice (ASPP) provides essential quality assurance for ASPP, which is significantly different to entry-level practice and is developing worldwide. Several credentialing models are in place or under development internationally. Synthesis of the views and experiences of pharmacists and other relevant stakeholders on credentialing is an important research gap. Objective(s)To determine pharmacy stakeholders' views and experiences of ASPP credentialing and to explore facilitators and barriers to credentialing implementation and uptake. MethodsThe Joanna Briggs Institute convergent integrated approach for mixed methods systematic reviews was followed. The review protocol was pre-registered with PROSPERO. Five electronic databases (Medline, CINAHL, Embase, Web of Science, Google Scholar) were searched from inception to August 2022 for qualitative, quantitative, or mixed methods studies that reported the views and experiences of pharmacy stakeholders on ASPP credentialing. The Mixed Methods Appraisal Tool was used to quality appraise included studies. Thematic synthesis was undertaken to analyse and integrate data from included studies. All screening and data analysis steps were performed by two reviewers independently, with additional author input where required. ResultsSixty studies were included, after screening titles and abstracts (n = 9055) and full texts (n = 228). Studies represented the views of pharmacists, pharmacy managers/employers and professional/representative bodies in hospital, community pharmacy, general practice/primary care, and academic sectors, from 40 countries. Four analytical themes were generated describing the factors, including facilitators and barriers, to be considered when developing or optimising ASPP credentialing: I. Drivers of credentialing, II. Developing ASPP competence, III. Optimising credentialing implementation, and IV. Enhancing credentialing uptake. ConclusionsThis systematic review is the first to synthesise pharmacy stakeholders' views and experiences of ASPP credentialing. A conceptual framework highlights contextual factors, facilitators, barriers, and inter-relationships which should be considered by pharmacists, policymakers, and other key stakeholders when implementing ASPP credentialing.

External quality assurance of chest X-ray interpretation to strengthen diagnosis of childhood TB.

Chest X-ray (CXR) misinterpretation negatively affects the accuracy of childhood TB diagnosis. External quality assurance (EQA) could strengthen CXR reading skills. We assessed the uptake, performance and challenges of an EQA of CXR interpretation within the childhood TB-Speed decentralisation study in six resource-limited countries. Every quarter, TB suggestive or unreadable CXRs and 10% of remaining CXRs from children with presumptive TB were selected for blind re-reading by national re-readers. The proportion of CXRs selected for EQA and re-read assessed the uptake. The performance was assessed by the proportion of discordant interpretations and the sensitivity and specificity of clinicians' vs re-readers' interpretations. Challenges were retrieved from country reports. Of 513 eligible CXRs, 309 (60.8%) were selected for EQA and 278/309 (90.0%) re-read. The proportion of discordant interpretation was between 13/48 (27%) in Sierra Leone and 7/13 (53.8%) in Cote d'Ivoire during the first EQA and decreased after the EQAs periods in 3/5 countries. Clinician sensitivity reached 100% in all countries over EQA. Specificity ranged between 13% in Sierra Leone and 65% in Cambodia (first EQA) and increased in 4/5 countries after the EQA periods. CXR transfer and re-readers' workload were the main challenges. EQA can enhance CXR interpretation for childhood TB diagnosis, provided operational challenges are overcome.

A phase field finite element study and evaluation of sulfide stress cracking in DCB specimen testing

The challenges presented by sour environments rich in hydrogen sulfide (H2S) underscore the necessity for a comprehensive understanding of material behavior under such conditions. The cracking susceptibility of metals and alloys used for subsurface equipment in downhole oil and gas exploration operations is particularly concerning. The NACE Double Cantilever Beam (DCB) test has emerged as a widely used quality assurance tool in the petroleum industry, leveraging fracture mechanics principles to assess the environment-assisted cracking (EAC) resistance of metals and alloys. The DCB test evaluates the fracture toughness KISSC of materials in H2S-containing environments via assessment of the crack arrest, which serves as a vital parameter in structural integrity assessments to mitigate the risk of service-related failures from sulfide stress cracking (SSC). However, various studies suggest that different test parameters, such as arm displacement and initial notch, significantly influence KISSC. This work presents a detailed numerical investigation on a comprehensive simulation of the DCB test, examining the effects of different test parameters on KISSC prediction. A coupled deformation-diffusion phase field framework is adopted to simulate SSC in DCB specimens arising from a complex interplay between material deformation, hydrogen diffusion, and fracture. The numerical results show good agreement with experimental results reported in the literature and provide deeper insights into the factors affecting crack growth and arrest in DCB testing.

FUNDAMENTALS OF QUALITY ASSURANCE IN THE HIGHER EDUCATION SYSTEM

This study explores the critical issue of quality assurance in higher education systems, both in Kazakhstan and globally, where universities operate in a «consumer market» with students selecting educational programs, institutions, and resources. Based on an analysis of international and domestic research, the study aims to identify the foundations of quality assurance in higher education. The authors highlight key aspects of higher education quality, including student quality, teaching characteristics, academic regulations, and administrative support. Educational quality is examined within the context of international standards as a matter of national importance, with education levels serving as a foundation for economic development of both state and society. The research analysis reveals that various approaches, methods, and criteria for quality management are employed in creating systems for ensuring and assessing the quality of higher education institutions in Kazakhstan and abroad. These include the evaluative method of university activity quality management (SWOT analysis), Total Quality Management (TQM) strategy, and an approach based on the requirements of international quality standards ISO 9000:2000. The study notes that Kazakhstan has adopted a management model based on the ISO 9000:2000 international quality standards. This comprehensive review contributes to the understanding of quality assurance mechanisms in higher education and their implications for educational policy and practice.

Chemometrics and electrochemistry joined hands to develop a novel and intelligent electronic device for simultaneous determination of malathion and diazinon in fruit juices: A progress in multidisciplinary studies

In this work, chemometrics and electrochemistry connected to each other to open a new way for assisting food industry specialists based on developing a novel electrochemical sensor for simultaneous determination of malathion (MT) and diazinon (DZ) in the presence of patulin (PT) and citrinin (CT) as uncalibrated interference in fruit juices. The sensor was fabricated based on modification of a glassy carbon electrode (GCE) by chitosan-ionic liquid (Ch-IL), electrodeposition of gold nanoparticles (Au NPs), drop-casting of multiwalled carbon nanotubes-IL (MWCNTs-IL), and electrochemical synthesis of dual templates molecularly imprinted polymers (DTMIPs) in which MT and DZ were used as templates. Effects of experimental variables on structure and response of the sensor were screened and optimized by Min Run screening and central composite design, respectively. After optimization, the third-order hydrodynamic differential pulse voltammetric (HDPV) data were generated based on changing modulation times and modulation amplitudes as instrumental parameters and modeled by N-PLS/RTL, U-PLS/RTL, U-PCA/RTL, APARAFAC, PARAFAC2 and MCR-ALS to select the best one to assist the sensor for ultra selective simultaneous determination of MT in the presence of PT and CT as uncalibrated interference in fruit samples. The results confirmed the MCR-ALS was the best assistance for DTMIPs/MWCNTs-IL/Au NPs/Ch-IL/GCE for simultaneous determination of MT and DZ in the presence of PT and CT as uncalibrated interference in both synthesis and real samples. Performance of the sensor assisted by MCR-ALS for ultra selective simultaneous determination of MT (0.1 pM to 12.5 pM, LOD=0.01 pM) and DZ (0.25 pM to 8.5 pM, LOD=0.15 pM) was really admirable which was comparable with HPLC with UV detection while it was faster, simpler and low-cost in comparison to HPLC-UV which motivated us to introduce it as a reliable method to assist food industry specialists for quality assurance purposes.

Technical Quality Assurance (TQA) Procedure for Ultrasound Systems in Clinical Practice – Survey

Technical Quality Assurance (TQA) Procedure for Ultrasound Systems in Clinical Practice – Survey

What Enables Implementation of Pain Management Interventions in Intensive Care Units and Why: A Realist Evaluation to Refine Program Theory.

To uncover perspectives and refine 12 initial program theories concerning the implementation of pain management interventions in intensive care units. Contexts enabling implementation are delineated, and causal mechanisms within these contexts are described. A realist evaluation approach was employed. Fourteen purposively selected Australian nurses of variant roles were virtually and individually interviewed between July and September 2023. Participants were presented with initial program theory, and their perspectives were collated. Data were analysed using an integrated approach of context (C), mechanism (M), outcome (O) categorisation coding, CMO configurations connecting and pattern matching. Pain management interventions work if perceived to be beneficial, precise, comprehensive and fit for purpose. Nurses should be willing to change attitudes and update knowledge. Unit leaders should nurture the development of nurses' professional identity, access to learning, autonomy and self-determination. Organisations should change the infrastructure, provide resources, mitigate barriers, develop shared mental models, update evidence and institute quality assurance. Adherence to interventions is affected by the outcomes of implementation and intrinsic merits of interventions. In these contexts, confidence is boosted; feelings of empowerment, self-efficacy, reflective motivation, trust, awareness and autonomy are developed; and capacity is built. Furthermore, frustration from the variability of practices is reduced, accountability and ownership are augmented, yielding positive implementation outcomes. Findings have implications on nurses, team leaders and organisations concerned with implementation. The findings provided a fortified understanding of conditions favouring successful implementation of pain management interventions. Actions should be undertaken at an individual, unit and organisation level to ensure successful implementation. RAMESES II Reporting Standards for Realist Evaluations informed presentation of study. Intensive care nurses contributed insights to refine the program theory.

Using continuous glucose monitoring to measure and improve quality metrics: Updates on the Healthcare Effectiveness Data and Information Set 2024 Glucose Management Indicator measure.

Value-based diabetes care is a proactive approach to providing quality care to individuals with diabetes. This approach focuses on improving clinical outcomes rather than the volume of services provided. Implementation of value-based diabetes care requires an established set of standardized quality measures against which all stakeholders can assess and benchmark their performance. The National Committee for Quality Assurance recently added the Glucose Management Indicator to its Healthcare Effectiveness Data and Information Set. The Glucose Management Indicator can be used as a measure of glucose control. This article discusses the benefits of value-based care, the importance of diabetes quality measures, and how the rapidly increasing adoption of continuous glucose monitoring is impacting these measures while improving the lives of individuals with diabetes.

Library and Information Sciences in Romanian higher education today

With 33 years of existence in Romania, higher education in the field of library and information science is today organised by four universities: University of Bucharest, Babes Bolyai University of Cluj Napoca, Lucian Blaga University of Sibiu and West University of Timisoara. In 2005, the Bologna Process was implemented in this field as well, with specialized education being organized in three specific cycles: undergraduate and master's studies, postgraduate studies and doctoral studies. Starting with this moment, we are assisting the attempt to standardise the curriculum, implicitly the set of skills and competences that graduates must have after graduation. This is supervised by the Romanian Agency for Quality Assurance in Higher Education; the competences and skills are listed in the register drawn up by the National Agency for Qualifications, and they are correlated with the ESCO register (European Skills, Competences, Qualifications and Occupations). By analysing the most recent RAQAHE recommendations (updated in 2022), the ESCO and NAQ registers, we aim to highlight the topicality of the study programmes offered by the four universities. The discussions can be held, in essence, on how prepared graduates are for the labour market and what would be the next steps for a more frequent adaptation of the content of subjects in curriculum in order to take into account the views formulated by The European Network Of Public Employment Services in June 2023, as a contribution to the European Year of Skills. It allows us to formulate some conclusions on the current state of curriculum in Romania.

Identification methods as a factor affecting the performance of clinical microbiology laboratories participating in an external quality assessment program: a cross-sectional, retrospective analysis.

Introduction. Laboratory participation in external quality assessment (EQA) programmes including proficiency testing (PT) is a requirement of clinical laboratory conformance to ISO 15189:2022 Medical laboratories - Requirements for quality and competence. PT is one EQA method whereby laboratories are sent blinded samples for characterization by routine laboratory diagnostic methods. Importantly, PT enables a laboratory's performance to be evaluated in comparison to the standard reference methods and to the performance of other peer laboratories using similar diagnostic methods.Gap statement. The desired outcome of participating in PT is to help laboratories identify possible sources of error in each step of the total testing process and particularly in their test methods during the analytical phase.Aim. This cross-sectional study investigated the impact of using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) compared to conventional phenotypic biochemical testing on laboratory performance in a clinical bacteriology PT scheme.Methodology. During a 6-year period from 2017-2022, the Canadian Microbiology Proficiency Testing implemented 112 PT challenges comprising 22 different sample types and included 61 different bacterial species. This was translated into 5883 graded test events for analysis. Multiple logistic regression techniques were employed to explore the association between the test method employed and laboratory performance. The sample type and aerobic classification of challenge organisms were included as confounding variables.Results. Laboratories using MALDI-TOF MS performed significantly better in characterizing microorganisms than laboratories using phenotypic biochemical testing alone [odds ratio OR = 5.68, confidence interval (CI): 3.92, 8.22] regardless of the sample type and aerobic classification. Notably, our analysis identified a significant association between anaerobic organisms and laboratory performance (OR: 0.24, CI: 0.17-0.35), suggesting that culturing and identifying fastidious organisms remains a significant obstacle for many clinical microbiology laboratories.Conclusions. Although no method is infallible and its performance will depend on the validation and quality assurance procedures, this finding may help the management in the decision for implementing MALDI-TOF MS in the microbiology laboratory. This study highlights the important role PT providers play in the objective assessment of laboratory performance and how it can provide evidence for quality improvement.

Development of a compact neutron spectrometer based on multi-element activation

In recent years, due to the introduction of accelerator-based facilities, the interest of the medical and scientific communities in the Boron Neutron Capture Theraphy (BNCT) dramatically increased. As far as beam diagnostics is concerned, the availability of spectrometry techniques adapted to BNCT is required for quality assurance and daily control measurements. This work aims to present a novel compact spectrometer with an isotropic response called Neutron Capture Therapy- Activation Compact Spectrometer (NCT-ACS), funded by INFN, highly sensitive in the energy interval ranging from thermal to 100 keV and suitable for in-phantom irradiation. The detector characteristics and the experimental results collected at the Torino neutron facility are shown.

258 Safety of a Community Tele-Paramedicine Program: Results of a Quality Assurance Review

258 Safety of a Community Tele-Paramedicine Program: Results of a Quality Assurance Review

A hybrid meta-heuristic framework with ensemble deep learning for multi-functional simultaneous optimized automatic intensity-modulated radiotherapy planning

Intensity-modulated radiotherapy (IMRT) is one of the main treatments for patients with cancer, and its treatment planning holds significant importance. Compared to manual treatment planning, automatic treatment planning (ATP) is expected to improve plan quality and efficiency, which is of great clinical importance. However, treatment planning is an intractable “black art” that calls for intuition and heuristics from medical dosimetrists. There are two main issues with the current ATP methods: (i) they rely strongly on prior clinical experience and are not sufficiently scalable, and (ii) they use a single-functional optimization concept that ignores delivery accuracy information, which lowers the delivery accuracy of the generated ATP plans. To address these issues, this paper presents a novel multi-functional simultaneous optimized automatic treatment planning (MFSO-ATP) method. First, to address the issues of high reliance and insufficient scalability, an evolutionary strategy (ES) and simulated annealing (SA)-based hybrid meta-heuristic trial-and-error (ESSA-HMTE) framework is designed to automatically adjust optimization parameters without human intervention. Second, to address the issue of delivery accuracy deterioration, an ensemble deep learning-based gamma passing rate (GPR) prediction (EnDL-GPR) framework was constructed and trained to predict the plan delivery accuracy a priori. The ESSA-HMTE framework effectively fuses dosimetric quality information and delivery accuracy a priori information to simultaneously optimize the two, ensuring delivery accuracy while achieving automatic planning. We tested the MFSO-ATP method using multiple diseases with high inter-tumor heterogeneity. The results showed that the proposed method can improve the quality and delivery accuracy of IMRT plans, reduce the percentage of quality assurance failures, is highly scalable, and has good clinical application prospects.

Ethical Exploration of Teacher Professional Ethics and Education Quality Assurance

Ethical Exploration of Teacher Professional Ethics and Education Quality Assurance

Structural Requirements for the Outpatient Treatment of Benign Diseases of the Uterus.

In many cases, outpatient surgical treatment of benign diseases of the uterus has advantages over inpatient care. This has been demonstrated by the healthcare situation in other countries. However, the prerequisite for the provision of outpatient services is that this does not lead to any impairment in the quality of care or of patient safety. The ultimate goal should not be to reduce costs but rather to maintain and, ideally, improve the quality of care. This requires that services are not just defined by the surgical procedure but also by the entire treatment chain, including, for example, psychosocial support, and are remunerated accordingly. It is particularly worrying that the final decision as to whether an outpatient operation is possible is not the responsibility of the operating unit, but of the "Medizinischer Dienst," with the corresponding options and threats of sanctions. This situation is unique internationally and requires a paradigm shift. Furthermore, structural prerequisites must be maintained which currently only exist inadequately in Germany. Since a substantial proportion of planned outpatient operations require immediate or secondary inpatient treatment, there must be a barrier-free transition between the outpatient and inpatient sectors. This will require the creation of networks between outpatient service providers and one or more hospitals that are equipped and competent to manage even complex complications. It is important to create structures that, with intensive involvement of the operating unit, include adequate preoperative evaluation and patient education as well as needs-oriented postoperative care at home. The current separation of sectors is a significant hinderance. Moreover, when expanding and promoting outpatient surgery, the aspect of training and further education of specialist staff must be taken into account, as well as cross-sectoral quality assurance. Based on a review of the international literature, this article presents 13 recommendations for adequate structures when providing outpatient services which should serve as a prerequisite for the greatest possible guarantee of patient safety.

Validation of MLC leaf open time calculation methods for PSQA in adaptive radiotherapy with tomotherapy units.

Treatment delivery safety and accuracy are essential to control the disease and protect healthy tissues in radiation therapy. For usual treatment, a phantom-based patient specific quality assurance (PSQA) is performed to verify the delivery prior to the treatment. The emergence of adaptive radiation therapy (ART) adds new complexities to PSQA. In fact, organ at risks and target volume re-contouring as well as plan re-optimization and treatment delivery are performed with the patient immobilized on the treatment couch, making phantom-based pretreatment PSQA impractical. In this case, phantomless PSQA tools based on multileaf collimator (MLC) leaf open times (LOTs) verifications provide alternative approaches for the Radixact® treatment units. However, their validity is compromised by the lack of independent and reliable methods for calculating the LOT performed by the MLC during deliveries. To provide independent and reliable methods of LOT calculation for the Radixact® treatment units. Two methods for calculating the LOTs performed by the MLC during deliveries have been implemented. The first method uses the signal recorded by the build-in detector and the second method uses the signal recorded by optical sensors mounted on the MLC. To calibrate the methods to the ground truth, in-phantom ionization chamber LOT measurements have been conducted on a Radixact® treatment unit. The methods were validated by comparing LOT calculations with in-phantom ionization chamber LOT measurements performed on two Radixact® treatment units. The study shows a good agreement between the two LOT calculation methods and the in-phantom ionization chamber measurements. There are no notable differences between the two methods and the same results were observed on the different treatment units. The two implemented methods have the potential to be part of a PSQA solution for ART in tomotherapy.

Academic Workloads: Insights from Medical and Non-medical Lecturers’ Experience in Universiti Sains Malaysia

Academic workload is crucial for effective educational management, but measuring it is challenging due to varying field-specific demands. This study explored the components of academic workload among medical and non-medical lecturers at a Malaysian public university through a phenomenological approach. Focus group discussions (FGDs) with full-time, permanent lecturers were used to gather insights. The FGDs were moderated, audio-recorded, and transcribed verbatim. Thematic analysis was conducted using ATLAS.ti version 7, following six steps: reading transcripts, labelling meaningful texts into codes, identifying important codes, compiling related codes into categories, labelling categories, and presenting results. Each transcript was coded by two researchers, with final themes discussed for consensus. Twenty-three lecturers from diverse fields (arts, humanities, health sciences, medicine, engineering, pure sciences, and social sciences) participated. Ten categories of academic workload were identified: teaching, research, administration, supervision, quality assurance, external activities, service, assessment, income generation, and continuous education. These were grouped into four themes: educational load (teaching, supervision, and assessment), scholarly activity load (research and external activities), academic quality load (quality assurance and continuous education), and institutional load (administration, income generation, and service). The study highlighted that academic workloads are intricately linked to the multifaceted roles of academics as educators, scholars, leaders, managers, and professionals.

Development of Risk-Based Methodologies for Highway Pavement Construction Inspection

Construction inspection plays a critical role in Portland cement concrete pavement (PCCP) and hot mix asphalt (HMA) pavement projects. To ensure the quality of pavement projects, state departments of transportation (DOTs) in the U.S. typically conduct construction material tests and inspect workmanship processes using quality assurance (QA) programs. Given today’s reality of reduced QA inspection resources such as funding, staff ability, and availability, several state DOTs have used a risk-based inspection (RBI) approach to optimize their QA processes. A thorough review of existing literature revealed limited studies examining RBI methodologies in highway pavement construction projects. The aim of this study is to investigate the use of RBI for pavement construction projects. It employed a triangulation research methodology, including an extensive literature review, a survey questionnaire of 50 state DOTs, focus groups, and a vetting workshop. A list of 16 core items in field inspection for both PCCP and HMA pavement projects was developed and verified. A generic risk rating of these critical inspection activities was determined. Additionally, inspection frequency, documentation effort, and inspector experience associated with these critical inspection activities identified through focus groups and the vetting workshop served as a reference point when conducting RBI for PCCP and HMA pavement projects. This study contributes to the body of knowledge and the highway construction industry by identifying and prioritizing 16 core inspection items for PCCP and HMA pavement construction. Construction project managers and inspectors may benefit from this study by analyzing the risks of core inspection items and implementing appropriate risk mitigation plans.