Quality Of Treatment Research Articles

A Bayesian CUSUM plot: Diagnosing quality of treatment.

To present a CUSUM plot based on Bayesian diagnostic reasoning displaying evidence in favour of "healthy" rather than "sick" quality of treatment (QOT), and to demonstrate a technique using Kaplan-Meier survival curves permitting application to case series with ongoing follow-up. For a case series with known final outcomes: Consider each case a diagnostic test of good versus poor QOT (expected vs. increased failure rates), determine the likelihood ratio (LR) of the observed outcome, convert LR to weight taking log to base 2, and add up weights sequentially in a plot showing how many times odds in favour of good QOT have been doubled. For a series with observed survival times and an expected survival curve: Divide the curve into time intervals, determine "healthy" and specify "sick" risks of failure in each interval, construct a "sick" survival curve, determine the LR of survival or failure at the given observation times, convert to weights, and add up. The Bayesian plot was applied retrospectively to 39 children with acute lymphoblastic leukaemia with completed follow-up, using Nordic collaborative results as reference, showing equal odds between good and poor QOT. In the ongoing treatment trial, with 22 of 37 children still at risk for event, QOT has been monitored with average survival curves as reference, odds so far favoring good QOT 2:1. QOT in small patient series can be assessed with a Bayesian CUSUM plot, retrospectively when all treatment outcomes are known, but also in ongoing series with unfinished follow-up.

Predicting procedural justice behavior: examining communication and personality

PurposeLaw enforcement agencies have historically used psychological examinations, in addition to other methods, to screen candidates out of the applicant pool. However, agencies could be better served by ensuring recruits are predisposed to the expected behaviors and qualities that are required as part of community-oriented and respectful policing. The purpose of this paper is to provide an initial look into what officer-level characteristics might lead to improved treatment in police-community interactions (PCIs). Characteristics under review include communication styles and personality dimensions.Design/methodology/approachData come from the National Police Research Platform’s longitudinal recruit study and its PCI survey. Community members were surveyed about their interactions with officers involved in the study. Hierarchical linear modeling was used to analyze these two-level data.FindingsThe findings suggest that certain officer-level characteristics were associated with higher perceptions of procedurally just behavior. Specifically, officers with higher levels of empathy and lower levels of neuroticism scored higher on both the officer’s quality of treatment (QT) and quality of decision making toward the community member. Additional to those dimensions, officers with increased emotional control received higher scores on their QT.Originality/valueThese findings have important implications for identifying and measuring new characteristics to be used in police hiring procedures. To the authors’ knowledge, this is the first instance where personality dimensions and communications styles have been used to predict law enforcement officers’ procedural justice behaviors in the field.

IMPROVED PREDICTION FROM A REVISED INJURY SEVERITY CLASSIFICATION(RISC) OVER TRAUMA AND INJURY SEVERITY SCORE (TRISS) OF ANINDEPENDENT EVALUATION OF MAJOR TRAUMA PATIENTS

BACKGROUND Celje General Hospital started implementing a polytrauma registry in 1992 to collect thedata for comparison of treatment efficacy with international standards. The quality oftreatment was evaluated with TRISS, but structural differences to MTOS study significantlyimpacted obtained results. At 2006 they started adding data to DGU Traumaregister where quality of treatment was evaluated with RISC. The aim of the study was to assess theusefulness of the RISC analysis for the evaluation of the quality of treatment of severelyinjured patients and to compare it with TRISS. METHODS The cohort of 155 major trauma patients treated in the Celje General Hospital in the years2006–2007 was included in DGU Traumaregister. The structure of patients was compared to the registry and TRISS and RISC analyses were performed. M-statistic was used tocompare the distribution of injury severity between groups, TRISS and RISC were evaluated with ROC curves and the Hosmer-Lemeshow test. RESULTS M-statistic (0.83) showed a good match of probability of survival between groups. Moreover, RISC evaluation (AUC 0.94), H-L test (3.5, p = 0.94) proved the efficacy of this method.The TRISS with AUC 0.89 and H-L test 21.1 was not reliable tool for comparing outcomesbetween groups. CONCLUSIONS RISC demonstrated very good performance and should replace TRISS in the evaluation oftreatment in major trauma patient population

PD.94 Monitoring of effiency and quality oftreatment of oral cancer and precancer by optical coherence tomography

PD.94 Monitoring of effiency and quality oftreatment of oral cancer and precancer by optical coherence tomography

Argon plasma coagulation in Barrett's esophagus.

Despite the availability of many clinical trials, there is no evidence that APC has any role in the management of Barrett's esophagus. Ablation therapy is not indicated for nondysplastic Barrett's esophagus (and this is true, whatever the technique used), and it should not be performed outside of a carefully designed and approved clinical trial. Indeed, these patients have a low risk of cancer, and there is no evidence that Barrett's esophagus ablation will be of any benefit for these patients. In some cases, APC could be of some help, especially for treating short segments of dysplastic Barrett's esophagus. In this field, however, it competes with the growing indication of mucosectomy, which clearly offers advantages in terms of treatment's quality control assessment.