Standardized Data Collection Methods Research Articles

The Citizen Science Landscape: From Volunteers to Citizen Sensors and Beyond

Within conservation and ecology, volunteer participation has always been an important component of research. Within the past two decades, this use of volunteers in research has proliferated and evolved into “citizen science.” Technologies are evolving rapidly. Mobile phone technologies and the emergence and uptake of high-speed Web-capable smart phones with GPS and data upload capabilities can allow instant collection and transmission of data. This is frequently used within everyday life particularly on social networking sites. Embedded sensors allow researchers to validate GPS and image data and are now affordable and regularly used by citizens. With the “perfect storm” of technology, data upload, and social networks, citizen science represents a powerful tool. This paper establishes the current state of citizen science within scientific literature, examines underlying themes, explores further possibilities for utilising citizen science within ecology, biodiversity, and biology, and identifies possible directions for further research. The paper highlights (1) lack of trust in the scientific community about the reliability of citizen science data, (2) the move from standardised data collection methods to data mining available datasets, and (3) the blurring of the line between citizen science and citizen sensors and the need to further explore online social networks for data collection.

Knowledge, attitudes and practices of private sector providers of tuberculosis care: a scoping review [Review article

The past decade has seen a significant increase in private sector provision of tuberculosis (TB)care. While patients often seek and select treatment from private providers at significant out-of-pocket expense,treatment outcomes remain largely unknown. To investigate the knowledge, attitudes and practices of private sector TB care providers in high burden countries. Medline, PubMed, Embase, International Pharmaceutical Abstracts and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched using Medical Subject Headings terms,Emtree terms and key words. Searches were limited to the English language and published between 1998 and week 2 of November 2009. Studies were included if they reported the knowledge, attitudes or practice behaviours of private health care providers working in one of 22 high-TB-burden countries. Each included study was critically assessed using a structured data extraction tool. Data extracted included the study setting, objective, design, sample, response rate, outcomes and limitations. The 34 studies that met review inclusion criteriaen compassed diverse study methods and designs.All categories of TB care providers lacked comprehensive knowledge of national treatment guidelines. Procedures for referral, treatment monitoring, record keeping and case holding were not systematically implemented.However, there was a high degree of willingness to collaborate with national TB programmes. Research using standardised data collection methods may assist in identifying gaps in knowledge and practice among all providers of TB care. Further studies in developing and evaluating needs-based interventions should be undertaken; systematic reviews of such studies may then assist in strategic decision making in public-private mix DOTS expansion.

Evidence of the invisible: toward a credibility revolution in the empirical analysis of tax evasion and the informal economy

Empirical research about tax evasion and the informal economy has exploded in the past few decades, seeking to shed light on the magnitude and (especially policy) determinants of these phenomena. Quantitative information informs the analysis of policy choices, enables the testing of hypotheses about determinants of this phenomenon, and can help with the accurate construction of national income accounts. Even as empirical analysis has burgeoned, some have expressed doubts about the quality and usefulness of some prominent measures. The fact that high-quality data is elusive is neither surprising nor a coincidence. The defining characteristic of tax evasion and informal economic activity—that they are generally illegal—often renders unreliable standard data collection methods such as surveys. Unlike invisible phenomena in the natural sciences, these invisible social science phenomena are hard to measure because of choices made by individuals. Analysis of tax evasion and the informal economy must proceed even in the absence of the direct observability of key variables, and theory should guide the construction and interpretation of evidence of the “invisible.” In this paper, we address what can be learned using micro or macro data regarding tax evasion and the informal economy under given conditions and assumptions, and critically review some of the most common empirical methods in light of our conclusions. We conclude with an entreaty for researchers in this field to enlist in the “credibility revolution” (Angrist and Pischke in J. Econ. Perspect. 4(2):3–30, 2010) in applied econometrics.

Morbidity and Mortality after Colorectal Procedures: Comparison of Data from the American College of Surgeons Case Log System and the ACS NSQIP

Improving the quality of surgical care depends upon collection of robust data. The American College of Surgeons Case Log System enables surgeons to self-report patient risk factors and outcomes. In contrast, the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) uses trained data abstractors to record similar data and uses a strict data collection methodology. The objective of this study was to assess bias in data entry for colorectal cases by comparing data in these 2 registries. One year of NSQIP (July 1, 2008 to June 30, 2009) and 7 years of Case Log (2003 to 2010) data were examined. Colorectal cases were identified by current procedural terminology code. The frequencies of comparably defined variables were compared, and mortality models were developed using logistic regression. Observed and expected mortality rates were compared. Rates of most risk factor and outcome variables were significantly higher in NSQIP than those in Case Log. NSQIP had a higher unadjusted mortality rate (4.46% versus 3.69%, p < 0.001); however, the adjusted odds of mortality was significantly higher in Case Log (odds ratio 1.32, p < 0.05). The Case Log model overpredicted mortality in NSQIP by 22%, whereas the NSQIP model underpredicted mortality in Case Log by 12%. Significant differences exist between risk factor and outcome data in NSQIP and Case Log for colorectal procedures. These differences demonstrate the need for standardized data collection methods, as is required by NSQIP, including use of standard definitions, adherence to a follow-up period for outcomes, and use of audits. These measures would improve the validity of using a self-reported database to evaluate and benchmark performance.

Collaboration in Wound Photography Competency Development

The objective of this study was to enhance conventional wound assessment and documentation of clinicians by incorporating the use of digital imaging into the medical record using standardized photography requirements. A review of current literature, existing clinician practice, and identification of barriers preceded the development and implementation of a clinical practice guideline, with a performance checklist, aimed at improving the wound photography (WP) process. In addition, establishing standards of practice and behavior modification were used to improve clinician proficiency in digital photography. Wound clinicians providing specialty care within the acute care setting. Following educational sessions, evaluation of clinician competence in using equipment and adherence to standard digital imaging protocols with the use of a performance checklist permitted educators to validate clinician skill. Establishing consistency in digital imaging results is an overall enhancement of the WP process by increasing clinician satisfaction and efficiency, improving assessment skills, and enriching documentation. Competency strengthens one's skill set and serves to create a common language, leading to improved communication among clinicians and resulting in enhanced wound assessment. WP plays a valuable role in delivering effective patient care by strengthening wound assessments and documentation. Recognizing the need for consistent standards, clinical educators from Lehigh Valley Health Network designed an educational program using a multifaceted approach, including clinical practice guideline development, education, and competency assessment. Enmeshing current practices, expert opinion, and clinician knowledge resulted in an innovative process using interdependent, yet independent, components to achieve enhanced wound assessment.

Evaluating the Performance of Trauma Centers: Hierarchical Modeling Should be Used

Comparing trauma centers in terms of patient survival is a key element of performance evaluation. The current standard in trauma center profiling is based on Ordinary Logistic Regression (OLR). However, OLR does not take account of the hierarchical structure of trauma systems. Hierarchical Logistic Regression (HLR) accounts for the clustering of patients within hospitals and is therefore more theoretically appropriate. The objective of this study was to evaluate whether HLR generates different profiling results than OLR. The study was based on the Quebec Trauma Registry with mandatory participation of all 59 designated trauma centers in the province of Quebec, uniform inclusion criteria, and standardized data collection methods. Trauma profiling was based on adjusted odds ratios, which represent the odds that a patient will die in a specific hospital compared with an "average" hospital. Risk adjustment was performed with the Trauma Risk Adjustment Model score. Hospitals were ranked according to odds ratio, and outliers were identified by comparing each hospital with all other hospitals. Hospital ranks and statistical outliers generated by OLR and HLR were compared. The study population comprised 83,504 patients including 4,731 hospital deaths (5.7%). OLR identified 11 hospitals as statistical outliers whereas HLR flagged only four of these hospitals as outliers. In addition, 54 of 59 hospitals changed ranks and 24 hospitals changed by more than five ranks when HLR replaced OLR. This study shows that replacing OLR with HLR has an important impact on the results of hospital profiling. Along with the many theoretical advantages of HLR, these results support the adoption of hierarchical modeling as the standard method for trauma center profiling.

Assessing Hand Hygiene Resources and Practices at a Large African Teaching Hospital

To gather baseline data on hand hygiene (HH) practices in an African hospital with a newly established infection prevention and control team. Cross-sectional, observational study. Setting. Komfo Anokye Teaching Hospital, a large teaching hospital in Ghana with approximately 1,000 beds. All hospital staff with patient contact were eligible for assessment of HH practices. HH observations were conducted using a standardized data collection tool and method based on the World Health Organization's "5 Moments of Hand Hygiene." Small-group interviews were conducted to gather additional information on perceptions of HH and barriers to its use. HH resource needs were also assessed using a standardized tool. HH was attempted in 12% of the opportunities and was performed appropriately in 4% of the opportunities. Most main wards (89%) had at least 1 functional HH station. The most commonly identified barriers to HH were limited resources and lack of knowledge on appropriate times to perform HH. We developed and applied tools to evaluate HH resources and practices in a large African hospital. These assessments were undertaken to guide future efforts to improve HH at this hospital but can also serve as a model of the way to perform a systematic assessment at acute care hospitals in developing countries.

The Role of Local Health Departments in Providing Sexually Transmitted Disease Services and Surveillance in Rural Communities

Local health departments (LHDs) are an important source for screening and treating sexually transmitted diseases (STDs) in rural communities. Yet, they oftentimes lack the resources needed to adequately assess and monitor these conditions. The purpose of this study was to (1) explore how rural LHDs assess and monitor STDs; (2) identify barriers to effective surveillance; (3) examine STD patterns in their communities; and (4) provide recommendations for improving surveillance. Data were collected from questionnaires, LHD site visits, client management system records, and state reports. One of the greatest challenges to adequately monitoring STDs was the lack of standardized data collection methods among LHDs. In addition, race/ethnicity information, which is critical to monitoring disparities, was lacking in most records. Among records where recorded, racial/ethnic minorities were most affected. STD patterns indicated adolescents lead all age groups in STDs. LHDs should consider regionalized or statewide approaches to assessing and monitoring STDs and develop standardized STD interview/intake forms, paying particular attention to race, ethnicity, and income data. Demographic and coding variables should be included and standardized across all forms for consistency. STD interventions and campaigns targeting adolescents and racial/ethnic minorities in rural counties should also be considered. Due to limited time and resources, little can be done by rural LHDs in regards to prevention and education, yet, state and federal agencies should consider how additional resources and enhanced support could be provided to assist them in fulfilling their public health role in STD surveillance.

A New Method for Evaluating Trauma Centre Outcome Performance

To develop a method of evaluating trauma center mortality that addresses the limitations of currently available methodology-Standardized Mortality Ratios (SMRs) based on the Trauma and Injury Severity Score. TRISS SMRs have important limitations including inadequate risk adjustment, comparison to an inappropriate standard, lack of consideration for inter- and intrahospital variation, and incomparability across hospitals. The methodology was developed using data from a provincial trauma registry with mandatory participation of all trauma centers, uniform inclusion criteria, and standardized data collection methods. Institutional performance was described with estimates of risk-adjusted mortality derived from a hierarchical logistic regression model. Risk adjustment was performed with a risk score generated by the Trauma Risk Adjustment Model (TRAM), as well as a term for incoming transfers and an interaction between transfer and the risk score. Outliers were identified by comparing each hospital to all remaining hospitals. The study population comprised 88,235 patients including 4731 deaths (5.4%) from 59 trauma centers. Crude mortality varied between 1.3% and 14.3%. TRAM-adjusted mortality estimates varied between 3.7% (95% CI: 3.2%-4.3%) and 6.9% (5.8%-8.2%). Three trauma centers had significantly higher adjusted mortality and one center had statistically significant lower mortality when compared with all other centers. The proposed method of trauma center profiling offers comprehensive adjustment for patient-level risk factors and consideration of transfer status, is based on comparisons to an internal standard, accounts for inter- and intrahospital variation, and replaces SMRs with estimates of regression-adjusted mortality that are comparable across hospitals. TRAM-adjusted mortality estimates can be used to describe institutional outcome performance and to identify institutional outliers. Such information is the key to identifying ways to improve the quality of modern trauma care.

Comparing different data collection and analysis techniques for quantifying healthy knee joint function during stair ascent and descent

There is currently no standard data collection or analysis method for the assessment of stair gait using motion analysis. This makes the comparison of results from different studies difficult. It is important to gain an appreciation of the discrepancies in kinematic and kinetic information generated by employing different computational approaches, as these differences may be critical in cases where methodologies were to change over a long-term study. This study explores the effect of using different methodologies for the assessment of non-pathological knee function of ten subjects during stair ascent and descent. Two methods of computing knee kinematics were compared: (a) using in-house software and a pointer method of anatomical calibration and (b) using commercial software, Visual3D (C-motion, Inc.) and skin-mounted markers. Significant differences were found between the two methods when calculating a frontal plane range of motion (p < 0.05). Three methods of computing knee moments were compared. Knee moments computed using the inverse dynamic analysis (IDA) approach of Visual3D (C-motion, Inc.) were significantly different (p < 0.05) to those calculated using in-house IDA software that ignores the foot and ankle and to those computed using a vector cross-product approach. This study highlights the implications of comparing data generated from different collection and analysis methods.

Structured Home Study Evaluations: Perceived Benefits of SAFE Versus Conventional Home Studies

Structured decision-making methods are gaining ascendance in child welfare services, in which professionals combine standardized methods of data collection and analysis with clinical judgments. This study measures professionals’ perception of a new approach to home study assessments, the Structured Analysis Family Evaluation (SAFE). Findings indicate that workers favor the use of SAFE overall. Less experienced workers are especially positive about SAFE, while more experienced workers and supervisors tend to be less positive. State-by-state differences also emerged. Open-ended responses offer areas for clarification, training, and potential improvement.

The Trilling Files

The FBI dossier on Lionel Trilling discloses that the Bureau followed his activities intermittently for almost three decades. An active file was maintained on Trilling from the late 1930s to the mid-1960s. Most of these reports address Trilling’s peripheral connection to ongoing FBI probes and to its scrutiny of communist figures and issues, and reveal how out of touch FBI intelligence was about which American intellectuals posed security threats. Although Trilling’s FBI dossier contains no bombshell revelations and discloses no technical violations of his civil liberties, his surveillance by the FBI was wasteful and unnecessary; in any event, it demonstrates a skewed understanding of the balance among national security, social order, and personal liberty.

Favorable Immunologic Response Profile to Recombinant Thrombin Application in Surgery: An Integrated Analysis of 8 Clinical Trials

Recombinant thrombin (rThrombin) is an active topical hemostat approved by the FDA as an aid to hemostasis. Treatment with thrombin derived from bovine sources has occasionally been associated with adverse events which appear to be related to the formation of antibodies against bovine thrombin and/or Factor V. The safety and immunogenicity of rThrombin have been evaluated in 8 clinical trials: 1 Phase 1 study, 5 Phase 2 studies, 1 randomized, double-blind Phase 3 study, and 1 open-label, single-group Phase 3b study. Pooled results from these trials provide a consistent and clinically relevant summary of safety information on the use of rThrombin in surgery. These trials utilized standardized data collection methods; more than 100 investigators from over 60 institutions participated. With 514 subjects treated with rThrombin in clinical trials to date (cut-off date July 2008), these results represent the largest safety database available for any commercially-available thrombin product. Standard safety measures were collected prior to surgery (baseline) through Day 29 post-surgery. Immunogenicity was evaluated at baseline and Day 29 using enzyme-linked immunosorbent assays and a time-to-clot assay to measure neutralizing potential of any detected anti-rThrombin antibodies. Of the subjects for whom data are currently available (N=514), 54% were male and 46% were female. Mean age was 57.0 years (SD, 15.7; range, 12–89 years). The following surgery types were represented: spine, 32% of patients; liver, 14%; peripheral arterial bypass, 23%; arteriovenous graft, 18%; burn, 12%. The median dose of rThrombin was 10,000 IU (range, 1000–50,000 IU). Topical application of rThrombin was well tolerated by study subjects. Common adverse events (AEs; reported by ≥10% of subjects) were similar regardless of surgery type and were consistent with the post-surgical setting. Common AEs included incision site complication, procedural pain, nausea, constipation, pyrexia, anemia, vomiting, insomnia, incision site pain, and pruritus. No single serious adverse event type occurred in >1% of patients. Twelve of 514 subjects (2.3%) had anti-rThrombin product antibodies at baseline, a finding that is consistent with reports of antibodies to other recombinant forms of endogenous proteins. None of the 12 subjects with anti-rThrombin product antibodies at baseline had a change in titer ≥1.0 unit at Day 29. Among subjects who did not have anti-rThrombin product antibodies at baseline, 5/502 (1.0%) had detectable antibodies at Day 29. In total, 5/514 subjects (1.0%) were antibody positive at Day 29. None of the antibodies neutralized native human thrombin. These clinical studies, enrolling 514 subjects to date, collectively demonstrate that rThrombin is well-tolerated and has a favorable immunologic response profile when used in numerous surgical settings.

Key Factors for Implementing Supported Employment

Key Factors for Implementing Supported Employment

A SYSTEM FOR INTEGRATED SCAT DATA COLLECTION AND MANAGEMENT: ESCAT, SCATDB, AND PHOTOLOGGER

ABSTRACT During response, oiled shorelines must be surveyed to guide cleanup operations. The Shoreline Cleanup and Assessment Technique (SCAT) is a standard method for conducting these surveys. Multiple field teams often conduct SCAT. SCAT surveys quickly produce a large and complex dataset comprised of SCAT observations, GPS positions, and photographs. In order to guide response decision-making, SCAT field data must be processed and analyzed in a timely manner. Until recently, SCAT and GPS data were collected on standardized paper worksheets, transcribed to electronic form, and then incorporated into maps and other decision-making products. Photographs were not tightly managed alongside SCAT data. Today, with the emergence of robust handheld computing technology, the deficiencies inherent in paper data collection are no longer necessary or acceptable. Paper data collection can be slow, error prone, and lacking quality control and integration with GPS technology. Digital options are available to address these challenges. To improve methods, the Office of Response and Restoration is developing a digital field data collection and management system for SCAT data and photographs composed of: (1) specialized software for efficient SCAT data collection with GPS enabled handheld devices, (2) a relational SCAT database which expedites the synthesis of field data into decision making products, promotes community standards, and supports standard paper worksheet and digital data collection methods, and (3) an image database which allows for the processing, documenting, and sharing of large quantities of digital photographs. For this project, commonly used, readily available, and Open Source computing resources were chosen so that end-users could easily test, adopt, and improve this system.

Variation and Temporal Trends in the Use of Diagnostic Testing During Hospitalization for Acute Myocardial Infarction by Age, Gender, Race, and Geography (the Atherosclerosis Risk In Communities Study)

The use of cardiovascular procedures has become routine in the management of acute myocardial infarction (MI). However, diagnostic testing beyond coronary revascularization procedures and use over time has not been well characterized. Records of 35- to 74-year-old adults hospitalized with MI in 4 US communities from 1987 to 2001 were abstracted using standardized data collection methods. Rates of procedure use and outcomes were compared by patient characteristics. Of 11,242 patients (mean age 61 years, 43% women, 22% black), angiography use increased substantially over time, echocardiography use increased more in women than men (interaction p<0.05), use of right-sided cardiac catheterization decreased, and use of nuclear scans and exercise tests remained constant. Men, whites, and locations with the highest angiography and right-sided cardiac catheterization use had lower noninvasive testing. In multivariate analysis, women had less angiograms and more echocardiograms obtained than men, but only in those with no previous MI before this hospitalization (both interaction p<0.05). Similarly, in those without previous MI, blacks were even less likely than whites to undergo angiography compared with those with a history of MI (interaction p=0.0001). Adjusted mortality rates were similar by gender, but mortality was higher in blacks than whites, a difference that decreased with adjustment for angiography use. In conclusion, in patients hospitalized with MI, use of many diagnostic cardiovascular procedures varied over time, with differences by gender, age, race, and geography that persisted over time unexplained by many measurable characteristics. There may also be continued perception of lower risk in women and blacks without a known diagnosis of MI.

An Online Dual-Certification Program in Advanced Practice Nursing and Nursing Education

Educating nurses for the healthcare delivery workforce is stymied as qualified applicants to nursing programs are being turned away. Although applications to baccalaureate programs have increased, between 41,683 and 147,000 undergraduate and graduate applicants were turned away from nursing education programs in 2005 due largely to shortages of nursing faculty. In this article, the evidence-based rationale for the development of a dual-certification program for the preparation of clinical nurse specialists and nurse educators is described. Because faculty shortages are nationwide, we developed the program to be delivered, in its entirety, online. Standardized data collection methods for evaluating student progress and their achievement of competencies expected of clinical nurse specialists and nurse educators are provided. The program may be a model for preparing clinically competent nurse educators who prefer practice settings to full-time faculty positions.

An Online Dual-Certification Program in Advanced Practice Nursing and Nursing Education

Educating nurses for the healthcare delivery workforce is stymied as qualified applicants to nursing programs are being turned away. Although applications to baccalaureate programs have increased, between 41 683 and 147 000 undergraduate and graduate applicants were turned away from nursing education programs in 2005 due largely to shortages of nursing faculty. In this article, the evidence-based rationale for the development of a dual-certification program for the preparation of clinical nurse specialists and nurse educators is described. Because faculty shortages are nationwide, we developed the program to be delivered, in its entirety, online. Standardized data collection methods for evaluating student progress and their achievement of competencies expected of clinical nurse specialists and nurse educators are provided. The program may be a model for preparing clinically competent nurse educators who prefer practice settings to full-time faculty positions.

Creating Financial Transparency in Public Health

Financial transparency is based on concepts for valid, standardized information that is readily accessible and routinely disseminated to stakeholders. While Congress and others continuously ask for an accounting of public health investments, transparency remains an ignored concept. The objective of this study was to examine financial transparency practices in other industries considered as part of the public health system. Key informants, regarded as financial experts on the operations of hospitals, school systems, and higher education, were a primary source of information. Principal findings were that system partners have espoused some concepts for financial transparency beginning in the early 20th century--signifying an 80-year implementation gap for public health. Critical features that promote accountability included standardized data collection methods and infrastructures, uniform practices for quantitative analysis of financial performance, and credentialing of the financial management workforce. Recommendations are offered on the basis of these findings to aid public health to close this gap by framing a movement toward transparency.

The Status of National HIV Case Surveillance, United States 2006

Since the height of HIV incidence in the mid-1980s, advances in treatment have delayed progression of HIV infection. As a result, surveillance of AIDS cases alone is no longer sufficient to monitor the current status of the HIV epidemic. At the national level, new HIV diagnoses and progression of these cases to AIDS are used to describe the epidemic. The capacity to monitor the national HIV epidemic has consistently improved over the last several years. An increasing number of states report diagnosed HIV cases to the national surveillance system, allowing data from this system to better represent the national picture. Monitoring the national HIV epidemic depends on a nationwide system using standardized methods of data collection, and establishing such a comprehensive system remains one of the highest priorities for national HIV case surveillance.