Completeness and Geodesic Distance Properties for Fractional Sobolev Metrics on Spaces of Immersed Curves

We investigate the geometry of the space of immersed closed curves equipped with reparametrization-invariant Riemannian metrics; the metrics we consider are Sobolev metrics of possible fractional-order q ∈ [ 0 , ∞ ) . We establish the critical Sobolev index on the metric for several key geometric properties. Our first main result shows that the Riemannian metric induces a metric space structure if and only if q > 1 / 2 . Our second main result shows that the metric is geodesically complete (i.e., the geodesic equation is globally well posed) if q > 3 / 2 , whereas if q < 3 / 2 then finite-time blowup may occur. The geodesic completeness for q > 3 / 2 is obtained by proving metric completeness of the space of H q -immersed curves with the distance induced by the Riemannian metric.

Assessing the accuracy and completeness of artificial intelligence language models in providing information on methotrexate use

We aimed to assess Large Language Models (LLMs)-ChatGPT 3.5-4, BARD, and Bing-in their accuracy and completeness when answering Methotrexate (MTX) related questions for treating rheumatoid arthritis. We employed 23 questions from an earlier study related to MTX concerns. These questions were entered into the LLMs, and the responses generated by each model were evaluated by two reviewers using Likert scales to assess accuracy and completeness. The GPT models achieved a 100% correct answer rate, while BARD and Bing scored 73.91%. In terms of accuracy of the outputs (completely correct responses), GPT-4 achieved a score of 100%, GPT 3.5 secured 86.96%, and BARD and Bing each scored 60.87%. BARD produced 17.39% incorrect responses and 8.7% non-responses, while Bing recorded 13.04% incorrect and 13.04% non-responses. The ChatGPT models produced significantly more accurate responses than Bing for the "mechanism of action" category, and GPT-4 model showed significantly higher accuracy than BARD in the "side effects" category. There were no statistically significant differences among the models for the "lifestyle" category. GPT-4 achieved a comprehensive output of 100%, followed by GPT-3.5 at 86.96%, BARD at 60.86%, and Bing at 0%. In the "mechanism of action" category, both ChatGPT models and BARD produced significantly more comprehensive outputs than Bing. For the "side effects" and "lifestyle" categories, the ChatGPT models showed significantly higher completeness than Bing. The GPT models, particularly GPT 4, demonstrated superior performance in providing accurate and comprehensive patient information about MTX use. However, the study also identified inaccuracies and shortcomings in the generated responses.

Risk factors as causes of accidents: Criterion of causality, logical structure of relationship to accidents and completeness of explanations

The causes of accidents are studied in the belief that by finding causes, accidents can be prevented by removing or controlling their causes. It follows that the risk factors that have traditionally been regarded as contributing to accidents can only be regarded as causes if it is possible to alter them by means of one or more road safety measures. Risk factors are causes if their relationship to accidents can be changed by implementing one or more road safety measures influencing the risk factors. Hence, road safety measures that could have been implemented to change risk factors identified as contributing to an accident, but have not, are also causes of accidents. Many of the human factors that have traditionally been identified as risk factors for accidents, like age, gender, driving experience, expectations or involuntary inattention are not causes of accidents, because they cannot be changed by means of any realistic road safety measure. What cannot be changed (could not have been different) is not a cause. It is possible, both in case studies and in statistical analyses, to determine when a set of factors precipitating or contributing to accidents is complete. A list of road safety measures that could have been implemented is only limited by our creativity and imagination and will therefore never be complete.

Forensic anthropologists and estimates of skeletal completeness: The impacts of training and experience

Forensic anthropologists engage with numerous and diverse stakeholders in their casework. Regarding the recovery of human remains, these stakeholders may be interested in quantifying or qualifying the amount of remains recovered. How forensic anthropologists respond to such questions, whether verbally or in written reporting, has the potential to impact the trajectory of a case. However, communications about skeletal completeness are rarely discussed within the field. Current data-collection procedures recommend the use of inventories. This approach may be less feasible for complicated assemblages involving commingling or high degrees of fragmentation. Numerous methods exist to quantify the amount of skeletal remains present in complex or larger assemblages, but it remains unclear to what extent forensic anthropologists utilize these methods and whether factors like degree of expertise influence analysts' ability to report skeletal completeness consistently and precisely. A study was designed to examine differences between public and professional perceptions of skeletal completeness, presenting images of incomplete bones and skeletal remains. Survey participants were asked to assess the completeness of the remains in each image. Few patterns were observed regarding photographs of skeletal assemblages, but distinct differences were observed among individual bones between respondents with different degrees of expertise. These responses reflect potentially unexamined assumptions underlying assessments of incomplete bones and skeletal assemblages. This highlights the necessity of standardizing how we report estimates of completeness within the forensic anthropology community and how we discuss these results with external stakeholders. Completeness estimates must be either removed from reports and bench notes or annotated and cited clearly, as is standard with other aspects of forensic anthropological analysis. Several methods are summarized, with recommendations for integrating them into casework.

The consequences of data dispersion in genomics: a comparative analysis of data sources for precision medicine

BACKGROUND

Genomics-based clinical diagnosis has emerged as a novel medical approach to improve diagnosis and treatment. However, advances in sequencing techniques have increased the generation of genomics data dramatically. This has led to several data management problems, one of which is data dispersion (i.e., genomics data is scattered across hundreds of data repositories). In this context, geneticists try to remediate the above-mentioned problem by limiting the scope of their work to a single data source they know and trust. This work has studied the consequences of focusing on a single data source rather than considering the many different existing genomics data sources.

METHODS

The analysis is based on the data associated with two groups of disorders (i.e., oncology and cardiology) accessible from six well-known genomic data sources (i.e., ClinVar, Ensembl, GWAS Catalog, LOVD, CIViC, and CardioDB). Two dimensions have been considered in this analysis, namely, completeness and concordance. Completeness has been evaluated at two levels. First, by analyzing the information provided by each data source with regard to a conceptual schema data model (i.e., the schema level). Second, by analyzing the DNA variations provided by each data source as related to any of the disorders selected (i.e., the data level). Concordance has been evaluated by comparing the consensus among the data sources regarding the clinical relevance of each variation and disorder.

RESULTS

The data sources with the highest completeness at the schema level are ClinVar, Ensembl, and CIViC. ClinVar has the highest completeness at the data level data source for the oncology and cardiology disorders. However, there are clinically relevant variations that are exclusive to other data sources, and they must be considered in order to provide the best clinical diagnosis. Although the information available in the data sources is predominantly concordant, discordance among the analyzed data exist. This can lead to inaccurate diagnoses.

CONCLUSION

Precision medicine analyses using a single genomics data source leads to incomplete results. Also, there are concordance problems that threaten the correctness of the genomics-based diagnosis results.

Data completeness and consistency in individual medical records of institutional births: retrospective crossectional study from Northwest Ethiopia, 2022

BACKGROUND

Ensuring the data quality of Individual Medical Records becomes a crucial strategy in mitigating maternal and newborn morbidity and mortality during and around childbirth. However, previous research in Ethiopia primarily focused on studying data quality of institutional birth at the facility level, overlooking the data quality within Individual Medical Records. This study examined the data completeness and consistency within Individual Medical Records of the institutional birth service and associated factors.

METHODS

An institution-based retrospective cross-sectional study was conducted in two districts of Northwest Ethiopia. Data were obtained by reviewing three sets of Individual Medical Records of 651 women: the delivery register, Integrated Individual Folder, and integrated card. The proportions of completeness and consistency were computed. A multilevel binary logistic regression was used to identify factors of completeness and consistency. An odds ratio with a 95% confidence interval was used to assess the level of significance.

RESULTS

Overall, 74.0% of women's Individual Medical Records demonstrated good data completeness ( > = 70%), 95%CI (70.5, 77.3), while 26% exhibited good consistency, 95%CI (22.9, 29.7). The presence of trained providers in data quality (AOR = 2.9, 95%CI: (1.5, 5.7)) and supportive supervision (AOR = 11.5, 95%CI: (4.8, 27.2)) were found to be associated with completeness. Health facilities' practice of root cause analysis on data quality gaps (AOR = 8.7, 9%CI: (1.5, 50.9)) was statistically significantly associated with the consistency.

CONCLUSIONS

Most medical records were found to have good completeness, but nearly only a quarter of them found to contain consistent data. Completeness and consistency varied on the type of medical record. Health facility's root cause analysis of data quality gaps, the presence of trained providers in data quality, and supportive supervision from higher officials were identified as factors affecting data quality in institutional birth service. These results emphasize the importance of focused efforts to enhance data completeness and consistency within Individual Medical Records, particularly through consideration of Individual Medical Records in future provider training, supervision, and the implementation of root cause analysis practices.

Completeness of regional cancer registry data in Northwest Russia 2008-2017

BACKGROUND

A national framework for population-based cancer registration was established in Russia in the late 1990s. Data comparability and validity analyses found substantial differences across ten population-based cancer registries (PBCRs)in Northwest Russia, and only four out of ten met international standards. This study aimed to assess the completeness of the PBCR data of those registries.

METHODS

Qualitative and quantitative methods recommended for completeness and timeliness assessment were applied to the data from ten Russian regional PBCRs in Northwest Russia, covering a population of 13 million. We used historic data methods (using several European PBCRs reference rates), mortality-to-incidence ratios (M:I) comparison, and death certificate methods to calculate the proportion of unregistered cases (Lincoln-Petersen estimator and Ajiki formula).

RESULTS

Incidence rate trends of different cancer types were stable over time (except one region - Leningrad oblast). A slight drop in incidence rates in older age groups for several sites in the Northwestern regions was observed compared to the reference from European countries. Comparing M:I ratios against five-year survival revealed systematic differences in Leningrad oblast and Vologda oblast. Assessment of completeness revealed low or unrealistic estimates in Leningrad oblast and completeness below 90% in St. Petersburg. In other regions, the completeness was above 90%. The national annual report between 2008-2017 did not include about 10% of the cases collected later in the registry database of St. Petersburg. This difference was below 3% for Arkhangelsk oblast, Murmansk oblast, Novgorod oblast, Vologda oblast and the Republic of Karelia.

CONCLUSIONS

Eight out of ten regional PBCRs in Northwest Russia collected data with an acceptable degree of completeness. Mostly populated St. Petersburg and Leningrad oblast did not reach such completeness. PBCR data from several regions in Northwest Russia are suitable for epidemiological research and monitoring cancer control activities.

Enhancing students' online collaborative PBL learning performance in the context of coauthoring-based technologies: A case of wiki technologies

Understandability and completeness are essential in modern collaborative digital platforms and their learning systems. These platforms have shaken up the traditional education setting, particularly in leveraging the coauthoring approach in problem-solving and streamlining the learning behavior of cowriting or corevising. Such a learning context has attracted considerable interest from various stakeholders; however, it needs to be explored further as an independent topic. Based on social capital and social identity theories, we explore how online collaborative problem-based learning (PBL) effectiveness, relational quality, and social identity influence students' perceived PBL performance during learning activities. Based on the core elements of online coauthoring processes (i.e., platform, cocreation, and problem-solving), this study employs a holistic view of the coauthor to discuss the effects of understandability and completeness. This study also highlights the mediating impact of trust on students' social identity. Based on the responses of 240 students, the results support the proposed hypotheses using partial least squares analysis. The study's implications suggest guidelines to educators on how to enhance students' perceived PBL performance by using wiki technologies.

Estimation of the completeness of road traffic mortality data in Zambia using a three source capture recapture method

BACKGROUND

Accurate and reliable data are essential for tracking progress and evaluating the effectiveness of road safety intervention measures. However, in many low- and medium-income countries, good quality data on road traffic crashes are often difficult to obtain. This situation has led to an underestimation of the severity of the problem and distortions in trends when the reporting changes over time. This study estimates the completeness of road traffic crash fatality data in Zambia.

METHODS

Data from the police, hospitals, and the civil registration and vital statistics (CRVS) databases was collected for the period 1st January to 31st December 2020 and analyzed using a three-source capture-recapture technique.

RESULTS

A total of 666 unique records on mortalities as a result of road traffic crashes were collected from the three data sources during the period under review. The capture-recapture technique estimated the completeness of police, hospital, and CRVS databases to be 19%, 11% and 14% respectively. The combination of the three data sets was found to increase completeness to 37%. Based on this completion rate, we estimate that the actual number of people who died as a result of road traffic crashes in Lusaka Province in the year 2020 was approximately 1,786 (95% CI [1,448-2,274]). This corresponds to an estimated mortality rate of around 53 deaths per 100,000 population.

CONCLUSIONS

There is no single database contains complete data to provide a comprehensive picture of Lusaka province and by extension the country's road traffic injury burden. This study has shown how capture and recapture method can address this problem. It shows the need for the continuous review of the data collection processes and procedures in order to identify gaps and bottlenecks, improve efficiency, and increase the quality and completeness of road traffic data on injuries and fatalities. Based on the findings of this study, it is recommended that the city of Lusaka province and Zambia as a whole utilize more than one database for official reporting of road traffic fatalities to increase completeness.

Comparison of surgical completeness in patients operated on conventional open total thyroidectomy (OT) or trans-axillary robot-assisted total thyroidectomy (RATT) by a single axillary approach

Trans-axillary robot-assisted total thyroidectomy (RATT) is nowadays worldwide accepted but the completeness obtained by RATT is still debated. The Aim of this study was to compare the completeness and safety of RATT with conventional open thyroidectomy (OT). We enrolled patients with nontoxic multinodular goiter, cytologically indeterminate nodules and well differentiated thyroid cancer without local and/or distant metastasis. In all cases the biggest nodule should be < 6 cm. The surgical completeness was evaluated by means of serum thyroglobulin (hs-Tg) and neck ultrasound (nUS) performed three months postoperatively. 100 patients underwent either RATT or OT. The type of surgical procedure was chosen by patients. They were then divided in two subgroups based on benign or malignant histology. There were no significant differences in the postoperatively values of hs-Tg in patients operated with RATT or OT, both in benign and malignant subgroups. The post-operative thyroid remnant volume estimated by nUS was not significantly different between the two groups, both in benign and malignant subgroups. We also analyzed the difference of the volume of the thyroid remnant ipsilateral to the axillary access vs that of the remnant on the contralateral side and there was not significantly difference in both subgroups. RATT was demonstrated to determine a comparable surgical completeness as OT, both in benign and malignant thyroid diseases, with no differences in the prevalence of surgical complications. In our hands the surgical completeness of RATT by a single trans-axillary was satisfying.

Hemispherotomy in Children: A Retrospective Analysis of 152 Surgeries in a Single Center and Predictors for Long-Term Seizure Outcome

OBJECTIVE

Completeness as a predictor of seizure freedom is broadly accepted in epilepsy surgery. We focused on the requirements for a complete hemispherotomy and hypothesized that the disconnection of the insula contributes to a favorable postoperative seizure outcome. We analyzed surgical and non-surgical predictors influencing long-term seizure outcome before and after a modification of our hemispherotomy technique.

METHODS

We retrospectively studied surgical procedures, electro-clinical parameters, MRI results, and follow-up data in all children who had undergone hemispherotomy between 2001 and 2018 at our institution. We used logistic regression models to analyze the influence of different factors on seizure outcome.

RESULTS

152 patients were eligible for seizure outcome analysis only. Of these, 140 cases had complete follow-up data for ≥24 months and provide the basis for the following results. The median age at surgery was 4.3 years (range 0.3-17.9 years). Complete disconnection (including the insular tissue) was achieved in 63.6% (89/140). At two-year follow-up, seizure freedom (Engel class IA) was observed in 34.8% (8/23) with incomplete insular disconnection while this was achieved in 88.8% (79/89) with complete surgical disconnection (p<0.001, OR=10.41). In the latter group (N=89), a potentially epileptogenic contralateral MRI lesion was the strongest predictor for postoperative seizure recurrence (OR=22.20).

SIGNIFICANCE

Complete surgical disconnection is the most important predictor of seizure freedom following hemispherotomy and requires disconnection of the insular tissue at the basal ganglia level. Even if the hemispherotomy is performed completely surgically, a potentially epileptogenic contralateral lesion on preoperative MRI significantly reduces the chances of postoperative seizure freedom.

Timeliness and completeness of weekly surveillance data reporting on epidemic prone diseases in Uganda, 2020-2021

INTRODUCTION

Disease surveillance provides vital data for disease prevention and control programs. Incomplete and untimely data are common challenges in planning, monitoring, and evaluation of health sector performance, and health service delivery. Weekly surveillance data are sent from health facilities using mobile tracking (mTRAC) program, and synchronized into the District Health Information Software version 2 (DHIS2). The data are then merged into district, regional, and national level datasets. We described the completeness and timeliness of weekly surveillance data reporting on epidemic prone diseases in Uganda, 2020-2021.

METHODS

We abstracted data on completeness and timeliness of weekly reporting of epidemic-prone diseases from 146 districts of Uganda from the DHIS2.Timeliness is the proportion of all expected weekly reports that were submitted to DHIS2 by 12:00pm Monday of the following week. Completeness is the proportion of all expected weekly reports that were completely filled and submitted to DHIS2 by 12:00pm Wednesday of the following week. We determined the proportions and trends of completeness and timeliness of reporting at national level by year, health region, district, health facility level, and facility ownership.

RESULTS

National average reporting timeliness and completeness was 44% and 70% in 2020, and 49% and 75% in 2021. Eight of the 15 health regions achieved the target for completeness of ≥ 80%; Lango attained the highest (93%) in 2020, and Karamoja attained 96% in 2021. None of the regions achieved the timeliness target of ≥ 80% in either 2020 or 2021. Kampala District had the lowest completeness (38% and 32% in 2020 and 2021, respectively) and the lowest timeliness (19% in both 2020 and 2021). Referral hospitals and private owned health facilities did not attain any of the targets, and had the poorest reporting rates throughout 2020 and 2021.

CONCLUSION

Weekly surveillance reporting on epidemic prone diseases improved modestly over time, but timeliness of reporting was poor. Further investigations to identify barriers to reporting timeliness for surveillance data are needed to address the variations in reporting.

Evaluation of data quality at the Hungarian National Cancer Registry, 2000-2019

BACKGROUND

The Hungarian National Cancer Registry (HNCR) was legally established as a population-based cancer registry in 1999, and its operation started in 2000 supporting the planning and development of the Hungarian oncology network as well as informing national cancer control policies. Ensuring comparable, accurate, and complete data on malignant and in situ neoplasms is critical in determining the applicability of the database. The aim of this study was to perform a comprehensive evaluation of the data quality at the HNCR.

METHODS

Based on qualitative and semiquantitative methods from current international guidelines, we assess the comparability, completeness, validity, and timeliness of the collected data over the diagnostic period 2000-2019, with a focus on the year 2018.

RESULTS

Coding practices and the classification system used at the HNCR are based on the International Classification of Diseases (ICD-10), which differs from the internationally recommended ICD-O. The annual trends in incidence did not indicate major fluctuations, that may have resulted from data collection discrepancies, while comparisons of the mortality-to-incidence ratio (M:I) compared with 1 minus 5-year observed survival indicated some systematic differences requiring further exploration. The age-standardized (European standard) incidence rate per 100 000 measured by the HNCR in 2018 was very high: 647.9 for men and 501.6 for women, 11.6% and 14.6% higher than the International Agency for Research on Cancer (IARC) estimates respectively. Behind the overall differences between the two data sources, we identified that the vast majority were due to ill-defined ICD codes: malignant neoplasm of other and ill-defined sites (C76), and malignant neoplasm without specification of site (C80). Otherwise, there were no major discrepancies by localization. The proportion of morphologically verified cancer cases was 57.8% overall, that of death certificates was 2.3%, and that of unknown primary tumors was 1.4%.

CONCLUSION

Further implementations and interventions are required to ensure that the operations, coding practices, and the classification system used at the national registry are in accordance with international standards, and to increase the completeness and validity of the collected cancer data. In particular, the low morphologically verified proportion questions the overall accuracy of the stated diagnoses within the database. Nevertheless, our examination implies that the data of the HNCR are reasonably comparable, and without doubt fulfill the requirements to support national oncology services and cancer planning. However, most importantly, a review of registry personnel and resource requirements to run the national population-based cancer registry should be an essential part of Hungary's national cancer strategy.

Completeness of Reporting of Systematic Reviews and Meta-Analysis of Diagnostic Test Accuracy (DTA) of Radiological Articles Based on the PRISMA-DTA Reporting Guideline

RATIONALE AND OBJECTIVES

This study evaluated the completeness of systematic reviews and meta-analyses in radiology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy (PRISMA-DTA) and PRISMA-DTA for Abstracts guidelines between articles published before and those published after the issuance of the guideline and identify areas that have been poorly reported.

MATERIALS AND METHODS

PubMed were searched for systematic reviews on DTA with or without meta-analyses published in general radiology journals between January 1, 2016 and December 31, 2020. The identified articles were assessed for completeness of reporting according to the PRISMA-DTA. Subgroup analyses were performed for association of completeness of reporting with multiple cofactors.

RESULTS

The search identified 183 reviews from 12 journals. The mean numbers (standard deviation) of reported PRISMA-DTA and PRISMA-DTA for Abstracts items in the full texts and abstracts were 18.45 (2.02) and 5.66 (1.28), respectively. Subgroup analysis showed that compared to the corresponding reference groups, a higher mean number of reported PRISMA-DTA items was associated with publication during July 2018-December 2020 [(17.82 (2.01) vs 18.89 (1.91); p = 0.034), citation of the PRISMA-DTA [17.62 (1.86) vs 20.27 (2.02); p < 0.001], and inclusion of supplementary materials [17.64 (2) vs 19.09 (1.8); p < 0.001] on multiple-linear regression analysis.

CONCLUSION

Completeness of reporting with respect to the PRISMA-DTA and PRISMA-DTA for Abstracts has improved modestly since the publication of the PRISMA-DTA guideline; however, increasing awareness of the specific weakness provides the chance for completeness improvement.

Unifying Splitting

AVATAR is an elegant and effective way to split clauses in a saturation prover using a SAT solver. But is it refutationally complete? And how does it relate to other splitting architectures? To answer these questions, we present a unifying framework that extends a saturation calculus (e.g., superposition) with splitting and that embeds the result in a prover guided by a SAT solver. The framework also allows us to study locking, a subsumption-like mechanism based on the current propositional model. Various architectures are instances of the framework, including AVATAR, labeled splitting, and SMT with quantifiers.

Reporting of the safety from allergic rhinitis trials registered on ClinicalTrials.gov and in publications: An observational study

BACKGROUND

Incomplete and inconsistent reporting of adverse events (AEs) through multiple sources can distort impressions of the overall safety of the medical interventions examined as well as the benefit-risk relationship. We aimed to assess completed allergic rhinitis (AR) trials registered in ClinicalTrials.gov for completeness and consistency of AEs reporting comparing ClinicalTrials.gov and corresponding publications.

METHODS

We retrospectively examined completed randomised controlled trials on AR registered in ClinicalTrials.gov on or after 9/27/2009 to trials updated with results on or before 12/31/2021 along with any corresponding publications. Complete reporting of AEs in ClinicalTrials.gov were summarised in tables describing AE information, and complete reporting in publications was an explicit statement of serious AE, death or other AE. Difference in completeness, number, or description of AEs between ClinicalTrials.gov and publication was classified as inconsistent reporting of AEs.

RESULTS

There were 99 registered trials with 45 (45.5%) available publications. All published trials completely reported AEs in ClinicalTrials.gov, and 21 (46.7%) in publications (P < .001). In 43 (95.6%) publications, there was at least one inconsistency in the reporting of AEs (P < .001). 8 (17.8%) publications had different number of serious AEs (P = .003), 36 (80.0%) of other AEs (P < .001) while deaths reporting was inconsistent in 8 (57.1%) publications (P = .127).

CONCLUSION

The reporting of AEs from AR trials is complete in ClinicalTrials.gov and incomplete and inconsistent in corresponding publications. There is a need to improve the reporting of AEs from AR trials in corresponding publications, and thus to improve patient safety.

Maternal and child health data quality in health care facilities at the Cape Coast Metropolis, Ghana

Background

The demand for quality maternal and child health (MCH) data is critical for tracking progress towards attainment of the Sustainable Development Goal 3. However, MCH cannot be adequately monitored where health data are inaccurate, incomplete, untimely, or inconsistent. Thus, this study assessed the level of MCH data quality.

Method

A facility-based cross-sectional study design was adopted, including a review of MCH service records. It was a stand-alone study involving 13 healthcare facilities of different levels that provided MCH services in the Cape Coast Metropolis. Data quality was assessed using the dimensions of accuracy, timeliness, completeness, and consistency. Health facilities registers were counted, collated, and compared with data on aggregate monthly forms, and a web-based data collation and reporting system, District Health Information System (DHIS2). The aggregate monthly forms were also compared with data in the DHIS2. Eight MCH variables were selected to assess data accuracy and consistency and two monthly reports were used to assess completeness and timeliness. Percentages and verification factor were estimated in the SPSS version 22 package.

Results

Data accuracy were recorded between the data sources: Registers and Forms, 102.1% (95% CI = 97.5%—106.7%); Registers and DHIS2, 102.4% (95% CI = 94.4%—110.4%); and Forms and DHIS2, 100.1% (95% CI = 96.4%—103.9%). Across the eight MCH variables, data were 93.2% (95% CI = 82.9%—103.5%) complete in Registers, 91.0% (95% CI = 79.5%—102.5%) in the Forms, and 94.9% (95% CI = 89.9%—99.9%) in DHIS2 database. On the average, 87.2% (95% CI = 80.5%—93.9%) of the facilities submitted their Monthly Midwife’s Returns reports on time, and Monthly Vaccination Report was 94% (95% CI = 89.3%—97.3%). The overall average data consistency was 93% (95% CI = 84%—102%).

Conclusion

Given the WHO standard for data quality, the level of MCH data quality in the health care facilities at the Cape Coast Metropolis, available through the DHIS2 is complete, reported on timely manner, consistent, and reflect accurately what exist in facility’s source document. Although there is evidence that data quality is good, there is still room for improvement in the quality of the data.

Characteristics of clinical trials related to hip fractures and factors associated with completion

BACKGROUND

This study aimed at investigating the characteristics of clinical trials related to hip fractures that were registered at ClinicalTrials.gov. It also aimed to identify potential risk factors associated with completion.

MAIN BODY

We obtained 733 clinical studies related to hip fractures from the ClinicalTrials.gov database and included 470 studies in the analysis. These clinical trials were divided into behavioral, drug/biological, device, procedure, and other categories based on intervention types. Clinical trials investigating drugs or biologics were categorized based on the specific agents administered in each trial. Multiple logistic and Cox regression models were used to test the ability of 24 potential risk factors in predicting recruitment status and completion time, respectively. Among the included clinical trials, 44.89% (211/470) had complete recruitment status. The overall median completion time was 931.00 days (95% confidence interval [CI]: 822.56-1039.44 days). The results of only 8.94% (42/470) of clinical trials were presented on the ClinicalTrials.gov website. Bupivacaine (a local anesthetic) was most commonly investigated (in 25 clinical trials); this was followed by ropivacaine (another local anesthetic, 23 clinical trials) and tranexamic acid (a hemostatic, 21 clinical trials). Multivariate analysis showed that trials including children (P = 0.03) and having National Institutes of Health funds (P < 0.01) had significantly higher rates of complete recruitment. Higher enrollment (P < 0.01), National Institutes of Health funding (P < 0.01), location in the United States (P = 0.04), and location in Europe (P = 0.03) predisposed to longer completion time, while studies involving drugs/biologics (P < 0.01) had shorter completion times.

CONCLUSIONS

A considerable proportion of clinical trials related to hip fractures were completed, but the results of only a small fraction were presented on the ClinicalTrials.gov website. The commonly investigated drugs focused on anesthesia, pain relief, and hemostasis. Several independent risk factors that affect recruitment status and completion time were identified. These factors may guide the design of clinical trials relating to hip fractures.

Compliance with the World Health Organization's surgical safety checklist and related postoperative outcomes: a nationwide survey among 172 health facilities in Ethiopia

Background

Ministry of Health (MOH) of Ethiopia adopted World Health Organization’s evidence-proven surgical safety checklist (SSC) to reduce the occurrence of surgical complications, i.e., death, disability and prolong hospitalization. MOH commissioned this evaluation to learn about SSC completeness and compliance, and its effect on magnitude of surgical complications.

Methods

Health institution-based cross-sectional study with retrospective surgical chart audit was used to evaluate SSC utilization in 172 public and private health facilities in Ethiopia, December 2020–May 2021. A total of 1720 major emergency and elective surgeries in 172 (140 public and 32 private) facilities were recruited for chart review by an experienced team of surgical clinicians. A pre-tested tool was used to abstract data from patient charts and national database. Analyzed descriptive, univariable and bivariable data using Stata version-15 statistical software.

Results

In 172 public and private health facilities across Ethiopia, 1603 of 1720 (93.2%) patient charts were audited; representations of public and private facilities were 81.4% (n = 140) and 18.6% (n = 32), respectively. Of surgeries that utilized SSC (67.6%, 1083 of 1603), the proportion of SSC that were filled completely and correctly were 60.8% (659 of 1083). Surgeries compliant to SSC guide achieved a statistically significant reduction in perioperative mortality (P = 0.002) and anesthesia adverse events (P = 0.005), but not in Surgical Site Infection (P = 0.086). Non-compliant surgeries neither utilized SSC nor completed the SSC correctly, 58.9% (944 of 1603).

Conclusions

Surgeries that adhered to the SSC achieved a statistically significant reduction in perioperative complications, including mortality. Disappointingly, a significant number of surgeries (58.9%) failed to adhere to SSC, a missed opportunity for reducing complications.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13037-022-00329-6.

Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT)

BACKGROUND

With the aim of obtaining more uniformity and quality in the treatment of corpus uteri cancer in Belgium, the EFFECT project has prospectively collected detailed information on the real-world clinical care offered to 4063 Belgian women with primary corpus uteri cancer. However, as data was collected on a voluntary basis, data may be incomplete and biased. Therefore, this study aimed to assess the completeness and potential selection bias of the EFFECT database.

METHODS

Five databases were deterministically coupled by use of the patient's national social security number. Participation bias was assessed by identifying characteristics associated with hospital participation in EFFECT, if any. Registration bias was assessed by identifying patient, tumor and treatment characteristics associated with patient registration by participating hospitals, if any. Uni- and multivariable logistic regression were applied.

RESULTS

EFFECT covers 56% of all Belgian women diagnosed with primary corpus uteri cancer between 2012 and 2016. These women were registered by 54% of hospitals, which submitted a median of 86% of their patients. Participation of hospitals was found to be biased: low-volume and Walloon-region centers were less likely to participate. Registration of patients by participating hospitals was found to be biased: patients with a less favorable risk profile, with missing data for several clinical-pathological risk factors, that did not undergo curative surgery, and were not discussed in a multidisciplinary tumor board were less likely to be registered.

CONCLUSIONS

Due to its voluntary nature, the EFFECT database suffers from a selection bias, both in terms of the hospitals choosing to participate and the patients being included by participating institutions. This study, therefore, highlights the importance of assessing the selection bias that may be present in any study that voluntarily collects clinical data not otherwise routinely collected. Nevertheless, the EFFECT database covers detailed information on the real-world clinical care offered to 56% of all Belgian women diagnosed with corpus uteri cancer between 2012 and 2016, and may therefore act as a powerful tool for measuring and improving the quality of corpus uteri cancer care in Belgium.

Making EHRs Trustable: A Quality Analysis of EHR-Derived Datasets for COVID-19 Research

One approach to verifying the quality of research data obtained from EHRs is auditing how complete and correct the data are in comparison with those collected by manual and controlled methods. This study analyzed data quality of an EHR-derived dataset for COVID-19 research, obtained during the pandemic at Hospital Universitario 12 de Octubre. Data were extracted from EHRs and a manually collected research database, and then transformed into the ISARIC-WHO COVID-19 CRF model. Subsequently, a data analysis was performed, comparing both sources through this convergence model. More concepts and records were obtained from EHRs, and PPV (95% CI) was above 85% in most sections. In future studies, a more detailed analysis of data quality will be carried out.

Effect of mobile phone text message and call reminders in the completeness of pentavalent vaccines in Kano state, Nigeria

PURPOSE

This study assessed the effect of mobile phone text message and call reminders in the completeness of the pentavalent vaccine administered against diphtheria, pertussis, tetanus, hepatitis B, and Haemophilus influenza.

DESIGN AND METHODS

The population for this quasi-experimental study were recent mothers of children not more than three weeks old selected from six local government areas of Kano State, Northern Nigeria. Three local government areas were each allocated to the intervention (reminder) and control groups of the study. Mobile phone reminders (SMS and follow-up calls) were sent to mothers in the reminder group three days to and on the due date of their child's schedule for the 1st, 2nd and 3rd doses of the pentavalent vaccine. All statistical data were entered into the Statistical Package for Social Sciences (SPSS) version 23.0 and analysed using descriptive and inferential statistics.

RESULTS

A total of 541 mothers (271 in the intervention group and 270 in the control group) participated in the study. Completion rates for the three doses of the pentavalent vaccine were observed to be higher for children in the reminder group (n = 161, 59.4%) compared to those in the control group (n = 92, 34.1%).

CONCLUSION

Mobile phone reminders were effective and improved the rate of completeness of the pentavalent vaccine in the studied population. In line with the findings of the study, it is recommended that future studies should focus on identifying the best approach to remind parents either through SMS, phone calls, or voice messages or a combination of any of the approaches.

PRACTICE IMPLICATION

Nurses and other health care providers will have empirical evidence on the use of mobile phone technology to improve the health and wellbeing of children by protecting them from vaccine-preventable diseases.

Neuroblastoma in Spain: Linking the national clinical database and epidemiological registries - A study by the Joint Action on Rare Cancers

PURPOSE

Linkage between clinical databases and population-based cancer registries may serve to evaluate European Reference Networks' (ERNs) activity, by monitoring the proportion of patients benefiting from these and their impact on survival at a population level. To test this, a study targeting neuroblastoma (Nb) was conducted in Spain by the European Joint Action on Rare Cancers.

MATERIAL AND METHODS

Subjects: Nb cases, incident 1999-2017, aged < 15 years. Linkage included: Spanish Neuroblastoma Clinical Database (NbCDB) (1217 cases); Spanish Registry of Childhood Tumours (RETI) (1514 cases); and 10 regional population-based registries (RPBCRs) which cover 33% of the childhood population (332 cases). Linkage was semiautomatic. We estimated completeness, incidence, contribution, deficit, and 5-year survival in the databases and specific subsets.

RESULTS

National completeness estimates for RETI and NbCDB were 91% and 72% respectively, using the Spanish RPBCRs on International Incidence of Childhood Cancer (https://iicc.iarc.fr/) as reference. RPBCRs' specific contribution was 1.6%. Linkage required manual crossover in 54% of the semiautomatic matches. Five-year survival was 74% (0-14 years) and 90% (0-18 months).

CONCLUSIONS

All three databases were incomplete as regards Spain as a whole and should therefore be combined to achieve full childhood cancer registration. A unique personal patient identifier could facilitate such linkage. Most children have access to Nb clinical trials. Consolidated interconnections between the national registry and clinical registries (including ERNs and paediatric oncology clinical groups) should be established to evaluate outcomes.

The currency and completeness of specialized databases of COVID-19 publications

Objective

Several specialized collections of COVID-19 literature have been developed during the global health emergency. These include the WHO COVID-19 Global Literature Database, Cochrane COVID-19 Study Register, CAMARADES COVID-19 SOLES, Epistemonikos’ COVID-19 L-OVE, and LitCovid. Our objective was to evaluate the completeness of these collections and to measure the time from when COVID-19 articles are posted to when they appear in the collections.

Study Design and Setting

We tested each selected collection for the presence of 440 included studies from 25 COVID-19 systematic reviews. We sampled 112 journals and prospectively monitored their websites until a new COVID-19 article appeared. We then monitored for 2 weeks to see when the new articles appeared in each collection. PubMed served as a comparator.

Results

Every collection provided at least one record not found in PubMed. Four records (1%) were not in any of the sources studied. Collections contained between 83% and 93% of the primary studies with the WHO database being the most complete. By 2 weeks, between 60% and 78% of tracked articles had appeared.

Conclusion

Our findings support the use of the best performing COVID-19 collections by systematic reviews to replace paywalled databases.

Immunization data quality and decision making in pertussis outbreak management in southern Ethiopia: a cross sectional study

Background

The aim of this study was to investigate the quality of immunization data and monitoring systems in the Dara Malo District (Woreda) of the Gamo Administrative Zone, within the Southern Nations, Nationalities, and Peoples’ Region (SNNPR) of Ethiopia.

Methods

A cross-sectional study was conducted from August 4 to September 27, 2019, in Dara Malo District. The district was purposively selected during the management of a pertussis outbreak, based on a hypothesis of ‘there is no difference in reported and recounted immunization status of children 7 to 23 months in Dara Malo District of Ethiopia’. The study used the World Health Organization (WHO) recommended Data Quality Self-Assessment (DQS) tools. The accuracy ratio was determined using data from routine Expanded Program of Immunization (EPI) and household surveys. Facility data spanning the course of 336 months were abstracted from EPI registers, tally sheets, and monthly routine reports. In addition, household surveys collected data from caretakers, immunization cards, or oral reports. Trained DQS assessors collected the data to explore the quality of monitoring systems at health posts, health centers, and at the district health office level. A quality index (QI) and proportions of completeness, timeliness, and accuracy ratio of the first and third doses of pentavalent vaccines and the first dose of measles-containing vaccines (MCV) were formulated.

Results

In this study, facility data spanning 336 months were extracted. In addition, 595 children aged 7 to 23 months, with a response rate of 94.3% were assessed and compared for immunization status, using register and immunization cards or caretakers’ oral reports through the household survey. At the district level, the proportion of the re-counted vaccination data on EPI registers for first dose pentavalent was 95.20%, three doses of pentavalent were 104.2% and the first dose of measles was 98.6%. However, the ratio of vaccination data compared using tallies against the reports showed evidence of overreporting with 50.8%, 45.1%, and 46.5% for first pentavalent, third pentavalent, and the first dose of measles vaccinations, respectively. The completeness of the third dose of pentavalent vaccinations was 95.3%, 95.6%, and 100.0% at health posts, health centers, and the district health office, respectively. The timeliness of the immunization reports was 56.5% and 64.6% at health posts and health centers, respectively, while the district health office does not have timely submitted on time to the next higher level for twelve months. The QI scores ranged between 61.0% and 80.5% for all five categories, namely, 73.0% for recording, 71.4% for archiving and reporting, 70.4% for demographic information, 69.7% for core outputs, and 70.4% for data use and were assessed as suboptimal at all levels. The district health office had an emergency preparedness plan. However, pertussis was not on the list of anticipated outbreaks.

Conclusion

Immunization data completeness was found to be optimal. However, in the study area, the accuracy, consistency, timeliness, and quality of the monitoring system were found to be suboptimal. Therefore, poor data quality has led to incorrect decision making during the reported pertussis outbreak management. Availing essential supplies, including tally sheets, monitoring charts, and stock management tools, should be prioritized in Daro Malo District. Enhancing the capacity of healthcare providers on planning, recording, archiving, and reporting, analyzing, and using immunization data for evidence-based decision making is recommended. Improving the availability of recording and reporting tools is also likely to enhance the data accuracy and completeness of the community health information system. Adapting pertussis outbreak management guidelines and conducting regular data quality assessments with knowledge sharing events to all stakeholders is recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00805-6.

FAIR and Quality Assured Data - The Use Case of Trueness

The FAIR Guiding Principles do not address the quality of data and metadata. Therefore, data collections could be FAIR but useless. In a funding initiative of registries for health services research, trueness of data received special attention. Completeness in the definition of recall was selected to represent this dimension in a cross-registry benchmarking. The first analyses of completeness revealed a diversity of its implementation. No registry was able to present results exactly as requested in a guideline on data quality. Two registries switched to a source data verification as alternative, the three others downsized to the dimension integrity. The experiences underline that the achievement of appropriate data quality is a matter of costs and resources, whereas the current Guiding Principles quote for a transparent culture regarding data and metadata. We propose the extension to FAIR-Q, data collections should not only be findable, accessible, interoperable, and reusable, but also quality assured.

Have inequalities in completeness of death registration between states in India narrowed during two decades of civil registration system strengthening?

Background

In India the number of registered deaths increased substantially in recent years, improving the potential of the civil registration and vital statistics (CRVS) system to be the primary source of mortality data and providing more families of decedents with the benefits of possessing a death certificate. This study aims to identify whether inequalities in the completeness of death registration between states in India, including by sex, have narrowed during this period of CRVS system strengthening.

Methods

Data used in this study are registered deaths by state and year from 2000 to 2018 (and by sex from 2009 to 2018) reported in the Civil Registration Reports published by the Office of Registrar General of India. Completeness of death registration is calculated using the empirical completeness method. Levels and trends inequalities in completeness are measured in each state a socio-economic indicator – the Socio-Demographic Index (SDI).

Results

Estimated completeness of death registration in India increased from 58% in 2000 to 81% in 2018. Male completeness rose from 60% in 2009 to 85% in 2018 and was much higher than female completeness, which increased from 54 to 74% in the same period. Completeness remained very low in some states, particularly from the eastern (e.g. Bihar) and north-eastern regions. However, in states from the northern region (e.g. Uttar Pradesh) completeness increased significantly from a low level. There was a narrowing of inequalities in completeness according to the SDI during the period, however large inequalities between states remain.

Conclusions

The increase in completeness of death registration in India is a substantial achievement and increases the potential of the death registration system as a routine source of mortality data. Although narrowing of inequalities in completeness demonstrates that the benefits of higher levels of death registration have spread to relatively poorer states of India in recent years, the continued low completeness in some states and for females are concerning. The Indian CRVS system also needs to increase the number of registered deaths with age at death reported to improve their usability for mortality statistics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-021-01534-y.

Generating age-specific mortality statistics from incomplete death registration data: two applications of the empirical completeness method

Background

The study aims to assess two approaches that apply the empirical completeness method to generate age-specific mortality statistics from incomplete death registration systems.

Methods

We use the empirical completeness method to calculate all-age death registration completeness, which is used with a model life table to generate mortality statistics and age-specific completeness using (1) the conventional method and (2) the equivalent deaths method. The results are compared with a capture-recapture (C-RC) study and three alternative mortality estimates for Brazilian states, and C-RC studies in Thailand, Oman and Vietnam, which independently estimate the level and age pattern of mortality or completeness.

Results

The empirical completeness method produces similar estimates of all-age completeness of registration to the C-RC studies. Compared with C-RC studies, at 15-59 years, the conventional method’s estimates of mortality and completeness are more concordant, while at 60-84 years the equivalent death method’s estimates are closer. Estimates of life expectancy from the two approaches each have similar concordance with the C-RC studies. For male adult mortality in Brazilian states, there is relatively strong average correlation of this study's estimates with three alternative estimates.

Conclusions

The two approaches produce mortality statistics from incomplete data that are mostly concordant with C-RC studies, and can be most usefully applied to subnational populations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12963-021-00262-3.

Timeliness, completeness, and timeliness-and-completeness of serial routine vaccinations among rural children in Southwest China: A multi-stage stratified cluster sampling survey

INTRODUCTION

Vaccination coverage is widely used as metric of vaccination programme performance. However, VPDs outbreaks were reported in areas with high vaccination coverage. Timeliness and completeness have been considered more important assessment indicators of routine vaccination than overall vaccination coverage, but little is known in rural China. This study aimed to assess the timeliness and completeness of serial routine vaccinations among children in rural Southwest China.

METHODS

A multi-stage stratified cluster survey was conducted among 1062 children aged 18-48 months in rural Guangxi. Vaccination status was obtained from child's vaccination certificate. We calculated timely vaccination coverage, complete vaccination coverage, timely-and-complete vaccination coverage and 95% CI for routine vaccination through weighted estimation analysis. Weighted Kaplan-Meier analyses were applied to estimate the median delay periods for each dose of serial routine vaccines, including one-dose BCG, three-dose HepB, three-dose OPV, four-dose DTP, two-dose MCV, two-dose JEV and two-dose MPV-A. Complete coverage, and timely-and-complete coverage for combined 5-vaccine series were calculated.

RESULTS

For each dose of routine vaccines, overall vaccination coverages were over 90%, but timely vaccination coverage ranged from the lowest of 44.4% for JEV1 to the highest of 92.5% for MPV-A1. For multi-dose routine vaccines, complete vaccination coverages varied from the lowest of 92.9% for MCV to the highest of 100% for HepB, and timely-and-complete vaccination coverages were lower than 80%, ranging from the lowest of 30% for JEV to the highest of 77.2% for MPV-A. For combined 5-vaccine series, complete coverage was 77%, while timely-and-complete coverage was 12.1%. MPV-A1 had the longest median delay of 176 days, but BCG and HepB1 had the shortest of 1 day.

CONCLUSIONS

The overall coverages of serial routine vaccinations were high, but the timeliness and completeness were poor. Relevant agencies of vaccination service should address timeliness-and-completeness into the assessment indicators of routine vaccination service quality.

Termination of pregnancy data completeness and feasibility in population-based surveys: EN-INDEPTH study

BACKGROUND

Termination of pregnancy (TOP) is a common cause of maternal morbidity and mortality in low- and middle-income countries. Population-based surveys are the major data source for TOP data in LMICs but are known to have shortcomings that require improving. The EN-INDEPTH multi-country survey employed a full pregnancy history approach with roster and new questions on TOP and Menstrual Restoration. This mixed methods paper assesses the completeness of responses to questions eliciting TOP information from respondents and reports on practices, barriers, and facilitators to TOP reporting.

METHODS

The EN-INDEPTH study was a population-based cross-sectional study. The Full Pregnancy History arm of the study surveyed 34,371 women of reproductive age between 2017 and 2018 in five Health and Demographic Surveillance System (HDSS) sites of the INDEPTH network: Bandim, Guinea-Bissau; Dabat, Ethiopia; IgangaMayuge, Uganda; Kintampo, Ghana; and Matlab, Bangladesh. Completeness and time spent in answering TOP questions were evaluated using simple tabulations and summary statistics. Exact binomial 95% confidence intervals were computed for TOP rates and ratios. Twenty-eight (28) focus group discussions were undertaken and analysed thematically.

RESULTS

Completeness of responses regarding TOP was between 90.3 and 100.0% for all question types. The new questions elicited between 2.0% (1.0-3.4), 15.5% (13.9-17.3), and 11.5% (8.8-14.7) lifetime TOP cases over the roster questions from Dabat, Ethiopia; Matlab, Bangladesh; and Kintampo, Ghana, respectively. The median response time on the roster TOP questions was below 1.3 minutes in all sites. Qualitative results revealed that TOP was frequently stigmatised and perceived as immoral, inhumane, and shameful. Hence, it was kept secret rendering it difficult and uncomfortable to report. Miscarriages were perceived to be natural, being easier to report than TOP. Interviewer techniques, which were perceived to facilitate TOP disclosure, included cultural competence, knowledge of contextually appropriate terms for TOP, adaptation to interviewee's individual circumstances, being non-judgmental, speaking a common language, and providing detailed informed consent.

CONCLUSIONS

Survey roster questions may under-represent true TOP rates, since the new questions elicited responses from women who had not disclosed TOP in the roster questions. Further research is recommended particularly into standardised training and approaches to improving interview context and techniques to facilitate TOP reporting in surveys.

Evaluating performance of health care facilities at meeting HIV-indicator reporting requirements in Kenya: an application of K-means clustering algorithm

Background

The ability to report complete, accurate and timely data by HIV care providers and other entities is a key aspect in monitoring trends in HIV prevention, treatment and care, hence contributing to its eradication. In many low-middle-income-countries (LMICs), aggregate HIV data reporting is done through the District Health Information Software 2 (DHIS2). Nevertheless, despite a long-standing requirement to report HIV-indicator data to DHIS2 in LMICs, few rigorous evaluations exist to evaluate adequacy of health facility reporting at meeting completeness and timeliness requirements over time. The aim of this study is to conduct a comprehensive assessment of the reporting status for HIV-indicators, from the time of DHIS2 implementation, using Kenya as a case study.

Methods

A retrospective observational study was conducted to assess reporting performance of health facilities providing any of the HIV services in all 47 counties in Kenya between 2011 and 2018. Using data extracted from DHIS2, K-means clustering algorithm was used to identify homogeneous groups of health facilities based on their performance in meeting timeliness and completeness facility reporting requirements for each of the six programmatic areas. Average silhouette coefficient was used in measuring the quality of the selected clusters.

Results

Based on percentage average facility reporting completeness and timeliness, four homogeneous groups of facilities were identified namely: best performers, average performers, poor performers and outlier performers. Apart from blood safety reports, a distinct pattern was observed in five of the remaining reports, with the proportion of best performing facilities increasing and the proportion of poor performing facilities decreasing over time. However, between 2016 and 2018, the proportion of best performers declined in some of the programmatic areas. Over the study period, no distinct pattern or trend in proportion changes was observed among facilities in the average and outlier groups.

Conclusions

The identified clusters revealed general improvements in reporting performance in the various reporting areas over time, but with noticeable decrease in some areas between 2016 and 2018. This signifies the need for continuous performance monitoring with possible integration of machine learning and visualization approaches into national HIV reporting systems.

Data quality of the routine health management information system at the primary healthcare facility and district levels in Tanzania

BACKGROUND

Effective planning for disease prevention and control requires accurate, adequately-analysed, interpreted and communicated data. In recent years, efforts have been put in strengthening health management information systems (HMIS) in Sub-Saharan Africa to improve data accessibility to decision-makers. This study assessed the quality of routine HMIS data at primary healthcare facility (HF) and district levels in Tanzania.

METHODS

This cross-sectional study involved reviews of documents, information systems and databases, and collection of primary data from facility-level registers, tally sheets and monthly summary reports. Thirty-four indicators from Outpatient, Inpatient, Antenatal care, Family Planning, Post-natal care, Labour and Delivery, and Provider-Initiated Testing and Counselling service areas were assessed. Indicator records were tracked and compared across the process of data collection, compilation and submission to the district office. Copies of monthly report forms submitted by facilities to the district were also reviewed. The availability and utilization of HMIS tools were assessed, while completeness and data accuracy levels were quantified for each phase of the reporting system.

RESULTS

A total of 115 HFs (including hospitals, health centres, dispensaries) in 11 districts were involved. Registers (availability rate = 91.1%; interquartile range (IQR) 66.7-100%) and report forms (86.9%; IQR 62.2-100%) were the most utilized tools. There was a limited use of tally-sheets (77.8%; IQR 35.6-100%). Tools availability at the dispensary was 91.1%, health centre 82.2% and hospital 77.8%, and was low in urban districts. The availability rate at the district level was 65% (IQR 48-75%). Wrongly filled or empty cells in registers and poor adherence to the coding procedures were observed. Reports were highly over-represented in comparison to registers' records, with large differences observed at the HF phase of the reporting system. The OPD and IPD areas indicated the highest levels of mismatch between data source and district office. Indicators with large number of clients, multiple variables, disease categorization, or those linked with dispensing medicine performed poorly.

CONCLUSION

There are high variations in the tool utilisation and data accuracy at facility and district levels. The routine HMIS is weak and data at district level inaccurately reflects what is available at the source. These results highlight the need to design tailored and inter-service strategies for improving data quality.

Unbiasedness and efficiency of non-parametric and UMVUE estimators of the probabilistic index and related statistics

In reliability theory, diagnostic accuracy, and clinical trials, the quantity P(X>Y)+1/2P(X=Y), also known as the Probabilistic Index (PI), is a common treatment effect measure when comparing two groups of observations. The quantity P(X>Y)-P(Y>X), a linear transformation of PI known as the net benefit, has also been advocated as an intuitively appealing treatment effect measure. Parametric estimation of PI has received a lot of attention in the past 40 years, with the formulation of the Uniformly Minimum-Variance Unbiased Estimator (UMVUE) for many distributions. However, the non-parametric Mann-Whitney estimator of the PI is also known to be UMVUE in some situations. To understand this seeming contradiction, in this paper a systematic comparison is performed between the non-parametric estimator for the PI and parametric UMVUE estimators in various settings. We show that the Mann-Whitney estimator is always an unbiased estimator of the PI with univariate, completely observed data, while the parametric UMVUE is not when the distribution is misspecified. Additionally, the Mann-Whitney estimator is the UMVUE when observations belong to an unrestricted family. When observations come from a more restrictive family of distributions, the loss in efficiency for the non-parametric estimator is limited in realistic clinical scenarios. In conclusion, the Mann-Whitney estimator is simple to use and is a reliable estimator for the PI and net benefit in realistic clinical scenarios.

On the Classification Between ψ -Ontic and ψ -Epistemic Ontological Models

Harrigan and Spekkens (Found Phys 40:125-157, 2010) provided a categorization of quantum ontological models classifying them as ψ -ontic or ψ -epistemic if the quantum state ψ describes respectively either a physical reality or mere observers' knowledge. Moreover, they claimed that Einstein-who was a supporter of the statistical interpretation of quantum mechanics-endorsed an epistemic view of ψ . In this essay we critically assess such a classification and some of its consequences by proposing a twofold argumentation. Firstly, we show that Harrigan and Spekkens' categorization implicitly assumes that a complete description of a quantum system (its ontic state, λ ) only concerns single, individual systems instantiating absolute, intrinsic properties. Secondly, we argue that such assumptions conflict with some current interpretations of quantum mechanics, which employ different ontic states as a complete description of quantum systems. In particular, we will show that, since in the statistical interpretation ontic states describe ensembles rather than individuals, such a view cannot be considered ψ -epistemic. As a consequence, the authors misinterpreted Einstein's view concerning the nature of the quantum state. Next, we will focus on relational quantum mechanics and perspectival quantum mechanics, which in virtue of their relational and perspectival metaphysics employ ontic states λ dealing with relational properties. We conclude that Harrigan and Spekkens' categorization is too narrow and entails an inadequate classification of the mentioned interpretations of quantum theory. Hence, any satisfactory classification of quantum ontological models ought to take into account the variations of λ across different interpretations of quantum mechanics.

Exploring Completeness of Adverse Event Reports as a Tool for Signal Detection in Pharmacovigilance

BACKGROUND

Completeness of adverse event (AE) reports is an important component of quality for good pharmacovigilance practices. We aimed to evaluate the impact of incorporating a measure of completeness of AE reports on quantitative signal detection.

METHODS

An internal safety database from a global pharmaceutical company was used in the analysis. vigiGrade, an index score of completeness, was derived for each AE report. Data from various patient support programs (PSPs) were categorized based on average vigiGrade score per PSP. Performance of signal detection was compared between: (1) weighting and not weighting by vigiGrade score; and, (2) well documented and poorly documented PSPs using sensitivity, specificity, area under the receiver operating characteristics curve (AUC) and time-to-signal detection.

RESULTS

The ability to detect signals did not differ significantly when weighting by vigiGrade score [sensitivity (50% vs. 45%, p = 1), specificity (82.8% vs. 82.8%, p = 1), AUC (0.66 vs. 0.63, p = 0.051) or time-to-signal detection (HR 0.81, p = 0.63)] compared to not weighting. Well documented PSPs were better at detecting signals than poorly documented PSPs (AUC 0.66 vs. 0.52; p = 0.041) but time-to-signal detection did not differ significantly (HR 1.54, p = 0.42).

CONCLUSION

Completeness of AE reports did not significantly impact the ability to detect signals when weighting by vigiGrade score or restricting the database based on the level of completeness. While the vigiGrade helps provide quality assessments of AE reports and prioritize cases for review, our findings indicate the tool might not be useful for quantitative signal detection when used by itself.

Toward a more holistic method of genome assembly assessment

Background

A key use of high throughput sequencing technology is the sequencing and assembly of full genome sequences. These genome assemblies are commonly assessed using statistics relating to contiguity of the assembly. Measures of contiguity are not strongly correlated with information about the biological completion or correctness of the assembly, and a commonly reported metric, N50, can be misleading. Over the years, multiple research groups have rejected the overuse of N50 and sought to develop more informative metrics.

Results

This paper presents a review of problems that arise from relying solely on contiguity as a measure of genome assembly quality as well as current alternative methods. Alternative methods are compared on the basis of how informative they are about the biological quality of the assembly and how easy they are to use. A comprehensive method for using multiple metrics of measuring assembly quality is presented.

Conclusions

This study aims to report on the status of assembly assessment methods and compare them, as well as to offer a comprehensive method that incorporates multiple facets of quality assessment. Weaknesses and strengths of varying methods are presented and explained, with recommendations based on speed of analysis and user friendliness.

Assessment of completeness and legibility of handwritten prescriptions in six community chain pharmacies of Asmara, Eritrea: a cross-sectional study

BACKGROUND

Incompleteness and illegibility of prescriptions are prescription errors that account for a high proportion of medication errors that could potentially result in serious adverse effects. Thus, the objective of this study was to assess the completeness and legibility of prescriptions filled in the community chain pharmacies.

METHODS

An analytical and cross-sectional study was conducted in the six government owned community chain pharmacies of Asmara, Eritrea from June 3rd to 10th, 2019 using a stratified random sampling technique. A total of 385 prescriptions were analyzed for completeness and legibility by three pharmacists (two experienced and one intern pharmacist). Descriptive statistics and multinomial logistic regression were employed using IBM SPSS® (Version 22).

RESULTS

A total of 710 drugs were prescribed from the 385 prescriptions assessed. On average, a prescription was found to have 78.63% overall completeness. In the majority of the prescriptions, patient's information such as name, age, sex, and prescriber's identity were present. Prescribed drugs' information such as dose, frequency and quantity and/or duration were present in 83.7, 87.7, and 95.1% respectively. Moreover, generic names were used in 83.3% of the drugs prescribed. About half (54.3%) of the prescriptions' legibility were classified in grade four (clearly legible) and 30.6% in grade three (moderately legible). It was observed that legibility significantly increased with an increase in percentage completeness (r_s = 0.14, p = 0.006). However, as the number of drugs written in brand name increased, legibility decreased (r_s = - 0.193, p < 0.001). Similarly, as the number of drugs prescribed increased, legibility decreased (r_s = - 0.226, p < 0.006).

CONCLUSION

Majority of the handwritten prescriptions received in the community pharmacies of Asmara are complete and clearly legible.

Timely completion of vaccination and its determinants among children in northwest, Ethiopia: a multilevel analysis

BACKGROUND

Timely vaccination is key to prevent unnecessary childhood mortality from vaccine-preventable diseases. Despite the substantial efforts to improve vaccination completeness, the effort towards timeliness of vaccination is limited with non-attendance and delays to vaccination appointments remaining a big challenge in developing countries. There is also a limited evidence on timeliness of vaccination. Therefore, this study aimed to determine the magnitude and associated factors for timely completion of vaccination among children in Gondar city administration, north-west, Ethiopia.

METHOD

This study employed a community-based cross sectional study design. A sample size of 821 children aged 12 to 23 months were considered. Two stages random sampling technique was used to select study subjects. To account the effect of clustering, bivariable and multivariable multilevel logistic regression analysis were applied. The measures of association estimates were expressed as adjusted odds ratio (AOR) with their 95% confidence intervals (CIs).

RESULTS

Of the 774 children included for analysis, 498 (64.3%) were fully vaccinated while 247 (31.9%) were fully vaccinated on-time. Caregivers who had secondary education and above (AOR = 2.391; 95% CI: 1.317-4.343), from richest households (AOR = 2.381; 95% CI: 1.502-3.773), children whose mother attended four or more ante natal care visits (AOR = 2.844; 95% CI: 1.310-6.174) and whose mother had two or more post natal care visits (AOR = 2.054; 95%CI:1.377-3.063) were positively associated with on-time full vaccination. In contrary, caregivers aged above 35 years (AOR = 0.469; 95 % CI: 0.253-0.869], being vaccinated at health post (AOR = 0.144; 95%CI: 0.048-0.428) and travelling more than 30 min to the vaccination site (AOR = 0.158; 95%CI: 0.033-0.739) were negatively associated with on-time full vaccination. The random effects indicated that 26% of the variability in on-time full vaccination was attributable to differences between communities.

CONCLUSION

In this study, untimely vaccination was found to be high. Different individual and contextual factors were found to be associated with on-time full vaccination. Therefore, tailored strategies have to be designed and implemented to address people and the communities where they live. Moreover, timeliness of vaccination should be considered as important indicator of the immunization program performance in Ethiopia.

Quantity is not enough: completeness of suspected adverse drug reaction reports in Spain-differences between regional pharmacovigilance centres and pharmaceutical industry

PURPOSE

The aim of this study is to compare the completeness of relevant structured fields such as age, sex, drug and reaction start dates, time to onset, outcome and drug indication, in serious spontaneous cases reported in Spain depending on whether they have been collected by regional pharmacovigilance centres or by the marketing authorization holders.

METHODS

We analyzed the completeness of key variables for causality assessment related to the patient, the reaction and the suspected drug in all serious cases spontaneously reported and registered in the Spanish Pharmacovilance database, called FEDRA, from 1 January 2011 until 31 December 2018. The completeness scores were calculated according to the type of field and taking into account the VigiGrade tool. Cases were classified according to the reporting pathway, that is whether they were received and transmitted by marketing authorization holder or by regional pharmacovigilance centres.

RESULTS

The completeness score of cases collected by regional pharmacovigilance centres was higher in all the studied variables. The main differences were found in drug and reaction start date, and time to onset.

CONCLUSIONS

This study shows a high completeness score in cases of suspected adverse reactions reported to the regional pharmacovigilance centres with regard to key elements for causality assessment, signal and duplicate detection. In contrast, marketing authorization holder cases show a low completeness score and a decreasing tendency in all the studied variables over the studied period.

Spatial analysis of completeness of death registration in Egypt

PURPOSE

Civil registration and vital statistics (CRVS) systems should be the primary source of routine mortality data. However, there is lack of information about the completeness of death registration at the sub-national level of Egypt. The current study was conducted to estimate the completeness of death registration at the national and sub-national levels of Egypt, to investigate the spatial patterns of the completeness, and to examine the factors that influence it.

METHODS

Data from the Central Agency for Public Mobilization and Statistics (CAPMAS, 2018) and Egypt Demographic and Health Survey (EDHS 2008, 2014) were used to estimate the completeness of death registration using an empirical method (random-effects models); hot spot analysis was conducted using Moran's I and Getis-Ord Gi*; and the geographically weighted regression (GWR) model has been also carried out.

RESULTS

The study estimates show that Egypt has 96% completeness of death registration, and all governorates have completeness of more than 90% except for Beni-Suef, Menia, Aswan, Suhag, Luxor, ELWadi ELGidid, and South Sinai. According to sex, the death registration of females is slightly better than that of males (96.8% compared to 95.4%). Concerning residence, urban area has almost complete death registration compared to rural area (99.5% and 85.4%, respectively). Hot spot analysis shows that all hot spots are centered on the north of Egypt, while all cold spots are focused on the south. However, according to the geographically weighted regression (GWR) model, poverty, illiteracy, and health office density are considered major factors for the completeness of death registration.

CONCLUSION

Although the completeness in Egypt is almost 100%, this analysis suggests that it may not be, and that it could be somewhat lower in some rural areas. However, there is uncertainty in the sub-national estimates because deaths are only reported by place of occurrence and not place of usual residence. Thus, efforts should focus on improving the quality of data of the vital registration system in some rural areas and in lower Egyptian governorates.

Abasy Atlas v2.2: The most comprehensive and up-to-date inventory of meta-curated, historical, bacterial regulatory networks, their completeness and system-level characterization

Some organism-specific databases about regulation in bacteria have become larger, accelerated by high-throughput methodologies, while others are no longer updated or accessible. Each database homogenize its datasets, giving rise to heterogeneity across databases. Such heterogeneity mainly encompasses different names for a gene and different network representations, generating duplicated interactions that could bias network analyses. Abasy (Across-bacteria systems) Atlas consolidates information from different sources into meta-curated regulatory networks in bacteria. The high-quality networks in Abasy Atlas enable cross-organisms analyses, such as benchmarking studies where gold standards are required. Nevertheless, network incompleteness still casts doubts on the conclusions of network analyses, and available sampling methods cannot reflect the curation process. To tackle this problem, the updated version of Abasy Atlas presented in this work provides historical snapshots of regulatory networks. Thus, network analyses can be performed at different completeness levels, making possible to identify potential bias and to predict future results. We leverage the recently found constraint in the complexity of regulatory networks to develop a novel model to quantify the total number of regulatory interactions as a function of the genome size. This completeness estimation is a valuable insight that may aid in the daunting task of network curation, prediction, and validation. The new version of Abasy Atlas provides 76 networks (204,282 regulatory interactions) covering 42 bacteria (64% Gram-positive and 36% Gram-negative) distributed in 9 species (Mycobacterium tuberculosis, Bacillus subtilis, Escherichia coli, Corynebacterium glutamicum, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pyogenes, Streptococcus pneumoniae, and Streptomyces coelicolor), containing 8459 regulons and 4335 modules.

Database URL: https://abasy.ccg.unam.mx/.

EPI immunization coverage, timeliness and dropout rate among children in a West Cameroon health district: a cross sectional study

BACKGROUND

Monitoring of the expanded program on immunization's performance is not only limited to routine periodic reports but equally includes surveys. Based on unpublished national EPI surveillance data from the past 5 years in Cameroon, the Foumban health district has reported a high number of vaccine preventable disease suspected cases. Contradictory information on the immunization coverage in this district exists from both administrative data and published literature. As a result, the objective of this study was to estimate the immunization coverage and dropout rate in age group 12-23 months and timeliness in age group 0-59 months among children in Foumban Health District (Cameroon), in 2018.

METHOD

This was a descriptive cross-sectional study targeting randomly selected children aged 0-59 months from Foumban health district. Data were collected by trained and supervised surveyors using a pretested questionnaire to describe the immunization coverage, timeliness and dropout rate in eighty clusters of about thirty buildings selected by stratified random sampling in July 2018.

RESULTS

In total, 80 clusters covering 2121 buildings were selected and all were reached (100%). A total of 1549 (81.2%) households accepted to participate in the survey and 1430 children aged 0-59 months including 294 (20.6%) aged 12-23 months were enrolled into the study. Of these 1430 children, 427 [29.9 (27.4-32.2)%] aged 0-59 months were vaccinated with evidence. In the age group 12-23 months, the immunization coverage with evidence of BCG, DPT-Hi + Hb 3 and measles/rubella were 28.6(23.4-33.9)%, 22.8 (18.1-27.6)% and 14.3 (10.3-18.1)% respectively. Within age group 0-59 months; the proportion of children who missed their vaccination appointments increased from 23.3 to 31.7% for the vaccine planned at birth (BCG) and last vaccine planned (Measles/Rubella) for the EPI program respectively. In age group 12-23 months; the specific (DPT-Hi + Hb1-3) and general (BCG-Measles/Rubella) dropout rates of vaccination with evidence were 14.1 and 50.0% respectively.

CONCLUSION

Documented immunization coverage, dropout rate and timeliness in Foumban Health district are lower than that targeted by the Cameroon EPI. Competent health authorities have to take necessary actions to ensure the implementation of national guidelines with regards to children access to immunization. Also, studies have to be conducted to identify determinants of low immunization coverage and delays in immunization schedules as well as high dropout rates.

Feasibility analysis of conducting observational studies with the electronic health record

Background

The secondary use of electronic health records (EHRs) promises to facilitate medical research. We reviewed general data requirements in observational studies and analyzed the feasibility of conducting observational studies with structured EHR data, in particular diagnosis and procedure codes.

Methods

After reviewing published observational studies from the University Hospital of Erlangen for general data requirements, we identified three different study populations for the feasibility analysis with eligibility criteria from three exemplary observational studies. For each study population, we evaluated the availability of relevant patient characteristics in our EHR, including outcome and exposure variables. To assess data quality, we computed distributions of relevant patient characteristics from the available structured EHR data and compared them to those of the original studies. We implemented computed phenotypes for patient characteristics where necessary. In random samples, we evaluated how well structured patient characteristics agreed with a gold standard from manually interpreted free texts. We categorized our findings using the four data quality dimensions “completeness”, “correctness”, “currency” and “granularity”.

Results

Reviewing general data requirements, we found that some investigators supplement routine data with questionnaires, interviews and follow-up examinations. We included 847 subjects in the feasibility analysis (Study 1 n = 411, Study 2 n = 423, Study 3 n = 13). All eligibility criteria from two studies were available in structured data, while one study required computed phenotypes in eligibility criteria. In one study, we found that all necessary patient characteristics were documented at least once in either structured or unstructured data. In another study, all exposure and outcome variables were available in structured data, while in the other one unstructured data had to be consulted. The comparison of patient characteristics distributions, as computed from structured data, with those from the original study yielded similar distributions as well as indications of underreporting. We observed violations in all four data quality dimensions.

Conclusions

While we found relevant patient characteristics available in structured EHR data, data quality problems may entail that it remains a case-by-case decision whether diagnosis and procedure codes are sufficient to underpin observational studies. Free-text data or subsequently supplementary study data may be important to complement a comprehensive patient history.

The Swedish Neonatal Quality Register - contents, completeness and validity

AIM

To describe the Swedish Neonatal Quality Register (SNQ) and to determine its completeness and agreement with other registers.

METHODS

SNQ collects data for infants admitted to neonatal units during the first four postnatal weeks. Completeness and registers' agreement were determined cross-linking SNQ data with Swedish population registers (the Inpatient, Medical Birth and Cause of Death Registers) for a study period of five years.

RESULTS

In total, 84 712 infants were hospitalised. A total of 52 806 infants occurred in both SNQ and the population registers; 28 692 were only found in the population registers, and 3214 infants were only found in SNQ. Between gestational weeks 24-34, completeness of SNQ was 98-99%. Below and above these gestational ages, completeness was lower. Infants missing in SNQ were term or near-term in 99% of the cases, and their diagnoses indicated conditions managed in maternity units, or re-admissions for acute infections, managed in paediatric units. For most diagnoses, the agreement between SNQ and population registers was high, but some (bronchopulmonary dysplasia and grade of hypoxic-ischaemic encephalopathy) were often missing in the population registers.

CONCLUSION

SNQ completeness and agreement against other registers, especially for preterm infants, is excellent. SNQ is a valid tool for benchmarking, quality improvement and research.

Meta-analyses indexed in PsycINFO had a better completeness of reporting when they mention PRISMA

OBJECTIVES

To investigate the effect of the explicit mention of PRISMA, a statement designed to help authors report meta-analyses (MAs), on the reporting completeness of MAs.

STUDY DESIGN AND SETTING

Two investigators evaluated a random sample of 206 MAs indexed in PsycINFO in 2016; 100 explicitly mentioned PRISMA and 106 did not. Two authors independently evaluated the 27 PRISMA items and extracted factors that could potentially be associated with reporting completeness. The data were analyzed descriptively.

RESULTS

Among our 206 MAs, perfect adherence to PRISMA was found in less than 4%, of which 87% explicitly followed PRISMA. The following items were encountered significantly more frequently in MAs that explicitly mentioned PRISMA than in those that did not: summary, protocol, information sources, search strategy, study characteristics, results of individual studies, funding, study selection, risk of bias in individual studies, and bias across studies. The journal's impact factor, endorsement of PRISMA by the journal, number of authors, country of author, open access, and design of the included studies were significantly and positively associated with the explicit mention of PRISMA.

CONCLUSIONS

Even if far from optimal, the explicit mention of PRISMA has a positive influence on the reporting completeness of MAs from PsycINFO.

Completeness of a newly implemented general cancer registry in northern France: Application of a three-source capture-recapture method

BACKGROUND

Completeness, timeliness and accuracy are important qualities for registries. The objective was to estimate the completeness of the first two years of full registration (2008/2009) of a new population-based general cancer registry, at the time of national data centralisation.

METHODS

Records followed international standards. Numbers of cases missed were estimated from a three-source (pathology labs, healthcare centres, health insurance services) capture-recapture method, using log-linear models for each gender. Age and place of residence were considered as potential variables of heterogeneous catchability.

RESULTS

When data were centralized (2011/2012), 4446 cases in men and 3642 in women were recorded for 2008/2009 in the Registry. Overall completeness was estimated at 95.7% (95% CI: 94.3-97.2) for cases in men and 94.8% (95% CI: 92.6-97.0) in women. Completeness appeared higher for younger than for older subjects, with a significant difference of 4.1% (95% CI: 1.4-6.7) for men younger than 65 compared with their older counterparts. Estimates were collated with the number of cases registered in 2014 for the years 2008/2009 (4566 cases for men/3755 for women), when additional structures had notified cases retrospectively to the Registry. These numbers were consistent with the stratified capture-recapture estimates.

CONCLUSION

This method appeared useful to estimate the completeness quantitatively. Despite a rather good completeness for the new Registry, the search for cases among older subjects must be improved.

Injury registration for primary prevention in a provincial Russian region: setting up a new trauma registry

Background

The Shenkursk Injury Registry (SHIR) was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention. The SHIR covers all injuries (ICD-10 diagnoses from S00 to T78) for which medical aid is given at the Shenkursk central district hospital and includes data about injury circumstances. We used the SHIR data to assess the quality of the SHIR as an evidence basis and for the local preventive applications.

Methods

Completeness, representativeness, and reliability of the SHIR data were assessed using a sample of 1696 injuries which have occurred in July 2015–June 2016. Chi-square tests were used to assess differences between the registered and missed cases in the registry and Cohen’s kappa were applied to assess the agreement between independent data entries.

Results

The completeness of the SHIR with respect to the coverage of cases treated at the Shenkursk central district hospital was 86%. There were no differences between the registered and the missed injuries by sex, ICD-10 codes, weekday of admission, but there were differences in their distribution by attending physicians. Also, higher proportions of child injuries and injuries in the summer time were among the missed cases. Signs of lower injury severity (different distribution by ICD-10 codes and lower proportion of traffic injuries) were observed among injuries in rural areas which were not covered by the registry because of treatment at rural primary health care units without referrals to the central hospital. Two independent data entries from standard paper injury registration forms showed a 79–99% agreement, depending on the variable considered.

Conclusion

With consideration of possible insubstantial overestimates of the average injury severity, the SHIR data can be considered sufficiently complete, reliable, and representative of the injury situation in the Shenkursk District. Therefore, SHIR is an adequate evidentiary basis for planning local injury prevention.

Measuring the quality and completeness of medication-related information derived from hospital electronic health records database

Objective

Electronic Health Records (EHRs) database is a great source for pharmacoepidemiological research as thousands of patients' clinical and medication information is stored in the database. However, the use of EHRs database for research purposes depends greatly on the accuracy and completeness of the data being used. This study mainly aimed to assess the completeness of EHRs patients' medication-related information.

Design

A retrospective cross-sectional study using data extracted from the EHRs database was conducted.

Setting

The EHRs data was obtained from a single tertiary hospital in Saudi Arabia.

Main outcome measures

The completeness of data was measured considering if a patients' record contains all desired types of data (i.e., patients' demographics, clinical diagnosis, and medication-related information).

Results

A total of 23,411 unique individuals were identified after extracting the data from the EHRs. The study found that 89.9% of the patients had a complete data (i.e., age, gender, marital status, nationality, encounter type, and clinical diagnosis). Further, 83.1% of the patients had complete medication-related information. Subgroup analysis by the encounter type indicated that the data was 91.0% complete for outpatient encounter and 93.2% complete for inpatient encounter.

Conclusion

The study findings indicate that the completeness of the data varies by the desired types of data. EHRs can be a potentially great resource to conduct research to assess medication use. Further studies focusing on the content and completeness of EHRs for a specific patient population and evaluate other dimensions of EHRs data quality are needed.

Completeness and Accuracy of Death Registry Data in Golestan, Iran

BACKGROUND

We aimed to evaluate completeness and accuracy of the Golestan Death Registry (GDR) to identify cancer-related causes of death (CCoD).

METHODS

The GDR data (2004-2015) were compared with cancer data collected from clinical/pathological sources (the considered gold standard) by the Golestan Population-Based Cancer Registry (GPCR). Using a linkage method, matched cases, including subjects with CCoD and those with ill-defined cause of death (ICoD) (garbage codes), were identified and entered into the final analysis as study subjects. The completeness (percentage of study subjects with CCoD) and accuracy (number of subjects with correct CoD from the total number of study subjects) of the GDR were calculated.

RESULTS

In total, 3,766 matched cases were enrolled. Overall, the completeness and accuracy of the GDR for identifying CCoD were 92.7% and 53.2%, respectively. There were variations by cancer site and age group, with completeness and accuracy highest for brain cancer (96.3%) and leukaemia (79.8%) while the lowest accuracy was observed for colorectal cancer (29.9%). The completeness and accuracy of GDR was higher in patients aged under 60 years (95.7% and 53.6%, respectively). We also found higher completeness (93.7%) and accuracy (55.8%) in residents of rural areas.

CONCLUSION

Linkage of death registry data with cancer registry data can be a significant resource for evaluating quality of the death registry data. Our findings suggested that completeness of the GDR for identifying CCoD is reasonable, but accuracy is relatively low. Access to clinical and pathological data from other sources and enhanced training of death certifiers can improve the present situation.

Safety assessment of automated vehicles: how to determine whether we have collected enough field data?

Objective: The amount of collected field data from naturalistic driving studies is quickly increasing. The data are used for, among others, developing automated driving technologies (such as crash avoidance systems), studying driver interaction with such technologies, and gaining insights into the variety of scenarios in real-world traffic. Because data collection is time consuming and requires high investments and resources, questions like "Do we have enough data?," "How much more information can we gain when obtaining more data?," and "How far are we from obtaining completeness?" are highly relevant. In fact, deducing safety claims based on collected data-for example, through testing scenarios based on collected data-requires knowledge about the degree of completeness of the data used. We propose a method for quantifying the completeness of the so-called activities in a data set. This enables us to partly answer the aforementioned questions. Method: In this article, the (traffic) data are interpreted as a sequence of different so-called scenarios that can be grouped into a finite set of scenario classes. The building blocks of scenarios are the activities. For every activity, there exists a parameterization that encodes all information in the data of each recorded activity. For each type of activity, we estimate a probability density function (pdf) of the associated parameters. Our proposed method quantifies the degree of completeness of a data set using the estimated pdfs. Results: To illustrate the proposed method, 2 different case studies are presented. First, a case study with an artificial data set, of which the underlying pdfs are known, is carried out to illustrate that the proposed method correctly quantifies the completeness of the activities. Next, a case study with real-world data is performed to quantify the degree of completeness of the acquired data for which the true pdfs are unknown. Conclusion: The presented case studies illustrate that the proposed method is able to quantify the degree of completeness of a small set of field data and can be used to deduce whether sufficient data have been collected for the purpose of the field study. Future work will focus on applying the proposed method to larger data sets. The proposed method will be used to evaluate the level of completeness of the data collection on Singaporean roads, aimed at defining relevant test cases for the autonomous vehicle road approval procedure that is being developed in Singapore.