Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

Morphological classification of microtidal sand and gravel beaches

A new classification of microtidal sand and gravel beaches with very different morphologies is presented below. In 557 studied transects, 14 variables were used. Among the variables to be emphasized is the depth of the Posidonia oceanica. The classification was performed for 9 types of beaches: Type 1: Sand and gravel beaches, Type 2: Sand and gravel separated beaches, Type 3: Gravel and sand beaches, Type 4: Gravel and sand separated beaches, Type 5: Pure gravel beaches, Type 6: Open sand beaches, Type 7: Supported sand beaches, Type 8: Bisupported sand beaches and Type 9: Enclosed beaches. For the classification, several tools were used: discriminant analysis, neural networks and Support Vector Machines (SVM), the results were then compared. As there is no theory for deciding which is the most convenient neural network architecture to deal with a particular data set, an experimental study was performed with different numbers of neuron in the hidden layer. Finally, an architecture with 30 neurons was chosen. Different kernels were employed for SVM (Linear, Polynomial, Radial basis function and Sigmoid). The results obtained for the discriminant analysis were not as good as those obtained for the other two methods (ANN and SVM) which showed similar success.