Causes of injuries resulting in hospitalisation in Australia : assessing coder agreement on external causes

Objective: To assess extent of coder agreement for external causes of injury using ICD-10-AM for injury-related hospitalisations in Australian public hospitals. Methods: A random sample of 4850 discharges from 2002 to 2004 was obtained from a stratified random sample of 50 hospitals across four states in Australia. On-site medical record reviews were conducted and external cause codes were assigned blinded to the original coded data. Code agreement levels were grouped into the following agreement categories: block level, 3-character level, 4-character level, 5th-character level, and complete code level. Results: At a broad block level, code agreement was found in over 90% of cases for most mechanisms (eg, transport, fall). Percentage disagreement was 26.0% at the 3-character level; agreement for the complete external cause code was 67.6%. For activity codes, the percentage of disagreement at the 3-character level was 7.3% and agreement for the complete activity code was 68.0%. For place of occurrence codes, the percentage of disagreement at the 4-character level was 22.0%; agreement for the complete place code was 75.4%. Conclusions: With 68% agreement for complete codes and 74% agreement for 3-character codes, as well as variability in agreement levels across different code blocks, place and activity codes, researchers need to be aware of the reliability of their specific data of interest when they wish to undertake trend analyses or case selection for specific causes of interest.

Investment decision-making under risk (reliability) and uncertainty for infrastructure asset management

Risks and uncertainties are inevitable in engineering projects and infrastructure investments. Decisions about investment in infrastructure such as for maintenance, rehabilitation and construction works can pose risks, and may generate significant impacts on social, cultural, environmental and other related issues. This report presents the results of a literature review of current practice in identifying, quantifying and managing risks and predicting impacts as part of the planning and assessment process for infrastructure investment proposals. In assessing proposals for investment in infrastructure, it is necessary to consider social, cultural and environmental risks and impacts to the overall community, as well as financial risks to the investor. The report defines and explains the concept of risk and uncertainty, and describes the three main methodology approaches to the analysis of risk and uncertainty in investment planning for infrastructure, viz examining a range of scenarios or options, sensitivity analysis, and a statistical probability approach, listed here in order of increasing merit and complexity. Forecasts of costs, benefits and community impacts of infrastructure are recognised as central aspects of developing and assessing investment proposals. Increasingly complex modelling techniques are being used for investment evaluation. The literature review identified forecasting errors as the major cause of risk. The report contains a summary of the broad nature of decision-making tools used by governments and other organisations in Australia, New Zealand, Europe and North America, and shows their overall approach to risk assessment in assessing public infrastructure proposals. While there are established techniques to quantify financial and economic risks, quantification is far less developed for political, social and environmental risks and impacts. The report contains a summary of the broad nature of decision-making tools used by governments and other organisations in Australia, New Zealand, Europe and North America, and shows their overall approach to risk assessment in assessing public infrastructure proposals. While there are established techniques to quantify financial and economic risks, quantification is far less developed for political, social and environmental risks and impacts. For risks that cannot be readily quantified, assessment techniques commonly include classification or rating systems for likelihood and consequence. The report outlines the system used by the Australian Defence Organisation and in the Australian Standard on risk management. After each risk is identified and quantified or rated, consideration can be given to reducing the risk, and managing any remaining risk as part of the scope of the project. The literature review identified use of risk mapping techniques by a North American chemical company and by the Australian Defence Organisation. This literature review has enabled a risk assessment strategy to be developed, and will underpin an examination of the feasibility of developing a risk assessment capability using a probability approach.

A medical data reliability assessment model

There is currently a strong focus worldwide on the potential of large-scale Electronic Health Record (EHR) systems to cut costs and improve patient outcomes through increased efficiency. This is accomplished by aggregating medical data from isolated Electronic Medical Record databases maintained by different healthcare providers. Concerns about the privacy and reliability of Electronic Health Records are crucial to healthcare service consumers. Traditional security mechanisms are designed to satisfy confidentiality, integrity, and availability requirements, but they fail to provide a measurement tool for data reliability from a data entry perspective. In this paper, we introduce a Medical Data Reliability Assessment (MDRA) service model to assess the reliability of medical data by evaluating the trustworthiness of its sources, usually the healthcare provider which created the data and the medical practitioner who diagnosed the patient and authorised entry of this data into the patient’s medical record. The result is then expressed by manipulating health record metadata to alert medical practitioners relying on the information to possible reliability problems.

The reliability of information on work-related injuries available from hospitalisation data in Australia

Objective: To examine the reliability of work-related activity coding for injury-related hospitalisations in Australia. Method: A random sample of 4373 injury-related hospital separations from 1 July 2002 to 30 June 2004 were obtained from a stratified random sample of 50 hospitals across 4 states in Australia. From this sample, cases were identified as work-related if they contained an ICD-10-AM work-related activity code (U73) allocated by either: (i) the original coder; (ii) an independent auditor, blinded to the original code; or (iii) a research assistant, blinded to both the original and auditor codes, who reviewed narrative text extracted from the medical record. The concordance of activity coding and number of cases identified as work-related using each method were compared. Results: Of the 4373 cases sampled, 318 cases were identified as being work-related using any of the three methods for identification. The original coder identified 217 and the auditor identified 266 work-related cases (68.2% and 83.6% of the total cases identified, respectively). Around 10% of cases were only identified through the text description review. The original coder and auditor agreed on the assignment of work-relatedness for 68.9% of cases. Conclusions and Implications: The current best estimates of the frequency of hospital admissions for occupational injury underestimate the burden by around 32%. This is a substantial underestimate that has major implications for public policy, and highlights the need for further work on improving the quality and completeness of routine, administrative data sources for a more complete identification of work-related injuries.

A review on degradation models in reliability analysis

With increasingly complex engineering assets and tight economic requirements, asset reliability becomes more crucial in Engineering Asset Management (EAM). Improving the reliability of systems has always been a major aim of EAM. Reliability assessment using degradation data has become a significant approach to evaluate the reliability and safety of critical systems. Degradation data often provide more information than failure time data for assessing reliability and predicting the remnant life of systems. In general, degradation is the reduction in performance, reliability, and life span of assets. Many failure mechanisms can be traced to an underlying degradation process. Degradation phenomenon is a kind of stochastic process; therefore, it could be modelled in several approaches. Degradation modelling techniques have generated a great amount of research in reliability field. While degradation models play a significant role in reliability analysis, there are few review papers on that. This paper presents a review of the existing literature on commonly used degradation models in reliability analysis. The current research and developments in degradation models are reviewed and summarised in this paper. This study synthesises these models and classifies them in certain groups. Additionally, it attempts to identify the merits, limitations, and applications of each model. It provides potential applications of these degradation models in asset health and reliability prediction.

A review on reliability models with covariates

Modern Engineering Asset Management (EAM) requires the accurate assessment of current and the prediction of future asset health condition. Suitable mathematical models that are capable of predicting Time-to-Failure (TTF) and the probability of failure in future time are essential. In traditional reliability models, the lifetime of assets is estimated using failure time data. However, in most real-life situations and industry applications, the lifetime of assets is influenced by different risk factors, which are called covariates. The fundamental notion in reliability theory is the failure time of a system and its covariates. These covariates change stochastically and may influence and/or indicate the failure time. Research shows that many statistical models have been developed to estimate the hazard of assets or individuals with covariates. An extensive amount of literature on hazard models with covariates (also termed covariate models), including theory and practical applications, has emerged. This paper is a state-of-the-art review of the existing literature on these covariate models in both the reliability and biomedical fields. One of the major purposes of this expository paper is to synthesise these models from both industrial reliability and biomedical fields and then contextually group them into non-parametric and semi-parametric models. Comments on their merits and limitations are also presented. Another main purpose of this paper is to comprehensively review and summarise the current research on the development of the covariate models so as to facilitate the application of more covariate modelling techniques into prognostics and asset health management.

High-level concept annotation using ontology and probabilistic inference

Image annotation is a significant step towards semantic based image retrieval. Ontology is a popular approach for semantic representation and has been intensively studied for multimedia analysis. However, relations among concepts are seldom used to extract higher-level semantics. Moreover, the ontology inference is often crisp. This paper aims to enable sophisticated semantic querying of images, and thus contributes to 1) an ontology framework to contain both visual and contextual knowledge, and 2) a probabilistic inference approach to reason the high-level concepts based on different sources of information. The experiment on a natural scene database from LabelMe database shows encouraging results.

Mid-level concept learning with visual contextual ontologies and probabilistic inference for image annotation

To date, automatic recognition of semantic information such as salient objects and mid-level concepts from images is a challenging task. Since real-world objects tend to exist in a context within their environment, the computer vision researchers have increasingly incorporated contextual information for improving object recognition. In this paper, we present a method to build a visual contextual ontology from salient objects descriptions for image annotation. The ontologies include not only partOf/kindOf relations, but also spatial and co-occurrence relations. A two-step image annotation algorithm is also proposed based on ontology relations and probabilistic inference. Different from most of the existing work, we specially exploit how to combine representation of ontology, contextual knowledge and probabilistic inference. The experiments show that image annotation results are improved in the LabelMe dataset.

Multi-level order, friction and contradiction : the evolution of Australian film industry policy

Cultural policy studies have previously highlighted the importance of multiple logics, friction and contradiction in cultural policy. Recent developments in institutional theory provide a framework for analysing change in cultural policy which explores movement between these multiple and sometimes contradictory logics. This paper analyses the role of friction in the evolution of Australian film industry policy and in particular the tension between competing logics regarding nationalism, commercialism and the state. The paper is suggestive of the relevance of institutional theory as a framework for understanding cultural policy evolution.

EMI issues in high power and high level diode-clamped converters

Planar busbar is a good candidate to reduce interconnection inductance in high power inverters compared with cables. However, power switching components with fast switching combined with hard switched-converters produce high di/dt during turn off time and busbar stray inductance then becomes an important issue which creates overvoltage. It is necessary to keep the busbar stray inductance as low as possible to decrease overvoltage and Electromagnetic Interference (EMI) noise. In this paper, the effect of different transient current loops on busbar physical structure of the high-voltage high-level diode-clamped converters will be highlighted. Design considerations of proper planar busbar will also be presented to optimise the overall design of diode-clamped converters.

Foldback current control for a DG to achieve Fast Arc Extinction in a distribution network

The distribution network reliability can be increased if distributed generators (DGs) are allowed to operate in both grid-connected and islanded operations when the network has a high DG penetration level. However, the current utility regulations do not allow for the islanded operation. The arc faults are the one of the major issues preventing the islanded operation, since the arc will not extinguish if the DGs are not disconnected. In this paper, the effect of a converter interfaced DG on an arc fault is investigated by considering different control strategies for the converter. The foldback current control characteristic is proposed to a converter interfaced DG to achieve quick arc extinction and self-restoration without disconnecting the DG in the event of an arc fault. The results are validated through PSCAD/EMTDC simulations.

Self-commutated current source converter with multi-level current reinjection

The multi-level current reinjection concept described in literature is well-known to produce high quality AC current waveforms in high power and high voltage self-commutating current source converters. This paper proposes a novel reinjection circuitry which is capable of producing a 7-level reinjection current. It is shown that this reinjection current effectively increases the pulse number of the converter to 72. The use of PSCAD/EMTDC simulation validates the functionality of the proposed concept illustrating its effectiveness on both AC and DC sides of the converter.