The role of complexity metrics in a multi-institutional dosimetry audit of VMAT

OBJECTIVE: To demonstrate the benefit of complexity metrics such as the modulation complexity score (MCS) and monitor units (MUs) in multi-institutional audits of volumetric-modulated arc therapy (VMAT) delivery.

METHODS: 39 VMAT treatment plans were analysed using MCS and MU. A virtual phantom planning exercise was planned and independently measured using the PTW Octavius(®) phantom and seven29(®) 2D array (PTW-Freiburg GmbH, Freiburg, Germany). MCS and MU were compared with the median gamma index pass rates (2%/2 and 3%/3 mm) and plan quality. The treatment planning systems (TPS) were grouped by VMAT modelling being specifically designed for the linear accelerator manufacturer's own treatment delivery system (Type 1) or independent of vendor for VMAT delivery (Type 2). Differences in plan complexity (MCS and MU) between TPS types were compared.

RESULTS: For Varian(®) linear accelerators (Varian(®) Medical Systems, Inc., Palo Alto, CA), MCS and MU were significantly correlated with gamma pass rates. Type 2 TPS created poorer quality, more complex plans with significantly higher MUs and MCS than Type 1 TPS. Plan quality was significantly correlated with MU for Type 2 plans. A statistically significant correlation was observed between MU and MCS for all plans (R = -0.84, p < 0.01).

CONCLUSION: MU and MCS have a role in assessing plan complexity in audits along with plan quality metrics. Plan complexity metrics give some indication of plan deliverability but should be analysed with plan quality.

ADVANCES IN KNOWLEDGE: Complexity metrics were investigated for a national rotational audit involving 34 institutions and they showed value. The metrics found that more complex plans were created for planning systems which were independent of vendor for VMAT delivery.

The intra-industry effects of going concern withdrawn audit reports

Dissertação de mestrado, Finanças Empresariais, Faculdade de Economia, Universidade do Algarve, 2014

Review of state government motor vehicle resources

The LAC was requested to review state motor vehicle resources and make recommendations. It focused on three statewide objectives posed by the committees: (1) Determine if any wasteful duplication exists among state-owned vehicle maintenance facilities. (2) Identify any waste or inefficiency in the use of state owned vehicles. (3) Identify unnecessary or personal use of state-owned vehicles.

Audit report GE McCormick - 2010

This audit report by the South Carolina State Election Commission for the 2010 general election in McCormick County provides 5 reports generated by the iVotronic voting machines and Unity election system, including comparisons of number of ballots, number of votes for each candidate, and Personal Electronic Ballot devices used.

Departmental Select Committees

The idea of departmental select committees in the House of Commons was floated as long ago as the Haldane Report in 1918 and periodically mooted by figures from both left and right as varied as Amery and Laski in the inter‐war years. It was raised again during the wartime investigations of the Machinery of Government committee, only to be shot down by the then Cabinet Secretary, Sir Edward Bridges, on the grounds that it would constrain the frankness with which the Civil Service could advise ministers. Departmental select committees were not to be introduced until 1979. Ten years ago the Institute of Contemporary British History organised a symposium to review their progress. On 31 January 1996 in committee room 10 at the House of Commons the ICBH, in conjunction with the Hansard Society, held another seminar to re‐examine the development of the departmental select committee system, its successes and failings. It was chaired by George Cunningham (Labour MP 1970–82, SDP MP 1982–83). The principal participants were Sir Peter Kemp (Deputy Secretary, Treasury 1983–88, Next Steps Project Manager, Cabinet Office, 1988–92), Douglas Millar (Clerk of Select Committees, House of Commons since 1994), Dr Ann Robinson (author of Parliament and Public Spending, head of the policy unit at the Institute of Directors [IOD], 1989–95 and Director‐General of the National Association of Pension Funds Ltd since 1995), Robert Sheldon (Labour MP since 1964, Financial Secretary to the Treasury 1974–75, member of the Public Accounts Committee [PAC] 1965–70 and 1975–79 and chairman since 1983, member, Public Expenditure Committee 1972–74, and member of the Treasury and Civil Service Committee [TCSC] 1979–81) and Sandy Walkington (head of corporate affairs at BT [British Telecom] plc), with further contributions from Peter Riddell (assistant editor: politics, The Times, since 1993), Chloe Miller, Sean McDougall, Tim King and Chris Stevens.

The Public Accounts Committee of the House of Commons

This chapter evaluates the Public Accounts Committee (PAC) of the House of Commons in light of recent changes to public audit and broader changes across United Kingdom governance. Structural and organisational features are analysed, as are working practices and relationships. The analyses confirm that the PAC remains a key oversight tool to Parliament and that its profile has increased under the leadership of its first directly-elected Chair. Heightened visibility contains risks for a non-partisan committee and the National Audit Office acts as a shield to deflect criticism. Traditional variables used to measure the impact of the PAC are likely to understate the committee’s actual influence.

Strengthening PACs in small Parliaments: perspectives from the Caribbean

Recent efforts to strengthen the oversight capacity of the Parliaments of Jamaica and Trinidad and Tobago have paid particular attention to the public accounts committee (PAC). This chapter provides an analysis of the PACs in both countries. The committees have some similar features in terms of mandate and composition, but both have struggled to be effective, partly because of the difficulties in developing functioning committees in small jurisdictions and partly because of an unhelpful external context. Progress has been made in developing the internal environment of the PACs, but producing and demonstrating significant outputs and outcomes remain a major challenge.

Siawise Audit

Intitulada SIAWISE AUDIT, esta dissertação pretende apresentar o desenvolvimento de uma aplicação informática com o mesmo nome, e o conceito que esta defende e de que forma pode simplificar e reduzir o trabalho dos seus utilizadores. O SIAWISE AUDIT surge da necessidade de modernizar, informatizar e acelerar o processo de auditoria de conformidade legal prestado pela empresa acolhedora e mentora do projeto – a SIA. Sucintamente, o projeto visava a implementação de uma aplicação desenvolvida inicialmente tendo como alvo o Windows 8.1 mas que atualmente já é compatível com o novo Windows 10. A solução tem como principal característica o funcionamento em modo offline, essencial ao trabalho no terreno e em instalações de recursos frequentemente limitados no que refere à utilização de Internet. A aplicação tem como fonte de dados o software de gestão de legislação da SIA – o SIAWISE – que contém todos os dados relativos à legislação aplicável a cada cliente. Por se tratar de uma ferramenta exclusivamente para uso interno da organização, a interação e comunicações são sempre efetuadas através do BackOffice – o SIAWISE MASTER – este permite a importação e exportação de dados referentes à auditoria para o SIAWISE AUDIT. O resultado do processo de auditoria com recurso ao SIAWISE AUDIT tem como principal output a geração automática de um relatório de auditoria pronto a entregar ao cliente.

Extent of non-publication in cohorts of studies approved by research ethics committees or included in trial registries

BACKGROUND: The synthesis of published research in systematic reviews is essential when providing evidence to inform clinical and health policy decision-making. However, the validity of systematic reviews is threatened if journal publications represent a biased selection of all studies that have been conducted (dissemination bias). To investigate the extent of dissemination bias we conducted a systematic review that determined the proportion of studies published as peer-reviewed journal articles and investigated factors associated with full publication in cohorts of studies (i) approved by research ethics committees (RECs) or (ii) included in trial registries. METHODS AND FINDINGS: Four bibliographic databases were searched for methodological research projects (MRPs) without limitations for publication year, language or study location. The searches were supplemented by handsearching the references of included MRPs. We estimated the proportion of studies published using prediction intervals (PI) and a random effects meta-analysis. Pooled odds ratios (OR) were used to express associations between study characteristics and journal publication. Seventeen MRPs (23 publications) evaluated cohorts of studies approved by RECs; the proportion of published studies had a PI between 22% and 72% and the weighted pooled proportion when combining estimates would be 46.2% (95% CI 40.2%-52.4%, I2 = 94.4%). Twenty-two MRPs (22 publications) evaluated cohorts of studies included in trial registries; the PI of the proportion published ranged from 13% to 90% and the weighted pooled proportion would be 54.2% (95% CI 42.0%-65.9%, I2 = 98.9%). REC-approved studies with statistically significant results (compared with those without statistically significant results) were more likely to be published (pooled OR 2.8; 95% CI 2.2-3.5). Phase-III trials were also more likely to be published than phase II trials (pooled OR 2.0; 95% CI 1.6-2.5). The probability of publication within two years after study completion ranged from 7% to 30%. CONCLUSIONS: A substantial part of the studies approved by RECs or included in trial registries remains unpublished. Due to the large heterogeneity a prediction of the publication probability for a future study is very uncertain. Non-publication of research is not a random process, e.g., it is associated with the direction of study findings. Our findings suggest that the dissemination of research findings is biased.

Uptake of new treatment strategies for deep vein thrombosis: an international audit.

OBJECTIVE: Study of the uptake of new medical technologies provides useful information on the transfer of published evidence into usual practice. We conducted an audit of selected hospitals in three countries (Canada, France, and Switzerland) to identify clinical predictors of low-molecular-weight (LMW) heparin use and outpatient treatment, and to compare the pace of uptake of these new therapeutic approaches across hospitals. DESIGN: Historical review of medical records. SETTING AND PARTICIPANTS: We reviewed the medical records of 3043 patients diagnosed with deep vein thrombosis (DVT) in five Canadian, two French, and two Swiss teaching hospitals from 1994 to 1998. Measures. We explored independent clinical variables associated with LMW heparin use and outpatient treatment, and determined crude and adjusted rates of LMW heparin use and outpatient treatment across hospitals. RESULTS: For the years studied, the overall rates of LMW heparin use and outpatient treatment in the study sample were 34.1 and 15.8%, respectively, with higher rates of use in later years. Many comorbidities were negatively associated with outpatient treatment, and risk-adjusted rates of use of these new approaches varied significantly across hospitals. CONCLUSION: There has been a relatively rapid uptake of LMW heparins and outpatient treatment for DVT in their early years of availability, but the pace of uptake has varied considerably across hospitals and countries.

Edit du Roy, portant suppression des offices de contrôlleurs des bans de mariage qui avoient esté créez par l'Edit du mois de septembre 1697 . Et tarif des droits que Sa Majesté veut estre payez à l'avenir pour le contrôlle & l'enregistrement de chacune publication de ban de mariage conformement audit Edit. Donné à Versailles au mois de mars 1702. Registré en Parlement le 26 avril 1702.

[Acte royal. 1702-03-00. Versailles]

Arrêt du conseil d'état qui maintient et garde Monsieur le duc d'Orléans au droit de nommer et pourvoir aux offices de son apanage, terres patrimoniales, mentionnés audit arrêt ainsi qu'il faisait avant l'arrêt du conseil d'état du 25 septembre 1718 dans lequel Sa Majesté n'a entendu comprendre lesdits offices

[Acte. 1719-03-24. Paris]

Arrêt du grand conseil concernant les abbayes du royaume (qui condamne Denis Coignet, curé de St-Roch à Paris et prieur de Saint-Julien de Courcelles, à payer à Franç. des Bertrons de Crillon, évêque de Vienne, 29 années d'arrérages de la cense par lui due audit des Bertrons, en sa qualité d'abbé de St-Florent-lez-Saumur dont relève ledit prieuré de Saint-Julien.)

[Acte. 1719-03-04. Paris]