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Domestic and imported products--the Malaysian experience in assuring safe and sufficient plasma products

Ayob Y

Dev Biol (Basel), 2007;127:169-73.
PMID: 17486890
Matched MeSH terms: Quality Assurance, Health Care/standards*
Global quality control perspective for the physical and technical aspects of screen-film mammography--image quality and radiation dose

Ng KH, Jamal N, DeWerd L

Radiat Prot Dosimetry, 2006;121(4):445-51.
PMID: 16709704

The systematic monitoring of image quality and radiation dose is an ultimate solution to ensuring the continuously high quality of mammography examination. At present several protocols exist around the world, and different test objects are used for quality control (QC) of the physical and technical aspects of screen-film mammography. This situation may lead to differences in radiation image quality and dose reported. This article reviews the global QC perspective for the physical and technical aspects of screen-film mammography with regard to image quality and radiation dose. It points out issues that must be resolved in terms of radiation dose and that also affect the comparison.

Matched MeSH terms: Quality Assurance, Health Care/standards*
Comparison of radiology residency programs in ten countries

Willatt JM, Mason AC

Eur Radiol, 2006 Feb;16(2):437-44.
PMID: 15702337

The purpose of our study was to compare various aspects of radiology training schemes in ten countries. A questionnaire was sent to senior residents in the UK, USA, Canada, Australia, New Zealand, Italy, Egypt, India, Malaysia and Greece. The questions concerned length of training, required pre-training experience, the organization of the training scheme, teaching, resources, stages at which residents can independently perform and report examinations, fellowships, and progression to jobs. A wide variety of training, ranging from highly scheduled programs with detailed aims and objectives, to self-learning occurs across the world. Examinations and assessments are also variable. There are lessons to be learned from varying practices; more exchanges of ideas should be encouraged. In view of the "internationalization" of radiology services and the variation in training styles an international qualification for quality assurance purposes may be desirable.

Matched MeSH terms: Quality Assurance, Health Care/standards
Fulltext Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions

Jarrar M, Abdul Rahman H, Don MS

Glob J Health Sci, 2016;8(6):44132.
PMID: 26755459 DOI: 10.5539/gjhs.v8n6p75

Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia.

Matched MeSH terms: Quality Assurance, Health Care/standards*
Fulltext Development and validation of a new Prescription Quality Index

Hassan NB, Ismail HC, Naing L, Conroy RM, Abdul Rahman AR

Br J Clin Pharmacol, 2010 Oct;70(4):500-13.
PMID: 20840442 DOI: 10.1111/j.1365-2125.2009.03597.x

The aims were to develop and validate a new Prescription Quality Index (PQI) for the measurement of prescription quality in chronic diseases.

Matched MeSH terms: Quality Assurance, Health Care/standards
Fulltext Analysis of dose comparison techniques for patient-specific quality assurance in radiation therapy

Yu L, Tang TLS, Cassim N, Livingstone A, Cassidy D, Kairn T, et al.

J Appl Clin Med Phys, 2019 Nov;20(11):189-198.
PMID: 31613053 DOI: 10.1002/acm2.12726

PURPOSE: Gamma evaluation is the most commonly used technique for comparison of dose distributions for patient-specific pretreatment quality assurance in radiation therapy. Alternative dose comparison techniques have been developed but not widely implemented. This study aimed to compare and evaluate the performance of several previously published alternatives to the gamma evaluation technique, by systematically evaluating a large number of patient-specific quality assurance results.
METHODS: The agreement indices (or pass rates) for global and local gamma evaluation, maximum allowed dose difference (MADD) and divide and conquer (D&C) techniques were calculated using a selection of acceptance criteria for 429 patient-specific pretreatment quality assurance measurements. Regression analysis was used to quantify the similarity of behavior of each technique, to determine whether possible variations in sensitivity might be present.
RESULTS: The results demonstrated that the behavior of D&C gamma analysis and MADD box analysis differs from any other dose comparison techniques, whereas MADD gamma analysis exhibits similar performance to the standard global gamma analysis. Local gamma analysis had the least variation in behavior with criteria selection. Agreement indices calculated for 2%/2 mm and 2%/3 mm, and 3%/2 mm and 3%/3 mm were correlated for most comparison techniques.
CONCLUSION: Radiation oncology treatment centers looking to compare between different dose comparison techniques, criteria or lower dose thresholds may apply the results of this study to estimate the expected change in calculated agreement indices and possible variation in sensitivity to delivery dose errors.

Matched MeSH terms: Quality Assurance, Health Care/standards*
Fulltext How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals' views

Lee PY, Lee YK, Ng CJ

BMC Public Health, 2012;12:313.
PMID: 22545648 DOI: 10.1186/1471-2458-12-313

BACKGROUND: The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public-private) health system.
METHODS: In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010-11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach.
RESULTS: Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients' peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose monitoring equipment. Finally, the healthcare professionals proposed the establishment of multidisciplinary teams as a strategy to increase the rate of insulin initiation. Having team members from different ethnic backgrounds would help to overcome language and cultural differences when communicating with patients.
CONCLUSION: The challenges faced by a dual-sector health system in delivering insulin initiation may be addressed by greater collaborations between the private and public sectors and governmental and non-government organisations, and among different healthcare professionals.
Study site: Healthcare professionals from three states (Wilayah Federal Territory, Negeri Sembilan and Selangor) and from both urban and semi-rural locations (including Klinik Kesihatan), Malaysia

Matched MeSH terms: Quality Assurance, Health Care/standards*
A thermoluminescent dosimetry postal dose inter-comparison of radiation therapy centres in Malaysia

Rassiah P, Ng KH, DeWerd LA, Kunugi K

Australas Phys Eng Sci Med, 2004 Mar;27(1):25-9.
PMID: 15156705

A thermoluminescent dosimetry (TLD) postal dose inter-comparison was carried out amongst radiotherapy centres in Malaysia. The aim of this TLD inter-comparison was to compare the uniformity involved in the measurement of absorbed dose among the participating centres. A set of 5 TLD chips placed within acrylic trays were mailed to all participating centres for irradiation to an absorbed dose to water of 2 Gy. Measurements were made for 6 MV and 60Co photon beams. Results show an agreement of +/- 5% for all but three radiotherapy centres. The ratios of the TLD readings to that of the reference centre are comparable with other national/regional dose inter-comparisons. The importance of a proper ongoing quality assurance program is essential in maintaining the consistency and uniformity of doses delivered.

Matched MeSH terms: Quality Assurance, Health Care/standards*