Suchergebnisse

Organs available for transplantation are scarce and valuable medical resources and decisions about who is to receive them should not be made more difficult by complicated calculations of desert. Consideration of likely clinical outcome must always take priority when allocating such a precious resource otherwise there is a danger of wasting that resource. However, desert may be a relevant concern in decision-making where the clinical risk is identical between two or more potential recipients of organs. Unlikely as this scenario is, such a decision procedure makes clear the interdependence of organ recipient and organ donor and hints at potential disadvantages for those who are willing to accept but unwilling to donate organs (free-riders). A combined opting-out and preference system weakens many of the objections to opting-out systems and may make the decision to donate organs on behalf of their deceased relatives easier for families.

AbstractScoring schemes were first introduced in water‐chemistry inter‐laboratory proficiency tests. Such scoring does not behave in a comparable manner when applied to microbiology external quality assessment. Conventional scores can become a lottery. This poses a challenge to (a) find helpful statistical methods which will look beyond this natural variation and (b) attempt to identify any poor performance by the participants. The aim is to provide useful management tools.In the Public Health Laboratory Service, water external quality assessment scheme participants have detected methodology problems. Formal analyses are carried out on cumulated results in two stages, first demonstrating whether there is any systematic difference between laboratories of microbiological as well as statistical significance and only then allocating participants to categories of acceptable, or poor, performance. The scheme has been operating for several years and performance improvements are evident.