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Testing for Inter-rater reliability

22 November 2011 by Nathalie Abejero Leave a Comment

I haven’t used a stats package in a long time. I remember back in grad school how interesting my Biostats and BioInformatics courses were, especially Janet Hughes‘ classes. But in my professional life, I hardly ventured beyond the first five tasks in the function button on the standard Excel toolbar.

via http://www.effective-time-management-strategies.com

My QI (Quality Improvement) team has been pre-testing some clinical assessment questionnaires for Health Centers. The questionnaires consist of a checklist and a rating, for two assessors to fill out while observing a specific consultation eg an Antenatal Care visit. The checklist scores are weighted with qualitative ratings. For example, of the items which the midwife conducted during the Physical Examination, the assessors rate the quality in which these items were carried out.

There’s a lot of room for bias in any data collection method, but at least I want to know that my instrument is reliable. So I want to test the inter-rater agreement (eg did they see the same things? did they rate the items similarly?). You’d think this is a simple enough calculation to carry out in excel, in a neat and tidy point-and-click experience. But no. Apparently this seems to be an obscure corner of statistics that you need macros for to carry out in SAS and SPSS.

I ask for the billionth time in my short life: what did people do before internet? I’m a bit less stumped since I’ve found these handy sources below, which provide a free or low-cost stats package for content analysis. Whew!

  • kappa2 – free downloadable automated excel workbook (although I’ve had some problems using this one)
  • ReCal – free to use, online interface to enter your data
  • AgreeStat – $45 downloadable automated Excel workbook

Filed Under: Work Tagged With: content analysis, inter-rater, inter-rater reliability, QI, quality improvement, reliability, reliability testing, statistics, testing

a nursing mom at work

15 September 2011 by Nathalie Abejero 1 Comment

Having a baby is a life changer, and thankfully our life outside the US has been good for us. The social culture in SE Asia and my profession are both supportive of young families. Staff and diners here don’t cringe when we walk into a restaurant or food shop; instead they fight over who gets to hold the baby while we eat, and he’s returned to us with the bill. Second, we’re lucky that my employer is so supportive of new mothers. There’s a nursery at the office so nursing moms to bring our babies to work. My colleagues help make sure that I can pump on the days I don’t bring the baby by scheduling me into the meeting rooms. I have an unofficial flex time. And on travels I can bring the baby (and his nanny) with me.

My current work has to do with quality improvement of health facilities in USAID-supported provinces. Two of the three people on my team have young babies, and we bring them along with us to the health centers. Since my husband does freelance and can work anywhere there’s an internet connection, he often joins us on my work trips.

One of the areas my team is working on is improvement of labor and delivery procedures. We’ve watched several deliveries lately – an endlessly fascinating miracle to me. It brings me back to the time my son became real to me, a little someone in my arms… Check these photos out. The baby is 2.5kg.

 

Filed Under: Work Tagged With: baby, delivery, expat, expatriate, family, parenthood, parenting, work

Budget cuts by hatchet or scalpel?

5 August 2011 by Nathalie Abejero Leave a Comment

The excerpt below is from PBS’s Need to Know. Read the entire piece, Budget Cuts by Hatchet or Scalpel, written by Joshua Foust. Follow him on Google+.

This weekend’s “debt deal” in Congress, which raised the debt ceiling and agreed to some cuts in the future, contains a change in how the international affairs budget is calculated within the federal budget. In Section 102 of the bill, Function 150 budgets are reclassified as “security.” This means foreign assistance and development programs — USAID, the Millennium Challenge Corporation (MCC) and lots of State Department programs — are now in the same budget category as the Departments of Defense, Homeland Security and the National Nuclear Safety Administration.

It might seem like a minor thing, but this actually provides a sneaky way for the Congress to cut money from “national security” without actually touching sacred DOD programs. By cutting assistance agencies like USAID — a GOP goal for the last 18 months — Congress can cut from development assistance programs and say it is reducing national security spending. This change in language is damaging in that it furthers the militarization of civilian aid programs.

Respected defense analysts like Gordon Adams and Cindy Williams have argued forcefully that USAID is a part of the national security budget. And they are right to a degree: The argument that the U.S. has a compelling national security interest in developing poor countries, in responding to disasters and in alleviating famine is a perfectly reasonable one. Afghanistan and Pakistan are two of the biggest recipients of USAID money because the Obama administration believes USAID’s programs serve a vital function in America’s relationship to both countries.

But just because USAID can serve a national security function, it doesn’t automatically mean the international affairs budget should be militarized, or even considered part of the security budget. USAID, but also the MCC and other Function 150 programs (consisting of 12 departments, 25 agencies and nearly 60 government offices) perform lots of functions that have no direct bearing on national security. There is intrinsic value in effective programs like the Millennium Challenge Account Philippines that advance American national interests but do not play a security function. But, now they are all fall under a rubric of “security.”

Filed Under: Work Tagged With: aid and development, budget cuts, defense, development, foreign aid, security, usaid

Telemedical emergency care in the US

27 February 2011 by Nathalie Abejero Leave a Comment

It’s about time someone thought of this!

Medical Provider Adds Virtual House Calls To Its Services (image from CarenaMD.com)

Filed Under: Work Tagged With: medical care, telemedicine, virtual house call

Breastfeeding is a partisan issue??

23 February 2011 by Nathalie Abejero Leave a Comment

Image from babynursingblog.com

Really?? A “leftist agenda” of a “nanny state”? I especially love the bashing of Michelle Obama’s breastfeeding advocacy after Palin’s own breastfeeding initiative in 2007.

Why people choose leaders with nothing constructive to add to the dialogue except to auto-bash the other party’s efforts is beyond me. Great quote from one of the commenters to the above blog post:

“Empty vessels make the loudest sound, they have the least wit and are the greatest blabbers” Plato

And a shame that people blindly follow.

Filed Under: Interests, Life, Work Tagged With: breastfeeding, Let's Move, Let's Move campaign, Michelle Obama, mother, Palin, Sarah Palin

Review: Wrike (web-based project management tool)

23 December 2010 by Nathalie Abejero 6 Comments

The context of this review is at the end of this post. Other useful reviews I’ve found, some which echo a few points below, are here (reviewed against LiquidPlanner, 2010), here (reviewed against BaseCamp, 2007), here (comments from 2009), and here (2007).

My main complaint is the inconsistency problem in user experience: between users, within each user’s experience in using the same function, and then our team’s experience conflicts directly with what Wrike says its platform can do. What could this be from? The caching? The firewalls? We already all use the same version of Chrome.

Basic functionalities I expect from a project management platform:

1. Buffering between dependencies is unreliable – sometimes the buffer periods stick, but most of the time they don’t – and you don’t know it until you open those tasks again and see that your timeline has completely shifted. Wrike’s response as of Nov 2010: Wrike dependencies don’t support creating a time-delay between tasks.

2. Viewing your tasks in the timeline –

  • There’s no differentiation between types of tasks (eg meeting, action, appointment) or group levels (eg Output level vs subfolders like Province or Facility) in timeline – The headings have no color coding or font effects etc, making viewing it a bit of an eyeache.
  • The timeline view does not allow user-determined ordering of tasks and folders. I put the folder for Output 1 at the top for a reason, followed by the folders for Output 2, 3, etc. But Wrike’s timeline limits how these folders stack to the chronology of tasks within these folders.
  • The details box for each task doesn’t list its full folder path (eg in “Included in” box on details view)

3. Being able to view or export a list of tasks the user has sorted – This to me seems a critical function – You filter, search, sort all tasks by X person in X facility in X province within a specified date range. You want to see all tasks meeting these criteria across all Output folders. You get a list. But this list cannot be displayed online on the timeline nor can it be exported on CSV so I can view it on excel. Wrike’s response as of Dec 2010: Export function does not take search criteria into account.


4. Batch-edits such as selecting many tasks at once and deleting or moving them to another folder is not possible.

5. Recurring tasks – Changes to the original task does not cascade to the recurrences created from it! eg if you edit / delete a task, its recurrences do not reflect the edit – you must edit / delete all 12 or 300 individually. See #4 above – you cannot batch edit! So be careful using this “handy” function!

6. When editing tasks that are placed in two or more folders, the user is not prompted to replicate the adjustment in the other folders as well eg when the edited task’s timeline is adjusted it does not automatically update in the other folders, even though this is the same task in both folders. [Read more…] about Review: Wrike (web-based project management tool)

Filed Under: Work Tagged With: Cambodia, development, foreign aid, GTD, productivity, project management, wrike

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Those little feet pitter-pattering about rule our lives lately. But on the occasional free moment I get to tap out scatterbrained bursts of consciousness about raising toddlers in Cambodia, traveling with them and working abroad. These posts are my personal updates to friends and family. But since you’re here, have a look around. Thanks for stopping by…

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