Optimal Design of a Soft Robotic Gripper for Grasping Unknown Objects.

This study presents the design of an underactuated, two-finger, motor-driven compliant gripper for grasping size-varied unknown objects. The gripper module consists of one main frame structure and two identical compliant fingers. The compliant finger is a monolithic compliant mechanism synthesized using a topology optimization method, and then prototyped by 3D printing using flexible filament.

Bringing Patient-Centered Outcomes Research to Life.

A substantial gap exists between medical evidence that is known and medical evidence that is put into practice. Although the Agency for Healthcare Research and Quality (AHRQ) has a long history of developing the content of evidence, the agency now pivots to close that gap by focusing on evidence dissemination and implementation. Achieving better health outcomes requires both the generation of new patient-centered outcomes research (PCOR) knowledge and the appropriate and timely implementation of that knowledge into practice.

The National Emphysema Treatment Trial (NETT): a study in agency collaboration.

The National Emphysema Treatment Trial (NETT) was a multicenter, randomized, controlled clinical trial, comparing the efficacy of lung volume reduction surgery (LVRS) plus medical management with rehabilitation to medical management with rehabilitation in 1,218 patients with severe emphysema. The NETT was a precedent-setting collaborative effort of three government agencies: the Centers for Medicare and Medicaid Services (CMS); the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH); and the Agency for Healthcare Research and Quality (AHRQ). NETT provided Medicare beneficiaries with controlled access to a promising but unproven procedure, while scientifically valid data on the efficacy and costs were collected to guide future use, coverage decisions, and policy.

The validity of ICD-9-CM codes in identifying postoperative deep vein thrombosis and pulmonary embolism.

Background: Deep vein thrombosis and pulmonary embolism (DVT/PE) are common complications after surgery and are associated with substantial excess mortality and length of stay. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes recorded in hospital claims have been used to identify and study DVT/PE, but the validity of this method is not well studied.

Methods: Identification of postoperative DVT/PE events were compared using ICD-9-CM codes and medical record abstraction in random samples of hospital discharges of Medicare beneficiaries in 2002-2004.

Enhancing measurement in health outcomes research supported by Agencies within the US Department of Health and Human Services.

Many of the Institutes, Agencies and Centers that make up the US Department of Health and Human Services (DHHS) have recognized the need for better instrumentation in health outcomes research, and provide support, both internally and externally, for research utilizing advances in measurement theory and computer technology (informatics). In this paper, representatives from several DHHS agencies and institutes will discuss their need for better instruments within their discipline and describe current or future initiatives for exploring the benefits of these technologies. Together, the perspectives underscore the importance of developing valid, precise, and efficient measures to capture the full burden of disease and treatment on patients.

Modifying DRG-PPS to include only diagnoses present on admission: financial implications and challenges.

Objective: The inability to distinguish complications acquired in hospital from comorbid conditions that are present on admission (POA) has long hampered the use of claims data in quality and safety research. Now pay-for-performance initiatives and legislation requiring Medicare to reduce payment for acquired infections add imperative for POA coding. This study used data from 2 states currently coding POA to assess the financial impact if Medicare pays based on POA conditions only and to examine the challenges in implementing POA coding.