Maternal and Child Health Care Quality Assessment: An Improved Approach Using K-Means Clustering

High maternal and child deaths in developing countries are frequently linked to poor health services provided to pregnant women and children. To improve the quality of maternal, neonatal and child health (MNCH) services, the government and other stakeholders in MNCH emphasize the importance of quality assessment. However, effective quality assessment approaches are mostly lacking in most developing countries, particularly in Tanzania. This study, therefore, aimed at developing a quality assessment approach that can effectively assess and report on the quality of MNCH services. Due to the need for a good quality assessment approach that suits a resource-constrained environment, machine learning-based approach was proposed and developed. K-means algorithm was used to develop a clustering model that groups MNCH data and performs cluster summarization to discover the knowledge portrayed in each group on the quality of MNCH services. Results confirmed the clustering model’s ability to assign the data points into appropriate clusters;cluster analysis with the collaboration of MNCH experts successfully discovered insights on the quality of services portrayed by each group.

Value of quality of life analysis in liver cancer: A clinician's perspective

Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.