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Purpose Outcome of endovascular treatment in acute ischemic stroke patients is depending on the collateral circulation maintaining blood flow to the ischemic territory. We evaluated the inter-rater reliability and accuracy of raters and an automated algorithm for assessing the collateral score (CS, range: 0–3) in acute ischemic stroke patients. Methods Baseline CTA scans with an intracranial anterior occlusion from the MR CLEAN study (n=500) were used. For each core lab CS, ten CTA scans with sufficient quality were randomly selected. After a training session in collateral scoring, all selected CTA scans were individually evaluated for a visual CS by three groups: 7 radiologists, 13 junior and 9 senior radiology residents. Two additional radiologists scored CS to be used as reference, with a third providing a CS to produce a 2 out of 3 consensus CS in case of disagreement. An automated algorithm was also used to compute CS. Inter-rater agreement was reported with intraclass correlation coefficient (ICC). Accuracy of visual and automated CS were calculated. Results 39 CTA scans were assessed (1 corrupt CTA-scan excluded). All groups showed a moderate ICC (0.689-0.780) in comparison to the reference standard. Overall human accuracy was 65± 7% and increased to 88± 5% for dichotomized CS (0–1, 2–3). Automated CS accuracy was 62%, and 90% for dichotomized CS. No significant difference in accuracy was found between groups with different levels of expertise. Conclusion After training, inter-rater reliability in collateral scoring was not influenced by experience. Automated CS performs similar to residents and radiologists in determining a collateral score.

In this paper, we describe the development of a collaborative approach to elicit and analyse service process experience as part of a project commissioned by the Dutch Ministry of Infrastructure and Environment. We designed and deployed a model-based instrument for measuring the experiences of both the general public and the civil servants, involved in information sharing, delivery and use and execution of environmental permit application services. In addition, information on the case-specific process structure that is underlying the service delivery was to be gathered with the instrument. We combined a collaborative, stakeholder-oriented process modelling technique with workshops, inspired by the CoMPArE method, with detailed service experience-oriented probing questions focusing on interactions, roles and process ‘bottlenecks’. We carried out a first, baseline measurement on the information, processes and experiences around environmental permit services through 6 identical six-hour workshop sessions with 67 civil servants. Our experiences in executing the baseline measurement are reported, as well as some main results, and lessons learned in developing and applying the workshop approach.

Equivalent results between different laboratories enable optimal patient care and can be achieved with harmonisation. We report on EQA-initiated national harmonisation of seven enzymes using commutable samples.EQA samples were prepared from human serum spiked with human recombinant enzymes. Target values were assigned with the IFCC Reference Measurement Procedures. The same samples were included at four occasions in the EQA programmes of 2012 and 2013. Laboratories were encouraged to report IFCC traceable results. A parallel study was done to confirm commutability of the samples.Of the 223 participating laboratories, 95% reported IFCC traceable results, ranging from 98% (ASAT) to 87% (amylase). Users of Roche and Siemens (97%) more frequently reported in IFCC traceable results than users of Abbott (91%), Beckman (90%), and Olympus (87%). The success of harmonisation, expressed as the recovery of assigned values and the inter-laboratory CV was: ALAT (recovery 100%; inter-lab CV 4%), ASAT (102%; 4%), LD (98%; 3%), CK (101%; 5%), GGT (98%; 4%), AP (96%; 6%), amylase (99%; 4%). There were no significant differences between the manufacturers. Commutability was demonstrated in the parallel study. Equal results in the same sample in the 2012 and 2013 EQA programmes demonstrated stability of the samples.The EQA-initiated national harmonisation of seven enzymes, using stable, commutable human serum samples, spiked with human recombinant enzymes, and targeted with the IFCC Reference Measurement Procedures, was successful in terms of implementation of IFCC traceable results (95%), recovery of the target (99%), and inter-laboratory CV (4%).

Deformation measurements are important in the field of ground engineering. Deformation can have a non-natural cause (e.g., surface deformation due to tunnel construction) or a natural one (e.g., dike deformation due to a high water level). Radar interferometry can in principle provide deformations with millimetre to centimetre accuracy over large areas. This report describes the work carried out for the BCRS project "2-D deformationmeasurements with ASAR and PHARUS". The objective of this project was: To develop and evaluate the capabilities and limitations of the combined me ofspaceborne (ASAR) and airborne SAR for two-dimensional deformation measurements in a representative ground engineering application, namely the monitoring of the settlement and deformation of river dikes in The Netherlands. This report is the sequel to the BCRS report "Repeat pass interferometry with PHARUS" (NRSP-2 report 00-23) which described details of the technique, e.g., about the necessary precision navigation, beam steering etc.