Sample solutions
A few recent case studies of solutions we’ve provided to clients.
A secure database for abstraction of medical data in clinical research
The need:
Dr. Salomeh Keyhani of UCSF is conducting a study of older veterans affected by carotid stenosis. Her team examines data from the vast Veteran’s Administration data system, to determine cohort members’ risk factors, image reports and surgical procedures. Dr. Keyhani needed database software to track and record the abstracted data, applying complex rules for eligibility, data validity, and classification by group.
The solution:
Quicksilver worked with Dr. Keyhani’s team to define and map out the study’s flow and rules. We then developed a Microsoft Access database (installed on a secure VA-approved virtual desktop) to match the study’s needs and flow. The application was developed in Access over VPN (rather than as a web application) to secure the project’s PHI in accordance with the VA’s requirements. The database uses extensive VBA programming to apply the study’s extensive business rules.
A web database for foster care youth
The need:
John Burton Advocates for Youth is a well-established nonprofit providing policy, training and advocacy in support of youth in the California foster care system. Policy-makers urgently needed reliable data on these youth as they moved through the system (e.g. progress in education, employment, housing, use of benefits, etc.) and beyond.
The solution:
We worked closely with JBAY to develop a web-based tracking system that collects data on the youth at entry, exit and quarterly intervals in between. The system provides fine-grained access to records and aggregate reports as appropriate for the specific user. Ten years later, the system is still in daily use and has even been cloned to a sister program.
A web-based gauge for medical assessment
The need:
Subarachnoid hemorrhage (SAH) is a neurological emergency. Newer forms of imaging are highly accurate in detecting SAH in the first six hours after onset. However, emergency rooms still commonly administer a lumbar puncture (LP) as part of a backup test if no bleeding is revealed through imaging. Is it possible to spare patients the risks and discomfort of LP, by giving ER physicians an easy way to calculate patient-specific risks and probabilities of SAH?
The solution:
Dr. Prasanthi Govindarajan of Stanford University asked Quicksilver to work her team’s probability algorithm into a visually striking, easy-to-use tool as proof of concept. The tool is described in A web-based decision tool…, published January, 2018.
Online statistical calculators
The need:
Dr. Michael Kohn of UCSF had a vision of a public-facing website offering free calculators to carry out statistical tests of interest to clinical researchers. Calculating the appropriate sample size for a research study can be challenging, especially if the control and affected groups are of different sizes. Dr. Kohn derived the algorithms and equations for many tests of interest, but needed a programmer to implement them in a single easy-to-navigate website.
The solution:
We developed the site sample-size.net, currently with seventeen of Dr. Kohn’s calculators implemented in PHP and Javascript. The site is very popular among researchers world-wide (over 29K distinct users a month, per last Google Analytics report!), and more calculators are in the works for future release.