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Although the Mexican government has agreed to a series of actions to enhance its counternarcotics capacity and the United States has begun to provide a larger level of assistance , no performance measures have been established to assess the effectiveness of these efforts . This information would have been used to assess the necessity for funding these types of projects . Several special instruments have been developed to assess autism . Although rubrics have been designed to assess the overall quality of online courses ( e.g ., see http://www.csuchico.edu/celt/roi/ ) , the rubric described here marks the first time such an instrument has focused on quality of interaction in distance courses and has collected data to validate the instrument in practice . He is one of the originators ( together with Frederick L. Grover , MD ) in 1987 of the ongoing VA Continuous Improvement in Cardiac Surgery Program , where risk-adjusted outcomes have been used to assess and improve the quality of cardiac surgery throughout the VA . Nurse Run allergy Clinic is staffed by registered nurses that have been trained to assess and treat people with seasonal allergies without a history of asthma . To increase the sensitivity to change , disease-specific measures have been developed to assess the impairment of chronic sinusitis and the effects of interventions .