scholarly journals Online symptom checker diagnostic and triage accuracy for HIV and hepatitis C

2019 ◽  
Vol 147 ◽  
Author(s):  
A.C. Berry ◽  
B.D. Cash ◽  
B. Wang ◽  
M.S. Mulekar ◽  
A.B. Van Haneghan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Hepatitis C ◽  
Diagnostic Accuracy ◽  
Real Life ◽  
Consecutive Series ◽  
Specific Patient ◽  
Complex Patient ◽  
Complex Patients ◽  
Geographic Regions ◽  
Diagnostic Capabilities

AbstractWe sought to address the prior limitations of symptom checker accuracy by analysing the diagnostic and triage feasibility of online symptom checkers using a consecutive series of real-life emergency department (ED) patient encounters, and addressing a complex patient population – those with hepatitis C or HIV. We aimed to study the diagnostic and triage accuracy of these symptom checkers in relation to an emergency room physician-determined diagnosis. An ED retrospective analysis was performed on 8363 consecutive adult patients. Eligible patients included: 90 HIV, 67 hepatitis C, 11 both HIV and hepatitis C. Five online symptom checkers were utilised for diagnosis (Mayo Clinic, WebMD, Symptomate, Symcat, Isabel), three with triage capabilities. Symptom checker output was compared with ED physician-determined diagnosis data in regards to diagnostic accuracy and differential diagnosis listing, along with triage advice. All symptom checkers, whether for combined HIV and hepatitis C, HIV alone or hepatitis C alone had poor diagnostic accuracy in regards to Top1 (<20%), Top3 (<35%), Top10 (<40%), Listed at All (<45%). Significant variations existed for each individual symptom checker, as some appeared more accurate for listing the diagnosis in the top of the differential, vs. others more apt to list the diagnosis at all. In regards to ED triage data, a significantly higher percentage of hepatitis C patients (59.7%; 40/67) were found to have an initial diagnosis with emergent criteria than HIV patients (35.6%; 32/90). Symptom checker diagnostic capabilities are quite inferior to physician diagnostic capabilities. Complex patients such as those with HIV or hepatitis C may carry a more specific differential diagnosis, warranting symptom checkers to have diagnostic algorithms accounting for such complexity. Symptom checkers carry the potential for real-time epidemiologic monitoring of patient symptoms, as symptom entries and subsequent symptom checker diagnosis could allow health officials a means to track illnesses in specific patient populations and geographic regions. In order to do this, accurate and reliable symptom checkers are warranted.

scholarly journals Possibilities of Automated Diagnostics of Odontogenic Sinusitis According to the Computer Tomography Data

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1198
Author(s):  
Oleg G. Avrunin ◽  
Yana V. Nosova ◽  
Ibrahim Younouss Abdelhamid ◽  
Sergii V. Pavlov ◽  
Natalia O. Shushliapina ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Real Life ◽  
Tomographic Images ◽  
Anatomical Features ◽  
Multiplanar Reconstructions ◽  
Urgent Task ◽  
Odontogenic Sinusitis ◽  
Diagnostic Capabilities ◽  
Tomography Data ◽  
Maxillary Sinuses

Individual anatomical features of the paranasal sinuses and dentoalveolar system, the complexity of physiological and pathophysiological processes in this area, and the absence of actual standards of the norm and typical pathologies lead to the fact that differential diagnosis and assessment of the severity of the course of odontogenic sinusitis significantly depend on the measurement methods of significant indicators and have significant variability. Therefore, an urgent task is to expand the diagnostic capabilities of existing research methods, study the significance of the measured indicators, and substantiate the expediency of their use in the diagnosis of specific pathologies in an automated mode. Methods of digital filtering, image segmentation and analysis, fluid dynamics, and statistical and discriminant analysis were used. Preliminary differential diagnosis of odontogenic sinusitis can be performed by densitemetric analysis of tomographic images of the maxillary sinuses, performed using frontal multiplanar reconstructions according to a given algorithm. The very manifestation of the characteristic changes in the densitography of the maxillary sinus allows for the initiation of certain pathological processes and permits the development of the effectiveness of the diagnosis of the pathology of the sinus sinuses, which can be realized automatically in real life.

Position Paper on Treatment of Hepatitis C in Romania 2017. Part Two

2017 ◽  
Vol 26 (3) ◽  
pp. 309-317 ◽  
Author(s):  
Liana Gheorghe ◽  
Ioan Sporea ◽  
Speranța Iacob ◽  
Roxana Șirli ◽  
Anca Trifan ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Sustained Virologic Response ◽  
Real Life ◽  
Virologic Response ◽  
Position Paper ◽  
Hcv Infection ◽  
End Stage Liver Disease ◽  
End Stage

Background & Aims: Hepatitis C virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania, the mean prevalence is about 3%. New treatments have become available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country.Methodology: A group of recognized experts was created who screened the available literature and the major available guidelines. A list of items requiring attention was created and these were discussed and rated. Decisions were taken by consensus.Recommendations: We present here the second part of the Society’s recommendations for chronic HCV infection treatment. An agreement between experts was reached regarding the therapy of the special categories of patients infected with HCV, complications and monitoring of the therapy, follow-up of the patients who reached sustained virologic response and re-treatment of the patients with therapy failure.Conclusions: This Position Paper represents a guide for the assessment and the therapy of HCV infection. The recommendations are in concordance with other guidelines but are applied to real-life conditions in Romania. Abbreviations: CKD: Chronic kidney disease; DAAs: Direct-acting antivirals; DDIs: Drug-drug interactions; ESDL: End-stage liver disease; FCH: Fibrosing cholestatic hepatitis; GT: Genotype; HCV: Hepatitis C virus; HCC: Hepatocellular carcinoma; LT: Liver transplantation; MELD score: Mayo-Clinic End-Stage Liver Disease score; PDC: Premature discontinuation; PWID: Persons who inject drugs; RASs: Resistance associated substitutions; RBV: Ribavirin; RCT: Randomized controlled trial; SAE: Serious adverse events; SRGH: Romanian Society of Gastroenterology and Hepatology; SVR: Sustained virologic response.

Assessing the diagnostic capabilities of the app DemDx in an acute care setting (Preprint)

2018 ◽  
Author(s):  
Cian Murphy
Keyword(s):  
Differential Diagnosis ◽  
Care Setting ◽  
Medical Student Education ◽  
Initial Assessment ◽  
Junior Doctors ◽  
Doctor Who ◽  
Clinical Accuracy ◽  
Education Tool ◽  
Clinical Records ◽  
Diagnostic Capabilities

UNSTRUCTURED DemDx is a differential diagnosis app for students and junior doctors. Starting with a patient’s presenting complaint the app goes through a step-by-process through history, examination and investigation findings to an increasingly refined differential diagnosis list until a single most likely diagnosis is reached. The aim of this project was to assess the accuracy of DemDx in an Emergency Department (ED) setting. Anonymised clinical records for 100 patients were retrospectively obtained from the ED in Beth Israel, Boston, USA. This contained the differential diagnoses from the clerking doctor, who performed the initial assessment (D1). The discharge diagnosis was used as the gold standard diagnosis (D2). D1 agreed with D2 in 74.44% of cases while DemDx agreed with D2 in 85.56% of cases (p=0.0003716). When the first, and thus most likely, differential was taken from D1 and DemDx, they agreed with D2 in 20 and 18.8% of cases, respectively (p=0.1428). This demonstration of the clinical accuracy of the app highlights how it can be a useful medical student education tool.

A Serological Storm

1970 ◽  
Vol 9 (2) ◽  
Author(s):  
Bertha Wong MD ◽  
Maria Bagovich MD ◽  
Ivan Blasutig PhD ◽  
Simon Carette MD MPhil
Keyword(s):  
Differential Diagnosis ◽  
Hepatitis C Virus ◽  
Immune System ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Clinical Context ◽  
Autoantibody Profile ◽  
Life Threatening ◽  
Clinically Significant ◽  
Sensory Polyneuropathy

This article describes a patient presenting with a sensory polyneuropathy and multiple autoantibodies, leading to the diagnosis of hepatitis C virus (HCV) infection. His widely positive autoantibody profile in the absence of clinically significant rheumatic disease illustrates the importance of interpreting autoimmune serology in the appropriate clinical context and the concept of HCV being a non-specific activator of the immune system. In addition, it highlights the importance of considering untreated HCV infection in the differential diagnosis of rheumatic complaints, particularly if the workup reveals multiple autoantibodies, as HCV is a potentially severe and life-threatening disease, which can be appropriately managed with effective antiviral therapy.

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