scholarly journals Evaluation of Triage Tests When Existing Test Capacity Is Constrained: Application to Rapid Diagnostic Testing in COVID-19

2021 ◽  
pp. 0272989X2110141
Author(s):  
Janet Bouttell ◽  
Neil Hawkins
Keyword(s):  
Diagnostic Tests ◽  
Diagnostic Testing ◽  
High Accuracy ◽  
Cost Utility ◽  
Polymerase Chain Reaction Test ◽  
Lower Sensitivity ◽  
Reference Test ◽  
Rapid Diagnostic Testing ◽  
Lower Accuracy ◽  
Triage Test

Objectives A triage test is used to determine which patients will undergo an existing or “reference” test. This article explores the potential value of using triage tests before reference tests when the capacity of the reference test is constrained. Methods We developed a simple model with inputs: prevalence, sensitivity, specificity, and reference test capacity. We included a case study of rapid diagnostic tests for SARS-CoV-2 antigens used as triage tests before a reference polymerase chain reaction test. Performance data were obtained from an evaluation performed by an academic center on 425 samples from testing centers in the United Kingdom and Germany. Results When reference test capacity is constrained, the use of a triage test leads to a relative expansion of the population tested and cases identified; both are higher with a high-specificity triage test. When reference test capacity is not constrained, the potential advantages of introducing a triage test can be assessed using a standard cost-utility framework, balancing the utility of the reduction in the number of reference tests required against the disutility of missed cases associated with the use of a lower-sensitivity triage test. In the constrained case, the advantage of a triage testing strategy in terms of population covered and cases identified is reduced as the prevalence increases. In the unconstrained case, the reduction in reference tests required is reduced and the number of cases missed increase as the prevalence rises. Conclusion When the availability of the reference test is constrained, tests added in a triage position do not need high levels of accuracy to increase the number of cases diagnosed. This has implications in many disease areas, including COVID-19. Twitter: Lower-accuracy #COVID19 tests can still be useful, according to a new article, “Evaluation of Triage Tests When Existing Test Capacity Is Constrained: Application to Rapid Diagnostic Testing in COVID-19,” co-authored by @janetbouttell & @NeilSHawkins @HEHTAGlasgow @MedDecMak There is much emphasis on high-accuracy #COVID19 tests, but lower-accuracy tests have their place, according to a new study on triage tests when test capacity is constrained, co-authored by @janetbouttell & @NeilSHawkins @HEHTAGlasgow @MedDecMak A new study, co-authored by @janetbouttell & @NeilSHawkins @HEHTAGlasgow, has shown that when there is limited capacity of high-accuracy #COVID19 diagnostic tests, triage testing strategies can increase the population covered and the number of #COVID19 cases identified. @MedDecMak

scholarly journals Predictors of Time to Effective and Optimal Antimicrobial Therapy in Patients With Positive Blood Cultures Identified via Molecular Rapid Diagnostic Testing

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Maya Beganovic ◽  
Tristan T Timbrook ◽  
Sarah M Wieczorkiewicz
Keyword(s):  
Patient Outcomes ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
Diagnostic Tests ◽  
Diagnostic Testing ◽  
Rapid Diagnostic Tests ◽  
Blood Cultures ◽  
Effective Therapy ◽  
Rapid Diagnostic Testing ◽  
Optimal Therapy

Abstract Antimicrobial stewardship (AMS) programs integrated with rapid diagnostic tests optimize patient outcomes and reduce time to effective therapy (TTET) and time to optimal therapy (TTOT). This study identifies predictors of TTET and TTOT among patients with positive blood cultures and identifies limitations to current TTOT definitions and outcomes.

scholarly journals SPREAD OF TOXOPLASMOSIS AND RAPID DIAGNOSTIC TESTING

2020 ◽  
pp. 307-312
Author(s):  
M. Novak ◽  
A. Novak ◽  
S. Nazarova
Keyword(s):  
Diagnostic Testing ◽  
Rapid Test ◽  
High Accuracy ◽  
Statistical Information ◽  
Diagnostic Methods ◽  
Disease Spread ◽  
Wide Spread ◽  
Rapid Diagnostic Testing ◽  
Hygienic Measures ◽  
The Russian Federation

The study of statistical information on the Central Region of the Russian Federation and the results of studies of pigs and mouse-like rodents using the immunochromatographic method (IHM) showed a wide spread of toxoplasmosis. The preventive and sanitary-hygienic measures prescribed by the veterinary legislation and the health and hygiene rules and standards for toxoplasmosis are not sufficiently implemented, which results in the disease spread. Toxoplasma immunoreagents developed for the immunochromatographic method were studied in accordance with the standard requirements (activity, specificity), and an IHM rapid test was checked for information content (diagnostic effectiveness). The IHM rapid test allows us to detect Toxoplasma gondii antigens in the blood and tissues of animals with high accuracy and, in combination with other diagnostic methods (IIT, PCR), to determine the stage and form of the course of the disease. The use of the IHM rapid test in medical and veterinary practice will allow a detailed study of the epidemic and epizootic situation on toxoplasmosis in Russia, and carrying out comprehensive measures based on the results of screening.

scholarly journals Overuse of diagnostic testing in healthcare: a systematic review

2021 ◽  
pp. bmjqs-2020-012576
Author(s):  
Joris L J M Müskens ◽  
Rudolf Bertijn Kool ◽  
Simone A van Dulmen ◽  
Gert P Westert
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Tests ◽  
Patient Population ◽  
English Language ◽  
Diagnostic Testing ◽  
Low Back ◽  
Preoperative Testing ◽  
Healthcare Settings ◽  
Major Variation

BackgroundOveruse of diagnostic testing substantially contributes to healthcare expenses and potentially exposes patients to unnecessary harm. Our objective was to systematically identify and examine studies that assessed the prevalence of diagnostic testing overuse across healthcare settings to estimate the overall prevalence of low-value diagnostic overtesting.MethodsPubMed, Web of Science and Embase were searched from inception until 18 February 2020 to identify articles published in the English language that examined the prevalence of diagnostic testing overuse using database data. Each of the assessments was categorised as using a patient-indication lens, a patient-population lens or a service lens.Results118 assessments of diagnostic testing overuse, extracted from 35 studies, were included in this study. Most included assessments used a patient-indication lens (n=67, 57%), followed by the service lens (n=27, 23%) and patient-population lens (n=24, 20%). Prevalence estimates of diagnostic testing overuse ranged from 0.09% to 97.5% (median prevalence of assessments using a patient-indication lens: 11.0%, patient-population lens: 2.0% and service lens: 30.7%). The majority of assessments (n=85) reported overuse of diagnostic testing to be below 25%. Overuse of diagnostic imaging tests was most often assessed (n=96). Among the 33 assessments reporting high levels of overuse (≥25%), preoperative testing (n=7) and imaging for uncomplicated low back pain (n=6) were most frequently examined. For assessments of similar diagnostic tests, major variation in the prevalence of overuse was observed. Differences in the definitions of low-value tests used, their operationalisation and assessment methods likely contributed to this observed variation.ConclusionOur findings suggest that substantial overuse of diagnostic testing is present with wide variation in overuse. Preoperative testing and imaging for non-specific low back pain are the most frequently identified low-value diagnostic tests. Uniform definitions and assessments are required in order to obtain a more comprehensive understanding of the magnitude of diagnostic testing overuse.

scholarly journals Deep learning for cephalometric landmark detection: systematic review and meta-analysis

2021 ◽  
Author(s):  
Falk Schwendicke ◽  
Akhilanand Chaurasia ◽  
Lubaina Arsiwala ◽  
Jae-Hong Lee ◽  
Karim Elhennawy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Learning ◽  
Meta Analysis ◽  
High Accuracy ◽  
Risk Of Bias ◽  
Automated Detection ◽  
Reference Test ◽  
Landmark Detection ◽  
Future Studies ◽  
Using Data

Abstract Objectives Deep learning (DL) has been increasingly employed for automated landmark detection, e.g., for cephalometric purposes. We performed a systematic review and meta-analysis to assess the accuracy and underlying evidence for DL for cephalometric landmark detection on 2-D and 3-D radiographs. Methods Diagnostic accuracy studies published in 2015-2020 in Medline/Embase/IEEE/arXiv and employing DL for cephalometric landmark detection were identified and extracted by two independent reviewers. Random-effects meta-analysis, subgroup, and meta-regression were performed, and study quality was assessed using QUADAS-2. The review was registered (PROSPERO no. 227498). Data From 321 identified records, 19 studies (published 2017–2020), all employing convolutional neural networks, mainly on 2-D lateral radiographs (n=15), using data from publicly available datasets (n=12) and testing the detection of a mean of 30 (SD: 25; range.: 7–93) landmarks, were included. The reference test was established by two experts (n=11), 1 expert (n=4), 3 experts (n=3), and a set of annotators (n=1). Risk of bias was high, and applicability concerns were detected for most studies, mainly regarding the data selection and reference test conduct. Landmark prediction error centered around a 2-mm error threshold (mean; 95% confidence interval: (–0.581; 95 CI: –1.264 to 0.102 mm)). The proportion of landmarks detected within this 2-mm threshold was 0.799 (0.770 to 0.824). Conclusions DL shows relatively high accuracy for detecting landmarks on cephalometric imagery. The overall body of evidence is consistent but suffers from high risk of bias. Demonstrating robustness and generalizability of DL for landmark detection is needed. Clinical significance Existing DL models show consistent and largely high accuracy for automated detection of cephalometric landmarks. The majority of studies so far focused on 2-D imagery; data on 3-D imagery are sparse, but promising. Future studies should focus on demonstrating generalizability, robustness, and clinical usefulness of DL for this objective.

scholarly journals Implementation of a Pharmacist-Directed Antimicrobial Stewardship Protocol Utilizing Rapid Diagnostic Testing

2016 ◽  
Vol 51 (10) ◽  
pp. 815-822 ◽  
Author(s):  
Angel Heyerly ◽  
Ron Jones ◽  
Gordon Bokhart ◽  
Mary Shoaff ◽  
Douglas Fisher
Keyword(s):  
Antimicrobial Stewardship ◽  
Diagnostic Testing ◽  
Rapid Diagnostic Testing

Limitations of rapid diagnostic testing in the work-up of dengue infection – a case report

2020 ◽  
Vol 58 (10) ◽  
pp. e245-e246
Author(s):  
Shaun S. Tan ◽  
Sharon Saw ◽  
Gabriel Yan ◽  
Ai Teng Chong ◽  
Zhixin Yang ◽  
...  
Keyword(s):  
Case Report ◽  
Dengue Infection ◽  
Diagnostic Testing ◽  
Rapid Diagnostic Testing ◽  
Work Up

Analysis of the tendency of development of biosensors based on GaN

2021 ◽  
Author(s):  
S.I. Agasieva ◽  
E.A. Smetanin ◽  
A.R. Vechkanov ◽  
A.V. Gubanov
Keyword(s):  
Clinical Trials ◽  
Infectious Diseases ◽  
Diagnostic Tests ◽  
Diagnostic Testing ◽  
Healthcare Systems ◽  
Clinical Analysis ◽  
Molecular Diagnostic ◽  
Economic Damage ◽  
Disease Research ◽  
Local Healthcare

Statement of the problem of this article - one of the most important problems is protection from especially dangerous infectious diseases. The use of biosensors in clinical trials will significantly reduce the time for obtaining the results of analyzes, thereby speeding up the appointment of treatment to patients. The purpose of the article is to present modern designs of biosensors based on gallium nitride, the possibilities of their application and characteristics. Consider the principles of operation, areas of application and characteristics. As a result, the design of modern biosensors and modern trends in their use from various sources of literature in recent years are shown. Biosensors, principles of their action, areas of application and characteristics are considered, which will reduce the possible socio-economic damage from temporary disability for sick citizens due to the rapid and timely implementation of anti-epidemic measures. Practical value: the proposed biosensors are of interest as devices for detecting diseases. The use of biosensors in clinical disease research has several potential advantages over other clinical analysis methods, including increased analysis speed and flexibility, multipurpose analysis capability, automation, reduced diagnostic testing costs, and the ability to integrate molecular diagnostic tests into local healthcare systems.

scholarly journals Operational evaluation of rapid diagnostic testing for Ebola Virus Disease in Guinean laboratories

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0188047 ◽  
Author(s):  
Amanda VanSteelandt ◽  
Josephine Aho ◽  
Kristyn Franklin ◽  
Jacques Likofata ◽  
Jean Baptiste Kamgang ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Diagnostic Testing ◽  
Ebola Virus Disease ◽  
Rapid Diagnostic Testing

scholarly journals Emergence and evolution of Plasmodium falciparum histidine-rich protein 2 and 3 deletion mutant parasites in Ethiopia

2021 ◽  
Author(s):  
Sindew M. Feleke ◽  
Emily N. Reichert ◽  
Hussein Mohammed ◽  
Bokretsion G. Brhane ◽  
Kalkidan Mekete ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Falciparum Malaria ◽  
Diagnostic Tests ◽  
Deletion Mutant ◽  
Diagnostic Testing ◽  
Rapid Diagnostic Tests ◽  
Horn Of Africa ◽  
Diagnostic Strategies ◽  
Genomic Tools ◽  
Subtelomeric Deletion

AbstractMalaria diagnostic testing in Africa is threatened by Plasmodium falciparum parasites lacking histidine-rich protein 2 (pfhrp2) and 3 (pfhrp3) genes. Among 12,572 subjects enrolled along Ethiopia’s borders with Eritrea, Sudan, and South Sudan and using multiple assays, we estimate HRP2-based rapid diagnostic tests would miss 9.7% (95% CI 8.5-11.1) of falciparum malaria cases due to pfhrp2 deletion. Established and novel genomic tools reveal distinct subtelomeric deletion patterns, well-established pfhrp3 deletions, and recent expansion of pfhrp2 deletion. Current diagnostic strategies need to be urgently reconsidered in Ethiopia, and expanded surveillance is needed throughout the Horn of Africa.

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