ASSESSMENT OF DIAGNOSTIC TEST RESULT REPORTING AND FOLLOW-UP

2015 ◽  
pp. 329-368
2005 ◽  
Vol 44 (01) ◽  
pp. 124-126 ◽  
Author(s):  
W. Lehmacher ◽  
M. Hellmich

Summary Objectives: Bayes’ rule formalizes how the pre-test probability of having a condition of interest is changed by a diagnostic test result to yield the post-test probability of having the condition. To simplify this calculation a geometric solution in form of a ruler is presented. Methods: Using odds and the likelihood ratio of a test result in favor of having the condition of interest, Bayes’ rule can succinctly be expressed as ”the post-test odds equals the pre-test odds times the likelihood ratio”. Taking logarithms of both sides yields an additive equation. Results: The additive log odds equation can easily be solved geometrically. We propose a ruler made of two scales to be adjusted laterally. A different, widely used solution in form of a nomogram was published by Fagan [2]. Conclusions: Whilst use of the nomogram seems more obvious, the ruler may be easier to operate in clinical practice since no straight edge is needed for precise reading. Moreover, the ruler yields more intuitive results because it shows the change in probability due to a given test result on the same scale.


2006 ◽  
Vol 14 (7S_Part_15) ◽  
pp. P823-P823
Author(s):  
Leonie N.C. Visser ◽  
Sophie Pelt ◽  
Marij A. Hillen ◽  
Femke H. Bouwman ◽  
Wiesje M. Van der Flier ◽  
...  

2020 ◽  
Vol 27 (8) ◽  
pp. 1214-1224
Author(s):  
Judith Thomas ◽  
Maria R Dahm ◽  
Julie Li ◽  
Peter Smith ◽  
Jacqui Irvine ◽  
...  

Abstract Objective The management and follow-up of diagnostic test results is a major patient safety concern. The aim of this qualitative study was to explore how clinicians manage test results on an everyday basis (work-as-done) in a health information technology–enabled emergency department setting. The objectives were to identify (1) variations in work-as-done in test results management and (2) the strategies clinicians use to ensure optimal management of diagnostic test results. Materials and Methods Qualitative interviews (n = 26) and field observations were conducted across 3 Australian emergency departments. Interview data coded for results management (ie, tracking, acknowledgment, and follow-up), and artifacts, were reviewed to identify variations in descriptions of work-as-done. Thematic analysis was performed to identify common themes. Results Despite using the same test result management application, there were variations in how the system was used. We identified 5 themes relating to electronic test results management: (1) tracking test results, (2) use and understanding of system functionality, (3) visibility of result actions and acknowledgment, (4) results inbox use, and (5) challenges associated with the absence of an inbox for results notifications for advanced practice nurses. Discussion Our findings highlight that variations in work-as-done can function to overcome perceived impediments to managing test results in a HIT-enabled environment and thus identify potential risks in the process. By illuminating work-as-done, we identified strategies clinicians use to enhance test result management including paper-based manual processes, cognitive reminders, and adaptive use of electronic medical record functionality. Conclusions Test results tracking and follow-up is a priority area in need of health information technology development and training to improve team-based collaboration/communication of results follow-up and diagnostic safety.


2016 ◽  
Vol 55 (10) ◽  
pp. 1379-1382
Author(s):  
Toshihide Izumida ◽  
Hidenao Sakata ◽  
Masahiko Nakamura ◽  
Yumiko Hayashibara ◽  
Noriko Inasaki ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050667
Author(s):  
Meaghan Lunney ◽  
Paul E Ronksley ◽  
Robert G Weaver ◽  
Lianne Barnieh ◽  
Norman Blue ◽  
...  

ObjectivesThis report estimates the risk of COVID-19 importation and secondary transmission associated with a modified quarantine programme in Canada.Design and participantsProspective analysis of international asymptomatic travellers entering Alberta, Canada.InterventionsAll participants were required to receive a PCR COVID-19 test on arrival. If negative, participants could leave quarantine but were required to have a second test 6 or 7 days after arrival. If the arrival test was positive, participants were required to remain in quarantine for 14 days.Main outcome measuresProportion and rate of participants testing positive for COVID-19; number of cases of secondary transmission.ResultsThe analysis included 9535 international travellers entering Alberta by air (N=8398) or land (N=1137) that voluntarily enrolled in the Alberta Border Testing Pilot Programme (a subset of all travellers); most (83.1%) were Canadian citizens. Among the 9310 participants who received at least one test, 200 (21.5 per 1000, 95% CI 18.6 to 24.6) tested positive. Sixty-nine per cent (138/200) of positive tests were detected on arrival (14.8 per 1000 travellers, 95% CI 12.5 to 17.5). 62 cases (6.7 per 1000 travellers, 95% CI 5.1 to 8.5; 31.0% of positive cases) were identified among participants that had been released from quarantine following a negative test result on arrival. Of 192 participants who developed symptoms, 51 (26.6%) tested positive after arrival. Among participants with positive tests, four (2.0%) were hospitalised for COVID-19; none required critical care or died. Contact tracing among participants who tested positive identified 200 contacts; of 88 contacts tested, 22 were cases of secondary transmission (14 from those testing positive on arrival and 8 from those testing positive thereafter). SARS-CoV-2 B.1.1.7 lineage was not detected in any of the 200 positive cases.Conclusions21.5 per 1000 international travellers tested positive for COVID-19. Most (69%) tested positive on arrival and 31% tested positive during follow-up. These findings suggest the need for ongoing vigilance in travellers testing negative on arrival and highlight the value of follow-up testing and contact tracing to monitor and limit secondary transmission where possible.


2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982731 ◽  
Author(s):  
Graham D. Pallante ◽  
Shawn W. O’Driscoll

Background: The hook test is a sensitive and specific tool that has been previously described for diagnosing distal biceps tendon ruptures in an efficient, cost-effective manner. However, its application in postoperative evaluations after surgical repair of distal biceps tendon ruptures is not documented. Hypothesis/Purpose: We hypothesized that the hook test result returns to normal at some point postoperatively after distal biceps repair. This information could be used in decision making during follow-up examinations with both normal and abnormal findings. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: We retrospectively reviewed records of distal biceps repair. Between July 1, 2003, and July 1, 2016, a total of 56 patients underwent distal biceps repair and also had clear documentation of the results of the hook test during the postoperative period. Hook test results consisted of “intact,” “abnormal,” or “absent.” The timing of the return to a normal hook test result was recorded. Results: Overall, 51 of 57 (89%) repairs were documented to have the hook test result return to “intact.” The test result returned to intact by a mean of 10 weeks after surgery (range, 2 weeks to 15 months). The biceps tendon was intact according to the hook test at the 4-month follow-up in 45 of the 51 patients (88%) in whom it ultimately returned. The hook test result was abnormal in 5 repairs in 5 patients with only a short-term follow-up, ranging from 2 to 7 weeks postoperatively. One patient with an abnormal hook test result at 2 weeks postoperatively underwent revision and was confirmed to have a partial tear of the biceps insertion. His hook test result returned to intact 3 months after revision repair. Conclusion: The hook test result returns to normal in patients who undergo distal biceps repair in the primary and revision settings with adequate follow-up. The vast majority of patients have a normal hook test result by 4 months postoperatively. An abnormal hook test result at 4 months postoperatively may indicate a failed repair and should prompt further investigation.


1960 ◽  
Vol 106 (445) ◽  
pp. 1486-1492 ◽  
Author(s):  
James Inglis ◽  
Catherine Colwell ◽  
Felix Post

Few studies of psychological tests which have been shown to differentiate between psychiatric groups have attempted to follow-up the patients originally tested so as to determine what the predictive power of the test might be in the light of subsequent events. One of these few studies has been reported by Walton (1958) and commented upon by Inglis (1959) who was able to show that the test Walton described was better able to predict the outcome of illness after a follow-up period of two years, than was the original diagnostic label. The importance of this kind of study has been pointed out most clearly by Payne (1958). His argument is that, “Description is only one implication of the diagnostic label. Can the test score aid the doctor in making a prognosis? This need not be the case. Let us consider the original validation of the test again. The doctor who diagnosed the standardization group of patients might well be able to give a more or less accurate prognosis for this group of patients. In fact there might be a significant relationship between the presence or absence of the label he assigns, and prognosis. We also know that there is a significant correlation between presence or absence of his label and the test scores. This does not prove, however, that there is any relationship whatsoever between the diagnostic test score and prognosis. Two things which correlate with the same thing do not necessarily correlate with each other, unless the correlations concerned are greater than ·7” (1958, p. 27).


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