scholarly journals Patient’s travel distance to specialised cancer diagnostics and the association with the general practitioner’s diagnostic strategy and satisfaction with the access to diagnostic procedures: an observational study in Denmark

2020 ◽  
Author(s):  
Line Flytkjær Virgilsen ◽  
Line Hvidberg ◽  
Peter Vedsted
Keyword(s):  
Medical Treatment ◽  
Waiting Time ◽  
Travel Distance ◽  
Diagnostic Process ◽  
Diagnostic Strategy ◽  
Long Distance ◽  
Serious Illness ◽  
Diagnostic Facility ◽  
Wait And See ◽  
Diagnostic Investigations

Abstract Background: Research indicate that when general practitioners (GPs) refer their patients for specialist care, the patient often has long distance. This study had a twofold aim: in accordance to the GP’s suspicion of cancer, we investigated the association between: 1) cancer patient’s travel distance to the first specialised diagnostic facility and the GP’s diagnostic strategy and 2) cancer patient’s travel distance to the first specialised diagnostic facility and satisfaction with the waiting time and the availability of diagnostic investigations.Method: This combined questionnaire- and registry-based study included incident cancer patients diagnosed in the last six months of 2016 where the GP had been involved in the diagnostic process of the patients prior to their diagnosis of cancer (n=3,455). The patient’s travel distance to the first specialised diagnostic facility was calculated by ArcGIS Network Analyst. The diagnostic strategy of the GP and the GP’s satisfaction with the waiting times and the available investigations were assessed from GP questionnaires. Results: When the GP did not suspect cancer or serious illness, an insignificant tendency was seen that longer travel distance to the first specialised diagnostic facility increased the likelihood of the GP using ’wait-and-see’ approach and ’medical treatment’ as diagnostic strategies. The GPs of patients with travel distance longer than 49 kilometres to the first specialised diagnostic facility were more likely to report dissatisfaction with the waiting time for requested diagnostic investigations (PR: 1.98, 95% CI: 1.20-3.28).Conclusion: A insignificant tendency to use ‘wait-and-see’ and ‘medical treatment’ were more likely in GPs of patients with long travel distance to the first diagnostic facility when the GP did not suspect cancer or serious illness. Long distance was associated with higher probability of GP dissatisfaction with the waiting time for diagnostic investigations.

scholarly journals Patient’s travel distance to specialised cancer diagnostics and the association with the general practitioner’s diagnostic strategy and satisfaction with the access to diagnostic procedures: an observational study in Denmark

2020 ◽  
Author(s):  
Line Flytkjær Virgilsen ◽  
Line Hvidberg ◽  
Peter Vedsted
Keyword(s):  
Medical Treatment ◽  
Waiting Time ◽  
Travel Distance ◽  
Diagnostic Process ◽  
Diagnostic Strategy ◽  
Long Distance ◽  
Diagnostic Investigation ◽  
Serious Illness ◽  
Wait And See ◽  
Diagnostic Investigations

Abstract Background: Patients with cancer often consult their general practitioner (GP) prior to the diagnosis. Thus, actions taken by the GP are crucial for optimisation of cancer care. This study aimed to investigate the association between cancer patient’s travel distance to the first specialised diagnostic investigation and the GP’s diagnostic strategy and satisfaction with the waiting time and the availability of diagnostic investigations.Method: This combined questionnaire- and registry-based study included incident cancer patients diagnosed in the last six months of 2016 where the GP had been involved in the diagnostic process of the patients prior to their diagnosis of cancer (n=3,455). The patient’s travel distance to the first specialised diagnostic investigation was calculated by ArcGIS Network Analyst. The diagnostic strategy of the GP and the GP’s satisfaction with the waiting times and the available investigations were assessed from GP questionnaires. Results: The patient’s travel distance to the first specialised diagnostic investigation was not associated with the diagnostic strategy of the GP. However, when the GP did not suspect cancer or serious illness, a tendency was seen that longer travel distance to the first specialised diagnostic investigation increased the likelihood of the GP using ’wait-and-see’ approach and ’medical treatment’ as diagnostic strategies. The GPs of patients with travel distance longer than 49 kilometres to the first specialised diagnostic investigation were more likely to report dissatisfaction with the waiting time for requested diagnostic investigations (PRR: 1.98, 95% CI: 1.20-3.28).Conclusion: A tendency to use ‘wait-and-see’ and ‘medical treatment’ were more likely in GPs of patients with long travel distance to the first diagnostic investigation when the GP did not suspect cancer or serious illness. Long distance was associated with higher probability of GP dissatisfaction with the waiting time for diagnostic investigations.

Factors influencing inbound medical travel to India

2019 ◽  
Vol 33 (2) ◽  
pp. 155-172 ◽  
Author(s):  
Anita Medhekar ◽  
Ho Yin Wong ◽  
John Edward Hall
Keyword(s):  
Patient Safety ◽  
Medical Treatment ◽  
Waiting Time ◽  
Policy Implications ◽  
Private Hospitals ◽  
Content Type ◽  
Post Surgery ◽  
Factors Influencing ◽  
Travel Abroad ◽  
Treatment Surgery

PurposeThe purpose of this paper is to explore the demand-side factors that influence the inbound medical tourists’ (MTs) decision to travel abroad for medical treatment/surgery.Design/methodology/approachThe researchers conducted thematic analysis of in-depth interviews in India with 24 foreign MTs’ to generate the themes, identify factors and propose a model with hypothesis for future quantitative survey.FindingsThe findings conclude that patients ranked in ascending order less waiting time for surgery, healthcare quality and accreditation, staff/surgeons expertise, healthcare information, hospital facilities and services, patient safety, travel risk, surgical costs and holiday opportunity as important factors that influence the decision to travel abroad for medical treatment/surgery.Research limitations/implicationsForeign patients from six private hospitals were willing to be interviewed with the permission of the hospital. Due to confidentiality and privacy policy, many hospitals declined interviews with foreign patients.Practical implicationsThe findings are generalised in case of foreign patients as MTs and all private hospitals treating foreign patients in India and other global healthcare destinations. Policy implications suggest that private hospitals in developing countries need to provide first-class quality of healthcare as foreign patients look for internationally accredited quality, no waiting time, patient safety, qualified and experienced surgeons, healthcare workers education and experience hospital facilities and post-surgery care with positive healthcare outcomes.Originality/valueThere is little empirical research on the views of inbound MTs, about factors influencing their decision to travel abroad for surgery to India.

scholarly journals Assessment of Discordance Between Surrogate Care Goals and Medical Treatment Provided to Older Adults With Serious Illness

2020 ◽  
Vol 3 (5) ◽  
pp. e205179
Author(s):  
Amber R. Comer ◽  
Susan E. Hickman ◽  
James E. Slaven ◽  
Patrick O. Monahan ◽  
Greg A. Sachs ◽  
...  
Keyword(s):  
Older Adults ◽  
Medical Treatment ◽  
Serious Illness

Diagnostic Strategy for Suspected Scaphoid Fractures in the Presence of Other Fractures in the Carpal Region

2006 ◽  
Vol 31 (4) ◽  
pp. 416-418 ◽  
Author(s):  
F. J. P. BEERES ◽  
M. HOGERVORST ◽  
P. DEN HOLLANDER ◽  
S. J. RHEMREV
Keyword(s):  
Bone Scintigraphy ◽  
Bone Fractures ◽  
Scaphoid Fracture ◽  
Diagnostic Process ◽  
Scaphoid Bone ◽  
Diagnostic Strategy ◽  
X Rays ◽  
Scaphoid Fractures ◽  
Bone Injury ◽  
Suspected Scaphoid Fracture

Bone scintigraphy will identify up to 25% of occult scaphoid bone fractures after negative scaphoid X-rays. Consequently, it deserves a place in the diagnostic process of suspected scaphoid fractures. However, the role of bone scintigraphy is less clear if scaphoid X-rays show other fractures in the carpal region. We analysed 111 consecutive patients with a suspected scaphoid fracture on physical examination. Scaphoid X-rays revealed 61 fractures. Fifty-five patients had scaphoid fractures only and six patients had other fractures in the carpal region but no scaphoid fracture. In 50 cases, no bone injury was seen on these X-rays. In three out of the six patients with other fractures in the carpal region, bone scintigraphy revealed four occult concomitant fractures: one scaphoid, one scaphoid and trapezial and one capitate fracture. In conclusion, bone scintigraphy is required when scaphoid X-rays do not confirm a suspected scaphoid fracture, even in the presence of other fractures in the carpal region.

scholarly journals An Adaptive Web-based Framework for Mobile Telemonitoring System

2017 ◽  
Vol 11 (1) ◽  
pp. 40
Author(s):  
Andik Setyono ◽  
Hanny Haryanto ◽  
Erna Zuni Astuti
Keyword(s):  
Medical Treatment ◽  
Monitoring System ◽  
Healthcare Services ◽  
Multimedia Data ◽  
Clinical Environment ◽  
Mobile Environment ◽  
Long Distance ◽  
Web Based ◽  
Patient Will ◽  
Physiology Parameters

Mobile long distance monitoring system using web-based will be deliberated as one of the primary industry in the near future. This paper focuses on the development of the healthcare service for telemonitoring system using an adaptive web-based framework with several parameters at the same time. The proposed system is used to make easy the patient and physician for accessing healthcare system. It tries to combine many functions in healthcare services for long distance monitoring system. Physiological parameters are used such as blood pressure, blood sugar, respiration, heartbeat, pulse, temperature will be received by the system then it is sent to the clinic server immediately. All of these parameters can be inputted by patients themselves while the patients are far from the clinical environment and forward to the physician for further diagnosis and medical treatment. The advantages of the proposed system are the patient will be easy to access the system through internet and easy to connect the physician from a remote area. Smartphone with multimedia features and internet connection in mobile environment can be used to perform mobile computing anywhere and anytime. It keeps real-time recording and monitoring of physiology parameters of the patients at lowest cost and at home. The physiology parameters of patient are increased to be multimedia data. By using the good quality of the multimedia data, the physician will be more precise to perform diagnosis and medical treatment to the patient. The proposed framework can be used to develop a practical web-based mobile telemonitoring system in mobile environment.

scholarly journals The Implementation of DNA Methylation Profiling into a Multistep Diagnostic Process in Pediatric Neuropathology: A 2-Year Real-World Experience by the French Neuropathology Network

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1377
Author(s):  
Melanie Pages ◽  
Emmanuelle Uro-Coste ◽  
Carole Colin ◽  
David Meyronet ◽  
Guillaume Gauchotte ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Current Approach ◽  
Diagnostic Process ◽  
Histopathological Diagnosis ◽  
Diagnostic Strategy ◽  
Pediatric Tumors ◽  
Histopathological Findings ◽  
Dna Methylation Profiling ◽  
The Impact ◽  
Methylation Profiling

DNA methylation profiling has recently emerged as a powerful tool to help establish diagnosis in neuro-oncology. Here we present our national diagnostic strategy as the French neuropathology network (RENOCLIP-LOC) and our current approach of integrating DNA methylation profiling into our multistep diagnostic process for challenging pediatric CNS tumors. The tumors with diagnostic uncertainty were prospectively selected for DNA methylation after two rounds of review by neuropathology experts. We first integrated the classifier score into the histopathological findings. Subsequent analyses using t-SNE (t-Distributed Stochastic Neighbor Embedding) representation were performed. An additional step consisted of analyzing copy-number variation data (CNV). Finally, we combined all data to establish diagnoses and evaluated the impact of DNA methylation profiling on diagnostic and grading changes that would affect patient management. Over two years, 62 pediatric tumors were profiled. (1) Integrating the classifier score to the histopathological findings impacted the diagnosis in 33 cases (53%). (2) t-SNE analysis provided arguments for diagnosis in 26/35 cases with calibrated scores <0.84 (74.3%). (3) CNV investigations also evidenced alterations used for diagnosis and prognostication. (4) A diagnosis was finally established for 44 tumors (71%). Our results support the use of DNA methylation for challenging pediatric tumors. We demonstrated how additional methylation-based analyses complement the classifier score to support conventional histopathological diagnosis.

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