Telehealth-based diagnostic testing in general practice during the COVID-19 pandemic: an observational study

BackgroundSince the World Health Organisation declared COVID-19 a pandemic on 11 March 2020, health technologies have been rapidly scaled up to ensure access to care. A significant innovation has been telehealth in general practice. Now widespread, it remains unknown how this shift to virtual care has impacted on quality-of-care indicators such as pathology testing and diagnosis.AimTo undertake a comparison of telehealth and face-to-face general practice consultations to: identify if there were differences in the proportion of pathology test referrals from 2019-2020; and quantify any change in pathology test collection and follow-up patterns.Design and SettingRetrospective observational study of routinely collected electronic patient data from 807 general practices across New South Wales and Victoria, Australia.MethodMultivariate generalised estimating equation models were used to estimate the proportion of pathology test referrals for: overall, face-to-face, and telehealth consultations. Pathology test follow-up was described through median (and interquartile range (IQR)) time.ResultsPathology test referrals declined during periods of high COVID-19 cases, falling from 10.8% in February 2020 to a low 4.5% during the first peak in April. Overall, pathology test referrals were lower for telehealth than face-to-face. Median time between referral and test collection was 3 days (IQR 1–14) for telehealth and 1 day (IQR 0–7) for face-to-face.ConclusionFor telehealth to become part of routine care, it is crucial that gaps in functionality, including difficulty in test referral processes, be addressed. Quality improvements supporting care practices will ensure clinicians’ workflows are supported and patients receive diagnostic testing.

74. Evaluation of the Differences in Appropriateness of BioFire® FilmArray® Gastrointestinal Panel Testing between Emergency Department and Inpatient Services

Background Use of rapid molecular diagnostic panels in the evaluation of diarrhea provides increased sensitivity for organism identification and decreased time to results. However, their inappropriate use can lead to unnecessary expenditures and antimicrobial exposures. We aimed to characterize the appropriateness of testing using the BioFire® FilmArray® Gastrointestinal Panel (SFA) in different clinical settings and to describe the impact of SFA results on patient care. Methods Retrospective study of adult patients presenting to hospitals part of an integrated health system in Des Moines, Iowa, between July 30 and September 30, 2019, and who had a SFA ordered and collected in the Emergency Department (ED) or an inpatient service. The appropriateness of SFA testing was determined according to adherence to a local algorithm available through the hospital’s intranet (Figure 1). Reason for testing, appropriateness of SFA test, molecular targets identified, and antibiotic exposures were collected. Results We identified 257 patients, 111 (43.2%) who had SFA done in the ED and 146 (56.8%) as inpatients. Testing was deemed inappropriate in 46 (41.4%) of ED patients compared to 100 (68.5%) of inpatients (p< 0.0001). Documented indications for SFA are presented in Table 1. Among ED patients testing was most frequently considered inappropriate due to absence of diarrhea on the day of test collection (41.3%), and among inpatients due to the use of SFA for assessment of hospital-onset diarrhea (47.0%) (Table 2). Overall, there were 94 (36.6%) positive SFA (Figure 2). Among ED patients, the percentage of positive SFA samples was 30.4% and 50.8% for inappropriate and appropriate testing respectively (p=0.03), while for inpatients it was 33.0% for inappropriate orders and 30.4% for appropriate orders (p=0.76). Antibiotics were prescribed to 28.2% and 28.1% of patients tested in the ED and inpatient service respectively. Conclusion High proportions of inappropriate SFA testing were identified both in the ED and inpatient services, with distinct issues in each site. Characterization of the reasons underlying inappropriate use of SFA can aid in the design of diagnostic stewardship interventions tailored to each clinical setting. Disclosures All Authors: No reported disclosures

sOCRates - a post-OCR text correction method

A significant portion of the textual information of interest to an organization is stored in PDF files that should be converted into plain text before their contents can be processed by an information retrieval or text mining system. When the PDF documents consist of scanned documents, optical character recognition (OCR) is typically used to extract the textual contents. OCR errors can have a negative impact on the quality of information retrieval systems since the terms in the query will not match incorrectly extracted terms in the documents. This work introduces sOCRates, a post-OCR text correction method that relies on contextual word embeddings and on a classifier that uses format, semantic, and syntactic features. Our experimental evaluation on a test collection in Portuguese showed that sOCRates can accurately correct errors and improve retrieval results.

Analisis Kesalahan Siswa dalam Menyelesaikan Masalah Open Ended Berdasarkan Teori Newman

Analysis Of Students’ Error In Solving Problems Of An Open Ended Based On The Newman Theory. Abstract is The purpose of this research is to describe the types of students’ errors and find out the number of errors committed by students on each type of error in resolving the open ended problems. Classify the type of error based on Newman theory, which are error reading, understanding, transformation, process skills, and error writing answers. The subject of this research is from 30 students of VIII grade of SMPN 24 Malang. This research using data test collection techniques which is an open ended question on statistical material and interviews to obtain additional data. Data analysis was done by reduction, presentation, and conclusion. The result of the analysis obtained that the students’ error are reading errors, errors of understanding, transformation’s errors, process skills’ errors, and write response’s errorsPenelitian ini bertujuan untuk mendeskripsikan tipe-tipe kesalahan siswa dan mengetahui banyaknya kesalahan yang dilakukan siswa pada tiap tipe kesalahan dalam menyelesaikan masaalah open ended. Pengklasifikasian tipe kesalahan berdasarkan teori Newman, yaitu kesalahan membaca, memahami, transformasi, keterampilan proses, dan kesalahan penulisan jawaban. Subjek penelitian ini adalah siswa kelas VIII SMP Negeri 24 Malang yang berjumlah 30 orang. Penelitian ini menggunakan teknik pengumpulan data berupa tes yaitu soal open ended pada materi statistika dan wawancara untuk memperoleh data tambahan. Analisis data dilakukan dengan reduksi, penyajian, dan penyimpulan. Hasil analisis didapatkan bahwa kesalahan yang dilakukan siswa adalah kesalahan membaca, kesalahan memahami, kesalahan transformasi, kesalahan keterampilan proses, dan kesalahan penulisan jawaban.

Randomized, Controlled Clinical Study on the Use of Noninvasive (Near-Infrared Light) Technology Compared with the Conventional Technique for Peripheral Venous Access Puncture in Pediatrics

Highlights Abstract Background: Obtaining peripheral venous access, especially in children, is usually a challenging procedure for nursing professionals. In pediatric patients this is because of the small caliber of the vessels, deep localization in the tissue, and multiple previous attempts of venipuncture. This experiment compared the success in obtaining venous access in pediatric patients with the use of near-infrared light and with the conventional technique. Method: True experiment, developed in a large private general hospital and a public general hospital under the same management. The study included children aged 0 to 6 y (including newborns and pediatric patients up to 5 y, 11 mo and 29 d) under clinical or surgical treatment, undergoing peripheral venous puncture both for laboratory test collection and for infusion of medications and solutions. A total of 144 punctures were analyzed, 51.4% with the conventional technique and 48.6% using the device with near-infrared light. Results: The success for the conventional technique was 89.2%, and 97.1% on the technique with near-infrared light, P = 0.098, with no evidence of significant differences. Conclusion: The success rate for obtaining peripheral venous access in children was similar in the study groups. This study expands the knowledge about the success in the peripheral venous puncture by considering that this is not exclusively related to the use of supportive technologies.