clinical utility
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2022 ◽  
Vol 44 (2) ◽  
pp. 151-157
Author(s):  
Nada M. Gamal ◽  
Eman R. Badawy ◽  
Esraa A Talaat ◽  
Hamdy M. Ibrahim ◽  
Mona H. Abd Elsamea

Viruses ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 159
Author(s):  
Robert A. Kozak ◽  
Candace Rutherford ◽  
Melissa Richard-Greenblatt ◽  
N. Y. Elizabeth Chau ◽  
Ana Cabrera ◽  
...  

Hepatitis A virus (HAV) is an emerging public health concern and there is an urgent need for ways to rapidly identify cases so that outbreaks can be managed effectively. Conventional testing for HAV relies on anti-HAV IgM seropositivity. However, studies estimate that 10–30% of patients may not be diagnosed by serology. Molecular assays that can directly detect viral nucleic acids have the potential to improve diagnosis, which is key to prevent the spread of infections. In this study, we developed a real-time PCR (RT-PCR) assay to detect HAV RNA for the identification of acute HAV infection. Primers were designed to target the conserved 5′-untranslated region (5′-UTR) of HAV, and the assay was optimized on both the Qiagen Rotor-Gene and the BD MAX. We successfully detected HAV from patient serum and stool samples with moderate differences in sensitivity and specificity depending on the platform used. Our results highlight the clinical utility of using a molecular assay to detect HAV from various specimen types that can be implemented in hospitals to assist with diagnostics, treatment and prevention.


2022 ◽  
Author(s):  
Sabrina Qassim ◽  
Grace L Golden ◽  
Dominique Slowey ◽  
Mary Sarfas ◽  
Kate Whitmore ◽  
...  

The objective of this paper is to discuss perceived clinical utility and impact on physician-patient relationship of a novel, artificial-intelligence (AI) enabled clinical decision support system (CDSS) for use in the treatment of adults with major depression. Patients had a baseline appointment, followed by a minimum of two appointments with the CDSS. For both physicians and patients, study exit questionnaires and interviews were conducted to assess perceived clinical utility, impact on patient-physician relationship, and understanding and trust in the CDSS. 17 patients consented to participate in the study, of which 14 completed. 86% of physicians (6/7) felt the information provided by the CDSS provided a more comprehensive understanding of patient situations and 71% (5/7) felt the information was helpful. 86% of physicians (6/7) reported the AI/predictive model was useful when making treatment decisions. 62% of patients (8/13) reported improvement in their care as a result of the tool. 46% of patients (6/13) felt the app significantly or somewhat improved their relationship with their physicians; 54% felt it did not change. 71% of physicians (5/7) and 62% of patients (8/13) rated they trusted the tool. Qualitative results are analyzed and presented. Findings suggest physicians perceived the tool as useful in conducting appointments and used it while making treatment decisions. Physicians and patients generally found the tool trustworthy, and it may have positive effects on physician-patient relationships.


2022 ◽  
Author(s):  
Steven P. Rowe ◽  
Andreas Buck ◽  
Ralph A. Bundschuh ◽  
Constantin Lapa ◽  
Sebastian E. Serfling ◽  
...  

AbstractProstate-specific membrane antigen (PSMA)-directed positron emission tomography (PET) has gained increasing interest for imaging of men affected by prostate cancer (PC). In recent years, 68Ga-labeled PSMA compounds have been widely utilized, although there is a trend towards increased utilization of 18F-labeled agents. Among others, [18F]DCFPyL (piflufolastat F 18, PYLARIFY) has been tested in multiple major trials, such as OSPREY and CONDOR, which provided robust evidence on the clinical utility of this compound for staging, restaging, and change in management. Recent explorative prospective trials have also utilized [18F]DCFPyL PET/CT for response assessment, e.g., in patients under abiraterone or enzalutamide, rendering this 18F-labeled PSMA radiotracer as an attractive biomarker for image-guided strategies in men with PC. After recent approval by the U.S. Food and Drug Administration, one may expect more widespread use, not only in the U.S., but also in Europe in the long term. In the present review, we will provide an overview of the current clinical utility of [18F]DCFPyL in various clinical settings for men with PC.


2022 ◽  
Vol 12 ◽  
Author(s):  
Yu Jiang ◽  
Lili Wu ◽  
Yunshen Ge ◽  
Jian Zhang ◽  
Yanru Huang ◽  
...  

Background: The prenatal BACs-on-Beads™ (PNBoBs™) assay has been applied worldwide for prenatal diagnosis. However, there are neither guidelines nor consensus on choosing patients, sample types, or clinical pathways for using this technique. Moreover, different perspectives have emerged regarding its clinical value. This study aimed to evaluate its clinical utility in the context of clinical practice located in a prenatal diagnostic center in Xiamen, a city in southeast China.Methods: We tested 2,368 prenatal samples with multiple referral indications using both conventional karyotyping and PNBoBs™. Positive results from PNBoBs™ were verified using current gold-standard approaches.Results: The overall rates for the detection of pathogenic copy number variation (pCNV) by karyotyping and PNBoBs™ were 1.9% (46/2,368) and 2.0% (48/2,368), respectively. The overall detection rate of karyotyping combined with PNBoBs™ for pCNV was 2.3% (54/2,368). A total of 13 cases of copy number variation (CNV)with a normal karyotype were detected by PNBoBs™. Another case with a normal karyotype that was detected as a CNV of sex chromosomes by PNBoBs™ was validated to be maternal cell contamination by short tandem repeat analysis.Conclusion: Karyotyping combined with PNBoBs™ can improve both the yield and efficiency of prenatal diagnosis and is appropriate in the second trimester in all patients without fetal ultrasound anomalies who undergo invasive prenatal diagnosis.


2022 ◽  
Vol 11 ◽  
Author(s):  
Shengsen Chen ◽  
Chao Wang ◽  
Yuwei Gu ◽  
Rongwei Ruan ◽  
Jiangping Yu ◽  
...  

Background and AimsAs a key pathological factor, microvascular invasion (MVI), especially its M2 grade, greatly affects the prognosis of liver cancer patients. Accurate preoperative prediction of MVI and its M2 classification can help clinicians to make the best treatment decision. Therefore, we aimed to establish effective nomograms to predict MVI and its M2 grade.MethodsA total of 111 patients who underwent radical resection of hepatocellular carcinoma (HCC) from January 2015 to September 2020 were retrospectively collected. We utilized logistic regression and least absolute shrinkage and selection operator (LASSO) regression to identify the independent predictive factors of MVI and its M2 classification. Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were calculated to select the potential predictive factors from the results of LASSO and logistic regression. Nomograms for predicting MVI and its M2 grade were then developed by incorporating these factors. Area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were respectively used to evaluate the efficacy, accuracy, and clinical utility of the nomograms.ResultsCombined with the results of LASSO regression, logistic regression, and IDI and NRI analyses, we founded that clinical tumor-node-metastasis (TNM) stage, tumor size, Edmondson–Steiner classification, α-fetoprotein (AFP), tumor capsule, tumor margin, and tumor number were independent risk factors for MVI. Among the MVI-positive patients, only clinical TNM stage, tumor capsule, tumor margin, and tumor number were highly correlated with M2 grade. The nomograms established by incorporating the above variables had a good performance in predicting MVI (AUCMVI = 0.926) and its M2 classification (AUCM2 = 0.803). The calibration curve confirmed that predictions and actual observations were in good agreement. Significant clinical utility of our nomograms was demonstrated by DCA.ConclusionsThe nomograms of this study make it possible to do individualized predictions of MVI and its M2 classification, which may help us select an appropriate treatment plan.


2022 ◽  
pp. 1-9
Author(s):  
John Peabody ◽  
David Paculdo ◽  
Czarlota Valdenor ◽  
Peter A. McCullough ◽  
Eisei Noiri ◽  
...  

<b><i>Introduction:</i></b> Contrast-induced acute kidney injury (CI-AKI) is a major clinical complication of percutaneous cardiovascular procedures requiring iodinated contrast. Despite its relative frequency, practicing physicians are unlikely to identify or treat this condition. <b><i>Methods:</i></b> In a 2-round clinical trial of simulated patients, we examined the clinical utility of a urine-based assay that measures liver-type fatty acid-binding protein (L-FABP), a novel marker of CI-AKI. We sought to determine if interventional cardiologists’ ability to diagnose and treat potential CI-AKI improved using the biomarker assay for 3 different patient types: pre-procedure, peri-procedure, and post-procedure patients. <b><i>Results:</i></b> 154 participating cardiologists were randomly divided into either control or intervention. At baseline, we found no difference in the demographics or how they identified and treated potential complications of AKI, with both groups providing less than half the necessary care to their patients (46.4% for control vs. 47.6% for intervention, <i>p</i> = 0.250). The introduction of L-FABP into patient care resulted in a statistically significant improvement of 4.6% (<i>p</i> = 0.001). Compared to controls, physicians receiving L-FABP results were 2.9 times more likely to correctly identify their patients’ risk for AKI (95% CI 2.1–4.0) and were more than twice as likely to treat for AKI by providing volume expansion and withholding nephrotoxic medications. We found the greatest clinical utility in the pre-procedure and peri-procedure settings but limited value in the post-procedure setting. <b><i>Conclusion:</i></b> This study suggests L-FABP as a clinical marker for assessing the risk of potential CI-AKI, has clinical utility, and can lead to more accurate diagnosis and treatment.


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