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Trends in Biotechnology Jul 2019Point-of-care (PoC) diagnostics promises to yield test results accessible anytime and anywhere. Its application has expanded from providing healthcare necessities to the... (Review)
Review
Point-of-care (PoC) diagnostics promises to yield test results accessible anytime and anywhere. Its application has expanded from providing healthcare necessities to the real-time monitoring of the ageing and health conscious population. Following the evolving consumer demand, there is a trend toward developing non- and minimally invasive PoC tests. Emerging PoC sensors have not only demonstrated multifunctional capabilities such as sweat stimulation but also can be connected to drug delivery units via a wireless network, enabling an active role of the technology in disease management. This review article summarises the latest developments in non- and minimally invasive PoC diagnostics and provides an overview on the progress towards closed-loop integration of complementary technologies for comprehensive and autonomous patient care.
Topics: Biosensing Techniques; Body Fluids; Diagnostic Tests, Routine; Disease Management; Humans; Point-of-Care Systems
PubMed: 30683459
DOI: 10.1016/j.tibtech.2018.12.004 -
Clinical Microbiology and Infection :... Jul 2017Clinical microbiology is a field in constant evolution, with increasing technological opportunities and a growing emphasis on human and social issues. Maintaining... (Review)
Review
BACKGROUND
Clinical microbiology is a field in constant evolution, with increasing technological opportunities and a growing emphasis on human and social issues. Maintaining knowledge and skills and anticipating future changes is challenging both for laboratory managers and for all the co-workers. Training and succession preparation represents a unique opportunity to adapt/prepare future generations according to the evolutions of the field.
AIMS
The aim of this review is to provide to clinical microbiologists a reflection on ongoing technological and social changes in their field and a deepening of the central role of preparing future generations to these changes through a fruitful mentor-mentee relationship.
SOURCES
This narrative review relies on selected publications addressing mentor-mentee interactions in various academic fields, on interview with our colleagues and pairs, as well as on our personal experience.
CONTENT
From the qualities and aspects that emerged as necessary for a productive mentor-mentee interaction, we selected and discuss five of them for the mentor: the role and responsibility, the positioning, the vision, the scientific credibility, and the moral credibility, as well as five for the mentee: creativity, flexibility, energy, responsibility, and self evaluation.
IMPLICATIONS
This review emphasizes the importance of both the scientific and the ethical credibility of the mentor and the mentee as well as the importance of human and social values such as solidarity, equality, equity, respectfulness, and empathy, and might support mentor and mentee in the field of clinical microbiology and also in the field of infectious disease in their intent for a fruitful interaction.
Topics: Diagnostic Tests, Routine; Humans; Mentors; Microbiological Techniques; Professional Competence
PubMed: 28478239
DOI: 10.1016/j.cmi.2017.04.027 -
Research Synthesis Methods May 2023We developed metadta, a flexible, robust, and user-friendly statistical procedure that fuses established and innovative statistical methods for meta-analysis,... (Meta-Analysis)
Meta-Analysis Review
We developed metadta, a flexible, robust, and user-friendly statistical procedure that fuses established and innovative statistical methods for meta-analysis, meta-regression, and network meta-analysis of diagnostic test accuracy studies in Stata. Using data from published meta-analyses, we validate metadta by comparing and contrasting its features and output to popular procedures dedicated to the meta-analysis of diagnostic test accuracy studies; (midas [Stata], metandi [Stata], metaDTA [web application], mada [R], and MetaDAS [SAS]). We also demonstrate how to perform network meta-analysis with metadta, for which no alternative procedure is dedicated to network meta-analysis of diagnostic test accuracy data in the frequentist framework. metadta generated consistent estimates in simple and complex diagnostic test accuracy data sets. We expect its availability to stimulate better statistical practice in the evidence synthesis of diagnostic test accuracy studies.
Topics: Software; Research Design; Network Meta-Analysis; Diagnostic Tests, Routine
PubMed: 36999350
DOI: 10.1002/jrsm.1634 -
Journal of Clinical Microbiology Sep 2019Advanced microbiology technologies are rapidly changing our ability to diagnose infections, improve patient care, and enhance clinical workflow. These tools are... (Review)
Review
Advanced microbiology technologies are rapidly changing our ability to diagnose infections, improve patient care, and enhance clinical workflow. These tools are increasing the breadth, depth, and speed of diagnostic data generated per patient, and testing is being moved closer to the patient through rapid diagnostic technologies, including point-of-care (POC) technologies. While select stakeholders have an appreciation of the value/importance of improvements in the microbial diagnostic field, there remains a disconnect between clinicians and some payers and hospital administrators in terms of understanding the potential clinical utility of these novel technologies. Therefore, a key challenge for the clinical microbiology community is to clearly articulate the value proposition of these technologies to encourage payers to cover and hospitals to adopt advanced microbiology tests. Specific guidance on how to define and demonstrate clinical utility would be valuable. Addressing this challenge will require alignment on this topic, not just by microbiologists but also by primary care and emergency room (ER) physicians, infectious disease specialists, pharmacists, hospital administrators, and government entities with an interest in public health. In this article, we discuss how to best conduct clinical studies to demonstrate and communicate clinical utility to payers and to set reasonable expectations for what diagnostic manufacturers should be required to demonstrate to support reimbursement from commercial payers and utilization by hospital systems.
Topics: Communicable Diseases; Diagnostic Tests, Routine; Humans; Microbiological Techniques; Point-of-Care Systems
PubMed: 31217268
DOI: 10.1128/JCM.00495-19 -
Journal of Clinical Microbiology Jul 2017Malaria is a potentially life-threatening disease requiring rapid diagnosis and treatment. Although microscopic examination of thick and thin blood films remains the... (Review)
Review
Malaria is a potentially life-threatening disease requiring rapid diagnosis and treatment. Although microscopic examination of thick and thin blood films remains the gold standard for laboratory diagnosis, rapid antigen tests and nucleic acid amplification methods may also play a useful role in detection of acute infection. This review discusses the advantages and disadvantages of the commonly used diagnostic methods and provides important practice points for optimal malaria test utilization.
Topics: Chromatography, Affinity; Diagnostic Tests, Routine; Humans; Malaria; Microscopy; Nucleic Acid Amplification Techniques
PubMed: 28404673
DOI: 10.1128/JCM.02562-16 -
The Journal of Antimicrobial... Sep 2014Prosthetic joint infection (PJI) poses a significant burden on patients, clinicians and the healthcare economy. Although various tests have been established for the... (Review)
Review
Prosthetic joint infection (PJI) poses a significant burden on patients, clinicians and the healthcare economy. Although various tests have been established for the diagnosis of PJI, the diagnosis remains challenging. In this review, established and potential future diagnostic tests are presented, some of which could provide stepping stones towards improved diagnosis, identification of aetiological agents and efficacious therapeutic options for the management of PJI.
Topics: Diagnostic Tests, Routine; Humans; Osteoarthritis; Prosthesis-Related Infections
PubMed: 25135083
DOI: 10.1093/jac/dku248 -
Journal of Immunoassay & Immunochemistry 2019Traditionally, definitive diagnosis of infectious diseases is made by cultivation of the causative agent, while various antigens and antibodies as biomarkers of various... (Review)
Review
Traditionally, definitive diagnosis of infectious diseases is made by cultivation of the causative agent, while various antigens and antibodies as biomarkers of various diseases are detected by commercially available ELISA kits. PCR has emerged as a major innovation that greatly accelerated the accumulation of genomic and transcriptomic data, yet it has also revolutionized microbial diagnostics by enabling the detection of pathogen nucleic acid. Despite the advantages of and vast experience in ELISA and PCR, the next generation research and diagnostic tools have to fulfill the requirements of systems and synthetic biology era. Multiplex bead assays hold this promise by providing a more complete multi-parametric picture of the biological phenomenon of interest at a fraction of time, sample volume and cost required for conventional assay systems. To date, numerous multiplex bead assays have been described to detect multiple antigen, antibody and nucleic acid targets of both microbial pathogens and immune response. These assays have been successfully used in diagnostic, cohort screening and research setups.
Topics: Communicable Diseases; Diagnostic Tests, Routine; Humans
PubMed: 30663510
DOI: 10.1080/15321819.2018.1563551 -
Helicobacter Sep 2019Endoscopic imaging of the stomach is improving. In addition to narrow band imaging, other methods, for example, blue light imaging and linked color imaging, are now... (Review)
Review
Endoscopic imaging of the stomach is improving. In addition to narrow band imaging, other methods, for example, blue light imaging and linked color imaging, are now available and can be combined with artificial intelligence systems to obtain information on the gastric mucosa and detect early gastric cancer. Immunohistochemistry is only recommended as an ancillary stain in case of chronic active gastritis without Helicobacter pylori detection by standard staining, and recommendations to exclude false negative H. pylori results have been made. Molecular methods using real-time PCR, droplet digital PCR, or amplification refractory mutation system PCR have shown a high accuracy, both for detecting H. pylori and for clarithromycin susceptibility testing, and can now be used in clinical practice for targeted therapy. The most reliable non-invasive test remains the C-urea breath test. Large data sets show that DOB values are higher in women and that the cut-off for positivity could be decreased to 2.74 DOB. Stool antigen tests using monoclonal antibodies are widely used and may be a good alternative to UBT, particularly in countries with a high prevalence of H. pylori infection. Attempts to improve serology by looking at specific immunodominant antigens to distinguish current and past infection have been made. The interest of Gastropanel which also tests pepsinogen levels was confirmed.
Topics: Breath Tests; Diagnostic Tests, Routine; Endoscopy, Gastrointestinal; Helicobacter Infections; Humans; Immunoassay; Molecular Diagnostic Techniques
PubMed: 31486244
DOI: 10.1111/hel.12641 -
International Journal of Molecular... Jun 2017Drug hypersensitivity reactions have multiple implications for patient safety and health system costs, thus it is important to perform an accurate diagnosis. The... (Review)
Review
Drug hypersensitivity reactions have multiple implications for patient safety and health system costs, thus it is important to perform an accurate diagnosis. The diagnostic procedure includes a detailed clinical history, often unreliable; followed by skin tests, sometimes with low sensitivity or unavailable; and drug provocation testing, which is not risk-free for the patient, especially in severe reactions. In vitro tests could help to identify correctly the responsible agent, thus improving the diagnosis of these reactions, helping the physician to find safe alternatives, and reducing the need to perform drug provocation testing. However, it is necessary to confirm the sensitivity, specificity, negative and positive predictive values for these in vitro tests to enable their implementation in clinical practice. In this review, we have analyzed these parameters from different studies that have used in vitro test for evaluating drug hypersensitivity reactions and estimated the added value of these tests to the in vivo diagnosis.
Topics: Diagnostic Tests, Routine; Drug Hypersensitivity; Humans; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Immunoglobulin E; T-Lymphocytes
PubMed: 28590437
DOI: 10.3390/ijms18061222 -
Biomarkers in Medicine 2015The emergence of companion diagnostic devices has been spurred by drug discovery and development efforts towards targeted therapies, particularly in oncology. Companion... (Review)
Review
The emergence of companion diagnostic devices has been spurred by drug discovery and development efforts towards targeted therapies, particularly in oncology. Companion diagnostics and their corresponding therapeutics are often codeveloped, or developed in parallel, to ensure the safe and effective use of the products. The regulatory framework for companion diagnostics has gradually evolved as a result of the essential role of diagnostic tests to identify the intended population for a corresponding treatment. Here, we describe the current regulatory model for companion diagnostics in the US and outline key strategies for a successful codevelopment program from the device perspective. We also discuss how technological advances and changes in clinical management may challenge the regulatory model in the future.
Topics: Biomarkers; Diagnostic Tests, Routine; Government Regulation; Humans; Neoplasms; Precision Medicine
PubMed: 25605456
DOI: 10.2217/bmm.14.98