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Nursing Standard (Royal College of... May 2016Essential facts According to data gathered by the Health and Social Care Information Centre, the NHS in England completed 10.6 million operations in 2012/13, compared...
Essential facts According to data gathered by the Health and Social Care Information Centre, the NHS in England completed 10.6 million operations in 2012/13, compared with 6.61 million a decade before - a rise of 60%. Over the same period, pre-operative assessment has changed radically, with most people seen well in advance of their surgery in a pre-operative assessment unit. While the number of routine tests for young, healthy people having minor surgery has reduced significantly, there remains a concern that some unnecessary tests continue to be requested, says the National Institute for Health and Care Excellence (NICE).
Topics: Diagnostic Tests, Routine; Patient Education as Topic; Practice Guidelines as Topic; Preoperative Care; State Medicine; United Kingdom; Unnecessary Procedures
PubMed: 27206180
DOI: 10.7748/ns.30.37.16.s16 -
Clinical Chemistry and Laboratory... Nov 2015
Topics: Diagnostic Tests, Routine; Humans; Urinalysis; Urinary Tract Physiological Phenomena; Urine Specimen Collection
PubMed: 26457788
DOI: 10.1515/cclm-2015-0898 -
Methods in Molecular Biology (Clifton,... 2017Blood proteome analysis for biomarker discovery represents one of the most challenging tasks to be achieved through clinical proteomics due to the sample complexity,... (Review)
Review
Blood proteome analysis for biomarker discovery represents one of the most challenging tasks to be achieved through clinical proteomics due to the sample complexity, such as the extreme heterogeneity of proteins in very dynamic concentrations, and to the observation of proper sampling and storage conditions. Quantitative and qualitative proteomics profiling of plasma and serum could be useful both for the early detection of diseases and for the evaluation of pathological status. Two main sources of variability can affect the precision and accuracy of the quantitative experiments designed for biomarker discovery and validation. These sources are divided into two categories, pre-analytical and analytical, and are often ignored; however, they can contribute to consistent errors and misunderstanding in biomarker research. In this chapter, we review critical pre-analytical and analytical variables that can influence quantitative proteomics. According to guidelines accepted by proteomics community, we propose some recommendations and strategies for a proper proteomics analysis addressed to biomarker studies.
Topics: Animals; Biomarkers; Blood Proteins; Diagnostic Tests, Routine; Humans; Plasma; Prognosis; Proteome; Proteomics; Quality Control; Serum
PubMed: 28674873
DOI: 10.1007/978-1-4939-7057-5_1 -
Revue Scientifique Et Technique... Jun 2021Before tools became available to consider diagnostic test validation studies where a 'gold-standard' is not available, new diagnostic tests were compared to a reference... (Review)
Review
Before tools became available to consider diagnostic test validation studies where a 'gold-standard' is not available, new diagnostic tests were compared to a reference standard assumed to be highly accurate if not perfect. This paper reviews such 'traditional' situations with examples and methods of study design and analysis. Three situations are described, two where a perfect reference is available for either positive or negative animals, and one where the reference is perfect for both. Thus, here the authors review circumstances to be considered when validating a diagnostic test with a credible reference standard. An appropriate study design requires an unbiased selection of animals from the population to which a new test will be applied. Examples for calculating sample size and data analysis are provided. Finally, the authors discuss situations where it may be appropriate to include influential variables ('covariates') in a diagnostic test validation study..
Topics: Animals; Diagnostic Tests, Routine; Reference Standards; Sensitivity and Specificity
PubMed: 34140725
DOI: 10.20506/rst.40.1.3223 -
Pediatric Radiology Mar 2015The foundation for the usefulness of any diagnostic test should be that it is both reliable and accurate in its clinical diagnosis. In this article we present the second... (Review)
Review
The foundation for the usefulness of any diagnostic test should be that it is both reliable and accurate in its clinical diagnosis. In this article we present the second of a two-part series on validity and reliability, discussing the assessment of reliability among raters of diagnostic tests and between diagnostics tests themselves. To examine reproducibility (reliability) among raters of diagnostic tests we present the calculation of two statistical procedures: (1) the kappa coefficient statistic when presented with categorical data for the presence or absence of a clinical diagnosis and (2) the intraclass correlation coefficient (ICC) for continuously scaled data among raters. The accuracy among diagnostic tests (i.e. their interchangeability) can be evaluated by application of (1) a Bland-Altman plot procedure (with its 95% limits of agreement) and (2) the Passing-Bablok regression procedure (for the identification and evaluation of systematic and proportional differences). When deciding whether to select a diagnostic test one must evaluate its ability to provide more precise information than a gold standard test, and whether in clinical practice it would be more beneficial for patients to adopt it.
Topics: Biometry; Diagnostic Tests, Routine; Humans; Reproducibility of Results; Research Design
PubMed: 25726014
DOI: 10.1007/s00247-014-2944-x -
South Dakota Medicine : the Journal of... Mar 2016
Topics: Diagnostic Tests, Routine; Humans
PubMed: 27156257
DOI: No ID Found -
Revue Medicale Suisse Aug 2019
Topics: Diagnostic Tests, Routine; Female; Humans; Papillomaviridae; Papillomavirus Infections; Sequence Analysis, RNA; Uterine Cervical Neoplasms
PubMed: 31496179
DOI: No ID Found -
Clinical Gastroenterology and... Oct 2016The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering... (Review)
Review
BACKGROUNG & AIMS
The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs.
METHODS
We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing.
RESULTS
The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence.
CONCLUSIONS
These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology.
Topics: Diagnostic Tests, Routine; Gastroenterology; Gastrointestinal Diseases; Humans
PubMed: 27215366
DOI: 10.1016/j.cgh.2016.05.022 -
Surgical Pathology Clinics Mar 2016As the cost of health care continues to rise and reimbursement rates decrease, there is a growing demand and need to cut overall costs, enhance quality of services, and... (Review)
Review
As the cost of health care continues to rise and reimbursement rates decrease, there is a growing demand and need to cut overall costs, enhance quality of services, and maintain as a top priority the needs and safety of the patient. In this article, we provide an introduction to test utilization and outline a general approach to creating an efficient, cost-effective test utilization strategy. We also present and discuss 2 test utilization algorithms that are evidence-based and may be of clinical utility as we move toward the future of doing the necessary tests at the right time.
Topics: Algorithms; Clinical Laboratory Services; Cost-Benefit Analysis; Diagnostic Tests, Routine; Evidence-Based Medicine; Humans; Lymphoma; Myelodysplastic Syndromes; Neoplasm Staging; Pathology, Clinical; Physician's Role; Practice Guidelines as Topic
PubMed: 26940264
DOI: 10.1016/j.path.2015.10.002 -
Clinical Microbiology and Infection :... Jun 2020Cerebrospinal fluid (CSF) testing is a key component for the diagnosis of central nervous system (CNS) infections. Current meningitis and encephalitis management... (Review)
Review
BACKGROUND
Cerebrospinal fluid (CSF) testing is a key component for the diagnosis of central nervous system (CNS) infections. Current meningitis and encephalitis management guidelines agree on the need for CSF molecular testing in combination with other direct and indirect biological testing, both in CSF and blood. Multiplex molecular tests have been developed to reduce turnaround times and facilitate the diagnostic approach.
OBJECTIVES
We aim to discuss the role of multiplex molecular panels in the management of CNS infections.
SOURCES
The MEDLINE database and the grey literature have been searched for relevant articles.
CONTENT
New molecular multiplex panels are being developed to simultaneously detect a large array of neuropathogens in CSF. Although one of these assays has been US Food and Drug Administration-approved, extensive analytical and clinical validation is still missing, and suboptimal performance related issues have been raised. Its use has been associated with decreased costs, reduced length of hospital stay and reduced antiviral therapy administration in retrospective, industry-sponsored studies. The pros and cons of this multiplex syndromic approach are discussed in this narrative review.
IMPLICATIONS
Molecular multiplex CNS infection diagnosis panels have been developed and present several attractive features, including ease of use and low turnaround time. However, suboptimal analytical performances render these tests difficult to use without additional confirmatory tests. Such panels are not comprehensive nor adapted to all situations, depending on the epidemiological or clinical context. Overall, available data in the literature currently do not support the use of a multiplex PCR panel in clinical routine as a 'stand-alone' molecular assay. Except in restricted laboratory capacity settings where such easy-to-use multiplex panels offer the diagnostic means that would otherwise not be available, the stepwise testing approach remains a more rational option. Serological testing both in blood and CSF should not be neglected, but it represents essential complementary tools regarding some neuropathogens.
Topics: Central Nervous System Infections; Diagnostic Tests, Routine; Encephalitis; Humans; Meningitis; Molecular Diagnostic Techniques; Retrospective Studies
PubMed: 31899336
DOI: 10.1016/j.cmi.2019.12.013