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Health Informatics Journal Dec 2019Autism spectrum disorder is associated with significant healthcare costs, and early diagnosis can substantially reduce these. Unfortunately, waiting times for an autism... (Review)
Review
Autism spectrum disorder is associated with significant healthcare costs, and early diagnosis can substantially reduce these. Unfortunately, waiting times for an autism spectrum disorder diagnosis are lengthy due to the fact that current diagnostic procedures are time-consuming and not cost-effective. Overall, the economic impact of autism and the increase in the number of autism spectrum disorder cases across the world reveal an urgent need for the development of easily implemented and effective screening methods. This article proposes a new mobile application to overcome the problem by offering users and the health community a friendly, time-efficient and accessible mobile-based autism spectrum disorder screening tool called ASDTests. The proposed ASDTests app can be used by health professionals to assist their practice or to inform individuals whether they should pursue formal clinical diagnosis. Unlike existing autism screening apps being tested, the proposed app covers a larger audience since it contains four different tests, one each for toddlers, children, adolescents and adults as well as being available in 11 different languages. More importantly, the proposed app is a vital tool for data collection related to autism spectrum disorder for toddlers, children, adolescent and adults since initially over 1400 instances of cases and controls have been collected. Feature and predictive analyses demonstrate small groups of autistic traits improving the efficiency and accuracy of screening processes. In addition, classifiers derived using machine learning algorithms report promising results with respect to sensitivity, specificity and accuracy rates.
Topics: Autistic Disorder; Early Diagnosis; Humans; Machine Learning; Mass Screening; Mobile Applications
PubMed: 30230414
DOI: 10.1177/1460458218796636 -
JACC. Heart Failure May 2024
Topics: Humans; Dementia; Mass Screening; Aged
PubMed: 38719384
DOI: 10.1016/j.jchf.2024.03.002 -
Hormone and Metabolic Research =... Jun 2020Primary aldosteronism (PA) is characterized by hypertension caused by inappropriately high adrenal aldosterone secretion, consecutively low plasma renin, and an elevated...
Primary aldosteronism (PA) is characterized by hypertension caused by inappropriately high adrenal aldosterone secretion, consecutively low plasma renin, and an elevated aldosterone to renin ratio. It is nowadays the universally accepted main cause of endocrine hypertension. According to the most recent epidemiological data, PA is present in 5.8% of unselected hypertensives in primary care, 6-12% of hypertensives treated in hypertension centers, and up to 30% in subjects with resistant hypertension 1. Despite this high prevalence, a recent survey demonstrated that screening for PA is not universally followed. Renin and aldosterone measurements, the basis for PA screening, are currently performed by only 7% of general practitioners in Italy and 8% in Germany 2. Accordingly, the prevalence of PA was low with 1% among hypertensives in Italy and 2% in Germany. In a retrospective cohort study of 4660 patients with resistant hypertension in California the screening rate for PA was 2.1% 3. Based on these data, it is clear that we still miss the majority of PA cases, despite advances in diagnosis and therapy.
Topics: Congresses as Topic; Endocrinology; Germany; History, 21st Century; Humans; Hyperaldosteronism; Hypertension; Mass Screening; Prevalence; Retrospective Studies; Review Literature as Topic
PubMed: 32544975
DOI: 10.1055/a-1156-9926 -
Acta Diabetologica Jul 2020Diabetic retinopathy (DR) is the leading cause of blindness among working-age adults worldwide. Early detection and treatment are necessary to forestall vision loss from... (Review)
Review
BACKGROUND
Diabetic retinopathy (DR) is the leading cause of blindness among working-age adults worldwide. Early detection and treatment are necessary to forestall vision loss from DR.
METHODS
A working group of ophthalmic and diabetes experts was established to develop a consensus on the key principles of an effective DR screening program. Recommendations are based on analysis of a structured literature review.
RESULTS
The recommendations for implementing an effective DR screening program are: (1) Examination methods must be suitable for the screening region, and DR classification/grading systems must be systematic and uniformly applied. Two-field retinal imaging is sufficient for DR screening and is preferable to seven-field imaging, and referable DR should be well defined and reliably identifiable by qualified screening staff; (2) in many countries/regions, screening can and should take place outside the ophthalmology clinic; (3) screening staff should be accredited and show evidence of ongoing training; (4) screening programs should adhere to relevant national quality assurance standards; (5) studies that use uniform definitions of risk to determine optimum risk-based screening intervals are required; (6) technology infrastructure should be in place to ensure that high-quality images can be stored securely to protect patient information; (7) although screening for diabetic macular edema (DME) in conjunction with DR evaluations may have merit, there is currently insufficient evidence to support implementation of programs solely for DME screening.
CONCLUSION
Use of these recommendations may yield more effective DR screening programs that reduce the risk of vision loss worldwide.
Topics: Adult; Consensus; Diabetes Mellitus; Diabetic Retinopathy; Female; Humans; Macular Edema; Male; Mass Screening; Middle Aged; Practice Guidelines as Topic; Program Evaluation; Referral and Consultation
PubMed: 32222818
DOI: 10.1007/s00592-020-01506-8 -
Current Diabetes Reports Dec 2019Currently, the diagnosis of gestational diabetes mellitus (GDM) lacks uniformity. Several controversies are still under debate, especially on the method of screening and... (Review)
Review
PURPOSE OF REVIEW
Currently, the diagnosis of gestational diabetes mellitus (GDM) lacks uniformity. Several controversies are still under debate, especially on the method of screening and diagnosis. This review focuses on recent literature and provides current evidence for the screening and diagnosis of GDM.
RECENT FINDINGS
Selective screening would miss a significant number of women with GDM. In contrast, universal screening has been shown to be cost-effective, compared with selective screening, and is recommended by many medical societies. For the diagnostic methods for GDM, most observational cohort studies reported that the one-step method is associated with improved pregnancy outcomes and is cost-saving or cost-effective, compared with the two-step method, although these findings should be confirmed in the upcoming randomized controlled trials which compare the performance of one-step and two-step methods. On the other hand, the methods of early screening or diagnosis of GDM are varied, and current evidence does not justify their use during early pregnancy. In conclusion, current evidence favors universal screening for GDM using the one-step method. Early screening for GDM is not favorably supported by the literature.
Topics: Cost-Benefit Analysis; Diabetes, Gestational; Diagnostic Techniques, Endocrine; Female; Humans; Mass Screening; Pregnancy; Pregnancy Outcome
PubMed: 31802260
DOI: 10.1007/s11892-019-1271-x -
Pediatrics Mar 2021Universal screening for autism promotes early evidence-based treatment. However, many children are not screened, and screened children are often not referred for autism...
BACKGROUND
Universal screening for autism promotes early evidence-based treatment. However, many children are not screened, and screened children are often not referred for autism evaluation.
METHODS
We implemented process changes in 3 phases: phase 1, changing the screening instrument and adding decision support; phase 2, adding automatic reminders; and phase 3, adding a referral option for autism evaluations in primary care. We analyzed the proportion of visits with autism screening at 2 intervention clinics before and after implementation of process changes versus 27 community clinics (which received only automatic reminders in phase 2) with χ test and interrupted time series. We evaluated changes in referral for autism evaluation by calculating the rate ratio for referral.
RESULTS
In 12 233 visits over 2 years (baseline and phased improvements), autism screening increased by 52% in intervention clinics (58.6%-88.8%; < .001) and 21% in community clinics (43.4%-52.4%; < .001). In phase 1, interrupted time series trend for screening in intervention clinics increased by 2% per week (95% confidence interval [CI]: 1.1% to 2.9%) and did not increase in community clinics. In phase 2, screening in the community clinics increased by 0.46% per week (95% CI: 0.03% to 0.89%). In phase 3, the intervention clinic providers referred patients for diagnostic evaluation 3.4 times more frequently (95% CI: 2.0 to 5.8) than at baseline.
CONCLUSIONS
We improved autism screening and referrals by changing the screening instrument, adding decision support, using automatic reminders, and offering autism evaluation in primary care in intervention clinics. Automatic reminders alone improved screening in community clinics.
Topics: Autistic Disorder; Chi-Square Distribution; Child, Preschool; Decision Support Techniques; Electronic Health Records; Humans; Infant; Interrupted Time Series Analysis; Mass Screening; Primary Health Care; Referral and Consultation; Reminder Systems; Sensitivity and Specificity
PubMed: 33568493
DOI: 10.1542/peds.2020-1609 -
Missouri Medicine 2020Sexually transmitted infections have increased dramatically in the past 10 years. Rates are higher in Missouri than nationally, and higher in the large urban areas, in...
Sexually transmitted infections have increased dramatically in the past 10 years. Rates are higher in Missouri than nationally, and higher in the large urban areas, in young adults, racial minority groups, among men having sex with men, and are associated with injection drug and methamphetamine use. Clinicians need to perform an appropriate sexual history and follow guidelines for screening and treatment. There is increasing concern for resistance among gonococcal isolates which limits future treatment options.
Topics: Adolescent; Female; Humans; Male; Mass Screening; Missouri; Professional-Patient Relations; Public Health; Risk Factors; Sexual Behavior; Sexually Transmitted Diseases; Young Adult
PubMed: 32848268
DOI: No ID Found -
JAMA Jun 2023
Topics: Humans; Anxiety; Anxiety Disorders; Fear; Mass Screening
PubMed: 37338897
DOI: 10.1001/jama.2023.7239 -
Thorax Jun 2021
Topics: Humans; Idiopathic Pulmonary Fibrosis; Mass Screening; Quality of Life
PubMed: 33622980
DOI: 10.1136/thoraxjnl-2021-216863 -
Radiology Feb 2022
Topics: Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mass Screening; Outcome Assessment, Health Care; Physician's Role; Quality Improvement; Radiologists; Registries; Stakeholder Participation
PubMed: 34751611
DOI: 10.1148/radiol.2021211525