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Journal of Diabetes Research 2020Recently, telemedicine has become remarkably important, due to increased deployment and development of digital technologies. National and international guidelines should... (Review)
Review
Recently, telemedicine has become remarkably important, due to increased deployment and development of digital technologies. National and international guidelines should consider its inclusion in their updates. During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments has made telemedicine the safest interactive system between patients, both infected and uninfected, and clinicians. A few potential evidence-based scenarios for the application of telemedicine have been hypothesized. In particular, its use in diabetes and complication monitoring has been remarkably increasing, due to the high risk of poor prognosis. New evidence and technological improvements in telemedicine application in diabetic retinopathy (DR) have demonstrated efficacy and usefulness in screening. Moreover, despite an initial increase for devices and training costs, teleophthalmology demonstrated a good cost-to-efficacy ratio; however, no national screening program has yet focused on DR prevention and diagnosis. Lack of data during the COVID-19 pandemic strongly limits the possibility of tracing the real management of the disease, which is only conceivable from past evidence in normal conditions. The pandemic further stressed the importance of remote monitoring. However, the deployment of device and digital application used to increase screening of individuals and monitor progression of retinal disease needs to be easily accessible to general practitioners.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Cost-Benefit Analysis; Diabetic Retinopathy; Humans; Mass Screening; Ophthalmology; Pandemics; Pneumonia, Viral; SARS-CoV-2; Telemedicine
PubMed: 33123599
DOI: 10.1155/2020/9036847 -
Clinics in Geriatric Medicine Feb 2023Elderly patients and their families are concerned about the patients' cognitive abilities, and cognitive screening is an efficient diagnostic tool, as long as clinicians... (Review)
Review
Elderly patients and their families are concerned about the patients' cognitive abilities, and cognitive screening is an efficient diagnostic tool, as long as clinicians administer the screens in a standardized manner and interpret the screen results accurately. The following brief summary reviews commonly used screening instruments and provides information about how to interpret screening test results. It concludes by showing how cognitive screening fits into a four-step process (Education, Screening, Follow-up, and Referral) of how to respond to patients with cognitive concerns.
Topics: Humans; Aged; Cognitive Dysfunction; Cognition Disorders; Cognition; Mass Screening; Dementia
PubMed: 36404027
DOI: 10.1016/j.cger.2022.07.002 -
The Medical Journal of Australia Apr 2021
Topics: Antirheumatic Agents; Australia; Drug-Related Side Effects and Adverse Reactions; Guidelines as Topic; Humans; Hydroxychloroquine; Mass Screening; Prevalence; Retinal Diseases; Risk Factors
PubMed: 33684959
DOI: 10.5694/mja2.50973 -
Journal of the American Association of... Aug 2020Alcohol misuse (AM) among young adults remains a public health issue that is underaddressed in primary care. Despite well-supported recommendations to screen and offer...
BACKGROUND
Alcohol misuse (AM) among young adults remains a public health issue that is underaddressed in primary care. Despite well-supported recommendations to screen and offer brief interventions for AM, most primary care providers do not address the issue.
LOCAL PROBLEM
Increasing rates of alcohol-related incidents and lack of a standardized alcohol Screening and Brief Intervention (SBI) program were identified in a private university health center.
METHODS
Nurse practitioners, staff nurses, and physicians received education on alcohol SBI. Young adult students visiting a college health center were administered the Alcohol Use Disorders Identification Test-Consumption electronically followed by a brief motivational intervention if they screened positive using embedded Electronic Health Record templates. Preimplementation/postimplementation chart audit and surveys were used to evaluate effectiveness.
INTERVENTIONS
Following staff education, a standardized alcohol SBI program was implemented in a private university health center.
RESULTS
Increased alcohol screening and intervention rates, as well as increased knowledge about AM, and reduced alcohol use among participants were identified.
CONCLUSIONS
Through staff education and by embedding standard alcohol SBI templates, more at-risk young adults were identified and rendered alcohol interventions during routine visits. This replicable program can improve outcomes related to AM in the primary care setting.
Topics: Adult; Alcoholism; Female; Humans; Male; Mass Screening; Primary Health Care; Quality Improvement; Retrospective Studies; Surveys and Questionnaires
PubMed: 31385939
DOI: 10.1097/JXX.0000000000000259 -
The Journal of Molecular Diagnostics :... May 2020Testing asymptomatic individuals for unsuspected conditions is not new to the medical and public health communities. Protocols to develop screening tests are well... (Review)
Review
Testing asymptomatic individuals for unsuspected conditions is not new to the medical and public health communities. Protocols to develop screening tests are well established. However, the application of screening principles to inherited diseases presents unique challenges. Unlike most screening tests, the natural history and disease prevalence of most rare inherited diseases in an unselected population are unknown. It is difficult or impossible to obtain a truth set cohort for clinical validation studies. As a result, it is not possible to accurately calculate clinical positive and negative predictive values for likely pathogenic variants, which are commonly returned in genetic screening assays. In addition, many of the genetic conditions included in screening panels do not have clinical confirmatory tests. All these elements are typically required to justify the development of a screening test, according to the World Health Organization screening principles. Nevertheless, as the cost of DNA sequencing continues to fall, more individuals are opting to undergo genomic testing in the absence of a clinical indication. Despite the challenges, reasonable estimates can be deduced and used to inform test design strategies. Herein, we review basic test design principles and apply them to genetic screening.
Topics: Genetic Association Studies; Genetic Diseases, Inborn; Genetic Predisposition to Disease; Genetic Testing; Genetic Variation; Humans; Mass Screening; Research Design
PubMed: 32092541
DOI: 10.1016/j.jmoldx.2020.01.014 -
BMC Health Services Research Aug 2020The substantial prevalence and consequences of intimate partner violence (IPV) underscore the need for effective healthcare response in the way of screening and follow...
BACKGROUND
The substantial prevalence and consequences of intimate partner violence (IPV) underscore the need for effective healthcare response in the way of screening and follow up care. Despite growing evidence regarding perspectives on healthcare-based screening for IPV experiences (i.e., victimization), there is an extremely limited evidence-base to inform practice and policy for detecting IPV use (i.e., perpetration). This study identified barriers, facilitators, and implementation preferences among United States (US) Veterans Health Administration (VHA) patients and providers for IPV use screening.
METHODS
We conducted qualitative interviews with patients enrolled in VHA healthcare (N = 10) and focus groups with VHA providers across professional disciplines (N = 29). Data was analyzed using thematic and content analyses.
RESULTS
Qualitative analysis revealed convergence between patients' and providers' beliefs regarding key factors for IPV use screening, including the importance of a strong rapport, clear and comprehensive processes and procedures, universal implementation of screening, and a self-report screening tool that assesses for both IPV use and experiences concurrently.
CONCLUSIONS
Findings provide foundational information regarding patient and provider barriers, facilitators, and preferences for IPV use screening that can inform clinical practice and next steps in this important but understudied aspect of healthcare.
Topics: Adult; Aged; Female; Focus Groups; Health Services Accessibility; Health Services Research; Humans; Intimate Partner Violence; Male; Mass Screening; Middle Aged; Patient Preference; Qualitative Research; United States; United States Department of Veterans Affairs
PubMed: 32791967
DOI: 10.1186/s12913-020-05595-7 -
Pediatrics Feb 2022Adverse childhood experiences (ACEs) are associated with increased risk of poor mental health outcomes. Although there is interest in screening for ACEs for early... (Meta-Analysis)
Meta-Analysis
CONTEXT
Adverse childhood experiences (ACEs) are associated with increased risk of poor mental health outcomes. Although there is interest in screening for ACEs for early identification and intervention, it is not known whether screening improves outcomes for children.
OBJECTIVE
To systematically review whether screening for ACEs in children leads to an increase in (1) identification of ACEs, (2) referrals to services, (3) increased uptake of services, and (4) improved mental health outcomes for children and parents.
DATA SOURCES
Ovid Medline, PsycINFO, CINAHL, and Center for Clinical and Translational Research electronic databases were searched between 2009 and 2021.
STUDY SELECTION
Studies were included if researchers screened for current ACEs in children aged 0 to 12 years and they had a control comparison.
DATA EXTRACTION
Information was extracted, including study characteristics, sample demographics, screening tool characteristics, referral rates to services, uptake rates, and mental health outcomes.
RESULTS
A total of 5816 articles were screened, with 4 articles meeting inclusion criteria. Screening for ACEs increases identification of adversity and may increase referrals to services. There are limited data about whether this leads to an increase in referral uptake by families. There are no reported data addressing mental health outcomes.
LIMITATIONS
There are few published control trials of moderate quality.
CONCLUSIONS
There is limited evidence that screening for ACEs improves identification of childhood adversity and may improve referrals. If we are to realize the hypothesized benefits of ACEs screening on child and parent mental health, it is essential to understand the barriers for families taking up referrals.
Topics: Adverse Childhood Experiences; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Mass Screening; Mental Health; Randomized Controlled Trials as Topic
PubMed: 35104358
DOI: 10.1542/peds.2021-051884 -
The Journal of Surgical Research Jan 2021Armenia has a high incidence of and mortality from colorectal cancer (CRC). No organized screening programs for CRC exist in Armenia. This study seeks to evaluate...
BACKGROUND
Armenia has a high incidence of and mortality from colorectal cancer (CRC). No organized screening programs for CRC exist in Armenia. This study seeks to evaluate knowledge of and attitudes toward CRC and screening programs in Armenia.
METHODS
Adults aged 40-64 y were administered a survey using convenience sampling throughout polyclinics in Yerevan city. Survey questions were based on the Health Belief Model and were translated and modified for local relevance.
RESULTS
A total of 368 surveys were completed. Eighty-four percent had knowledge of CRC, 91% believed that early detection leads to improved outcomes, but only 22% had knowledge of screening. Women were more likely to have knowledge of CRC (odds ratio 2.19, P < 0.05). Although 19% have personally worried about having CRC, only 7% admitted to discussing their worries with a provider and 76% were willing to undergo screening if recommended by their doctor. Seventy-eight percent of respondents would only undergo screening if free or less than ~$20 USD.
CONCLUSIONS
Self-reported knowledge of CRC is high, whereas knowledge of screening remains low in Armenia. There is a willingness to undergo screening if recommended by a health care professional; however, this willingness is cost-sensitive. Interventions aimed at (1) increasing awareness of the disease and screening tests, (2) improving physician counseling, and (3) reducing financial barriers to screening should be considered along with the implementation of a national screening program in Armenia.
Topics: Armenia; Colorectal Neoplasms; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Mass Screening; Middle Aged; Patient Acceptance of Health Care; Surveys and Questionnaires
PubMed: 32949994
DOI: 10.1016/j.jss.2020.08.038 -
Best Practice & Research. Clinical... 2021Gastric cancer (GC) is a significant global health problem, with Helicobacter pylori infection estimated to be responsible for 89% of non-cardiac GC cases, or 78% of all... (Review)
Review
Gastric cancer (GC) is a significant global health problem, with Helicobacter pylori infection estimated to be responsible for 89% of non-cardiac GC cases, or 78% of all GC cases. The International Agency for Research on Cancer has called for Helicobacter pylori test-and-treat strategies in countries with high rates of GC. However, for countries with low rates of GC, such as most Western countries, the balance between benefits, harms and costs of screening is less clear-cut. GC is a disease with a well-characterized precancerous process, providing the basis for primary and secondary prevention efforts. However, rigorous data assessing the impact of such interventions in Western countries are lacking. In the absence of clinical trials, modelling offers a unique approach to evaluate the potential impact of various screening and surveillance interventions. In this paper, we provide an overview of modelling studies evaluating the cost-effectiveness of GC screening and surveillance in Western countries.
Topics: Cost-Benefit Analysis; Early Detection of Cancer; Humans; Mass Screening; Stomach Neoplasms
PubMed: 33975689
DOI: 10.1016/j.bpg.2021.101735 -
Biostatistics (Oxford, England) Jul 2020Group testing involves pooling individual specimens (e.g., blood, urine, swabs, etc.) and testing the pools for the presence of disease. When the proportion of diseased...
Group testing involves pooling individual specimens (e.g., blood, urine, swabs, etc.) and testing the pools for the presence of disease. When the proportion of diseased individuals is small, group testing can greatly reduce the number of tests needed to screen a population. Statistical research in group testing has traditionally focused on applications for a single disease. However, blood service organizations and large-scale disease surveillance programs are increasingly moving towards the use of multiplex assays, which measure multiple disease biomarkers at once. Tebbs and others (2013, Two-stage hierarchical group testing for multiple infections with application to the Infertility Prevention Project. Biometrics69, 1064-1073) and Hou and others (2017, Hierarchical group testing for multiple infections. Biometrics73, 656-665) were the first to examine hierarchical group testing case identification procedures for multiple diseases. In this article, we propose new non-hierarchical procedures which utilize two-dimensional arrays. We derive closed-form expressions for the expected number of tests per individual and classification accuracy probabilities and show that array testing can be more efficient than hierarchical procedures when screening individuals for multiple diseases at once. We illustrate the potential of using array testing in the detection of chlamydia and gonorrhea for a statewide screening program in Iowa. Finally, we describe an R/Shiny application that will help practitioners identify the best multiple-disease case identification algorithm.
Topics: Algorithms; Biological Assay; Chlamydia Infections; Communicable Diseases; Gonorrhea; Humans; Iowa; Mass Screening; Models, Theoretical
PubMed: 30371749
DOI: 10.1093/biostatistics/kxy058