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PloS One 2024The objective of this study was to map place of cancer diagnosis in relation to Human Immunodeficiency Virus (HIV) care centre among people living with HIV (PLHIV)...
OBJECTIVE
The objective of this study was to map place of cancer diagnosis in relation to Human Immunodeficiency Virus (HIV) care centre among people living with HIV (PLHIV) within South Africa (SA) using national laboratory database.
DESIGN
We linked HIV and cancer laboratory data from 2004-2014 using supervised machine-learning algorithms. We performed a cross-sectional analysis comparing province where individuals accessed their HIV care versus where they had their cancer diagnosis.
SETTING
We used laboratory test records related to HIV diagnostics and care, such as CD4 cell counts and percentages, rapid tests, qualitative Polymerase Chain Reaction (PCR), antibody and antigen tests for HIV data that was documented as HIV positive and laboratory diagnosed cancer records from SA.
STUDY POPULATION
Our study population consisted of HIV records from the National Health Laboratory Service (NHLS) that linked to cancer record at the National Cancer Registry (NCR) between 2004-2014.
PRIMARY AND SECONDARY OUTCOMES
We linked HIV records from NHLS to cancer records at NCR in order to study the inherent characteristics of the population with both HIV and cancer.
RESULTS
The study population was 68,284 individuals with cancer and documented HIV related laboratory test. The median age at cancer diagnosis was 40 [IQR, 33-48] years for the study population with most cancers in PLHIV diagnosed in females 70.9% [n = 46,313]. Of all the PLHIV and cancer, 25% (n = 16,364 p < 0.001) sought treatment outside their province of residence with 60.7% (n = 10,235) travelling to Gauteng. KZN had 46.6% (n = 4,107) of its PLHIV getting cancer diagnosis in Gauteng. Western Cape had 95% (n = 6,200) of PLHIV getting cancer diagnosis within the province.
CONCLUSIONS
Our results showed health systems inequalities across provinces in SA with respect to cancer diagnosis. KZN for example had nearly half of the PLHIV getting cancer diagnosis outside the province while Western Cape is able to offer cancer diagnostic services to most of the PLHIV in the province. Gauteng is getting over burdened with referral for cancer diagnosis from other provinces. More effort is required to ensure equitable access to cancer diagnostic services within the country.
Topics: Humans; South Africa; HIV Infections; Female; Cross-Sectional Studies; Male; Neoplasms; Adult; Middle Aged; Diagnostic Services; Young Adult; Adolescent
PubMed: 38870151
DOI: 10.1371/journal.pone.0291897 -
Medicina Oral, Patologia Oral Y Cirugia... May 2020The objective of this study was to describe the upper and lower lip lesion occurrence in an oral diagnostic service.
BACKGROUND
The objective of this study was to describe the upper and lower lip lesion occurrence in an oral diagnostic service.
MATERIAL AND METHODS
Retrospective descriptive sectional study was performed. Clinical records were obtained from the archives of an Oral Diagnostic Service referral center between 2006 and 2016. Data such as gender, age, anatomical location, and diagnosis were collected and categorized. The collected data were submitted to a descriptive analysis and Pearson's chi-square test (p ≤ 0.05).
RESULTS
A total of 587 patient records of lip lesions were analyzed. Most lesions were diagnosed in female (52.1%) and adults (56.9%) patients in the lower lip (76.2%). Among all lip lesions, the reactive/inflammatory lesions (n = 238; 40.5%) and oral potentially malignant disorders (n = 164; 28%) were the most frequent group lesions. Mucocele (n = 147; 25%), actinic cheilitis (n = 136; 23.1%) and vascular lesions (n = 51; 8.7%) were the most frequent lesion in the sample. Actinic cheilitis was significant in relation to gender (p < 0.001), all three most frequent lesions were significant in concerning to age group and anatomical site.
CONCLUSIONS
Mucocele was the most common lower lip lesion in all age groups, followed by actinic cheilitis and vascular lesions, which mainly affected adults and the elderly.
Topics: Adult; Aged; Cheilitis; Diagnostic Services; Female; Humans; Lip; Lip Neoplasms; Mouth Diseases; Retrospective Studies
PubMed: 32040463
DOI: 10.4317/medoral.23390 -
Medical Progress Through Technology 1985
Topics: Diagnostic Services; Health Services; Health Services Misuse; Humans
PubMed: 4033595
DOI: No ID Found -
Orphanet Journal of Rare Diseases Jun 2016The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services...
BACKGROUND
The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services delivered through Genetic Services of Western Australia (GSWA). GSWA has provided a state-wide service for clinical genetic care for 28 years and it serves a population of 2.5 million people across a geographical area of 2.5milion Km(2). Within this context, GSWA has established a clinically integrated genomic diagnostic platform in partnership with other public health system managers and service providers, including but not limited to the Office of Population Health Genomics, Diagnostic Genomics (PathWest Laboratories) and with executive level support from the Department of Health. Herein we describe report presents the components of this service that are most relevant to the heterogeneity of paediatric clinical genetic care.
RESULTS
Briefly the platform : i) offers multiple options including non-genetic testing; monogenic and genomic (targeted in silico filtered and whole exome) analysis; and matchmaking; ii) is delivered in a patient-centric manner that is resonant with the patient journey, it has multiple points for entry, exit and re-entry to allow people access to information they can use, when they want to receive it; iii) is synchronous with precision phenotyping methods; iv) captures new knowledge, including multiple expert review; v) is integrated with current translational genomic research activities and best practice; and vi) is designed for flexibility for interactive generation of, and integration with, clinical research for diagnostics, community engagement, policy and models of care.
CONCLUSION
The RUDDS has been established as part of routine clinical genetic services and is thus sustainable, equitably managed and seeks to translate new knowledge into efficient diagnostics and improved health for the whole community.
Topics: Australia; Delivery of Health Care; Diagnostic Services; Genomics; High-Throughput Nucleotide Sequencing; Humans; Rare Diseases
PubMed: 27287197
DOI: 10.1186/s13023-016-0462-7 -
African Health Sciences Sep 2019Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are global public health problems. TB and HIV diagnostic services linkage is imperative for the fight against...
BACKGROUND
Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are global public health problems. TB and HIV diagnostic services linkage is imperative for the fight against the two diseases.
OBJECTIVE
To assess the diagnostic service linkage and testing of TB-HIV diagnostic services and identify predictors in Public hospitals of Northern Ethiopia.
METHODS
A cross-sectional study was conducted in five hospitals of Northern Ethiopia. Study subjects' socio-demographic, household and clinical variables were assessed. Data was analyzed using SPSS. Logistic regressions were used to determine the predictors of uptake of TB and HIV testing among HIV and TB patients, respectively.
RESULT
The level of HIV testing among TB patients was 94.4% and of TB screening among HIV patients was 90.5%. Factors that independently predict HIV testing among TB patients were Residence AOR=0.187(95% CI 0.05-0.76), being 9 grade and above AOR=13.17 (95%CI 2.67-65.03) and drinking alcohol AOR=0.03(95% CI 0.002-0.475). Likewise, being grade 9 and above AOR=6.92 (95% CI 1.75-27.4) and having chronic cough AOR=0.23 (95% CI 0.06-0.92) were predictor variables for having TB screening among HIV patients.
CONCLUSION
The levels of TB-HIV linkages and testing are high. Moreover, educational status is a strong predictor of TB screening among HIV patients and HIV testing among TB cases. The regional health bureau has to continue supporting its TB and HIV case teams in every health facility.
Topics: Delivery of Health Care, Integrated; Diagnostic Services; Female; HIV Infections; Hospitals, Public; Humans; Male; Mass Screening; Tuberculosis
PubMed: 32127802
DOI: 10.4314/ahs.v19i3.5 -
JAMA Network Open Aug 2022Delayed engagement in tuberculosis (TB) services is associated with ongoing transmission and poor clinical outcomes.
IMPORTANCE
Delayed engagement in tuberculosis (TB) services is associated with ongoing transmission and poor clinical outcomes.
OBJECTIVE
To assess whether patients with TB have differential preferences for strategies to improve the public health reach of TB diagnostic services.
DESIGN, SETTING, AND PARTICIPANTS
A cross-sectional study was undertaken in which a discrete choice experiment (DCE) was administered between September 18, 2019, and January 17, 2020, to 401 adults (>18 years of age) with microbiologically confirmed TB in Lusaka, Zambia. The DCE had 7 attributes with 2 to 3 levels per attribute related to TB service enhancements. Latent class analysis was used to identify segments of participants with unique preferences. Multiscenario simulations were used to estimate shares of preferences for different TB service improvement strategies.
MAIN OUTCOMES AND MEASURES
The main outcomes were patient preference archetypes and estimated shares of preferences for different strategies to improve TB diagnostic services. Collected data were analyzed between January 3, 2022, to July 2, 2022.
RESULTS
Among 326 adults with TB (median [IQR] age, 34 [27-42] years; 217 [66.8%] male; 158 [48.8%] HIV positive), 3 groups with distinct preferences for TB service improvements were identified. Group 1 (192 participants [58.9%]) preferred a facility that offered same-day TB test results, shorter wait times, and financial incentives for testing. Group 2 (83 participants [25.4%]) preferred a facility that provided same-day TB results, had greater privacy, and was closer to home. Group 3 (51 participants [15.6%]) had no strong preferences for service improvements and had negative preferences for receiving telephone-based TB test results. Groups 1 and 2 were more likely to report at least a 4-week delay in seeking health care for their current TB episode compared with group 3 (29 [51.3%] in group 1, 95 [35.8%] in group 2, and 10 [19.6%] in group 3; P < .001). Strategies to improve TB diagnostic services most preferred by all participants were same-day TB test results alone (shares of preference, 69.9%) and combined with a small financial testing incentive (shares of preference, 79.3%), shortened wait times (shares of preference, 76.1%), or greater privacy (shares of preference, 75.0%). However, the most preferred service improvement strategies differed substantially by group.
CONCLUSIONS AND RELEVANCE
In this study, patients with TB had heterogenous preferences for TB diagnostic service improvements associated with differential health care-seeking behavior. Tailored strategies that incorporate features most valued by persons with undiagnosed TB, including same-day results, financial incentives, and greater privacy, may optimize reach by overcoming key barriers to timely TB care engagement.
Topics: Adult; Cross-Sectional Studies; Diagnostic Services; Female; Humans; Male; Patient Preference; Tuberculosis; Zambia
PubMed: 36036933
DOI: 10.1001/jamanetworkopen.2022.29091 -
Clinical Microbiology and Infection :... Aug 2000
Topics: Communicable Diseases; Diagnostic Services; Humans; Microbiology; Time Factors
PubMed: 11168169
DOI: 10.1046/j.1469-0691.2000.00127.x -
International Journal of Laboratory... Oct 2012The Shared Resource Laboratory (SRL) model recently described for research activities would also appear to be highly suitable for diagnostic services. Using modern SRL...
INTRODUCTION
The Shared Resource Laboratory (SRL) model recently described for research activities would also appear to be highly suitable for diagnostic services. Using modern SRL design criteria and benchmarks, the aim of our study was to verify whether the consolidation of a diagnostic cytofluorimetric activity could improve the overall service.
METHODS
Outcome indicators such as impact on analytical quality, clinical satisfaction, team work involvement, and economic performance were evaluated in the planning and setting up of a new central laboratory. Comparison with preconsolidation status allowed us to investigate possible indicators of improvement.
RESULTS
A total of 30 140 cytofluorimetric analyses performed before and after consolidation at the Central Laboratory in Pievesestina in north-central Italy were evaluated. The overall score of the clinical satisfaction questionnaire (range, between 1 and 5) increased from 4.3 to 4.9. Full-time equivalent (FTE) operators were reduced from 9 to 4.5 and cytofluorimeters from 6 to 2; economic indicator analyses showed a 17.75% reduction in unitary test costs.
CONCLUSIONS
The adoption of new benchmarks and design criteria increased the quality of cytofluorimetric analysis, thus improving specialized diagnostic services and promoting the shared resource clinical laboratory.
Topics: Benchmarking; Blood Specimen Collection; Clinical Laboratory Techniques; Cost-Benefit Analysis; Diagnostic Services; Flow Cytometry; Health Resources; Humans; Medical Laboratory Personnel; Reproducibility of Results
PubMed: 22613137
DOI: 10.1111/j.1751-553X.2012.01431.x -
JAMA Sep 1978
Topics: Costs and Cost Analysis; Diagnostic Services; Physician-Patient Relations
PubMed: 682283
DOI: No ID Found -
Sexually Transmitted Infections Mar 2019To describe the factors that influence gay, bisexual and other men who have sex with men's (gbMSM) experiences with (GCO) in British Columbia (BC), Canada. GCO clients...
Qualitative analysis of the experiences of gay, bisexual and other men who have sex with men who use : a comprehensive internet-based diagnostic service for HIV and other STIs.
OBJECTIVES
To describe the factors that influence gay, bisexual and other men who have sex with men's (gbMSM) experiences with (GCO) in British Columbia (BC), Canada. GCO clients complete an internet-based risk assessment and print a laboratory test requisition form for HIV and other STIs to take to a private laboratory for diagnostic services.
METHODS
Drawing on a purposive stratified sampling framework, we conducted 37 in-depth semistructured interviews with gbMSM who had used GCO at least once between 2015 and 2017.
RESULTS
Participants expressed a preference for GCO (instead of clinic-based testing) because of convenience, privacy and control over specimen collection (specifically with doing one's own throat or anal swab). Participants preferred receiving their results online via GCO compared with phone or email follow-up by clinic staff. GCO was viewed positively because it offers gbMSM living outside of urban city centres easy access to diagnostic services, including access to pooled nucleic acid amplification testing. Many participants also continued to positively view the clinic-based services available for gbMSM in their community. These services were frequently described as highly competent, tailored and comprehensive in responding to more complex needs. For example, attending a clinic was viewed as preferential to GCO in instances where there was a desire to access services addressing co-occurring health issues (eg, mental health; substance use disorders). Almost all of the participants anticipated using both GCO and clinic-based services in the future.
CONCLUSIONS
gbMSM report positive experiences and perceptions of GCO; however, they do not view GCO as a panacea. The results of this study point to the need to ensure that a wide range of integrated service options (eg, online; clinic-based) are available to address the range of sexual health needs of gbMSM living in BC's diverse settings.
Topics: Adult; Aged; British Columbia; Delivery of Health Care; Diagnostic Services; Diagnostic Tests, Routine; HIV; HIV Infections; Homosexuality, Male; Humans; Internet; Male; Middle Aged; Patient Preference; Qualitative Research; Risk Assessment; Sexual Behavior; Sexual Partners; Sexual and Gender Minorities; Sexually Transmitted Diseases; Young Adult
PubMed: 30636705
DOI: 10.1136/sextrans-2018-053645