Validation and verification of examination procedures in medical laboratories: opinion of the EFLM Working Group Accreditation and ISO/CEN standards (WG-A/ISO) on dealing with ISO 15189:2012 demands for method verification and validation.

This paper reflects the opinion of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group Accreditation and ISO/CEN standards (WG-A/ISO). It aims to provide guidance for drawing up local/national documents about validation and verification of laboratory methods. We demonstrate how risk evaluation can be used to optimize laboratory policies to meet intended use requirements as well as requirements of standards. This is translated in a number of recommendations on how to introduce risk evaluation in various stages of the implementation of new methods ultimately covering the whole process cycle.

[Selective internal pudendal arteriography in the diagnosis of arteriogenic erectile dysfunction].

OBJECTIVE: To explore the procedure of selective internal pudendal arteriography (IPA) and its application in the diagnosis of arteriogenic erectile dysfunction (AED). METHODS: We performed selective IPA for 62 patients highly suspected of AED with abnormal nocturnal penile tumescence (NPT) and peak systolic velocity (PSV) of the penile cavernosal artery < 25 ml/s. Using digital subtraction angiography, we assessed the stenosis of the main internal pudendal artery and measured the lengths of the dorsal penile arteries and cavernosal arteries. RESULTS: Of the total number of patients, 21 were found with normal internal pudendal arteries, dorsal penile arteries and cavernosal arteries, 7 with abnormal pudendal arteries and atherosclerotic lesions, 37 with inadequately visualized dorsal penile arteries and/or cavernosal arteries, and 3 with both abnormal pundendal and dorsal penile arteries or inadequately visualized cavernosal arteries. No complications were observed except for 3 cases of subcutaneous hematoma at the puncture site. CONCLUSIONS: Selective IPA can display the morphological features of internal pudendal, dorsal penile and cavernosal arteries and help to localize arterial lesions and evaluate blood supply in the penile artery. Therefore, it is a safe and reliable method for the diagnosis of AED.

A Platform for Health Record Management of the Conscripts in the Hellenic Navy.

eMass project aims to digitalize the medical examination procedure of recruitment phase of conscripts in the Hellenic Navy. eMass integrates recruits' Electronic Health Record (EHR), while allows a pre-screening test, through portable telemedicine equipment. The data will be exploited to assess the individual's cardiovascular risk through appropriate digital tools and algorithms. The eMass digital platform, will be accessible to health experts involved in the recruitment procedure for further assessment and processing. Recruits' personal data is stored in the database encrypted using Advanced Encryption Standard (AES). eMass solution contributes to beneficial management and medical data analysis, preventing inessential physical or medical examinations minimizing danger of possible errors and reducing time-consuming processes. Moreover, eMass exploits Electronic Health Record data through a machine-learning based cardiovascular risk assessment tool.

Outpatient Waiting Time at Vietnam Health Facilities: Policy Implications for Medical Examination Procedure.

Our study aims to measure outpatient waiting times at Vietnam health facilities according to the socioeconomic characteristics. We employed the 2015 Vietnam District and Commune Health Facility Survey which was a cross-sectional study designed by the World Bank in collaboration with the Vietnam Health Strategy and Policy Institute. This survey was designed to be representative of six provinces (Dien Bien, Hanoi, Binh Dinh, Dak Lak, Dong Nai, and Dong Thap) drawn from six distinct geographical regions of Vietnam. Data from 4949 outpatients at district hospitals (DHs) and 1724 outpatients at commune health centers (CHCs) were extracted for final analysis. We recorded average outpatient waiting times of 32.58 min at DHs and of 11.58 min at CHCs. Four hundred and forty-five outpatients at DHs (9.0%) and 720 those at CHCs (42.8%) were examined immediately (waiting time = 0 min). Outpatient waiting times were various in six distinct geographical regions. With an investigation according to several socioeconomic characteristics, significant differences in outpatient waiting times were observed at both two levels of health facilities as measured by province, age, self-reported health status, patient's wealth, ethnicity, and health insurance. Conclusions. Outpatient waiting times from arrival at health facility until receiving care were significantly distinct amongst two health facility levels, revealing longer at DHs compared to at CHCs. There was significantly higher proportion of outpatients examined immediately at CHCs compared to at DHs. Our study suggests that, vulnerable populations, with longer outpatient waiting time, should be dealt with in appropriate models towards each medical facility according to key socioeconomic factors to contribute to simplify the process of medical examination and treatment for outpatients.