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1.
Rev. venez. cir. ortop. traumatol ; 53(1): 20-26, jun. 2021. ilus
Artículo en Español | LILACS, LIVECS | ID: biblio-1252895

RESUMEN

Cuando fracasa el tratamiento conservador en el Estadio I de Disfunción del Tendón Tibial posterior (DTTP), se debe indicar sinovectomía y debridamiento del tendón. En este estudio evaluamos la evolución con 8 años mínimo de seguimiento, de los pacientes con esta patología tratados vía tenoscópica. Este es un estudio retrospectivo de pacientes operados entre el año 2008 y el año 2011. En ese período de tiempo se intervinieron 11 pacientes con esta patología. Sólo 9 de los 11 pacientes operados pudieron ser evaluados. 7 pacientes mejoraron su sintomatología según el VAS y no progresaron a estadio II. En 3 pacientes se evidenció lesión tendinosa durante la tendoscopía y ameritaron reparación a cielo abierto. La sinovectomía tendoscópica del TTP es un procedimiento quirúrgico efectivo para tratar a los pacientes con DTTP Estadio I, rebeldes a tratamiento conservador(AU)


When conservative treatment fails for Stage I Posterior Tibial tendon dysfunction (PTTD), synovectomy and tendon debridement is indicated. In this study we evaluate tendoscopic treatment results for this pathology with a minimum of 8 years follow up. This is a retrospective study of patients after tendoscopic surgery performed between 2008 and 2011. 9 of the 11 patients were available for evaluation. 7 improved their symptoms according to VAS scale, and did not progress to stage II. In 3 patients tendon tear was visualized during tendoscopy and needed open repair. PTT tendoscopy is an effective surgical treatment to treat Stage I PTTD, failing to conservative treatment(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Pie Plano , Espectroscopía de Resonancia Magnética , Antiinflamatorios no Esteroideos/uso terapéutico , Disfunción del Tendón Tibial Posterior/patología , Tendinopatía , Sinovectomía , Ultrasonido , Crioterapia , Técnicas y Procedimientos Diagnósticos , Desbridamiento
2.
Rev. cuba. inform. méd ; 13(1): e442, ene.-jun. 2021. tab, graf
Artículo en Español | LILACS, CUMED | ID: biblio-1251728

RESUMEN

El Sistema de Información Hospitalaria XAVIA HIS desarrollado por el Centro de Informática Médica (CESIM) está compuesto por módulos que aseguran la informatización de los procesos de las áreas de la institución hospitalaria. En la actualidad la gestión de los principales medios de diagnóstico se realiza de forma dispersa en diferentes módulos o sistemas. En este trabajo se presenta el módulo de Medios de Diagnóstico, desarrollo que permite la gestión de informes de solicitudes y resultados de forma configurable, así como la planificación de horarios y gestión de citas. Se analizó el proceso de negocio asociado a la gestión de información de medios de diagnóstico, se realizó un estudio de sistemas existentes con propósitos similares y se evaluaron tecnologías para su implementación. Se utilizó AUP-UCI como metodología de desarrollo, Java como lenguaje de programación y otras tecnologías libres y multiplataforma. El patrón arquitectónico implementado fue modelo-vista-controlador. El módulo de Medios de Diagnóstico del sistema XAVIA HIS, permite el soporte de los procesos de atención al paciente y la integración de la información sobre los medios de diagnóstico, además fomenta un aumento en la calidad del servicio. El módulo facilita la configuración de aspectos de solicitud e informe de las pruebas diagnósticas y la planificación de horarios y citas(AU)


Hospital Information System XAVIA HIS developed by the Medical Informatics Center (CESIM) is made up of modules that ensure the computerization of hospital institution areas processes. Currently, the management of the main diagnostic means is realized in a dispersed way in different modules or systems. This paper presents the Diagnostic Means module, development that allows the requests and results reports management in a configurable way, as well as the schedules planning and appointments management. The business process associated with the diagnostic means information management was analyzed, an existing systems study with similar purposes was carried out, and technologies for their implementation were evaluated. AUP-UCI were used as development methodology, Java as programming language and other free and multiplatform technologies. The architectural pattern implemented was model-view-controller. The XAVIA HIS system Diagnostic Means module, allows the patient care processes support and integration of information regarding diagnostic means, also encourages an increase in the service quality. The module facilitates the request and report aspects configuration of the diagnostic tests and the schedules and appointments planning(AU)


Asunto(s)
Humanos , Sistemas de Información en Hospital/normas , Telemedicina , Técnicas y Procedimientos Diagnósticos , Registros Electrónicos de Salud , Estándar HL7/normas
3.
Aktuelle Urol ; 52(3): 237-244, 2021 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-34020505

RESUMEN

Urinary incontinence causes significant limitations in quality of life and reduces mental and physical health. It is a widespread and chronic disease. About 200 million people are affected by urinary incontinence worldwide. Females are more often affected than males. For the therapy of female urinary incontinence various conservative and surgical treatment measures are available. A comprehensive diagnostic work-up is crucial for effective and successful use of those therapeutical measures. The current paper gives a review of diagnostic options for female urinary incontinence: from non-invasive up to invasive investigations. It presents potential pitfalls and possibilities for improving the diagnostic work-up.


Asunto(s)
Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Técnicas y Procedimientos Diagnósticos , Femenino , Humanos , Calidad de Vida , Incontinencia Urinaria/diagnóstico , Incontinencia Urinaria/etiología , Incontinencia Urinaria/terapia
4.
Bull World Health Organ ; 99(4): 312-318, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33953449

RESUMEN

Since January 2020, the coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching impact on global morbidity and mortality. The effects of varying degrees of implementation of public health and social measures between countries is evident in terms of widely differing disease burdens and levels of disruption to public health systems. Despite Thailand being the first country outside China to report a positive case of COVID-19, the subsequent number of cases and deaths has been much lower than in many other countries. As of 7 January 2021, the number of confirmed COVID-19-positive cases in Thailand was 9636 (138 per million population) and the number of deaths was 67 (1 per million population). We describe the nature of the health workforce and function that facilitated the capacity to respond to this pandemic. We also describe the public health policies (laboratory testing, test-and-trace system and mandatory 14-day quarantine of cases) and social interventions (daily briefings, restriction of mobility and social gatherings, and wearing of face masks) that allowed the virus to be successfully contained. To enhance the capacity of health-care workers to respond to the pandemic, the government (i) mobilized staff to meet the required surge capacity; (ii) developed and implemented policies to protect occupational safety; and (iii) initiated packages to support morale and well-being. The results of the policies that we describe are evident in the data: of the 66 countries with more than 100 COVID-19-positive cases in health-care workers as at 8 May 2020, Thailand ranked 65th.


Asunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles/organización & administración , Personal de Salud/organización & administración , Política de Salud , Técnicas y Procedimientos Diagnósticos , Humanos , Salud Mental , Salud Laboral , Pandemias , SARS-CoV-2 , Tailandia
5.
Rev. colomb. cir ; 36(2): 193-204, 20210000. fig, tab
Artículo en Español | LILACS | ID: biblio-1222629

RESUMEN

El propósito de esta publicación es describir los fundamentos de los estudios diagnósticos, proporcionando elementos de juicio para evaluar la validez, puntualizar sobre las medidas de utilidad o rendimiento de las mismas y resaltar la importancia de los estudios diagnósticos en la práctica clínica usual. Dentro de los fundamentos de las pruebas diagnósticas se explican los principios básicos sobre las pruebas diagnósticas, la estructura de estas y se detalla cómo se analizan los resultados de la prueba diagnóstica de interés y los resultados de la prueba diagnóstica de referencia. Se evalúa la validez de una prueba diagnóstica examinando tres criterios importantes que sustentan la solidez metodológica de este tipo de estudio: representatividad, constatación y determinación. Por otro lado, se estudia el primer tipo de medidas de rendimiento de una prueba diagnóstica, las medidas de probabilidad (sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo). Cuando los resultados de una prueba diagnóstica son expresados en una escala cuantitativa continua es necesario escoger "el mejor punto de corte" que se corresponda con una alta sensibilidad y especificidad, para así distinguir los enfermos de los sanos. Con este fin, podemos utilizar las propiedades de la curva COR (acrónimo de Característica Operativa del Receptor). En la presente publicación se describe y pormenoriza la construcción de la curva COR y se puntualiza sobre la mejor manera de analizarla y sacarle provecho. Por último, se ilustra cómo un estudio diagnóstico cambia el paradigma de manejo de una enfermedad


The purpose of this publication is to describe the fundamentals of diagnostic studies, providing elements of judgment to evaluate their validity, to point out their usefulness or performance measures, and to highlight the importance of diagnostic studies in usual clinical practice. Within the fundamentals of diagnostic tests, the basic principles of diagnostic tests, their structure, and how the results of the diagnostic test of interest and the results of the reference diagnostic test are analyzed and explained. The validity of a diagnostic test is eva-luated by examining three important criteria that support the methodological soundness of this type of study: representativeness, verification, and determination. On the other hand, the first type of performance measures of a diagnostic test are studied, the probability measures (sensitivity, specificity, positive predictive value, ne-gative predictive value). When the results of a diagnostic test are expressed on a continuous quantitative scale, it is necessary to choose the best cut-off point that corresponds to high sensitivity and specificity, in order to distinguish the sick from the healthy. To this end, we can use the properties of the ROC (Receiver Operating Characteristics) curve. In this publication, the construction of the ROC curve is described and detailed, and the best way to analyze it and take advantage of it is specified. Finally, it illustrates how a diagnostic study changes the paradigm of disease management


Asunto(s)
Humanos , Técnicas y Procedimientos Diagnósticos , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Prueba de Laboratorio
7.
Medicine (Baltimore) ; 100(12): e25083, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761668

RESUMEN

ABSTRACT: The purpose of this study was to investigate the predictive value of combined clinical and imaging features, compared with the clinical or radiological risk factors only. Moreover, the expected results aimed to improve the identification of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) patients who may have critical outcomes.This retrospective study included laboratory-confirmed SARS-COV-2 cases between January 18, 2020, and February 16, 2020. The patients were divided into 2 groups with noncritical illness and critical illness regarding severity status within the hospitalization. Univariable and multivariable logistic regression models were used to explore the risk factors associated with clinical and radiological outcomes in patients with SARS-COV-2. The ROC curves were performed to compare the prediction performance of different factors.A total of 180 adult patients in this study included 20 critical patients and 160 noncritical patients. In univariate logistic regression analysis, 15 risk factors were significantly associated with critical outcomes. Of importance, C-reactive protein (1.051, 95% confidence interval 1.024-1.078), D-dimer (1.911, 95% CI, 1.050-3.478), and CT score (1.29, 95% CI, 1.053-1.529) on admission were independent risk factors in multivariate analysis. The combined model achieved a better performance in disease severity prediction (P = .05).CRP, D-dimer, and CT score on admission were independent risk factors for critical illness in adults with SARS-COV-2. The combined clinical and radiological model achieved better predictive performance than clinical or radiological factors alone.


Asunto(s)
COVID-19/epidemiología , COVID-19/fisiopatología , Técnicas y Procedimientos Diagnósticos/estadística & datos numéricos , Adulto , Anciano , Proteína C-Reactiva/análisis , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
8.
Front Public Health ; 9: 640009, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33768086

RESUMEN

A simple, common-sense, three-component procedure-the Carrier Separation Plan (CSP)-can immediately halt the transmission of SARS-CoV-2 or a comparable pathogen, allow the safe reopening of an entire economy without the need for social distancing, and quickly eradicate the pathogen from the population (assuming the pathogen can be killed by the immune systems of the carriers). The three components are (a) nearly simultaneous self-testing for the pathogen by an entire population, followed rapidly by (b) nearly simultaneous self-isolation of carriers, and (c) secondary screening at entrances to facilities where people congregate. After a period of preparation lasting roughly 5-10 weeks, these steps could and probably should be taken in a single day. The power of this methodology has already been demonstrated in varying degrees with groups ranging in size from 1,000 to 11 million. Although this plan might seem daunting, its costs are minimal compared to the losses we have incurred by relying on half measures, and the US and other countries have the technological, logistical, and industrial capacities to implement this plan in a matter of weeks. With proper messaging during the weeks leading up to the testing, compliance in such a program is likely to be high given the potential benefits, and because participation is voluntary and testing is noninvasive, the legal and ethical issues associated with such a program are minimal - trivial, in fact, compared to those associated with imposing a months-long lockdown on an entire population. A SIRD/CSP model suggests that the single-day testing and separation procedure will substantially lower the number of infections, even if compliance with the procedure is modest. Modeling also suggests that when long-term secondary screening is added to the 1-day procedure, over time, the pathogen is eradicated from the population. This can occur even when compliance with secondary screening is itself relatively low.


Asunto(s)
COVID-19/prevención & control , Control de Enfermedades Transmisibles/métodos , Técnicas y Procedimientos Diagnósticos/normas , Tamizaje Masivo/métodos , Distanciamiento Físico , Vigilancia de la Población/métodos , Salud Pública/normas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Guías de Práctica Clínica como Asunto , SARS-CoV-2
9.
Am J Hum Genet ; 108(4): 696-708, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33743207

RESUMEN

The complexities of gene expression pose challenges for the clinical interpretation of splicing variants. To better understand splicing variants and their contribution to hereditary disease, we evaluated their prevalence, clinical classifications, and associations with diseases, inheritance, and functional characteristics in a 689,321-person clinical cohort and two large public datasets. In the clinical cohort, splicing variants represented 13% of all variants classified as pathogenic (P), likely pathogenic (LP), or variants of uncertain significance (VUSs). Most splicing variants were outside essential splice sites and were classified as VUSs. Among all individuals tested, 5.4% had a splicing VUS. If RNA analysis were to contribute supporting evidence to variant interpretation, we estimated that splicing VUSs would be reclassified in 1.7% of individuals in our cohort. This would result in a clinically significant result (i.e., P/LP) in 0.1% of individuals overall because most reclassifications would change VUSs to likely benign. In ClinVar, splicing VUSs were 4.8% of reported variants and could benefit from RNA analysis. In the Genome Aggregation Database (gnomAD), splicing variants comprised 9.4% of variants in protein-coding genes; most were rare, precluding unambiguous classification as benign. Splicing variants were depleted in genes associated with dominant inheritance and haploinsufficiency, although some genes had rare variants at essential splice sites or had common splicing variants that were most likely compatible with normal gene function. Overall, we describe the contribution of splicing variants to hereditary disease, the potential utility of RNA analysis for reclassifying splicing VUSs, and how natural variation may confound clinical interpretation of splicing variants.


Asunto(s)
Empalme Alternativo/genética , Técnicas y Procedimientos Diagnósticos , Enfermedad/genética , ARN/análisis , Análisis de Secuencia de ARN , Incertidumbre , Estudios de Cohortes , Simulación por Computador , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , ARN/genética , Sitios de Empalme de ARN/genética
11.
Poult Sci ; 100(3): 100895, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33518305

RESUMEN

The purpose of this study was to explore a specific, simple, and sensitive method for diagnosis of avian infectious laryngotracheitis virus. Recombinase-aided amplification (RAA) and lateral flow dipstick (LFD) were combined for labeling the optimized RAA probe with 6-carboxyfluorescein (FAM) and the 5'-end of the downstream primer with biotin, respectively. By optimizing the reaction time, temperature, and primer concentration of RAA, a RAA-LFD assay, which could be used for detection of infectious laryngotracheitis, was established. After the specificity and sensitivity test, the target gene fragments could be amplified by RAA-LFD assay in 20 min under isothermal conditions (37°C), and the amplification products could be visually observed and determined by LFD within 3 min. There was no cross-reaction with nucleic acids of other avian pathogens, the lowest detectable limit of RAA-LFD was 102 copies/µL, and the sensitivity of this method was 100 times higher than that of conventional PCR with the lowest detectable limit of 104 copies/µL. The results showed that RAA-LFD assay was highly sensitive, easy to use, and more suitable for clinical detection.


Asunto(s)
Enfermedades de las Aves , Técnicas y Procedimientos Diagnósticos , Infecciones por Herpesviridae , Herpesvirus Gallináceo 1 , Técnicas de Amplificación de Ácido Nucleico , Animales , Enfermedades de las Aves/diagnóstico , Enfermedades de las Aves/virología , Técnicas y Procedimientos Diagnósticos/normas , Técnicas y Procedimientos Diagnósticos/veterinaria , Infecciones por Herpesviridae/diagnóstico , Infecciones por Herpesviridae/veterinaria , Infecciones por Herpesviridae/virología , Herpesvirus Gallináceo 1/genética , Técnicas de Amplificación de Ácido Nucleico/normas , Técnicas de Amplificación de Ácido Nucleico/veterinaria , Recombinasas/metabolismo , Sensibilidad y Especificidad
13.
Artif Intell Med ; 111: 101983, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33461683

RESUMEN

CONTEXT AND BACKGROUND: Corona virus (COVID) has rapidly gained a foothold and caused a global pandemic. Particularists try their best to tackle this global crisis. New challenges outlined from various medical perspectives may require a novel design solution. Asymptomatic COVID-19 carriers show different health conditions and no symptoms; hence, a differentiation process is required to avert the risk of chronic virus carriers. OBJECTIVES: Laboratory criteria and patient dataset are compulsory in constructing a new framework. Prioritisation is a popular topic and a complex issue for patients with COVID-19, especially for asymptomatic carriers due to multi-laboratory criteria, criterion importance and trade-off amongst these criteria. This study presents new integrated decision-making framework that handles the prioritisation of patients with COVID-19 and can detect the health conditions of asymptomatic carriers. METHODS: The methodology includes four phases. Firstly, eight important laboratory criteria are chosen using two feature selection approaches. Real and simulation datasets from various medical perspectives are integrated to produce a new dataset involving 56 patients with different health conditions and can be used to check asymptomatic cases that can be detected within the prioritisation configuration. The first phase aims to develop a new decision matrix depending on the intersection between 'multi-laboratory criteria' and 'COVID-19 patient list'. In the second phase, entropy is utilised to set the objective weight, and TOPSIS is adapted to prioritise patients in the third phase. Finally, objective validation is performed. RESULTS: The patients are prioritised based on the selected criteria in descending order of health situation starting from the worst to the best. The proposed framework can discriminate among mild, serious and critical conditions and put patients in a queue while considering asymptomatic carriers. Validation findings revealed that the patients are classified into four equal groups and showed significant differences in their scores, indicating the validity of ranking. CONCLUSIONS: This study implies and discusses the numerous benefits of the suggested framework in detecting/recognising the health condition of patients prior to discharge, supporting the hospitalisation characteristics, managing patient care and optimising clinical prediction rule.


Asunto(s)
COVID-19/fisiopatología , Portador Sano/fisiopatología , Técnicas de Apoyo para la Decisión , Técnicas y Procedimientos Diagnósticos/estadística & datos numéricos , Adulto , Anciano , Simulación por Computador , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Factores de Riesgo , SARS-CoV-2 , Factores de Tiempo
14.
Sci Rep ; 11(1): 2402, 2021 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-33510181

RESUMEN

The COVID-19 pandemic has resulted in an urgent need for a rapid, point of care diagnostic testing that could be rapidly scaled on a worldwide level. We developed and tested a highly sensitive and robust assay based on reverse transcription loop mediated isothermal amplification (RT-LAMP) that uses readily available reagents and a simple heat block using contrived spike-in and actual clinical samples. RT-LAMP testing on RNA-spiked samples showed a limit of detection (LoD) of 2.5 copies/µl of viral transport media. RT-LAMP testing directly on clinical nasopharyngeal swab samples in viral transport media had an 85% positive percentage agreement (PPA) (17/20), and 100% negative percentage agreement (NPV) and delivered results in 30 min. Our optimized RT-LAMP based testing method is a scalable system that is sufficiently sensitive and robust to test for SARS-CoV-2 directly on clinical nasopharyngeal swab samples in viral transport media in 30 min at the point of care without the need for specialized or proprietary equipment or reagents. This cost-effective and efficient one-step testing method can be readily available for COVID-19 testing world-wide, especially in resource poor settings.


Asunto(s)
Prueba de COVID-19/métodos , COVID-19/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificación de Ácido Nucleico/métodos , ARN Viral/aislamiento & purificación , SARS-CoV-2/genética , Técnicas de Laboratorio Clínico/métodos , Técnicas y Procedimientos Diagnósticos , Pruebas Diagnósticas de Rutina , Humanos , Límite de Detección , Pruebas en el Punto de Atención , ARN Viral/genética , Transcripción Reversa , SARS-CoV-2/química , SARS-CoV-2/metabolismo , Sensibilidad y Especificidad
15.
Nat Protoc ; 16(2): 1276-1296, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33462443

RESUMEN

RNA sequencing (RNA-seq) has emerged as a powerful approach to discover disease-causing gene regulatory defects in individuals affected by genetically undiagnosed rare disorders. Pioneering studies have shown that RNA-seq could increase the diagnosis rates over DNA sequencing alone by 8-36%, depending on the disease entity and tissue probed. To accelerate adoption of RNA-seq by human genetics centers, detailed analysis protocols are now needed. We present a step-by-step protocol that details how to robustly detect aberrant expression levels, aberrant splicing and mono-allelic expression in RNA-seq data using dedicated statistical methods. We describe how to generate and assess quality control plots and interpret the analysis results. The protocol is based on the detection of RNA outliers pipeline (DROP), a modular computational workflow that integrates all the analysis steps, can leverage parallel computing infrastructures and generates browsable web page reports.


Asunto(s)
Secuencia de Bases/genética , Expresión Génica/genética , Análisis de Secuencia de ARN/métodos , Diagnóstico , Técnicas y Procedimientos Diagnósticos , Enfermedad/genética , Perfilación de la Expresión Génica/métodos , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Humanos , ARN/genética , Programas Informáticos , Flujo de Trabajo
16.
J Med Internet Res ; 23(2): e22841, 2021 02 23.
Artículo en Inglés | MEDLINE | ID: mdl-33493130

RESUMEN

BACKGROUND: Misdiagnosis, arbitrary charges, annoying queues, and clinic waiting times among others are long-standing phenomena in the medical industry across the world. These factors can contribute to patient anxiety about misdiagnosis by clinicians. However, with the increasing growth in use of big data in biomedical and health care communities, the performance of artificial intelligence (Al) techniques of diagnosis is improving and can help avoid medical practice errors, including under the current circumstance of COVID-19. OBJECTIVE: This study aims to visualize and measure patients' heterogeneous preferences from various angles of AI diagnosis versus clinicians in the context of the COVID-19 epidemic in China. We also aim to illustrate the different decision-making factors of the latent class of a discrete choice experiment (DCE) and prospects for the application of AI techniques in judgment and management during the pandemic of SARS-CoV-2 and in the future. METHODS: A DCE approach was the main analysis method applied in this paper. Attributes from different dimensions were hypothesized: diagnostic method, outpatient waiting time, diagnosis time, accuracy, follow-up after diagnosis, and diagnostic expense. After that, a questionnaire is formed. With collected data from the DCE questionnaire, we apply Sawtooth software to construct a generalized multinomial logit (GMNL) model, mixed logit model, and latent class model with the data sets. Moreover, we calculate the variables' coefficients, standard error, P value, and odds ratio (OR) and form a utility report to present the importance and weighted percentage of attributes. RESULTS: A total of 55.8% of the respondents (428 out of 767) opted for AI diagnosis regardless of the description of the clinicians. In the GMNL model, we found that people prefer the 100% accuracy level the most (OR 4.548, 95% CI 4.048-5.110, P<.001). For the latent class model, the most acceptable model consists of 3 latent classes of respondents. The attributes with the most substantial effects and highest percentage weights are the accuracy (39.29% in general) and expense of diagnosis (21.69% in general), especially the preferences for the diagnosis "accuracy" attribute, which is constant across classes. For class 1 and class 3, people prefer the AI + clinicians method (class 1: OR 1.247, 95% CI 1.036-1.463, P<.001; class 3: OR 1.958, 95% CI 1.769-2.167, P<.001). For class 2, people prefer the AI method (OR 1.546, 95% CI 0.883-2.707, P=.37). The OR of levels of attributes increases with the increase of accuracy across all classes. CONCLUSIONS: Latent class analysis was prominent and useful in quantifying preferences for attributes of diagnosis choice. People's preferences for the "accuracy" and "diagnostic expenses" attributes are palpable. AI will have a potential market. However, accuracy and diagnosis expenses need to be taken into consideration.


Asunto(s)
Inteligencia Artificial , Diagnóstico , Prioridad del Paciente , Médicos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19 , China , Conducta de Elección , Técnicas y Procedimientos Diagnósticos/economía , Femenino , Gastos en Salud , Humanos , Análisis de Clases Latentes , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
18.
Ann Allergy Asthma Immunol ; 126(4): 411-416.e1, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33422649

RESUMEN

BACKGROUND: Alpha-gal syndrome (AGS) is an emerging immunoglobulin E (IgE)-mediated allergy to galactose-alpha-1,3-galactose (alpha-gal). The geographic distribution and burden of AGS in the United States are unknown. OBJECTIVE: To characterize alpha-gal IgE testing patterns and describe the trends and distribution from 2010 to 2018 in the United States. METHODS: This retrospective analysis included all persons tested for alpha-gal IgE antibodies by Viracor-IBT Laboratories (Lee's Summit, Missouri), the primary site of testing in the United States. Data included age and sex of person tested, specimen state of origin, collection date, and result value; persons with at least 1 positive test result (≥0.1 kU/L) were compared with negatives. Proportions tested and with positive test results were calculated using the US Census population estimates. RESULTS: Overall, 122,068 specimens from 105,674 persons were tested for alpha-gal IgE during July 1, 2010, to December 31, 2018. Nearly one-third (34,256, 32.4%) had at least 1 positive result. The number of persons receiving positive test results increased 6-fold from 1110 in 2011 to 7798 in 2018. Of those receiving positive test results, mean [SD] age was 46.9 (19.8) years; men were more likely to test positive than women (43.3% vs 26.0%). Arkansas, Virginia, Kentucky, Oklahoma, and Missouri had the highest number of persons who were tested and had a positive result per 100,000 population. CONCLUSION: More than 34,000 persons, most presumably symptomatic, have received positive test results for IgE antibodies to alpha-gal, suggesting AGS is an increasingly recognized public health problem. The geographic distribution of persons who tested positive is consistent with exposure to Amblyomma americanum ticks.


Asunto(s)
Alérgenos/inmunología , Hipersensibilidad a los Alimentos/inmunología , Galactosa/inmunología , Adolescente , Adulto , Anciano , Animales , Anticuerpos/inmunología , Niño , Preescolar , Técnicas y Procedimientos Diagnósticos , Femenino , Humanos , Inmunoglobulina E/inmunología , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Mordeduras de Garrapatas/inmunología , Garrapatas/inmunología , Estados Unidos , Adulto Joven
19.
Porto Alegre; CEVS/RS; 7 abr. 2021. 1-33 p. ilus., graf., tab., mapas.
Monografía en Portugués | Coleciona SUS, CONASS, SES-RS | ID: biblio-1178004
20.
Porto Alegre; CEVS/RS; 26 mar. 2021. 1-33 p. ilus., graf., tab., mapas.
Monografía en Portugués | Coleciona SUS, CONASS, SES-RS | ID: biblio-1151664
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