Vitamin D Testing in the General Population: A Review of the Clinical and Cost-Effectiveness and Guidelines – Canadian Agency for Drugs and Technologies in Health – January 2015
Rapid Response Report: Summary with Critical Appraisal
“Rising awareness about the potential link between vitamin D deficiency and adverse health outcomes has seen an increase in the rate of vitamin D testing in developed countries. The cost of a single vitamin D test is moderate (e.g., $61.32 in British Colombia) but the elevated testing rate contributes to substantial healthcare costs. Concern over rising costs led to reform in testing coverage in 2010 in Ontario, followed by other provinces. The changes in Ontario were based on a 2010 report by the Ontario Health Technology Advisory Committee (OHTAC) on the clinical utility of vitamin D testing (reviewed in this report). Despite a lack of direct evidence on testing, a recommendation was made against providing testing for the general population. Tests are now indicated only for individuals with specific conditions (i.e., osteoporosis, rickets, osteomalacia, malabsorption syndromes, renal disease, and individuals taking medications that may affect vitamin D status). The Endocrine Society and Osteoporosis Canada also recommend against screening for low risk individuals. There is a lack of evidence to suggest that the rise in test frequency has translated into improved healthcare practices. For example, the temporal increase in testing in Australia has not resulted in improved osteoporosis detection in women aged 45 to 74. There is also a lack of evidence on the cost-effectiveness of testing. In light of the rise in test frequency, assay and cut-off inconsistency, and the lack of evidence for the utility of testing, this report will investigate the clinical and cost-effectiveness of testing in the general population.”Read Full Post | Make a Comment ( Comments Off on Vitamin D Testing in the General Population: A Review of the Clinical and Cost-Effectiveness and Guidelines – Canadian Agency for Drugs and Technologies in Health – January 2015 )
Patient safety alert on standardising the early identification of Acute Kidney Injury – NHS England – 9 June 2014
“A patient safety alert has been issued today (9 June 2014) by NHS England on standardising the early identification of Acute Kidney Injury (AKI). The alert has been issued to all NHS acute trusts and foundation trusts providing pathology services.
A national algorithm, standardising the definition of AKI has now been agreed. This provides the ability to ensure that a timely and consistent approach to the detection and diagnosis of patients with AKI is taken across the NHS.
This algorithm has been endorsed by NHS England and it is recommended that the algorithm is implemented across the NHS. When integrated into a Laboratory Information Management System (LIMS) the algorithm will identify potential cases of AKI from laboratory data in real time and produce a test result. The laboratory system will then send the test result, using existing IT connections to patient management systems.”
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Costing seven day services: The financial implications of seven day services for acute emergency and urgent services and supporting diagnostics – Healthcare Financial Management Association (HFMA) – 17 December 2013
Costing seven day services: The financial implications of seven day services for acute emergency and urgent services and supporting diagnostics – Healthcare Financial Management Association (HFMA) – 17 December 2013Read Full Post | Make a Comment ( Comments Off on Costing seven day services: The financial implications of seven day services for acute emergency and urgent services and supporting diagnostics – Healthcare Financial Management Association (HFMA) – 17 December 2013 )
“Spirometry is one of the most common diagnostic tests performed in primary care but its quality can be very variable. As a result spirometry results cannot be relied on in around a quarter of all patients on GP COPD registers.
This step-by-step guide shows clinicians how to ensure that diagnostic spirometry performed in primary care and other settings is quality assured and provides valid results for patients. It details how spirometry should be performed, the interpretation and reporting of results and methods for quality assurance. The guide also illustrates common technical errors and offers a Top Ten Tips for reporting spirometry results.”Read Full Post | Make a Comment ( Comments Off on A Guide to Performing Quality Assured Diagnostic Spirometry – NHS – 16 April 2013 )
The NHS Technology Adoption Centre (NTAC) has published a Technology Implementation Pack which provides NHS organisations information, guidance and financial savings around implementing D-dimer blood testing in the diagnosis of Deep Vein Thrombosis (DVT) in primary care settings.
“Deep Vein Thrombosis (DVT) is the formation of a blood clot in the deep veins of the legs. When testing for a DVT health professionals can use blood tests to determine the presence and concentration of a marker “D-dimer”. This helps to measure whether a clot has formed and is breaking down. There are a number of products currently on the market which are able to detect D-dimer in the blood. Some of these can be used in primary care settings rather than hospital laboratories.
The rationale behind the use of D-dimer testing within a primary care setting is to speed up patient assessment; this enables clinicians to determine which patients should be urgently referred for hospital intervention. It also aims to give optimum care in terms of patient experience by offering care ‘closer to home’ and assisting signposting to other services where appropriate.
Savings generated from introducing this technology are in relation to the reduction in secondary care referrals for suspected DVT. These relate to those patients who are found to be at low risk and can be excluded from the DVT pathway following both a Wells assessment and D-dimer testing.”
… continues on the siteRead Full Post | Make a Comment ( Comments Off on NHS Technology Adoption Centre NTAC D-Dimer Implementation Pack published – 24 October 2012 )
Generating Evidence for Genomic Diagnostic Test Development – IoM Workshop Summary – 6 May 2011
“Ten years after the sequencing of the human genome, scientists have developed genetic tests that can predict a person’s response to certain drugs, estimate the risk of developing Alzheimer’s disease, and make other predictions based on known links between genes and diseases. However, most clinical practitioners do not use these tests regularly, and genetic testing has yet to become part of routine medical care. One barrier is the lack of evidence for their effectiveness—there is little to show that using these tests improves patients’ health.
The IOM’s Roundtable on Translating Genomic-Based Research for Health held a workshop on November 17, 2010, to explore barriers and solutions to generating evidence for genetic tests. Participants discussed stakeholder views on the use of evidence in decision-making processes such as clearance, reimbursement, clinical practice adoption, and patient utility; innovative methods to generate high-quality evidence more efficiently; and potential ways to overcome current limitations in generating evidence of clinical utility. This document summarizes the workshop.”Read Full Post | Make a Comment ( None so far )
Diagnosing Dementia – [UK] Parliamentary Office of Science and Technology – Postnote #349 January 2010
“Dementia currently affects 700,000 people in the UK, yet only 1 in 3 cases receives a formal diagnosis from a doctor.1 Dementia costs the UK economy £17bn a year and is one of the main causes of disability in later life. A key aim of the Department of Health’s 2009 National Dementia Strategy is early diagnosis. This is intended to improve quality of life through increased support, prevention of harm and reduction in care home admissions. This briefing outlines current diagnostic practices, research into newer tools and service provision proposals that aim to increase early diagnosis.”Read Full Post | Make a Comment ( None so far )
Spotting the Sick Child is funded by the UK Department of Health and is aimed at all front line professionals in the field of child health and teaches the basic facts and relevant examination of the seven commonest presenting complaints in acutely ill children.
[*Subsidised by the UK Department Of Health for UK Medical Professionals until March 2010]
“Helping health care professionals spot children with serious illness.
This is a new interactive tool commissioned by the [UK] department of health to support health professionals in the assessment of the acutely sick child.”
“Why use this website? It is recognised that the assessment of an acutely sick child is challenging and requires health care professionals to have the appropriate skills and competencies. The original DVD of Spotting the Sick Child was developed to support health care professionals spot children with serious illness. Since its release in 2004 the DVD has been a great success and is still a popular seller in the medical education market.
Spotting the Sick Child 2 was commissioned by the Department of Health and has been developed as a collaboration between academics, clinicians, instructional designers and web developers (see contributors) to provide an online interactive and evidence based tool using real life clinical scenario’s and footage. The concept behind the 2nd edition is to expand upon the depth of material and better align the resource with recent changes in both medical training and technology to include:” … continues on the About page for the siteRead Full Post | Make a Comment ( None so far )
Comparative Effectiveness of Core Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions – final research review – AHRQ US – 15 December 2009
Comparative Effectiveness of Core Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions – final research review – AHRQ (US) – 15 December 2009
“Some methods of minimally invasive biopsy for breast cancer are nearly as accurate as surgical biopsy but have much less risk of harms, according to a new report funded by HHS’ Agency for Healthcare Research and Quality (AHRQ).
The report, prepared by the ECRI Institute’s Evidence-based Practice Center under contract to AHRQ’s Effective Health Care Program, compares traditional surgical biopsies with various types of “core needle biopsies,” which involve removing tissue through a special large hollow needle inserted through the skin.”Read Full Post | Make a Comment ( None so far )
Updated antiviral guidelines and rapid tests for diagnosing influenza – Australian National Prescribing Service June 2009
“Guidelines for prescribing antivirals for people who have been in contact with suspected or confirmed cases of swine influenza (H1N1) have been updated by the Department of Health and Ageing following more confirmed cases in Australia. The Department now recommends the following.
Antiviral medication may be prescribed to close contacts of confirmed or influenza A positive suspected cases provided it is commenced within 7 days of last contact with the patient while the patient was still infectious.
Any prescription of antiviral medication should be on the recommendation of the local public health unit.” …continues on the websiteRead Full Post | Make a Comment ( None so far )
Rapid tests for the diagnosis of influenza
Hong Foo, Microbiology Registrar, and Dominic E Dwyer, Clinical Professor of Medicine, Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney
from: Australian Prescriber
Strengthening Forensic Science in the United States: A Path Forward – National Academies Press – February 2009
Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community.
The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs.
While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.
From Canada’s Health Newsweekly – Health Edition Online
Ontario sets ER wait-time targets
February 20, 2009
Ontario is setting firm targets for ER wait times.
The clock starts ticking when a patient registers at the ER and stops when the patient is discharged home or admitted to a hospital bed.
….continues on the Health Edition websiteRead Full Post | Make a Comment ( None so far )