scholarly journals Automated collection of pathogen-specific diagnostic data for real-time syndromic epidemiological studies

2017 ◽  
Author(s):  
Lindsay Meyers ◽  
Christine C. Ginocchio ◽  
Aimie N. Faucett ◽  
Frederick S. Nolte ◽  
Per H. Gesteland ◽  
...  
Keyword(s):  
Real Time ◽  
Standard Of Care ◽  
The United States ◽  
Epidemiological Studies ◽  
Respiratory Pathogen ◽  
Molecular Diagnostic ◽  
Patient Privacy ◽  
Public Health Professionals ◽  
Clinical Laboratories ◽  
Molecular Diagnostic Test

AbstractHealth-care and public health professionals rely on accurate, real-time monitoring of infectious diseases for outbreak preparedness and response. Early detection of outbreaks is improved by systems that are pathogen-specific. We describe a system, FilmArray® Trend, for rapid disease reporting that is syndrome-based but pathogen-specific. Results from a multiplex molecular diagnostic test are sent directly to a cloud database. www.syndromictrends.com presents these data in near real-time. Trend preserves patient privacy by removing or obfuscating patient identifiers. We summarize the respiratory pathogen results, for 20 organisms from 344,000 patient samples acquired as standard of care testing over the last four years from 20 clinical laboratories in the United States. The majority of pathogens show influenza-like seasonality, rhinovirus has fall and spring peaks and adenovirus and bacterial pathogens show constant detection over the year. Interestingly, the rate of pathogen co-detections, on average 7.7%, matches predictions based on the relative abundance of organisms present.

scholarly journals Automated Real-Time Collection of Pathogen-Specific Diagnostic Data: Syndromic Infectious Disease Epidemiology (Preprint)

2018 ◽  
Author(s):  
Lindsay Meyers ◽  
Christine C Ginocchio ◽  
Aimie N Faucett ◽  
Frederick S Nolte ◽  
Per H Gesteland ◽  
...  
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Real Time ◽  
Large Scale ◽  
The United States ◽  
Molecular Diagnostic ◽  
Respiratory Pathogens ◽  
Test Results ◽  
Patient Privacy ◽  
Clinical Laboratories

BACKGROUND Health care and public health professionals rely on accurate, real-time monitoring of infectious diseases for outbreak preparedness and response. Early detection of outbreaks is improved by systems that are comprehensive and specific with respect to the pathogen but are rapid in reporting the data. It has proven difficult to implement these requirements on a large scale while maintaining patient privacy. OBJECTIVE The aim of this study was to demonstrate the automated export, aggregation, and analysis of infectious disease diagnostic test results from clinical laboratories across the United States in a manner that protects patient confidentiality. We hypothesized that such a system could aid in monitoring the seasonal occurrence of respiratory pathogens and may have advantages with regard to scope and ease of reporting compared with existing surveillance systems. METHODS We describe a system, BioFire Syndromic Trends, for rapid disease reporting that is syndrome-based but pathogen-specific. Deidentified patient test results from the BioFire FilmArray multiplex molecular diagnostic system are sent directly to a cloud database. Summaries of these data are displayed in near real time on the Syndromic Trends public website. We studied this dataset for the prevalence, seasonality, and coinfections of the 20 respiratory pathogens detected in over 362,000 patient samples acquired as a standard-of-care testing over the last 4 years from 20 clinical laboratories in the United States. RESULTS The majority of pathogens show influenza-like seasonality, rhinovirus has fall and spring peaks, and adenovirus and the bacterial pathogens show constant detection over the year. The dataset can also be considered in an ecological framework; the viruses and bacteria detected by this test are parasites of a host (the human patient). Interestingly, the rate of pathogen codetections, on average 7.94% (28,741/362,101), matches predictions based on the relative abundance of organisms present. CONCLUSIONS Syndromic Trends preserves patient privacy by removing or obfuscating patient identifiers while still collecting much useful information about the bacterial and viral pathogens that they harbor. Test results are uploaded to the database within a few hours of completion compared with delays of up to 10 days for other diagnostic-based reporting systems. This work shows that the barriers to establishing epidemiology systems are no longer scientific and technical but rather administrative, involving questions of patient privacy and data ownership. We have demonstrated here that these barriers can be overcome. This first look at the resulting data stream suggests that Syndromic Trends will be able to provide high-resolution analysis of circulating respiratory pathogens and may aid in the detection of new outbreaks.

scholarly journals Testing telediagnostic thyroid ultrasound in Peru: a new horizon in expanding access to imaging in rural and underserved areas

2021 ◽  
Author(s):  
T. J. Marini ◽  
S. L. Weiss ◽  
A. Gupta ◽  
Y. T. Zhao ◽  
T. M. Baran ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Standard Of Care ◽  
The United States ◽  
Epidemiological Studies ◽  
Thyroid Ultrasound ◽  
Target Region ◽  
Experienced Radiologist ◽  
Significant Difference ◽  
Size Evaluation

Abstract Purpose Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide. Methods The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard. Results Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen’s kappa 0.91, P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care. Conclusion Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.

scholarly journals Randomized prospective evaluation of genome sequencing versus standard-of-care as a first molecular diagnostic test

2021 ◽  
Author(s):  
Deanna G. Brockman ◽  
Christina A. Austin-Tse ◽  
Renée C. Pelletier ◽  
Caroline Harley ◽  
Candace Patterson ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Genome Sequencing ◽  
Standard Of Care ◽  
Molecular Diagnostic ◽  
Prospective Evaluation ◽  
Molecular Diagnostic Test

scholarly journals Transferring a Quantitative Molecular Diagnostic Test to Multiple Real-Time Quantitative PCR Platforms

2018 ◽  
Vol 20 (4) ◽  
pp. 398-414 ◽  
Author(s):  
Claudia Gürtler ◽  
Mark Laible ◽  
Wolfgang Schwabe ◽  
Heike Steinhäuser ◽  
Xingmin Li ◽  
...  
Keyword(s):  
Real Time ◽  
Diagnostic Test ◽  
Quantitative Pcr ◽  
Molecular Diagnostic ◽  
Real Time Quantitative Pcr ◽  
Molecular Diagnostic Test

scholarly journals Rapid Telehealth Implementation during the COVID-19 Global Pandemic: A Rapid Review

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 517
Author(s):  
Cristian Lieneck ◽  
Joseph Garvey ◽  
Courtney Collins ◽  
Danielle Graham ◽  
Corein Loving ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Organizations ◽  
Standard Of Care ◽  
The United States ◽  
Rapid Review ◽  
Patient Privacy ◽  
Privacy And Security ◽  
Global Pandemic ◽  
Facilitators And Barriers

The implementation and continued expansion of telehealth services assists a variety of health care organizations in the delivery of care during the current COVID-19 global pandemic. However, limited research has been conducted on recent, rapid telehealth implementation and expansion initiatives regarding facilitators and barriers surrounding the provision of quality patient care. Our rapid review evaluated the literature specific to rapid telehealth implementation during the current COVID-19 pandemic from three research databases between January 2020 and May 2020 and reported using preferred reporting items for systematic reviews and meta-analyses (PRISMA). The results indicate the rapid implementation and enhanced use of telehealth during the COVID-19 pandemic in the United States surrounding the facilitators and barriers to the provision of patient care, which are categorized into three identified themes: (1) descriptive process-oriented implementations, (2) the interpretation and infusion of the CARES Act of 2020 telehealth exemptions related to the relaxation of patient privacy and security (HIPAA) protocols, and (3) the standard of care protocols and experiences addressing organizational liability and the standard of care. While the study limitation of sample size exists (n = 21), an identification of rapid telehealth implementation advancements and challenges during the current pandemic may assist health care organizations in the delivery of ongoing quality care during the COVID-19 pandemic.

scholarly journals Assessing a chip based rapid RTPCR test for SARS CoV-2 detection (TrueNat assay): A diagnostic accuracy study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257834
Author(s):  
Ujjala Ghoshal ◽  
Atul Garg ◽  
Shruthi Vasanth ◽  
Akshay K. Arya ◽  
Ankita Pandey ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Real Time ◽  
Gold Standard ◽  
Standard Test ◽  
Molecular Diagnostic ◽  
Resource Limited ◽  
Accuracy Study ◽  
Trained Manpower ◽  
Sensitivity Specificity ◽  
Molecular Diagnostic Test

COVID-19 testing is required before admission of a patient in the hospitals, invasive procedures, major and minor surgeries etc. Real Time Polymerase chain reaction is the gold standard test for the diagnosis, but requires well equipped biosafety laboratory along with trained manpower. In this study we have evaluated the diagnostic accuracy of novel TrueNat molecular assay for detecting SARS CoV-2. TrueNat is a chip-based real time PCR test and works on portable, light weight, battery powered equipment and can be used in remote areas with poor infrastructure. In this study 1807 patients samples were collected for both TrueNat and RTPCR COVID-19 testing during study period. Of these 174 (9.7%) and 174 (15%) were positive by RTPCR and TrueNat respectively and taking results of RTPCR as gold standard TrueNat test showed a sensitivity, specificity and diagnostic accuracy of 69.5, 90.9% and 89.2% respectively. It can be concluded that TrueNat is a simple, easy to use, good rapid molecular diagnostic test for diagnosis of COVID-19 especially in resource limited settings and will prove to be a game changer of molecular diagnostics in future.

scholarly journals Extraction-free COVID-19 (SARS-CoV-2) diagnosis by RT-PCR to increase capacity for national testing programmes during a pandemic

2020 ◽  
Author(s):  
Paul R Grant ◽  
Melanie A Turner ◽  
Gee Yen Shin ◽  
Eleni Nastouli ◽  
Lisa J Levett
Keyword(s):  
Real Time ◽  
Rna Extraction ◽  
Random Access ◽  
Extraction Process ◽  
Molecular Diagnostic ◽  
Qrt Pcr ◽  
Multistep Process ◽  
Automated Platform ◽  
Thermal Cycler ◽  
Molecular Diagnostic Test

AbstractSevere Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19), a respiratory tract infection. The standard molecular diagnostic test is a multistep process involving viral RNA extraction and real-time quantitative reverse transcriptase PCR (qRT-PCR). Laboratories across the globe face constraints on equipment and reagents during the COVID-19 pandemic. We have developed a simplified qRT-PCR assay that removes the need for an RNA extraction process and can be run on a real-time thermal cycler. The assay uses custom primers and probes, and maintains diagnostic sensitivity within 98.0% compared to the assay run on a high-throughput, random-access automated platform, the Panther Fusion (Hologic). This assay can be used to increase capacity for COVID-19 testing for national programmes worldwide.

scholarly journals Evaluation of Commercial Molecular Diagnostic Methods for Detection and Determination of Macrolide Resistance in Mycoplasma pneumoniae

2020 ◽  
Vol 58 (6) ◽  
Author(s):  
Sixto M. Leal ◽  
Arthur H. Totten ◽  
Li Xiao ◽  
Donna M. Crabb ◽  
Amy Ratliff ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Large Scale ◽  
The United States ◽  
Macrolide Resistance ◽  
Diagnostic Methods ◽  
Respiratory Pathogen ◽  
Molecular Diagnostic ◽  
Content Type ◽  
Significant Difference ◽  
The Impact

ABSTRACT We evaluated six commercial molecular tests targeting Mycoplasma pneumoniae, namely, the BioFire FilmArray respiratory panel (RP), the Meridian Alethia Mycoplasma Direct, the GenMark ePlex respiratory pathogen panel (RPP), the Luminex NxTAG RPP, the ELITech ELITe InGenius Mycoplasma MGB research use only (RUO) PCR, and the SpeeDx Resistance Plus MP assays. Laboratory-developed PCR assays at the University of Alabama at Birmingham and the Centers for Disease Control and Prevention were used as reference standards. Among 428 specimens, 212 were designated confirmed positives for M. pneumoniae. The highest clinical sensitivities were found with the InGenius PCR (99.5%) and the FilmArray RP (98.1%). The Resistance Plus MP identified 93.3% of the confirmed-positive specimens, whereas 83.6, 64.6, and 55.7% were identified by the ePlex RPP, NxTAG RPP, and Mycoplasma Direct assays, respectively. There was no significant difference between the sensitivity of the reference methods and that of the FilmArray RP and InGenius assays, but the remaining four assays detected significantly fewer positive specimens (P < 0.05). Specificities of all assays were 99.5 to 100%. The Resistance Plus MP assay detected macrolide resistance in 27/33 specimens, resulting in a sensitivity of 81.8%. This study provides the first large-scale comparison of commercial molecular assays for detection of M. pneumoniae in the United States and identified clear differences among their performance. Additional studies are necessary to explore the impact of various test performances on patient outcome.

Potential Urban Rainfall Prediction Measurement System

1984 ◽  
Vol 16 (8-9) ◽  
pp. 349-362 ◽  
Author(s):  
John L Vogel
Keyword(s):  
Real Time ◽  
The United States ◽  
Monitoring Systems ◽  
Climatic Region ◽  
Convective Storm ◽  
Rainfall Prediction ◽  
Water Quality Regulations ◽  
General Data ◽  
Real Time Information ◽  
Time Information

Continued growth of urban regions and more stringent water quality regulations have resulted in an increased need for more real-time information about past, present, and future patterns and intensities of precipitation. Detailed, real-time information about precipitation can be obtained using radar and raingages for monitoring and prediction of precipitation amounts. The philosophy and the requirements for the development of real-time radar prediction-monitoring systems are described for climatic region similar to the Midwest of the united States. General data analysis and interpretation techniques associated with rainfall from convective storm systems are presented.

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