Development and Validation of a Portable Hearing Self-Testing System Based on a Notebook Personal Computer

2015 ◽  
Vol 26 (08) ◽  
pp. 716-723
Author(s):  
Yan Liu ◽  
Dong Yang ◽  
Fen Xiong ◽  
Lan Yu ◽  
Fei Ji ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Personal Computer ◽  
Normal Hearing ◽  
Standard Test ◽  
Test Method ◽  
The Self ◽  
Testing System ◽  
Self Testing ◽  
Hearing Thresholds ◽  
Self Test

Background: Hearing loss affects more than 27 million people in mainland China. It would be helpful to develop a portable and self-testing audiometer for the timely detection of hearing loss so that the optimal clinical therapeutic schedule can be determined. Purpose: The objective of this study was to develop a software-based hearing self-testing system. Research Design: The software-based self-testing system consisted of a notebook computer, an external sound card, and a pair of 10-Ω insert earphones. The system could be used to test the hearing thresholds by individuals themselves in an interactive manner using software. The reliability and validity of the system at octave frequencies of 0.25 Hz to 8.0 kHz were analyzed in three series of experiments. Study Sample: Thirty-seven normal-hearing particpants (74 ears) were enrolled in experiment 1. Forty individuals (80 ears) with sensorineural hearing loss (SNHL) participated in experiment 2. Thirteen normal-hearing participants (26 ears) and 37 participants (74 ears) with SNHL were enrolled in experiment 3. Each participant was enrolled in only one of the three experiments. Data Collection and Analysis: In all experiments, pure-tone audiometry in a sound insulation room (standard test) was regarded as the gold standard. SPSS for Windows, version 17.0, was used for statistical analysis. The paired t-test was used to compare the hearing thresholds between the standard test and software-based self-testing (self-test) in experiments 1 and 2. In experiment 3 (main study), one-way analysis of variance and post hoc comparisons were used to compare the hearing thresholds among the standard test and two rounds of the self-test. Linear correlation analysis was carried out for the self-tests performed twice. The concordance was analyzed between the standard test and the self-test using the kappa method. p < 0.05 was considered statistically significant. Results: Experiments 1 and 2: The hearing thresholds determined by the two methods were not significantly different at frequencies of 250, 500, or 8000 Hz (p > 0.05) but were significantly different at frequencies of 1000, 2000, and 4000 Hz (p < 0.05), except for 1000 Hz in the right ear in experiment 2. Experiment 3: The hearing thresholds determined by the standard test and self-tests repeated twice were not significantly different at any frequency (p > 0.05). The overall sensitivity of the self-test method was 97.6%, and the specificity was 98.3%. The sensitivity was 97.6% and the specificity was 97% for the patients with SNHL. The self-test had significant concordance with the standard test (kappa value = 0.848, p < 0.001). Conclusions: This portable hearing self-testing system based on a notebook personal computer is a reliable and sensitive method for hearing threshold assessment and monitoring.

Evaluation of Hearing and Balance Functions of Patients with Sickle Cell Anemia

2018 ◽  
Vol 23 (2) ◽  
pp. 122-125 ◽  
Author(s):  
Elif Tugba Sarac ◽  
Bilgehan Boke ◽  
Semsettin Okuyucu
Keyword(s):  
Hearing Loss ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Pure Tone ◽  
Mixed Type ◽  
Normal Hearing ◽  
Spontaneous Nystagmus ◽  
Control Group ◽  
Hearing Thresholds ◽  
Significant Difference

Introduction: Sickle cell anemia is a disease characterized by a wide vaso-occlusive incident from micro-vascular incident to muscularactivity. The cochlear function can also get affected by this vaso-occlusion. Objective: It is aimed at determining what kind of effects sickle cell anemia has on hearing and balance system. Methods: This study has been conducted on 46 patients with sickle cell anemia and 45 healthy individuals. For all participants, their pure tone hearing thresholds and videonystagmography (VNG) findings have been determined in 17 frequencies between 125–16.000 Hz. Results: All hearing thresholds between 125 and 16,000 Hz, pure tone averages of patients with sickle cell anemia have been found statistically significant to be higher than the corresponding values in the control group(p < 0.05). The normal hearing rate of patients with sickle cell anemia has been determined to be 71.1% conductive hearing loss (CHL) to be 4.4%, sensorineural hearing loss (SNHL) to be 22.2%, and mixed type hearing loss to be 2.2% in right ear; the normal hearing rate has been determined to be 71.1%, CHL to be 2.2%, SNHL to be 22.2%, and mixed type hearing loss to be 4.4% in left ear. Statistically significant difference has not been found between head shake, spontaneous nystagmus, optokinetic, tracking test batteries, static and dynamic positional tests used in VNG, saccade accuracy and saccade peak velocity, which are saccadic test findings of 2 groups. However, saccadic latency, which is a saccadic test finding, has been determined to be longer in patients with sickle cell anemia in comparison to the control group. Conclusion: While sickle cell anemia causes hearing deficits, it does not have any effect on the central or peripheral vestibular system.

scholarly journals Susceptibility to Residual Inhibition is Associated with Hearing Loss and Tinnitus Chronicity

2020 ◽  
Author(s):  
Suyi Hu ◽  
Lukas Anschuetz ◽  
Deborah A. Hall ◽  
Marco Caversaccio ◽  
Wilhelm Wimmer
Keyword(s):  
Hearing Loss ◽  
Narrow Band ◽  
Auditory Pathway ◽  
Acoustic Stimulation ◽  
Normal Hearing ◽  
Short Term ◽  
Factors Associated ◽  
Band Noise ◽  
Hearing Thresholds ◽  
Residual Inhibition

Residual inhibition, i.e. the temporary suppression of tinnitus loudness after acoustic stimulation, is a frequently observed phenomenon that may have prognostic value for clinical applications. However, it is unclear in which subjects residual inhibition is more likely and how stable the suppression can be induced repeatedly. The primary aim of this work was to evaluate the effect of hearing loss and tinnitus chronicity on residual inhibition susceptibility. The secondary aim was to investigate the short-term repeatability of residual inhibition. Residual inhibition was assessed in 74 tinnitus subjects with 60-second narrow-band noise stimuli in 10 consecutive trials. The subjects were assigned to groups according to their depth of suppression (substantial residual inhibition vs. comparator group). In addition, a categorization in normal hearing and hearing loss groups, related to the degree of hearing loss at the frequency corresponding to the tinnitus pitch, was made. Logistic regression was used to identify factors associated with susceptibility to residual inhibition. Repeatability of residual inhibition was assessed using mixed-effects ordinal regression including post-stimulus time and repetitions as factors. Tinnitus chronicity was not associated with residual inhibition for subjects with hearing loss, while a statistically significant negative association between tinnitus chronicity and residual inhibition susceptibility was observed in normal hearing subjects (odds ratio: 0.63; CI: 0.41 to 0.83; p = 0.0076). Moreover, repeated states of suppression can be stably induced. Our results suggest that long chronicity and residual inhibition susceptibility could be indicators for hidden lesions along the auditory pathway in subjects with normal hearing thresholds at their tinnitus frequency.

scholarly journals The Relevance of the High Frequency Audiometry in Tinnitus Patients with Normal Hearing in Conventional Pure-Tone Audiometry

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Veronika Vielsmeier ◽  
Astrid Lehner ◽  
Jürgen Strutz ◽  
Thomas Steffens ◽  
Peter M. Kreuzer ◽  
...  
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Normal Hearing ◽  
High Frequency Hearing Loss ◽  
Additional Information ◽  
Tinnitus Severity ◽  
Hearing Thresholds ◽  
High Frequency Audiometry

Objective. The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz–8 kHz). Here we explored whether the results of the high frequency audiometry (>8 kHz) provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical characteristics.Subjects and Methods. From the database of the Tinnitus Clinic at Regensburg we identified 75 patients with normal hearing thresholds in the conventional pure-tone audiometry. We contrasted these patients with normal and pathological high-frequency audiogram and compared them with respect to gender, age, tinnitus severity, pitch, laterality and duration, comorbid symptoms and triggers for tinnitus onset.Results. Patients with pathological high frequency audiometry were significantly older and had higher scores on the tinnitus questionnaires in comparison to patients with normal high frequency audiometry. Furthermore, there was an association of high frequency audiometry with the laterality of tinnitus.Conclusion. In tinnitus patients with normal pure-tone audiometry the high frequency audiometry provides useful additional information. The association between tinnitus laterality and asymmetry of the high frequency audiometry suggests a potential causal role for the high frequency hearing loss in tinnitus etiopathogenesis.

scholarly journals Clinical Evaluation of a Self-Testing Kit for Vaginal Infection Diagnosis

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ching-Ju Shen ◽  
Chung-Yao Yang ◽  
Huan-Yun Chen ◽  
Wei-Chun Chen ◽  
Ting-Chang Chang ◽  
...  
Keyword(s):  
Health Management ◽  
Test Method ◽  
Diagnostic Tools ◽  
Vaginal Infection ◽  
Sexually Transmitted ◽  
Test Tool ◽  
Self Testing ◽  
Personal Nature ◽  
Self Test ◽  
Measurable Change

Vaginitis is a common disorder among women of varying ages that arises from a change in the normal pH balance of vaginal bacteria or an infection. Characteristic symptoms of itching, irritation, and odor cause considerable discomfort and increase the risk of contracting other sexually transmitted infections. Because of the sensitive and personal nature of the condition, some women may be reluctant to seek treatment. This behavior not only fails to solve the problem but may also delay medical treatment and result in additional medical complications. The pH changes associated with vaginitis and vaginosis, which are characterized by the presence or absence of inflammation, respectively, are well known but can vary. For example, bacterial vaginosis and trichomoniasis infection will raise vaginal pH above 4.5, while vulvovaginal candidiasis does not result in any measurable change to pH. Nonetheless, diagnostic tools relying on pH measurement are a valuable approach from which additional testing and treatment may be launched. Here, we focused on the use of a vaginal self-test tool and tested 50 patients, including pregnant women. When used according to the instructions, the Hygeia Touch Self-Testing Kit for Vaginal Infection demonstrated over 88% accuracy compared to a clinical diagnostic workup, with a sensitivity of 87% and a specificity of 89% in the patients where the swab was correctly interpreted. This study demonstrated an effective self-test method with high acceptability among women that provided them with greater autonomy regarding health management.

scholarly journals Hematocrit Self-Testing in Patients with Polycythemia Vera: A Proof-of-Concept Study Assessing the Accuracy of the Statstrip Xpress ® 2 Hb/Hct Device and Its Impact on Patients' Quality of Life in Clinical Practice

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1935-1935
Author(s):  
Alicia Rovo ◽  
Claudia Baierlein-Leimbach ◽  
Cesare Medri ◽  
Ioannis Chanias ◽  
Loreen Errass ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Blood Cell ◽  
Financial Support ◽  
Research Funding ◽  
The Self ◽  
Cell Counts ◽  
Self Testing ◽  
Data Points ◽  
Self Test ◽  
At Home

Abstract Introduction: Patients with polycythemia vera (PV) have an increased risk of morbidity and mortality from thromboembolic events and cardiovascular disease, particularly for hematocrit (Hct) levels &gt; 45% (Marchioli et al., 2013). Maintaining Hct &lt; 45% is therefore important to reduce these risks. A device that patients can use to frequently monitor their own Hct levels could provide a detailed picture of the change in Hct over time, enable timely clinical visits and disease management, reduce disease burden, and increase patients' quality of life (QoL). A meter to measure hemoglobin (Hb) and Hct that has been approved for medical professional use (StatStrip Xpress ® 2 Hb/Hct meter, Nova Biomedical Corporation) has potential as an at-home, self-testing device. Purpose: To carry out a proof-of-concept study in clinical practice to test the accuracy of the StatStrip Xpress 2 Hb/Hct meter, to evaluate its feasibility for patient self-testing, and to assess its impact on patient-reported outcomes. Methods: Adults (aged &gt; 18 years) who had PV (according to the World Health Organization 2016 criteria), or conditions with Hct &lt; 35% or Hct &gt; 50%, who required monitoring of Hct/Hb values in clinical practice and who provided informed consent were enrolled from two Swiss centers in this observational study. During each routine visit, patients collected and analyzed a finger-prick blood sample using StatStrip Xpress 2 Hb/Hct (self-test) without guidance or intervention from healthcare professionals (HCPs); HCPs then repeated this test (professional test). At each visit, HCPs also collected and analyzed a venous blood sample using a laboratory hematology analyzer (Sysmex), and patients completed a 15-minute questionnaire about use of the self-test device. The primary endpoint was mean difference in absolute percentage points between Hct values from the professional test and the analyzer (mdiff, 90% confidence interval [CI]; Spearman correlation [r]). Secondary endpoints included mdiff for Hct (%) and Hb (g/dl) between values obtained from the self-test and professional test, and the self-test and analyzer. Other endpoints included the correlation between the professional test Hct values and other blood cell counts. The study was approved by local ethics committees. Results: Blood measurements from 68 visits for 60 patients (PV = 32; other conditions with Hct &lt; 35% or &gt; 50% = 28) were included in the analysis. For the primary endpoint, Hct values were very similar for the analyzer and professional test (66 data points after removal of 1 outlier; mdiff = 0.1% [CI: ‒0.5-0.8]; r = 0.95, p &lt; 0.001). Importantly, Hct results were also similar for the self-test and professional test (63 data points after removal of 2 outliers; mdiff = -0.2% [CI: ‒0.98-0.5]; r = 0.93, p &lt; 0.001) and the analyzer and self-test (64 data points after removal of 2 outliers; mdiff = 0.1% [CI: ‒0.6-0.8]; r = 0.93, p &lt; 0.001). Similar results were obtained for Hb measurements across the tests. There was no correlation between the accuracy of Hct values from the professional test (vs the analyzer) and blood cell counts, but this should be interpreted with caution because there was a limited number of patients with extreme white blood cell and platelet counts. There was no influence of sex (male/female), age (≤ 75 years/&gt; 75 years) or, in the case of patients with PV, time from diagnosis on the results. Responses to the patient questionnaire showed that 92% of patients were satisfied or very satisfied with the self-test device, 100% found it easy to use, and 97% were willing to start using it at home. Of patients with PV, 71% stated that using a self-testing device would make them feel safer and 56% felt that it would have a positive effect on their QoL. Conclusions: This study demonstrates the accuracy of the StatStrip Xpress 2 Hct/Hb meter vs a laboratory analyzer for measuring Hct and Hb levels. Importantly, it shows that measurements taken by patients are as accurate as those taken by HCPs. These findings highlight the potential benefits of introducing an instrument for at-home self-testing to the management of patients with PV or other hematological conditions that require regular Hct/Hb monitoring. Benefits to patients may include increased QoL, improved clinical outcomes, and reduced morbidity and mortality through timely clinical action. In addition, fewer outpatient appointments may mean reduced healthcare costs. Figure 1 Figure 1. Disclosures Rovo: Novartis: Honoraria; BMS: Honoraria; Amgen: Other: Financial support for congresses and conference travel; AstraZeneca: Other; Swedish Orphan Biovitrum AG: Honoraria; AG Alexion: Honoraria; OrPhaSwiss GmbH: Honoraria; AstraZeneca: Honoraria; BMS: Other; Sanofi: Other; Roche: Other; Novartis: Research Funding; CSL Behring: Research Funding; AG Alexion: Research Funding. Baierlein-Leimbach: Novartis Pharma Schweiz AG: Current Employment. Triemer: Novartis Pharma Schweiz AG: Current Employment. McCarthy-Pontier: Novartis Pharma Schweiz AG: Current Employment. Lehmann: AbbVie: Honoraria; Novartis: Research Funding; Janssen: Honoraria; Swedish Orphan Biovitrum AG: Honoraria; Janssen: Other; Roche: Other; Abbvie: Other: Financial support for congress and conference travel ; Amgen: Other: Financial support for congress and conference travel ; Celgene: Research Funding; Incyte: Honoraria; BMS: Honoraria; Amgen: Honoraria.

Clinical Application and Psychometric Properties of a Norwegian Questionnaire for the Self-Assessment of Communication in Quiet and Adverse Conditions Using Two Revised APHAB Subscales

2018 ◽  
Vol 29 (01) ◽  
pp. 025-034 ◽  
Author(s):  
Peder O. Laugen Heggdal ◽  
Øyvind Nordvik ◽  
Jonas Brännström ◽  
Flemming Vassbotn ◽  
Anne Kari Aarstad ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Psychometric Properties ◽  
Hearing Aid ◽  
Normal Hearing ◽  
The Self ◽  
Response Patterns ◽  
Self Assessment ◽  
Adverse Conditions ◽  
Communication Ability ◽  
Hearing Aid Benefit

AbstractDifficulty in following and understanding conversation in different daily life situations is a common complaint among persons with hearing loss. To the best of our knowledge, there is currently no published validated Norwegian questionnaire available that allows for a self-assessment of unaided communication ability in a population with hearing loss.The aims of the present study were to investigate a questionnaire for the self-assessment of communication ability, examine the psychometric properties of this questionnaire, and explore how demographic variables such as degree of hearing loss, age, and sex influence response patterns.A questionnaire based on the subscales of the Norwegian translation of the Abbreviated Profile of Hearing Aid Benefit was applied to a group of hearing aid users and normal-hearing controls.A total of 108 patients with bilateral hearing loss, and 101 controls with self-reported normal hearing.The psychometric properties were evaluated. Associations and differences between outcome scores and descriptive variables were examined. A regression analysis was performed to investigate whether descriptive variables could predict outcome.The measures of reliability suggest that the questionnaire has satisfactory psychometric properties, with the outcome of the questionnaire correlating to hearing loss severity, thus indicating that the concurrent validity of the questionnaire is good.The findings indicate that the proposed questionnaire is a valid measure of self-assessed communication ability in both quiet and adverse listening conditions in participants with and without hearing loss.

Hidden hearing loss in tinnitus with normal hearing thresholds

2016 ◽  
Vol 139 (4) ◽  
pp. 2075-2075
Author(s):  
Brandon T. Paul ◽  
Ian Bruce ◽  
Larry Roberts
Keyword(s):  
Hearing Loss ◽  
Normal Hearing ◽  
Hearing Thresholds ◽  
Hidden Hearing Loss

Motivation to Address Self-Reported Hearing Problems in Adults With Normal Hearing Thresholds

2017 ◽  
Vol 60 (12) ◽  
pp. 3642-3655 ◽  
Author(s):  
Carly C. M. Alicea ◽  
Karen A. Doherty
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Rhode Island ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
Personal Distress ◽  
Motivation To Change ◽  
Hearing Thresholds ◽  
Hearing Handicap ◽  
Hearing Problems

PurposeThe purpose of this study was to compare the motivation to change in relation to hearing problems in adults with normal hearing thresholds but who report hearing problems and that of adults with a mild-to-moderate sensorineural hearing loss. Factors related to their motivation were also assessed.MethodThe motivation to change in relation to self-reported hearing problems was measured using the University of Rhode Island Change Assessment (McConnaughy, Prochaska, & Velicer, 1983). The relationship between objective and subjective measures and an adult's motivation was examined.ResultsThe level of hearing handicap did not differ significantly between adults with normal hearing who reported problems hearing in background noise and adults who had a mild-to-moderate sensorineural hearing loss. Hearing handicap, personal distress, and minimization of hearing loss were factors significantly related to motivation. Age, degree of hearing loss, speech-in-noise scores, working memory, and extended high-frequency average thresholds were not significantly related to their motivation.ConclusionsAdults with normal hearing thresholds but self-reported hearing problems had the same level of hearing handicap and were equally motivated to take action for their hearing problems as age-matched adults with a mild-to-moderate sensorineural hearing loss. Hearing handicap, personal distress, and minimization of hearing loss were most strongly correlated with an individual's motivation to change.

scholarly journals Feasibility of large-scale population testing for SARS-CoV-2 detection by self-testing at home

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paula Iruzubieta ◽  
Tatiana Fernández-Lanas ◽  
Laura Rasines ◽  
Lorena Cayon ◽  
Ana Álvarez-Cancelo ◽  
...  
Keyword(s):  
Large Scale ◽  
Rapid Test ◽  
The Self ◽  
Healthcare Personnel ◽  
Testing Strategy ◽  
Self Testing ◽  
Scale Population ◽  
Self Test ◽  
Test Result ◽  
At Home

AbstractThe simplicity and low cost of rapid point-of-care tests greatly facilitate large-scale population testing, which can contribute to controlling the spread of the COVID-19 virus. We evaluated the applicability of a self-testing strategy for SARS-CoV2 in a population-based, cross-sectional study in Cantabria, Spain, between April and May 2020. For the self-testing strategy, participants received the necessary material for the self-collection of blood and performance of a rapid antibody test using lateral flow immunoassay at home without the supervision of healthcare personnel. A total of 1,022 participants were enrolled. Most participants correctly performed the COVID-19 self-test the first time (91.3% [95% CI 89.4–92.9]). Only a minority of the participants (0.7%) needed the help of healthcare personnel, while 6.9% required a second kit delivery, for a total valid test result in 96.9% of the participants. Incorrect use of the self-test was not associated with the educational level, age over 65, or housing area. Prevalence of IgG antibodies against SARS-CoV2 for subjects with a valid rapid test result was 3.1% (95% CI 2.2–4.4), similar to the seroprevalence result obtained using a conventional approach carried out by healthcare professionals. In conclusion, COVID-19 self-testing should be considered as a screening tool.

scholarly journals Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S426-S426
Author(s):  
Nitika Pant Pai ◽  
Megan Smallwood ◽  
Laurence Desjardins ◽  
Alexandre Goyette ◽  
Anne-Fanny Vassal ◽  
...  
Keyword(s):  
Testing Procedure ◽  
The Self ◽  
Health Clinic ◽  
Test Results ◽  
Testing Strategy ◽  
Self Testing ◽  
Hiv Test ◽  
Post Test ◽  
Self Test ◽  
Sex With Men

Abstract Background Although HIV self-tests are recommended by the WHO, they are not yet approved in Canada. Service delivery gaps such as linkages to counseling and care remain unachieved by offering self-tests without adequate support. In this first Canadian study, we evaluated the feasibility of operationalizing an innovative HIVSmart! app-optimized oral HIV self-testing strategy in men who have sex with men (MSM), presenting at a large sexual health clinic in Montreal. Methods Between July 2016 to February 2017, participants were offered the OraQuick In-Home HIV Test, and a tablet installed with the HIVSmart! app, at a private office in the clinic to simulate an unsupervised home environment. With the HIVSmart! app, participants independently performed and interpreted self-tests, and were linked to in-person post-test counseling and care. Self-test results were confirmed by laboratory tests (p24, Western Blot, RNA as needed). Results The mean age of the 451 participants was 34 years (18–73); 85% were well educated (beyond high school, n = 371/438); 53% (230/438) were frequent testers (past 6 months), and 13% were on PrEP (52/451). 99% (417/422) of participants found the HIVSmart! app helpful in guiding them through the self-testing procedure; 93% (418/451) of participants interpreted their tests accurately; and 94% (395/419) stated they would recommend the app-optimized self-testing strategy to their partners. Feasibility (completion rate of self-testing) was 93% (419/451), and acceptability of the strategy was high at 99% (451/458). All HIV self-test negative participants (448/451, 100%) were counseled following the self-test. Three participants self-tested positive, were confirmed HIV positive (0.7% prevalence), and were rapidly linked to care with a physician. Conclusion The HIVSmart! app-optimized strategy was feasible, and highly accepted by an educated, frequently testing, urban MSM population of Montréal. With the app, participants were able to interpret their test results accurately and were rapidly linked to care. Innovations like HIVSmart! which engage, aid, and facilitate linkages to care, can be adapted to suit the needs of many populations in Canada and internationally, maximizing global impact through reverse innovation. Disclosures All authors: No reported disclosures.

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