Articles: mass-screening.
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Pediatr Crit Care Me · Oct 2024
Multicenter StudyDelirium Screening in Critically Ill Children: Secondary Analysis of the Multicenter PICU Up! Pilot Trial Dataset, 2019-2020.
To determine the patient-level factors associated with performing daily delirium screening in PICUs with established delirium screening practices. ⋯ In the 2019-2020 PICU UP! cohort, across six PICUs, delirium screening occurred on only 57% of days, despite the presence of established practices. Female gender, patients in the early stages of their PICU stay, and patients not receiving mechanical ventilation were associated with lower odds of daily delirium screening. Our results highlight the need for structured quality improvement processes to both standardize and increase the frequency of delirium screening.
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
Cost-Effectiveness of HIV Screening in Emergency Departments: Results From the Pragmatic Randomized HIV Testing Using Enhanced Screening Techniques in Emergency Departments Trial.
Identification of HIV remains a critical health priority for which emergency departments (EDs) are a central focus. The comparative cost-effectiveness of various HIV screening strategies in EDs remains largely unknown. The goal of this study was to compare programmatic costs and cost-effectiveness of nontargeted and 2 forms of targeted opt-out HIV screening in EDs using results from a multicenter, pragmatic randomized clinical trial. ⋯ Nontargeted HIV screening was more costly than targeted screening largely due to an increased number of HIV tests performed. Each HIV screening strategy had similar within-strategy costs per new HIV diagnosis with traditional targeted screening yielding the lowest cost per new diagnosis. For settings with budget constraints or very low HIV prevalences, the traditional targeted approach may be preferred; however, given only a slightly higher cost per new HIV diagnosis, ED settings looking to detect the most new cases may prefer nontargeted screening.
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Randomized Controlled Trial Multicenter Study
Five-Year Outcomes of the Danish Cardiovascular Screening (DANCAVAS) Trial.
Limited data suggest a benefit of population-based screening for cardiovascular disease with respect to the risk of death. ⋯ After more than 5 years, the invitation to undergo comprehensive cardiovascular screening did not significantly reduce the incidence of death from any cause among men 65 to 74 years of age. (Funded by the Southern Region of Denmark and others; DANCAVAS ISRCTN Registry number, ISRCTN12157806.).
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The lancet oncology · Jul 2022
Multicenter StudyAberrant circulating tumour DNA methylations as biomarkers for early detection of pancreatic ductal adenocarcinoma: a retrospective study.
Pancreatic ductal adenocarcinoma is a cancer with high mortality and low survival, the early detection of which is hampered by the absence of specific symptoms until an advanced stage is reached. No reliable early screening tool for pancreatic ductal adenocarcinoma is currently available. Circulating tumour DNA (ctDNA) methylation has emerged as a promising new type of biomarker for blood-based early detection of multiple types of cancer. As a part of the PanSeerX study, which aims to discover robust ctDNA methylation markers for multicancer early screening, a customised pancreatic ductal adenocarcinoma-specific targeted methylation sequencing panel has been preliminarily developed and validated for its accuracy in classifying pancreatic ductal adenocarcinoma from retrospective clinical plasma samples. ⋯ The National Key Research and Development Project of China (grant 2019YFC1315904), the 234 Discipline Climbing Plan Project of the First Affiliated Hospital of Naval Military Medical University (grant 2019YXK033), and the Shanghai Science and Technology Committee.
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Randomized Controlled Trial Multicenter Study Comparative Study Pragmatic Clinical Trial
Effect of a Community-Based Medical Oncology Depression Screening Program on Behavioral Health Referrals Among Patients With Breast Cancer: A Randomized Clinical Trial.
Implementation of guideline-recommended depression screening in medical oncology remains challenging. Evidence suggests that multicomponent care pathways with algorithm-based referral and management are effective, yet implementation of sustainable programs remains limited and implementation-science guided approaches are understudied. ⋯ Among patients with breast cancer treated in community-based oncology practices, tailored strategies for implementation of routine depression screening compared with an education-only control group resulted in a greater proportion of referrals to behavioral care. Further research is needed to understand the clinical benefit and cost-effectiveness of this program.