Point of Care Testing is een innovative stroming binnen de geneeskunde. Aan de hand van een voorbeeld, waarbij het doel is flebitis in een vroeg stadium te kunnen onderkennen, wordt in dit artikel het belang van deze methode toegelicht.
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In this post I give an overview of the theory, tools, frameworks and best practices I have found until now around the testing (and debugging) of machine learning applications. I will start by giving an overview of the specificities of testing machine learning applications.
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Purpose – purpose of this article is to report about the progress of the development of a method that makes sense of knowledge productivity, in order to be able to give direction to knowledge management initiatives. Methodology/approach – the development and testing of the method is based on the paradigm of the Design Sciences. In order to increase the objectivity of the research findings, and in order to test the transferability of the method, this article suggests a methodology for beta testing. Findings – based on the experiences within this research, the concept of beta testing seems to fit Design Science Research very well. Moreover, applying this concept within this research resulted in valuable findings for further development of the method. Research implications – this is the first article that explicitly applies the concept of beta testing to the process of developing solution concepts. Originality/value – this article contributes to the further operationalization of the relatively new concept of knowledge productivity. From a methodological point of view, this article aims to contribute to the paradigm of the Design Sciences in general, and the concept of beta testing in particular.
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In het werkveld van Life Sciences & Chemistry heeft Innovative testing te maken met het testen van stoffen op hun werking en veiligheid. Met stoffen wordt hier bedoeld alle mogelijke chemicaliën waar aan we blootgesteld worden, zoals chemicaliën in onze leef- en werkomgeving, medicijnen (inclusief biologicals), maar ook stoffen in de voeding (inclusief voedselbestanddelen en natuurlijke stoffen). Mijn les zal echter voornamelijk gaan over de laatste twee categorieën, medicijnen en stoffen in de voeding. Ik wil in mijn openbare les eerst uiteenzetten waarom het zo belangrijk is om vast te stellen wat de werking en veiligheid van stoffen is. Vervolgens wil ik beschrijven welke innovaties op dit moment al plaatsvinden, in de toxicologie en de farmacologie. Dit wil ik doen om aan te geven waar de parallellen en mogelijkheden voor synergie liggen. Daarna zal ik aan de hand van een aantal voorbeelden aangeven tegen welke grenzen men zoal aanloopt bij het testen van werking en veiligheid van stoffen, om daarbij ook aan te geven dat er duidelijk aanwijzingen zijn voor het vervagen van grenzen tussen farmacologie en toxicologie. Tot slot zal ik aangeven welke rol het Kenniscentrum Life Sciences & Chemistry van Hogeschool Utrecht op het gebied van onderzoek én onderwijs in het werkveld van Innovative testing in Life Sciences & Chemistry wil gaan spelen.
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Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases were performed for articles describing reference values for CPET published between March 2014 and February 2019. Expert opinion: Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well defined in consensus statements.
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In de openbare les van mijn collega lector Raymond Pieters, is het domein van het lectoraat ‘Innovative Testing in Life Sciences & Chemistry’ toegelicht. Kort samengevat richt dit lectoraat zich op de ontwikkeling en toepassing van innovatieve teststrategieën om geneesmiddelen, voedingsmiddelen of chemicaliën (stoffen) te beoordelen op hun werkzaamheid (effectiviteit) en veiligheid. De nadruk ligt op de ontwikkeling van snelle, kosteneffectieve testmethoden die een relevante voorspelling van effecten op de gezondheid van de mens en het milieu opleveren én waarbij geen of minder proefdieren worden gebruikt. In mijn les zal ik u laten zien waar proefdieren voor gebruikt worden. Hierbij zal ik mij voornamelijk richten op de Nederlandse situatie. Ik zal ingaan op de wetenschappelijke en maatschappelijke wens om minder proefdieren te gebruiken en op de vraag wat we verstaan onder ‘alternatieven voor dierproeven’. Daarna zal ik bespreken waarom er in Nederland en Europa recentelijk meer aandacht is voor dit onderwerp. Het overzicht zal niet uitputtend zijn, maar zal u een goede indruk geven van het landschap. Ook zal ik stil staan bij de vraag: Waarom zijn we tot nog toe zo weinig succesvol geweest op het gebied van alternatieven voor dierproeven? Wat zijn de obstakels en wat kunnen we hier van leren? Hoe zouden we in de praktijk de toepassing van alternatieven kunnen stimuleren? Wat moet er beter, en hoe gaan we dat doen? Als we slimmer willen testen moeten we de huidige grenzen verleggen, of beter over de grenzen van ons vakgebied heen kijken. Ik zal aangeven waar prioriteiten liggen en hoe we de meeste ‘winst’ kunnen behalen in termen van proefdiervermindering in relatie tot productinnovatie. Tot slot zal ik aangeven welke bruggen we moeten bouwen en wat de rol is van de Hogeschool Utrecht
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Standard SARS-CoV-2 testing protocols using nasopharyngeal/throat (NP/T) swabs are invasive and require trained medical staff for reliable sampling. In addition, it has been shown that PCR is more sensitive as compared to antigen-based tests. Here we describe the analytical and clinical evaluation of our in-house RNA extraction-free saliva-based molecular assay for the detection of SARS-CoV-2. Analytical sensitivity of the test was equal to the sensitivity obtained in other Dutch diagnostic laboratories that process NP/T swabs. In this study, 955 individuals participated and provided NP/T swabs for routine molecular analysis (with RNA extraction) and saliva for comparison. Our RT-qPCR resulted in a sensitivity of 82,86% and a specificity of 98,94% compared to the gold standard. A false-negative ratio of 1,9% was found. The SARS-CoV-2 detection workflow described here enables easy, economical, and reliable saliva processing, useful for repeated testing of individuals.
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Background: In the Netherlands, general practitioners (GPs) play a key role in provider-initiated HIV testing, but opportunities for timely diagnosis are regularly missed. We implemented an educational intervention to improve HIV testing by GPs from 2015 to 2020, and observed a 7% increase in testing in an evaluation using laboratory data. The objective for the current study was to gain a deeper understanding of whether and how practices and perceptions of GPs’ HIV/sexually transmitted infection (STI) testing behaviour changed following the intervention. Methods: We performed a mixed-methods study using questionnaires and semi-structured interviews to assess self-reported changes in HIV/STI testing by participating GPs. Questionnaires were completed by participants at the end of the final educational sessions from 2017 through 2020, and participating GPs were interviewed from January through March 2020. Questionnaire data were analysed descriptively, and open question responses were categorised thematically. Interview data were analysed following thematic analysis methods. Results: In total, 101/103 participants completed questionnaires. Of 65 participants that were included in analyses on the self-reported effect of the programme, forty-seven (72%) reported it had changed their HIV/STI testing, including improved STI consultations, adherence to the STI consultation guideline, more proactive HIV testing, and more extragenital STI testing. Patients’ risk factors, patients’ requests and costs were most important in selecting STI tests ordered. Eight participants were interviewed and 15 themes on improved testing were identified, including improved HIV risk-assessment, more proactive testing for HIV/STI, more focus on HIV indicator conditions and extragenital STI testing, and tools to address HIV during consultations. However, several persistent barriers for optimal HIV/STI testing by GPs were identified, including HIV-related stigma and low perceived risk. Conclusions: Most GPs reported improved HIV/STI knowledge, attitude and testing, but there was a discrepancy between reported changes in HIV testing and observed increases using laboratory data. Our findings highlight challenges in implementation of effective interventions, and in their evaluation. Lessons learned from this intervention may inform follow-up initiatives to keep GPs actively engaged in HIV testing and care, on our way to zero new HIV infections.
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While the original definition of replacement focuses on the replacement of the use of animals in science, a more contemporary definition focuses on accelerating the development and use of predictive and robust models, based on the latest science and technologies, to address scientific questions without the use of animals. The transition to animal free innovation is on the political agenda in and outside the European Union. The Beyond Animal Testing Index (BATI) is a benchmarking instrument designed to provide insight into the activities and contributions of research institutes to the transition to animal free innovation. The BATI allows participating organizations to learn from each other and stimulates continuous improvement. The BATI was modelled after the Access to Medicine Index, which benchmarks pharmaceutical companies on their efforts to make medicines widely available in developing countries. A prototype of the BATI was field-tested with three Dutch academic medical centers and two universities in 2020-2021. The field test demonstrated the usability and effectiveness of the BATI as a benchmarking tool. Analyses were performed across five different domains. The participating institutes concluded that the BATI served as an internal as well as an external stimulus to share, learn, and improve institutional strategies towards the transition to animal free innovation. The BATI also identified gaps in the development and implementation of 3R technologies. Hence, the BATI might be a suitable instrument for monitoring the effectiveness of policies. BATI version 1.0 is ready to be used for benchmarking at a larger scale.
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Point of Care Testing
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