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.
DOCUMENT
Artikel gepubliceerd in Nurse Academy O&T | nummer 3 | 2024: Steeds vaker meten patiënten hun eigen gezondheid. Deze metingen zijn voorbeelden van ‘point of care’-testen (POCT), een voorbeeld is de COVID-19-test. De ontwikkeling en inzet van POCT dragen bij aan betaalbare en toegankelijke gezondheidszorg. POCT kan een belangrijk instrument zijn voor het monitoren van veranderingen in de gezondheid. Het kan thuiswonende ouderen helpen bij het versterken van hun zelfmanagement LEERDOELEN Na het lezen van dit artikel: •weet u wat de kenmerken van ‘point of care’-testen (POCT) zijn en kent u een aantal voorbeelden van POCT; • heeft u inzicht in de voordelen van het gebruik van POCT in gezondheidsbevordering van oudere cliënten; • kent u een aantal uitdagingen die samenhangen met het gebruik van POCT in de praktijk; • heeft u inzicht in de betekenis van verpleegkundigen voor de inzet van POCT bij de ondersteuning van ouderen
DOCUMENT
Steeds vaker meten patiënten hun eigen gezondheid. Deze metingen zijn voorbeelden van ‘point of care’-testen (POCT), een voorbeeld is de COVID-19-test. De ontwikkeling en inzet van POCT dragen bij aan betaalbare en toegankelijke gezondheidszorg. POCT kan een belangrijk instrument zijn voor het monitoren van veranderingen in de gezondheid. Het kan thuiswonende ouderen helpen bij het versterken van hun zelfmanagement.
DOCUMENT
This chapter describes the growing influence of point-of-care diagnostics (POCD) on the daily lives of citizens, their immediate families, and healthcare providers. With a view to the future, the most important contemporary developments in this field are discussed, such as noninvasive sensor technology in the diagnostic process, practical examples of point-of-care diagnostics (POCD), including the quantify-self movement and infrared technology. Cost-effectiveness, adoption of POCD, and the contribution of POCD innovations to self-management and health literacy are also discussed. Developments in which deep learning and artificial intelligence are used to make the diagnostic results more reliable are also conferred, such as the development of point-of-care Internet diagnostics. The discussion of professional advice dilemma’s in POCD, the patient’s appreciation of POCD, and ethical and philosophical considerations conclude this chapter.
DOCUMENT
Point of Care Testing
IMAGE
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.
LINK
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.
DOCUMENT
Implementation of reliable methodologies allowing Reduction, Refinement, and Replacement (3Rs) of animal testing is a process that takes several decades and is still not complete. Reliable methods are essential for regulatory hazard assessment of chemicals where differences in test protocol can influence the test outcomes and thus affect the confidence in the predictive value of the organisms used as an alternative for mammals. Although test guidelines are common for mammalian studies, they are scarce for non-vertebrate organisms that would allow for the 3Rs of animal testing. Here, we present a set of 30 reporting criteria as the basis for such a guideline for Developmental and Reproductive Toxicology (DART) testing in the nematode Caenorhabditis elegans. Small organisms like C. elegans are upcoming in new approach methodologies for hazard assessment; thus, reliable and robust test protocols are urgently needed. A literature assessment of the fulfilment of the reporting criteria demonstrates that although studies describe methodological details, essential information such as compound purity and lot/batch number or type of container is often not reported. The formulated set of reporting criteria for C. elegans testing can be used by (i) researchers to describe essential experimental details (ii) data scientists that aggregate information to assess data quality and include data in aggregated databases (iii) regulators to assess study data for inclusion in regulatory hazard assessment of chemicals.
DOCUMENT
This systematic review aims to get insight into the feasibility of cardiopulmonary exercise testing (CPET) in patients with cancer prior to a physical exercise programme. We will focus on quality (defined as the adherence to international guidelines for methods of CPET) and safety of CPET. Furthermore, we compare the peak oxygen uptake (V̇O2peak) values of patients with cancer with reference values for healthy persons to put these values into a clinical perspective. A computer aided search with ‘cardiopulmonary exercise testing’ and ‘cancer’ using MEDLINE, EMBASE, Pedro, CINAHL® and SPORTDiscus™ was carried out. We included studies in which CPET with continuous gas exchange analysis has been performed prior to a physical exercise programme in adults with cancer. Twenty studies describing 1158 patients were eligible. Reported adherence to international recommendations for CPET varied per item. In most studies, the methods of CPET were not reported in detail. Adverse events occurred in 1% of patients. The percentage V̇O2peak of reference values for healthy persons varied between 65% and 89% for tests before treatment, between 74% and 96% for tests during treatment and between 52% and 117% for tests after treatment. Our results suggest that CPET is feasible and seems to be safe for patients with cancer prior to a physical exercise programme. We recommend that standard reporting and quality guidelines should be followed for CPET methods. The decreased V̇O2peak values of patients with cancer indicate that physical exercise should be implemented in their standard care.
DOCUMENT
Background: A patient decision aid (PtDA) can support shared decision making (SDM) in preference-sensitive care, with more than one clinically applicable treatment option. The development of a PtDA is a complex process, involving several steps, such as designing, developing and testing the draft with all the stakeholders, known as alpha testing. This is followed by testing in ‘real life’ situations, known as beta testing, and then finalising the definite version. Our aim was developing and alpha testing a PtDA for primary treatment of early stage breast cancer, ensuring that the tool is considered relevant, valid and feasible by patients and professionals. Methods: Our qualitative descriptive study applied various methods including face-to-face think-aloud interviews, a focus group and semi-structured telephone interviews. The study population consisted of breast cancer patients facing the choice between breast-conserving therapy with or without preceding neo-adjuvant chemotherapy and mastectomy, and professionals involved in breast cancer care in dedicated multidisciplinary breast cancer teams. Results: A PtDA was developed in four iterative test rounds, taking nearly 2 years, involving 26 patients and 26 professionals. While the research group initially opted for simplicity for the sake of implementation, the clinicians objected that the complexity of the decision could not be ignored. Other topics of concern were the conflicting views of professionals and patients regarding side effects, the amount of information and how to present it. Conclusion: The development was an extensive process, because the professionals rejected the simplifications proposed by the research group. This resulted in the development of a completely new draft PtDA, which took double the expected time and resources. The final version of the PtDA appeared to be well-appreciated by professionals and patients, although its acceptability will only be proven in actual practice (beta testing)
DOCUMENT
