can new diagnostic methods contribute in healthcar What are doctors looking for? • Better support in their clinical decision makings, which includes omore accurate diagnosis oreliable prognostic estimation otools for therapy stratification and monitoring • Rapid answers to the patient in order to: oreduce the need for later reevaluation of the patient oprovide the patient with maximal information at the doctor´s vi
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How can new diagnostic methods contribute in healthcare ? What are doctors looking for?
How can new diagnostic methods contribute in healthcare ? What are doctors looking for?. Better support in their clinical decision makings, which includes: more accurate diagnosis reliable prognostic estimation tools for therapy stratification and monitoring - PowerPoint PPT Presentation
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How can new diagnostic methods contribute in healthcare? What are doctors looking for?
•Better support in their clinical decision makings, which includes:
omore accurate diagnosisoreliable prognostic estimationotools for therapy stratification and monitoring
•Rapid answers to the patient in order to:
oreduce the need for later reevaluation of the patientoprovide the patient with maximal information at the doctor´s visit
How can new diagnostic methods contribute in healthcare? What are doctors looking for?
1. More accurate diagnostic and prognostic markers in cardio-vascular disease
2. Markers for the distinction between bacterial and viral causes of acute infections
3. And more
Heart disease accounts for 49% of all deaths in Europe
The estimated cost for the society in Europe is 169 billion euros
Cardiac troponins in a healthy population –the impact of an ultra-sensitive troponin assay
35 40 45 50 55 60 65 70 75 80
Age
0,00
0,01
0,02
0,03
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cTn
I, A
ccu
Tn
I g
/L
99th percentile URL
99th percentile <60 y
ULSAM-studyUppsala Longitudinal Study of Adult Men
• All men in Uppsala born between 1920 and 1924All 50 years old men (n=2841) were invited for the investigation, 81.7% (n=2322) participated
• Remaining cohort at 70 years of age n =1673 (73%
participated n=1221)– Men without cardiovascular disease disease n = 853
– Men with cardiovascular disease n = 368
• Follow-up period 10.4 years
Outcome (Death) in 70 years old men, with or without CVD, in relation to cTroponin I (AccuTnI)
NT-proBNP in healthy 70-year old men in relation to all-cause death during a 10 year follow-up, n=839 (ULSAM)
05
101520
2530
354045
<100 100 200 300 400 500 >600
NT-proBNP, ng/L
% D
eath
Should my patient be prescribed antibiotics or not?
49% of all patients visiting a primary health care unit in Sweden called the doctor because of symptoms of acute infection
The clinical diagnosis of most respiratory infections such as pneumonia, pharyngitis/tonsillitis, otitis has, when based on symptoms and physical signs only,
a diagnostic sensitivity and specificity of 55-60% in the distinction between a viral or bacterial cause of the infection
And how can we slow down the epidemics of antibiotics resistance?
Is the discovery of Human neutrophil lipocalin (HNL) the answer to our needs?
P-CRP and B-PMN in acute infections
Bacteria Virus Virus Bacteria
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250
500
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0
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20
CRP PMN
mg
/Lx10
9/L
HNL/NGAL in serum in acute infections
Bacteria Virus0
200
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1000
g/
L
P-CRP
S-HNL
0 20 40 60 80 100
100
80
60
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0
100-Specificity
Sens
itivi
ty
Discrimination between acute bacterial and viral infectionsHospitalized adult population
Highest diagnosti
c accu
racy in le
ft corner
Internists base their clinical management to 70-80% on laboratory tests
Primary care doctors base their clinical management to 10-20% on laboratory tests
Laboratory testing is an efficient means to save money in health caresince it provides the doctor with:
Some conclusions
more accurate diagnosismore reliable prognostic estimationbetter tools for therapy stratification and monitoring
All for the benefit of our patients and the society