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Found 87 results
  1. Content Article
    This study compared the blood of patients with confirmed Covid-19 infection with that of uninfected controls. The authors found that there were changes to serum proteins in the blood of patients experiencing Long Covid. This indicates activation of the immune system’s complement cascade, altered coagulation and tissue injury. At the cellular level, Long Covid was linked to aggregates comprising monocytes and platelets. These findings provide knowledge of potential biomarkers for diagnosis and may inform directions for treatments.
  2. Content Article
    This report by the Patients Association analyses the opinions and experiences of diagnostic testing services of more than 1,000 NHS patients. It highlights that patients view diagnostics as a fundamental part of the NHS—and one that should be prioritised. Most respondents (93%) want testing capacity to be invested in over the coming years so that patients can receive tests and diagnosis more quickly. Patients place such importance on diagnostics that 60% would consider paying for the tests they need if they faced a long wait on the NHS.
  3. Content Article
    Thomas Ithell was aged 77 at the time of his death on 20 November 2022. He was diagnosed with prostate cancer in September 2017 and biopsies revealed bilateral adenocarcinoma of the prostate. He underwent radiotherapy in 2018 and hormone deprivation treatment. From April 2021 onwards his PSA levels increased periodically. In October 2021 his level was 5.5ng/ml having been 1.5ng/m lin April 2021 and 2.7ng/m in July 2021 indicating a recurrence of the cancer and likely incurable. Thomas Ithell was reluctant to undergo further hormone treatment as he found tolerating the side effects difficult. He did not then have his PSA levels tested after November 2021 and was not reviewed at all due to becoming missed to follow up. After he had been seen by the nurse practitioner on 5 November 2021, the letter written by the nurse practitioner for advice from the consultant did not reach the consultant. He was reviewed by a consultant on 22 October 2022 after an urgent suspected cancer GP referral following routine set of blood tests in September 2022, some 10 months later. Mr Ithell died in hospital on 20 November 2022 having been admitted with shortness of breath, the malignancy having caused his death.
  4. News Article
    A prostate cancer patient went a year without a check-up because his referral to a consultant was lost. An inquest into the death of Thomas Ithell also heard that when the error was spotted it was not recorded because staff at Wrexham Maelor Hospital were too busy. The 77-year-old from Wrexham died in November 2022 after being admitted to hospital with shortness of breath. Assistant Coroner for North Wales East and Central, Kate Robertson, has submitted a Prevention of Future Deaths report to the health board in relation to Mr Ithell's case. As well as concerns over the lack of an investigation, she also questioned how the patient's follow-up appointment was missed. "There have been no assurances as to what, if any, changes and learning have been identified other than a tracking system for PSA monitoring," she wrote, referring to a type of blood test that helps diagnose prostate cancer. She was also concerned to learn that the hospital's Datix system - used for reporting incidents such as Mr Ithell's - had been described as "not user-friendly". Time constraints also sometimes prevented staff from completing these reports, thereby failing to trigger subsequent investigations by the board, the assistant coroner added. "I remain incredibly concerned that where matters are not raised in accordance with internal health board processes that assurances given to me in previous Prevention of Future Deaths reports cannot be supported," Ms Robertson added. Read full story Source: BBC News, 27 January 2024
  5. Content Article
    People taking methotrexate (for inflammatory conditions such as rheumatoid arthritis) have regular blood tests to check for certain side effects. Researchers have developed a tool to predict the likelihood of them discontinuing methotrexate due to these side effects, which could in future lead to less frequent testing for most people (68%) on methotrexate. The tool uses information routinely collected by GPs. The study found that it could predict people’s risk of discontinuing methotrexate because of side effects. It was accurate for most people across different ages, inflammatory conditions, methotrexate doses and routes of administration. The researchers say the tool could in future be used by GPs to identify people who need more or less frequent blood tests. This article refers to the original research study Risk stratified monitoring for methotrexate toxicity in immune mediated inflammatory diseases: prognostic model development and validation using primary care data from the UK
  6. News Article
    One of the biggest challenges facing clinicians who treat Long Covid is a lack of consensus when it comes to recognising and diagnosing the condition. But a new study suggests testing for certain biomarkers may identify Long Covid with accuracy approaching 80%. Effective diagnostic testing would be a game-changer in the Long Covid fight, for it’s not just the fatigue, brain fog, heart palpitations, and other persistent symptoms that affect patients. Two out of three people with Long Covid also suffer mental health challenges like depression and anxiety. Some patients say their symptoms are not taken seriously by their doctors. And as many as 12% of Long Covid patients are unemployed because of the severity of their illness and their employers may be sceptical of their condition. Researchers at Cardiff University School of Medicine in Cardiff, Wales, United Kingdom, tracked 166 patients, 79 of whom had been diagnosed with Long Covid and 87 who had not. All participants had recovered from a severe bout of acute Covid-19. In an analysis of the blood plasma of the study participants, researchers found elevated levels of certain components. Four proteins in particular—Ba, iC3b, C5a, and TCC—predicted the presence of Long Covid with 78.5% accuracy. "I was gobsmacked by the results. We’re seeing a massive dysregulation in those four biomarkers," says study author Wioleta Zelek, PhD, a research fellow at Cardiff University. "It’s a combination that we showed was predictive of Long Covid.." Read full story Source: Medscape, 29 November 2023
  7. News Article
    About 17,500 women in Northern Ireland are to have their smear tests re-checked as part of a major review of cervical screening dating back to 2008. Some of these women will be recalled to have new smear tests carried out, BBC News NI can reveal. The Southern Trust said that the women affected should receive letters by post from Tuesday. It follows a highly critical report commissioned by the Royal College of Pathologists (RCPath). It found: Several cytology staff were "significantly underperforming". Mechanisms to check their work were flawed. Action taken by management was inadequate over many years. While a majority of negative results issued by the laboratory were correct, a "significant number" of these would likely have been identified as "potentially abnormal" by other laboratories. Read full story Source: BBC News, 9 October 2023
  8. Content Article
    Urgent funding is required to clear waiting list backlogs and drive Northern Ireland's long-term healthcare transformation, the Northern Ireland Audit Office has said in a new report which outlines the health service's "critical situation" after almost a decade of worsening waiting lists for elective care. The NI Audit Office looked at waiting list data from 2014 to 2023. It found the number of patients waiting for elective care has risen by 452,000 during that nine-year period. The Audit Office also said: "Available information suggests waiting list performance levels are significantly worse in Northern Ireland compared with the other UK regions."
  9. News Article
    Women are being unnecessarily alarmed about their risk of breast cancer by consumer genetic test results that do not take family history into account, researchers have said. Women who discover outside a clinical setting that they carry a disease-causing variant of the BRCA1 or BRCA2 genes may be told that their risk of breast cancer is 60-80%. But analysis of UK Biobank data suggests the risk could be less than 20% for those who do not have a close relative with the condition. Dr Leigh Jackson, of the University of Exeter’s medical school, who is the lead author of the analysis published in the journal eClinical Medicine, said that in extreme cases this could result in women unnecessarily undergoing surgery. “Being told you are at high genetic risk of disease can really influence levels of fear of a particular condition and the resulting action you may take,” he said. “Up to 80% risk of developing breast cancer is very different from 20%.” Until recently, women who received BRCA results did so because they had attended clinic due to symptoms or a family history of disease. However, an increasing number are now learning of their genetic risk after paying for home DNA testing kits or taking part in genetic research, without ever having any personal link with breast cancer. Read full story Source: The Guardian, 15 September 2023
  10. News Article
    Patients with cancer symptoms could bypass their GP in the future and go straight for a scan, the health secretary has suggested, in the latest “radical” attempt by the government to cut huge NHS waiting lists. The suggestion, which comes as the government is expected to reduce the number of NHS cancer waiting time targets, could form part of proposals to “design out bottlenecks” in the NHS system, Steve Barclay said in an interview. Health department officials are reportedly working on proposals that would mean some patients experiencing cancer symptoms could go straight to an NHS diagnostic centre – or “one-stop shop” – without a GP referral. “We are very much looking at those patient pathways,” Barclay told the Daily Telegraph. “Where there are bottlenecks in the system of referral from the GP, is there scope to go direct to the relevant diagnostic test or to the clinician? Breast cancer is a good example because almost always the GP refers on … and therefore there’s an opportunity to design out bottlenecks in the system.” Read full story Source: Guardian, 16 August 2023
  11. Content Article
    Tests that indicate the health of newborns, moments after birth, are limited and not fit-for-purpose for Black, Asian and ethnic minority babies, and need immediate revision according to the NHS Race and Health Observatory.
  12. Content Article
    Postpartum hypertensive disorders pose a serious health risk to new mothers; nearly 75 percent of maternal deaths associated with hypertensive disorders occur in the postpartum period. For the past decade, the obstetrics department at the Hospital of the University of Pennsylvania (HUP) has tried to lower these risks by checking patients’ blood pressure after they are released from the hospital. Their initial efforts to have patients return to the office for an in-person blood pressure check shortly after discharge yielded disappointing results, so the team revamped their approach and ultimately developed an extremely successful program called Heart Safe Motherhood. The programme started when the team at HUP gave a small group of women a blood pressure cuff each. They told them they would receive text messages after discharge instructing them to take their blood pressure at 8am, and that they would need to send in the reading. At 1pm, they would get another text requesting that they send their blood pressure again. This article describes how Heart Safe Motherhood evolved to improve the likelihood of mothers submitting their readings, and how the programme was scaled up to five hospitals in the group. It looks at how the approach has helped tackled health inequalities and improved the safety of postpartum mothers.
  13. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation focuses on the systems used by healthcare providers to book patient appointments for clinical investigations, such as diagnostic tests and scans. ‘Clinical investigation booking systems’ are used throughout the NHS to support the delivery of patient care. Healthcare services use paper-based or fully electronic systems, or a combination of the two (hybrid systems), to communicate to patients the time, date and location of their appointment. These systems also produce information for patients about actions they need to take to prepare for their appointment. Written patient communication is a key output of clinical investigation booking systems. This investigation examines the safety implications of patient communications, produced by booking systems, that do not account for the needs of the patient. In addition, it looks at why patients are ‘lost to follow-up’ after an appointment is cancelled, rescheduled or not attended. Lost to follow-up is the term used to describe a patient who does not return for planned appointments (whether for continued care or evaluations) or is no longer being tracked in the healthcare system when they should be.
  14. Content Article
    Study into patient attitudes and perspectives related to viewing immediately released test results through an online patient portal. In this survey study of 8139 respondents at four US academic medical centres, 96% of patients preferred receiving immediately released test results online even if their healthcare practitioner had not yet reviewed the result. However a subset of respondents experienced increased worry after receiving abnormal results.
  15. News Article
    Lives could be saved by a new tool that identifies those most at risk of developing lung cancer, according to researchers. The CanPredict tool can spot those most at risk of developing the disease over the next decade and put them forward for screening tests earlier, researchers from the University of Oxford and the University of Nottingham said. They created and tested CanPredict using the anonymised health records of more than 19 million adults from across the UK and hope it can save “time, money and, most importantly, lives”. Lung cancer is the leading cause of cancer deaths worldwide and the second most common form of the disease, but early diagnosis has been shown to improve survival rates. Professor Julia Hippisley-Cox, senior author and professor of clinical epidemiology and general practice at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said: “We hope that this new validated risk tool will help better prioritise patients for screening and ultimately help spot lung cancer earlier when treatments are more likely to help. We’d like to thank the many thousands of GPs who have shared anonymised data for research without whom this would not have been possible.” Read full story Source: The Independent, 6 April 2023
  16. News Article
    A new non-invasive diagnostic test for oral cancer test developed by researchers at the University of Surrey is said to be over 92% accurate at detecting oral squamous cell carcinoma (OSCC) and more than 80% accurate at identifying pre-cancerous oral epithelial dysplasia (OED), according to a proof-of-concept study. The news comes in the wake of a recent report showing that cases of oral cancer in the UK increased by 34% over the last decade and have more than doubled compared with 20 years ago. The State of mouth cancer UK report 2022, released last November by the Oral Health Foundation, showed that there were 8846 new cases of mouth cancer diagnosed in the UK over the previous year, with 3034 deaths from the disease. The test could pave the way for better oral cancer detection, the researchers said. The samples were collected in dental surgeries and mailed to their laboratory for analysis, which demonstrated that the test could be "used in primary care to identify patients in need of specialist care". Study co-author Dr Fatima Labeed, senior lecturer in human biology from the University of Surrey, said: "Over 300,000 people are diagnosed with oral cancer worldwide–a disease with an alarming mortality rate of around 50%. This suggests that the scientific community doesn't have the tools available to identify oral cancer early enough, and we hope that PANDORA paves the way for more effective clinical diagnostic tools for this terrible disease." Read full story Source: Medscape, 5 April 2023
  17. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) explored the detection and diagnosis of jaundice in newborn babies, in particular babies born prematurely (before 37 weeks of pregnancy). Specifically, it explored delayed diagnosis due to there being no obvious visual signs of jaundice apparent to clinical staff. Jaundice is a condition caused by too much bilirubin in a person’s blood. Bilirubin is a yellow substance produced when red blood cells are broken down. If left undiagnosed and untreated, high bilirubin levels in newborn babies can lead to significant harm. Newborn babies have a higher number of red blood cells in their blood which increases their risk of jaundice. Jaundice can cause yellowing of the skin and whites of the eyes; however, sometimes the visual signs of jaundice are not obvious, particularly for premature or newborn babies with brown or black skin. The reference event for this investigation was the case of baby Elliana, who was born at 32 weeks and 1 day via a forceps delivery and then transferred to the Trust’s special care baby unit (SCBU). Elliana was assessed on admission to the SCBU by staff as a clinically stable premature baby and a routine blood sample was taken from around two hours after her birth to establish a baseline. Analysis of the blood sample indicated bilirubin was present and so the level was measured. This result was uploaded onto the Trust’s computer system alongside the results of the blood tests that had been requested by the clinical team. The bilirubin result was seen by a SCBU member of staff who recognised that the level was high, indicating the possible need for treatment. However, this member of staff was then required to attend an emergency and the bilirubin result was not acted upon. Another blood sample was taken when Elliana was two days old and was uploaded to the Trust’s computer system. It is unclear if this bilirubin result was seen by staff; it was not documented in clinical records and was not acted upon. Over the next two days, Elliana continued to show no visible signs of jaundice that were detected by staff and she was documented to be developing well. When Elliana was five days old, a change in her skin colour was observed and visible signs of jaundice were detected. A further blood sample was taken which showed she had a high level of bilirubin in her blood and treatment was started accordingly. Elliana’s bilirubin levels returned to within acceptable levels over the next three days and she was subsequently discharged home.
  18. Content Article
    Elizabeth Holmes, the 38 year old founder of failed diagnostic start-up Theranos, was sentenced to more than 11 years in prison this November. The sentence was handed down nearly a year after she was found guilty of defrauding investors about her finger prick blood testing devices, and seven years after the Wall Street Journal published its first investigation exposing the company’s struggles. Theranos’ customers received false laboratory test results indicating life threatening conditions such as cancer and HIV. Patients were left to wait anxiously while traditional laboratories repeated the tests, and at least one customer stopped taking his medication on the basis of erroneous results. Holmes was ultimately not convicted of charges relating to patient harm, instead she will be locked up for misleading wealthy investors.
  19. Content Article
    The waiting list in England stood at more than seven million in September 2022, up by 1.2 million since September 2021 and 2.6 million since 2019. This analysis by the King's Fund outlines what different patients on the waiting list are waiting for, breaking this figure down into: different medical and surgical specialties whether patients are waiting for admission, diagnostics or decisions It highlights that many on the waiting list are awaiting further diagnostics or decisions before treatment can commence, and others are waiting for treatment that does not require admission to hospital.
  20. Content Article
    In this interview for Healthcare IT News, Lisa Hedges, associate principal analyst at Software Advice, discusses the findings of a survey of 1,000 patients on telemedicine usage after the worst of the pandemic. She also talks about the future of telemedicine. The survey found that: more than half of patients are concerned about the quality of care they're receiving through telemedicine. the majority of people prefer virtual appointments for common illnesses. 86% of patients rate their telemedicine experience as positive. 91% are more likely to choose a provider that offers telemedicine. 49% prefer telemedicine visits for mental health treatment, despite it being one of the more remote-ready specialties.
  21. News Article
    All GP practices in England will be able to book cancer tests directly for their patients from later this month, NHS bosses say. The option of GPs booking CT scans, ultrasounds and MRIs has been gradually rolled out in recent years, as community testing centres have opened. NHS England chief executive Amanda Pritchard will announce later all GPs will now be able to do this. GPs have previously relied on referring on to specialist hospital doctors. Before referring, they have to identify clear symptoms the patient may have a specific type of cancer. But only one out of every five cancer cases is diagnosed through these urgent GP referrals. Patients with less clear symptoms face long waits for check-ups or are diagnosed only after presenting at an accident-and-emergency (A&E) unit or being referred to hospital for something else. And Ms Pritchard will tell delegates at the NHS Providers annual conference of health managers, in Liverpool, today, she hopes the new initiative will lead to tens of thousands of cancer cases every year being detected sooner. Read full story Source: BBC News, 16 November 2022
  22. Content Article
    In the UK, regulation prevents prescription-only medications being advertised directly to consumers, but not medical tests. This opinion piece in the BMJ raises concerns about the growing availability and popularity of consumer blood testing. The authors found that dozens of companies are offering health screening for a range of conditions and deficiencies through blood testing kits for use at home. They are often advertised to people with symptoms such as tiredness, low energy, irritability, sleep problems and weight issues. The authors highlight that reading blood test results requires context and training, and results can give people a false sense of security or panic depending on whether they are perceived to be in 'normal' range. They call for guidance on mixing NHS and private care to be updated and recommend that the Care Quality Commission (CQC) should be empowered to appraise private screening and the apps that recommend it.
  23. Content Article
    The number of people on NHS Wales waiting lists for treatment has reached record levels. This problem has worsened since the Covid-19 pandemic, with the average wait time for treatment more than doubling since December 2019. This report by the Welsh Centre for Public Policy identifies five key areas in which policy could be developed to improve outcomes and reduce waiting times. These areas target the underlying factors causing increased waiting times, and are likely to both improve the overall performance of the health system, and to impact outcomes which matter to patients, resulting in a more patient-centred approach: Workforce capacity Digital technology Reimagining primary care Systems collaboration Follow-up care
  24. News Article
    Private companies are offering “misleading” home blood-testing kits that fuel health anxieties and pile pressure on the NHS, a report has suggested. There has been a boom in sales of the kits, which promise to reveal everything from cancer risk to how long patients can expect to live. But an investigation by the BMJ found these “unnecessary and potentially invasive tests” can be misleading and generate false alarms. The NHS is then left to “clear up the mess” as worried patients see GPs for reassurance or extra tests, piling more pressure on the overstretched service. One GP described patients coming in “clutching the results of private screening tests”, with doctors asked to review the results. The companies have been criticised for not providing sufficient follow-ups after the “poor quality and overhyped” tests, and for misleading results such as wrongly telling people their test levels are outside the “normal” range. Bernie Croal, president of the Association for Clinical Biochemistry and Laboratory Medicine, said: “Most of the online [tests] will send the results to the patient with at best a sort of asterisk next to the ones that are abnormal, with advice to either pay some more money to get some sort of health professional to speak about it or go and see your own GP.” Doctors are calling for the tests to be more tightly regulated by the health watchdog, the Care Quality Commission. Read full story (paywalled) Source: The Times, 27 October 2022
  25. Content Article
    This editorial in BMJ Quality & Safety looks at the need for urgent improvement in the test result management and communication process in primary care. The authors highlight the inconsistency in tracking and communicating test results and look at potential solutions to reduce the patient safety risks associated with test results. They look at the evidence surrounding automated alerts built into provider IT systems and giving patient direct access to test results through apps, highlighting the growing importance of patients in safeguarding their own care through actively pursuing test results.
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