Development and implementation of a clinical decision support system tool for the evaluation of suspected monkeypox infection

Albin, John S.; Lazarus, Jacob E.; Hysell, Kristen; Rubins, David; Germaine, Lindsay; Dugdale, Caitlin M; Heller, Howard M.; Hohmann, Elizabeth L.; Baugh, Joshua J; Shenoy, Erica S.

doi:10.1093/jamia/ocac151

Cited by 7 publications

(8 citation statements)

References 7 publications

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“…Moreover, the effective public health measure adoption in these endemic regions has also limited the spread of mpox infections [ 4 , 7 ]. An additional factor that should be noted is that mpox has neither a lifelong survival nature nor has purely the characteristic nature of sexually transmitted diseases such as HIV [ 4 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. The disease mostly remains self-limiting and resolves within 2–4 weeks of symptoms, as the host slowly develops immunity against it.…”

Section: Resultsmentioning

confidence: 99%

“…So far, these are limited to African countries; however, some recent outbreaks have been reported in other continents as far as America, Asia, and Europe. The situation is thus alarming for scientific and healthcare networks around the world [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

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Recent Developments in Mpox Prevention and Treatment Options

Malik¹,

Ahmad

Ahsan

et al. 2023

Vaccines

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Human mpox is an emerging epidemic in the world. The monkey pox virus (MPXV) belongs to the same family of zoonotic Orthopoxviridae as that of the smallpox virus and exhibits similar clinical symptomology. Information regarding its diagnostics, disease epidemiology, surveillance, preventive methods, and treatment strategies are being collated with time. The purpose of this review is to trace the recent events in the scientific platform that have defined new preventive and treatment strategies against mpox. A methodological approach has been used to gather data from the latest literature to comprehensively overview the emerging treatment options. The results portion will cover details regarding the prevention of mpox. It will also shed light on a brief description of contemporary vaccines and antiviral agents that have been evaluated for their treatment potential since the emergence of the mpox threat. These treatment options are setting the pace for controlling the widespread monkeypox infection. However, the limitations attached to these treatment strategies need to be tackled quickly to increase their efficacy so that they can be deployed on a large scale for the prevention of this epidemic becoming another pandemic in this decade.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recent Developments in Mpox Prevention and Treatment Options

Malik¹,

Ahmad

Ahsan

et al. 2023

Vaccines

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“…Vaccine hesitancy is among the top ten challenges faced by WHO which has extended after the COVID-19 pandemic worldwide [ 18 ]. With regard to Pakistan specifically, the country has always suffered from the issue of vaccination hesitancy, such as for the polio vaccination, COVID-19 vaccination, or for the proposal of the current Mpox vaccination drive [ 57 ].…”

Section: Is There a Need For Mpox Vaccination Amidst The Hesitancy Of...mentioning

confidence: 99%

“…Treatment and preventive strategies are of the utmost importance in any viral outbreak, and thus the following [ 18 ] recommendations should be implemented to increase treatment and preventive practices against Mpox and related infections in developing nations, such as Pakistan [ 11 , 12 , 67 , 68 ].…”

Section: Recommended Mitigation Measures Against Mpox For Developing ...mentioning

confidence: 99%

“…Owing to its similarity with smallpox infection, the smallpox vaccine can be utilized against Mpox as directed by WHO. A few vaccine candidates, including mainly the smallpox vaccine, along with therapeutics such as tecovirimat (antiviral agent), are currently being employed for the treatment of Mpox infection in endemic regions [ 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Mitigation Measures to Control the Expected Mpox Outbreak in a Developing Country—Pakistani Scenario

Malik¹,

Asghar

Waheed

2023

Vaccines

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Mpox (previously named Monkeypox) is one of the neglected viral infectious diseases that remained silent for a long period before finally emerging as a threat to the healthcare system in endemic regions of the world in recent years. It has been mostly centered in African countries but has now been reported in other non-endemic regions as well. While keeping a strict eye on COVID pandemic handling, there is a need to remain concerned and alert about viral threats such as Mpox infections in the future. This situation has altered the healthcare system of endemic regions, including Pakistan, to stay vigilant against the expected Mpox outbreaks in the coming months. Though no specific cases have been reported in Pakistan, the healthcare system needs to take mitigation measures to tackle an expected threat before it arrives. This is important in order to avoid another major shock to the health care system of Pakistan. Moreover, since no specific treatment is available for Mpox, we can only rely upon mitigation measures, involving preventive and treatment strategies devised around some already in-use antiviral agents against Mpox viruses. Moreover, there is an imperative need to proactively prepare the healthcare system against Mpox outbreaks, spread awareness, and involve the public in a participatory approach to stay well prepared against any such infection. Moreover, there is a need to utilize financial sources, aids, and funds wisely, to create awareness in the public about such expected healthcare outbreaks in the future.

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TB or not TB? Development and validation of a clinical decision support system to inform airborne isolation requirements in the evaluation of suspected tuberculosis

Dugdale,

Zachary,

Craig

et al. 2025

Infect. Control Hosp. Epidemiol.

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Background: The study objective was to develop and validate a clinical decision support system (CDSS) to guide clinicians through the diagnostic evaluation of hospitalized individuals with suspected pulmonary tuberculosis (TB) in low-prevalence settings. Methods: The “TBorNotTB” CDSS was developed using a modified Delphi method. The CDSS assigns points based on epidemiologic risk factors, TB history, symptoms, chest imaging, and sputum/bronchoscopy results. Below a set point threshold, airborne isolation precautions are automatically discontinued; otherwise, additional evaluation, including infection control review, is recommended. The model was validated through retrospective application of the CDSS to all individuals hospitalized in the Mass General Brigham system from July 2016 to December 2022 with culture-confirmed pulmonary TB (cases) and equal numbers of age and date of testing-matched controls with three negative respiratory mycobacterial cultures. Results: 104 individuals with TB (cases) and 104 controls were identified. Prior residence in a highly endemic country, positive interferon release assay, weight loss, absence of symptom resolution with treatment for alternative diagnoses, and findings concerning for TB on chest imaging were significant predictors of TB (all P < 0.05). CDSS contents and scoring were refined based on the case–control analysis. The final CDSS demonstrated 100% sensitivity and 27% specificity for TB with an AUC of 0.87. Conclusions: The TBorNotTB CDSS demonstrated modest specificity and high sensitivity to detect TB even when AFB smears were negative. This CDSS, embedded into the electronic medical record system, could help reduce risks of nosocomial TB transmission, patient-time in airborne isolation, and person-time spent reviewing individuals with suspected TB.

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Development and implementation of a clinical decision support system tool for the evaluation of suspected monkeypox infection

Cited by 7 publications

References 7 publications

Recent Developments in Mpox Prevention and Treatment Options

Recent Developments in Mpox Prevention and Treatment Options

Mitigation Measures to Control the Expected Mpox Outbreak in a Developing Country—Pakistani Scenario

TB or not TB? Development and validation of a clinical decision support system to inform airborne isolation requirements in the evaluation of suspected tuberculosis

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