The Democratization of Diagnosis: Bringing the Power of Medical Diagnosis to the Masses

Bose, Rupan; Saxon, Leslie A.

doi:10.1016/j.eclinm.2019.03.004

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…A major benefit of moving diagnostics into the community is that of democratisation-the enabling and empowering of patients to be more in control of the diagnostic process. 208 For PALM, this approach can involve self-testing (when an individual collects their own specimen, performs the test, and interprets the result-eg, home diabetes care and COVID-19 testing) and self-sampling (when an individual collects their own specimen and sends it away for testing). For both PALM and DI, institutional testing and examinations (in which testing or examinations take place in a pharmacy, school, correctional facility, or other institution) is another means of putting the diagnostic process more in the control of the patient.…”

Section: Democratisation Of Diagnosticsmentioning

confidence: 99%

“…Furthermore, democratisation can also relieve the health-care burden through triaging of individual care and allowing appointments with primary care physicians to be reserved for patients who, for instance, have tested positive. 208,214 Ultimately, this approach can lead to reduced health-care costs and improved patient outcomes. Another benefit of this process is that it facilitates involvement of local communities in developing innovative solutions for their own problems relating to health-care delivery.…”

Section: Democratisation Of Diagnosticsmentioning

confidence: 99%

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The Lancet Commission on diagnostics: transforming access to diagnostics

et al. 2021

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1 47% of the global population has little to no access to diagnostics. 2 Diagnostics are central and fundamental to quality health care. This notion is underrecognised, leading to underfunding and inadequate resources at all levels. 3 The level of primary health care is the diagnostic so-called last mile and particularly affects poor, rural, and marginalised communities globally; appropriate access is essential for equity and social justice. 4 The COVID-19 pandemic has emphasised the crucial role of diagnostics in health care and that without access to diagnostics, delivery of universal health coverage, antimicrobial resistance mitigation, and pandemic preparedness cannot be achieved. 5 Innovations within the past 15 years in many areas (eg, in financing, technology, and workforce) can reduce the diagnostic gap, improve access, and democratise diagnostics to empower patients. 6 As an example of the potential impact, 1•1 million premature deaths in low-income and middle-income countries could be avoided annually by reducing the diagnostic gap for six priority conditions: diabetes, hypertension, HIV, and tuberculosis in the overall population, and hepatitis B virus infection and syphilis for pregnant women. 7 The economic case for such investment is strong. The median benefit-cost exceeds one for five of the six priority conditions in middle-income countries, and exceeds one for four of the six priority conditions in low-income countries, with a range of 1•4:1 to 24:1.Given the depth and breadth of the problems, sustained access to quality, affordable diagnostics will require multi-decade prioritisation, commitment, and investment.Incorporating diagnostics into universal health coverage packages will begin this process.

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Section: Democratisation Of Diagnosticsmentioning

confidence: 99%

Section: Democratisation Of Diagnosticsmentioning

confidence: 99%

The Lancet Commission on diagnostics: transforming access to diagnostics

et al. 2021

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“…We believe that this research serves as a crucial step toward democratizing medical diagnostics by providing the masses with accessible tools to assess their hydration status beyond the confines of medical facilities. 22 …”

Section: Discussionmentioning

confidence: 95%

Accuracy of smartphone camera urine photo colorimetry as indicators of dehydration

Bustam,

Poh,

Shuin Soo

et al. 2023

DIGITAL HEALTH

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Objective Direct urine color assessment has been shown to correlate with hydration status. However, this method is subject to inter- and intra-observer variability. Digital image colorimetry provides a more objective method. This study evaluated the diagnostic accuracy of urine photo colorimetry using different smartphones under different lighting conditions, and determined the optimal cut-off value to predict clinical dehydration. Methods The urine samples were photographed in a customized photo box, under five simulated lighting conditions, using five smartphones. The images were analyzed using Adobe Photoshop to obtain Red, Green, and Blue (RGB) values. The correlation between RGB values and urine laboratory parameters were determined. The optimal cut-off value to predict dehydration was determined using area under the receiver operating characteristic curve. Results A total of 56 patients were included in the data analysis. Images captured using five different smartphones under five lighting conditions produced a dataset of 1400 images. The study found a statistically significant correlation between Blue and Green values with urine osmolality, sodium, urine specific gravity, protein, and ketones. The diagnostic accuracy of the Blue value for predicting dehydration were “good” to “excellent” across all phones under all lighting conditions with sensitivity >90% at cut-off Blue value of 170. Conclusions Smartphone-based urine colorimetry is a highly sensitive tool in predicting dehydration.

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“…Nevertheless, there is also a clear value and demand for diagnostic tools that allow for in situ quick screening by scientifically untrained operators. This is becoming an essential component in the fight against the spread of infectious diseases [ 53 ]. Not only does it provide a “frontline” during epidemics but importantly it shifts some of the diagnostic responsibility to the affected, whether they be patients, doctors, or farmers, thereby facilitating engagement, ownership, and a “demystification” of scientific methods.…”

Section: New and Old Technologiesmentioning

confidence: 99%

New Virus Diagnostic Approaches to Ensuring the Ongoing Plant Biosecurity of Aotearoa New Zealand

Delmiglio

Waite

Lilly

et al. 2023

Viruses

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To protect New Zealand’s unique ecosystems and primary industries, imported plant materials must be constantly monitored at the border for high-threat pathogens. Techniques adopted for this purpose must be robust, accurate, rapid, and sufficiently agile to respond to new and emerging threats. Polymerase chain reaction (PCR), especially real-time PCR, remains an essential diagnostic tool but it is now being complemented by high-throughput sequencing using both Oxford Nanopore and Illumina technologies, allowing unbiased screening of whole populations. The demand for and value of Point-of-Use (PoU) technologies, which allow for in situ screening, are also increasing. Isothermal PoU molecular diagnostics based on recombinase polymerase amplification (RPA) and loop-mediated amplification (LAMP) do not require expensive equipment and can reach PCR-comparable levels of sensitivity. Recent advances in PoU technologies offer opportunities for increased specificity, accuracy, and sensitivities which makes them suitable for wider utilization by frontline or border staff. National and international activities and initiatives are adopted to improve both the plant virus biosecurity infrastructure and the integration, development, and harmonization of new virus diagnostic technologies.

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The Democratization of Diagnosis: Bringing the Power of Medical Diagnosis to the Masses

Cited by 5 publications

References 2 publications

The Lancet Commission on diagnostics: transforming access to diagnostics

The Lancet Commission on diagnostics: transforming access to diagnostics

Accuracy of smartphone camera urine photo colorimetry as indicators of dehydration

New Virus Diagnostic Approaches to Ensuring the Ongoing Plant Biosecurity of Aotearoa New Zealand

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