CONTEXT: Sensitive D-dimer assays have been developed to exclude the diagnosis of deep vein thrombosis (DVT) and have exhibited great success when used in conjunction with a diagnostic algorithm, including pretest probability scoring and a compression ultrasound (CUS). Improving specificity of D-dimer assays would...

PURPOSE – The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. DESIGN/METHODOLOGY/APPROACH – This paper is a viewpoint. FINDINGS – One’s...

Tight glycemic control (TGC) in the intensive care unit is essential to comprehensive clinical management.  However, TGC that is too aggressive in the wrong patient populations (particularly non-diabetics) can result in hypoglycemia, which brings with it a set of sequelae that can increase morbidity and mortality....

Sensitivity and specificity define the discriminative power of a diagnostic procedure, whereas predictive values relate to the predictive ability of a test to identify disease or its absence in individuals.  Predictive values are greatly influenced by the prevalence of the disease and should not be generalized beyond ...

Sepsis and septic shock lead to local and systemic activation of different response systems, including coagulation and fibrinolysis.  Despite numerous attempts the high mortality rate of these patients has remained stable over the last 20 years. In this overview the pathophysiological insights and possible...

Patients with heart failure (HF) experience significant morbidity and mortality and those admitted for acute decompensated HF are at particularly high risk for adverse events. Hospitalization represents the major component of the high cost associated with the management of patients with HF. Accordingly, early and...

The discriminative ability of a diagnostic procedure is called diagnostic accuracy, and a number of quantitative measures out of which sensitivity and specificity are mostly used in the biomedical literature can express it. Each diagnostic-accuracy measure relates to some specific aspects of a diagnostic procedure....

In an exclusive acutecaretesting.org interview, Dr Mario Plebani, Head of the Department of Laboratory Medicine at the University Hospital of Padova, Italy and international patient safety advocate, talks about how laboratory, clinicians and manufacturers can work together to reduce errors in testing and diagnosing...

With the use of a new Data Management System (DMS) software program [1], the majority of Point Of Care Testing (POCT) equipment throughout the Waikato District Health Board region has been connected to the Laboratory Information System (LIS) and the Hospital Information System (HIS). Prior to the new DMS, viewing...

Introduction of point–of-care testing (POCT) in hospitals requires the use of principles of change management. Manufacturers can support this process. E-learning programs adapted to the local situation with regular updates, a centralized accreditation and user-registration system and service level agreements are...