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Articles by E. M. Clarke
Showing articles by "E. M. Clarke"
Article
October 2009
Diagnostic accuracy – Part 2
Predictive value and likelihood ratio
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 ...
Information management
Article
October 2009
D-dimer testing in the treatment and monitoring of septic patients
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...
Coagulation/fibrinolysis
D-dimer
Article
October 2009
Low troponin I concentrations and clinical decision making
Troponin values above the 99th percentile and increasing/falling values found by serial testing in addition to signs and symptoms of myocardial ischemia means AMI.
Low troponin values, near or below the 99th percentile, can be used for prognosis. Highest hazard ratios were found when using the 90th percentile,...
Cardiac markers
Troponins
Natriuretic peptide
Article
June 2009
The utility of natriuretic peptide in the management of patients with acute and chronic heart failure: Insights from randomized controlled trials
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...
Cardiac markers
Article
June 2009
Diagnostic accuracy – Part 1
Basic concepts: sensitivity and specificity, ROC analysis, STARD statement
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....
Information management
Article
April 2009
Biomarkers in sepsis: the present and the future
Timely and accurate diagnosis of sepsis is of great importance for the choice of treatment, level of monitoring and prognosis. For this biomarkers could be a significant aid, and thus the search for and application of sepsis biomarkers are of great importance.
Current evidence suggests that C-reactive protein and...
Infection/sepsis
Troponins
PCT
CRP
Article
April 2009
Using "lean" process mapping to integrate testing to point(s) of care in the clinical enterprise
As point-of-care applications of lab testing demand more rapid and clinically integrated order entry and results-reporting processes, it becomes paramount for the laboratory to investigate entire clinical processes.
Direct observation and process mapping of these clinical applications – end to end - are "lean" tools...
Blood gases/acid-base
Point-of-care testing
Process optimization
Creatinine/urea
Article
January 2009
Partners in error prevention
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...
Point-of-care testing
Process optimization
Article
January 2009
C-reactive protein and procalcitonin in the assessment of infection response to antibiotic therapy
Definite diagnosis of infection requires microbiological
documentation; however, the identification of a specific etiology
is frequently missing. In addition, bacterial cultures require at
least 24-48 hours for a final result, which is too long for a
decision to start antibiotics.
Currently, the evaluation of the...
Infection/sepsis
Article
October 2008
Troponin Testing and the Tyranny of Distance
Chest pain is a frequent cause of hospitalization and comprises a significant proportion of the acute medical workload in the western world. This issue is compounded for those living in regional or remote communities due to limited access to pathology services and tertiary-referral institutions.
Evidence suggests...
Cardiac markers
Point-of-care testing
Troponins
