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How can new diagnostic methods contribute in healthcare ? What are doctors looking for?

How can new diagnostic methods contribute in healthcare ? What are doctors looking for?. Better support in their clinical decision makings, which includes: more accurate diagnosis reliable prognostic estimation tools for therapy stratification and monitoring

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How can new diagnostic methods contribute in healthcare ? What are doctors looking for?

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  1. Howcan new diagnosticmethodscontribute in healthcare? What are doctorslooking for? • Better support in their clinical decision makings, which includes: • more accurate diagnosis • reliable prognostic estimation • tools for therapy stratification and monitoring • Rapid answers to the patient in order to: • reduce the need for later reevaluation of the patient • provide the patient with maximal information at the doctor´s visit

  2. Howcan new diagnosticmethodscontribute in healthcare? What are doctorslooking for? Moreaccuratediagnostic and prognostic markers in cardio-vasculardisease Markers for the distinctionbetweenbacterial and viral causes of acuteinfections And more

  3. Heart disease accounts for 49% of all deaths in Europe The estimated cost for the society in Europe is 169 billion euros

  4. Cardiac troponins in a healthy population –the impact of an ultra-sensitive troponinassay 99th percentile URL 99th percentile <60 y

  5. ULSAM-studyUppsala Longitudinal Study of Adult Men • All men in Uppsala born between 1920 and 1924All 50 years old men (n=2841) were invited for the investigation, 81.7% (n=2322) participated • Remaining cohort at 70 years of age n =1673 (73% participated n=1221) • Men without cardiovascular disease disease n = 853 • Men with cardiovascular disease n = 368 • Follow-up period 10.4 years

  6. Thus, the development and use of ultra-sensitive troponin assays as indicators of myocardial dysfunction and leakage will enable us to identify many more subjects at risk of premature death in cardio-vascular disease

  7. Heart failure – a deadly disease and a diagnostic dilemma Correct diagnosis – correct treatment False diagnosis – wrong treatment Missed diagnosis – no treatment

  8. Heart failure – the impact of assayingbloodlevels of natriureticpeptides (BNP and NT-proBNP) Correct diagnosis – correct treatment False diagnosis – wrong treatment Missed diagnosis – no treatment

  9. NT-proBNP in healthy 70-year old men in relation to all-cause death during a 10 year follow-up, n=839 (ULSAM) % Death NT-proBNP, ng/L

  10. Should my patient be prescribed antibiotics or not? 49% of all patients visiting a primary health care unit in Sweden called the doctor because of symptoms of acute infection The clinical diagnosis of most respiratory infections such as pneumonia, pharyngitis/tonsillitis, otitis has, when based on symptoms and physical signs only, a diagnostic sensitivity and specificity of 55-60% in the distinction between a viral or bacterial cause of the infection

  11. And how can we slow down the epidemics of antibiotics resistance?

  12. Is the discovery of Human neutrophil lipocalin (HNL) the answer to our needs?

  13. Discrimination between acute bacterial and viral infections Hospitalized adult population 100 Highest diagnostic accuracy in left corner 80 60 Sensitivity 40 P-CRP S-HNL 20 0 0 20 40 60 80 100 100-Specificity

  14. Someconclusions Internists basetheirclinical management to 70-80% on laboratory tests Primarycaredoctorsbasetheirclinical management to 10-20% on laboratory tests Laboratory testing is an efficientmeans to savemoney in healthcare since it provides the doctor with: • more accurate diagnosis • more reliable prognostic estimation • better tools for therapy stratification and monitoring • All for the benefit of our patients and the society

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