Exciting, selected scientific publications from the world of (digital) diagnostics from market access, health care systems, policy, and clinical value perspectives.
Healthcare systems
1. Point-of-care testing in Paediatric settings in the UK and Ireland: a cross-sectional study
This survey demonstrates significant consensus in POCT practice in the UK and Ireland but highlights specific inequity in newer biomarkers, some of which do not have support from national guidance. A clear strategy to overcome the key obstacles of funding, evidence base, and standardizing variation will be essential if there is a drive toward increasing implementation of POCT.
2. Overuse of diagnostic testing in healthcare: a systematic review
118 assessments of diagnostic testing overuse, extracted from 35 studies, were included in this study. Assessments were divided into imaging procedures (n=96) and other diagnostic tests (n=22), which included laboratory tests (n=19), and electroencephalography procedures.
Missed opportunities for diagnosing cancer cause patients harm and have been attributed to suboptimal use of tests and referral pathways in primary care. Primary care physician (PCP) factors have been suggested to affect decisions to investigate cancer, but their influence is poorly understood.
There is a lack of integration of appropriate digital health applications (DiGA) into the first healthcare market in Germany. The aim of this study was the development of strategies to modify and improve access of DiGA to SHI reimbursement. The recently introduced Digitale-Versorgung-Gesetz (DVG) is an initial step in this direction.
Clinical value
5. Role of Precision Medicine in Pediatric Oncology
This study reviews the implementation of precision medicine in pediatric oncology and its effect on diagnosis, management, and treatment of pediatric cancers, diagnostics overuse, general medicine; oncology; primary care; public health, Cost-effectiveness; Genetic disease; Genome sequencing; Rare disease, DIGA, comprehensive genomic profiling; cost-effectiveness; next-generation sequencing; precision cancer medicine; targeted therapy, pediatric oncology, pediatric cancers
6. Clinical Value of Pepsinogen in the Screening, Prevention, and Diagnosis of Gastric Cancer
The combined detection of PGI, PGII, and PGR has important clinical value for the screening, prevention, and diagnosis of GC and could allow for earlier detection, diagnosis, and treatment of GC.
Cost-effectiveness
This review brings together the cost-effectiveness literature for novel diagnostic methods in prostate cancer, showing that most studies have found new methods to be more cost-effective than standard of care.
This paper estimates the cost-effectiveness of genome sequencing (GS) for diagnosing critically ill infants and noncritically ill pediatric patients (children) with suspected rare genetic diseases from a United States health sector perspective.
CGP not only enables prediction of response to treatment, but also resistance, and could thus prevent administration of unnecessary (and costly) therapies. In clinical practice, the presence of clinical frameworks, such as the Recommendations for the Use of NGS for Patients with Metastatic Cancers from the ESMO Precision Medicine Working Group, and the ESMO Scale for Clinical Actionability of Molecular Targets, are essential in appropriately identifying situations where PCM is clinically meaningful, thereby improving its cost-effectiveness.
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