Presentation describes survey results on patient and public attitudes to use of patient data for research and related purposes. Presented by Cicely Marston at the Data Management in Practice workshop, which took place at the London School of Hygiene and Tropical Medicine on Nov 14th 2013
MT115 Precision Medicine: Integrating genomics to enable better patient outcomesDell EMC World
"The emergence of genomics and real-time screening is helping to transform the practice of medicine as we know it today. New technologies present improved ways to tackle health issues and what was once thought to be “untouchable” due to cost, timing or resources, is now achievable through genetic screenings and genome sequencing.
During this session, we will explore:
1. The benefits of incorporating a genomics strategy early in lifeline
2. The Precision Medicine Initiative – how does this help? Does this encourage more people to get genetic screenings?
3. What’s involved in a genetic screening
"
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
Cancer care is increasingly tailored to individual patients, who can undergo genetic or biomarker testing soon after diagnosis, to determine which treatments have the best chance of shrinking or eliminating tumours.
In this webinar, a pathologist and clinical oncologist discuss:
● how they are using these new tests,
● how they communicate results and treatment options to patients and caregivers, and
● how patients can be better informed on the kinds of tests that are in development or in use across Canada
View the video: https://youtu.be/_Wai_uMQKEQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
Presentation describes survey results on patient and public attitudes to use of patient data for research and related purposes. Presented by Cicely Marston at the Data Management in Practice workshop, which took place at the London School of Hygiene and Tropical Medicine on Nov 14th 2013
MT115 Precision Medicine: Integrating genomics to enable better patient outcomesDell EMC World
"The emergence of genomics and real-time screening is helping to transform the practice of medicine as we know it today. New technologies present improved ways to tackle health issues and what was once thought to be “untouchable” due to cost, timing or resources, is now achievable through genetic screenings and genome sequencing.
During this session, we will explore:
1. The benefits of incorporating a genomics strategy early in lifeline
2. The Precision Medicine Initiative – how does this help? Does this encourage more people to get genetic screenings?
3. What’s involved in a genetic screening
"
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
Cancer care is increasingly tailored to individual patients, who can undergo genetic or biomarker testing soon after diagnosis, to determine which treatments have the best chance of shrinking or eliminating tumours.
In this webinar, a pathologist and clinical oncologist discuss:
● how they are using these new tests,
● how they communicate results and treatment options to patients and caregivers, and
● how patients can be better informed on the kinds of tests that are in development or in use across Canada
View the video: https://youtu.be/_Wai_uMQKEQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
Driving networks locally - Embedding genomics in the South West: Professor Si...NHS England
Professor Ellard shares her experience as Clinical Director of one of the Genomic Medicine Centre and how she, as a healthcare scientist, has been able to take a technological development and transform the local healthcare system.
Transforming the NHS through genomic and personalised medicine, pop up uni, 1...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Decision makers in the healthcare field like doctors, patients and policy makers need access to clinical evidence to address issues that have bearing on the health of the population and the treatment prescribed and thereby on the financials implications of the healthcare industry.
With significant unmet needs for RA patients, it's more important than ever to overcome your Rheumatoid Arthritis development pain points with an experienced and trusted partner.
OSU Medical Center CEO Steven Gabbe, MD delivers a talk on facilitating learning healthcare systems: Focus on approaches to leverage Health IT investments for advancements in research and personalized healthcare and learning from every patient.
This session will focus on the usages of HIT to learn from every patient so that this knowledge can be used to further the practice of medicine. The discussion will address the implications for research, privacy, and HIT to change the paradigm of advancing healthcare discoveries so that it is a continuous process driven through every patient interaction.
The global precision medicine market has benefitted greatly from advancements in the life science industry. Although in its nascent stage, targeted therapies hold high chances of becoming a massive success in the coming years because of the potential to treat and cure chronic illnesses. The market is thus expected to expand at a compound annual growth rate (CAGR) of 11.60% between 2018 and 2023, generating USD 88.25 Bn in revenue by 2023.
Precision Medicine is now a funded NIH initiative and an organic movement in the clinic and at the research institute. Based on work with Genomics England, multiple large pharmaceutical firms, and research hospitals, attendees will learn about the best practices for epidemiology, signal detection, research, and the clinical diagnostics associated with Precision Medicine, including the development of high-scale bio-repositories that link traditional patient data with genomic information. Come hear about how leadership, collaboration, consent, and compute can lead to success or failure in your Precision Medicine initiative, and how to bring your stakeholders together for an aligned mission response.
Precision Medicine: Opportunities and Challenges for Clinical TrialsMedpace
The momentum and muscle behind "finding the right drug for the right patient at the right dose" has further escalated with President Barack Obama’s announcement of a $215 million dollar Precision Medicine Initiative earlier this year. In this webinar, Dr. Frank Smith will explore advances in precision medicine and how it is affecting clinical research. As a pediatric hematologist/oncologist, he will use his extensive clinical and research background as a backdrop for the discussion.
Topics will include:
The evolution of "personalized medicine" to "precision medicine"
How state-of-the-art molecular biology is creating new diagnostic and prognostic strategies
How these new strategies are helping inform the design of clinical trials
Case study: How precision medicine is improving clinical trials in hematology and oncology
The Virtual Consulting Room is an internet/intranet platform with four levels of incremental consultation in order to bridge the divide between primary and secondary care.
Biomedical Informatics project for implementing a state wide screening program for narcotic seeking patients. Project defined from abstract to specific implementation and measurement criteria.
Secondary Malignancy after Treatment of Prostate Cancer. Radical Prostatectom...asclepiuspdfs
Background: This study aims to determine whether the treatment of locally confined prostate cancer (PCa) with external radiotherapy (EBRT) increases the risk to develop secondary malignancies (SM) compared to radical prostatectomy (RPE). Materials and Methods: Data from patients who were treated curatively with RPE or EBRT from 2010 to 2018 and who did not have distant metastases, previous malignancy, or previous treatment with radiotherapy or chemotherapy at the time of diagnosis were reviewed to determine the incidence of SM over a median follow-up period of 47 months (range 12–96 months). Regression models were used to correlate the clinicopathological factors with the incidence of SM.
Driving networks locally - Embedding genomics in the South West: Professor Si...NHS England
Professor Ellard shares her experience as Clinical Director of one of the Genomic Medicine Centre and how she, as a healthcare scientist, has been able to take a technological development and transform the local healthcare system.
Transforming the NHS through genomic and personalised medicine, pop up uni, 1...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Decision makers in the healthcare field like doctors, patients and policy makers need access to clinical evidence to address issues that have bearing on the health of the population and the treatment prescribed and thereby on the financials implications of the healthcare industry.
With significant unmet needs for RA patients, it's more important than ever to overcome your Rheumatoid Arthritis development pain points with an experienced and trusted partner.
OSU Medical Center CEO Steven Gabbe, MD delivers a talk on facilitating learning healthcare systems: Focus on approaches to leverage Health IT investments for advancements in research and personalized healthcare and learning from every patient.
This session will focus on the usages of HIT to learn from every patient so that this knowledge can be used to further the practice of medicine. The discussion will address the implications for research, privacy, and HIT to change the paradigm of advancing healthcare discoveries so that it is a continuous process driven through every patient interaction.
The global precision medicine market has benefitted greatly from advancements in the life science industry. Although in its nascent stage, targeted therapies hold high chances of becoming a massive success in the coming years because of the potential to treat and cure chronic illnesses. The market is thus expected to expand at a compound annual growth rate (CAGR) of 11.60% between 2018 and 2023, generating USD 88.25 Bn in revenue by 2023.
Precision Medicine is now a funded NIH initiative and an organic movement in the clinic and at the research institute. Based on work with Genomics England, multiple large pharmaceutical firms, and research hospitals, attendees will learn about the best practices for epidemiology, signal detection, research, and the clinical diagnostics associated with Precision Medicine, including the development of high-scale bio-repositories that link traditional patient data with genomic information. Come hear about how leadership, collaboration, consent, and compute can lead to success or failure in your Precision Medicine initiative, and how to bring your stakeholders together for an aligned mission response.
Precision Medicine: Opportunities and Challenges for Clinical TrialsMedpace
The momentum and muscle behind "finding the right drug for the right patient at the right dose" has further escalated with President Barack Obama’s announcement of a $215 million dollar Precision Medicine Initiative earlier this year. In this webinar, Dr. Frank Smith will explore advances in precision medicine and how it is affecting clinical research. As a pediatric hematologist/oncologist, he will use his extensive clinical and research background as a backdrop for the discussion.
Topics will include:
The evolution of "personalized medicine" to "precision medicine"
How state-of-the-art molecular biology is creating new diagnostic and prognostic strategies
How these new strategies are helping inform the design of clinical trials
Case study: How precision medicine is improving clinical trials in hematology and oncology
The Virtual Consulting Room is an internet/intranet platform with four levels of incremental consultation in order to bridge the divide between primary and secondary care.
Biomedical Informatics project for implementing a state wide screening program for narcotic seeking patients. Project defined from abstract to specific implementation and measurement criteria.
Secondary Malignancy after Treatment of Prostate Cancer. Radical Prostatectom...asclepiuspdfs
Background: This study aims to determine whether the treatment of locally confined prostate cancer (PCa) with external radiotherapy (EBRT) increases the risk to develop secondary malignancies (SM) compared to radical prostatectomy (RPE). Materials and Methods: Data from patients who were treated curatively with RPE or EBRT from 2010 to 2018 and who did not have distant metastases, previous malignancy, or previous treatment with radiotherapy or chemotherapy at the time of diagnosis were reviewed to determine the incidence of SM over a median follow-up period of 47 months (range 12–96 months). Regression models were used to correlate the clinicopathological factors with the incidence of SM.
Hospital treated pneumonia - Diagnosis and TreatmentBostonsp
In 2014, US healthcare spending exceeded $3.0 trillion with nearly 1/3 spent on hospitalizations. Informed by real-world data from an Electronic Health Record (EHR) database of clinical and administrative records spanning 273 million encounters for 60 million patients in 600+ hospitals across the US, Boston Strategic Partners (BSP) Clinical Insights report, Hospital-Treated Pneumonia, estimates 30% of all hospital discharges involve treatment of infectious organisms. Pneumonia is responsible for an estimated 12% of all hospital stays. At an average cost of $15,500 per occurrence, we estimate that hospitalizations for severe infections account for around $212 billion in annual spending or 7% of total healthcare expenditure. In this report, we conduct an in-depth analysis of pneumonia patient characteristics, medication management, costs, and laboratory testing.
Hospital-Treated Pneumonia is available at www.bostonsp.com/reports.
Gram-negative bacteria are the likely causative agents of most pneumonia infections and physicians treat most of these patients with levofloxacin, ceftriaxone, and azithromycin. From 2010-2015, drug resistant organisms caused a surprising 20% of bacterial pneumonia infections.
This report provides quantitative, objective data captured by hospitals contributing to Cerner Health Facts. This data provides real-world patient encounters and reflects real physician decisions and encounter characteristics (e.g. patient response to therapy and outcomes) in key areas, such as antibiotic resistant pathogens and antimicrobial stewardship.
'Use of linked health care data for research: experiences with the Hampshire ...Health Innovation Wessex
The fifth presentation delivered at the 'Big Data in health and care: using data to gain new insights’ event, hosted by Wessex Academic Health Science Network (AHSN) on 19 April 2015.
In 2014, US healthcare spending exceeded $3.0 trillion with nearly 1/3 spent on hospitalizations. Informed by real-world data from an Electronic Health Record (EHR) database of clinical and administrative records spanning 273 million encounters for 60 million patients in 600+ hospitals across the US, Boston Strategic Partners (BSP) Clinical Insights report, Hospital Treated Sepsis, estimates 30% of all hospital discharges involve treatment of infectious organisms.
Sepsis is responsible for an estimated 12% of all hospital stays. At an average cost of $15,500 per occurrence, we estimate that hospitalizations for severe infections account for $212 billion in annual spending or 7% of total healthcare expenditure. In this report, we conduct an in-depth analysis of sepsis patient characteristics, medication management, costs, and laboratory testing.
The Hospital-Treated Sepsis Report is available at www.bostonsp.com/reports
Gram-positive bacteria are the likely causative agents of most sepsis infections. Physicians treat the vast majority of these infections with vancomycin, piperacillin-tazobactam, levofloxacin, and ceftriaxone. From 2010-2015, drug-resistant organisms caused an astonishing 40% of bacterial sepsis infections. After confirmatory diagnosis, over half of sepsis patients undergo a change in antibiotic therapy.
This report provides quantitative, objective data captured by hospitals contributing to Cerner Health Facts. This data provides real-world patient encounters and reflects real physician decisions and encounter characteristics (e.g. patient response to therapy and outcomes) in key areas, such as antibiotic resistant pathogens and antimicrobial stewardship.
Remote Patient Monitoring (RPM) is becoming an essential part of future healthcare. Read this guide, to learn more about remote patient monitoring. Click here :https://bluestartelehealth.com/
The Envisia Genomic Classifier is the first commercially available genomic test to improve the diagnosis of idiopathic pulmonary fibrosis (IPF). The test harnesses the power of RNA sequencing and machine learning to improve physicians’ ability to differentiate IPF from other interstitial lung diseases (ILD) without the need for invasive, risky and costly surgery.
Ομιλία-Παρουσίαση: Γιώτα Τουλούμη, Καθηγήτρια Βιοστατιστικής και Επιδημιολογίας, Εργαστήριο Υγιεινής, Επιδημιολογίας και Ιατρικής Στατιστικής, Ιατρική Σχολή, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
HEART DISEASES PREDICTION USING MACHINE LEARNING ALGORITHMPoojaSri45
Implemented a machine learning project aimed at predicting heart diseases using various algorithms and techniques. Developed as a part of academic or professional endeavor, the project demonstrates proficiency in data preprocessing, feature selection, model training, and evaluation.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
What Do We Know About Adherence in ICAP Programs?: A Review of the Data
1. ICAP Adherence Data Molly McNairy, MD, MSc Supporting Sustainable Adherence to HIV Prevention, Care & Treatment ICAP Technical Workshop October 19-22, 2009Kigali, Rwanda
2.
3. Meta-Analysis: Adherence at 2 years Rosen et al. PLoS 2007 32 studies in SSA 1996-2007 ~75,000 patients in non-research ART 6 mo = 80% pts retained 12 mo = 60% pts retained At 2 Years*: BEST CASE = 84% WORST CASE = 46% AVERAGE = 61% ~40% LTFU at 2 years Of which, LTFU 56%, Death 40% 61% at 24 months
4. A closer look at ICAP Adherence Data June 2009 URS, PFaCTS, Patient-level “Those are other programs”
5.
6.
7.
8. Two-year cumulative risk of death, loss to follow-up9, and loss to program8among ART patients since ART initiation (Total 91,612 patients)
9. Pediatric ART patients since ART Initiation Patient level data through June 2009 (n= 28 sites)
10. Applying the Meta-Analysis ResultsTo ICAP Adherence Data “Good Adherence>95%” Our GAP *Rosen et al PLoS Med 4 (10) 2007
11. Cumulative and current enrollment in ART care at ICAP-supported HIV care and treatment programsas of June 2009 (n= 327,092) Cumulative initiating ART Lost to follow up Reported dead Number of patients ART patients retained in care
12. Status of ART patients at ICAP sites June 2009 (n= 327,092) 10.3% per year on ART Lost to Follow-up 5.3% per year on ART Reported Dead .59% per year on ART Stopped ART *Includes patients who transferred out while on ART.
13. PFaCTS Data on Adherence services Type of patient support service Type of adherence service # outreach workers Methods for tracking missed appointments Time to follow-up/tracking
14. Sites offering on-site patient support services (n=323) Take Home: All sites have services, but what are those services doing? % sites with service
17. Mean number of outreach workers at ICAP-supported HIV care and treatment sites (n=183) Mean number of outreach workers
18. Number of outreach workers per 1,000 active ART patients at ICAP sites with at least 1 dedicated outreach worker,PFaCTS Round 4 (Jan-Jun 2009) n=8 n=48 n=18 n=11 n=17 n=39 n=8 n=33 n=207 n=24 n=1 Note: The bubbles represent the median across sites and the bars represent the IQR.
30. Proportion of adult ART patients on second line regimens in ICAP supported care and treatment sites, June 2009 Note: Restricted to sites that report >=90% of regimen data
31.
32. ICAP has LTFU rates similar to other large ARV programs
![To Review Patients on ART in resource-limited settings can have good immunologic and virologic outcomes Rates of adherence and barriers to adherence similar across settings LTFU increases over time ,[object Object],LTFU relationship with mortality ,[object Object],Rosen 2007, McPherson 2008](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)