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The underlying technology and the range of test parameters available are evolving rapidly. The primary advantage of POCT is the convenience of performing the test close to the patient and the speed at which test results can be obtained, compared to sending a sample to a laboratory and waiting for results to be returned. Thus, a series of clinical applications are possible that can shorten the time for clinical decision-making about additional testing or therapy, as delays are no longer caused by preparation of clinical samples, transport, and central laboratory analysis. Tests in a POC format can now be found for many medical disciplines including endocrinology/diabetes, cardiology, nephrology, critical care, fertility, hematology/coagulation, infectious disease and microbiology, and general health screening. Point-of-care testing (POCT) enables health care personnel to perform clinical laboratory testing near the patient. The idea of conventional and POCT laboratory services presiding within a hospital seems contradictory; yet, they are, in fact, complementary: together POCT and central laboratory are important for the optimal functioning of diagnostic processes. They complement each other, provided that a dedicated POCT coordination integrates the quality assurance of POCT into the overall quality management system of the central laboratory. The motivation of the third edition of the POCT book from Luppa/Junker, which is now also available in English, is to explore and describe clinically relevant analytical techniques, organizational concepts for application and future perspectives of POCT. From descriptions of the opportunities that POCT can provide to the limitations that clinician’s must be cautioned about, this book provides an overview of the many aspects that challenge those who choose to implement POCT. Technologies, clinical applications, networking issues and quality regulations are described as well as a survey of future technologies that are on the future horizon. The editors have spent considerable efforts to update the book in general and to highlight the latest developments, e.g., novel POCT applications of nucleic acid testing for the rapid identification of infectious agents. Of particular note is also that a cross-country comparison of POCT quality rules is being described by a team of international experts in this field.
This book unravels the role of Point-of-Care (POC) glucose monitoring as an essential part of diabetes management. It provides the reader with an in-depth knowledge and understanding of diabetes management, including: the need for POC glucose monitoring the glucose detection technologies (invasive, noninvasive and continuous) being used in the POC devices the analytical performance, characteristics, pros and cons of the POC devices developed to date the importance and role of glycated hemoglobin (HbA1c) monitoring for diabetes management the various POC devices and analyzers for the determination of HbA1c. This is the first book to provide complete up-to-date information on POC glucose detection technologies and devices for diabetic monitoring and management. It will be an important reference for healthcare professionals, biomedical engineers, researchers, economists and policy makers. This book also serves as an asset and teaching aid for professionals and researchers in diabetic monitoring and management.
As the number of patients with diabetes increases annually, it is not surprising that the number of patients with diabetes who are admitted to the hospital also increases. Once in the hospital, patients with diabetes or hyperglycemia may be admitted to the Intensive Care Unit, require urgent or elective surgery, enteral or parenteral nutrition, intravenous insulin infusion, or therapies that significantly impact glycemic control (e.g., steroids). Because many clinical outcomes are influenced by the degree of glycemic control, knowledge of the best practices in inpatient diabetes management is extremely important. The field of inpatient management of diabetes and hyperglycemia has grown substantially in the last several years. This body of knowledge is summarized in this book, so it can reach the audience of hospitalists, endocrinologists, nurses and other team members who take care of hospitalized patients with diabetes and hyperglycemia.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Personalized Predictive Modeling in Diabetes features state-of-the-art methodologies and algorithmic approaches which have been applied to predictive modeling of glucose concentration, ranging from simple autoregressive models of the CGM time series to multivariate nonlinear regression techniques of machine learning. Developments in the field have been analyzed with respect to: (i) feature set (univariate or multivariate), (ii) regression technique (linear or non-linear), (iii) learning mechanism (batch or sequential), (iv) development and testing procedure and (v) scaling properties. In addition, simulation models of meal-derived glucose absorption and insulin dynamics and kinetics are covered, as an integral part of glucose predictive models. This book will help engineers and clinicians to: select a regression technique which can capture both linear and non-linear dynamics in glucose metabolism in diabetes, and which exhibits good generalization performance under stationary and non-stationary conditions; ensure the scalability of the optimization algorithm (learning mechanism) with respect to the size of the dataset, provided that multiple days of patient monitoring are needed to obtain a reliable predictive model; select a features set which efficiently represents both spatial and temporal dependencies between the input variables and the glucose concentration; select simulation models of subcutaneous insulin absorption and meal absorption; identify an appropriate validation procedure, and identify realistic performance measures. Describes fundamentals of modeling techniques as applied to glucose control Covers model selection process and model validation Offers computer code on a companion website to show implementation of models and algorithms Features the latest developments in the field of diabetes predictive modeling
Rev. ed. of: Clinical diagnosis and management by laboratory methods / [edited by] John Bernard Henry. 20th ed. c2001.
This book provides teaching scripts for medical educators in internal medicine and coaches them in creating their own teaching scripts. Every year, thousands of attending internists are asked to train the next generation of physicians to master a growing body of knowledge. Formal teaching time has become increasingly limited due to rising clinical workload, medical documentation requirements, duty hour restrictions, and other time pressures. In addition, today’s physicians-in-training expect teaching sessions that deliver focused, evidence-based content that is integrated into clinical workflow. In keeping with both time pressures and trainee expectations, academic internists must be prepared to effectively and efficiently teach important diagnostic and management concepts. A teaching script is a methodical and structured plan that aids in effective teaching. The teaching scripts in this book anticipate learners’ misconceptions, highlight a limited number of teaching points, provide evidence to support the teaching points, use strategies to engage the learners, and provide a cognitive scaffold for teaching the topic that the teacher can refine over time. All divisions of internal medicine (e.g. cardiology, rheumatology, and gastroenterology) are covered and a section on undifferentiated symptom-based presentations (e.g. fatigue, fever, and unintentional weight loss) is included. This book provides well-constructed teaching scripts for commonly encountered clinical scenarios, is authored by experienced academic internists and allows the reader to either implement them directly or modify them for their own use. Each teaching script is designed to be taught in 10-15 minutes, but can be easily adjusted by the reader for longer or shorter talks. Teaching Scripts in Internal Medicine is an ideal tool for internal medicine attending physicians and trainees, as well as physician’s assistants, nurse practitioners, and all others who teach and learn internal medicine.
Series Editors: Moira Stewart, Judith Belle Brown and Thomas R Freeman The application of the patient-centered clinical method has received international recognition. This book introduces and fully examines the patient-centered clinical method and illustrates how it can be applied in primary care. It presents case examples of the many problems encountered in patient-doctor interactions and provides ideas for dealing with these more effectively. It covers a wide range of topics and issues including palliative care, abuse, dying patients, ethical challenges and the role of self-awareness. Many narratives originate from patients' and family members' experiences, providing perspectives of great power and value. The Patient-Centered Care series is of great value to all health professionals, teachers and students in primary care.