1
|
Jain AK, Sharma P, Saleh S, Dolai TK, Saha SC, Bagga R, Khadwal AR, Trehan A, Nielsen I, Kaviraj A, Das R, Saha S. Multi-criteria decision making to validate performance of RBC-based formulae to screen [Formula: see text]-thalassemia trait in heterogeneous haemoglobinopathies. BMC Med Inform Decis Mak 2024; 24:5. [PMID: 38167309 PMCID: PMC10759673 DOI: 10.1186/s12911-023-02388-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND India has the most significant number of children with thalassemia major worldwide, and about 10,000-15,000 children with the disease are born yearly. Scaling up e-health initiatives in rural areas using a cost-effective digital tool to provide healthcare access for all sections of people remains a challenge for government or semi-governmental institutions and agencies. METHODS We compared the performance of a recently developed formula SCS[Formula: see text] and its web application SUSOKA with 42 discrimination formulae presently available in the literature. 6,388 samples were collected from the Postgraduate Institute of Medical Education and Research, Chandigarh, in North-Western India. Performances of the formulae were evaluated by eight different measures: sensitivity, specificity, Youden's Index, AUC-ROC, accuracy, positive predictive value, negative predictive value, and false omission rate. Three multi-criteria decision-making (MCDM) methods, TOPSIS, COPRAS, and SECA, were implemented to rank formulae by ensuring a trade-off among the eight measures. RESULTS MCDM methods revealed that the Shine & Lal and SCS[Formula: see text] were the best-performing formulae. Further, a modification of the SCS[Formula: see text] formula was proposed, and validation was conducted with a data set containing 939 samples collected from Nil Ratan Sircar (NRS) Medical College and Hospital, Kolkata, in Eastern India. Our two-step approach emphasized the necessity of a molecular diagnosis for a lower number of the population. SCS[Formula: see text] along with the condition MCV[Formula: see text] 80 fl was recommended for a higher heterogeneous population set. It was found that SCS[Formula: see text] can classify all BTT samples with 100% sensitivity when MCV[Formula: see text] 80 fl. CONCLUSIONS We addressed the issue of how to integrate the higher-ranked formulae in mass screening to ensure higher performance through the MCDM approach. In real-life practice, it is sufficient for a screening algorithm to flag a particular sample as requiring or not requiring further specific confirmatory testing. Implementing discriminate functions in routine screening programs allows early identification; consequently, the cost will decrease, and the turnaround time in everyday workflows will also increase. Our proposed two-step procedure expedites such a process. It is concluded that for mass screening of BTT in a heterogeneous set of data, SCS[Formula: see text] and its web application SUSOKA can provide 100% sensitivity when MCV[Formula: see text] 80 fl.
Collapse
Affiliation(s)
- Atul Kumar Jain
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Prashant Sharma
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sarkaft Saleh
- Department of Materials and Production, Aalborg University, 9220, Aalborg, Denmark
| | - Tuphan Kanti Dolai
- Department of Hematology, Nil Ratan Sircar Medical College and Hospital, Kolkata, 700014, West Bengal, India
| | | | - Rashmi Bagga
- Department of Obstetrics and Gynecology, PGIMER, Chandigarh, India
| | - Alka Rani Khadwal
- Department of Clinical Hematology and Medical Oncology, PGIMER, Chandigarh, India
| | - Amita Trehan
- Pediatric Hematology/Oncology Unit, Department of Pediatric Medicine, Advanced Pediatric Centre, PGIMER, Chandigarh, India
| | - Izabela Nielsen
- Department of Materials and Production, Aalborg University, 9220, Aalborg, Denmark
| | - Anilava Kaviraj
- Department of Zoology, University of Kalyani, Kalyani, 741235, India
| | - Reena Das
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Subrata Saha
- Department of Materials and Production, Aalborg University, 9220, Aalborg, Denmark.
- Department of Mathematics, University of Engineering & Management, Action Area III, B/5, Newtown, Kolkata , 700160, India.
| |
Collapse
|
2
|
Van Haute M, Agagon A, Gumapac FF, Anticuando MA, Coronel DN, David MC, Davocol DA, Din EJ, Grey CA, Lee YH, Muyot MB, Ragasa CL, Shao G, Tamaña CA, Uy TS, De Silos J. Determinants of differences in RT-PCR testing rates among Southeast Asian countries during the first six months of the COVID-19 pandemic. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002593. [PMID: 37934719 PMCID: PMC10629619 DOI: 10.1371/journal.pgph.0002593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/16/2023] [Indexed: 11/09/2023]
Abstract
A positive correlation has been demonstrated between gross domestic product (GDP) per capita and COVID-19 tests per 1000 people. Although frequently used as an indicator of economic performance, GDP per capita does not directly reflect income distribution inequalities and imposed health costs. In this longitudinal ecological study, we aimed to determine if, besides GDP per capita, indicators relating to governance, public health measures enforcement, and health and research investment explain differences in RT-PCR testing rates among countries in Southeast Asia (SEA) during the first six months of the COVID-19 pandemic. Using open-access COVID-19 panel data, we estimated the effect of various indicators (GDP per capita, health expenditure per capita, number of researchers per one million population, corruption perceptions index, stringency index, regional authority index) on daily COVID-19 testing by performing fixed-effects negative binomial regression. After accounting for all indicators, the number of daily confirmed COVID-19 cases, and population density, the model provided a 2019 GDP per capita coefficient of 0.0046330 (95% CI: 0.0040171, 0.0052488; p <0.001), indicating that a rise in 2019 GDP per capita by 100 international dollars is associated with a 46.33% increase in the number of daily tests performed. Additionally, all indicators were significantly associated with the daily number of RT-PCR testing on multivariable analysis. In conclusion, we identified different country-level indicators significantly associated with differences in COVID-19 testing rates among SEA countries. Due to the study's ecological design, we caution on applying our results to the individual level given potential for systematic differences between the included countries. Additional investigation is likewise needed to understand how government expenditure on healthcare may have impacted COVID-19 testing capacity during the initial stages of the pandemic.
Collapse
Affiliation(s)
- Michael Van Haute
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Alexandra Agagon
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Franz Froilan Gumapac
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Marie Abigail Anticuando
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Dianne Nicole Coronel
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Mary Coleen David
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Dan Ardie Davocol
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Eunice Jairah Din
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Carlos Alfonso Grey
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Young Hee Lee
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Marvin Bryan Muyot
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Charissma Leiah Ragasa
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Genesis Shao
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Cailin Adrienne Tamaña
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Trixia Scholastica Uy
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| | - Jeriel De Silos
- College of Medicine, De La Salle Medical and Health Sciences Institute, City of Dasmariñas, Cavite, Philippines
| |
Collapse
|