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Merino P, Guinea J, Muñoz-Gallego I, González-Donapetry P, Galán JC, Antona N, Cilla G, Hernáez-Crespo S, Díaz-de Tuesta JL, Gual-de Torrella A, González-Romo F, Escribano P, Sánchez-Castellano MÁ, Sota-Busselo M, Delgado-Iribarren A, García J, Cantón R, Muñoz P, Folgueira MD, Cuenca-Estrella M, Oteo-Iglesias J. Multicenter evaluation of the Panbio™ COVID-19 rapid antigen-detection test for the diagnosis of SARS-CoV-2 infection. Clin Microbiol Infect 2021; 27:S1198-743X(21)00076-8. [PMID: 33601009 PMCID: PMC7884234 DOI: 10.1016/j.cmi.2021.02.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The standard RT-PCR assay for coronavirus disease 2019 (COVID-19) is laborious and time-consuming, limiting testing availability. Rapid antigen-detection tests are faster and less expensive; however, the reliability of these tests must be validated before they can be used widely. The objective of this study was to determine the performance of the Panbio™ COVID-19 Ag Rapid Test Device (PanbioRT) (Abbott) in detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swab specimens. METHODS This prospective multicentre study was carried out in ten Spanish university hospitals and included individuals with clinical symptoms or epidemiological criteria of COVID-19. Only individuals with ≤7 days from the onset of symptoms or from exposure to a confirmed case of COVID-19 were included. Two nasopharyngeal samples were taken to perform the PanbioRT as a point-of-care test and a diagnostic RT-PCR test. RESULTS Among the 958 patients studied, 325 (90.5%) had true-positive results. The overall sensitivity and specificity for the PanbioRT were 90.5% (95%CI 87.5-93.6) and 98.8% (95%CI 98-99.7), respectively. Sensitivity in participants who had a threshold cycle (CT) < 25 for the RT-PCR test was 99.5% (95%CI 98.4-100), and in participants with ≤5 days of the clinical course it was 91.8% (95%CI 88.8-94.8). Agreement between techniques was 95.7% (κ score 0.90; 95%CI 0.88-0.93). CONCLUSIONS The PanbioRT performs well clinically, with even more reliable results for patients with a shorter clinical course of the disease or a higher viral load. The results must be interpreted based on the local epidemiological context.
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Affiliation(s)
- Paloma Merino
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Jesús Guinea
- Microbiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Irene Muñoz-Gallego
- Clinical Microbiology Department, Hospital Universitario Doce de Octubre, Madrid, Spain
| | | | - Juan Carlos Galán
- Microbiology Department, Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Investigación en Salud Pública (CIBERESP), Madrid, Spain
| | - Nerea Antona
- Osakidetza Basque Health Service, Hospital Universitario Cruces, Microbiology Department, Barakaldo, Spain
| | - Gustavo Cilla
- Health Research Institute, Biodonostia, San Sebastián, Spain; Osakidetza Basque Health Service, Hospital Universitario Donostia, Microbiology Department, San Sebastián, Spain
| | - Silvia Hernáez-Crespo
- Osakidetza Basque Health Service, Hospital Universitario Araba, Microbiology Department, Vitoria, Spain
| | - José Luis Díaz-de Tuesta
- Osakidetza Basque Health Service, Hospital Universitario Basurto, Microbiology Department, Bilbao, Spain
| | - Ana Gual-de Torrella
- Osakidetza Basque Health Service, Hospital Universitario Galdakao-Usansolo, Microbiology Department, Galdakao, Spain
| | - Fernando González-Romo
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Pilar Escribano
- Microbiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - Mercedes Sota-Busselo
- Osakidetza Basque Health Service, Hospital Universitario Donostia, Clinical Management Unit of Gipuzkoa Laboratories, San Sebastián, Spain
| | - Alberto Delgado-Iribarren
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Julio García
- Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Rafael Cantón
- Microbiology Department, Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Spain
| | - Patricia Muñoz
- Microbiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - María Dolores Folgueira
- Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain; Clinical Microbiology Department, Hospital Universitario Doce de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Imas12, Madrid, Spain
| | | | - Jesús Oteo-Iglesias
- Osakidetza Basque Health Service, Hospital Universitario Donostia, Clinical Management Unit of Gipuzkoa Laboratories, San Sebastián, Spain; National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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Wang J, Cai K, He X, Shen X, Wang J, Liu J, Xu J, Qiu F, Lei W, Cui L, Ge Y, Wu T, Zhang Y, Yan H, Chen Y, Yu J, Ma X, Shi H, Zhang R, Li X, Gao Y, Niu P, Tan W, Wu G, Jiang Y, Xu W, Ma X. Multiple-centre clinical evaluation of an ultrafast single-tube assay for SARS-CoV-2 RNA. Clin Microbiol Infect 2020; 26:1076-1081. [PMID: 32422410 PMCID: PMC7227500 DOI: 10.1016/j.cmi.2020.05.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the performance of an ultrafast single-tube nucleic acid isothermal amplification detection assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA using clinical samples from multiple centres. METHODS A reverse transcription recombinase-aided amplification (RT-RAA) assay for SARS-CoV-2 was conducted within 15 minutes at 39°C with portable instruments after addition of extracted RNA. The clinical performance of RT-RAA assay was evaluated using 947 clinical samples from five institutions in four regions of China; approved commercial fluorescence quantitative real-time PCR (qRT-PCR) kits were used for parallel detection. The sensitivity and specificity of RT-RAA were compared and analysed. RESULTS The RT-RAA test results of 926 samples were consistent with those of qRT-PCR (330 were positive, 596 negative); 21 results were inconsistent. The sensitivity and specificity of RT-RAA was 97.63% (330/338, 95% confidence interval (CI) 95.21 to 98.90) and 97.87% (596/609, 95% CI 96.28 to 98.81) respectively. The positive and negative predictive values were 96.21% (330/343, 95% CI 93.45 to 97.88) and 98.68% (596/604, 95% CI 97.30 to 99.38) respectively. The total coincidence rate was 97.78% (926/947, 95% CI 96.80 to 98.70), and the kappa was 0.952 (p < 0.05). CONCLUSIONS With comparable sensitivity and specificity to the commercial qRT-PCR kits, RT-RAA assay for SARS-CoV-2 exhibited the distinctive advantages of simplicity and rapidity in terms of operation and turnaround time.
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Affiliation(s)
- J Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - K Cai
- Hubei Center for Disease Control and Prevention, Wuhan 430000, China
| | - X He
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Shen
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Hebei Medical University, Shijiazhuang 050031, China
| | - J Liu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J Xu
- Hubei Center for Disease Control and Prevention, Wuhan 430000, China
| | - F Qiu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - W Lei
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L Cui
- NHC Key Laboratories of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Y Ge
- NHC Key Laboratories of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - T Wu
- NHC Key Laboratories of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Y Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, China
| | - H Yan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, China
| | - Y Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, China
| | - J Yu
- The NO.1 Affiliated hospital of Shanxi Datong University, Institute of Brain Science-Shanxi Key Laboratory of Inflammatory Neurodegenerative Diseases, Datong 037000, China
| | - X Ma
- The NO.1 Affiliated hospital of Shanxi Datong University, Institute of Brain Science-Shanxi Key Laboratory of Inflammatory Neurodegenerative Diseases, Datong 037000, China; The Fifth People's Hospital of DaTong, Datong 037000, China
| | - H Shi
- Datong City Center for Disease Control and Prevention, Datong 037000, China
| | - R Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Hebei Medical University, Shijiazhuang 050031, China
| | - X Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y Gao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Hebei Medical University, Shijiazhuang 050031, China
| | - P Niu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - W Tan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - G Wu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y Jiang
- Hubei Center for Disease Control and Prevention, Wuhan 430000, China.
| | - W Xu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - X Ma
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China.
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Talamonti C, Russo S, Pimpinella M, Falco MD, Cagni E, Pallotta S, Stasi M, Mancosu P. Community approach for reducing small field measurement errors: Experience over 24 centres. Radiother Oncol 2018; 132:218-222. [PMID: 30385173 DOI: 10.1016/j.radonc.2018.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 08/20/2018] [Accepted: 10/10/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The complexity of the modern Stereotactic Body Radiation Therapy (SBRT) techniques requires comprehensive quality assurance programs, to ensure the right treatment to the patient. Dosimetry of small radiation fields is a challenge especially for radiotherapy centres starting to work on this issue. The matter to be discussed here concerns the need of detailed measurement procedures and cross checks to be paired to the usual recommendations on detectors and correction factors. MATERIALS AND METHODS The presented work involved 24 Italian radiotherapy centres, with the specific purpose to minimize systematic errors in output factor measurements over different radiotherapy centres. Using the unshielded silicon diode IBA Razor, reference curves for the relative signal ratio (RSR) as a function of beam size were created for each Linac family. RESULTS With this study we have demonstrated consistency of small field dosimetry on all the centres involved, moreover all radiotherapy centres using Razor are allowed to compare measurements amongst each other and centres with values deviating more than 5% from the reference curve are advised to repeat their measurements. With this procedure, some critical issues were detected from two centres in RSR measurements, that, if implemented into the own treatment planning system, would induce an unwanted overdosage larger than 5%. CONCLUSIONS The proposed approach could allow one to envision high-skilled therapy centres providing support to those featuring minor experience and could represent an important strategy for the clinical implementation of emerging technologies at high quality levels. The methodology adopted exploits crowd knowledge methods which could be applied in others areas of radiation dosimetry.
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Affiliation(s)
- Cinzia Talamonti
- University of Florence, Dept Biomedical Experimental and Clinical Science, "Mario Serio", Medical Physics Unit, AOU Careggi, Florence, Italy.
| | - Serenella Russo
- Medical Physics Unit, Azienda USL Toscana Centro, Florence, Italy
| | - Maria Pimpinella
- Istituto Nazionale di Metrologia delle Radiazioni Ionizzanti, ENEA-INMRI C R Casaccia, I-00123 Roma, Italy
| | - Maria Daniela Falco
- Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy
| | - Elisabetta Cagni
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Pallotta
- University of Florence, Dept Biomedical Experimental and Clinical Science, "Mario Serio", Medical Physics Unit, AOU Careggi, Florence, Italy
| | - Michele Stasi
- Medical Physics Department, A.O. Ordine Mauriziano, Turin, Italy
| | - Pietro Mancosu
- Medical Physics Unit of Radiation Oncology Dept., Humanitas Clinical and Research Hospital, Milano, Italy
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Oates K, Wilson I, Hu W, Walker B, Nagle A, Wiley J. Changing medical student attitudes to patient safety: a multicentre study. BMC Med Educ 2018; 18:205. [PMID: 30153841 PMCID: PMC6114839 DOI: 10.1186/s12909-018-1313-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 08/16/2018] [Indexed: 05/24/2023]
Abstract
BACKGROUND Although patient safety is becoming widely taught in medical schools, its effect has been less rigorously evaluated. We describe a multicentre study to evaluate student changes in patient safety attitudes using a standardised instrument, the Attitudes to Patient Safety Questionnaire3 (APSQ3). METHODS A patient safety training package designed for medical students was delivered in the first year and second year in four Australian medical schools. It comprises eight face-to-face modules, each of two hours. Seminars start with an interactive introduction using questions, video and role play, followed by small group break-outs to discuss a relevant case study. Groups are led by medical school tutors with no prior training in patient safety. Students and tutors then reassemble to give feedback and reinforce key concepts. Knowledge and attitudes to patient safety were measured using the APSQ3, delivered prior to safety teaching, at the end of the first and second years and 12 months after teaching ceased. RESULTS A significant improvement in attitude over time was demonstrated for four of nine key items measured by the APSQ3: value of patient safety teaching; danger of long working hours, value of team work and the contribution patients can make in reducing error. Informal feedback from students was very positive. CONCLUSION We showed persistent, positive learning from a patient safety education intervention 12 months after teaching finished. Building on the introduction of patient safety teaching into medical schools, pathways for motivated students such as appropriate electives, option terms and team-based research projects would be of value.
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Affiliation(s)
- Kim Oates
- NSW Clinical Excellence Commission Rawson Place, Sydney and University of Sydney, Sydney, Australia
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
| | - Ian Wilson
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, Australia
| | - Wendy Hu
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Ben Walker
- Joint Medical Program, Universities of Newcastle and New England, Newcastle, Australia
| | - Amanda Nagle
- School of Rural Medicine, University of New England, Armidale, Australia
| | - Janice Wiley
- School of Medicine, University of Notre Dame, Sydney, Australia
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Knecht S, Sohal M, Deisenhofer I, Albenque JP, Arentz T, Neumann T, Cauchemez B, Duytschaever M, Ramoul K, Verbeet T, Thorsten S, Jadidi A, Combes S, Tavernier R, Vandekerckhove Y, Ernst S, Packer D, Rostock T. Multicentre evaluation of non-invasive biatrial mapping for persistent atrial fibrillation ablation: the AFACART study. Europace 2018; 19:1302-1309. [PMID: 28204452 DOI: 10.1093/europace/euw168] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/15/2016] [Indexed: 11/13/2022] Open
Abstract
Aims Non-invasive electrocardiogram (ECG) mapping allows the activation of the entire atrial epicardium to be recorded simultaneously, potentially identifying mechanisms critical for atrial fibrillation (AF) persistence. We sought to evaluate the utility of ECG mapping as a practical tool prior to ablation of persistent AF (PsAF) in centres with no practical experience of the system. Methods and results A total of 118 patients with continuous AF duration <1 year were prospectively studied at 8 European centres. Patients were on a median of 1 antiarrhythmic drug (AAD) that had failed to restore sinus rhythm. Electrocardiogram mapping (ECVUE™, CardioInsight, USA) was performed prior to ablation to map AF drivers (local re-entrant circuits or focal breakthroughs). Ablation targeted drivers depicted by the system, followed by pulmonary vein (PV) isolation, and finally left atrial linear ablation if AF persisted. The primary endpoint was AF termination. Totally, 4.9 ± 1.0 driver sites were mapped per patient with a cumulative mapping time of 16 ± 2 s. Of these, 53% of drivers were located in the left atrium, 27% in the right atrium, and 20% in the anterior interatrial groove. Driver-only ablation resulted in AF termination in 75 of the 118 patients (64%) with a mean radiofrequency (RF) duration of 46 ± 28 min. Acute termination rates were not significantly different amongst all 8 centres (P = 0.672). Ten additional patients terminated with PV isolation and lines resulting in a total AF termination rate of 72%. Total RF duration was 75 ± 27 min. At 1-year follow-up, 78% of the patients were off AADs and 77% of the patients were free from AF recurrence. Of the patients with no AF recurrence, 49% experienced at least one episode of atrial tachycardia (AT) which required either continued AAD therapy, cardioversion, or repeat ablation. Conclusion Non-invasive mapping identifies biatrial drivers that are critical in PsAF. This is validated by successful AF termination in the majority of patients treated in centres with no experience of the system. Ablation targeting these drivers results in favourable AF-free survival at 1 year, albeit with a significant rate of AT recurrence requiring further management.
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Affiliation(s)
- Sébastien Knecht
- CHU-Brugmann, Brussels, Belgium.,Department of Cardiology, AZ Sint-Jan, Ruddershove 10, 8000 Brugge, Belgium
| | - Manav Sohal
- CHU-Brugmann, Brussels, Belgium.,Department of Cardiology, AZ Sint-Jan, Ruddershove 10, 8000 Brugge, Belgium
| | | | | | - Thomas Arentz
- Universitäts Herzzentrum Freiburg, Bad Krozingen, Germany
| | | | | | | | | | | | | | - Amir Jadidi
- Universitäts Herzzentrum Freiburg, Bad Krozingen, Germany
| | | | - René Tavernier
- Department of Cardiology, AZ Sint-Jan, Ruddershove 10, 8000 Brugge, Belgium
| | | | - Sabine Ernst
- Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, Imperial College, London, UK
| | | | - Thomas Rostock
- II. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Germany
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