software

软件
  • 文章类型: Journal Article
    在与学生一对一教授科学过程技能时,管理和评估文献综述过程可能是一项耗时的挑战,无论是通过独立研究,荣誉合同,或本科研究。在这篇文章中,我分享我的解决方案,以解决这种类型的教学和指导带来的教学和组织挑战:引用管理软件Zotero与模板工作表结合使用。总的来说,这种方法将节省时间,向学生介绍一种新的多用途软件工具,并为未来的教学带来一套可重用的资源。
    Managing and evaluating the literature review process can be a time-consuming challenge when working one-on-one with students to teach scientific process skills, whether through an independent study, honors contract, or undergraduate research. In this article, I share my solution to address the pedagogical and organizational challenge posed by this type of teaching and mentoring: the citation management software Zotero used in conjunction with a template worksheet. Overall, this approach will save time, introduce students to a new multipurpose software tool, and lead to a set of reusable resources for future teaching.
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  • 文章类型: Journal Article
    目的:用于数据的元数据欧洲药品管理局资助的项目(EUPAS39322),定义了一组元数据来描述现实世界的数据源(RWDS),并在原型目录中试行了元数据收集,以帮助调查人员通过研究进行数据源的可发现性。
    方法:元数据列表是根据对现有元数据目录和建议的审查而创建的,结构化面试,利益相关者调查,和技术研讨会。原型的设计符合FAIR原则(可找到,可访问,可互操作,可重用),使用MOLGENIS软件。元数据收集由来自欧洲各地的15个数据访问合作伙伴(DAP)进行试点。
    结果:总共在六个领域中定义了442个元数据变量:机构(连接到数据源的组织);数据库(由组织维持的数据收集);数据源(涵盖共同基础人群的可链接数据库的集合);研究;(机构)网络;和通用数据模型(CDM)。原型中总共记录了26个机构。每个DAP填充一个数据源及其所选数据库的元数据。数据库的数量因数据源而异;最常见的数据库是医院管理记录和药房分配记录(每个10个数据源)。从符合不同CDM的三个数据源中成功提取了定量元数据,并将其输入到原型中。
    结论:最终确定了元数据列表,一个原型被成功填充,并制定了良好的实践指南。建立和维护RWDS的元数据目录将需要大量努力来支持数据源的可发现性和欧洲研究的可重复性。
    OBJECTIVE: Metadata for data dIscoverability aNd study rEplicability in obseRVAtional studies (MINERVA), a European Medicines Agency-funded project (EUPAS39322), defined a set of metadata to describe real-world data sources (RWDSs) and piloted metadata collection in a prototype catalogue to assist investigators from data source discoverability through study conduct.
    METHODS: A list of metadata was created from a review of existing metadata catalogues and recommendations, structured interviews, a stakeholder survey, and a technical workshop. The prototype was designed to comply with the FAIR principles (findable, accessible, interoperable, reusable), using MOLGENIS software. Metadata collection was piloted by 15 data access partners (DAPs) from across Europe.
    RESULTS: A total of 442 metadata variables were defined in six domains: institutions (organizations connected to a data source); data banks (data collections sustained by an organization); data sources (collections of linkable data banks covering a common underlying population); studies; networks (of institutions); and common data models (CDMs). A total of 26 institutions were recorded in the prototype. Each DAP populated the metadata of one data source and its selected data banks. The number of data banks varied by data source; the most common data banks were hospital administrative records and pharmacy dispensation records (10 data sources each). Quantitative metadata were successfully extracted from three data sources conforming to different CDMs and entered into the prototype.
    CONCLUSIONS: A metadata list was finalized, a prototype was successfully populated, and a good practice guide was developed. Setting up and maintaining a metadata catalogue on RWDSs will require substantial effort to support discoverability of data sources and reproducibility of studies in Europe.
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  • 文章类型: Journal Article
    分子HLA分型技术目前正在经历快速发展。虽然实时PCR被确立为组织分型实验室关于实体器官分配的标准方法,用于高分辨率HLA分型的下一代测序(NGS)正变得不可或缺,但还不适合于已故供体.相比之下,高分辨率分型对于干细胞移植至关重要,对于各种疾病相关问题的要求也越来越高.在这项多中心临床研究中,应用NanoTYPE™试剂盒和NanoTYPER™软件(OmixonBiocomputingLtd.,布达佩斯,匈牙利)关于结果与NGS的一致性及其在诊断实验室中的实用性。381个样本的结果显示11个HLA基因座的一致性为99.58%,HLA-A,-B,-C,-DRB1、-DRB3、-DRB4、-DRB5、-DQA1、-DQB1、-DPA1和-DPB1。质量控制(QC)数据显示每个实验室进行的测序质量非常高,34,926(97.15%)个QC值作为“已通过”返回,862(2.4%)为“检查”,162(0.45%)为“失败”。我们表明\'inspect\'或\'失败\'QC警告不会自动导致不正确的HLA分型。纳米孔测序的优点是速度,灵活性,流动池的可重用性和易于在实验室中实现。有挑战,例如外显子覆盖和处理大量数据。最后,纳米孔测序显示了在表观遗传学和基因组学领域的基础研究中的应用潜力,并且对临床关注具有重要意义。
    Molecular HLA typing techniques are currently undergoing a rapid evolution. While real-time PCR is established as the standard method in tissue typing laboratories regarding allocation of solid organs, next generation sequencing (NGS) for high-resolution HLA typing is becoming indispensable but is not yet suitable for deceased donors. By contrast, high-resolution typing is essential for stem cell transplantation and is increasingly required for questions relating to various disease associations. In this multicentre clinical study, the TGS technique using nanopore sequencing is investigated applying NanoTYPE™ kit and NanoTYPER™ software (Omixon Biocomputing Ltd., Budapest, Hungary) regarding the concordance of the results with NGS and its practicability in diagnostic laboratories. The results of 381 samples show a concordance of 99.58% for 11 HLA loci, HLA-A, -B, -C, -DRB1, -DRB3, -DRB4, -DRB5, -DQA1, -DQB1, -DPA1 and -DPB1. The quality control (QC) data shows a very high quality of the sequencing performed in each laboratory, 34,926 (97.15%) QC values were returned as \'passed\', 862 (2.4%) as \'inspect\' and 162 (0.45%) as \'failed\'. We show that an \'inspect\' or \'failed\' QC warning does not automatically lead to incorrect HLA typing. The advantages of nanopore sequencing are speed, flexibility, reusability of the flow cells and easy implementation in the laboratory. There are challenges, such as exon coverage and the handling of large amounts of data. Finally, nanopore sequencing presents potential for applications in basic research within the field of epigenetics and genomics and holds significance for clinical concerns.
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  • 文章类型: Journal Article
    高通量成像(HTI)从大量实验扰动中生成复杂的成像数据集。用于图像分析工作流程的商业HTI软件程序通常不允许在分析模块中完全定制和采用新的图像处理算法。虽然开源HTI分析平台在工作流中提供了单个模块,像细胞核分割一样,斑点检测,或细胞追踪,它们通常在集成新颖的分析模块或算法方面受到限制。这里,我们引入了高通量图像处理软件(HITIPS),以扩展现有HTI分析功能的范围和定制。HITIPS结合了先进的图像处理和机器学习算法,用于自动的细胞和细胞核分割,光斑信号检测,细胞核追踪,原子核注册,现场跟踪,和点信号强度的量化。此外,HiTIPS具有一个图形用户界面,可以集成现有分析管道的新分析模块并添加新分析模块。为了证明HiTIPS的实用性,我们介绍了高通量DNAFISH的图像分析工作流程的三个示例,免疫荧光(IF),和单细胞转录的活细胞成像。总之,我们证明了HiTIPS是一个用户友好的,灵活,和各种细胞生物学应用的开源HTI软件平台。
    High-throughput imaging (HTI) generates complex imaging datasets from a large number of experimental perturbations. Commercial HTI software programs for image analysis workflows typically do not allow full customization and adoption of new image processing algorithms in the analysis modules. While open-source HTI analysis platforms provide individual modules in the workflow, like nuclei segmentation, spot detection, or cell tracking, they are often limited in integrating novel analysis modules or algorithms. Here, we introduce the High-Throughput Image Processing Software (HiTIPS) to expand the range and customization of existing HTI analysis capabilities. HiTIPS incorporates advanced image processing and machine learning algorithms for automated cell and nuclei segmentation, spot signal detection, nucleus tracking, nucleus registration, spot tracking, and quantification of spot signal intensity. Furthermore, HiTIPS features a graphical user interface that is open to integration of new analysis modules for existing analysis pipelines and to adding new analysis modules. To demonstrate the utility of HiTIPS, we present three examples of image analysis workflows for high-throughput DNA FISH, immunofluorescence (IF), and live-cell imaging of transcription in single cells. Altogether, we demonstrate that HiTIPS is a user-friendly, flexible, and open-source HTI software platform for a variety of cell biology applications.
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  • 文章类型: Journal Article
    了解全膝关节置换术(TKA)中的对齐和间隙平衡对于受训者和经验丰富的骨科医生来说可能具有挑战性。传统的学习方法可能无法有效地转化为现实场景。机器人手术和导航系统等先进技术的出现彻底改变了术中对间隙平衡技术的理解。该试验旨在研究机器人TKA计划软件在教育学员有关对准和韧带平衡方面的有效性。我们假设与软件的单个会话将显着增强学员对这些技术的理解。这个英国的单一中心,双臂,在全国机器人关节成形术研讨会期间进行了小组平行随机对照试验.它旨在评估机器人膝关节置换术软件训练对使用多项选择题(MCQ)理解TKA对准和间隙平衡原则的影响。MCQ测试是根据该领域专家共识的不同机构的既定指南制作的。我们的研究表明,所有参与者对差距平衡和对齐原则的基线知识普遍较低。然而,干预组,接受了全面的机器人软件培训,与对照组相比,他们的MCQ得分显着提高,他们没有接受训练。总之,我们的研究表明,机器人关节成形术软件训练显著提高了骨科学员对TKA对位和平衡原则的理解.二级证据。
    Understanding alignment and gap balancing in Total Knee Arthroplasty (TKA) can be challenging for trainee and experienced orthopedic surgeons. Traditional learning methods may not effectively translate to real-life scenarios. The advent of advanced technologies like robotic surgery and navigation systems has revolutionized intraoperative understanding of gap balancing techniques. This trial aims to investigate the effectiveness of robotic TKA planning software in educating trainees about alignment and ligament balancing. We hypothesize that a single session with the software will significantly enhance trainees\' understanding of these techniques. This UK-based single-center, two-arm, group parallel randomized controlled trial was conducted during a national robotic arthroplasty symposium. It aims to evaluate the effect of robotic knee arthroplasty software training on understanding TKA alignment and gap balancing principles using Multiple Choice Questions (MCQs). The MCQ test was crafted based on established guidelines from a different institution with expert consensus in the field. Our study revealed that baseline knowledge of gap balancing and alignment principles was generally low among all participants. However, the intervention group, which received comprehensive robotic software training, demonstrated a significant improvement in their MCQ scores compared to the control group, which did not undergo the training. In conclusion, our study demonstrates that robotic arthroplasty software training significantly improves the understanding of TKA alignment and balancing principles among orthopedic trainees. Level of Evidence II.
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  • 文章类型: Journal Article
    本研究旨在通过文献计量学方法和软件来概括和描述眼内炎的研究热点,并分析过去30年来关于这种严重疾病的工作的演变趋势。
    这项研究采用了严格的文献计量学方法。我们通过在WebofScienceCoreCollection下对科学引文索引扩展数据库进行全面搜索,确定了所有与眼内炎相关的文献。然后使用CiteSpace和VOSviewer对数据进行分析和可视化,两个在文献计量学领域得到广泛认可的软件工具。CiteSpace被用来分析国家分布,期刊的双重地图叠加,关键字突发,和共同引用的参考文献。VOSviewer被用来描述作者和共同引用的作者,期刊,共同引用的期刊,和关键词共现网络。这种稳健的方法确保了研究结果的可靠性和有效性。
    共2960种出版物,包括2695篇文章和265条评论,被纳入本文献计量学研究。自1993年以来,与眼内炎相关的出版物并不缺乏,近年来有明显的上升趋势。还分析了与COVID-19大流行的可能相关性。这些研究由来自全球75个国家的11,048名作者完成。以美国为首。在关键词共现网络中,除了眼内炎术语,白内障手术成为频率最高的关键词。不同类别的眼内炎,包括术后,注射后,创伤后,和内源性眼内炎,以及感染性眼内炎的抗菌和抗炎治疗,按类别讨论。从时间线的角度来看,术后和注射后眼内炎分别是2000年前后的主要形式.共引分析表明,1995年进行的眼内炎玻璃体切除术研究(EVS)为以后的研究提供了关键的指导。多种致病菌(例如,凝固酶阴性葡萄球菌,痤疮丙酸杆菌,病毒链球菌,和蜡状芽孢杆菌)或真菌(例如,念珠菌,曲霉菌,和镰刀菌)有助于不同的治疗原则和临床预后,这是应该认真对待的。此外,玻璃体内和前房内抗生素是治疗和预防感染性眼内炎的主要药物,分别。
    我们的文献计量学分析概述了眼内炎研究领域的动态演变和结构关系。显示的热点和发展方向对未来的调查具有参考价值。
    UNASSIGNED: This study is designed to generalize and depict the research hotspots of endophthalmitis through bibliometric methods and software and analyze the evolutive tendency of the work on this severe disease over the past 30 years.
    UNASSIGNED: This study employed a rigorous bibliometric approach. We identified all endophthalmitis-related literature by conducting a comprehensive search of the Science Citation Index Expanded database under the Web of Science Core Collection. The data was then analyzed and visualized using CiteSpace and VOSviewer, two widely recognized software tools in the field of bibliometrics. CiteSpace was used to analyze the country distributions, dual map overlay of journals, keyword bursts, and co-cited references. VOSviewer was employed to describe the authors and co-cited authors, the journals, the co-cited journals, and the keywords co-occurrence network. This robust methodology ensures the reliability and validity of the study\'s findings.
    UNASSIGNED: A total of 2960 publications, including 2695 articles and 265 reviews, were included in this bibliometric study. There has been no shortage of endophthalmitis-related publications since 1993, with an apparent upward trend during recent years. Possible correlations with the COVID-19 pandemic are also analyzed. These studies were finished by 11,048 authors from 75 countries worldwide, with the United States in the lead. In the keyword co-occurrence network, except for the endophthalmitis term, cataract surgery becomes the keyword with the highest frequency. Different categories of endophthalmitis, including postoperative, post-injection, post-traumatic, and endogenous endophthalmitis, and antibacterial and anti-inflammatory therapies of infectious endophthalmitis, are discussed by categories. From the perspective of the timeline, postoperative and post-injection endophthalmitis were the dominant forms before and after the year 2000, respectively. Co-citation analyses reveal that the Endophthalmitis Vitrectomy Study (EVS) conducted in 1995 provides pivotal guidance for later research. Diverse pathogenic bacteria (e.g., Coagulase-negative Staphylococci, Propionibacterium acnes, Viridians Streptococci, and Bacillus cereus) or fungi (e.g., Candida, Aspergillus, and Fusarium) contribute to varying treatment principles and clinical prognosis, which should be taken seriously. In addition, intravitreal and intracameral antibiotics are the mainstay for treating and preventing infectious endophthalmitis, respectively.
    UNASSIGNED: Our bibliometric analysis provides an overview of dynamic evolution and structural relationships in the research field of endophthalmitis. The displayed hotspots and developmental directions have reference values for future investigation.
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  • 文章类型: Journal Article
    全基因组关联研究(GWAS)显着增强了我们对复杂疾病遗传基础的理解。尽管技术进步,我们的理解仍然存在差距,部分原因是效应大小小和遗传变异覆盖率不足。多祖先GWAS荟萃分析(MAGMA)通过整合来自不同人群的遗传数据来解决这些挑战,从而增加检测基因座的能力,并提高精细映射分辨率,以识别不同祖先群体的因果变异。这篇综述提供了协议的概述,统计方法,和MAGMA的软件,以及强调与这种方法相关的一些挑战。
    Genome-wide association studies (GWAS) have significantly enhanced our understanding of the genetic basis of complex diseases. Despite the technological advancements, gaps in our understanding remain, partly due to small effect sizes and inadequate coverage of genetic variation. Multiancestry GWAS meta-analysis (MAGMA) addresses these challenges by integrating genetic data from diverse populations, thereby increasing power to detect loci and improving fine-mapping resolution to identify causal variants across different ancestry groups. This review provides an overview of the protocols, statistical methods, and software of MAGMA, as well as highlighting some challenges associated with this approach.
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  • 文章类型: Journal Article
    背景:我们在自由生活条件下评估人类的身体行为越准确,我们就越能更好地理解其与健康和福祉的关系。大腿磨损的加速度计可用于高精度地识别基本活动类型以及不同姿势。无需专门编程的用户友好的软件可以支持采用这种方法。本研究旨在评估两种新颖的无代码分类方法的分类精度,即SENS运动和ActiPASS。
    方法:38名健康成年人(30.8±9.6岁;53%的女性)在各种体育活动中在大腿上佩戴SENS运动加速度计(12.5Hz;±4g)。参与者在实验室中完成了强度不同的标准化活动。活动包括散步,跑步,骑自行车,坐着,站立,躺下.随后,参与者在实验室外进行不受限制的自由生活活动,同时使用胸部摄像头进行录像.使用预定义的标签方案对视频进行了注释,并将注释作为自由生活条件的参考。将SENS运动软件和ActiPASS软件的分类输出与参考标签进行比较。
    结果:共分析了63.6小时的活性数据。我们观察到两种分类算法及其各自在两种条件下的参考之间的高度一致性。在自由生活条件下,科恩的卡帕系数为SENS为0.86,ActiPASS为0.92。在所有活动类型中,SENS的平均平衡精度范围为0.81(骑自行车)至0.99(跑步),ActiPASS的平均平衡精度范围为0.92(步行)至0.99(久坐)。
    结论:研究表明,两种可用的无代码分类方法可用于准确识别基本的身体活动类型和姿势。我们的结果强调了基于相对较低采样频率数据的两种方法的准确性。分类方法表现出差异,在自由生活骑自行车(SENS)和慢速跑步机步行(ActiPASS)中观察到较低的敏感性。这两种方法都使用不同定义的活动类的不同集合,这可以解释观察到的差异。我们的结果支持使用SENS运动系统和两种无代码分类方法。
    BACKGROUND: The more accurate we can assess human physical behaviour in free-living conditions the better we can understand its relationship with health and wellbeing. Thigh-worn accelerometry can be used to identify basic activity types as well as different postures with high accuracy. User-friendly software without the need for specialized programming may support the adoption of this method. This study aims to evaluate the classification accuracy of two novel no-code classification methods, namely SENS motion and ActiPASS.
    METHODS: A sample of 38 healthy adults (30.8 ± 9.6 years; 53% female) wore the SENS motion accelerometer (12.5 Hz; ±4 g) on their thigh during various physical activities. Participants completed standardized activities with varying intensities in the laboratory. Activities included walking, running, cycling, sitting, standing, and lying down. Subsequently, participants performed unrestricted free-living activities outside of the laboratory while being video-recorded with a chest-mounted camera. Videos were annotated using a predefined labelling scheme and annotations served as a reference for the free-living condition. Classification output from the SENS motion software and ActiPASS software was compared to reference labels.
    RESULTS: A total of 63.6 h of activity data were analysed. We observed a high level of agreement between the two classification algorithms and their respective references in both conditions. In the free-living condition, Cohen\'s kappa coefficients were 0.86 for SENS and 0.92 for ActiPASS. The mean balanced accuracy ranged from 0.81 (cycling) to 0.99 (running) for SENS and from 0.92 (walking) to 0.99 (sedentary) for ActiPASS across all activity types.
    CONCLUSIONS: The study shows that two available no-code classification methods can be used to accurately identify basic physical activity types and postures. Our results highlight the accuracy of both methods based on relatively low sampling frequency data. The classification methods showed differences in performance, with lower sensitivity observed in free-living cycling (SENS) and slow treadmill walking (ActiPASS). Both methods use different sets of activity classes with varying definitions, which may explain the observed differences. Our results support the use of the SENS motion system and both no-code classification methods.
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  • 文章类型: Journal Article
    目的:作为随机对照试验的一部分收集的纵向患者耐受性数据通常以一种丢失信息且无法获取治疗经验的方式进行总结。为了解决这个问题,我们开发了一个交互式网络应用程序,使临床医生和研究人员能够探索和可视化患者的耐受性数据.
    方法:我们使用了NSABP-B35III期临床试验的不良事件(AE)数据(不良事件通用术语标准)和患者报告结果(PRO)。将阿那曲唑与他莫昔芬的无乳腺癌生存率进行了比较,演示工具。使用R和ShinyWeb应用程序框架开发了一个交互式Web应用程序,该框架使用四个工具生成Sankey图以可视化AE和Pro:AEExplorer,PROExplorer,队列探险家,和自定义资源管理器。
    结果:为了说明用户如何使用交互式工具,使用来自自定义浏览器的NSABP-B35III期试验和NSABP-B30试验的数据,提供了四个应用程序中每个应用程序的示例。在AE和PRO探险家中,用户可以选择AE或PRO在指定的时间段内可视化,并比较不同的治疗。在队列探险家中,用户可以选择具有特定症状的患者子集,严重程度,和接受的治疗,以在指定的时间间隔内随时间的轨迹可视化。有了自定义浏览器,用户可以上传和可视化结构化的纵向毒性和耐受性数据。
    结论:我们为临床医生和研究人员创建了一个交互式网络应用程序和工具,以探索和可视化临床试验耐受性数据。该适应性工具可以被扩展用于其他临床试验数据可视化,并且被结合到关于治疗决策的未来患者-临床医生交互中。
    OBJECTIVE: Longitudinal patient tolerability data collected as part of randomized controlled trials are often summarized in a way that loses information and does not capture the treatment experience. To address this, we developed an interactive web application to empower clinicians and researchers to explore and visualize patient tolerability data.
    METHODS: We used adverse event (AE) data (Common Terminology Criteria for Adverse Events) and patient-reported outcomes (PROs) from the NSABP-B35 phase III clinical trial, which compared anastrozole with tamoxifen for breast cancer-free survival, to demonstrate the tools. An interactive web application was developed using R and the Shiny web application framework that generates Sankey diagrams to visualize AEs and PROs using four tools: AE Explorer, PRO Explorer, Cohort Explorer, and Custom Explorer.
    RESULTS: To illustrate how users can use the interactive tool, examples for each of the four applications are presented using data from the NSABP-B35 phase III trial and the NSABP-B30 trial for the Custom Explorer. In the AE and PRO explorers, users can select AEs or PROs to visualize within specified time periods and compare across treatments. In the cohort explorer, users can select a subset of patients with a specific symptom, severity, and treatment received to visualize the trajectory over time within a specified time interval. With the custom explorer, users can upload and visualize structured longitudinal toxicity and tolerability data.
    CONCLUSIONS: We have created an interactive web application and tool for clinicians and researchers to explore and visualize clinical trial tolerability data. This adaptable tool can be extended for other clinical trial data visualization and incorporated into future patient-clinician interactions regarding treatment decisions.
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  • 文章类型: Journal Article
    背景:巴基斯坦已大大加强了其结核病(TB)主动发现病例(ACF)的能力,该能力正在该国大规模实施。然而,ACF的产量低于预期,对其在方案环境中的有效性表示关注。结核病在社区中的分布可能在空间上是异质的,在结核病患病率较高的地区靶向ACF可能有助于提高产量。SPOT-TB的主要目的是调查政策是否改变,以使用人工智能(AI)软件支持的针对ACF的地理针对性方法。MATCH-AI,可以提高巴基斯坦的产量。
    方法:SPOT-TB将使用实用的,阶梯式楔形簇随机设计。共有30个移动X射线单位及其现场团队将被随机分配以接受干预。在干预地区选择ACF的地点将主要通过使用MATCH-AI软件进行指导,该软件对分区结核病患病率进行建模并确定潜在的疾病热点。控制区将使用基于员工知识的现有选址方法,经验和历史数据的分析。主要结果指标是干预措施中检测到的细菌学证实的事件结核病相对于对照地区的差异。所有剩余的ACF相关程序和算法将不受该试验的影响。
    背景:已获得卫生服务学院的道德批准,伊斯兰堡,巴基斯坦(7-82/IERC-HSA/2022-52)和结核病共同管理股,艾滋病毒和疟疾,卫生部,监管和协调,伊斯兰堡,巴基斯坦(26-IRB-CMU-2023)。这项研究的结果将通过同行评审期刊上的出版物以及在巴基斯坦与执行伙伴和公共部门官员举行的利益相关者会议进行传播。研究结果还将在当地和国际医疗和公共卫生会议上发表。
    背景:NCT06017843。
    BACKGROUND: Pakistan has significantly strengthened its capacity for active case finding (ACF) for tuberculosis (TB) that is being implemented at scale in the country. However, yields of ACF have been lower than expected, raising concerns on its effectiveness in the programmatic setting. Distribution of TB in communities is likely to be spatially heterogeneous and targeting of ACF in areas with higher TB prevalence may help improve yields. The primary aim of SPOT-TB is to investigate whether a policy change to use a geographically targeted approach towards ACF supported by an artificial intelligence (AI) software, MATCH-AI, can improve yields in Pakistan.
    METHODS: SPOT-TB will use a pragmatic, stepped wedge cluster randomised design. A total of 30 mobile X-ray units and their field teams will be randomised to receive the intervention. Site selection for ACF in the intervention areas will be guided primarily through the use of MATCH-AI software that models subdistrict TB prevalence and identifies potential disease hotspots. Control areas will use existing approaches towards site selection that are based on staff knowledge, experience and analysis of historical data. The primary outcome measure is the difference in bacteriologically confirmed incident TB detected in the intervention relative to control areas. All remaining ACF-related procedures and algorithms will remain unaffected by this trial.
    BACKGROUND: Ethical approval has been obtained from the Health Services Academy, Islamabad, Pakistan (7-82/IERC-HSA/2022-52) and from the Common Management Unit for TB, HIV and Malaria, Ministry of Health Services, Regulation and Coordination, Islamabad, Pakistan (26-IRB-CMU-2023). Findings from this study will be disseminated through publications in peer-reviewed journals and stakeholder meetings in Pakistan with the implementing partners and public-sector officials. Findings will also be presented at local and international medical and public health conferences.
    BACKGROUND: NCT06017843.
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