Checking liver blood tests (LFTs) should be an opportunity to diagnose liver problems, but abnormal results are often incompletely investigated. There is a growing epidemic of advanced liver disease, this could be offset by early detection and management. This can be achieved with minor changes to working practices and exploitation of functionality existing within modern laboratory diagnostics systems. ILFT increases liver disease diagnoses, improves quality of care, and is highly cost-effective. iLFT was cost-effective with a low initial incremental cost-effectiveness ratio of £284 per correct diagnosis, and a saving to the NHS of £3,216 per patient lifetime. Additionally, there were significant increases in the rates of GP visits after diagnosis and the number of referrals to secondary care in the iLFT group. In the iLFT group, the diagnosis of liver disease was increased by 43%.
The primary diagnostic outcome was based on the general practitioner diagnosis, which agreed with the iLFT diagnosis in 67% of cases. Of eligible patients with abnormal LFTs, 490 were recruited to the control group and 64 were recruited to the intervention group. Diagnostic outcomes were collated and compared.
#NIH ILIFT ULTRASONIC TRIAL#
A stepped-wedged trial design was utilised to compare LFT outcomes in general practices in the 6 months before and after introduction of the iLFT system. This algorithm then generated a diagnosis and/or management plan. We integrated this automated investigation algorithm into the laboratory management system, based on minimal diagnostic criteria, liver fibrosis estimation, and reflex testing for causes of liver disease.
We developed an automated system that further investigated abnormal LFTs on initial testing samples to generate a probable diagnosis and management plan. We developed an automated investigation algorithm, intelligent liver function testing (iLFT), with the aim of increasing the early diagnosis of liver disease in a cost-effective manner. This can lead to missed opportunities to diagnose and treat liver disease at an early stage. LFTs are commonly abnormal, the causes of which can be complex and are frequently under investigated. Published by John Wiley & Sons Ltd.Liver function tests (LFTs) are frequently requested blood tests which may indicate liver disease. Indoor air quality air circulation and ventilation chemical analysis household measurement humidifier indoor air pollutants particulate matter. This study emphasizes the need to further investigate the impact of humidifier operation, both on human health and on the indoor atmospheric chemistry, for example, partitioning of acidic and basic compounds. The transport and loss of PM 2.5 depended on the rate of air circulation and ventilation. Operation of a single ultrasonic humidifier resulted in PM 2.5 concentrations up to hundreds of μg m -3, and its influence extended across the entire household. A whole-house experiment was further conducted at an actual residential house, with five low-cost sensors (AirBeam) monitoring PM in real time. Preliminary results of organic compounds being present in humidifier PM are also presented. Ion chromatography analysis revealed a large amount of SO 4 2- in PM, representing a previously unrecognized indoor source. The mass of PM generated showed a correlation with the total alkalinity of charge water, suggesting that CaCO 3 is likely making a major contribution to PM.
In this study, we first conducted laboratory experiments to investigate the size, quantity, and chemical composition of PM generated by an ultrasonic humidifier. In particular, ultrasonic humidifiers are known to generate fine particulate matter (PM). While the benefits of household humidification are widely perceived, its implications to the indoor air have not been critically appraised. Household humidification is widely practiced to combat dry indoor air.
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