Showing papers by "Saskatchewan Health published in 1994"
TL;DR: It is suggested that for laboratories that use EIA for Chlamydia testing, a study such as this one will identify an appropriate optical density range for confirmatory testing for samples from that particular population.
Abstract: TThe Syva MicroTrak Chlamydia enzyme immunoassay (EIA; Syva Company, San Jose, Calif.) with cytospin and direct fluorescent-antibody assay (DFA) confirmation was evaluated on 43,630 urogenital specimens over a 1-year period in the Provincial Laboratory in Regina, Saskatchewan, Canada. This was a two-phase study intended to define a testing algorithm for Chlamydia trachomatis that would be both highly accurate and cost-effective in our high-volume (> 3,000 tests per month) laboratory. The prevalence of C. trachomatis infection in our population is moderate (8 to 9%). In phase 1, we tested 6,022 male and female urogenital specimens by EIA. All specimens with optical densities above the cutoff value and those within 30% below the cutoff value were retested by DFA. This was 648 specimens (10.8% of the total). A total of 100% (211 of 211) of the specimens with optical densities equal to or greater than 1.00 absorbance unit (AU) above the cutoff value, 98.2% (175 of 178) of the specimens with optical densities of between 0.500 and 0.999 AU above the cutoff value, and 83% (167 of 201) of the specimens with optical densities within 0.499 AU above the cutoff value were confirmed to be positive. A total of 12% (7 of 58) of the specimens with optical densities within 30% below the cutoff value were positive by DFA. In phase 2, we tested 37,608 specimens (32,495 from females; 5,113 from males) by EIA. Only those specimens with optical densities of between 0.499 AU above and 30% below the cutoff value required confirmation on the basis of data from phase 1 of the study. This was 4.5% of all specimens tested. This decrease in the proportion of specimens requiring confirmation provides a significant cost savings to the laboratory. The testing algorithm gives us a 1-day turnaround time to the final confirmed test results. The MicroTrak EIA performed very well in both phases of the study, with a sensitivity, specificity, positive predictive value, and negative predictive value of 96.1, 99.1, 90.3, and 99.7%, respectively, in phase 2. We suggest that for laboratories that use EIA for Chlamydia testing, a study such as this one will identify an appropriate optical density range for confirmatory testing for samples from that particular population.
27 citations
19 citations
Journal Article•
TL;DR: The rationale underlying the shift to a needs-driven, outcome-oriented, locally controlled health system is discussed and some of the elements of the newly constituted delivery system, such as district boards, needs assessment, core services, and provincial components such as the Health Services Utilization Review Commission and the Provincial Health Council are discussed.
Abstract: This paper describes the direction of health reform taking place in Saskatchewan. The rationale underlying the shift to a needs-driven, outcome-oriented, locally controlled health system is discussed. This shift is in concert with nationally recognized directions in improving health status, maintaining standards, ensuring a more cost-effective system, and providing a continuum of services characterized by a shift from institutional to community-based services, health-related public policy and health promotion. Included is a discussion of the process of change and some of the elements of the newly constituted delivery system, such as district boards, needs assessment, core services, and provincial components such as the Health Services Utilization Review Commission and the Provincial Health Council. Some implications for issues such as stroke prevention are noted.
6 citations