Objectives: To describe the step-by-step person-centered, theory-based development of the KELA.AE app for Arabic speaking hemodialysis patients. Methods: A step-by-step person-driven theory-based approach was conducted to develop a self-monitoring and educational dietary app for hemodialysis patients. The development follows the Integration, Design, Assessment, and Sharing (IDEAS) framework. Qualitative, semi-structured interviews with 6 hemodialysis patients and 6 healthcare practitioners (dietitians and nephrologists) were performed to assess the need for an app, the willingness to use an app, and features desired in an app. Results: The KELA.AE app, which includes a self-monitoring feature, CKD-friendly recipes, and a theory-based, evidence-based educational feature was developed. Qualitative analysis of interviews revealed two predominant themes from patient interviews 'Experience with the diet' , ' App evaluation' , and one theme from interviews with healthcare practitioners ' App evaluation'. Patients expressed frustration with current accessibility of dietary information along with the need for educational materials in the app. The review of the KELA.AE prototype was positive overall, and patients reported a willingness to use the app. Healthcare practitioners considered the app accurate, simple, and culturally sensitive but expressed concerns about app misuse and the replacement of healthcare practitioners. Conclusions: The KELA.AE app was found to be satisfactory and supportive of the participants' needs. Changes were made to the app as suggested during the interviews.
Background: Multiple malnutrition diagnostic tools are available in clinical practice, yet, evidence on their validity and reliability is limited. We aim to assess and compare the validity and reliability of the different combinations of indicators of the three most used diagnostic tools with two validated malnutrition screening tools. Methods: Nutrition risk screening was evaluated using the Mini Nutritional Assessment-Short Form (MNA-SF) and the Nutrition Risk Screening-2002 (NRS-2002). Nutrition assessment was conducted using different combinations of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN), the European Society for Clinical Nutrition and Metabolism (ESPEN), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Concurrent criterion validity and inter-rater reliability of the overall and the different combinations of indicators in the diagnostic tools were evaluated and compared. Sensitivity, specificity, positive predictive value, negative predictive value, and Cohen kappa were calculated to determine tool validity and reliability. Results: The AND/ASPEN (132 [22.8%]) combination and GLIM-1 (133 [23.0%])(weight loss + compromised food intake) predicted the highest number of malnourished patients and reported a high degree of concurrent criterion validity, agreement, and reliability. On the contrary, overall ESPEN (using any combination) and GLIM-2 (reduced body mass index [BMI] + compromised food intake) reported only moderate criterion validity and low agreement and reliability. Conclusion:Different combinations of diagnostic criteria led to varying validity and reliability, with the lowest validation results rising from the combinations of indicators using BMI as a criterion for malnutrition diagnosis.
Background:In the last decade, point of care testing (POCT) such as lateral flow immunoassays (LFIA) were developed for rapid TSH measurement. Most of these TSH-LFIAs are designed for qualitative measurements (i.e., if TSH values >5, or >15 IU/L) and as screening tests for primary hypothyroidism in children and adults. Serum or plasma, but not venepuncture whole-blood, or fingerstick/capillary, are usually used for accurate quantitation of TSH. Studies on performance evaluation of TSH-LFIAs POCT using venepuncture or fingerstick whole-blood are limited. Aim: We aim to evaluate the performance of a new fluorescence-based LFIA and its FinecareTM fluorescent reader for quantitative measurement of TSH from a fingerstick, venepuncture whole-blood, and serum. Methods: 102 fingerstick, venepuncture whole-blood, and serum samples (with normal and abnormal TSH values) were analyzed by FinecareTM Rapid Quantitative LFIA test and Roche CobasPro-c503 as a reference test. Results: Using serum, when compared to CobasPro-c503 reference method, FinecareTM showed high sensitivity (90.5%) and specificity (96.3%) for diagnosis of thyroid abnormalities (<0.35 or > 4.5 mIU/L). The actual test values (mIU/L) of FinecareTM showed excellent agreement (Cohen Kappa=0.85) and strong correlation (r=0.93, p<0.0001) with CobasPro-c503. Using venepuncture whole-blood samples, FinecareTM showed similar results to serum with high sensitivity (95.2%), specificity (97.5%), excellent agreement (Cohen Kappa=0.91), and very strong correlation (r=0.95, p<0.0001) with CobasPro-c503. These results suggest that FinecareTM can be used for quantitative measurement of TSH using serum or venepuncture whole-blood. These key performance indicators were slightly decreased when fingerstick whole-blood samples were used: Sensitivity (85.7%), specificity (90.0%), good agreement (Cohen Kappa=0.7) and very strong correlation (r=0.9, p<0.0001) with CobasPro-c503. Conclusion: Our results indicate that the FinecareTM is appropriate for TSH screening and quantitative measurement of TSH using serum samples and fingersticks, particularly in none or small laboratory settings.
Objectives Our aim is to determine whether different malnutrition diagnostic tools [European Society of Clinical Nutrition and Metabolism (ESPEN), Academy of Nutrition and Dietetics/American Society of Parenteral and Enteral Nutrition (AND/ASPEN) and the Global Leadership Initiative on Malnutrition (GLIM)] are associated with common malnutrition-related risk factors in a sample of newly admitted hospital patients. Methods This study is a prospective observational study. Newly admitted hospital patients were screened for nutritional risk. At-risk patients were then assessed for malnutrition using ESPEN, AND/ASPEN and GLIM criteria. Bivariate analyses were computed for all predictors and tested with the result of the nutritional assessment of each of the diagnostic tools. Similarly, a logistic regression was then conducted to determine the predictors associated with each malnutrition diagnostic criteria. Results 578 patients were screened for malnutrition, of which 121(20.93%) were nutritionally at risk and were subjected to nutritional assessment. The regression model suggested that the presence of pressure ulcers (OR 21.252, 95% CI 4.495–100.485), higher Charlson Comorbidiy Index (CCI) score (OR 1.321, 95% CI 1.098–1.591), lower Body Mass Index (BMI) (OR 0.478, 95% CI 0.389–0.588), and older age (OR 1.035, 95% CI 1.005–1.065) were significant predictors of malnutrition diagnosed on ESPEN criteria. While female gender [(OR 2.406, 95% CI 1.446–4.004); (OR 2.300; 95% CI 1.397–3.786)], lower BMI [(OR 0.842, 95% CI 0.792–0.895); (OR 0.835 95% CI 0.785–0.888)], higher CCI score [(OR 1.323,95% 1.185–1.477); (OR = 1.294, 95% CI 1.164–1.438)] and pressure ulcers presence [(OR 15.501, 95% CI 3.650–66.661); (OR 15.816; 95%CI 3.683–67.926)] were significant predictors of malnutrition diagnosed through AND/ASPEN and GLIM criteria respectively. Admission to the orthopedics unit indicated 91% lower risk of malnutrition on both tools respectively [(OR 0.090, 95% CI 0.008–0.968); (OR 0.090, 95% CI 0.008–0.962)]. Conclusions The presence of pressure ulcers, higher CCI score and lower BMI were the significant predictors that were associated with malnutrition on all tools. AND/ASPEN and GLIM diagnostic tools predicted the same risk factors. Funding Sources Lebanese American University.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.