Clinical Performance Research Articles

Are clinical hip muscle strength or functional task performance measures associated with hip cartilage defects in young adults with femoroacetabular impingement syndrome?

Are clinical hip muscle strength or functional task performance measures associated with hip cartilage defects in young adults with femoroacetabular impingement syndrome?

A Prospective Comparative Study on the Clinical Diagnostic Performance of Blood Inflammatory Markers in Acute Appendicitis.

Despite the substantial advancements in imaging techniques for the diagnosis and differential diagnosis of acute appendicitis (AA) over recent decades, the specificity and sensitivity of widely utilized laboratory biomarkers in clinical practice remain inadequate.This study aimed to investigate the diagnostic utility of commonly employed blood inflammatory markers for AA. A total of 399 participants who either sought medical care or underwent health examinations were enrolled in this prospective study. The cohort comprised 200 patients diagnosed with AA (AA group), 100 patients presenting with abdominal pain but without AA (AP group), and 99healthy individuals undergoing routine health check-ups (HC group). For all subjects, the following biomarkers were measured: plasma neutrophil gelatinase-associated lipocalin (NGAL), white blood cell count (WBC), neutrophil count (NEU), percentage of neutrophils (NEU%), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP). The diagnostic performance of the observed indicators, both individually and in combination, was assessed for the diagnosis of AA using Receiver Operating Characteristic (ROC) curves analysis and Delong's test. The laboratory indicators demonstrated a progressive increase from the HC group to the AP group, and further to the AA group (all p<0.05). Multifactorial logistic regression analysis identified NEU% and plasma NGAL as significant risk factors for the occurrence of AA. ROC curve analysis and Delong's test indicated that, in distinguishing the AA group from the HC group, the diagnostic performance of plasma NGAL, CRP, and NLR was equally substantial and superior to that of NEU and WBC. Within the AP group, plasma NGAL and CRP exhibited comparable diagnostic efficacy, outperforming NEU, WBC, and NLR. When differentiating AA in the non-appendicitis group (ie HC group + AP group), NGAL and CRP demonstrated comparable diagnostic efficacy, surpassing that of NEU, white WBC, and NLR. While the integration of multiple diagnostic tests can potentially improve overall diagnostic accuracy, the observed enhancement in the AUC is not statistically significant. NGAL, CRP, WBC, NEU% and NLR were significantly increased in patients with acute abdomen. NGAL and NEU% may function as independent risk factors for predicting the incidence of AA, with NGAL and CRP demonstrating similar and favorable diagnostic performance. While the combined evaluation of these biomarkers may enhance the diagnostic value for AA, the improvement in the area under the curve (AUC) is not substantial.

Effect of implementing an integrated oncology dashboard on clinical and operational quality in a community-based cancer network.

420 Background: MaineHealth Cancer Care Network (MHCCN) encompasses nine regional cancer centers and one affiliate cancer center located in rural south-central Maine and New Hampshire. MHCCN developed an integrated operational dashboard to improve clinical and operational performance. In this report, we detail improvements in a variety of quality metrics after implementation of the dashboard. Methods: Extracts from various non-interoperable data sources were integrated using a MS Power BI platform to create the dashboard. Divided into pages— summary, growth, service excellence, innovation and transformation —the dashboard provides searchable and regularly updated snapshots of numerous relevant metrics in these domains. Access to the dashboard was extended to all clinical and operational staff, with data reviewed bi-monthly in provider and operational meetings. The dashboard played a pivotal role in identifying MHCCN’s 2023 key performance indicator, specifically the electronic health record (EHR)-based TNM staging, along with notable care gaps such as underutilization of the NCCN distress thermometer (DT) for psychosocial distress assessment. Bottlenecks to timely care delivery were similarly identified by leveraging time to treatment data in the service excellence page. Targeted quality improvement initiatives were devised to address the gaps. Results: EHR-based structured TNM staging by providers improved from 29% in Fiscal Year (FY) 2022 to 47% in FY 2023 and 64% in FY 2024 year-to-date (YTD). Use of the NCCN DT improved from 1.1% in FY 2022 to 30.9% in FY 2023 and 49.9% in FY 2024 YTD. Process changes resulting from identifying delayed scheduling of PET scans as a bottleneck reduced the lead time from scan ordering to scan appointment from 18 days (January-July 2023) to 9 days (January-April 2024). Leveraging access to monthly productivity data through the dashboard, provider compensation reform incorporating production-based incentives was launched in July 2023, improving throughput and access as well as provider recruitment and retention. Information transparency from a freely accessible dashboard contributed to a 0.67-point gain in the 2023 Gallup provider core engagement CE3 score, reaching 3.45 (on a five-point scale). Conclusions: Clinical and operational metrics are often fragmented across different platforms, leading to inefficiencies and limited insights. Creating a system-wide integrated quality dashboard improved data visibility, provider engagement and led to measurable improvement in quality metrics across various domains.

Correlation between Bone Marrow Microvascular Density, Angiogenesis Factors and Bortezomib Resistance in Multiple Myeloma

To investigate the correlation between bone marrow microvascular density, angiogenesis factors and bortezomib resistance in multiple myeloma (MM). The data of 200 patients with MM treated in our hospital from January 2020 to August 2023 were retrospectively analyzed, and the patients with MM were divided into drug-resistant group(n=68) and non-drug-resistant group(n=132) according to their drug resistance during bortezomib treatment. The univariate and multivariate logistic analysis were used to screen the independent influencing factors of bortezomib resistance in MM patients during treatment. The receiver operating characteristic (ROC) curve and clinical decision curve (DCA) were used to evaluate the predictive performance and clinical application value of the risk prediction model, the consistency between the actual incidence rate and the predicted incidence rate was judged by validating the calibration chart, and the goodness-of-fit of the model was judged by H-L test. 68 of the 200 MM patients developed resistance and poor clinical efficacy during bortezomib treatment, and the clinical resistance rate of bortezomib was 34.0%. The results of multivariate analysis showed that high bone marrow microvessel density (MVD) and high bone marrow supernatant VEGF, HGF, and bFGF expression levels were independent risk factors for bortezomib resistance in MM patients (P < 0.05). The area under the ROC curve (AUC) of the model jointly constructed by bone marrow MVD, serum VEGF, HGF, bFGF and TNF-α levels was 0.924, and its sensitivity and specificity were 92.6% and 78.8%, which were higher than those of the bone marrow MVD model (AUC=0.743) and the vasogenesis factor model (AUC=0.878). The calibration curve of the joint prediction model was close to the standard curve, indicating that the model is more consistent. The results of H-L goodness -of - fit test showed χ2=14.748， P =0.164, the joint prediction model had a good fit. The DCA curve showed that the clinical net benefit of intervention in the range of 0.0~1.0 was greater than that of full intervention and no intervention. The prediction model based on bone marrow MVD and vasogenesis factors (VEGF, HGF, bFGF) in MM patients has higher clinical evaluation performance and predictive value.

34 - Clinical competencies and performance of radiologic technology interns in general radiography

34 - Clinical competencies and performance of radiologic technology interns in general radiography

Clinical Utility and Performance of Urinary L-FABP as a Potentially Suitable Biomarker for Early Detection of Contrast-Induced AKI among Adult Filipino In-Patients Undergoing Coronary Angiography

Clinical Utility and Performance of Urinary L-FABP as a Potentially Suitable Biomarker for Early Detection of Contrast-Induced AKI among Adult Filipino In-Patients Undergoing Coronary Angiography

82 Clinical Performance of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase L1 for Prediction of Intracranial Injuries on Head Computed Tomography in Mild Traumatic Brain Injury

82 Clinical Performance of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase L1 for Prediction of Intracranial Injuries on Head Computed Tomography in Mild Traumatic Brain Injury

Structured Debriefing to Assess Performance of Entrustable Professional Activities.

Background The medical workplace presents challenges for workplace-based learning. Structured debriefing of shared clinical experiences has been proposed as a way to take advantage of workplace-based learning in a setting that facilitates deep learning conversations. Objective To investigate faculty and learner acceptance of private, face-to-face, structured debriefing of performance of entrustable professional activities (EPAs). Methods During the 2020-2021 academic year, faculty at the University of Colorado (CU) and the University of Utah (UU) debriefed fellow performance of jointly selected EPAs in neonatal-perinatal medicine pertinent to shared 1- to 3-week clinical rotations. Private face-to-face debriefing was structured by a comprehensive EPA-specific list of behavioral anchors describing 3 levels of entrustment/accomplishment. Sessions ended with joint decisions as to level of entrustment/accomplishment and goals for improvement. We used thematic analysis of semistructured fellow interviews and faculty focus groups to identify themes illustrated with representative quotations. Results We interviewed 17 fellows and 18 faculty. CU participants debriefed after clinical rotations; UU usually debriefed during rotations. Debriefing sessions for 1 to 2 EPAs lasted 20 to 40 minutes. Themes represented in fellow interviews and faculty focus groups suggested that debriefing facilitated formative feedback along with shared understanding of clinical performance and assessment criteria. The standardized format and private conversations supported assessment of aspects of performance for which review might otherwise have been overlooked or avoided. The conversations also provided valuable opportunities for formative discussion of other matters of importance to fellows. Conclusions Structured debriefing of recently shared clinical experiences fostered formative assessment viewed positively by teachers and learners.

Higher Grit Scores Are Associated With Greater Scholarly Productivity Among Orthopaedic Surgery Residents

Introduction: Scholarly research is a core component of resident education, designed to advance the orthopaedic field while facilitating an evidence-based approach to patient care. Grit, defined as trait-level perseverance, has been shown in prior studies to predict clinical performance, burnout rates, and residency match rates. No previous study has investigated the relationship between grit and research productivity. Study Description: This study is a cross-sectional survey of orthopaedic surgery residents from the American Academy of Orthopaedic Surgeons. Residents were assessed via online survey of scholarly productivity and the 12-item grit scale. Methods: Surveys distributed to the Academy of Orthopaedic Surgeons residents assessed the number of peer-reviewed publications, presentations, first author publications, book chapters, and articles. Respondents were also evaluated through the 12-item grit scale, with scores ranging from 1 (minimum grit) to 5 (maximum grit). Residents were divided into low (score ≤3.4), medium (score: 3.5 to 3.9), and high grit (score ≥4.0) cohorts. Analysis of variance analysis compared the cohorts regarding the scholarly productivity metrics. Linear regression models analyzed grit score as a continuous variable. Findings were statistically significant at P &lt; 0.05. Results: The mean grit score was 3.8. The high grit cohort was more likely to have increased publications, presentations, articles, and first authorship (P &lt; 0.0001). Analyzed as a continuous variable, increased grit positively correlated with increased publications, presentations, articles, first authorship, and book chapters (P &lt; 0.0001). Conclusions: The results suggest that higher grit scores are associated with scholarly productivity.

Clinical Performance of the Therapy Option FlexPoint (Flexible Volume and Dwell Time Management) of the PD Cycler Sleep Safe Harmony

Clinical Performance of the Therapy Option FlexPoint (Flexible Volume and Dwell Time Management) of the PD Cycler Sleep Safe Harmony

Clinical performances of 3-different restorative materials in Class-II cavities

Clinical performances of 3-different restorative materials in Class-II cavities

Evaluating the clinical performance of an updated microRNA classifier in indeterminate and RAS-mutated thyroid nodule management: A multi-institutional study

BackgroundIntegrating microRNA markers with next-generation sequencing panels may enhance risk assessment of cytologically indeterminate thyroid nodules. The ThyGeNEXT–ThyraMIRv1 multiplatform test version 1 demonstrated limited utility in risk-stratifying RAS-mutated indeterminate thyroid nodules. We sought to validate the updated ThyraMIRv2 platform in clinical practice. MethodsThyGeNEXT/ThyraMIRv2, a 3-tiered microRNA classifier, were evaluated using a previously studied multi-institutional cohort of Bethesda III/IV nodules, with positive results having risk of malignancy ≥10%. In addition, ThyraMIRv2's clinical utility in RAS-mutated indeterminate thyroid nodules was assessed. ResultsIn 366 indeterminate thyroid nodules, ThyraMIRv2 platform yielded a 30.3% positive-call rate. ThyraMIRv2 platform + nodules had greater operative rates (63.9% vs 36.1%, P < .0001) and cancer/noninvasive follicular thyroid neoplasm with papillary-like nuclear features diagnosis (65.9% vs 25.0%, P < .0001) than ThyraMIRv2 platform nodules. Compared with multiplatform test version 1, ThyraMIRv2 platform’s diagnostic testing parameters did not improve significantly. Among 68 RAS-mutated nodules, ThyraMIRv2 classified 36.8%, 55.9%, and 7.4% as positive, moderate, and negative, respectively. All moderate nodules had risk of malignancy ≥10% and were combined with the positive cohort. No significant differences existed in operative rate (81.0% vs 60.0%, P = .272) or cancer/noninvasive follicular thyroid neoplasm with papillary-like nuclear features diagnosis (47.6% vs 40.0%, P > .999) between RAS-mutated positive/moderate and negative groups. For RAS-mutated nodules, ThyraMIRv2 demonstrated improved sensitivity (93.8% vs 64.7, P = .003) and decreased specificity (4.5% vs 34.8%, P = .008) compared with ThyGeNEXT–ThyraMIRv1 multiplatform test version 1, with comparable negative predictive value (33.3% vs 40.0%, P = .731) and positive predictive value (58.8% vs 59.5%, P = .864). ConclusionThyraMIRv2 platform does not improve indeterminate thyroid nodule malignancy stratification compared to ThyGeNEXT–ThyraMIRv1 multiplatform test version 1. ThyraMIRv2 improves malignant RAS-mutated nodule detection but increases false positives. Future studies encompassing a larger cohort of RAS-mutated with surgical pathology results are warranted to better characterize the performance parameters of this classifier.

Differentiation of Alzheimer's disease from other neurodegenerative disorders using chemiluminescence immunoassays measuring cerebrospinal fluid biomarkers.

Prior research identified four neurochemical cerebrospinal fluid (CSF) biomarkers, Aβ1-42, Aβ1-40, tTau, and pTau(181), as core diagnostic markers for Alzheimer's disease (AD). Determination of AD biomarkers using immunoassays can support differential diagnosis of AD vs. several neuropsychiatric disorders, which is important because the respective treatment regimens differ. Results of biomarker determination can be classified according to the Amyloid/Tau/Neurodegeneration (ATN) system into profiles. Less is known about the clinical performance of chemiluminescence immunoassays (ChLIA) measuring specific biomarkers in CSF samples from patients suffering from neuropsychiatric impairments with various underlying causes. Chemiluminescence immunoassays (ChLIAs, EUROIMMUN) were used to determine Beta-Amyloid (1-40), Beta-Amyloid (1-42), Total-Tau, and pTau(181) concentrations in precharacterized cerebrospinal fluid (CSF) samples from 219 AD patients, 74 patients with mild cognitive impairment (MCI), and 220 disease control (DC) patients. 83.0% of AD patients had ATN profiles consistent with AD, whereas 85.5% of DC patients and 77.0% of MCI patients had profiles inconsistent with AD. AD patients showed significantly lower amyloid ratio Aβ1-42/Aβ1-40 (mean: 0.07) and significantly higher concentrations of tTau (mean: 901.6 pg/ml) and pTau(181) (mean: 129 pg/ml) compared to DC and MCI patients (all p values < 0.0071). The ChLIAs effectively determined specific biomarkers and can support differential diagnostics of AD. Their quality was demonstrated in samples from 513 patients with cognitive impairments, representing a realistic mix of underlying causes for seeking treatment at a memory clinic.

Justification of Widened Dissolution Specifications of an Extended Release Product Using Physiologically Based Biopharmaceutics Modeling

Drug product meeting the dissolution specifications is crucial in order to ensure consistent clinical performance. However, in certain cases wider dissolution specifications may be required based on product behavior. While justification of such wider specifications may be challenging from a regulatory context, approaches such as physiological based biopharmaceutics modeling (PBBM) can be utilized for this purpose. Product DRL is a fixed dose combination product consisting of an immediate (IR) and extended release (ER) portions. For the ER portion, the dissolution specifications consisted of four time points and a proposal was made to relax the specification at the 2h time point (from 50-70% to 45-67%) to reduce the batch failures at commercial scale. To support wider specification, a PBBM was developed and extensively validated with literature & in-house studies. Virtual bioequivalence was performed using the pivotal clinical study data. Virtual dissolution profiles for proposed wider specifications were generated using three different approaches. Incorporation of lower and upper dissolution profiles into the model indicated absence of impact on in vivo performance thereby justifying the specifications. Regulatory acceptance of proposed specifications with PBBM indicated the significance of using modeling approaches to reduce repeated testing thereby facilitating faster approvals.

Clinical Performance of an Extended Range of Vision Intraocular Lens After LASIK.

To evaluate the clinical and patient-reported outcomes (PROMs) of cataract surgery with implantation of a wavefront-shaping extended depth of focus (EDOF) intraocular lens (IOL) in eyes with previous laser in situ keratomileusis (LASIK) for myopia correction. This prospective observational study enrolled 50 eyes with previous LASIK from 25 patients (age: 46 to 70 years) who underwent cataract surgery with implantation of the AcrySof IQ Vivity IOL (Alcon Laboratories, Inc). Visual and refractive outcomes were evaluated during a 3-month follow-up. PROMs were evaluated with the Intraocular Lens Satisfaction (IOLSAT; Alcon Vision, LLC) (general satisfaction), Catquest-9SF (difficulty in doing vision-related activities), and Questionnaire for Visual Disturbances (QUVID; Alcon Vision, LLC) (photic phenomena) questionnaires. Mean 3-month postoperative binocular uncorrected distance, intermediate, and near visual acuities were 0.02 ± 0.11, -0.02 ± 0.09, and 0.14 ± 0.13 logarithm of the minimum angle of resolution (logMAR), respectively. Mean binocular distance-corrected intermediate and near visual acuities were 0.05 ± 0.11 and 0.32 ± 0.14 logMAR, respectively. All eyes had a postoperative spherical equivalent within ±0.75 diopters (D). The mean defocus curve showed visual acuity values better than 0.20 logMAR for defocus levels from +0.50 to -1.50 D. Most patients (92.0%) confirmed that they had no vision-related difficulties limiting their normal daily life. Perception of starbursts, halos, glare, hazy vision, blurry vision, and double vision was referred by 24%, 24%, 28%, 28%, 8%, and 4% of patients, respectively. Most of symptoms were described as mild and not or a little bothersome. The wavefront-shaping EDOF IOL evaluated provides efficacious distance, intermediate, and near visual restoration in eyes with previous LASIK, with minimal photic phenomena associated. [J Refract Surg. 2024;40(10):e742-e753.].

Clinical accuracy of OncoPredict HPV Quantitative Typing (QT) assay on self-samples

BackgroundThe VALHUDES initiative was established to assess the clinical accuracy of HPV assays to detect cervical precancers using urine and vaginal self-samples compared to cervical clinician-collected samples. Here, the clinical performance of OncoPredict HPV Quantitative Typing (QT) assay (OncoPredict QT) was evaluated. Methods490 women referred to colposcopy self-collected a urine and a vaginal specimen using Colli-Pee and FLOQSwab, respectively. Subsequently, a colposcopy was performed, and a cervical sample was collected with Cervex-Brush, followed by biopsy if clinically indicated. Vaginal samples were transported dry and resuspended in 5mL of eNAT medium, whilst cervical brushings were immediately transferred in 20mL ThinPrep. ResultsThe clinical sensitivity of OncoPredict HPV QT testing for CIN2+ in urine and vaginal self-samples was similar to cervical samples (ratios of 0.99 [95% CI 0.94-1.05] and 1.00 [95% CI 0.96-1.04]), respectively, when manufacturer's cut-offs were applied. The specificity for <CIN2 on both self-samples was lower than on cervical samples (urine/cervical ratio = 0.91 [95% CI 0.84-0.98]; vaginal/cervical ratio = 0.90 [95 % CI 0.84-0.98]). Cut-off optimisation improved specificity without compromising sensitivity. Median viral load values adjusted for cellularity were significantly higher in cervical samples compared to urine or vaginal self-samples, in general for all 12 high-risk HPV and in particular for HPV16, 18, 31, 33, 35, 45, 51, 58 (p<0.05). No difference was observed in median viral loads between urine and vaginal samples. ConclusionFollowing cut-off optimisation OncoPredict HPV QT assay demonstrated similar accuracy on self-collected versus cervical samples.

Clinical Performances of Porcelain Laminate Veneers: 1-11 years

Clinical Performances of Porcelain Laminate Veneers: 1-11 years

Evaluation of the Effect of Occluso-gingival Distance and different shapes of Non-Carious Cervical Lesions on the Clinical Performance of Recent Types of Restorative Materials. (An In Vivo Study).

Evaluation of the Effect of Occluso-gingival Distance and different shapes of Non-Carious Cervical Lesions on the Clinical Performance of Recent Types of Restorative Materials. (An In Vivo Study).

Quality improvement scorecards driving innovation and best practice in a large community oncology practice.

417 Background: Lean Six Sigma Visual Management dashboards, or scorecards, are visual tools designed to drive and improve quality patient care, operationalize best practices, and promote a culture of operational excellence. Practice scorecards create a disciplined problem-solving culture where root causes are identified, and systemic process-based improvements are implemented. Scorecards are created to show full practice data transparency, allowing all employees and sites to see each other’s data. Scorecards are designed so that providers can efficiently review the maximum amount of data, following a Green, Yellow, Red visual cue to signify goal adherence. Methods: Phase 1 (2018 – 2019): Clinical scorecards were created and introduced to all staff on a weekly basis focusing on a few key patient metrics (ex: pain scale, pain care plan, ACP, PHQ-9, teaching/consents, patient portal access). Phase 2 (2020 – 2022): Clinical scorecards were expanded with additional patient care initiatives. New nurse navigator scorecards created (ex: patient teaching and survivorship visits). New physician and APP scorecards created with practice-specific provider metrics. Phase 3 (2023 – 2024): Scorecards updated yearly to match practice quality initiatives. New dashboards for non-clinical employees initiated. Physician and APP compensation changed to include quality metric performance tied to financial incentive. Results: Over the course of 5 years, OHC quality scorecard metrics improved from below national averages (red) to exceeding top-tier threshold goals (green). Scorecard utilization increased across all areas of the business, expanding from one scorecard in 2018 to eight in 2024. Scorecards increased overall practice data transparency leading to increase practice quality metric performance. OHC staff utilize scorecards on a weekly, monthly, and quarterly basis to drive quality improvement adherence. Improved outcomes through full data transparency increased staff participation and ownership in quality metrics and led to achieved shared savings in managed care programs. Example of metrics and results: Patient NCCN Staging 36% (2588/7263) to 96% (10299/10749), Teaching/Consents 37% (423/1147) to 97% (3067/3160), and Oral regimen NCCN entry 69% (586/845) to 98% (1037/1055). Conclusions: Visual Management dashboards or practice scorecards are instrumental in driving and supporting practice change. Scorecards allowed OHC staff to efficiently visualize practice-wide actionable data with eye-catching colors to promote optimal clinical performance. As increased data procurement is on the rise, practices can empower their staff to drive change through data utilization. OHC’s scorecards have proven to bridge the gap to goal, facilitate transparent data sharing, and empower providers and staff toward collaboration and embracing operational excellence.

Potential use of anti-thrombospondin-related apical merozoite protein (TRAMP) polyclonal antibodies in sandwich enzyme-linked immunosorbent assay (ELISA) for detection of Plasmodium knowlesi.

Plasmodium knowlesi, primarily a zoonotic malaria species is the most common malaria pathogen in the Southeast Asia especially in Malaysian Borneo, Malaysia. Due to morphological resemblance of P. knowlesi to other human Plasmodium, the sensitivity for microscopic detection of P. knowlesi, which is the gold standard, is compromised. Thus, efforts have been made in finding alternatives for the disease diagnosis. This study described the potential use of anti-PkTRAMP polyclonal antibodies in sandwich ELISA for P. knowlesi detection. Anti-PkTRAMP polyclonal antibodies raised from mice and rabbit were first evaluated for their binding capability towards native proteins in P. knowlesi lysates using Western blot. These mice and rabbit polyclonal antibodies were then used in the sandwich ELISA as capture and detection antibodies, respectively. P. knowlesi A1H1 culture was utilised to determine the limit of detection (LOD) of this assay. Its clinical performance was determined by testing with archived human malaria and uninfected samples. Western blot analysis affirmed the polyclonal antibodies reactivity to P. knowlesi. The LOD obtained from three replicated assays was at 0.015% parasitaemia. The assay has 76% sensitivity and 75% specificity for P. knowlesi. Its positive and negative predictive values were 76% and 75%, respectively. No cross reactivity with P. falciparum and healthy samples was observed, except for P. vivax where 10 out of 12 samples were detected. In conclusion, anti-PkTRAMP polyclonal antibodies can be useful in detecting P. knowlesi. Regardless, the full potential of anti-PkTRAMP antibodies for diagnostic purposes need to be explored further.