Medical Assessment Research Articles

Identification of postpartum symptom informedness and preparedness typologies and their associations with psychological health: A latent class analysis

BackgroundBirthing parents, defined as postpartum women and people with various gender identities who give birth, commonly experience challenging postpartum symptoms. However, many report feeling uninformed and unprepared to navigate their postpartum health. ObjectiveTo identify typologies of postpartum symptom informedness and preparedness using latent class analysis (LCA) and to examine the associated patient and healthcare characteristics. MethodsWe used survey data from a large, multi-method, longitudinal research project Postnatal Safety Learning Lab. Participants were recruited using convenience sampling and enrolled between November 2020 and June 2021. LCA was used to identify subgroups of birthing parents with different symptom informedness and preparedness using 10 binary variables (N = 148). Bivariate analysis was conducted to examine the association between characteristics and each typology. FindingsThe 3-class models had better fit indices and interpretability for both informedness and preparedness typologies: High, High-moderate, and Moderate-low. The sample characteristics were different by typologies. In the modified discrimination in medical settings assessment, we found higher discrimination scores in the moderate-low informedness and preparedness typologies. The moderate-low preparedness typology had a higher percentage of birthing parents who did not have private insurance, underwent cesarean section, and planned for formula or mixed infant feeding. The median PHQ-4 scores at 4 weeks postpartum were lower among those in high informedness and preparedness typologies. ConclusionIn our sample, 18 to 21 % of birthing parents were in the moderate-low informedness or preparedness typologies. Future research and practice should consider providing tailored information and anticipatory guidance as a part of more equitable and supportive care.

Être médecin en prison : perspectives d’avenir et question déontologique

As a consequence of the law passed on January 18th 1994, the responsibility of healthcare was transferred from the judicial system to the public health authorities.Since then, a medical team from a hospital unit offers healthcare to detained patients, after a first medical assessment upon arrival in detention. The healthcare provided is diverse with the aim of prioritising care for the more vulnerable patients, for example with anxiety issues, depression as well as somatic illness. The foundation of carceral medicine is based on equality: to guarantee access to healthcare for all with respect of medical confidentiality.Furthermore, continuity of care must be ensured by creating a link with healthcare professionals "outside" prison, involved in the follow-up of a detained patient after her/his liberation. The latter being a crucial point to enhance the attractivity of carceral medicine.

DOES PRE-HOSPITAL DELAY AFFECT OUTCOMES IN HIP FRACTURE PATIENTS?

BackgroundHip fractures cost the NHS £2 billion per annum. British guidelines within 36 hours of admission. However, these guidelines do not consider the time the patient spends between injury and admission. Our study aims to investigate pre-hospital time (PHT) and its effect on outcomes. Primary outcome measures were mortality, length of stay (LOS), pressure sores and abbreviated mental test scores (AMTS).MethodsHip fracture data was retrospectively collected from our hospital IT system (Clinical Workstation) between February and August 2020. Admission data, ambulance timings, and outcome data was extracted. Statistical analysis was performed using GraphPad Prism V9.5.1.ResultsTwo hundred eleven data sets were analysed. Mean age was 82.4, with 2:1 Females to males and median ASA of 3. The mean PHT was 690 minutes (85 to 6057). There was a positive correlation between increased PHT and mortality, though this did not reach statistical significance. There was a significant positive association between PHT and LOS (P=0.0027). Increased PHT was associated with lower admission AMTS (P<0.0001) and higher rate of pressure sore formation (P=0.0001). There was also a significantly positive correlation between PHT and time to mobility (P=0.049).ConclusionThere is an unobserved delay in hip fracture patients presenting to the hospital. Current treatment guidelines advocate early surgery but do not consider pre-hospital time. PHT in our patient population is 690 minutes on average, with increasing delay correlating with worse outcomes. Pre-hospital time should be considered when managing hip fracture patients with a view to expedite surgery and medical assessment.

Incorporation of Trauma-Informed Care Into Entrustable Professional Activities for Medical Student Assessment.

Trauma-informed care (TIC) provides a medical framework for addressing and mitigating the negative consequences of trauma. In response to student and faculty advocacy, medical schools are developing trauma-informed curricular content. However, medical education literature does not present a comprehensive assessment rubric to evaluate medical students' acquisition of trauma-informed clinical skills. A committee of medical students, trainees, and faculty developed a longitudinal TIC curricular theme at Harvard Medical School (HMS). Guided by the National Collaborative on Trauma-Informed Health Care Education and Research competencies, the committee created a set of medical student TIC competencies from July to December 2019. From November 2021 to November 2022, 3 committee subgroups generated new TIC descriptors for each HMS entrustable professional activity (EPA), then circulated these to other subgroups, external experts, and stakeholders for review and feedback. From April to June 2023, the committee iteratively reviewed the materials until reaching consensus for content and pedagogy. The committee integrated TIC content into HMS's existing EPAs expected of students, provided anchoring descriptions of each level, and achieved consensus using a process of iterative review with TIC content experts. The committee identified 10 TIC competencies and revised all 13 general HMS EPAs to include specific items based on these competencies. The committee incorporated at least 1 trauma-informed competency into each HMS EPA. This novel set of HMS EPAs provides a framework for assessment of TIC clinical skills. Faculty will be trained to correctly and reliably incorporate TIC competencies into patient care and to use the TIC-inclusive EPAs for student assessment, ensuring that TIC is standard medical practice at HMS. This work may facilitate the adoption of trauma-inclusive EPAs by other institutions to educate the next generation of physicians to practice TIC and thus promote a more accessible, safe, and equitable health care system.

Implementation of the admission transfer unit to reduce emergency department boarding: A quality improvement initiative.

Emergency Department (ED) boarding crowds the emergency department, strains resources, leads to higher hospital costs, and is associated with increased morbidity/mortality, a negative patient experience, and patient adverse events. The time Ontario patients wait in emergency departments for inpatient beds continues to rise, with the average time admitted patients spend in the ED increasing between 2015 and 2019 from 13.8hours to 16.2hours. As reported in this quality improvement initiative, one potential solution is to repurpose short-stay medical assessment units for complex admitted medicine patients using an objective patient selection tool. Objectively selecting admitted ED patients with the highest risk for adverse events and prioritizing them to move to a transitional unit advances safe quality patient care and decreases Time-to-Inpatient Bed (TIB). Results from this quality improvement initiative include reducing the organization's TIB by 13hours.

Discrepancy between medical conditions self-reported by bus drivers and medical records.

Medical incapacity at the wheel is a rare but high-profile factor in accident causation. The UK Driver and Vehicle Licensing Agency (DVLA) does not require a review of medical records on the application for a bus licence, but applicants sign a self-declaration of medical history. There is debate over what, if any, verification of medical information is required for doctors who complete the medical assessment. To assess how self-declaration compares against General Practitioner (GP) patient records for a series of bus drivers undergoing driver licensing assessment in a 12-month period. Review of GP reports received for bus driver medicals undertaken in a 12-month period between 1 July 2022 and 30 June 2023. Of the 145 medicals undertaken, 12 (8.3%) GP reports contained undeclared medical conditions that required further evaluation and may have impacted on fitness to drive. Studies into the contribution of medical incapacity at the wheel to vehicle accidents are sparse, as, thankfully, are the events themselves. Nevertheless, given the updated General Medical Council guidance to doctors on confidentiality and public protection responsibilities, and evidence to suggest that doctors' knowledge of the DVLA guidelines is poor, it might be pertinent for the DVLA to reconsider its approach to driver self-reporting in some circumstances, given the discrepancy highlighted here.

Uncertainty quantification via localized gradients for deep learning-based medical image assessments

Objective. Deep learning models that aid in medical image assessment tasks must be both accurate and reliable to be deployed within clinical settings. While deep learning models have been shown to be highly accurate across a variety of tasks, measures that indicate the reliability of these models are less established. Increasingly, uncertainty quantification (UQ) methods are being introduced to inform users on the reliability of model outputs. However, most existing methods cannot be augmented to previously validated models because they are not post hoc, and they change a model’s output. In this work, we overcome these limitations by introducing a novel post hoc UQ method, termed Local Gradients UQ, and demonstrate its utility for deep learning-based metastatic disease delineation. Approach. This method leverages a trained model’s localized gradient space to assess sensitivities to trained model parameters. We compared the Local Gradients UQ method to non-gradient measures defined using model probability outputs. The performance of each uncertainty measure was assessed in four clinically relevant experiments: (1) response to artificially degraded image quality, (2) comparison between matched high- and low-quality clinical images, (3) false positive (FP) filtering, and (4) correspondence with physician-rated disease likelihood. Main results. (1) Response to artificially degraded image quality was enhanced by the Local Gradients UQ method, where the median percent difference between matching lesions in non-degraded and most degraded images was consistently higher for the Local Gradients uncertainty measure than the non-gradient uncertainty measures (e.g. 62.35% vs. 2.16% for additive Gaussian noise). (2) The Local Gradients UQ measure responded better to high- and low-quality clinical images (p < 0.05 vs p > 0.1 for both non-gradient uncertainty measures). (3) FP filtering performance was enhanced by the Local Gradients UQ method when compared to the non-gradient methods, increasing the area under the receiver operating characteristic curve (ROC AUC) by 20.1% and decreasing the false positive rate by 26%. (4) The Local Gradients UQ method also showed more favorable correspondence with physician-rated likelihood for malignant lesions by increasing ROC AUC for correspondence with physician-rated disease likelihood by 16.2%. Significance. In summary, this work introduces and validates a novel gradient-based UQ method for deep learning-based medical image assessments to enhance user trust when using deployed clinical models.

Medical assessments for abuse and neglect in contacts of maltreated children.

Identifying abuse or neglect in one child (index) implicates risk to other children residing in the same home (contacts). While child protection investigators may interview and visually examine contacts, there is lack of consensus regarding when contacts should have a medical assessment. Our goal was to describe the prevalence, characteristics and predictors of abuse and neglect among contacts medically assessed by a child maltreatment evaluation centre over a 5-year period. Records of 381 maltreated index children and their 588 contacts were reviewed. Abuse or neglect was diagnosed in 15% of contact children. When index children had more than one type of maltreatment or more than three risk factors, their contacts were more likely to be neglected or abused, respectively. Failure to thrive, patterned injuries, and unmet medical needs were the most common findings among maltreated contacts, and most were diagnosed with injuries or conditions that would not be evident to a child protection investigator. Clinicians should consider evaluating contacts of maltreated children who have multiple risk factors or maltreatment types. These evaluations should include a careful assessment for injuries, growth and unmet medical needs.

What are they considering when they face a fetus with birth defects? A qualitative study on ethical attitudes of health professionals in China

BackgroundBirth defects are the leading cause of mortality in newborn babies and children under five years old. In response, the Chinese government has implemented a three-tiered prevention strategy, which has brought ethical concerns about fetuses with birth defects. This study aims to explore the attitudes toward fetuses with birth defects among health professionals engaged in maternal and child health services.MethodsA qualitative study was conducted among 13 health professionals engaged in maternal and child health services in Hunan Province, China. The questions were designed to elicit the participants' work experience and attitudes toward fetuses with birth defects. The data were collected through in-depth semi-structured interviews, and NVivo 12 was used for data coding and analysis. A thematic analysis approach was employed following the SRQR checklist.ResultsFive themes and 13 attributes were generated regarding health professionals' perspectives on fetuses with birth defects. The five themes included: (1) severity and curability of diseases (two attributes), (2) family relations (four attributes), (3) medical assessments (two attributes), (4) social situations (three attributes), (5) self-value orientations (three attributes). The findings showed that the majority of health professionals held the view that a fetus with a curable disease could be born, whereas a fetus with severe disability and teratogenesis should be terminated. Twelve out of the 13 health professionals believed that parents should be the decision-makers, while only one thought that the family should make a decision together.ConclusionsAttitudes toward birth defects were influenced by various factors, indicating the complexity of real-world cases identified in this study. The findings highlight the dilemmas faced by both families and health professionals regarding birth defects. Adequate medical knowledge and support from society are crucial to inform decision-making among family members. Additionally, standardized norms and policies for birth defects are needed. Establishing an ethics committee for prenatal diagnosis is necessary to address current ethical issues in this field.

Analysis and Evaluation of Treatment and Rehabilitation Measures for Children with Cerebral Palsy

The study is devoted to the analysis of disability in children with cerebral palsy in the Kyrgyz Republic. Social impairment is typical for children with cerebral palsy, caused in most cases by multiple types of disability - restrictions on physical independence and mobility; ability to obtain an education, and master the basics of professional activity in the future, readiness for integration into society. In addition, there are problems about the impact of medical, demographic, socio-economic factors, as well as health care resources on morbidity statistics and the incidence of cerebral palsy. The article analyzes the activities of the rehabilitation center for children with musculoskeletal disabilities in the city of Osh for 2021-2023. In order to assess the quality of medical rehabilitation, an analysis and assessment of the medical history of the Center for Medical Rehabilitation from 2021-2023 was also carried out. The interviewing was carried out using a questionnaire specially developed by us, including 12 questions. When analyzing the medical history of children diagnosed with cerebral palsy who underwent medical rehabilitation at the center, it was revealed that the main causes of this condition are: birth injuries, intrauterine infection, premature birth, low birth weight, neuroinfection and severe meningococcal infection before the age of years, anemia, congenital malformations and various somatic diseases. The data obtained confirm the need to create a unified database of children with cerebral palsy (CP). This will improve the organization of medical and social rehabilitation of children suffering from cerebral palsy. The joint database will help collect information on the reasons, characteristics and effectiveness of various rehabilitation methods, which in turn will contribute to more effective management and care of this vulnerable group of children.

The Effectiveness of a Human Trafficking Protocol in the Emergency Department: A 5-Year Retrospective Analysis.

Human trafficking affects nearly 1.1 million persons in the United States. Over 50% of victims will receive care in an emergency department (ED) during their exploitation. The purpose of this study was to assess the effectiveness of a human trafficking protocol and electronic medical record screening and assessment tool in identifying victims of human trafficking in the ED. A 5-year, retrospective chart audit was conducted. Over 2 million ED visits occurred during the 5-year study period. Less than 1% (n =525) of those patients screened positive as potential victims, while 45 (8.6%) were confirmed trafficking victims. The number of victims identified dropped following the pandemic. Pandemic issues, staffing turnover, and lack of ongoing trafficking education impeded the identification of victims. Recommended changes to the protocol are presented.

Recommended exercises for lower back pain on YouTube videos; Are they useful or harmful?

ObjectiveLow back pain (LBP), a common public health problem affecting nearly 80 % of the population, causes disability and work absence, while exercise is recommended as an adjuvant treatment. YouTube is one of the most frequently used source of information, especially by patients. The aim of the study was to analyze clinically the reliability, feasibility and the content quality of exercises videos recommended for LBP on YouTube. channel. MethodsBased on the observational study of the number of views of YouTube videos, 154 videos worth evaluation were selected using the keywords "low back pain” and “exercises",. The content quality of each video was evaluated with a) the American Medical Association Journal (JAMA), b) DISCERN, c) Global Quality Score (GQS), and d) Medical Quality Video Assessment Tool (MQ-VET) scales, while Pearson correlation analysis was performed to determine the correlation between the JAMA, GQS, DISCERN, MQ-VET scale scores. ResultsAccording to the findings, the primary source for uploading exercise videos were physicians (32.5 %), with a high content quality. There was a statistically significant positive correlation between the total scores of all quality scales and the independent variables defined as view rates and number of comments (p < .05). The analysis of the video content showed that only 35 % (n = 54) of the videos explained the risks of the recommended exercises in detail ConclusionIt can be concluded that the relability and feasibility of exercise videos for LBP on YouTube depend highly on the upload source. Thus digital content in health should be created with a multi-disciplinary team including healthcare professionals and also standardized to inform patients with the risks and benefits to avoid the potential harm due to the complex causes of low back pain. Public Interest SummaryLow Back Pain, which a major health problem, is the most common musculoskeletal disorder leading to increased medical expenses and work absenteeism, while the most appropriate intervention remains elusive.. The therapeutic exercise program might differ according to patient's age, physical condition and the severity of the disease, while sustainability of the exercise program depends on the preference of exercise type of each patient. From this perspective, it is an important advantage that different exercise videos are available on YouTube. However, the content quality and reliability of exercise videos are the discriminators for the expected outcomes, since good quality content will benefit patients and prevent possible injuries and worsening of pain.

Medical and sociological assessment of patients' opinions on the state of the oncological service in the Moscow region and suggestions for its improvement

Medical and sociological assessment of patients' opinions on the state of the oncological service in the Moscow region and suggestions for its improvement

Heads up on concussion: Aboriginal and Torres Strait Islander peoples' knowledge and understanding of mild traumatic brain injury.

Concussion awareness and knowledge among Aboriginal and Torres Strait Islander peoples residing in Perth, Western Australia and factors preventing presentation at a health service for assessment after such an injury. Qualitative study with participants aged between 18 and 65 years. Recruitment was by Facebook advertising and snowball sampling. A semi-structured topic yarning guide was used to guide conversations through 1:1, multi-person or group yarns. Yarns were audio-recorded, transcribed and thematically analysed. Twenty-four participants were recruited. A good knowledge of modes of concussion injury was identified in these participants. However, they identified difficulty differentiating this injury from other injuries or medical conditions. Multiple factors contributed to a reluctance to seek assessment and further management of a potential concussion. Multiple strategies to enhance education and presentation for assessment were suggested by participants. Aboriginal and Torres Strait Islander-owned and led concussion education is the first step in enhancing understanding of this condition. Education must be coupled with improvements in the cultural safety of healthcare services, as without this, patients will continue to fail to present for assessment and management. SO WHAT?: It is recommended that concussion education focuses on the differentiation of concussion as a diagnosis from other injuries. Information regarding where and when to seek medical assessment is recommended, and this must be in a culturally safe environment. Typical recovery and potential sequelae must be explored, in programs led and devised by Aboriginal and Torres Strait Islander peoples engaged with the community for which the education is proposed.

Oxygen uptake efficiency plateau is unaffected by fitness level - the NOODLE study

BackgroundEndurance athletes (EA) are an emerging population of focus for cardiovascular health. The oxygen uptake efficiency plateau (OUEP) is the levelling-off period of ratio between oxygen uptake (VO2) and ventilation (VE). In the cohort of EA, we externally validated prediction models for OUEP and derived with internal validation a new equation.Methods140 EA underwent a medical assessment and maximal cycling cardiopulmonary exercise test. Participants were 55% male (N = 77, age = 21.4 ± 4.8 years, BMI = 22.6 ± 1.7 kg·m− 2, peak VO2 = 4.40 ± 0.64 L·min− 1) and 45% female (N = 63, age = 23.4 ± 4.3 years, BMI = 22.1 ± 1.6 kg·m− 2, peak VO2 = 3.21 ± 0.48 L·min− 1). OUEP was defined as the highest 90-second continuous value of the ratio between VO2 and VE. We used the multivariable stepwise linear regression to develop a new prediction equation for OUEP.ResultsOUEP was 44.2 ± 4.2 mL·L− 1 and 41.0 ± 4.8 mL·L− 1 for males and females, respectively. In external validation, OUEP was comparable to directly measured and did not differ significantly. The prediction error for males was − 0.42 mL·L− 1 (0.94%, p = 0.39), and for females was + 0.33 mL·L− 1 (0.81%, p = 0.59). The developed new prediction equation was: 61.37–0.12·height (in cm) + 5.08 (for males). The developed model outperformed the previous. However, the equation explained up to 12.9% of the variance (R = 0.377, R2 = 0.129, RMSE = 4.39 mL·L− 1).ConclusionOUEP is a stable and transferable cardiorespiratory index. OUEP is minimally affected by fitness level and demographic factors. The predicted OUEP provided promising but limited accuracy among EA. The derived new model is tailored for EA. OUEP could be used to stratify the cardiorespiratory response to exercise and guide training.

The Transformative Role of Microsoft Azure AI in Healthcare

This paper explores the transformative impact of Azure AI technologies on healthcare, focusing on diagnostics, predictive analytics, operational efficiency, and drug discovery. Azure AI tools are reshaping healthcare delivery by harnessing data-driven insights and advanced machine learning algorithms to enhance patient outcomes significantly. Azure AI enables more precise diagnostics through advanced image recognition and pattern analysis, improving the speed and accuracy of medical assessments. It supports predictive analytics models that personalize treatment plans based on individual patient data, thereby optimizing care and reducing risks. In hospital settings, Azure AI enhances operational efficiencies by predicting maintenance needs and optimizing resource allocation, streamlining workflows and improving overall service delivery. Furthermore, Azure AI accelerates drug discovery processes by analyzing extensive datasets to identify potential drug candidates swiftly. These advancements not only improve the efficiency and effectiveness of healthcare services but also hold promise for addressing healthcare disparities and promoting equitable access to quality care globally.

Relative validity of an intelligent ordering system to estimate dietary intake among university students from a medical school in Shanghai, China

BackgroundDietary assessment methods have limitations in capturing real-time eating behaviour accurately. Equipped with automated dietary-data-collection capabilities, the “intelligent ordering system” (IOS) has potential applicability in obtaining long-term consecutive, relatively detailed on-campus dietary records among university students with little resource consumption. We investigated (1) the relative validity of IOS-derived nutrient/food intakes compared to those from the 7-day food diary (7DFD); (2) whether including a supplemental food frequency questionnaire (SFFQ) improves IOS accuracy; and (3) sex differences in IOS dietary intake estimation.MethodsMedical students (n = 221; age = 22.2 ± 2.4 years; 38.5% male and 61.5% female) completed the 7DFD and SFFQ. During the consecutive 7-day survey period, students weighed and photographed each meal before and after consumption. Then, students reviewed their 3-month diet and completed the SFFQ, which includes eight underprovided school-canteen food items (e.g., dairy, fruits, nuts). Meanwhile, 9385 IOS dietary data entries were collected. We used Spearman coefficients and linear regression models to estimate the associations among the different dietary intake assessment methods. Individual- and group-level agreement was assessed using the Wilcoxon signed-rank test, cross-classification, and Bland‒Altman analysis.ResultsIOS mean daily energy, protein, fat, and carbohydrate intake estimations were significantly lower (-15-20%) than those of the 7DFD. The correlation coefficients varied from 0.52 (for added sugar) to 0.88 (for soybeans and nuts), with fruits (0.37) and dairy products (0.29) showing weaker correlations. Sixty-two (milk and dairy products) to 97% (soybeans and nuts) of participants were classified into the same or adjacent dietary intake distribution quartile using both methods. The energy and macronutrient intake differences between the IOS + SFFQ and 7DFD groups decreased substantially. The separate fruit intake measurements from each assessment method did not significantly differ from each other (p > 0.05). IOS and IOS + SFFQ regression models generally yielded higher R2 values for males than for females.ConclusionDespite estimation differences, the IOS can be reliable for medical student dietary habit assessment. The SFFQ is useful for measuring consumption of foods that are typically unavailable in school cafeterias, improving the overall dietary evaluation accuracy. The IOS assessment was more accurate for males than for females.

682 Impact of Regionalisation of Major Trauma Services on Hip Fracture Care in England: A Comparative Study

Abstract Aim Following the establishment of Major Trauma Networks in England in 2012, there were concerns that pressures regarding resource allocation in Major Trauma Centres (MTCs) may negatively impact their care of hip fracture patients. This study aimed to compare outcomes in hip fracture care between MTCs and trauma units (TUs). Method National Hip Fracture Database data was extracted from 01/01/2015 to 31/12/2022 for all hospitals in England. Outcome measures included perioperative medical and physiotherapy assessments, time to surgery, Best Practice Tariff (BPT) compliance, discharge to original residence, and mortality. Data was pooled and weighted for MTCs and remaining hospitals (TUs). Results 487,089 patients were included from 167 hospitals (23 MTCs, 144 TUs). MTCs achieved marginally higher rates of orthogeriatrician assessment within 72 hours of admission (91.1% vs 90.4%, p&amp;lt;0.001) and mobilisation by first postoperative day (81.9% vs 79.7%, p&amp;lt;0.001). Fewer patients underwent surgery by the day after admission in MTCs (65.2% vs 69.7%, p&amp;lt;0.001). There was poorer compliance with BPT criteria in MTCs (57.3% vs 60.4%, p&amp;lt;0.001), and fewer MTC patients were discharged to their original residence (60.4% vs 63.5%, p&amp;lt;0.001). There was no difference between MTCs and TUs in 30-day mortality (6.8% vs 6.8%, p=0.825). Conclusions This study demonstrates that MTCs have greater difficulty in providing prompt surgery to hip fracture patients. However, their marginally superior perioperative care outcomes appear to compensate for this, with similar mortality rates compared to TUs. These findings suggest that the regionalisation of major trauma in England has not significantly compromised the overall care of hip fracture patients.

Reducing Wait Times for Children's Developmental Disorders Consultations Via Simplified Primary Care Assessments

The number of children diagnosed with developmental disorders in Japan is increasing annually, primarily assessed byspecialized physicians in pediatrics, pediatric neurology, and child psychiatry. However, medical institutions for children withdevelopmental disorders often have fully booked schedules, forcing long waiting periods until initial consultations can be obtained. Onereason for this is the shortage of specialized medical institutions and specialists. Prolonged waiting periods may not only delayintervention and support but also exacerbate the child's symptoms and cause psychological distress to the caregivers. Therefore,reducing the waiting period for initial consultations from the perspective of early detection and early support is an urgent issue.However, there is insufficient research on how to shorten the waiting period. Therefore, we focused on local primary care physicians,who are familiar with shortening the waiting time for initial consultations at specialist medical institutions. This aimed to investigatewhether there was a change in the waiting time for initial consultations at specialist medical institutions when local primary carephysicians used a simplified assessment sheet supervised by pediatric specialists, and referrals were made to specialist medical institutionsafter assessment. The participants consisted of 15 individuals referred from primary care physicians to specialist medical institutions and15 who directly visited medical institutions, totaling 30 participants for evaluation. As a result, the group that made appointments andvisited specialist medical institutions directly showed significantly longer waiting periods than those assessed by primary care physiciansand referred to specialist medical institutions (p &lt; 0.05). Assessment and treatment of developmental disorders in early childhood haveprimarily been conducted at specialized medical institutions. Still, using a simplified assessment sheet by primary care physicians suggestsa potential reduction in the waiting time for initial consultations with specialists.

Revolutionary Point-of-Care Wearable Diagnostics for Early Disease Detection and Biomarker Discovery through Intelligent Technologies.

Early-stage disease detection, particularly in Point-Of-Care (POC) wearable formats, assumes pivotal role in advancing healthcare services and precision-medicine. Public benefits of early detection extend beyond cost-effectively promoting healthcare outcomes, to also include reducing the risk of comorbid diseases. Technological advancements enabling POC biomarker recognition empower discovery of new markers for various health conditions. Integration of POC wearables for biomarker detection with intelligent frameworks represents ground-breaking innovations enabling automation of operations, conducting advanced large-scale data analysis, generating predictive models, and facilitating remote and guided clinical decision-making. These advancements substantially alleviate socioeconomic burdens, creating a paradigm shift in diagnostics, and revolutionizing medical assessments and technology development. This review explores critical topics and recent progress in development of 1) POC systems and wearable solutions for early disease detection and physiological monitoring, as well as 2) discussing current trends in adoption of smart technologies within clinical settings and in developing biological assays, and ultimately 3) exploring utilities of POC systems and smart platforms for biomarker discovery. Additionally, the review explores technology translationfrom research labs to broader applications. It also addresses associated risks, biases, and challenges of widespread Artificial Intelligence (AI) integration in diagnostics systems, while systematically outlining potential prospects, current challenges, and opportunities.