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McIsaac M, Knaul FM. How economic implications of gender gaps in employment affect global health equity. Bull World Health Organ 2024; 102:87-87A. [PMID: 38313143 PMCID: PMC10835639 DOI: 10.2471/blt.23.291271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Affiliation(s)
- Michelle McIsaac
- Health Workforce Department, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, United States of America
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Nuruzzaman M, Zapata T, McIsaac M, Wangmo S, Islam MJ, Almamun M, Alam S, Talukder MHK, Dussault G. Informing investment in health workforce in Bangladesh: a health labour market analysis. Hum Resour Health 2022; 20:73. [PMID: 36224554 PMCID: PMC9554982 DOI: 10.1186/s12960-022-00769-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND As the 2016 Global Strategy on Human Resources for Health: Workforce 2030 (GSHRH) outlines, health systems can only function with health workforce (HWF). Bangladesh is committed to achieving universal health coverage (UHC) hence a comprehensive understanding of the existing HWF was deemed necessary informing policy and funding decisions to the health system. METHODS The health labour market analysis (HLMA) framework for UHC cited in the GSHRH was adopted to analyse the supply, need and demand of all health workers in Bangladesh. Government's information systems provided data to document the public sector HWF. A national-level assessment (2019) based on a country representative sample of 133 geographical units, served to estimate the composition and distribution of the private sector HWF. Descriptive statistics served to characterize the formal and informal HWF. RESULTS The density of doctors, nurses and midwives in Bangladesh was only 9.9 per 10 000 population, well below the indicative sustainable development goals index threshold of 44.5 outlined in the GSHRH. Considering all HWFs in Bangladesh, the estimated total density was 49 per 10 000 population. However, one-third of all HWFs did not hold recognized roles and their competencies were unknown, taking only qualified and recognized HWFs into account results in an estimated density 33.2. With an estimate 75 nurses per 100 doctors in Bangladesh, the second area, where policy attention appears to be warranted is on the competencies and skill-mix. Thirdly, an estimated 82% of all HWFs work in the private sector necessitates adequate oversight for patient safety. Finally, a high proportion of unfilled positions in the public sector, especially in rural areas where 67% of the population lives, account only 11% of doctors and nurses. CONCLUSION Bangladesh is making progress on many of the milestones of the GSHRH, notably, the establishment of the HWF unit and reporting through the national health workforce accounts. However, particular investment on strengthening the intersectoral HWF coordination across sectors; regulation for assurance of patient safety and adequate oversight of the private sector; establishing accreditation mechanisms for training institutions; and halving inequalities in access to a qualified HWF are important towards advancing UHC in Bangladesh.
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Affiliation(s)
| | - Tomas Zapata
- WHO South-East Asia Regional Office (Former HRH Advisor), New Delhi, India
| | | | | | | | | | - Sabina Alam
- Health Services Division, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | - Gilles Dussault
- Global Health and Tropical Medicine, Instituto de Higiene E Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
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Garg S, Tripathi N, McIsaac M, Zurn P, Zapata T, Mairembam DS, Singh NB, de Graeve H. Implementing a health labour market analysis to address health workforce gaps in a rural region of India. Hum Resour Health 2022; 20:50. [PMID: 35659250 PMCID: PMC9167498 DOI: 10.1186/s12960-022-00749-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Human Resources for Health (HRH) are essential for making meaningful progress towards universal health coverage (UHC), but health systems in most of the developing countries continue to suffer from serious gaps in health workforce. The Global Strategy on Human Resources for Health-Workforce 2030, adopted in 2016, includes Health Labor Market Analysis (HLMA) as a tool for evidence based health workforce improvements. HLMA offers certain advantages over the traditional approach of workforce planning. In 2018, WHO supported a HLMA exercise in Chhattisgarh, one of the predominantly rural states of India. METHODS The HLMA included a stakeholder consultation for identifying policy questions relevant to the context. The HLMA focused on state HRH at district-level and below. Mixed methods were used for data collection and analysis. Detailed district-wise data on HRH availability were collected from state's health department. Data were also collected on policies implemented on HRH during the 3 year period after the start of HLMA and changes in health workforce. RESULTS The state had increased the production of doctors but vacancies persisted until 2018. The availability of doctors and other qualified health workers was uneven with severe shortages of private as well as public HRH in rural areas. In case of nurses, there was a substantial production of nurses, particularly from private schools, however there was a lack of trusted accreditation mechanism and vacancies in public sector persisted alongside unemployment among nurses. Based on the HLMA, pragmatic recommendations were decided and followed up. Over the past 3 years since the HLMA began an additional 4547 health workers including 1141 doctors have been absorbed by the public sector. The vacancies in most of the clinical cadres were brought below 20%. CONCLUSION The HLMA played an important role in identifying the key HRH gaps and clarifying the underlying issues. The HLMA and the pursuant recommendations were instrumental in development and implementation of appropriate policies to improve rural HRH in Chhattisgarh. This demonstrates important progress on key 2030 Global Strategy milestones of reducing inequalities in access to health workers and improving financing, retention and training of HRH.
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Affiliation(s)
- Samir Garg
- State Health Resource Centre, Raipur, Chhattisgarh India
| | | | | | - Pascal Zurn
- Health Workforce Department, WHO, Geneva, Switzerland
| | - Tomas Zapata
- WHO, South East Asia Regional Office, New Delhi, India
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Boniol M, McCarthy C, Lawani D, Guillot G, McIsaac M, Diallo K. Inequal distribution of nursing personnel: a subnational analysis of the distribution of nurses across 58 countries. Hum Resour Health 2022; 20:22. [PMID: 35248061 PMCID: PMC8898534 DOI: 10.1186/s12960-022-00720-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/20/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Nursing personnel are critical for enabling access to health service in primary health care. However, the State of the World's Nursing 2020 report showed important inequalities in nurse availability between countries. METHODS The purpose of this study/analysis was to describe the differences in nurse-to-population density in 58 countries from six regional areas and the relationship between differences in access to nurses and other indicators of health equity. RESULTS All countries and income groups showed subnational inequalities in the distribution of nursing personnel with Gini coefficients ranging from 1 to 39. The latter indicated situation such as 13% of the population having access to 45% of nurses in a country. The average max-to-min ratio was on average of 11-fold. In our sample, the African region had the highest level of subnational inequalities with the average Gini coefficient of 19.6. The European Region had the lowest level of within-country inequalities with the average Gini coefficient being 5.6. A multivariate analysis showed a clustering of countries in three groups: (1) high Gini coefficients comprised mainly African countries; (2) moderate Gini coefficients comprised mainly South-East Asian, Central and South American countries; (3) low Gini coefficients comprised mainly Western countries, Japan, and Korea. The analysis also showed that inequality in distribution of nurses was correlated with other indices of health and inequality such as the Human Development Index, maternal mortality, and life expectancy. CONCLUSIONS This study showed that there is a high level of geographic inequality in the distribution of nurses at subnational level. Inequalities in nursing distribution are multifactorial, to improve access to nurses, policies should be bundled, tailored to the local context and tackle the various root causes for inequalities.
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Affiliation(s)
- Mathieu Boniol
- Health Workforce Department, World Health Organization, Geneva, Switzerland.
| | - Carey McCarthy
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Deen Lawani
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Gilles Guillot
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Michelle McIsaac
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Khassoum Diallo
- Health Workforce Department, World Health Organization, Geneva, Switzerland
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Ajuebor O, Boniol M, McIsaac M, Onyedike C, Akl EA. Increasing access to health workers in rural and remote areas: what do stakeholders' value and find feasible and acceptable? Hum Resour Health 2020; 18:77. [PMID: 33066792 PMCID: PMC7565226 DOI: 10.1186/s12960-020-00519-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/02/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND The primary aim of this study is to assess stakeholders' views of the acceptability and feasibility of policy options and outcome indicators presented in the 2010 World Health Organization (WHO) global policy recommendations on increasing access to health workers in remote and rural areas through improved retention. METHODS A survey on the acceptability, feasibility of recruitment and retention policy options, and the importance of their outcome indicators was developed. It followed a cross-sectional approach targeting health workers in rural and remote settings as well as policy- and decision-makers involved in the development of recruitment and retention policies for such areas. Respondents were asked their perception of the importance of the policy outcomes of interest, as well as the acceptability and feasibility of the 2010 WHO guidelines' policy options using a 9-point Likert scale. RESULTS In total, 336 participants completed the survey. Almost a third worked in government; most participants worked in community settings and were involved in the administration and management of rural health workers. Almost all 19 outcomes of interests assessed were valued as important or critical. For the 16 guideline policy options, most were perceived to be "definitely acceptable" and "definitely feasible", although the policy options were generally considered to be more acceptable than feasible. CONCLUSION The findings of this study provide insight into the revision and update of the 2010 WHO guideline on increasing access to health workers in remote and rural areas. Stakeholders' views of the acceptability, feasibility of policy options and the importance of outcomes of interest are important for the development of relevant and effective policies to improve access to health workers in rural and remote areas.
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Affiliation(s)
- Onyema Ajuebor
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland.
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Michelle McIsaac
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Chukwuemeka Onyedike
- Health Workforce Department, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
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Affiliation(s)
- Peter Salama
- Universal Health Coverage Across the Life Course Division, World Health Organization, Geneva, Switzerland
| | - Michelle McIsaac
- Health Workforce Department, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - James Campbell
- Health Workforce Department, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
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McIsaac M, Scott A, Kalb G. The role of financial factors in the mobility and location choices of General Practitioners in Australia. Hum Resour Health 2019; 17:34. [PMID: 31126294 PMCID: PMC6534889 DOI: 10.1186/s12960-019-0374-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/09/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The geographic distribution of health workers is a pervasive policy concern. Many governments are responding by introducing financial incentives to attract health care workers to locate in areas that are underserved. However, clear evidence of the effectiveness of such financial incentives is lacking. METHODS This paper examines General Practitioners' (GPs) relocation choices in Australia and proposes a dynamic location choice model accounting for both source and destination factors associated with a choice to relocate, thereby accounting for push and pull factors associated with job separation. The model is used to simulate financial incentive policies and assess potential for such policies to redistribute GPs. This paper examines the role of financial factors in relocating established GPs into neighbourhoods with relatively low socioeconomic status. The paper uses a discrete choice model and panel data on GPs' actual changes in location from one year to the next. RESULTS This paper finds that established GPs are not very mobile, even when a financial incentive is offered. Policy simulation predicts that 93.2% of GPs would remain at their current practice and that an additional 0.8% would be retained or would relocate in a low-socioeconomic status (SES) neighbourhood in response to a hypothetical financial incentive of a 10% increase in the earnings of all metropolitan GPs practising in low-SES neighbourhoods. CONCLUSION With current evidence on the effectiveness of redistribution programmes limited to newly entering GPs, the policy simulations in this paper provide an insight into the potential effectiveness of financial incentives as a redistribution policy targeting the entire GP population. Overall, the results suggest that financial considerations are part of many factors influencing the location choice of GPs. For instance, GP practice ownership played almost as important a role in mobility as earnings.
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Affiliation(s)
- Michelle McIsaac
- World Health Organization, Avenue Appia 20, 1293 Geneva, Switzerland
| | - Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, 111 Barry Street, Carlton, VIC 3053 Australia
| | - Guyonne Kalb
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, 111 Barry Street, Carlton, VIC 3053 Australia
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Russo G, Xu L, McIsaac M, Matsika-Claquin MD, Dhillon I, McPake B, Campbell J. Health workers' strikes in low-income countries: the available evidence. Bull World Health Organ 2019; 97:460-467H. [PMID: 31258215 PMCID: PMC6593336 DOI: 10.2471/blt.18.225755] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/19/2019] [Accepted: 04/05/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To analyse the characteristics, frequency, drivers, outcomes and stakeholders of health workers' strikes in low-income countries. Methods We reviewed the published and grey literature from online sources for the years 2009 to 2018. We used four search strategies: (i) exploration of main health and social sciences databases; (ii) use of specialized websites on human resources for health and development; (iii) customized Google search; and (iv) consultation with experts to validate findings. To analyse individual strike episodes, pre-existing conditions and influencing actors, we developed a conceptual framework from the literature. Results We identified 116 records reporting on 70 unique health workers' strikes in 23 low-income countries during the period, accounting for 875 days of strike. Year 2018 had the highest number of events (17), corresponding to 170 work days lost. Strikes involving more than one professional category was the frequent strike modality (32 events), followed by strikes by physicians only (22 events). The most commonly reported cause was complaints about remuneration (63 events), followed by protest against the sector's governance or policies (25 events) and safety of working conditions (10 events). Positive resolution was achieved more often when collective bargaining institutions and higher levels of government were involved in the negotiations. Conclusion In low-income countries, some common features appear to exist in health sector strikes' occurrence and actors involved in such events. Future research should focus on both individual events and regional patterns, to form an evidence base for mechanisms to prevent and resolve strikes.
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Affiliation(s)
- Giuliano Russo
- Centre for Primary Care and Public Health, Queen Mary University of London, 58 Turner Street, E1 2AB London, England
| | - Lihui Xu
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Michelle McIsaac
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | | | - Ibadat Dhillon
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Barbara McPake
- Nossal Institute for Global Health, Melbourne, Australia
| | - James Campbell
- Health Workforce Department, World Health Organization, Geneva, Switzerland
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Affiliation(s)
- Michelle McIsaac
- Health Workforce Department, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Joseph Kutzin
- Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
| | - Elina Dale
- Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
| | - Agnès Soucat
- Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
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McIsaac M, Scott A, Kalb G. The supply of general practitioners across local areas: accounting for spatial heterogeneity. BMC Health Serv Res 2015; 15:450. [PMID: 26433574 PMCID: PMC4592750 DOI: 10.1186/s12913-015-1102-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The geographic distribution of general practitioners (GPs) remains persistently unequal in many countries despite notable increases in overall supply. This paper explores how the factors associated with the supply of general practitioners (GPs) are aligned with the arbitrary geographic boundaries imposed by the use of spatially referenced GP supply data. METHODS Data on GP supply in postcodes within Australia are matched to data on the population characteristics and levels of amenities in postcodes. Tobit regression models are used that examine the associations between GP supply and postcode characteristics, whilst accounting for spatial heterogeneity. RESULTS The results demonstrate that GPs do not consider space in a one-dimensional sense. Location choice is related to both neighbourhood-specific factors, such as hospitals, and broader area factors, such as area income and proximity to private schools. Although the proportion of females and elderly were related to GPs supply, mortality rate was not. CONCLUSIONS This paper represents the first attempt to map the factors influencing GP supply to the appropriate geographic level at which GPs may be considering that factor. We suggest that both neighbourhood and broader regional characteristics can influence GPs' locational choices. This finding is highly relevant to the design and evaluation of relocation incentive programmes.
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Affiliation(s)
- Michelle McIsaac
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, 111 Barry Street, Carlton, VIC, 3053, Australia.
| | - Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, 111 Barry Street, Carlton, VIC, 3053, Australia.
| | - Guyonne Kalb
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, 111 Barry Street, Carlton, VIC, 3053, Australia.
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Mohamed A, McIsaac M, Janssen I. SOCIODEMOGRAPHIC VARIATIONS IN EXPOSURE TO FAST FOOD RESTAURANTS AND ITS ASSOCIATION WITH FAST FOOD CONSUMPTION AMONG YOUTH. Br J Soc Med 2015. [DOI: 10.1136/jech-2014-205217.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Heckert RA, McIsaac M, Chan M, Zhou EM. Experimental infection of emus ( Dromaiius novaehollandiae ) with avian influenza viruses of varying virulence: Clinical signs, virus shedding and serology. Avian Pathol 2010; 28:13-6. [PMID: 16147545 DOI: 10.1080/03079459994993] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Two groups of emus were experimentally inoculated with a low and high pathogenic strain of avian influenza virus (AIV), type A to determine the virus susceptibility, pathogenicity, shedding and seroconversion. Emus were found susceptible to infection with AIV, with virus shedding detectable in tracheal and cloacal swabs between 3 and 10 days post-infection. Only the birds infected with the highly pathogenic viral isolate showed a brief period of mild clinical signs associated with infection. Virus recovered from the infected emus was found to be of similar pathogenicity to that of the virus inoculum. All the birds seroconverted by 10 days post-infection, as determined by haemagglutination inhibition, agar gel immunodiffusion and competitive ELISA assays. This study suggests that emus are similar to wild waterfowl in their response to AIV infection, in that they are susceptible and will replicate and shed the virus, but do not show any marked clinical signs of infection.
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Affiliation(s)
- R A Heckert
- Canadian Food Inspection Agency, Animal Diseases Research Institute, Nepean, Ontario, Canada.
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Abstract
BACKGROUND Testing to determine HER2 status has come into focus since the approval of trastuzumab (Herceptin) for the treatment of HER2-positive breast cancer. We compared the cost-effectiveness of various strategies used to test HER2 status, an important first step toward evaluating the overall cost-effectiveness of trastuzumab therapy. METHODS We performed a systematic review of studies that evaluated concordance between immunohistochemistry and fluorescence in situ hybridization testing to determine HER2 status. We performed a meta-analysis to estimate the distribution of immunohistochemistry scores in each category (0, 1+, 2+, 3+) and the probability of receiving a positive result of fluorescence in situ hybridization (which we assumed to be the "gold-standard" test) for each category. We calculated the accuracy and incremental cost per accurate diagnosis for each testing strategy compared with the base strategy (immunohistochemistry testing, followed by confirmation of 2+ scores by fluorescence in situ hybridization). RESULTS The median percentage of patients in each category of immunohistochemistry score was: 0, 36.1%; 1+, 35.5%; 2+, 12.0%; and 3+, 16.2%. The median percentage of results of fluorescence in situ hybridization that were positive in each immunohistochemistry category was: 0, 1.6%; 1+, 4.9%; 2+, 29.8%; and 3+, 92.4%. The base strategy was expected to correctly determine the HER2 status of 96% of patients with breast cancer. Confirmation of the HER2 status by fluorescence in situ hybridization in cases that received a score of 3+ reduced the percentage of false-positive results to 0% and increased the percentage of accurately determined HER2 results to 97.6%. Compared with the base strategy, this strategy was associated with a median incremental cost-effectiveness ratio of $6175 per case of accurately determined HER2 status. The strategy of performing fluorescence in situ hybridization testing in all cases of breast cancer was associated with a median incremental cost-effectiveness ratio of $8401 per case of accurately determined HER2 status. INTERPRETATION The strategy with the lowest cost-effectiveness ratio involved screening all newly diagnosed cases of breast cancer with immunohistochemistry and confirming scores of 2+ or 3+ with fluorescence in situ hybridization testing.
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Affiliation(s)
- Nandini Dendukuri
- Technology Assessment Unit, McGill University Health Centre, Montréal, Que.
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Janardhan KS, McIsaac M, Fowlie J, Shrivastav A, Caldwell S, Sharma RK, Singh B. Toll like receptor-4 expression in lipopolysaccharide induced lung inflammation. Histol Histopathol 2006; 21:687-96. [PMID: 16598667 DOI: 10.14670/hh-21.687] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Bacterial lipopolysaccharides (LPS) initiate immune response through Toll-like receptor 4 (TLR4). Because many a times host is confronted with secondary bacterial challenges, it is critical to understand TLR4 expression following initial provocation. We studied TLR4 expression in rats at various times after intra-tracheal instillation of LPS. Although TLR4 mRNA was undetectable in normal lungs, it increased at 6h and 12h and declined at 36h post-LPS treatment. Western blots showed TLR4 protein at all time points. Immunohistochemistry localized TLR4 in alveolar septal cells, bronchial epithelium, macrophages and endothelium of large and peribronchial blood vessels. Dual label immunoelectron microscopy showed co-localization of TLR4 and LPS in the cytoplasm and nucleus of various lung and inflammatory cells. Nuclear localization of TLR4 was confirmed with Western blots on lung nuclear extracts. We conclude that TLR4 expression in lung is sustained up to 36 hours and that TLR4 and LPS are localized in the cytoplasm and nuclei of lung cells.
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Affiliation(s)
- K S Janardhan
- Immunology Research Group, Department of Veterinary Biomedical Sciences, Saskatchewan Cancer Agency, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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Zhou EM, Chan M, McIsaac M, Heckert RA. Evaluation of antibody responses of emus (Dromaius novaehollandiae) to avian influenza virus infection. Avian Dis 1998; 42:757-61. [PMID: 9876845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Emu antibody responses to avian influenza virus (AIV) infection were evaluated by the competitive enzyme-linked immunosorbent assay (C-ELISA), agar gel immunodiffusion (AGID) and hemagglutination inhibition (HI) tests. All birds infected with AIV H5N1, H5N3, or H7N7 developed antinucleoprotein (NP) antibodies as early as 7 days postinfection as detected by the C-ELISA. The responses lasted 49 days for the emus receiving H5N3 and at least 56 days for emus receiving the other two viruses. By evaluating 50 emu field serum samples, the C-ELISA was found more sensitive than the AGID test for the detection of anti-NP antibodies. This study indicates that emus experimentally infected with AIV developed antibody responses that can be detected by C-ELISA, AGID, and HI tests. The results from this and our previous studies demonstrate the use of the C-ELISA as a substitute for the AGID test in a routine serodiagnostic screening for detection of antibodies to AIV infection in multiple avian species.
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Affiliation(s)
- E M Zhou
- Virology Section, Animal Diseases Research Institute, Canadian Food Inspection Agency, Nepear, Ontario, Canada
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Zhou EM, Chan M, McIsaac M, Heckert RA. Evaluation of Antibody Responses of Emus (Dromaius novaehollandiae) to Avian Influenza Virus Infection. Avian Dis 1998. [DOI: 10.2307/1592712] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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McIsaac M. Ophthalmic surgery in the elderly. Prim Care 1982; 9:173-9. [PMID: 6918027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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