Determination of the relative economic impact of different molecular-based laboratory algorithms for respiratory viral pathogen detection, including Pandemic (H1N1), using a secure web based platform

<p>Abstract</p> <p>Background</p> <p>During period of crisis, laboratory planners may be faced with a need to make operational and clinical decisions in the face of limited information. To avoid this dilemma, our laboratory utilizes a secure web based platform, Data Integration for Alberta Laboratories (DIAL) to make near real-time decisions.</p> <p>This manuscript utilizes the data collected by DIAL as well as laboratory test cost modeling to identify the relative economic impact of four proposed scenarios of testing for Pandemic H1N1 (2009) and other respiratory viral pathogens.</p> <p>Methods</p> <p>Historical data was collected from the two waves of the pandemic using DIAL. Four proposed molecular testing scenarios were generated: A) Luminex respiratory virus panel (RVP) first with/without US centers for Disease Control Influenza A Matrix gene assay (CDC-M), B) CDC-M first with/without RVP, C) RVP only, and D) CDC-M only. Relative cost estimates of different testing algorithm were generated from a review of historical costs in the lab and were based on 2009 Canadian dollars.</p> <p>Results</p> <p>Scenarios A and B had similar costs when the rate of influenza A was low (< 10%) with higher relative cost in Scenario A with increasing incidence. Scenario A provided more information about mixed respiratory virus infection as compared with Scenario B.</p> <p>Conclusions</p> <p>No one approach is applicable to all conditions. Testing costs will vary depending on the test volume, prevalence of influenza A strains, as well as other circulating viruses and a more costly algorithm involving a combination of different tests may be chosen to ensure that tests results are returned to the clinician in a quicker manner. Costing should not be the only consideration for determination of laboratory algorithms.</p

DIAL: A Platform for real-time Laboratory Surveillance

Laboratory information systems fulfill many of the requirements for individual result management within a public health laboratory. However, access to the systems by data users, timely data extraction, integration, and data analysis are difficult tasks. These difficulties are further complicated by often having multiple laboratory results for specific analytes or related analytes per specimen tested as part of complex laboratory algorithms requiring specialized expertise for result interpretation. We describe DIAL, (Data Integration for Alberta Laboratories), a platform allowing laboratory data to be extracted, interpreted, collated and analyzed in near real-time using secure web based technology, which is adapted from CNPHI’s Canadian Early Warning System (CEWS) technology. The development of DIAL represents a major technical advancement in the public health information management domain, building capacity for laboratory based surveillance

Use of an Innovative Web-Based Laboratory Surveillance Platform to Analyze Mixed Infections Between Human Metapneumovirus (hMPV) and Other Respiratory Viruses Circulating in Alberta (AB), Canada (2009–2012)

We investigated the proportions of mono vs. mixed infections for human metapneumovirus (hMPV) as compared to adenovirus (ADV), four types of coronavirus (CRV), parainfluenza virus (PIV), RSV, and enterovirus/rhinovirus (ERV) in Alberta, Canada. Using the Data Integration for Alberta Laboratories (DIAL) platform, 26,226 respiratory specimens at ProvLab between 1 July 2009 and 30 June 2012 were selected and included in the study. Using the Respiratory Virus Panel these specimens tested positive for one or more respiratory virus and negative for influenza A and B. From our subset hMPV was the fourth most common virus (n=2,561) with 373 (15%) identified as mixed infection using DIAL. Mixed infection with hMPV was most commonly found in infants less than 6 months old and ERV was most commonly found in mixed infection with hMPV (230/373, 56%) across all age groups. The proportion of mixed-infection vs. mono-infection was highest for ADV (46%), followed by CRV 229E (32%), CRV HKU1 (31%), CRV NL63 (28%), CRV OC43 (23%), PIV (20%), RSV (17%), hMPV (15%) and ERV (13%). hMPV was significantly more likely to be identified in mono infection as compared with ADV, CRV, PIV, and RSV with the exception of ERV [p < 0.05]

DIAL: A Platform for real-time Laboratory Surveillance

Laboratory information systems may fulfill many of the requirements for individual result management within a public health laboratory but typically system access by data users, timely data extraction, integration and analysis is difficult. This is further complicated by often having multiple laboratory results for specific analytes or related analytes per specimen tested as part of complex laboratory algorithms requiring specialized expertise for result interpretation. We describe DIAL, (Data Integration for Alberta Laboratories), a platform allowing laboratory data to be extracted, interpreted, collated and analyzed in near real-time using secure web based technology, which is adapted from CNPHI`s Canadian Early Warning System (CEWS) technology. The development of DIAL represents a major technical advancement in the public health information management domain, building capacity for laboratory based surveillance

Aperçu - Hospitalisations et visites à l’urgence en raison d’un empoisonnement aux opioïdes au Canada

L’augmentation des méfaits attribuables aux opioïdes constitue un problème de plus en plus préoccupant en santé publique au Canada. Cette analyse a utilisé les données de la Base de données sur la morbidité des hôpitaux et du Système national de rapports sur les soins ambulatoires pour déterminer le nombre d’hospitalisations et de visites aux services d’urgence en raison d’un empoisonnement aux opioïdes au Canada. Le nombre d’hospitalisations pour empoisonnement aux opioïdes a augmenté au cours des 10 dernières années, atteignant 15,6 par tranche de 100 000 habitants en 2016-2017, et celui des visites aux services d’urgence en raison d’un empoisonnement aux opioïdes a également augmenté en Alberta et en Ontario, les deux provinces qui ont recueilli des données des services d’urgence assez détaillées pour être analysées. Ces résultats soulignent l’importance de la surveillance pancanadienne des méfaits attribuables aux opioïdes, ainsi que la nécessité de politiques fondées sur des données probantes pour aider à les réduire

Foodborne Botulism in Canada, 1985–2005

During 1985–2005, a total of 91 laboratory-confirmed outbreaks of foodborne botulism occurred in Canada; these outbreaks involved 205 cases and 11 deaths. Of the outbreaks, 75 (86.2%) were caused by Clostridium botulinum type E, followed by types A (7, 8.1%) and B (5, 5.7%). Approximately 85% of the outbreaks occurred in Alaska Native communities, particularly the Inuit of Nunavik in northern Quebec and the First Nations population of the Pacific coast of British Columbia. These populations were predominantly exposed to type E botulinum toxin through the consumption of traditionally prepared marine mammal and fish products. Two botulism outbreaks were attributed to commercial ready-to-eat meat products and 3 to foods served in restaurants; several cases were attributed to non-Native home-prepared foods. Three affected pregnant women delivered healthy infants. Improvements in botulism case identification and early treatment have resulted in a reduction in the case-fatality rate in Canada