Challenges for Australia's Bio/Nanopharma Policies: trade deals, public goods and reference pricing in sustainable industrial renewal

Industrial renewal in the bio/nanopharma sector is important for the long term strength of the Australian economy and for the health of its citizens. A variety of factors, however, may have caused inadequate attention to focus on systematically promoting domestic generic and small biotechnology manufacturers in Australian health policy

Assessment of Tissue Autofluorescence and Reflectance for Oral Cavity Cancer Screening

OBJECTIVE: Although approved by the U.S. Food and Drug Administration for clinical use, the utility of hand-held tissue reflectance and autofluorescence devices for screening head and neck cancer patients is poorly defined. There is limited published evidence regarding the efficacy of these devices. We investigated the sensitivity and specificity of these modalities compared to standard exam. STUDY DESIGN: Prospective, cross sectional analysis. SETTING: Tertiary care medical center. SUBJECTS AND METHODS: Patients who were treated previously for head and neck cancer (n=88) between 2009-2010 were included. Patients were screened using white light visualization (standard of care) and compared to tissue reflectance and autofluorescence visualization. Screening results were compared to biopsy or long term follow-up. RESULTS: Autofluorescence visualization had inferior specificity (81%) and equivalent sensitivity (50%), for detecting oral cavity cancer, when compared to white light visualization (98% specificity, 50% sensitivity). Tissue reflectance visualization had poor sensitivity (0%) and good specificity (86%). The positive and negative predictive values for standard white light exam (50% and 98% respectively) were superior to either tissue reflectance or autofluorescence. CONCLUSION: Standard clinical lighting has a higher sensitivity than tissue reflectance and autofluorescence visualization for detection of disease in patients with a history of head and neck cancer. This study does not support the added costs associated with these devices