Estimating the number of people with hepatitis C virus who have ever injected drugs and have yet to be diagnosed: an evidence synthesis approach for Scotland.

AIMS: To estimate the number of people who have ever injected drugs (defined here as PWID) living in Scotland in 2009 who have been infected with the hepatitis C virus (HCV) and to quantify and characterize the population remaining undiagnosed. METHODS: Information from routine surveillance (n=22616) and survey data (n=2511) was combined using a multiparameter evidence synthesis approach to estimate the size of the PWID population, HCV antibody prevalence and the proportion of HCV antibody prevalent cases who have been diagnosed, in subgroups defined by recency of injecting (in the last year or not), age (15-34 and 35-64 years), gender and region of residence (Greater Glasgow and Clyde and the rest of Scotland). RESULTS: HCV antibody-prevalence among PWID in Scotland during 2009 was estimated to be 57% [95% CI=52-61%], corresponding to 46657 [95% credible interval (CI)=33812-66803] prevalent cases. Of these, 27434 (95% CI=14636-47564) were undiagnosed, representing 59% [95% CI=43-71%] of prevalent cases. Among the undiagnosed, 83% (95% CI=75-89%) were PWID who had not injected in the last year and 71% (95% CI=58-85%) were aged 35-64 years. CONCLUSIONS: The number of undiagnosed hepatitis C virus-infected cases in Scotland appears to be particularly high among those who have injected drugs more than 1 year ago and are more than 35 years old

Symptomatic venous thromboembolism following a hip fracture: Incidence and risk factors in 5,300 patients

Background and purpose Venous thromboembolism (VTE) remains a substantial cause of morbidity and mortality following hip fracture. Previous work has not identified any risk factors associated with the type of hip fracture. We report the incidence of and risk factors for development of symptomatic VTE in patients following a hip fracture

Performance of Mcm5 and NMP22 tests for bladder carcinoma detection for all patients with test results available.

<p>Abbreviations: CI, 95% confidence interval; NPV, negative predictive value; PPV, positive predictive value; Sens, sensitivity; Spec, specificity.</p

Patient demographics and clinicopathological data.

<p>Abbreviations: CIS, carcinoma in situ; IQR, interquartile range; SD, standard deviation.</p>a<p>n = 221.</p>b<p>Percentage of patients excluding those with stage T0 and Tx.</p>c<p>Percentage of recorded cases only.</p

Receiver operating characteristics curves for Mcm5 and NMP22 tests for the detection of bladder cancer in all studied patients with valid test results.

<p>Receiver operating characteristics curves for Mcm5 and NMP22 tests for the detection of bladder cancer in all studied patients with valid test results.</p

Comparison of Mcm5 and NMP22 test performance across grade and stage.

<p>Abbreviations: CI, 95% confidence interval; IQR, interquartile range; med, median; FNR, false negative rate.</p>a<p>Mann-Whitney test (for Test value) or Chi-squared test (for FNR), comparison with Normal group.</p>b<p>Mann-Whitney test (for Test value) or Chi-squared test (for FNR), comparison with previous, i.e. Grade 2 vs Grade 1, Grade 3 vs Grade 2.</p>c<p>Jonckheere-Terpstra test for trend (for Test value) or Chi-squared test for linear by linear association, across Grade or Stage, excluding Normal group.</p>d<p>Data analysis using 2150-cell cut-point for Mcm5 test.</p>e<p>Excludes 8 CIS and 1 adenocarcinoma from 210 UCC cases having an MCM5 test value.</p>f<p>Data analysis using 10 U/mL cut-point for NMP22 test.</p>g<p>Excludes 7 CIS from the 195 UCC cases having an NMP22 test value.</p

False positive rates for the Mcm5 and NMP22 tests across benign conditions.

<p>For each subgroup, only those patients with a test results were considered.</p><p>Abbreviations: BPH, benign prostatic hyperplasia; FPR, false positive rate; IQR, interquartile range; med, median; UTI, urinary tract infection.</p>a<p>Mann-Whitney test, comparison of test value with normal.</p>b<p>False positive rate determined using 2150-cell cut-point for Mcm5 test and 10 U/mL cut-point for NMP22 test.</p>c<p>Chi-squared test, comparison of false positive rate with Normal group.</p>d<p>Excludes 53 “other cancers” of the 1354 patients without UCC having an Mcm5 test value.</p>e<p>Excludes 47 “other cancers” of the 1201 patients without UCC having an NMP22 test value.</p