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Non-Stress Test

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1. What is the most accurate and cost-effective direct test (ELF test, hyaluronic acid, P3NP, Fibroscan or ARFI elastography) for detecting and staging liver fibrosis and/or cirrhosis in patients with diagnosed or suspected non-alcoholic fatty liver disease,

What is the most accurate and cost-effective direct test (ELF test, hyaluronic acid, P3NP, Fibroscan or ARFI elastography) for detecting and staging liver fibrosis and/or cirrhosis in patients with diagnosed or suspected non-alcoholic fatty liver disease, SHTG Evidence note | 1 Evidence Note Number 82 July 2018 In response to an enquiry from the Scottish Clinical Biochemistry Managed Diagnostic Network What is the most accurate and cost-effective direct test (ELF test™, hyaluronic acid, P3NP (...) of interest had sensitivity =70% for detection of fibrosis and cirrhosis in patients with hepatitis C or non-alcoholic fatty liver disease (NAFLD). ? In a meta-analysis of 13 studies (n=1,163) the direct imaging tests Fibroscan® and ARFI elastography had similar sensitivity and specificity for the detection of significant fibrosis and cirrhosis. ? In a meta-analysis of four studies (n=612) Fibroscan® imaging was slightly more sensitive and more specific for diagnosing cirrhosis compared with the ELF test

2018 Evidence Notes from Healthcare Improvement Scotland

2. Comparison of umbilical artery Doppler and non-stress test in assessment of fetal well-being in gestational diabetes mellitus: A prospective cohort study (PubMed)

Comparison of umbilical artery Doppler and non-stress test in assessment of fetal well-being in gestational diabetes mellitus: A prospective cohort study Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is related to poor perinatal outcomes. Reduction of neonatal complications of GDM is feasible by assessment of fetal well-being. Both fetal Doppler and NST are used for the screening of high-risk pregnancies.We aimed to compare the non-stress (...) as Apgar scores at 1-min and 5-min <7, hypoglycemia (blood glucose <45 mg/dl), neonatal acidosis (PH<7.2), hypocalcemia (Ca<8 mg/dl), admission to the NICU for more than 24 hours, and perinatal death. Statistical analyses were performed with SPSS version 16 using Chi-square, Fisher's exact test, and independent-samples t-test. The significance level was considered at 0.05.Totally, 22% and 12% of women had an abnormal UA Doppler and a non-reactive NST respectively. Poor outcomes were detected in 13

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2017 Electronic physician

4. The effect of music on the non-stress test and maternal anxiety. (PubMed)

The effect of music on the non-stress test and maternal anxiety. This study aimed to determine the effect of music that was listened to by pregnant women during the non-stress test (NST) on the test result and maternal anxiety.The study utilized a non-randomized controlled trial design. Sequential sample selection method was used. The pregnant women in the experimental group listened to music during the NST (20 min).There were significant differences between the two groups in terms of mean

2019 Complementary Therapies in Clinical Practice

5. Non-Invasive Prenatal Testing (NIPT) for common Trisomies (21, 18 and 13)

Non-Invasive Prenatal Testing (NIPT) for common Trisomies (21, 18 and 13) 1 Public Summary Document Application No. 1492 – Non-Invasive Prenatal Testing Applicant: Royal College of Pathologists of Australasia (RCPA) and Roche Diagnostics Australia Pty Ltd Date of MSAC consideration: MSAC 73 rd Meeting, 26-27 July 2018 Context for decision: MSAC makes its advice in accordance with its Terms of Reference, visit the MSAC website 1. Purpose of application An application requesting Medicare Benefit (...) Schedule (MBS) listing for non-invasive prenatal testing (NIPT) for trisomies 21, 18, 13 and monosomy X (Application 1458) was received from the RCPA, while an application also requesting MBS listing for NIPT , to test common trisomies 21, 18 and 13 (Application 1461) was received from Roche Diagnostics. Due to the similarities between the applications 1458 and 1461, the PICO Advisory Sub- Committee (PASC) advised that these applications should be merged into one MSAC application. 2. MSAC’s advice

2019 Medical Services Advisory Committee

6. Core IM 5 pearls on stress testing

Core IM 5 pearls on stress testing Core IM 5 Pearls on Stress Testing – Clinical Correlations Search Core IM 5 Pearls on Stress Testing April 28, 2019 2 min read Podcast: | Subscribe: | For a transcript of the podcast and show notes: Time Stamps What are the indications for a stress test? ( 2:18) How to choose stress protocol in a stress test? (8:29) How to choose diagnostic modality in a stress test? (14:46) How do we interpret results from stress tests, and how should this be communicated (...) for the assessment of coronary artery disease: a meta-analysis of diagnostic performance. American heart journal, 154(3), 415-423. Aziz, E. F., Javed, F., Alviar, C. L., & Herzog, E. (2011). Triple vessel coronary artery disease presenting as a markedly positive stress electrocardiographic test and a negative SPECT-TL scintigram: a case of balanced ischemia. Heart international, 6(2), hi-2011. “ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers” www.asnc.org/files

2019 Clinical Correlations

7. Stress Tests Part 3: Stress test accuracy

with chest pain. The Journal of Emergency Medicine. 2010;39(2):135-143. PMID: A prospective observational trial looking at a convenience sample of emergency department patients presenting with chest pain or other symptoms suggestive of myocardial ischemia, with non-diagnostic ECGs and one negative troponin. (This is a higher risk group than we usually test, because they didn’t wait for the second troponin). All patients had an exercise stress test using the Duke Treadmill Score. Their primary outcome (...) was a composite that combined death, MI, and revascularization. They included 196 patients. 20 were lost to follow-up. Of the 171 stress tests, 150 (88%) were normal, 16 (9%) were non diagnostic, and 5 (3%) were positive according to cardiology. According the the Duke Treadmill Score, 119 (70%) were low risk, 51 (30%) were intermediate risk, and 1 was high risk. Although they conclude that the Duke Treadmill Score is associated with adverse outcomes, a closer look at the data suggests otherwise. (Although

2019 First10EM

8. Non-invasive diagnostic tests for Helicobacter pylori infection. (PubMed)

Non-invasive diagnostic tests for Helicobacter pylori infection. Helicobacter pylori (H pylori) infection has been implicated in a number of malignancies and non-malignant conditions including peptic ulcers, non-ulcer dyspepsia, recurrent peptic ulcer bleeding, unexplained iron deficiency anaemia, idiopathic thrombocytopaenia purpura, and colorectal adenomas. The confirmatory diagnosis of H pylori is by endoscopic biopsy, followed by histopathological examination using haemotoxylin and eosin (H (...) & E) stain or special stains such as Giemsa stain and Warthin-Starry stain. Special stains are more accurate than H & E stain. There is significant uncertainty about the diagnostic accuracy of non-invasive tests for diagnosis of H pylori.To compare the diagnostic accuracy of urea breath test, serology, and stool antigen test, used alone or in combination, for diagnosis of H pylori infection in symptomatic and asymptomatic people, so that eradication therapy for H pylori can be started.We searched

2018 Cochrane

9. Diagnostic testing for ROS proto-oncogene 1 (ROS1) rearrangements in non-small cell lung cancer (NSCLC) to determine eligibility for crizotinib treatment

Diagnostic testing for ROS proto-oncogene 1 (ROS1) rearrangements in non-small cell lung cancer (NSCLC) to determine eligibility for crizotinib treatment 1 Public Summary Document Application No. 1454- Diagnostic testing for ROS proto-oncogene1 (ROS1) rearrangements in patients with non-small cell lung cancer (NSCLC) to determine eligibility for crizotinib treatment Applicant: Pfizer Australia Pty Ltd Date of MSAC consideration: MSAC 73 rd Meeting, 26-27 July 2018 MSAC 71 st Meeting, 23 (...) November 2017 Context for decision: MSAC makes its advice in accordance with its Terms of Reference, visit the MSAC website 1. Purpose of application The codependent application requested: ? a new Medicare Benefits Schedule (MBS) item number for ROS proto-oncogene 1 (ROS1) fluorescent in situ hybridisation (FISH) testing as a codependent medical service that is performed to inform eligibility for crizotinib treatment in patients with locally advanced (Stage IIIB) or metastatic (Stage IV), non-squamous

2018 Medical Services Advisory Committee

10. Genomics-based non-invasive prenatal testing for detection of fetal chromosomal aneuploidy in pregnant women. (PubMed)

Genomics-based non-invasive prenatal testing for detection of fetal chromosomal aneuploidy in pregnant women. Common fetal aneuploidies include Down syndrome (trisomy 21 or T21), Edward syndrome (trisomy 18 or T18), Patau syndrome (trisomy 13 or T13), Turner syndrome (45,X), Klinefelter syndrome (47,XXY), Triple X syndrome (47,XXX) and 47,XYY syndrome (47,XYY). Prenatal screening for fetal aneuploidies is standard care in many countries, but current biochemical and ultrasound tests have high (...) false negative and false positive rates. The discovery of fetal circulating cell-free DNA (ccfDNA) in maternal blood offers the potential for genomics-based non-invasive prenatal testing (gNIPT) as a more accurate screening method. Two approaches used for gNIPT are massively parallel shotgun sequencing (MPSS) and targeted massively parallel sequencing (TMPS).To evaluate and compare the diagnostic accuracy of MPSS and TMPS for gNIPT as a first-tier test in unselected populations of pregnant women

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2017 Cochrane

11. Feasibility and safety of exercise stress testing using an anti-gravity treadmill with Tc-99m tetrofosmin single-photon emission computed tomography (SPECT) myocardial perfusion imaging: A pilot non-randomized controlled study. (PubMed)

Feasibility and safety of exercise stress testing using an anti-gravity treadmill with Tc-99m tetrofosmin single-photon emission computed tomography (SPECT) myocardial perfusion imaging: A pilot non-randomized controlled study. Exercise is the AHA/ACC guideline-recommended stress modality for myocardial perfusion imaging, but many patients are unable to exercise to target heart rate on a conventional treadmill. We examined the feasibility and safety of stress imaging using an anti-gravity (...) treadmill in patients with perceived poor exercise capacity.49 patients were recruited for stress testing by anti-gravity treadmill (n = 29) or to a regadenoson control group (n = 20). Seventeen anti-gravity test patients (59%) reached target heart rate obviating the need for a pharmacologic stress agent. Adverse effects of the anti-gravity treadmill were limited to minor muscle aches in 5 subjects. Stress myocardial perfusion image quality judged by 3 blinded readers on a 5-point scale was comparable

2018 Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

12. Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial) (PubMed)

Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial) The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could (...) , respectively. We observed no differences in 28-day mortality (62.1 versus 58.3%, P = 0.68), 7-day fluid balance, or RRT dependence at day 28. However, hypophosphatemia occurred more frequently in the early RRT arm (P = 0.002).The furosemide stress test appears to be feasible and effective in identifying patients for randomization to different RRT initiation times. Our findings should guide implementation of large-scale randomized controlled trials for the timing of RRT initiation.clinicaltrials.gov

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2018 Critical Care

13. A pilot study of cardiopulmonary exercise testing and cardiac stress positron emission tomography before major non-cardiac surgery. (PubMed)

A pilot study of cardiopulmonary exercise testing and cardiac stress positron emission tomography before major non-cardiac surgery. Cardiac events are a common cause of peri-operative morbidity. Cardiopulmonary exercise testing can objectively assess risk, but it does not quantify myocardial ischaemia. With appropriate dietary preparation to suppress basal myocardial glucose uptake, positron emission tomography with 18 F-fluorodeoxyglucose can identify post-ischaemic myocardium, providing (...) an attractive complement to exercise testing. We aimed to investigate the feasibility of this diagnostic algorithm. Patients referred for cardiopulmonary exercise testing before major cancer surgery were prospectively recruited. Exercise testing and positron emission tomography imaging were performed after a high fat-low carbohydrate meal. Protocol feasibility (primary end-point) included compliance with pre-test diet instructions and the completion of tests. Stress myocardial perfusion imaging

2018 Anaesthesia

14. Accuracy of non-invasive stress testing in women and men with angina in the absence of obstructive coronary artery disease. (PubMed)

Accuracy of non-invasive stress testing in women and men with angina in the absence of obstructive coronary artery disease. While >20% of patients presenting to the cardiac catheterization laboratory with angina have no obstructive coronary artery disease (CAD), a majority (77%) have an occult coronary abnormality (endothelial dysfunction, microvascular dysfunction (MVD), and/or a myocardial bridge (MB)). There are little data regarding the ability of noninvasive stress testing to identify (...) . An abnormal HRR was associated with endothelial dysfunction and MVD, but not an MB.Conventional stress testing is insufficient for identifying occult coronary abnormalities that are frequently present in patients with angina in the absence of obstructive CAD. A normal stress test does not rule out a non-obstructive coronary etiology of angina, nor does it negate the need for comprehensive invasive testing.Copyright © 2018 Elsevier B.V. All rights reserved.

2018 International journal of cardiology

15. Sex and stress: Men and women show different cortisol responses to psychological stress induced by the Trier Social Stress Test and the Iowa Singing Social Stress Test (PubMed)

Sex and stress: Men and women show different cortisol responses to psychological stress induced by the Trier Social Stress Test and the Iowa Singing Social Stress Test Acute psychological stress affects each of us in our daily lives and is increasingly a topic of discussion for its role in mental illness, aging, cognition, and overall health. A better understanding of how such stress affects the body and mind could contribute to the development of more effective clinical interventions (...) and prevention practices. Over the past 3 decades, the Trier Social Stress Test (TSST) has been widely used to induce acute stress in a laboratory setting based on the principles of social evaluative threat, namely, a judged speech-making task. A comparable alternative task may expand options for examining acute stress in a controlled laboratory setting. This study uses a within-subjects design to examine healthy adult participants' (n = 20 men, n = 20 women) subjective stress and salivary cortisol responses

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2017 Journal of Neuroscience Research

16. PD-L1 testing for access to pembrolizumab in treatment naïve patients with locally advanced or metastatic non-small cell lung cancer

PD-L1 testing for access to pembrolizumab in treatment naïve patients with locally advanced or metastatic non-small cell lung cancer 1 Public Summary Document Application No. 1440.1- PD-L1 testing for access to pembrolizumab in treatment naïve patients with locally advanced or metastatic non- small cell lung cancer Applicant: Merck, Sharp & Dohme (Australia) Pty Ltd Date of MSAC consideration: MSAC 71 st Meeting, 23 November 2017 Context for decision: MSAC makes its advice in accordance (...) with its Terms of Reference, visit the MSAC website 1. Purpose of application The integrated codependent resubmission requested: ? Medicare Benefits Schedule (MBS) listing of immunohistochemistry (IHC) testing for the evaluation of programmed cell death ligand 1 (PD-L1) expression in patients diagnosed with metastatic non-small cell lung cancer (NSCLC); and ? Section 100 (Efficient Funding of Chemotherapy [EFC]) Authority Required Pharmaceutical Benefits Scheme (PBS) listing for first-line treatment

2017 Medical Services Advisory Committee

17. Urgent, Non-Screening Fecal Occult Blood Testing for Patients with Suspected Gastrointestinal Bleeding: A Review of Clinical Effectiveness and Guidelines

Urgent, Non-Screening Fecal Occult Blood Testing for Patients with Suspected Gastrointestinal Bleeding: A Review of Clinical Effectiveness and Guidelines Urgent, Non-Screening Fecal Occult Blood Testing for Patients with Suspected Gastrointestinal Bleeding: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Urgent, Non-Screening Fecal Occult Blood Testing for Patients with Suspected Gastrointestinal Bleeding: A Review of Clinical Effectiveness (...) and Guidelines Urgent, Non-Screening Fecal Occult Blood Testing for Patients with Suspected Gastrointestinal Bleeding: A Review of Clinical Effectiveness and Guidelines Published on: January 3, 2017 Project Number: RC0839-000 Product Line: Research Type: Other Diagnostics Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of urgent non-screening fecal occult blood testing for patients with suspected gastrointestinal bleeding? What are the evidence

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

18. PD-L1 testing for access to pembrolizumab in treatment naïve patients with locally advanced or metastatic non-small cell lung cancer

PD-L1 testing for access to pembrolizumab in treatment naïve patients with locally advanced or metastatic non-small cell lung cancer 1 Public Summary Document Application No. 1440 – PDL1 testing for access to pembrolizumab in treatment naïve patients with locally advanced or metastatic non- small cell lung cancer (NSCLC) Applicant: Merck, Sharpe & Dohme Date of MSAC consideration: MSAC 69 th Meeting, 6-7 April 2017 Context for decision: MSAC makes its advice in accordance with its Terms (...) of Reference, visit the MSAC website 1. Purpose of application The co-dependent application requested: ? Medicare Benefits Schedule (MBS) listing of immunohistochemistry (IHC) testing for the evaluation of programmed cell death ligand 1 (PD-L1) expression in treatment- naïve patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) and who do not have an activating epidermal growth factor receptor (EGFR) gene mutation or an anaplastic lymphoma kinase (ALK) gene rearrangement in tumour

2017 Medical Services Advisory Committee

19. Diagnostic testing for ROS proto-oncogene 1 (ROS1) rearrangements in non-small cell lung cancer (NSCLC) to determine eligibility for crizotinib treatment

Diagnostic testing for ROS proto-oncogene 1 (ROS1) rearrangements in non-small cell lung cancer (NSCLC) to determine eligibility for crizotinib treatment 1 Public Summary Document Application No. 1454- Diagnostic testing for ROS proto-oncogene1 (ROS1) rearrangements in patients with non-small cell lung cancer (NSCLC) to determine eligibility for crizotinib treatment Applicant: Pfizer Australia Pty Ltd Date of MSAC consideration: MSAC 71 st Meeting, 23 November 2017 Context for decision: MSAC (...) makes its advice in accordance with its Terms of Reference, visit the MSAC website 1. Purpose of application The integrated codependent application requested: ? a new Medicare Benefits Schedule (MBS) item number for ROS proto-oncogene 1 (ROS1) fluorescent in situ hybridisation (FISH) testing as a codependent medical service that is performed to inform eligibility for crizotinib treatment in patients with locally advanced (Stage IIIB) or metastatic (Stage IV), non-squamous or histology not otherwise

2017 Medical Services Advisory Committee

20. Screening of fetal aneuploidies whereby non-invasive prenatal test (NIPT)

Screening of fetal aneuploidies whereby non-invasive prenatal test (NIPT) Dec2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged 1 EUnetHTA Joint Action 3 WP4 Version 1.5, 23 rd February 2018 Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment SCREENING OF FETAL TRISOMIES 21, 18 AND 13 BY NONINVASIVE PRENATAL TESTING Project ID: OTCA03 Screening of fetal trisomies 21, 18 and 13 by noninvasive (...) prenatal testing Version 1.5, 23rd February 2018 EUnetHTA Joint Action 3 WP4 2 DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 31/07/2017 First draft V1.1 18/09/2017 Input from the co-author has been processed V1.2 31/10/2017 Input from dedicated reviewers has been processed V1.3 22/12/2017 Input from external experts and manufacturers has been processed V1.4 8/02/2018 Input from medical editor has been processed V1.5 23/02/2018 Minor change: the citation of Bayón Yusta et al. 2016 has

2018 EUnetHTA

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