Perceptions Among Canadian Physicians and Patients Regarding the Risk of Human T-Lymphotropic Virus in Solid Organ Transplantation
Notice bibliographique
Résumé
Human T-Lymphotropic Virus (HTLV) has a low prevalence in the general Canadian population, and rarely causes disease. Solid organ donors are screened for HTLV, however the incidence of transplant-related HTLV disease is low. We assessed knowledge, attitudes, and risk acceptance of HTLV in solid organ transplantation (SOT) among Canadian physicians and local ambulatory care patients. After piloting and ethics approval, physicians in Canadian academic institutions completed a web-based survey. Randomly-chosen local patients attending select clinics completed a questionnaire in person or by telephone. Surveys assessed knowledge of HTLV and assessed theoretical risk of HTLV in SOTs, using standard-gamble and time-tradeoff methods. Patient surveys featured hypothetical scenarios where the particpant estmiated their willingness to accept an organ with potential risk for viral infections, including HTLV. In total, 68 clinicians responded to the survey (response rate of approximately 14.8%). Approximately 26.1% of participants would recommend SOT regardless of community HTLV prevalence. In a community where the prevalence was similar to that of the general Canadian population, SOT recommendation rose to 45.8%. A minority of participating physicians would recommended elimination of HTLV screening in SOT. A total of 75 patients, with a median age of 61.5 years, particpated in the survey. Approxmiately 26% of those surveyed would accept an organ regardless of HTLV risk, however risk acceptance fell to approximately 15% when HTLV was described in terms of rare neurological outcomes. A similar trend was seen in time-tradeoff scenario, whereby participants were willing to trade a median of 4 years (of a 20 year survival after SOT) to ensure an HTLV-free organ, which increased to a median of 10 years, when neurological sequelae were emphasized. This is the first known study to address the opinions of Canadian physicians and patients regarding HTLV risk in SOT. Both groups were willing to accept some risk related to HTLV in SOT, however physicians would not abandon HTLV screening completely. This was consistent with concerns implied bythe patient group, especially regarding the potential for neurological disease. T. Hatchette, GSK: Grant Investigator, Grant recipient. Pfizer: Grant Investigator, Grant recipient. Abbvie: Speaker for a talk on biologics and risk of TB reactivation, Speaker honorarium
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».