News in brief: Rapid DVT test may avoid need for anticoagulants; VITT deaths a one in a million risk for AZ vaccine; Telehealth MBS items now available for hospital inpatients

Thursday, 23 Sep 2021

Rapid DVT test may avoid need for anticoagulants

DVT may be diagnosed rapidly with a point of care test using an artificial intelligence (AI) algorithm instead of a radiologist to interpret ultrasound scans, according to UK researchers.

A team at Oxford University Haemophilia and Thrombosis Centre developed a deep learning algorithm on ultrasound videos from 255 volunteers and evaluate on a sample size of 53 prospectively enrolled patients from a DVT diagnostic clinics. They found that algorithmic DVT diagnosis had a sensitivity within a 95% CI range of (0.82 – 0.94), specificity of (0.70 – 0.82), a positive predictive value of (0.65 – 0.89), and a negative predictive value of (0.99 – 1.00) when compared to the clinical gold standard.

The research team hope that the combination of the AutoDVT tool, with the inclusion of the AI algorithm, will allow non-specialist healthcare professionals, like GPs and nurses, to quickly diagnose and treat DVT.

“Currently, many patients do not have a definitive diagnosis within 24 hours of a suspected DVT, and so many patients end up receiving painful injections of what can often be an unnecessary anticoagulant, with potential side-effects,’ said study lead investigator Dr Nicola Curry of the Oxford Centre for Haematology.

The results from the study are published in the journal Digital Medicine.

VITT deaths a one in a million risk for AZ vaccine

There have now been 141 cases and eight deaths from thrombocytopenia syndrome (TTS, also known as VITT) related to Vaxzevria (AstraZeneca)  vaccine from approximately 11.3 million vaccine doses, the TGA reports.

Analysis of the adverse events showed that fewer than half of the cases were classified as Tier 1 clots in an unusual location, such as the brain or abdomen that are more likely to have serious outcomes, and younger women seem to be slightly more likely to develop clots in unusual locations.

So far, 42 of the 141 people with TTS had been treated in ICU and eight died, of whom six were women, representing a one in a million risk of dying from TTS after vaccination.

The TGA said it had received a seven reports of TTS in the past week, of which two were in people aged under 60 years.

“We continue to closely monitor cases of TTS as Vaxzevria (AstraZeneca) is now being used more frequently in people aged under 60 years. To date, we have not observed a significant change in the rate of TTS in people aged 50-59 years,” it said.

“Australian data indicates that patients aged under 50 years of age are more likely to be classified as Tier 1 and/or require treatment in intensive care. However, more than one third of these younger patients have not required treatment in intensive care,” it added.

Telehealth MBS items now available for hospital inpatients

New MBS telehealth items have been introduced to cover in-hospital services for private admitted patients receiving specialist care where the doctor is unable to attend due to the COVID-19 pandemic.

Available from 15 September 2021, the 40 temporary items (valid until 31 December) for specialists cover video and phone consultations for a specialist who is located in COVID-19 hotspot, or in isolation or quarantine.

According to Medicare, private health insurance rebates and gapcover schemes do not apply for these telehealth attendances.

Out of pocket costs for the new items will count towards the patient’s Medicare Safety Nets (original and extended).

In its Factsheets, Medicare says MBS specialist telehealth items do not need to be bulk billed, although this is encouraged

“The fee structure for the new items aligns with equivalent face-to-face items and existing COVID-19 telehealth specialist items introduced from March 2020,” it says.

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