ABSTRACT
BACKGROUND: Implementing technological solutions to screen for and detect early the most prevalent communicable diseases on cruise ships is contingent on, among others, willingness of passengers to accept use of such solutions. METHOD: We surveyed passenger preferences to record their willingness to accept technological solutions for screening and early detection of communicable diseases on cruise ships. Self-reported sociodemographic characteristics, use of technology and acceptance of solutions were recorded anonymously in paper format. Multiple logistic regression analyses investigated the association of demographic and other characteristics with willingness and barriers/concerns of passengers to endorse proposed solutions. RESULTS: Of a total of 1344 passengers on two successive cruises on board CELESTYAL OLYMPIA, 336 (1 every 4) participated in the survey. The vast majority of passengers (92.3 %, n = 310) agreed with at least one solution. Passengers showed lower levels of acceptance for more personalized solutions, such as use of wearable devices (45.5 %) and monitoring with cameras (64.0 %), whereas they were more receptive to less personally invasive solutions, such as integration of cabins with air purifiers (89.6 %) and air quality sensors (80.4 %). Age, self-employment status, educational level, and fear of contacting a communicable disease were significantly correlated with passengers' willingness to adopt proposed solutions. CONCLUSIONS: To successfully integrate screening and early detection technological solutions in cruise ships, it is imperative that targeted awareness and education interventions are implemented on passengers to strengthen understanding and acceptance of such solutions and assuage concerns around monitoring and handling of personal health data.
ABSTRACT
(1) Background: Lung cancer causes a substantial epidemiological burden in Greece. Yet, no formal national lung cancer screening program has been introduced to date. This study modeled the impact on lung cancer life years (LCLY) of a hypothetical scenario of comprehensive screening for lung cancer with low-dose computed tomography (LDCT) of the high-risk population in Greece, as defined by the US Preventive Services Taskforce, would be screened and linked to care (SLTC) for lung cancer versus the current scenario of background (opportunistic) screening only; (2) Methods: A stochastic model was built to monitor a hypothetical cohort of 100,000 high-risk men and women as they transitioned between health states (without cancer, with cancer, alive, dead) over 5 years. Transition probabilities were based on clinical expert opinion. Cancer cases, cancer-related deaths, and LCLYs lost were modeled in current and hypothetical scenarios. The difference in outcomes between the two scenarios was calculated. 150 iterations of simulation scenarios were conducted for 100,000 persons; (3) Results: Increasing SLTC to a hypothetical 100% of eligible high-risk people in Greece leads to a statistically significant reduction in deaths and in total years lost due to lung cancer, when compared with the current SLTC paradigm. Over 5 years, the model predicted a difference of 339 deaths and 944 lost years between the hypothetical and current scenario. More specifically, the hypothetical scenario led to fewer deaths (−24.56%, p < 0.001) and fewer life years lost (−31.01%, p < 0.001). It also led to a shift to lower-stage cancers at the time of diagnosis; (4) Conclusions: Our study suggests that applying a 100% screening strategy amongst high-risk adults aged 50−80, would result in additional averted deaths and LCLYs gained over 5 years in Greece.
ABSTRACT
BACKGROUND: Screening and linkage to care (SLTC) for osteoporosis is suboptimal in several settings. In Greece, it is estimated that only up to 8.6% of postmenopausal women are SLTC for osteoporosis, despite having suffered a previous fracture. AIMS: This study aims to estimate the impact of comprehensive screening on future fracture burden amongst post-menopausal women aged 50-74, with one prior osteoporotic fracture, in Greece. METHODS: We developed a cohort stochastic model, based on published epidemiological and clinical data, to assess impact of screening on future fracture burden in two scenarios: a current, assuming an 8.6% background SLTC, and a completely hypothetical, assuming 100% SLTC. RESULTS: Amongst a cohort of 50,000 post-menopausal women aged 50-74, with one prior osteoporotic fracture, applying the hypothetical versus the current scenario would result in a reduction in deaths (-0.6%) and fractures (-4.3%) over 10 years. The hypothetical scenario leads to greater reductions in costs associated with vertebral (-8.1%) and hip (-5.5%) fractures, followed by other non-vertebral (-3.0%) and forearm (-2.5%) fractures. In the hypothetical scenario, treatment initiations and total screenings increased almost tenfold versus the current scenario, at an estimated direct incremental cost of 27.83 per woman per year in the cohort. DISCUSSION: Our study adds to the existing evidence on the impact of screening to prevent fractures amongst post-menopausal women. Despite being based on a stochastic model, our study confirms findings most recently published in the literature. CONCLUSIONS: Our study models the positive public health impact of increasing SLTC levels amongst post-menopausal women with a prior osteoporotic fracture.
