High acceptability and viral suppression of patients on Dolutegravir-based first-line regimens in pilot sites in Uganda: A mixed-methods prospective cohort study.

Uganda adopted the integrase inhibitor dolutegravir (DTG) as part its preferred first-line HIV treatment regimen in 2018. Prior to the national rollout, the Uganda Ministry of Health and Clinton Health Access Initiative (CHAI) launched a pilot study in July 2017 aimed at better understanding patients' and prescribers' experience and acceptability of DTG. Patients were enrolled in the study if they were newly initiating treatment or switched from an NNRTI regimen due to intolerance. Patients were followed up for 6 months after initiation onto DTG and acceptability and experiences were assessed through questionnaires at one-month and six-month follow-up visits. In addition to acceptability side effects of patients on DTG regimens were assessed. Analysis was conducted using MS Excel and SAS 9.4 and confidence intervals were adjusted for facility level clustering. A total of 365 patients from 6 study sites were enrolled in the study, of whom 50% were treatment-experienced and 50% treatment naïve. 325 patients completed the 6 months of follow-up. Survey results showed a high level of acceptability (more than 90%) of DTG-containing regimens for both categories of patients during the from one-month and six-months interviews. The rate of self-reported side effects amongst patients was 33% overall and higher for experienced (37%) than naïve (29%) patients at 6 months. Although frequencies declined between month-1 and month-6, the changes were not statistically significant. Almost all patients (94%) were virally suppressed at 6 months. Overall, the study findings showed a very high level of acceptability of Dolutegravir-based regimens across both experienced and naïve patients. The overall viral suppression rate in this cohort was 94% at six months of taking DTG-based regimen.

A method for selecting an efficient diagnostic protocol for classification of perceptive and cognitive impairments in neurological patients.

An important and unresolved problem in the assessment of perceptual and cognitive deficits in neurological patients is how to choose from the many existing behavioral tests, a subset that is sufficient for an appropriate diagnosis. This problem has to be dealt with in clinical trials, as well as in rehabilitation settings and often even at bedside in acute care hospitals. The need for efficient, cost effective and accurate diagnostic-evaluations, in the context of clinician time constraints and concerns for patients' fatigue in long testing sessions, make it imperative to select a set of tests that will provide the best classification of the patient's deficits. However, the small sample size of the patient population complicates the selection methodology and the potential accuracy of the classifier. We propose a method that allows for ordering tests based on having progressive increases in classification using cross-validation to assess the classification power of the chosen test set. This method applies forward linear regression to find an ordering of the tests with leave-one-out cross-validation to quantify, without biasing to the training set, the classification power of the chosen tests.