Aim: Prompt evaluation is critical for patients with suspected acute ST-elevation MI (STEMI), although not all cases result in a confirmed diagnosis. This study aimed to develop a diagnostic score to predict false-positive STEMI activations. Methods: This is a cross-sectional observational study that includes patients consulted for acute STEMI via a mobile app. Multivariable logistic regression analysis identified independent predictors of false STEMI activation, which were used to create a diagnostic scoring system. Results: Among 301 patients, the incidence of false STEMI activation was 38.21%, with left ventricular hypertrophy being the most commonly misinterpreted presentation. Predictors of false activation included absence of typical chest pain (OR 260.73; 95% CI [37.36–1,819.48]), absence of reciprocal changes (OR 180.87; 95% CI [18.67–1,752.35]), and localised ST elevation within leads V1–V3 (OR 101.43; 95% CI [13.46–764.16]). A simple diagnostic score, called the false STEMI score, was developed by assigning 1 point for each predictor. Scores of 2 or more indicated a high likelihood of false STEMI activation. The score demonstrated excellent diagnostic performance, with an area under the receiver operating characteristic curve of 0.983, sensitivity of 96.5%, and specificity of 95.7%. Conclusion: A simple diagnostic score was developed to predict false STEMI activation effectively. Larger-scale validation studies are needed to confirm its reliability and evaluate its potential for reducing unnecessary STEMI activations in clinical practice.
BACKGROUND:Transitioning from pediatric to adult HIV care is critical for adolescents and young adults living with HIV (AYLH). This study assessed the timing and factors associated with this transition in Asia. SETTING:Retrospective study of AYLH enrolled in Therapeutics Research, Education, and AIDS Training Asia Pediatric HIV Observational Database clinics between May 1991 and December 2020. METHODS:Eligible AYLH were categorized into <18-year-old transitions, and ≥18-year-old transitions or continued pediatric care. RESULTS:The analysis included 1803 AYLH from 6 countries. Of these, 92.7% (n = 1672) had perinatally acquired HIV, and 69.9% (n = 1260) were ≥18-year-old transitions or continued pediatric care. Excluding AYLH who remained in pediatric care, median age at transition was 16.1 years (interquartile range [IQR]: 14.9-17.0) for <18-year-old transitions and 20.0 years (IQR: 19.1-21.2) for ≥18-year-old transitions. At age 18, among 1368 AYLH with available viral load data, 72.9% (n = 998) had viral loads <50 copies/mL (78.9% in <18-year-old transitions [n = 310/393] vs 70.6% in ≥18-year-old transitions [n = 688/975]; P = 0.002). The median CD4 count was 635 cells/μL (IQR: 450-842). Factors independently associated with transitions at ≥18-year-old or continued pediatric care included residence in an upper-middle-income country (adjusted odds ratio [aOR] 10.68 [95% confidence interval (CI): 7.76 to 14.68], P < 0.001), living with family (aOR 2.81 [95% CI: 1.99 to 3.97], P < 0.001), and previous antiretroviral therapy class switching (aOR 1.91 [95% CI: 1.34 to 2.72], P < 0.001). CONCLUSION:Most AYLH in this cohort transitioned at ≥18 years of age. About one-fourth had unsuppressed viral loads at age 18, irrespective of transition status, underscoring the need for personalized treatment approaches that support antiretroviral therapy adherence from pediatric care, preparing AYLH for transition to adult clinics.
BackgroundParkinson's disease (PD) remains underdiagnosed in Thailand, and its rising prevalence presents a growing challenge for the healthcare system. The previously validated CheckPD digital population screening platform has been implemented nationally in collaboration with the Thai Red Cross Society (TRCS) and the National Health Security Office (NHSO), enabling integration of digital PD risk screening into preventive health frameworks.ObjectiveTo evaluate the early phase of a national rollout of the CheckPD platform, focusing on population reach, adoption, predictive performance, exploratory usability, and implementation factors influencing scalability across diverse real-world settings.MethodsThis RE-AIM-guided implementation study in 10 Thai provinces assessed reach, adoption, completion, system performance and positive predictive value among neurologist-evaluated screen-positive participants. Preliminary usability was assessed in 30 post-screening completers using the SUS and UEQ-S. Supplementary implementation feedback was collected from Village Health Volunteers and public health officers.ResultsBetween January 2024 and October 2025, 13,381 out of 18,520 users completed screening across 10 provinces (completion rate: 72.3%). The mean SUS score was 83, with a 92% first-time task completion rate. Programme reach was achieved through multiple channels, including Village Health Volunteers (6,742 participants), community field campaigns (5,207), facilitated online training initiatives (3,448), and self-initiated app downloads (3,123). When compared with neurologists' diagnoses among 730 screen-positive participants who underwent evaluation, the screening demonstrated a positive predictive value of 81.23% (593/730; 95% CI 78.39%-84.07%). Key facilitators of implementation included TRCS endorsement and network support, community volunteer engagement, and user-centred app design. Exploratory multivariable logistic regression analysis identified educational attainment and geographic context as significant predictors of screening completion, with higher educational attainment and residence outside Bangkok associated with a higher likelihood of completing the screening workflow.ConclusionsThe CheckPD programme demonstrates that national-scale digital screening for neurological disorders is feasible in a low-to-middle-income country when embedded within trusted institutions, supported by community networks, and aligned with data protection standards. Thailand's experience provides an early, promising, and potentially scalable model for implementing population-level improvements in brain health by enabling earlier detection and assessment of individuals at risk, in alignment with the World Health Organization's Brain Health framework.
Cancer remains a major global health challenge and is a leading cause of morbidity and mortality in Thailand. Industry-sponsored oncology trials (ISOTs) provide critical access to innovative therapies, including targeted agents, immunotherapies (IO), and antibody–drug conjugates (ADCs), particularly in resource-limited settings. We conducted a retrospective multicenter study to characterize temporal trends, geographic distribution, and clinical trial characteristics of ISOTs across institutions participating in the Thai Society of Clinical Oncology (TSCO) network between January 2012 and September 2024. Data on trial characteristics, geographic distribution, and patient enrollment were collected from institutions affiliated with the TSCO using a standardized data collection instrument. A total of 651 ISOTs were identified. Analyses were performed using available data for each variable, with complete-case analyses (n = 581) applied where complete trial-level information was required. Most trials were conducted in Bangkok (67
