Project description:Thyroglobulin (Tg) protein is synthesised uniquely by thyroid tissue and is measured as a post-operative differentiated thyroid cancer (DTC) tumour-marker. Tg autoantibodies (TgAb), present in ?20 percent of DTC patients, interfere with Tg immunometric assay (IMA) measurements causing falsely low/undetectable serum Tg values. Tg radioimmunoassay (RIA) methodology appears resistant to such interferences but has limited availability, whereas new Tg mass-spectrometry methods have inferior sensitivity and unproven clinical value. When present, TgAb concentrations respond to changes in thyroid tissue mass. Thus, when Tg IMA measurements are compromised by the presence of TgAb the TgAb trend can serve as a surrogate DTC tumour-marker. Unfortunately, both physiologic and technical factors impact the interpretation of Tg and TgAb used as DTC tumour-markers. Serum Tg Testing Circulating Tg concentrations change in response to thyroid tissue mass, injury (surgery, biopsy or radioiodine) and the degree of TSH stimulation. Technical factors (Tg assay sensitivity, specificity and interferences) additionally impact the clinical utility of Tg testing. Specifically, new 2nd generation Tg IMAs (functional sensitivities ? 0.1 ?g/L) now mostly obviate the need for expensive recombinant human TSH(rhTSH)-stimulated Tg testing. Tg molecular heterogeneity remains responsible for two-fold between-method differences in Tg values that preclude switching methods and TgAb interference remains especially problematic. Serum TgAb Testing Reliable TgAb testing is critical for authenticating that Tg IMA measurements are not compromised by interference. Unfortunately, TgAb methodologies vary widely in sensitivity, specificity and the absolute values they report, necessitating that TgAb concentrations be monitored using the same method. Furthermore, adopting the manufacturer’s TgAb cut-off value to define a ‘detectable’ TgAb results in falsely classifying sera as TgAb-negative, because manufacturers’ cut-offs are set to diagnose thyroid autoimmunity and not to detect TgAb interference.

Project description:In 2019, Norwegian implementation researchers formed a network to promote implementation research and practice in the Norwegian context. On November 19th, 2021, the second annual Norwegian implementation conference was held in Oslo. Ninety participants from all regions of the country gathered to showcase the frontiers of Norwegian implementation research. The conference also hosted a panel discussion about critical next steps for implementation science in Norway. The conference included 17 presentations from diverse disciplines within health and welfare services, including schools. The themes presented included stakeholder engagement, implementation mechanisms, evaluations of the implementation of specific interventions, the use of implementation guidelines and frameworks, the development and validation of implementation measurements, and barriers and facilitators for implementation. The panel discussion highlighted several critical challenges with the implementation of evidence-informed practices in Norway, including limited implementation competence and capacity among practice leaders and workforces, few opportunities for education in implementation science, limited implementation research in the Norwegian context, scarce funding possibilities for implementation research, and a lack of long-term perspectives on implementation processes. Overall, the 2021 Norwegian implementation conference showed an encouraging sign of a maturing field of science in Norway. The more voluminous proceedings from the 2020 conference called for several important advancements to improve implementation science and practice in Norway, and the 2021 conference indicates that steps have already been taken in favorable directions in terms of, for instance, research designs and measurements. However, there are still unexploited potentials for improvements in implementation research, funding, policies, and practice. Norwegian implementation researcher should be mindful of the challenges and potential pitfalls implementation science currently face as a scientific discipline.Supplementary informationThe online version contains supplementary material available at 10.1007/s43477-022-00069-w.

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Proceedings of the 18th Annual Conference of INEBRIA.

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