A BBI

A £4 billion program that involves the development of 15 new hospitals in the UK was given the go-ahead by Health Secretary John Reid in late July. The new hospital developments will be funded largely through the Private Finance Initiative (PFI) and include plans for new mental health facilities for Leicestershire, Merseyside, and Teesside; a new cardiac research institute and upgraded cardiac wing for Great Ormond Street Hospital; and new buildings for what Reid termed Papworth Hospital's "world-class cardiothoracic services."

Local health organizations now will be responsible for advancing the programs to the next stages of development.

Reid said the 15 projects will bring investment in new National Health Service (NHS) hospitals to more than £16 billion since 1997. He said the NHS is "well on course to meet the NHS Plan target of 100 new hospital schemes open to patients by 2010," with more than 40 already built and operational. "The NHS is in the middle of the biggest hospital building program in its history," Reid said. "After years of under-investment, the infrastructure of the NHS is at last being modernized and made fit for the 21st century."

The new hospital developments include just over £1 billion for the North Mersey Future Healthcare Project, which involves the redevelopment of facilities at the Royal Liverpool Children's Hospital incorporating the concept of a Children's Health Park, the redevelopment of the Royal Liverpool University Hospital, and an elective care center and additional ward facilities at University Hospital Aintree; £880 million in spending in Bedfordshire and Hertfordshire, with plans for redevelopment and expansion at Watford and a new hospital at Hatfield; and £591 million for Sandwell and West Birmingham Acute Trust, including new acute sector facilities and development of community based alternatives to hospital care.

"[These] plans represent the type of bright, modern, clean environments that all NHS patients should experience during their treatment," said Reid. "I look forward to seeing further progress on these ... and all of the other hospital building projects that are under way, and particularly to seeing the benefits they will bring to their local communities."

France, Spain top healthcare ratings

In a recent survey by HI Europe (London), a subsidiary of Harris Interactive (Rochester, New York), respondents in the five largest European countries – Britain, France, Germany, Italy and Spain – were asked whether they felt positively about their nations' healthcare systems.

In only one country, France, did the percentage of those who expressed positive feelings about the healthcare system top 50%. Just about two-thirds (65%) of the 2,018 persons aged 16 and older who responded to the online HI Europe survey in that country said they feel positive about France's healthcare system. The next-highest percentage of "positive" responses came from Spain, with 42% of the 1,382 Spaniards who participated in the survey responding thusly. They were followed by Britain, 32% (2,339 respondents); Germany, 28% (2,078 respondents); and Italy, 21% (2,120 respondents).

When people in those five countries were asked to say which of the other countries' – along with the U.S., Canada, China, Japan and Russia – healthcare systems they felt positively about, few lauded the systems of any other countries. In each of the five European countries, more people felt positively about their own systems than about all the other countries' systems. Overall, France topped the list with 28% of Europeans, on average, rating their system positively, but HI Europe said that partly reflects the very high level of satisfaction in France itself. Germany (22%) was the only other country to score moderately among people living in the five countries, followed by Britain (15%), Canada (14%) and Spain (12%).

CE mark for Medicsight reader

Medicsight (London) said last month that it had received the CE mark for the Medicsight Lung CAR (Computer-Assisted Reader), an image analysis software tool that assists radiologists in evaluating lesions or nodules found during CT (computed tomography) scans of the lung. The company said the Medicsight Lung CAR is the first "joint-read" software available for CT lung scans, and as such represents "an important milestone" in how radiologists identify and track lung nodules.

Differing from "second-read" software, in which software is employed after radiologists complete their initial reviews, joint-read software enables the radiologist to review "unfiltered" images side-by-side and simultaneously with software-enhanced regions of interest. With radiologists reviewing as many as 600 images from a single CT scan, Medicsight said the joint-read capability "saves time and aids in the evaluation of nodules."

Claudia Henschke, MD, principal investigator of the International Early Lung Cancer Action Project, which Medicsight said is the largest international study on CT screening for lung cancer, said that software is of great benefit to radiologists. "Our biggest ongoing concern is that we potentially fail to detect small cancers, as it is easy to miss them when you are scrolling through up to 600 images," she said, adding that the filters in the Medicsight Lung CAR "will help us do our job better."

The company said the Lung CAR, which also has been approved by the FDA, works by deploying a series of filters against the image data derived from CT scans. Those filters aid the radiologist by highlighting areas of the image that contain potential nodules. The software can extract the boundaries of suspect nodules and show them in 3-D with a volume measurement, which the company said "allows the radiologist to accurately review and track any growth in the nodule."

Medicsight Lung CAR has a number of automatic and manual measurement tools to aid diagnosis, the company said in a statement, including the ability to review follow-up scans and doubling times, the length of time it took for the nodule's volume to double in size, as well as additional filters to reduce background "noise" on the image and enhance the boundary of the nodule.

Medicsight is using its core technology to develop automatic detection and analytical tools for clinicians to improve their ability to diagnose and treat disease, with an initial focus on lung cancer, colon cancer and coronary heart disease.

Proteome optimistic following setback

Proteome Sciences (Cobham, UK) last month explained why partner Biosite (San Diego) declined to use the UK firm's biomarkers in its first stroke diagnostic device and gave an optimistic assessment of prospects for commercializing its proteomics markers before existing cash reserves are exhausted in mid-2005. Biosite's decision prompted shares in Proteome to fall from £1.09 to 62.25 pence on July 30. They fell further the following week to close at 58.5 pence.

CEO Christopher Pearce said the market's reaction to the news was overdone. "Should we have announced it? Yes. But it is a storm in a teacup. It may be that our markers will find their way onto [Biosite's] first [stroke diagnostic] panel. They will certainly be on subsequent ones." Pearce added that Proteome has budgeted for a nominal financial contribution from its deal with Biosite. "They are a development partner. They have invested millions of dollars in making antibodies to our markers."

Biosite has been evaluating Proteome's stroke markers for about 18 months, and short-listed a number of them for its first point-of-care panel. Proteome says those markers are highly sensitive and specific for stroke and ischemic attack at very early time points in the disease process. However, as a point-of-care test, Biosite's diagnostic uses whole blood, and it transpired that Proteome's markers were affected by hemolysis, in which blood cells burst open during sample collection and handling. The issue of hemolysis is well understood in the diagnostics industry, and in central laboratory high-throughput diagnosis (90% of the market), serum or plasma is used instead of whole blood to avoid the problem.

"In no shape or form does Biosite's decision affect the value of our stroke markers because if we don't get them into point of care, we will get them into high-throughput diagnostics, which we have always viewed as being the important area for us," Pearce said. Biosite is continuing to evaluate other Proteome biomarkers that are not affected by hemolysis.

Forensic Service expands TrueAllele use

Cybergenetics (Pittsburgh, Pennsylvania) said the Forensic Science Service (FSS), an executive agency of the British Home Office, has expanded its license for Cybergenetics' TrueAllele technology to crime scene evidence. The company said that three years ago, the FSS became the first group to validate and operate the TrueAllele software for automated forensic DNA data review. The FSS uses the TrueAllele process for the UK National DNA Database, which stores more than 2-1/2 million profiles and is the largest of its kind in the world.

Cybergenetics said its technology uses computational methods that fully automate routine DNA analysis, replacing what it called "the slow and costly manual scoring that represents a substantial portion of the cost of analyzing DNA data."

In conjunction with the TrueAllele technology, 95% of UK DNA Database profiles are analyzed and entered within five days and a similar percentage of of crime scene DNA evidence samples are processed within 10 days.

Pathology Modernization Group named

UK Health Minister John Hutton last month appointed 16 persons to the new National Pathology Modernization Group, which will have a key role in the Department of Health's effort to improve and expand national pathology services. Dr. Ian Barnes, national pathology adviser in the Department of Health, was named to chair the group, which includes 13 other members who are either administrators or medical personnel with various NHS trusts, along with one representative each from the Royal College of Pathologists and the Modernization Agency.

The National Pathology Modernization Group is charged with advising the Department of Health on using funding resources for success, supporting sharing of good practice in pathology across the NHS, networking with the Modernization Agency and other key stakeholders to support redesign in pathology services, and working with the diagnostics industry to support the uptake of new technology, new ways of working and effective point-of-care testing services.

Hutton said the group will "[work] together to help the NHS implement change in pathology services ... supporting the NHS in delivering the 21st century pathology services that patients want and need."

New colorectal cancer test

Scientists from Giessen Medical University (Giessen, Germany) have described a progressive new test that detects cancer cells in the stool through the enzyme Tumor M2-PK in the British Journal of Cancer. The ScheBo-Tumor M2-PK Stool Test is available from ScheBo-Biotech AG (also Giessen). A research group headed by Professor Hans-Ulrich Kloer and Dr. Philip Hardt said the results of their study investigating stool samples for changes in Tumor M2-PK represented "a new, precise and non-invasive method for colorectal cancer screening."

Kloer, Hardt and their co-authors from the University Clinic of Giessen investigated the marker Tumor M2-PK in studying a patient group with colorectal cancer and a healthy control group of 204 subjects altogether, all of whom underwent colonoscopy. They said the sensitivity (accuracy) of the new test in detecting a tumor lay between 60% and 90%, depending on the tumor stage. Current tests such as blood-in-the-stool tests have a sensitivity of around 25%.

By measuring Tumor M2-PK, the ScheBo test detects a tumor-specific enzyme. The researchers said the results for the new test represent a breakthrough in the early detection of colorectal cancer. Kloer, chief investigator of the study, said: "Unlike blood-in-the-stool tests, this test also discovers tumors that don't bleed." He said the Tumor M2-PK marker "has very good prerequisites for population screening, with its simple analysis as well as its practicability and test characteristics." Kloer added, "This stool test, used in combination with colonoscopy to clarify the positive findings, represents a promising tool to improve the early detection of colorectal cancers."

Esophageal cancer test developed

A new and simple test for esophageal cancer could be in general use within five years, allowing much earlier treatment and improving the outlook for patients. An initial evaluation has shown that it may allow accurate detection of this cancer long before any symptoms become apparent. The test, which is easily automated, relies on finding a protein that is present only in cells with the potential to divide. It has been developed by the charity Cancer Research UK, which holds the patent on it. The commercial arm of the organization, Cancer Research Technology, is looking for commercial partners to help it develop the test further.

Kai Stoeber, lecturer in the Wolfson Institute for Biomedical Research at University College London, said: "Our results show that we can detect esophageal cancer with the same accuracy in fluid from the food pipe as we have already reported for bladder and prostate cancer using urine samples. This test is turning out to be applicable to a whole range of cancers in epithelial-lined organ systems. The implications for people with esophageal cancer are particularly important because until now there has been no test to diagnose this disease at an early stage before symptoms develop."

Five-year survival following esophageal cancer in the UK is currently around 8%. One reason for this is that symptoms, which include difficulty in swallowing, pain while swallowing, weight loss, acid indigestion, regurgitation or vomiting, and hoarseness or chronic cough, often do not appear until the disease is at an advanced stage. In addition, many of these symptoms can be caused by other conditions and it is difficult for the physician to know which patients need further investigation. Patients who are referred to a specialist undergo endoscopy to allow a visual examination of the esophagus and perhaps a biopsy. This procedure is expensive, can be unpleasant and requires sedation.

The new, less-invasive test raises the prospect of being able to diagnose esophageal cancer at a stage when it may be cured. Early diagnosis, coupled with subsequent treatment by surgery and chemotherapy, can improve five-year survival rates to more than 80%. The test detects levels of a protein, called MCM5, which is found only in cells that have the potential to divide. Such cells are not normally exposed on the surface epithelium of an organ -- unless a tumor is present.

New president for Baxter Europe

Jim Utts, whose promotion to president of Baxter Europe (Wallisellen, Switzerland) was reported by Baxter International (Deerfield, Illinois) in August, brings a widely varied background and previous experience in Europe to the position. He previously was general manager of global oncology within Baxter's Medication Delivery business, and served as president of that business in Europe from 1996-2000. He subsequently was general manager of the company's global Nutrition and global Oncology units and also ran the North American operations for the Renal business.

Utts began his career at American Hospital Supply (which later merged with Baxter) in 1975, and progressed through roles in sales, marketing, planning and development, and corporate management. Baxter Europe employs about 14,000 persons across 92 offices and facilities, including 19 manufacturing facilities, two distribution centers, two research and development centers and various combined office/ warehouse facilities. It has businesses in 17 European countries and 18 countries in the Europe Middle East and Asia (EMEA) region.

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