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An Intelligent Search & Retrieval System (IRIS) and Clinical and Research Repository for Decision Support Based on Machine Learning and Joint Kernel-based Supervised Hashing. 基于机器学习和基于联合核的监督哈希算法的智能搜索与检索系统(IRIS)以及用于决策支持的临床与研究资料库。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2024-02-04 eCollection Date: 2024-01-01 DOI: 10.1177/11769351231223806
David J Foran, Wenjin Chen, Tahsin Kurc, Rajarshi Gupta, Jakub Roman Kaczmarzyk, Luke Austin Torre-Healy, Erich Bremer, Samuel Ajjarapu, Nhan Do, Gerald Harris, Antoinette Stroup, Eric Durbin, Joel H Saltz

Large-scale, multi-site collaboration is becoming indispensable for a wide range of research and clinical activities in oncology. To facilitate the next generation of advances in cancer biology, precision oncology and the population sciences it will be necessary to develop and implement data management and analytic tools that empower investigators to reliably and objectively detect, characterize and chronicle the phenotypic and genomic changes that occur during the transformation from the benign to cancerous state and throughout the course of disease progression. To facilitate these efforts it is incumbent upon the informatics community to establish the workflows and architectures that automate the aggregation and organization of a growing range and number of clinical data types and modalities ranging from new molecular and laboratory tests to sophisticated diagnostic imaging studies. In an attempt to meet those challenges, leading health care centers across the country are making steep investments to establish enterprise-wide, data warehouses. A significant limitation of many data warehouses, however, is that they are designed to support only alphanumeric information. In contrast to those traditional designs, the system that we have developed supports automated collection and mining of multimodal data including genomics, digital pathology and radiology images. In this paper, our team describes the design, development and implementation of a multi-modal, Clinical & Research Data Warehouse (CRDW) that is tightly integrated with a suite of computational and machine-learning tools to provide actionable insight into the underlying characteristics of the tumor environment that would not be revealed using standard methods and tools. The System features a flexible Extract, Transform and Load (ETL) interface that enables it to adapt to aggregate data originating from different clinical and research sources depending on the specific EHR and other data sources utilized at a given deployment site.

在肿瘤学的广泛研究和临床活动中,大规模、多地点合作正变得不可或缺。为了促进下一代癌症生物学、精准肿瘤学和群体科学的发展,有必要开发和实施数据管理和分析工具,使研究人员能够可靠、客观地检测、描述和记录从良性状态向癌症状态转变过程中以及整个疾病进展过程中发生的表型和基因组变化。为了促进这些工作,信息学界有责任建立工作流程和架构,以自动汇总和组织范围和数量不断扩大的临床数据类型和模式,从新的分子和实验室测试到复杂的诊断成像研究。为了应对这些挑战,全国领先的医疗保健中心正在进行大量投资,以建立全企业范围的数据仓库。然而,许多数据仓库的一个重大局限是,它们在设计上只能支持字母数字信息。与这些传统设计不同,我们开发的系统支持自动收集和挖掘多模态数据,包括基因组学、数字病理学和放射学图像。在本文中,我们的团队介绍了多模态临床与研究数据仓库(CRDW)的设计、开发和实施,该数据仓库与一整套计算和机器学习工具紧密集成,可为肿瘤环境的潜在特征提供可操作的洞察力,而这些特征是标准方法和工具无法揭示的。该系统具有灵活的提取、转换和加载(ETL)接口,可根据特定部署地点使用的特定电子病历和其他数据源,对来自不同临床和研究来源的数据进行聚合。
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引用次数: 0
Designing a Deep Learning-Driven Resource-Efficient Diagnostic System for Metastatic Breast Cancer: Reducing Long Delays of Clinical Diagnosis and Improving Patient Survival in Developing Countries. 为转移性乳腺癌设计一个深度学习驱动的资源高效诊断系统:减少临床诊断的长时间延误,提高发展中国家患者的生存率。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-11-26 eCollection Date: 2023-01-01 DOI: 10.1177/11769351231214446
William Gao, Dayong Wang, Yi Huang

Breast cancer is one of the leading causes of cancer mortality. Breast cancer patients in developing countries, especially sub-Saharan Africa, South Asia, and South America, suffer from the highest mortality rate in the world. One crucial factor contributing to the global disparity in mortality rate is long delay of diagnosis due to a severe shortage of trained pathologists, which consequently has led to a large proportion of late-stage presentation at diagnosis. To tackle this critical healthcare disparity, we have developed a deep learning-based diagnosis system for metastatic breast cancer that can achieve high diagnostic accuracy as well as computational efficiency and mobile readiness suitable for an under-resourced environment. We evaluated 4 Convolutional Neural Network (CNN) architectures: MobileNetV2, VGG16, ResNet50 and ResNet101. The MobileNetV2-based diagnostic model outperformed the more complex VGG16, ResNet50 and ResNet101 models in diagnostic accuracy, model generalization, and model training efficiency. The ROC AUC of MobilenetV2 (0.933, 95% CI: 0.930, 0.936) was higher than VGG16 (0.911, 95% CI: 0.908, 0.915), ResNet50 (0.869, 95% CI: 0.866, 0.873), and ResNet101 (0.873, 95% CI: 0.869, 0.876). The time per inference step for the MobileNetV2 model (15 ms/step) was substantially lower than that of VGG16 (48 ms/step), ResNet50 (37 ms/step), and ResNet110 (56 ms/step). The visual comparisons between the model prediction and ground truth have demonstrated that the MobileNetV2 diagnostic models can identify very small cancerous nodes embedded in a large area of normal cells which is challenging for manual image analysis. Equally Important, the light weight MobleNetV2 models were computationally efficient and ready for mobile devices or devices of low computational power. These advances empower the development of a resource-efficient and high performing AI-based metastatic breast cancer diagnostic system that can adapt to under-resourced healthcare facilities in developing countries.

乳腺癌是导致癌症死亡的主要原因之一。发展中国家,特别是撒哈拉以南非洲、南亚和南美洲的乳腺癌患者死亡率是世界上最高的。造成全球死亡率差异的一个关键因素是,由于训练有素的病理学家严重短缺,导致诊断长期拖延,从而导致很大一部分患者在诊断时出现晚期症状。为了解决这一关键的医疗保健差距,我们开发了一种基于深度学习的转移性乳腺癌诊断系统,该系统可以实现高诊断准确性,以及适用于资源不足环境的计算效率和移动准备。我们评估了4种卷积神经网络(CNN)架构:MobileNetV2、VGG16、ResNet50和ResNet101。基于mobilenetv2的诊断模型在诊断精度、模型泛化和模型训练效率方面优于更复杂的VGG16、ResNet50和ResNet101模型。MobilenetV2的ROC AUC (0.933, 95% CI: 0.930, 0.936)高于VGG16 (0.911, 95% CI: 0.908, 0.915)、ResNet50 (0.869, 95% CI: 0.866, 0.873)和ResNet101 (0.873, 95% CI: 0.869, 0.876)。MobileNetV2模型的每个推理步骤的时间(15 ms/步)大大低于VGG16 (48 ms/步),ResNet50 (37 ms/步)和ResNet110 (56 ms/步)。模型预测和实际情况之间的视觉比较表明,MobileNetV2诊断模型可以识别嵌入在大面积正常细胞中的非常小的癌节点,这对于人工图像分析来说是具有挑战性的。同样重要的是,轻量级的MobleNetV2模型具有计算效率,可用于移动设备或低计算能力的设备。这些进步有助于开发资源高效和高性能的基于人工智能的转移性乳腺癌诊断系统,以适应发展中国家资源不足的医疗机构。
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引用次数: 2
Applying a Gene Reversal Rate Computational Methodology to Identify Drugs for a Rare Cancer: Inflammatory Breast Cancer. 应用基因逆转率计算方法鉴定罕见癌症的药物:炎症性乳腺癌症。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.1177/11769351231202588
Xiaojia Ji, Kevin P Williams, Weifan Zheng

The aim of this study was to utilize a computational methodology based on Gene Reversal Rate (GRR) scoring to repurpose existing drugs for a rare and understudied cancer: inflammatory breast cancer (IBC). This method uses IBC-related gene expression signatures (GES) and drug-induced gene expression profiles from the LINCS database to calculate a GRR score for each candidate drug, and is based on the idea that a compound that can counteract gene expression changes of a disease may have potential therapeutic applications for that disease. Genes related to IBC with associated differential expression data (265 up-regulated and 122 down-regulated) were collated from PubMed-indexed publications. Drug-induced gene expression profiles were downloaded from the LINCS database and candidate drugs to treat IBC were predicted using their GRR scores. Thirty-two (32) drug perturbations that could potentially reverse the pre-compiled list of 297 IBC genes were obtained using the LINCS Canvas Browser (LCB) analysis. Binary combinations of the 32 perturbations were assessed computationally to identify combined perturbations with the highest GRR scores, and resulted in 131 combinations with GRR greater than 80%, that reverse up to 264 of the 297 genes in the IBC-GES. The top 35 combinations involve 20 unique individual drug perturbations, and 19 potential drug candidates. A comprehensive literature search confirmed 17 of the 19 known drugs as having either anti-cancer or anti-inflammatory activities. AZD-7545, BMS-754807, and nimesulide target known IBC relevant genes: PDK, Met, and COX, respectively. AG-14361, butalbital, and clobenpropit are known to be functionally relevant in DNA damage, cell cycle, and apoptosis, respectively. These findings support the use of the GRR approach to identify drug candidates and potential combination therapies that could be used to treat rare diseases such as IBC.

本研究的目的是利用基于基因逆转率(GRR)评分的计算方法,重新利用现有药物治疗罕见且研究不足的癌症:癌症炎性癌(IBC)。该方法使用来自LINCS数据库的IBC相关基因表达特征(GES)和药物诱导的基因表达谱来计算每种候选药物的GRR评分,并且基于这样的想法,即可以抵消疾病基因表达变化的化合物可能对该疾病具有潜在的治疗应用。从PubMed索引的出版物中整理与IBC相关的基因和相关的差异表达数据(265个上调和122个下调)。从LINCS数据库下载药物诱导的基因表达谱,并使用其GRR评分预测治疗IBC的候选药物。使用LINCS Canvas Browser(LCB)分析获得了三十二(32)种药物扰动,这些药物扰动可能会逆转预先编制的297个IBC基因的列表。通过计算评估32个扰动的二进制组合,以确定GRR得分最高的组合扰动,并产生131个GRR大于80%的组合,这些组合逆转了IBC-GES中297个基因中的264个。前35种组合涉及20种独特的个体药物扰动,以及19种潜在的候选药物。综合文献检索证实,19种已知药物中有17种具有抗癌或抗炎活性。AZD-7545、BMS-754807和尼美舒利分别靶向已知的IBC相关基因:PDK、Met和COX。已知AG-14361、丁苄酯和氯苄丙肽分别在DNA损伤、细胞周期和细胞凋亡中具有功能相关性。这些发现支持使用GRR方法来确定可用于治疗罕见疾病(如IBC)的候选药物和潜在的联合疗法。
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引用次数: 0
Corrigendum to "The Role of DNA Viruses in Human Cancer". 更正“DNA病毒在人类癌症中的作用”。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.1177/11769351231208757

[This corrects the article DOI: 10.1177/11769351231154186.].

[这更正了文章DOI:10.1177/117693351231154186]。
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引用次数: 0
Comparing Individualized Survival Predictions From Random Survival Forests and Multistate Models in the Presence of Missing Data: A Case Study of Patients With Oropharyngeal Cancer. 比较随机生存森林和多态模型在缺失数据情况下的个体化生存预测:口咽癌患者病例研究》。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-06-29 eCollection Date: 2023-01-01 DOI: 10.1177/11769351231183847
Madeline R Abbott, Lauren J Beesley, Emily L Bellile, Andrew G Shuman, Laura S Rozek, Jeremy M G Taylor

Background: In recent years, interest in prognostic calculators for predicting patient health outcomes has grown with the popularity of personalized medicine. These calculators, which can inform treatment decisions, employ many different methods, each of which has advantages and disadvantages.

Methods: We present a comparison of a multistate model (MSM) and a random survival forest (RSF) through a case study of prognostic predictions for patients with oropharyngeal squamous cell carcinoma. The MSM is highly structured and takes into account some aspects of the clinical context and knowledge about oropharyngeal cancer, while the RSF can be thought of as a black-box non-parametric approach. Key in this comparison are the high rate of missing values within these data and the different approaches used by the MSM and RSF to handle missingness.

Results: We compare the accuracy (discrimination and calibration) of survival probabilities predicted by both approaches and use simulation studies to better understand how predictive accuracy is influenced by the approach to (1) handling missing data and (2) modeling structural/disease progression information present in the data. We conclude that both approaches have similar predictive accuracy, with a slight advantage going to the MSM.

Conclusions: Although the MSM shows slightly better predictive ability than the RSF, consideration of other differences are key when selecting the best approach for addressing a specific research question. These key differences include the methods' ability to incorporate domain knowledge, and their ability to handle missing data as well as their interpretability, and ease of implementation. Ultimately, selecting the statistical method that has the most potential to aid in clinical decisions requires thoughtful consideration of the specific goals.

背景:近年来,随着个性化医疗的流行,人们对预测患者健康结果的预后计算器的兴趣与日俱增。这些可为治疗决策提供依据的计算器采用了许多不同的方法,每种方法都各有利弊:我们通过对口咽鳞状细胞癌患者预后预测的案例研究,对多态模型(MSM)和随机生存森林(RSF)进行了比较。MSM 是高度结构化的,考虑到了临床背景和口咽癌知识的某些方面,而 RSF 可视为一种黑箱非参数方法。这一比较的关键在于这些数据的高缺失率以及 MSM 和 RSF 处理缺失的不同方法:结果:我们比较了两种方法预测的生存概率的准确性(区分度和校准),并通过模拟研究更好地了解预测准确性如何受到以下方法的影响:(1) 处理缺失数据;(2) 对数据中存在的结构/疾病进展信息建模。我们得出的结论是,两种方法的预测准确性相似,MSM 稍占优势:尽管 MSM 的预测能力略优于 RSF,但在选择解决特定研究问题的最佳方法时,考虑其他差异也很关键。这些关键差异包括方法纳入领域知识的能力、处理缺失数据的能力、可解释性以及实施的难易程度。最终,选择最有可能帮助临床决策的统计方法需要对具体目标进行深思熟虑。
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引用次数: 0
The Role of DNA Viruses in Human Cancer. DNA病毒在人类癌症中的作用。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-06-13 eCollection Date: 2023-01-01 DOI: 10.1177/11769351231154186
Zohreh-Al-Sadat Ghoreshi, Hamid Reza Molaei, Nasir Arefinia

This review discusses the possible involvement of infections-associated cancers in humans, with virus infections contributing 15% to 20% of total cancer cases in humans. DNA virus encoded proteins interact with host cellular signaling pathways and control proliferation, cell death and genomic integrity viral oncoproteins are known to bind cellular Deubiquitinates (DUBs) such as cyclindromatosis tumor suppressor, ubiquitin-specific proteases 7, 11, 15 and 20, and A-20 to improve their intracellular stability and cellular signaling pathways and finally transformation. Human papillomaviruses (cervical carcinoma, oral cancer and laryngeal cancer); human polyomaviruses (mesotheliomas, brain tumors); Epstein-Barr virus (B-cell lymphoproliferative diseases and nasopharyngeal carcinoma); Kaposi's Sarcoma Herpesvirus (Kaposi's Sarcoma and primary effusion lymphomas); hepatitis B (hepatocellular carcinoma (HCC)) cause up to 20% of malignancies around the world.

这篇综述讨论了人类感染相关癌症的可能参与,病毒感染占人类癌症总病例的15%至20%。DNA病毒编码的蛋白质与宿主细胞信号通路相互作用,并控制增殖、细胞死亡和基因组完整性已知病毒癌蛋白结合细胞双奎酸盐(DUBs),如细胞周期蛋白增多症肿瘤抑制因子、泛素特异性蛋白酶7、11、15和20,和A-20以改善它们的细胞内稳定性和细胞信号通路,并最终转化。人乳头瘤病毒(宫颈癌、癌症和癌症);人类多瘤病毒(间皮瘤、脑肿瘤);EB病毒(B细胞淋巴增生性疾病和鼻咽癌);卡波西肉瘤疱疹病毒(卡波西肉瘤和原发性渗出性淋巴瘤);乙型肝炎(肝细胞癌(HCC))在全世界引起高达20%的恶性肿瘤。
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引用次数: 2
Quantifying the Contributions of Environmental Factors to Prostate Cancer and Detecting Risk-Related Diet Metrics and Racial Disparities. 量化环境因素对前列腺癌的影响,检测与风险相关的饮食指标和种族差异。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-04-27 eCollection Date: 2023-01-01 DOI: 10.1177/11769351231168006
Wensheng Zhang, Kun Zhang

The relevance of nongenetic factors to prostate cancer (PCa) has been elusive. We aimed to quantify the contributions of environmental factors to PCa and identify risk-related diet metrics and relevant racial disparities. We performed a unique analysis of the Diet History Questionnaire data of 41 830 European Americans (EAs) and 1282 African Americans (AAs) in the PLCO project. The independent variables in the regression models consisted of age at trial entry, race, family history of prostate cancer (PCa-fh), diabetes history, body mass index (BMI), lifestyle (smoking and coffee consumption), marital status, and a specific nutrient/food factor (X). P < .05 and a 95% confidence interval excluding zero were adopted as the criteria for determining a significant difference (effect). We established a priority ranking among PCa risk-related genetic and environmental factors according to the deviances explained by them in the multivariate Cox-PH regression analysis: age > PCa-fh > diabetes ⩾ race > lifestyle ⩾marital-status ⩾BMI > X. We confirmed previous studies showing that (1) high protein and saturated fat levels in diet were related to increased PCa risk, (2) high-level supplementary selenium intake was harmful rather than beneficial for preventing PCa, and (3) supplementary vitamin B6 was beneficial for preventing benign PCa. We obtained the following novel findings: high-level organ meat intake was an independent predictor for increased aggressive PCa risk; supplementary iron, copper and magnesium increased benign PCa risk; and the AA diet was "healthy" in terms of the relatively lower protein and fat levels and was "unhealthy" in that it more commonly contained organ meat. In conclusion, we established a priority ranking among the contributing factors for PCa and identified several risk-related diet metrics and the racial disparities. Our findings suggested some new approaches to prevent PCa such as restriction of organ meat intake and supplementary microminerals.

非遗传因素与前列腺癌(PCa)的相关性一直难以捉摸。我们旨在量化环境因素对 PCa 的影响,并确定与风险相关的饮食指标和相关的种族差异。我们对 PLCO 项目中 41 830 名欧洲裔美国人(EA)和 1282 名非洲裔美国人(AA)的饮食史问卷数据进行了独特的分析。回归模型中的自变量包括参加试验时的年龄、种族、前列腺癌家族史(PCa-fh)、糖尿病史、体重指数(BMI)、生活方式(吸烟和喝咖啡)、婚姻状况以及特定的营养素/食物因子(X)。我们证实了之前的研究显示:(1)饮食中的高蛋白和饱和脂肪水平与 PCa 风险增加有关;(2)高水平的补充硒摄入对预防 PCa 有害而无益;(3)补充维生素 B6 对预防良性 PCa 有益。我们得出了以下新发现:高水平的内脏肉类摄入量是增加侵袭性 PCa 风险的独立预测因素;补充铁、铜和镁会增加良性 PCa 风险;AA 饮食的 "健康 "之处在于其蛋白质和脂肪水平相对较低,而 "不健康 "之处在于其更常含有内脏肉类。总之,我们对导致 PCa 的因素进行了优先排序,并确定了几种与风险相关的饮食指标和种族差异。我们的研究结果提出了一些预防 PCa 的新方法,如限制内脏肉类的摄入和补充微量元素。
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引用次数: 0
Cervical Transformation Zone Segmentation and Classification based on Improved Inception-ResNet-V2 Using Colposcopy Images. 基于改进的Inception-ResNet-V2阴道镜图像的宫颈转化区分割与分类。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-01-01 DOI: 10.1177/11769351231161477
Srikanta Dash, Prabira Kumar Sethy, Santi Kumari Behera

The second most frequent malignancy in women worldwide is cervical cancer. In the transformation(transitional) zone, which is a region of the cervix, columnar cells are continuously converting into squamous cells. The most typical location on the cervix for the development of aberrant cells is the transformation zone, a region of transforming cells. This article suggests a 2-phase method that includes segmenting and classifying the transformation zone to identify the type of cervical cancer. In the initial stage, the transformation zone is segmented from the colposcopy images. The segmented images are then subjected to the augmentation process and identified with the improved inception-resnet-v2. Here, multi-scale feature fusion framework that utilizes 3 × 3 convolution kernels from Reduction-A and Reduction-B of inception-resnet-v2 is introduced. The feature extracted from Reduction-A and Reduction -B is concatenated and fed to SVM for classification. This way, the model combines the benefits of residual networks and Inception convolution, increasing network width and resolving the deep network's training issue. The network can extract several scales of contextual information due to the multi-scale feature fusion, which increases accuracy. The experimental results reveal 81.24% accuracy, 81.24% sensitivity, 90.62% specificity, 87.52% precision, 9.38% FPR, and 81.68% F1 score, 75.27% MCC, and 57.79% Kappa coefficient.

全世界妇女中第二常见的恶性肿瘤是宫颈癌。在转化(过渡)区,即子宫颈的一个区域,柱状细胞不断转化为鳞状细胞。宫颈上异常细胞发育最典型的位置是转化区,即转化细胞的区域。本文提出了两阶段的方法,包括分割和分类转化区,以确定宫颈癌的类型。在初始阶段,从阴道镜图像中分割出变换区域。然后对分割后的图像进行增强处理,并使用改进的inception-resnet-v2进行识别。本文介绍了利用inception-resnet-v2的reduce - a和reduce - b的3 × 3卷积核的多尺度特征融合框架。将从reduce - a和Reduction -B中提取的特征串接并馈送给SVM进行分类。这样,该模型结合了残差网络和Inception卷积的优点,增加了网络宽度,解决了深度网络的训练问题。由于多尺度特征融合,该网络可以提取多个尺度的上下文信息,提高了准确率。实验结果显示:准确率81.24%,灵敏度81.24%,特异性90.62%,精密度87.52%,FPR 9.38%, F1评分81.68%,MCC 75.27%, Kappa系数57.79%。
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引用次数: 0
Development of an eHealth Tool for Capturing and Analyzing the Immune-related Adverse Events (irAEs) in Cancer Treatment. 用于捕获和分析癌症治疗中免疫相关不良事件(irAEs)的电子健康工具的开发。
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-01-01 DOI: 10.1177/11769351231178587
Saeed Moradian, Shive Ghasemi, Babak Boutorabi, Zakieh Sharifian, Fay Dastjerdi, Catriona Buick, Charlotte T Lee, Samantha J Mayo, Plinio P Morita, Doris Howell
<p><strong>Introduction: </strong>Immunotherapy has revolutionized the treatment of many different types of cancer, but it is associated with a myriad of immune-related adverse events (irAEs). Patient-reported outcome (PRO) measures have been identified as valuable tools for continuously collecting patient-centered data and are frequently used in oncology trials. However, few studies still research an ePRO follow-up approach on patients treated with Immunotherapy, potentially reflecting a lack of support services for this population.</p><p><strong>Methods: </strong>The team co-developed a digital platform (V-Care) using ePROs to create a new follow-up pathway for cancer patients receiving immunotherapy. To operationalize the first 3 phases of the CeHRes roadmap, we employed multiple methods that were integrated throughout the development process, rather than being performed in a linear fashion. The teams employed an agile approach in a dynamic and iterative manner, engaging key stakeholders throughout the process.</p><p><strong>Results: </strong>The development of the application was categorized into 2 phases: "user interface" (UI) and "user experience" (UX) designs. In the first phase, the pages of the application were segmented into general categories, and feedback from all stakeholders was received and used to modify the application. In phase 2, mock-up pages were developed and sent to the Figma website. Moreover, the Android Package Kit (APK) of the application was installed and tested multiple times on a mobile phone to proactively detect and fix any errors. After resolving some technical issues and adjusting errors on the Android version to improve the user experience, the iOS version of the application was developed.</p><p><strong>Discussion: </strong>By incorporating the latest technological developments, V-Care has enabled cancer patients to have access to more comprehensive and personalized care, allowing them to better manage their condition and be better informed about their health decisions. These advances have also enabled healthcare professionals to be better equipped with the knowledge and tools to provide more effective and efficient care. In addition, the advances in V-Care technology have allowed patients to connect with their healthcare providers more easily, providing a platform to facilitate communication and collaboration. Although usability testing is necessary to evaluate the efficacy and user experience of the app, it can be a significant investment of time and resources.</p><p><strong>Conclusion: </strong>The V-Care platform can be used to investigate the reported symptoms experienced by cancer patients receiving Immune checkpoint inhibitors (ICIs) and to compare them with the results from clinical trials. Furthermore, the project will utilize ePRO tools to collect symptoms from patients and provide insight into whether the reported symptoms are linked to the treatment.</p><p><strong>Clinical relevance: </strong>V-Care
免疫疗法已经彻底改变了许多不同类型癌症的治疗,但它与无数的免疫相关不良事件(irAEs)有关。患者报告结果(PRO)测量已被确定为持续收集以患者为中心的数据的有价值的工具,并经常用于肿瘤试验。然而,很少有研究对接受免疫治疗的患者进行ePRO随访,这可能反映了对这一人群缺乏支持服务。方法:该团队利用ePROs共同开发了一个数字平台(V-Care),为接受免疫治疗的癌症患者创造了新的随访途径。为了实现CeHRes路线图的前3个阶段,我们在整个开发过程中集成了多种方法,而不是以线性方式执行。团队以动态和迭代的方式采用敏捷方法,在整个过程中吸引关键涉众。结果:应用程序的开发分为两个阶段:“用户界面”(UI)和“用户体验”(UX)设计。在第一阶段,将应用程序的页面划分为一般类别,并接收来自所有涉众的反馈,并使用这些反馈来修改应用程序。在第二阶段,开发了模型页面并将其发送到Figma网站。此外,应用程序的Android Package Kit (APK)在手机上进行了多次安装和测试,主动发现并修复任何错误。在解决了Android版本的一些技术问题并调整错误以改善用户体验后,开发了iOS版本的应用程序。讨论:通过结合最新的技术发展,V-Care使癌症患者能够获得更全面和个性化的护理,使他们能够更好地管理自己的病情,并更好地了解自己的健康决定。这些进步还使医疗保健专业人员能够更好地配备知识和工具,以提供更有效和高效的护理。此外,V-Care技术的进步使患者能够更轻松地与医疗保健提供者联系,提供了一个促进沟通和协作的平台。尽管可用性测试对于评估应用的有效性和用户体验是必要的,但它可能需要大量的时间和资源投入。结论:V-Care平台可用于调查接受免疫检查点抑制剂(ICIs)的癌症患者所报告的症状,并将其与临床试验结果进行比较。此外,该项目将利用ePRO工具收集患者的症状,并深入了解所报告的症状是否与治疗有关。临床相关性:V-Care为患者与临床医生的沟通和数据交换提供了一个安全、易于使用的界面。其临床系统在安全的环境中存储和管理患者数据,而其临床决策支持系统帮助临床医生做出更明智、更有效和更具成本效益的决策。该系统具有提高患者安全和护理质量的潜力,同时也有助于降低医疗成本。
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引用次数: 0
Determinants of Time-to-Death of Chronic Lymphocytic Leukemia Patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. 埃塞俄比亚巴希尔达尔Felege Hiwot转诊医院慢性淋巴细胞白血病患者死亡时间的决定因素
IF 2 Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Pub Date : 2023-01-01 DOI: 10.1177/11769351231183849
Gedam Derbew Addisia, Awoke Seyoum Tegegne, Denekew Bitew Belay, Mahider Abere Kassaw, Mitiku Wale Muluneh, Koyachew Bitew Abebe, Bezanesh Melese Masresha, Solomon Sisay Mulugeta, Setegn Muche Fentaw, Dejen Gedamu Damtie
Background: Leukemia is a group of cancers that usually begin in the bone marrow and results in a large number of abnormal white blood cells. Chronic Lymphocytic Leukemia is the most prevalent leukemia in Western countries, with an estimated incidence rate of less than 1 to 5.5 per 100 000 people, and average age at diagnosis of 64 to 72 years. It is more common in men among Chronic Lymphocytic Leukemia patients in Ethiopia’s hospitals at Felege Hiwot Referal Hospital. Methods: A retrospective cohort research design was employed to acquire critical information from patients’ medical records in order to achieve the study’s purpose. The study comprised the medical records of 312 Chronic Lymphocytic Leukemia who were followed from January 1, 2018 to December 31, 2020. A Cox proportional hazard model was used to determine the risk factors for time to death in Chronic Lymphocytic Leukemia patients. Results: Accordingly the Cox proportional hazard model, age (Hazard Ratio = 11.36; P < .001), sex of male (Hazard Ratio = 1.04; P = .004), married status (Hazard Ratio = 0.03; P = .003), medium stages of Chronic Lymphocytic Leukemia (Hazard Ratio = 1.29; P = .024), high stages of Chronic Lymphocytic Leukemia (Hazard Ratio = 1.99; P < .001), presence of anemia (Hazard Ratio =0.09; P = .005), platelets (Hazard Ratio = 2.11; P = .007), hemoglobin (Hazard Ratio = 0.02; P < .001), lymphocytes (Hazard Ratio = 0.29; P = .006), red blood cell (Hazard Ratio = 0.02; P < .001), which patients with Chronic Lymphocytic Leukemia had a significant relationship with time to death. Conclusions: Age, sex, Chronic Lymphocytic Leukemia stage, anemia, platelets, hemoglobin, lymphocytes, and red blood cells were all statistically significant determinants in the time to death of Chronic Lymphocytic Leukemia patients, according to the data. As a result, healthcare providers should pay particular attention to and emphasize the identified characteristics, as well as provide frequent counseling on how to enhance the health of Chronic Lymphocytic Leukemia patients.
背景:白血病是一组通常起源于骨髓并导致大量异常白细胞的癌症。慢性淋巴细胞白血病是西方国家最常见的白血病,估计发病率低于每10万人1至5.5人,诊断时的平均年龄为64至72岁。在埃塞俄比亚费利格·希沃特转诊医院的慢性淋巴细胞白血病患者中,男性更常见。方法:采用回顾性队列研究设计,从患者病历中获取关键信息,以达到研究目的。该研究包括从2018年1月1日至2020年12月31日随访的312例慢性淋巴细胞白血病患者的医疗记录。采用Cox比例风险模型确定慢性淋巴细胞白血病患者死亡时间的危险因素。结果:相应的Cox比例风险模型,年龄(风险比= 11.36;P = .004)、婚姻状况(风险比= 0.03;P = 0.003),慢性淋巴细胞白血病中期(风险比= 1.29;P = 0.024),高分期慢性淋巴细胞白血病(风险比= 1.99;P = 0.005),血小板(风险比= 2.11;P = .007),血红蛋白(风险比= 0.02;P = 0.006)、红细胞(风险比= 0.02;结论:年龄、性别、慢性淋巴细胞白血病分期、贫血、血小板、血红蛋白、淋巴细胞、红细胞是影响慢性淋巴细胞白血病患者死亡时间的有统计学意义的因素。因此,医疗保健提供者应特别关注和强调已识别的特征,并就如何增强慢性淋巴细胞白血病患者的健康提供经常的咨询。
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Cancer Informatics
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