Health Care Science最新文献

{"title":"Sex-Related Differences in Risk Factors Associated With Nonhealing or Recurrence of Hyperthyroidism in Patients With Graves' Disease Treated With Radioactive Iodine","authors":"Haolin Shen,&nbsp;Yuegui Wang,&nbsp;Jianmei Liao,&nbsp;Xianbo Zuo,&nbsp;Bo Zhang,&nbsp;Xiao Yang","doi":"10.1002/hcs2.70021","DOIUrl":"https://doi.org/10.1002/hcs2.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To evaluate sex-related differences in the risk factors associated with nonhealing or recurrence of hyperthyroidism (NHRH) in patients with Graves' disease (GD) treated with radioactive iodine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 285 patients were enrolled. Data on radioactive iodine (RAI) dosage, ultrasound indexes of the thyroid, and other clinical factors were collected. Patients were divided into NHRH and non-NHRH (hypothyroidism or euthyroidism) groups based on treatment outcomes. Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH. Sex-specific analyses of these risk factors were also conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant differences between the two groups in terms of sex, thyroid shear wave elastography velocity values, or pretreatment serum free thyroxine (FT4) levels. Thyroid volume and age were independently associated with NHRH, with the odds of NHRH gradually decreasing as age increased. In subgroup analyses, both age and thyroid volume were independent risk factors for NHRH in female patients (<i>p</i> &lt; 0.05), while in male patients, only FT4 was independently associated with NHRH (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients of different sexes, the influence of thyroid volume, age, and FT4 on treatment outcomes exhibits distinct patterns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"188-194"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Reasons for Using Non-Primary Care Providers as Usual Source of Health Care: Insights From the All of Us Study","authors":"Abbey Gregg,&nbsp;Hui Wang,&nbsp;Brankeciara Ard,&nbsp;Marcelo Takejame Galafassi,&nbsp;Maryam Bidgoli","doi":"10.1002/hcs2.70020","DOIUrl":"https://doi.org/10.1002/hcs2.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Having a primary care usual source of care (USC) is associated with better population health outcomes. However, the percent of adults in the United States (US) with a usual primary care provider is declining. We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 57,152 participants in the <i>All of Us</i> study who reported having a USC. We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing, enabling, and need factors, according to the source of usual care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An urgent care clinic, minute clinic, or emergency department was the source of usual care for 6.3% of our sample. The odds of seeking care at this type of facility increased with younger age, lower educational attainment, and better health status. Black and Hispanic individuals, as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity, were also less likely to have a primary care USC. Financial concerns, being anxious about seeing a provider, and the inability to take time off from work also increased the likelihood of having a non-primary care USC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient, affordable primary care. Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"195-205"},"PeriodicalIF":0.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart Healthcare: The Role of Digital Health in Modern Medicine","authors":"Nidha Shapoo,&nbsp;Naveed Shapoo,&nbsp;Abdul Rehman,&nbsp;Noella Boma","doi":"10.1002/hcs2.70019","DOIUrl":"https://doi.org/10.1002/hcs2.70019","url":null,"abstract":"<p>Digital health is transforming healthcare by integrating advanced technologies to make healthcare more accessible, efficient, and personalized. From electronic health records, telemedicine, wearable devices, and artificial intelligence to the recent smart hospitals, digital health is improving patient care and outcomes while reducing healthcare costs. However, the integration of digital health faces several challenges, including data privacy, cybersecurity risks, and inequitable access to technology. This article provides an overview of the current state of digital health, key challenges in implementation, and potential solutions to maximize the benefits of digital health and ensure efficient, equitable, and patient-centered healthcare in the future.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"179-187"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Mental Health Care: A Comprehensive Review of Digital Tools and Technologies for Enhancing Diagnosis, Treatment, and Wellness","authors":"Muhammad Khalid Anser,&nbsp;Agha Amad Nabi,&nbsp;Ishfaq Ahmad,&nbsp;Muhammad Moinuddin Qazi Abro,&nbsp;Khalid Zaman","doi":"10.1002/hcs2.70018","DOIUrl":"https://doi.org/10.1002/hcs2.70018","url":null,"abstract":"<p>An individual's mental health influences their capacity to think effectively, feel emotionally stable, and perform daily activities. As mental health concerns become more prevalent worldwide, new awareness and diagnostic and treatment tactics are needed. Digital tools and technology are helping solve these problems by providing scalable, tailored solutions for large populations. This detailed review examines mental health-promoting internet tools. Smartphone applications, web-based therapy systems, wearable tech, artificial intelligence-powered resources, and virtual reality (VR) technologies were evaluated for efficacy and side effects. PubMed, PsycINFO, Scopus, IEEE Xplore, and Google Scholar were carefully searched. Search terms included “digital mental health tools,” “online therapy,” and “AI in mental health.” Randomized controlled trials, cohort studies, cross-sectional studies, systematic reviews, and meta-analyses of digital technology and mental health were included from among the literature published after 2010. Cognitive behavioral therapy methods, mood monitoring, and mindfulness exercises are among the numerous features of smartphone applications that have been demonstrated to mitigate symptoms of anxiety, depression, and tension. Online therapy platforms let marginalized individuals obtain therapy remotely. Wearable technology may detect heart rate, blood pressure, and sleep length, which may reveal mental health difficulties. Chatbots employ machine learning algorithms and natural language processing to deliver customized support and show promise for quick intervention. Exposure therapy for anxiety and trauma is increasingly using virtual reality environments. Although digital mental health therapies face challenges in relation to data privacy, limited long-term efficacy, and technological inequality, digital technologies are modernizing mental healthcare. By offering inexpensive and effective alternatives to traditional therapies, digital technologies may help healthcare systems meet the growing demand for mental health services and overall well-being.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"163-178"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine in Action: Improving Perceived Healthcare Accessibility in Rural China","authors":"Zhongmou Huang,&nbsp;Xizi Wan,&nbsp;Shaojie Zhou,&nbsp;Miao Yu","doi":"10.1002/hcs2.70017","DOIUrl":"https://doi.org/10.1002/hcs2.70017","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The scarcity of healthcare resources and inadequate access to medical services in rural and remote areas are pervasive challenges many countries face, particularly in the developing world. Telemedicine, with its capacity to overcome geographical barriers and provide patients with real-time medical services, has shown considerable potential in addressing these issues, attracting widespread attention. Compact medical communities and family doctor systems play important roles in improving healthcare accessibility. However, despite the critical nature of patients' perceptions of healthcare accessibility, research in this domain is sparse. This study aimed to explore the impact of telemedicine on rural residents' perceived healthcare accessibility in China, analyze the mechanisms underpinning this relationship, and elucidate the roles of compact medical communities and the family doctor system.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Survey data from 3311 rural residents were analyzed using a probit model, instrumental variables, and subgroup regression analyses to ascertain causal effects, perform heterogeneity analysis, examine mechanisms, and ascertain the robustness of the findings.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Telemedicine significantly enhanced rural residents' perceived healthcare accessibility, with particularly notable benefits for those in sparsely populated areas, regions with high-speed internet access, within the purview of compact healthcare consortiums, and those with access to family doctor services. Furthermore, telemedicine improved rural residents' perceived healthcare accessibility by encouraging the use of primary care services.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Telemedicine in China has played a significant role in improving the perceived healthcare accessibility among rural residents and aiding in the reduction of disparities in accessibility across different demographic groups. This is consistent with the broader objective of achieving universal health coverage. However, the efficacy of telemedicine in enhancing healthcare accessibility is contingent upon certain preconditions. Policymakers must confront local infrastructure challenges, particularly regarding internet connectivity, when expanding telemedicine services to ensure their effective operation. The synergistic interaction observed between telemedicine, the family doctor system, and compact medical communities highlights the importance of integrating telemedicine into existing healthcare systems","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"215-224"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical and Medical Co-Management in an 82-Year-Old Patient With Hemophilia a Undergoing Pancreaticoduodenectomy","authors":"Wenning Lu,&nbsp;Chaoyang Liu,&nbsp;Jing He,&nbsp;Rui Cheng","doi":"10.1002/hcs2.70016","DOIUrl":"https://doi.org/10.1002/hcs2.70016","url":null,"abstract":"<p>We report the successful application of a surgical and medical co-management (SMC) strategy in an 82-year-old man with hemophilia A (HA) undergoing pancreaticoduodenectomy for pancreatic head carcinoma. No major complications or perioperative bleeding occurred. Optimal management of HA patients undergoing major surgery requires multidisciplinary coordination to avoid postoperative complications. The SMC team integrates internists (who assess chronic disease status, adjust medications, and determine best hemostatic therapies) and surgeons (who evaluate the surgical feasibility of procedures and rely on advanced surgical skills) to improve perioperative planning to minimize complications and promote recovery. This case illustrates the utility of a shift from passive and conservative treatment to active and preventive treatment and highlights the value of SMC in many complex clinical situations.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"229-233"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges to and Countermeasures for the Value Realization of Healthcare Data Elements in China","authors":"Tianan Yang,&nbsp;Wenhao Deng,&nbsp;Ran Liu,&nbsp;Tianyu Wang,&nbsp;Yuanyuan Dai,&nbsp;Jianwei Deng","doi":"10.1002/hcs2.70015","DOIUrl":"https://doi.org/10.1002/hcs2.70015","url":null,"abstract":"<p>The market for healthcare data elements in China has shown strong growth, but still fails to effectively realize the value of circulation and transactions. By identifying the five major challenges, this article proposes countermeasures to accelerate the release of multidimensional value and integrative value creation of healthcare data elements.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"225-228"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value Evaluation for Urban Medical Groups in China: A Case From Dapeng New District in Shenzhen","authors":"Yan Cui,&nbsp;Leiyu Shi,&nbsp;Shilan Tang,&nbsp;Yansui Yang,&nbsp;Lijie Ren","doi":"10.1002/hcs2.70014","DOIUrl":"https://doi.org/10.1002/hcs2.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>An urban medical group in Dapeng New District was established in 2017 with the objective of enhancing outcomes for common diseases and reinforcing primary care by integrating high-level hospitals with primary health services. This study aimed to evaluate the performance of the urban medical group using the triangular value chain framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The evaluation was conducted using the Donabedian model, focusing on three key dimensions: safety and quality, accessibility, and affordability. Longitudinal data were collected from 2016 to 2022 through government annual reports, the medical insurance bureau, and hospital information systems. Preprogram and postprogram outcome measurements were compared to assess differences and trends, providing a clear picture of the program's effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Accessibility improved significantly, with the number of hospital beds per 1000 residents increasing from 2.62 in 2017 to 3.76 in 2022. The availability of general practitioners (GPs) also rose markedly, from 0 per 10,000 residents in 2017 to 6.27 in 2022. Regarding safety and quality, the proportion of complex medical procedures conducted within the New District expanded substantially, from 7.35% in 2017 to 38.11% in 2021. Additionally, there was an enhancement in the standardized management rate of chronic diseases. Affordability assessments showed that the proportion of medical income derived from the medical insurance fund increased by nearly 22.81 percentage points between 2012 and 2021. By 2021, 75.02% of medical patients were covered by medical insurance, representing an increase of approximately 44 percentage points from 31.19% in 2012.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The implementation of the urban medical group in Dapeng New District has led to substantial improvements in healthcare accessibility, safety and quality, and affordability. Future initiatives will focus on advancing the “Dapeng Mode” to generate exemplary healthcare outcomes and minimize disparities in basic health services and health status between urban and rural populations. The reform agenda includes piloting payment reforms and innovative payment models within the Dapeng group, complemented by a health assessment and performance incentive system aimed at encouraging healthcare institutions to prioritize health management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 3","pages":"206-214"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Hospital Pharmacists Ready for Precision Medicine in Nigerian Healthcare? Insights From a Multi-Center Study","authors":"Goodness C. Nwokebu,&nbsp;Shadrach C. Eze,&nbsp;Prince J. Meziem,&nbsp;Catherine C. Eleje,&nbsp;Emmanuel I. Ugwu,&nbsp;Manuella O. Dagogo-George,&nbsp;Favour O. Orisakwe,&nbsp;Gerald O. Ozota,&nbsp;Abdulmuminu Isah","doi":"10.1002/hcs2.70008","DOIUrl":"https://doi.org/10.1002/hcs2.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Precision medicine (PM) has taken center stage in healthcare since the completion of the genomic project. Developed countries have gradually integrated PM into mainstream patient management. However, Nigeria still grapples with wide acceptance, key translational research and implementation of PM. This study sought to explore the knowledge and attitude of PM among pharmacists as key stakeholders in the healthcare team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in selected tertiary hospitals across the country. A 21-item semi-structured questionnaire was administered by hybrid online and physical methods and the results analyzed with Statistical Package for the Social Sciences Version 25. Descriptive statistics were used to summarize the data. A chi-square test was employed to determine the association of knowledge of PM and the sociodemographic characteristics of the study population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 167 hospital pharmacists participated in the study. A high proportion of the participants are familiar with artificial intelligence (91.75%), Pharmacogenomics (84.5%), and precision medicine (61%). Overall, 38.9% of the pharmacists had a good knowledge while 13.2% had a poor knowledge of PM and associated terms. The level of knowledge did not correlate significantly with gender (<i>X</i>² = 3.21, <i>p</i> = 0.201), age (<i>X</i>² = 5, <i>p</i> = 0.27), marital status (<i>X</i>² = 3.21, <i>p</i> = 0.201), and professional level (<i>X</i>² = 6.85, <i>p</i> = 0.144). The most important value of precision medicine to hospital pharmacists is the ability to minimize the impact of disease through preventive medicine (49%) while a large portion are pursuing and or actively planning to pursue additional education in precision medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is a highly positive attitude toward the prospect of PM among hospital pharmacists in Nigeria. Education modules in this field are highly recommended as most do not have a holistic knowledge of terms used in PM. Also, more research aimed at translating PM knowledge into clinical practice is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 2","pages":"82-93"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Domain-Specific Pretraining by Supervised or Self-Supervised Learning for Chest Radiograph Classification: A Comparative Study Against ImageNet Counterparts in Cold-Start Active Learning","authors":"Han Yuan,&nbsp;Mingcheng Zhu,&nbsp;Rui Yang,&nbsp;Han Liu,&nbsp;Irene Li,&nbsp;Chuan Hong","doi":"10.1002/hcs2.70009","DOIUrl":"https://doi.org/10.1002/hcs2.70009","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Deep learning (DL) has become the prevailing method in chest radiograph analysis, yet its performance heavily depends on large quantities of annotated images. To mitigate the cost, cold-start active learning (AL), comprising an initialization followed by subsequent learning, selects a small subset of informative data points for labeling. Recent advancements in pretrained models by supervised or self-supervised learning tailored to chest radiograph have shown broad applicability to diverse downstream tasks. However, their potential in cold-start AL remains unexplored.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To validate the efficacy of domain-specific pretraining, we compared two foundation models: supervised TXRV and self-supervised REMEDIS with their general domain counterparts pretrained on ImageNet. Model performance was evaluated at both initialization and subsequent learning stages on two diagnostic tasks: psychiatric pneumonia and COVID-19. For initialization, we assessed their integration with three strategies: diversity, uncertainty, and hybrid sampling. For subsequent learning, we focused on uncertainty sampling powered by different pretrained models. We also conducted statistical tests to compare the foundation models with ImageNet counterparts, investigate the relationship between initialization and subsequent learning, examine the performance of one-shot initialization against the full AL process, and investigate the influence of class balance in initialization samples on initialization and subsequent learning.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;First, domain-specific foundation models failed to outperform ImageNet counterparts in six out of eight experiments on informative sample selection. Both domain-specific and general pretrained models were unable to generate representations that could substitute for the original images as model inputs in seven of the eight scenarios. However, pretrained model-based initialization surpassed random sampling, the default approach in cold-start AL. Second, initialization performance was positively correlated with subsequent learning performance, highlighting the importance of initialization strategies. Third, one-shot initialization performed comparably to the full AL process, demonstrating the potential of reducing experts' repeated waiting during AL iterations. Last, a U-shaped correlation was observed between the class balance of initialization samples and model performance, suggesting that the class balance is more strongly associated with performance at middle budget levels than at low or high budgets.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 2","pages":"110-143"},"PeriodicalIF":0.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}