Lancet Digital Health最新文献

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Digital solutions in paediatric sepsis: current state, challenges, and opportunities to improve care around the world 儿科败血症的数字化解决方案:改善全球护理的现状、挑战和机遇。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-12 DOI: 10.1016/S2589-7500(24)00141-9
L Nelson Sanchez-Pinto MD , María del Pilar Arias López MD , Halden Scott MD , Kristen Gibbons PhD , Michael Moor PhD , Prof R Scott Watson MD , Matthew O Wiens PhD , Prof Luregn J Schlapbach MD , Tellen D Bennett MD
{"title":"Digital solutions in paediatric sepsis: current state, challenges, and opportunities to improve care around the world","authors":"L Nelson Sanchez-Pinto MD ,&nbsp;María del Pilar Arias López MD ,&nbsp;Halden Scott MD ,&nbsp;Kristen Gibbons PhD ,&nbsp;Michael Moor PhD ,&nbsp;Prof R Scott Watson MD ,&nbsp;Matthew O Wiens PhD ,&nbsp;Prof Luregn J Schlapbach MD ,&nbsp;Tellen D Bennett MD","doi":"10.1016/S2589-7500(24)00141-9","DOIUrl":"10.1016/S2589-7500(24)00141-9","url":null,"abstract":"<div><p>The digitisation of health care is offering the promise of transforming the management of paediatric sepsis, which is a major source of morbidity and mortality in children worldwide. Digital technology is already making an impact in paediatric sepsis, but is almost exclusively benefiting patients in high-resource health-care settings. However, digital tools can be highly scalable and cost-effective, and—with the right planning—have the potential to reduce global health disparities. Novel digital solutions, from wearable devices and mobile apps, to electronic health record-embedded decision support tools, have an unprecedented opportunity to transform paediatric sepsis research and care. In this Series paper, we describe the current state of digital solutions in paediatric sepsis around the world, the advances in digital technology that are enabling the development of novel applications, and the potential effect of advances in artificial intelligence in paediatric sepsis research and clinical care.</p></div>","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 9","pages":"Pages e651-e661"},"PeriodicalIF":23.8,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024001419/pdfft?md5=31f8722a8d750546a71029215e4dfdf0&pid=1-s2.0-S2589750024001419-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of wearable activity trackers on physical activity in children and adolescents: a systematic review and meta-analysis 可穿戴活动追踪器对儿童和青少年体育活动的影响:系统综述和荟萃分析。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-06 DOI: 10.1016/S2589-7500(24)00139-0
Whitney W Au BBiomedSc , Francesco Recchia MSc , Daniel Y Fong PhD , Prof Stephen H S Wong PhD , Derwin K C Chan PhD , Catherine M Capio PhD , Clare C W Yu PhD , Sam W S Wong DPT , Prof Cindy H P Sit PhD , Prof Patrick Ip MD , Prof Ya-Jun Chen PhD , Prof Walter R Thompson PhD , Prof Parco M Siu PhD
{"title":"Effect of wearable activity trackers on physical activity in children and adolescents: a systematic review and meta-analysis","authors":"Whitney W Au BBiomedSc ,&nbsp;Francesco Recchia MSc ,&nbsp;Daniel Y Fong PhD ,&nbsp;Prof Stephen H S Wong PhD ,&nbsp;Derwin K C Chan PhD ,&nbsp;Catherine M Capio PhD ,&nbsp;Clare C W Yu PhD ,&nbsp;Sam W S Wong DPT ,&nbsp;Prof Cindy H P Sit PhD ,&nbsp;Prof Patrick Ip MD ,&nbsp;Prof Ya-Jun Chen PhD ,&nbsp;Prof Walter R Thompson PhD ,&nbsp;Prof Parco M Siu PhD","doi":"10.1016/S2589-7500(24)00139-0","DOIUrl":"10.1016/S2589-7500(24)00139-0","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Physical inactivity in children and adolescents has become a pressing public health concern. Wearable activity trackers can allow self-monitoring of physical activity behaviour and promote autonomous motivation for exercise. However, the effects of wearable trackers on physical activity in young populations remain uncertain.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this systematic review and meta-analysis, we searched PubMed, Embase, SPORTDiscus, and Web of Science for publications from database inception up to Aug 30, 2023, without restrictions on language. Studies were eligible if they were randomised controlled trials or clustered randomised controlled trials that examined the use of wearable activity trackers to promote physical activity, reduce sedentary behaviours, or promote overall health in participants with a mean age of 19 years or younger, with no restrictions on health condition or study settings. Studies were excluded if children or adolescents were not the primary intervention cohort, or wearable activity trackers were not worn on users’ bodies to objectively track users’ physical activity levels. Two independent reviewers (WWA and FR) assessed eligibility of studies and contacted authors of studies if more information was needed to assess eligibility. We also searched reference lists from relevant systematic reviews and meta-analyses. Systematic review software Covidence was used for study screening and data extraction. Study characteristics including study setting, participant characteristics, intervention characteristics, comparator, and outcome measurements were extracted from eligible studies. The two primary outcomes were objectively measured daily steps and moderate-to-vigorous physical activity. We used a random-effects model with Hartung–Knapp adjustments to calculate standardised mean differences. Between-study heterogeneity was examined using Higgins &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; and Cochran Q statistic. Publication bias was assessed using Egger's regression test. This systematic review was registered with PROSPERO, CRD42023397248.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;We identified 9619 studies from our database research and 174 studies from searching relevant systematic reviews and meta-analyses, of which 105 were subjected to full text screening. We included 21 eligible studies, involving 3676 children and adolescents (1618 [44%] were female and 2058 [56%] were male, mean age was 13·7 years [SD 2·7]) in our systematic review and meta-analysis. Ten studies were included in the estimation of the effect of wearable activity trackers on objectively measured daily steps and 11 were included for objectively measured moderate-to-vigorous physical activity. Compared with controls, we found a significant increase in objectively measured daily steps (standardised mean difference 0·37 [95% CI 0·09 to 0·65; p=0·013]; Q 47·60 [p&lt;0·0001]; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; 72·7% [95% CI 53·4 to 84·0]), but not for moderate-to-vig","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 9","pages":"Pages e625-e639"},"PeriodicalIF":23.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024001390/pdfft?md5=36380a4a62a32c50449fd9f8bf44ceca&pid=1-s2.0-S2589750024001390-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Human mobility patterns in Brazil to inform sampling sites for early pathogen detection and routes of spread: a network modelling and validation study 为早期病原体检测采样点和传播途径提供信息的巴西人口流动模式:网络建模和验证研究。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00099-2
Juliane F Oliveira PhD , Prof Andrêza L Alencar PhD , Maria Célia L S Cunha PhD , Adriano O Vasconcelos PhD , Gerson G Cunha PhD , Ray B Miranda BSc , Fábio M H S Filho BSc , Corbiniano Silva PhD , Emanuele Gustani-Buss PhD , Ricardo Khouri PhD , Thiago Cerqueira-Silva PhD , Prof Luiz Landau PhD , Prof Manoel Barral-Netto MD , Pablo Ivan P Ramos PhD
{"title":"Human mobility patterns in Brazil to inform sampling sites for early pathogen detection and routes of spread: a network modelling and validation study","authors":"Juliane F Oliveira PhD ,&nbsp;Prof Andrêza L Alencar PhD ,&nbsp;Maria Célia L S Cunha PhD ,&nbsp;Adriano O Vasconcelos PhD ,&nbsp;Gerson G Cunha PhD ,&nbsp;Ray B Miranda BSc ,&nbsp;Fábio M H S Filho BSc ,&nbsp;Corbiniano Silva PhD ,&nbsp;Emanuele Gustani-Buss PhD ,&nbsp;Ricardo Khouri PhD ,&nbsp;Thiago Cerqueira-Silva PhD ,&nbsp;Prof Luiz Landau PhD ,&nbsp;Prof Manoel Barral-Netto MD ,&nbsp;Pablo Ivan P Ramos PhD","doi":"10.1016/S2589-7500(24)00099-2","DOIUrl":"10.1016/S2589-7500(24)00099-2","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Detecting and foreseeing pathogen dispersion is crucial in preventing widespread disease transmission. Human mobility is a fundamental issue in human transmission of infectious agents. Through a mobility data-driven approach, we aimed to identify municipalities in Brazil that could comprise an advanced sentinel network, allowing for early detection of circulating pathogens and their associated transmission routes.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this modelling and validation study, we compiled a comprehensive dataset on intercity mobility spanning air, road, and waterway transport from the Brazilian Institute of Geography and Statistics (2016 data), National Transport Confederation (2022), and National Civil Aviation Agency (2017–23). We constructed a graph-based representation of Brazil's mobility network. The Ford–Fulkerson algorithm was used to rank the 5570 Brazilian cities according to their suitability as sentinel locations, allowing us to predict the most suitable locations for early detection and to track the most likely trajectory of a newly emerged pathogen. We also obtained SARS-CoV-2 genetic data from Brazilian municipalities during the early stage (Feb 25–April 30, 2020) of the virus's introduction and the gamma (P.1) variant emergence in Manaus (Jan 6–March 1, 2021), for the purposes of model validation.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;We found that flights alone transported 79·9 million (95% CI 58·3–101·4 million) passengers annually within Brazil during 2017–22, with seasonal peaks occurring in late spring and summer, and road and river networks had a maximum capacity of 78·3 million passengers weekly in 2016. By analysing the 7 746 479 most probable paths originating from source nodes, we found that 3857 cities fully cover the mobility pattern of all 5570 cities in Brazil, 557 (10·0%) of which cover 6 313 380 (81·5%) of the mobility patterns in our study. By strategically incorporating mobility patterns into Brazil's existing influenza-like illness surveillance network (ie, by switching the location of 111 of 199 sentinel sites to different municipalities), our model predicted that mobility coverage would have a 33·6% improvement from 4 059 155 (52·4%) mobility patterns to 5 422 535 (70·0%) without expanding the number of sentinel sites. Our findings are validated with genomic data collected during the SARS-CoV-2 pandemic period. Our model accurately mapped 22 (51%) of 43 clade 1-affected cities and 28 (60%) of 47 clade 2-affected cities spread from São Paulo city, and 20 (49%) of 41 clade 1-affected cities and 28 (58%) of 48 clade 2-affected cities spread from Rio de Janeiro city, Feb 25–April 30, 2020. Additionally, 224 (73%) of the 307 suggested early-detection locations for pathogens emerging in Manaus corresponded with the first cities affected by the transmission of the gamma variant, Jan 6–16, 2021.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;By providing essential clues for effective pathogen ","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 8","pages":"Pages e570-e579"},"PeriodicalIF":23.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024000992/pdfft?md5=b74d298dd27f122d3107c7fb202b0a16&pid=1-s2.0-S2589750024000992-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Remote illness detection faces a trust barrier 远程疾病检测面临信任障碍。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00145-6
Benjamin L Smarr
{"title":"Remote illness detection faces a trust barrier","authors":"Benjamin L Smarr","doi":"10.1016/S2589-7500(24)00145-6","DOIUrl":"10.1016/S2589-7500(24)00145-6","url":null,"abstract":"","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 8","pages":"Pages e537-e538"},"PeriodicalIF":23.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024001456/pdfft?md5=9f1b7ea2d874e81511d0a2671601c363&pid=1-s2.0-S2589750024001456-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The next generation of evidence synthesis for diagnostic accuracy studies in artificial intelligence 新一代人工智能诊断准确性研究的证据综合。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00115-8
{"title":"The next generation of evidence synthesis for diagnostic accuracy studies in artificial intelligence","authors":"","doi":"10.1016/S2589-7500(24)00115-8","DOIUrl":"10.1016/S2589-7500(24)00115-8","url":null,"abstract":"","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 8","pages":"Pages e541-e542"},"PeriodicalIF":23.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024001158/pdfft?md5=63d2ae9f56a06a00c10c7d09f23c13cb&pid=1-s2.0-S2589750024001158-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A deep learning-based model to estimate pulmonary function from chest x-rays: multi-institutional model development and validation study in Japan 基于深度学习的胸部 X 射线肺功能估算模型:日本多机构模型开发与验证研究。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00113-4
{"title":"A deep learning-based model to estimate pulmonary function from chest x-rays: multi-institutional model development and validation study in Japan","authors":"","doi":"10.1016/S2589-7500(24)00113-4","DOIUrl":"10.1016/S2589-7500(24)00113-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Chest x-ray is a basic, cost-effective, and widely available imaging method that is used for static assessments of organic diseases and anatomical abnormalities, but its ability to estimate dynamic measurements such as pulmonary function is unknown. We aimed to estimate two major pulmonary functions from chest x-rays.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this retrospective model development and validation study, we trained, validated, and externally tested a deep learning-based artificial intelligence (AI) model to estimate forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV&lt;sub&gt;1&lt;/sub&gt;) from chest x-rays. We included consecutively collected results of spirometry and any associated chest x-rays that had been obtained between July 1, 2003, and Dec 31, 2021, from five institutions in Japan (labelled institutions A–E). Eligible x-rays had been acquired within 14 days of spirometry and were labelled with the FVC and FEV&lt;sub&gt;1&lt;/sub&gt;. X-rays from three institutions (A–C) were used for training, validation, and internal testing, with the testing dataset being independent of the training and validation datasets, and then x-rays from the two other institutions (D and E) were used for independent external testing. Performance for estimating FVC and FEV&lt;sub&gt;1&lt;/sub&gt; was evaluated by calculating the Pearson's correlation coefficient (&lt;em&gt;r&lt;/em&gt;), intraclass correlation coefficient (ICC), mean square error (MSE), root mean square error (RMSE), and mean absolute error (MAE) compared with the results of spirometry.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;We included 141 734 x-ray and spirometry pairs from 81 902 patients from the five institutions. The training, validation, and internal test datasets included 134 307 x-rays from 75 768 patients (37 718 [50%] female, 38 050 [50%] male; mean age 56 years [SD 18]), and the external test datasets included 2137 x-rays from 1861 patients (742 [40%] female, 1119 [60%] male; mean age 65 years [SD 17]) from institution D and 5290 x-rays from 4273 patients (1972 [46%] female, 2301 [54%] male; mean age 63 years [SD 17]) from institution E. External testing for FVC yielded &lt;em&gt;r&lt;/em&gt; values of 0·91 (99% CI 0·90–0·92) for institution D and 0·90 (0·89–0·91) for institution E, ICC of 0·91 (99% CI 0·90–0·92) and 0·89 (0·88–0·90), MSE of 0·17 L&lt;sup&gt;2&lt;/sup&gt; (99% CI 0·15–0·19) and 0·17 L&lt;sup&gt;2&lt;/sup&gt; (0·16–0·19), RMSE of 0·41 L (99% CI 0·39–0·43) and 0·41 L (0·39–0·43), and MAE of 0·31 L (99% CI 0·29–0·32) and 0·31 L (0·30–0·32). External testing for FEV&lt;sub&gt;1&lt;/sub&gt; yielded &lt;em&gt;r&lt;/em&gt; values of 0·91 (99% CI 0·90–0·92) for institution D and 0·91 (0·90–0·91) for institution E, ICC of 0·90 (99% CI 0·89–0·91) and 0·90 (0·90–0·91), MSE of 0·13 L&lt;sup&gt;2&lt;/sup&gt; (99% CI 0·12–0·15) and 0·11 L&lt;sup&gt;2&lt;/sup&gt; (0·10–0·12), RMSE of 0·37 L (99% CI 0·35–0·38) and 0·33 L (0·32–0·35), and MAE of 0·28 L (99% CI 0·27–0·29) and 0·25 L (0·25–0·26).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;This deep learning model allowed ","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 8","pages":"Pages e580-e588"},"PeriodicalIF":23.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024001134/pdfft?md5=d7024a15c05d0bb8522e24f48c3cce86&pid=1-s2.0-S2589750024001134-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical artificial intelligence for clinicians: the lost cognitive perspective 面向临床医生的医学人工智能:迷失的认知视角。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00095-5
Lana Tikhomirov BPsych [Hons] , Prof Carolyn Semmler PhD , Melissa McCradden PhD , Rachel Searston PhD , Marzyeh Ghassemi PhD , Lauren Oakden-Rayner MD PhD
{"title":"Medical artificial intelligence for clinicians: the lost cognitive perspective","authors":"Lana Tikhomirov BPsych [Hons] ,&nbsp;Prof Carolyn Semmler PhD ,&nbsp;Melissa McCradden PhD ,&nbsp;Rachel Searston PhD ,&nbsp;Marzyeh Ghassemi PhD ,&nbsp;Lauren Oakden-Rayner MD PhD","doi":"10.1016/S2589-7500(24)00095-5","DOIUrl":"10.1016/S2589-7500(24)00095-5","url":null,"abstract":"<div><p>The development and commercialisation of medical decision systems based on artificial intelligence (AI) far outpaces our understanding of their value for clinicians. Although applicable across many forms of medicine, we focus on characterising the diagnostic decisions of radiologists through the concept of ecologically bounded reasoning, review the differences between clinician decision making and medical AI model decision making, and reveal how these differences pose fundamental challenges for integrating AI into radiology. We argue that clinicians are contextually motivated, mentally resourceful decision makers, whereas AI models are contextually stripped, correlational decision makers, and discuss misconceptions about clinician–AI interaction stemming from this misalignment of capabilities. We outline how future research on clinician–AI interaction could better address the cognitive considerations of decision making and be used to enhance the safety and usability of AI models in high-risk medical decision-making contexts.</p></div>","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 8","pages":"Pages e589-e594"},"PeriodicalIF":23.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024000955/pdfft?md5=c4262279ee0696247e86b8dc47f4a153&pid=1-s2.0-S2589750024000955-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A prognostic and predictive computational pathology immune signature for ductal carcinoma in situ: retrospective results from a cohort within the UK/ANZ DCIS trial 导管原位癌的预后和预测性计算病理学免疫特征:英国/新西兰 DCIS 试验队列的回顾性结果。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00116-X
{"title":"A prognostic and predictive computational pathology immune signature for ductal carcinoma in situ: retrospective results from a cohort within the UK/ANZ DCIS trial","authors":"","doi":"10.1016/S2589-7500(24)00116-X","DOIUrl":"10.1016/S2589-7500(24)00116-X","url":null,"abstract":"<div><h3>Background</h3><p>The density of tumour-infiltrating lymphocytes (TILs) could be prognostic in ductal carcinoma in situ (DCIS). However, manual TIL quantification is time-consuming and suffers from interobserver and intraobserver variability. In this study, we developed a TIL-based computational pathology biomarker and evaluated its association with the risk of recurrence and benefit of adjuvant treatment in a clinical trial cohort.</p></div><div><h3>Methods</h3><p>In this retrospective cohort study, a computational pathology pipeline was developed to generate a TIL-based biomarker (CPath TIL categories). Subsequently, the signature underwent a masked independent validation on H&amp;E-stained whole-section images of 755 patients with DCIS from the UK/ANZ DCIS randomised controlled trial. Specifically, continuous biomarker CPath TIL score was calculated as the average TIL density in the DCIS microenvironment and dichotomised into binary biomarker CPath TIL categories (CPath TIL-high <em>vs</em> CPath TIL-low) using the median value as a cutoff. The primary outcome was ipsilateral breast event (IBE; either recurrence of DCIS [DCIS-IBE] or invasive progression [I-IBE]). The Cox proportional hazards model was used to estimate the hazard ratio (HR).</p></div><div><h3>Findings</h3><p>CPath TIL-score was evaluable in 718 (95%) of 755 patients (151 IBEs). Patients with CPath TIL-high DCIS had a greater risk of IBE than those with CPath TIL-low DCIS (HR 2·10 [95% CI 1·39–3·18]; p=0·0004). The risk of I-IBE was greater in patients with CPath TIL-high DCIS than those with CPath TIL-low DCIS (3·09 [1·56–6·14]; p=0·0013), and the risk of DCIS-IBE was non-significantly higher in those with CPath TIL-high DCIS (1·61 [0·95–2·72]; p=0·077). A significant interaction (p<sub>interaction</sub>=0·025) between CPath TIL categories and radiotherapy was observed with a greater magnitude of radiotherapy benefit in preventing IBE in CPath TIL-high DCIS (0·32 [0·19–0·54]) than CPath TIL-low DCIS (0·40 [0·20–0·81]).</p></div><div><h3>Interpretation</h3><p>High TIL density is associated with higher recurrence risk—particularly of invasive recurrence—and greater radiotherapy benefit in patients with DCIS. Our TIL-based computational pathology signature has a prognostic and predictive role in DCIS.</p></div><div><h3>Funding</h3><p>National Cancer Institute under award number U01CA269181, Cancer Research UK (C569/A12061; C569/A16891), and the Breast Cancer Research Foundation, New York (NY, USA).</p></div>","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 8","pages":"Pages e562-e569"},"PeriodicalIF":23.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258975002400116X/pdfft?md5=995a38719dfb36fc24e8288708c57372&pid=1-s2.0-S258975002400116X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to Lancet Digit Health 2024; 6: e562–69 Lancet Digit Health 2024; 6: e562-69 更正。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00156-0
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引用次数: 0
Evaluation and communication of pandemic scenarios 大流行病情景的评估和传播。
IF 23.8 1区 医学
Lancet Digital Health Pub Date : 2024-08-01 DOI: 10.1016/S2589-7500(24)00144-4
Philip Gerlee , Henrik Thorén , Anna Saxne Jöud , Torbjörn Lundh , Armin Spreco , Anders Nordlund , Thomas Brezicka , Tom Britton , Magnus Kjellberg , Henrik Källberg , Anders Tegnell , Lisa Brouwers , Toomas Timpka
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引用次数: 0
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