Michael W. Gach , Gilbert Lazarus , Daniel Martin Simadibrata , Robert Sinto , Yulia Rosa Saharman , Ralalicia Limato , Erni J. Nelwan , H. Rogier van Doorn , Anis Karuniawati , Raph L. Hamers
{"title":"Antimicrobial resistance among common bacterial pathogens in Indonesia: a systematic review","authors":"Michael W. Gach , Gilbert Lazarus , Daniel Martin Simadibrata , Robert Sinto , Yulia Rosa Saharman , Ralalicia Limato , Erni J. Nelwan , H. Rogier van Doorn , Anis Karuniawati , Raph L. Hamers","doi":"10.1016/j.lansea.2024.100414","DOIUrl":"https://doi.org/10.1016/j.lansea.2024.100414","url":null,"abstract":"<div><h3>Background</h3><p>The WHO Global Antimicrobial Resistance Surveillance System (GLASS) aims to describe antimicrobial resistance (AMR) patterns and trends in common bacterial pathogens, but data remain limited in many low and middle-income countries including Indonesia.</p></div><div><h3>Methods</h3><p>We systematically searched Embase, PubMed and Global Health Database and three Indonesian databases for original peer-reviewed articles in English and Indonesian, published between January 1, 2000 and May 25, 2023, that reported antimicrobial susceptibility for the 12 GLASS target pathogens from human samples. Pooled AMR prevalence estimates were calculated for relevant pathogen-antimicrobial combinations accounting for the sampling weights of the studies (PROSPERO: CRD42019155379).</p></div><div><h3>Findings</h3><p>Of 2182 search hits, we included 102 papers, comprising 19,517 bacterial isolates from hospitals (13,647) and communities (5870). In hospital settings, 21.6% of <em>Klebsiella pneumoniae</em> isolates, 18.3% of <em>Escherichia coli</em> isolates, 35.8% of <em>Pseudomonas aeruginosa</em> isolates and 70.7% of <em>Acinetobacter baumannii</em> isolates were carbapenem-resistant; 29.9% of <em>Streptococcus pneumoniae</em> isolates were penicillin-resistant; and 22.2% of <em>Staphylococcus aureus</em> isolates were methicillin-resistant. Hospital prevalence of carbapenem-resistant <em>K. pneumoniae</em> and <em>E. coli</em>, and penicillin-resistant <em>S. pneumoniae</em> increased over time. In communities, 28.3% of <em>K. pneumoniae</em> isolates and 15.7% of <em>E. coli</em> isolates were carbapenem-resistant, 23.9% of <em>S. pneumoniae</em> isolates were penicillin-resistant, and 11.1% of <em>S. aureus</em> isolates were methicillin-resistant. Data were limited for the other pathogens.</p></div><div><h3>Interpretation</h3><p>AMR prevalence estimates were high for critical gram-negative bacteria. However, data were insufficient to draw robust conclusions about the full contemporary AMR situation in Indonesia. Implementation of national AMR surveillance is a priority to address these gaps and inform context-specific interventions.</p></div><div><h3>Funding</h3><p><span>Wellcome</span> Africa Asia Programme Vietnam.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"26 ","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224000647/pdfft?md5=3a023fcfbce4a0e1c95db870c118060c&pid=1-s2.0-S2772368224000647-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917826","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":"Distribution of catheterisation laboratories in Indonesia 2017–2022: a nationwide survey","authors":"Farizal Rizky Muharram , Chaq El Chaq Zamzam Multazam , Wigaviola Socha Harmadha , Andrianto Andrianto , Senitza Anisa Salsabilla , Iwan Dakota , Hananto Andriantoro , Doni Firman , Maya Marinda Montain , Radityo Prakoso , Dilla Anggraeni","doi":"10.1016/j.lansea.2024.100418","DOIUrl":"https://doi.org/10.1016/j.lansea.2024.100418","url":null,"abstract":"<div><h3>Background</h3><p>Geographical terrains of Indonesia pose a major hindrance to transportation. The difficulty of transportation affects the provision of acute time-dependent therapy such as percutaneous coronary intervention (PCI). Also, Indonesia’s aging population would have a significant impact on the prevalence of acute coronary syndrome in the next decade. Therefore, the analysis and enhancement of cardiovascular care are crucial. The catheterisation laboratory performs PCI procedures. In the current study, we mapped the number and distribution of catheterisation laboratories in Indonesia.</p></div><div><h3>Methods</h3><p>A direct survey was used to collect data related to catheterisation laboratory locations in July 2022. The population data was sourced from the Ministry of Home Affairs. The recent growth of catheterisation laboratories was examined and evaluated based on geographical areas. The main instruments for comparing regions and changes throughout time are the ratio of catheterisation laboratories per 100,000 population and the Gini index (a measure of economic and healthcare inequality. Gini index ranges from 0 to 1, with greater values indicating more significant levels of inequality). Regression analysis was carried out to see how the number of catheterisation laboratories was affected by health demand (prevalence) and economic capacity (Gross Domestic Regional Product [GDRP] per Capita).</p></div><div><h3>Findings</h3><p>The number of catheterisation laboratories in Indonesia significantly increased from 181 to 310 during 2017–2022, with 44 of the 119 new labs built in an area that did not have one. Java has the most catheterisation laboratories (208, 67%). The catheterisation laboratory ratio in the provinces of Indonesia ranges from 0.0 in West Papua and Maluku to 4.46 in Jakarta; the median is 1.09 (IQR 0.71–1.18). The distribution remains a problem, as shown by the high catheterisation laboratory Gini index (0.48). Regression shows that distribution of catheterisation laboratories was significantly affected by GDRP and the prevalence of heart disease.</p></div><div><h3>Interpretation</h3><p>The number of catheterisation laboratories in Indonesia has increased significantly recently, however, maldistribution remains a concern. To improve Indonesia’s cardiovascular emergency services, future development of catheterisation laboratories must be better planned considering the facility’s accessibility and density.</p></div><div><h3>Funding</h3><p>Airlangga Research Fund - Universitas Airlangga.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"26 ","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224000684/pdfft?md5=6da6cae0850a13bac406f1f686b8e2fb&pid=1-s2.0-S2772368224000684-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140906481","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":"Emerging trends in antimicrobial resistance in bloodstream infections: multicentric longitudinal study in India (2017–2022)","authors":"Jasmine Kaur , Harpreet Singh , Tavpritesh Sethi","doi":"10.1016/j.lansea.2024.100412","DOIUrl":"https://doi.org/10.1016/j.lansea.2024.100412","url":null,"abstract":"<div><h3>Background</h3><p>Antimicrobial resistance (AMR) has escalated to pandemic levels, posing a significant global health threat. This study examines the patterns and trends of AMR in Bloodstream Infections (BSIs) across India, aiming to inform better surveillance and intervention strategies.</p></div><div><h3>Methods</h3><p>Six-year data from 21 tertiary care centers in the Indian Council of Medical Research's AMR Surveillance Network (IAMRSN) were retrospectively analyzed to estimate cluster-robust trends in resistance. Time-series analysis was used to discern lead/lag relationships between antibiotic pairs and the directional influence of resistance in community and hospital-acquired BSIs(CA/HA BSIs). A data-driven Bayesian network ensemble averaged over 301 bootstrap samples was modelled to uncover systemic associations between AMR and Sustainable Development Goals (SDGs).</p></div><div><h3>Findings</h3><p>Our findings indicate significant (p < 0.001) monthly increases in Imipenem and Meropenem resistance for <em>Klebsiella</em>, <em>E. coli</em>, and <em>Acinetobacter</em> BSIs. Importantly, Carbapenem resistance in HA-BSIs preceded that in CA-BSIs for <em>Klebsiella</em> and <em>Acinetobacter</em> (p < 0.05). At a national level, Cefotaxime resistance emerged as a potential early indicator for emerging Carbapenem resistance, proposing a novel surveillance marker. In <em>Klebsiella</em> BSIs, states with higher achievement of SDG3 goals showed lower Imipenem resistance. A model-based AMR scorecard is introduced for focused interventions and continuous monitoring.</p></div><div><h3>Interpretation</h3><p>The identified spatiotemporal trends and drug resistance associations offer critical insights for AMR surveillance aligning with WHO GLASS standards.The escalation of carbapenem resistance in BSIs demands vigilant monitoring and may be crucial for achieving SDGs by 2030. Implementing the proposed framework for data-driven evidence can help nations achieve proactive AMR surveillance.</p></div><div><h3>Funding</h3><p>No specific funding was received for this analysis.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"26 ","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224000623/pdfft?md5=93095294fd1d792400f17943d6503c4b&pid=1-s2.0-S2772368224000623-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902317","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":"Observational studies: practical tips for avoiding common statistical pitfalls","authors":"Anna Freni Sterrantino","doi":"10.1016/j.lansea.2024.100415","DOIUrl":"https://doi.org/10.1016/j.lansea.2024.100415","url":null,"abstract":"<div><p>This Personal View is intended for early-career researchers who are not yet experts in statistics. The Personal View focuses on common but usually avoidable flaws in the context of observational studies. I point out how study design, data collection, and statistical methods impact statistical results and research conclusions. With particular attention to study planning, sample selection, biases, lack of transparency and results misinterpretations.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"25 ","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224000659/pdfft?md5=6559a3da2b3e56f434cc29711a421238&pid=1-s2.0-S2772368224000659-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894271","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}
Tuck Seng Cheng , Farzana Zahir , Solomi V. Carolin , Ashok Verma , Sereesha Rao , Saswati Sanyal Choudhury , Gitanjali Deka , Pranabika Mahanta , Swapna Kakoty , Robin Medhi , Shakuntala Chhabra , Anjali Rani , Amrit Bora , Indrani Roy , Bina Minz , Omesh Kumar Bharti , Rupanjali Deka , Charles Opondo , David Churchill , Marian Knight , Manisha Nair
{"title":"Risk factors for labour induction and augmentation: a multicentre prospective cohort study in India","authors":"Tuck Seng Cheng , Farzana Zahir , Solomi V. Carolin , Ashok Verma , Sereesha Rao , Saswati Sanyal Choudhury , Gitanjali Deka , Pranabika Mahanta , Swapna Kakoty , Robin Medhi , Shakuntala Chhabra , Anjali Rani , Amrit Bora , Indrani Roy , Bina Minz , Omesh Kumar Bharti , Rupanjali Deka , Charles Opondo , David Churchill , Marian Knight , Manisha Nair","doi":"10.1016/j.lansea.2024.100417","DOIUrl":"https://doi.org/10.1016/j.lansea.2024.100417","url":null,"abstract":"<div><h3>Background</h3><p>Guidelines for labour induction/augmentation involve evaluating maternal and fetal complications, and allowing informed decisions from pregnant women. This study aimed to comprehensively explore clinical and non-clinical factors influencing labour induction and augmentation in an Indian population.</p></div><div><h3>Methods</h3><p>A prospective cohort study included 9305 pregnant women from 13 hospitals across India. Self-reported maternal socio-demographic and lifestyle factors, and maternal medical and obstetric histories from medical records were obtained at recruitment (≥28 weeks of gestation), and women were followed up within 48 h after childbirth. Maternal and fetal clinical information were classified based on guidelines into four groups of clinical factors: (i) ≥2 indications, (ii) one indication, (iii) no indication and (iv) contraindication. Associations of clinical and non-clinical factors (socio-demographic, healthcare utilisation and lifestyle related) with labour induction and augmentation were investigated using multivariable logistic regression analyses.</p></div><div><h3>Findings</h3><p>Over two-fifths (n = 3936, 42.3%, 95% confidence interval [CI] 41.3–43.3%) of the study population experienced labour induction and more than a quarter (n = 2537, 27.3%, 95% CI 26.4–28.2%) experienced augmentation. Compared with women with ≥2 indications, those with one (adjusted odds ratio [aOR] 0.50, 95% CI 0.42–0.58) or no indication (aOR 0.24, 95% CI 0.20–0.28) or with contraindications (aOR 0.12, 95% CI 0.07–0.20) were less likely to be induced, adjusting for non-clinical characteristics. These associations were similar for labour augmentation. Notably, 34% of women who were induced or augmented did not have any clinical indication. Several maternal demographic (age at labour, parity and body mass index in early pregnancy), healthcare utilization (number of antenatal check-ups, duration of iron-folic acid supplementation and individuals managing childbirth) and socio-economic factors (religion, living below poverty line, maternal education and partner’s occupation) were independently associated with labour induction and augmentation.</p></div><div><h3>Interpretation</h3><p>Although decisions about induction and augmentation of labour in our study population in India were largely guided by clinical recommendations, we cannot ignore that more than a third of the women did not have an indication. Decisions could also be influenced by non-clinical factors which need further research.</p></div><div><h3>Funding</h3><p>The MaatHRI platform is funded by a <span>Medical Research Council Career Development Award</span> (Grant Ref: <span>MR/P022030/1</span>) and a <span>Transition Support Award</span> (Grant Ref: <span>MR/W029294/1</span>).</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"25 ","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224000672/pdfft?md5=4859f1d317421cfb41f20454d959b124&pid=1-s2.0-S2772368224000672-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140879834","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}
Sok King Ong , Sarah K. Abe , Gillian Li Gek Phua , Harindra Jayasekara , Kayo Togawa , Laureline Gatellier , Jeongseon Kim , Yawei Zhang , Siti Zuhrini Kahan , Siti Norbayah Yusof , Jong Soo Han , C.S. Pramesh , Manju Sengar , Abhishek Shankar , Clarito Cairo , Suleeporn Sangrajran , Erdenekhuu Nansalmaa , Tseveen Badamsuren , Tashi Dendup , Kinley Tshering , Tomohiro Matsuda
{"title":"Mapping recommendations towards an Asian Code Against Cancer (ACAC) as part of the World Code Against Cancer Framework: an Asian National Cancer Centers Alliance (ANCCA) initiative","authors":"Sok King Ong , Sarah K. Abe , Gillian Li Gek Phua , Harindra Jayasekara , Kayo Togawa , Laureline Gatellier , Jeongseon Kim , Yawei Zhang , Siti Zuhrini Kahan , Siti Norbayah Yusof , Jong Soo Han , C.S. Pramesh , Manju Sengar , Abhishek Shankar , Clarito Cairo , Suleeporn Sangrajran , Erdenekhuu Nansalmaa , Tseveen Badamsuren , Tashi Dendup , Kinley Tshering , Tomohiro Matsuda","doi":"10.1016/j.lansea.2023.100316","DOIUrl":"10.1016/j.lansea.2023.100316","url":null,"abstract":"<div><p>This paper outlines the process undertaken by Asian National Cancer Centers Alliance (ANCCA) members in working towards an Asian Code Against Cancer (ACAC). The process involves: (i) identification of the criteria for selecting the existing set of national recommendations for ACAC (ii) compilation of existing national codes or recommendations on cancer prevention (iii) reviewing the scientific evidence on cancer risk factors in Asia and (iv) establishment of one or more ACAC under the World Code Against Cancer Framework. A matrix of national codes or key recommendations against cancer in ANCCA member countries is presented. These include taking actions to prevent or control tobacco consumption, obesity, unhealthy diet, physical inactivity, alcohol consumption, exposure to occupational and environmental toxins; and to promote breastfeeding, vaccination against infectious agents and cancer screening. ANCCA will continue to serve as a supportive platform for collaboration, development, and advocacy of an ACAC jointly with the International Agency for Research on Cancer/World Health Organization (IARC/WHO).</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"24 ","pages":"Article 100316"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368223001762/pdfft?md5=6d317d5563e37db062567d5270a06f4e&pid=1-s2.0-S2772368223001762-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139300539","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":"Survival of patients with cervical cancer in India – findings from 11 population based cancer registries under National Cancer Registry Programme","authors":"Krishnan Sathishkumar , Jayasankar Sankarapillai , Aleyamma Mathew , Rekha A. Nair , Nitin Gangane , Sushma Khuraijam , Debabrata Barmon , Shashank Pandya , Gautam Majumdar , Vinay Deshmane , Eric Zomawia , Tseten Wangyal Bhutia , Kaling Jerang , Preethi Sara George , Swapna Maliye , Rajesh Laishram , Anand Shah , Shiromani Debbarma , Shravani Koyande , Lalawmpuii Pachuau , Prashant Mathur","doi":"10.1016/j.lansea.2023.100296","DOIUrl":"10.1016/j.lansea.2023.100296","url":null,"abstract":"<div><h3>Background</h3><p>Cancer survival data from Population Based Cancer Registries (PBCR) reflect the average outcome of patients in the population, which is critical for cancer control efforts. Despite decreasing incidence rates, cervical cancer is the second most common female cancer in India, accounting for 10% of all female cancers. The objective of the study is to estimate the five-year survival of patients with cervical cancer diagnosed between 2012 and 2015 from the PBCRs in India.</p></div><div><h3>Methods</h3><p>A single primary incidence of cervical cancer cases of 11 PBCRs (2012–2015) was followed till June 30, 2021 (n = 5591). Active follow-ups were conducted through hospital visits, telephone calls, home or field visits, and public databases. Five-year Observed Survival (OS) and Age Standardised Relative Survival (ASRS) was calculated. OS was measured by age and clinical extent of disease for cervical cancers.</p></div><div><h3>Findings</h3><p>The five-year ASRS (95% CI) of cervical cancer was 51.7% (50.2%–53.3%). Ahmedabad urban (61.5%; 57.4%–65.4%) had a higher survival followed by Thiruvananthapuram (58.8%; 53.1%–64.3%) and Kollam (56.1%; 50.7%–61.3%). Tripura had the lowest overall survival rate (31.6%; 27.2%–36.1%). The five-year OS% for pooled PBCRs was 65.9%, 53.5%, and 18.0% for localised, regional, and distant metastasis, respectively.</p></div><div><h3>Interpretation</h3><p>We observed a wide variation in cervical cancer survival within India. The findings of this study would help the policymakers to identify and address inequities in the health system. We re-emphasise the importance of awareness, early detection, and increase the improvement of the health care system.</p></div><div><h3>Funding</h3><p>The National Cancer Registry Programme is funded through intra-mural funding by <span>Indian Council of Medical Research</span>, <span>Department of Health Research, India</span>, <span>Ministry of Health & Family Welfare</span>.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"24 ","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368223001567/pdfft?md5=fd18389e3b382b70e8b70188e58646b0&pid=1-s2.0-S2772368223001567-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135707010","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":"Deep-learning enabled ultrasound based detection of gallbladder cancer in northern India: a prospective diagnostic study","authors":"Pankaj Gupta , Soumen Basu , Pratyaksha Rana , Usha Dutta , Raghuraman Soundararajan , Daneshwari Kalage , Manika Chhabra , Shravya Singh , Thakur Deen Yadav , Vikas Gupta , Lileswar Kaman , Chandan Krushna Das , Parikshaa Gupta , Uma Nahar Saikia , Radhika Srinivasan , Manavjit Singh Sandhu , Chetan Arora","doi":"10.1016/j.lansea.2023.100279","DOIUrl":"10.1016/j.lansea.2023.100279","url":null,"abstract":"<div><h3>Background</h3><p>Gallbladder cancer (GBC) is highly aggressive. Diagnosis of GBC is challenging as benign gallbladder lesions can have similar imaging features. We aim to develop and validate a deep learning (DL) model for the automatic detection of GBC at abdominal ultrasound (US) and compare its diagnostic performance with that of radiologists.</p></div><div><h3>Methods</h3><p>In this prospective study, a multiscale, second-order pooling-based DL classifier model was trained (training and validation cohorts) using the US data of patients with gallbladder lesions acquired between August 2019 and June 2021 at the Postgraduate Institute of Medical Education and research, a tertiary care hospital in North India. The performance of the DL model to detect GBC was evaluated in a temporally independent test cohort (July 2021–September 2022) and was compared with that of two radiologists.</p></div><div><h3>Findings</h3><p>The study included 233 patients in the training set (mean age, 48 ± (2SD) 23 years; 142 women), 59 patients in the validation set (mean age, 51.4 ± 19.2 years; 38 women), and 273 patients in the test set (mean age, 50.4 ± 22.1 years; 177 women). In the test set, the DL model had sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of 92.3% (95% CI, 88.1–95.6), 74.4% (95% CI, 65.3–79.9), and 0.887 (95% CI, 0.844–0.930), respectively for detecting GBC which was comparable to both the radiologists. The DL-based approach showed high sensitivity (89.8–93%) and AUC (0.810–0.890) for detecting GBC in the presence of stones, contracted gallbladders, lesion size <10 mm, and neck lesions, which was comparable to both the radiologists (p = 0.052–0.738 for sensitivity and p = 0.061–0.745 for AUC). The sensitivity for DL-based detection of mural thickening type of GBC was significantly greater than one of the radiologists (87.8% vs. 72.8%, p = 0.012), despite a reduced specificity.</p></div><div><h3>Interpretation</h3><p>The DL-based approach demonstrated diagnostic performance comparable to experienced radiologists in detecting GBC using US. However, multicentre studies are warranted to explore the potential of DL-based diagnosis of GBC fully.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"24 ","pages":"Article 100279"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368223001397/pdfft?md5=ec711d990a668397721c2ca0e9a08ce0&pid=1-s2.0-S2772368223001397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249078","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":"The cost of cancer care in India requires careful reporting and interpretation","authors":"Parth Sharma , Santam Chakraborty","doi":"10.1016/j.lansea.2024.100380","DOIUrl":"10.1016/j.lansea.2024.100380","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"24 ","pages":"Article 100380"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224000295/pdfft?md5=d92edc96539ceb846183315486daa62a&pid=1-s2.0-S2772368224000295-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140089638","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}