A comparative study of Watson for Oncology and tumor boards in breast cancer treatment

PURPOSE: Watson for Oncology (WFO) is a computing system for considering treatment option with patients. The aim of this study is to determine the concordance rate of WFO and tumor board in treatment options of breast cancer.METHODS: One hundred and seventy breast cancer patients who were treated at Gachon University Gil Medical Center (GMC) from December 2016 to March 2018 were investigated. “Concordance” is defined that treatment provided by GMC tumor board and WFO-provided treatments (Recommend or For Consideration) were coincide. “Discordance” is defined that treatment provided by GMC tumor board and WFO-provided treatments (Not Recommended or Not Available) were coincide.RESULTS: In chemotherapy, of the total 170 patients, 23 patients were excluded, and the concordance rate was compared in 147 patients. Concordance rate was 93% (136/147). In the 11 patients who were discordant, seven patients complied with the treatment proposed by GMC tumor board due to insurance problems and age, and two patients did not follow the treatment proposed by WFO due to pregnancy and patient's choice, and one patient chose a treatment determined by WFO, last one patient was not treated with chemotherapy because it was not considered to be clinically necessary. In radiotherapy, the overall agreement rate was as high as 99% (147/148).CONCLUSION: Through this study, we found that many of the treatment proposals provided by WFO are highly reliable. Although the overall agreement is high in the radiotherapy regimen, the indication for radiotherapy by WFO is more aggressive and hypofractionated high dose intensity radiotherapy is growing trend by WFO.

Shared and Distinct Neurocognitive Endophenotypes of Schizophrenia and Psychotic Bipolar Disorder

OBJECTIVE: Schizophrenia and bipolar disorder are characterized by the presence of neurocognitive impairments on the psychosis continuum. The present study aimed to explore the shared and distinct endophenotypes between these disorders. METHODS: The study included 34 probands with remitted schizophrenia and 34 probands with euthymic bipolar disorder who had a history of psychotic symptoms that met the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) criteria, unaffected first-degree relatives of probands (31 relatives of probands with schizophrenia and 29 relatives of probands with bipolar disorder), and 34 healthy controls. Cognitive assessments were performed using the digit span, continuous performance, Rey auditory and visual learning, complex figure, verbal fluency, Wisconsin card sorting, and finger tapping tests. RESULTS: Probands with schizophrenia showed the most generalized and severe cognitive deficits across cognitive domains (working memory, verbal learning and memory, visual memory, verbal fluency, and executive function). Some domains of cognitive function (working memory, verbal learning, and memory) were also impaired in probands with bipolar disorder, but to a lesser degree than in probands with schizophrenia. All probands and relatives showed a common deficit in working memory compared to healthy controls. Relatives of probands with schizophrenia also showed verbal fluency dysfunction. Cognitive performance of all relatives was intermediate to the performance of both patients and healthy controls. CONCLUSION: These findings suggest that a deficit in working memory could be a shared endophenotype of genetic vulnerability to schizophrenia and psychotic bipolar disorder, and verbal fluency could be a candidate endophenotype for schizophrenia specifically.

Real-time Assay of Toxic Lead in In Vivo Living Plant Tissue

A method of detecting lead was developed using square wave anodic stripping voltammetry (SWASV) with DNA-carbon nanotube paste electrode (CNTPE). The results indicated a sensitive oxidation peak current of lead on the DNA-CNTPE. The curves were obtained within a concentration range of 50 ngL-1-20 mgL-1 with preconcentration time of 100, 200, and 400 sec at the concentration of mgL-1, microgL-1, and ngL-1, respectively. The observed relative standard deviation was 0.101% (n = 12) in the lead concentration of 30.0 microgL-1 under optimum conditions. The low detection limit (S/N) was pegged at 8 ngL-1 (2.6 x10-8 M). Results showed that the developed method can be used in real-time assay in vivo without requiring any pretreatment and pharmaceutical samples, and food samples, as well as other materials requiring water source contamination analyses.

A Quality Function Deployment Framework for the Service Quality of Health Information Websites / 대한의료정보학회지

OBJECTIVES: This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. METHODS: Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. RESULTS: Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. CONCLUSIONS: The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results.

Evaluation of Allergen Specific IgE assay on ADVIA Centaur Immunoassay System / 대한진단검사의학회지

BACKGROUND: Allergen specific IgE (sIgE) assay is an important aid in the diagnosis and treatment of allergy. We evaluated the analytical performance of a quantitative chemiluminescence immunoassay for sIgE using the continuous random access ADVIA Centaur. METHODS: Six ADVIA Centaur sIgE reagents for common inhalant allergens in Korea, d1, d2, e1, e5, t3, and t7, were evaluated for precision, dilution recovery (parallelism), comparison with Pharmacia UniCAP sIgE assay and skin prick test, sample volume, and analytical speed according to the NCCLS guidelines (I/LA20-A, EP5-A2). Commercialized positive and negative quality control materials were used for a precision study, and samples from a total of 110 patients were used for dilution recovery and comparison studies. RESULTS: Within-run coefficients of variation (CV) of the 6 items were 3.45-6.14% and within-device CVs (total CVs) of all items were below 10%. Interdilutional CVs of all items were 2.84-11.95%, which showed a good linearity and parallelism over its measuring range. Positive/negative concordance rates of the 6 items with UniCAP sIgE assay were 76.3-96.1% (d1, 88.2%; d2, 96.1%; e1, 91.0%; e5, 77.0%; t3, 90.5%; and t7, 76.3%). Concordance rates of the six items with skin prick test were all above 80%. The quantity of sample volume (25 micro L/test) needed was relatively small, and a high throughput (120 tests/hr) and rapid turnaround time (47 min) could be achieved. CONCLUSIONS: The ADVIA Centaur sIgE assay was thought to be a convenient and efficient method to be used in medium- to large-sized laboratories.

Application of the HoQ Model to Operations of Health Information Websites / 대한의료정보학회지

OBJECTIVE: Despite the increasing number of websites about health information, there have been few studies on the issues of enhancing the service quality of health information websites. The purpose of this study is twofold. The first objective is to identify what customers request from health information websites and the key attributes of service operations. The second objective is to determine a strategy to improve the service quality of health information websites by applying the House of Quality(HoQ) framework. METHODS: Service attributes and functional characteristics were gathered through an online survey: in particular, 250 questionnaires were collected through an online survey at a large internet community. Based on the survey, conducted are various statistical methods including principal component factor, logistic regression, correlation, and multiple regression analyses. RESULTS: First of all, 9 key service attributes and 5 key functional characteristics to health information websites are derived from principal component factor analysis. And the logistic regression analysis determines the relative importance of service attributes. To complete the relation matrix at the center of the HoQ model, it is necessary to measure the interdependency, if any, between all service attributes and functional characteristics. All the relationships are exhibited as standardized estimates. The completed HoQ results show that the search function represents the highest importance to customers. CONCLUSION: The result of this study confirms the proposition that it is critical for website managers to provide health information service that best meet customers' needs. The HoQ framework employed in this study provides an efficient way of improving healthcare websites. Moreover, the insights from the study will serve as a good stepping stone towards a marketing strategy for the website providers under a fierce competition.

Attributes of User-centered Evaluation for Health Information Websites / 대한의료정보학회지

OBJECTIVE: Despite of increasing number of websites for health information, there have been few studies on the issues of enhancing the service quality of health information websites. In this article, we examine and identify the key service attributes of the websites for health information, thereby providing a direction to improve the website service quality. METHODS: The research takes three steps to identify customers' requirements for health information websites. Starting from a comprehensive literature review and brainstorming, we narrow down the possible candidates of key service attributes as going through the steps. Lastly, conducted is an extensive customer survey followed by multivariate statistical analyses such as reliability tests, principal component analysis, discriminant analysis, etc. RESULTS: Based on 250 questionnaires completed through the online survey, derived are 9 key service attributes for efficient operations of healthcare websites. These include reliability, information transparency, customer care, capability, publicity, ease-of-use, security and integrity, responsiveness, and elucidation. CONCLUSION: The research results presented in the paper will provide an efficient way of operating healthcare websites. Moreover, the insights from the study will be a good stepping? stone toward a marketing strategy for the website providers under a fierce competition.