ABSTRACT
The risk potential on German roads remains high: Even in 2021 with less traffic due to the Covid-pandemic, the police counted 2.3 million traffic accidents [1]. Many accidents occur due to individual mistakes of road users. Dangerous situations are often misjudged or not recognized on time, for example, due to distraction while driving [2]. Autonomous systems in vehicles show the potential to avoid driver-related accidents, but for a Dynamic Risk Management (DRM) reliable data is needed. This is exactly where the project “Early Detection of Dangerous Areas in road traffic using smart data - EDDA+” comes in. The road hazard map created by using the EDDA+ method evaluates the Germany-wide road network according to a hazard score. This digital, safety-related data includes a lot of contextual information like weather or daytime conditions and can be used as an additional basis for the DRM risk analysis. For example, an autonomous system could react more sensitively at road areas where the hazard score is high. This continuously updated hazard map is published on www.gefahrenstellen.de and also available in a more detailed way on our platform for professional users such as local authorities, police, science, engineering offices, navigation providers and car manufacturers. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Introduction: Even after completion of curative treatment for non-small cell lung cancer (NSCLC), patients have a high risk of recurrence and consequently, active surveillance is recommended. The SUPE_R trial is an ongoing trial, designed to explore whether surveillance with F-18 fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) and cell-free tumor DNA sequencing (ctDNA) can improve recurrence detection and increase the number of treatable relapses. Methods: Patients diagnosed with NSCLC who are candidates for curative therapy, are recruited prior to therapy to obtain a baseline blood sample for ctDNA analysis (part 1). After successful completion of curative treatment verified at the first post-treatment surveillance CT scan, patients are randomized to either continue standard surveillance or surveillance with FDG PET/CT replacing CT every 6 months, for two years or until recurrence (part 2). Baseline characteristics were recorded for all patients, as well as reasons for dropout or exclusion of patients not randomized for part 2. [Formula presented] Results: Patient enrollment started in 2018 and the inclusion goal of 750 randomized patients was met in November 2021. As of February 2022, 40.4% (n = 303) of randomized patients have completed the intervention. 923 patients were enrolled in part 1 (table 1). 492 (53.3%) patients included in part 1 were not randomized for part 2. This was most frequently due to dropout before screening for part 2 (n = 203, 41.3%), refusal to participate in part 2 (n = 118, 12.8%), exclusion due to unmet inclusion criteria for part 2 (n = 97, 10.5%) or progressive disease (n = 62, 6.7%). Twenty-two patients missed screening for part 2 due to Covid-19. 319 patients were included in part 2 without prior inclusion in part 1. The proportion of patients not randomized for part 2 was higher for patients with advanced disease at diagnosis (stage III) compared to patients with localized disease (stage I-II, 64.7 vs 47.8%, p < 0.001), which is partially explained by a higher risk of death (6.3 vs 2.2%, p = 0.008) and disease progression (9.5 vs 5.5%, p = 0.063) in these patients. Conclusions: Enrollment in the SUPE_R trial was recently completed after 3 years of patient recruitment. Half of patients included in part 1 were not randomized for part 2 and the proportion of patients not randomized was higher for patients with more advanced disease at diagnosis. Whether this will affect the outcome of the SUPE_R trial remains to be explored. Keywords: Surveillance, PET/CT, ctDNA