A user-centered chatbot to identify and interconnect individual, social and environmental risk factors related to overweight and obesity

The objective of this study was to assess the feasibility of using a user-centered chatbotfor collecting linked data to study overweight and obesity causes ina target population. In total 980 people participated in the feasibility study organized in three studies: (1) within a group of university students (88 participants), (2) in a small town (422 participants), and (3) within a university community (470 participants). We gathered self-reported data through the Wakamola chatbot regarding participants diet, physical activity, social network, living area, obesity-associated diseases, and sociodemographic data. For each study, we calculated the mean Body Mass Index (BMI) and number of people in each BMI level. Also, we defined and calculated scores (1-100 scale) regarding global health, BMI, alimentation, physical activity and social network. Moreover, we graphically represented obesity risk for living areas and the social network with nodes colored by BMI. Students group results: Mean BMI 21.37 (SD 2.57) (normal weight), 8 people underweight, 5 overweight, 0 obesity, global health status 78.21, alimentation 63.64, physical activity 65.08 and social 26.54, 3 areas with mean BMI level of obesity, 17 with overweight level. Small town´s study results: Mean BMI 25.66 (SD 4.29) (overweight), 2 people underweight, 63 overweight, 26 obesity, global health status 69.42, alimentation 64.60, physical activity 60.61 and social 1.14, 1 area with mean BMI in normal weight; University´s study results: Mean BMI 23.63 (SD 3.7) (normal weight), 22 people underweight, 86 overweight, 28 obesity, global health status 81.03, alimentation 81.84, physical activity 70.01 and social 1.47, 3 areas in obesity level, 19 in overweight level. Wakamola is a health care chatbot useful to collect relevant data from populations in the risk of overweight and obesity. Besides, the chatbot provides individual self-assessment of BMI and general status regarding the style of living. Moreover, Wakamola connects users in a social network to help the study of O&O´s causes from an individual, social and socio-economic perspective.

Evaluation of MR imaging-targeted biopsies of the prostate in biopsy-naïve patients. A single centre study

PURPOSE

To evaluate the differences in prostate cancer detection rate and biopsy effectiveness between magnetic resonance imaging (MRI) target biopsy (TB) and transperineal standard biopsy (SB) in biopsy-naïve patients.

MATERIAL AND METHODS

Between October 2014 and April 2016, 60 men with a mean age of 64.1±6.7 (SD) years (range: 53-82 years) were prospectively enrolled. All patients underwent a prostate MRI study, evaluated by two radiologists, before undergoing the biopsy. A transperineal 12-core SB was carried out before TB, without the information from the MRI. The detection rate for all tumors and for clinically significant tumors (CS) was recorded. Sampling variables such as the proportion of cores positive for CS cancer (PCP-CS) and the maximum cancer core length (MCCL) were also calculated. The ability of MRI to predict the presence of a CS tumor at biopsy was studied using a sector analysis. Patients with negative biopsies were followed during a minimum of 12 months.

RESULTS

The detection rate for SB and TB was 53.3% (32/60) and 46.7% (28/60) respectively for all tumors (P=0.289) and 45% (27/60) in both techniques for CS tumors. TB obtained a larger PCP-CS (P<0.001) and MCCL (P=0.018). The sensitivity, specificity, positive predictive value, negative predictive value and cancer prevalence was 83.3%, 92.9%, 83.3%, 92.9% and 30% for peripheral zone sectors and 43.8%, 97.1%, 70.0%, 91.8% and 13,3% for transitional zone sectors. The proportion of patients that showed an increase of PSA faster than 0.75ng/mL/year after a negative biopsy was 26.1%.

CONCLUSION

Detection rate of prostate cancer did not show significant differences between a TB and a SB technique in biopsy-naïve patients. However, targeted prostate biopsies demonstrated a better sampling effectiveness thus reducing the cores needed to diagnose clinically significant tumors.

Development and validation of a new Spanish instrument to measure health-related quality of life in patients with allergic rhinitis: the ESPRINT questionnaire

OBJECTIVES

To develop and validate an instrument to measure health-related quality of life (HRQOL) specific to patients with allergic rhinitis (AR) and primarily for use in Spanish and Spanish-speaking populations.

METHODS

An initial item pool was generated from literature review, focus groups with AR patients, and consultations with clinical experts. Item reduction was performed using clinimetric and psychometric approaches after administration of the item pool to 400 AR patients. The resulting instrument's internal consistency, test-retest (2-4 weeks) reliability, known groups and convergent validity, and sensitivity to change were tested in a longitudinal, observational, multicenter study in 210 AR patients who also completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ).

RESULTS

The new questionnaire took a mean (SD) of 7.1 (5.4) minutes to answer. Floor and ceiling effects were less than 15% on all dimensions. Cronbach's alpha values and intraclass correlation coefficient values for six of the sevendimensions and the overall score exceeded 0.70. Statistically significant differences (P < 0.01) were observed on all ESPRINT-28 dimensions and the overall score between patients with mild (mean overall score 1.97, SD 0.99), moderate (mean overall score 2.78, SD 0.88), and severe AR (mean overall score 3.89, SD 0.87). Patients with persistent AR had worse scores (P < 0.05) on all dimensions than patients with intermittent AR. Correlations between the ESPRINT-28 and the RQLQ were generally as expected. Effect sizes for score changes between the two study visits ranged from 0.96 to 1.76 for individual dimensions and the overall score.

CONCLUSIONS

This new, Spanish-developed instrument to measure HRQOL in AR patients has shown good reliability, validity, and sensitivity to change. It has also proved easy to use and administer.

Connection between two peripherical markers in a group of asthmatic patients

We have studied the goniometric value of the tda angle and the alpha 1 antitrypsin phenotypes in a group of thirty atopic patients with the following patterns: 1) they were affected with asthma, atopic dermatitis and rhinitis. 2) they presented positive prick skin tests for pneumo-allergens and had. 3) positive allergic antecedents. There exists a significant statistical value for the lower tda angle in the right hand, in the MZ phenotypes of alpha 1 antitrypsin bearers, with P less than 0.05 significance. In the left hand there are many individual values that are identical (62% of the total test effected) thus the statistical methods cannot be applied satisfactorily, bearing in mind the significant difference as the statistical group recognized. From this and other previous works, we can conclude that an individual whose right hand tda angle reaches values near 75%, and with a MZ phenotype of alpha 1 antitrypsin, has a greater possibility of pertaining to one of the groups of asthma, atopic dermatitis and rhinitis symptomatology.