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Aung N, Fung K, Woodbridge SP, Kenawy AA, Jensen MT, Khanji MY, Petersen SE. Annotation and quality assessment of left ventricular filling and relaxation pattern using one-dimensional convolutional neural network. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeac141.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute For Health Research (NIHR), UK
Introduction
Aberrations in left ventricular (LV) filling or relaxation – known as diastolic dysfunction – occur in heart failure with preserved ejection fraction. CMR is the reference modality for the assessment of ventricular systolic function, however, its role in evaluation of diastolic function is limited at present. One promising technique to assess diastolic function by CMR is the derivation of LV filling and emptying rates from the volume-time curves of cine images.
Purpose
To automatically assess the quality of LV filling-rate curves and annotate the peak emptying and filling rates.
Methods
A previously-described deep-learning network was used to automatically segment the entire cardiac cycle captured by short-axis SSFP cine images from the UK Biobank1. The LV filling-rate curves derived from the volume-time data were smoothed with Savitzky–Golay filter. The peak emptying rate (PER), early peak filling rate (PFR-E) and late peak filling rate (PFR-A) were first annotated by a simple peak finding algorithm from Python Scipy signal module. The preliminary annotated curves were reviewed by five human experts (i) to check for peak-annotation errors and (ii) to provide the curve quality score ranging from 1 to 3 for each peak (score 1 denotes good quality, score 2 represents moderate quality and score 3 indicates poor quality). Higher total score (minimum = 3, maximum = 9), therefore, represents poorer overall curve quality. This expert-annotated dataset was used to train two separate one-dimensional convolutional neural networks (1D-CNN) (Figure 1) for peak annotation and curve quality assessment (QA) using Tensorflow library in Python.
Results
The data from 6,328 LV filling-rate curves were split into the training and testing sets (80:20). The fine-tuned 1D-CNN comprising six hidden layers with two residual connections annotated the PER, PFR-E and PFR-A with the test-set accuracy of 95%, 95% and 98%, respectively. A second trained 1D-CNN for QA based on similar architecture predicted the overall curve quality score with a small error rate (mean absolute error: 0.46, mean squared error: 0.68). These two networks were used to quality check and label 19,409 UK Biobank CMR studies (See Figure 2 for exemplary results). After removing data from poor-quality curves (quality score ≥ 5), 18,735 studies remained. The mean±standard deviation of PER, PFR-E and PFR-A are 461±110 ml/s, 359±117 ml/s and 336±120 ml/s, respectively. Ageing is associated with lower PFR-E (−58.4 ml/s, 95% confidence interval [CI]: −56.1 to −60.7 ml/s per decade increment) and higher PFR-A (18.3 ml/s, 95% CI: 15.8 to 20.8 ml/s per decade increment).
Conclusion
The 1D-CNN models can be used to automatically grade the quality of LV filling rate curves and label important diastolic parameters with a high level of accuracy. The derived data recapitulate impaired LV relaxation pattern associated with ageing and can be used as surrogate indices of diastology by CMR. Figure 1Figure 2
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Affiliation(s)
- N Aung
- Queen Mary University of London, William Harvey Research Institute , London , United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute , London , United Kingdom of Great Britain & Northern Ireland
| | - S P Woodbridge
- Queen Mary University of London, William Harvey Research Institute , London , United Kingdom of Great Britain & Northern Ireland
| | - A A Kenawy
- Queen Mary University of London, William Harvey Research Institute , London , United Kingdom of Great Britain & Northern Ireland
| | - M T Jensen
- Queen Mary University of London, William Harvey Research Institute , London , United Kingdom of Great Britain & Northern Ireland
| | - M Y Khanji
- Queen Mary University of London, William Harvey Research Institute , London , United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute , London , United Kingdom of Great Britain & Northern Ireland
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McCready A, Quinn M, Francis P, Stortz R, Kuruvilla S, Stewart P, Palma D, Lang P, Read N, Sathya J, Venkatesan V, Nichols A, MacNeil D, Fung K, Mendez A, Carreau C, Hawkins S, Parker C, Warner L, Winquist E. Impact of a Head and Neck Cancer Chemoradiation (HNC CRT) Nurse Practitioner (NP) on Patient Outcomes. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Palma D, Prisman E, Berthelet E, Tran E, Hamilton S, Wu J, Eskander A, Higgins K, Karam I, Poon I, Husain Z, Enepekides D, Hier M, Sultanem K, Richardson K, Mlynarek A, Johnson-Obaseki S, Eapen L, Odell M, Bayley A, Dowthwaite S, Jackson J, Dzienis M, O'Neil J, Chandarana S, Banerjee R, Hart R, Chung J, Tenenholz T, Krishnan S, Le H, Yoo J, Mendez A, Winquist E, Kuruvilla S, Stewart P, Warner A, Mitchell S, Chen J, Parker C, Wehrli B, Kwan K, Theurer J, Sathya J, Hammond J, Read N, Venkatesan V, MacNeil D, Fung K, Nichols A. A Randomized Trial of Radiotherapy vs. Trans-Oral Surgery for Treatment De-Escalation in HPV-Associated Oropharyngeal Squamous Cell Carcinoma (ORATOR2). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zayed S, Lin C, Boldt G, Lang P, Read N, Venkatesan V, Sathya J, Fung K, MacNeil D, Mendez A, Yoo J, Warner A, Nichols A, Palma D. Survival Outcomes in Primary Head and Neck Adult Sarcoma: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zayed S, Lin C, Boldt G, Lang P, Read N, Venkatesan V, Sathya J, Fung K, MacNeil D, Mendez A, Yoo J, Warner A, Nichols A, Palma D. Survival Outcomes in Primary Angiosarcoma of the Head and Neck: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Simon J, Fung K, Raisi-Estabragh Z, Aung N, Khanji MY, Kolossvary M, Merkely B, Munroe PB, Harvey NC, Piechnik SK, Neubauer S, Petersen SE, Maurovich-Horvat P. Association of daily coffee consumption with cardiovascular health – results from the UK Biobank. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are conflicting reports on the association of coffee consumption with cardiovascular (CV) health. The UK Biobank is a prospective cohort study including data for half a million middle-aged individuals.
Purpose
We studied the association of daily coffee consumption with all-cause and CV mortality, and incidence of the major CV diseases in the UK Biobank. In a subgroup of participants who underwent cardiovascular magnetic resonance (CMR), we evaluated the association between regular coffee intake and cardiac structure and function parameters.
Methods
UK Biobank cohort of participants without clinically manifested heart disease at the time of recruitment were included. Regular coffee intake was categorized into 3 groups: zero, light-to-moderate (0.5–3 cups/day) and high (>3 cups/day) coffee drinkers. We estimated association of daily coffee consumption with incident outcomes using multivariable Cox-regression models (median follow-up of 11 years) and, in the subset with CMR data, with left and right ventricular (LV, RV) end-systolic and end-diastolic volumes, LV mass, and LV/RV stroke volume using multivariable linear regression. Models were adjusted for potential confounders and mediators, including: age, sex, non-European ethnicities, body mass index, smoking, physical activity, Townsend deprivation index, alcohol, meat, fruit and vegetable intake, hypertension, diabetes mellitus, and cholesterol level.
Results
We included 468,629 individuals (mean age 56.2±8.1 years, 44.2% male). Among them, 22.1% did not consume coffee on a regular basis, 58.4% had 0.5–3 cups per day and 19.5% had >3 cups per day. After adjustment for potential confounders and mediators, compared to non-coffee drinkers, light-to-moderate coffee drinking was associated with lower risk of all-cause mortality (HR=0.88, p<0.001), CV mortality (HR=0.83, p=0.006), and incident stroke (HR=0.79; p=0.037). CMR data were available in 30,650 participants. In multivariable analysis, compared to non-coffee drinkers, both the light-to-moderate and high coffee consuming categories, were associated with significantly increased LV and RV ventricular end-systolic (β=0.91 and 1.64 for LV and 1.10 and 1.72 for RV), end-diastolic (β=2.21 and 3.28 for LV and 2.24 and 3.35 for RV) and stroke volumes (β=1.31 and 1.64 for LV and 1.15 and 1.63 for RV), as well as greater LV mass (β=0.78 and 1.64; all p<0.001).
Conclusion
In this large study of the UK Biobank population, regular coffee consumption of up to 3 cups per day was associated with favorable cardiovascular outcomes, in particular, decreased all-cause and CV mortality and stroke incidence. Regular coffee consumption was also associated with a pattern of CMR metrics in keeping with the reverse of age-related cardiac alterations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Simon
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - K Fung
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - Z Raisi-Estabragh
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - N Aung
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - M Y Khanji
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - M Kolossvary
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Merkely
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - P B Munroe
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - N C Harvey
- University of Southampton, MRC Lifecourse Epidemiology Unit, Southampton, United Kingdom
| | - S K Piechnik
- University of Oxford, National Institute for Health Research, Oxford Biomedical Research Centre, Division of Cardiovascul, Oxford, United Kingdom
| | - S Neubauer
- University of Oxford, National Institute for Health Research, Oxford Biomedical Research Centre, Division of Cardiovascul, Oxford, United Kingdom
| | - S E Petersen
- Queen Mary University of London, 2William Harvey Research Institute, NIHR Barts Biomedical Research Centre, London, United Kingdom
| | - P Maurovich-Horvat
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
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Rauseo E, Lockhart L, Paiva JM, Fung K, Khanji MY, Raisi-Estabragh Z, Amir-Khalili A, Petersen SE. Automated myocardial segmentation in native t1-mapping cardiovascular magnetic resonance images based on machine learning: a validation study in the UK biobank"s covid-19 subset. Eur Heart J Cardiovasc Imaging 2021. [PMCID: PMC8344639 DOI: 10.1093/ehjci/jeab090.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Innovate UK Background Regional assessment of septal native T1 values with cardiovascular magnetic resonance (CMR) is used to characterise diffuse myocardial diseases. Previous studies suggest its potential role in detecting early pathological alterations, which may help identify high-risk subjects at early disease stages. Automated analysis of myocardial native T1 images may enable faster CMR analysis and reduce inter-observer variability of manual analysis. However, the technical performance of such methodologies has not been previously reported. Purpose We tested, in a subset of UK Biobank participants, the degree of agreement between CMR septal myocardial T1 values obtained from our machine learning (ML) algorithm and septal native T1 values computed from manual segmentations. Methods We analysed the first 292 participants who were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and had CMR imaging (1.5 Tesla, Siemens MAGNETOM Aera). T1 mapping was performed in a single mid-ventricular short axis (SAX) slice using ShMOLLI (WIP780B) sequences. Three experienced CMR readers independently measured native T1 values by manually placing a single region of interest (ROI) covering half of the anteroseptal and half of the inferoseptal wall using cvi42 post-processing software (version 5.11). A mean T1 value for each participant was then calculated. A ML algorithm developed by Circle Cardiovascular Imaging Inc. was then applied to the same images to derive the myocardium T1 values automatically. The algorithm was previously trained to segment myocardium from SAX T1 and non-T1 mapping images on two external CMR datasets. We compared the mean septal ROI T1 values to the mean myocardium T1 values predicted by the ML algorithm. Results Two studies were excluded after quality control. The ML-derived and the manually calculated mean T1 values were significantly correlated (r = 0.82, p < 0.001). The Bland-Altman analysis between the two methods showed a mean bias of 3.64 ms, with 95% limits of agreement of −38.88 to 53.46 ms, indicating good agreement (figure 1). Conclusions We demonstrated strong correlation and good agreement between native T1 values obtained from our automated analysis method and manual T1 septal analysis in a subset of UK Biobank participants. This algorithm may represent a valuable tool for clinicians allowing for fast and potentially less operator-dependent myocardial tissue characterisation. However, validation of more extensive datasets and quality control processes are needed.
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Affiliation(s)
- E Rauseo
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary, London, United Kingdom of Great Britain & Northern Ireland
| | - L Lockhart
- Circle Cardiovascular Imaging, Calgary, Canada
| | - JM Paiva
- Circle Cardiovascular Imaging, Calgary, Canada
| | - K Fung
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary, London, United Kingdom of Great Britain & Northern Ireland
| | - MY Khanji
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary, London, United Kingdom of Great Britain & Northern Ireland
| | - Z Raisi-Estabragh
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary, London, United Kingdom of Great Britain & Northern Ireland
| | | | - SE Petersen
- William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary, London, United Kingdom of Great Britain & Northern Ireland
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Kenawy A, Khanji MY, Chirvasa M, Fung K, Sojoudi A, Paiva JOSEM, Samy N, Farid W, Khalil TS, Petersen SE. Application of a machine learning contouring tool for the evaluation of left ventricular strain in clinical practice. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): AK has been funded by the Egyptian cultural centre and educational bureau of the Egyptian embassy in London and the Ministry of higher education in Egypt. SEP acknowledges support from the “SmartHeart” EPSRC programme grant (www.nihr.ac.uk; EP/P001009/1) and the London Medical Imaging and AI Centre for Value-Based Healthcare. This new centre is one of the UK Centres supported by a £50m investment from the Data to Early Diagnosis and Precision Medicine strand of the government’s Industrial Strategy Challenge Fund, managed and delivered by UK Research and Innovation (UKRI). SEP acknowledges support from the CAP-AI programme, London’s first AI enabling programme focused on stimulating growth in the capital’s AI Sector. CAP-AI is led by Capital Enterprise in partnership with Barts Health NHS Trust and Digital Catapult and is funded by the European Regional Development Fund and Barts Charity. SEP also acts as a paid consultant to Circle Cardiovascular Imaging Inc., Calgary, Canada and Servier
onbehalf
Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, UK
Background
Manual contouring of cardiovascular magnetic resonance (CMR) cine images remains common practice and the reference standard for left ventricular (LV) volumes and mass evaluation. However, it is time-consuming and machine learning (ML) may significantly reduce the time required for contouring. Accurate LV contours are the basis for reliable LV strain analysis using tissue tracking.
Purpose
To assess the impact of a ML contouring tool alone versus expert adjusted contours on LV strain.
Methods
We retrospectively selected 402 CMR studies with diagnoses of myocardial infarction (n = 108), myocarditis (n = 130) and healthy controls (n = 164) from the Barts BioResource between January 2015 to June 2018. CMR examinations were obtained using 1.5T and 3T scanners (Siemens Healthineers, Germany). We excluded 32 cases due to phase inconsistency between short (SAX) and long axes (LAX) cine images or suboptimal cine image quality. For the remaining 370 cases, steady state free precession cine images for LAX and SAX were analysed by the ML contouring tool (using CVI42 research prototype software 5.11). Manual expert adjustment for the contours was done for each case if considered suboptimal for strain analysis in the reference end-diastolic phase. Strain results from ML and expert adjusted ML methods were compared for strain agreement. Times taken by these methods were recorded and compared against the time taken for standard manual contouring.
Results
SAX and LAX derived strains by ML and expert adjusted ML methods showed good agreement by Bland-Altman analysis (Figure 1) with excellent coefficient of concordance using Kendall W which is 0.98 for global SAX, radial and circumferential strains (mean difference(MD) = -1.7% (lower and upper limits of agreement (UL,LL) -6.6,3.2), MD = 0.5% (-1.0,2.1)) and is 0.95 for global LAX derived strain (radial and longitudinal, MD = 0.7% (UL,LL -8.7 ,7.4),MD= 0.2% (-1.9,2.5), respectively). Time taken for adjustment of ML contours was significantly shorter than manual contouring (1.35 minutes vs 8.0 minutes, around 590% time saving in ML adjusted method).
Conclusions
ML contouring compared to expert manual adjustment has a clinically reasonable agreement when used for measuring LV strain. Also, using the ML tool with expert adjustment shows significant time saving for analysis and reporting time compared to entirely manual analysis, favouring its application in routine clinical practice.
Abstract Figure.
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Affiliation(s)
- A Kenawy
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, United Kingdom of Great Britain & Northern Ireland
| | - MY Khanji
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom of Great Britain & Northern Ireland
| | - M Chirvasa
- Circle Cardiovascular Imaging Inc., , Calgary,AB, Canada
| | - K Fung
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, United Kingdom of Great Britain & Northern Ireland
| | - A Sojoudi
- Circle Cardiovascular Imaging Inc., , Calgary,AB, Canada
| | - JOSE M Paiva
- Circle Cardiovascular Imaging Inc., , Calgary,AB, Canada
| | - N Samy
- Faculty of medicine Menoufia university, Menoufia, Egypt
| | - W Farid
- Faculty of medicine Menoufia university, Menoufia, Egypt
| | - TS Khalil
- Faculty of medicine Menoufia university, Menoufia, Egypt
| | - SE Petersen
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, United Kingdom of Great Britain & Northern Ireland
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Omer M, Amir-Khalili A, Sojoudi A, Thao Le T, A Cook S, Faye Toh D, Bryant J, Chin C, Miguel Paiva J, Fung K, Aung N, Y Khanji M, Rauseo E, Cooper J, E Petersen S. Assessing automated CMR contouring algorithms using systematic contour quality scoring analysis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): SmartHeart EPSRC programme grant (www.nihr.ac.uk), London Medical Imaging and AI Centre for Value-Based Healthcare
Background
Quality measures for machine learning algorithms include clinical measures such as end-diastolic (ED) and end-systolic (ES) volume, volumetric overlaps such as Dice similarity coefficient and surface distances such as Hausdorff distance. These measures capture differences between manually drawn and automated contours but fail to capture the trust of a clinician to an automatically generated contour.
Purpose
We propose to directly capture clinicians’ trust in a systematic way. We display manual and automated contours sequentially in random order and ask the clinicians to score the contour quality. We then perform statistical analysis for both sources of contours and stratify results based on contour type.
Data
The data selected for this experiment came from the National Health Center Singapore. It constitutes CMR scans from 313 patients with diverse pathologies including: healthy, dilated cardiomyopathy (DCM), hypertension (HTN), hypertrophic cardiomyopathy (HCM), ischemic heart disease (IHD), left ventricular non-compaction (LVNC), and myocarditis. Each study contains a short axis (SAX) stack, with ED and ES phases manually annotated. Automated contours are generated for each SAX image for which manual annotation is available. For this, a machine learning algorithm trained at Circle Cardiovascular Imaging Inc. is applied and the resulting predictions are saved to be displayed in the contour quality scoring (CQS) application.
Methods: The CQS application displays manual and automated contours in a random order and presents the user an option to assign a contour quality score
1: Unacceptable, 2: Bad, 3: Fair, 4: Good. The UK Biobank standard operating procedure is used for assessing the quality of the contoured images. Quality scores are assigned based on how the contour affects clinical outcomes. However, as images are presented independent of spatiotemporal context, contour quality is assessed based on how well the area of the delineated structure is approximated. Consequently, small contours and small deviations are rarely assigned a quality score of less than 2, as they are not clinically relevant. Special attention is given to the RV-endo contours as often, mostly in basal images, two separate contours appear. In such cases, a score of 3 is given if the two disjoint contours sufficiently encompass the underlying anatomy; otherwise they are scored as 2 or 1.
Results
A total of 50991 quality scores (24208 manual and 26783 automated) are generated by five expert raters. The mean score for all manual and automated contours are 3.77 ± 0.48 and 3.77 ± 0.52, respectively. The breakdown of mean quality scores by contour type is included in Fig. 1a while the distribution of quality scores for various raters are shown in Fig. 1b.
Conclusion
We proposed a method of comparing the quality of manual versus automated contouring methods. Results suggest similar statistics in quality scores for both sources of contours.
Abstract Figure 1
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Affiliation(s)
- M Omer
- Circle Cardiovascular Imaging Inc., Calgary, Canada
| | | | - A Sojoudi
- Circle Cardiovascular Imaging Inc., Calgary, Canada
| | - T Thao Le
- National Heart Centre Singapore, Singapore, Singapore
| | - S A Cook
- National Heart Centre Singapore, Singapore, Singapore
| | - D Faye Toh
- National Heart Centre Singapore, Singapore, Singapore
| | - J Bryant
- National Heart Centre Singapore, Singapore, Singapore
| | - C Chin
- National Heart Centre Singapore, Singapore, Singapore
| | | | - K Fung
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - M Y Khanji
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - E Rauseo
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - J Cooper
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
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Kassirian S, Dzioba A, Hamel S, Patel K, Sahovaler A, Palma DA, Read N, Venkatesan V, Nichols AC, Yoo J, Fung K, Mendez A, MacNeil SD. Delay in diagnosis of patients with head-and-neck cancer in Canada: impact of patient and provider delay. Curr Oncol 2020; 27:e467-e477. [PMID: 33173386 PMCID: PMC7606041 DOI: 10.3747/co.27.6547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Head-and-neck cancers (hncs) often present at an advanced stage, leading to poor outcomes. Late presentation might be attributable to patient delays (reluctance to seek treatment, for instance) or provider delays (misdiagnosis, prolonged wait time for consultation, for example). The objective of the present study was to examine the length and cause of such delays in a Canadian universal health care setting. Methods Patients presenting for the first time to the hnc multidisciplinary team (mdt) with a biopsy-proven hnc were recruited to this study. Patients completed a survey querying initial symptom presentation, their previous medical appointments, and length of time between appointments. Clinical and demographic data were collected for all patients. Results The average time for patients to have their first appointment at the mdt clinic was 15.1 months, consisting of 3.9 months for patients to see a health care provider (hcp) for the first time since symptom onset and 10.7 months from first hcp appointment to the mdt clinic. Patients saw an average of 3 hcps before the mdt clinic visit (range: 1-7). No significant differences in time to presentation were found based on stage at presentation or anatomic site. Conclusions At our tertiary care cancer centre, a patient's clinical pathway to being seen at the mdt clinic shows significant delays, particularly in the time from the first hcp visit to mdt referral. Possible methods to mitigate delay include education about hnc for patients and providers alike, and a more streamlined referral system.
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Affiliation(s)
- S Kassirian
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - A Dzioba
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - S Hamel
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - K Patel
- Department of Otolaryngology, Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, U.S.A
| | - A Sahovaler
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - D A Palma
- Department of Radiation Oncology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - N Read
- Department of Radiation Oncology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - V Venkatesan
- Department of Radiation Oncology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - A C Nichols
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - J Yoo
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - K Fung
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - A Mendez
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
| | - S D MacNeil
- Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON
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Sommer DD, Engels PT, Weitzel EK, Khalili S, Corsten M, Tewfik MA, Fung K, Cote D, Gupta M, Sne N, Brown TFE, Paul J, Kost KM, Witterick IJ. Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic. J Otolaryngol Head Neck Surg 2020; 49:23. [PMID: 32340627 PMCID: PMC7184547 DOI: 10.1186/s40463-020-00414-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The performance of tracheotomy is a common procedural request by critical care departments to the surgical services of general surgery, thoracic surgery and otolaryngology - head & neck surgery. A Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force was convened with multi-specialty involvement from otolaryngology-head & neck surgery, general surgery, critical care and anesthesiology to develop a set of recommendations for the performance of tracheotomies during the COVID-19 pandemic. MAIN BODY The tracheotomy procedure is highly aerosol generating and directly exposes the entire surgical team to the viral aerosol plume and secretions, thereby increasing the risk of transmission to healthcare providers. As such, we believe extended endotracheal intubation should be the standard of care for the entire duration of ventilation in the vast majority of patients. Pre-operative COVID-19 testing is highly recommended for any non-emergent procedure. CONCLUSION The set of recommendations in this document highlight the importance of avoiding tracheotomy procedures in patients who are COVID-19 positive if at all possible. Recommendations for appropriate PPE and environment are made for COVID-19 positive, negative and unknown patients requiring consideration of tracheotomy. The safety of healthcare professionals who care for ill patients and who keep critical infrastructure operating is paramount.
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Affiliation(s)
- D D Sommer
- Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster University, 3V1 Clinic, 1200 Main St West, Hamilton, ON, L8N 3Z5, Canada.
| | - P T Engels
- Department of Surgery and Critical Care, McMaster University, Hamilton, ON, Canada
| | - E K Weitzel
- United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA
| | - S Khalili
- Aurora Neuroscience Innovation Institute, Milwaukee, WI, USA
| | - M Corsten
- Division of Otolaryngology - Head & Neck Surgery, Dalhousie University, Halifax, NS, Canada
| | - M A Tewfik
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - K Fung
- Department of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada
| | - D Cote
- Division of Otolaryngology - Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - M Gupta
- Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster University, 3V1 Clinic, 1200 Main St West, Hamilton, ON, L8N 3Z5, Canada
| | - N Sne
- Department of Surgery and Critical Care, McMaster University, Hamilton, ON, Canada
| | - T F E Brown
- Division of Otolaryngology - Head & Neck Surgery, Dalhousie University, Halifax, NS, Canada
| | - J Paul
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - K M Kost
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - I J Witterick
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
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Palma D, Theurer J, Prisman E, Read N, Berthelet E, Fung K, de Almeida J, Bayley A, Richardson K, Mlynarek A, Krishnan S, Le H, Mitchell S, Chen J, Corsten M, Johnson-Obaseki S, Odell M, Parker C, Kwan K, Nichols A. Radiotherapy vs. Trans-Oral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma (OPSCC): Results of a Randomized Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fung K, Vivier D, Price E, Zeglis B. Development of a MUC1-targeting PET probe for ovarian cancer. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30346-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fung K, Biasiolli L, Aung N, Hann E, Paiva JM, Lukaschuk E, Sanghvi MM, Carapella V, Rayner JJ, Werys K, Thomas K, Moon NO, Neubauer S, Piechnik SK, Petersen SE. 282Reference values for aortic distensibility derived from UK Biobank cardiovascular magnetic resonance (CMR) imaging cohort. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- K Fung
- Queen Mary University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - L Biasiolli
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Queen Mary University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - E Hann
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J M Paiva
- Queen Mary University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - E Lukaschuk
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - M M Sanghvi
- Queen Mary University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - V Carapella
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J J Rayner
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - K Werys
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - K Thomas
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - N O Moon
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S K Piechnik
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, London, United Kingdom of Great Britain & Northern Ireland
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Aung N, Vargas JD, Manichaikul AW, Yang CP, Cabrera CP, Warren HR, Fung K, Tzanis E, Barnes MR, Piechnik SK, Neubauer S, Bluemke DA, Munroe PB, Petersen SE. P463Heritability and genotypic correlation of CMR-derived LV phenotypes in the UK Biobank population imaging study. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Aung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - J D Vargas
- National Institutes of Health, Radiology and Imaging Sciences, Bethesda, United States of America
| | - A W Manichaikul
- University of Virginia, Center for Public Health and Genomics, Department of Public Health Sciences, Charlottesville, United States of America
| | - C P Yang
- University of Virginia, Center for Public Health and Genomics, Department of Public Health Sciences, Charlottesville, United States of America
| | - C P Cabrera
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - H R Warren
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - E Tzanis
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M R Barnes
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - S K Piechnik
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - D A Bluemke
- National Institutes of Health, Radiology and Imaging Sciences, Bethesda, United States of America
| | - P B Munroe
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
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Akhtar AMA, Patel K, Chahal A, Akhtar M, Nay A, Fung K, Sekhri N, Treibel T, Westwood M, Davies C, Khanji M, Manisty C, Lorenzini M, Moon J, Petersen SE. P593Hypereosinophilic carditis (HEC): a cmr-based case series from a quaternary cardiology centre. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A M A Akhtar
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - K Patel
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - A Chahal
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Akhtar
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - A Nay
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - N Sekhri
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - T Treibel
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Westwood
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - C Davies
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Khanji
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - C Manisty
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Lorenzini
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - J Moon
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
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Jensen MT, Fung K, Aung N, Sanghvi MM, Chadalavada S, Paiva JM, Khanji MY, De Knegt MC, Lukaschuk E, Lee AM, Carapella V, Piechnik SK, Neubauer S, Petersen SE. 347Early changes in cardiac morphology and function in individuals with diabetes and preserved ejection fraction detected by cardiovascular magnetic resonance tagging - The UK Biobank. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez103.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M T Jensen
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - M M Sanghvi
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - S Chadalavada
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Paiva
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - M Y Khanji
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - M C De Knegt
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - E Lukaschuk
- John Radcliffe Hospital, Department of Cardiovascular Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - A M Lee
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
| | - V Carapella
- John Radcliffe Hospital, Department of Cardiovascular Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S K Piechnik
- John Radcliffe Hospital, Department of Cardiovascular Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- John Radcliffe Hospital, Department of Cardiovascular Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Barts and The London School of Medicine and Dentistry, London, United Kingdom of Great Britain & Northern Ireland
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Aung N, Vargas JD, Manichaikul AW, Yang C, Cabrera CP, Warren HR, Fung K, Tzanis E, Barnes MR, Bluemke DA, Piechnik SK, Neubauer S, Munroe PB, Petersen SE. 199Genetic architecture of left ventricular phenotypes derived from 17,000 CMR studies in the UK Biobank population imaging cohort. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Aung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - J D Vargas
- National Institutes of Health, Radiology and Imaging Sciences, Bethesda, United States of America
| | - A W Manichaikul
- University of Virginia, Center for Public Health and Genomics, Department of Public Health Sciences, Charlottesville, United States of America
| | - C Yang
- University of Virginia, Center for Public Health and Genomics, Department of Public Health Sciences, Charlottesville, United States of America
| | - C P Cabrera
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - H R Warren
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - E Tzanis
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M R Barnes
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - D A Bluemke
- National Institutes of Health, Radiology and Imaging Sciences, Bethesda, United States of America
| | - S K Piechnik
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - P B Munroe
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
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Fung K, Kellman P, Mcgrath L, Xue H, Moon JC, Manisty C. P368Paradoxical worsening of myocardial perfusion with rest. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez109.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Fung
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - P Kellman
- National Institutes of Health, National Heart, Lung and Blood Institute, Bethesda, United States of America
| | - L Mcgrath
- Queens Square Imaging Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - H Xue
- National Institutes of Health, National Heart, Lung and Blood Institute, Bethesda, United States of America
| | - J C Moon
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
| | - C Manisty
- Barts Health NHS Trust, London, United Kingdom of Great Britain & Northern Ireland
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Aung N, Lee AM, Sanghvi MM, Fung K, Paiva JM, Thomson RJ, Khanji MY, Munro PB, Petersen SE. P622Automatic classification of CMR image sequences with convolutional neural networks. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez116.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Aung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - A M Lee
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M M Sanghvi
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Paiva
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - R J Thomson
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M Y Khanji
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - P B Munro
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
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Raisi-Estabragh Z, Fung K, Aung N, Sanghvi M, Paiva J, Khanji M, Lukaschuk E, Lee AM, Carapella V, Piechnik S, Neubauer S, Harvey N, Petersen SE. P149Measures of bone quality are associated with aortic distensibility. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Z Raisi-Estabragh
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M Sanghvi
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
| | - J Paiva
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M Khanji
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
| | - E Lukaschuk
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - A M Lee
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
| | - V Carapella
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Piechnik
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - N Harvey
- University of Southampton, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey research institute, London, United Kingdom of Great Britain & Northern Ireland
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Sanghvi M, Biasiolli L, Aung N, Cooper JA, Fung K, Lukaschuk E, Paiva JM, Carapella V, Hann E, Rayner JJ, Werys K, Puchta H, Piechnik SK, Neubauer S, Petersen SE. 345The impact of modifiable cardiovascular risk factors on aortic distensibility: insights from the UK Biobank. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Sanghvi
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - L Biasiolli
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - J A Cooper
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - E Lukaschuk
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J M Paiva
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - V Carapella
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - E Hann
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J J Rayner
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - K Werys
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - H Puchta
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S K Piechnik
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
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Thomson RJ, Aung N, Sanghvi MM, Fung K, Paiva JM, Khanji MY, Lukaschuk E, Carapella V, Piechnik SK, Neubauer SK, Petersen SE. P419Cardiac structure and the QRISK cardiovascular risk prediction score: insights from the UK Biobank. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R J Thomson
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M M Sanghvi
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - J M Paiva
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - M Y Khanji
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
| | - E Lukaschuk
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - V Carapella
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S K Piechnik
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S K Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom of Great Britain & Northern Ireland
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Fleming P, Fung K, Chan A. 194 Dermatologic assessment is associated with improved melanoma outcomes: population-based cohort study. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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MacNeil SD, Patel K, Liu K, Shariff S, Yoo J, Nichols A, Fung K, Garg AX. Survival of patients with subglottic squamous cell carcinoma. ACTA ACUST UNITED AC 2018; 25:e569-e575. [PMID: 30607125 DOI: 10.3747/co.25.3864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Subglottic squamous cell carcinoma is a rare subsite of laryngeal cancer that behaves more aggressively and portends a worse prognosis. Using a population-based cancer registry, our objective was to report overall survival (os) and laryngectomy-free survival (lfs) in patients diagnosed with subglottic squamous cell carcinoma, and to determine whether primary laryngectomy results in improved survival. Methods This retrospective population-based study considered patients with a new diagnosis of squamous cell carcinoma in the province of Ontario over a 15-year period (1995-2009). The Ontario Cancer Registry was examined for patients with the diagnosis of interest during the period of interest. Linked population-based databases were used to obtain patient demographics, comorbidity measures, staging, survival, and primary treatment with laryngectomy. Results Of 4927 patients identified to have laryngeal carcinoma, 89 were defined as having primary subglottic carcinoma (1.8%). In the subglottic cohort, 68 patients were men (76.4%), and mean age at diagnosis was 68 years (interquartile range: 60-77 years). The 5-year os was 47.2%, and the 5-year lfs was 31.5%. In 13 patients (15%), the primary treatment was laryngectomy, which, compared with primary radiation, did not predict for improved os. No differences in os or lfs were observed during the 15-year study period (os p = 0.42, lfs p = 0.83). Conclusions The survival of patients with subglottic carcinoma is poor and has remained stable over time (1995-2009). Compared with primary radiation, primary treatment with laryngectomy does not appear to improve os.
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Affiliation(s)
- S D MacNeil
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON.,Institute for Clinical Evaluative Sciences, Toronto, ON
| | - K Patel
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON
| | - K Liu
- Institute for Clinical Evaluative Sciences, Toronto, ON
| | - S Shariff
- Institute for Clinical Evaluative Sciences, Toronto, ON
| | - J Yoo
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON
| | - A Nichols
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON
| | - K Fung
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON
| | - A X Garg
- Institute for Clinical Evaluative Sciences, Toronto, ON.,Department of Epidemiology and Biostatistics, Western University, London, ON.,Division of Nephrology, Department of Medicine, Western University, London, ON
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Ansari S, Fung K, MacNeil S, Nichols A, Yoo J, Sowerby L. The use of standardized order sets to improve adherence to evidence-based postoperative management in major head and neck surgery. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S107-S111. [DOI: 10.1016/j.anorl.2018.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 11/28/2022]
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Aung N, Gilbert K, Suinesiaputra A, Lee A, Sanghvi MM, Zemrak F, Fung K, Paiva JM, Lukaschuk E, Carapella V, Kim YJ, Piechnik SK, Neubauer S, Young AA, Petersen SE. P3693Impact of cardiovascular risk factors on atlas-based left ventricular shape phenotypes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Aung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom
| | - K Gilbert
- The University of Auckland, Department of Anatomy and Medical Imaging, Auckland, New Zealand
| | - A Suinesiaputra
- The University of Auckland, Department of Anatomy and Medical Imaging, Auckland, New Zealand
| | - A Lee
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom
| | - M M Sanghvi
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom
| | - F Zemrak
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom
| | - K Fung
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom
| | - J M Paiva
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom
| | - E Lukaschuk
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - V Carapella
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - Y J Kim
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - S K Piechnik
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - S Neubauer
- University of Oxford, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - A A Young
- The University of Auckland, Department of Anatomy and Medical Imaging, Auckland, New Zealand
| | - S E Petersen
- Queen Mary University of London, William Harvey Research Institute, London, United Kingdom
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Ricci F, Aung N, Boubertakh R, Camaioni C, Doimo S, Fung K, Khanji M, Malcomson J, Mantini C, Paiva J, Gallina S, Fedorowski A, Mohiddin S, Aquaro GD, Petersen SE. 3004Pulmonary blood volume index as a quantitative biomarker of diastolic function in hypertrophic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Ricci
- G. D'Annunzio University, Institute of Cardiology and Center of Excellence on Aging, Chieti, Italy
| | - N Aung
- Queen Mary University of London, London, United Kingdom
| | | | - C Camaioni
- Barts Health NHS Trust, London, United Kingdom
| | - S Doimo
- University of Trieste, Trieste, Italy
| | - K Fung
- Queen Mary University of London, London, United Kingdom
| | - M Khanji
- Queen Mary University of London, London, United Kingdom
| | - J Malcomson
- Queen Mary University of London, London, United Kingdom
| | - C Mantini
- G. d'Annunzio University, Chieti, Italy
| | - J Paiva
- Queen Mary University of London, London, United Kingdom
| | - S Gallina
- G. d'Annunzio University, Chieti, Italy
| | | | - S Mohiddin
- Barts Health NHS Trust, London, United Kingdom
| | - G D Aquaro
- Gabriele Monasterio Foundation, Pisa, Italy
| | - S E Petersen
- Queen Mary University of London, London, United Kingdom
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Chan A, Fung K, Austin P, Kim S, Singer L, Baxter N, Alhusayen R, Rochon P. 522 Improved keratinocyte carcinoma outcomes with annual dermatology assessment after solid organ transplantation: Population-based cohort study. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chan C, Patton-Rivera K, Beck J, Fung K, Garan A, Han J, Ando M, Cevasco M, Colombo P, Naka Y, Takayama H, Takeda K. Usefulness of Near-infrared Reflectance Spectroscopy to Assess Lower-limb Perfusion on Femoral Veno-arterial Extracorporeal Membrane Oxygenation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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31
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Davidson S, Palma D, Kuruvilla S, Venkatesan V, Read N, Hammond J, Nichols A, Fung K, MacNeil D, Yoo J, Warner A, Winquist E. TPF Induction Chemotherapy Prior to Chemoradiation for Locally Advanced Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mundi N, Theurer J, Warner A, Yoo J, Fung K, MacNeil D, Dhaliwal S, Winquist E, Palma DA, Nichols AC. The impact of seasonal operating room closures on wait times for oral cancer surgery. Curr Oncol 2018; 25:67-72. [PMID: 29507486 DOI: 10.3747/co.25.3726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Operating room slowdowns occur at specific intervals in the year as a cost-saving measure. We aim to investigate the impact of these slowdowns on the care of oral cavity cancer patients at a Canadian tertiary care centre. Methods A total of 585 oral cavity cancer patients seen between 1999 and 2015 at the London Health Science Centre (lhsc) Head and Neck Multidisciplinary Clinic were included in this study. Operating room hours and patient load from 2006 to 2014 were calculated. Our primary endpoint was the wait time from consultation to definitive surgery. Exposure variables were defined according to wait time intervals occurring during time periods with reduced operating room hours. Results Overall case volume rose significantly from 2006 to 2014 (p < 0.001), while operating room hours remained stable (p = 0.555). Patient wait times for surgery increased from 16.3 days prior to 2003 to 25.5 days in 2015 (p = 0.008). Significant variability in operating room hours was observed by month, with lowest reported for July and August (p = 0.002). The greater the exposure to these months, the more likely patients were to wait longer than 28 days for surgery (odds ratio per day [or]: 1.07, 95% confidence interval [ci]: 1.05 to 1.10, p < 0.001). Individuals seen in consultation preceding a month with below average operating room hours had a higher risk of disease recurrence and/or death (hazard ratio [hr]: 1.59, 95% ci: 1.10 to 2.30, p = 0.014). Conclusions Scheduled reductions in available operating room hours contribute to prolonged wait times and higher disease recurrence. Further work is needed to identify strategies maximizing efficient use of health care resources without negatively affecting patient outcomes.
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Affiliation(s)
- N Mundi
- Department of Otolaryngology, London Health Sciences Centre, London, Ontario, Canada
| | - J Theurer
- Department of Otolaryngology, London Health Sciences Centre, London, Ontario, Canada
| | - A Warner
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - J Yoo
- Department of Otolaryngology, London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - K Fung
- Department of Otolaryngology, London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - D MacNeil
- Department of Otolaryngology, London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - S Dhaliwal
- Department of Otolaryngology, London Health Sciences Centre, London, Ontario, Canada
| | - E Winquist
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - D A Palma
- Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
| | - A C Nichols
- Department of Otolaryngology, London Health Sciences Centre, London, Ontario, Canada.,Department of Oncology, London Health Sciences Centre, London, Ontario, Canada
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Lam JS, Scott GM, Palma DA, Fung K, Louie AV. Development of an online, patient-centred decision aid for patients with oropharyngeal cancer in the transoral robotic surgery era. ACTA ACUST UNITED AC 2017; 24:318-323. [PMID: 29089799 DOI: 10.3747/co.24.3669] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Radiotherapy (rt) has been the standard treatment for early oropharyngeal cancer, achieving excellent outcomes, but with significant toxicities. Transoral robotic surgery (tors) has emerged as a promising alternative. A decision aid (da) can help to establish patient treatment preferences. METHODS A da was developed and piloted in 40 healthy adult volunteers. Assuming equal oncologic outcomes of the treatments, participants indicated their preference. The treatment trade-off point was then established, and participant perceptions were elicited. RESULTS More than 80% of participants initially selected tors for treatment, regardless of facilitator background. For all participants, the treatment trade-off point changed after an average 15% cure benefit. Treatment toxicities, duration, novelty, and perceptions all influenced treatment selection. All subjects valued the da. CONCLUSIONS A da developed for early oropharyngeal cancer treatment holds promise in the era of shared decision-making. Assuming equal cure rates, tors was preferred over rt by healthy volunteers.
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Affiliation(s)
- J S Lam
- Department of Radiation Oncology, and
| | | | - D A Palma
- Department of Radiation Oncology, and
| | | | - A V Louie
- Department of Radiation Oncology, and
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Abdel-Qadir H, Austin P, Thavendiranathan P, Fang J, Fung K, Amir E, Lee D, Tu J, Anderson G. A RISK SCORE FOR PREDICTING CARDIOVASCULAR EVENTS AFTER EARLY STAGE BREAST CANCER. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abdel-Qadir H, Thavendiranathan P, Austin P, Lee D, Amir E, Tu J, Ma H, Fung K, Anderson G. 2020The spectrum of cardiovascular disease after early stage breast cancer: a population-based cohort study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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36
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Aung N, Woodbridge S, Paiva J, Sanghvi M, Zemrak F, Cooper J, Thomson R, Fung K, Lukaschuk E, Lee A, Carapella V, Kim Y, Piechnik S, Neubauer S, Petersen S. P3992Relationship between left ventricular trabeculation and physical activity in a middle-aged population cohort. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Aung N, Sanghvi M, Zemrak F, Cooper J, Paiva J, Thomson R, Fung K, Lukaschuk E, Lee A, Carapella V, Kim Y, Piechnik S, Neubauer S, Petersen S. 2896Age attenuates the relationship between systolic blood pressure and left ventricular mass: evidence from the UK Biobank. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.2896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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38
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Stall N, Fischer H, Fung K, Bronskill S, Austin P, Mitchell S, Bell C, Rochon P. BURDENSOME INTERVENTIONS AND ANTIBIOTIC USE AMONG END-OF-LIFE NURSING HOME RESIDENTS WITH DEMENTIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N. Stall
- Division of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada,
| | - H. Fischer
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada,
| | - K. Fung
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada,
| | - S. Bronskill
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada,
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,
| | - P. Austin
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada,
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,
| | - S. Mitchell
- Harvard Medical School, Boston, Massachusetts,
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts,
| | - C. Bell
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada,
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada,
| | - P. Rochon
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada,
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,
- Women’s College Research Institute, Toronto, Ontario, Canada
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Ho K, Jegathesan T, Fung K, Young E, Minhas R, Huber J. ANTICIPATORY GUIDANCE FOR THE PREVENTION OF PEDIATRIC DEATHS DUE TO HEAT STROKE CAUSED BY BEING LEFT UNATTENDED IN VEHICLES. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
PURPOSE The objective of the present study was to use a large, population-based cohort to examine the association between metformin and breast cancer stage at diagnosis while accounting for mammography differences. METHODS We used data from Ontario administrative health databases to identify women 68 years of age or older with diabetes and invasive breast cancer diagnosed from 1 January 2007 to 31 December 2012. Adjusted logistic regression models were used to compare breast cancer stage at diagnosis (stages i and ii vs. iii and iv) between the women exposed and not exposed to metformin. We also examined the association between metformin use and estrogen receptor status, tumour size, and lymph node status in the subset of women for whom those data were available. RESULTS We identified 3125 women with diabetes and breast cancer; 1519 (48.6%) had been exposed to metformin before their cancer diagnosis. Median age at breast cancer diagnosis was 76 years (interquartile range: 72-82 years), and mean duration of diabetes was 8.8 ± 5.9 years. In multivariable analyses, metformin exposure was not associated with an earlier stage of breast cancer (odds ratio: 0.98; 95% confidence interval: 0.81 to 1.19). In secondary analyses, metformin exposure was not associated with estrogen receptor-positive breast cancer, tumours larger than 2 cm, or positive lymph nodes. CONCLUSIONS This population-based study did not show an association between metformin use and breast cancer stage or tumour characteristics at diagnosis. Our study considered older women with long-standing diabetes, and therefore further studies in younger patients could be warranted.
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Affiliation(s)
- I C Lega
- Women's College Research Institute, Women's College Hospital.,Department of Medicine, University of Toronto
| | - K Fung
- Women's College Research Institute, Women's College Hospital.,Institute for Clinical Evaluative Sciences; and
| | - P C Austin
- Institute for Clinical Evaluative Sciences; and.,Institute of Health, Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - L L Lipscombe
- Women's College Research Institute, Women's College Hospital.,Department of Medicine, University of Toronto.,Institute for Clinical Evaluative Sciences; and.,Institute of Health, Policy, Management and Evaluation, University of Toronto, Toronto, ON
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Vigod SN, Rochon-Terry G, Fung K, Gruneir A, Dennis CL, Grigoriadis S, Kurdyak PA, Ray JG, Rochon P, Seeman MV. Factors associated with postpartum psychiatric admission in a population-based cohort of women with schizophrenia. Acta Psychiatr Scand 2016; 134:305-13. [PMID: 27437875 DOI: 10.1111/acps.12622] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We aimed to identify factors associated with postpartum psychiatric admission in schizophrenia. METHOD In a population-based cohort study of 1433 mothers with schizophrenia in Ontario, Canada (2003-2011), we compared women with and without psychiatric admission in the 1st year postpartum on demographic, maternal medical/obstetrical, infant and psychiatric factors and identified factors independently associated with admission. RESULTS Admitted women (n = 275, 19%) were less likely to be adolescents, more likely to be low income and less likely to have received prenatal ultrasound before 20 weeks gestation compared to non-admitted women. They also had higher rates of predelivery psychiatric comorbidity and mental health service use. Factors independently associated with postpartum admission were age (<20 vs. ≥35 years: adjusted risk ratio, aRR, 0.48, 95% CI 0.24-0.96), income (lowest vs. highest income: aRR 1.67, 1.13-2.47) and the following mental health service use factors in pregnancy: admission (≥35 days/year vs. no days, aRR 4.54, 3.65-5.65), outpatient mental health care (no visits vs. ≥2 visits aRR 0.35, 0.27-0.47) and presence of a consistent mental health care provider during pregnancy (aRR 0.69, 0.54-0.89). CONCLUSION Certain subgroups of women with schizophrenia may benefit from targeted intervention to mitigate risk for postpartum admission.
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Affiliation(s)
- S N Vigod
- Women's College Hospital, Toronto, ON, Canada. .,University of Toronto, Toronto, ON, Canada. .,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
| | | | - K Fung
- Women's College Hospital, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - A Gruneir
- Women's College Hospital, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,University of Alberta, Edmonton, AB, Canada
| | - C-L Dennis
- Women's College Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - S Grigoriadis
- University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - P A Kurdyak
- University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - J G Ray
- University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,St. Michael's Hospital, Toronto, ON, Canada
| | - P Rochon
- Women's College Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - M V Seeman
- University of Toronto, Toronto, ON, Canada
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Winquist E, Teft W, Nichols A, Parker C, Trinnear M, Francis P, Bukhari N, Lukovic J, Choi YH, Kuruvilla S, Richter S, Hammond A, Macneil D, Read N, Fung K, Venkatesan V, Welch S, Palma D, Yoo J, Kim R. Pharmacogenomic predictors of cisplatin oto- and nephrotoxicity in head and neck cancer patients treated with chemoradiation. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kobylianskii A, Jegathesan T, Young E, Fung K, Huber J, Minhas R. Inner-City Fathers of Children Affected by Chronic Illness: A Systematic Scoping Review of Their Experiences. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e90c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND: Childhood chronic illness often impacts not just the child but the whole family, particularly the parents. Parents from inner-city backgrounds (defined as low income/socioeconomic status, unemployed, immigrant, refugee, or ethnic minority, and living in an urban area) face additional challenges. Research has traditionally centred on the mother’s role in caring for a child with a chronic illness, but with the increasing role of fathers caring for these children, research has shifted its focus on paternal experience. However, the experiences of inner-city fathers remain largely unknown.
OBJECTIVES: This systematic scoping review aims to explore the experiences of fathers of children with disabilities or chronic health conditions from inner city families, using the Double ABCX model as a conceptual framework.
DESIGN/METHODS: A systematic scoping review was conducted between November 2014 and January 2015 using the Arksey and O'Malley framework. Seven databases were searched (Medline, PsycInfo, Embase, Web of Science, CINAHL, Scopus, and Social Work Abstracts). Titles and abstracts meeting inclusion and exclusion criteria were included in the full text review for further assessment. Qualifying articles were critically appraised and relevant data were extracted. The Double ABCX model was used to qualitatively evaluate the articles in terms of stressors, resources, perception, coping, and adaptation.
RESULTS: 5114 articles were initially identified and 14 articles met the inclusion criteria. Most of the included studies were conducted in the USA. Most articles discussed fathers from low income/SES backgrounds, while others discussed ethnic minority, immigrant/refugee, and unemployed fathers. Fathers' stressors included financial strain and barriers to accessing healthcare. Fathers' resources, or sources of support, ranged from immediate to extended family members, depending on ethnicity. In terms of perceptions, fathers had different approaches to reconciling the care-giver role with cultural gender norms. Inner-city fathers had more desire for information about their children’s health, but some were uncomfortable with asking physicians. Inner-city fathers were more at risk for coping difficulties and used different coping strategies compared to higher income fathers. Inner-city fathers were at higher risk for maladaptation, including depression, PTSD and less acceptance of the child.
CONCLUSION: Fathers from inner-city backgrounds caring for their children affected by chronic illnesses and disabilities have unique experiences requiring a comprehensive approach to providing and communicating care to these children and caregivers. Findings from this review can be used to guide pediatricians in advocating for resources to reduce stressors, enhance coping, and promote positive adaptation for inner-city fathers.
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Zhang T, Low T, Yeh D, Araslanova R, Hammond J, Palma D, Read N, Fung K, MacNeil S, Nichols A, Yoo J, Venkatesan V. Outcomes in T1 Glottic Cancer Treated With Radiation Therapy: A Single-Institution Experience. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang T, Low T, Yeh D, Araslanova R, Hammond J, Palma D, Read N, Fung K, MacNeil S, Nichols A, Yoo J, Venkatesan V. Outcomes of Stage II Glottic Cancer in a Single Institution: Conventional Versus Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yeh DH, Tam S, Fung K, MacNeil SD, Yoo J, Winquist E, Palma DA, Nichols AC. Transoral robotic surgery vs. radiotherapy for management of oropharyngeal squamous cell carcinoma - A systematic review of the literature. Eur J Surg Oncol 2015; 41:1603-14. [PMID: 26461255 DOI: 10.1016/j.ejso.2015.09.007] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/14/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Intensity-modulated radiation therapy (IMRT) with or without concurrent chemotherapy is widely utilized for the treatment of oropharyngeal squamous cell carcinoma (OPSCC). However, due to significant acute and late toxicities there has been increasing interest in minimally invasive surgical approaches, particularly transoral robotic surgery (TORS) in an attempt to preserve patient quality of life while maintaining oncologic outcomes. The aim of this study was to review the current literature in order to compare primary IMRT versus TORS in the management of OPSCC. METHODS A MEDLINE search was conducted to identify studies reporting on the outcomes of TORS or IMRT in the treatment of OPSCC. Reference lists were also reviewed for relevant articles. Oncologic, functional, and quality of life data is summarized and discussed. RESULTS One hundred-ninety papers were identified through the MEDLINE search. An additional 52 papers were retrieved by hand searching the reference lists. Ultimately, 44 papers were identified that discussed outcomes after IMRT or TORS for OPSCC. No outcomes from randomized trials were identified. CONCLUSION No randomized trials comparing TORS versus IMRT to each other were identified. Uncontrolled reports from the current literature suggest comparable oncologic outcomes with TORS compared to IMRT and functional outcomes may be superior. However, the median follow-up was relatively short and the TORS studies included patients with earlier stage OPSCC on average compared to IMRT studies. Prospective, randomized controlled trials and direct, well-matched comparisons are needed to further elucidate the role for TORS in the treatment of oropharyngeal squamous cell carcinoma.
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Affiliation(s)
- D H Yeh
- Department of Otolaryngology Head & Neck Surgery, Western University, London, Ontario, Canada
| | - S Tam
- Department of Otolaryngology Head & Neck Surgery, Western University, London, Ontario, Canada
| | - K Fung
- Department of Otolaryngology Head & Neck Surgery, Western University, London, Ontario, Canada; London Health Sciences Centre, London, Ontario, Canada
| | - S D MacNeil
- Department of Otolaryngology Head & Neck Surgery, Western University, London, Ontario, Canada; London Health Sciences Centre, London, Ontario, Canada
| | - J Yoo
- Department of Otolaryngology Head & Neck Surgery, Western University, London, Ontario, Canada; London Health Sciences Centre, London, Ontario, Canada
| | - E Winquist
- London Health Sciences Centre, London, Ontario, Canada; Division of Medical Oncology, Western University, London, Ontario Canada
| | - D A Palma
- London Health Sciences Centre, London, Ontario, Canada; Division of Radiation Oncology, Western University, London, Ontario, Canada
| | - A C Nichols
- Department of Otolaryngology Head & Neck Surgery, Western University, London, Ontario, Canada; London Health Sciences Centre, London, Ontario, Canada
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MacNeil S, Liu K, Shariff S, Thind A, Winquist E, Yoo J, Nichols A, Fung K, Hall S, Garg A. Secular trends in the survival of patients with laryngeal carcinoma, 1995-2007. Curr Oncol 2015; 22:e85-99. [PMID: 25908925 PMCID: PMC4399628 DOI: 10.3747/co.22.2361] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Recent reports suggest a decline over time in the survival of patients newly diagnosed with laryngeal cancer in spite of developments in treatment practices. Our study set out to determine whether the survival of patients with laryngeal cancer in Ontario has changed over time. METHODS This population-based cohort study of patients diagnosed with laryngeal cancer in the province of Ontario between 1995 and 2007 used data extracted from linked provincial administrative and registry databases. Its main outcomes were overall survival, laryngectomy-free survival, and survival ratio relative to an age- and sex-matched general population. RESULTS The 4298 patients newly diagnosed with laryngeal cancer during the period of interest were predominantly men (n = 3615, 84.1%) with glottic cancer (n = 2787, 64.8%); mean age in the group was 66 years (interquartile range: 59-74 years). Patient demographics did not significantly change over time. Overall, 5-year survival was 57.4%; laryngectomy-free survival was 45.4%. Comparing patients from three eras (1995-1998, 1999-2003, 2004-2007) and adjusting for age, sex, and comorbidity status, we observed no differences in overall survival or laryngectomy-free survival over time. The 5-year relative survival ratio for patients with laryngeal cancer compared with an age- and sex-matched group from the general population was 81.1% for glottic cancer and 44.5% for supraglottic cancer. CONCLUSIONS In patients with a new diagnosis of laryngeal cancer, overall and laryngectomy-free survival have remained unchanged since the mid-1990s. New methods to improve survival and the rate of laryngeal preservation in this patient population are needed.
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Affiliation(s)
- S.D. MacNeil
- Department of Otolaryngology–Head and Neck Surgery, Western University, London, ON
- Institute for Clinical and Evaluative Sciences, Toronto, ON
- Department of Oncology, Western University, London, ON
| | - K. Liu
- Institute for Clinical and Evaluative Sciences, Toronto, ON
| | - S.Z. Shariff
- Institute for Clinical and Evaluative Sciences, Toronto, ON
| | - A. Thind
- Institute for Clinical and Evaluative Sciences, Toronto, ON
- Department of Epidemiology and Biostatistics, Western University, London, ON
- Department of Family Medicine, Western University, London, ON
| | - E. Winquist
- Department of Oncology, Western University, London, ON
| | - J. Yoo
- Department of Otolaryngology–Head and Neck Surgery, Western University, London, ON
- Department of Oncology, Western University, London, ON
| | - A. Nichols
- Department of Otolaryngology–Head and Neck Surgery, Western University, London, ON
- Department of Oncology, Western University, London, ON
| | - K. Fung
- Department of Otolaryngology–Head and Neck Surgery, Western University, London, ON
- Department of Oncology, Western University, London, ON
| | - S. Hall
- Institute for Clinical and Evaluative Sciences, Toronto, ON
- Department of Otolaryngology–Head and Neck Surgery, Cancer Care and Epidemiology, Queen’s University, Kingston, ON
| | - A.X. Garg
- Institute for Clinical and Evaluative Sciences, Toronto, ON
- Department of Epidemiology and Biostatistics, Western University, London, ON
- Division of Nephrology, Department of Medicine, Western University, London, ON
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Beck JR, Fung K, Lopez H, Mongero LB, Argenziano M. Real-time data acquisition and alerts may reduce reaction time and improve perfusionist performance during cardiopulmonary bypass. Perfusion 2014; 30:41-4. [PMID: 25138244 DOI: 10.1177/0267659114548257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Delayed perfusionist identification and reaction to abnormal clinical situations has been reported to contribute to increased mortality and morbidity. The use of automated data acquisition and compliance safety alerts has been widely accepted in many industries and its use may improve operator performance. A study was conducted to evaluate the reaction time of perfusionists with and without the use of compliance alert. A compliance alert is a computer-generated pop-up banner on a pump-mounted computer screen to notify the user of clinical parameters outside of a predetermined range. A proctor monitored and recorded the time from an alert until the perfusionist recognized the parameter was outside the desired range. Group one included 10 cases utilizing compliance alerts. Group 2 included 10 cases with the primary perfusionist blinded to the compliance alerts. In Group 1, 97 compliance alerts were identified and, in group two, 86 alerts were identified. The average reaction time in the group using compliance alerts was 3.6 seconds. The average reaction time in the group not using the alerts was nearly ten times longer than the group using computer-assisted, real-time data feedback. Some believe that real-time computer data acquisition and feedback improves perfusionist performance and may allow clinicians to identify and rectify potentially dangerous situations.
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Affiliation(s)
- J R Beck
- Section of Adult Cardiac Surgery, Department of Clinical Perfusion, New York Presbyterian Hospital, Columbia Campus, New York, NY, USA
| | - K Fung
- Section of Adult Cardiac Surgery, Department of Clinical Perfusion, New York Presbyterian Hospital, Columbia Campus, New York, NY, USA
| | - H Lopez
- Section of Adult Cardiac Surgery, Department of Clinical Perfusion, New York Presbyterian Hospital, Columbia Campus, New York, NY, USA
| | - L B Mongero
- Section of Adult Cardiac Surgery, Department of Clinical Perfusion, New York Presbyterian Hospital, Columbia Campus, New York, NY, USA
| | - M Argenziano
- Section of Adult Cardiac Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
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Sughrue M, Maurer A, Bonney P, Ebeling P, Fung K. Tumor Necrosis-Initiated Complement Activation Stimulates Proliferation of Medulloblastoma Cells. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Koganti S, Fung K, Jones D, Rathod K, Gallagher S, Weerackody R, Amersey R, Mathur A, Knight C, Wragg A. No difference in mortality between immediate vs delayed staged intervention of non culprit vessel in patients with multivessel disease following primary angioplasty. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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