Concordance Study in Hepatectomy Recommendations Between Watson for Oncology and Clinical Practice for Patients with Hepatocellular Carcinoma in China

Use and accuracy of decision support systems using artificial intelligence for tumor diseases: a systematic review and meta-analysis

Background

For therapy planning in cancer patients multidisciplinary team meetings (MDM) are mandatory. Due to the high number of cases being discussed and significant workload of clinicians, Clinical Decision Support System (CDSS) may improve the clinical workflow.

Methods

This review and meta-analysis aims to provide an overview of the systems utilized and evaluate the correlation between a CDSS and MDM.

Results

A total of 31 studies were identified for final analysis. Analysis of different cancers shows a concordance rate (CR) of 72.7% for stage I-II and 73.4% for III-IV. For breast carcinoma, CR for stage I-II was 72.8% and for III-IV 84.1%, P≤ 0.00001. CR for colorectal carcinoma is 63% for stage I-II and 67% for III-IV, for gastric carcinoma 55% and 45%, and for lung carcinoma 85% and 83% respectively, all P>0.05. Analysis of SCLC and NSCLC yields a CR of 94,3% and 82,7%, P=0.004 and for adenocarcinoma and squamous cell carcinoma in lung cancer a CR of 90% and 86%, P=0.02.

Conclusion

CDSS has already been implemented in clinical practice, and while the findings suggest that its use is feasible for some cancers, further research is needed to fully evaluate its effectiveness.

Comparison of case-based learning using Watson for oncology and traditional method in teaching undergraduate medical students

BACKGROUND

Watson for Oncology (WFO) is a decision-making system generated by artificial intelligence (AI) and has been widely used in treatment recommendations of cancer patients. However, the application of WFO in clinical teaching among medical students has not been reported.

OBJECTIVE

To establish a novel teaching and learning method with WFO in undergraduate medical students and evaluate its efficiency and students' satisfaction compared with traditional case-based learning model.

METHODS

72 undergraduates majoring in clinical medicine in Wuhan University were enrolled and were randomly divided into the WFO-based group and the control group. 36 students in the WFO-based group learned clinical oncology cases via WFO platform while 36 students in the control group using traditional teaching methods. After the course, final examination and questionnaire survey of teaching assessment were conducted on the two groups of students.

RESULTS

According to the questionnaire survey of teaching assessment, WFO-based group showed significant higher score in the aspect of cultivating ability of independent learning (17.67 ± 1.39 vs. 15.17 ± 2.02, P = 0.018), increasing knowledge mastery (17.75 ± 1.10 vs. 16.25 ± 1.18, P = 0.001), enhancing learning interest (18.41 ± 1.42 vs. 17.00 ± 1.37, P = 0.002), increasing course participation (18.33 ± 1.67 vs. 15.75 ± 1.67, P = 0.001) and the overall course satisfaction (89.25 ± 5.92 vs. 80.75 ± 3.42, P = 0.001) than those of the control group students.

CONCLUSION

Our practice has established a novel clinical case-based teaching pattern with WFO, providing undergraduate students with convenient and scientific training and guidance. It empowers students with improved learning experiences and equips them with essential tools for clinical practices.

Assessing the decision quality of artificial intelligence and oncologists of different experience in different regions in breast cancer treatment

Background

AI-based clinical decision support system (CDSS) has important prospects in overcoming the current informational challenges that cancer diseases faced, promoting the homogeneous development of standardized treatment among different geographical regions, and reforming the medical model. However, there are still a lack of relevant indicators to comprehensively assess its decision-making quality and clinical impact, which greatly limits the development of its clinical research and clinical application. This study aims to develop and application an assessment system that can comprehensively assess the decision-making quality and clinical impacts of physicians and CDSS.

Methods

Enrolled adjuvant treatment decision stage early breast cancer cases were randomly assigned to different decision-making physician panels (each panel consisted of three different seniority physicians in different grades hospitals), each physician made an independent "Initial Decision" and then reviewed the CDSS report online and made a "Final Decision". In addition, the CDSS and guideline expert groups independently review all cases and generate "CDSS Recommendations" and "Guideline Recommendations" respectively. Based on the design framework, a multi-level multi-indicator system including "Decision Concordance", "Calibrated Concordance", " Decision Concordance with High-level Physician", "Consensus Rate", "Decision Stability", "Guideline Conformity", and "Calibrated Conformity" were constructed.

Results

531 cases containing 2124 decision points were enrolled; 27 different seniority physicians from 10 different grades hospitals have generated 6372 decision opinions before and after referring to the "CDSS Recommendations" report respectively. Overall, the calibrated decision concordance was significantly higher for CDSS and provincial-senior physicians (80.9%) than other physicians. At the same time, CDSS has a higher " decision concordance with high-level physician" (76.3%-91.5%) than all physicians. The CDSS had significantly higher guideline conformity than all decision-making physicians and less internal variation, with an overall guideline conformity variance of 17.5% (97.5% vs. 80.0%), a standard deviation variance of 6.6% (1.3% vs. 7.9%), and a mean difference variance of 7.8% (1.5% vs. 9.3%). In addition, provincial-middle seniority physicians had the highest decision stability (54.5%). The overall consensus rate among physicians was 64.2%.

Conclusions

There are significant internal variation in the standardization treatment level of different seniority physicians in different geographical regions in the adjuvant treatment of early breast cancer. CDSS has a higher standardization treatment level than all physicians and has the potential to provide immediate decision support to physicians and have a positive impact on standardizing physicians' treatment behaviors.

Application of Absorbable Suture in Strabismus Correction and Nursing Management Advantage of Watson Care Theory in Perioperative Period

Objectives

The article is aimed at investigating the suture effect of absorbable suture in strabismus correction and the advantage of Watson care theory.

Methods

148 children with strabismus were enrolled in this study and divided into two groups. The control group received routine nursing, and on this basis, the observation group was given Watson care theory nursing and eye muscle suture with absorbable sutures. The degree of cooperation (induction compliance checklist (ICC) score), negative emotion (modified Yale preoperative anxiety scale (m-YAPS) score), pain (face pain scale (FPS) score), quality of nursing management, parents' satisfaction, clinical efficacy, and adverse reactions were compared.

Results

After nursing and surgical treatment, all children's strabismus symptoms were improved, and the improvement of strabismus and visual function in the observation group was more obvious. Watson care nursing can effectively improve the nursing management quality, parents' satisfaction, children's negative emotions, and treatment compliance.

Conclusions

As a result, Watson care theory nursing is of great significance for improving the relationship between nurses and patients and building a harmonious hospital.

Long noncoding RNA MACC1-AS1 promotes the stemness of hepatocellular carcinoma cells by antagonizing miR-145

Objectives

This work aimed to investigate the roles of long noncoding (lnc)RNA MACC1-AS1 (MACC1 antisense RNA 1) in progression of hepatocellular carcinoma (HCC).

Methods

Real-time quantitative PCR, western blot, spheroid formation, aldehyde dehydrogenase isoform 1 (ALDH1) activity analysis, luciferase reporter assay, and RNA pull-down analysis were used to examine MACC1-AS1–mediated effects on HCC cell stemness.

Results

MACC1-AS1 was highly expressed in HCC tissues and cells. MACC1-AS1 positively regulated the expression of stemness master regulators and inhibited spheroid-forming ability and ALDH1 activity. Furthermore, MACC1-AS1 promoted the stemness of HCC cells by antagonizing microRNA (miR)-145 activity. Overexpression of miR-145 also attenuated HCC cell stemness.

Conclusions

This work revealed a novel MACC1-AS1/miR-145 axis that regulates the stemness of HCC cells.