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Zhang L, Shi R, Youssefi N. Oral cancer diagnosis based on gated recurrent unit networks optimized by an improved version of Northern Goshawk optimization algorithm. Heliyon 2024; 10:e32077. [PMID: 38912510 PMCID: PMC11190545 DOI: 10.1016/j.heliyon.2024.e32077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/12/2024] [Accepted: 05/28/2024] [Indexed: 06/25/2024] Open
Abstract
Oral cancer early diagnosis is a critical task in the field of medical science, and one of the most necessary things is to develop sound and effective strategies for early detection. The current research investigates a new strategy to diagnose an oral cancer based upon combination of effective learning and medical imaging. The current research investigates a new strategy to diagnose an oral cancer using Gated Recurrent Unit (GRU) networks optimized by an improved model of the NGO (Northern Goshawk Optimization) algorithm. The proposed approach has several advantages over existing methods, including its ability to analyze large and complex datasets, its high accuracy, as well as its capacity to detect oral cancer at the very beginning stage. The improved NGO algorithm is utilized to improve the GRU network that helps to improve the performance of the network and increase the accuracy of the diagnosis. The paper describes the proposed approach and evaluates its performance using a dataset of oral cancer patients. The findings of the study demonstrate the efficiency of the suggested approach in accurately diagnosing oral cancer.
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Affiliation(s)
- Lei Zhang
- Department of Stomatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, Shandong, China
| | - Rongji Shi
- Department of Stomatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, Shandong, China
| | - Naser Youssefi
- Islamic Azad University, Science and Research Branch, Tehran, Iran
- College of Technical Engineering, The Islamic University, Najaf, Iraq
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2
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Dai YM, Axelin A, Fu ZH, Zhu Y, Wan HW. Mobile Health System for Meeting Health Information Needs in Patients With Head and Neck Cancer Undergoing Radiotherapy: Development and Feasibility Study. Comput Inform Nurs 2024; 42:448-456. [PMID: 38261470 DOI: 10.1097/cin.0000000000001091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Patients with head and neck cancer undergoing radiotherapy encounter physical and psychosocial challenges, indicating unmet needs. Mobile health technology can potentially support patients. This single-armed feasibility study included 30 patients with head and neck cancer undergoing radiotherapy. Patients were asked to use the Health Enjoy System, a mobile health support system that provides a disease-related resource for 1 week. We assessed the usability of the system and its limited efficacy in meeting patients' health information needs. The result showed that the system was well received by patients and effectively met their health information needs. They also reported free comments on the system's content, backend maintenance, and user engagement. This study supplies a foundation for further research to explore the potential benefits of the Health Enjoy System in supporting patients with head and neck cancer.
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Affiliation(s)
- Yu-Mei Dai
- Author Affiliations: Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital (Dai, Fu, Zhu, Dr Wan); Shanghai Key Laboratory of Radiation Oncology (Dai, Fu, Zhu, Dr Wan); and Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy (Dai, Fu, Zhu, Dr Wan), Shanghai, China; and Department of Nursing Science, University of Turku (Dr Axelin), Finland
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de Lima TMNR, Moura ABR, Bezerra PMM, Valença AMG, Vieira TI, Santiago BM, Cavalcanti YW, de Sousa SA. Accuracy of Remote Examination for Detecting Potentially Malignant Oral Lesions: A Systematic Review and Meta-Analysis. Telemed J E Health 2024; 30:381-392. [PMID: 37651222 DOI: 10.1089/tmj.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Objective: We aimed to investigate the accuracy of remote examination by photographs compared to in-person clinical examination for detecting potentially malignant oral lesions (PMOLs). Methods: The Reporting Guide and Guidelines for Writing Systematic Reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analysis [PRISMA]) guided the reporting of findings. The search was conducted by two independent reviewers in six databases with no language restriction until November 2022. The Population, Test-Index, Reference Standard, Outcome and Study Design (PIROS) strategy guided the eligibility criteria, and studies with adult patients (P) examined remotely (I) and in-person (R) to verify the detection of PMOLs (O) were considered. The methodological quality was assessed by QUADAS-2, and the certainty of the evidence was measured by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results: A total of 769 files were identified. After removing duplicates and reading titles and abstracts, 16 were read in full, from which 6 articles then comprised the qualitative synthesis. The oral clinical examination was the reference standard in four studies. Five studies presented high risk of bias in at least one assessment domain. A high probability of detection of PMOL by remote examination (97.37%) was observed for the three studies included in the meta-analysis, which presented high heterogeneity among them. The certainty of evidence for the outcome was considered very low. Conclusions: Remote tools for detecting PMOLs may be feasible and assertive, but new studies are required to incorporate them into clinical practice. Clinical Relevance: Remote examination for the detection of PMOLs has the potential to favoring the early diagnosis of malignant lesions.
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Affiliation(s)
| | | | | | | | - Thiago Isidro Vieira
- Program in Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
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Ross MW, Bennis SL, Zoschke N, Simon Rosser BR, Stull CL, Nyitray AG, Khariwala SS, Nichols M, Flash C, Wilkerson M. Screening for HPV-Related Oropharyngeal Cancer in Gay and Bisexual Men: Acceptability and Predicting Possible Use of "Oral Selfies" by Smartphone as a Secondary Prevention Approach. VENEREOLOGY (BASEL, SWITZERLAND) 2023; 2:180-193. [PMID: 38515606 PMCID: PMC10956645 DOI: 10.3390/venereology2040016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Oropharyngeal cancers (OPCa) caused by HPV have emerged as one of the leading causes of malignancies caused by HPV infection. They are also significantly more likely to occur in males and in people with a history of oral sex with multiple partners. Gay and bisexual men are disproportionately affected by HPV-positive oropharyngeal cancers. We studied 1699 gay and bisexual men on 2 major dating sites in the US to assess their knowledge about HPV-related OPCa, attitudes toward screening for it, beliefs about oropharyngeal cancer screening based on the Health Belief Model, and attitudes toward possible screening approaches for OPCa. Knowledge on a 12-item scale was low, with a median of 5 items correct: 72% knew of the benefits of HPV vaccination. Significant predictors of needing OPCa screening included perception of risk for OPCa, seeing it as severe, having lower barriers, fewer reasons to avoid screening, higher knowledge, and being HPV vaccinated were significant predictors, explaining half the total variance. Most participants would accept routine, virtual/online doctor or dental appointments, and over half would accept an in-person screening. Nearly two-thirds stated that they would accept getting checked for OPCa if they could do self-screening at home, and half were prepared to use an online screening tool or app, where they could take an "oral selfie" and send it to a healthcare provider for examination. One-third stated that they would trust the results of a home screening completed by themselves and posted to a website equally as cancer screening completed online by a healthcare provider. Data indicate that despite low OPCA knowledge levels, the risk of HPV-associated OPCa was known. Being at personal risk and having knowledge of disease severity had 70% of the sample thinking about, or preparing to get, screening. Self-screening by a smartphone "oral selfie" transmitted to a screening website was acceptable to many gay and bisexual men, and online screening by a doctor or dentist was acceptable to most. OPCa screening in this population using electronic technology, together with the increasing incidence of HPV-associated OPCa in gay and bisexual men, brings together an opportunity to detect OPCa early.
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Affiliation(s)
- Michael W. Ross
- Institute of Sexual and Gender Health, Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
| | - Sarah L. Bennis
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Niles Zoschke
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Brian R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Cyndee L. Stull
- School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alan G. Nyitray
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53202, USA
| | - Samir S. Khariwala
- Department of Otolaryngology, Head and Neck Surgery, Medical School, University of Minnesota, Minneapolis, MN 55455, USA
| | - Mark Nichols
- Avenue360 Health Services, Houston, TX 77008, USA
| | | | - Michael Wilkerson
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Ross MW, Bennis SL, Nichols CM, Zoschke IN, Wilkerson JM, Rosser BRS, Stull CL, Nyitray AG, Flash C, Khariwala SS. Oral/oropharyngeal "selfies" in gay and bisexual men: a pilot study exploring oropharyngeal screening for HPV-related possible malignancies. Front Public Health 2023; 11:1233274. [PMID: 37780435 PMCID: PMC10537951 DOI: 10.3389/fpubh.2023.1233274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/16/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives This study aims to determine the potential uptake and quality of oropharyngeal "selfies" taken by gay/bisexual men as a screening approach for HPV-associated oropharyngeal cancer. Methods From 1,699 gay/bisexual men in the US, surveyed about knowledge and attitudes to HPV-associated oropharyngeal cancer, a random sample of 320 men were invited to take an oropharyngeal "selfie" by smartphone and send it to the study website: 113 (35.5%) did so. Images were rated for quality by three healthcare professional raters blinded to each other's rating, with an otolaryngologist as the gold standard. In the second wave, those whose images were rated as unacceptable were sent a short instructional video and asked to send another image. Of the 65 invited, 46 did so. An additional 15.2% sent acceptable images, and a total of 28.3% of the sample was acceptable. Results A total of 1,121 men willing to participate in the future study who believed they could take a quality "oral selfie" were potentially eligible for this activity. A random sample of 320 participated: 153 participants started (47.8%) and 113 participants (35.3%) submitted an image. Responders were more likely to be younger, have higher knowledge scores on oropharyngeal HPV-related cancer, and have had HPV vaccination. There was high agreement between the three raters. Images of good/acceptable quality were 22.1%; oropharynx partially occluded images were 29.2%; oropharynx not visible images were 18.6%; images too dark were 21.2%; and images too small were 8.8%. From the second wave of requests with instructional videos, an additional 15.2% sent in quality images, with the remaining issues being partial occlusion of the tonsils by the tongue. Conclusion One-third of the invited gay and bisexual men sent oropharyngeal selfie images to the study website and a total of 28.3% were of clinically acceptable quality. Following an instructional video on poorer-quality images, additional quality images were received. One barrier, i.e., partial occlusion of the oropharynx by the tongue remained. Quality oropharyngeal "selfies" are obtainable online.
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Affiliation(s)
- Michael W. Ross
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Sarah L. Bennis
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | | | - I. Niles Zoschke
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - J. Michael Wilkerson
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Cyndee L. Stull
- School of Dentistry, University of Minnesota, Minneapolis, MN, United States
| | - Alan G. Nyitray
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Samir S. Khariwala
- Department of Otolaryngology, Head and Neck Surgery, Medical School, University of Minnesota, Minneapolis, MN, United States
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de Souza LL, Fonseca FP, Araújo ALD, Lopes MA, Vargas PA, Khurram SA, Kowalski LP, Dos Santos HT, Warnakulasuriya S, Dolezal J, Pearson AT, Santos-Silva AR. Machine learning for detection and classification of oral potentially malignant disorders: A conceptual review. J Oral Pathol Med 2023; 52:197-205. [PMID: 36792771 DOI: 10.1111/jop.13414] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 02/17/2023]
Abstract
Oral potentially malignant disorders represent precursor lesions that may undergo malignant transformation to oral cancer. There are many known risk factors associated with the development of oral potentially malignant disorders, and contribute to the risk of malignant transformation. Although many advances have been reported to understand the biological behavior of oral potentially malignant disorders, their clinical features that indicate the characteristics of malignant transformation are not well established. Early diagnosis of malignancy is the most important factor to improve patients' prognosis. The integration of machine learning into routine diagnosis has recently emerged as an adjunct to aid clinical examination. Increased performances of artificial intelligence AI-assisted medical devices are claimed to exceed the human capability in the clinical detection of early cancer. Therefore, the aim of this narrative review is to introduce artificial intelligence terminology, concepts, and models currently used in oncology to familiarize oral medicine scientists with the language skills, best research practices, and knowledge for developing machine learning models applied to the clinical detection of oral potentially malignant disorders.
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Affiliation(s)
- Lucas Lacerda de Souza
- Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Felipe Paiva Fonseca
- Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Marcio Ajudarte Lopes
- Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Harim Tavares Dos Santos
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA
- Department of Bond Life Sciences Center, University of Missouri, Columbia, Missouri, USA
| | - Saman Warnakulasuriya
- King's College London, London, UK
- WHO Collaborating Centre for Oral Cancer, London, UK
| | - James Dolezal
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Alexander T Pearson
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Alan Roger Santos-Silva
- Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
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Mobile Health (mHealth) Technology in Early Detection and Diagnosis of Oral Cancer-A Scoping Review of the Current Scenario and Feasibility. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4383303. [PMID: 36312594 PMCID: PMC9605853 DOI: 10.1155/2022/4383303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Abstract
Objective Oral cancer is one of the most common types of cancer with dreadful consequences. But it can be detected early without much expensive equipment. Screening and early detection of oral cancer using Mobile health (mHealth) technology are reported due to the availability of the extensive network of mobile phones across populations. Therefore, we aimed to explore the existing literature regarding mHealth feasibility in the early detection of oral cancer. Materials and Method. An extensive search was conducted to explore the literature on the feasibility of mobile health for early oral cancer. Clinical studies reporting kappa agreement between on-site dentists and offsite health care workers/dentists in the early detection of oral cancer were included in this review. Studies describing the development of a diagnostic device, app development, and qualitative interviews among practitioners trained in using mobile health were also included in this review for a broader perspective on mHealth. Results While most of the studies described various diagnostic accuracies using mHealth for oral cancer early detection, few studies reported the development of mobile applications, novel device designs for mHealth applications, and the feasibility of a few mHealth programs for early oral cancer detection. Community health workers equipped with a mobile phone-based app could identify “abnormal” oral lesions. Overall, many studies reported high sensitivity, specificity, and Kappa value of agreement. Effectiveness, advantages, and barriers in oral cancer screening using mHealth are also described. Conclusion The overall results show that remote diagnosis for early detection of oral cancer using mHealth was found useful in remote settings.
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Challenges in the Early Diagnosis of Oral Cancer, Evidence Gaps and Strategies for Improvement: A Scoping Review of Systematic Reviews. Cancers (Basel) 2022; 14:cancers14194967. [PMID: 36230890 PMCID: PMC9562013 DOI: 10.3390/cancers14194967] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/03/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Oral cancer presents a worldwide incidence of 377,713 new cases and 177,757 deaths per year (GLOBOCAN, IARC, WHO). Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of oral malignancies and has a 5-year mortality rate close to 50%. We aim to better understand, based on the evidence, and to discuss in depth, the reasons for the diagnostic delay of oral cancer by reviewing systematic reviews and meta-analyses. We also aim to, identify gaps in evidence, recommend future lines of research that should be implemented, and formulate strategies for improvement. Abstract Oral cancer is a growing problem, accounting for 377,713 worldwide new cases per year, and 177,757 deaths annually and representing a 5-year mortality rate close to 50%, which is a considerable mortality that has not decreased substantially in the last 40 years. The main cause of this high mortality is related to the diagnosis of a high percentage of oral cancers in advanced stages (stages III and IV) in which treatment is complex, mutilating or disabling, and ineffective. The essential cause of a cancer diagnosis at a late stage is the delay in diagnosis, therefore, the achievement of the objective of improving the prognosis of oral cancer involves reducing the delay in its diagnosis. The reasons for the delay in the diagnosis of oral cancer are complex and involve several actors and circumstances—patients, health care providers, and health services. In this paper, we present the results of a scoping review of systematic reviews on the diagnostic delay in oral cancer with the aim to better understand, based on the evidence, and discuss in depth, the reasons for this fact, and to identify evidence gaps and formulate strategies for improvement.
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Northridge ME, Weiserbs KF, Sabounchi SS, Torroni A, Mohadjeri-Franck NS, Gargano S, George E, Littlejohn TC, Troxel AB, Wu Y, Testa PA, Wismer J, Zaremba K, Tylawsky P, Bina B. A feasibility and acceptability study of using an intra-oral camera and an asynchronous tele-mentoring protocol to detect and identify oral lesions. J Public Health Res 2022; 11:22799036221115778. [PMID: 36081898 PMCID: PMC9445478 DOI: 10.1177/22799036221115778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: To examine the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions at the dental clinics of a Federally Qualified Health Center network. Design and Methods: General Practice Residency faculty and residents completed research ethics courses and trained dentists to use intra-oral cameras at chairside to photograph oral lesions of patients at routine dental visits. These images were then uploaded into the patient electronic health records (EHRs) with attendant descriptions and an oral surgeon was notified, who reviewed the charts, placed his observations in the EHR, and communicated his findings via secure e-mail to the involved residents, who in turn contacted their patients regarding follow-up actions. Feasibility was assessed via checklists completed by provider participants and semi-structured interviews. Acceptability was assessed via brief exit interviews completed by patient participants. Results: All 12 of the dentist participants reported that they had successfully provided the tele-mentoring intervention, and that the process (from EHR data entry to interaction with the oral surgeon over findings to patient referral) was clear and straightforward. Of 39 patient participants, most strongly agreed or agreed that the use of an intra-oral camera by their dentists helped them to better understand oral cancer screening (94.9%) and that dentists answered their questions about oral cancer and were able to provide them with resources (94.8%). Conclusions: Findings support further implementation research into adapting tele-mentoring using intra-oral cameras for training dental residents to detect and identify oral lesions and educating patients about oral cancer across settings.
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Affiliation(s)
- Mary E Northridge
- Department of Dental Medicine, NYU Langone Health, New York, NY, USA
| | - Kera F Weiserbs
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Andrea Torroni
- Department of Dental Medicine, NYU Langone Health, New York, NY, USA
| | | | - Steven Gargano
- Department of Dental Medicine, NYU Langone Health, New York, NY, USA
| | - Eliot George
- Department of Dental Medicine, NYU Langone Health, New York, NY, USA
| | - Tina C Littlejohn
- Department of Dental Medicine, NYU Langone Health, New York, NY, USA
| | - Andrea B Troxel
- Department of Dental Medicine, NYU Langone Health, New York, NY, USA
| | - Yinxiang Wu
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Paul A Testa
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Jennifer Wismer
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Kiah Zaremba
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Peter Tylawsky
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Babak Bina
- Department of Dental Medicine, NYU Langone Health, New York, NY, USA
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Rajendran S, Lim JH, Yogalingam K, Kallarakkal TG, Zain RB, Jayasinghe RD, Rimal J, Kerr AR, Amtha R, Patil K, Welikala RA, Lim YZ, Remagnino P, Gibson J, Tilakaratne WM, Liew CS, Yang YH, Barman SA, Chan CS, Cheong SC. Image collection and annotation platforms to establish a multi-source database of oral lesions. Oral Dis 2022. [PMID: 35398971 DOI: 10.1111/odi.14206] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/02/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the development of a platform for image collection and annotation that resulted in a multi-sourced international image dataset of oral lesions to facilitate the development of automated lesion classification algorithms. MATERIALS AND METHODS We developed a web-interface, hosted on a web server to collect oral lesions images from international partners. Further, we developed a customised annotation tool, also a web-interface for systematic annotation of images to build a rich clinically labelled dataset. We evaluated the sensitivities comparing referral decisions through the annotation process with the clinical diagnosis of the lesions. RESULTS The image repository hosts 2474 images of oral lesions consisting of oral cancer, oral potentially malignant disorders and other oral lesions that were collected through MeMoSA® UPLOAD. Eight-hundred images were annotated by seven oral medicine specialists on MeMoSA® ANNOTATE, to mark the lesion and to collect clinical labels. The sensitivity in referral decision for all lesions that required a referral for cancer management/surveillance was moderate to high depending on the type of lesion (64.3%-100%). CONCLUSION This is the first description of a database with clinically labelled oral lesions. This database could accelerate the improvement of AI algorithms that can promote the early detection of high-risk oral lesions.
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Affiliation(s)
| | - Jian Han Lim
- Centre of Image and Signal Processing, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Thomas George Kallarakkal
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research and Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Rosnah Binti Zain
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research and Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Malaysia
| | - Ruwan Duminda Jayasinghe
- Department of Oral Medicine and Periodontology, Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Jyotsna Rimal
- Department of Oral Medicine and Radiology, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Alexander Ross Kerr
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University, New York, New York, USA
| | - Rahmi Amtha
- Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
| | - Karthikeya Patil
- Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education & Research, Mysuru, India
| | - Roshan Alex Welikala
- Digital Information Research Centre, Faculty of Science, Engineering and Computing, Kingston University, Surrey, UK
| | - Ying Zhi Lim
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Paolo Remagnino
- Digital Information Research Centre, Faculty of Science, Engineering and Computing, Kingston University, Surrey, UK
| | - John Gibson
- Institute of Dentistry, University of Aberdeen, Aberdeen, UK
| | - Wanninayake Mudiyanselage Tilakaratne
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Department of Oral Medicine and Periodontology, Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Chee Sun Liew
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, Kuala Lumpur, Malaysia.,Centre of Data Analytics, Research Management & Innovation Complex, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Data Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Yi-Hsin Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Sarah Ann Barman
- Digital Information Research Centre, Faculty of Science, Engineering and Computing, Kingston University, Surrey, UK
| | - Chee Seng Chan
- Centre of Image and Signal Processing, Faculty of Computer Science and Information Technology, University of Malaya, Kuala Lumpur, Malaysia
| | - Sok Ching Cheong
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Malaysia.,Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Rajendran S, Mohamad Zaini Z, Lim YZ, Kallarakkal TG, Ramanathan A, Chan SW, Goh YC, Tan CC, Lim D, Hassan MK, Kanapathy J, Pathmanathan D, Chan CS, Liew CS, Ismail SM, Cheong SC. Accelerated implementation of teleconsultation services for the monitoring of oral potentially malignant disorders as a result of the COVID-19 pandemic. Oral Oncol 2022; 126:105730. [PMID: 35176655 PMCID: PMC8842584 DOI: 10.1016/j.oraloncology.2022.105730] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Senthilmani Rajendran
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Zuraiza Mohamad Zaini
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia; Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ying Zhi Lim
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Thomas George Kallarakkal
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia; Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Anand Ramanathan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia; Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Siew Wui Chan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yet Ching Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chuey Chuan Tan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Daniel Lim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Kamil Hassan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jananezwary Kanapathy
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | | | - Chee Seng Chan
- Centre of Image and Signal Processing, Faculty of Computer Science and Information Technology, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chee Sun Liew
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Centre for Data Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siti Mazlipah Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Sok Ching Cheong
- Digital Health Research Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia; Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
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12
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Walsh T, Warnakulasuriya S, Lingen MW, Kerr AR, Ogden GR, Glenny AM, Macey R. Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults. Cochrane Database Syst Rev 2021; 12:CD010173. [PMID: 34891214 PMCID: PMC8664456 DOI: 10.1002/14651858.cd010173.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The early detection of oral cavity squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD), followed by appropriate treatment, may improve survival and reduce the risk for malignant transformation respectively. This is an update of a Cochrane Review first published in 2013. OBJECTIVES To estimate the diagnostic test accuracy of conventional oral examination, vital rinsing, light-based detection, mouth self-examination, remote screening, and biomarkers, used singly or in combination, for the early detection of OPMD or OSCC in apparently healthy adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 October 2020), MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the test accuracy of any of the aforementioned tests in detecting OPMD or OSCC during a screening procedure. Diagnosis of OPMD or OSCC was provided by specialist clinicians or pathologists, or alternatively through follow-up. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction, and quality assessment were carried out by at least two authors independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). We reported the sensitivity and specificity of the included studies. We provided judgement of the certainty of the evidence using a GRADE assessment. MAIN RESULTS We included 18 studies, recruiting 72,202 participants, published between 1986 and 2019. These studies evaluated the diagnostic test accuracy of conventional oral examination (10 studies, none new to this update), mouth self-examination (four studies, two new to this update), and remote screening (three studies, all new to this update). One randomised controlled trial of test accuracy directly evaluated conventional oral examination plus vital rinsing versus conventional oral examination alone. There were no eligible studies evaluating light-based detection or blood or salivary sample analysis (which tests for the presence of biomarkers for OPMD and OSCC). Only one study of conventional oral examination was judged as at overall low risk of bias and overall low concern regarding applicability. Given the clinical heterogeneity of the included studies in terms of the participants recruited, setting, prevalence of the target condition, the application of the index test and reference standard, and the flow and timing of the process, the data could not be pooled within the broader categories of index test. For conventional oral examination (10 studies, 25,568 participants), prevalence in the test accuracy sample ranged from 1% to 51%. For the seven studies with prevalence of 10% or lower, a prevalence more comparable to the general population, the sensitivity estimates were variable, and ranged from 0.50 (95% confidence interval (CI) 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00); the specificity estimates were more consistent and ranged from 0.94 (95% CI 0.88 to 0.97) to 0.99 (95% CI 0.98 to 1.00). We judged the overall certainty of the evidence to be low, and downgraded for inconsistency and indirectness. Evidence for mouth self-examination and remote screening was more limited. We judged the overall certainty of the evidence for these index tests to be very low, and downgraded for imprecision, inconsistency, and indirectness. We judged the evidence for vital rinsing (toluidine blue) as an adjunct to conventional oral examination compared to conventional oral examination to be moderate, and downgraded for indirectness as the trial was undertaken in a high-risk population. AUTHORS' CONCLUSIONS There is a lack of high-certainty evidence to support the use of screening programmes for oral cavity cancer and OPMD in the general population. Frontline screeners such as general dentists, dental hygienists, other allied professionals, and community healthcare workers should remain vigilant for signs of OPMD and OSCC.
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Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Mark W Lingen
- Pritzker School of Medicine, Division of Biological Sciences, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, USA
| | - Graham R Ogden
- Division of Oral and Maxillofacial Clinical Sciences, School of Dentistry, University of Dundee, Dundee, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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13
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Abstract
Oral cancer is a major public health problem, and there is an increasing trend
for oral cancer to affect young men and women. Public awareness is poor, and
many patients present with late-stage disease, contributing to high mortality.
Oral cancer is often preceded by a clinical premalignant phase accessible to
visual inspection, and thus there are opportunities for earlier detection and to
reduce morbidity and mortality. Screening asymptomatic individuals by systematic
visual oral examinations to detect the disease has been shown to be feasible. A
positive screen includes both oral cancer and oral potentially malignant
disorders. We review key screening studies undertaken, including 1 randomized
clinical trial. Screening of high-risk groups is cost-effective. Strengths and
weaknesses of oral cancer screening studies are presented to help guide new
research in primary care settings and invigorated by the prospect of using
emerging new technologies that may help to improve discriminatory accuracy of
case detection. Most national organizations, including the US Preventive
Services Task Force, have so far not recommended population-based screening due
a lack of sufficient evidence that screening leads to a reduction in oral cancer
mortality. Where health care resources are high, opportunistic screening in
dental practices is recommended, although the paucity of research in primary
care is alarming. The results of surveys suggest that dentists do perform oral
cancer screenings, but there is only weak evidence that screening in dental
practices leads to downstaging of disease. Where health care resources are low,
the feasibility of using primary health care workers for oral cancer screening
has been tested, and measures indicate good outcomes. Most studies reported in
the literature are based on 1 round of screening, whereas screening should be a
continuous process. This review identifies a huge potential for new research
directions on screening for oral cancer.
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Affiliation(s)
- S. Warnakulasuriya
- King’s College London and WHO
Collaborating Centre for Oral Cancer, London, UK
- S. Warnakulasuriya, Faculty of Dentistry,
Oral & Craniofacial Sciences, King’s College London and WHO Collaborating
Centre for Oral Cancer, London, UK.
| | - A.R. Kerr
- Department of Oral and Maxillofacial
Pathology, Radiology & Medicine, New York University College of Dentistry, New
York, NY, USA
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