• 제목/요약/키워드: High-risk groups

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Stratifying Patients with Haematuria into High or Low Risk Groups for Bladder Cancer: a Novel Clinical Scoring System

  • Tan, Guan Hee;Shah, Shamsul Azhar;Ann, Ho Sue;Hemdan, Siti Nurhafizah;Shen, Lim Chun;Abdul Galib, Nurudin Al-Fahmi;Singam, Praveen;Kong, Ho Chee Christopher;Hong, Goh Eng;Bahadzor, Badrulhisham;Zainuddin, Zulkifli Md
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6327-6330
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    • 2013
  • Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This study aimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groups for having bladder cancer to help clinicians decide which patients need more urgent assessment. This cross-sectional study included all adult patients referred for haematuria and subsequently undergoing full urological evaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the study population were used to design the scoring system. Accuracy was determined by the area under the receiver operating characteristic (ROC) curve. A total of 325 patients with haematuria were included, out of which 70 (21.5%) were diagnosed to have bladder cancer. Significant risk factors associated with bladder cancer were male gender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinical parameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicated high risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of 80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designed in this study has the potential to help clinicians stratify patients who present with haematuria into high or low r isk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.

초음파를 이용한 갑상선암의 집단검진 (Ultrasonographic Mass Screening for Thyroid Carcinoma)

  • 정웅윤;장항석;김은경;박정수
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.177-181
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    • 1999
  • Objective: The clinical significance of mass screening for thyroid carcinoma remains unclear. This study was carried out to clarify the value of mass screening for thyroid carcinoma. Materials and Methods: From December 1997 through July 1998, a total of 1,401 subjects who were enrolled to receive breast screening or follow-up examination for breast cancer were included in this study. Thyroid glands were examined by 10 MHz ultrasonography by one experienced radiologist. The patients with thyroid nodules were classified into 2 groups according to their potential risk of malignancy by ultrasonographic findings(high-risk : hypoechogenicity, microcalcification, irregular margin, taller than wider shape). High-risk patients were advised to undergo fine-needle aspiration biopsy and thyroidectomy. The characteristics of the thyroid cancers detected by ultrasonographic mass screening were compared by those of clinical thyroid cancer excluding male patients during the same period. Results: Thyroid nodules were detected in 353(25.2%) of the subjects and 259(73.4%) were listed in the low-risk group and 94(26.6%) in high-risk group. Among 94 patients in the high-risk group, 43 underwent thyroidectomy and 37 turned out to have thyroid carcinomas. Thus, the detection rates for carcinoma were 2.6% of all subject, 10.5% of the detected nodules, 36.4% of the high risk women and 86.0% of the operated cases. The tumor size was significantly smaller in the mass-screening group than in the clinical cancer group(p<0.05). However, there was no statistical differences between two groups in the prevalences of neck node involvement and extracapsular invasion and the patients distributions by AMES score, MACIS score and TNM stage. Conclusion: Ultrasonogrpahic mass screening may be useful for the early detection of thyroid carcinoma in women who are scheduled to have breast examination.

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청소년 건강행태에 따른 정신건강 위험 예측: 하이브리드 머신러닝 방법의 적용 (Predicting Mental Health Risk based on Adolescent Health Behavior: Application of a Hybrid Machine Learning Method)

  • 고은경;전효정;박현태;옥수열
    • 한국학교보건학회지
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    • 제36권3호
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    • pp.113-125
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    • 2023
  • Purpose: The purpose of this study is to develop a model for predicting mental health risk among adolescents based on health behavior information by employing a hybrid machine learning method. Methods: The study analyzed data of 51,850 domestic middle and high school students from 2022 Youth Health Behavior Survey conducted by the Korea Disease Control and Prevention Agency. Firstly, mental health risk levels (stress perception, suicidal thoughts, suicide attempts, suicide plans, experiences of sadness and despair, loneliness, and generalized anxiety disorder) were classified using the k-mean unsupervised learning technique. Secondly, demographic factors (family economic status, gender, age), academic performance, physical health (body mass index, moderate-intensity exercise, subjective health perception, oral health perception), daily life habits (sleep time, wake-up time, smartphone use time, difficulty recovering from fatigue), eating habits (consumption of high-caffeine drinks, sweet drinks, late-night snacks), violence victimization, and deviance (drinking, smoking experience) data were input to develop a random forest model predicting mental health risk, using logistic and XGBoosting. The model and its prediction performance were compared. Results: First, the subjects were classified into two mental health groups using k-mean unsupervised learning, with the high mental health risk group constituting 26.45% of the total sample (13,712 adolescents). This mental health risk group included most of the adolescents who had made suicide plans (95.1%) or attempted suicide (96.7%). Second, the predictive performance of the random forest model for classifying mental health risk groups significantly outperformed that of the reference model (AUC=.94). Predictors of high importance were 'difficulty recovering from daytime fatigue' and 'subjective health perception'. Conclusion: Based on an understanding of adolescent health behavior information, it is possible to predict the mental health risk levels of adolescents and make interventions in advance.

An empirical study of the risk-benefit perceptions between the nuclear and non-nuclear groups towards the nuclear power plant in Bangladesh

  • Md Shafiqul Islam;Swapnil Roy;Sadia Lena Alfee;Animesh Pal
    • Nuclear Engineering and Technology
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    • 제55권12호
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    • pp.4617-4627
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    • 2023
  • Public perception of benefit over risk is the de facto factor in planning, construction, operation, halting, or phase-out of a nuclear power plant in any country. Even if there are multiple pathways of perceiving risk/benefit among different stakeholders, the perception of nuclear and non-nuclear groups needs to be individually tracked to help understand sectoral influence. Related studies were basically performed between the STEM (Science, Technology, Engineering, and Mathematics) and non-STEM groups. However, there are no such studies between the nuclear and non-nuclear groups. This study investigated the risk-benefit perceptions between the nuclear group (N = 102) and the non-nuclear group (N = 467) using survey data to measure their stake and identify the underlying factors by validating the hypotheses, through descriptive analysis, and structural equation modeling (SEM). Results showed that risk perception is significantly high in the non-nuclear group (as the P-value is > 0.001 to <0.01) while the benefit perception is slightly low in the nuclear group (as the P-value is > 0.01 to <0.05). The non-nuclear group was significantly influenced by risk perception due to a lack of involvement in nuclear activities. Notably, the nuclear group is less interactive in disseminating nuclear energy benefits to the non-nuclear group. Surprisingly, misperceptions and lack of confidence about the benefits of nuclear energy also exist in the nuclear group. The study emphasizes debunking nuclear myths in the nuclear and non-nuclear groups through meaningful interactions and demands effective public awareness-building programs by competent authorities for the growth of the nuclear industry.

Evaluation of Biochemical Recurrence-free Survival after Radical Prostatectomy by Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) Score

  • Aktas, Binhan Kagan;Ozden, Cuneyt;Bulut, Suleyman;Tagci, Suleyman;Erbay, Guven;Gokkaya, Cevdet Serkan;Baykam, Mehmet Murat;Memis, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2527-2530
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    • 2015
  • Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

Bayesian Survival Analysis of High-Dimensional Microarray Data for Mantle Cell Lymphoma Patients

  • Moslemi, Azam;Mahjub, Hossein;Saidijam, Massoud;Poorolajal, Jalal;Soltanian, Ali Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.95-100
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    • 2016
  • Background: Survival time of lymphoma patients can be estimated with the help of microarray technology. In this study, with the use of iterative Bayesian Model Averaging (BMA) method, survival time of Mantle Cell Lymphoma patients (MCL) was estimated and in reference to the findings, patients were divided into two high-risk and low-risk groups. Materials and Methods: In this study, gene expression data of MCL patients were used in order to select a subset of genes for survival analysis with microarray data, using the iterative BMA method. To evaluate the performance of the method, patients were divided into high-risk and low-risk based on their scores. Performance prediction was investigated using the log-rank test. The bioconductor package "iterativeBMAsurv" was applied with R statistical software for classification and survival analysis. Results: In this study, 25 genes associated with survival for MCL patients were identified across 132 selected models. The maximum likelihood estimate coefficients of the selected genes and the posterior probabilities of the selected models were obtained from training data. Using this method, patients could be separated into high-risk and low-risk groups with high significance (p<0.001). Conclusions: The iterative BMA algorithm has high precision and ability for survival analysis. This method is capable of identifying a few predictive variables associated with survival, among many variables in a set of microarray data. Therefore, it can be used as a low-cost diagnostic tool in clinical research.

재난피해자의 외상 후 위기와 외상 후 성장, 주관적 안녕감 간의 관계 - 사회적 지지의 매개효과, 소득의 조절효과 - (Disaster Victims' Post-trauma Risk, Posttraumatic Growth and Subjective Well-being - Social Support as a Mediator and Income as a Moderator -)

  • 심서영;손영우;박상현;윤지원
    • 한국안전학회지
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    • 제31권6호
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    • pp.105-112
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    • 2016
  • The current study examined the relationships between disaster victims' post-trauma risk and posttraumatic growth, and the mediational role of social support for this relationships. In addition, we tested the hypothesis that income status would moderate the relationship between post-trauma risk and subjective well-being. Two hundred disaster victims completed Post-trauma Risk Checklist (PRC), Posttraumatic growth scale, Social support scale and Concise Measure of Subjective Well-Being (COMOSWB) as well as questions about their demographic characteristics. Results showed that those with high post-trauma risk demonstrated significantly higher levels of posttraumatic growth as compared to those with low post-trauma risk and social support partially mediated this relationship. Also, high levels of post-trauma risk predicted low levels of recent subjective well-being. Participants with high income obtained higher subjective well-being than did those with low income among high post-trauma risk groups. Implications for post-trauma risk and posttraumatic growth are discussed.

Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study

  • Alexopoulos, Evangelos C.;Kavalidou, Katerina;Messolora, Fani
    • Safety and Health at Work
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    • 제7권1호
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    • pp.1-5
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    • 2016
  • Background: Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. Methods: Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). Results: Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Conclusion: Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.

A Policy Intervention Study to Identify High-Risk Groups to Prevent Industrial Accidents in Republic of Korea

  • Yi, Kwan Hyung;Lee, Seung Soo
    • Safety and Health at Work
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    • 제7권3호
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    • pp.213-217
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    • 2016
  • Background: The objective of this study is to identify high-risk groups for industrial accidents by setting up 2003 as the base year and conducting an in-depth analysis of the trends of major industrial accident indexes the index of industrial accident rate, the index of occupational injury rate, the index of occupational illness and disease rate per 10,000 people, and the index of occupational injury fatality rate per 10,000 people for the past 10 years. Methods: This study selected industrial accident victims, who died or received more than 4 days of medical care benefits, due to occupational accidents and diseases occurring at workplaces, subject to the Industrial Accident Compensation Insurance Act, as the study population. Results: According to the trends of four major indexes by workplace characteristics, the whole industry has shown a decreasing tendency in all four major indexes since the base year (2003); as of 2012, the index of industrial accident rate was 67, while the index of occupational injury fatality rate per 10,000 people was 59. Conclusion: The manufacturing industry, age over 50 years and workplaces with more than 50 employees showed a high severity level of occupational accidents. Male workers showed a higher severity level of occupational accidents than female workers. The employment period of < 3 years and newly hired workers with a relatively shorter working period are likely to have more occupational accidents than others. Overall, an industrial accident prevention policy must be established by concentrating all available resources and capacities of these high-risk groups.

Feedback on Baseline Use of Staging Images is Important to Improve Image Overuse with Newly Diagnosed Prostate Cancer Patients

  • Sawazaki, Harutake;Sengiku, Atsushi;Imamura, Masaaki;Takahashi, Takeshi;Kobayashi, Hisato;Ogura, Keiji
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권4호
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    • pp.1707-1710
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    • 2014
  • Background: The objective of this study was to evaluate baseline use and positive rates of staging images (bone scan, CT) in newly diagnosed patients with prostate cancer (PCa) and to improve staging image overuse. Materials and Methods: This retrospective study covered a consecutive series of patients with PCa who underwent stage imaging at our institution between 2006 and 2011. Various clinical and pathological variables (age, PSA, biopsy Gleason score, clinical T stage, positive biopsy core rate) were evaluated by multivariate logistic regression analysis for their ability to predict a positive staging image. All patients were stratified according to the NCCN risk stratification and positive rates were compared in each risk group. Results: 410 patients (100%) underwent a bone scan and 315 patients (76.8%) underwent a CT scan. Some 51 patients (12.4%) had a positive bone scan, clinical T3 and T4 being significant independent predictors. Positive bone scan rates for low-, intermediate-, high-, and very high-risk groups were 0%, 0%, 8.25%, and 56.6%. Some 59 (18.7%) patients had a positive CT scan, with elevated PSA and clinical T3, T4 as significant independent predictors. Low-, intermediate-, high- and very high-risk group rates were 0%, 0%, 13.8% and 80.0%. Conclusions: The incidences of positive staging image in low- and intermediate- risk group were reasonably low. Following feedback on these results, staging in low- and intermediate- risk groups could be omitted.