• Title/Summary/Keyword: Prediction of survival

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Radiomics-based Machine Learning Approach for Quantitative Classification of Spinal Metastases in Computed Tomography (컴퓨터 단층 촬영 영상에서의 전이성 척추 종양의 정량적 분류를 위한 라디오믹스 기반의 머신러닝 기법)

  • Lee, Eun Woo;Lim, Sang Heon;Jeon, Ji Soo;Kang, Hye Won;Kim, Young Jae;Jeon, Ji Young;Kim, Kwang Gi
    • Journal of Biomedical Engineering Research
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    • v.42 no.3
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    • pp.71-79
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    • 2021
  • Currently, the naked eyes-based diagnosis of bone metastases on CT images relies on qualitative assessment. For this reason, there is a great need for a state-of-the-art approach that can assess and follow-up the bone metastases with quantitative biomarker. Radiomics can be used as a biomarker for objective lesion assessment by extracting quantitative numerical values from digital medical images. In this study, therefore, we evaluated the clinical applicability of non-invasive and objective bone metastases computer-aided diagnosis using radiomics-based biomarkers in CT. We employed a total of 21 approaches consist of three-classifiers and seven-feature selection methods to predict bone metastases and select biomarkers. We extracted three-dimensional features from the CT that three groups consisted of osteoblastic, osteolytic, and normal-healthy vertebral bodies. For evaluation, we compared the prediction results of the classifiers with the medical staff's diagnosis results. As a result of the three-class-classification performance evaluation, we demonstrated that the combination of the random forest classifier and the sequential backward selection feature selection approach reached AUC of 0.74 on average. Moreover, we confirmed that 90-percentile, kurtosis, and energy were the features that contributed high in the classification of bone metastases in this approach. We expect that selected quantitative features will be helpful as biomarkers in improving the patient's survival and quality of life.

The Height of Fall as a Predictor of Fatality of Fall (추락 후 사망 예측인자로서의 추락 높이)

  • Suh, Joo Hyun;Eo, Eun Kyung;Jung, Koo Young
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.101-106
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    • 2005
  • Purpose: The number of the deceased from free-fall is increasing nowadays. Free-fall comes to a great social problem in that even the survivor will be suffering for cord injury or brain injury, and so on. We analyzed the cases of free-fall patients to find out whether the injury severity is mainly correlated with the height of fall. Methods: We retrospectively investigated the characteristics of patients, who fall from the height above 2m from January 2000 to August 2004. We excluded the patients who transferred to other hospital, transferred from other hospital, and not known the height of fall. 145 patients were evaluated. Variables included in data analysis were age, height of fall, injury severity score (ISS), the being of barrier, and the survival or not. To find out the correlation between height of fall and death, we used receive operating characteristics (ROC) curve analysis. Results: The mean age of patients was $36.5{\pm}19.4$ years old. 110 were male and 35 were female. Mean height of fall was $11.1{\pm}8.5m$. 51 patients (35.2%) were died and 30 patients of them (58.9%) got emergency room on dead body. The mean height of fall is $8.9{\pm}5.8m$ for 94 survivors and $15.2{\pm}11.0m$ for the 51 deceased (p<0.001). The area under the ROC curve was 0.646, which means the height of fall was not adequate factor for predicting for death. At 13.5m, as cut?off value, sensitivity is 52.9%, specificity is 86.2%, positive predictive value is 67.5% and negative predictive value is 77.1%. There were statistical differences in mortality rate and ISS between 'below 13.5m group' and 'above 13.5m group', but there was not statistical difference in head and neck AIS. Conclusion: The height of fall is not adequate factor for prediction of death. So other factors like intoxication or not, the being of barrier or protection device need to be evaluated for predicting of free-fall patient's death.

Validity and Necessity of Sub-classification of N3 in the 7th UICC TNM Stage of Gastric Cancer

  • Li, Fang-Xuan;Zhang, Ru-Peng;Liang, Han;Quan, Ji-Chuan;Liu, Hui;Zhang, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2091-2095
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    • 2013
  • Background: The $7^{th}$ TNM staging is the first authoritative standard for evaluation of effectiveness of treatment of gastric cancer worldwide. However, revision of pN classification within TNM needs to be discussed. In particular, the N3 sub-stage is becoming more conspicuous. Methods: Clinical data of 302 pN3M0 stage gastric cancer patients who received radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital from January 2001 to May 2006 were retrospectively analyzed. Results: Location of tumor, depth of invasion, extranodal metastasis, gastric resection, combined organs resection, lymph node metastasis, rate of lymph node metastasis, negative lymph nodes count were important prognostic factors of pN3M0 stage gastric cancers. TNM stage was also associated with prognosis. Patients at T2N3M0 stage had a better prognosis than other sub-classification. T3N3M0 and T4aN3aM0 patients had equal prognosis which followed the T2N3M0. T4aN3bM0 and T4bN3aM0 had lower survival rate than the formers. T4bN3bM0 had worst prognosis. In multivariate analysis, TNM stage group and rate of lymph node metastasis were independent prognostic factors. Conclusions: The sub-stage of N3 may be useful for more accurate prediction of prognosis; it should therefore be applied in the TNM stage system.

Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio

  • Yoo, Jeong-Ju;Cho, Eun Ju;Lee, Bora;Kim, Sang Gyune;Kim, Young Seok;Lee, Yun Bin;Lee, Jeong-Hoon;Yu, Su Jong;Kim, Yoon Jun;Yoon, Jung-Hwan
    • Gut and Liver
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    • v.12 no.6
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    • pp.714-721
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    • 2018
  • Background/Aims: Recently reported prognostic models for primary biliary cholangitis (PBC) have been shown to be effective in Western populations but have not been well-validated in Asian patients. This study aimed to compare the performance of prognostic models in Korean patients and to investigate whether inflammation-based scores can further help in prognosis prediction. Methods: This study included 271 consecutive patients diagnosed with PBC in Korea. The following prognostic models were evaluated: the Barcelona model, the Paris-I/II model, the Rotterdam criteria, the GLOBE score and the UK-PBC score. The neutrophil-to-lymphocyte ratio (NLR) was analyzed with reference to its association with prognosis. Results: For predicting liver transplant or death at the 5-year and 10-year follow-up examinations, the UK-PBC score (areas under the receiver operating characteristic curve [AUCs], 0.88 and 0.82) and GLOBE score (AUCs, 0.85 and 0.83) were significantly more accurate in predicting prognosis than the other scoring systems (all p<0.05). There was no significant difference between the performance of the UK-PBC and GLOBE scores. In addition to the prognostic models, a high NLR (>2.46) at baseline was an independent predictor of reduced transplant-free survival in the multivariate analysis (adjusted hazard ratio, 3.74; p<0.01). When the NLR was applied to the prognostic models, it significantly differentiated the prognosis of patients. Conclusions: The UK-PBC and GLOBE scores showed good prognostic performance in Korean patients with PBC. In addition, a high NLR was associated with a poorer prognosis. Including the NLR in prognostic models may further help to stratify patients with PBC.

Prediction of Risk Factors after Spine Surgery in Patients Aged >75 Years Using the Modified Frailty Index

  • Kim, Ji-Yoon;Park, In Sung;Kang, Dong-Ho;Lee, Young-Seok;Kim, Kyoung-Tae;Hong, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.827-833
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    • 2020
  • Objective : Spine surgery is associated with higher morbidity and mortality rates in elderly patients. The modified Frailty Index (mFI) is an evaluation tool to determine the frailty of an individual and how preoperative status may impact postoperative survival and outcomes. This study aimed to determine the usefulness of mFI in predicting postoperative complications in patients aged ≥75 years undergoing surgery with instrumentation. Methods : We retrospectively reviewed the perioperative course of 137 patients who underwent thoracolumbar-instrumentation spine surgery between 2011 and 2016. The preoperative risk factors were the 11 variables of the mFI, as well as body mass index (kg/㎠), preoperative hemoglobin, platelet, albumin, creatinine, anesthesia time, operation time, estimated blood loss, and transfusion amount. The 60-day occurrences of complication rates were used for outcome assessment. Results : Major complications after spinal instrumentation surgery occurred in 34 of 138 patients (24.6%). The mean mFI score was 0.18±0.12. When we divided patients into a pre-frail group (mFI, 0.09-0.18; n=94) and a frail group (mFI ≥0.27; n=44), only the rate of sepsis was statistically higher in the frail group than in the pre-frail group. There were significantly more major complications in patients with low albumin levels or in patients with infection or who had experienced trauma. The mFI was a more useful predictor of postoperative complications than the American Society of Anesthesiologists physical status score. Conclusion : The mFI can successfully predict postoperative morbidity and mortality in patients aged ≥75 years undergoing spine surgery. The mFI improves perioperative risk stratification that provides important information to assist in the preoperative counselling of patients and their families.

Cyr61/CCN1 Overexpression Induces Epithelial-Mesenchymal Transition Leading to Laryngeal Tumor Invasion and Metastasis and Poor Prognosis

  • Liu, Ying;Zhou, Yan-Dong;Xiao, Yu-Li;Li, Ming-Hua;Wang, Yu;Kan, Xuan;Li, Qiu-Ying;Lu, Jian-Guang;Jin, De-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2659-2664
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    • 2015
  • Background: To examine the expression of cysteine-rich 61 (Cyr61/CCN1) protein in laryngeal squamouscell carcinoma (LSCC) tissues, and its relationship with the tumor epithelial-mesenchymal transition (EMT), invasion, metastasis, and prognosis. Materials and Methods: Immunohistochemistry was used to detect the expressions of Cyr61, Vimentin (Vim), and E-cadherin (E-cad) in 88 cases of LSCC tissues and 30 cases of tumor-adjacent normal tissues. Vim and E-cad were used as mesenchymal and epithelial markers, respectively, to determine the relationship between Cyr61 expression and the EMT of LSCC cells. In addition, clinical and histopathological data were combined to analyze the relationship between the positive-expression rates of Cyr61, Vim and E-cad and LSCC invasion, metastasis and prognosis. Results: In LSCC tissues, Vim expression rate was significantly higher than that of the tumor-adjacent tissues, whereas E-cad expression rate was significantly lower than that of the tumor-adjacent tissues. The Vim expression rate was significantly higher in stages T3 and T4 than in stages T1 and T2 LSCC tissues, whereas E-cad expression rate was significantly lower in stages T3 and T4 than in stages T1 and T2 LSCC tissues. Compared to the group without lymph node metastasis, the Vim expression rate was significantly higher and the E-cad expression rate was significantly lower in the group with lymph node metastasis. The expression rate of Cyr61 was significantly higher in LSCC tissues than in the tumor-adjacent normal tissues. In addition, the Cyr61 expression rate was higher in stages T3 and T4 than in stages T1 and T2 LSCC, and higher in the group with lymph node metastasis than in the group without lymph node metastasis. The Vim expression rate was significantly higher in the Cyr61 positive group than in the Cyr61 negative group, whereas the E-cad expression rate was significantly higher in the Cyr61 negative group than in the Cyr61 positive group. Survival analysis indicated that survival rates of Cyr61 positive, Vim positive and E-cad negative groups were significantly lower than that of Cyr61 negative, Vim negative and E-cad positive groups, respectively. Conclusions: Cyr61 expression is closely associated with LSCC invasion and lymph node metastasis. Overexpression of Cyr61 may induce EMT and therefore leads to LSCC invasion and metastasis and poor prognosis. Cyr61 may become a new maker for clinical prediction of LSCC invasion and metastasis and a new target for LSCC treatment.

A Study on the Sustainability of New SMEs through the Analysis of Altman Z-Score: Focusing on New and Renewable Energy Industry in Korea (알트만 Z-스코어를 이용한 신생 중소기업의 지속가능성 분석: 신재생에너지산업을 중심으로)

  • Oh, Nak-Kyo;Yoon, Sung-Soo;Park, Won-Koo
    • Journal of Technology Innovation
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    • v.22 no.2
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    • pp.185-220
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    • 2014
  • The purpose of this study is to get a whole picture of financial conditions of the new and renewable energy sector which have been growing rapidly and predict bankruptcy risk quantitatively. There have been many researches on the methodologies for company failure prediction, such as financial ratios as predictors of failure, analysis of corporate governance, risk factors and survival analysis, and others. The research method for this study is Altman Z-score which has been widely used in the world. Data Set was composed of 121 companies with financial statements from KIS-Value. Covering period for the analysis of the data set is from the year 2006 to 2011. As a result of this study, we found that 38 percent of the data set belongs to "Distress" Zone (on alert) while 38% (on watch), summed into 76%, whose level could be interpreted to doubt about the sustainability. The average of the SMEs in wind energy sector was worse than that of SMEs in solar energy sector. And the average of the SMEs in the "Distress" Zone (on alert) was worse than that of the companies of large group in the "Distress" Zone (on alert). In conclusion, Altman Z-score was well proved to be effective for New & Renewable Energy Industry in Korea as a result of this study. The importance of this study lies on the result to demonstrate empirically that the majority of solar and wind enterprises are facing the risk of bankruptcy. And it is also meaningful to have studied the relationship between SMEs and large companies in addition to advancing research on new start-up companies.

Clinicopathological Features and Prognostic Factors for Patients with Clinical T4 Gastric Cancer that Underwent Combined Resection of Invaded Organs (위암의 주위 장기 침윤으로 합병 절제를 실시한 환자의 병리학적 병기 및 예후)

  • Byun, Gun-Young;Park, Joong-Min;Kim, He-Il;Kim, Jong-Han;Park, Sung-Soo;Kim, Seong-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.117-123
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    • 2007
  • Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.

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A Strategic Analysis of Digital Transformation for Data Integration based on Platform Business Model: Focusing on Financial Industry (디지털 트랜스포메이션의 플랫폼 비즈니스 모델 기반 데이터 통합 관점 분석: 금융산업 사례를 중심으로)

  • Kim, Iljoo
    • The Journal of Society for e-Business Studies
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    • v.26 no.4
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    • pp.119-131
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    • 2021
  • With the boom of platform businesses, digital transformation has become the most important topic for businesses. Digital transformation has now become the most urgent strategy for survival, from a strategy considered as an option to choose in the past. Many companies are desperately seeking the ways to be digitally transformed. Even though there have been many studies on digital transformation, most of them are on strategic and conceptual model levels based on simple case analyses. In this study, we analyze the benefits of data integration and network effects from it, based on platform business model at the core of digital transformation. The change based on platform can be categorized into the internal one for the integration of data and better decision making, and the external one for the expansion of the businesses and better prediction of consumer behaviors through the integration of external data sets by the platform business model based enterprises. While the progress for digital transformation is not mature enough yet, financial industry is one of the most promising industries for the change and realization of the aim of it with its relatively much more advanced IT infrastructure. Many companies are making various efforts for the integration of external data, and if the good results can be accomplished, financial industry will contribute to the advancement of digital transformation in other industries as well. For "My Data" project by Korean government, we suggest the data structure and transaction of data (of Korea) should be advanced and established more quickly.

Clinical Change of Terminally Ill Cancer Patients at the End-of-life Time (임종 전 말기 암 환자의 임상 증상 및 징후의 변화)

  • Koh, Su-Jin;Lee, Kyung-Shik;Hong, Yeong-Seon;Yoo, Yang-Sook;Park, Hyea-Ja
    • Journal of Hospice and Palliative Care
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    • v.11 no.2
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    • pp.99-105
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    • 2008
  • Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients. Methods: We enrolled the terminal cancer patients from Kangnam St. Mary's Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use. Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death. Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.

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