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A Comparative Study on the Clinical Efficacy and Safety between Combination Therapy with CDK 4/6 Inhibitor and AI Versus AI Monotherapy in HR+/HER type2- Advanced Breast Cancer: Updated Meta-analysis (메타분석을 이용한 호르몬 수용체 양성/인체 상피세포 성장 인자 수용체 음성 진행성 유방암에서 사이클린 의존성 인산화효소 4/6 억제제와 방향화효소 억제제 병용요법과 방향화효소 억제제 단독요법의 임상적 유효성 및 안전성 비교 연구)

  • Kim, Min Ji;Kim, Kyung;Cho, MoonKyoung;Sohn, KieHo;Baek, In-hwan
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.1-10
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    • 2020
  • Objective: The aim of the study was to perform a meta-analysis of randomized clinical trials to compare the clinical efficacy and safety between combination of cyclin-dependent kinase (CDK) 4/6 inhibitors with aromatase inhibitors (AIs) and AIs alone in patients with hormone receptor+/human epidermal growth factor receptor type2-(HR+/HER2-) advanced breast cancer. Methods: Published clinical studies were identified through electronic database searches until February 2019. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. Key endpoints of efficacy were progression-free survival (PFS), objective response rate (ORR), and clinical benefit (CB). Endpoints of safety were adverse events (AEs) (neutropenia, leukopenia, any grade 3/4 AEs, and serious AEs) and on-treatment death. Meta-analysis was performed using the RevMan 5.3 software. Results: The selected five studies were evaluated as "good" in quality assessment. Compared to AIs alone, the combination therapy significantly improved PFS (pooled hazard ratio=0.55; 95% confidence interval (CI) 0.49-0.62), ORR (odds ratio=1.78; 95% CI=1.49-2.13), and CB (odds ratio=1.86; 95% CI=1.51-2.28). The prevalence of AEs was significantly higher in the combination group than in the AIs alone group. On-treatment death was greater in the combination group than in the AIs alone group, although insignificant. Conclusion: The combination therapy of CDK4/6 inhibitors with AIs was more effective for the treatment of HR+/HER2- advanced breast cancer, but less safe than AIs alone. The combination therapy should be effectively managed through patient monitoring, and further studies are needed to reduce AEs in the combination therapy of CDK4/6 inhibitors with AIs.

A Study on the Patient Satisfaction Survey at the General Hospitals in Korea (국내 종합병원 환자만족도 조사현황 분석)

  • Lee, Sunhee;Kim, Ji In;Cho, Woohyun;Lee, Jijeon
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.42-57
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    • 1998
  • Background : It is increasing the concern for patient satisfaction as a customer information. This study was planned to investigate the activities related to patient satisfaction survey at the Korean hospitals. Methods : We performed the nationwide survey on 235 general hospitals by using the self-administrated checklist from Sep. 9 to Oct. 9, 1996. The response rate were 50.2%. We analyzed the descriptive statistics and chi-square test by SAS software on 118 hospitals. Results : First of all, 62.7% of study hospitals showed to conduct the patient satisfaction survey, and most of hospitals which did not conduct it had a plan to do it within 5 years. The reason that hospitals did not conduct satisfaction survey was due to a lack of administrator's interest or adequate questionnaire form. Second, the bigger, public and being more located in the big city or opened more than 10 years, the more hospitals conducted the patient satisfaction survey. Also, patient satisfaction survey was mainly handled by planning dept. or administrative team. Third, most hospitals had their own way of making questionnaires without proving reliability and validity. The results of the survey were applied to hospital management timely, and were mostly reported to top manager level. Most CEO concerned about the results of satisfaction survey. Fourth, the staffs in charge of survey had problems such as skill related to data analysis and development of questionnaire and they suggested that this problems could be solved through inducing the implementation of the survey results on hospital management, support for the development of standardized questionnaires and increasing the top manager's interests. Fifth, most questionnaires composed of lots of questioning items on hospital equipments and environment, and kindness of hospital employee to patients. Conclusions : Although this study had some limitations in generalization due to low response rate in big hospitals, it is meaningful to find the present state and the problems related to patient satisfaction survey of the general hospitals. We can conclude that there are increasing the concern for patient satisfaction survey among the hospitals nationwide, and it can be needed for technical support related to development of survey tool or method.

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Efficiency and accuracy of artificial intelligence in the radiographic detection of periodontal bone loss: A systematic review

  • Asmhan Tariq;Fatmah Bin Nakhi;Fatema Salah;Gabass Eltayeb;Ghada Jassem Abdulla;Noor Najim;Salma Ahmed Khedr;Sara Elkerdasy;Natheer Al-Rawi;Sausan Alkawas;Marwan Mohammed;Shishir Ram Shetty
    • Imaging Science in Dentistry
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    • v.53 no.3
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    • pp.193-198
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    • 2023
  • Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.