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Journal of Pathology Informatics Dec 2024Numerous machine learning (ML) models have been developed for breast cancer using various types of data. Successful external validation (EV) of ML models is important... (Review)
Review
Performance of externally validated machine learning models based on histopathology images for the diagnosis, classification, prognosis, or treatment outcome prediction in female breast cancer: A systematic review.
Numerous machine learning (ML) models have been developed for breast cancer using various types of data. Successful external validation (EV) of ML models is important evidence of their generalizability. The aim of this systematic review was to assess the performance of externally validated ML models based on histopathology images for diagnosis, classification, prognosis, or treatment outcome prediction in female breast cancer. A systematic search of MEDLINE, EMBASE, CINAHL, IEEE, MICCAI, and SPIE conferences was performed for studies published between January 2010 and February 2022. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed, and the results were narratively described. Of the 2011 non-duplicated citations, 8 journal articles and 2 conference proceedings met inclusion criteria. Three studies externally validated ML models for diagnosis, 4 for classification, 2 for prognosis, and 1 for both classification and prognosis. Most studies used Convolutional Neural Networks and one used logistic regression algorithms. For diagnostic/classification models, the most common performance metrics reported in the EV were accuracy and area under the curve, which were greater than 87% and 90%, respectively, using pathologists' annotations/diagnoses as ground truth. The hazard ratios in the EV of prognostic ML models were between 1.7 (95% CI, 1.2-2.6) and 1.8 (95% CI, 1.3-2.7) to predict distant disease-free survival; 1.91 (95% CI, 1.11-3.29) for recurrence, and between 0.09 (95% CI, 0.01-0.70) and 0.65 (95% CI, 0.43-0.98) for overall survival, using clinical data as ground truth. Despite EV being an important step before the clinical application of a ML model, it hasn't been performed routinely. The large variability in the training/validation datasets, methods, performance metrics, and reported information limited the comparison of the models and the analysis of their results. Increasing the availability of validation datasets and implementing standardized methods and reporting protocols may facilitate future analyses.
PubMed: 38089005
DOI: 10.1016/j.jpi.2023.100348 -
American Journal of Speech-language... Jan 2024Craniofacial microsomia (CFM) is a complex congenital condition primarily affecting the ear, mandible, facial nerve and muscles, and tongue. Individuals with CFM are at... (Review)
Review
INTRODUCTION
Craniofacial microsomia (CFM) is a complex congenital condition primarily affecting the ear, mandible, facial nerve and muscles, and tongue. Individuals with CFM are at increased risk of hearing loss, obstructive sleep apnea, and feeding/swallowing difficulties. The purpose of this scoping review was to summarize evidence pertaining to speech production in CFM.
METHOD
All articles reporting any characteristic of speech production in CFM were included and screened by two independent reviewers by title, abstract, and full text. Data charting captured details related to study population and design, CFM diagnostic criteria, speech outcome measurement, and key findings. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist guided reporting of results. Our protocol was registered on the Open Science Framework (https://osf.io/npr94/) and published elsewhere.
RESULTS
Forty-five articles were included in the detailed review. Most articles originated from the United States, were published in the past decade, and utilized case report/series study design. A speech-language pathologist authored 29%. The prevalence of velopharyngeal insufficiency ranged from 19% to 55% among studies. Oral distortion of alveolar and palatal fricatives and affricates primarily characterized articulation errors. Studies identified increased disordered speech and lower intelligibility in adolescents with CFM compared to unaffected peers. Evidence pertaining to phonatory and respiratory speech findings is limited.
CONCLUSIONS
Evidence supports that individuals with CFM are at increased risk of both velopharyngeal and articulatory speech differences. Additional information is needed to develop speech screening guidelines for children with CFM. Heterogeneity in study design and outcome measurement precludes comparisons across studies.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.24424555.
Topics: Child; Adolescent; Humans; United States; Goldenhar Syndrome; Speech; Speech Disorders; Communication Disorders; Phenotype
PubMed: 37931079
DOI: 10.1044/2023_AJSLP-23-00152 -
The Laryngoscope Jun 2024Adenotonsillectomy is one of the most common surgical procedures performed on children. Caregivers are often concerned about voice change after the procedure, and such... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Adenotonsillectomy is one of the most common surgical procedures performed on children. Caregivers are often concerned about voice change after the procedure, and such concerns remain unsettled. This meta-analysis analyzed voice change in children after adenotonsillectomy.
DATA SOURCES
The PubMed, Medline, EMBASE, and Cochrane databases.
REVIEW METHODS
The study protocol was registered on PROSPERO. Two authors independently searched for articles using keywords "adenoidectomy," "tonsillectomy, "voice," "nasalance,"and "speech." English articles specifying voice changes after adenotonsillectomy were pooled with standardized mean difference (SMD) using random-effects model. Evaluation methods were computerized acoustic voice analysis, aerodynamic analysis, nasometer, rhinomanometry, evaluations from a speech-language pathologist or otolaryngologist, and a caregiver assessment questionnaire.
RESULTS
Twenty-three studies with 2154 children were analyzed (mean age: 8.0 y; 58% boys; mean sample size: 94 children). Due to insufficient data for other outcome variables, this meta-analysis only summarized changes in the computerized acoustic voice analysis 1 month and 3 months after surgery. The computerized acoustic analysis revealed significant changes in jitter (SMD = -0.36; 95% confidence interval [CI]: -0.60 to -0.11), shimmer (SMD = -0.34; 95% CI: -0.57 to -0.11), and soft phonation index (SMD = -0.36; 95% CI: -0.57 to -0.15) at 1 month after surgery. Parameters including fundamental frequency, jitter, noise-to-harmonics ratio, and shimmer were not significantly changed at 3 months after surgery.
CONCLUSIONS
This meta-analysis observed small improvements in jitter, shimmer, and soft phonation index 1 month after surgery. No significant effects were observed in voice outcomes 3 months after surgery. Laryngoscope, 134:2538-2550, 2024.
Topics: Humans; Tonsillectomy; Adenoidectomy; Child; Voice Quality; Voice Disorders; Female; Male; Postoperative Complications
PubMed: 37909678
DOI: 10.1002/lary.31140 -
The Medico-legal Journal Dec 2023A judicial on-site examination is essential for the correct analysis of a forensic case, particularly when there has been a fatal fire, as heat-related changes to bodies... (Review)
Review
A judicial on-site examination is essential for the correct analysis of a forensic case, particularly when there has been a fatal fire, as heat-related changes to bodies make identification by the forensic pathologist and other specialists difficult along with estimating the post-mortem interval and determining the precise cause and manner of death. We systematically reviewed all relevant articles dating from 2003 to 2022 in the PubMed database with a view to updating recommendations on how best to proceed. Our recommendations highlight the importance of a multidisciplinary team approach involving various forensic specialists.
Topics: Humans; Autopsy; Burns; Soft Tissue Injuries
PubMed: 37793642
DOI: 10.1177/00258172231191214 -
Forensic Science International Nov 2023Dog bites pose a significant global public health issue and are the most common type of injury caused by animals. While most dog bites result in minor harm, they can... (Review)
Review
Dog bites pose a significant global public health issue and are the most common type of injury caused by animals. While most dog bites result in minor harm, they can also lead to severe or even fatal consequences. In cases involving serious injury or death, forensic pathologists investigate various aspects, including the crime scene, the injuries sustained by the victim, and the characteristics of the dog suspected to have caused the bite. The aim of this study is to provide a systematic review of the literature on the medical-legal implications of dog bites in forensic practice, in order to recognize the dog bite victim features, the injuries and their consequences related to, and to identify the offending dogs. The literature search was performed using PubMed, Scopus and Web of Science from January 1980 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about dog bites to humans. A total of 116 studies met the inclusion criteria and were included in the review and they were organized and discussed by issue of interest (biting dog features, dog bite victim features, anatomical distribution of dog bites, injuries related to dog bites, cause of death, bite features, dog identification and post-mortem dog depredation). The findings of this systematic review highlight the importance of bite mark analysis in reconstructing the events leading to the attack and identifying the dog responsible. In medical forensic evaluations of dog bite cases, a multidisciplinary approach is crucial. This approach involves thorough analysis of the crime scene, identification of risk factors, examination of dog characteristics, and assessment of the victim's injuries. By combining expertise from both human and veterinary forensic fields, a comprehensive understanding can be achieved in dog bite cases.
Topics: Humans; Dogs; Animals; Bites and Stings; Forensic Medicine; Crime; Risk Factors; Autopsy
PubMed: 37783138
DOI: 10.1016/j.forsciint.2023.111849 -
Digestive Endoscopy : Official Journal... May 2024Lymphovascular invasion (LVI) is a critical risk factor for lymph node metastasis (LNM), which requires additional surgery after endoscopic resection of T1 colorectal... (Meta-Analysis)
Meta-Analysis
Additional staining for lymphovascular invasion is associated with increased estimation of lymph node metastasis in patients with T1 colorectal cancer: Systematic review and meta-analysis.
OBJECTIVES
Lymphovascular invasion (LVI) is a critical risk factor for lymph node metastasis (LNM), which requires additional surgery after endoscopic resection of T1 colorectal cancer (CRC). However, the impact of additional staining on estimating LNM is unclear. This systematic review aimed to evaluate the impact of additional staining on determining LNM in T1 CRC.
METHODS
We searched five electronic databases. Outcomes were diagnostic odds ratio (DOR), assessed using hierarchical summary receiver operating characteristic curves, and interobserver agreement among pathologists for positive LVI, assessed using Kappa coefficients (κ). We performed a subgroup analysis of studies that simultaneously included a multivariable analysis for other risk factors (deep submucosal invasion, poor differentiation, and tumor budding).
RESULTS
Among the 64 studies (18,097 patients) identified, hematoxylin-eosin (HE) and additional staining for LVI had pooled sensitivities of 0.45 (95% confidence interval [CI] 0.32-0.58) and 0.68 (95% CI 0.44-0.86), specificities of 0.88 (95% CI 0.78-0.94) and 0.76 (95% CI 0.62-0.86), and DORs of 6.26 (95% CI 3.73-10.53) and 6.47 (95% CI 3.40-12.32) for determining LNM, respectively. In multivariable analysis, the DOR of additional staining for LNM (DOR 5.95; 95% CI 2.87-12.33) was higher than that of HE staining (DOR 1.89; 95% CI 1.13-3.16) (P = 0.01). Pooled κ values were 0.37 (95% CI 0.22-0.52) and 0.62 (95% CI 0.04-0.99) for HE and additional staining for LVI, respectively.
CONCLUSION
Additional staining for LVI may increase the DOR for LNM and interobserver agreement for positive LVI among pathologists.
Topics: Humans; Colorectal Neoplasms; Lymph Nodes; Lymphatic Metastasis; Neoplasm Invasiveness; Neoplasm Staging; ROC Curve; Staining and Labeling
PubMed: 37746764
DOI: 10.1111/den.14691 -
Journal of Medical Internet Research Sep 2023Multimodal treatment-induced dysphagia has serious negative effects on survivors of head and neck cancer. Owing to advances in communication technologies, several... (Review)
Review
BACKGROUND
Multimodal treatment-induced dysphagia has serious negative effects on survivors of head and neck cancer. Owing to advances in communication technologies, several studies have applied telecommunication-based interventions that incorporate swallowing exercises, education, monitoring, feedback, self-management, and communication. It is especially urgent to implement home-based remote rehabilitation in the context of the COVID-19 pandemic. However, the optimal strategy and effectiveness of remote interventions are unclear.
OBJECTIVE
This systematic review aimed to examine the evidence regarding the efficacy of telerehabilitation for reducing physiological and functional impairments related to swallowing and for improving adherence and related influencing factors among head and neck cancer survivors.
METHODS
The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Library databases were systematically searched up to July 2023 to identify relevant articles. In total, 2 investigators independently extracted the data and assessed the methodological quality of the included studies using the quality assessment tool of the Joanna Briggs Institute.
RESULTS
A total of 1465 articles were initially identified; ultimately, 13 (0.89%) were included in the systematic review. The quality assessment indicated that the included studies were of moderate to good quality. The results showed that home-based telerehabilitation improved the safety of swallowing and oral feeding, nutritional status, and swallowing-related quality of life; reduced negative emotions; improved swallowing rehabilitation adherence; was rated by participants as highly satisfactory and supportive; and was cost-effective. In addition, this review investigated factors that influenced the efficacy of telerehabilitation, which included striking a balance among swallowing training strategy, intensity, frequency, duration, and individual motor ability; treating side effects of radiotherapy; providing access to medical, motivational, and educational information; providing feedback on training; providing communication and support from speech pathologists, families, and other survivors; and addressing technical problems.
CONCLUSIONS
Home-based telerehabilitation has shown great potential in reducing the safety risks of swallowing and oral feeding, improving quality of life and adherence, and meeting information needs for dysphagia among survivors of head and neck cancer. However, this review highlights limitations in the current literature, and the current research is in its infancy. In addition, owing to the diversity of patient sociodemographic, medical, physiological and functional swallowing, and behavioral factors, we recommend the development of tailored telemedicine interventions to achieve the best rehabilitation effects with the fewest and most precise interventions.
Topics: Humans; Deglutition Disorders; Telerehabilitation; Pandemics; Quality of Life; COVID-19; Neoplasms
PubMed: 37682589
DOI: 10.2196/47324 -
Language, Speech, and Hearing Services... Oct 2023There is an important need for interprofessional practice (IPP) between speech-language pathologists (SLPs) and classroom teachers (CTs) in mainstream schools to support...
PURPOSE
There is an important need for interprofessional practice (IPP) between speech-language pathologists (SLPs) and classroom teachers (CTs) in mainstream schools to support student outcomes. This mixed methods systematic review aimed to synthesize existing literature to describe the experiences of IPP between SLPs and CTs in mainstream schools.
METHOD
A systematic review protocol was utilized to conduct a comprehensive search of six databases (PubMed Central, EMBASE, Cochrane Library, CINAHL EBSCO, ERIC, and ProQuest Dissertations & Theses Global) using key words related to the research question. A total of 1,876 unique studies were retrieved. Of these, 18 studies were identified as relevant to the research question, as they described the experiences of IPP between SLPs and CTs. Thematic analysis was used to analyze the quantitative and qualitative studies.
RESULTS
Six main themes describing IPP experiences were identified: (1) what are you bringing to the collaboration table? (2) putting the value in collaboration, (3) sharing is collaborating, (4) the nature of collaboration varies, (5) the educational context matters, and (6) influences to collaboration beyond professional control.
CONCLUSIONS
IPP between SLPs and CTs is complex, with various facilitators and barriers to IPP emerging within the education context. Competencies for SLPs and CTs related to having a shared understanding, adequate communication, and building relationships with each other help support IPP in schools. The utilization of a relationship-centered care approach between SLPs and CTs is also important to foster and support student outcomes.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.24018732.
Topics: Humans; Communication Disorders; Pathologists; Qualitative Research; Speech; Speech-Language Pathology
PubMed: 37668590
DOI: 10.1044/2023_LSHSS-22-00168 -
International Journal of Language &... 2024Children with Tourette syndrome (TS) have historically experienced problems in academic and social settings, yet their language and communication abilities have not been... (Review)
Review
BACKGROUND
Children with Tourette syndrome (TS) have historically experienced problems in academic and social settings, yet their language and communication abilities have not been extensively researched.
AIMS
This scoping review maps the literature on the oral language and social communication abilities of children with TS in order to describe the nature of the current literature, present a summary of major findings and identify where gaps exist.
METHODS
A scoping review was completed to identify studies measuring the oral language or social communication abilities of children with TS. A systematic search of six electronic databases was conducted to obtain published and unpublished literature. All English studies measuring the oral language or social communication abilities of children with TS were included. Information was extracted from records and knowledge was synthesised in a narrative summary.
MAIN CONTRIBUTION
We identified 56 records for inclusion. Almost all records were located in journals within the fields of psychology and psychiatry. Skills most often studied were verbal IQ and verbal fluency. The literature suggests an increased prevalence of language disorders and social communication problems in children with TS; however, literature comprehensively detailing these challenges was scarce. Language strengths were identified in verbal intelligence, story/sentence recall, categorisation and performance on tasks at the single-word level.
CONCLUSIONS
Oral language and social communication skills are important for academic and social success. This review brings scattered literature together to provide up-to-date information about language in children with TS and highlights that there are considerable gaps in our knowledge about language and communication in this population. This scoping review can inform future research and support speech language pathologists in the assessment of young people with TS.
WHAT THIS PAPER ADDS
What is already known on the subject Speech-language pathologists (SLPs) working in various contexts (e.g., schools, mental health teams) are likely to encounter children with Tourette syndrome (TS); however, the description of this population and potential communication characteristics is not well represented in the SLP literature. Previous literature reviews have reported strengths in verbal fluency and morphological processing. Challenges in expressive language, higher order language, social cognition and a propensity towards autistic traits have also been identified. What this paper adds to existing knowledge This review differs from previous narrative reviews by employing a systematic approach to searching for literature. As a result, we identified 25 additional studies that had not been cited in previous reviews and additional relevant findings in 23 previously reviewed studies. This review confirms several previous conclusions about language in children with TS and extends or clarifies several others, thereby providing the most current information on oral language and social communication abilities. The use of current taxonomies of language and social communication helps to organise this literature for clinicians and researchers in speech-language pathology and identifies a need for further research from the SLP perspective. What are the potential or actual clinical implications of this work? These results imply that SLPs should screen children with TS for language disorders and investigate social communication and social interaction development. Clinicians can expect greater challenges in language and communication development for children with complex forms of TS (i.e., those who exhibit co-occurring conditions such as attention-deficit/hyperactivity disorder). The multidisciplinary nature of the current literature implies that clinical collaboration with other disciplines will be of particular benefit to serving this group of children.
Topics: Adolescent; Child; Humans; Attention Deficit Disorder with Hyperactivity; Communication; Language Disorders; Tourette Syndrome
PubMed: 37667569
DOI: 10.1111/1460-6984.12949 -
Archives of Pathology & Laboratory... May 2024Automated prostate cancer detection using machine learning technology has led to speculation that pathologists will soon be replaced by algorithms. This review covers...
CONTEXT
Automated prostate cancer detection using machine learning technology has led to speculation that pathologists will soon be replaced by algorithms. This review covers the development of machine learning algorithms and their reported effectiveness specific to prostate cancer detection and Gleason grading.
OBJECTIVE
To examine current algorithms regarding their accuracy and classification abilities. We provide a general explanation of the technology and how it is being used in clinical practice. The challenges to the application of machine learning algorithms in clinical practice are also discussed.
DATA SOURCES
The literature for this review was identified and collected using a systematic search. Criteria were established prior to the sorting process to effectively direct the selection of studies. A 4-point system was implemented to rank the papers according to their relevancy. For papers accepted as relevant to our metrics, all cited and citing studies were also reviewed. Studies were then categorized based on whether they implemented binary or multi-class classification methods. Data were extracted from papers that contained accuracy, area under the curve (AUC), or κ values in the context of prostate cancer detection. The results were visually summarized to present accuracy trends between classification abilities.
CONCLUSIONS
It is more difficult to achieve high accuracy metrics for multiclassification tasks than for binary tasks. The clinical implementation of an algorithm that can assign a Gleason grade to clinical whole slide images (WSIs) remains elusive. Machine learning technology is currently not able to replace pathologists but can serve as an important safeguard against misdiagnosis.
Topics: Humans; Prostatic Neoplasms; Male; Machine Learning; Artificial Intelligence; Neoplasm Grading; Algorithms
PubMed: 37594900
DOI: 10.5858/arpa.2022-0460-RA