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Sensors (Basel, Switzerland) Dec 2022Currently, not all children that need speech therapy have access to a therapist. With the current international shortage of speech-language pathologists (SLPs), there is... (Review)
Review
Currently, not all children that need speech therapy have access to a therapist. With the current international shortage of speech-language pathologists (SLPs), there is a demand for online tools to support SLPs with their daily tasks. Several online speech therapy (OST) systems have been designed and proposed in the literature; however, the implementation of these systems is lacking. The technical knowledge that is needed to use these programs is a challenge for SLPs. There has been limited effort to systematically identify, analyze and report the findings of prior studies. We provide the results of an extensive literature review of OST systems for childhood speech communication disorders. We systematically review OST systems that can be used in clinical settings or from home as part of a treatment program for children with speech communication disorders. Our search strategy found 4481 papers, of which 35 were identified as focusing on speech therapy programs for speech communication disorders. The features of these programs were examined, and the main findings are extracted and presented. Our analysis indicates that most systems which are designed mainly to support the SLPs adopt and use supervised machine learning approaches that are either desktop-based or mobile-phone-based applications. Our findings reveal that speech therapy systems can provide important benefits for childhood speech. A collaboration between computer programmers and SLPs can contribute to implementing useful automated programs, leading to more children having access to good speech therapy.
Topics: Child; Humans; Speech; Speech Therapy; Speech-Language Pathology; Communication Disorders; Speech Disorders
PubMed: 36560082
DOI: 10.3390/s22249713 -
Archives of Gynecology and Obstetrics Oct 2023After performing laparoscopic unilateral adnexectomy in a 53-year-old woman for a rapidly grown unilateral adnexal mass, pathologists reported a primary ovarian...
After performing laparoscopic unilateral adnexectomy in a 53-year-old woman for a rapidly grown unilateral adnexal mass, pathologists reported a primary ovarian leiomyoma with no genuine ovarian tissue. This rare diagnosis is found in less than 100 reports after systematic literature review, a greater number of asymptomatic ovarian leiomyomas can be expected. Thorough preoperative diagnostic measures are essential as rare cases of malignancy have been described.
Topics: Female; Humans; Middle Aged; Leiomyoma; Ovarian Neoplasms; Adnexal Diseases; Laparoscopy
PubMed: 36539622
DOI: 10.1007/s00404-022-06842-4 -
Diagnostics (Basel, Switzerland) Nov 2022The likelihood of timely treatment for cervical cancer increases with timely detection of abnormal cervical cells. Automated methods of detecting abnormal cervical cells... (Review)
Review
OBJECTIVE
The likelihood of timely treatment for cervical cancer increases with timely detection of abnormal cervical cells. Automated methods of detecting abnormal cervical cells were established because manual identification requires skilled pathologists and is time consuming and prone to error. The purpose of this systematic review is to evaluate the diagnostic performance of artificial intelligence (AI) technologies for the prediction, screening, and diagnosis of cervical cancer and pre-cancerous lesions.
MATERIALS AND METHODS
Comprehensive searches were performed on three databases: Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A & HCI Timespan) and Scopus to find papers published until July 2022. Articles that applied any AI technique for the prediction, screening, and diagnosis of cervical cancer were included in the review. No time restriction was applied. Articles were searched, screened, incorporated, and analyzed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
RESULTS
The primary search yielded 2538 articles. After screening and evaluation of eligibility, 117 studies were incorporated in the review. AI techniques were found to play a significant role in screening systems for pre-cancerous and cancerous cervical lesions. The accuracy of the algorithms in predicting cervical cancer varied from 70% to 100%. AI techniques make a distinction between cancerous and normal Pap smears with 80-100% accuracy. AI is expected to serve as a practical tool for doctors in making accurate clinical diagnoses. The reported sensitivity and specificity of AI in colposcopy for the detection of CIN2+ were 71.9-98.22% and 51.8-96.2%, respectively.
CONCLUSION
The present review highlights the acceptable performance of AI systems in the prediction, screening, or detection of cervical cancer and pre-cancerous lesions, especially when faced with a paucity of specialized centers or medical resources. In combination with human evaluation, AI could serve as a helpful tool in the interpretation of cervical smears or images.
PubMed: 36428831
DOI: 10.3390/diagnostics12112771 -
Cancers Oct 2022Breast cancer is among the most common and fatal diseases for women, and no permanent treatment has been discovered. Thus, early detection is a crucial step to control... (Review)
Review
Breast cancer is among the most common and fatal diseases for women, and no permanent treatment has been discovered. Thus, early detection is a crucial step to control and cure breast cancer that can save the lives of millions of women. For example, in 2020, more than 65% of breast cancer patients were diagnosed in an early stage of cancer, from which all survived. Although early detection is the most effective approach for cancer treatment, breast cancer screening conducted by radiologists is very expensive and time-consuming. More importantly, conventional methods of analyzing breast cancer images suffer from high false-detection rates. Different breast cancer imaging modalities are used to extract and analyze the key features affecting the diagnosis and treatment of breast cancer. These imaging modalities can be divided into subgroups such as mammograms, ultrasound, magnetic resonance imaging, histopathological images, or any combination of them. Radiologists or pathologists analyze images produced by these methods manually, which leads to an increase in the risk of wrong decisions for cancer detection. Thus, the utilization of new automatic methods to analyze all kinds of breast screening images to assist radiologists to interpret images is required. Recently, artificial intelligence (AI) has been widely utilized to automatically improve the early detection and treatment of different types of cancer, specifically breast cancer, thereby enhancing the survival chance of patients. Advances in AI algorithms, such as deep learning, and the availability of datasets obtained from various imaging modalities have opened an opportunity to surpass the limitations of current breast cancer analysis methods. In this article, we first review breast cancer imaging modalities, and their strengths and limitations. Then, we explore and summarize the most recent studies that employed AI in breast cancer detection using various breast imaging modalities. In addition, we report available datasets on the breast-cancer imaging modalities which are important in developing AI-based algorithms and training deep learning models. In conclusion, this review paper tries to provide a comprehensive resource to help researchers working in breast cancer imaging analysis.
PubMed: 36358753
DOI: 10.3390/cancers14215334 -
Journal of Pathology Informatics 2022Digital pathology had a recent growth, stimulated by the implementation of digital whole slide images (WSIs) in clinical practice, and the pathology field faces shortage... (Review)
Review
Digital pathology had a recent growth, stimulated by the implementation of digital whole slide images (WSIs) in clinical practice, and the pathology field faces shortage of pathologists in the last few years. This scenario created fronts of research applying artificial intelligence (AI) to help pathologists. One of them is the automated diagnosis, helping in the clinical decision support, increasing efficiency and quality of diagnosis. However, the complexity nature of the WSIs requires special treatments to create a reliable AI model for diagnosis. Therefore, we systematically reviewed the literature to analyze and discuss all the methods and results in AI in digital pathology performed in WSIs on H&E stain, investigating the capacity of AI as a diagnostic support tool for the pathologist in the routine real-world scenario. This review analyzes 26 studies, reporting in detail all the best methods to apply AI as a diagnostic tool, as well as the main limitations, and suggests new ideas to improve the AI field in digital pathology as a whole. We hope that this study could lead to a better use of AI as a diagnostic tool in pathology, helping future researchers in the development of new studies and projects.
PubMed: 36268059
DOI: 10.1016/j.jpi.2022.100138 -
The Cochrane Database of Systematic... Sep 2022Autism spectrum disorder is a neurodevelopmental disorder characterised by social communication difficulties, restricted interests and repetitive behaviours. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Autism spectrum disorder is a neurodevelopmental disorder characterised by social communication difficulties, restricted interests and repetitive behaviours. The clinical pathway for children with a diagnosis of autism spectrum disorder is varied, and current research suggests some children may not continue to meet diagnostic criteria over time.
OBJECTIVES
The primary objective of this review was to synthesise the available evidence on the proportion of preschool children who have a diagnosis of autism spectrum disorder at baseline (diagnosed before six years of age) who continue to meet diagnostic criteria at follow-up one or more years later (up to 19 years of age).
SEARCH METHODS
We searched MEDLINE, Embase, PsycINFO, and eight other databases in October 2017 and ran top-up searches up to July 2021. We also searched reference lists of relevant systematic reviews.
SELECTION CRITERIA
Two review authors independently assessed prospective and retrospective follow-up studies that used the same measure and process within studies to diagnose autism spectrum disorder at baseline and follow-up. Studies were required to have at least one year of follow-up and contain at least 10 participants. Participants were all aged less than six years at baseline assessment and followed up before 19 years of age.
DATA COLLECTION AND ANALYSIS
We extracted data on study characteristics and the proportion of children diagnosed with autism spectrum disorder at baseline and follow-up. We also collected information on change in scores on measures that assess the dimensions of autism spectrum disorder (i.e. social communication and restricted interests and repetitive behaviours). Two review authors independently extracted data on study characteristics and assessed risk of bias using a modified quality in prognosis studies (QUIPS) tool. We conducted a random-effects meta-analysis or narrative synthesis, depending on the type of data available. We also conducted prognostic factor analyses to explore factors that may predict diagnostic outcome.
MAIN RESULTS
In total, 49 studies met our inclusion criteria and 42 of these (11,740 participants) had data that could be extracted. Of the 42 studies, 25 (60%) were conducted in North America, 13 (31%) were conducted in Europe and the UK, and four (10%) in Asia. Most (52%) studies were published before 2014. The mean age of the participants was 3.19 years (range 1.13 to 5.0 years) at baseline and 6.12 years (range 3.0 to 12.14 years) at follow-up. The mean length of follow-up was 2.86 years (range 1.0 to 12.41 years). The majority of the children were boys (81%), and just over half (60%) of the studies primarily included participants with intellectual disability (intelligence quotient < 70). The mean sample size was 272 (range 10 to 8564). Sixty-nine per cent of studies used one diagnostic assessment tool, 24% used two tools and 7% used three or more tools. Diagnosis was decided by a multidisciplinary team in 41% of studies. No data were available for the outcomes of social communication and restricted and repetitive behaviours and interests. Of the 42 studies with available data, we were able to synthesise data from 34 studies (69% of all included studies; n = 11,129) in a meta-analysis. In summary, 92% (95% confidence interval 89% to 95%) of participants continued to meet diagnostic criteria for autism spectrum disorder from baseline to follow-up one or more years later; however, the quality of the evidence was judged as low due to study limitations and inconsistency. The majority of the included studies (95%) were rated at high risk of bias. We were unable to explore the outcomes of change in social communication and restricted and repetitive behaviour and interests between baseline and follow-up as none of the included studies provided separate domain scores at baseline and follow-up. Details on conflict of interest were reported in 24 studies. Funding support was reported by 30 studies, 12 studies omitted details on funding sources and two studies reported no funding support. Declared funding sources were categorised as government, university or non-government organisation or charity groups. We considered it unlikely funding sources would have significantly influenced the outcomes, given the nature of prognosis studies.
AUTHORS' CONCLUSIONS
Overall, we found that nine out of 10 children who were diagnosed with autism spectrum disorder before six years of age continued to meet diagnostic criteria for autism spectrum disorder a year or more later, however the evidence was uncertain. Confidence in the evidence was rated low using GRADE, due to heterogeneity and risk of bias, and there were few studies that included children diagnosed using a current classification system, such as the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the eleventh revision of the International Classification of Diseases (ICD-11). Future studies that are well-designed, prospective and specifically assess prognosis of autism spectrum disorder diagnoses are needed. These studies should also include contemporary diagnostic assessment methods across a broad range of participants and investigate a range of relevant prognostic factors.
Topics: Adult; Autism Spectrum Disorder; Child; Child, Preschool; Female; Humans; Infant; Male; Prognosis; Prospective Studies; Retrospective Studies; Schools; Young Adult
PubMed: 36169177
DOI: 10.1002/14651858.CD012749.pub2 -
Nursing Forum Nov 2022To identify the current research involving interprofessional collaboration between registered nurses (RNs) and speech language pathologists (SLPs) in healthcare and...
AIMS AND OBJECTIVE
To identify the current research involving interprofessional collaboration between registered nurses (RNs) and speech language pathologists (SLPs) in healthcare and educational settings.
BACKGROUND
As the complexity of healthcare increases, the need for active interprofessional collaboration between RNs and SLPs grows. A review of the literature revealed no systematic reviews currently exist about interprofessional collaborative studies between RNs and SLPs.
DESIGN
Researchers conducted a scoping review using PRISMA guidelines.
METHODS
Online databases were used to identify qualitative and quantitative research studies written in English and conducted between 2011 and 2020. Databases included Academic Search Ultimate, ASHA Wire, CINAHL, Cochrane Database of Systematic Reviews, ERIC, MEDLINE, PubMed, PsycINFO, and SEMANTIC SCHOLAR. The studies needed to focus on the interprofessional collaboration between RNs and SLPs or students in these professions.
FINDINGS
Of the 128 sources, only six studies met scoping review criteria. The primary focus of three studies was an evaluation of interprofessional education activities between nursing, speech language pathology, and other health profession students. One study explored interprofessional education in clinical practice between RNs and SLPs. Two studies explored interprofessional collaboration in the clinical setting.
CONCLUSION
More research is needed that investigates interprofessional collaboration and practice of RNs and SLPs in the healthcare setting.
RELEVANCE TO CLINICAL PRACTICE
This review identified the need for RNs and SLPs to work effectively as interprofessional teams are important in improving patient outcomes.
Topics: Humans; Pathologists; Speech; Speech-Language Pathology; Delivery of Health Care; Nurses
PubMed: 36161720
DOI: 10.1111/nuf.12802 -
Modern Pathology : An Official Journal... Dec 2022Reflex mismatch repair immunohistochemistry (MMR IHC) testing for MLH1, PMS2, MSH2 and MSH6 is used to screen for Lynch syndrome. Recently MMR-deficiency (MMRd) has been... (Meta-Analysis)
Meta-Analysis
Reflex mismatch repair immunohistochemistry (MMR IHC) testing for MLH1, PMS2, MSH2 and MSH6 is used to screen for Lynch syndrome. Recently MMR-deficiency (MMRd) has been approved as a pan-cancer predictive biomarker for checkpoint inhibitor therapy, leading to a vast increase in the use of MMR IHC in clinical practice. We explored whether immunohistochemical staining with PMS2 and MSH6 can be used as a reliable substitute. This two-antibody testing algorithm has the benefit of saving tissue, cutting costs and saving time. PubMed, Embase and Cochrane library were systematically searched for articles reporting on MMR IHC. The weighed percentage of cases with isolated MLH1 or MSH2 loss or combined MLH1/MSH2 loss alone was analyzed using a random effects model meta-analysis in R. The search yielded 1704 unique citations, of which 131 studies were included, describing 9014 patients. A weighed percentage of 1.1% (95% CI 0.53-18.87, I = 87%) of cases with isolated MLH1 or MSH2 loss or combined MLH1/MSH2 loss alone was observed. In the six articles with the main aim of investigating the two-antibody testing algorithm all MMRd cases were detected with the two-antibody testing algorithm, there were no cases with isolated MLH1 or MSH2 loss or combined MLH1/MSH2 loss alone. This high detection rate of MMRd of the two-antibody testing algorithm supports its use in clinical practice by specialized pathologists. Staining of all four antibodies should remain the standard in cases with equivocal results of the two-antibody testing algorithm. Finally, educational sessions in which staining pattern pitfalls are discussed will continue to be important.
Topics: Humans; Mismatch Repair Endonuclease PMS2; MutL Protein Homolog 1; MutS Homolog 2 Protein; DNA-Binding Proteins; Colorectal Neoplasms; DNA Mismatch Repair; Biomarkers, Tumor; Algorithms
PubMed: 36104536
DOI: 10.1038/s41379-022-01149-w -
Cytopathology : Official Journal of the... Jan 2023Whole slide imaging (WSI) allows pathologists to view virtual versions of slides on computer monitors. With increasing adoption of digital pathology, laboratories have... (Review)
Review
Whole slide imaging (WSI) allows pathologists to view virtual versions of slides on computer monitors. With increasing adoption of digital pathology, laboratories have begun to validate their WSI systems for diagnostic purposes according to reference guidelines. Among these the College of American Pathologists (CAP) guideline includes three strong recommendations (SRs) and nine good practice statements (GPSs). To date, the application of WSI to cytopathology has been beyond the scope of the CAP guideline due to limited evidence. Herein we systematically reviewed the published literature on WSI validation studies in cytology. A systematic search was carried out in PubMed-MEDLINE and Embase databases up to November 2021 to identify all publications regarding validation of WSI in cytology. Each article was reviewed to determine if SRs and/or GPSs recommended by the CAP guideline were adequately satisfied. Of 3963 retrieved articles, 25 were included. Only 4/25 studies (16%) satisfied all three SRs, with only one publication (1/25, 4%) fulfilling all three SRs and nine GPSs. Lack of a suitable validation dataset was the main missing SR (16/25, 64%) and less than a third of the studies reported intra-observer variability data (7/25, 28%). Whilst the CAP guideline for WSI validation in clinical practice helped the widespread adoption of digital pathology, more evidence is required to routinely employ WSI for diagnostic purposes in cytopathology practice. More dedicated validation studies satisfying all SRs and/or GPSs recommended by the CAP are needed to help expedite the use of WSI for primary diagnosis in cytopathology.
Topics: Humans; Microscopy; Image Interpretation, Computer-Assisted; Observer Variation; Cytodiagnosis; Laboratories
PubMed: 36082410
DOI: 10.1111/cyt.13178 -
The Cochrane Database of Systematic... Aug 2022Autism spectrum disorder (ASD; also known as autism) is a developmental disability that begins in childhood and is typically seen in around 1% to 2% of children. It is... (Review)
Review
BACKGROUND
Autism spectrum disorder (ASD; also known as autism) is a developmental disability that begins in childhood and is typically seen in around 1% to 2% of children. It is characterised by social communication difficulties and repetitive and restricted behaviours and routines that can have a negative impact on a child's quality of life, achievement at school, and social interactions with others. It has been hypothesised that memantine, which is traditionally used to treat dementia, may be effective in reducing the core symptoms of autism as well as some co-occurring symptoms such as hyperactivity and language difficulties. If memantine is being used to treat the core symptoms of autism, it is important to review the evidence of its effectiveness.
OBJECTIVES
To assess the effects of memantine on the core symptoms of autism, including, but not limited to, social communication and stereotypical behaviours.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, nine other databases and three trials registers up to February 2022. We also checked reference lists of key studies and checked with experts in the field for any additional papers. We searched for retractions of the included studies in MEDLINE, Embase, and the Retraction Watch Database. No retractions or corrections were found.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) of any dose of memantine compared with placebo in autistic people. We also included RCTs in which only one group received memantine, but both groups received the same additional therapy (e.g. a behaviour intervention).
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methods. Our primary outcomes were core autism symptoms and adverse effects. Secondary outcomes were language, intelligence, memory, adaptive behaviour, hyperactivity, and irritability. We used GRADE to assess certainty of evidence.
MAIN RESULTS
We included three RCTs (two double-blind and one single-blind) with 204 participants that examined the short-term effect (immediately postintervention) of memantine in autistic people. Two studies took place in the USA and the other in Iran. All three studies focused on children and adolescents, with a mean age of 9.40 (standard deviation (SD) 2.26) years. Most participants were male (range across studies 73% to 87%). The diagnosis of ASD was based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition; 4th edition, text revision; or 5th edition). To confirm the diagnosis, one study used the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R); one used ADOS, ADI-R or the Autism Diagnostic Interview Screener; and one used the Gilliam Autism Rating Scale. Dosage of memantine was based on the child's weight and ranged from 3 mg to 15 mg per day. Comparisons Two studies examined memantine compared with placebo; in the other study, both groups had a behavioural intervention while only one group was given memantine. Risk of bias All studies were rated at high risk of bias overall, as they were at high or unclear risk of bias across all but four domains in one study, and all but two domains in the other two studies. One study was funded by Forest Laboratories, LLC, (Jersey City, New Jersey), Allergan. The study sponsor was involved in the study design, data collection (via contracted clinical investigator sites), analysis and interpretation of data, and the decision to present these results. The other two studies reported no financial support or sponsorship; though in one of the two, the study medication was an in-kind contribution from Forest Pharmaceuticals. Primary outcomes There was no clear evidence of a difference between memantine and placebo with respect to severity of core symptoms of autism, although we are very uncertain about the evidence. The standardised mean difference in autism symptoms score in the intervention group versus the control group was -0.74 standard deviations (95% confidence interval (CI) -2.07 to 0.58; 2 studies, 181 participants; very low-certainty evidence; medium effect size); lower scores indicate less severe autistic symptoms. Two studies (144 participants) recorded adverse effects that the authors deemed related to the study and found there may be no difference between memantine and placebo (odds ratio (OR) 0.64, 95% CI 0.17 to 2.39; low-certainty evidence). Secondary outcomes There may be no difference between memantine and placebo on language (2 studies, 144 participants; low-certainty evidence); memory or adaptive behaviour (1 study, 23 participants; both low-certainty evidence); or hyperactivity or irritability (1 study, 121 participants; both low-certainty evidence).
AUTHORS' CONCLUSIONS
It is unclear whether memantine is an effective treatment for autistic children. None of the three included trials reported on the effectiveness of memantine in adults. Further studies using rigorous designs, larger samples, longer follow-up and clinically meaningful outcome measures that are important to autistic people and their families will strengthen our knowledge of the effects of memantine in autism.
Topics: Adolescent; Adult; Autism Spectrum Disorder; Child; Female; Humans; Male; Memantine; Odds Ratio; Outcome Assessment, Health Care; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 36006807
DOI: 10.1002/14651858.CD013845.pub2