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PloS One 2024To evaluate the effect of olfactory and/or gustatory stimulation interventions on feeding outcomes in preterm infants. (Meta-Analysis)
Meta-Analysis
AIM
To evaluate the effect of olfactory and/or gustatory stimulation interventions on feeding outcomes in preterm infants.
METHODS
We conducted systematic searches across various academic databases, including PubMed, Embase, Web of Science, the Cochrane Library, the Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, the Wanfang Database, and the Wipu Database. These searches aimed to identify randomized controlled trials investigating the impact of olfactory and/or gustatory stimulation on preterm infants. The search period spanned from the inception of the databases until December 2022. Two independent evaluators autonomously reviewed the literature, extracted pertinent data, assessed the quality of the included studies, and conducted a meta-analysis using RevMan 5.3 software.
RESULTS
A total of 7 randomized controlled trials or quasi-experimental studies were included, with a total of 871 participants. Olfactory and gustatory stimulation demonstrated a reduction in the time to full enteral feeds in preterm infants when compared to usual care (MD = -1.60 days; 95% CI = -2.31, -0.89; p<0.0001). No substantial evidence was identified regarding the influence of olfactory and gustatory stimulation on the duration of gastric tube placement, length of hospitalization, incidence of necrotizing enterocolitis, or occurrence of spontaneous bowel perforation in preterm infants.
CONCLUSIONS
Olfactory and gustatory stimulation show potential benefits for preterm infants. However, due to the low to very low level of certainty associated with the available data, our ability to assess the effects is limited. Further trials and studies are essential to enhance our understanding of the mechanisms and effectiveness of olfactory and gustatory stimulation therapies.
Topics: Humans; Infant, Premature; Infant, Newborn; Enteral Nutrition; Smell; Taste; Randomized Controlled Trials as Topic
PubMed: 38713686
DOI: 10.1371/journal.pone.0301186 -
Cureus Apr 2024The number one cause of cancer in women worldwide is breast cancer. Over the last three decades, the use of traditional screen-film mammography has increased, but in... (Review)
Review
The number one cause of cancer in women worldwide is breast cancer. Over the last three decades, the use of traditional screen-film mammography has increased, but in recent years, digital mammography and 3D tomosynthesis have become standard procedures for breast cancer screening. With the advancement of technology, the interpretation of images using automated algorithms has become a subject of interest. Initially, computer-aided detection (CAD) was introduced; however, it did not show any long-term benefit in clinical practice. With recent advances in artificial intelligence (AI) methods, these technologies are showing promising potential for more accurate and efficient automated breast cancer detection and treatment. While AI promises widespread integration in breast cancer detection and treatment, challenges such as data quality, regulatory, ethical implications, and algorithm validation are crucial. Addressing these is essential for fully realizing AI's potential in enhancing early diagnosis and improving patient outcomes in breast cancer management. In this review article, we aim to provide an overview of the latest developments and applications of AI in breast cancer screening and treatment. While the existing literature primarily consists of retrospective studies, ongoing and future prospective research is poised to offer deeper insights. Artificial intelligence is on the verge of widespread integration into breast cancer detection and treatment, holding the potential to enhance early diagnosis and improve patient outcomes.
PubMed: 38711711
DOI: 10.7759/cureus.57619 -
JAMA Jun 2024Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast...
IMPORTANCE
Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate.
OBJECTIVE
The USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer-specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review.
POPULATION
Cisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer.
EVIDENCE ASSESSMENT
The USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density.
RECOMMENDATION
The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).
Topics: Humans; Breast Neoplasms; Female; Mammography; Early Detection of Cancer; Middle Aged; Aged; Adult; Magnetic Resonance Imaging; Age Factors; Ultrasonography, Mammary; United States; Mass Screening
PubMed: 38687503
DOI: 10.1001/jama.2024.5534 -
JAMA Jun 2024Breast cancer is a leading cause of cancer mortality for US women. Trials have established that screening mammography can reduce mortality risk, but optimal screening...
IMPORTANCE
Breast cancer is a leading cause of cancer mortality for US women. Trials have established that screening mammography can reduce mortality risk, but optimal screening ages, intervals, and modalities for population screening guidelines remain unclear.
OBJECTIVE
To review studies comparing different breast cancer screening strategies for the US Preventive Services Task Force.
DATA SOURCES
MEDLINE, Cochrane Library through August 22, 2022; literature surveillance through March 2024.
STUDY SELECTION
English-language publications; randomized clinical trials and nonrandomized studies comparing screening strategies; expanded criteria for screening harms.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently assessed study eligibility and quality; data extracted from fair- and good-quality studies.
MAIN OUTCOMES AND MEASURES
Mortality, morbidity, progression to advanced cancer, interval cancers, screening harms.
RESULTS
Seven randomized clinical trials and 13 nonrandomized studies were included; 2 nonrandomized studies reported mortality outcomes. A nonrandomized trial emulation study estimated no mortality difference for screening beyond age 74 years (adjusted hazard ratio, 1.00 [95% CI, 0.83 to 1.19]). Advanced cancer detection did not differ following annual or biennial screening intervals in a nonrandomized study. Three trials compared digital breast tomosynthesis (DBT) mammography screening with digital mammography alone. With DBT, more invasive cancers were detected at the first screening round than with digital mammography, but there were no statistically significant differences in interval cancers (pooled relative risk, 0.87 [95% CI, 0.64-1.17]; 3 studies [n = 130 196]; I2 = 0%). Risk of advanced cancer (stage II or higher) at the subsequent screening round was not statistically significant for DBT vs digital mammography in the individual trials. Limited evidence from trials and nonrandomized studies suggested lower recall rates with DBT. An RCT randomizing individuals with dense breasts to invitations for supplemental screening with magnetic resonance imaging reported reduced interval cancer risk (relative risk, 0.47 [95% CI, 0.29-0.77]) and additional false-positive recalls and biopsy results with the intervention; no longer-term advanced breast cancer incidence or morbidity and mortality outcomes were available. One RCT and 1 nonrandomized study of supplemental ultrasound screening reported additional false-positives and no differences in interval cancers.
CONCLUSIONS AND RELEVANCE
Evidence comparing the effectiveness of different breast cancer screening strategies is inconclusive because key studies have not yet been completed and few studies have reported the stage shift or mortality outcomes necessary to assess relative benefits.
Topics: Humans; Breast Neoplasms; Female; Mammography; Early Detection of Cancer; Aged; Middle Aged; Ultrasonography, Mammary; Mass Screening; United States; Practice Guidelines as Topic
PubMed: 38687490
DOI: 10.1001/jama.2023.25844 -
Journal of the American College of... Apr 2024Breast cancer screening trends of transgender and gender diverse (TGD) people remain largely unknown. This is concerning, as data are necessary to inform recommendations...
BACKGROUND
Breast cancer screening trends of transgender and gender diverse (TGD) people remain largely unknown. This is concerning, as data are necessary to inform recommendations made by clinicians to their patients and by national guidelines to clinicians. The aim of this review is to explore the state of existing research literature and provide a summary report of current breast cancer screening rates in TGD adults.
METHODS
All articles were identified using Medical Subject Headings terms. Inclusion criteria were all the following: (1) documents inclusion of at least one participant who identifies as a TGD person; (2) at least one TGD participant with top surgery or currently receiving estrogen-based gender-affirming hormone therapy; (3) results that report rates of breast cancer screening or mammogram referral.
RESULTS
Twelve articles met inclusion criteria, six cross-sectional studies and six retrospective chart reviews. Three studies conducted secondary analysis of the Behavioral Risk Factor Surveillance System national dataset, and nine articles recruited their own sample with number of TGD participants ranging from 30 to 1,822 and number of cisgender women ranging from 242 to 18,275. Three studies found lower rates of screening in transfeminine persons receiving gender-affirming care compared with cisgender women; two studies found lower rates among TGD people compared with cisgender women; and three studies found no differences between the breast cancer screening rates of TGD and cisgender participants.
CONCLUSION
Limited studies recruit and report trends in breast cancer screening of TGD people. Those that do include TGD participants have mixed results, but overall TGD people had lower rates of breast cancer screening. More research is needed regarding breast cancer screening of TGD people to inform the development of protocols that ensure equitable access to preventative care.
PubMed: 38663835
DOI: 10.1016/j.jacr.2024.04.006 -
Cancer Medicine Apr 2024Contrast-enhanced spectral imaging (CEM) is a new mammography technique, but its diagnostic value in dense breasts is still inconclusive. We did a systematic review and... (Meta-Analysis)
Meta-Analysis
PURPOSE
Contrast-enhanced spectral imaging (CEM) is a new mammography technique, but its diagnostic value in dense breasts is still inconclusive. We did a systematic review and meta-analysis of studies evaluating the diagnostic performance of CEM for suspicious findings in dense breasts.
MATERIALS AND METHODS
The PubMed, Embase, and Cochrane Library databases were searched systematically until August 6, 2023. Prospective and retrospective studies were included to evaluate the diagnostic performance of CEM for suspicious findings in dense breasts. The QUADAS-2 tool was used to evaluate the quality and risk of bias of the included studies. STATA V.16.0 and Review Manager V.5.3 were used to meta-analyze the included studies.
RESULTS
A total of 10 studies (827 patients, 958 lesions) were included. These 10 studies reported the diagnostic performance of CEM for the workup of suspicious lesions in patients with dense breasts. The summary sensitivity and summary specificity were 0.95 (95% CI, 0.92-0.97) and 0.81 (95% CI, 0.70-0.89), respectively. Enhanced lesions, circumscribed margins, and malignancy were statistically correlated. The relative malignancy OR value of the enhanced lesions was 28.11 (95% CI, 6.84-115.48). The relative malignancy OR value of circumscribed margins was 0.17 (95% CI, 0.07-0.45).
CONCLUSION
CEM has high diagnostic performance in the workup of suspicious findings in dense breasts, and when lesions are enhanced and have irregular margins, they are often malignant.
Topics: Female; Humans; Breast; Breast Density; Breast Neoplasms; Contrast Media; Mammography; Sensitivity and Specificity
PubMed: 38659408
DOI: 10.1002/cam4.7128 -
Radiography (London, England : 1995) May 2024Mammographic breast screening/rescreening rates are suboptimal for women with obesity and/or physical disabilities. This study describes development of an intervention...
BACKGROUND
Mammographic breast screening/rescreening rates are suboptimal for women with obesity and/or physical disabilities. This study describes development of an intervention framework targeting obesity- and disability-related barriers to improve participation.
METHODS
Mixed methods combined a systematic review with first-person perspectives to optimise screening engagement among women with obesity and/or physical disabilities. Phase 1 (systematic review) was conducted following the PRISMA framework. Phase 2 involved in-depth interviews with n = 8 women with lived experience of obesity and/or physical disabilities. An inductive coding approach was applied to the data which was then combined with Phase 1 results to develop the intervention framework.
RESULTS
Six studies were included in the systematic review. Tailored education based on individual risk increased willingness to undergo mammographic screening. Recommendations to improve the screening experience included partnerships with consumers, targeted messaging, and enhanced professional development for breast screening staff. Participants also identified strategies to improve the uptake of screening and the experience itself.
CONCLUSION
Development and evaluation of interventions informed by frameworks like the one developed in this study are needed to improve engagement in screening to promote regular participation among women with physical disabilities and/or obesity.
IMPLICATIONS FOR PRACTICE
Successful implementation of practice interventions co-designed by women with obesity and/or physical disabilities are likely to improve their breast screening participation. Enhanced training of radiographers aimed at upskilling in empathetic communication around required manoeuvring and potentially longer screening times for clients with obesity and/or physical disabilities may encourage more positive client practitioner interactions. Client information aimed at women with obesity should include information on how to prepare for the appointment and explain there may be equipment limitations compromising imaging which may not be completed at an initial appointment.
Topics: Humans; Female; Mammography; Obesity; Disabled Persons; Breast Neoplasms; Middle Aged; Early Detection of Cancer; Mass Screening; Adult; Patient Acceptance of Health Care
PubMed: 38657389
DOI: 10.1016/j.radi.2024.04.011 -
Breast (Edinburgh, Scotland) Jun 2024Online patient education materials (OPEMs) are an increasingly popular resource for women seeking information about breast cancer. The AMA recommends written patient... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Online patient education materials (OPEMs) are an increasingly popular resource for women seeking information about breast cancer. The AMA recommends written patient material to be at or below a 6th grade level to meet the general public's health literacy. Metrics such as quality, understandability, and actionability also heavily influence the usability of health information, and thus should be evaluated alongside readability.
PURPOSE
A systematic review and meta-analysis was conducted to determine: 1) Average readability scores and reporting methodologies of breast cancer readability studies; and 2) Inclusion frequency of additional health literacy-associated metrics.
MATERIALS AND METHODS
A registered systematic review and meta-analysis was conducted in Ovid MEDLINE, Web of Science, Embase.com, CENTRAL via Ovid, and ClinicalTrials.gov in June 2022 in adherence with the PRISMA 2020 statement. Eligible studies performed readability analyses on English-language breast cancer-related OPEMs. Study characteristics, readability data, and reporting of non-readability health literacy metrics were extracted. Meta-analysis estimates were derived from generalized linear mixed modeling.
RESULTS
The meta-analysis included 30 studies yielding 4462 OPEMs. Overall, average readability was 11.81 (95% CI [11.14, 12.49]), with a significant difference (p < 0.001) when grouped by OPEM categories. Commercial organizations had the highest average readability at 12.2 [11.3,13.0]; non-profit organizations had one of the lowest at 11.3 [10.6,12.0]. Readability also varied by index, with New Fog, Lexile, and FORCAST having the lowest average scores (9.4 [8.6, 10.3], 10.4 [10.0, 10.8], and 10.7 [10.2, 11.1], respectively). Only 57% of studies calculated average readability with more than two indices. Only 60% of studies assessed other OPEM metrics associated with health literacy.
CONCLUSION
Average readability of breast cancer OPEMs is nearly double the AMA's recommended 6th grade level. Readability and other health literacy-associated metrics are inconsistently reported in the current literature. Standardization of future readability studies, with a focus on holistic evaluation of patient materials, may aid shared decision-making and be critical to increased screening rates and breast cancer awareness.
Topics: Humans; Breast Neoplasms; Comprehension; Health Literacy; Female; Patient Education as Topic; Language; Internet
PubMed: 38603836
DOI: 10.1016/j.breast.2024.103722 -
Journal of Medicine and Life Dec 2023Early detection measures for breast cancer, such as breast self-exams, clinical breast exams, and mammography, have considerable benefits in effectively reducing breast... (Review)
Review
Early detection measures for breast cancer, such as breast self-exams, clinical breast exams, and mammography, have considerable benefits in effectively reducing breast cancer-related mortality. As the incidence of breast cancer is steadily increasing, it is crucial to raise awareness on early detection. This scoping review assessed the current knowledge, attitudes, practices, and perceptions of breast cancer screening among female medical students. We used the six phases of Arksey and O'Malley's framework from the Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) template. Our analysis included 43 articles from Google Scholar and PubMed search engines, focusing on female medical students. Our results showed that most female medical students had a satisfactory level of knowledge about the most common signs, symptoms, and early detection methods of breast cancer. Generally, their attitude and perceptions were positive regarding breast cancer-related preventive measures. However, the level of practice was reduced. Further efforts are necessary to promote and improve the practice of breast self-examination, clinical breast exams, and mammography among female medical students. Potential interventions could include modifications to the medical curriculum and social media campaigns to enhance engagement and adoption of these practices.
Topics: Female; Humans; Breast Neoplasms; Early Detection of Cancer; Students, Medical; Health Knowledge, Attitudes, Practice; Mammography
PubMed: 38585536
DOI: 10.25122/jml-2023-0412 -
Frontiers in Oncology 2024Breast cancer is the leading cause of cancer-related fatalities among women worldwide. Conventional screening and risk prediction models primarily rely on demographic...
BACKGROUND
Breast cancer is the leading cause of cancer-related fatalities among women worldwide. Conventional screening and risk prediction models primarily rely on demographic and patient clinical history to devise policies and estimate likelihood. However, recent advancements in artificial intelligence (AI) techniques, particularly deep learning (DL), have shown promise in the development of personalized risk models. These models leverage individual patient information obtained from medical imaging and associated reports. In this systematic review, we thoroughly investigated the existing literature on the application of DL to digital mammography, radiomics, genomics, and clinical information for breast cancer risk assessment. We critically analyzed these studies and discussed their findings, highlighting the promising prospects of DL techniques for breast cancer risk prediction. Additionally, we explored ongoing research initiatives and potential future applications of AI-driven approaches to further improve breast cancer risk prediction, thereby facilitating more effective screening and personalized risk management strategies.
OBJECTIVE AND METHODS
This study presents a comprehensive overview of imaging and non-imaging features used in breast cancer risk prediction using traditional and AI models. The features reviewed in this study included imaging, radiomics, genomics, and clinical features. Furthermore, this survey systematically presented DL methods developed for breast cancer risk prediction, aiming to be useful for both beginners and advanced-level researchers.
RESULTS
A total of 600 articles were identified, 20 of which met the set criteria and were selected. Parallel benchmarking of DL models, along with natural language processing (NLP) applied to imaging and non-imaging features, could allow clinicians and researchers to gain greater awareness as they consider the clinical deployment or development of new models. This review provides a comprehensive guide for understanding the current status of breast cancer risk assessment using AI.
CONCLUSION
This study offers investigators a different perspective on the use of AI for breast cancer risk prediction, incorporating numerous imaging and non-imaging features.
PubMed: 38571502
DOI: 10.3389/fonc.2024.1343627