SUMSearch and TRIP database are meta search engines for searching clinical evidence. This article introduces major contents and search methods of the SUMSearch and TRIP database, so as to provide quick search resources and technical help for evidence-based practice.
Early screening is an important means to reduce breast cancer mortality. In order to solve the problem of low breast cancer screening rates caused by limited medical resources in remote and impoverished areas, this paper designs a breast cancer screening system aided with portable ultrasound Clarius. The system automatically segments the tumor area of the B-ultrasound image on the mobile terminal and uses the ultrasound radio frequency data on the cloud server to automatically classify the benign and malignant tumors. Experimental results in this study show that the accuracy of breast tumor segmentation reaches 98%, and the accuracy of benign and malignant classification reaches 82%, and the system is accurate and reliable. The system is easy to set up and operate, which is convenient for patients in remote and poor areas to carry out early breast cancer screening. It is beneficial to objectively diagnose disease, and it is the first time for the domestic breast cancer auxiliary screening system on the mobile terminal.
ObjectiveTo analyze the relationship between occupation and tumor characteristics of colorectal patients served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data of DACCA was updated on January 5, 2022. All data items included occupation, tumor morphology, distance of tumor from dentate line, tumor site, properties of tumor, differentiation degree, postoperative complex physiological index (CPI) stage, tumor comorbidities, tumor location, and tumor occurrence. According to the 2015 edition of the Occupational Classification of the People’s Republic of China, the occupational parameters of patients in this study were divided into three groups: Mental workers, physical workers and unemployed residents. ResultsThe DACCA database was filtered according to the conditions, obtaining 3 215 valid data. In terms of tumor complications, there were significant differences in the proportion of tumor bleeding, perforation grade, mechanical intestinal obstruction degree and pain degree among the different occupational groups (P<0.05). There were no significant difference in the ratio of edema degree and intussusception of tumor site among the different occupational groups (P>0.05). There were no significant difference in the composition ratio of tumor differentiation degree, tumor occurrence, tumor orientation and tumor morphology among the different occupational groups (P>0.05). The composition ratio of CPI staging of colorectal cancer, the distance between tumor and dentate line, the composition ratio of different tumor pathological properties, and the composition ratio of tumor located in rectum and colon were statistically significant (P<0.05). ConclusionPreoperative tumor characteristics of patients with colorectal cancer are associated with various occupations. In patients with rectal cancer, the distance from the dentate line to the physical work of the tumor is smaller, lower site, some tumor complications are more severe, and the stage is relatively later.
ObjectiveTo analyze the risks and complications after operation of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on July 28th, 2020. The data items included surgery reaction, body temperature, flatus, pain and mental status; preoperative complication, postoperative complication, short-term and long-term complication. The selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 6 422, including 4 185 (65.2%) valid data on surgery reaction, 3 833 (59.7%) valid data on body temperature, 3 835 (59.7%) valid data on flatus, 3 597 (56.0%) valid data on pain, 3 551 (55.3%) valid data on mental status, 6 422 (100%) valid data on preoperative complications, postoperative complications, short-term complications and long-term complications. In the surgical response, 1 517 (36.2%) lines of data showed “normal” structure were the most. Among the days with elevated body temperature, the number of 0-day data lines with the structure of “body temperature >37.5 ℃” was the highest, with 1 980 (51.7%). In postoperative flatus, there were 1 675 (43.7%) data lines with the structure showing “3 days”. The largest number of rows (2 755, 76.6%) showed a structure that was “not obvious” in the pain scale. The mental status showed the highest number of “better” rows (2 976, 83.8%). There were 50 preoperative complications (0.8%). And 595 postoperative complications (9.3%), including anastomotic leakage (80, 13.4%), inflammatory ileus (62, 10.4%), pulmonary infection (57, 9.6%), and anastomotic bleeding (56, 9.4%), etc. There were 6 169 (96.1%) without short-term complication in structural form. There were 6 283 (97.8%) without long-term complications.ConclusionsThe changes in complications shown in the real world data from DACCA suggest that the focus of postoperative risks must be changed with the over the follow-up time. As for the complication evaluation system, it is necessary to establish a complete evaluation system combining the corresponding types and risks, to carry out valuable complication researches.
Objective To analyze the relationship between age and tumor characteristics of colorectal patients served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on January 5, 2022. All data items included age, precancerous lesions, family history of cancer, tumor site, distance of tumor from dentate line, tumor morphology, location, pathological properties of tumor, differentiation, and preoperative TNM stage. The patients were divided into three groups according to the age segment proposed by the United Nations World Health Organization (WHO): 35 years old and below (including infant, infant, child, teenager and youth, young group), 35 to 59 years old (middle-aged group), and 60 years old and above (elderly group). Results After scanning, 7 856 data rows were analyzed. ① There was significant difference in the composition ratio of precancerous lesions with or without among different age groups (χ2=6.219, P=0.045), and the constituent ratio of various precancerous lesions in different age groups was also statistically significant (χ2=51.698, P<0.001). ② There was significant difference in the composition ratio of family history of cancer with or without among different age groups (χ2=50.212, P<0.001), and there was significant difference in the composition ratio of different tumor history among different age groups (χ2=9.880, P=0.027), and there was significant difference in the constituent ratio of various tumor history among relatives in different age groups (χ2=16.138, P=0.003). ③ There were significant differences in the number of primary cancers among different age groups (χ2=12.973, P=0.036). In all patients with single primary rectal cancer, the constituent ratio of different rectal tumor sites among different age groups was statistically significant (χ2=43.817, P<0.001), and in all patients with single primary colon cancer, there was significant difference in the composition ratio of different colon tumor sites between different age groups (χ2=86.704, P<0.001). ④ The distance of tumor from dentate line was statistically significant in different age groups (H=28.589, P<0.001). ⑤ There was no significant difference in the composition ratio of tumor location among different age groups (χ2=14.795, P=0.140). ⑥ There was significant difference in the composition ratio of pathological properties of tumor among different age groups (χ2=121.387, P<0.001). ⑦ The proportion of tumor morphology was significantly different among different age groups (χ2=89.719, P<0.001). ⑧ There were significant differences in differentiation degree of tumor among different age groups (H=43.544, P<0.001). ⑨ There was statistically significant difference in preoperative TNM stage of colorectal cancer among different age groups (H=7.547, P=0.023). Conclusions Preoperative tumor characteristics of colorectal cancer patients are associated with age at diagnosis. Most young colorectal cancer patients do not have precancerous lesions, and once precancerous lesions are present, familial adenomatous polyposis is more common. Younger patients with colorectal cancer also have a higher percentage of relatives with a family history of cancer with colorectal cancer. From the perspective of tumor location, the proportion of single primary cancer in young colorectal cancer is higher than that in middle-aged and elderly patients. Younger patients with rectal cancer have a lower distance of tumor from dentate line, a higher proportion of low differentiated malignant tumors, and a relatively later neoplasm staging.
Objective To summarize the ultrasonographic and pathological features of benign thyroid nodules in thyroid imaging reporting and data system (TI-RADS) 4 class. Methods The preoperative ultrasonographic features and pathological features of 46 patients (52 nodules) with TI-RADS 4 class benign thyroid nodules who got treatment in Affiliated Hospital of Nanjing University of Traditional Chinese Medicine between June 2016 and June 2017 were retrospectively analyzed. Results Among the 52 thyroid nodules, 32 nodules (61.54%) were categorized as TI-RADS 4A, 12 nodules (23.08%) were categorized as TI-RADS 4B, and 8 nodules (15.38%) were categorized as TI-RADS 4C. On ultrasonographic images, the 52 thyroid nodules showed hypoechogenicity (90.38%), solid or predominantly solid (98.08%), nodules>1 cm in diameter (61.54%), defined margin (63.46%), microcalcification (50.00%), abundant or pointy blood flow (65.39%), morphological rule (90.38%), aspect ratio≤1 (92.31%), and no suspicious lymph nodes (86.54%). On histology, these thyroid nodules revealed nodular goiter with fibrosis or calcification (38.46%), nodular goiter with adenoma (30.77%), nodular goiter (9.61%), Hashimoto’s thyroiditis (17.31%), and thyroid follicular adenoma (3.85%). Conclusion Nodular goiter (thyroid nodules with fibrosis, calcification or adenomatoid hyperplasia), Hashimoto’s thyroiditis, and thyroid follicular adenoma will lead to malignant signs on ultrasonographic images, we should refer to other examination methods to make combinated evaluation.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on April 16, 2020. The data items including: procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, drainage, coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants were analyzed for the characteristics of each selected data item.ResultsA total of 6 338 analyzable data rows were obtained by screening the DACCA database. Among the 6 338 pieces of data, the most common one was the double staple technique (58.1%), end-to-end anastomosis (69.4%), one-total-circle of enhancement (33.2%), and without stuffing (54.1%) in the items of procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, respectively; the ratio with drainage was higher (79.2%) in the term of drainage, the drainage time was (3.74±2.89) d and median drainage time was 3.00 d; the ratio with covering part of major omentum, without anti-adhesion material, with unilateral partial closure, without contaminate, and without drug implants were more higher, which was 41.1%, 79.8%, 58.7%, 73.9%, and 53.9% in the items of coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants, respectively.ConclusionIt might better explain the outcome of surgery associated with intraoperative operation by studying the features of surgery of DACCA and guide the operation in the future for better outcomes.
ObjectiveTo analyze the staging methods of colorectal cancer data in the current version of the Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was updated at April 16th, 2020. The columns included stage during surgery, comprehensive stage of clinical, pathologic and imaging (cpi comprehensive stage), TNM stage, pathologic T stage, imaging T stage, nerves involvement, pathologic anus stage, clinical anus stage, imaging anus stage, pathologic mesentery stage, clinical mesentery stage, imaging mesentery stage, pathologic N stage, imaging N stage, positive lymph nodes ratio, cancerous nodules, M stage, cancerous emboli, pathologic vessel stage, clinical vessel stage, imaging vessel stage, cancerous contamination, and high-risk factors. Extracted data were statistically analyzed.ResultsThe total number of data medical records (data rows) that met the criteria was 6 474, the valid data of TNM stage was 4 511 (69.7%), the valid data of stage during surgery was 5 684 (87.8%), and the valid data of cpi comprehensive stage was 4 045 (62.5%). 1 540 data (41.6%) were consistent with stage during surgery and TNM stage, and 2 884 data (76.7%) were consistent with cpi comprehensive stage and TNM stage. According to the data of T, N, and M stage, the proportion of patients with pathologic T4a stage was the highest (40.5%), followed by T3 stage (24.8%); the most T4a stage (31.9%) on the image, followed by T4b stage (28.7%). The pathologic N stage with lymph node metastasis was about 41.9% (N1 and N2), and the imaging N stage lymph node metastasis was about 51.4%. There were a total of 4 745 valid data in the M stage (73.3%). There were 4 313 valid data in the nerves involvement (66.7%), suspected involvement and confirmed involvement, were 691 (16.0%) and 253 (5.9%) respectively. The valid data of anal pathology, clinical, and imaging stage were 4 115 (63.6%), 599 (9.3%), and 598 (9.2%), and only 30 (0.7%), 8 (1.3%), and 13 (2.2%) on muscle involvement respectively. The valid data of pathologic, clinical, and imaging mesentery stage were 732 (11.3%), 589 (9.1%), and 592 (9.1%). There were 4 458 (68.9%) valid data of positive lymph nodes ratio, and 2 908 (44.9%) valid data of cancerous nodules. There were 4 286 valid data of cancerous emboli (66.2%). A total of 244 data (41.1%) of increased blood vessels around tumors in the imaging vessel stage, 274 data (46.4%) of that in clinical vessel stage, and only 1 063 (27.7%) of pathologic vessel stage. There were 3 865 valid data (59.7%) of the cancerous contamination, and the proportion of the third level (746/2 753, 27.1%) in the high-risk factors was the highest.ConclusionThrough detailed analysis of the DACCA database, it is hoped that a more complete and accurate evaluation system of tumor severity can be established, and high-risk factors can provide some ideas for judging prognosis.
Given the growing importance of real-world data (RWD) in drug development, efficacy evaluation, and regulatory decision-making, establishing a scientific and systematic data quality regulatory framework has become a strategic priority for global pharmaceutical regulatory authorities. This paper analyzed the EU's advanced practices in RWD quality regulation, compared the RWD quality regulatory systems of China and the EU, and aimed to derive implications for enhancing China's own framework. The EU has made significant progress by promoting the interconnection, intercommunication, and efficient utilization of data resources, implementing a collaborative responsibility mechanism spanning the entire data lifecycle, developing a standardized, tool-based quality assessment system, and facilitating international cooperation and alignment of rules. While China has established an initial regulatory system for RWD quality, it still confronts challenges such as unclear mechanisms for data acquisition and utilization, underdeveloped operational standards, and unclear responsibility delineation. In contrast, by adapting relevant EU experience, China can refine its regulatory framework, establish mechanisms for the interconnection, intercommunication, and efficient utilization of RWD, develop more practical quality assessment toolkits, improve the lifecycle responsibility-sharing mechanism, and promote the alignment of RWD quality regulation with international standards. These enhancements will advance the standardization and refinement of RWD quality regulation in China, ultimately strengthening the scientific rigor and reliability of regulatory decisions.
ObjectiveTo analyze the impact of neoadjuvant regimens on prognosis in patients with rectal cancer in the current version of the Database from Colorectal Cancer (DACCA) database. MethodsPatient information was extracted from the updated version of DACCA on November 24, 2022 according to the established screening criteria, and the following items were analyzed: gender, age, body mass index (BMI), marriage, economic conditions, degree of differentiation, neoadjuvant treatment regimen, and pTNM staging. According to the neoadjuvant treatment regimen, the patients were divided into three groups: chemotherapy group, chemotherapy combined radiotherapy group, and chemotherapy combined targeted therapy group, and the overall survival (OS) and disease-specific survival (DSS) of patients in the three groups were analyzed, and the influencing factors of OS and DSS were analyzed by univariate and multivariate Cox proportional hazard regression models. ResultsAccording to the screening criteria, 1 716 valid data were obtained from the DACCA database, of which 954 (55.6%) were in the chemotherapy group, 332 (19.3%) in the chemotherapy combined radiotherapy group, and 430 (25.1%) in the chemotherapy combined targeted therapy group. The differences in the Kaplan-Merier survival curves of patients with different neoadjuvant regimens for OS and DSS in the three groups were statistically significant (χ2=142.142, P＜0.001; χ2=129.528, P＜0.001). There were significant differences in OS rate and DSS rate between the three groups in 3 years and 5 years (P<0.001). Further comparison of different neoadjuvant therapy groups showed that the OS of the chemotherapy combined targeted therapy group was slightly better than that of the chemotherapy group in 3 years, however, OS and DSS in 5 years were slightly worse than those the chemotherapy group, but the difference were not statistically significant (P>0.05). The OS and DSS of the chemotherapy group and the chemotherapy combined targeted therapy group were better than those of the chemotherapy combined radiotherapy group in 3 years and 5 years, and the differences were statistically significant (P<0.01). The results of multivariate analysis showed that patients’ age, economic conditions, degree of tumor differentiation, new auxiliary scheme and pTNM staging were the influencing factors of OS and DSS. ConclusionNeoadjuvant treatment regimen will affect the long-term survival prognosis of rectal cancer patients.