Individual Patient Research Articles

How Can We Show That Artificial Intelligence May Improve Our Assessment and Management of Lower Urinary Tract Dysfunctions?-ICI-RS 2024.

The integration of artificial intelligence (AI) into functional urology management must be assessed for its clinical utility, but hopefully will change, perhaps to revolutionize the way LUTD and other conditions are assessed, the aim being to offer patients more rapid and effective management which enhances patient outcomes. The aim of this proposal, discussed at the ICI-RS annual meeting, is to evaluate the available evidence on AI and the way it might change the approach to urodynamic (UDS) diagnoses, including overactive bladder syndrome (OAB), and perhaps other LUTDs such as bladder outflow obstruction. A compendium of discussion based on the current evidence related to AI and its potential applications in UDS and OAB. AI-powered diagnostic tools are being developed to analyze complex datasets from urodynamic studies, imaging, and other diagnostic tests. AI systems can leverage large volumes of clinical data to recommend personalized treatment plans based on individual patient profiles to optimize surgical procedures, enhance diagnostic precision, tailor the therapy, reduce the risk of complications, and improve outcomes. In the future, AI will be able to provide tailored counseling regarding the outcomes and potential side effects of drugs and procedures to a given patient. AI's role in functional urology has been poorly investigated, and its implementation across several areas may improve clinical care and the pathophysiological understanding of functional urologic conditions.

"Redefining Patient Experience: Strategies for Enhancing Patient-centered Care"

In recent years, the focus on patient-centered care has gained significant momentum, as healthcare organizations recognize the importance of delivering high-quality care that is responsive to individual patient preferences, needs, and values. This paper explores strategies for redefining the patient experience by emphasizing the integration of patient-centered care practices. Key strategies include enhancing communication between healthcare providers and patients, utilizing technology to support patient engagement, implementing shared decision-making models, and fostering a compassionate care environment. The study also examines the role of leadership in driving organizational culture changes that prioritize patient-centered care. By adopting these strategies, healthcare institutions can improve patient satisfaction, outcomes, and overall experience, leading to a more effective and empathetic healthcare system.

Heart disease prediction using machine learning models

Abstract. Heart disease remains a global health threat, making rapid identification crucial. Using the Heart Disease Dataset from Kaggle, this research employs a Random Forest model to analyze 13 clinical variables from 1,025 samples. To improve accuracy and address class imbalance, the dataset was split into training and test sets, utilizing methods such as Z-scores, SMOTE, and feature selection. The Random Forest model, which combines multiple decision trees, achieved high performance with an accuracy of 98.54%, identifying key predictors such as chest pain type, maximum heart rate, and thalassemia. Compared to a single decision tree, the Random Forest model reduces overfitting, improves generalization, and increases predictive accuracy. Factors like cholesterol levels, resting blood pressure, and exercise-induced angina were also considered. By averaging results from multiple trees, the model offers reliable and stable predictions, highlighting its potential in clinical settings for early detection and personalized treatment strategies. This study aims to assist healthcare providers in better allocating resources, planning preventive measures, and tailoring treatment plans to individual patients.

Factors Associated with Maternal Morbidity in Patients with Eclampsia in Three Obstetric Intensive Care Units: A Retrospective Study

(1) Introduction. Eclampsia is a rare complication that can occur during pregnancy and has a significant impact on maternal and neonatal outcomes. The aim of this study was to investigate the risk factors associated with significant maternal morbidity after an eclamptic seizure. (2) Methods. An observational retrospective study was performed in three maternity hospitals in Romania between 2015 and 2023 and included pregnant patients diagnosed with eclampsia. Clinical and paraclinical data were investigated, and the impact of several risk factors was assessed using multiple logistic regression analysis. The results were reported as risk ratios (RRs) and 95% confidence intervals (Cis). (3) Results. A total of 104 patients with preeclampsia, of whom 23 experienced eclamptic seizures, were included in this study. A total of 82.6% of the patients diagnosed with eclampsia experienced a form of significant morbidity (stroke, PRES syndrome, or any organ failure/dysfunction). Our regression analysis revealed that advanced maternal age (RR: 12.24 95% CI: 4.29–36.61, p = 0.002), the presence of thrombotic disorders (RR: 9.17, 95% CI: 3.41–23.70, p = 0.03), obesity (RR: 4.89, 95% CI: 0.78–18.15, p = 0.036), and smoking status (RR: 2.18, 95% CI: 0.13- 6.51, p = 0.042) significantly increase the risk of maternal comorbidities. (4) Conclusions. Careful monitoring of pregnant patients, adequate weight control during pregnancy, and correct anticoagulation of individual patients could reduce the extent of postpartum comorbidities that can result from an eclamptic seizure.

Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis.

Radioligand therapy (RLT) with 177Lu-labelled prostate specific membrane antigen ([177Lu]Lu-PSMA-X, referring with "PSMA-X" to a generic PSMA chemical compound) inhibitors has emerged as a viable treatment option in metastatic castration resistant prostate cancer patients having previously progressed on taxane and androgen receptor inhibitors. The aim of this study was to perform a systematic review and meta-analysis to assess the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer. Searches in several bibliographic databases were made using relevant key words, and articles published up to March 2024 were included. The endpoints included prostate specific antigen (PSA) response rate (RR), progression-free survival, and overall survival. Individual patient data were pooled when feasible. PSA50 was defined as the median proportion of patients achieving at least a 50% decline in serum PSA from baseline. A meta-analysis of the PSA50 response rate (proportion meta-analysis) was performed, generating pooled estimates and 95% confidence intervals (95% CI). From the initially selected 8,414 studies published between 2019 and 2023, 24 were included in the [177Lu]Lu-PSMA-X treated group and 17 in the taxane treated group. Our findings show that [177Lu]Lu-PSMA-X RLT yielded comparable PSA50 responses in taxane-naïve patients versus those receiving taxane chemotherapy, despite considerable study heterogeneity. Notably, the taxane-naïve group had more extensive pretreatment. This meta-analysis combines the largest cohorts of taxane-naïve mCRPC patients treated with [177Lu]Lu-PSMA-X RLT and taxane-treated mCRPC. It underscores similar PSA50 response rates in both groups, suggesting a potential role for [177Lu]Lu-PSMA-X RLT in taxane-naïve patients who cannot or choose not to undergo chemotherapy.

Motion-mimicking Robotic Finger Prosthesis for Burn-induced Partial Hand Amputee: A Case Report.

Burn injuries often result in severe hand complications, including joint contractures and nerve damage, sometimes leading to amputation. Despite early treatment, hypertrophic scarring frequently hampers hand function recovery, and the thick raised scar blocks electromyography (EMG) sensing. A promising solution involves motion-mimicking robotic finger prostheses tailored to individual patient requirements. By utilizing the versatility of motion-capturing technology on a sound finger, a robotic finger prosthesis can mimic the movement of a sound finger simultaneously with less latency than EMG-based sensory mechanisms through hypertrophic scars. This case study evaluated the clinical efficacy of a customized three-dimensional printed robotic finger prosthesis in a 24-year-old man who sustained left second finger loss due to electrical burns. Despite undergoing reconstructive surgery, the patient struggled with manual dexterity. Following the adoption of a personalized robotic finger prosthesis with a finger motion-capturing device, significant improvements in grip strength and daily task performance were observed. This innovative approach has advantages such as customization, reduced latency time for finger movements, and affordability from low-cost manufacturing, suggesting its potential for broader adoption among burn-induced amputees.

Stenting for symptomatic intracranial arterial stenosis with different qualifying arteries: a preplanned pooled individual patient data analysis

BackgroundThe efficacy of percutaneous transluminal angioplasty and stenting (PTAS) relative to medical management in treating symptomatic intracranial arterial stenosis (ICAS) varies based on the qualifying artery. This study aims to...

Systematic review and indirect treatment comparisons of ritlecitinib against baricitinib in alopecia areata.

Ritlecitinib and baricitinib are recently approved systemic treatments for severe alopecia areata (AA). Both demonstrated superiority over placebo in hair regrowth measured by the Severity of Alopecia Tool (SALT), but they have not been directly compared in randomized controlled trials (RCTs). We conducted a systematic review of RCTs evaluating treatments in AA and estimated the efficacy and safety of ritlecitinib and baricitinib at Week 24 using Bayesian network meta-analysis. To adjust and explore effect modifiers, population-adjusted indirect comparison was performed via multilevel network meta-regression (ML-NMR) using ritlecitinib individual patient data (IPD). Co-primary endpoints were SALT ≤20 and SALT ≤10 at Week 24. Unanchored population adjusted ITCs were also computed to evaluate SALT ≤10 and SALT ≤20 endpoints at Week 48/52. Four RCTs (ALLEGRO 2a [NCT02974868], ALLEGRO 2b/3 [NCT03732807], BRAVE-AA1 [NCT03570749] and BRAVE-AA2 [NCT03899259]) were included. No evidence of a difference between ritlecitinib 50 mg and baricitinib 4 mg on SALT ≤10 (odds ratio, OR: 0.96, 95% credible interval, CrI: 0.18-7.21) and SALT ≤20 (OR: 2.16, 95% CrI: 0.48-16.46) at Week 24 was found. ML-NMR using ALLEGRO IPD adjusted for sex, SALT score at baseline, duration of current episode and disease duration found evidence of effect modification, although relative efficacy between ritlecitinib 50 mg and baricitinib 4 mg remained unchanged. Unanchored population-adjusted ITC at Week 48/52 was consistent with previous results. We found similar efficacy between ritlecitinib 50 mg and baricitinib 4 mg. These ITCs was informed by only four RCTs, uncertainty was considerable, and there was evidence of effect modification, highlighting the need for further quality research in AA.

Clinical indications associated with new opioid use for pain management in the United Kingdom: using national primary care data.

Prescription opioids for noncancer pain in the United Kingdom have increased over the past 2 decades, alongside associated harms. Policies addressing opioid prescribing must be tailored to individual patient needs with specific disease systems. The aim of this study was to evaluate clinical conditions associated with new opioid initiation in noncancer pain using nationally representative UK data. Primary care electronic health records from January 1, 2006, to September 31, 2021, were used from the Clinical Research Practice Datalink to identify incident opioid prescriptions. Patient histories were reviewed using code lists for opioid-related conditions with a 5-year look-back for chronic conditions and a 1-year look-back for surgical indications before opioid initiation. In total, 3,030,077 new opioid use episodes in 2,027,402 patients were identified, with 61% being women, 77% aged 45 years and older, and 48% from the highest deprivation quintile. Ten systems associated with opioid initiation were identified, which were not mutually exclusive, as patients could have opioids prescribed for multiple indications. The most common were musculoskeletal (80.8%), respiratory (57.6%), infections (30.4%), trauma/injury (20.4%), neurology (19.9%), and postsurgical indications (5.5%). Osteoarthritis (60.7%) and low back pain (41.0%) were the most frequent musculoskeletal conditions. Orthopedic surgeries accounted for 41.2% of all postsurgical indications. This is the first study in the United Kingdom evaluating large-scale national data to assess indications associated with opioid initiation. Nearly 3 quarters of new opioid prescriptions for noncancer pain were in patients with musculoskeletal conditions, often for conditions with limited evidence for opioid efficacy. These findings could inform targeted interventions and future policies to support nonpharmacological interventions in the most common conditions where opioid harms outweigh benefits.

Nurses’ implementation of evidence based practice in nursing process and its associated factors in South Wollo Zone public hospitals, Northeast Ethiopia: a mixed method study

BackgroundEvidence-based practice is clinical decision-making using the best evidence available in the context of individual patients’ preferences and clinical expertise. It is serving as a crucial instrument for the health science disciplines to minimize the theory-practice gap although the level of practice is unknown. Thus, this study aimed to assess nurses’ implementation of evidence-based practice in nursing process and its associated factors in South Wollo Zone Public Hospitals.MethodsAn explanatory sequential mixed method was employed from April 1 to May 29, 2023, among 419 nurses for the quantitative part and 15 others for the qualitative part. The data were collected using structured, pretested, self-administered questionnaires. Simple random and purposive sampling techniques were used to select participants for the quantitative and qualitative studies, respectively. The bivariable analysis was done primarily, and variables with a p-value < 0.25 were further examined using a multivariable logistic regression model to control con-founders. Then, variables having a p-value less than 0.05 with a 95% CI were used to declare significantly associated factors. The key informants were interviewed using pre-made interview guidelines, and then open code software was utilized to conduct a thematic analysis.ResultNurses who had poor implementation of evidence-based practice in the nursing process were 228 [54.42%; 95% CI: (49.8–59.3)]. Similarly, the key informants concluded that the implementation of evidence-based practice in the nursing process was low. Participants who were 31– 40 years old [AOR = 0.61, 95% CI: (0.38–0.99)], 41–50 years [AOR = 0.32, 95% CI: (0.15–0.65)], working at general hospitals [AOR = 3.37, 95% CI: (1.39–8.18)] and comprehensive specialized hospitals [AOR = 7.29, 95% CI: (3.06 − 17.31)], lack of training about evidence-based practice (AOR = 2.50, 95% CI: (1.36–4.56)], and lack of internet access [AOR = 2.46, 95% CI: (1.43–4.23)] were factors associated with poor levels of nurses’ implementation of evidence-based practice in the nursing process. The absence of computers, libraries, and updated guidelines were other factors identified on the quality analysis.ConclusionNurses’ implementation of evidence-based practice in the nursing process was low. Age, working in general hospitals, and comprehensive and specialized hospitals, lack of training, and internet access were factors that had significant associations. Hence, hospital managers should give an attention to internet access and training about utilization of evidence-based practice in nursing process, particularly for those aged above thirty years old.

Modelling post-chemotherapy stem cell dynamics in the bone marrow niche of AML patients

Acute myeloid leukemia (AML) is a stem cell-driven malignancy of the blood forming (hematopoietic) system. Despite of high dose chemotherapy with toxic side effects, many patients eventually relapse. The “7+3 regimen”, which consists of 7 days of cytarabine in combination with daunorubicin during the first 3 days, is a widely used therapy protocol. Since peripheral blood cells are easily accessible to longitudinal sampling, significant research efforts have been undertaken to characterize and reduce adverse effects on circulating blood cells. However, much less is known about the impact of the 7+3 regimen on human hematopoietic stem cells and their physiological micro-environments, the so-called stem cell niches. One reason for this is the technical inability to observe human stem cells in vivo and the discomfort related to bone marrow biopsies. To better understand the treatment effects on human stem cells, we consider a mechanistic mathematical model of the stem cell niche before, during and after chemotherapy. The model accounts for different maturation stages of leukemic and hematopoietic cells and considers key processes such as cell proliferation, self-renewal, differentiation and therapy-induced cell death. In the model, hematopoietic (HSCs) and leukemic stem cells (LSCs) compete for a joint niche and respond to both systemic and niche-derived signals. We relate the model to clinical trial data from literature which longitudinally quantifies the counts of hematopoietic stem like (CD34+CD38-ALDH+) cells at diagnosis and after therapy. The proposed model can capture the clinically observed interindividual heterogeneity and reproduce the non-monotonous dynamics of the hematopoietic stem like cells observed in relapsing patients. Our model allows to simulate different scenarios proposed in literature such as therapy-related impairment of the stem cell niche or niche-mediated resistance. Model simulations suggest that during the post-therapy phase a more than 10-fold increase of hematopoietic stem-like cell proliferation rates is required to recapitulate the measured cell dynamics in patients achieving complete remission. We fit the model to data of 7 individual patients and simulate variations of the treatment protocol. These simulations are in line with the clinical finding that G-CSF priming can improve the treatment outcome. Furthermore, our model suggests that a decline of HSC counts during remission might serve as an indication for salvage therapy in patients lacking MRD (minimal residual disease) markers.

Family caregiver narratives of hospice death vigils

BackgroundOften, family members and friends gather around a dying hospice patient to say goodbye in what is known as a death vigil. The purpose of this study is to explore...

The Australian paediatric brachytherapy experience: A pathway to a national programme.

Paediatric cancers are rare, and most children requiring radiation therapy receive external beam radiation (EBRT). Although EBRT may offer organ preservation compared to surgery, it can be associated with significant late effects. Image-guided brachytherapy is a highly specialised technique offering both organ preservation and dose conformity to minimise late toxicity. This is a retrospective mono-institutional review of paediatric brachytherapy in one of the largest paediatric centres in Australia. Outcomes and toxicities are presented as well as brachytherapy versus proton plan comparison in four patients. A total of 14 patients were treated with adjuvant brachytherapy between 2012 and 2022. The predominant histology was rhabdomyosarcoma, and all patients had pelvic tumours. High-dose rate (HDR) brachytherapy was given for 13 patients with one patient receiving low-dose rate (LDR) brachytherapy. Only one grade three late toxicity was reported and two patients developed metastatic disease within one year of completion of treatment. The brachytherapy plan was superior to protons in two of four patients and equivocal in one patient. This is the first Australian publication of a paediatric brachytherapy series from a single institution. This retrospective series demonstrates the feasibility and safety of brachytherapy in paediatric pelvic tumours. The initial work presented here demonstrates the value of a comprehensive radiation plan review in selecting the optimal modality for an individual paediatric patient.

Genetic Prediction Modeling in Large Cohort Studies via Boosting Targeted Loss Functions.

Polygenic risk scores (PRS) aim to predict a trait from genetic information, relying on common genetic variants with low to medium effect sizes. As genotype data are high-dimensional in nature, it is crucial to develop methods that can be applied to large-scale data (large and large ). Many PRS tools aggregate univariate summary statistics from genome-wide association studies into a single score. Recent advancements allow simultaneous modeling of variant effects from individual-level genotype data. In this context, we introduced snpboost, an algorithm that applies statistical boosting on individual-level genotype data to estimate PRS via multivariable regression models. By processing variants iteratively in batches, snpboost can deal with large-scale cohort data. Having solved the technical obstacles due to data dimensionality, the methodological scope can now be broadened-focusing on key objectives for the clinical application of PRS. Similar to most methods in this context, snpboost has, so far, been restricted to quantitative and binary traits. Now, we incorporate more advanced alternatives-targeted to the particular aim and outcome. Adapting the loss function extends the snpboost framework to further data situations such as time-to-event and count data. Furthermore, alternative loss functions for continuous outcomes allow us to focus not only on the mean of the conditional distribution but also on other aspects that may be more helpful in the risk stratification of individual patients and can quantify prediction uncertainty, for example, median or quantile regression. This work enhances PRS fitting across multiple model classes previously unfeasible for this data type.

Intraoperative Hypotension Prediction: Current Methods, Controversies, and Research Outlook.

Intraoperative hypotension prediction has been increasingly emphasized due to its potential clinical value in reducing organ injury and the broad availability of large-scale patient datasets and powerful machine learning tools. Hypotension prediction methods can mitigate low blood pressure exposure time. However, they have yet to be convincingly demonstrated to improve objective outcomes; furthermore, they have recently become controversial. This review presents the current state of intraoperative hypotension prediction and makes recommendations on future research. We begin by overviewing the current hypotension prediction methods, which generally rely on the prevailing mean arterial pressure as one of the important input variables and typically show good sensitivity and specificity but low positive predictive value in forecasting near-term acute hypotensive events. We make specific suggestions on improving the definition of acute hypotensive events and evaluating hypotension prediction methods, along with general proposals on extending the methods to predict reduced blood flow and treatment effects. We present a start of a risk-benefit analysis of hypotension prediction methods in clinical practice. We conclude by coalescing this analysis with the current evidence to offer an outlook on prediction methods for intraoperative hypotension. A shift in research toward tailoring hypotension prediction methods to individual patients and pursuing methods to predict appropriate treatment in response to hypotension appear most promising to improve outcomes.

Traditional Chinese Medicine treatment for postoperative axial symptoms of cervical spondylotic myelopathy: a systematic review

BackgroundAxial symptoms (AS) represent one of the primary complications after cervical spondylotic myelopathy (CSM) surgery. Traditional Chinese Medicine (TCM), as a complementary and alternative therapy, is widely used in the...

Frequency and clinical implications of findings on true whole-body 18F-FDG PET in the assessment of breast cancer.

In the assessment of breast cancer using 18-F FDG PET/CT, the incremental clinical benefit in performing a true whole-body PET/CT (with a field of view (FOV) from the vertex to the toes) over a limited whole-body PET/CT (with a FOV from the base of skull to the mid-thighs) is uncertain. Two hundred and one studies of 120 patients who underwent staging or restaging true whole body 18F-FDG PET/CT for breast cancer were retrospectively identified. Any abnormal hypermetabolic or structural focus outside the limited FOV was recorded and characterised, and referenced with the patient's known disease status and any symptomatology. A total of 18 (9.0%) studies had FDG avid and/or structural abnormalities detected outside the limited whole-body FOV which were identified as malignant. Seventeen out of 18 (94.4%) were skeletal and of these, 15/17 (88.2%) were located within the lower limbs. In three cases, there were de novo findings but identified in the presence of interval progression of other metastases within the limited whole-body FOV. None of these additional findings is known to have resulted in a change to staging or clinical management. In the assessment of breast cancer, a true whole-body PET/CT can reveal metastases outside the limited whole-body FOV, but these are unlikely to be encountered in isolation and therefore may have little bearing on clinical stage or management. Ultimately, while the choice of FOV should still be based on the individual patient situation, routine utilisation of the true whole-body FOV in the asymptomatic patient may not be necessary.

Inguinal Hernia Repair: Comparative Study between TEP versus Extended Totally Extraperitoneal.

Inguinal hernia repair is a common surgical procedure, with laparoscopic techniques offering advantages over open surgery. The extended Totally Extraperitoneal (eTEP) technique provides a larger working space compared to the traditional Totally Extraperitoneal (TEP) approach, potentially improving outcomes. A prospective study was conducted comparing eTEP and TEP techniques for inguinal hernia repair at Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. Forty patients (20 in each group) aged 15-65 with uncomplicated inguinal hernias were included. Surgical procedures were performed based on patient preference. Data on surgical duration, pain scores, hospital stay, and complications were collected and analyzed using statistical methods. eTEP surgery had a significantly shorter mean duration (48.70 ± 7.505 minutes) compared to TEP surgery (74.20 ± 7.78 minutes; P = 0.00). Patients undergoing eTEP experienced lower mean pain scores (3.75 ± 0.55) compared to those undergoing TEP (5.15 ± 0.745; P = 0.00). Hospital stay following eTEP surgery was shorter (1.70 ± 0.657 days) than following TEP surgery (3.65 ± 1.137 days; P = 0.00). eTEP had lower incidences of hematoma and surgical emphysema but higher seroma complications. TEP surgeries were associated with more post-operative complications and a higher likelihood of requiring conversion to open surgery. The eTEP technique offers several advantages over TEP, including shorter surgical duration, less post-operative pain, and shorter hospital stays. However, TEP had more complications related to seroma. Individual patient factors and surgeon experience should guide the choice of technique. The eTEP technique appears to be a promising option for inguinal hernia repair, offering advantages over TEP in terms of surgical outcomes. However, further studies are needed to evaluate long-term outcomes and complication rates comprehensively.

Impact of Anastomotic Leakage After Colorectal Cancer Surgery on Quality of Life: A Systematic Review.

Colorectal anastomotic leakage remains one of the most frequent and dreaded postoperative complications following colorectal resection. However, limited research has been conducted on the impact of this complication on quality of life of patients undergoing colorectal cancer surgery. The aim of this systematic review was to identify, appraise and synthesize the available evidence regarding quality of life in patients with anastomotic leakage following oncological colorectal resections in order to inform clinical decision-making. PubMed, Embase, and the Cochrane library were searched for studies reporting on quality of life using validated questionnaires in patients with anastomotic leakage after oncological colorectal resections. The literature search was performed systematically and according to PRISMA guidelines. Outcomes of quality of life questionnaire scores of patients with and without anastomotic leakage were analyzed. Thirteen articles reporting on 4618 individual patients were included, among which 527 patients developed anastomotic leakage. Quality of life was evaluated utilizing ten distinct questionnaires administered at various postoperative time points, ranging from 1 month to 14 years. Quality of life outcomes differed across studies and timepoints, but overall scores were most negatively affected by anastomotic leakage up to 12 months postoperatively. There was a high heterogeneity between the included studies based on used questionnaires and time of assessment. The published evidence suggests that anastomotic leakage following oncologic colorectal resection is associated with impaired quality of life, especially within the first postoperative year. The impact of anastomotic leakage on quality of life warrants further evaluation and discussion with patients.

The SINFONIA project repository for AI-based algorithms and health data

The SINFONIA project’s main objective is to develop novel methodologies and tools that will provide a comprehensive risk appraisal for detrimental effects of radiation exposure on patients, workers, caretakers, and comforters, the public, and the environment during the management of patients suspected or diagnosed with lymphoma, brain tumors, and breast cancers. The project plan defines a series of key objectives to be achieved on the way to the main objective. One of these objectives is to develop and operate a repository to collect, pool, and share data from imaging and non-imaging examinations and radiation therapy sessions, histological results, and demographic information related to individual patients with lymphoma, brain tumors, and breast cancers. This paper presents the final version of that repository, a cloud-based platform for imaging and non-imaging data. It results from the implementation and integration of several software tools and programming frameworks under an evolutive architecture according to the project partners’ needs and the constraints of the General Data Protection Regulation. It provides, among other services, data uploading and downloading, data sharing, file decompression, data searching, DICOM previsualization, and an infrastructure for submitting and running Artificial Intelligence models.