Publications by authors named "Chien Chang Lee"

Procalcitonin is a useful biomarker for infection. Over the past two decades, there has been much research on the clinical applications of procalcitonin, yet the majority of these studies have been conducted in the intensive care setting. Despite the extensive use of procalcitonin in emergency departments, there have been no guidelines focusing specifically on these clinical settings.

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Objectives: To pioneer the first artificial intelligence system integrating radiological and objective clinical data, simulating the clinical reasoning process, for the early prediction of high-risk influenza patients.

Materials And Methods: Our system was developed using a cohort from National Taiwan University Hospital in Taiwan, with external validation data from ASST Grande Ospedale Metropolitano Niguarda in Italy. Convolutional neural networks pretrained on ImageNet were regressively trained using a 5-point scale to develop the influenza chest X-ray (CXR) severity scoring model, FluDeep-XR.

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Background: To evaluate and compare the long-term efficacy of medical treatments for normal tension glaucoma (NTG) in controlling intraocular pressure (IOP), and establish a hierarchical ranking based on their effectiveness. 'Long-term' is defined as a treatment duration of over 12 weeks in randomised controlled trials (RCTs).

Methods: This systematic review and model-based network meta-analysis (MBNMA) collected data of 795 patients with 997 eyes from RCTs.

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Background: Vitamin D supplementation may prevent acute respiratory infections (ARIs). This study aimed to identify the optimal methods of vitamin D supplementation.

Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.

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Background: Early identification of impending in-hospital cardiac arrest (IHCA) improves clinical outcomes but remains elusive for practicing clinicians.

Objective: We aimed to develop a multimodal machine learning algorithm based on ensemble techniques to predict the occurrence of IHCA.

Methods: Our model was developed by the Multiparameter Intelligent Monitoring of Intensive Care (MIMIC)-IV database and validated in the Electronic Intensive Care Unit Collaborative Research Database (eICU-CRD).

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This cross-sectional study examined sleep disturbance associations between parents and their school-age children with overweight and obesity. A 7-day wrist-worn actigraph recording was performed on 246 children aged 6-9 years with overweight and obesity recruited from 10 public elementary schools in Taipei, Taiwan. Children's sleep disturbance was assessed using the Children's Sleep Habits Questionnaire.

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Article Synopsis
  • The Panbio COVID-19/Flu A&B Panel is a rapid diagnostic test that detects SARS-CoV-2 and influenza A and B proteins from nasal swab samples taken from symptomatic individuals.
  • This study is the largest of its kind, involving over 1,600 participants across multiple continents to evaluate the test's sensitivity and specificity compared to a standard assay using nasopharyngeal swabs.
  • The results showed that the Panbio test has high sensitivity (around 80-94%) and specificity (over 99%) for detecting COVID-19 and influenza, making it a reliable option for quick diagnosis in various populations.
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Background: There are no sex-specific guidelines for chronic aortic regurgitation (AR). This retrospective study examined sex-specific differences and propose treatment criteria from an Asian AR cohort.

Methods and results: Consecutive 1,305 patients with moderate-severe AR or greater at 3 tertiary centers in Taiwan and Japan (2008-2022) were identified.

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Background: The use of antiviral agents, specifically tenofovir disoproxil fumarate (TDF), in pregnant women to prevent mother-to-child HBV transmission is a key step towards hepatitis elimination. However, data on using tenofovir alafenamide (TAF) is insufficient. The frequent occurrence of postpartum ALT flares may impact the clinical implementation.

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This randomized controlled trial was conducted to assess the effectiveness of a family-based and mobile-assisted lifestyle intervention in reducing weight gain among school-age children with overweight and obesity. A total of 164 school-age children with overweight or obesity and their parents were randomized to the treatment intervention (n = 82) or an attention-control group (n = 82). The treatment intervention included three face-to-face education sessions, augmented by monthly text messages sent to parents on their mobile devices.

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Aims: Risk stratification of atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS), diagnosed using breast biopsy, has great clinical significance. Clinical trials are currently exploring the possibility of active surveillance for low-risk lesions, whereas axillary lymph node staging may be considered during surgical planning for high-risk lesions. We aimed to develop a machine-learning algorithm based on whole-slide images of breast biopsy specimens and clinical information to predict the risk of upstaging to invasive breast cancer after wide excision.

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Article Synopsis
  • The study investigates the relationship between sleep duration and the occurrence of dental caries and myopia in first graders, noting that the transition to first grade may affect children's sleep patterns.* -
  • Results show that children sleeping less than 9 hours per night have a significantly higher risk of developing dental caries, and maternal dental health is a strong predictor of children's caries risk, while sleep was not linked to myopia.* -
  • The findings suggest the need for early screening for insufficient sleep among children to identify those at high risk for dental issues and recommend involving family nurses to implement effective sleep interventions and oral health practices.*
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In traumatology physicians heavily rely on computed tomography (CT) 2D axial scans to identify and assess the patient's injuries after an accident. However, in some cases it can be difficult to rigorously evaluate the real extent of the damage considering only the bidimensional slices produced by the CT, and some life-threatening lesions can be missed. With the development of 3D holographic rendering and extended reality (XR) technology, CT images can be projected in a 3D format through head-mounted holographic displays, allowing multi-view from different angles and interactive slice intersections, thus increasing anatomical intelligibility.

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Sepsis patients have a high risk of developing in-hospital cardiac arrest (IHCA), which portends poor survival. However, little is known about whether the increased incidence of IHCA is due to sepsis itself or to comorbidities harbored by sepsis patients. We conducted a retrospective population-based cohort study comprising 20,022 patients admitted with sepsis to hospitals in Taiwan using the National Health Insurance Research Database (NHIRD).

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Sleep disturbances in children with epilepsy are prevalent, and are associated with substantial adverse medical and psychosocial consequences. This study is a 5-year follow-up of a clinic-based sleep intervention study that randomized 100 toddlers and preschool-age children with epilepsy to a usual care group or a sleep intervention group. The intervention group received standard paediatric neurology care plus three education sessions during the child's routine clinic visit.

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Background: Mitral regurgitation (MR) and tricuspid regurgitation (TR) are common cardiac conditions with high mortality risks, which can be improved through early intervention. Telehealth services, which allow for remote monitoring of patient conditions, have been proven to improve the health management of chronic diseases, but the effects on MR and TR progression are unknown.

Objective: This study aimed to explore whether patients receiving telehealth services have less MR and TR progression compared with a control group.

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The European Society of Cardiology recommends the 0/1-hour algorithm for risk stratification of patients with suspected non-ST-elevation myocardial infarction as class I, level B; however, there are few reports on the long-term prognosis, resulting in a rule-out group. We aimed to determine whether implementation of the 0-hour/1-hour algorithm is safe and effective in emergency department (ED) patients with possible acute coronary syndrome (ACS) through a 1-year follow-up period. Our study analyzed the 1-year follow-up data from a prospective pre-post study of 1106 ED patients with possible ACS from 4 hospitals in Japan and Taiwan.

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Purpose: Acne is an extremely common skin disease with an estimated global prevalence of 9.4%. We aim to provide comprehensive comparisons of the common pharmacological treatments for acne.

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Article Synopsis
  • - The study focused on understanding genetic factors related to headaches in individuals of East Asian ancestry, specifically Han Chinese, using a large sample size of 108,855 participants, which included 12,026 headache cases from the Taiwan Biobank.
  • - Significant genetic variants were identified linked to headache phenotypes: one on Chromosome 17 for broadly defined headaches (rs8072917) and another on Chromosome 8 for severe headaches (rs13272202), highlighting their potential roles in headache biology.
  • - The research findings suggest that the identified genetic variants could also have implications for related health issues, and the study's methodology could be applied to diverse populations globally, paving the way for new genetic tests and drug development. *
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This was a cross-sectional study to examine sleep and its variability in relation to behavioral outcomes in school-age children with overweight and obesity. A total of 246 school-age children with overweight or obesity were recruited between 2019 and 2021 from 10 public elementary schools in Northern Taiwan. Parents completed sleep and behavior questionnaires, with children wearing an actigraphy monitor for 7 days.

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Importance: Chronic hemodynamically significant aortic regurgitation (AR) is associated with excess risk of death, yet data for Asian patients are lacking, and whether Asian patients can abide by Western guidelines as to when aortic valve surgery should be performed is unknown.

Objective: To assess AR presentation and cutoffs of left ventricular ejection fraction (LVEF), LV end-systolic dimension index (LVESDi), and LV end-systolic volume index (LVESVi) that are associated with risk of death in Asian patients with AR.

Design, Setting, And Participants: This retrospective cohort study included consecutive patients with chronic, moderately severe to severe AR from 3 tertiary referral centers (2 in Japan and 1 in Taiwan) from June 11, 2008, through November 19, 2020, with follow-up through November 11, 2021.

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Background: Although the Asian population is growing globally, data in Asian subjects regarding differences between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in aortic regurgitation (AR) remain unexplored.

Objectives: The aim of this study was to examine differences between Asian BAV-AR and TAV-AR in significant AR, including aorta complications.

Methods: The study included 711 consecutive patients with chronic moderate to severe and severe AR from 2008 to 2020.

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