Publications by authors named "Kieran Zucker"

Purpose: Assessing the long-term impact of cancer on people's lives is challenging due to confounding issues such as aging and comorbidities. We aimed to investigate this impact by comparing the outcomes of cancer survivors with a matched control cohort.

Methods: This was a cross-sectional survey of breast, colorectal and ovarian cancer survivors approximately 5 years post-diagnosis and a cohort of age, sex and social deprivation-matched controls who had never had a cancer diagnosis.

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Background: Recent studies have challenged the notion that patients with brain metastasis (BM) or leptomeningeal metastasis (LM) should be excluded from systemic therapy clinical trials. This scoping study summarizes the BM/LM clinical studies published between 2010 and 2023.

Methods: MEDLINE, CINAHL, CAB Abstracts, PsycINFO, Cochrane Library, HINARI, International Pharmaceutical Abstracts, PubMed, Scopus, Web of Science, and EMBASE electronic databases were searched on June 21, 2021.

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Introduction: This study is a retrospective evaluation of the performance of deep learning models that were developed for the detection of COVID-19 from chest x-rays, undertaken with the goal of assessing the suitability of such systems as clinical decision support tools.

Methods: Models were trained on the National COVID-19 Chest Imaging Database (NCCID), a UK-wide multi-centre dataset from 26 different NHS hospitals and evaluated on independent multi-national clinical datasets. The evaluation considers clinical and technical contributors to model error and potential model bias.

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This study evaluates the quality of published research using artificial intelligence (AI) for ovarian cancer diagnosis or prognosis using histopathology data. A systematic search of PubMed, Scopus, Web of Science, Cochrane CENTRAL, and WHO-ICTRP was conducted up to May 19, 2023. Inclusion criteria required that AI was used for prognostic or diagnostic inferences in human ovarian cancer histopathology images.

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Most data collected by hospitals as a consequence of the delivery of routine care is not utilised for analytics or organisational intelligence. This project aims to develop tools to enhance the utilisation of routinely collected cancer data within hospitals across England. This was achieved by developing a web application using open source tools to provide health care professionals and hospital managers with easy to use, interactive analytics for cancer data.

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Since the emergence of COVID-19, deep learning models have been developed to identify COVID-19 from chest X-rays. With little to no direct access to hospital data, the AI community relies heavily on public data comprising numerous data sources. Model performance results have been exceptional when training and testing on open-source data, surpassing the reported capabilities of AI in pneumonia-detection prior to the COVID-19 outbreak.

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Introduction: More people are living with and beyond a cancer diagnosis. There is limited understanding of the long-term effects of cancer and cancer treatment on quality of life and personal and household finances when compared to people without cancer. In a separate protocol we have proposed to link de-identified data from electronic primary care and hospital records for a large population of cancer survivors and matched controls.

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Article Synopsis
  • Linked healthcare data has significant potential for improving knowledge and services, but it raises ethical and legal issues around privacy and confidentiality that need to be addressed effectively.
  • The research developed a clear data flow protocol to create pseudonymous and anonymous datasets, which was successfully implemented in the Comprehensive Patient Records study in Leeds, UK.
  • The framework created not only received ethical approval but also provides a robust method that enhances current standards for data protection, ensuring compliance while facilitating research.
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Introduction: The number of older adults diagnosed with cancer is increasing. Older adults are more likely to have pre-existing frailty, which is associated with greater chemotherapy-related toxicity. Early identification of those at risk of toxicity is important to reduce patient morbidity and mortality.

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Article Synopsis
  • The study focuses on using process mining to understand the complicated treatment pathways of endometrial cancer, aiming to make these pathways more transparent for analysis.
  • Researchers extracted patient data from a hospital information system and constructed a process model to examine variations in treatment pathways, specifically looking at the 62-day timeline from a General Practitioner referral to the first hospital treatment.
  • The analysis considered variations based on three criteria: the type of the initial treatment, patients' age at diagnosis, and the year of diagnosis, highlighting the potential of process mining in improving understanding of complex healthcare processes.
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Article Synopsis
  • The paper addresses the need to analyze how healthcare processes change over time, particularly to meet individual patient needs.
  • It introduces a structured approach that examines changes at three levels: holistic (overall process), middle (specific traces), and detailed (individual activities).
  • A case study on cancer pathways in Leeds illustrates this approach, revealing multiple change points and emphasizing its value in fostering discussions among experts when contradictions arise in the findings.
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To characterize treatment patterns and survival outcomes for patients with locally advanced or metastatic malignancy of the urothelial tract during a period immediately preceding the widespread use of immune checkpoint inhibitors in the UK. We retrospectively examined the electronic case notes of patients attending the Leeds Cancer Center, UK with locally advanced or metastatic urothelial carcinoma, receiving chemotherapy between January 2003 and March 2017. Patient characteristics, treatment patterns, and outcomes were collected.

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