Publications by authors named "Shum E"

Introduction: Mobile technology has revolutionised the way people interact with others and gain access to healthcare services. Given that cultural background is a strong moderator for technology penetration, this systematic review aims to examine end-user perceptions and design recommendations for mobile health applications among Asian older people.

Methods And Analysis: Five electronic databases (PubMed, CINAHL, PsycINFO, Medline and Cochrane Central Register of Controlled Trials) will be searched until May 2025.

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Purpose: Datopotamab deruxtecan (Dato-DXd) is a trophoblast cell-surface antigen-2-directed antibody-drug conjugate with a highly potent topoisomerase I inhibitor payload. The TROPION-Lung05 phase II trial (ClinicalTrials.gov identifier: NCT04484142) evaluated the safety and clinical activity of Dato-DXd in patients with advanced/metastatic non-small cell lung cancer (NSCLC) with actionable genomic alterations progressing on or after targeted therapy and platinum-based chemotherapy.

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Anthracycline-mediated cardiotoxicity is a common concern following lymphoma therapy, particularly in patients with high cardiovascular risk (CVR). In non-cancer populations, coronary artery calcium scoring (CACS) effectively identifies individuals who may benefit from aggressive CVR modification to lower the risk of cardiovascular events. Emerging evidence suggests that CACS can also predict cancer therapy-related cardiotoxicity, potentially identifying candidates for cardioprotective strategies.

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Article Synopsis
  • Lung cancer is a significant public health challenge with ongoing difficulties in prevention, diagnosis, and treatment, prompting a review of current research and management strategies.
  • Experts from various fields collaborated to discuss ways to enhance lung cancer care, emphasizing the importance of tobacco cessation, early detection, and addressing treatment side effects.
  • Effective lung cancer management requires global cooperation, better education, improved access to care and trials, and a focus on personalized treatment through innovative research.
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  • Scientists found that using two medications together, one that stops cancer and another that helps blood vessels, can help people with a certain type of lung cancer live longer without their cancer getting worse.
  • They ran a study (called the RAMOSE trial) comparing one medication plus the blood vessel helper to just the medication alone.
  • The results showed that people taking both medications had better outcomes, living longer without cancer progression, even though both groups experienced side effects from the treatments.
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Background: A technologically integrated, multidisciplinary approach to stroke rehabilitation service was delivered and embedded into conventional health care practice. This article reports an evaluation of cost-effectiveness analysis of a new Virtual Multidisciplinary Stroke Care Clinic (VMSCC) service for community-dwelling survivors of stroke.

Methods And Results: A randomized controlled trial was conducted.

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The year 2024 is the 20 anniversary of the discovery of activating epidermal growth factor receptor () mutations in non-small cell lung cancer (NSCLC). Since then, tremendous advances have been made in the treatment of NSCLC based on this discovery. Some of these studies have led to seismic changes in the concept of oncology research and spurred treatment advances beyond NSCLC, leading to a current true era of precision oncology for all solid tumors.

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Caregiving for the fast-growing but vulnerable oldest-old population may involve distinct challenges but also gratification. We analyzed quantitative and qualitative data from family caregivers of community-dwelling older adults aged 95 or above in Hong Kong. Quantitative analysis of 143 caregivers revealed that higher age, dependence on basic activities of daily living, independence on instrumental activities of daily living, and intact hearing ability of the older adults, and absence of a domestic helper and better self-rated health of the caregivers were associated with more positive aspects of caregiving.

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Background: We previously demonstrated in a meta-analysis there was no difference in risk ratio (RR) of lung cancer detected by low-dose computed tomography (LDCT) screening among female never-smokers (NS) and male ever-smokers (ES) in Asia. LDCT screening significantly decreased lung cancer death among Asian NS compared to Asian ES (RR =0.27, P<0.

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  • The study investigates the link between exercise and brain-derived neurotrophic factor (BDNF) levels in individuals with overweight and obesity, amid concerns over the cognitive impacts of rising obesity rates.
  • A systematic review of 13 studies found no significant effect of exercise on resting BDNF levels, with most studies demonstrating a low risk of bias but showing consistent results across different participant ages and control conditions.
  • The authors recommend conducting more rigorous and larger-scale studies to better understand the role of BDNF in cognitive function related to obesity.
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Background: Our study aims to explore the current utilisation of F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the diagnostic pathway of pyrexia of unknown origin (PUO) and associated cost of illness in a large tertiary teaching hospital in Australia.

Method: 1257 febrile patients between June 2016 and September 2022 were retrospectively reviewed. There were 57 patients who met the inclusion criteria of "classical PUO", of which FDG-PET/CT was performed in 31 inpatients, 15 outpatients and 11 inpatients did not have an FDG-PET/CT scan.

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Purpose: Standard therapy for locally advanced non-small-cell lung cancer (LA-NSCLC) is concurrent chemoradiotherapy followed by adjuvant durvalumab. For biomarker-selected patients with LA-NSCLC, we hypothesized that sequential pembrolizumab and risk-adapted radiotherapy, without chemotherapy, would be well-tolerated and effective.

Methods: Patients with stage III NSCLC or unresectable stage II NSCLC and an Eastern Cooperative Oncology Group performance status of 0-1 were eligible for this trial.

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  • This study examines successful ageing in older adults, particularly those aged 95 and above, using data from the Hong Kong Centenarian Study 2 conducted between April 2021 and September 2022.
  • It highlights three distinct subphenotypes of successful ageing based on caregivers' assessments: one group with poor health (46.6%), another with good functional health (37.0%), and a third with overall good health (16.4%).
  • The findings emphasize the diversity in health outcomes among nonagenarians and centenarians, suggesting that tailored interventions are needed to promote healthier ageing in this vulnerable population.
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PCR has been a reliable and inexpensive method for nucleic acid detection in the past several decades. In particular, multiplex PCR is a powerful tool to analyze many biomarkers in the same reaction, thus maximizing detection sensitivity and reducing sample usage. However, balancing the amplification kinetics between amplicons and distinguishing them can be challenging, diminishing the broad adoption of high order multiplex PCR panels.

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  • Patients with relapsed small cell lung cancer (SCLC), known for its poor prognosis, showed some improvement when the drug berzosertib was added to topotecan in a phase 2 study.
  • A randomized clinical trial conducted from December 2019 to December 2022 involved 60 patients who received either topotecan alone or in combination with berzosertib, assessing their outcomes based on progression-free survival (PFS) and overall survival (OS).
  • Results indicated that after a median follow-up of 21.3 months, there was no significant difference in PFS or OS between the two treatment groups, highlighting the challenge in treating relapsed SCLC.
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Background: Stroke survivors constantly feel helpless and unprepared after discharge from hospitals. More flexible and pragmatic support are needed for their optimized recovery. We examined the effects of a virtual multidisciplinary stroke care clinic on survivors' health and self-management outcomes.

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The standard of care (SoC) for medically operable patients with early-stage (stages I-IIIB) NSCLC is surgery combined with (neo)adjuvant systemic therapy for patients with stages II to IIIB disease and some stage IB or, rarely, chemoradiation (stage III disease with mediastinal lymph node metastases). Despite these treatments, metastatic recurrence is common and associated with poor survival, highlighting the need for systemic therapies that are more effective than the current SoC. After the success of targeted therapy (TT) in patients with advanced NSCLC harboring oncogenic drivers, these agents are being investigated for the perioperative (neoadjuvant and adjuvant) treatment of patients with early-stage NSCLC.

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In a prior practice and policy article published in Healthcare Science, we introduced the deployed application of an artificial intelligence (AI) model to predict longer-term inpatient readmissions to guide community care interventions for patients with complex conditions in the context of Singapore's Hospital to Home (H2H) program that has been operating since 2017. In this follow on practice and policy article, we further elaborate on Singapore's H2H program and care model, and its supporting AI model for multiple readmission prediction, in the following ways: (1) by providing updates on the AI and supporting information systems, (2) by reporting on customer engagement and related service delivery outcomes including staff-related time savings and patient benefits in terms of bed days saved, (3) by sharing lessons learned with respect to (i) analytics challenges encountered due to the high degree of heterogeneity and resulting variability of the data set associated with the population of program participants, (ii) balancing competing needs for simpler and stable predictive models versus continuing to further enhance models and add yet more predictive variables, and (iii) the complications of continuing to make model changes when the AI part of the system is highly interlinked with supporting clinical information systems, (4) by highlighting how this H2H effort supported broader Covid-19 response efforts across Singapore's public healthcare system, and finally (5) by commenting on how the experiences and related capabilities acquired from running this H2H program and related community care model and supporting AI prediction model are expected to contribute to the next wave of Singapore's public healthcare efforts from 2023 onwards. For the convenience of the reader, some content that introduces the H2H program and the multiple readmissions AI prediction model that previously appeared in the prior Healthcare Science publication is repeated at the beginning of this article.

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  • LKB1/STK11 is a key serine/threonine kinase involved in cell metabolism, with implications for treating cancers that have LKB1 mutations.
  • Research identified CD38, an NAD-degrading enzyme, as a new therapeutic target specifically in LKB1-mutant non-small cell lung cancer (NSCLC).
  • The study showed that targeting CD38 with the anti-CD38 antibody daratumumab effectively inhibited tumor growth in mouse models, highlighting its potential in treating LKB1-mutant lung cancers.
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Background: Pleural effusion is a common cause of hospitalisation and a poor prognostic marker that is associated with morbidity and mortality. The evaluation and management of pleural effusion may be performed more effectively by a specialised pleural disease service (SPDS).

Aims: To evaluate the impact of a SPDS established in 2017 at a 400-bed metropolitan hospital in Victoria, Australia.

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The statistical assessments needed to establish anti-drug antibody (ADA) assay cut points (CPs) can be challenging for bioanalytical scientists. Poorly established CPs that are too high could potentially miss treatment emergent ADA or, when set too low, result in detection of responses that may have no clinical relevance. We evaluated 16 validation CP datasets generated with ADA assays at Regeneron's bioanalytical laboratory and compared results obtained from different CP calculation tools.

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Animal health is directly linked to population viability, which may be impacted by anthropogenic disturbances and diseases. Reference intervals (RIs) for haematology and blood biochemistry are essential tools for the assessment of animal health. However, establishing and interpreting robust RIs for threatened species is often challenged by small sample sizes.

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Introduction: Lung cancer in never-smokers is the major cancer cause of death globally. We compared the efficacy of low-dose computed tomography (LDCT) lung cancer screening among never-smokers versus ever-smokers using systematic review and meta-analysis.

Methods: LDCT lung cancer screening studies that simultaneously included both ever-smoker and never-smoker participants published by April 30, 2021, were searched through PubMed and Scopus.

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Article Synopsis
  • Brain metastases (BM) from non-small-cell lung cancer (NSCLC) have historically been viewed as a fatal condition, but advancements like stereotactic radiosurgery (SRS) and new systemic therapies have improved survival rates.
  • Recent data from 606 NSCLC patients treated with SRS between 2008 and 2020 indicate a median overall survival of 17 months, with factors such as younger age, high performance status, fewer brain metastases, and the use of targeted therapies associated with better outcomes.
  • The study identifies long-term survival (≥5 years) as a possibility, with 16% of these patients maintaining stable disease without requiring active treatment for three or more years.
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