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AI Predicts Cancer Patient Survival Using Medical Records

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A team of researchers from the University of British Columbia and BC Cancer have developed an artificial intelligence (AI) model that predicts cancer patient survival more accurately and with more readily available data than previous tools.

The model uses natural language processing (NLP) – a branch of AI that understands complex human language – to analyze oncologist notes following a patient’s initial consultation visit, which is the first step in the cancer journey after diagnosis. By identifying characteristics unique to each patient, the model was shown to predict six-month, 36-month and 60-month survival with greater than 80 per cent accuracy. The findings were published today in JAMA Network Open.

“Predicting cancer survival is an important factor that can be used to improve cancer care,” said lead author Dr. John-Jose Nunez, a psychiatrist and clinical research fellow with the UBC Mood Disorders Centre and BC Cancer. “It might suggest health providers make an earlier referral to support services or offer a more aggressive treatment option upfront. Our hope is that a tool like this could be used to personalize and optimize the care a patient receives right away, giving them the best outcome possible.”

Traditionally, cancer survival rates have been calculated retrospectively and categorized by only a few generic factors such as cancer site and tissue type. Despite familiarity with these rates, it can be challenging for oncologists to accurately predict an individual patient’s survival due to the many complex factors that influence patient outcomes.

The model developed by Dr. Nunez and his collaborators, which includes researchers from BC Cancer and UBC’s departments of computer science and psychiatry, is able to pick up on unique clues within a patient’s initial consultation document to provide a more nuanced assessment. It is also applicable to all cancers, whereas previous models have been limited to certain cancer types.

“The AI essentially reads the consultation document similar to how a human would read it,” said Dr. Nunez. “These documents have many details like the age of the patient, the type of cancer, underlying health conditions, past substance use, and family histories. The AI brings all of this together to paint a more complete picture of patient outcomes.”

The researchers trained and tested the model using data from 47,625 patients across all six BC Cancer sites located across British Columbia. To protect privacy, all patient data remained stored securely at BC Cancer and was presented anonymously. Unlike patient chart reviews by human research assistants, the new AI approach has the added benefit of maintaining complete confidentiality of patient records.

“Because the model is trained on B.C. data, that makes it a potentially powerful tool for predicting cancer survival here in the province,” said Dr. Nunez.

In the future, the technology could be applied in cancer clinics across Canada and around the world.

“Our hope is that a tool like this could be used to personalize and optimize the care a patient receives right away, giving them the best outcome possible.”– Dr. John-Jose Nunez.

“The great thing about neural NLP models is that they are highly scalable, portable and don’t require structured data sets,” said Dr. Nunez. “We can quickly train these models using local data to improve performance in a new region. I would suspect that these models provide a good foundation anywhere in the world where patients are able to see an oncologist.”

Dr. Nunez is a recipient of the 2022/23 UBC Institute of Mental Health Marshall Fellowship, and is also supported by funding from the BC Cancer Foundation. In another stream of work, Dr. Nunez is examining how to facilitate the best-possible psychiatric and counselling care for cancer patients using advanced AI techniques. He envisions a future where AI is integrated into many aspects of the health system to improve patient care.

“I see AI acting almost like a virtual assistant for physicians,” said Dr. Nunez. “As medicine gets more and more advanced, having AI to help sort through and make sense of all the data will help inform physician decisions. Ultimately, this will help improve quality of life and outcomes for patients.”

Reference: Nunez JJ, Leung B, Ho C, Bates AT, Ng RT. Predicting the survival of patients with cancer from their initial oncology consultation document using natural language processing. JAMA Network Open. 2023;6(2):e230813. doi: 10.1001/jamanetworkopen.2023.0813

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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