1.Next-Generation Patient-Based Real-Time Quality Control Models
Xincen DUAN ; Minglong ZHANG ; Yan LIU ; Wenbo ZHENG ; Chun Yee LIM ; Sollip KIM ; Tze Ping LOH ; Wei GUO ; Rui ZHOU ; Tony BADRICK ;
Annals of Laboratory Medicine 2024;44(5):385-391
Patient-based real-time QC (PBRTQC) uses patient-derived data to assess assay performance. PBRTQC algorithms have advanced in parallel with developments in computer science and the increased availability of more powerful computers. The uptake of Artificial Intelligence in PBRTQC has been rapid, with many stated advantages over conventional approaches. However, until this review, there has been no critical comparison of these. The PBRTQC algorithms based on moving averages, regression-adjusted real-time QC, neural networks and anomaly detection are described and contrasted. As Artificial Intelligence tools become more available to laboratories, user-friendly and computationally efficient, the major disadvantages, such as complexity and the need for high computing resources, are reduced and become attractive to implement in PBRTQC applications.
2.Next-Generation Patient-Based Real-Time Quality Control Models
Xincen DUAN ; Minglong ZHANG ; Yan LIU ; Wenbo ZHENG ; Chun Yee LIM ; Sollip KIM ; Tze Ping LOH ; Wei GUO ; Rui ZHOU ; Tony BADRICK ;
Annals of Laboratory Medicine 2024;44(5):385-391
Patient-based real-time QC (PBRTQC) uses patient-derived data to assess assay performance. PBRTQC algorithms have advanced in parallel with developments in computer science and the increased availability of more powerful computers. The uptake of Artificial Intelligence in PBRTQC has been rapid, with many stated advantages over conventional approaches. However, until this review, there has been no critical comparison of these. The PBRTQC algorithms based on moving averages, regression-adjusted real-time QC, neural networks and anomaly detection are described and contrasted. As Artificial Intelligence tools become more available to laboratories, user-friendly and computationally efficient, the major disadvantages, such as complexity and the need for high computing resources, are reduced and become attractive to implement in PBRTQC applications.
3.Next-Generation Patient-Based Real-Time Quality Control Models
Xincen DUAN ; Minglong ZHANG ; Yan LIU ; Wenbo ZHENG ; Chun Yee LIM ; Sollip KIM ; Tze Ping LOH ; Wei GUO ; Rui ZHOU ; Tony BADRICK ;
Annals of Laboratory Medicine 2024;44(5):385-391
Patient-based real-time QC (PBRTQC) uses patient-derived data to assess assay performance. PBRTQC algorithms have advanced in parallel with developments in computer science and the increased availability of more powerful computers. The uptake of Artificial Intelligence in PBRTQC has been rapid, with many stated advantages over conventional approaches. However, until this review, there has been no critical comparison of these. The PBRTQC algorithms based on moving averages, regression-adjusted real-time QC, neural networks and anomaly detection are described and contrasted. As Artificial Intelligence tools become more available to laboratories, user-friendly and computationally efficient, the major disadvantages, such as complexity and the need for high computing resources, are reduced and become attractive to implement in PBRTQC applications.
4.Next-Generation Patient-Based Real-Time Quality Control Models
Xincen DUAN ; Minglong ZHANG ; Yan LIU ; Wenbo ZHENG ; Chun Yee LIM ; Sollip KIM ; Tze Ping LOH ; Wei GUO ; Rui ZHOU ; Tony BADRICK ;
Annals of Laboratory Medicine 2024;44(5):385-391
Patient-based real-time QC (PBRTQC) uses patient-derived data to assess assay performance. PBRTQC algorithms have advanced in parallel with developments in computer science and the increased availability of more powerful computers. The uptake of Artificial Intelligence in PBRTQC has been rapid, with many stated advantages over conventional approaches. However, until this review, there has been no critical comparison of these. The PBRTQC algorithms based on moving averages, regression-adjusted real-time QC, neural networks and anomaly detection are described and contrasted. As Artificial Intelligence tools become more available to laboratories, user-friendly and computationally efficient, the major disadvantages, such as complexity and the need for high computing resources, are reduced and become attractive to implement in PBRTQC applications.
5.Health-Related Quality of Life Assessment in Prostate Cancer Patient Undergoing Androgen Deprivation Therapy: Real-World Experience in the READT Study
Jasmine LIM ; Chi-Fai NG ; Yong WEI ; Teng Aik ONG ; Peggy Sau-Kwan CHU ; Wayne Kwun Wai CHAN ; Chao Yuan HUANG ; Kuo-Kang FENG ; Jeremy Yuen-Chun TEOH ; Ning XU ; Jer Wei LOW ; Wei Sien YEOH ; Peter Ka-Fung CHIU ; Chi-Hang YEE ; Steven Chi Ho LEUNG
The World Journal of Men's Health 2024;42(2):449-459
Purpose:
To investigate the effect of androgen deprivation therapy (ADT) on health-related quality of life (HRQOL) in Asian men with all stages of prostate cancer.
Materials and Methods:
READT (real-life evaluation of the effect of ADT in prostate cancer patients in Asia) was a multi-center, prospective observational study involving six sites across four Asian populations. We enrolled eligible prostate cancer patients, who opted for ADT alone or in combination without prior neoadjuvant or adjuvant ADT within 12 months. The EuroQoL-5 dimensions, 5 level scale (EQ-5D-5L) utility index scores and visual analog scale (VAS) were evaluated at baseline, month 6 and month 12.
Results:
A total of 504 patients were recruited into READT between September 2016 and May 2020 with 52.9% diagnosed with metastatic prostate cancer. The EQ-5D-5L was evaluable in 442/504 (87.7%) of patients. Overall baseline EQ-5D-5L utility index score was 0.924 (interquartile range [IQR] 0.876–1.000). We observed a statistically significant difference in baseline EQ-5D-5L utility index score among different populations with a median EQ-5D-5L utility index score of 1 for Taiwan & Hong Kong, 0.897 for China and 0.838 for Malaysia. Similar trend was observed throughout multiple treatment time-points. Stage IV prostate cancer were significantly associated with a lower baseline EQ-5D-5L utility index score compared to stage I–III prostate cancer, producing a median disutility value of -0.080. Participants had a high median VAS (80, IQR 70–90), indicating good overall health on average during ADT initiation.
Conclusions
The study highlights the differences in health state utility index scores among various Asian prostate cancer patients receiving ADT at real-world setting. Our findings will be informative and useful in cost-effectiveness evaluation and policy decision making.
6.Calibration Practices in Clinical Mass Spectrometry: Review and Recommendations
Wan Ling CHENG ; Corey MARKUS ; Chun Yee LIM ; Rui Zhen TAN ; Sunil Kumar SETHI ; Tze Ping LOH ;
Annals of Laboratory Medicine 2023;43(1):5-18
Background:
Calibration is a critical component for the reliability, accuracy, and precision of mass spectrometry measurements. Optimal practice in the construction, evaluation, and implementation of a new calibration curve is often underappreciated. This systematic review examined how calibration practices are applied to liquid chromatography-tandem mass spectrometry measurement procedures.
Methods:
The electronic database PubMed was searched from the date of database inception to April 1, 2022. The search terms used were “calibration,” “mass spectrometry,” and “regression.” Twenty-one articles were identified and included in this review, following evaluation of the titles, abstracts, full text, and reference lists of the search results.
Results:
The use of matrix-matched calibrators and stable isotope-labeled internal standards helps to mitigate the impact of matrix effects. A higher number of calibration standards or replicate measurements improves the mapping of the detector response and hence the accuracy and precision of the regression model. Constructing a calibration curve with each analytical batch recharacterizes the instrument detector but does not reduce the actual variability. The analytical response and measurand concentrations should be considered when constructing a calibration curve, along with subsequent use of quality controls to confirm assay performance. It is important to assess the linearity of the calibration curve by using actual experimental data and appropriate statistics. The heteroscedasticity of the calibration data should be investigated, and appropriate weighting should be applied during regression modeling.
Conclusions
This review provides an outline and guidance for optimal calibration practices in clinical mass spectrometry laboratories.
7.Functional Reference Limits: Describing Physiological Relationships and Determination of Physiological Limits for Enhanced Interpretation of Laboratory Results
Tyng Yu CHUAH ; Chun Yee LIM ; Rui Zhen TAN ; Busadee PRATUMVINIT ; Tze Ping LOH ; Samuel VASIKARAN ; Corey MARKUS ;
Annals of Laboratory Medicine 2023;43(5):408-417
Functional reference limits describe key changes in the physiological relationship between a pair of physiologically related components. Statistically, this can be represented by a significant change in the curvature of a mathematical function or curve (e.g., an observed plateau). The point at which the statistical relationship changes significantly is the point of curvature inflection and can be mathematically modeled from the relationship between the interrelated biomarkers. Conceptually, they reside between reference intervals, which describe the statistical boundaries of a single biomarker within the reference population, and clinical decision limits that are often linked to the risk of morbidity or mortality and set as thresholds. Functional reference limits provide important physiological and pathophysiological insights that can aid laboratory result interpretation. Laboratory professionals are in a unique position to harness data from laboratory information systems to derive clinically relevant values. Increasing research on and reporting of functional reference limits in the literature will enhance their contribution to laboratory medicine and widen the evidence base used in clinical decision limits, which are currently almost exclusively contributed to by clinical trials. Their inclusion in laboratory reports will enhance the intellectual value of laboratory professionals in clinical care beyond the statistical boundaries of a healthy reference population and pave the way to them being considered in shaping clinical decision limits. This review provides an overview of the concepts related to functional reference limits, clinical examples of their use, and the impetus to include them in laboratory reports.
8.EPOSTER • DRUG DISCOVERY AND DEVELOPMENT
Marwan Ibrahim ; Olivier D LaFlamme ; Turgay Akay ; Julia Barczuk ; Wioletta Rozpedek-Kaminska ; Grzegorz Galita ; Natalia Siwecka ; Ireneusz Majsterek ; Sharmni Vishnu K. ; Thin Thin Wi ; Saint Nway Aye ; Arun Kumar ; Grace Devadason ; Fatin Aqilah Binti Ishak ; Goh Jia Shen ; Dhaniya A/P Subramaniam ; Hiew Ke Wei ; Hong Yan Ren ; Sivalingam Nalliah ; Nikitha Lalindri Mareena Senaratne ; Chong Chun Wie ; Divya Gopinath ; Pang Yi Xuan ; Mohamed Ismath Fathima Fahumida ; Muhammad Imran Bin Al Nazir Hussain ; Nethmi Thathsarani Jayathilake ; Sujata Khobragade ; Htoo Htoo Kyaw Soe ; Soe Moe ; Mila Nu Nu Htay ; Rosamund Koo ; Tan Wai Yee ; Wong Zi Qin ; Lau Kai Yee ; Ali Haider Mohammed ; Ali Blebil ; Juman Dujaili ; Alicia Yu Tian Tan ; Cheryl Yan Yen Ng ; Ching Xin Ni ; Michelle Ng Yeen Tan ; Kokila A/P Thiagarajah ; Justin Jing Cherg Chong ; Yong Khai Pang ; Pei Wern Hue ; Raksaini Sivasubramaniam ; Fathimath Hadhima ; Jun Jean Ong ; Matthew Joseph Manavalan ; Reyna Rehan ; Tularama Naidu ; Hansi Amarasinghe ; Minosh Kumar ; Sdney Jia Eer Tew ; Yee Sin Chong ; Yi Ting Sim ; Qi Xuan Ng ; Wei Jin Wong ; Shaun Wen Huey Lee ; Ronald Fook Seng Lee ; Wei Ni Tay ; Yi Tan ; Wai Yew Yang ; Shu Hwa Ong ; Yee Siew Lim ; Siddique Abu Nowajish ; Zobaidul Amin ; Umajeyam Anbarasan ; Lim Kean Ghee ; John Pinto ; Quek Jia Hui ; Ching Xiu Wei ; Dominic Lim Tao Ran ; Philip George ; Chandramani Thuraisingham ; Tan Kok Joon ; Wong Zhi Hang ; Freya Tang Sin Wei ; Ho Ket Li ; Shu Shuen Yee ; Goon Month Lim ; Wen Tien Tan ; Sin Wei Tang
International e-Journal of Science, Medicine and Education 2022;16(Suppl1):21-37
9.Prevalence and factors associated with sexual dysfunction among middle-aged women in a multi-ethnic country: A cross sectional study in Malaysia
Yin Yee Tey ; Siew Mooi Ching ; Mari Kannan Maharajan ; Kai Wei Lee ; Zhen Yee Chow ; Pei Wen Chua ; Chin Xuan Tan ; Shi Nie Lim ; Chun Han Tan ; Hui Zhu Thew ; Vasudevan Ramachandran ; Fan Kee Hoo
Malaysian Family Physician 2022;17(2):56-63
Introduction:
This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia.
Methods:
The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis.
Results:
A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents’ ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (OR=16.60, 95% CI=2.54–108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (OR=0.13, 95% CI=0.08–0.24).
Conclusion
Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.
Prevalence
;
Sexual Dysfunction, Physiological
;
Women
;
Ambulatory Care Facilities
;
Middle Aged
10.High intensity non-invasive positive pressure ventilation for refractory decompensated acute hypercapnic respiratory failure in advanced chronic obstructive pulmonary disease
Kuan Yee Lim ; Rathika Rajah ; Boon Hau Ng ; Chun Ian Soo
The Medical Journal of Malaysia 2020;75(4):430-432
Chronic obstructive pulmonary disease (COPD) is a
debilitating progressive lung disease characterised by
irreversible airflow obstruction. In addition to an increase in
morbidity and mortality, exacerbation also results in frequent
hospital visits, which place a burden on healthcare systems.
Non-invasive positive pressure ventilation (NPPV) with
conventional inspiratory pressures is the standard ventilatory
support for patients in exacerbation. At present, the use of
higher inspiratory pressures through high intensity noninvasive positive pressure ventilation (Hi-NPPV) during an
exacerbation remains unknown. We describe a novel
application of Hi-NPPV in a patient with acute exacerbation
who was refractory to conventional NPPV.


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