Thomas W Kelsey

University of St Andrews · School of Computer Science

Background There remains a considerable concern among both patients and oncologists that having a live birth (LB) after breast cancer might adversely impact survival. Methods analysis of survival in a national cohort of women with breast cancer diagnosed at age 20–39 years between 1981 and 2017 (n = 5181), and subsequent LB using Scottish Cancer R...

Purpose Accurate diagnosis and prediction of loss of ovarian function after chemotherapy for premenopausal women with early breast cancer (eBC) is important for future fertility and clinical decisions regarding the need for subsequent adjuvant ovarian suppression. We have investigated the value of anti-mullerian hormone (AMH) as serum biomarker for...

Radiation to the female pelvis as part of treatment for cancer predisposes young women to develop Premature Ovarian Insufficiency (POI). As the human female is born with their full complement of non-growing follicles which decline in an exponential fashion until the menopause, the age at which POI occurs is dependent on the age of the patient at tr...

Background From a healthcare professional's perspective, the use of ChatGPT (Open AI), a large language model (LLM), offers huge potential as a practical and economic digital assistant. However, ChatGPT has not yet been evaluated for the interpretation of polysomnographic results in patients with suspected obstructive sleep apnea (OSA). Aims/objec...

Hypertensive patients need regular checkups and constant monitoring for taking time critical decisions by the medical experts. Unfortunately, it is hard to maintain uninterrupted patient health surveillance due to limited medical staff resulting in an increasing mortality rate annually. Thanks to recent developments in wireless sensor networking, w...

PURPOSE Response assessment of classical Hodgkin lymphoma (cHL) with positron emission tomography-computerized tomography (PET-CT) is standard of care in well-resourced settings but unavailable in most African countries. We aimed to investigate correlations between changes in PET-CT findings at interim analysis with changes in blood test results in...

Background Survival from childhood and adolescent cancer has increased, but the chance of a livebirth in female survivors under 18 years at diagnosis may be reduced. Methods We performed a national population-based analysis, including all female cancer survivors diagnosed in Scotland before the age of 18 years between 1981 and 2012. Scottish Cance...

This paper focuses the multilingual sentiment analysis of short text using three popular, commercial decoder-only Large Language Models (“LLMs”), OpenAI’s ChatGPT, Anthropic’s Claude, and Google’s Gemini. The training data for some of these models is approximately 90% English, and it is an open question about whether it is better to evaluate text d...

Study question Can the growth of individual follicles during ovarian stimulation in medically assisted reproduction (MAR) cycles be modelled to enable prediction of final follicle profiles? Summary answer Mean follicle growth rate is 1.35 mm per day. Our model reliably forecasts follicle size profiles on the final scan within ±2mm with 75.1% accur...

Study question Which follicle sizes on trigger day (TD) are key to obtaining mature oocytes, embryos, and blastocysts, thereby enhancing live birth rates? Summary answer Follicles sized 13-18mm are most likely to yield mature oocytes. Live birth rate (LBR) was increased with a greater proportion of follicles in this range. What is known already A...

Background: The IDENTIFY study developed a model to predict urinary tract cancer using patient characteristics from a large multicentre, international cohort of patients referred with haematuria. In addition to calculating an individual's cancer risk, it proposes thresholds to stratify them into very-low-risk (<1%), low-risk (1-<5%), intermediate-r...

Background: Large Language Models (LLMs) might offer a solution for the lack of trained health personnel, particularly in low- and middle-income countries. However, their strengths and weaknesses remain unclear. Aims/objectives: Here we benchmark different LLMs (Bard 2023.07.13, Claude 2, ChatGPT 4) against six consultants in otorhinolaryngology...

In recent years, researchers have successfully recognised human activities using commercially available WiFi (Wireless Fidelity) devices. The channel state information (CSI) can be gathered at the access point with the help of a network interface controller (NIC card). These CSI streams are sensitive to human body motions and produce abrupt changes...

Infertility affects 1-in-6 couples, with repeated intensive cycles of assisted reproductive technology (ART) required by many to achieve a desired live birth. In ART, typically, clinicians and laboratory staff consider patient characteristics, previous treatment responses, and ongoing monitoring to determine treatment decisions. However, the reprod...

Objectives To determine the feasibility and acceptability of implementing the Mini-AFTERc intervention. Design Non-randomised cluster-controlled pilot trial. Setting Four NHS out-patient breast cancer centres in Scotland. Participants Ninety-two women who had successfully completed primary treatment for breast cancer were screened for moderate l...

Background Large language models (LLMs), such as ChatGPT (Open AI), are increasingly used in medicine and supplement standard search engines as information sources. This leads to more “consultations” of LLMs about personal medical symptoms. Objective This study aims to evaluate ChatGPT’s performance in answering clinical case–based questions in ot...

Background Historic South African 5‐year overall survival (OS) rates for Hodgkin lymphoma (HL) from 2000 to 2010 were 46% and 84% for human immunodeficiency virus (HIV)‐positive and HIV‐negative children, respectively. We investigated whether a harmonised treatment protocol using risk stratification and response‐adapted therapy could increase the O...

Study question Is the morphology of ovarian tissue from paediatric and adolescent girls similar to that from adults? Summary answer The presence of biovular follicles was more frequently observed in paediatric ovary than in the adult ovary. What is known already At birth there are approximately 1 million ovarian follicles that reduce to around 38...

Study question Which follicle sizes on the day of trigger (DoT) are most likely to yield oocytes after different IVF treatment protocols and trigger types? Summary answer Follicles sized 11-19mm on DoT are most likely to yield oocytes in both 'long' and 'short' protocols after using either hCG or GnRH agonist triggers. What is known already On th...

BACKGROUND Large language models (LLMs), such as ChatGPT (Open AI), are increasingly used in medicine and supplement standard search engines as information sources. This leads to more “consultations” of LLMs about personal medical symptoms. OBJECTIVE This study aims to evaluate ChatGPT’s performance in answering clinical case–based questions in ot...

The human ovarian reserve is defined by the number of non-growing follicles (NGFs) in the ovary, with the age-related decline in NGF population determining age at menopause for healthy women. In this chapter, the concept of ovarian reserve is explored in detail, with a sequence of models described that in principle allow any individual to be compar...

Study question: Do the Edinburgh Selection Criteria correctly identify female cancer patients under the age of 18 who are at risk of premature ovarian insufficiency (POI) as candidates for ovarian tissue cryopreservation (OTC)? Summary answer: Patient assessment using these criteria accurately identifies those at risk of POI, who can be offered...

Study question: How does in vitro culture alter the human ovarian cortical extracellular matrix (ECM) network structure? Summary answer: The ECM composition and architecture vary in the different layers of the ovarian cortex and are remodelled during in vitro culture. What is known already: The ovarian ECM is the scaffold within which follicle...

Study question Does subsequent live birth (LB) after breast cancer affect survival, and what are the factors that influence this? Summary answer Overall survival was increased in women who had a LB after breast cancer, including in those aged <30 at diagnosis and without a previous LB. What is known already As a hormone-sensitive cancer, there ha...

Further advances in the treatment of young people with cancer have led to improved survival, with 85.6% 5-year relative survival for ages 0–14 in the USA for the years 2010–2016 [18]. However, successful cancer treatment during childhood can cause infertility and premature ovarian insufficiency (POI) in some patients [20, 33]. The risk of developin...

Objective To assess family size and timescale for achieving pregnancy in women who remain fertile after cancer. Design Population-based analysis. Setting National databases. Patient(s) All women diagnosed with cancer before the age of 40 years in Scotland, 1981–2012 (n = 10,267) with no previous pregnancy; each was matched with 3 population cont...

Background: Lung cancer is one of the most common and aggressive forms of cancer, resulting in a low survival and high mortality rate. To improve cancer related outcomes, high-risk subpopulations should be identified to reduce overdiagnosis of lung cancer and aid in the implementation of interventions. Electronic Health Records (EHRs) have been eff...

Context Antenatal complications such as hypertensive disorders of pregnancy (HDP), fetal growth restriction (FGR), gestational diabetes (GDM), and preterm birth (PTB) are associated with placental dysfunction. Kisspeptin has emerged as a putative marker of placental function, but limited data exist describing circulating kisspeptin levels across al...

Study question Do the Edinburgh selection criteria correctly identify females, diagnosed with cancer under 18 years old, at high risk of future premature ovarian insufficiency (POI)? Summary answer Patient assessment using these criteria accurately identifies those at risk of POI. Ovarian tissue cryopreservation with future transplantation can be...

552 Background: It is now well established that AMH can indicate the extent of chemotherapy-induced damage on the ovarian reserve. Very low AMH levels in women after chemotherapy for early breast cancer (eBC) may indicate treatment-induced premature ovarian failure (POI), but the evidence to implement its routine clinical use remains limited. Metho...

BACKGROUND Electronic health records (EHRs) provide potential for more efficient patient recruitment into clinical studies. In recent years, machine learning techniques have gained increasing popularity in EHR-based research, with several studies reporting that machine learning methods can be used for disease diagnosis, outcome prediction, and trea...

Objective To compare the performance of kisspeptin and beta human chorionic gonadotropin (βhCG), both alone and in combination, as biomarkers for miscarriage throughout the first trimester. Design Prospective, nested case-control study. Setting Tertiary Centre, Queen Charlotte Hospital, London, United Kingdom. Patient(s) Adult women who had misc...

This new edition provides a much-needed reference book to accommodate emerging and expanding knowledge in fertility preservation, the rapidly growing field of reproductive medicine associated with advances in oncology. Written by a team of world-leading experts in the field and comprehensive in its scope, the book covers the full range of technique...

Talk given at the EUOS Conference 2021

Background Secondary oligo/amenorrhoea occurs in 3‐5% of women of reproductive age. The two most common causes are Polycystic Ovary Syndrome (PCOS) (2‐13%) and Functional Hypothalamic Amenorrhoea (FHA) (1‐2%). Whilst both conditions have distinct pathophysiology and their diagnosis is supported by guidelines, in practice, differentiating these two...

IntroductionTrials often struggle to achieve their target sample size with only half doing so. Some researchers have turned to Electronic Health Records (EHRs), seeking a more efficient way of recruitment. The Scottish Health Research Register (SHARE) obtained patients’ consent for their EHRs to be used as a searching base from which researchers ca...

TB is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. Decreasing the length of time for TB treatment is an important step towards the goal of reducing mortality. Mechanistic in silico modelling can provide us with the tools to explore gaps in our knowledge, with the opportunity to model the...

Objective The maturation of oocytes to acquire competence for fertilization is critical to the success of in vitro fertilization (IVF) treatment. It requires LH-like exposure, provided by either human chorionic gonadotropin (hCG), or gonadotropin releasing hormone agonist (GnRHa). More recently, the hypothalamic stimulator, kisspeptin, was used to...

Harnessing the power of data: Applications of data science in reproductive medicine

Final maturation of follicles has, in connection with ovarian stimulation and infertility treatment, traditionally been achieved by the administration of a human chorionic gonadotropin (hCG) bolus trigger of 5,000 to 10,000 IU. This trigger serves two purposes: induce oocyte maturation; and serve as luteal phase support owing to its long half-life....

Objective: Graves' disease is the commonest cause of hyperthyroidism in populations with sufficient dietary iodine intake. Anti-thyroid drugs (ATD) are often used as the initial treatment for Graves' hyperthyroidism, however there is a paucity of data relating the dose of ATD therapy to the effect on thyroid hormone levels, increasing the risk of b...

Background: Placentation (invasion of the placenta into the maternal endometrium) is hypothesised to be critical for healthy placental function and is abnormal in two thirds of miscarriage. Kisspeptin has emerged as a putative regulator of physiological placentation; it is highly expressed in placental syncitio-trophoblasts, whereas its receptor is...

Background: Fear of cancer recurrence (FCR) is common in people affected by breast cancer. FCR is associated with increased health service and medication use, anxiety, depression and reduced quality of life. Existing interventions for FCR are time and resource intensive, making implementation in a National Health Service (NHS) setting challenging....

Background: Trials often struggle to achieve their target sample size with only half doing so. Some researchers have turned to Electronic Health Records (EHRs), seeking a more efficient way of recruitment. The Scottish Health Research Register (SHARE) obtained patients' consent for their EHRs to be used as a searching base from which researchers c...

Background: Trials often struggle to achieve their target sample size with only half doing so. Some researchers have turned to Electronic Health Records (EHRs), seeking a more efficient way of recruitment. The Scottish Health Research Register (SHARE) obtained patients’ consent for their EHRs to be used as a searching base from which researchers ca...

Background: Trials often struggle to achieve their target sample size with only half doing so. Some researchers have turned to Electronic Health Records (EHRs), seeking a more efficient way of recruitment. The Scottish Health Research Register (SHARE) obtained patients’ consent for their EHRs to be used as a searching base from which researchers ca...

Background: Trials often struggle to achieve their target sample size with only half doing so. Some researchers have turned to Electronic Health Records (EHRs), seeking a more efficient way of recruitment. The Scottish Health Research Register (SHARE) obtained patients’ consent for their EHRs to be used as a searching base from which researchers ca...

Clinical Insights from Mathematical Modelling of Biological Systems

Introduction: Polycystic ovarian syndrome (PCOS) is a leading cause of female subfertility worldwide, however due to the heterogeneity of the disorder, the criteria for diagnosis remains subject to conjecture. In the present study, we evaluate the utility of serum Anti-Müllerian hormone (AMH) in the diagnosis of menstrual disturbance due to PCOS. M...

Introduction: Ovarian follicle growth is a key step in the success of assisted reproductive treatment, but limited data exists to directly relate follicle growth to recombinant FSH (rFSH) dose. In this study, we aim to evaluate FSH requirements for follicular growth during controlled ovarian stimulation. Method: Single center retrospective cohort s...

APOC 2019 presentation

Background: Observational studies have suggested that perinatal outcomes are worse in offspring of cancer survivors. We conducted a systematic review and meta-analysis to examine the risks of perinatal complications in female cancer survivors diagnosed before the age of 40 years. Methods: All published articles on pregnancy, perinatal or congeni...

Setting University hospital. Patient(s) Fifteen girls and young women with TS aged 5–22 years at OTC were included, together with 42 control girls and young women aged 1–25 years who underwent OTC because of cancer. Intervention(s) None. Main Outcome Measure(s) Follicle density (follicles/mm3), morphology, and health were assessed in ovarian cor...

Background Many patients who have been treated for breast cancer experience high levels of fear that the cancer will return. The FORECAST pilot study showed that for a third of the patients, fears of cancer recurrence (FCR) increase during radiotherapy treatment and that conversations with their therapeutic radiographer at the weekly review meeting...

Preconceptions, assumptions and the role of the domain expert from the viewpoint of the Health Data Scientist

PurposeThe aim was to describe the first experience with fertility preservation by cryopreservation of ovarian tissue (OTC) in pre-pubertal girls with galactosemia and further to characterize ovarian follicular morphology and expression of proteins important for ovarian function. Methods Retrospectively, follicle density was estimated in ovarian co...

Study question: What is the impact of cancer in females aged ≤39 years on subsequent chance of pregnancy? Summary answer: Cancer survivors achieved fewer pregnancies across all cancer types, and the chance of achieving a first pregnancy was also lower. What is known already: The diagnosis and treatment of cancer in young females may be associa...

The cover image, by A. Abbara et al., is based on the Original Article Clinical parameters of ovarian hyperstimulation syndrome following different hormonal triggers of oocyte maturation in IVF treatment, DOI: 10.1111/cen.13569.

Objective To identify follicle sizes on the day of trigger most likely to yield a mature oocyte following hCG, GnRH agonist (GnRHa), or kisspeptin during IVF treatment. Design Retrospective analysis to determine the size of follicles on day of trigger contributing most to the number of mature oocytes retrieved using generalized linear regression a...