Tony Hsiu-Hsi Chen

National Taiwan University, T’ai-pei, Taipei, Taiwan

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Publications (136)448.48 Total impact

  • Shih-Pin Lin · Kuang-Yi Chang · Mei-Yung Tsou · Tony Hsiu-Hsi Chen
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    ABSTRACT: Objectives: To elucidate the dynamics of analgesic consumption regarding intravenous patient controlled analgesia (IVPCA) during postoperative period is rather complex partly due to between-patient variation and partly due to within-patient variation. A statistical method was proposed to classify serial analgesic consumption into different classifications that were further taken as the multiple outcomes on which we were based to explore the associated predictors. Methods: We retrospectively included 3284 patients administrated by IVPCA for three days after surgery. A repeated measurement design corresponding to serial analgesic consumption variables defined as six-hour total analgesic consumptions was adopted. After determining the numbers of clusters, serial analgesic consumptions were classified into several homogeneous subgroups. Factors associated with new classifications were identified and quantified with a multinominal logistic regression model. Results: Three distinct analgesic classifications were aggregated, including "high", "middle" and "low" level of analgesic consumption of IVPCA. The mean analgesic consumptions on twelve successive analgesic consumptions at six-hour interval of each classification consistently revealed a decreasing trend. As the trends were almost parallel with time, this suggests the time-invariant proportionality of analgesic consumption between the levels of analgesic consumption of IVPCA. Patient's characteristics, like age, gender, weight, height, and cancer status, were significant factors associated with analgesic classifications. Surgical sites had great impacts on analgesic classifications. Discussion: The serial analgesic consumptions were simplified into three analgesic consumptions classifications. The identified predictors are useful to recognize patient's analgesic classifications before using IVPCA. This study explored a new approach to analysing dynamic changes of postoperative analgesic consumptions.
    No preview · Article · Dec 2015 · Clinical Journal of Pain
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    ABSTRACT: Stomach cancer is one of leading causes of death worldwide. In Thailand, the incidence and mortality of stomach cancer are in the top ten for cancers. Effects of DNA repair gene X-ray repair cross complementary protein 1 (XRCC1) polymorphisms and clinicopathological characteristics on survival of stomach cancer in Thailand have not been previously reported. The aim of this study was to investigate the effects of XRCC1 gene and clinicopathological characteristics on survival of stomach cancer patients in Thailand. Data and blood samples were collected from 101 newly diagnosed stomach cancer cases pathologically confirmed and recruited during 2002 to 2006 and followed-up for vital status until 31 October 2012. Genotype analysis was performed using real-time PCR-HRM. The data were analyzed using the Kaplan-Meier method to yield cumulative survival curve, log-rank test to assess statistical difference of survival and Cox proportional hazard models to estimate adjusted hazard ratio. The total followed-up times were 2,070 person-months, and the mortality rate was 4.3 per 100 person-months. The median survival time after diagnosis was 8.07 months. The cumulative 1-, 3-, 5-years survival rates were 40.4%, 15.2 % and 10.1 % respectively. After adjustment, tumour stage were associated with an increased risk of death (p= 0.036). The XRCC1 Gln339Arg, Arg/Arg homozygote was also associated with increased risk but statistically this was non-significant. In addition to tumour stage, which is an important prognostic factor affecting to the survival of stomach cancer patients, the genetic variant Gln339Arg in XRCC1 may non-significantly contribute to risk of stomach cancer death among Thai people. Larger studies with different populations are need to verify ours findings.
    Full-text · Article · Aug 2015 · Asian Pacific journal of cancer prevention: APJCP
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    ABSTRACT: This chapter provides a comprehensive review of the conflicting theories concerning better control of breast cancer. The evidence from randomized controlled trials and service screening, based upon individualized patient data, overwhelmingly confirms that detection and treatment of breast cancer at an earlier phase have accomplished a significantly reduced mortality from the disease. The revolution in breast imaging and its impact upon breast cancer management, despite the unquestionable benefits, have incited a debate over the perceived benefits and risks of current practice. The pros and cons of this ongoing debate are carefully analyzed in this chapter. As breast cancer is detected at an ever-earlier phase, the complexity of the disease challenges the current terminology and necessitates the diagnostic and therapeutic team members to reevaluate the standards of care, which have been based upon palpable, advanced breast cancer. Better correlation of imaging with histopathology necessitates large-section histopathology technique to provide a more reliable determination of surgical margins, tumor extent, and especially demonstration of the multifocal and diffusely infiltrating forms of breast cancer. Adding the mammographic tumor features to the current histologic prognostic features improves the prediction of long-term patient outcome and facilitates treatment planning.
    No preview · Chapter · Jan 2014
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    Full-text · Article · Nov 2013
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    ABSTRACT: Background: The prognostic significance of molecular phenotype in breast cancer is well established in the literature. Recent studies have demonstrated that subgross lesion distribution (unifocal, multifocal, and diffuse) and disease extent also carry prognostic significance in this disease. However, the correlation of molecular phenotypes with subgross parameters has not yet been investigated in detail. Methods: In total, 444 consecutive invasive breast cancers that were documented in large-format histology slides and worked up with detailed radiologic-pathologic correlation were sampled into tissue microarray blocks and stained immunohistochemically to delineate the molecular subtypes. Results: Diffuse or multifocal distribution of the invasive component of breast carcinomas in this series was associated with a 4.14-fold respectively 2.75-fold risk of cancer-related death compared with unifocal tumors irrespective of molecular phenotype. Patients who had human epidermal growth factor receptor 2 (HER2)-positive cancers; estrogen receptor-negative, progesterone receptor-negative, and HER2-negative (triple-negative) cancers; or basal-like cancers had a 2.18-fold, 2.33-fold, and 4.07-fold risk of dying of disease, respectively, compared with patients who had luminal A carcinomas. Unifocal luminal A, HER2-positive, and basal-like cancers were associated with significantly better long-term survival outcomes than their multifocal or diffuse counterparts; luminal B and triple-negative tumors also had the same tendency. In multivariate analysis, patient age, tumor size category, lymph node status, lesion distribution, and molecular phenotypes remained significant. Conclusions: Multifocality and diffuse distribution of the invasive component were associated with significantly poorer survival in women with breast carcinomas compared with unifocal disease in patients with luminal A, HER2 type, and basal-like cancers. Molecular classification of breast cancer is a powerful tool but gains in power when combined with conventional and subgross morphologic parameters.
    No preview · Article · Dec 2012 · Cancer
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    ABSTRACT: This study estimated the excess incidence (overdiagnosis) of breast cancer associated with starting mammographic screening at an earlier age, by using data from the Dalarna County component of the Swedish Two-County Trial of breast cancer screening. In Dalarna County, Sweden, 38,589 women aged 40 to 74 years were randomized to invitation to regular mammographic screening (active study population [ASP]) and 18,582 women to usual care (passive study population [PSP]). After 3 screening rounds (6-8 years after randomization), the PSP was invited to screening. The cumulative incidence of breast cancer was calculated in the ASP and PSP from randomization to 29 years later. In addition, cumulative incidence was calculated for invasive cancers, advanced invasive cancers (≥2 cm in maximum diameter or node-positive), and nonadvanced cancers (<2 cm and node negative). There was no excess of cancers in the ASP at 29 year follow-up (relative risk, 1.00; 95% confidence interval, 0.92-1.08). Cumulative incidence in the 2 arms approximately equalized at the conclusion of the first round of screening of the PSP. There was an excess of nonadvanced cancers and a deficit of advanced cancers in the ASP, both of which persisted to 29 years. There was no additional breast cancer incidence associated with 100,000 additional screens in the ASP. Results suggest that overdiagnosis is small and largely confined to the prevalence screen. Cancer 2012.
    No preview · Article · Dec 2012 · Cancer
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    ABSTRACT: To evaluate the reliability, validity, and predicted probabilities of a Chinese version of the Dysfunctional Voiding Symptom Score (DVSS) and to explore the latent factors underlying dysfunctional voiding. We enrolled 60 children (38 girls and 22 boys) with a diagnosis of dysfunctional voiding. The Chinese version of the DVSS was completed at the clinics and again 1 week later. We enrolled 235 age- and gender-matched healthy children as the control group. The DVSS consisted of 10 items with each item scores 0-3. The internal consistency and test-retest reliability was assessed with Chronbach's alpha test and intraclass correlation (ICC), respectively. The predictive validity was analyzed using logistic regression and receiver operating characteristic curve analysis. Factor analysis was used to classify symptoms into latent factors. The Bayesian method was used to adjust the predicted probabilities of the DVSS. Mean total scores of the DVSS in the cases and controls were 9.65 ± 3.87 and 4.13 ± 2.60, respectively. The alpha coefficient was 0.448, showing a heterogeneous composition of symptoms. Test-retest reliability was 0.89. The chosen cut-off point for the total score of DVSS was 6.66, with a sensitivity of 81.67%, and specificity of 82.63%. Factor analysis revealed three latent variables. Using the Bayesian method, the application of the DVSS in areas with different prevalence figures produced significantly different probabilities of dysfunctional voiding. The Chinese version of the DVSS is reliable with validity. With the same total score, we found significantly different predicted probabilities of dysfunctional voiding. Neurourol. Urodynam. 31:1247-1251, 2012. © 2012 Wiley Periodicals, Inc.
    No preview · Article · Nov 2012 · Neurourology and Urodynamics
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    ABSTRACT: Objective: To evaluate the benefit of mass eradication of Helicobacter pylori infection in reducing premalignant gastric lesions. Design: Mass eradication of H pylori infection was started from 2004 for a Taiwanese population with prevalent H pylori infection, who were >30 years of age. Participants positive for the (13)C-urea breath test underwent endoscopic screening and 1-week clarithromycin-based triple therapy. For subjects whose initial treatment failed, 10-day levofloxacin-based triple therapy was administered. The main outcome measures were changes in the prevalence of H pylori infection and premalignant gastric lesions, and changes in the incidence of premalignant gastric lesions and gastric cancer before (1995-2003) and after (2004-2008) chemoprevention using various comparators. Results: The reduction in H pylori infection was 78.7% (95% CI 76.8% to 80.7%), and the estimated incidence of re-infection/recrudescence was 1% (95% CI 0.6% to 1.4%) per person-year. The effectiveness of reducing the incidence of gastric atrophy resulting from chemoprevention was significant at 77.2% (95% CI 72.3% to 81.2%), while the reduction in intestinal metaplasia was not significant. Compared with the 5-year period before chemoprevention and in the absence of endoscopic screening, the effectiveness in reducing gastric cancer incidence during the chemoprevention period was 25% (rate ratio 0.753, 95% CI 0.372 to 1.524). The reduction in peptic ulcer disease was 67.4% (95% CI 52.2% to 77.8%), while the incidence of oesophagitis was 6% (95% CI 5.1% to 6.9%) after treatment. Conclusions: Population-based eradication of H pylori infection has led to a significant reduction in gastric atrophy at the expense of increased oesophagitis. The ultimate benefit in reducing gastric cancer incidence and its mortality should be validated by a further long-term follow-up.
    Full-text · Article · Jun 2012 · Gut

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  • No preview · Article · May 2012
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    Preview · Article · Jan 2012
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    ABSTRACT: To estimate the long-term (29-year) effect of mammographic screening on breast cancer mortality in terms of both relative and absolute effects. This study was carried out under the auspices of the Swedish National Board of Health and Welfare. The board determined that, because randomization was at a community level and was to invitation to screening, informed verbal consent could be given by the participants when they attended the screening examination. A total of 133 065 women aged 40-74 years residing in two Swedish counties were randomized into a group invited to mammographic screening and a control group receiving usual care. Case status and cause of death were determined by the local trial end point committees and, independently, by an external committee. Mortality analysis was performed by using negative binomial regression. There was a highly significant reduction in breast cancer mortality in women invited to screening according to both local end point committee data (relative risk [RR] = 0.69; 95% confidence interval: 0.56, 0.84; P < .0001) and consensus data (RR = 0.73; 95% confidence interval: 0.59, 0.89; P = .002). At 29 years of follow-up, the number of women needed to undergo screening for 7 years to prevent one breast cancer death was 414 according to local data and 519 according to consensus data. Most prevented breast cancer deaths would have occurred (in the absence of screening) after the first 10 years of follow-up. Invitation to mammographic screening results in a highly significant decrease in breast cancer-specific mortality. Evaluation of the full impact of screening, in particular estimates of absolute benefit and number needed to screen, requires follow-up times exceeding 20 years because the observed number of breast cancer deaths prevented increases with increasing time of follow-up.
    Full-text · Article · Jun 2011 · Radiology
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    ABSTRACT: Useful predictive models for identifying patients at high risk of bacteremia at the emergency department (ED) are lacking. This study attempted to provide useful predictive models for identifying patients at high risk of bacteremia at the ED. A prospective cohort study was conducted at the ED of a tertiary care hospital from October 1 to November 30, 2004. Patients aged 15 years or older, who had at least two sets of blood culture, were recruited. Data were analyzed on selected covariates, including demographic characteristics, predisposing conditions, clinical presentations, laboratory tests, and presumptive diagnosis, at the ED. An iterative procedure was used to build up a logistic model, which was then simplified into a coefficient-based scoring system. A total of 558 patients with 84 episodes of true bacteremia were enrolled. Predictors of bacteremia and their assigned scores were as follows: fever greater than or equal to 38.3°C [odds ratio (OR), 2.64], 1 point; tachycardia greater than or equal to 120/min (OR, 2.521), 1 point; lymphopenia less than 0.5×10(3)/μL (OR, 3.356), 2 points; aspartate transaminase greater than 40IU/L (OR, 2.355), 1 point; C-reactive protein greater than 10mg/dL (OR, 2.226), 1 point; procalcitonin greater than 0.5 ng/mL (OR, 3.147), 2 points; and presumptive diagnosis of respiratory tract infection (OR, 0.236), -2 points. The area under the receiver operating characteristic curves of the original logistic model and the simplified scoring model using the aforementioned seven predictors and their assigned scores were 0.854 (95% confidence interval, 0.806-0.902) and 0.845 (95% confidence interval, 0.798-0.894), respectively. This simplified scoring system could rapidly identify high-risk patients of bacteremia at the ED.
    No preview · Article · Jun 2011 · Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi
  • Shu-Mei Hsu · Tony Hsiu-Hsi Chen · Ching-Ho Wang
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    ABSTRACT: Vaccination is an effective method for controlling avian influenza (AI), especially in countries with endemic infection. This study conducted a Bayesian meta-analysis to evaluate the efficacy of AI vaccines in chickens. We included both inactivated and recombinant fowlpox virus expressing H5 (rFPV-H5) vaccine studies that used specific-pathogen-free chickens where outcomes against the H5N1 or H5N2 AI viruses were measured. Vaccine efficacy was evaluated by protection from mortality, protection from morbidity, reductions in virus isolation from the respiratory tract, and reductions in virus isolation from the cloaca. The efficacies for homologous inactivated vaccines by those four outcomes were 92% (95% confidence interval 90%-95%), 94% (91%-96%), 54% (50%-58%), and 88% (84%-91%), respectively. Corresponding figures for heterologous inactivated vaccines were 68% (63%-73%), 78% (74%-81%), 24% (16%-31%), and 71% (64%-77%); and efficacies for rFPV-H5 vaccine were 97% (94%-99%), 93% (90%-94%), 21% (14%-27%), and 78% (72%-84%), respectively. Although those vaccines protect chickens from morbidity and mortality, virus shedding would be an important biosecurity issue for further AI endemic control.
    No preview · Article · Dec 2010 · Avian Diseases
  • Shou-Jen Kuo · Tony Hsiu-Hsi Chen · Amy Ming-Fang Yen · Dar-Ren Chen · Li-Sheng Chen
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    ABSTRACT: This study is to identify an optimal cut-off for two-stage breast cancer screening making allowance for variation of the baseline incidence rate and utility values between sensitivity and specificity. We used data from a two-stage breast cancer screening of Taiwanese women aged 50-69 years for whom risk stratification was based on a composite risk score (conventional risk factors); subjects with a risk score greater than the cut-off score were screened using mammography. The Bayesian posterior risk for breast cancer was computed by incorporation of the baseline incidence rate and the risk score. Bayes' maximum utility decision rule was then developed to determine the optimal screening cut-off. With a risk score of -9 applied to the current two-stage breast cancer screening programme, we could detect one breast cancer case for every 1406 women. Given different predetermined risks, the selected cut-offs were -9 for 1:1200, -8 for 1:800, -4 for 1:600, -1 for 1:400 and 3 for 1:200 for women aged 50-59 years. When the regret utility ratio of positive predictive value to negative predictive value was set at 1:10, the specificity and sensitivity were 58.5% and 70.4%, respectively, and the optimal cut-off was -5.5. When the ratio was set at 10:1, the sensitivity and specificity were 75.5% and 57.1%, respectively, and the optimal cut-off value was -7.5. This study demonstrates that Bayes' maximum utility decision rule can be used to determine optimal cut-off values for two-stage breast cancer screening in countries or areas with lower or intermediate incidence of breast cancer.
    No preview · Article · Dec 2010 · Journal of Evaluation in Clinical Practice
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    ABSTRACT: Community-associated methicillin-resistant Staphylococcus aureus (MRSA) has become an important pathogen in community and nosocomial infections. The impact of these emerging MRSA strains on mortality in adult patients with community-onset S aureus bacteremia remains uncertain. We defined community strain MRSA (CoSt-MRSA) and hospital strain MRSA (HoSt-MRSA) according to the results of staphylococcus cassette chromosome mec (SCCmec) molecular typing: CoSt-MRSA isolates had SCCmec type IV or V genes, and HoSt-MRSA isolates had SCCmec type I, II, or III genes. We quantitatively evaluated the impact of the MRSA strain on mortality in patients with CoSt-MRSA or HoSt-MRSA bacteremia by comparison with mortality in patients with methicillin-susceptible S aureus (MSSA) bacteremia.We studied an observational cohort of 500 patients with MSSA bacteremia, 111 patients with CoSt-MRSA, and 133 patients with HoSt-MRSA bacteremia from January 1, 2001, through December 31, 2007. The 90-day cumulative probability of survival in patients with MSSA, CoSt-MRSA, and HoSt-MRSA bacteremia was 71%, 70%, and 55%, respectively (p = 0.014, by Wilcoxon rank-sum test).Compared to patients with MSSA bacteremia, patients with HoSt-MRSA bacteremia were associated with an increased risk of mortality in the first multivariate analysis model adjusting for all potential confounders (hazard ratio [HR], 1.525; 95% confidence interval [CI], 1.091-2.131), in the second model adjusting for all confounders except acute severity of bacteremia (HR, 1.489; 95% CI, 1.071-2.070), and in stratified analysis in patients with low Charlson comorbidity scores (score 0-2) (HR, 3.093; 95% CI, 1.507-6.350).Compared to patients with MSSA bacteremia, patients with CoSt-MRSA bacteremia did not show significant differences in mortality rate in the 2 multivariate analysis models (first model: HR, 1.106; 95% CI, 0.748-1.637; second model: HR, 1.028; 95% CI, 0.697-1.516) or in stratified analysis (HR, 1.092; 95% CI, 0.539-2.214).In conclusion, using MSSA as reference, traditional hospital strain MRSA had a higher impact on bacteremia mortality than community strain MRSA.
    No preview · Article · Sep 2010 · Medicine
  • Shin-Liang Pan · I-Nan Lien · Tony Hsiu-Hsi Chen
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    ABSTRACT: To investigate the prognostic effects of the serum total cholesterol (TC) levels on long-term functional outcomes in patients with first-time noncardioembolic ischemic stroke. Cohort study. Referral center. Patients (N=109) with first-time ischemic stroke. Not applicable. Serial Barthel Index (BI) scores at onset; 2 weeks; and 1, 2, 4, and 6 months after stroke. We analyzed the impact of the serum TC level and other clinical factors on the repeated measurements of BI scores at these 6 time points by using a linear mixed regression model. Taking correlation across repeated measurement of BI scores, the TC level, baseline BI, follow-up time, and infarct size were identified as significant predictors for serial BI scores. Higher TC levels correlated with better functional outcomes. A 1-unit (mmol/L) increase in the TC caused a 3.12 (95% confidence interval [CI], .79-5.46) increase in the BI score after controlling for other clinical factors such as age, baseline functional status, and size of infarct. An elevation of 1 unit of baseline BI led to a .49 increase (95% CI, .38-.59) per unit in subsequent BI scores. A small infarct (<1cm) had higher BI scores than larger infarct by 9.09 (95% CI, 2.03-16.16). The serum TC level measured at the acute stage of noncardioembolic ischemic stroke is an independent predictor for long-term functional outcomes.
    No preview · Article · Jun 2010 · Archives of physical medicine and rehabilitation
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    ABSTRACT: Evaluation of long-term effectiveness of population-based breast cancer service screening program in a small geographic area may suffer from self-selection bias and small samples. Under a prospective cohort design with exposed and non-exposed groups classified by whether women attended the screen upon invitation, we proposed a Bayesian acyclic graphic model for correcting self-selection bias with or without incorporation of prior information derived from previous studies with an identical screening program in Sweden by chronological order and applied it to an organized breast cancer service screening program in Pirkanmaa center of Finland. The relative mortality rate of breast cancer was 0.27 (95% CI 0.12–0.61) for the exposed group versus the non-exposed group without adjusting for self-selection bias. With adjustment for selection-bias, the adjusted relative mortality rate without using previous data was 0.76 (95% CI 0.49–1.15), whereas a statistically significant result was achieved [0.73 (95% CI 0.57–0.93)] with incorporation of previous information. With the incorporation of external data sources from Sweden in chronological order, adjusted relative mortality rate was 0.67 (0.55–0.80). We demonstrated how to apply a Bayesian acyclic graphic model with self-selection bias adjustment to evaluating an organized but non-randomized breast cancer screening program in a small geographic area with a significant 27% mortality reduction that is consistent with the previous result but more precise. Around 33% mortality was estimated by taking previous randomized controlled data from Sweden. KeywordsBreast cancer screening-Self-selection bias-Bayesian acyclic graphic model-Mortality reduction
    Full-text · Article · Jun 2010 · Breast Cancer Research and Treatment
  • Ting-Kuang Chao · Tony Hsiu-Hsi Chen
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    ABSTRACT: To establish a predictive model for evaluating improvement in patients with idiopathic sudden sensorineural hearing loss (ISSHL). Bayesian cure rate model. Tertiary referral center. Two hundred patients whose conditions were diagnosed as ISSHL from January 2001 to April 2007 were enrolled to build a model and to train relevant parameters for prediction. The time to improvement and potential predictive factors were collected for analysis. Established factors and significant variables in the univariate analysis were included in the final model. A Bayesian approach with the WinBUGS program was applied to predict the median and 95% confidence intervals (CIs) for the time to improvement, long-term probability of improvement, and improvement probabilities at specific days. The significant predictors in the final model include distortion product otoacoustic emission, auditory brainstem response, vestibular evoked myogenic potential, and audiometric types. The overall results predicted by the different combinations of covariates were summarized and organized in an Access program file that is convenient for clinical application. The results of area under the receiver operating characteristic curves at the 7th, 14th, and 30th days were 0.709 (95% CI, 0.692-0.717), 0.752 (95% CI, 0.737-0.753), and 0.807 (95% CI, 0.788-0.811), respectively. It showed that predictive validity, particularly at 1 month or so, is satisfactory. By using the cure rate model under the context of a Bayesian survival analysis, we first identified auditory objective factors as significant predictors of improvement of ISSHL patients and further predicted the time to improvement with these correlates. The model showed a satisfactory predictive validity, particularly for 1-month individual prediction, which prompted one to make an individual prediction with an available Access program.
    No preview · Article · Apr 2010 · Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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    ABSTRACT: Previous studies using linear regression analysis have shown that age, weight, gender, and the site of operation affect intravenous patient-controlled analgesia (IVPCA) narcotic use. However, there are inconsistent observations in the literature. The authors postulate that patient variables could have different effects at various doses of narcotics. To test this hypothesis, the authors analyzed the effect of patient variables on increasing doses of IVPCA narcotic with quantile regression. The authors collected retrospective data from 1,782 patients who received IVPCA for a minimum of 3 days after surgery. The authors used stepwise linear regression model to identify variables that significantly affected the total IVPCA requirements. Quantile regression model was further applied to assess the effects of selected variables on the ascending percentile of IVPCA narcotic use. Gender, age, body weight, cancer, and surgical site were identified as significant predictors for IVPCA demand. Body weight had the most and cancer had the least significant effects on total IVPCA demands. The results of quantile regression model revealed that the determinants under consideration varied with different percentiles of IVPCA demand. The patient variables correlated with IVPCA narcotic use differently when the dose exceeded the seventieth to eightieth percentiles compared with other percentiles of narcotic use. The authors' findings highlight the heterogeneous postoperative pain requirements among patients and the consequent complex process of efficiently managing postoperative pain.
    Full-text · Article · Mar 2010 · Anesthesiology

Publication Stats

3k Citations
448.48 Total Impact Points

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  • 1998-2012
    • National Taiwan University
      • • Institute of Preventive Medicine
      • • Department of Public Health
      • • College of Public Health
      • • Graduate Institute of Epidemiology and Preventive Medicine
      T’ai-pei, Taipei, Taiwan
  • 2008-2010
    • University of Tampere
      Tammerfors, Province of Western Finland, Finland
    • National Taiwan University Hospital
      Hsin-chu-hsien, Taiwan, Taiwan
  • 2007
    • Chang Gung University
      • Department of Medical Imaging and Radiological Sciences
      Taoyuan, Taiwan, Taiwan
    • Far Eastern Memorial Hospital
      T’ai-pei, Taipei, Taiwan
  • 2006
    • Taipei City Hospital
      T’ai-pei, Taipei, Taiwan
    • Kaohsiung Medical University
      Kao-hsiung-shih, Kaohsiung, Taiwan
    • Shin Kong Wu Ho-Su Memorial Hospital
      T’ai-pei, Taipei, Taiwan
    • National Yang Ming University
      • Institute of Public Health
      T’ai-pei, Taipei, Taiwan
  • 2005
    • En Chu Kong Hospital
      T’ai-pei, Taipei, Taiwan
  • 2004
    • Tzu Chi University
      Hua-lien, Taiwan, Taiwan
  • 2003
    • Mid Sweden University
      Härnösand, Västernorrland, Sweden