Browsing by Author "Wang, Shuo"

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    Automated Assessment of Psychiatric Patients Using Medical Notes
    (2022-12) Wang, Shuo; Miled, Zina Ben; King, Brain; Lee, John
    Psychiatric patients require continuous monitoring on par with their severity status. Unfortunately, current assessment instruments are often time-consuming. The present thesis introduces several passive digital markers (PDMs) that can help reduce this burden by automating the assessment using medical notes. The methodology leverages medical notes already annotated according to the General Assessment of Functioning (GAF) scale to develop a disease severity PDM for schizophrenia, bipolar type I or mixed bipolar and non-psychotic patients. Topic words that are representative of three disease severity levels (severe impairment, serious impairment, moderate to no impairment) are identified and the top 50 words from each severity level are used to summarize the raw text of the medical notes. The summary of the text is processed by a classifier that generates a disease severity level. Two classifiers are considered: BERT PDM and Clinical BERT PDM. The evaluation of these classifiers showed that the BERT PDM delivered the best performance. The PDMs developed using the BERT PDM can assign medical notes from each encounter to a severe impairment level with a positive predictive value higher than 0.84. These PDMs are generalizable and their development was facilitated by the availability of a substantial number of medical notes from multiple institutions that were annotated by several health care providers. The methodology introduced in the present thesis can support the automated monitoring of the progression of the disease severity for psychiatric patients by digitally processing the medical note produced at each encounter without additional burden on the health care system. Applying the same methodology to other diseases is possible subject to availability of the necessary data.
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    Comparing the long-term prognosis and renal function changes of partial nephrectomy (PN) and radical nephrectomy (RN) in T1 stage renal cell carcinoma patients
    (AME, 2025) Cao, Yudong; Cui, Yushuang; Li, Ruojing; Tang, Xingxing; Lin, Chen; Yang, Xiao; Liu, Jia; Zhao, Qiang; Ma, Jinchao; Paludo, Artur de Oliveira; Schmeusser, Benjamin N.; Wang, Shuo; Du, Peng; Urology, School of Medicine
    Background: Radical nephrectomy (RN) and partial nephrectomy (PN) are common surgical treatments for T1 stage renal cell carcinoma (RCC). However, the long-term impact of these surgical approaches on prognosis and renal function remains an area of ongoing investigation. This study compared the effects of these procedures on prognosis and renal function. Methods: The data of 1,030 T1 stage RCC patients treated at Peking University Cancer Hospital & Institute between January 2014 and August 2022 were analyzed. The primary endpoints of the study were overall survival (OS) and cancer-specific survival (CSS). The secondary endpoints included the annual mean estimated glomerular filtration rate (eGFR) and the average annual eGFR change rates. Results: Based on a median follow-up time of 57 months, the OS and CSS rates were 96.6% and 98.5% in the overall cohort, respectively. The multivariate analysis identified age [hazard ratio (HR), 2.664; 95% confidence interval (CI): 1.147-6.192; P=0.02], tumor grade (HR, 2.247; 95% CI: 1.050-4.810; P=0.04), and surgical approach (HR, 2.585; 95% CI: 1.056-6.325; P=0.04) as adverse prognostic factors for OS, and age (HR, 4.603; 95% CI: 1.035-20.471; P=0.045) and tumor grade (HR, 4.972; 95% CI: 1.752-14.111; P=0.003) as adverse prognostic factors for CSS. Throughout the follow-up period, the eGFR of the RN patients showed a gradual increase, while that of the PN patients remained stable (P<0.001). Among the patients with preoperative diabetes, the eGFR of the RN patients decreased significantly compared to that of the PN patients (P=0.03). Conclusions: T1 stage RCC has a favorable prognosis with surgery, and PN is an oncologically safe option. A persistent eGFR difference was observed between the PN and RN groups, with RN showing a gradual upward trend. However, patients with pre-existing diabetes experienced a greater decline in renal function after RN, which highlights the advantages of PN for such patients.