ORCID Profile
0000-0003-4225-4116
Current Organisation
Royal Brisbane and Women's Hospital
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Publisher: Wiley
Date: 30-07-2019
DOI: 10.1111/ANS.15350
Abstract: Electronic health records (EHR) systems have been utilized in New South Wales for more than a decade however, there is no agreement as to what clinical benefits they provide. This study aims at determining whether the introduction of EHR systems resulted in changes in documentation quality and other markers of clinical performance such as post-operative length of stay (PO LOS), use of imaging modality, rates of readmission and morbidity. A before and after study was conducted utilizing both written and electronic patient documentation in a single surgical ward. Patients who underwent appendicectomy at Blacktown Hospital had inpatient documentation collated at three distinct time-points. Documentation was then assessed against the QNOTE assessment criteria. Other markers of clinical performance assessed included PO LOS, ultrasound use, computed tomography use, rate of readmission, rate of morbidity and rate of positive histological findings. There was a significant (P = 0.001) improvement in QNOTE score between group 1 (6 months prior to the implementation of EHR) and group 3 (12 months after the implementation of EHR) of 9 points. PO LOS was reduced following the implementation of EHR from 1.94 to 1.37 days (P = 0.001). This study demonstrated that following the implementation of EHR system in an inpatient surgical ward, notation quality improved. It was also found that the implementation of EHR was associated with a decrease in PO LOS.
Publisher: Elsevier BV
Date: 12-2022
Publisher: Elsevier BV
Date: 10-2021
Publisher: Wiley
Date: 12-06-2023
DOI: 10.1002/HED.27426
Abstract: Human papillomavirus association has changed the landscape of treatment for oropharyngeal squamous cell carcinoma it remains to be seen whether current post‐treatment surveillance schedules are effective. Evaluate whether post‐treatment surveillance of oropharyngeal cancer through FDG‐PET imaging is modified by human papillomavirus association. A prospective cohort analysis of retrospective data was conducted for patients undergoing treatment of oropharyngeal cancer between 2016 and 2018. This study was conducted at a single large tertiary referral center in Brisbane, Australia. Two‐hundred and twenty‐four patients were recruited for the purposes of the study, 193 (86%) with HPV‐associated disease. In this cohort FDG‐PET had a sensitivity of 48.3%, specificity of 72.6%, positive predictive value of 23.7%, and negative predictive value of 88.8% in detecting disease recurrence. FDG‐PET in HPV‐associated oropharyngeal cancer has significantly lower positive predictive value when compared to non‐HPV‐associated oropharyngeal cancer. Caution should be used when interpreting positive post‐treatment FDG‐PET.
Publisher: Springer Science and Business Media LLC
Date: 23-06-2022
DOI: 10.1007/S13402-022-00681-W
Abstract: Local recurrence and metastasis remain the major causes of death in head and neck cancer (HNC) patients. Circulating tumour cells (CTCs) are shed from primary and metastatic sites into the circulation system and have been reported to play critical roles in the metastasis and recurrence of HNC. Here, we explored the use of CTCs to predict the response to treatment and disease progression in HNC patients. Blood s les were collected at diagnosis from HNC patients (n = 119). CTCs were isolated using a spiral microfluidic device and were identified using immunofluorescence staining. Correlation of baseline CTC numbers to 13-week PET-CT data and multidisciplinary team consensus data were conducted. CTCs were detected in 60/119 (50.4%) of treatment naïve HNC patients at diagnosis. Baseline CTC numbers were higher in stage III vs. stage I-II p16-positive oropharyngeal cancers (OPCs) and other HNCs ( p = 0.0143 and 0.032, respectively). In addition, we found that baseline CTC numbers may serve as independent predictors of treatment response, even after adjusting for other conventional prognostic factors. CTCs were detected in 10 out of 11 patients exhibiting incomplete treatment responses. We found that baseline CTC numbers are correlated with treatment response in patients with HNC. The expression level of cell-surface vimentin (CSV) on CTCs was significantly higher in patients with persistent or progressive disease, thus providing additional prognostic information for stratifying the risk at diagnosis in HNC patients. The ability to detect CTCs at diagnosis allows more accurate risk stratification, which in the future may be translated into better patient selection for treatment intensification and/or de-intensification strategies.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Zhen Yu Liu.