Application and evaluation of artificial intelligence TPS-assisted cytologic screening system in urine exfoliative cytology / 中华病理学杂志

Objective: To explore the application of manual screening collaborated with the Artificial Intelligence TPS-Assisted Cytologic Screening System in urinary exfoliative cytology and its clinical values. Methods: A total of 3 033 urine exfoliated cytology samples were collected at the Henan People's Hospital, Capital Medical University, Beijing, China. Liquid-based thin-layer cytology was prepared. The slides were manually read under the microscope and digitally presented using a scanner. The intelligent identification and analysis were carried out using an artificial intelligence TPS assisted screening system. The Paris Report Classification System of Urinary Exfoliated Cytology 2022 was used as the evaluation standard. Atypical urothelial cells and even higher grade lesions were considered as positive when evaluating the recognition sensitivity, specificity, and diagnostic accuracy of artificial intelligence-assisted screening systems and human-machine collaborative cytologic screening methods in urine exfoliative cytology. Among the collected cases, there were also 1 100 pathological tissue controls. Results: The accuracy, sensitivity and specificity of the AI-assisted cytologic screening system were 77.18%, 90.79% and 69.49%; those of human-machine coordination method were 92.89%, 99.63% and 89.09%, respectively. Compared with the histopathological results, the accuracy, sensitivity and specificity of manual reading were 79.82%, 74.20% and 95.80%, respectively, while those of AI-assisted cytologic screening system were 93.45%, 93.73% and 92.66%, respectively. The accuracy, sensitivity and specificity of human-machine coordination method were 95.36%, 95.21% and 95.80%, respectively. Both cytological and histological controls showed that human-machine coordination review method had higher diagnostic accuracy and sensitivity, and lower false negative rates. Conclusions: The artificial intelligence TPS assisted cytologic screening system has achieved acceptable accuracy in urine exfoliation cytologic screening. The combination of manual screening and artificial intelligence TPS assisted screening system can effectively improve the sensitivity and accuracy of cytologic screening and reduce the risk of misdiagnosis.

Estimation on the health life expectancy of adults in Zhejiang province, 2016 / 中华流行病学杂志

Objective: To estimate the health-adjusted life expectancy (HALE) of adults in Zhejiang province and evaluate the health status of the adults. Methods: This study was based on the mortality data collected from Zhejiang Chronic Disease Surveillance Information and Management System, and mortality rates from the underreporting survey and self-reported health data in 2016. Hierarchical Ordered Probit (HOPIT) model was used to estimate the severity-weighted prevalence of disability. Sullivan's method was used to calculate the HALE. Results: After adjustment by HOPIT model, the severity-weighted prevalence of disability increased significantly with age (χ(2)=5 795.81,P<0.001), and it was higher in females than in males (χ(2)=5 353.27, P<0.001). The life expectancy and self-evaluated HALE were 59.08 years and 48.68 years, respectively, in those aged ≥20 years, the difference was 10.40 years due to disability. The proportion of HALE loss due to disability in the total life expectancy was 17.61%, and it increased with age. HALE was higher in males than in females (49.21 years vs. 48.14 years), and in urban residents than in rural residents (49.92 years vs. 47.43 years). Conclusion: The proportion of loss of HALE in the total life expectancy in adults was high in Zhejiang, and it higher in males than in females, in urban residents than rural residents. Programs on improving health care in women and rural residents should be promoted.

Evaluation of peer support education mode for type 2 diabetes control in rural residents / 中华流行病学杂志

Objective: To evaluate the intervention effects of peer support education mode for type 2 diabetes control in rural residents. Methods: A random cluster sampling method has been used, including 300 rural residents aged above 18 years old from three villages (184 in control group, 116 in intervention group), in order to proceed the physical check-up and health education programs. Unchanged rate, transfer rate of patients, rate of impaired glucose tolerance, turn normal rate and other biochemical indicators of patients and people with impaired glucose tolerance from control group and intervention group were analyzed, to evaluate the intervention effects of peer support education mode. Results: The glycemic control rate of intervention group for patients and people with impaired glucose tolerance (72.2% and 71.4%) were higher than control group (43.6% and 26.7%), but the unchanged rate of intervention group (13.9% and 0.0%) were lower than control group (42.3% and 73.3%). Patients with diabetes or glucose intolerance in the education group improved significantly in waist-to-hip ratio, uric acid, total cholesterol and HDL-C. Glycemic hemoglobin level also improved significantly in diabetes patients of the education group. Conclusion: Peer support for education intervention seemed beneficial for diabetic control. The combination of education and effect evaluation was important in the evaluation of diabetes prevention and control. Peer support education also benefited the blood glucose control in general population.