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2. DB4US: A Decision Support System for Laboratory Information Management

Author

Carmona-Cejudo, José M, Hortas, Maria Luisa, Baena-García, Manuel, Lana-Linati, Jorge, González, Carlos, Redondo, Maximino, and Morales-Bueno, Rafael

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Medical technology, R855-855.5
Abstract

BackgroundUntil recently, laboratory automation has focused primarily on improving hardware. Future advances are concentrated on intelligent software since laboratories performing clinical diagnostic testing require improved information systems to address their data processing needs. In this paper, we propose DB4US, an application that automates information related to laboratory quality indicators information. Currently, there is a lack of ready-to-use management quality measures. This application addresses this deficiency through the extraction, consolidation, statistical analysis, and visualization of data related to the use of demographics, reagents, and turn-around times. The design and implementation issues, as well as the technologies used for the implementation of this system, are discussed in this paper. ObjectiveTo develop a general methodology that integrates the computation of ready-to-use management quality measures and a dashboard to easily analyze the overall performance of a laboratory, as well as automatically detect anomalies or errors. The novelty of our approach lies in the application of integrated web-based dashboards as an information management system in hospital laboratories. MethodsWe propose a new methodology for laboratory information management based on the extraction, consolidation, statistical analysis, and visualization of data related to demographics, reagents, and turn-around times, offering a dashboard-like user web interface to the laboratory manager. The methodology comprises a unified data warehouse that stores and consolidates multidimensional data from different data sources. The methodology is illustrated through the implementation and validation of DB4US, a novel web application based on this methodology that constructs an interface to obtain ready-to-use indicators, and offers the possibility to drill down from high-level metrics to more detailed summaries. The offered indicators are calculated beforehand so that they are ready to use when the user needs them. The design is based on a set of different parallel processes to precalculate indicators. The application displays information related to tests, requests, samples, and turn-around times. The dashboard is designed to show the set of indicators on a single screen. ResultsDB4US was deployed for the first time in the Hospital Costa del Sol in 2008. In our evaluation we show the positive impact of this methodology for laboratory professionals, since the use of our application has reduced the time needed for the elaboration of the different statistical indicators and has also provided information that has been used to optimize the usage of laboratory resources by the discovery of anomalies in the indicators. DB4US users benefit from Internet-based communication of results, since this information is available from any computer without having to install any additional software. ConclusionsThe proposed methodology and the accompanying web application, DB4US, automates the processing of information related to laboratory quality indicators and offers a novel approach for managing laboratory-related information, benefiting from an Internet-based communication mechanism. The application of this methodology has been shown to improve the usage of time, as well as other laboratory resources.

Published
2012
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12. Use of health services among long-term breast cancer survivors in Spain: longitudinal study based on real-world data

Author

Jansana, Anna, Domingo, Laia, Ibañez, Berta, Prados, Alexandra, Del Cura, Isabel, Padilla-Ruiz, Maria, Sanz, Teresa, Poblador, Beatriz, Tamayo, Ibai, Gimeno, Antonio, Alberquilla, Angel, Abizanda, Mercè, Comas, Mercè, Lanzuela, Manuela, Burgui, Rossana, Holgado, Antonio Diaz, Duarte-Salles, Talita, Moreno, Conchi, Louro, Javier, Baquedano, Javier, Molina, Cristobal, del Carmen Martinez, Maria, Gorricho, Javier, Redondo, Maximino, Castells, Xavier, and Sala, Maria

Published
2022
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15. Quality indicators and outcomes in colorectal cancer

Author

Quintana, Jose M., primary, Anton, Ane, additional, Lazaro, Santiago, additional, Gonzalez, Nerea, additional, Baré, Marisa, additional, Larrea-Baz, Nerea Fernández de, additional, Redondo, Maximino, additional, Escobar, Antonio, additional, Sarasqueta, Cristina, additional, GARCIA-GUTIERREZ, SUSANA, additional, Aguirre-Larracoechea, Urko, additional, and Briones, Eduardo, additional

Published
2024
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19. Biological and prognostic differences between symptomatic colorectal carcinomas and those detected by screening

Author

Quintana Lopez, José María, Mañas, Marisa Baré, Bautista, Maximino Redondo, Pérez de la Blanca, Eduardo Briones, Fernández de Larrea Baz, Nerea, Eizaguirre, Cristina Sarasqueta, Martínez, Antonio Escobar, Ruiz, Francisco Rivas, Morales-Suárez-Varela, María M., Blasco Amaro, Juan Antonio, Gonzalez, Isabel del Cura, Madariaga, Inmaculada Arostegui, González, Amaia Bilbao, Hernandez, Nerea González, García-Gutiérrez, Susana, Guerrero, Iratxe Lafuente, Larracoechea, Urko Aguirre, Calzada, Miren Orive, Corral, Josune Martin, Anton-Ladislao, Ane, Torà, Nuria, Pont, Marina, Martínez del Prado, María Purificación, Totorikaguena, Alberto Loizate, Estevez, Ignacio Zabalza, Alustiza, José Errasti, Gimeno García, Antonio Z., Aramburu, Santiago Lázaro, Serrano, Mercè Comas, Enríquez Navascues, José María, Galan, Carlos Placer, Perales, Amaia, Valmaña, Iñaki Urkidi, Erro Azkárate, José María, Lizarribar, Enrique Cormenzana, Muñoa, Adelaida Lacasta, Pibernat, Pep Piera, Cuevas, Elena Campano, Sotelo Gómez, Ana Isabel, Abril, Segundo Gómez, Medina-Cano, F., Alcaide, Julia, Del Rey-Moreno, Arturo, Alcántara, Manuel Jesús, Campo, Rafael, Casalots, Alex, Pericay, Carles, Gil, María José, Pera, Miquel, Collera, Pablo, Espinàs, Josep Alfons, Martínez, Mercedes, Espallargues, Mireia, Almazán, Caridad, Lindenbaum, Paula Dujovne, Fernández-Cebrián, José María, Fernández, Rocío Anula, Mayol Martínez, Julio Ángel, Cid, Ramón Cantero, Labajo, Héctor Guadalajara, Garceau, María Heras, Olmo, Damián García, Montalvo, Mariel Morey, Mar, Javier, Téllez, Teresa, Abitei, Cristina, Padilla-Ruiz, María del Carmen, Rivas-Ruiz, Francisco, Fúnez, Rafael, Pereda, Teresa, Rodrigo, Isabel, Baré, María Luisa, Morales Suárez-Varela, María Manuela, Zabalza, Iñaki, Sánchez del Charco, Matilde, Borrero Martín, Juan José, García del Moral, Raimundo, Escobar, Antonio, Quintana, José María, Aguirre, Urko, and Redondo, Maximino

Published
2019
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29. Prevalence and Influence on Prognosis of Mental Health Comorbidities in Long-term Breast Cancer Survivors: Results From the Surbcan Study

Author

Padilla-Ruiz, María, primary, Gimeno-Miguel, Antonio, additional, Rivas-Ruiz, Francisco, additional, Martínez-Casanova, Mª Carmen, additional, Jansana, Anna, additional, Prados-Torres, Alexandra, additional, Poblador-Plou, Beatriz, additional, Cura, Isabel Del, additional, Sanz-Cuesta, Teresa, additional, Ibáñez, Berta, additional, Castells, Xavier, additional, Sala, María, additional, and Redondo, Maximino, additional

Published
2022
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34. Impact of Detection Mode in a Large Cohort of Women Taking Part in a Breast Screening Program

Author

García, Marilina, primary, Redondo, Maximino, additional, Zarcos, Irene, additional, Louro, Javier, additional, Rivas-Ruiz, Francisco, additional, Téllez, Teresa, additional, Pérez, Diego, additional, Medina Cano, Francisco, additional, Machan, Kenza, additional, Domingo, Laia, additional, del Mar Vernet, Maria, additional, Padilla-Ruiz, Maria, additional, Castells, Xavier, additional, and Sala, Maria, additional

Published
2022
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36. Effect of comorbidities on long-term outcomes of colorectal cancer patients

Author

Quintana, José M, Anton-Ladislao, Ane, Lázaro, Santiago, Gonzalez, Nerea, Bare, Marisa, Fernandez-de-Larrea, Nerea, Redondo, Maximino, Escobar, Antonio, Sarasqueta, Cristina, Garcia-Gutierrez, Susana, Aguirre, Urko, and REDISSEC-CARESS/CCR group

Subjects
comorbidity, Logistic Models, Oncology, Rectal Neoplasms, prospective cohort, Quality of Life, Humans, colorectal cancer, Comorbidity, Prospective Studies, outcomes
Abstract

The objective of this work is to evaluate the association of comorbidities with various outcomes in patients diagnosed with colon or rectal cancer. We conducted a prospective cohort study of patients diagnosed with colon or rectal cancer who underwent surgery. Data were gathered on sociodemographic, clinical characteristics, disease course, and the EuroQol EQ-5D and EORTC QLQ-C30 scores, up to 5 years after surgery. The main outcomes of the study were mortality, complications, readmissions, reoperations, and changes in PROMs up to 5 years. Multivariable multilevel logistic regression models were used in the analyses. Mortality at some point during the 5-year follow-up was related to cardiocerebrovascular, hemiplegia and/or stroke, chronic obstructive pulmonary disease (COPD), diabetes, cancer, and dementia. Similarly, complications were related to cardiovascular disease, COPD, diabetes, hepatitis, hepatic or renal pathologies, and dementia; readmissions to cardiovascular disease, COPD, and hepatic pathologies; and reoperations to cerebrovascular and diabetes. Finally, changes in EQ-5D scores at some point during follow-up were related to cardiocerebrovascular disease, COPD, diabetes, pre-existing cancer, hepatic and gastrointestinal pathologies, and changes in EORTC QLQ-C30 scores to cardiovascular disease, COPD, diabetes, and hepatic and gastrointestinal pathologies. Optimising the management of the comorbidities most strongly related to adverse outcomes may help to reduce those events in these patients.

Published
2022

37. Influence of Diagnostic Delay on Survival Rates for Patients with Colorectal Cancer

Author

Padilla-Ruiz, María, Morales-Suárez-Varela, María, Rivas-Ruiz, Francisco, Alcaide, Julia, Varela-Moreno, Esperanza, Zarcos-Pedrinaci, Irene, Téllez, Teresa, Fernandez de Larrea, Nerea, Baré, Marisa, Bilbao, Amaia, Sarasqueta, Cristina, Aguirre-Larracoechea, Urko, Quintana, José María, Redondo, Maximino, CARESS-CCR Study Group, Instituto de Salud Carlos III, and Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)

Subjects
Male, Delayed Diagnosis, Survival, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, Colorectal neoplasms, Survival Rate, Prospective cohort study, Humans, Female, Prospective Studies, Mortality, Colorectal Neoplasms, Neoplasm Staging, Retrospective Studies, Delayed diagnosis
Abstract

Colorectal cancer affects men and women alike. Sometimes, due to clinical-pathological factors, the absence of symptoms or the failure to conduct screening tests, its diagnosis may be delayed. However, it has not been conclusively shown that such a delay, especially when attributable to the health system, affects survival. The aim of the present study is to evaluate the overall survival rate of patients with a delayed diagnosis of colorectal cancer. This observational, prospective, multicenter study was conducted at 22 public hospitals located in nine Spanish provinces. For this analysis, 1688 patients with complete information in essential variables were included. The association between diagnostic delay and overall survival at five years, stratified according to tumor location, was estimated by the Kaplan-Meier method. Hazard ratios for this association were estimated using multivariable Cox regression models. The diagnostic delay ≥ 30 days was presented in 944 patients. The presence of a diagnostic delay of more than 30 days was not associated with a worse prognosis, contrary to a delay of less than 30 days (HR: 0.76, 0.64-0.90). In the multivariate analysis, a short delay maintained its predictive value (HR: 0.80, 0.66-0.98) regardless of age, BMI, Charlson index or TNM stage. A diagnostic delay of less than 30 days is an independent factor for short survival in patients with CRC. This association may arise because the clinical management of tumors with severe clinical characteristics and with a poorer prognosis are generally conducted more quickly. This study was supported by public grants from Instituto de Salud Carlos III (PI09/90397, PS09/00314, PS09/00746, PI09/90453, PI09/00910, PI09/90460, PI09/90490, PI13/01692, PI13/00013, PI18/01181, PI18/01589, PS0900805 & PI0900441) and was co-funded by the European Regional Development Fund. Sí

Published
2022

38. Factors related to early readmissions after acute heart failure: a nested case–control study.

Author

Garcia-Gutierrez, Susana, Villanueva, Ane, Lafuente, Iratxe, Rodriguez, Ibon, Lozano-Bahamonde, Ainara, Murga, Nekane, Orus, Josefina, Camacho, Emilia Rosa, Quintana, Jose María, Quiros, Raul, the ReIC-REDISSEC working group, Onaindia, Jose Juan, Fernández-Ruiz, Jose, Cacicedo, Angela, Escobar, Vanessa, Redondo, Maximino, Cabello, Gloria, and Baré, Marisa

Subjects
PATIENT readmissions, HEART failure, ARRHYTHMIA, CASE-control method
Abstract

Aims: To describe the main characteristics of patients who were readmitted to hospital within 1 month after an index episode for acute decompensated heart failure (ADHF). Methods and results: This is a nested case–control study in the ReIC cohort, cases being consecutive patients readmitted after hospitalization for an episode of ADHF and matched controls selected from those who were not readmitted. We collected clinical data and also patient-reported outcome measures, including dyspnea, Minnesota Living with Heart Failure Questionnaire (MLHFQ), Tilburg Frailty Indicator (TFI) and Hospital Anxiety and Depression Scale scores, as well as symptoms during a transition period of 1 month after discharge. We created a multivariable conditional logistic regression model. Despite cases consulted more than controls, there were no statistically significant differences in changes in treatment during this first month. Patients with chronic decompensated heart failure were 2.25 [1.25, 4.05] more likely to be readmitted than de novo patients. Previous diagnosis of arrhythmia and time since diagnosis ≥ 3 years, worsening in dyspnea, and changes in MLWHF and TFI scores were significant in the final model. Conclusion: We present a model with explanatory variables for readmission in the short term for ADHF. Our study shows that in addition to variables classically related to readmission, there are others related to the presence of residual congestion, quality of life and frailty that are determining factors for readmission for heart failure in the first month after discharge. Trial Registration: ClinicalTrials.gov Identifier: NCT03300791. First registration: 03/10/2017. [ABSTRACT FROM AUTHOR]

Published
2023
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41. Quality Indicators and Outcomes in a Prospective Cohort of Colorectal Cancer Patients

Author

Quintana, José M., primary, Anton-Ladislao, Ane, additional, Lázaro, Santiago, additional, Gonzalez, Nerea, additional, Bare, Marisa, additional, de Larrea, Nerea Fernandez, additional, Redondo, Maximino, additional, Escobar, Antonio, additional, Sarasqueta, Cristina, additional, Garcia-Gutierrez, Susana, additional, Aguirre, Urko, additional, Briones, Eduardo, additional, and group, for the REDISSEC-CARESS/C. C. R., additional

Published
2021
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42. Laboratory protocol for the digital multiplexed gene expression analysis of nasopharyngeal swab samples using the NanoString nCounter system

Author

García Aranda, Marilina, López-Rodríguez, Inmaculada, García-Gutiérrez, Susana, Padilla-Ruiz, Maria, de Luque, Vanessa, Hortas, Maria Luisa, Diaz, Tatiana, Álvarez, Martina, Barragan-Mallofret, Isabel, Redondo, Maximino, and Research Network on Health Services in Chronic Diseases (Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas, REDISSEC)

Subjects
DNA, Complementary, General Immunology and Microbiology, Immunology, Gene Expression, Reproducibility of Results, COVID-19, General Medicine, nasopharyngeal swab, General Biochemistry, Genetics and Molecular Biology, respiratory infection, Nasopharynx, Digital RNA quantification, gene expression, Humans, RNA, Messenger, General Pharmacology, Toxicology and Pharmaceutics
Abstract

This paper describes a laboratory protocol to perform the NanoString nCounter Gene Expression Assay from nasopharyngeal swab samples. It is urgently necessary to identify factors related to severe symptoms of respiratory infectious diseases, such as COVID-19, in order to assess the possibility of establishing preventive or preliminary therapeutic measures and to plan the services to be provided on hospital admission. At present, the samples recommended for microbiological diagnosis are those taken from the upper and/or the lower respiratory tract. The NanoString nCounter Gene Expression Assay is a method based on the direct digital detection of mRNA molecules by means of target-specific, colour-coded probe pairs, without the need for mRNA conversion to cDNA by reverse transcription or the amplification of the resulting cDNA by PCR. This platform includes advanced analysis tools that reduce the need for bioinformatics support and also offers reliable sensitivity, reproducibility, technical robustness and utility for clinical application, even in RNA samples of low RNA quality or concentration, such as paraffin-embedded samples. Although the protocols for the analysis of blood or formalin-fixed paraffin-embedded samples are provided by the manufacturer, no corresponding protocol for the analysis of nasopharyngeal swab samples has yet been established. Therefore, the approach we describe could be adopted to determine the expression of target genes in samples obtained from nasopharyngeal swabs using the nCOUNTER technology.

Published
2022

43. Influence of depression on survival of colorectal cancer patients drawn from a large prospective cohort.

Author

Varela‐Moreno, Esperanza, Rivas‐Ruiz, Francisco, Padilla‐Ruiz, María, Alcaide‐García, Julia, Zarcos‐Pedrinaci, Irene, Téllez, Teresa, Fernández‐de Larrea‐Baz, Nerea, Baré, Marisa, Bilbao, Amaia, Sarasqueta, Cristina, Morales‐Suárez‐Varela, María Manuela, Aguirre, Urko, Quintana, José María, Redondo, Maximino, Varela-Moreno, Esperanza, Rivas-Ruiz, Francisco, Padilla-Ruiz, María, Alcaide-García, Julia, Zarcos-Pedrinaci, Irene, and Larrea-Baz, Nerea Fernández-de

Subjects
RESEARCH, RESEARCH methodology, EVALUATION research, COLORECTAL cancer, COMPARATIVE studies, MENTAL depression, RESEARCH funding, LONGITUDINAL method, PROPORTIONAL hazards models
Abstract

Objective: The prevalence of depressive symptoms immediately after the diagnosis of colorectal cancer (CRC) is high and has important implications both psychologically and on the course of the disease. The aim of this study is to analyse the association between depressive symptoms and CRC survival at 5 years after diagnosis.Methods: This multicentre, prospective, observational cohort study was conducted on a sample of 2602 patients with CRC who completed the Hospital Anxiety and Depression Scale (HADS-D) at 5 years of follow-up. Survival was analysed using the Kaplan-Meier method and Cox regression models.Results: According to our analysis, the prevalence of depressive symptoms after a CRC diagnosis was 23.8%. The Cox regression analysis identified depression as an independent risk factor for survival (HR = 1.47; 95% CI: 1.21-1.8), a finding which persisted after adjusting for sex (female: HR = 0.63; 95% CI: 0.51-0.76), age (>70 years: HR = 3.78; 95% CI: 1.94-7.36), need for help (yes: HR = 1.43; 95% CI: 1.17-1.74), provision of social assistance (yes: HR = 1.46; 95% CI: 1.16-1.82), tumour size (T3-T4: HR = 1.56; 95% CI: 1.22-1.99), nodule staging (N1-N2: HR = 2.46; 95% CI: 2.04-2.96), and diagnosis during a screening test (yes: HR = 0.71; 95% CI: 0.55-0.91).Conclusions: There is a high prevalence of depressive symptoms in patients diagnosed with CRC. These symptoms were negatively associated with the survival rate independently of other clinical variables. Therefore, patients diagnosed with CRC should be screened for depressive symptoms to ensure appropriate treatment can be provided. [ABSTRACT FROM AUTHOR]

Published
2022
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47. Protein Kinase Targets in Breast Cancer

Author

Garcia-Aranda, Marilina, Redondo, Maximino, [Garcia-Aranda, Marilina] REDISSEC, Hosp Costa Sol, Biochem Dept, Carretera Cadiz Km 187, Malaga 29600, Spain, [Redondo, Maximino] REDISSEC, Hosp Costa Sol, Biochem Dept, Carretera Cadiz Km 187, Malaga 29600, Spain, [Redondo, Maximino] Univ Malaga, Fac Med, Biochem Dept, Bulevar Louis Pasteur 32, Malaga 29010, Spain, Junta de Andalucia, and Fondo Europeo de Desarrollo Regional (FEDER)

Subjects
Factor receptor 2, Cyclin-dependent kinases, Investigational aurora kinase, Postmenopausal women, target, breast cancer, kinases, To-mesenchymal transition, Akt inhibitor mk-2206, Phase-ii trial, Pten-deficient breast, Cell lung-cancer, Phosphatidylinositol 3-kinase pathway, phosphatases
Abstract

With 1.67 million new cases and 522,000 deaths in the year 2012, breast cancer is the most common type of diagnosed malignancy and the second leading cause of cancer death in women around the world. Despite the success of screening programs and the development of adjuvant therapies, a significant percentage of breast cancer patients will suffer a metastatic disease that, to this day, remains incurable and justifies the research of new therapies to improve their life expectancy. Among the new therapies that have been developed in recent years, the emergence of targeted therapies has been a milestone in the fight against cancer. Over the past decade, many studies have shown a causal role of protein kinase dysregulations or mutations in different human diseases, including cancer. Along these lines, cancer research has demonstrated a key role of many protein kinases during human tumorigenesis and cancer progression, turning these molecules into valid candidates for new targeted therapies. The subsequent discovery and introduction in 2001 of the kinase inhibitor imatinib, as a targeted treatment for chronic myelogenous leukemia, revolutionized cancer genetic pathways research, and lead to the development of multiple small-molecule kinase inhibitors against various malignancies, including breast cancer. In this review, we analyze studies published to date about novel small-molecule kinase inhibitors and evaluate if they would be useful to develop new treatment strategies for breast cancer patients.

Published
2017

49. Use of health services among long-term breast cancer survivors in Spain: longitudinal study based on real-world data

Author

Jansana, Anna, primary, Domingo, Laia, additional, Ibañez, Berta, additional, Prados, Alexandra, additional, Del Cura, Isabel, additional, Padilla-Ruiz, Maria, additional, Sanz, Teresa, additional, Poblador, Beatriz, additional, Tamayo, Ibai, additional, Gimeno, Antonio, additional, Alberquilla, Angel, additional, Abizanda, Mercè, additional, Comas, Mercè, additional, Lanzuela, Manuela, additional, Burgui, Rossana, additional, Holgado, Antonio Diaz, additional, Duarte-Salles, Talita, additional, Moreno, Conchi, additional, Louro, Javier, additional, Baquedano, Javier, additional, Molina, Cristobal, additional, del Carmen Martinez, Maria, additional, Gorricho, Javier, additional, Redondo, Maximino, additional, Castells, Xavier, additional, and Sala, Maria, additional

Published
2021
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