John Kelly

Yansong Liu, Li-Hsi, Lin et al.

Remote patient monitoring depends on patient-reported data to capture the subjective dimension of recovery that devices cannot measure. The Quality of Recovery (QoR-15) survey is the gold-standard instrument for this purpose. It was designed and validated for occasional in-hospital assessment, yet remote monitoring now administers it to patients daily. In our own post-surgical deployment, only 55% of patients submitted the survey more than 14 days of 30 monitoring days. We developed QoR-compact, a five-item daily input for the RPM prediction pathway. Setting a deployment-driven target of one-third of the daily items, we exhaustively evaluated all 3,003 five-question subsets of the QoR-15 and tested whether the best of them matches the full instrument in predicting near-term postoperative recovery severity. QoR-compact achieves a mean AUC-ROC of 0.968 (95% CI 0.915-0.988), statistically comparable to the 0.964 baseline obtained with one-third of the items. Patient-level backtesting indicates that it tracks readmission events as faithfully as the full form. Its five items span the physical and psychological axes of recovery: Q3 (feeling rested), Q9 (feeling comfortable and in control), Q10 (general well-being), Q12 (severe pain), and Q14 (feeling worried or anxious). The QoR-15 remains the gold-standard measure of recovery; QoR-compact complements it as a shorter daily input designed for prediction. This parity provides the basis for a prospective study of whether a lighter daily input is, in turn, completed more consistently. External validation on larger cohorts is required before clinical use.

Zhen Yu, Jennifer Nguyen, Toan D Nguyen et al.

Dermatologists often diagnose or rule out early melanoma by evaluating the follow-up dermoscopic images of skin lesions. However, existing algorithms for early melanoma diagnosis are developed using single time-point images of lesions. Ignoring the temporal, morphological changes of lesions can lead to misdiagnosis in borderline cases. In this study, we propose a framework for automated early melanoma diagnosis using sequential dermoscopic images. To this end, we construct our method in three steps. First, we align sequential dermoscopic images of skin lesions using estimated Euclidean transformations, extract the lesion growth region by computing image differences among the consecutive images, and then propose a spatio-temporal network to capture the dermoscopic changes from aligned lesion images and the corresponding difference images. Finally, we develop an early diagnosis module to compute probability scores of malignancy for lesion images over time. We collected 179 serial dermoscopic imaging data from 122 patients to verify our method. Extensive experiments show that the proposed model outperforms other commonly used sequence models. We also compared the diagnostic results of our model with those of seven experienced dermatologists and five registrars. Our model achieved higher diagnostic accuracy than clinicians (63.69% vs. 54.33%, respectively) and provided an earlier diagnosis of melanoma (60.7% vs. 32.7% of melanoma correctly diagnosed on the first follow-up images). These results demonstrate that our model can be used to identify melanocytic lesions that are at high-risk of malignant transformation earlier in the disease process and thereby redefine what is possible in the early detection of melanoma.