Modelos de inteligencia artificial para la detección temprana de cáncer de páncreas y estómago.

Problema: En Colombia, el cáncer es considerado un problema de salud pública dado el incremento en las tasas de incidencia y mortalidadADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1002/ijc.32956","ISSN":"0020-7136","abstract":"In May 2018, the World Health Organization (WHO) called for the elimination of cervical cancer. To monitor this Initiative, we examined cervical cancer incidence and mortality in the Latin America and Caribbean (LAC) region using GLOBOCAN 2018, Cancer Incidence in Five Continents Series, and the World Health Organization Mortality Database. We estimated the number of cases and age-standardized rates (ASRs) for cervical cancer incidence and mortality for 2018. We also presented the ASRs for recorded cervical cancer incidence from the 2008?2012 period. We calculated annual rates and analysed trends in cervical cancer incidence and mortality for all ages combined and for the following age groups: 0?29; 30?49; 50?64; 65+. Finally, we calculated the estimated average annual percentage change in incidence and mortality rates for the past ten years. In 2018, an estimated 56,000 new cervical cancer cases and 28,000 cervical cancer deaths occurred among women in LAC, with great variations between sub-regions and countries/territories. Overall, trends in cervical cancer incidence and mortality have decreased over the past decade; however, the rates are still above the elimination threshold of 4 per 100,000 in most LAC countries/territories. Despite the encouraging trends observed, achieving the elimination of cervical cancer in the Region still requests substantial political commitment and economic effort. Population-based cancer registries are critical in monitoring the elimination Initiative. This article is protected by copyright. All rights reserved.","author":[{"dropping-particle":"","family":"Pilleron","given":"Sophie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cabasag","given":"Citadel J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ferlay","given":"Jacques","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bray","given":"Freddie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Luciani","given":"Silvana","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Almonte","given":"Maribel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Piñeros","given":"Marion","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Cancer","id":"ITEM-1","issue":"n/a","issued":{"date-parts":[["2020","3","9"]]},"note":"doi: 10.1002/ijc.32956","publisher":"John Wiley & Sons, Ltd","title":"Cervical cancer burden in Latin America and the Caribbean: Where are we?","type":"article-journal","volume":"n/a"},"uris":["http://www.mendeley.com/documents/?uuid=21032caf-0d24-4967-bac3-8076d87b3bd6"]}],"mendeley":{"formattedCitation":"1","plainTextFormattedCitation":"1","previouslyFormattedCitation":"1"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}1. De acuerdo con GLOBOCAN 2018, cerca de 126 hombres y mujeres mueren diariamente en el país debido a esta enfermedadADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"International Agency for Research on Cancer","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2018"]]},"title":"GLOBOCAN 2018: Colombia Fact sheet","type":"report"},"uris":["http://www.mendeley.com/documents/?uuid=7e19ea5e-6fc3-441d-8f57-44d5aa1a81a7"]}],"mendeley":{"formattedCitation":"2","plainTextFormattedCitation":"2","previouslyFormattedCitation":"2"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}2. A pesar de que el diagnóstico temprano y el acceso a tratamiento oportuno son fundamentalesADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1200/JGO.19.00388","ISSN":"2687-8941","author":[{"dropping-particle":"","family":"Broeders","given":"Mireille","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Elfström","given":"K Miriam","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JCO global oncology","id":"ITEM-1","issued":{"date-parts":[["2020","2"]]},"language":"eng","page":"180-181","publisher":"American Society of Clinical Oncology","title":"Importance of International Networking and Comparative Research in Screening to Meet the Global Challenge of Cancer Control","type":"article-journal","volume":"6"},"uris":["http://www.mendeley.com/documents/?uuid=e6f5d53a-2d6c-4be3-b243-f7c07fa11ad1"]}],"mendeley":{"formattedCitation":"3","plainTextFormattedCitation":"3","previouslyFormattedCitation":"3"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}3, en países en vía de desarrollo, los programas de tamizaje y prevención continúan enfrentando grandes retos de implementaciónADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/S0140-6736(20)30157-4","ISSN":"0140-6736","author":[{"dropping-particle":"","family":"Canfell","given":"Karen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kim","given":"Jane J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brisson","given":"Marc","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Keane","given":"Adam","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Simms","given":"Kate T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Caruana","given":"Michael","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Burger","given":"Emily A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Martin","given":"Dave","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nguyen","given":"Diep T N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bénard","given":"Élodie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sy","given":"Stephen","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Regan","given":"Catherine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Drolet","given":"Mélanie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gingras","given":"Guillaume","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Laprise","given":"Jean-Francois","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Torode","given":"Julie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"Megan A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fidarova","given":"Elena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Trapani","given":"Dario","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bray","given":"Freddie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ilbawi","given":"Andre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Broutet","given":"Nathalie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hutubessy","given":"Raymond","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The Lancet","id":"ITEM-1","issue":"10224","issued":{"date-parts":[["2020","2","22"]]},"note":"doi: 10.1016/S0140-6736(20)30157-4","page":"591-603","publisher":"Elsevier","title":"Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries","type":"article-journal","volume":"395"},"uris":["http://www.mendeley.com/documents/?uuid=31cdebca-5a97-4be1-bef1-ff194776ad4a"]},{"id":"ITEM-2","itemData":{"DOI":"10.1007/s00404-012-2575-0","ISSN":"09320067","abstract":"Introduction: Thousands of women living in many middle and low-income countries are unnecessarily dying from cervical cancer, partly due to limited screening coverage. Objectives: To identify social determinants of health (SDH) associated with cervical screening for women living in middle and low-income countries, to inform responses to improve SDH and screening coverage, and to identify research gaps. Methods: A scoping literature review. We located original research articles on SDH associated with cervical cancer screening through bibliographic databases, supplemented by hand searching (n = 166 + 4). Included were those conducted in middle and low-income countries and published in English, Portuguese and Spanish academic journals between January 2000 and June 2011 (n = 37). Excluded were those from high-income countries or focusing on screening-diagnostic techniques or HPV vaccine. Narrative synthesis examined the results in relation to a SDH framework. Results: A number of factors influence access along the pathway to cervical cancer screening. Structural (cultural and societal values, socioeconomic position, ethnicity), intermediary (geographic location, health seeking behaviours, psychosocial factors, nature of the health system), and cross-cutting (social cohesion) SDH were all important. No single factor could entirely explain the observed cervical screening patterns. Conclusion: Cervical cancer screening among women living in middle and low-income countries are influenced by the interaction among several different SDH. The majority of researchers studying cervical cancer screening focused on exploring single socio-demographic variables, which is typical of positivist, biomedical and epidemiological research. An inter-sectionality approach may provide a richer understanding of the complexities that influence women's pathways to cervical cancer screening and assist design of international programmes and policies from a social justice perspective. © 2012 Springer-Verlag Berlin Heidelberg.","author":[{"dropping-particle":"","family":"Williams-Brennan","given":"Leslie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gastaldo","given":"Denise","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cole","given":"Donald C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Paszat","given":"Lawrence","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Archives of Gynecology and Obstetrics","id":"ITEM-2","issue":"6","issued":{"date-parts":[["2012"]]},"page":"1487-1505","title":"Social determinants of health associated with cervical cancer screening among women living in developing countries: A scoping review","type":"article-journal","volume":"286"},"uris":["http://www.mendeley.com/documents/?uuid=f5ac7745-1157-4073-b287-b76e4c483e5f"]}],"mendeley":{"formattedCitation":"4,5","plainTextFormattedCitation":"4,5","previouslyFormattedCitation":"4,5"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}4,5. En consecuencia, los registros administrativos disponibles en los sistemas de información, son potencialmente valiosos para el desarrollo de modelos de predicción y la mejora en la oportunidad de diagnósticoADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1186/s12913-017-2440-8","ISBN":"1291301724408","ISSN":"14726963","abstract":"Background: While, at its inception in 1993, the health care system in Colombia was publicized as a paradigm to be copied across the developing world, numerous problems in its implementation have led to, what is now, an inefficient and crisis-ridden health system. Furthermore, as a result of inappropriate tools to measure the quality of the health service providers, several corruption scandals have arisen in the country. This study attempts to tackle this situation by proposing a strategy for the quality assessment of the health service providers (Entidades Promotoras de Salud, EPS) in the Colombian health system. In particular, as a case study, the quality of the treatment of stomach cancer is analyzed. Methods: The study uses two complementary techniques to address the problem. These techniques are applied based on data of the treatment of gastric cancer collected on a nationwide scale by the Colombian Ministry of Health and Welfare. First, Data Envelopment Analysis (DEA) and the Malmquist Index (MI) are used to establish the most efficient EPS's within the system, according to indicators such as opportunity indicators. Second, sequential clustering algorithm, related to process mining a field of data mining, is used to determine the medical history of all patients and to construct typical care pathways of the patients belonging to efficient and inefficient EPS's. Lastly, efforts are made to identify traits and differences between efficient and inefficient EPS's. Results: Efficient and inefficient EPS were identified for the years 2010 and 2011. Additionally, a Malmquist Index was used to calculate the relative changes in the efficiency of the health providers. Using these efficiency rates, the typical treatment path of patients with gastric cancer was found for two EPSs: one efficient and another inefficient. Finally, the typical traits of the care pathways were established. Conclusions: Combining DEA and process mining proved to be a powerful approach understanding the problem and gaining valuable insight into the inner workings of the Colombian Health System, especially in terms of the treatment process performed by health care providers in critical illnesses such as cancer. However, no sufficiently compelling results were found to establish the contribution of such a combination to evaluate the quality in the delivery of health services.","author":[{"dropping-particle":"","family":"Villamil","given":"María Del Pilar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Barrera","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Velasco","given":"Nubia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bernal","given":"Oscar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fajardo","given":"Esteban","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Urango","given":"Carlos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Buitrago","given":"Sebastian","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"BMC Health Services Research","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2017"]]},"page":"1-16","title":"Strategies for the quality assessment of the health care service providers in the treatment of Gastric Cancer in Colombia","type":"article-journal","volume":"17"},"uris":["http://www.mendeley.com/documents/?uuid=7bb0a137-d20a-49f8-be5d-d0c9af7ccfd1"]}],"mendeley":{"formattedCitation":"6","plainTextFormattedCitation":"6","previouslyFormattedCitation":"6"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}6. Este proyecto propone responder la pregunta ¿Es posible clasificar los pacientes, en función del riesgo de desarrollar cáncer de páncreas y estómago, haciendo uso la información disponible el Sistema General de Seguridad Social en Salud (SGSSS) de Colombia? Métodos: Se propone una metodología de tres fases para dar respuesta a la pregunta de investigación. En la primera fase, se evaluará la capacidad predictiva de las variables incluidas en los sistemas de información del SGSSS, para la identificación del riesgo de desarrollar cáncer de páncreas y estómago. Posteriormente, se implementarán algoritmos de minería de procesos para modelar y caracterizar las rutas asistenciales típicas en el diagnóstico y tratamiento de las dos enfermedades. Finalmente, se cuantificará la precisión de diferentes modelos para la predicción de riesgo de desarrollar cáncer. A lo largo de las tres fases, se realizará validación y análisis de las implicaciones de los resultados, desde el punto de vista clínico. Aporte: El desarrollo de este proyecto permitirá: i) la cuantificación de la capacidad predictiva de las variables disponibles en los sistemas de información colombianos, para facilitar el diagnóstico oportuno de dos tipos de cáncer ii) la identificación y validación médica de las rutas asistenciales típicas en el tratamiento de los dos diagnósticos seleccionados. iii) La comparación de diferentes algoritmos de aprendizaje automático y una discusión respecto a su desempeño en relación a la precisión en la clasificación y la interpretabilidad de sus resultados. Productos esperados: Con el desarrollo de este proyecto se espera fortalecer la actividad investigativa de la Pontificia Universidad Javeriana y su relación con el Hospital Universitario San Ignacio. En particular se busca: i) formar dos estudiantes de maestría, ii) presentar al menos una ponencia en eventos científicos y iii) someter dos artículos originales en los índices bibliográficos de citaciones ISI-SCI-SCI o SCOPUS. Adicionalmente se desarrollarán capacitaciones de transferencia tecnológica y se participará en un curso de maestría.