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    Developing and Validating an Automatic Support System for Tumor Coding in Pathology Reports in Spanish
    (American Society of Clinical Oncology (ASCO), 2025-02)
    Fabián Villena
    ;
    Pablo Báez
    ;
    Sergio Peñafiel
    ;
    Matías Rojas
    ;
    Inti Paredes
    Purpose Pathology reports provide valuable information for cancer registries to understand, plan, and implement strategies to mitigate the impact of cancer. However, coding essential information from unstructured reports is performed by experts in a time-consuming manual process. We developed and validated a novel two-step automatic coding system that first recognizes tumor morphology and topography mentions from free text and then suggests codes from the International Classification of Diseases for Oncology (ICD-O) in Spanish. Materials and Methods We created an annotated corpus of tumor morphology and topography mentions consisting of 1,101 documents. We combined it with the CANTEMIST corpus (Cancer Text Mining Shared Task). Specifically, we implemented a named entity recognition (NER) model using the bidirectional long short-term memory network-conditional random field architecture enhanced with a stacked embedding layer. We applied transfer learning from state-of-the-art pretrained language models to obtain high-quality contextual representations, thus improving the detection of entities. The mentions found using this model were subsequently oded using a search engine tailored to the ICD-O codes. Results Our NER models achieved an F1 score of 0.86 and 0.90 for tumor morphology and topography, respectively. The overall performance of our automatic coding system achieved an accuracy at five suggestions of 0.72 and 0.65 for tumor morphology and topography, respectively. Conclusion These results demonstrate the feasibility of implementing natural language processing tools in the routine of a cancer center to extract and code valuable information from pathology reports. Our recommender system allows reliable and transparent coding at the moment of consultation. This publication shares the annotated corpus in Spanish, annotation guidelines, and source code to reproduce our experiments.
    Scopus© Citations 3  1
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    Scopus© Citations 6  5
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    Validación del instrumento Self-Compassion Scale para valoración de la autocompasión en estudiantes y médicos en Chile
    (2023)
    Francisco J. Villalón López
    ;
    Maximiliano Escaffi-Schwarz
    ;
    M. Eliana Correa Matus
    Scopus© Citations 1  10
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    Spanish version of the ICIQ-Bowel questionnaire among colorectal cancer patients: construct and criterion validity
    (2023)
    SACOMORI, CINARA  
    ;
    Luz Alejandra Lorca
    ;
    Mónica Martinez-Mardones
    ;
    Marta Natalia Pizarro-Hinojosa
    ;
    Gonzalo Sebastián Rebolledo-Diaz
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>Bowel complaints are very common among patients with colorectal cancer. However, the most used questionnaires for colorectal cancer survivors do not comprehensively comprise bowel symptoms. This study aimed to examine construct and criterion validity, as well as internal consistency, of the Chilean Version of the International Consultation on Incontinence Questionnaire Bowel Module (ICIQ-B) among people with colorectal cancer.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Cross-sectional, validation study performed with 106 colorectal cancer patients from Hospital del Salvador, Chile. Bowel function was assessed with the ICIQ-B. Construct validity was assessed with confirmatory factor analysis and hypothesis testing. Specific items of a quality-of-life questionnaire (EORTC QLQ-CR29) were used to correlate with similar ICIQ-B items for criterion validity. For internal consistency, Cronbach’s alpha was computed.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>For construct validity, the confirmatory factor analysis showed that the three factors model did not fit our data. Meanwhile, hypothesis testing favored the construct validity of the instrument, considering that rectal cancer patients showed worse bowel pattern (p = 0.001), bowel control (p = 0.001) and quality of life (p &lt; 0.001) scores compared to colon cancer patients. In addition, those patients assessed before surgery also presented worse scores bowel control (p = 0.023) and quality of life (p = 0.009) compared to post-surgical patients. Regarding criterion validity, the ICIQ-B items showed a significant correlation with similar QLQ-CR29 items. The internal reliability of the instrument was good (Cronbach’s α = 0.909).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Considering that this questionnaire appraises bowel function in more depth, it is recommended for use in clinical practice and research with colorectal cancer patients.</jats:p> </jats:sec>
      2Scopus© Citations 4
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    Validation of the simplified modified Rankin scale for stroke trials: Experience from the ENCHANTED alteplase-dose arm
    (2020)
    Xiaoying Chen
    ;
    Jingwei Li
    ;
    Craig S Anderson
    ;
    Richard I Lindley
    ;
    Maree L Hackett
    <jats:sec><jats:title>Background and aims</jats:title><jats:p> The structured, simplified modified Rankin scale questionnaire (smRSq) may increase reliability over the interrogative approach to scoring the modified Rankin scale (mRS) in acute stroke research and practice. During the conduct of the alteplase-dose arm of the international ENhanced Control of Hypertension ANd Thrombolysis StrokE stuDy (ENCHANTED), we had an opportunity to compare each of these approaches to outcome measurement. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Baseline demographic data were recorded together with the National Institutes of Health Stroke Scale (NIHSS). Follow-up measures obtained at 90 days included mRS, smRSq, and the 5-Dimension European Quality of life scale (EQ-5D). Agreements between smRSq and mRS were assessed with the Kappa statistic. Multiple logistic regression was used to identify baseline predictors of Day 90 smRSq and mRS scores. Treatment effects, based on Day 90 smRSq/mRS scores, were tested in logistic and ordinal logistic regression models. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> SmRSq and mRS scores had good agreement (weighted Kappa 0.79, 95% confidence interval (CI) 0.78–0.81), while variables of age, atrial fibrillation, diabetes mellitus, pre-morbid mRS (1 vs. 0), baseline NIHSS scores, and imaging signs of cerebral ischemia, similarly predicted their scores. Odds ratios for death or disability, and ordinal shift, 90-day mRS scores using smRSq were 1.05 (95% CI 0.91–1.20; one-sided P = 0.23 for non-inferiority) and 0.98 (95% CI 0.87–1.11; P = 0.02 for non-inferiority), similar to those using mRS. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> This study demonstrates the utility of the smRSq in a large, ethnically diverse clinical trial population. Scoring of the smRSq shows adequate agreement with the standard mRS, thus confirming it is a reliable, valid, and useful alternative measure of functional status after acute ischemic stroke. </jats:p></jats:sec><jats:sec><jats:title>Clinical Trial registration</jats:title><jats:p> URL: http://www.clinicaltrials.gov . Unique identifier: NCT01422616. </jats:p></jats:sec>
    Scopus© Citations 9  7
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      1  1Scopus© Citations 5
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    Spanish Translation, Face Validity, and Reliability of the ICIQ-B Questionnaire with Colorectal Cancer Patients
    (2021)
    SACOMORI, CINARA  
    ;
    Luz Alejandra Lorca
    ;
    Mónica Martinez-Mardones
    ;
    Paulina Benavente
    ;
    Jorge Plasser
    <jats:title>Abstract</jats:title><jats:p> Purpose To describe the English-to-Spanish translation process and preliminary psychometric analysis (face validity, cultural adaptation, and test-retest reliability) of the International Consultation on Incontinence Questionnaire – Bowels Module (ICIQ-B) among Chilean colorectal cancer patients.</jats:p><jats:p> Materials and Methods The face validity was studied with 10 colorectal cancer patients, and the test-retest reliability, with 15 patients, 1 month before and 6 months after cancer surgery.</jats:p><jats:p> Results Two rounds of translation/back translation resulted in a Spanish version. The English expression open your bowels was translated as defecar, as it is easily understandable in Spanish. The patients reported that the instrument was easy to answer, with clear instructions, and that it was adequate to appraise their health condition. The test-retest reliability was good (Spearman rho [ρ] ≥ 0.842); only item 15a, the Bristol Stool Scale, obtained a moderate correlation (ρ = 0.639). The patients reported a variety of symptoms, including increased bowel movements, nocturnal bowel movements, fecal urgency, and incontinence.</jats:p><jats:p> Conclusions The first Spanish version of the ICIQ-B was culturally adapted for Chilean colorectal cancer patients, and showed good test-retest reliability. It might be a reference for other Spanish-speaking countries and for patients with other conditions. The ICIQ-B is a robust comprehensive questionnaire for bowel function.</jats:p>
      16  1Scopus© Citations 4
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    Experts by Experience: Qualitative Evaluation of Adolescent Participation in the Development of a Technological Intervention to Prevent Youth Suicide in Chile
    (2021)
    Sara Hamilton Schilling
    ;
    CARREÑO CALDERON, ALEJANDRA ANGELICA  
    ;
    Eric Tapia
    ;
    Franco Mascayano
    ;
    Romina Pitronello
    <jats:p>Adolescent suicide is a pressing problem in Chile that has not yet been sufficiently addressed, as suicide rates have stagnated in recent years. One possible explanation could be linked to the adult-centered paradigm that continues to prevail in relation to adolescent health initiatives. In light of this, programs that seek to promote youth mental health should consider incorporating adolescents in the design process using participatory methodologies, to ensure that these initiatives are well-suited for the population. In line with this recommendation, a group of seven adolescents, 13 to 20 years of age, were incorporated into a research team to actively guide the design, development, and validation of a technology-based intervention, known as Project Clan, which was piloted to reduce adolescent suicide in schools in Chile. This group was known as the “Group of Experts,” in acknowledgment of their role as experts by experience on adolescence. A qualitative case study was conducted to explore their lived experiences, through semistructured individual in-depth interviews with six members of the group. Results showed that the adolescents had a high level of interest in mental health and had experienced problems of their own or accompanied friends who were struggling, which motivated their participation in the study. They had a critical view of the previous interventions they had received through educational institutions and valued their role in the promotion of their peers' mental health through the Group of Experts. They also highlighted the importance of creating tools that complement their daily lives and provide an alternative to existing social networks, by respecting their anonymity, providing a secure place for divulgation and self-expression, and facilitating access to professional support. We conclude that programs that address issues that affect adolescents should incorporate adolescents in the decision-making and design processes to ensure the acceptability and effectivity of their interventions.</jats:p>
    Scopus© Citations 10  4
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      1Scopus© Citations 2
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    The Unplugged program in Chile (“Yo Sé Lo Que Quiero”) for substance use prevention among early adolescents: study protocol for a randomized controlled trial
    (2022)
    Jorge Gaete
    ;
    Saray Ramírez
    ;
    Sofía Gana
    ;
    Daniela Valenzuela
    ;
    Ricardo Araya
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Substance use is among the main contributors to disease among children and adolescents in the Americas region. The call for effective prevention of substance use among adolescents has resulted in numerous school-based programs, and particularly the Unplugged program has been proved to be successful in reducing the prevalence of different substances in seven European countries. The purpose of this study is to test the effectiveness of the Unplugged program in Chile (“Yo Sé Lo Que Quiero”).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>This is a cluster randomized controlled trial, parallel-group type, where “Yo Sé Lo Que Quiero” is compared to standard school preventive curricula in control schools. A total of 70 schools and 8400 adolescents are expected to be randomized with 1:1 allocation. During formative work, the Unplugged program was culturally adapted to Chile, and the instrument to assess the primary and secondary outcomes was validated. The effectiveness of this program will be assessed using the European Drug Addiction Prevention Trial Questionnaire (EU-Dap), measuring substance use prevalence and risk and protective factors in baseline, post-intervention, and four months after the end of the intervention.</jats:p> </jats:sec><jats:sec> <jats:title>Discussion</jats:title> <jats:p>The proposed study will be the first to test the effectiveness of a school-based substance use prevention program in Chile in a cluster randomized control trial and the first study evaluating the Unplugged program in Spanish-speaking Latin America. A model for disseminating the Unplugged program inside Europe already exists and has been implemented successfully in several countries. Thus, if the effects of the program are positive, wide implementation in Chile and Latin American countries is possible soon.</jats:p> </jats:sec><jats:sec> <jats:title>Trial registration</jats:title> <jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT04236999">ClinicalTrials.gov</jats:ext-link><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT04236999">NCT04236999</jats:ext-link>. Registered on January 17, 2020.</jats:p> </jats:sec>
      1Scopus© Citations 4