SUMSearch and TRIP database are meta search engines for searching clinical evidence. This article introduces major contents and search methods of the SUMSearch and TRIP database, so as to provide quick search resources and technical help for evidence-based practice.
ObjectiveTo analyze the relationship between occupation and tumor characteristics of colorectal patients served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data of DACCA was updated on January 5, 2022. All data items included occupation, tumor morphology, distance of tumor from dentate line, tumor site, properties of tumor, differentiation degree, postoperative complex physiological index (CPI) stage, tumor comorbidities, tumor location, and tumor occurrence. According to the 2015 edition of the Occupational Classification of the People’s Republic of China, the occupational parameters of patients in this study were divided into three groups: Mental workers, physical workers and unemployed residents. ResultsThe DACCA database was filtered according to the conditions, obtaining 3 215 valid data. In terms of tumor complications, there were significant differences in the proportion of tumor bleeding, perforation grade, mechanical intestinal obstruction degree and pain degree among the different occupational groups (P<0.05). There were no significant difference in the ratio of edema degree and intussusception of tumor site among the different occupational groups (P>0.05). There were no significant difference in the composition ratio of tumor differentiation degree, tumor occurrence, tumor orientation and tumor morphology among the different occupational groups (P>0.05). The composition ratio of CPI staging of colorectal cancer, the distance between tumor and dentate line, the composition ratio of different tumor pathological properties, and the composition ratio of tumor located in rectum and colon were statistically significant (P<0.05). ConclusionPreoperative tumor characteristics of patients with colorectal cancer are associated with various occupations. In patients with rectal cancer, the distance from the dentate line to the physical work of the tumor is smaller, lower site, some tumor complications are more severe, and the stage is relatively later.
Objective To analyze the relationship between age and tumor characteristics of colorectal patients served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on January 5, 2022. All data items included age, precancerous lesions, family history of cancer, tumor site, distance of tumor from dentate line, tumor morphology, location, pathological properties of tumor, differentiation, and preoperative TNM stage. The patients were divided into three groups according to the age segment proposed by the United Nations World Health Organization (WHO): 35 years old and below (including infant, infant, child, teenager and youth, young group), 35 to 59 years old (middle-aged group), and 60 years old and above (elderly group). Results After scanning, 7 856 data rows were analyzed. ① There was significant difference in the composition ratio of precancerous lesions with or without among different age groups (χ2=6.219, P=0.045), and the constituent ratio of various precancerous lesions in different age groups was also statistically significant (χ2=51.698, P<0.001). ② There was significant difference in the composition ratio of family history of cancer with or without among different age groups (χ2=50.212, P<0.001), and there was significant difference in the composition ratio of different tumor history among different age groups (χ2=9.880, P=0.027), and there was significant difference in the constituent ratio of various tumor history among relatives in different age groups (χ2=16.138, P=0.003). ③ There were significant differences in the number of primary cancers among different age groups (χ2=12.973, P=0.036). In all patients with single primary rectal cancer, the constituent ratio of different rectal tumor sites among different age groups was statistically significant (χ2=43.817, P<0.001), and in all patients with single primary colon cancer, there was significant difference in the composition ratio of different colon tumor sites between different age groups (χ2=86.704, P<0.001). ④ The distance of tumor from dentate line was statistically significant in different age groups (H=28.589, P<0.001). ⑤ There was no significant difference in the composition ratio of tumor location among different age groups (χ2=14.795, P=0.140). ⑥ There was significant difference in the composition ratio of pathological properties of tumor among different age groups (χ2=121.387, P<0.001). ⑦ The proportion of tumor morphology was significantly different among different age groups (χ2=89.719, P<0.001). ⑧ There were significant differences in differentiation degree of tumor among different age groups (H=43.544, P<0.001). ⑨ There was statistically significant difference in preoperative TNM stage of colorectal cancer among different age groups (H=7.547, P=0.023). Conclusions Preoperative tumor characteristics of colorectal cancer patients are associated with age at diagnosis. Most young colorectal cancer patients do not have precancerous lesions, and once precancerous lesions are present, familial adenomatous polyposis is more common. Younger patients with colorectal cancer also have a higher percentage of relatives with a family history of cancer with colorectal cancer. From the perspective of tumor location, the proportion of single primary cancer in young colorectal cancer is higher than that in middle-aged and elderly patients. Younger patients with rectal cancer have a lower distance of tumor from dentate line, a higher proportion of low differentiated malignant tumors, and a relatively later neoplasm staging.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on April 16, 2020. The data items including: procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, drainage, coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants were analyzed for the characteristics of each selected data item.ResultsA total of 6 338 analyzable data rows were obtained by screening the DACCA database. Among the 6 338 pieces of data, the most common one was the double staple technique (58.1%), end-to-end anastomosis (69.4%), one-total-circle of enhancement (33.2%), and without stuffing (54.1%) in the items of procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, respectively; the ratio with drainage was higher (79.2%) in the term of drainage, the drainage time was (3.74±2.89) d and median drainage time was 3.00 d; the ratio with covering part of major omentum, without anti-adhesion material, with unilateral partial closure, without contaminate, and without drug implants were more higher, which was 41.1%, 79.8%, 58.7%, 73.9%, and 53.9% in the items of coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants, respectively.ConclusionIt might better explain the outcome of surgery associated with intraoperative operation by studying the features of surgery of DACCA and guide the operation in the future for better outcomes.
ObjectiveTo analyze the staging methods of colorectal cancer data in the current version of the Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was updated at April 16th, 2020. The columns included stage during surgery, comprehensive stage of clinical, pathologic and imaging (cpi comprehensive stage), TNM stage, pathologic T stage, imaging T stage, nerves involvement, pathologic anus stage, clinical anus stage, imaging anus stage, pathologic mesentery stage, clinical mesentery stage, imaging mesentery stage, pathologic N stage, imaging N stage, positive lymph nodes ratio, cancerous nodules, M stage, cancerous emboli, pathologic vessel stage, clinical vessel stage, imaging vessel stage, cancerous contamination, and high-risk factors. Extracted data were statistically analyzed.ResultsThe total number of data medical records (data rows) that met the criteria was 6 474, the valid data of TNM stage was 4 511 (69.7%), the valid data of stage during surgery was 5 684 (87.8%), and the valid data of cpi comprehensive stage was 4 045 (62.5%). 1 540 data (41.6%) were consistent with stage during surgery and TNM stage, and 2 884 data (76.7%) were consistent with cpi comprehensive stage and TNM stage. According to the data of T, N, and M stage, the proportion of patients with pathologic T4a stage was the highest (40.5%), followed by T3 stage (24.8%); the most T4a stage (31.9%) on the image, followed by T4b stage (28.7%). The pathologic N stage with lymph node metastasis was about 41.9% (N1 and N2), and the imaging N stage lymph node metastasis was about 51.4%. There were a total of 4 745 valid data in the M stage (73.3%). There were 4 313 valid data in the nerves involvement (66.7%), suspected involvement and confirmed involvement, were 691 (16.0%) and 253 (5.9%) respectively. The valid data of anal pathology, clinical, and imaging stage were 4 115 (63.6%), 599 (9.3%), and 598 (9.2%), and only 30 (0.7%), 8 (1.3%), and 13 (2.2%) on muscle involvement respectively. The valid data of pathologic, clinical, and imaging mesentery stage were 732 (11.3%), 589 (9.1%), and 592 (9.1%). There were 4 458 (68.9%) valid data of positive lymph nodes ratio, and 2 908 (44.9%) valid data of cancerous nodules. There were 4 286 valid data of cancerous emboli (66.2%). A total of 244 data (41.1%) of increased blood vessels around tumors in the imaging vessel stage, 274 data (46.4%) of that in clinical vessel stage, and only 1 063 (27.7%) of pathologic vessel stage. There were 3 865 valid data (59.7%) of the cancerous contamination, and the proportion of the third level (746/2 753, 27.1%) in the high-risk factors was the highest.ConclusionThrough detailed analysis of the DACCA database, it is hoped that a more complete and accurate evaluation system of tumor severity can be established, and high-risk factors can provide some ideas for judging prognosis.
ObjectiveTo analyze the geographical distribution of patients with colorectal cancer by screening the current Database from Colorectal Cancer (DACCA) version in West China Hospital.MethodsThe selected DACCA database version of this data analysis was updated on September 5, 2019, and the two data of the " date of operation” and " address” were selected as the main research items. The characteristics of each selected data item were analyzed, and then the selected data were used as a joint feature analysis.ResultsAccording to the condition of selection by " address”, 7 096 valid data rows from the whole nation were obtained, 6 551 valid data rows from Sichuan province were obtained, and 2 954 valid data rows from Chengdu city were obtained. The geographic information provided by the DACCA database showed that, with the year changing, the provincial distribution area of patients was mainly the southwest region with middle-east of Sichuan province as center, mainly including the parts of Chongqing, Yunnan, and Guizhou; The distribution area of the municipal level in Sichuan province was mainly the east region with axis of the " Mianyang-Chengdu-Ya’an”, and Chengdu was the core; The regional distribution of patients in the Chengdu was mainly within the third ring load with Wuhou District, the Jinniu District, and the Qingyang District as the core area.ConclusionThegeographical information provided by DACCA database shows the geographical distribution characteristics of patients in the past 20 years, reflecting the basic characteristics and changes of the service area of West China Hospital, and can provide a basis for medical policy makers in screening, diagnosing and treating of colorectal cancer, and key management areas of following-up.
ObjectiveTo describe the constructive process of neoadjuvant therapy for colorectal cancer part in the West China Colorectal Cancer Database (DACCA).MethodWe used the form of text description.ResultsThe specific concept of neoadjuvant therapy for colorectal cancer including neoadjuvant treatment therapies, compliance of patients with neoadjuvant therapy, neoadjuvant therapy intensity scheme, the CEA value of patients during neoadjuvant therapy, changes of symptoms, changes of primary tumor size in colorectal cancer, and TRG grading of the DACCA in the West China Hospital were defined. Then the neoadjuvant therapies were detailed for their definition, label, structure, error correction, and update.ConclusionThrough detailed description and specification of neoadjuvant therapy for colorectal cancer in DACCA in West China Hospital, it can provide a reference for the standardized treatment of colorectal cancer and also provide experiences for the peers who wish to build a colorectal cancer database.
ObjectiveTo understand the impact of preoperative nutritional status on the postoperative complications for patients with low/ultra-low rectal cancer undergoing extreme sphincter-preserving surgery following neoadjuvant therapy. MethodsThe patients with low/ultra-low rectal cancer who underwent extreme sphincter-preserving surgery following neoadjuvant therapy from January 2009 to December 2020 were retrospectively collected using the Database from Colorectal Cancer (DACCA), and then who were assigned into a nutritional risk group (the score was low than 3 by the Nutrition Risk Screening 2002) and non-nutritional risk group (the score was 3 or more by the Nutrition Risk Screening 2002). The postoperative complications and survival were analyzed for the patients with or without nutritional risk. The postoperative complications were defined as early-term (complications occurring within 30 d after surgery), middle-term (complications occurring during 30–180 d after surgery), and long-term (complications occurring at 180 d and more after surgery). The survival indicators included overall survival and disease-specific survival. ResultsA total of 680 patients who met the inclusion criteria for this study were retrieved from the DACCA database. Among them, there were 500 (73.5%) patients without nutritional risk and 180 (26.5%) patients with nutritional risk. The postoperative follow-up time was 0–152 months (with average 48.9 months). Five hundreds and forty-three survived, including 471 (86.7%) patients with free-tumors survival and 72 (13.3%) patients with tumors survival. There were 137 deaths, including 122 (89.1%) patients with cancer related deaths and 15 (10.9%) patients with non-cancer related deaths. There were 48 (7.1%) cases of early-term postoperative complications, 51 (7.5%) cases of middle-term complications, and 17 (2.5%) cases of long-term complications. There were no statistical differences in the incidence of overall complications between the patients with and without nutritional risk (χ2=3.749, P=0.053; χ2=2.205, P=0.138; χ2=310, P=0.578). The specific complications at different stages after surgery (excluding the anastomotic leakage complications in the patients with nutritional risk was higher in patients without nutritional risk, P=0.034) had no statistical differences between the two groups (P>0.05). The survival curves (overall survival and disease-specific survival) using the Kaplan-Meier method had no statistical differences between the patients with and without nutritional risk (χ2=3.316, P=0.069; χ2=3.712, P=0.054). ConclusionsFrom the analysis results of this study, for the rectal cancer patients who underwent extreme sphincter-preserving surgery following neoadjuvant therapy, the patients with preoperative nutritional risk are more prone to anastomotic leakage within 30 d after surgery. Although other postoperative complications and long-term survival outcomes have no statistical differences between patients with and without nutritional risk, preoperative nutritional management for them cannot be ignored.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was \begin{document}${\hat {y}} $\end{document}=9.234 3x+22.394 (R2=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.ConclusionsIn the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.
Objective To develop and validate a prediction model to assess the risk of depression in patients with chronic kidney disease (CKD) based on National Health and Nutrition Examination Survey (NHANES) database. Methods Data on patients with CKD were selected from the NHANES between 2005 and 2018. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio for model development and validation, respectively. Multivariable logistic regression was used in the training set to identify independent risk factors associated with depression in CKD patients, with stepwise selection applied to determine the final predictors. Model performance was assessed using receiver operating characteristic curve (ROC), calibration plots, and decision curve analysis (DCA). Internal validation was performed through bootstrap resampling, and a predictive model was ultimately established. Results A total of 4413 CKD patients were included, including 2112 males (47.86%) and 2301 females (52.14%). Among them, 3089 patients were assigned to the training set and 1324 to the validation set. In the training set, 332 patients (10.75%) presented with depressive symptoms, while 143 patients (10.80%) in the validation set had depressive symptoms. Multivariate logistic regression analysis showed that other hispanic, current smoking, and sleep disorders were risk factors (P＜0.05). Male, middle or high-income, high school grad/ged or above, married or widowed were protective factors (P＜0.05). Finally, 7 variables were included to construct a prediction model, including gender, poverty income ratio, education level, marital status, smoking status, body mass index, and sleep disorders. The ROC curve showed that the AUC=0.773 [95% confidence interval (0.747, 0.799)] in the training set, the internal validation was evaluated by 1000 Bootstrap resampling methods, and the corrected C-index=0.763. The validation set AUC=0.778 [95% confidence interval (0.740, 0.815)], showed good discrimination ability. The calibration curve showed that the model’s predicted probability was highly consistent with the actual occurrence. Decision curve analysis showed that the model provided a significant net benefit for clinical decision-making at a threshold probability of 20%～50%. Conclusions The prediction model constructed in this study can effectively predict the risk of depression in patients with CKD and can provide guidance for early screening and personalized intervention for high-risk groups. However, the external validation and localization of the model still needed further research.