Prediction of Time to Recurrence and Influencing Factors for Gastric Cancer in Iran

Roshanaei, Ghodratollah,Ghannad, Masoud Sabouri,Safari, Maliheh,Sadighi, Sanambar Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.6

Background: The patterns of gastric cancer recurrence vary across societies. We designed the current study in an attempt to evaluate and reveal the outbreak of the recurrence patterns of gastric cancer and also prediction of time to recurrence and its effected factors in Iran. Materials and Methods: This research was performed from March 2003 to February 2007. Demographic characteristics, clinical and pathological diagnosis and classification including pathologic stage, tumor grade, tumor site and tumor size in of patients with GC recurrent were collected from patients' data files. To evaluate of factors affected on the relapse of the GC patients, gender, age at diagnosis, treatment type and Hgb were included in the research. Data were analyzed using Kaplan-Meier and logistic regression models. Results: After treatment, 82 patients suffered recurrence, 42, 33 and 17 by the ends of first, second and third years. The mean ( SD) and median ( IQR) time to recurrence in patients with GC were 25.5 (20.6-30.1) and 21.5 (15.6-27.1) months, respectively. The results of multivariate analysis logistic regression showed that only pathologic stage, tumor grade and tumor site significantly affected the recurrence. Conclusions: We found that pathologic stage, tumor grade and tumor site significantly affect on the recurrence of GC which has a high positive prognostic value and might be functional for better follow-up and selecting the patients at risk. We also showed time to recurrence to be an important factor for follow-up of patients.

Survival Analysis of Gastric Cancer Patients with Incomplete Data

Moghimbeigi, Abbas,Tapak, Lily,Roshanaei, Ghodaratolla,Mahjub, Hossein The Korean Gastric Cancer Association 2014 Journal of gastric cancer Vol.14 No.4

Purpose: Survival analysis of gastric cancer patients requires knowledge about factors that affect survival time. This paper attempted to analyze the survival of patients with incomplete registered data by using imputation methods. Materials and Methods: Three missing data imputation methods, including regression, expectation maximization algorithm, and multiple imputation (MI) using Monte Carlo Markov Chain methods, were applied to the data of cancer patients referred to the cancer institute at Imam Khomeini Hospital in Tehran in 2003 to 2008. The data included demographic variables, survival times, and censored variable of 471 patients with gastric cancer. After using imputation methods to account for missing covariate data, the data were analyzed using a Cox regression model and the results were compared. Results: The mean patient survival time after diagnosis was $49.1{\pm}4.4$ months. In the complete case analysis, which used information from 100 of the 471 patients, very wide and uninformative confidence intervals were obtained for the chemotherapy and surgery hazard ratios (HRs). However, after imputation, the maximum confidence interval widths for the chemotherapy and surgery HRs were 8.470 and 0.806, respectively. The minimum width corresponded with MI. Furthermore, the minimum Bayesian and Akaike information criteria values correlated with MI (-821.236 and -827.866, respectively). Conclusions: Missing value imputation increased the estimate precision and accuracy. In addition, MI yielded better results when compared with the expectation maximization algorithm and regression simple imputation methods.

Estimation of Survival Rates in Patients with Lung Cancer in West Azerbaijan, the Northwest of Iran

Abazari, Malek,Gholamnejad, Mahdia,Roshanaei, Ghodratollah,Abazari, Reza,Roosta, Yousef,Mahjub, Hossein Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9

Background: Lung cancer is a fatal malignancy with high mortality and short survival time. The aim of this study was to estimate survival rates of Iranian patients with lung cancer and its associate predictive factors. Materials and Methods: The study was conducted on 355 patients admitted to hospitals of West Azerbaijan in the year 2007. The patients were followed up by phone calls until the end of June 2014. The survival rate was estimated using the Kaplan-Meier method and log-rank test for comparison. The Cox's proportional hazard model was used to investigate the effect of various variables on patient survival time, including age, sex, Eastern Cooperative Oncology Group (ECOG) performance, smoking status, tumor type, tumor stage, treatment, metastasis, and blood hemoglobin concentration. Results: Of the 355 patients under study, 240 died and 115 were censored. The mean and median survival time of patients was 13 and 4.8 months, respectively. According to the results of Kaplan-Meier method, 1, 2, and 3 years survival rates were 39%, 18%, and 0.07%, respectively. Based on Cox regression analysis, the risk of death was associated with ECOG group V (1.83, 95% CI: 1 Conclusions: The survival time of the patients with lung cancer is very short. While early diagnosis may improve the life expectancy effective treatment is not available.

Evaluation of Drug Abuse Relapse Event Rate Over Time in Frailty Model

Somaye Hosseini,Abbas Moghimbeigi,Ghodratollah Roshanaei,Farzaneh Momeniarbat 질병관리본부 2014 Osong Public Health and Research Persptectives Vol.5 No.2

Objectives: Drug dependence as a chronic disorder is reversible over time and has a cost burden for individuals, families, and society. An individual who has stopped taking drugs for a long time may start taking drugs again. The variables affecting the reuse of drugs are not well known. Therefore a study of the factors that increase the length of time away from drugs is essential. Methods: This study used data collected by the Bushehr addiction treatment centers (Tolloe and Pasargadae) from 100 men with drug addiction from March 2006 to September 2010. The shared frailty model was used to study the influence of variables on the duration of time away from drug use. The most common method for entering intra-class (personal) correlation is the survival frailty model, which uses parametric survival data for the evaluation of recurrent events. A Weibull distribution for time to event with gamma shared frailty was used. Results: The mean (standard deviation) age and age at onset of opium use of the sample were 33.85 (8.11) and 20.65 (6.87), respectively. About 30% of the men studied had chronic disease and 36% had a mental illness. The mean (frequency mean) of the amount of opium used were 4.73 (3.8) g and 2.54 (1.14) times per day. The desire to end drug use was 97% and 3% for the men with drug addiction and their families, respectively, at the time when the men stopped using opium. The age at onset of opium use [p = 0.046, hazards ratio (HR) = 1.30], history of chronic disease (p = 0.005, HR = 249.635), and marital status (p = 0.06, HR = 0.027) are important in the reuse of opium. Conclusion: We found that opium addiction is related to other chronic diseases and to the age at onset of opium use. A prospective study following up individuals with drug addiction who try to stop drug use in addiction treatment centers could help to determine the risk factors of resuming drug use.

Comparison of the Performance of Log-logistic Regression and Artificial Neural Networks for Predicting Breast Cancer Relapse

Faradmal, Javad,Soltanian, Ali Reza,Roshanaei, Ghodratollah,Khodabakhshi, Reza,Kasaeian, Amir Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.14

Background: Breast cancer is the most common cancers in female populations. The exact cause is not known, but is most likely to be a combination of genetic and environmental factors. Log-logistic model (LLM) is applied as a statistical method for predicting survival and it influencing factors. In recent decades, artificial neural network (ANN) models have been increasingly applied to predict survival data. The present research was conducted to compare log-logistic regression and artificial neural network models in prediction of breast cancer (BC) survival. Materials and Methods: A historical cohort study was established with 104 patients suffering from BC from 1997 to 2005. To compare the ANN and LLM in our setting, we used the estimated areas under the receiver-operating characteristic (ROC) curve (AUC) and integrated AUC (iAUC). The data were analyzed using R statistical software. Results: The AUC for the first, second and third years after diagnosis are 0.918, 0.780 and 0.800 in ANN, and 0.834, 0.733 and 0.616 in LLM, respectively. The mean AUC for ANN was statistically higher than that of the LLM (0.845 vs. 0.744). Hence, this study showed a significant difference between the performance in terms of prediction by ANN and LLM. Conclusions: This study demonstrated that the ability of prediction with ANN was higher than with the LLM model. Thus, the use of ANN method for prediction of survival in field of breast cancer is suggested.

Survival Analysis of Gastric Cancer Patients with Incomplete Data

Abbas Moghimbeigi,Lily Tapak,Ghodaratolla Roshanaei,Hossein Mahjub 대한위암학회 2014 Journal of gastric cancer Vol.14 No.4

Purpose: Survival analysis of gastric cancer patients requires knowledge about factors that affect survival time. This paper attempted to analyze the survival of patients with incomplete registered data by using imputation methods. Materials and Methods: Three missing data imputation methods, including regression, expectation maximization algorithm, and multiple imputation (MI) using Monte Carlo Markov Chain methods, were applied to the data of cancer patients referred to the cancer institute at Imam Khomeini Hospital in Tehran in 2003 to 2008. The data included demographic variables, survival times, and censored variable of 471 patients with gastric cancer. After using imputation methods to account for missing covariate data, the data were analyzed using a Cox regression model and the results were compared. Results: The mean patient survival time after diagnosis was 49.1±4.4 months. In the complete case analysis, which used information from 100 of the 471 patients, very wide and uninformative confidence intervals were obtained for the chemotherapy and surgery hazard ratios (HRs). However, after imputation, the maximum confidence interval widths for the chemotherapy and surgery HRs were 8.470 and 0.806, respectively. The minimum width corresponded with MI. Furthermore, the minimum Bayesian and Akaike information criteria values correlated with MI (−821.236 and −827.866, respectively). Conclusions: Missing value imputation increased the estimate precision and accuracy. In addition, MI yielded better results when compared with the expectation maximization algorithm and regression simple imputation methods.

Effects of Group Training Based on the Health Belief Model on Knowledge and Behavior Regarding the Pap Smear Test in Iranian Women: a Quasi-Experimental Study

Shobeiri, Fatemeh,Javad, Masoumeh Taravati,Parsa, Parisa,Roshanaei, Ghodratollah Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.6

The Pap smear test is recommended for early diagnosis of cervical cancer. The aim of this study was to assess knowledge and behavior regarding the Pap smear test based on the Health Belief Model (HBM) in women referred to premarital counseling classes, Hamadan, Iran. This quasi-experimental study was conducted on 330 women, who were allocated randomly to two case and control groups (n=165). Two educational session classes were performed in the case group. Two stages in before and after intervention groups were evaluated. Analysis of data was performed by SPSS/16.0, using t-test, $x^2$, and McNemar's test. P-values <0.05 were regarded as significant. There was no significant difference between the mean scores of the various structures of this model in two groups before the intervention. However, after the intervention there were significant increase in mean score of knowledge and all variables of HBM in the intervention group(P<0.001). The findings of this study highlight the important role of education about cervical cancer on changing women's beliefs about cervical screening.

Evaluation of Related Risk Factors in Number of Musculoskeletal Disorders Among Carpet Weavers in Iran

Karimi, Nasim,Moghimbeigi, Abbas,Motamedzade, Majid,Roshanaei, Ghodratollah Occupational Safety and Health Research Institute 2016 Safety and health at work Vol.7 No.4

Background: Musculoskeletal disorders (MSDs) are a common problem among carpet weavers. This study was undertaken to introduce affecting personal and occupational factors in developing the number of MSDs among carpet weavers. Methods: A cross-sectional study was performed among 862 weavers in seven towns with regard to workhouse location in urban or rural regions. Data were collected by using questionnaires that contain personal, workplace, and information tools and the modified Nordic MSDs questionnaire. Statistical analysis was performed by applying Poisson and negative binomial mixed models using a full Bayesian hierarchical approach. The deviance information criterion was used for comparison between models and model selection. Results: The majority of weavers (72%) were female and carpet weaving was the main job of 85.2% of workers. The negative binomial mixed model with lowest deviance information criterion was selected as the best model. The criteria showed the convergence of chains. Based on 95% Bayesian credible interval, the main job and weaving type variables statistically affected the number of MSDs, but variables age, sex, weaving comb, work experience, and carpet weaving looms were not significant. Conclusion: According to the results of this study, it can be concluded that occupational factors are associated with the number of MSDs developing among carpet weavers. Thus, using standard tools and decreasing hours of work per day can reduce frequency of MSDs among carpet weavers.

Evaluation of Related Risk Factors in Number of Musculoskeletal Disorders Among Carpet Weavers in Iran

Nasim Karimi,Abbas Moghimbeigi,Majid Motamedzade,Ghodratollah Roshanaei 한국산업안전보건공단 산업안전보건연구원 2016 Safety and health at work Vol.7 No.4

Background: Musculoskeletal disorders (MSDs) are a common problem among carpet weavers. This study was undertaken to introduce affecting personal and occupational factors in developing the number of MSDs among carpet weavers. Methods: A cross-sectional study was performed among 862 weavers in seven towns with regard to workhouse location in urban or rural regions. Data were collected by using questionnaires that contain personal, workplace, and information tools and the modified Nordic MSDs questionnaire. Statistical analysis was performed by applying Poisson and negative binomial mixed models using a full Bayesian hierarchical approach. The deviance information criterion was used for comparison between models and model selection. Results: The majority of weavers (72%) were female and carpet weaving was the main job of 85.2% of workers. The negative binomial mixed model with lowest deviance information criterion was selected as the best model. The criteria showed the convergence of chains. Based on 95% Bayesian credible interval, the main job and weaving type variables statistically affected the number of MSDs, but variables age, sex, weaving comb, work experience, and carpet weaving looms were not significant. Conclusion: According to the results of this study, it can be concluded that occupational factors are associated with the number of MSDs developing among carpet weavers. Thus, using standard tools and decreasing hours of work per day can reduce frequency of MSDs among carpet weavers.

Knowledge of General Dentists and Senior Dental Students in Iran about Prevention of Infective Endocarditis

Fatemeh Ahmadi-Motamayel,Samaneh Vaziri,Ghodratollah Roshanaei 전남대학교 의과학연구소 2012 전남의대학술지 Vol.48 No.1

Infective endocarditis (IE) is an infection of the endothelial surface of the heart and heart valves with serious, even fatal, complications and that often requires long-term and expensive treatment. Dental procedures may lead to IE in high-risk patients. The aim of this study was to evaluate and compare the knowledge of general dentists and dental students concerning the prevention of IE in Hamadan, Iran. In this cross-sectional study, the awareness of general dentists and dentistry students concerning the prevention of IE was evaluated during 2010. A questionnaire was prepared and administered to 58 final-year dental students and 96 general dental practitioners in Hamadan. A total of 154 persons completed the questionnaire. The questionnaire consisted of some demographic questions and questions about awareness of IE in three sections. The gathered data were analyzed by using descriptive statistics, Pearson’s chi-square test, Mann-Whitney test, and independent t-tests. The gathered data showed that dentistry students answered the questions about awareness of the prevention of IE more correctly than did general dentists. The overall knowledge of endocarditis prophylaxis among students and dentists was about 65% and 56%,respectively. The students’ knowledge was better because 94.9% of the students had desired (acceptable) and relatively desired knowledge; this result for dentists, however,was 82.3%. In our study, the overall awareness level of the study population was moderate. Dentist and students believed that patients with prosthetic valves and previous IE were the most common cardiac disease cases that required prophylaxis. The most common prophylactic regimen was in accordance with the guidelines of the American Heart Association and was a single dose of 2 g amoxicillin 1 hour before treatment. The results indicated that gender had no effect on the level of knowledge;however, there was a statistically significant relationship between age and level of knowledge.