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Purpose To examine the effect that a test set from 1 region of the world has on the performance of expert breast radiologists from that region and from a distant region. Methods Forty-seven Australian and 15 Singaporean breast radiologists interpreted the same test set (ie, 60 mammograms of Australian women consisting of 40 typical and 20 atypical cases) in their respective locations. The radiologists assigned each case a confidence score of 1 to 5, where 1 was typical, 2 was benign, and 3 to 5 indicated identifiable cancer. Localization-response operating characteristic area under the curve (AUC), receiver operating characteristic AUC, location sensitivity, case sensitivity, and specificity were calculated for each radiologist and compared between Australian and Singaporean readers using nonparametric 2-tailed Mann-Whitney U tests. Results Australian readers performed better than did their Singaporean counterparts with respect to localization-response operating characteristic AUC (.738 vs .642, P = .0395) and location sensitivity (.775 vs .660, P = .0185). Discussion Technological advancement has made possible telereporting, in which radiologists report on mammograms originating from other countries. However, those readers' levels of performance might be affected by interpreting images from populations that are different from those with which they are familiar. Conclusion Radiologist performance differed between the groups when localization of lesions was taken into account. This difference might be because of the Australians' reading mammograms from populations with which they were familiar, in contrast to the Singaporeans. [ABSTRACT FROM AUTHOR]

Objectives: This study establishes age- and sex-specific reference values for fat mass index (FMI), lean mass index (LMI), appendicular LMI (aLMI), and body fat distribution indices including Android/Gynoid % fat ratio and Trunk/Limb % fat ratio in multi-ethnic Singaporean adults., Methods: A population-based cross-sectional study using dual-energy X-ray absorptiometry (Hologic Discovery Wi) was carried out to measure whole body and regional fat and lean mass in community-dwelling adults. A total of 537 adults (57.5% women), aged from 21 to 90 years, were recruited from the large north-eastern residential town of Yishun. Age- and sex-specific percentile reference values were generated for FMI, LMI, aLMI, Android/Gynoid % fat ratio and Trunk/Limb % fat ratio using the Lambda-Mu-Sigma method. The relationship between the parameters and age were assessed through the Pearson's correlation coefficient., Results: All parameters demonstrated significant correlation with age (p < 0.05) for both men and women, except for LMI in women, with the strength of r ranging from 0.12 (weak correlation) to 0.54 (strong correlation). LMI (r = -0.45) and appendicular LMI (r = -0.54) were negatively associated with age in men while none (r = -0.06) to weak correlation (r = -0.14) were shown in women for the same parameters respectively. The Android/Gynoid % fat ratio and Trunk/Limb % fat ratio were positively related to age for both men (r = 0.37 & 0.43, p < 0.001) and women (r = 0.52 & 0.48, p < 0.001)., Conclusion: We have established DXA-based body composition reference data for the Singapore adult population. These reference data will be particularly useful in geriatric, obesity and oncology clinics, enabling the prescription of appropriate therapy to individuals at risk of morbidity from unfavorable body composition phenotypes. It also adds on to the limited reference database on Southeast Asian body composition., Competing Interests: The authors have declared that no competing interests exist.

Purpose: To determine the rates and develop an initial risk prediction model for nonadherence to post screening ophthalmic referral (PSOR) in type 2 diabetes mellitus (T2DM) patients attending a national diabetic retinopathy screening program in Singapore., Methods: Data from 2387 patients with T2DM (mean [standard deviation] age: 66.5 [11] years; 52.5% female patients) who underwent teleophthalmic screening between 2010 and 2014 under the Singapore Integrated Diabetic Retinopathy Program were extracted from electronic medical records. All were referred for tertiary ophthalmic management at the Singapore National Eye Centre (SNEC). Nonadherence was defined as not attending the SNEC appointment within 6 months of the assigned appointment date. Regression analysis using traditional modified Poisson and conditional inference models was used to construct and evaluate the discriminative ability of the preliminary risk prediction model to identify nonadherent individuals., Results: Nonadherence rates to PSOR was 12.7% (95% confidence interval, 11.4%-14.1%). In traditional multivariable models adjusted for sociodemographic, lifestyle, and ocular factors, nonadherent individuals had higher triglyceride levels and were less likely to have a referable eye condition ( P < 0.05). This model was able to identify nonadherent individuals with an accuracy (area under the curve) of 84%. In contrast, the conditional inference model was able to achieve similar discriminative ability using only participants' ocular health characteristics., Conclusions: The rates of nonadherence to PSOR in Singaporean individuals with T2DM is low, with better ocular health being strongly predictive of nonadherence in our Asian population., Translational Relevance: Our results may inform interventions to decrease nonadherence to PSOR., Competing Interests: Disclosure: J.T. Sia, None; A.T.L. Gan, None; B.P. Soh, None; E. Fenwick, None; J. Quah, None; T. Sahil, None; Y. Tao, None; N.C. Tan, None; C. Sabanayagam, None; E.L. Lamoureux, None; R.E.K. Man, None, (Copyright 2020 The Authors.)