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1. Application of an Artificial Intelligence Trilogy to Accelerate Processing of Suspected Patients With SARS-CoV-2 at a Smart Quarantine Station: Observational Study

Author

Liu, Ping-Yen, Tsai, Yi-Shan, Chen, Po-Lin, Tsai, Huey-Pin, Hsu, Ling-Wei, Wang, Chi-Shiang, Lee, Nan-Yao, Huang, Mu-Shiang, Wu, Yun-Chiao, Ko, Wen-Chien, Yang, Yi-Ching, Chiang, Jung-Hsien, and Shen, Meng-Ru

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundAs the COVID-19 epidemic increases in severity, the burden of quarantine stations outside emergency departments (EDs) at hospitals is increasing daily. To address the high screening workload at quarantine stations, all staff members with medical licenses are required to work shifts in these stations. Therefore, it is necessary to simplify the workflow and decision-making process for physicians and surgeons from all subspecialties. ObjectiveThe aim of this paper is to demonstrate how the National Cheng Kung University Hospital artificial intelligence (AI) trilogy of diversion to a smart quarantine station, AI-assisted image interpretation, and a built-in clinical decision-making algorithm improves medical care and reduces quarantine processing times. MethodsThis observational study on the emerging COVID-19 pandemic included 643 patients. An “AI trilogy” of diversion to a smart quarantine station, AI-assisted image interpretation, and a built-in clinical decision-making algorithm on a tablet computer was applied to shorten the quarantine survey process and reduce processing time during the COVID-19 pandemic. ResultsThe use of the AI trilogy facilitated the processing of suspected cases of COVID-19 with or without symptoms; also, travel, occupation, contact, and clustering histories were obtained with the tablet computer device. A separate AI-mode function that could quickly recognize pulmonary infiltrates on chest x-rays was merged into the smart clinical assisting system (SCAS), and this model was subsequently trained with COVID-19 pneumonia cases from the GitHub open source data set. The detection rates for posteroanterior and anteroposterior chest x-rays were 55/59 (93%) and 5/11 (45%), respectively. The SCAS algorithm was continuously adjusted based on updates to the Taiwan Centers for Disease Control public safety guidelines for faster clinical decision making. Our ex vivo study demonstrated the efficiency of disinfecting the tablet computer surface by wiping it twice with 75% alcohol sanitizer. To further analyze the impact of the AI application in the quarantine station, we subdivided the station group into groups with or without AI. Compared with the conventional ED (n=281), the survey time at the quarantine station (n=1520) was significantly shortened; the median survey time at the ED was 153 minutes (95% CI 108.5-205.0), vs 35 minutes at the quarantine station (95% CI 24-56; P

Published
2020
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9. Prasugrel switching from clopidogrel after percutaneous coronary intervention for acute coronary syndrome in Taiwanese patients: an analysis of safety and efficacy

Author

Liu, Ping-Yen, Su, Cheng-Huang, Kuo, Feng-Yu, Lee, Wen-Lieng, Wang, Yi-Chih, Lin, Wei-Shiang, Chu, Pao-Hsien, Lu, Tse-Min, Lo, Ping-Han, Lee, Cheng-Han, Lan, Wei-Ren, Huang, Chien-Lung, Tsukiyama, Shuji, Yang, Wei-Chen, Cheng, Li-Chung, Rafael, Virginia, Nikolajsen, Christian, and Yin, Wei-Hsian

Published
2022
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16. 2021 Consensus Pathway of the Taiwan Society of Cardiology on Novel Therapy for Type 2 Diabetes

Author

Chiang, Chern-En, Ueng, Kwo-Chang, Chao, Ting-Hsing, Lin, Tsung-Hsien, Wu, Yih-Jer, Wang, Kang-Ling, Sung, Shih-Hsien, Yeh, Hung-I, Li, Yi-Heng, Liu, Ping-Yen, Chang, Kuan-Cheng, Shyu, Kou-Gi, Huang, Jin-Long, Tsai, Cheng-Dao, Hung, Huei-Fong, Liu, Ming-En, Chao, Tze-Fan, Cheng, Shu-Meng, Cheng, Hao-Min, Chu, Pao-Hsien, Yin, Wei-Hsian, Wu, Yen-Wen, Chen, Wen-Jone, Lai, Wen-Ter, Lin, Shing-Jong, Yeh, San-Jou, Hwang, Juey-Jen, and Hou, Charles Jia-Yin

Published
2021
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22. High premature atrial complex burden and risk of renal function decline.

Author

Chen, Chao-Yu, Yu, Chih-Hen, Lee, Po-Tseng, Huang, Mu-Shiang, Chiu, Pin-Hsuan, Su, Pei-Fang, Liu, Ping-Yen, and Huang, Ting-Chun

Subjects
CHRONIC kidney failure, DISEASE risk factors, PROPENSITY score matching, GLOMERULAR filtration rate, ATRIAL fibrillation
Abstract

Background Atrial arrhythmia, particularly atrial fibrillation (AF), is known to be associated with renal function decline and increased risk of end-stage kidney disease. In recent years, premature atrial complexes (PACs) as subclinical arrhythmia have been proposed to be a marker of atrial cardiomyopathy and associated with poor clinical outcomes. However, the relationship between excessive daily PAC burden and renal outcomes remains unexplored. Methods This retrospective, all-comers cohort study analyzed 30 488 consecutive Holter monitoring records obtained from a validated Holter databank at a referral medical center in Taiwan between 2011 and 2018. After exclusion, 10 981 patients were categorized into three groups: high daily PAC burden (≥100 beats per day), low PAC burden (<100 beats per day) and the AF group. We used parallel propensity score matching to balance confounding factors between groups. The primary study interest was major adverse kidney events, including an estimated glomerular filtration rate (eGFR) decline of 40%, eGFR <15 mL/min/1.73 m2 or the initiation of hemodialysis. Results After a mean follow-up of 4.07 ± 3.03 years, patients with high PAC burden had a 1.24-fold higher incidence of major adverse kidney events compared with the low PAC burden group [95% confidence interval (CI) 1.03–1.50]. The risk of major adverse kidney events was similar between patients with AF and those with high PAC burden [adjusted hazard ratio (HR) 1.05, 95% CI 0.87–1.25], but significantly higher in the AF group than in the low PAC burden group (adjusted HR 1.29, 95% CI 1.07–1.56). Conclusion Excessive daily PAC burden is associated with a higher risk of major adverse kidney events and has a comparable impact as AF. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Correction to: Prasugrel switching from clopidogrel after percutaneous coronary intervention for acute coronary syndrome in Taiwanese patients: an analysis of safety and efficacy

Author

Liu, Ping-Yen, Su, Cheng-Huang, Kuo, Feng-Yu, Lee, Wen-Lieng, Wang, Yi-Chih, Lin, Wei-Shiang, Chu, Pao-Hsien, Lu, Tse-Min, Lo, Ping-Han, Lee, Cheng-Han, Lan, Wei-Ren, Huang, Chien-Lung, Tsukiyama, Shuji, Yang, Wei-Chen, Cheng, Li-Chung, Rafael, Virginia, Nikolajsen, Christian, and Yin, Wei-Hsian

Published
2022
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33. Cover Image

Author

Ko, Cheng‐Yu, primary, Yu, Li‐Ying, additional, Chen, Po‐Wei, additional, Ko, Chih‐Chang, additional, Lin, Tian‐Xi, additional, Lee, Cheng‐Han, additional, Liu, Ping‐Yen, additional, and Chang, Hsien‐Yuan, additional

Published
2023
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35. 2018 consensus of the Taiwan Society of Cardiology and the Diabetes Association of Republic of China (Taiwan) on the pharmacological management of patients with type 2 diabetes and cardiovascular diseases

Author

Chiang, Chern-En, Lin, Shih-Yi, Lin, Tsung-Hsien, Wang, Tzung-Dau, Yeh, Hung-I, Chen, Jung-Fu, Tsai, Chia-Ti, Hung, Yi-Jen, Li, Yi-Heng, Liu, Ping-Yen, Chang, Kuan-Cheng, Wang, Kang-Ling, Chao, Ting-Hsing, Shyu, Kou-Gi, Yang, Wei-Shiung, Ueng, Kwo-Chang, Chu, Pao-Hsien, Yin, Wei-Hsian, Wu, Yen-Wen, Cheng, Hao-Min, Shin, Shyi-Jang, Huang, Chien-Ning, Chuang, Lee-Ming, Lin, Shing-Jong, Yeh, San-Jou, Sheu, Wayne Huey-Herng, and Lin, Jiunn-Lee

Published
2018
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39. 2020 Consensus of Taiwan Society of Cardiology on the pharmacological management of patients with type 2 diabetes and cardiovascular diseases

Author

Chiang, Chern-En, Ueng, Kwo-Chang, Chao, Ting-Hsing, Lin, Tsung-Hsien, Wu, Yih-Jer, Wang, Kang-Ling, Sung, Shih-Hsien, Yeh, Hung-I, Li, Yi-Heng, Liu, Ping-Yen, Chang, Kuan-Cheng, Shyu, Kou-Gi, Huang, Jin-Long, Tsai, Cheng-Dao, Hung, Huei-Fong, Liu, Ming-En, Chao, Tze-Fan, Cheng, Shu-Meng, Cheng, Hao-Min, Chu, Pao-Hsien, Yin, Wei-Hsian, Wu, Yen-Wen, Chen, Wen-Jone, Lai, Wen-Ter, Lin, Shing-Jong, Yeh, San-Jou, and Hwang, Juey-Jen

Published
2020
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42. 2023 Consensus of Taiwan Society of Cardiology on the Pharmacological Treatment of Chronic Heart Failure

Author

Chiang, Chern-En, Hung, Chung-Lieh, Wu, Yen-Wen, Lin, Tsung-Hsien, Ueng, Kwo-Chang, Sung, Shih-Hsien, Wu, Cho-Kai, Chao, Ting-Hsing, Lin, Hung-Ju, Lin, Yen-Hung, Huang, Jin-Long, Chen, Michael Yu Chih, Lin, Po-Lin, Chao, Tze-Fan, Cheng, Hao-Min, Liu, Ming-En, Wang, Tzung-Dau, Yeh, Hung-I, Li, Yi-Heng, Liu, Ping-Yen, Yin, Wei-Hsian, Hsieh, I-Chang, Wang, Chun-Chieh, Chen, Chen-Huan, Chu, Pao-Hsien, Lin, Shing-Jong, Yeh, San-Jou, Lin, Jiunn-Lee, Hwang, Juey-Jen, Hung, Huei-Fong, Chen, Wen-Jone, and Hou, Charles Jia-Yin

Subjects
Consensus
Abstract

The prevalence of heart failure is increasing, causing a tremendous burden on health care systems around the world. Although mortality rate of heart failure has been significantly reduced by several effective agents in the past 3 decades, yet it remains high in observational studies. More recently, several new classes of drugs emerged with significant efficacy in reducing mortality and hospitalization in chronic heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). To integrate these effective therapies and prioritize them in the management of Asian patients, Taiwan Society of Cardiology has recently appointed a working group to formulate a consensus of pharmacological treatment in patients with chronic heart failure. Based on most updated information, this consensus provides rationales for prioritization, rapid sequencing, and in-hospital initiation of both foundational and additional therapies for patients with chronic heart failure.

Published
2023

43. Management of Restenosis after Stenting in Left Main Coronary Artery Disease

Author

Huang, Chen-Wei, Huang, Mu-Shiang, Su, Pei-Fang, Chao, Ting-Hsing, Lee, Cheng-Han, and Liu, Ping-Yen

Subjects
Original Article
Abstract

BACKGROUND: The optimal alternative treatment strategy to coronary artery bypass graft surgery (CABG) for in-stent restenosis (ISR) in left main (LM) coronary artery disease remains uncertain. METHODS: We retrospectively screened all intervention reports from an intervention database and extracted those mentioning an LM stent. We then manually confirmed reports involving LM ISR and divided them into two groups, those in which the patient received a new drug-eluting stent (new-DES) strategy, and those in which the patient received a drug-coated balloon (DCB) only. A composite endpoint of major adverse cardiovascular events (MACEs) and each individual endpoint were compared. We also performed a brief analysis of similar designed studies. RESULTS: Between the new-DES (n = 40) and DCB-only (n = 22) groups, during median respective follow-up times of 581.5 and 642.5 days, no significant statistical differences were detected in MACEs (50.0% vs. 50.0%, p = 0.974), cardiovascular death (27.5% vs. 13.6%, p = 0.214), nonfatal myocardial infarction (30.0% vs. 31.8%, p = 0.835), or target lesion revascularization (35.0% vs. 45.5%, p = 0.542). We analyzed four similar studies and found comparable MACE findings (odds ratio: 0.85, 95% CI: 0.44-1.67). CONCLUSIONS: Our findings support both DCB angioplasty and repeat DES implantation for LMISR lesions in patients who were clinically judged to be unsuitable for CABG; the treatments achieved comparable clinical results in terms of MACEs in the medium term.

Published
2023

44. The Effects of Post-Acute Care in Patients with Heart Failure in Taiwan: A Single Center Experience

Author

Wang, Pei-Yi, Lin, Wen-Chih, Hsieh, Pei-Chun, Lin, Sheng-Hsiang, Liu, Ping-Yen, Chao, Ting-Hsing, and Hsu, Chih-Hsin

Subjects
Original Article
Abstract

BACKGROUND: The National Health Insurance Administration in Taiwan has promoted the heart failure post-acute care (HF-PAC) program as a means to provide proactive integrated care within the optimal treatment timeframe to enhance functional recovery after acute decompensated heart failure (HF). OBJECTIVES: The aim of this program was to reduce HF readmission rates, improved medication prescription rates, and improve the quality of life in HF patients. METHODS: Patients who had a reduced left ventricular ejection fraction (LVEF) of ≤ 40% were included and followed up for 6 months after discharge. They underwent cardiac rehabilitation and physiological, and nutritional status evaluations. The main clinical outcomes of the HF-PAC program were guideline-directed medical therapy prescription rate and 6-month readmission rate. RESULTS: A total of 122 patients were recruited from June 2018 to December 2020 at a medical center in southern Taiwan. The patients’ activities of daily living, nutritional status, quality of life and LVEF were significantly improved during the HF-PAC program. More than 95% of the patients received guideline-directed medical prescriptions at the end of the HF-PAC program. The cardiovascular-related 6-month re-admission rate after the HF-PAC program ended was 27.7%, and it could be predicted by the New York Health Association functional class [hazard ratio (HR) 95% confidence interval (95% CI) = 4.12 (1.36-12.46)], value of the Mini Nutritional Assessment - Short Form [HR (95% CI) = 0.46 (0.31-0.68)] and LVEF [HR (95% CI) = 0.95 (0.91-0.99)]. CONCLUSIONS: By incorporating multidisciplinary healthcare teams, the HF-PAC program improves the guideline- directed medical therapy prescription rate, thus improving patients’ cardiac function, physical activity recovery, the quality of life, and also reduces their readmission rate.

Published
2023

47. Comparison of Home and Ambulatory Blood Pressure Measurements in Association With Preclinical Hypertensive Cardiovascular Damage

Author

Lin, Ting-Tse, Juang, Jimmy Jyh-Ming, Lee, Jen-Kuang, Tsai, Chia-Ti, Chen, Chen-Huan, Yu, Wen-Chung, Cheng, Hao-min, Wu, Yen-Wen, Chiu, Yu-Wei, Kuo, Chi-Tai, Chen, Jin-Jer, Chen, Zhih-Cherng, Chang, Wei-Ting, Liu, Ping-Yen, Chen, Po-wei, Yen, Hsueh-Wei, Chen, Ying-Chih, Tseng, Wei-Kung, Chiang, Fu-Tien, and Wu, Cho-Kai

Published
2019
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50. Manual compression technique improves the success rate in the treatment of thrombosed aneurysmal arteriovenous fistula: A single‐center experience.

Author

Ko, Cheng‐Yu, Yu, Li‐Ying, Chen, Po‐Wei, Ko, Chih‐Chang, Lin, Tian‐Xi, Lee, Cheng‐Han, Liu, Ping‐Yen, and Chang, Hsien‐Yuan

Subjects
ARTERIOVENOUS fistula, ENDOVASCULAR surgery, PULMONARY embolism, ANGIOPLASTY
Abstract

Objective: Endovascular intervention for thrombosed aneurysmal arteriovenous fistula (AVF) is still a challenge. Manual compression technique (MCT)‐assisted angioplasty may be helpful, but there is no evidence or data to support it. Methods: From January 2018 to May 2021, patients with thrombosed aneurysmal AVFs were retrospectively enrolled. The patients were separated into the MCT group or the traditional group according to the procedure received. Technical failure, clinical failure, 90‐day patency, and safety were analyzed. Results: A total of 159 cases (64 ± 12 years old, 60% male) were enrolled, of which 87 cases received MCT and 72 underwent traditional angioplasty. No technical failure was observed in the MCT group, while five technical failures were observed in the traditional group (0% vs. 7%, p = 0.02). There were no differences in the clinical failure rate (3% vs. 7%, p = 0.30), 90‐day patency rate, or procedure time between the MCT group and the traditional group. There was no symptomatic pulmonary embolism or other complication in the two groups. Conclusion: MCT is a low‐cost, less invasive, and safe procedure for thrombosed aneurysmal AVF, and it achieves a higher technical success rate than traditional angioplasty. [ABSTRACT FROM AUTHOR]

Published
2023
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