Earticle

Background: As preexisting comorbidities are risk factors for Coronavirus Disease 19 (COVID-19), improved tools are needed for screening or diagnosing COVID-19 in clinical practice. Difficulties of including vulnerable patient data may create data imbalance and hinder the provision of well-performing prediction tools, such as artificial intelligence (AI) models. Thus, we systematically reviewed studies on AI prognosis prediction in patients infected with COVID-19 and existing comorbidities, including cancer, to investigate model performance and predictors dependent on patient data. PubMed and Cochrane Library databases were searched. This study included research meeting the criteria of using AI to predict outcomes in COVID-19 patients, whether they had cancer or not. Preprints, abstracts, reviews, and animal studies were excluded from the analysis. Majority of non-cancer studies (54.55 percent) showed an area under the curve (AUC) of >0.90 for AI models, whereas 30.77 percent of cancer studies showed the same result. For predicting mortality (3.85 percent), severity (8.33 percent), and hospitalization (14.29 percent), only cancer studies showed AUC values between 0.50 and 0.69. The distribution of comorbidity data varied more in non-cancer studies than in cancer studies but age was indicated as the primary predictor in all studies. Non-cancer studies with more balanced datasets of comorbidities showed higher AUC values than cancer studies. Based on the current findings, dataset balancing is essential for improving AI performance in predicting COVID-19 in patients with comorbidities, especially considering age.

Background: Recently, the employment retention rate (ERR) of hospital pharmacists has been decreasing and there are difficulties in conducting competency-based education (CBE) for pharmacy students. However, there is limited research on the impact of hospital pharmacists ERR on the quality of CBE. Therefore, this study aims to determine the relationship between the employment retention propensity (ERP) and the satisfaction with CBE of pharmacy students for patient consultation on the safe medication use. Method: A survey study was conducted using survey questionnaires of 5th year pharmacy school students who completed Introductory Pharmacy Practice Education from 2023 to 2024. Students’ perceptions of their ERP before graduation and satisfaction with CBE were assessed. This survey questions consisted of a 5-point Lickert scale and multiple-choice questions, expressed as percentages including multiple responses. Results: Among 57 students, 82.5% (n=47) responded. The most important determinant of employment retention was work environment (66.0%), followed by fair salary (59.6%). Compared to the satisfaction with patient consultation education on the safe medication use at tertiary hospitals, the satisfaction at general hospitals was higher (satisfaction: 66.7% at tertiary hospitals versus 80.0% at general hospitals). Overall satisfaction with the quality of CBE over time tended to gradually decline along with a decrease in pharmacists employment retention [satisfaction: 83% in 2019 vs 68% in 2024]. Conclusion: Employment retention was positively related to work environment and salary level. Further research is needed to establish the relationship between students’ satisfaction with the CBE and the ERP for the future pharmacists.

Background: Health information should be accurate and of high quality. While search websites are widely used to obtain health information, search results can vary depending on the availability of information in each language and the algorithms of search websites. We compared the search results and their reliability on popular search websites in Korea and the United States. Methods: Using the most popular search websites in Korea (A) and the US (B), with B divided into KR and US domains, we evaluated the search results for three diseases (hypertension, diabetes, osteoporosis) and two medications (Lipitor, Norvasc). We compared the proportion of paid ads and website categories, as well as quality and accuracy using a validated scoring tool. Results: Search website A had a high proportion of paid ads (40.3%), compared to B KR (4.3%) and B US (0%). B US had the highest proportion of reliable websites (58.1%), followed by B KR (52.9%) and A (14.6%). B US had the highest median quality score (25) while A had the lowest (14). Additionally, B US had the highest accuracy (95%), followed by B KR (87.7%) and A (52.2%). Conclusions: Our data suggest that health information provided by popular search website in Korea is inaccurate and of low quality compared with that provided by its counterpart in the US. Users should prioritize credible websites, be cautious of ads, and seek professional advice. In addition, joint efforts from the government, search websites, and healthcare professionals are needed to provide accurate online health information.

Background: The evolving healthcare environment necessitates changes in pharmacy education to meet these demands, with problem- based learning (PBL) being a promising approach. Methods: This study employed a single-group, repeated-measures design to evaluate the effects of PBL on the communication and problem-solving skills of fifth-year pharmacy students at S University. The course, which focused on pharmacy practice and communication, included 36 students who participated in structured pre- and post-intervention surveys, as well as self-reflection journals. The primary competencies assessed were problem-solving and communication skills. Data collection involved quantitative measures through surveys and qualitative insights from self-reflection notes. Results: Of the 36 students, 35 completed the pre-intervention surveys, and 27 completed the post-intervention assessments. Significant improvements were observed in problem-solving skills, including problem identification, information gathering, and planning. Communication skills showed overall improvement, though the differences were not statistically significant. Qualitative analysis of self-reflection notes revealed enhanced understanding of elderly patient care, increased responsibility, teamwork, and the importance of effective communication in pharmacy practice. Commonly identified themes included a heightened sense of responsibility, the importance of teamwork, and an appreciation for the multifaceted nature of pharmacy practice in elderly care. Conclusion: The PBL approach effectively enhanced students' problem-solving abilities and provided valuable experiential learning in pharmacy practice. The qualitative data indicated that students gained a deeper understanding of their roles and responsibilities, fostering greater motivation and teamwork. Further research should focus on broader applications across different institutions to validate these findings.

Background: Sunitinib, commonly used for metastatic renal cell carcinoma (mRCC), often induces hypothyroidism, affecting 27 to 85% of patients. There are clues suggesting an association between sunitinib-induced hypothyroidism and improved survival outcomes. This study aims to identify the predictive factors of sunitinib-induced hypothyroidism and evaluate whether the occurrence of overt or subclinical hypothyroidism predicts tumor outcome in patients with mRCC. Methods: Patients administered to sunitinib for mRCC was included in this retrospective study. Log-rank test and Cox proportional hazards model were conducted to identify predictive factors of hypothyroidism and prognostic factors of progression-free survival (PFS) and overall survival (OS). Results: A total of 156 patients with mRCC treated with sunitinib were included. Predictive factors of sunitinib-induced hypothyroidism were female (odds ratio (OR), 2.77), sunitinib-induced hypertension (OR, 2.99) and dose reduction of sunitinib due to intolerance (OR, 3.57). Sunitinib-induced overt hypothyroidism was a significant prognostic factor in predicting PFS and OS (hazard ratio, 0.38 and 0.23, respectively). Thyroid hormone replacement did not have an influence on PFS and OS. Conclusions: Female patients, patients who experienced sunitinib-induced hypertension and sunitinib dose reduction are at higher risk of hypothyroidism and need close monitoring. Overt hypothyroidism is a strong prognostic factor of sunitinib treatment outcome in mRCC patients and thyroid hormone replacement does not have a negative effect on tumor outcome.

Background: Asthma is a chronic inflammatory airway disease associated with systemic inflammation and increased prevalence of various comorbid conditions. This study investigates the prevalence of non-respiratory comorbidities among adult asthma patients in South Korea, aiming to elucidate potential correlations and impacts of asthma on overall health, thereby affecting patients’ quality of life and healthcare systems. Methods: This retrospective cohort study utilized the National Health Insurance Service data (HIRA-NPS-2020) and included adults diagnosed with asthma. Non-respiratory diseases were identified using the Korean Standard Disease Classification (KCD-8) codes, with exclusions applied for other respiratory conditions. The prevalence of comorbidities was analyzed and compared between asthma and non-asthma patients, adjusting for confounders such as age, gender, and insurance status through inverse probability treatment weighting (IPTW). Results: The analysis revealed that asthma patients exhibit significantly higher rates of cardiovascular diseases, metabolic disorders, gastrointestinal conditions, and mental health issues compared to the control group. Notably, conditions such as heart failure, gastroesophageal reflux disease, and anxiety were more prevalent, with odds ratios (OR) ranging from 1.18 to 3.90. These results demonstrate a substantial burden of comorbidities associated with asthma, indicating a broad impact on health beyond the respiratory system. Conclusion: The findings highlight the systemic nature of asthma and the interconnectedness of inflammatory processes across different organ systems. This comprehensive analysis confirms previous research linking asthma with an increased risk of various non-respiratory diseases, providing insights into the multifaceted impact of asthma on patient health.