This systematic review aims to address the research gap in the performance of computational algorithms for the digital image analysis of HER2 images in clinical settings. While numerous studies have explored various aspects of these algorithms, there is a lack of comprehensive evaluation regarding their effectiveness in real-world clinical applications. We conducted a search of the Web of Science and PubMed databases for studies published from 31 December 2013 to 30 June 2024, focusing on performance effectiveness and components such as dataset size, diversity and source, ground truth, annotation, and validation methods. The study was registered with PROSPERO (CRD42024525404). Key questions guiding this review include the following: How effective are current computational algorithms at detecting HER2 status in digital images? What are the common validation methods and dataset characteristics used in these studies? Is there standardization of algorithm evaluations of clinical applications that can improve the clinical utility and reliability of computational tools for HER2 detection in digital image analysis? We identified 6833 publications, with 25 meeting the inclusion criteria. The accuracy rate with clinical datasets varied from 84.19% to 97.9%. The highest accuracy was achieved on the publicly available Warwick dataset at 98.8% in synthesized datasets. Only 12% of studies used separate datasets for external validation; 64% of studies used a combination of accuracy, precision, recall, and F1 as a set of performance measures. Despite the high accuracy rates reported in these studies, there is a notable absence of direct evidence supporting their clinical application. To facilitate the integration of these technologies into clinical practice, there is an urgent need to address real-world challenges and overreliance on internal validation. Standardizing study designs on real clinical datasets can enhance the reliability and clinical applicability of computational algorithms in improving the detection of HER2 cancer.
Background/Objectives: There has been a lack of a holistic approach to evaluating antibiotic consumption in Kazakhstan over the past few years using an internationally recognized methodology. Therefore, this study aimed to provide a nationwide evaluation of antibiotic consumption in Kazakhstan during the period 2019–2023. Methods: Defined daily doses per 1000 inhabitants per day (DIDs) were calculated for systemic antibiotics (J01 code of the Anatomical Therapeutic Chemical Classification System (ATC)) following the methodology established by the Global Antimicrobial Resistance and Use Surveillance System (GLASS-AMC). The average annual percent change (AAPC) was computed for each chemical agent, pharmacological group, and J01 in general to evaluate past trends in antibiotic consumption. Results: The consumption of J01 antibiotics ranged between 10.869 DIDs (2022) and 14.470 DIDs (2020). There was an increase in antibiotic consumption during 2020 and 2021, but the overall trend was declining, with an AAPC of −2.45%. Azithromycin was the most consumed systemic antibiotic, followed by ceftriaxone and ciprofloxacin. The consumption of “Watch” group antibiotics prevailed in Kazakhstan during the study period, with the number of people consuming the top five “Watch” group antibiotics rising from 72,578 in 2019 to 94,617 in 2023. Conclusions: The findings of this study are crucial for the reorganization of the national antimicrobial stewardship program.
Background/Objectives: This study aims to analyze antibiotic consumption trends from 2014 to 2023 in Kazakhstan, Kyrgyzstan, Tajikistan, and Russia; forecast future trends up to 2030; and identify key social and economic factors influencing antibiotic use. Methods: Data on antibiotic consumption were obtained from the World Health Organization Regional Office for Europe Antimicrobial Consumption Network. Social and economic indicators were sourced from the World Bank DataBank. Of the 86 factors initially considered, 35 were included in the analyses. The forecast modeling of antibiotic consumption trends until 2030 and linear regression analysis to assess associations between antibiotic consumption and its predictors were conducted via SPSS. Results: The lowest antibiotic consumption rates were observed in Kazakhstan and Russia, whereas Kyrgyzstan and Tajikistan presented higher rates. The projected antibiotic consumption rates are expected to decline only in Kazakhstan, with other countries remaining stable. Birth and death rates, as well as under-five mortality rates, were significant determinants of antibiotic consumption in Kazakhstan and Tajikistan. In Russia, per capita GDP was a key determinant, whereas in Kazakhstan, inflation in consumer prices played a significant role. Additionally, cereal production was significantly associated with antibiotic consumption in Kazakhstan. In Kyrgyzstan and Russia, measles immunization rates were important determinants, whereas in Kyrgyzstan, access to clean fuels and technologies for cooking was significantly associated with antibiotic consumption. Conclusions: The findings of this study provide valuable insights for strengthening antimicrobial stewardship programs by addressing key social and economic determinants of antibiotic use.
Background/Objectives: While multiple studies have investigated antibiotic consumption rates, there are few studies on the consumption of systemic antifungals and antiprotozoals. This study aims to fill this gap by providing a comprehensive analysis of nationwide consumption trends in Kazakhstan over a seven-year period (2017–2023). Methods: Defined daily doses per 1000 inhabitants per day were calculated for systemic antifungals (J02 code of the Anatomical Therapeutic Chemical Classification System (ATC)) and antiprotozoals (P01 code of the ATC). Time series analyses were applied to examine historical trends, evaluate the impact of the COVID-19 pandemic, and make future projections until 2030. Results: The total consumption increased over the study period, with an average annual percent change of 1.11% for antifungals and 5.48% for antiprotozoals. Fluconazole was the most consumed antifungal agent, whereas metronidazole was the most consumed antiprotozoal agent. The COVID-19 pandemic had a positive but insignificant effect on the consumption of antifungals and a negative and also insignificant effect on the consumption of antiprotozoals. Forecast modeling indicates that the future trends in antifungal and antiprotozoal consumption until 2030 will largely remain stable, with the exception of antiprotozoal consumption in the hospital sector, which is projected to decline. Conclusions: These findings offer valuable insights into the development and implementation of targeted antimicrobial stewardship programs in Kazakhstan.