Using random forest for reliable classification and cost-sensitive learning for medical diagnosis

Background: Most machine-learning classifiers output label predictions for new instances without indicating how reliable the predictions are. The applicability of these classifiers is limited in critical domains where incorrect predictions have serious consequences, like medical diagnosis. Further, the default assumption of equal misclassification costs is most likely violated in medical diagnosis. Results: In this paper, we present a modified random forest classifier which is incorporated into the conformal predictor scheme. A conformal predictor is a transductive learning scheme, using Kolmogorov complexity to test the randomness of a particular sample with respect to the training sets. Our method show well-calibrated property that the performance can be set prior to classification and the accurate rate is exactly equal to the predefined confidence level. Further, to address the cost sensitive problem, we extend our method to a label-conditional predictor which takes into account different costs for misclassifications in different class and allows different confidence level to be specified for each class. Intensive experiments on benchmark datasets and real world applications show the resultant classifier is well-calibrated and able to control the specific risk of different class. Conclusion: The method of using RF outlier measure to design a nonconformity measure benefits the resultant predictor. Further, a label-conditional classifier is developed and turn to be an alternative approach to the cost sensitive learning problem that relies on label-wise predefined confidence level. The target of minimizing the risk of misclassification is achieved by specifying the different confidence level for different class

The Integration of Nanomedicine with Traditional Chinese Medicine: Drug Delivery of Natural Products and Other Opportunities

The integration of progressive technologies such as nanomedicine with the use of natural products from traditional medicine (TM) provides a unique opportunity for the longed-for harmonization between traditional and modern medicine. Although several actions have been initiated decades ago, a disparity of reasons including some misunderstandings between each other limits the possibilities of a truly complementation. Herein, we analyze some common challenges between nanomedicine and traditional Chinese medicine (TCM). These challenges, if solved in a consensual way, can give a boost to such harmonization. Nanomedicine is a recently born technology, while TCM has been used by the Chinese people for thousands of years. However, for these disciplines, the regulation and standardization of many of the protocols, especially related to the toxicity and safety, regulatory aspects, and manufacturing procedures, are under discussion. Besides, both TCM and nanomedicine still need to achieve a wider social acceptance. Herein, we first briefly discuss the strengths and weaknesses of TCM. This analysis serves to focus afterward on the aspects where TCM and nanomedicine can mutually help to bridge the existing gaps between TCM and Western modern medicine. As discussed, many of these challenges can be applied to TM in general. Finally, recent successful cases in scientific literature that merge TCM and nanomedicine are reviewed as examples of the benefits of this harmonization

A mixed methods sequential explanatory study of the utilisation and practice of traditional Chinese medicine by Chinese people in Hong Kong and Guangzhou

Little is known about why traditional Chinese (TCM) continues to be used and practised by Chinese people despite the existence of evidence-based Western medicine (WM). This study aims to explore Chinese patients and TCM practitioners’ attitudes and beliefs towards the utilisation and practice of TCM and to determine if there are any differences in the way in which Chinese people use and practice TCM in different regions of China, in this study, Hong Kong and Guangzhou. A mixed-method, sequential explanatory study was undertaken that involved two phases. In the first phase, a structured questionnaire translated into Chinese was used to collect data from a convenience sample of Chinese patients attending outpatient clinics in Hong Kong and Guangzhou. A Chinese research assistant who could speak Cantonese and Mandarin distributed the questionnaires to patients attending the TCM outpatient clinics in Hong Kong and Guangzhou. Also, a random sample of Chinese medicine practitioners in Hong Kong was sent a questionnaire by post, as a list of Chinese medicine practitioners names, and clinic addresses in Hong Kong are available on the Chinese Medical Council’s Internet website. For TCM practitioners in Guangzhou, a Chinese research assistant distributed the questionnaire in-person to a random sample of TCM doctors working at the Guangzhou University of Traditional Chinese medicine in Guangzhou. In the second phase of the study, semi-structured interviews were conducted with patients and Chinese medicine practitioners in Hong Kong and patients and TCM practitioners in Guangzhou. Patients and TCM practitioners who took part in an interview were randomly selected from a list of patients and TCM practitioners who had previously filled out a questionnaire in the first phase of the study. A total of 1,200 patients and 400 TCM practitioners took part in the study, which comprised of 600 patients attending an out-patient TCM clinic in Hong Kong and 600 attending an out-patient TCM clinic in Guangzhou. The response rate for patients who took part was 81.4% (n= 505) and for Guangzhou 91.6% (n=550). For TCM practitioners, the response rate was 55% (n=110) for practitioners in Hong Kong and 61.5% (n= 123) for practitioners in Guangzhou. Patients’ mean age was 44.6 years, and the sample consisted of 41.2% males and 58.8% females. For TCM practitioners, the mean age was 45.4 years and the sample consisting of 66.1% males and 33.9% females. In the second phase of the study, semi-structured interviews were conducted with 16 patients and 16 TCM practitioners in Hong Kong and Guangzhou, respectively. The results showed that for patients in Hong Kong and Guangzhou the most common use of TCM was for the treatment of acute medical conditions, such as colds and flu and also for chronic medical conditions, such as rheumatism and diabetes. Also, patients in Guangzhou were found to use TCM to “recuperate” the body after taking Western medicines prescribed by WM doctors, or after suffering a chronic illness. Concurrent use of TCM and WM was found to be more common in patients in Guangzhou, than in patients in Hong Kong. The integration of TCM services in hospitals in Hong Kong is notably different from that of China. Unlike China, where TCM practitioners are permitted to treat in-patients inside state-run hospitals, in Hong Kong, TCM practitioners are only permitted to treat patients on an outpatient basis and not as in-patients. The results of this study contribute to the existing body of literature about the utilisation and practice of TCM by Chinese people in Hong Kong and Guangzhou. The study also provides unique information about the practice of TCM in Hong Kong since the implementation of the Chinese medicine Ordinance and the establishment of the Chinese Medicine Council of Hong Kong. Although the study contributes to the existing body of literature concerning the utilisation and practice of TCM by Chinese people and TCM practitioners ‘respectively, it does have several inherent limitations. Among the significant limitations is the fact that, as a cross-sectional survey design was used, therefore no “cause and effect” relationships can be drawn from the results. Furthermore, because statistical tests, in general, require a large sample size to ensure a representative distribution of the population being studied, the total number of patients and TCM practitioners who participated in the study is relatively small

Cultural constructions of illness : the client and practitioner perspectives of traditional Chinese medicine. Perth Western Australia

An increased use of Complementary and alternate health care practices (CAM) and under which TCM is found assumed, is found in overseas countries and has become increasingly popular among Australian consumer. There has been a considerably increase in the consumer use of TCM over the past decade, but little is understood on the practice of the clinical encounter in TCM explained from the context within a clinic in western society.Investigation was made on how social and cultural processes have shaped people’s acceptance of TCM as a form of complementary health. Drawing from an ethnographic focus, the study explores the practice of TCM in several clinic settings in Perth. Attention is paid to the ways in which notions of health and illness are constructed by clients and practitioners. This study examined the interactions found in the process of ‘Kanbing’ from a TCM practice in Perth, Western Australia in order to understand how health practices are shaped by cultural and social processes. From an anthropological perspective, the ethnography of this study was guided an extended contact with the everyday clinical context of TCM, facilitated through participant observation, interviews with clients and practitioners and case study analysis. Interviews revealed perspectives from clients of non-Asian backgrounds to record the lived experiences of the encounters between the practitioner and client of TCM in the clinic. Participant observation took place over a two year period from February 2002 to March 2003 with further follow up work in the field conducted at intervals throughout 2004 and 2006 to gain additional data.The client centred interrelationships between practitioners of TCM, clients, and their perceptions, formed part of the interpretative process that informed the understanding of the cultural context from how an illness is described and explained through the process of Kanbing. My research was drawn from the reality of the encounter within the clinical context through participant observation within two western clinics of TCM. Thus the study makes a contribution to anthropology on the understanding of the structure and meaning found within the practice of traditional Chinese medicine in Australia

Accessing Healthcare in Ontario: Influences on Utilization Among Asian Immigrant Women

Previous research on immigrant integration has tended to focus on economic and social integration. As such, the factors shaping health integration are less understood. At the same time, health researchers suggest that immigrants in Canada may underutilize certain health services. For instance, studies have documented the low participation rates of cervical cancer screening among Asian immigrant women in Canada (Xiong, Murphy, Matthews, Gadag, & Wang, 2010; McDonald & Kennedy, 2007; Woltman & Newbold, 2007). This study sheds light on immigrant integration by exploring the experiences of Asian immigrant women with cervical cancer screening and Canadian healthcare services more broadly. Through in-depth interviews, Asian immigrant women share their experiences in the healthcare system. They report many difficulties including language, relationships with healthcare providers, cultural perspectives toward health, adjustment to a new healthcare system, and access to information. These findings help to shed light on health disparities and inform policies and practices that foster immigrant women’s health