 Extracorporeal Shock Wave Therapy in Calcific Shoulder Tendinitis: From Prognostic Prediction to AI application體外震波治療肩鈣化性肌腱炎：從預後因子到人工智慧運用 | |
| 主辦單位 | 社團法人高雄縣醫師公會 |
| 協辦單位 | 高雄市立鳳山醫院（委託長庚醫療財團法人經營） |
| 協辦廠商 | |
| 日期時間 | 114年5月21日（三）12:30-14:30 |
| 課程地點 | 高雄市立鳳山醫院（委託長庚醫療財團法人經營）八樓會議室（高雄市鳳山區經武路42號） |
| 報名截止日期 | 報名至即日起至114年5月14日下午四時止 |
| 講師 | 周文毅／長庚醫療財團法人高雄長庚紀念醫院骨科部運動醫學科 |
| 課程簡介 | Shoulder tendinitis, both with and without rotator cuff tears, is a common condition affecting the general population. Extracorporeal shock wave therapy (ESWT) has been extensively researched for its efficacy in managing shoulder tendinitis, including calcific cases. Although ESWT has shown promise, 20-30% of patients do not respond adequately. This presentation aims to explore advanced research on prognostic factors and the application of recent artificial intelligence (AI) methods to develop a predictive model for optimizing ESWT use in clinical settings. In a study involving 241 symptomatic shoulders treated with ESWT, complete resorption (CR) of calcification was observed in 134 cases (CR group), while 107 shoulders exhibited incomplete resorption (ICR group). Gartner type I calcification was predominant in the ICR group, comprising 64.5% of cases. The mean symptom duration prior to ESWT was significantly longer in the ICR group. Overall, 81% of the CR group and 23.4% of the ICR group experienced symptom relief. Poor prognosis was significantly associated with Gartner type I calcification, calcification size >15 mm, and symptom duration >11 months. Additionally, an analysis of shoulder tendinitis without calcification revealed differences between athletic (AG) and non-athletic (NAG) groups. At one-year follow-up, AG patients had a 53.8% satisfaction rate compared to 52.1% in NAG patients. High-dose ESWT was found to be more effective for type II/III calcific tendinosis and non-calcific shoulder tendinosis. Data mining of 248 patients with calcified shoulder tendinitis identified shorter symptom duration, smaller calcification size, and calcification type as significant predictors. The J48 decision tree method achieved an accuracy of 89.5% with 10-fold cross-validation. Another study involving 296 patients identified prognostic factors for ESWT failure in symptom relief: symptom duration >10 months, pre-ESWT Visual Analog Scale (VAS) score >5, and pre-ESWT Constant-Murley Score (CMS) >55. The application of the XGBoost algorithm demonstrated the ability to effectively predict minimal clinically important differences. In conclusion, ESWT shows superior efficacy in treating radiolucent calcific tendinitis of the shoulder. Factors predicting poor outcomes for calcification resorption include symptom duration >10 months, dense calcification (type I), and calcification size >10 mm. The J48 decision tree and XGBoost algorithms provide viable prediction models for optimizing ESWT treatment in shoulder calcific tendinitis. |
| 申請積分 | 中華民國醫師公會全國聯合會-專業課程、家醫科申請中 |
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