Table S4 shows a comparison of central cobas tissue and baseline cobas plasma test results for EG... more Table S4 shows a comparison of central cobas tissue and baseline cobas plasma test results for EGFR-TKI sensitizing mutations (All screened patients)
Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feas... more Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre–post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3 and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma-related care following plan use. About 84% (n = 59/70) completed the 6-months follow-up. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38...
Background:This study aimed to compare and correlate the post-bronchodilator forced expiratory vo... more Background:This study aimed to compare and correlate the post-bronchodilator forced expiratory volume in one second (PB-FEV1), exacerbation frequency, and scores of modified Medical Research Council (mMRC), COPD Assessment Tool (CAT), and St George’s Respiratory Questionnaire for COPD (SGRQ-c) of COPD patients. Methods:This was a post-hoc analysis of pooled data from two cross-sectional studies conducted from 1st June 2017 to 31st May 2018 at the respiratory clinic of University of Malaya Medical Center, and from 23rd January 2018 to 22nd January 2019 at the outpatient clinics of the Serian Divisional Hospital and Bau District Hospital in Malaysia, respectively. The parameters measured included PB-FEV1, exacerbation frequency, mMRC, CAT, and SGRQ-c. Descriptive, association and correlation statistics were used. Results:Of a total of 374 patients, the PB-FEV1 predicted was < 30% in 85 (22.7%), 30 – 49% in 142 (38.0%), 50 – 79% in 111 (29.7%), and ≥ 80% in 36 (9.6%) patients. Patie...
Purpose:To assess the utility of the cobas EGFR Mutation Test, with tissue and plasma, for first-... more Purpose:To assess the utility of the cobas EGFR Mutation Test, with tissue and plasma, for first-line osimertinib therapy for patients with EGFR-mutated (EGFRm; Ex19del and/or L858R) advanced or metastatic non–small cell lung cancer (NSCLC) from the FLAURA study (NCT02296125).Experimental Design:Tumor tissue EGFRm status was determined at screening using the central cobas tissue test or a local tissue test. Baseline circulating tumor (ct)DNA EGFRm status was retrospectively determined with the central cobas plasma test.Results:Of 994 patients screened, 556 were randomized (289 and 267 with central and local EGFR test results, respectively) and 438 failed screening. Of those randomized from local EGFR test results, 217 patients had available central test results; 211/217 (97%) were retrospectively confirmed EGFRm positive by central cobas tissue test. Using reference central cobas tissue test results, positive percent agreements with cobas plasma test results for Ex19del and L858R de...
Table S1 gives a summary of all screened patients with uncommon EGFR mutations detected by the ce... more Table S1 gives a summary of all screened patients with uncommon EGFR mutations detected by the central cobas® EGFR Mutation Test
Implementing asthma guideline recommendations is challenging in low- and middle-income countries.... more Implementing asthma guideline recommendations is challenging in low- and middle-income countries. We aimed to explore healthcare provider (HCP) perspectives on the provision of recommended care. Twenty-six HCPs from six public primary care clinics in a semi-urban district of Malaysia were purposively sampled based on roles and experience. Focus group discussions were guided by a semi-structured interview guide and analysed thematically. HCPs had access to guidelines and training but highlighted multiple infrastructure-related challenges to implementing recommended care. Diagnosis and review of asthma control were hampered by limited access to spirometry and limited asthma control test (ACT) use, respectively. Treatment decisions were limited by poor availability of inhaled combination therapy (ICS/LABA) and free spacer devices. Imposed Ministry of Health programmes involving other non-communicable diseases were prioritised over asthma. Ministerial policies need practical resources a...
Table S4 shows a comparison of central cobas tissue and baseline cobas plasma test results for EG... more Table S4 shows a comparison of central cobas tissue and baseline cobas plasma test results for EGFR-TKI sensitizing mutations (All screened patients)
Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feas... more Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre–post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3 and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma-related care following plan use. About 84% (n = 59/70) completed the 6-months follow-up. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38...
Background:This study aimed to compare and correlate the post-bronchodilator forced expiratory vo... more Background:This study aimed to compare and correlate the post-bronchodilator forced expiratory volume in one second (PB-FEV1), exacerbation frequency, and scores of modified Medical Research Council (mMRC), COPD Assessment Tool (CAT), and St George’s Respiratory Questionnaire for COPD (SGRQ-c) of COPD patients. Methods:This was a post-hoc analysis of pooled data from two cross-sectional studies conducted from 1st June 2017 to 31st May 2018 at the respiratory clinic of University of Malaya Medical Center, and from 23rd January 2018 to 22nd January 2019 at the outpatient clinics of the Serian Divisional Hospital and Bau District Hospital in Malaysia, respectively. The parameters measured included PB-FEV1, exacerbation frequency, mMRC, CAT, and SGRQ-c. Descriptive, association and correlation statistics were used. Results:Of a total of 374 patients, the PB-FEV1 predicted was < 30% in 85 (22.7%), 30 – 49% in 142 (38.0%), 50 – 79% in 111 (29.7%), and ≥ 80% in 36 (9.6%) patients. Patie...
Purpose:To assess the utility of the cobas EGFR Mutation Test, with tissue and plasma, for first-... more Purpose:To assess the utility of the cobas EGFR Mutation Test, with tissue and plasma, for first-line osimertinib therapy for patients with EGFR-mutated (EGFRm; Ex19del and/or L858R) advanced or metastatic non–small cell lung cancer (NSCLC) from the FLAURA study (NCT02296125).Experimental Design:Tumor tissue EGFRm status was determined at screening using the central cobas tissue test or a local tissue test. Baseline circulating tumor (ct)DNA EGFRm status was retrospectively determined with the central cobas plasma test.Results:Of 994 patients screened, 556 were randomized (289 and 267 with central and local EGFR test results, respectively) and 438 failed screening. Of those randomized from local EGFR test results, 217 patients had available central test results; 211/217 (97%) were retrospectively confirmed EGFRm positive by central cobas tissue test. Using reference central cobas tissue test results, positive percent agreements with cobas plasma test results for Ex19del and L858R de...
Table S1 gives a summary of all screened patients with uncommon EGFR mutations detected by the ce... more Table S1 gives a summary of all screened patients with uncommon EGFR mutations detected by the central cobas® EGFR Mutation Test
Implementing asthma guideline recommendations is challenging in low- and middle-income countries.... more Implementing asthma guideline recommendations is challenging in low- and middle-income countries. We aimed to explore healthcare provider (HCP) perspectives on the provision of recommended care. Twenty-six HCPs from six public primary care clinics in a semi-urban district of Malaysia were purposively sampled based on roles and experience. Focus group discussions were guided by a semi-structured interview guide and analysed thematically. HCPs had access to guidelines and training but highlighted multiple infrastructure-related challenges to implementing recommended care. Diagnosis and review of asthma control were hampered by limited access to spirometry and limited asthma control test (ACT) use, respectively. Treatment decisions were limited by poor availability of inhaled combination therapy (ICS/LABA) and free spacer devices. Imposed Ministry of Health programmes involving other non-communicable diseases were prioritised over asthma. Ministerial policies need practical resources a...
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Papers by Yong-Kek Pang