In this task, you are given a passage which has a question and the context. You have to generate an answer to the question based on the information present in the context.

Ex Input:
Context: Interobserver and intraobserver reliability study of improved method to evaluate radiographs of patients with scoliosis.', 'To determine the reliability of a computer-assisted measurement protocol for evaluating Cobb angle and King et al classification.', 'Evaluation of scoliosis radiographs is inherently unreliable because of technical and human judgmental errors. Objective, computer-assisted evaluation tools may improve reliability.', 'Posteroanterior preoperative radiographic images of 27 patients with adolescent idiopathic scoliosis were each displayed on a computer screen. They were marked 3 times in random sequence by each of 5 evaluators (observers) who marked 70 standardized points on the vertebrae and sacrum in each radiograph. A computer program (Spine 2002;27:2801-5) that identified curves, calculated Cobb angles, and generated the King et al classification automatically analyzed coordinates of these points. The interobserver and intraobserver variability of the Cobb angle and King et al classification evaluations were quantified and compared with values obtained by unassisted observers.', 'Average Cobb angle intraobserver standard deviation was 2.0 degrees for both the thoracic and lumbar curves (range 0.1 to 8.3 degrees for different curves). Interobserver reliability was 2.5 degrees for thoracic curves and 2.6 degrees for lumbar curves. Among the 5 observers, there was an inverse relationship between repeatability and time spent marking images, and no correlation with image quality or curve magnitude. Kappa values for the variability of the King et al classification averaged 0.85 (intraobserver).\Question: Do computer-assisted algorithms improve reliability of King classification and Cobb angle measurement of scoliosis?

Ex Output:
Variability of Cobb measurements compares favorably with previously published series. The classification was more reliable than achieved by unassisted observers evaluating the same radiographs. The same principles may be applicable to other radiographic measurement and evaluation procedures.


Ex Input:
Context: To evaluate response to radiation and clinical outcome of uterine cervical cancer patients with tumor-related leukocytosis (TRL) at initial diagnosis and during definitive radiotherapy.', 'We retrospectively analyzed 2456 patients with stage IA-IVA uterine cervical cancer who received definitive radiotherapy with (37.4%) or without (62.6%) platinum-based chemotherapy between 1986 and 2012. TRL was defined as two or more occurrences of leukocytosis over 9000/μl at the time of diagnosis and during the course of treatment. Locoregional failure-free survival (LFFS) and overall survival (OS) were compared between patients with or without TRL.', 'The median age of all patients was 55 years, and the median follow-up time was 65.1 months. TRL was observed in 398 patients (16%) at initial diagnosis; TRL (+) patients were younger and had larger tumors, advanced stage, and more frequent lymph node metastases (all P < 0.05). TRL (+) patients showed a significantly lower rate of complete remission than TRL (-) patients (89.9% versus 96.3%, respectively, P = 0.042). Ten-year LFFS and OS for all patients were 84% and 78%, respectively. LFFS and OS were significantly lower in TRL (+) patients than TRL (-) patients (10-year LFFS: 69% versus 87% respectively, P < 0.001; 10-year OS: 63% versus 81% respectively P < 0.001). After propensity score matching, LFFS and OS rates in TRL (+) patients remained significantly lower than for TRL (-) patients; this significant difference was also observed on multivariate analysis. Twenty-six percent of patients with locoregional failure (n = 345) were TRL (+) and had significantly poorer median OS (6 versus 12 months, P = 0.001).\Question: Is tumor-related leukocytosis associated with poor radiation response and clinical outcome in uterine cervical cancer patients?

Ex Output:
This study reveals the aggressive nature of cervical cancer with TRL and its poor response to radiation therapy. Given the unfavorable prognosis and higher probability of treatment failure, optimal diagnostic and therapeutic approaches and careful monitoring for early detection of recurrence should be considered for these patients.


Ex Input:
Context: Laparoscopic ventral hernia repair (LVHR) is associated with shorter hospitalization and lower complication rates compared to open ventral hernia repair. We sought to determine if hernia-related factors, such as defect size and re-operative status correlate with postoperative complications, operative times and length of stay (LOS).', 'The study is a retrospective review of 30-day perioperative outcomes following LVHR in 91 patients who underwent surgery at a single institution from August 2009 through June 2012. A single surgeon performed all procedures.', 'Indications for surgery were recurrent incisional hernia in 33\xa0% of patients and primary incisional or ventral abdominal hernias in the rest. Coated polyester mesh with an average size of 348\xa0cm(2) (±214; range 113-1,036) was used. Mean operative time was 132\xa0min (±66.1; range 53-412). The mean LOS was 4.0\xa0days (±3.5; range 1-22). Complications occurred in 13 patients for overall morbidity of 16.5\xa0% and no mortality. There was one recurrence in 30\xa0days (1.1\xa0%). Patients who had a surgery >120\xa0min or a LOS >1\xa0day were statistically more likely to have multiple hernias, larger defect sizes (>40\xa0cm(2)), larger mesh sizes (>300\xa0cm(2)) or a history of recurrent hernia (P\xa0<\xa00.05). No other clinical or demographic variable evaluated in this study correlated with operative time or LOS.\Question: Does laparoscopic hernia complexity predict operative time and length of stay?

Ex Output:

LVHR is safe with a low incidence of perioperative complications. Patients with multiple, larger and recurrent hernias have longer operative times and LOS. This information can be used to guide preoperative planning for the patient, surgeon and treating institution.