Clinical trials

This study tests whether an artificial intelligence (AI) system can help doctors write medical notes during cancer consultations. After a cancer patient is seen by a multidisciplinary team (a group of specialists who decide on the best treatment), they have a consultation with their oncologist to discuss the treatment plan. During this consultation, doctors must write detailed medical notes, which takes significant time and effort. In this study, an ambient AI system called VOCALI is used during oncology consultations at the National Cancer Center in Vilnius, Lithuania. Before the consultation begins, the doctor loads relevant pseudonymized clinical data from the electronic health record (such as diagnosis and treatment plan) into the system. During the consultation, VOCALI records the conversation (with the patient's consent) and combines it with the loaded clinical data to automatically generate a draft medical note in Lithuanian. Patients may ask the doctor to stop the recording at any time. The doctor then reviews the draft, makes any necessary corrections, and approves the final document. The AI does not make any medical decisions - the doctor is always responsible for the final note. What the study measures: The study has three main goals: * To assess the quality of the AI-generated notes, rated by two independent reviewers using the PDQI-10, a standardized documentation quality instrument translated into Lithuanian using forward-backward translation * To measure the time doctors spend reviewing and approving the AI-generated draft * To monitor safety - whether any AI errors could affect patient care The study also collects information on doctor workload, ease of use of the system, and patient satisfaction with the consultation. Who can participate: Adult patients (age 18 or older) attending a primary oncology consultation at the National Cancer Center in Vilnius, Lithuania, after a multidisciplinary team decision, who speak Lithuanian and provide written consent. Study details: 250 patients will be enrolled over 12 months. Each participant attends one consultation and completes a short satisfaction questionnaire (about 5 minutes). No additional visits are required. There is no comparator group - all participants receive the AI-assisted documentation. This is the first study to evaluate ambient AI documentation in the Lithuanian language and in the Lithuanian oncology setting.

This study hypothesizes that approximately 50% of rectal cancer patients can preserve their rectum using a watch-and-wait strategy if they achieve a complete or near-complete clinical response to total neoadjuvant therapy (TNT). The objective is to determine whether the complications, quality of life, and survival rates of rectal cancer patients who have achieved a complete or near-complete clinical response to TNT, followed by a watch-and-wait approach, are comparable to those of patients who undergo surgery first. Additionally, the study aims to identify potential prognostic and predictive markers for rectal cancer and examine survival rates and factors influencing responses to chemoradiotherapy (CRT) or TNT. The study is divided into two parts: \*\*Part One:\*\* Participants with cT1N1, T2-T3 N0-1 rectal cancer, MRF-, and EMVI-, with surgery as one of the possible first-line treatment options, will be randomized into two groups. The experimental group will consist of participants receiving TNT, including CRT and consolidation chemotherapy (Ch). If these participants achieve a complete or near-complete clinical response, they will be observed using a watch-and-wait strategy, which is a non-operative approach. The control group will consist of participants who undergo surgical treatment initially. \*\*Part Two:\*\* All participants with rectal cancer who have received CRT or TNT will be included. Additionally, participants diagnosed with rectal cancer who are scheduled for CRT or TNT but declined to participate in Part One or do not meet the inclusion criteria will also be included.

Infections remain a prevalent complication after major abdominal surgery. The common belief that most surgical site infections (SSIs) following elective surgery with modern antiseptic techniques are due to intraoperative contamination is still not confirmed. Therefore, alternative mechanisms for SSI development, such as the Trojan Horse theory-which suggests that pathogens from distant sites like the gastrointestinal tract may cause postoperative infections-should be explored. This study aims to analyze the preoperative microbiome of surgical patients' gut and oral cavities and assess whether microorganisms found there are present at the infection site. Additionally, this study will investigate a panel of biomarkers for predicting postoperative infections.