Developing a mHealth-based portable ultrasound platform for breast cancer screening

Background Breast cancer is amongst the 10 most common cancers globally. The disease burden is increasing rapidly in Sub-Saharan African countries, where women living in rural and or remote areas are particularly prone to be diagnosed with late-stage breast cancer. This is due to the limited availability of advanced screening and diagnostic options. Ultrasound is a feasible screening tool for breast cancer, due to its portability, affordability and accuracy. The integration of mHealth with portable ultrasound enables the provision of screening services in rural and remote areas, through electronic consultation by a non-specialist with a specialist for interpretation and reporting of the ultrasound results. This project developed an application for a mHealth-based portable ultrasound platform that could be used by a non-specialist to provide breast cancer screening services with remote specialist support. Methods A systematic review of the literature was conducted for the period of 2004 to 2019 to gather evidence on the use of mHealth-based portable ultrasound platforms for improved access to ultrasound services like breast cancer screening. The evidence from the literature was used to design and develop a prototype of an application for a mHealth-based portable ultrasound platform suitable for breast cancer screening. The prototype application was integrated with a mobile-based portable ultrasound from Philips Lumify. Images generated by scanning a phantom breast using the portable ultrasound were uploaded onto the application and downloaded from the application to demonstrate the concept. Results The systematic review showed only two clinical conditions (obstetrics and cardiovascular disease) which used a mHealth-based portable ultrasound platform. The outcomes from the studies showed improved access to the respective ultrasound services in terms of patient management, early detection, improved quality of care and increased patient attendance, which resulted in access to other services. The integration of the prototype application with a mobile-based portable ultrasound resulted into a mHealthbased portable ultrasound platform prototype intended for breast cancer screening. The ability to upload images onto the platform and download images from the platform satisfied the design requirements for the platform. Conclusion A mHealth-based portable ultrasound prototype was developed, which has potential for improving access to breast cancer screening services. Further research including testing of the application with health professionals and patients is recommended to strengthen the feasibility of the concept

Flexible Macroblock Ordering for Context-Aware Ultrasound Video Transmission over Mobile WiMAX

The most recent network technologies are enabling a variety of new applications, thanks to the provision of increased bandwidth and better management of Quality of Service. Nevertheless, telemedical services involving multimedia data are still lagging behind, due to the concern of the end users, that is, clinicians and also patients, about the low quality provided. Indeed, emerging network technologies should be appropriately exploited by designing the transmission strategy focusing on quality provision for end users. Stemming from this principle, we propose here a context-aware transmission strategy for medical video transmission over WiMAX systems. Context, in terms of regions of interest (ROI) in a specific session, is taken into account for the identification of multiple regions of interest, and compression/transmission strategies are tailored to such context information. We present a methodology based on H.264 medical video compression and Flexible Macroblock Ordering (FMO) for ROI identification. Two different unequal error protection methodologies, providing higher protection to the most diagnostically relevant data, are presented

Telesonography In Emergency Medicine : A Systematic Review

Funding: No specific funding was received for this work; however LE’s salary was paid from funding for the SatCare trial into remotely supported prehospital ultrasound, provided by the European Space Agency in collaboration with ViaSat (contract SC16005). The specific roles of this author are articulated in the ‘author contributions’ section. These funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

The technological growth in eHealth services

The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.Web of Scienceart. no. 89417

Uso da teleultrassonografia para o diagnóstico de afecções abdominais em cães e gatos

Orientadora: Profa. Dra. Tilde Rodrigues FroesDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências Agrárias, Programa de Pós-Graduação em Ciências Veterinárias. Defesa : Curitiba, 14/04/2022Inclui referênciasResumo: Os avanços da medicina veterinária e tecnologia tornaram possível a incorporação da telemedicina na rotina veterinária, em especial em diagnóstico por imagem. Apesar de já ser bem estabelecida a importância da ultrassonografia abdominal para a avaliação do trato gastrointestinal e urinário em cães e gatos, ainda há poucos estudos publicados na veterinária sobre teleultrassonografia, e nenhum que estabeleça a acurácia de teleultrassonografia para detecção de obstrução do trato gastrointestinal e de obstrução renal e ureteral em pequenos animais. Apesar de essa modalidade já estar sendo utilizada em alguns centros de imagem e hospitais, não há parâmetros e estudos que avaliem se é uma técnica confiável para ser usada na rotina e nem mesmo diretrizes publicadas para orientar os radiologistas quanto a seu uso e limitações. Dessa forma, o propósito deste trabalho foi estabelecer a acurácia e concordância interobservador da teleultrassonografia para o diagnóstico de obstrução gastrointestinal e de obstrução renal e ureteral, entre radiologistas com diferentes níveis de experiência. Para isso, este estudo consistiu em dois capítulos. Ambos foram estudos retrospectivos transversais com cães e gatos, porém o primeiro capítulo incluiu pacientes com sinais gastrointestinais e suspeita de obstrução gastrointestinal, que foram submetidos à ultrassonografia abdominal entre 2017 e 2019. Já o segundo capítulo incluiu pacientes submetidos à ultrassonografia devido a sinais do trato urinário e suspeita de obstrução do trato urinário superior, atendidos entre 2017 e 2018. Em ambos os estudos, os pacientes foram divididos em dois grupos, com e sem obstrução, e todas as imagens dos exames ultrassonográficos foram enviadas de modo aleatório para os radiologistas analisarem. Foram realizadas análises de sensibilidade, especificidade, acurácia, de valores preditivos positivos e negativos, além de concordância interobservador. A teleultrassonografia apresentou boa acurácia tanto para detecção de processos obstrutivos gastrointestinais e de obstrução renal e ureteral, porém com moderada concordância interobservador e baixo valor preditivo. Dessa forma, essa modalidade deve ser usada com cuidado nesses contextos clínicos, dado o potencial de decisão cirúrgico envolvido no diagnóstico dessas afecções.Abstract: Advances in veterinary medicine and technology have made it possible to incorporate telemedicine into the veterinary routine, especially in diagnostic imaging. The importance of abdominal ultrasonography for the evaluation of the gastrointestinal and the urinary tract in dogs and cats is already well established, however few studies have been published in veterinary teleultrasonography, and none that establishes the accuracy of teleultrasonography for the detection of gastrointestinal tract and renal and ureteral obstruction in small animals. Although some imaging centers and hospitals are already using this modality, there are no parameters and studies so far that assess whether it is a reliable technique for routine use and even no published guidelines to orientate radiologists in its use and its limitations. Thus, the purpose of this study was to establish the accuracy and interobserver agreement of tele-ultrasonography for diagnosing gastrointestinal and renal and ureteral obstruction, in radiologists with different levels of experience. For this, this study consisted of two chapters. Both were retrospective cross-sectional studies with dogs and cats, but the first chapter included patients with gastrointestinal signs and suspected gastrointestinal obstruction, which underwent abdominal ultrasound between 2017 and 2019. The second chapter included patients which underwent ultrasound due to urinary tract signs and suspected upper urinary tract obstruction, between 2017 and 2018. In both studies, patients were divided into two groups, with and without obstruction, and every ultrasonographic images were sent randomly for radiologists to analyze. Analyzes of sensitivity, specificity, accuracy, positive and negative predictive values, and interobserver agreement were performed. Teleultrasonography showed good accuracy both for detecting gastrointestinal obstructive processes and renal and ureteral obstruction, but it presented moderate interobserver agreement and low predictive value. Thus, this modality should be used with caution in these clinical contexts, given the potential for a surgical decision involved in the diagnosis of these conditions

Application of disruptive technologies in telemedicine for universal coverage of health services

[ES] La aplicación de tecnologías disruptivas en telemedicina facilita la accesibilidad a tecnologías diagnósticas de poblaciones remotas sin acceso a especialistas y mejora la cobertura universal de servicios de salud. Este estudio fue realizado por la Unidad de Telemedicina del Ministerio de Salud Pública y Bienestar Social (MSPBS) en colaboración con el Dpto. de Ingeniería Biomédica e Imágenes del Instituto de Investigaciones en Ciencias (IICS-UNA). Objetivo: Evaluar la utilidad de aplicaciones de tecnologías disruptivas en telemedicina para la cobertura universal de servicios de salud entre enero del 2014 y septiembre de 2019. Material y Método: Estudio de diseño observacional y descriptivo incluyó a 540.397 pacientes. Para el efecto se analizaron los resultados obtenidos por la red de telediagnóstico implementado en 67 hospitales del MSPBS. En dicho sentido se analizaron 540.397 diagnósticos remotos realizados entre enero del 2014 y septiembre de 2019. Resultados: D el total, el 33,174 % (179.274) correspondieron a estudios de tomografía, 64,825 % (350.313) a electrocardiografía (ECG), 1,997 % (10.791) a electroencefalografía (EEG) y 0,004 % (19) a ecografía. La concordancia entre el diagnóstico remoto y el diagnóstico “cara a cara” fue del 95 %. Conclusión: Con el diagnóstico remoto se logró una reducción del coste que supone un beneficio importante para cada ciudadano del interior del país. Los resultados obtenidos evidencian que la aplicación de tecnologías disruptivas en telemedicina puede contribuir para lacobertura universal de servicios con tecnologías diagnósticas, maximizando el tiempo y productividad del profesional, aumentando el acceso y la equidad, y disminuyendo los costos. Sin embargo, antes de su implementación generalizada se deberá contextualizar con el perfil epidemiológico regional.[EN] The application of disruptive technologies in telemedicine facilitates accessibility to diagnostic technologies of remote populations without access to specialists and improves universal coverage of health services. This study was carried out by the Telemedicine Unit of the Ministry of Public Health and Social Welfare (MSPBS) in collaboration with the Department of Biomedical Engineering and Imaging of the Institute of Research in Sciences (IICS-UNA). Objective: to evaluate the usefulness of disruptive technology applications in telemedicine for universal coverage of health services January 2014 to September 2019. Material and Method: observational and descriptive design study included 540,397 patients. For this purpose, the results obtained by the telediagnostic network implemented in 67 MSPBS hospitals were analyzed. In this regard, 540,397 remote diagnoses carried out between January 2014 and September 2019 were analysed. Results: of the total, 33.174% (179,274) were CT studies, 64.825% (350,313) electrocardiography (ECG), 1.997% (10,791) electroencephalography (EEG) and 0.004% (19) ultrasound. The concordance between remote diagnosis and "face-to-face" diagnosis was 95%. Conclusion: remote diagnosis achieved a cost reduction that is an important benefit for every citizen of the interior of the country. The results show that the application of disruptive technologies in telemedicine can contribute to the universal coverage of services with diagnostic technologies, maximizing the time and productivity of the professional, increasing access and equity, and lowering costs. However, prior to widespread implementation, the regional epidemiological profile should be contextualized