Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi.

Malawi has one of the world's highest rates of human immunodeficiency virus (HIV) infection (10.6%), and southern Malawi, where Thyolo district is located, bears the highest burden in the country (14.5%). Tuberculosis, common among HIV-infected people, requires radiologic diagnosis, yet Malawi has no radiologists in public service. This hinders rapid and accurate diagnosis and increases morbidity and mortality

The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

Introduction: Radiology was founded on a technological discovery by Wilhelm Roentgen in 1895. Teleradiology also had its roots in technology dating back to 1947 with the successful transmission of radiographic images through telephone lines. Diagnostic radiology has become the eye of medicine in terms of diagnosing and treating injury and disease. This article documents the empirical foundations of teleradiology. Methods: A selective review of the credible literature during the past decade (2005?2015) was conducted, using robust research design and adequate sample size as criteria for inclusion. Findings: The evidence regarding feasibility of teleradiology and related information technology applications has been well documented for several decades. The majority of studies focused on intermediate outcomes, as indicated by comparability between teleradiology and conventional radiology. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include reductions in patient transfer, rehospitalization, and length of stay.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140295/1/tmj.2016.0149.pd

Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population

Article approval pendingPaediatric radiology requires dedicated equipment, specific precautions related to ionising radiation, and specialist knowledge. Developing countries face difficulties in providing adequate imaging services for children. In many African countries, children represent an increasing proportion of the population, and additional challenges follow from extreme living conditions, poverty, lack of parental care, and exposure to tuberculosis, HIV, pneumonia, diarrhoea and violent trauma. Imaging plays a critical role in the treatment of these children, but is expensive and difficult to provide. The World Health Organisation initiatives, of which the World Health Imaging System for Radiography (WHIS-RAD) unit is one result, needs to expand into other areas such as the provision of maintenance servicing. New initiatives by groups such as Rotary and the World Health Imaging Alliance to install WHIS-RAD units in developing countries and provide digital solutions, need support. Paediatric radiologists are needed to offer their services for reporting, consultation and quality assurance for free by way of teleradiology. Societies for paediatric radiology are needed to focus on providing a volunteer teleradiology reporting group, information on child safety for basic imaging, guidelines for investigations specific to the disease spectrum, and solutions for optimising imaging in children

Teleradiology usage and user satisfaction with the telemedicine system operated by Médecins Sans Frontières

Médecins Sans Frontières (MSF) began a pilot trial of store-and-forward telemedicine in 2010, initially operating separate networks in English, French, and Spanish; these were merged into a single, multilingual platform in 2013. We reviewed the pattern of teleradiology usage on the MSF telemedicine platform in the 4-year period from April 2010. In total, 564 teleradiology cases were submitted from 22 different countries. A total of 1114 files were uploaded with the 564 cases, the majority being of type JPEG (n = 1081, 97%). The median file size was 938 kb (interquartile range, IQR 163-1659). A panel of 14 radiologists was available to report cases, but most (90%) were reported by only 4 radiologists. The median radiologist response time was 6.1 h (IQR 3.0-20). A user satisfaction survey was sent to 29 users in the last 6 months of the study. There was a 28% response rate. Most respondents found the radiologist's advice helpful and all of them stated that the advice assisted in clarification of a diagnosis. Although some MSF sites made substantial use of the system for teleradiology, there is considerable potential for expansion. More promotion of telemedicine may be needed at different levels of the organization to increase engagement of staff

Implementation of medical imaging with telemedicine for the early detection and diagnoses of breast cancer to women in remote areas

Nowadays, the cancer topic has become a global concern. Furthermore, breast cancer persists to be the top leading cause of death to women population and the second cause of cancer death after the lung cancer globally. Various technologies and techniques have been searched, developed and studied over the years to detect the disease at the early stage; the early diagnosis saves many lives in both developed and developing countries. The detection of cancer through a screening process before its symptoms emerge increases the survival rate dramatically (Li, Meaney and Paulsen). Moreover, sufficient knowledge of the disease, qualified staff, accurate, appropriate treatment and diagnosis contribute to the successful cure of the disease; however, the cancer treatment is not affordable by many and sometimes not available to the very needy, and more precisely in developing countries. In this research, we aimed to explore the early detection of breast cancer using the new image compression algorithm: DYNAMAC, a compression tool that finds its basis in nonlinear dynamical systems theory; we implemented this algorithm through the D-transform, a digital sequence used to compress the digital media (Wang and Huang) & (Antoine, Murenzi and Vandergheynst). The goal is to use this method to analyze the average profile of diseased and healthy breast images obtained from a digital mammography to detect diseased tissues. After the detection of cancerous tumors, we worked to establish a remote care to women victims of breast cancer using the Telecommunication infrastructure through primarily Teleradiology and the Next Generation Internet (NGI) technology. Over the methods and techniques previously used in the area of medical imaging techniques, DYNAMAC algorithm is the most easily implemented along with its features that include cost saving in addition to best meeting the requirements of the breast imaging technology

Intelligent computing applications to assist perceptual training in medical imaging

The research presented in this thesis represents a body of work which addresses issues in medical imaging, primarily as it applies to breast cancer screening and laparoscopic surgery. The concern here is how computer based methods can aid medical practitioners in these tasks. Thus, research is presented which develops both new techniques of analysing radiologists performance data and also new approaches of examining surgeons visual behaviour when they are undertaking laparoscopic training. Initially a new chest X-Ray self-assessment application is described which has been developed to assess and improve radiologists performance in detecting lung cancer. Then, in breast cancer screening, a method of identifying potential poor performance outliers at an early stage in a national self-assessment scheme is demonstrated. Additionally, a method is presented to optimize whether a radiologist, in using this scheme, has correctly localised and identified an abnormality or made an error. One issue in appropriately measuring radiological performance in breast screening is that both the size of clinical monitors used and the difficulty in linking the medical image to the observer s line of sight hinders suitable eye tracking. Consequently, a new method is presented which links these two items. Laparoscopic surgeons have similar issues to radiologists in interpreting a medical display but with the added complications of hand-eye co-ordination. Work is presented which examines whether visual search feedback of surgeons operations can be useful training aids

Realistic and interactive high-resolution 4D environments for real-time surgeon and patient interaction

Copyright © 2016 John Wiley & Sons, Ltd. Background: Remote consultations that are realistic enough to be useful medically offer considerable clinical, logistical and cost benefits. Despite advances in virtual reality and vision hardware and software, these benefits are currently often unrealised. Method: The proposed approach combines high spatial and temporal resolution 3D and 2D machine vision with virtual reality techniques, in order to develop new environments and instruments that will enable realistic remote consultations and the generation of new types of useful clinical data. Results: New types of clinical data have been generated for skin analysis and respiration measurement; and the combination of 3D with 2D data was found to offer potential for the generation of realistic virtual consultations. Conclusion: An innovative combination of high resolution machine vision data and virtual reality online methods, promises to provide advanced functionality and significant medical benefits, particularly in regions where populations are dispersed or access to clinicians is limited. Copyright © 2016 John Wiley & Sons, Ltd

Efficacy of Artificial Intelligence in the Categorisation of Paediatric Pneumonia on Chest Radiographs: A Systematic Review

This study aimed to systematically review the literature to synthesise and summarise the evidence surrounding the efficacy of artificial intelligence (AI) in classifying paediatric pneumonia on chest radiographs (CXRs). Following the initial search of studies that matched the pre-set criteria, their data were extracted using a data extraction tool, and the included studies were assessed via critical appraisal tools and risk of bias. Results were accumulated, and outcome measures analysed included sensitivity, specificity, accuracy, and area under the curve (AUC). Five studies met the inclusion criteria. The highest sensitivity was by an ensemble AI algorithm (96.3%). DenseNet201 obtained the highest level of specificity and accuracy (94%, 95%). The most outstanding AUC value was achieved by the VGG16 algorithm (96.2%). Some of the AI models achieved close to 100% diagnostic accuracy. To assess the efficacy of AI in a clinical setting, these AI models should be compared to that of radiologists. The included and evaluated AI algorithms showed promising results. These algorithms can potentially ease and speed up diagnosis once the studies are replicated and their performances are assessed in clinical settings, potentially saving millions of lives

Managing technological change in a military treatment facility: a case study of medical diagnostic imaging support (MDIS) system

Picture archiving and communication system (PACS) represents an enormously expensive technological innovation in digital imaging which has the potential to alter the way in which radiology is practiced. The purpose of this thesis is to provide a better understanding of the requirements for PACS technology and the implementation of information systems in medical facilities. The objective of PACS technology is to improve access to radiographic images and reports throughout medical facilities while decreasing the cost of image production and storage. Medical Diagnostic Imaging Support (MDIS) system is the military tri-service project to install PACS in selected U.S. military medical treatment facilities (MTF) in an attempt to create a totally filmless environment. This thesis includes a case study of the implementation of the MDIS system at Madigan Army Medical Center and the change management issues that surround the introduction of an information system in a health care organization. The issues brought forth in this study are derived from two change models in the implementation of information systems.http://archive.org/details/managingtechnolo1094542869U.S. Navy (USN) authorApproved for public release; distribution is unlimited

A web-based health technology assessment in tele-echocardiography: the experience within an Italian project

Due to major advances in the information technology, telemedicine applications are ready for a widespread use. Nonetheless, to allow their diffusion in National Health Care Systems (NHCSs) specific methodologies of health technology assessment (HTA ) should be used to assess the standardization, the overall quality, the interoperability, the addressing to legal, economic and cost benefit aspects. One of the limits to the diffusion of the digital tele-echocardiography (T-E) applications in the NHCS lacking of a specific methodology for the HTA . In the present study, a solution offering a structured HTA of T-E products was designed. The methodology assured also the definition of standardized quality levels for the application. The first level represents the minimum level of acceptance; the other levels are accessory levels useful for a more accurate assessment of the product. The methodology showed to be useful to rationalize the process of standardization and has received a high degree of acceptance by the subjects involved in the study.Grazie ai grandi progressi nell\u27information technology le applicazioni di telemedicina sono mature per un uso diffuso. Tuttavia per permettere la loro introduzione nel sistema sanitario nazionale devono essere utilizzate specifiche metodologie di health technology assessment (HTA ) per valutare il grado di standardizzazione, la qualit? totale, l\u27interoperabilit?, il rispetto dei requisiti legali ed economici e il rapporto costo-beneficio. Con riferimento alla tele-ecocardiografia digitale uno dei limiti ? la mancanza di una specifica metodologia di HTA . Nel presente studio, ? stata proposta una soluzione che offre un HTA strutturato di prodotti di tele-ecocardiografia (T-E) digitale. La metodologia ha assicurato anche la definizione di livelli standardizzati di qualit? per l\u27applicazione. Il primo livello rappresenta il livello minimo di accettazione; gli altri livelli riguardano aspetti accessori e sono utili per una pi? accurata valutazione del prodotto. La metodologia si ? mostrata di utilit? per razionalizzare il processo di standardizzazione ed ha ricevuto un elevato grado di accettazione dei soggetti coinvolti