Multivendor fully automatic uncertainty management approaches for the intuitive representation of DME fluid accumulations in OCT images

[Abstract]: Diabetes represents one of the main causes of blindness in developed countries, caused by fluid accumulations in the retinal layers. The clinical literature defines the different types of diabetic macular edema (DME) as cystoid macular edema (CME), diffuse retinal thickening (DRT), and serous retinal detachment (SRD), each with its own clinical relevance. These fluid accumulations do not present defined borders that facilitate segmentational approaches (specially the DRT type, usually not taken into account by the state of the art for this reason) so a diffuse paradigm is used for its detection and visualization. In this paper, we propose three novel approaches for the representation and characterization of these types of DME. A baseline proposal, using a convolutional neural network as backbone, another based on transfer learning from a general domain, and a third approach exploiting information of regions without a defined label. Overall, our baseline proposal obtained an AUC of 0.9583 ± 0.0093, the approach pretrained with a general-domain dataset an AUC of 0.9603 ± 0.0087, and the approach pretrained in the domain taking advantage of uncertainty, an AUC of 0.9619 ± 0.0073.Ministerio de Ciencia e Innovación; RTI2018-095894-B-I00Instituto de Salud Carlos III; DTS18/00136Ministerio de Ciencia e Innovación; FPU18/02271Ministerio de Ciencia e Innovación; PID2019-108435RB-I00Xunta de Galicia; ED431C 2020/24Xunta de Galicia; ED481B 2021/059Axencia Galega de Innovación; IN845D 2020/38Xunta de Galicia; ED431G 2019/0

Digital Health & Care Innovation Centre Phase 2 – Year 3 Annual Report (August 2021 to July 2022)

This Year 3 annual report sets out the significant impact made by DHI over the past 12 months with continued success to report evident, including 5 projects transferred to other organisations as ready to scale. DHI continues to respond to the unprecedented demands on health and care service partners and the imperative for accelerated innovation. DHI’s design led innovation approach and methodology continues to evolve, and is increasingly recognised by our partners as differentiating and effective. This has led and shaped a number of key initiatives at different stages of DHI’s innovation process model (Page 5 Fig. 4) including scoping of drug deaths prevention initiatives with the Scottish Government (SG) Digital Lifelines Programme, initiating and developing the transformation of frailty identification and management within Midlothian Health & Social Care Partnership and influencing next generation pharmaceutical delivery planning with Roche, one of the worlds largest Biotech companies. In addition to scoping activity, DHI continues to balance the project portfolio with over 14 projects managed this year. One major programme activated this year was the Rural Centre of Excellence for Digital Health and Care Innovation in the Moray Region, funded by UK Government. This initiative allows DHI to create more focussed opportunities for rural communities. In doing so this gives us the chance to broaden the innovation pipeline into the integrated care agenda - stretching the innovation model, with a greater focus on social care, data sharing and commercialisation. Launch of the Moray RCE was marked by an official visit from UK and Scottish Government representatives. Iain Stewart MP, Parliamentary Under Secretary of State for Scotland and Richard Lochhead Member of the Scottish Parliament

Report on SHAFE policies, strategies and funding

The objective of Working Group (WG) 4 of the COST Action NET4Age-Friendly is to examine existing policies, advocacy, and funding opportunities and to build up relations with policy makers and funding organisations. Also, to synthesize and improve existing knowledge and models to develop from effective business and evaluation models, as well as to guarantee quality and education, proper dissemination and ensure the future of the Action. The Working Group further aims to enable capacity building to improve interdisciplinary participation, to promote knowledge exchange and to foster a cross-European interdisciplinary research capacity, to improve cooperation and co-creation with cross-sectors stakeholders and to introduce and educate students SHAFE implementation and sustainability (CB01, CB03, CB04, CB05). To enable the achievement of the objectives of Working Group 4, the Leader of the Working Group, the Chair and Vice-Chair, in close cooperation with the Science Communication Coordinator, developed a template (see annex 1) to map the current state of SHAFE policies, funding opportunities and networking in the COST member countries of the Action. On invitation, the Working Group lead received contributions from 37 countries, in a total of 85 Action members. The contributions provide an overview of the diversity of SHAFE policies and opportunities in Europe and beyond. These were not edited or revised and are a result of the main areas of expertise and knowledge of the contributors; thus, gaps in areas or content are possible and these shall be further explored in the following works and reports of this WG. But this preliminary mapping is of huge importance to proceed with the WG activities. In the following chapters, an introduction on the need of SHAFE policies is presented, followed by a summary of the main approaches to be pursued for the next period of work. The deliverable finishes with the opportunities of capacity building, networking and funding that will be relevant to undertake within the frame of Working Group 4 and the total COST Action. The total of country contributions is presented in the annex of this deliverable

Swiss Pilot Low-Dose CT Lung Cancer Screening Study: First Baseline Screening Results

This pilot study conducted in Switzerland aims to assess the implementation, execution, and performance of low-dose CT lung cancer screening (LDCT-LCS). With lung cancer being the leading cause of cancer-related deaths in Switzerland, the study seeks to explore the potential impact of screening on reducing mortality rates. However, initiating a lung cancer screening program poses challenges and depends on country-specific factors. This prospective study, initiated in October 2018, enrolled participants meeting the National Lung Cancer Study criteria or a lung cancer risk above 1.5% according to the PLCOm2012 lung cancer risk-model. LDCT scans were assessed using Lung-RADS. Enrollment and follow-up are ongoing. To date, we included 112 participants, with a median age of 62 years (IQR 57–67); 42% were female. The median number of packs smoked each year was 45 (IQR 38–57), and 24% had stopped smoking before enrollment. The mean PLCOm2012 was 3.7% (±2.5%). We diagnosed lung cancer in 3.6% of participants (95%, CI:1.0–12.1%), with various stages, all treated with curative intent. The recall rate for intermediate results (Lung-RADS 3,4a) was 15%. LDCT-LCS in Switzerland, using modified inclusion criteria, is feasible. Further analysis will inform the potential implementation of a comprehensive lung cancer screening program in Switzerland

The Swiss Approach - feasibility of a national low-dose CT lung cancer screening program.

BACKGROUND Lung cancer is the leading cause of cancer-related deaths in Switzerland. Despite this, there is no lung cancer screening program in the country. In the United States, low-dose computed tomography (LDCT) lung cancer screening is partially established and endorsed by guidelines. Moreover, evidence is growing that screening reduces lung cancer-related mortality and this was recently shown in a large European randomized controlled trial. Implementation of a lung cancer screening program, however, is challenging and depends on many country-specific factors. The goal of this article is to outline a potential Swiss lung cancer screening program. FRAMEWORK An exhaustive literature review on international screening models as well as interviews and site visits with international experts were initiated. Furthermore, workshops and interviews with national experts and stakeholders were conducted to share experiences and to establish the basis for a national Swiss lung cancer screening program. SCREENING APPROACH General practitioners, pulmonologists and the media should be part of the recruitment process. Decentralisation of the screening might lead to a higher adherence rate. To reduce stigmatisation, the screening should be integrated in a "lung health check". Standardisation and a common quality level are mandatory. The PLCOm2012 risk calculation model with a threshold of 1.5% risk for developing cancer in the next six years should be used in addition to established inclusion criteria. Biennial screening is preferred. LUNG RADS and NELSON+ are applied as classification models for lung nodules. CONCLUSION Based on data from recent studies, literature research, a health technology assessment, the information gained from this project and a pilot study the Swiss Interest Group for lung cancer screening (CH-LSIG) recommends the timely introduction of a systematic lung cancer screening program in Switzerland. The final decision is for the Swiss Cancer Screening Committee to make

The Swiss Approach - feasibility of a national low-dose CT lung cancer screening program

BACKGROUND Lung cancer is the leading cause of cancer-related deaths in Switzerland. Despite this, there is no lung cancer screening program in the country. In the United States, low-dose computed tomography (LDCT) lung cancer screening is partially established and endorsed by guidelines. Moreover, evidence is growing that screening reduces lung cancer-related mortality and this was recently shown in a large European randomized controlled trial. Implementation of a lung cancer screening program, however, is challenging and depends on many country-specific factors. The goal of this article is to outline a potential Swiss lung cancer screening program. FRAMEWORK An exhaustive literature review on international screening models as well as interviews and site visits with international experts were initiated. Furthermore, workshops and interviews with national experts and stakeholders were conducted to share experiences and to establish the basis for a national Swiss lung cancer screening program. SCREENING APPROACH General practitioners, pulmonologists and the media should be part of the recruitment process. Decentralisation of the screening might lead to a higher adherence rate. To reduce stigmatisation, the screening should be integrated in a "lung health check". Standardisation and a common quality level are mandatory. The PLCOm2012 risk calculation model with a threshold of 1.5% risk for developing cancer in the next six years should be used in addition to established inclusion criteria. Biennial screening is preferred. LUNG RADS and NELSON+ are applied as classification models for lung nodules. CONCLUSION Based on data from recent studies, literature research, a health technology assessment, the information gained from this project and a pilot study the Swiss Interest Group for lung cancer screening (CH-LSIG) recommends the timely introduction of a systematic lung cancer screening program in Switzerland. The final decision is for the Swiss Cancer Screening Committee to make

Automatic Segmentation and Intuitive Visualisation of the Epiretinal Membrane in 3D OCT Images Using Deep Convolutional Approaches

[Abstract] Epiretinal Membrane (ERM) is a disease caused by a thin layer of scar tissue that is formed on the surface of the retina. When this membrane appears over the macula, it can cause distorted or blurred vision. Although normally idiopathic, its presence can also be indicative of other pathologies such as diabetic macular edema or vitreous haemorrhage. ERM removal surgery can preserve more visual acuity the earlier it is performed. For this purpose, we present a fully automatic segmentation system that can help the clinicians to determine the ERM presence and location over the eye fundus using 3D Optical Coherence Tomography (OCT) volumes. The proposed system uses a convolutional neural network architecture to classify patches of the retina surface. All the 2D OCT slices of the 3D OCT volume of a patient are combined to produce an intuitive colour map over the 2D fundus reconstruction, providing a visual representation of the presence of ERM which therefore facilitates the diagnosis and treatment of this relevant eye disease. A total of 2.428 2D OCT slices obtained from 20 OCT 3D volumes was used in this work. To validate the designed methodology, several representative experiments were performed. We obtained satisfactory results with a Dice Coefficient of 0.826 ± 0.112 and a Jaccard Index of 0.714 ± 0.155, proving its applicability for diagnosis purposes. The proposed system also demonstrated its simplicity and competitive performance with respect to other state-of-the-art approaches.10.13039/501100004587-Instituto de Salud Carlos III, Government of Spain, research project (Grant Number: DTS18/00136), 10.13039/501100004837-Ministerio de Ciencia e Innovación y Universidades, Government of Spain, research project (Grant Number: RTI2018-095894-B-I00), 10.13039/501100004837-Ministerio de Ciencia e Innovación, Government of Spain through the research project (Grant Number: PID2019-108435RB-I00), 10.13039/501100008425-Consellería de Cultura, Educación e Universidade, Xunta de Galicia, Grupos de Referencia Competitiva (Grant Number: ED431C 2020/24), 10.13039/501100010769-Axencia Galega de Innovación (GAIN), Xunta de Galicia (Grant Number: IN845D 2020/38), 10.13039/501100008425-CITIC, Centro de Investigación de Galicia, receives financial support from the Consellería de Educación, Universidade e Formación Profesional, Xunta de Galicia, through the ERDF (80%) and Secretaría Xeral de Universidades (20%) (Grant Number: ED431G 2019/01)Xunta de Galicia; ED431C 2020/24Xunta de Galicia; IN845D 2020/38Xunta de Galicia; ED431G 2019/0

Hesitancy around low dose CT screening for lung cancer

Lung cancer is the leading cause of cancer death worldwide. The absence of symptoms in early stage (I/II) disease, when curative treatment is possible, results in greater than 70% of cases being diagnosed at late stage (III/IV), when treatment is rarely curative. This contributes greatly to lung cancer's poor prognosis which sees only 16.2% of individuals diagnosed with the disease alive at 5 years. Early detection is key to improving lung cancer survival outcomes. As a result, there has been longstanding interest in finding a reliable screening test. After little success with chest radiography and sputum cytology, in 2011 the US National Lung Screening Trial (NLST) demonstrated that annual Low Dose Computed Tomography (LDCT) screening reduced lung cancer specific mortality by 20%, when compared with annual chest radiography. In 2020, the NELSON study demonstrated an even greater reduction in lung cancer specific mortality for LDCT screening at 0, 1, 3 and 5.5 years of 24% in men, when compared to no screening. Despite these impressive results, a call to arms in the 2017 European position statement on Lung Cancer Screening (LCS), and the widespread introduction across the US, there was, until recently, no population-based European national screening programme in place. We address the potential barriers and outstanding concerns including common screening foes, such as false positive tests, overdiagnosis, and the negative psychological impact of screening, as well as others more unique to LDCT LCS, including appropriate risk stratification of potential participants, radiation exposure and incidental findings. In doing this, we conclude that whilst the evidence generated from ongoing work can be used to refine the screening process, for those risks which remain, appropriate and acceptable mitigations are available, and none should serve as barriers to the implementation of national unified LCS programmes across Europe and beyond