Main Topic: Information Technology in Healthcare
Presentation title: Public Health in the Era of Big Data: From Online Evidence to Serious Games
IRDR, University College London, London, United Kingdom
Recently, the massive explosion of medical evidence on the Internet and mobile devices and increased citizens’ involvement in management of their health changed the delivery of healthcare. This rapid process changed healthcare delivery at developed world and increasingly improves community health in the low and middle income countries (LMIC).
In this presentation we will outline the issues surrounding the dissemination of medical evidence and understanding public information needs from Internet search weblogs analytics. Educational effectiveness of serious games highlights the opportunity mobile technology brought to training, community engagement and behaviour change. Social networking with increasing amount of user-generated content from social media and participatory surveillance systems provide readily available source of real-time monitoring and epidemic intelligence.
In this talk, we will draw from several mobile technology projects aimed at citizens in low and middle income countries. In particular, mobile training and crowdsourcing for community engagement to combat the zika virus in Brazil, social media use for vaccination campaigns, early warning epidemics dashboard, and serious mobile games for increasing resilience and disaster preparedness in perinatal women in Nepal.
Main Topic: Image Processing
Presentation title: Benchmarking of algorithms for biomedical image analysis
Centre for Biomedical Image Analysis, Masaryk University, Brno, Czech Republic
Biologists and physicians have to be able to rely on the correctness of results obtained by automatic analysis of biomedical images. This, in turn, requires paying proper attention to quality control of the developed algorithms and software for this task. Both the medical image analysis and bioimage analysis communities are becoming increasingly aware of the strong need for benchmarking various image analysis methods in order to compare their performance and assess their suitability for specific applications. Reference benchmark datasets with ground truth (both simulated and real data annotated by experts) have become publicly available and challenges (competitions) are being organized in association with well-known conferences, such as ISBI and MICCAI (https://grand-challenge.org/
This talk summarizes recent developments in this respect and describes common ways of measuring algorithm performance as well as providing guidelines for best practices for designing biomedical image analysis benchmarks and challenges, including proper dataset selection (training versus test sets, simulated versus real data), task description and defining corresponding evaluation metrics that can be used to rank performance.
Proper benchmarking of image analysis algorithms and software makes life easier not only for future developers (to learn the strengths and weaknesses of existing methods) but also for users (who can select methods that best suit their particular needs). Also reviewers can better assess the usefulness of a newly developed analysis method if it is compared to the best performing methods for a particular task on the same type of data using standard metrics.
Main Topic: Diagnostic Imaging
Presentation title: Fast Field-Cycling MRI: a new diagnostic modality?
David Lurie, Lionel Broche, Gareth Davies, James Ross
School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, United Kingdom
Most contrast in conventional MRI arises from differences in T1 relaxation time. Studies on small tissue samples have shown that extra information could be obtained from T1-dispersion (plots of T1 versus magnetic field strength), but this information is invisible in conventional MRI since scanners operate at fixed magnetic field (e.g. 1.5 T). We are developing Fast Field-Cycling Magnetic Resonance Imaging (FFC-MRI) to exploit T1-dispersion as a new biomarker, with the aim of increasing diagnostic potential.
FFC measures T1-dispersion by switching the magnetic field rapidly between levels during the pulse sequence, with relaxation occurring at the “evolution” field (usually a low value) and always returning to the same “detection” magnetic field (a higher value) for NMR signal measurement. FFC-MRI obtains spatially-resolved T1-dispersion data, by collecting images at a range of evolution magnetic fields.
We have built two whole-body human sized scanners, operating at detection fields of 0.06 T  and 0.2 T. The 0.06 T device uses a double magnet, with field-cycling being accomplished by switching on and off a resistive magnet inside the bore of a permanent magnet; this has the benefit of inherently high field stability during the detection period. The 0.2 T FFC-MRI system uses a single resistive magnet which has the advantage of increased flexibility in pulse sequence programming, at the expense of lower field stability during the detection period, necessitating more complex instrumentation.
We are investigating a range of applications of FFC relaxometry and FFC-MRI. Our work has demonstrated that FFC relaxometry can detect the formation of cross-linked fibrin protein from fibrinogen in vitro, through the measurement of 14N-1H cross-relaxation phenomena, known as “quadrupolar dips”. We have also shown that FFC-MRI can detect changes in human cartilage induced by osteoarthritis. Recent work has focused on speeding up FFC-MRI by incorporating rapid MRI scanning methods.
Main Topic: Biosignals Processing
Presentation title: Non-invasive assessment of cardioversion drugs through signal processing
José Millet Roig
ITACA. Biomedical Eng. LAb, Universitat Politecnica Valencia, Valencia, Spain
Different types of analysis of the surface electrocardiogram have been proposed for evaluating the effects of antiarrhythmic drugs, such as: heart rate variability, QT-dispersion, ST-segment or QRS-Morphology. A decade or so ago, new research began to appear on atrial antiarrhythmic drug effects, thanks to novel techniques for quantifying parameters related to atrial activity that commonly go overlapped by ventricular activity. Such techniques include analysis in terms of atrial fibrillatory rate and its variability, spectral characterization of fibrillatory waves during AF, P-wave signal averaged ECG during sinus rhythm among others.
This presentation analyzes how these techniques are being applied to a new field of study such as cardioversion drugs, providing knowledge on how they can act non-invasively and analyzing the evolution of atrial dominant frequency together with other parameters in the spectrum (spectral concentration, second peak ratio, harmonics, etc.), observing the different behaviors associated with their effectiveness. In order to validate the information obtained non-invasively, the analysis shows a comparison between the parameters obtained through the ECG analysis and those obtained through a duo-decapolar catheter during an electrophysiology study, in which both recordings are obtained simultaneously. Much of the information can be obtained through advanced analysis of the ECG signal, although asynchrony and heterogeneity continue to be difficult to obtain. Ultimately, these advances can contribute to overcoming today’s challenging clinical questions in AF management.
Main Topic: Health Technology Assessment
Presentation title: Health Technology Assessment of medical devices: challenges, gaps and recent developments.
School of Engineering, University of Warwick, Coventry, United Kingdom
Health Technology Assessment (HTA) aims to inform healthcare decisions regarding appropriate innovative health technologies. After many years in which HTA community focused mainly on drug assessment, the attention of HTA international community is returning on medical devices, given their growing diffusion, increasing complexity and associated costs.
This talk will report on challenges and gaps met while assessing medical devices suggesting, when relevant, possible solutions.
Since 2014, the Applied Biomedical Signal Processing and Intelligent eHealth (ABSPIeH) Lab at the University of Warwick, directed by Dr Pecchia, focused on peculiar aspects of medical devices, and relevant scientific literature, which affect their assessment. For instance, in a recent study, the ABSPIeH lab demonstrated that even the positioning of a sensor, may affect the significance of a test based on medical devices. In a different study, performing field analysis in Sub-Saharan Africa, ABSPIeH lab tried to quantify the extent of which HTA reports can be reliable when assessing safety or effectiveness of medical devices in low income countries.
This talk will report on those experiences and will conclude presenting the significant effort made by the ABSPIeH, in cooperation with the IFMBE HTAD and the WHO, in order to produce pragmatic teaching material and guidelines on HTA of medical devices, which was designed specifically to meet the needs of medical physicists and biomedical engineers scientific communities.
Main Topic: Information Technology in Healthcare
Presentation title: Medical informatics; where's the data and how can it be used
Medical Informatics, Michigan Technological University, Houghton, United States
Getting access and analyzing data is the driving force behind all progress in business today. This is also true in healthcare. Patient records hold the information for their current care and there is now intercommunication between heath systems to link data and create a complete patient electronic medical record (EMR). This requires robust security measures to ensure records are only accessible by people that should be accessing them. It also requires a dependable methodology to ensure the correct patient data is linked together.
Once you have the compete patient’s EMR it can still be difficult to find the needed data because there is often a lot of extraneous information that may hide what a clinician needs. So how do you find the relevant data? In addition, the data is often unstructured or there are structured and unstructured data combined. Consequently, an intelligent method to search and combine this data is needed. The EMR also needs to have a reliable method for updating personnel when critical findings are added to the EMR. But who should get this notification and how do you minimize notification overload? Also, how do you link a clinical recommendation to a result? This can make sure a patient’s care is done in a timely manner, but also provides data on outcomes that can increase the ability to determine the best treatment courses. In addition, there is much more data that needs to be accessible by clinicians to make the right decisions on care. Clinicians need to know all the latest advances and what experts in each area recommend.
This is just a small portion of things that are being done or are needed in medical informatics. A review of some of the methods that are being used to gather and analyze medical data will be presented.
Main Topic: Dosimetry and Radiation Protection
Presentation title: International radiation safety system - Advancements and challenges with its application in regulatory frameworks
NSRW/ Division of Radiation, Transport and Waste Safety, IAEA, Vienna, Austria
The presentation will introduce IAEA standards of safety for protection of health and minimization of danger to life and property so called International Basic Safety Standards on Radiation Protection and Safety of Radiation Sources (BSS), and advancements with their application in the radiations radiation safety systems. The first BSS were published in 1962 and have been revised and updated since then. The latest version which was approved in September 2011 and published in 2014, is jointly sponsored by seven other international organizations. It applies to all situations involving exposure due to radiation, whether of natural or artificial origin. As such, they are universally applicable to the protection of people in all exposure situations. In order o ensure consistency in the radiation protection system and in regulatory frameworks worldwide, BSS follow ICRP recommendations, in particularly designation of situations of exposure in accordance with ICRP Publication 103 - ‘planned exposure situations’, ‘emergency exposure situations’ and ‘existing exposure situations’, as well as introduce recommended revised reduced dose limits to the lens of the eyes. The presentation will also address three existing or foreseen challenges namely (1) need to address dose coefficients per unit exposure to radon and radon progeny which are being prepared by ICRP and UNSCEAR, (2) application of the concepts of exclusion, exemption, and clearance, and (3) food drinking water safety related to the presence of natural and artificial radionuclides. In the last part, the presentation will discuss specific challenges that were highlighter in the aftermath of the TEPCO Dai-ichi NPP accident in Japan, particularly radiation protection of workers in elevated exposure situations and communication of radiation protection measures with non-expert parties.
Main Topic: Diagnostic Imaging
Presentation title: MRI in patients with implantable electronic devices: a teamwork approach
E Russell Ritenour
Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, South Carolina, United States
In the US alone, there are approximately 650,000 new pacemaker (PM) and Implanted Cardio Defibrillator (ICD) procedures per year, with a projected growth rate of 15% per year. There is roughly a 50% chance of an indication for MRI in a PM/ICD patient over their lifetime.
MR Safe pacemakers came onto the market in 2011, but the patient population will continue to have MR “Unsafe” PMs and ICDs for many years. Remnants of the devices, such as abandoned pacemaker leads, will continue for some patients’ lifetimes and the number of patients needing MRIs will increase as the population ages. Despite the growing patient population, many hospitals still view the presence of PMs/ICDs as a contraindication for MR imaging, particularly of the thorax. Until recently, even some academic centers in the US have opted not to scan such patients or to limit their scanning to modalities other than MRI.
In this presentation, current literature and general recommendations of scientific and professional societies as well as regulatory bodies in the US and Europe will be reviewed. The Medical University of South Carolina (MUSC), an Academic Center for the Southeast of the United States has been scanning such patients for several years. This undertaking is an example of the use of a teamwork approach to hospital policy, an approach in which members of different disciplines and different departments work in concert to meet the medical and safety challenges of relatively new medical issues. Specific procedures, guidelines for pulse sequences, Specific Absorption Rate, electronic lead configuration, review of vendor information, and the steps for medical approval followed at MUSC will be presented.
Main Topic: Patient Safety
Presentation title: Medical devices safety – still current topic
Electrotechnical Testing Instituite,s.p., Praha 8, Czech Republic
Safety is a key factor, next to expected effectiveness, which characterizes quality of a medical device. Safety of medical devices became a big topic after the PIP scandal and as consequence, the authorities started to put more focus on strict and precise compliance with the requirements.
On the other hand, when putting a medical device on the market, the main goal is to safeguard the public health and to offer an effective and no compromizing therapy or diagnose. Therefore, it is crucial that manufacturers are complying with these requirements to highest possible level during the whole lifecycle of the device.
In the presentation, different aspects of safety of medical device will be discussed and also a short overview of safety requirements in the new regulations will be presented.