Johannes Dirnberger

Medical documentation of burn injuries

For successful treatment of burns one of the most important pillars is an adequate documentation. Otherwise, nobody in science, economics or quality control can comprehend this issue’s complexity [22]. Research, science and costing in burns are based on accurate assessment and documentation of burn injuries. Documentation required, is time consuming and labor intensive. For any scientific comparability of burns the exact and correct extent and depth of burns are essential.

BurnCase 3D – Realistic Adaptation of 3-Dimensional Human Body Models

This paper presents the results of the research project BurnCase in the field of realistic and anatomically correct deformations of 3D models of the human body. The project goal is to develop a software system named BurnCase 3D, which supports and enhances the documentation and diagnosis of human burn injuries.

Virtual cerebral aneurysm clipping with real-time haptic force feedback in neurosurgical education

OBJECTIVE Realistic, safe, and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education, and they should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force feedback and real-time deformation of the aneurysm and vessels. METHODS A prototype simulator was developed from 2012 to 2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software, and the prototype was evaluated by 18 neurosurgeons. In 4 patients with different medial cerebral artery aneurysms, virtual clipping was performed after real-life surgery, and surgical results were compared regarding clip application, surgical trajectory, and blood flow. RESULTS After head positioning and craniotomy, bimanual virtual aneurysm clipping with an original forceps was performed. Blood flow simulation demonstrated residual aneurysm filling or branch stenosis. The simulator improved anatomic understanding for 89% of neurosurgeons. Simulation of head positioning and craniotomy was considered realistic by 89% and 94% of users, respectively. Most participants agreed that this simulator should be integrated into neurosurgical education (94%). Our illustrative cases demonstrated that virtual aneurysm surgery was possible using the same trajectory as in real-life cases. Both virtual clipping and blood flow simulation were realistic in broad-based but not calcified aneurysms. Virtual clipping of a calcified aneurysm could be performed using the same surgical trajectory, but not the same clip type. CONCLUSIONS We have successfully developed a virtual aneurysm-clipping simulator. Next, we will prospectively evaluate this device for surgical procedure planning and education.

An ontology-based clinical data warehouse for scientific research

Medical research but also quality management is based upon medical data. The integration, validation, processing, and exploration of this data is known to be a technical obstacle for researching medical domain experts and a major pitfall to (bio‐)medical research projects. To overcome this pitfall and actively support the medical domain expert in these tasks, we present an ontology‐based clinical data warehouse for scientific research. It is completely generic and adapts itself at run‐time to the current domain‐ontology, which can be freely defined by the domain expert and describes the actual field of research. The whole system adapts is appearance and behavior to this central ontology and appears to the user like a custom made solution. Furthermore, the elaborate structural meta‐information from the ontology is used to actively support the user in tasks that usually require profound IT knowledge, such as defining complex search queries or data quality constraints, or applying advanced data visualization algorithms to the data. The proposed warehouse supports the domain expert trough the whole process of knowledge discovery from data integration to exploration.

Meta-model based knowledge discovery

Data acquisition and data mining are often seen as two independent processes in research. We introduce a meta-information based, highly generic data acquisition system which is able to store data of almost arbitrary structure. Based on the meta-information we plan to apply data mining algorithms for knowledge retrieval. Furthermore, the results from the data mining algorithms will be used to apply plausibility checks for the subsequent data acquisition, in order to maintain the quality of the collected data. So, the gap between data acquisition and data mining shall be decreased.

O24.5 The determination of burned surfaces: how big is the difference?

Rationale: The determination of the extent of a burn injury is a complex process. To aid this process, plenty methods and tools have been developed. The aim aim of this work is to show how accurate experts are able to estimate surfaces by using standard methods “palm-rule”, “rule-of-nine”, “lund-browder-chart” or others. The question we want to answer is how the results correlates when experts use those estimation methods. Methods: For this survey we visited a german-speaking conference in Austria this January 2010 dealing with burns. We provided a questionnaire with 3 pictures of burned patients where we marked the areas to estimate with a yellow line. The questionnaire asked the participants about their used estimation method and their profession. Additionally we provided sheets with graphical representations of the “palm-rule”, the “rule-of-nine” and a “lundbrowder-chart”. The participation of 51 persons has been voluntarily and without financial payment. Results: As we didn’t know the exact results our self, we calculated the mean value of all attendants per patient as a basis for statistical variance analysis in different type of professions as well as in different used methods. The usage of the “palm-rule” and the “rule-of-nine” has been almost equal; the “lund-browder-chart” has only been used by 7 persons. Concerning the standard deviations of the different used methods, the best results have been archived by the use of the “rule-of-nine”. Concerning the standard deviations of the different professions, the best results have been archived by the assistant physician and physicians could reach the best results. Conclusion: The standard deviations of all three estimations reached from 42 to 62 percent. The usage of existing methods shows significant deviations of their results, even used by experts. In order to overcome those anomalies, the usage of more objective methods should be considered in future.