Milton Santos

DICOM and Clinical Data Mining in a Small Hospital PACS: A Pilot Study

Technological developments in the medical imaging acquisition and storage process have triggered the use of Picture Archiving and Communication Systems (PACS) with gradually larger archives. This paper aims to exploit advantages of using a DICOM Data Mining Tool in a hospital PACS. The results showed the tool reliability and performance to obtain and index clinical data, as well as the possibility of conducting flexible research on DICOM data fields, providing means for continuous improved practices at the Radiology Departments.

Technologies for Ageing in Place to Support the Empowerment of Patients with Chronic Diseases

Objectives - This study aimed to identify: (i) the most relevant chronic diseases in terms of the application of technologies for ageing in place to promote the empowerment of patients; and (ii) types, outcomes and impacts of technologies for ageing in place being used to promote the empowerment of patients with chronic diseases. Methods - A systematic review of reviews and meta-analysis was performed based on a search of the literature. Results - A total of 34 reviews and meta-analysis across several chronic diseases were retrieved. These studies compare the empowerment of patients supported by different technologies with usual care. Conclusion - Technologies for ageing in place have positive effects on various health related outcomes, but further research is required to allow their incorporation in the clinical practice.

Characterization of the Stakeholders of Medical Imaging Based on an Image Repository

Background: The optimization of the performance of medical imaging departments should be supported by the quality of the available information, namely the characterization of the involved stakeholders. Objective: The study reported in this paper aimed to assess the quality of Digital Imaging and Communication in Medicine (DICOM) metadata related to the characterization of the stakeholders of medical imaging, particularly in terms of the availability of the attributes and their usage trends. Methods: The authors analysed the DICOM metadata related to all the imaging studies carried out by all medical imaging modalities and stored in the PACS of a medium size hospital during one year period (i.e. 5153870 images, corresponding to 97612 studies performed on 61256 patients). Results: It was identified a considerable variation in terms of the number of DICOM attributes available for each medical imaging modality (between 10 and 20), and how these attributes are used to characterize medical imaging stakeholders. Conclusion: A better use of DICOM metadata can be achieved, namely to characterize the stakeholders of medical imaging and to promote the communication between them.

Normalizing medical imaging archives for dose quality assurance and productivity auditing

Quality assurance for planned radiation exposure situations (e.g. x-ray, CT) requires the application of examination-specific scans tailored to patient age or size, body region and clinical indication for ensuring that the dose to each patient is as low as reasonably achievable for the clinical purpose of the image acquisition. Nevertheless, assuring quality implies a heavy manual labor to measure and optimize care services flow. There are already several methodologies and protocols that can be used to achieve this objective. However, the continuous monitoring of quality indicators is still not performed in many healthcare centers. The challenge is to find a way to analyze these metrics in an efficient, effective and convenient manner. Moreover, these results are not often shared, due to confidentiality and privacy of patients and medical staff. In this paper, we propose a methodology and a software tool to aggregate and normalize the monitoring data from distinct points, in order to collect indicators, namely about productivity, efficiency and dose usage, factors that are crucial for benchmarking and for improving the quality of protocol procedures. To evaluate the effectiveness of our solution, several results were collected from two medical institutions.

DICOM metadata quality auditing for medical imaging stakeholders characterisation: a pilot study

AbstractThe metadata that are part of a vast number of medical imaging exams might be a valuable source for medical imaging stakeholder’s characterisation. The study reported in this article aimed ...

DICOM metadata aggregation from multiple healhtcare facilities

Medical imaging procedures generate an enormous amount of information that is stored in multiple storage units by Picture Archiving and Communication Systems (PACS). Using Dicoogle and Digital Imaging and Communication in Medicine (DICOM) metadata the authors developed a merging and reconciliation procedure to create a seamlessly unique PACS view. This procedure was applied to the metadata held by 19 storage units of a PACS of a Portuguese hospital centre composed by three branches. In total, more than 36 million images, from more than ten modalities were collected. The merging and reconciliation procedure have proven to be robust and efficient. This shows that it is possible to merge the metadata collected from multiple PACS into a single unified view, preserving the relation between patients, studies, and images, which is essential for large-scale analyses of medical imaging repositories from multiple institutions.

Application for VTE stratification and risk assessment

Venous thromboembolism is a pathology that is responsible for high rates of morbidity and mortality in hospitals. An adequate thromboprophylaxis may contribute to an effective improvement of the well-being and safety of patients. One of the important factors for the prescription of a thromboprophylaxis is the determination of the risk of thromboembolism, which can be implemented in several ways, using different methodologies, namely by using risk scales. In this work, developed in the Hospital Center of Trás-os-Montes and Alto Douro, Portugal, we describe the development and implementation of an application with two scales for the assessment and stratification of the risk of thromboembolism, to be applied in hospitalized patients (Caprini scale) and in patients in ambulatory surgery (scale recommended by the Portuguese Ambulatory Surgery Association). The application was integrated into the hospital electronic health record system (SClínico).

Technologies for ageing in place to support community-dewlling older adults

Objectives: This study aimed to systematize current evidence of technologies for ageing in place designed to support the daily living of community-dwelling older adults. Methods: A systematic review of reviews and meta-analysis was performed based on a search of the literature. Results: A total of 24 reviews and meta-analysis were retrieved and interventions related to physical activity, nutrition and weight management, health education, loneliness and social isolation, and emergency situations were identified; These studies analyse the impact of different technologies in community-dwelling older adults, considering several health-related outcomes. Conclusion: Technologies for ageing in place have positive effects on various health related outcomes, but further research is required.

Information Model for Radiology Performance Indicators based on DICOM

The paper presents the information model of the DICOM - Radiology Performance Indicator (DICOMRPI). This model can be used to aggregate information related to the characterization of medical imaging health care services, namely information incorporated in the studies according to the format of the Digital Imaging and Communication in Medicine (DICOM). The model comprises several components including the ones required to define the context of medical imaging health care services (e.g. the entities involved) and the context of use of the indicator (e.g. Quality Dimensions). For the validation of the proposed information model 51,277 Digital Radiography (DX) studies performed on 27,559 patients from a single health care facility were considered. The results of this validation within the scope of DX modality make possible to anticipate the DICOM-RPI relevance in other imaging modalities and its contribution for comprehensive analysis of medical imaging health care services.

Pervasive Health and Regulatory Frameworks

Pervasive health deals with the application of pervasive computing for health and wellness management and its developments should be subject of regulatory oversight. The paper presents a general overview of pervasive health concepts and applications, and aims to verify the level of conformity of current developments with existing regulatory frameworks.