Proceedings XVI Winter Course

QUALITY CONTROL IN TELEMEDICINE. BIOBANKING

 

 

Edited by

Prof. Olga Ferrer-Roca MD, PhD

 

UNESCO Chair of Telemedicine

President, CATAI Consortium

Full Professor of Pathology, Faculty of Medicine,

University of La Laguna, Tenerife, Canary Islands, Spain.

 

 

 

 

 

 

 

 

 

 

 

 

 

CATAI editions 2007

Tenerife. Canary Islands. Spain

 

ISBN: 978-84-612-1364-1

 


 

Table of Contents

 

1-

SECURITY IN HEALTH CARE

4

 

Ch.Meinel, Al Nemr R.

 

2- 

P-HEALTH IN DIABETES SEFT CONTROL

11

 

Pallares R., Quintana JJ

 

3- 

Minimum invasive biosensors

16

 

Salazar P., Martin M., Gonzalez Mora JL.

 

4- 

NEW ASPECTS IN DICOM STANDARD

27

 

Horch A.

 

5- 

BIOBANKING MANAGEMENT

35

 

Acilu M, Martinez B

 

6- 

QUALITY CONTROL AND SOCIOECOMIC MODELS

40

 

Ferrer Roca O.

 

7-  

e-SLIDE IMAGING SYSTEM

46

 

V.DellaMea.

 

8- 

SELF MONITORING DIABETES

51

 

Kristensen GB, Sandberg S

 

9- 

TELECARDIOLOGY MODEL

56

 

Kastania A., Boudoulas H., Kossida S.

 

10-

DATA PROTECTION & BIOMEDICAL LAW

61

 

Igualada A.

 

11-

IMAGE BIOBANKING

68

 

Schmitt FC

 

12-

WAITING LISTS, WAITING TIMES AND ADMISSIONS. EFFECT OF TELEMEDICINE

73

 

Windmeijer F., Gravelle H, Hoonout P.

 

13-

DIABETIC CONTROL WITH NON-INVASIVE DEVICES

81

 

Sacks DB, Arnold M.

 

14-

EFFICIENT QUERY IN MEDICINE

87

 

M.E. Vidal, Ibañez L, Rodriguez H

 

15-

QUALITY BIOBANKING

92

 

De Alava E., Regalado AM

 

16-

STANDARDS ON HOSPITAL COMMUNICATION AND POINT OF CONTACT

96

 

Canals X

 

17-

HIGH RESOLUTION IMAGE MODALITIES

100

 

Hernandez Armas J.

 

18-

SPANISH SURGICAL ROBOTS

106

 

Muñoz FV.,Garcia-Morales I

 

19-

SMALL SIZE VIRTUAL SLIDES

115

 

Marcano F., Ferrer Roca O., Quintana JJ

 

20-

NANOZOOMER

120

 

Garcia Bailen J

 

21-

SUPERVISED ARCHITECTURE IN THE OR FOR ROBOTIC SURGERY

123

 

Azorin JM, Sabater JM., Compañ F., Garcia N, Perez C

 

22-

AMBIENTE ASSISTANT LIVING- Art 169 of the new  EU treaty

130

 

Ferrer-Roca O,

 

23-

TELEPATHOLOGY

135

 

Munabi I., Isyagi M, Royal J, Sewankambo NK

 

24-

Programa del XVI Curso de Invierno del CATAI y XXI Curso Analisis Imagen ULL

139

 

 

 

25-

Programme of the XVI Winter Course of the CATAI and XXI Image Analysis Course

140

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 Meinel Ch, Al Nemr R.

 

Abstract— Electronic Healthcare is a rapidly growing area that has attracted major attention due to its critical impact on the quality of life. Security and privacy issues arise from the dramatic increase in the role that IT plays in the delivery of healthcare. In this paper we discuss the role of different security technologies in e-healthcare and mobile e-healthcare systems and the need to select and interact with multiple providers and multiple security domains. As e-health systems are becoming more pervasive, trust management systems will be required to establish high levels of trust.

Index Terms—Security, healthcare, Pervasive Systems, Trust, Privacy

 


 

Pallarés del Egido R, Quintana JJ

 

Abstract  pHealth or personalizad health is based in the concept of individual disease prevention and treatment and wellfare in the health system. We propose for this a mobile system for diabetes that contain a decision support system (DSS) to calculate insulina shuts based on the patient situation at the moment. The system send the data into a data base that can be reviewed by the doctor or diet controler. 

 

Index Terms—pHealth, diabetes mellitus, PDA, smartphone, DSS, GSM, GPRS, UMTS.

 

 

 

 


 

Salazar P., Martín M., González-Mora J. L.

 

 

Abstract—Biosensors are devices, preferably small and portable, that allow the selective quantification of chemical and biochemical analytes. The advantages comprise: high spatial and temporal resolution, high selectivity, easy implementation, prone to miniaturization, short response, detection of the analyte without prior separation, etc.

Different approaches can be used to elaborate these devices depending on how electron transfer occurs between enzyme and transducer. Immobilization of biological material on the transducer and coating method used to prevent interference are the principal steps to improve these analytical devices.

A sensor for “in vivo” glucose monitoring require miniaturization of the device, long-term stability (minimizing drift and the need for calibration), elimination of oxygen dependency, user-friendly and biocompatibility.

Index Terms— biosensor, enzyme, glucose, glutamate, in vivo monitoring, lactate, Prussian blue and telemedicine.

 

 

 


Alexander Horsch

 

Abstract— This lecture gives an introduction to basics of the medical image communication standard DICOM and its implementation initiative IHE, and some of the recent extensions are introduced, addressing Substance Administration Information Services, Deformable Spatial Registration Storage, Encapsulation of CDA Documents, 3D X-Ray, and Specimen Identification and Revised Pathology, as well as the IHE Pathology Technical Framework. The corresponding DICOM Supplements indicate the ongoing extension of the standard to non-radiological medical domains. The IHE technical framework illustrates the continuing efforts put on the implementation of the standard in the clinical workflow.

 

Index Terms—DICOM, Medical Image Communication, IHE Technical Framework, Substance Administration, Spatial Registration, CDA Encapsulation, 3D X-Ray, Pathology.

 

 

 

 

 



 


Acilu M, Martinez B.

 

Abstract— This article introduce biobanks and its information management requirements and available systems. Norabay® software give various solutions depending on the type of biobank structure. The paper explains the advantages of having a robust data management system and its essential role for biobanking quality.

 

Index Terms—Biobank, data management system, ethical committee, law, quality system, regulate, science committee, traceability and security.

 

 

 

 

 


 

Ferrer Roca O.

 

Abstract—One of the main drawbacks for Telemedicine is the difficulty to demonstrate in  monetary value the cost-benefits when benefits are  mainly intangible in the utility sphere or health utility function ( U=Qm*t).

The paper list all health metric instruments that can be applied to TM and stated opportunities of the WTP (Willigness to pay) for co-responsibility in health care expensive and QALY (Quality adjusted life years) based on Equity and availability for rural areas.

 

Index Terms—Health metrics, telemedicine, WTP, QUALY.

 

 

 


Vincenzo Della Mea, Nicola Bortolotti, and Carlo A. Beltrami

 

Abstract—The present paper describes principles underlying the telepathology technique known as Whole Slide Imaging, and the design and implementation of a system for acquisition and visualization of digital slides.

Such system is available as open source at the web site http://www.eslide.net, together with sample acquired slides.

 

Index Terms—telemedicine, telepathology, digital pathology, image processing.

 

 


 

G.B.B. Kristensen and S. Sandberg

 

Abstract— This paper focus on different aspects of how to assess the analytical quality of SMBG instruments. It describe quality specifications used for SMBG devices, a standardized evaluation of SMBG performance, and to different approaches to monitor the quality of SMBG performance under daily life conditions in the hands of the diabetes patients.

 

Index Terms—Self Monitoring Blood Glucose (SMBG), quality assessment, quality specifications, method evaluation

 

 

 

 

 

 


A. Kastania, H. Boudoulas, S. Kossida

 

 

Abstract—Telecardiology is the practice of cardiology which utilizes telecommunications and signal/image compression technologies to manipulate ‘tele-data’ during monitoring of cardiac patients from their home or office and for remote consultation between cardiologists as well as between general practitioners and cardiologists. The e–Herophilus project aims at designing, developing and clinically validating a Telecardiology platform. The generation and evaluation of a National Prototype guaranteeing the quality and reliability of telecardiology in Greece is the final objective of this work.

 

Index Terms— quality, reliability, telecardiology

 

 

 

 


 

 

Ángel Igualada Menor

 

 

Abstract— With this article we intend to approach to the current legislation on the fundamental right on Data Protection recognized in article 18.4 of the Spanish Constitution of 1978, the processing of genetic data, especially with respect to the biomedical surveillance, analyzing the principles set fort in the Organic Act 15/1999, dated 13th December, on Protection of Personal Data, the duties of the controller and the implementation of security measures.

 

Index Terms— Health-related personal data, genetic personal data, biological sample, consent, file, controller, security measures..

 

 

 

 

 

 

 

 

 



 Fernando Carlos Schmitt

 

Abstract—Nowadays good material is essential for a correct diagnosis and treatment of cancer. Fine-needle aspiration cytology, is together with other biological samples a guaranty for personalized diagnosis and treatment of cancer. This means that image storage and access is an essential part of the Biobanking activities related with proteomics, genomics, pharmacokinetic and other techniques.

 

Index Terms—Biomaterial, Biobanking, cytology, EGFR, fine-needle aspiration (FNA) , HER2, KIT.

 

 

 


 

Windmeijer F., Gravelle H, Hoonout P.

 

Abstract— We report an empirical analysis of the responses of the supply and demand for secondary care to waiting list size and waiting times. Our analysis focuses on the supply responses of a single hospital and the demand responses of the GP practices it serves, and distinguishes between first outpatient visits, inpatient admissions, daycase treatment and emergency admissions. We find that the demand from practices for first outpatient visits is negatively affected by waiting times and distance to the hospital.  Increases in waiting times and waiting lists lead to increases in supply; the supply of elective inpatient admissions is affected negatively by current emergency admissions and positively by lagged waiting list and waiting time. The effect of telemedicine is considered.

 

Index Terms— hospital admissions, waiting time, waiting list

 

 

 


Sacks DB., Arnold M.

 

Abstract— There are more than 200 million people in the world with diabetes mellitus.  Tight control of blood glucose has been shown to significantly reduce the risk of diabetic complications.  Patients monitor their own blood glucose concentrations, usually using a sample of blood obtained from a finger-stick.  The development of a device for continuous, non-invasive in vivo monitoring of glucose concentration is a very high priority.  Several strategies have been adopted, including implanted sensors, reverse iontophoresis and infrared spectroscopy.  The development of a reliable, accurate and specific noninvasive method to measure blood glucose is likely to substantially improve the management of diabetes.

 

Index Terms— diabetes mellitus, monitoring, glucose, telemetry.

 

 

 

 

 


 

Vidal ME, Ibáñez L, Rodríguez H.

 

Abstract— Emerging technologies have make available a large number of life science data, which is related to relevant and important publications in the area. Popular authority-flow based ranking techniques have shown to be precise to discriminate hyperlinked objects in terms of relevance and importance; particularly, these ranking techniques are able to distinguish relevant and important publications or Golden publications. However, evaluating authority-flow based techniques is usually expensive in large datasets.  In this paper we present the problem of identifying Golden publications efficiently and we propose an approximated solution to this problem. The propose solution is defined in terms of the Direct Sampling technique propose to sample Bayesian networks. We conduct an experimental study on large biological datasets. Our experimental results show that the proposed technique is able to identify the 90% of Golden publications, while time needed is less than 50% of the execution time of the exact solution.

 

Index Terms—Ranking metrics, authority-flow, PageRank, ObjectRank, Golden publications, sampling techniques.

 

 

 

 


 

De Alava E., Regalado AM

 

Abstract— Biobanks are core repositories of clinical samples and related clinical/molecular information, to be used for research and or diagnosis, which have well defined quality criteria. The need to implement a quality assurance system comes from the need to guarantee the quality of the samples supplied to the researchers. In the present document we review how to set up a quality management system, and how to do it in accordance with the ISO 9001:2000 standard.

 

Index Terms—Biobank, repository, quality ISO 9001:2000 standard.

 

 

 

 


 Hernández Armas, J

 

Abstract.-We review the new micrcoscopic medical images at high resolution, indicating some of the most important characteristics. In many cases there are improvements of the existing image techniques, in others new technologies generate new image device modalities obtaining microscopio images.

 

Key words— Multicut computerized tomography; 3D- cel images; x-ray microscopy; Magnetic resonante with 3 Teslas; 4D-ecography.. 

 

 

 

 

 

 


 V. F. Muñoz, I. García-Morales

 

Abstract—Robots have been limited to industrial production areas. Nowadays are considered in the dayly life. Among those are the surgical robots with 10 years of history. The group of medical robotics of the University of Malaga have design and construct a surgical assistance robot for laparoscopic surgery that is being used for human treatment. We introduce the new research considered in this field.

 

Key words—Robotics, MIS (minima invasive surgery), security, alone surgical procedure .

 

 

 

 

 


 

 

F.Marcano,.O.Ferrer-Roca, JJ Quintana Melián

 

Abstract— Small Size Virtual Slide (SSVS) is a novel technique used by TEXCAN-II® software to make distant diagnosis on pathology slide images in intranet or Internet environment.  Slide images are seen online in the TEXCAN-II® virtual microscope, with diagnostic quality, in a fast and reliable way, minimizing storage requirements. Assessment of SSVS technique using ROC analysis is delivered.

 

 Palabras clave— Preparación virtual, Zoom digital, Telepatología, TEXCAN, JPEG200, JPIP. 

 

 


García-Balién, Jaime

 

Abstract-- Hamamatsu Photonics introduce an innovative slide scanning system which can create high resolution digital slides from the glass pathology slides. The automatic slide loader system allows up to 210 glass slides to be rapidly scanned at a choice of resolutions to produce images at diagnostic resolution and with superb colour fidelity. Special software allows the digital slides to be viewed locally or over a network as if using a “virtual microscope”.

 

Key words-- Virtual slide. Scanning microscopes.

 

 


 

José M. Azorín, José M. Sabater, Antonio F. Compañ, Nicolás M. García, and Carlos Pérez

 

Abstract—This paper describes a supervised architecture for telesurgery based in haptic master devices and slave robots. The architecture has been designed in order to be implanted in hospitals where a remote expert surgeon is required to guide and supervise a minimally invasive surgery (MIS) performed by a local non-expert surgeon. The system will allow that the remote expert surgeon guides the local surgeon using a surgical simulator. The local surgeon will perform the operation controlling the slave robots by the haptic masters in the operating room and following the indications of the remote expert surgeon.

 

Index Terms—Robotic surgery, supervised architecture, surgical simulation, telesurgery.

 

 

 

 

 

 


Ferrer-Roca O.

 

Abstract— The EU is in favour of the TIC to improve quality of life of the european citizens and put forwards a research programm called “Ambient assisted Living” that is recognized in the art. 169 of the new EU treaty.

 

Index Terms—Home care, Ambient intelligence

 

 

 

 

 

 


I G K Munabi, M M Isyagi, Julia Royall and N K Sewankambo

 

 

Abstract— In Uganda there is one pathologist for every 1.5 million of inhabitants. Rural physician takes 14-90 days to receive Biopsy results. The internet is accessible at most remote rural hospitals. To pilot use of static telepathology in a remote rural African hospital setting.

Touch imprint smears were made from routine biopsy samples at a rural hospital in a burkits lymphoma endemic area. They were stained with H &E then photographed using a 1.3 mega pixel digital photo microscopy camera. The images were viewed, captured and emailed to a pathologist, 600km away for comment on quality of image and possible diagnosis. The time interval between sending the image and receiving the response was noted.

Within an hour, response and feed back on how to improve the imaging were received. All the specimens were identified as non specific chronic inflammation and not burkits lymphoma. Diagnosis was confirmed by subsequent pathological sectioning and staining. All participants felt this was a better method for handling biopsy specimens.

Static telepathology works and can reduce the waiting time for biopsy results in remote rural African settings.

 

Key words: telepathology, lymphoma, diagnosis, Africa