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Katherine P Andriole

Publications and source records attributed to Katherine P Andriole.

14 recordsLinked to original sources
PubMed2006

Transforming medical imaging: the first SCAR TRIP conference a position paper from the SCAR TRIP subcommittee of the SCAR research and development committee.

The First Society for Computer Applications in Radiology (SCAR) Transforming the Radiological Interpretation Process (TRIP) Conference and Workshop, "Transforming Medical Imaging" was held on January 31-February 1, 2005 in Bethesda, MD. Representatives from all areas of medical and scientific imaging-academia, research, industry, and government agencies-joined together to discuss the future of medical imaging and potential new ways to manage the explosion in numbers, size, and complexity of images generated by today's continually advancing imaging technologies. The two-day conference included plenary, scientific poster, and breakout sessions covering six major research areas related to TRIP. These topic areas included human perception, image processing and computer-aided detection, data visualization, image set navigation and usability, databases and systems integration, and methodology evaluation and performance validation. The plenary presentations provided a general status review of each broad research field to use as a starting point for discussion in the breakout sessions, with emphasis on specific topics requiring further study. The goals for the breakout sessions were to define specific research questions in each topic area, to list the impediments to carrying out research in these fields, to suggest possible solutions and near- and distant-future directions for each general topic, and to report back to the general session. The scientific poster session provided another mechanism for presenting and discussing TRIP-related research. This report summarizes each plenary and breakout session, and describes the group recommendations as to the issues facing the field, major impediments to progress, and the outlook for radiology in the short and long term. The conference helped refine the definition of the SCAR TRIP Initiative and the problems facing radiology with respect to the dramatic growth in medical imaging data, and it underscored a present and future need for the support of interdisciplinary translational research in radiology bridging bench-to-bedside. SCAR will continue to fund research grants exploring TRIP solutions. In addition, the organization proposes providing an infrastructure to foster collaborative research partnerships between SCAR corporate and academic members in the form of a TRIP Imaging Informatics Network (TRIPI(2)N).

Databases as Topic↗
PubMed2005

Integrating multiple clinical information systems using the Java message service framework to enable the delivery of urgent exam results at the point of care.

The aim of this study is to determine if network-enabled personal digital assistants (PDAs) can be used to facilitate the timely delivery of urgent radiological exam results by reducing the interval from when the radiologist's initial interpretation is available to when it is first viewed by an emergency department (ED) physician. A web- and Java message service (JMS)-based application was built to replace the original fax-based wet-read procedure. The new system allows radiologists to enter wet-reads from the picture archiving and communication system (PACS) display station and to track discrepancies between the wet-read and final report. It also notifies the ED physicians when exam results are available via the PDAs and permits them to view the full text of the wet-read and final reports from the devices. The new system is compared to the original procedure with the results showing improvements with the wireless method. Furthermore, feedback from a qualitative survey of PDA users was positive, suggesting that PDAs may provide one means for accessing urgent clinical data at the point of care.

Computer Communication Networks↗
PubMed2004

Addressing the coming radiology crisis-the Society for Computer Applications in Radiology transforming the radiological interpretation process (TRIP) initiative.

The Society for Computer Applications in Radiology (SCAR) Transforming the Radiological Interpretation Process (TRIP) Initiative aims to spearhead research, education, and discovery of innovative solutions to address the problem of information and image data overload. The initiative will foster interdisciplinary research on technological, environmental and human factors to better manage and exploit the massive amounts of data. TRIP will focus on the following basic objectives: improving the efficiency of interpretation of large data sets, improving the timeliness and effectiveness of communication, and decreasing medical errors. The ultimate goal of the initiative is to improve the quality and safety of patient care. Interdisciplinary research into several broad areas will be necessary to make progress in managing the ever-increasing volume of data. The six concepts involved are human perception, image processing and computer-aided detection (CAD), visualization, navigation and usability, databases and integration, and evaluation and validation of methods and performance. The result of this transformation will affect several key processes in radiology, including image interpretation; communication of imaging results; workflow and efficiency within the health care enterprise; diagnostic accuracy and a reduction in medical errors; and, ultimately, the overall quality of care.

Humans↗
PubMed2004

Integrating multiple clinical information systems using the Java Message Service framework.

This article describes an application for capturing, delivering, and tracking urgent radiology exam results. Urgent exam findings are entered using a Web form embedded within the Picture archiving and communication system (PACS) display station. The findings are then accessible via soft copy using the PACS display stations, hospital information system (HIS) terminals, or wireless-enabled personal digital assistants (PDAs) or via hard copy printouts that are generated automatically or on demand. Additionally, quality control is performed on those findings entered by radiology residents and fellows, the results of which are used for both performance tracking and educational activities. The application was developed using Sun Microsystems' Java programming language. The Java Message Service (JMS) was used to manage the delivery of findings. JMS provides a robust, flexible framework for exchanging messages between disparate applications. The application is now used for all urgent exams; completely replacing the original paper-based system. The use of JMS provides the necessary level of reliability needed by this application.

Computer Communication Networks↗
PubMed2003

Implementing a MIRC query interface for a database driven teaching file.

This paper describes the authors' experience with integrating an existing database-driven teaching file with the RSNA (Radiological Society of North America) Medical Imaging Resource Center (MIRC). MIRC is the product of an RSNA-sponsored initiative to enable medical institutions to share their electronic medical content (images, text, and multimedia) by creating a distributed repository accessible from the Internet. An existing database-driven teaching file, developed by the authors and used extensively by the University of California San Francisco (UCSF) Department of Radiology since 1998, was retrofitted to include an interface for handling broadcast queries initiated by a MIRC query service. These queries take place through the exchange of XML documents via HTTP. After all the storage services have responded, the results are collated by the query service and presented to the user. The teaching file and MIRC interface were developed using the 4th Dimension Relational Database Management System (RDBMS). The integration process primarily involved mapping the "MIRCdocument" schema to the teaching file's schema, translating the actual MIRC query into the internal query language of the database and extending the access control mechanisms of the teaching file to allow public access. A working implementation of the interface required only 3 days of development time, with refinements taking place over several months. Interface development was greatly aided by MIRC's use of well-established Internet standards. This project has demonstrated the feasibility of implementing a MIRC interface on an existing teaching file server.

Computer-Assisted Instruction↗
PubMed2003

Productivity and cost assessment of computed radiography, digital radiography, and screen-film for outpatient chest examinations.

An objective assessment and comparison of computed radiography (CR) versus digital radiography (DR) and screen-film for performing upright chest examinations on outpatients is presented in terms of workflow, productivity, speed of service, and potential cost justification. Perceived ease of use and workflow of each device is collected via a technologist opinion survey. Productivity is measured as the rate of patient throughput from normalized timing studies. The overall speed of service is calculated from the time of examination ordering as stamped in the radiology information system (RIS), to the time of image availability on the picture archiving and communication system (PACS), to the time of interpretation rendered (from the RIS). A cost comparison is discussed in terms of potential productivity gains and device expenditures. Comparative results of a screen-film (analog) dedicated chest unit versus a CR reader and a DR dedicated chest unit show a higher patient throughput for the digital systems. A mean of 8.2 patients were moved through the analog chest room per hour, versus 9.2 patients per hour using the CR system and 10.7 patients per hour with the DR system. This represents a 12% increase in patient throughput for CR over screen-film; a 30% increase in patient throughput for DR over screen-film, which is statistically significant; and a 16% increase in patient throughput for DR over CR, which is not statistically significant. Measured time to image availability for interpretation is much faster for both CR and DR versus screen-film, with the mean minutes to image availability calculated as 29.2 +/- 14.3 min for screen-film, 6.7 +/- 1.5 min for CR, and 5.7 +/- 2.5 min for DR. This represents an improved time to image availability of 77% for CR over screen-film, 80% for DR over screen-film, and 15% for DR over CR. These results are statistically significant (P <.0001) for both CR over screen-film and DR over screen-film but not statistically significant for DR over CR. A comparison of the digital technology costs illustrates that the high cost of DR may not be justifiable unless a facility has a steady high patient volume to run the device at or near 100% productivity. Both CR and DR can improve workflow and productivity over analog screen-film in a PACS for delivery of projection radiography services in an outpatient environment. Cost justification for DR over CR appears to be tied predominantly to high patient volume and continuous rather than sporadic use patterns.

Ambulatory Care Facilities↗
PubMed2003

Digital image processing: a primer for JVIR authors and readers: part 2: digital image acquisition.

This is the second installment of a three-part series on digital image processing intended to prepare authors for online submission of manuscripts. In the first article of the series, we reviewed the fundamentals of digital image architecture. In this article, we describe the ways that an author can import digital images to the computer desktop. We explore the modern imaging network and explain how to import picture archiving and communications systems (PACS) images to the desktop. Options and techniques for producing digital hard copy film are also presented.

Algorithms↗
PubMed2003

Digital image processing: a primer for JVIR authors and readers: Part 3: Digital image editing.

This is the final installment of a three-part series on digital image processing intended to prepare authors for online submission of manuscripts. In the first two articles of the series, the fundamentals of digital image architecture were reviewed and methods of importing images to the computer desktop were described. In this article, techniques are presented for editing images in preparation for online submission. A step-by-step guide to basic editing with use of Adobe Photoshop is provided and the ethical implications of this activity are explored.

Authorship↗
PubMed2003

Digital image processing: a primer for JVIR authors and readers: part 1: the fundamentals.

Online submission of manuscripts will be mandatory for most journals in the near future. To prepare authors for this requirement and to acquaint readers with this new development, herein the basics of digital image processing are described. From the fundamentals of digital image architecture, through acquisition, editing, and storage of digital images, the steps necessary to prepare an image for online submission are reviewed. In this article, the first of a three-part series, the structure of the digital image is described. In subsequent articles, the acquisition and editing of digital images will be reviewed.

Computer Graphics↗
PubMed2003

Implementing a MIRC interface for a database driven teaching file.

This poster describes the feasibility of integrating an existing database driven teaching file with the Radiological Society of North America's (RSNA) Medical Imaging Resource Center (MIRC). MIRC is the product of an RSNA sponsored initiative to enable medical institutions to share their electronic medical content (images, text, and multimedia) by creating a distributed repository accessible from the Internet. A description of MIRC's query/storage service architecture is provided along with an overview of the author's experience with implementing a storage service front end for an existing, database driven teaching file system.

Computer Systems↗
PubMed2002

RIS minus PACS equals film.

Web-based integration methods can be used to resolve a fundamental issue in the transition from film to a picture archiving and communication system (PACS): the identification of relevant prior studies only available on film. Even in the most ambitious conversions from a film-based environment to PACS, there are issues regarding prior studies not on PACS. Failure to compare with prior exams is one of the known risk factors for malpractice in radiology. While most commercial PACS systems today have some degree of RIS integration, knowledge of prior studies is usually limited to an awareness of studies in the PACS. On the other hand, most RIS systems today do not or cannot distinguish between studies on film and those in PACS. We made the observation, from a set theory perspective, that in general: Therefore we sought to create a system that would query both the RIS and PACS and reconcile the results using the above set operation. The query is initiated from a display station via the invocation of a Web browser installed on that station. The process of starting the browser is implemented using a scripting language provided by the workstation vendor, though the use of other mechanisms, such as the CCOW (Clinical Context Object Workgroup) or IHE (RSNA Integrated Healthcare Enterprise) interfaces, can be supported by this architecture. The medical record number, which identifies the current patient and is the primary parameter of the query, is passed as part of the URL (Universal Resource Locator) used to launch the browser. Once running, the browser connects to a Web server that hosts a JSP (Java Server Page) page that performs a DICOM query of the PACS and an HL7 query of the RIS, and then collates the results using the set operation described above. Both the DICOM and HL7 functionality are provided by Java-based toolkits developed in house. The results are returned to the client's browser as a standard HTML page with a tabular format detailing which studies are on PACS and which are available only on film. The responsiveness of the system in terms of time required to complete the two queries and display the results was measured. In addition, the number of diagnostic reports, whose retrieval was triggered by the results of the queries, was monitored to determine the overall performance and use of the system. This project demonstrates that, with minimal modification of commercial software, Web-based integration methods exist to enable patient-context sensitive queries from the diagnostic workstation that identify relevant prior studies that exist only on film and are unknown to the PACS. As a result radiologist workflow is enhanced by the elimination of the need to consult a physically separate system for this type of information. In addition, quality of service is improved by providing more accurate and easier identification of relevant prior studies.

Information Storage and Retrieval↗
PubMed2002

Workflow assessment of digital versus computed radiography and screen-film in the outpatient environment.

An objective assessment and comparison of computed radiography (CR) versus digital radiography (DR) and screen-film in terms of workflow, productivity, speed-of-service, and potential cost justification for imaging ambulatory patients is presented. Perceived ease-of-use and workflow of each device is collected via a technologist opinion survey. Productivity is measured as the rate of patient throughput from normalized timing studies. The overall speed-of-service is calculated from the time of examination ordering as stamped in the radiology information system (RIS), to the time of image availability on the picture archiving and communication system (PACS), to the time of interpretation rendered (from the RIS). Comparative results of screen-film (analog) versus a CR reader and a DR dedicated chest unit show a higher patient throughput for the digital systems. A mean of 10.7 patients were moved through the DR chest room per hour, and 9.2 patients per hour using CR, versus 8.2 patients per hour for the analog device. Measured time to image availability for interpretation is much faster for both DR and CR versus screen-film, with the mean minutes to image availability calculated as 5.7 +/- 2.5 minutes for DR, 6.7 +/- 1.5 minutes for CR, and 29.2 +/- 14.3 minutes for screen film. DR and CR can improve workflow and productivity over analog screen-film in a PACS for delivery of projection radiography services in an outpatient environment, but DR requires high volume to be cost effective over CR.

Efficiency, Organizational↗
PubMed2002

The Stanford MediaServer Project: strategies for building a flexible digital media platform to support biomedical education and research.

Medical media collections are growing at a pace that exceeds the value they currently provide as research and educational resources. To address this issue, the Stanford MediaServer was designed to promote innovative multimedia-based application development. The nucleus of the MediaServer platform is a digital media database strategically designed to meet the information needs of many biomedical disciplines. Key features include an intuitive web-based interface for collaboratively populating the media database, flexible creation of media collections for diverse and specialized purposes, and the ability to construct a variety of end-user applications from the same database to support biomedical education and research.

Abstracting and Indexing↗