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PubMed2000

Converting to digital photography: a model for a large group or academic practice.

Digital photography has become an economical and efficient substitute for conventional photography. We recently converted our resident clinical photography to a digital format to make archiving more efficient and to save the costs of clinical photography. We present a model that can be applied to a large group or academic practice outlining the conversion of our clinical photography to digital format. We discuss the costs that we have incurred during the past 3 years of conventional photography, the economic benefit and costs for conversion to digital, and a 5-year projection of savings using digital photography. We also discuss the advantages of digital photography and the equipment needed for the conversion.

Cost-Benefit Analysis↗
PubMed2002

Digital photography for rhinoplasty.

Standardized, high-quality, preoperative photographs of the nose are critical for preoperative rhinoplasty planning, comparative postoperative assessment, and demonstration of surgical results. To produce these high-quality, reproducible photographs, it is essential to standardize lighting, to properly position the patient in standard views, to avoid lens distortion, and to maintain consistent camera-to-subject distances. Traditional photographic standards have been well documented in the literature; however, most do not address digital photography, and none address digital photography for rhinoplasty. Certain variables in digital photography that are not present in 35-mm photography can be critical to the appearance of the final image. Variables such as image color and contrast (which usually vary between digital cameras), focal length differences between 35-mm and most digital cameras, the effect of resolution and compression on image quality, and the effect of the printing method used can affect the appearance of the external anatomy of the nose in the final print or image. Lack of detail in the external nasal anatomy becomes an issue if the surgeon uses the photograph intraoperatively for reference, as the authors do. Initially, the authors experienced difficulties with observing subtleties in the tip-defining points and tip anatomy using digital photography when compared with our traditional methods of 35-mm photography. The lack of detail in the external anatomy was most prevalent in the frontal and basal views. Thus, the authors have since tailored their photographic methods to document the rhinoplasty patient to maximize the visual information of the external nasal anatomy in the photographic and the printed image. This article is intended to review the photographic principles for standardized rhinoplasty photography, address the additional considerations necessary when using digital photography, discuss the printing variables that can affect overall quality of the printed image, and discuss the authors' new method of photographing the rhinoplasty patient.

Humans↗
PubMed2003

Photography in dermatology: comparison between slides and digital imaging.

BACKGROUND: Clinical photography is an essential tool for any medical speciality, such as dermatology, wherein accurate records are required of pre, intra and postoperative findings, plus quick access to these records for comparison and evaluation purposes. Clinical photography is important not only to the surgeon, but also to the patient, so that a realistic objective assessment of improvement may be made. Conventional emulsion film-based prints from negatives and positive colour transparencies revolutionised clinical records when they first appeared. Now the appearance and rapid development of digital photography is bringing about yet another revolution. AIM: To compare conventional with digital photography from the standpoints of cost-effectiveness, ease of archiving and ease of retrieval. The quality of the imaging was not dealt with. METHODS: A professional clinical photographer took images using: Nikon F3 (conventional emulsion based photography); FotoFinder Derma (digital photography). RESULTS: Although traditional emulsion-based photographs are quicker to take, digital imaging provides an almost immediately available image and is much swifter to use for classification, later retrieval and comparison between serial images. CONCLUSIONS: Despite the initial expense of acquiring digital equipment compared with traditional photographic apparatus, when examined over a five-year period, both formats cost approximately the same. Digital photography offers advantages in ease of archiving and storage, savings in time and space, extremely quick retrieval and very easy comparison of images. Digital photography is very much the way of the future in dermatological clinical imaging.

Journal Article↗
PubMed2004

Screening for sight-threatening diabetic retinopathy: comparison of fundus photography with automated color contrast threshold test.

PURPOSE: To compare tritan contrast threshold (TCT) with fundus photography in screening for sight-threatening diabetic retinopathy (STDR), before significant visual loss. DESIGN: Prospective, comparative study. METHODS: A total of 510 consenting diabetic patients attending a hospital-based photographic screening clinic were recruited over a 2-year period. Exclusion criteria included visual acuity of worse than 6/9, previous photocoagulation, and a history of previous eye disease known to affect color vision. The automated TCT test was performed using a computerized cathode ray tube-based technique. Retinal photography was performed using a Polaroid mydriatic fundus camera with a 45 degrees field. Grading of diabetic retinopathy was carried out by an ophthalmologist using slit-lamp biomicroscopy and a 78-diopters lens. Assessments of sensitivity, specificity, and predictive values for both fundus photography and the TCT test were made. RESULTS: Both the fundus photography and TCT test correlated significantly with the presence of STDR (P <.0001, chi(2) test). The TCT test yielded a sensitivity of 94% (95% confidence interval [CI], 73%- 100%) and a specificity of 95% (95% CI, 92%- 96%) for detection of STDR compared with a sensitivity of 88% (95% CI, 66%-97%) and a specificity of 95% (95% CI, 93%-97%) with fundus photography. Combined modality improved overall screening performance. CONCLUSION: The TCT assessment is an effective and clinically viable technique, in comparison with fundus photography, to screen for STDR among a diabetic population. Additionally, our results also showed that combining the TCT test with fundus photography greatly increases the performance of screening for STDR.

Adolescent↗
PubMed2004

Estimation of pupil size by digital photography.

PURPOSE: To evaluate a digital photography method of pupil size estimation over a broad range of illumination conditions and to compare this method with common clinical techniques. SETTING: College of Optometry, Ohio State University, Columbus, Ohio, USA. METHODS: Two examiners measured the pupil diameter in 45 right eyes at 3 illumination levels: <0.63 lux (dark), 5 lux (dim), and 1000 lux (bright). Estimation by infrared video recording, the reference standard, was compared with measurements by digital photography, ruler, semicircular templates, and the Colvard pupillometer. Masked graders measured pupil size from infrared video recordings and digital photographs. RESULTS: The repeatability of the measurement method determined by the mean intraclass correlation coefficients was highest for video recording across conditions (0.86-0.97), followed by digital photography (0.76-0.94), Colvard pupillometry (0.63-0.82), ruler (0.71-0.85), and templates (0.70-0.83). An analysis of variance showed a significant difference in pupil size by method (P<.001). All methods except digital photography estimated smaller pupil sizes under dark and dim illumination than infrared video measurements (all P<.01). Under bright illumination, the ruler measurements were significantly smaller (-0.15 mm) and the Colvard pupillometer measurements were greater (+0.30 mm) than the reference (P<.01). The 95% limits of agreement (LoA) between examiners were smallest for video measurements at all light levels. The remaining measures ranked from best to worst by 95% LoA were digital photography, Colvard pupillometry, ruler, and templates. CONCLUSIONS: Estimation of pupil size by digital photography was more repeatable and accurate than estimates by common clinical techniques over a wide range of illumination. Although not as quick as other methods, digital photography is relatively inexpensive, permits lasting documentation, and allows independent grading suitable for clinical research purposes.

Adult↗
PubMed2002

Use of and beliefs about baseline photography in the management of patients with pigmented lesions: a survey of dermatology residency programmes in the United States.

Medical photography is often used in dermatology to aid in the clinical surveillance of patients with pigmented lesions. This study aimed to assess the utilization, logistics, rationale and beliefs about the usefulness of baseline photography in patients with pigmented lesions by physicians in dermatology residency programmes, and to compare current utilization to that reported in the last decade. Questionnaires were mailed to directors of all accredited dermatology residency programmes in the United States (n = 105). Eighty-three physicians responded to the questionnaire (79%). Utilization of total body and individual lesion photography was reported by 63% and 75% of the respondents, respectively; 16% of the respondents did not use any method of photography. Reasons for using photography included the following beliefs: that it helps detect early melanoma, it results in fewer biopsies, and it reduces patient anxiety. Financial and logistical constraints were reasons why some programmes were not utilizing photography. Thus baseline photography is currently used in a majority of academic dermatology programmes as an aid in the early detection of melanoma.

Dermatology↗
PubMed2004

The uses of photography in clinical nursing practice and research: a literature review.

AIMS: The aim of this paper is to report a study to identify themes and provide a 'snap-shot' of the scope and uses of photography in clinical nursing practice and research. BACKGROUND: Despite the dominance of vision as a way of understanding the world in Western societies, the applications of photography in clinical nursing practice and research have not been well synthesized or reported in the literature. METHODS: A computerized search of CINAHL database was performed using the terms photographs, photography, photographic, photovoice, videorecording and videotaping. Hand searching for additional citations was also undertaken. FINDINGS: The identified papers on photography were categorized into broad themes that reflected the different applications to which photography had been applied: documentation and surveillance; therapeutic intervention; teaching, learning and evaluating performance; research methods; and descriptive and instructional literature. Approaches to the use of photography, as recorded in the nursing literature, are broad and include: wound surveillance, covert patient surveillance, photo essay, art therapy, self-portraits, life albums, simulated recall, participant observation, photovoice, photo hermeneutics, production of research scenarios, and video modelling. CONCLUSIONS: The most common applications of photography in nursing and related journals include photo elicitation to promote understanding in research, videorecording as a method of teaching and learning, and as a method of observation, with more creative approaches tending to be employed in health professions other than nursing. Few reports gave explanations of how researchers negotiated ethical concerns when seeking approval for studies in clinical settings, and few gave details of the processes of data analysis.

Humans↗
PubMed2004

Image is everything: pearls and pitfalls of digital photography and PowerPoint presentations for the cosmetic surgeon.

BACKGROUND: Cosmetic surgery and photography are inseparable. Clinical photographs serve as diagnostic aids, medical records, legal protection, and marketing tools. In the past, taking high-quality, standardized images and maintaining and using them for presentations were tasks of significant proportion when done correctly. Although the cosmetic literature is replete with articles on standardized photography, this has eluded many practitioners in part to the complexity. A paradigm shift has occurred in the past decade, and digital technology has revolutionized clinical photography and presentations. Digital technology has made it easier than ever to take high-quality, standardized images and to use them in a multitude of ways to enhance the practice of cosmetic surgery. PowerPoint presentations have become the standard for academic presentations, but many pitfalls exist, especially when taking a backup disc to play on an alternate computer at a lecture venue. OBJECTIVE: Embracing digital technology has a mild to moderate learning curve but is complicated by old habits and holdovers from the days of slide photography, macro lenses, and specialized flashes. Discussion is presented to circumvent common problems involving computer glitches with PowerPoint presentations. CONCLUSION: In the past, high-quality clinical photography was complex and sometimes beyond the confines of a busy clinical practice. The digital revolution of the past decade has removed many of these associated barriers, and it has never been easier or more affordable to take images and use them in a multitude of ways for learning, judging surgical outcomes, teaching and lecturing, and marketing. Even though this technology has existed for years, many practitioners have failed to embrace it for various reasons or fears. By following a few simple techniques, even the most novice practitioner can be on the forefront of digital imaging technology. By observing a number of modified techniques with digital cameras, any practitioner can take high-quality, standardized clinical photographs and can make and use these images to enhance his or her practice. This article deals with common pitfalls of digital photography and PowerPoint presentations and presents multiple pearls to achieve proficiency quickly with digital photography and imaging as well as avoid malfunction of PowerPoint presentations in an academic lecture venue.

Documentation↗
PubMed2001

Digital photography technology offers unique capabilities, advantages, and challenges to dental practices.

Digital photography technology has both advanced substantially in the past few years and decreased in price. Today, high-resolution cameras offer an attractive option to dentists ready to incorporate digital photography into their practices. This article begins with a technical explanation of how digital photography works as the basis for understanding how it compares and contrasts with film photography, as well as how it offers unique benefits to dental practices. It describes how digital camera design affects image characteristics such as resolution and color fidelity and provides dentists with suggested camera features they should consider. The article explores issues associated with the display and storage of images. It then provides guidelines to help dentists determine whether they are ready to adopt digital photography, including a discussion about the advantages of digital photography as well as suggested ways digital photography will affect office workflows and productivity.

Computer Storage Devices↗
PubMed1993

[Is fundus photography useful in screening for diabetic retinopathy in patients with type II diabetes mellitus?].

OBJECTIVE: To determine the value of a screening programme with fundus photography for diabetic retinopathy in diabetes mellitus type II patients. DESIGN: Prospective. SETTING: General practices in the region Zwolle, The Netherlands. METHOD: 650 Patients from 50 general practices were photographed after dilating both eyes. Of these 215 were examined by an ophthalmologist. Data of patients who did not join the study were analysed in 13 general practices. Any symptom of retinopathy and/or photographs of poor quality implied referral to an ophthalmologist. RESULTS: Of a total of 1300 photographs 208 (16%) could hardly or not at all be assessed. The agreement in the group of 215 patients between photography and ophthalmoscopy was statistically significant at classification level (Cohen's kappa 0.41). The advice given to patients after photography did not differ from that after ophthalmoscopy (kappa: 0.50); photography did not miss any high-risk characteristics, it yielded more warnings, and underestimated the level of retinopathy in 8 out of 215 cases. With current ophthalmologic rates in the Netherlands fundus photography was not financially advantageous as 71 (33%) out of 215 patients needed to be referred to an ophthalmologist. However, in the other 144 (67%) patients photography sufficed. This may offer a solution where ophthalmic care is in short supply. Of 168/420 patients who did not apply for photography 116 (69%) were either under ophthalmic supervision already or too disabled to be screened. CONCLUSION: The use of a fundus camera is equivalent to funduscopy by an ophthalmologist in screening for retinopathy of type II diabetic patients. There are no financial benefits, but it reduces the work load of ophthalmologists.

Aged↗
PubMed2003

Endoscopic photography: digital or 35 mm?

OBJECTIVE: To compare off-the-shelf digital imaging equipment with a standard single lens reflex 35-mm endoscopic camera in a busy pediatric ears, nose, and throat setting. DESIGN: Two digital cameras with an endoscope adapter and a step-down ring were evaluated to obtain optimal settings for digital endoscopic photography. The equipment was used in various clinical and surgical settings to include otoscopy, sinonasal endoscopy, laryngoscopy, and bronchoscopy. The overall quality, color, brightness, and diagnostic quality of the endoscopic digital photographs were compared with those of the single-lens reflex 35-mm flash-generated photographs by experienced endoscopists. Cost analysis and ease of use were also compared. Subjects Initial digital endoscopic settings were formulated from cadaveric tests. These settings were then studied in multiple patients during endoscopy. RESULTS: Endoscopic digital photography resulted in high-quality images in all settings. Digital images were comparable to 35-mm images. The digital system was easier to use and less expensive than the 35-mm system. CONCLUSIONS: We introduce a simple, inexpensive, and easily available endoscopic digital photography system. Digital photography offers numerous advantages over analog photography in a clinical practice. Digital imaging and archiving is more durable and easier to incorporate into patient records and clinical presentations. As the demand for high-quality digital imaging increases, easy-to-use inexpensive digital endoscopic photography will soon replace 35-mm camera technology.

Endoscopy↗
PubMed1996

Retinopathy screening in type 2 diabetes: reliability of wide angle fundus photography.

The purpose of the study was to assess the reliability of mydriatic 60 degrees fundus photography in a retinopathy screening programme for Type 2 diabetic patients in a primary health care setting. In 323 eligible consecutive Type 2 diabetic patients above 40 years of age, attending a regional shared care diabetes project, mydriatic wide angle fundus photography was compared with standardized fundoscopy in dilated pupils as the recommended test for the detection of diabetic retinopathy. Fundus photography included two black and white transparencies per eye visualizing the central and nasal retinal field. Fundoscopy findings and pictures were scored according to modified Wisconsin criteria. Fundoscopy revealed in 95/646 eyes (14.7%) some degree of diabetic retinopathy. Sensitivity and specificity of fundus photography (omitting ungradable transparencies) were 97% for the diagnosis of any diabetic retinopathy (DRP). All patients with moderate and severe DRP (Wisconsin grade 3 and worse) according to fundoscopy were detected by fundus photography. In conclusion, mydriatic wide angle 60 degrees fundus photography, making two pictures per eye, can be applied effectively and reliably in the detection of diabetic retinopathy in patients with Type 2 diabetes.

Adult↗