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Future directions in electronic image handling.

After a relatively slow start compared with the United States and Japan, several projects are now being established in Europe that are aimed at the development of prototype systems for medical image processing and management. Frequently, this includes aspects of multimedia communication, as well as legal, ethical, and economic issues. Consideration is also often given to systems security, reliability, and data protection. All these projects are based on the application of modern computer and communication technologies. The following interesting conclusions can be drawn from these preliminary activities: 1. PACS and IMAC systems should not be regarded as products or devices, but as a means to improve the infrastructure in a given medical care environment. Sometimes this activity is also referred to as knowledge business. Individual components of these systems, for example image acquisition devices, networks, storage facilities, and medical workstations, should be provided with standard interfaces allowing a modular build-up and an easy adaptation to the specific conditions of clinical departments. 2. Digital luminescence radiography will further establish itself as a method for image acquisition and increasingly will replace analog radiologic methods. Consequently, digital processing, archiving, and communication will be a necessity for optimal patient care. 3. New network technologies and magnetic-optical storage media offer the possibility of an improved cost-effectiveness for communication and storage. They should therefore be considered an important factor in future economic considerations regarding health care services. 4. The practice of modern medicine is based on team-work; good communication among the parties concerned is a critical factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗

Compression and filtration of U.S. medical images with a modified inverse difference pyramid.

In this paper a new approach for compression and filtration of U.S. medical images is introduced. The application of the algorithm, based on image processing with an inverse difference pyramid (IDP) along with considerable image compression, permits filtration of a specific (speckle) noise in ultrasound images. The paper describes the principle of image decomposition and its modification designed specifically for this medical application. The paper also provides images that illustrate some of the results of this work.

Algorithms↗

Content-based ultrasound image retrieval using a coarse to fine approach.

One of the current issues for picture archiving and communication systems (PACS) is extending retrieval technologies to deal with multimedia information. This is particularly important for medical applications that assist in diagnostic processes and pathology studies. Accordingly, this paper presents a new approach to content-based image retrieval (CBIR) for a clinical ultrasound image database (DB). The proposed algorithm consists of two stages so as to maximize the retrieval efficiency. In the first stage, a coarse retrieval is performed using the statistical characteristics of the wavelet coefficients that narrow the search by eliminating up to 70% of the total DB images. In the second stage, a fine retrieval is carried out using the Legendre moment of the global histogram pdf on the reduced image set preretrieved by the coarse retrieval. When tested on an abdominal ultrasound image DB and compared with various other methods, the proposed algorithm gave promising results for applying CBIR to clinical ultrasound images.

Humans↗

Comparison of conventional photographs and telephonically transmitted compressed digitized images of melanomas and dysplastic nevi.

BACKGROUND: One of the most difficult problems in the in vivo diagnosis of cutaneous tumors is the differentiation clinically between early malignant melanoma (MM) and atypical (dysplastic) melanocytic nevi (AMNs) because these lesions share clinical features. High-quality digital imaging systems and store-and-forward technology have the potential for use in a teledermatology system with which experts would be able to immediately transmit their diagnostic opinions concerning these challenging lesions. OBJECTIVE: The main purpose of this study was to determine if the clinical and dermoscopic diagnoses and the dermoscopic features of AMN and early MM are unaltered after telephonic transmission of their digitized images. METHODS: Conventional and dermoscopic photographic transparencies of 22 AMNs and 9 early MMs, viewed on rearview projectors and then scanned, compressed, transmitted (Internet) and viewed on color monitors, were evaluated. RESULTS: The concordance in the diagnosis of AMN and of early MM by all four observers, both clinically and dermoscopically, when comparing rearview-projected conventional transparency slides to transmitted, compressed, digitized images, was high. For most specific dermoscopic features, the concordance was good, although less so for the presence or absence of some dermoscopic creatures, namely 'dots', 'blue/gray' color and 'red' color. CONCLUSION: The results reported support the conclusion that Internet transmission of digitized images of MMs and AMNs retains sufficient information for diagnostic purposes. This study is a step in the creation of an international teledermoscopy network for pigmented cutaneous lesions.

Computer Communication Networks↗

E-mail communication between pediatricians and their patients.

This report addresses specific e-mail patient communication issues relevant to pediatricians and their appropriate use of e-mail in the office setting. The report briefly reviews: 1) e-mail privacy and security concerns; 2) e-mail in the office environment; 3) the legal status of e-mail; and 4) available e-mail technologic solutions.

Communication↗

Defaults, exceptions and ambiguity in a medical knowledge representation system.

Inheritance methods for general semantic networks which allow for exceptions are essential to representing medical knowledge in forms which are familiar to doctors. Such systems give rise to the possibility of ambiguity and problems of computational efficiency. Efficient computational methods using conventional hardware for inheritance and the detection of ambiguity in general semantic networks are described. These methods have been implemented in PROLOG in a knowledge management system which is being used in the development of intelligent drug information and medical decision support systems.

Algorithms↗

Preventing medication errors in hospitals through a systems approach and technological innovation: a prescription for 2010.

Medication errors in hospital settings are considered both widespread and costly to the American healthcare system; yet, it is tractable to available solutions. This article offers a novel prescription for the problem that could be implemented by 2010. It consists of a systems approach--failure mode effects analysis (FMEA)--in combination with emerging technologies, such as a decision support system (DDS) with integrated real-time medical informatics, electronic medical records (EMR), computer physician order entry (CPOE), bar coding, automated dispensing machines (ADM), and robotics. Cost and benefit analysis reveals that this proposed integrated solution will radically reduce medication errors in hospitals and save the lives of thousands of Americans who frequent such facilities on an annual basis, as well as reduce healthcare costs.

Diffusion of Innovation↗

Surgery in the information age.

Currently, surgical procedures involve direct data flows of sensation and mechanical output. As information technology progresses, surgery will change to a system of electronic data flows, with technical, ethical, and training implications.

Biomedical Technology↗

Computers in ophthalmology practice.

Computers are already in widespread use in medical practice throughout the world and their utility and popularity is increasing day by day. While future generations of medical professionals will be computer literate with a corresponding increase in use of computers in medical practice, the current generation finds itself in a dilemma of how best to adapt to the fast-evolving world of information technology. In addition to practice management, information technology has already had a substantial impact on diagnostic medicine, especially in imaging techniques and maintenance of medical records. This information technology is now poised to make a big impact on the way we deliver medical care in India. Ophthalmology is no exception to this, but at present very few practices are either fully or partially computerized. This article provides a practical account of the uses and advantages of computers in ophthalmic practice, as well as a step-by-step approach to the optimal utilization of available computer technology.

Computers↗