Design of a PC-based multimedia telemedicine system for brain function teleconsultation

Implementation and performance evaluation of mobile ad hoc network for Emergency Telemedicine System in disaster areas

So far we have developed Emergency Telemedicine System (ETS) which is a robust system using heterogeneous networks. In disaster areas, however, ETS cannot be used if the primary network channel is disabled due to damages on the network infrastructures. Thus we designed network management software for disaster communication network by combination of Mobile Ad hoc Network (MANET) and Wireless LAN (WLAN). This software maintains routes to a Backbone Gateway Node in dynamic network topologies. In this paper, we introduce the proposed disaster communication network with management software, and evaluate its performance using ETS between Medical Center and simulated disaster areas. We also present the results of network performance analysis which identifies the possibility of actual Telemedicine Service in disaster areas via MANET and mobile network (e.g. HSDPA, WiBro).

Telemedicine and neurosciences

It is well known that in most countries there is a perennial shortage of specialists in neurosciences. The available neurologists and neurosurgeons are clustered in the metropolitan, urban areas. Those living in suburban and rural areas may have limited or no access to neurological care. Concurrently, there has been an unprecedented growth in information and communication technology (ICT). In this article, the author will demonstrate how the practice of neurosciences will change, with increasing use of telemedicine and ICT. In addition to presenting the author's personal experience, the literature on telemedicine in neurosciences is reviewed.

MPEG digital compression and analogue videotape: a comparison of moving images and electroencephalogram data in epileptic patients

PRIMARY OBJECTIVES

The objective of this study was to compare the clinical usefulness, in the field of epileptology, of digital moving images and electroencephalogram (EEG) waveforms by Motion Pictures Expert Group compression algorithms (MPEG-1 and MPEG-2) to that of conventional analogue recording.

RESEARCH DESIGN AND METHODS

Three epileptic seizure scenes consisting of moving images and the corresponding EEG waveforms in an epileptic patient were selected as the images to be evaluated. Each scene was recorded using MPEG-1, MPEG-2 and videotape. Ten doctors used six criteria to evaluate the quality of moving images, EEG data and audio.

MAIN OUTCOMES

Analysis of variance and Bonferroni tests indicated that the image quality of MPEG-2 was superior to that of MPEG-1 or videotape for all criteria. Furthermore, MPEG-2 obtained much higher scores in EEG waveform quality than did the other modalities.

CONCLUSIONS

Our findings suggested that data from MPEG-2 images will lead to more precise diagnosis and treatment decision-making than data from analogue videotape recordings.

Remote sessions and frequency analysis for improved insight into cerebral function during pediatric and neonatal intensive care

A project involving recording and analysing EEG together with cardiovascular signals and temperature has been initiated. The aim of this project is to establish difficulties and possibilities involved with implementing a system for remote sessions and analysing EEG in correlation with other physiological signals. One objective is to find indicators of cerebral function during postasphyxia neonatal intensive care and pediatric cardiopulmonary bypass surgery with hypothermia. Remote sessions for joint interpretation have been carried out between pediatricians and clinical neurophysiologists, and EEG has been analyzed using frequency analyzing tools. One result is the discovery of reversible spectral changes coinciding with blood pressure falls, which may indicate loss of autoregulation function. This finding is one outcome from initial use of a system, developed during the project to facilitate communication about, and analysis of the recorded signals. Thus, already from a limited number of remote sessions and the use of basic signal processing techniques, important results have been achieved and better insight has been gained of how cerebral function is affected by cardiopulmonary bypass surgery. In this paper, we present our experiences from introducing a system for remote consultations, and evaluate the use for such a system in the current applications.

Teleradiology Assessment of Computerized Tomographs Online Reliability Study (TRACTORS) for Acute Stroke Evaluation

Telemedicine has potential to increase the use of tissue plasminogen activator (t-PA) for ischemic stroke and is increasingly offered to provide stroke expertise to remote and underserved areas. The accuracy of stroke neurologists' use of telemedicine to read head computed tomography scans (CT) has not been demonstrated. We sought to determine the validity and reliability of neurologists' reading of acute stroke head CTs via teleradiology. The pilot study compared stroke neurologists' reading of CTs via teleradiology to gold standard readings of hard copies on a view box. Head CTs obtained during consecutive acute evaluations for thrombolytic therapy between February and July 2001 were used. For this study, each stroke neurologist was masked to all prior readings, clinical decisions regarding thrombolysis eligibility, and the reading of the other study neurologist. Each neurologist read one-half of the CT scans using teleradiology and the other one-half using a view box. We used the official reading by a neuroradiologist for comparison. The kappa statistic measured reliability. Validity was measured by sensitivity and specificity. Sixty scans were used for the analysis. The neurologists identified the same four hemorrhages using teleradiology that they and the neuroradiologist identified using the light board. Compared to the readings on a view box, the kappa statistic for eligibility for thrombolysis via teleradiology was 1.0. Sensitivity was 100%, 95% CI = (0.93, 1.0); specificity was 100%, 95% CI = (0.40, 0.98) in both comparisons. This pilot study provides encouraging preliminary evidence that neurologists with stroke expertise can determine radiological intravenous t-PA eligibility via teleradiology. Further analysis in a larger sample is necessary to validate these results.

Teleconsultation practice guidelines: report from G8 Global Health Applications Subproject 4

This report presents a series of recommendations derived from deliberations of the G8 countries Subproject 4 Group (SP4 Group) of the Global Health Care Applications Project entitled, A Teleconsultation Practice Guideline. The recommendations provide an initial step toward developing a general guideline platform for the practice of telemedicine/teleconsultation.