Internet agents for telemedicine services

Feasibility and diagnostic accuracy of Internet-based dynamic telepathology between Uganda and Germany

We assessed the feasibility and diagnostic accuracy of Internet-based telepathology compared with conventional microscopic examination. A total of 96 cases from the routine workload of the Department of Pathology at the Mulago Hospital in Uganda were examined by robotic telemicroscopy via the Internet at the Fuerth Hospital in Germany. The telepathology diagnoses were compared with those of conventional microscopy. Email and Skype telephony were used to exchange clinical and diagnostic information. The reference diagnosis (gold standard) was established by consensus between two or more experienced pathologists using both conventional microscopy and telemicroscopy; immunohistochemistry was used whenever it was necessary. It took approximately 30 min for a pathologist to learn to use the telepathology system and 4–25 min to read a case remotely. Internet speed was the main limiting factor. The images were of good quality and the pathologist at the remote site was able to navigate through the slide and change the magnification as necessary. In 92 of the specimens (97%), the pathologists at the two hospitals agreed exactly about the diagnosis. Agreement overall was moderate (kappa = 0.39). The discordant diagnoses were attributed to factors related to diseases morphologically difficult to diagnose, such as soft tissue sarcomas and primitive tumours. Internet-based conferencing systems offer an inexpensive method of obtaining a primary diagnosis by telepathology and consulting on cases that require subspecialty expertise.

A multiagent architecture for developing medical information retrieval agents

Information that is available on the world wide web (WWW) is already more vast than can be comprehensibly studied by individuals and this quantity is increasing at a staggering pace. The quality of service delivered by physicians is dependent on the availability of current information. The agent paradigm offers a means for enabling physicians to filter information and retrieve only information that is relevant to current patient treatments. As with many specialized domains, agent-based information retrieval in medical domains must satisfy several domain-dependent constraints. A multiple agent architecture is developed and described in detail to efficiently provide agent-based information retrieval from the WWW and other explicit information resources. A simulation of the proposed multiple agent architecture shows a 97% decrease in information overload and an 85% increase in information relevancy over existing meta-search tools (with even larger gains over standard search engines).

Delivery of medical multimedia contents through the TCP/IP network using RealSystem

We developed a low cost, user-friendly multimedia delivery system, to provide medical lectures saved as multimedia contents to persons engaged in medicine. This system was created using the RealSystem package with the TCP/IP network. Users can review lectures and medical meeting presentations with video and audio through the Internet, whenever convenient. Each medical source of video and slide has been clearly displayed on a screen. Members of medical associations or medical students can easily review the most interesting parts of these files. This system is being used efficiently in distance learning and aids the diffusion of the latest information and technology to busy physicians and medical students.

Telepathology: current status and future prospects in diagnostic histopathology

Telepathology is the process of diagnostic histopathology performed on digital images viewed on a display screen rather than by conventional glass slide light microscopy. The technology of telepathology has radically improved over the past 5 years so that it is no longer the limiting factor in the diagnostic process. This review looks at the resources needed for dynamic and static telepathology, including image quality, computers and software interfaces, means of transmission and human resources. It critically analyses 32 published trials of telepathology, including some large prospective studies, in all areas of diagnostic histopathology including intraoperative frozen sections, routine and referral cases. New developments, including internet solutions and virtual microscopy, are described and there is analysis of the economics of telepathology within health care systems. The review concludes that all the necessary technology for telepathology is available, there is strong published evidence for a diagnostic accuracy comparable with glass slide diagnosis, in many contexts there is a clear-cut economic argument in favour of telepathology, and that the technique should now be integrated into mainstream diagnostic histopathology.

Online Internet-based robotic telepathology in the diagnosis of neuro-oncology cases: a teleneuropathology feasibility study

This feasibility study examined the diagnostic accuracy of Internet-based dynamic-robotic telepathology using neuropathology cases. Randomly, 83 cases were selected from the routine diagnostic workload of the Neurosurgical Pathology Laboratory in Poznan, Poland. Telepathology diagnoses were compared with conventional paraffin section diagnosis. The neuropathologists, operating a robotically controlled motorized microscope over the Internet from 3 different Polish cities, individually reviewed the cases using computer workstations. Viewing times ranged from 2 minutes 54 seconds to 32 minutes 12 seconds per case. The mean diagnostic accuracy for telepathology diagnosis was 95%, with 2 of 3 observers achieving 100% diagnostic accuracy. Image quality was judged to be sufficient for correct evaluation, and the viewing times required to establish a final diagnosis by remote video microscopy were acceptable. Generally, user acceptance of robotic telepathology was high.

Agents acting and moving in healthcare scenario--a paradigm for telemedical collaboration

This communications describes a novel approach to the analysis and development of telemedicine systems, based on the multiagent paradigm. An agent is an autonomous, social, reactive, and proactive entity, sometimes also mobile. Since telemedicine is grounded on communication and sharing of resources, agents are suitable for its analysis and implementation, and we adopted them for developing a prototype telemedical agent.