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Файл:Ординатура / Офтальмология / Английские материалы / Digital Teleretinal Screening Teleophthalmology in Practice_Yogesan, Goldschmidt, Cuadros_2012.pdf
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- •Foreword
- •Preface
- •Contents
- •1.1 Introduction
- •1.2 Method
- •1.2.1 Databases
- •1.2.2 Dates
- •1.2.3 Keywords
- •1.2.4 Criteria for Inclusion
- •1.2.5 Criteria for Exclusion
- •1.2.6 Selection of Papers
- •1.3 Results
- •1.3.1 Subspecialty
- •1.3.2 Type of Telemedicine
- •1.3.3 Study Design
- •1.3.4 Final Conclusions of Papers
- •1.4 Discussion
- •References
- •2.1 Introduction
- •2.2 The Need for Diabetic Retinopathy Screening Programs
- •2.4 Guidelines for Referring Patients
- •2.7 Program Models for Diabetic Retinopathy Screening
- •2.9 Program Personnel and Operations
- •2.9.1 Primary Care Providers
- •2.9.2 Photographers
- •2.9.3 Clinical Consultants
- •2.9.4 Administrators
- •2.9.5 A Note to CEOs, Operations Directors, and Clinic Managers
- •2.10 Policies and Procedures
- •2.10.1 Sample Protocol 1
- •2.10.1.1 Diabetic Retinopathy Screening Services
- •Policy
- •Background
- •Procedure
- •2.10.2 Sample Protocol 2
- •2.10.2.1 Pupil Dilation Before Diabetic Retinopathy Photography
- •Policy
- •Background
- •Procedure
- •2.10.3 Sample Protocol 3
- •2.10.3.1 Diabetic Retinopathy Photography Review
- •Policy
- •Background
- •Procedure
- •2.11 Technical Requirements
- •2.11.1 Connectivity
- •2.11.2 Resolution
- •2.11.3 Color
- •2.11.4 Stereopsis
- •2.11.5 Compression
- •2.11.6 Enhancement
- •2.11.7 Pupil Dilation
- •2.11.8 Early California Telemedicine Initiatives Diabetic Retinopathy Screening
- •2.11.9 The American Indian Diabetes Teleophthalmology Grant Program
- •2.11.10 Central Valley EyePACS Diabetic Retinopathy Screening Project
- •2.12.1 Diabetic Retinopathy
- •2.12.1.1 ADA Guidelines Terms
- •2.12.1.2 Vitrectomy
- •References
- •3: Stereopsis and Teleophthalmology
- •3.1 Introduction
- •3.2 History of Stereopsis and Stereopsis in Ophthalmology
- •3.3 Technology and Photography
- •3.3.3 Imaging Fields
- •3.3.4 Image Viewing Techniques
- •3.3.5 Image Compression
- •3.4 Stereoscopic Teleophthalmology Systems
- •3.4.1 University of Alberta
- •3.4.4 Joslin Vision Network
- •3.5 Conclusion
- •References
- •4.1 Introduction
- •4.2 Methods
- •4.2.1 Main Outcome Measures
- •4.3 Results
- •4.3.1 Retinal Video Recording Versus Retinal Still Photography
- •4.3.2 Video Compression Analysis
- •4.4 Discussion
- •References
- •5.1 Introduction
- •5.1.1 Automated, Remote Image Analysis of Retinal Diseases
- •5.1.2 Telehealth
- •5.2 Design Requirements
- •5.2.1 Telehealth Network Architecture
- •5.2.2 Work Flow
- •5.2.3 Performance Evaluation of the Network
- •5.3 Automated Image Analysis Overview
- •5.3.1 Quality Assessment Module
- •5.3.2 Vascular Tree Segmentation
- •5.3.3 Quality Evaluation
- •5.4 Anatomic Structure Segmentation
- •5.4.1 Optic Nerve Detection
- •5.4.2 Macula
- •5.4.3 Lesion Segmentation
- •5.4.4 Lesion Population Description
- •5.4.5 Image Query
- •5.5 Summary
- •References
- •6.1 Introduction
- •6.3 Optical Coherence Tomography to Detect Leakage
- •References
- •7.1 Introduction
- •7.2 Patients and Methods
- •7.2.1 Participants
- •7.2.2 Methods
- •7.2.3 Statistics
- •7.3 Results
- •7.3.1 Reliability of Image Evaluation
- •7.3.2 Prevalence of Glaucomatous Optic Nerve Atrophy
- •7.4 Discussion
- •7.5 Perspectives
- •References
- •8.1 Introduction
- •8.1.2 Homology Between Retinal and Systemic Microvasculature
- •8.1.3 Need for More Precise CVD Risk Prediction
- •8.2.1 Retinal Microvascular Signs
- •8.2.2 Retinal Vessel Biometry
- •8.2.3 Newer Retinal Imaging for Morphologic Features of Retinal Vasculature
- •8.3 Associations of Retinal Imaging and CVD Risk
- •8.3.1.1 Risk of Pre-clinical CVD
- •8.3.1.2 Risk of Stroke
- •8.3.1.3 Risk of Coronary Heart Disease
- •8.3.2.1 Risk of Hypertension
- •8.3.2.2 Risk of Stroke
- •8.3.2.3 Risk of Coronary Heart Disease
- •8.3.2.4 Risk of Peripheral Artery Disease
- •8.3.3 Newer Morphologic Features of Retinal Vasculature
- •8.4 Retinal Imaging and Its Potential as a Tool for CVD Risk Prediction
- •References
- •9.1 Alzheimer’s Disease
- •9.2 Treatments
- •9.3 Diagnosis
- •9.6 Conclusions
- •References
- •10.1 Introduction
- •10.1.1 Stroke
- •10.1.2 Heart Disease
- •10.1.3 Arteriovenous Ratio
- •10.2 Purpose
- •10.3 Method
- •10.3.1 Medical Approach
- •10.3.2 Technical Approach
- •10.3.3 Output of Medical Data
- •10.4 Patients
- •10.5 Results
- •10.5.1 Medical History
- •10.5.2 Telemedical Evaluation of Retinal Vessels
- •10.5.2.1 Prevalence of Retinal Microangiopathy
- •10.5.2.2 Arteriovenous Ratio
- •10.5.2.3 PROCAM-Index
- •10.6 Discussion and Perceptive
- •10.6.1 Estimation of “Stroke Risk” Estimated by the Stage of Retinal Microangiopathy
- •References
- •11.1 Introduction
- •11.2 System Requirements
- •11.3 Fundus Camera
- •11.4 Imaging Procedure
- •11.4.1 Reading Center Procedure
- •11.5 Detection of Macular Edema
- •11.6 Implementation
- •11.7 Unreadable Images
- •11.7.1 Impact on Overall Diabetic Retinopathy Assessment Rates
- •11.7.2 Compliance with Recommendations
- •11.7.3 Challenges
- •11.7.4 Summary
- •References
- •12.1 Screening
- •12.2 Background
- •12.3 Historical Perspective in England
- •12.4 Methodology
- •12.4.1 The Aim of the Programme
- •12.5 Systematic DR Screening
- •12.6 Cameras for Use in the English Screening Programme
- •12.7 Software for Use in the English Screening Programme
- •12.9 Implementation in England
- •12.11 Quality Assurance
- •12.12 The Development of External Quality Assurance in the English Screening Programme
- •12.13 Information Technology (IT) Developments for the English Screening Programme
- •12.14 Dataset Development
- •12.15 The Development of External Quality Assurance Test Set for the English Screening Programme
- •12.16 Failsafe
- •12.17 The Epidemic of Diabetes
- •References
- •13.1 Introduction
- •13.2 Burden of Diabetes and Diabetic Retinopathy in India
- •13.3 Diabetic Retinopathy Screening Models
- •13.4 Need for Telescreening
- •13.5 Guidelines for Telescreening
- •13.6 ATA Categories of DR Telescreening Validation
- •13.7 Yield of Diabetic Retinopathy in a Telescreening Model
- •13.8 How Are Images Transferred
- •13.10 How Many Fields Are Enough for Diabetic Retinopathy Screening
- •13.11 Is Mydriasis Needed While Using Nonmydriatic Camera?
- •13.12 Validation Studies on Telescreening
- •13.12.1 Accuracy of Telescreening
- •13.12.2 Patient Satisfaction in Telescreening
- •13.12.3 Cost Effectivity
- •13.12.4 Telescreening for Diabetic Retinopathy: Our Experience
- •13.13 Future of Diabetic Retinopathy Screening
- •References
- •14.1 Introduction
- •14.2 Methods
- •14.3 Discussion
- •14.4 Conclusion
- •References
- •15.1 Introduction
- •15.1.1 Description of the EADRSI
- •15.5 State Support of Screening in the Safety Net
- •15.7 Screening Economics for Providers
- •15.8 Patient Sensitivity to Fees
- •15.9 Conclusion
- •References
- •16.1 Introduction
- •16.2 Setting Up the New Screening Model
- •16.2.1 Phase 1: Training
- •16.2.2 Phase 2: Evaluation of Agreement
- •16.2.3 Phase 3: Implementation of the Screening Model
- •16.3 Technologic Requirements
- •16.3.1 Data Management
- •16.3.2 Data Models
- •16.3.2.1 Data Scheme for Patient-Related Information
- •16.3.2.2 Data Scheme for Images
- •Fundus Camera VISUCAM Pro NM
- •PACS Server
- •ClearCanvas DICOM Visualizer
- •16.4 Results
- •16.4.1 Phase 2: Agreement Evaluation
- •16.4.2 Phase 3: Implementation of the Screening Model
- •16.5 Discussion
- •16.5.1 Evaluation of the Screening Model
- •16.5.2 Prevalence of DR
- •16.5.3 Quality Evaluation
- •16.6 Conclusion
- •References
- •17.1.3 Examination and Treatment
- •17.1.4 Limitations of Current Care
- •17.2 Telemedicine and ROP
- •17.2.2 Accuracy and Reliability of Telemedicine for ROP Diagnosis
- •17.2.3 Operational ROP Telemedicine Systems
- •17.2.4 Potential Barriers
- •17.3 Closing Remarks
- •17.3.1 Future Directions
- •References
- •18.1 Introduction
- •18.2 Neonatal Stress and Pain
- •18.3 ROP Screening Technique
- •18.4 Effect of Different Examination Techniques on Stress
- •18.5 Future of Retinal Imaging in Babies
- •References
- •19.1 Introduction
- •19.2 History of the Program
- •19.3 Telehealth Technologies
- •19.4 Impact of the Program
- •Selected References
- •Preamble
- •Introduction
- •Background
- •The Diabetic Retinopathy Study (DRS)
- •Mission
- •Vision
- •Goals
- •Guiding Principles
- •Ethics
- •Clinical Validation
- •Category 1
- •Category 2
- •Category 3
- •Category 4
- •Communication
- •Medical Care Supervision
- •Patient Care Coordinator
- •Image Acquisition
- •Image Review and Evaluation
- •Information Systems
- •Interoperability
- •Image Acquisition
- •Compression
- •Data Communication and Transmission
- •Computer Display
- •Archiving and Retrieval
- •Security
- •Reliability and Redundancy
- •Documentation
- •Image Analysis
- •Legal Requirements
- •Facility Accreditation
- •Privileging and Credentialing
- •Stark Act and Self-referrals
- •State Medical Practice Acts/Licensure
- •Tort Liability
- •Duty
- •Standards of Care
- •Consent
- •Quality Control
- •Operations
- •Customer Support
- •Originating Site
- •Transmission
- •Distant Site
- •Financial Factors
- •Reimbursement
- •Grants
- •Federal Programs
- •Other Financial Factors
- •Equipment Cost
- •Summary
- •Abbreviations
- •Appendices
- •Appendix A: Interoperability
- •Appendix B: DICOM Metadata
- •Appendix C: Computer-Aided Detection
- •Appendix D: Health Insurance Portability and Accountability Act (HIPAA)
- •Appendix F: Quality Control
- •Appendix H: Customer Support
- •Level 1
- •Level 2
- •Level 3
- •Appendix I: Reimbursement
- •Medicare
- •Medicaid
- •Commercial Insurance Carrier Reimbursement
- •Other Financial Factors
- •Disease Prevention
- •Resource Utilization
- •American Telemedicine Association’s Telehealth Practice Recommendations for Diabetic Retinopathy
- •Conclusion
- •References
- •Contributors
- •Second Edition
- •First Edition
- •Index
10 Screening the Retina for Heart Disease/Stroke (talkingeyes®) |
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Input |
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Central Formular |
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Output |
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Input of data and images for one patient
1.from several physicians
2.at different times
3.from different locations
On one glance past and future process steps
1.Which examinations were performed in the past?
2.What are the future steps?
Patient service: with one click demonstration of the potential effect of therapeutical means on the incident stroke risk
1.What is the effect of blood pressure reduction?
2.What is the effect of finishing smoking?
Integration of several medical data sources within one report
1. Calculation of two different risk indices
2.Comparison with age-adjusted regular risk level
3.Medical recommendation
4.All images are visible
Smart communication with other 
electronic systems
1.Save the medical report as pdf by a click in the electronic praxis system
2.Generate a novel patient chart
Fig. 10.4 Scheme of the smart adobe-form – named |
The interactive adobe-form couples automatically with the |
“Cardio-Vascular-Prevention-Plan” – showing at one glance |
central health server showing all data and images |
an overview of past and future medical process steps. |
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10.3.3 Output of Medical Data
Using the “Cardio-Vascular-Prevention-Plan”- formular, the cooperating physician has an overview of past and future process steps of an individual patient at one glance. Figure 10.4 showed as a scheme the functions of the CVPPformular. The CVPP of a selected patient shows symbolically the results of examinations performed in the past and exams planned in the future. As the “Cardio-Vascular-Prevention- Plan”-formular is an interactive system fed with
all individual patient data, the physician can demonstrate interactively the patient’s latest risk estimation. Within the adobe-formular, the therapeutic effect of specific medications on the incident stroke risk within an interactive figure becomes visible (see Fig. 10.5). Thus, the “Cardio-Vascular-Prevention-Plan”-formular allowed the integration of medical data of several data sources within one report. By the CVPPformular, the calculation of two different incident stroke risks was performed. The result was compared with age-adjusted regular risk levels.
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