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Ambulatory Systems
Published in Salvatore Volpe, Health Informatics, 2022
Curtis L. Cole, Adam D. Cheriff, J. Travis Gossey, Sameer Malhotra, Daniel M. Stein
While the federal incentive programs dramatically altered the economics of EHR adoption, it is only temporary. Further, money is only one barrier in a properly considered ROI equation. Doctors also care about quality, time, convenience, regulatory compliance, and a host of other issues that must all be taken into account to truly calculate ROI. This is, of course, not feasible, and the inadequacy of the literature to date reflects that.
Cost-effective continuing professional development
Published in Kieran Walsh, Liam Donaldson, Cost Effectiveness in Medical Education, 2021
The presentation of the results of cost-effectiveness studies will need to be easily understood by policy makers and providers. The wider world of evaluation of educational interventions in commercial sectors uses several measures that are both unfamiliar and challenging to CPD. The impact of educational interventions is often presented as return on investment (ROI), which is the rate at which education returns what was financially invested. The direct and indirect costs are calculated to identify the total cost of the education. The effects of the education on the outcomes before and after the education are identified. The usefulness of ROI is that it provides a clear indication of the benefit of an educational intervention and is easily understood. However, baseline data on outcomes has to be collected, and outcomes have to be quantified in monetary terms. A more radical approach is to consider ‘bottom line’ evaluations that try to determine the value added from the education of each participant.
Introduction
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
A radionuclide image demonstrates the distribution of the radionuclide/radiopharmaceutical in the organ or system. There are three main methods of detecting abnormalities/pathology in radionuclide images: Increased uptake in uniform areas, e.g. ‘hot spots’ in bone studies (Fig. 1.52a).Reduced uptake in uniform areas, e.g. defects (‘cold spots’) in lung studies (Fig. 1.52b).Quantification. Regions of interest (ROIs) are used to generate curves or quantify the activity in a given region. This data can then be compared to normal studies and used to assess abnormal processes of metabolism. In PET, quantification is referred to as a standardised uptake value (SUV), where a SUV reflects the activity within the region or mass defined and can, for example, help denote the ‘aggressiveness’ of a tumour or infection.
Refining feasibility assessment of endoscopic ear surgery: a radiomics model utilizing machine learning on external auditory canal CT scans
Published in Acta Oto-Laryngologica, 2023
Shuainan Chen, Fang Lucheng, Licai Shi, Anying Zou, Xingwang Rao, Rujie Li, Jiahui Zheng, Wei Guo, Yideng Huang
EAC region of interest (ROI) was manually delineated in each patient’s CT images using 3D Slicer software. The diameter of the ROI was adjusted to match the actual diameter of the EAC. A total of 139 radiomics features were extracted from each ROI using PyRadiomics software (version 3.0.1, https://pyradiomics.readthedocs.io/). The open-source software package Pyradiomics based on the Python 3.6 platform was used to extract the CT features. The CT features included first-order features, shape, the greyscale co-occurrence matrix (GLCM), grey-level size zone matrix (GLSZM), grey-level run length matrix (GLLRLM), and neighboring grey-tone difference matrix (NGTDM) and grey level dependence matrix (GLDM). A detailed description of the HCR features extracted in this study can be found in the Pyradiomics document (http://pyradiomics.readthedocs.io).
Quantitative evaluation of liver function with gadoxetic acid enhanced MRI: Comparison among signal intensity-, T1-relaxometry-, and dynamic-hepatocyte-specific-contrast-enhanced MRI- derived parameters
Published in Scandinavian Journal of Gastroenterology, 2022
Qiang Wang, Savas Kesen, Maria Liljeroth, Henrik Nilsson, Ying Zhao, Ernesto Sparrelid, Torkel B. Brismar
A 10-mm thick T1 weighted slice obtained at the level of bifurcation of the portal vein before contrast agent administration and after a 20-minute delay were analyzed to calculate the SI-and T1-relaxometry derived parameters. Researcher-defined circular regions of interest (ROIs, diameter ranges 10–30 mm) were placed carefully on left liver lobe, segment IV, right liver lobe, paravertebral muscle and the spleen. When placing ROIs, an attempt was always made to avoid blood vessels, bile ducts and marginal artifacts. ROI placement was replicated between the two time-points by visual comparison by two trained operators (Q.W and S.S) and confirmed by a senior radiologist (T.B.B) with 25 years of MR imaging analysis experience. The SI of liver was calculated as the average of the three liver ROIs (Figure 1).
Spatial profiling technologies and applications for brain cancers
Published in Expert Review of Molecular Diagnostics, 2021
Priyakshi Kalita-de Croft, Habib Sadeghi Rad, Harry Gasper, Ken O’Byrne, Sunil R Lakhani, Arutha Kulasinghe
NanoString GeoMxTM Digital Spatial Profiler (DSP) is a nondestructive technique capable of in-depth RNA/protein expression profiling [39]. Using oligonucleotide detection technology, the DSP platform provides highly multiplexed RNA/protein quantification with spatial resolution down to a few cells from fixed or fresh frozen tissues [40]. After tissue preparation, samples are incubated with visualization markers (e.g. pan-cytokeratin, CD8, and CD3) and conjugated with oligonucleotide tags [41]. This is followed by a selection of Regions of interest (ROIs) which are defined by the user to demarcate the tissue architecture [41]. Finally, oligo tags are released by ultraviolet (UV) exposure from discrete regions and are then subject to nanostring counting/sequencing to create a spatially resolved profile of the analyte abundance [41]. The technology has several advantages, including user-defined ROI analysis and multispectral imaging [42]. The DSP can also eliminate the need for chemical stripping, which is a downside of other multi-color IHC techniques, by using a UV-photocleavable signal. Taken together, by providing high-plex and high-throughput RNA/protein spatial profiling, the DSP platform will therefore be an important addition to current single-staining IHC methods in clinical diagnostics [42]. One of the challenges has been to get single-cell resolution compatibility, which is currently in development with the spatial molecular imager (SMI) to be released in 2021.