PP119 Innovative Screening System For COVID-19 Using Application Of Artificial Intelligence For Telemedicine

2021 ◽  
Vol 37 (S1) ◽  
pp. 20-20
Author(s):  
Pedro Galvan ◽  
Jose Fusillo ◽  
Felipe Gonzalez ◽  
Oraldo Vukujevic ◽  
Ronald Rivas ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Computed Tomography ◽  
Low Income ◽  
Public Hospitals ◽  
Health Science ◽  
Low Income Countries ◽  
Innovative Technology ◽  
Screening System ◽  
Rt Pcr ◽  
Regional Hospitals

IntroductionArtificial intelligence (AI) and innovative technology offer opportunities for enhanced health care during the COVID-19 pandemic. Populations living in low-income countries do not have access to reverse transcription polymerase chain reaction (RT-PCR) testing for COVID-19 and, thus, depend on the scarce resources of their health system. In this context, an automated screening system for COVID-19 based on AI for a telemedicine platform could be directed towards alleviating the current lack of trained radiologists who can interpret computed tomography images at countryside hospitals.MethodsThis descriptive study was carried out in Paraguay by the Telemedicine Unit of the Ministry of Public Health and Social Welfare in collaboration with the Department of Biomedical Engineering and Imaging of the Health Science Research Institute and the University of the Basque Country. The utility of the screening system for COVID-19 was analyzed by dividing the results from two tailored AI systems implemented in 14 public hospitals into four likelihood levels for COVID-19.ResultsBetween March and October 2020, 911 COVID-19 diagnoses were performed in 14 regional hospitals (62.6% were men and 37.4% were women). The average age of the patients diagnosed with COVID-19 was 50.7 years; 59.1% were aged 19 to 59 years. The two AI systems used have different background information for detecting COVID-19. The most common findings were severe pneumonia and bilateral pneumonia with pleural effusions. The role of computed tomography was to find lesions and evaluate the effects of treatment. The sensitivity of AI for detecting COVID-19 was 93%.ConclusionsAI technology could help in developing a screening system for COVID-19 and other respiratory pathologies. It could speed up medical imaging diagnosis at regional hospitals for patients with suspected infection during the COVID-19 pandemic and rationalize scarce RT-PCR and specialized human resources in low-income countries. These results must be contextualized with the local or regional epidemiological profile before widespread implementation.

scholarly journals Rapid screening for COVID-19 by applying artificial intelligence to chest computed tomography images: A feasibility study

2021 ◽  
Vol 5 ◽  
pp. 239920262110136
Author(s):  
Pedro Galván ◽  
José Fusillo ◽  
Felipe González ◽  
Oraldo Vukujevic ◽  
Luciano Recalde ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Computed Tomography ◽  
Pleural Effusion ◽  
Feasibility Study ◽  
Ct Images ◽  
Public Hospitals ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Computed Tomography Images ◽  
Respiratory Conditions

Aim: The aim of the study was to present the results and impact of the application of artificial intelligence (AI) in the rapid diagnosis of COVID-19 by telemedicine in public health in Paraguay. Methods: This is a descriptive, multi-centered, observational design feasibility study based on an AI tool for the rapid detection of COVID-19 in chest computed tomography (CT) images of patients with respiratory difficulties attending the country’s public hospitals. The patients’ digital CT images were transmitted to the AI diagnostic platform, and after a few minutes, radiologists and pneumologists specialized in COVID-19 downloaded the images for evaluation, confirmation of diagnosis, and comparison with the genetic diagnosis (reverse transcription polymerase chain reaction (RT-PCR)). It was also determined the percentage of agreement between two similar AI systems applied in parallel to study the viability of using it as an alternative method of screening patients with COVID-19 through telemedicine. Results: Between March and August 2020, 911 rapid diagnostic tests were carried out on patients with respiratory disorders to rule out COVID-19 in 14 hospitals nationwide. The average age of patients was 50.7 years, 62.6% were male and 37.4% female. Most of the diagnosed respiratory conditions corresponded to the age group of 27–59 years (252 studies), the second most frequent corresponded to the group over 60 years, and the third to the group of 19–26 years. The most frequent findings of the radiologists/pneumologists were severe pneumonia, bilateral pneumonia with pleural effusion, bilateral pulmonary emphysema, diffuse ground glass opacity, hemidiaphragmatic paresis, calcified granuloma in the lower right lobe, bilateral pleural effusion, sequelae of tuberculosis, bilateral emphysema, and fibrotic changes, among others. Overall, an average of 86% agreement and 14% diagnostic discordance was determined between the two AI systems. The sensitivity of the AI system was 93% and the specificity 80% compared with RT-PCR. Conclusion: Paraguay has an AI-based telemedicine screening system for the rapid stratified detection of COVID-19 from chest CT images of patients with respiratory conditions. This application strengthens the integrated network of health services, rationalizing the use of specialized human resources, equipment, and inputs for laboratory diagnosis.

scholarly journals Favorable Outcome in CLL Patients Not Treated Despite Presenting Iwcll Criteria: A Retrospective Analysis of the Brazilian CLL Group

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 12-12
Author(s):  
Fernanda de Morais Marques ◽  
Verena Pfister ◽  
Flavia Parra ◽  
Mihoko Yamamoto ◽  
Rodrigo Santucci Silva ◽  
...  
Keyword(s):  
Low Income ◽  
Conflicts Of Interest ◽  
International Workshop ◽  
Clinical Manifestations ◽  
Lymphocytic Leukemia ◽  
Public Hospitals ◽  
Low Income Countries ◽  
Treatment Indication ◽  
Treatment Indications

Introduction: Some patients with CLL will require treatment at diagnosis, but many other will remain untreated under observation for several years. In 2008, the International Workshop on Chronic Lymphocytic Leukemia(IWCLL) defined the criteria for treatment indications, which have been widely used in daily practice and in clinical trials. We have observed that many patients tolerate several of these clinical manifestations without treatment need, especially in public hospitals were resources and treatment options are scarce. We identified 5 reference centers for CLL that share the same profile of being more conservative in indicating treatment for CLL patients. We decided to analyze if more conservative local criteria for treatment indication impacts on patients' outcomes. Objective: To describe the outcomes of a series of CLL patients treated according to locally defined more conservative criteria for initiating treatment. Methods: The Brazilian Registry of CLL was started in 2004 as a prospective observational data collection tool. Inclusion criteria for enrollment followed the IWCLL guidelines. We retrospectively evaluated all patients with CLL in the Brazilian Registry of CLL who were followed between January 2013 and April 2020 at the 5 reference centers (3 public and 2 private). The following local criteria were used for treatment indications to all patients included: 1) persistent and progressive symptomatic cytopenias (no predefined minimum levels), 2) Massive or symptomatic lymphadenopathy, 3) Massive or symptomatic splenomegaly, 4) Disease-related symptoms, only if persistent and if other causes were excluded, and 5) Autoimmune complications including anemia or thrombocytopenia non-responsive to steroids. Progressive lymphocytosis and extranodal manifestations were not considered for treatment indication. Results: A total of 581 patients were followed during the observation period of 7 years (median follow-up was 40 months (range: 3-86). Median age was 65 years (range: 32-98) and most patients were male (57%). Binet stage was A in 67%, B in 14% and C in 19% of cases. FISH, performed in only 199 patients (34%), was normal in 47%, and showed del13q in 22%, trisomy 12 in 17%, del11q in 8% and del17p in 7%. According to IWCLL criteria, 257 (44%) presented indication for treatment over the time: 140 (55%) at diagnosis and 117 (45%) during follow-up. Based on the local criteria, 148 (25%) patients met criteria for indication of treatment. Therefore, 109 patients with IWCLL indication were not treated to date according to the local criteria. The IWCLL indications for these untreated patients were: cytopenias in 50 patients (48%), constitutional symptoms in 37 patients (35%), progressive lymphocytosis in 9 (9%), and lymphadenopathy or splenomegaly in 8 (8%). The median observation time for these untreated patients from the time of indication of treatment by IWCLL until the analysis was closed was 39 months, ranging from 3 to 86 months. Of the 109 untreated patients, 12 (13%) died during follow-up: 4 from infections probably unrelated to CLL (all patients were elderly, Binet A, non-neutropenic and non-hypoglobulinemic), 2 from cardiac causes, 1 from a car accident and 5 of unknown causes (lost follow-up after at least 2 years). No deaths were attributable to LLC. Overall survival at 4 years was 90% for the patients who were treated versus 89% for the patients who were not treated (P=0.85). Conclusion: Our data suggest that it is feasible and safe to adopt more conservative criteria to indicate treatment in a CLL patient. A more restrict approach may not only reflect in a significant financial impact to the health care system but also avoid premature exposition to prolonged and/or potentially toxic treatments. This finding might be of special interest to low-income countries. Disclosures No relevant conflicts of interest to declare.

scholarly journals Rapid, Cheap, and Effective COVID-19 Diagnostics for Africa

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2105
Author(s):  
Lukman Yusuf ◽  
Mark Appeaning ◽  
Taiwo Gboluwaga Amole ◽  
Baba Maiyaki Musa ◽  
Hadiza Shehu Galadanci ◽  
...  
Keyword(s):  
Low Income ◽  
Nucleic Acid Amplification ◽  
High Rate ◽  
Low Income Countries ◽  
Rt Pcr ◽  
Antibody Testing ◽  
Middle Income ◽  
Diagnostic Assays ◽  
Middle Income Countries ◽  
To Come

Background: Although comprehensive public health measures such as mass quarantine have been taken internationally, this has generally been ineffective, leading to a high infection and mortality rate. Despite the fact that the COVID-19 pandemic has been downgraded to epidemic status in many countries, the real number of infections is unknown, particularly in low-income countries. However, precision shielding is used in COVID-19 management, and requires estimates of mass infection in key groups. As a result, rapid tests for the virus could be a useful screening tool for asymptomatic virus shedders who are about to come into contact with sensitive groups. In Africa and other low- and middle-income countries there is high rate of COVID-19 under-diagnosis, due to the high cost of molecular assays. Exploring alternate assays to the reverse transcriptase polymerase chain reaction (RT-PCR) for COVID-19 diagnosis is highly warranted. Aim: This review explored the feasibility of using alternate molecular, rapid antigen, and serological diagnostic assays to accurately and precisely diagnose COVID-19 in African populations, and to mitigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR diagnostic challenges in Africa. Method: We reviewed publications from internet sources and searched for appropriate documents available in English. This included Medline, Google Scholar, and Ajol. We included primary literature and some review articles that presented knowledge on the current trends on SARS-CoV-2 diagnostics in Africa and globally. Results: Based on our analysis, we highlight the utility of four different alternatives to RT-PCR. These include two isothermal nucleic acid amplification assays (loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA)), rapid antigen testing, and antibody testing for tackling difficulties posed by SARS-CoV-2 RT-PCR testing in Africa. Conclusion: The economic burden associated COVID-19 mass testing by RT-PCR will be difficult for low-income nations to meet. We provide evidence for the utility and deployment of these alternate testing methods in Africa and other LMICs.

scholarly journals Evaluation of Head Computed Tomography Assessment of Brain Swelling after Acute Traumatic Brain Injury: A Pilot study

2019 ◽  
Vol 38 (04) ◽  
pp. 257-262
Author(s):  
Robson Luis Amorim ◽  
Barbara Albuquerque Morais ◽  
Francisco Otávio Camargo Pereira ◽  
Matheus Fernandes Oliveira ◽  
Almir Ferreira Andrade ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Low Income ◽  
Interobserver Reliability ◽  
Tertiary Hospital ◽  
Low Income Countries ◽  
Brain Swelling ◽  
Good Reliability ◽  
The Cost

Abstract Objective To evaluate the interobserver reliability of a new scale created for quantitatively assessing brain swelling in traumatic brain injury (TBI) patients using the computed tomography (CT) findings in three levels. Methods Computed tomography scans of severe head injury patients were randomly selected from a tertiary hospital image database and evaluated by independent groups of neurosurgeons, neurosurgery residents, radiologists, and intensivists from the same hospital. Each specialist assessed the tomographic findings, applying zero to six points in a new scale. The Kappa coefficient was calculated to assess interobserver agreement. Results The highest reliability coefficient was obtained by the neurosurgeons group (0.791; 95% confidence interval [CI]: 0.975–0.607; p < 0.001), followed by the neurosurgery residents group (0.402; 95%CI: 0.569–0.236; p < 0.001) and by the radiologists group (0.301; 95%CI: 0.488–0.113; p < 0.002). The lowest coefficient was found among the intensivists (0.248; 95%CI: 0.415–0.081; p = 0.004). Conclusion The proposed scale showed good reliability among neurosurgeons, and moderate overall reliability. This tomographic classification might be useful to better assist severe TBI victims, allowing to identify the worsening or amelioration of brain swelling, which should be further investigated. The scale seems to be feasible, even in low income countries, where the cost of intracranial pressure (ICP) monitoring is higher than that of CTs.

scholarly journals Need for implementation of pharmacoeconomics in healthcare system, case of analysis of antibiotic consumption in Republic of Macedonia for 2016

2018 ◽  
Vol 63 (02) ◽  
pp. 11-20
Author(s):  
Stevche Acevski ◽  
Zoran Nakov
Keyword(s):  
Medical Devices ◽  
Low Income ◽  
Pharmacoeconomic Analysis ◽  
Antibiotic Consumption ◽  
Pharmaceutical Products ◽  
Health Science ◽  
Low Income Countries ◽  
Pharmaceutical Companies ◽  
Traditional Concept ◽  
Republic Of Macedonia

Pharmacoeconomics is new and modern health science, implemented in developed societies, to play core role in creating health policies. The main aim of pharmacoeconomic analysis is development of science methodology for evaluation of costs and outcomes of treatment, evaluation of economic parameters in the face of outcomes of clinical results, from different treatment options. Pharmaceutical companies implemented pharmacoeconomic principles for diversifying marketing approach and market access in pharmaceutical development. New healthcare systems demand increased costs for medical care, pharmaceutical products and medical devices. Process of medical costs for evaluation of costs evolved, indirect and hidden costs are part of sole process of evaluation. Health authorities from one side and pharmaceutical companies from other side developed unique methodologies for evaluation. With these implemented changes, traditional concept for evaluation of efficacy and safety of medical devices and pharmaceutical products was overbridged and pharmacoeconomics is base for research, development, registration, reimbursement, as well as dispensing and follow the life cycle of medicines. Results from antibiotic consumption analysis in Republic of Macedonia at 2016 showed that total antibiotic consumption and antibiotic consumption per DDD/1000 citizens is according to average EU trends, mostly similarly to the usage trends of low-income countries. But usage of new and innovative antibiotic is on very low level, which indicates the need of further implementing of pharmacoeconomic analysis and principles in decision making process, for improved health care for the patients. The ultimate goal of implementing the pharmacoeconomic system in each country is enhancing the benefit to the patient through improved resource allocation. Keywords: pharmacoeconomics, type of pharmacoeconomic analysis, antibiotic consumption, Republic of Macedonia

scholarly journals Predictors of stunting among pediatric children living with HIV/AIDS, Eastern Ethiopia

2020 ◽  
Vol 9 (2) ◽  
pp. 82
Author(s):  
Dawit Gezahegn ◽  
Gudina Egata ◽  
Tesfaye Gobena ◽  
Berhanu Abebaw
Keyword(s):  
Low Income ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Public Hospitals ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
P Value ◽  
Eastern Ethiopia ◽  
Living With Hiv ◽  
Hiv Aids

Globally, there were about 3.4 million pediatric children (&lt;15 years of age) who were living with HIV/AIDS. Ethiopia has one of the highest rates of malnutrition in Sub-Saharan Africa. As of 2013, there were about 160,000 pediatric children living with HIV/AIDS in Ethiopia. Even though undernutrition makes it difficult to combat HIV/AIDS, there is paucity of information on the magnitude of stunting and its predictors among seropositive pediatric children in low-income countries like Ethiopia. Institution based quantitative cross sectional study design was employed on 414 randomly selected pediatric (5-15 years) children living with HIV/AIDS in Harari Region and Dire Dawa City Administration Public Hospitals, Eastern Ethiopia. Pretested interviewer administered questionnaire and patient card review was held to collect data. Data were entered through Epi-data and exported to SPSS for analysis. The WHO Anthros plus software was used to calculate the anthropometric indices. Bivariate and Multivariable analysis along with 95%CI were done to identify predictors of stunting. Level of statistical significance was declared at P-value &lt;0.05. The prevalence of stunting was found to be 30.9% (95%CI: 26.0-36.0%). Rural residence [AOR=4.0, (95%CI: 2.22, 7.17)], family monthly income of ≤500 ETB [AOR=5.79, (95%CI: 2.82, 11.60)], being anemic [AOR=3.17, (95% CI: 2.13, 4.93)] and the presence of diarrhea [AOR=6.21, 95% (CI: 3.39, 9.24)] were predictors of stunting. Thus, collaborative measures should be undertaken (to decrease frequent infections and to improve the economic status) to combat chronic malnutrition during HIV/AIDS treatment.

scholarly journals Access to Breast Cancer Diagnostic Devices in the East African Community: Moving the Needle

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 16-16
Author(s):  
Claire M. Wagner ◽  
Fidel Rubagumya ◽  
Miriam Mutebi ◽  
David Mutiibwa ◽  
Louis Ngendahayo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Human Capital ◽  
Low Income ◽  
Online Survey ◽  
Public Hospitals ◽  
Low Income Countries ◽  
East African ◽  
East African Community ◽  
Cancer Diagnostic ◽  
African Community

PURPOSE Globally, two million women develop breast cancer each year. Low-income countries bear a disproportionate burden as a result of systems strapped by limited resources. Inadequate access to diagnostic services is widely recognized as a driver of unfavorable outcomes, yet baseline data on supply, use, and pricing for breast cancer diagnostic devices are scant. The purpose of this study was to assess access to cancer biopsy devices in Burundi, Kenya, Rwanda, South Sudan, Tanzania, and Uganda, and to ascertain related pricing, procurement, and payment models. METHODS We conducted an observational online survey to capture institution-based data that address demographics, facility capacity, human capital, pathology systems, device sourcing and pricing, supply chains, and workarounds. Additional manufacturer information was obtained through public sources and communication with industry. RESULTS We received 58 survey responses from the 6 East African Community countries, most representing urban public hospitals (68%). Pathology laboratory capacity varied drastically: Although basic histopathology was consistently performed (92% of respondents), hormone receptor, human epidermal growth factor receptor 2, and genetic studies were not (63%, 53%, and 11%, respectively). Training varied among practitioners performing biopsies—for example, surgeons or nurses—and most practitioners did not have ultrasound guidance (80%). Both disposable and reusable core needle devices were in use, and stockouts were reported by most respondents (69%). Workarounds included reuse of disposable devices, alternative procedures (eg, surgical excision or fine-needle aspiration), patient rescheduling, and referral. Most patients received results at follow up, but one fifth of all respondents reported that some patients never received results. Of importance, there was no observable pattern to procurement channels or pricing. CONCLUSION Reliable, accurate, and timely diagnosis is vital to improving outcomes for patients with breast cancer in low-income countries. Significant variation related to operations, human capital management, product mix, procurement methods, and pricing was observed between and within the East African Community countries. Additional investigation is needed to identify opportunities for applying best practices and leveraging regional synergies for impact.

scholarly journals Impact of artificial intelligence on radiology: a EuroAIM survey among members of the European Society of Radiology

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Keyword(s):  
Artificial Intelligence ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Shared Responsibility ◽  
Public Hospitals ◽  
Time Saving ◽  
Task Definition ◽  
Job Opportunities ◽  
European Society Of Radiology ◽  
Neuro Imaging

Abstract We report the results of a survey conducted among ESR members in November and December 2018, asking for expectations about artificial intelligence (AI) in 5–10 years. Of 24,000 ESR members contacted, 675 (2.8%) completed the survey, 454 males (67%), 555 (82%) working at academic/public hospitals. AI impact was mostly expected (≥ 30% of responders) on breast, oncologic, thoracic, and neuro imaging, mainly involving mammography, computed tomography, and magnetic resonance. Responders foresee AI impact on: job opportunities (375/675, 56%), 218/375 (58%) expecting increase, 157/375 (42%) reduction; reporting workload (504/675, 75%), 256/504 (51%) expecting reduction, 248/504 (49%) increase; radiologist’s profile, becoming more clinical (364/675, 54%) and more subspecialised (283/675, 42%). For 374/675 responders (55%) AI-only reports would be not accepted by patients, for 79/675 (12%) accepted, for 222/675 (33%) it is too early to answer. For 275/675 responders (41%) AI will make the radiologist-patient relation more interactive, for 140/675 (21%) more impersonal, for 259/675 (38%) unchanged. If AI allows time saving, radiologists should interact more with clinicians (437/675, 65%) and/or patients (322/675, 48%). For all responders, involvement in AI-projects is welcome, with different roles: supervision (434/675, 64%), task definition (359/675, 53%), image labelling (197/675, 29%). Of 675 responders, 321 (48%) do not currently use AI, 138 (20%) use AI, 205 (30%) are planning to do it. According to 277/675 responders (41%), radiologists will take responsibility for AI outcome, while 277/675 (41%) suggest shared responsibility with other professionals. To summarise, responders showed a general favourable attitude towards AI.

scholarly journals Blockchain and Artificial Intelligence Technology for Novel Coronavirus Disease-19 Self-Testing

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 198 ◽  
Author(s):  
Tivani P. Mashamba-Thompson ◽  
Ellen Debra Crayton
Keyword(s):  
Artificial Intelligence ◽  
Low Income ◽  
Disease Surveillance ◽  
Transmission Rate ◽  
Low Cost ◽  
Emerging Infectious Diseases ◽  
Low Income Countries ◽  
Surveillance Systems ◽  
Self Testing ◽  
Novel Coronavirus

The novel coronavirus disease 19 (COVID-19) is rapidly spreading with a rising death toll and transmission rate reported in high income countries rather than in low income countries. The overburdened healthcare systems and poor disease surveillance systems in resource-limited settings may struggle to cope with this COVID-19 outbreak and this calls for a tailored strategic response for these settings. Here, we recommend a low cost blockchain and artificial intelligence-coupled self-testing and tracking systems for COVID-19 and other emerging infectious diseases. Prompt deployment and appropriate implementation of the proposed system have the potential to curb the transmissions of COVID-19 and the related mortalities, particularly in settings with poor access to laboratory infrastructure.

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