A novel approach to patient self-monitoring of sonographic examinations using a head-mounted display

Is the diagnostic radiological image an underutilised resource? Exploring the literature

The number of diagnostic imaging examinations being undertaken in the UK is rising. Due to the expensive nature of producing these examinations and the risks associated with exposing living tissue to the ionising radiation used by many of the imaging techniques, this growth comes with both a financial and a human cost.

In a time of limited resources, it is important that we are able to maximise the benefits which we extract from these resources. Therefore, a broad search of the current literature was undertaken to assess our current understanding of the nature of benefit available from diagnostic radiological images.

Two broad categories of benefit were identified: primary benefit (n = 470) and secondary benefit (n = 49). Primary benefits are those which are related to the justification for undertaking the imaging, e.g., abnormality detection, to assist in diagnosis or staging, or acting as an aid to clinical decision making, or intervention. Secondary benefits are those that are not related to the justification for imaging, e.g., to promote patient engagement and understanding or to facilitate communication.

Existing work considering primary benefits is comprehensive. Secondary benefit, however, is less well recognised and may not be reliably realised. Use of the image to realise these benefits has far-reaching potential. Particularly, there may be underexplored benefits which access to the images may provide to patients. This represents a gap in existing research which should be addressed.

A low-cost multimodal head-mounted display system for neuroendoscopic surgery

BACKGROUND

With rapid advances in technology, wearable devices as head-mounted display (HMD) have been adopted for various uses in medical science, ranging from simply aiding in fitness to assisting surgery. We aimed to investigate the feasibility and practicability of a low-cost multimodal HMD system in neuroendoscopic surgery.

METHODS

A multimodal HMD system, mainly consisted of a HMD with two built-in displays, an action camera, and a laptop computer displaying reconstructed medical images, was developed to assist neuroendoscopic surgery. With this intensively integrated system, the neurosurgeon could freely switch between endoscopic image, three-dimensional (3D) reconstructed virtual endoscopy images, and surrounding environment images. Using a leap motion controller, the neurosurgeon could adjust or rotate the 3D virtual endoscopic images at a distance to better understand the positional relation between lesions and normal tissues at will.

RESULTS

A total of 21 consecutive patients with ventricular system diseases underwent neuroendoscopic surgery with the aid of this system. All operations were accomplished successfully, and no system-related complications occurred. The HMD was comfortable to wear and easy to operate. Screen resolution of the HMD was high enough for the neurosurgeon to operate carefully. With the system, the neurosurgeon might get a better comprehension on lesions by freely switching among images of different modalities. The system had a steep learning curve, which meant a quick increment of skill with it. Compared with commercially available surgical assistant instruments, this system was relatively low-cost.

CONCLUSIONS

The multimodal HMD system is feasible, practical, helpful, and relatively cost efficient in neuroendoscopic surgery.

A review of wearable technology in medicine

With rapid advances in technology, wearable devices have evolved and been adopted for various uses, ranging from simple devices used in aiding fitness to more complex devices used in assisting surgery. Wearable technology is broadly divided into head-mounted displays and body sensors. A broad search of the current literature revealed a total of 13 different body sensors and 11 head-mounted display devices. The latter have been reported for use in surgery (n = 7), imaging (n = 3), simulation and education (n = 2) and as navigation tools (n = 1). Body sensors have been used as vital signs monitors (n = 9) and for posture-related devices for posture and fitness (n = 4). Body sensors were found to have excellent functionality in aiding patient posture and rehabilitation while head-mounted displays can provide information to surgeons to while maintaining sterility during operative procedures. There is a potential role for head-mounted wearable technology and body sensors in medicine and patient care. However, there is little scientific evidence available proving that the application of such technologies improves patient satisfaction or care. Further studies need to be conducted prior to a clear conclusion.

Video-otoscopy in children and patient-centered care: A randomized, controlled study

OBJECTIVES

Medicine today is moving towards patient centered care and patient empowerment. This enhances patient autonomy, allows shared decision making and increases satisfaction. Current technology enables the caregiver to share visual data with the patients, making them more active participants in a medical encounter. It has been shown that higher patient satisfaction rate has a positive effect on outcome and patient compliance. Otoscopic examination is one of the most common procedures performed in the pediatric population. Video-otoscopy uses endoscopic technology to project the image of the tympanic membrane onto a monitor visible to both the physician and the patient. The objective of this study is to assess whether video-otoscopy used in a pediatric emergency department can improve patient-centeredness and parental satisfaction with treatment.

METHODS

A randomized, controlled study comparing video-otoscopy with conventional otoscopy was performed. Patients were randomized into 2 groups. In one, ear examination was performed by video-otoscopy and in the other by conventional otoscopy. Following examination, parents in both groups were asked to fill a questionnaire regarding their satisfaction with the otoscopic examination and the patient-centeredness of the encounter.

RESULTS

60 children were recruited and were randomized into two groups: 30 in the video-otoscopy group and 30 in the conventional otoscopy group. Parental satisfaction was significantly higher in the video-otoscopy group. The level of patient-centeredness was significantly higher in the video-otoscopy group. There was a positive correlation between patient-centeredness and parental satisfaction in both groups, with a significantly higher correlation in the video-otoscopy group.

CONCLUSIONS

Video-otoscopy was found to encourage patient-centered care and increase parental satisfaction with otoscopy. There is a significantly higher positive correlation between patient-centeredness and parental satisfaction when video-otoscopy is used.