Biomedical subjects

K Foord

Publications and source records attributed to K Foord.

5 recordsLinked to original sources

PubMed2001

Year 2000: status of picture archiving and digital imaging in European hospitals.

The aim of this study was to compare the degrees of implementations of full and departmental Picture Archiving and Communication Systems (PACS), the usage of mini-PACS and to compare digital image equipment implementation rates in the countries of the European Union plus the Czech Republic, Cyprus, Malta, Norway, Poland and Switzerland. The degree to which Digital Image Communications in Medicine version 3.0 (DICOM 3.0) protocols are available for data exchange by different digital image equipment is surveyed, to assess underlying PACS preparedness. A questionnaire with an addressed reply envelope was posted to the heads of radiology of 1,594 hospitals in 19 countries in early 2000. Data returns were obtained from 17 countries. This indicates considerable variation in PACS implementation and preparedness between European nations. Possible reasons for this are discussed. The highest rates of PACS implementations have been in Austria, Norway and Sweden.

Cross-Cultural Comparison↗

PubMed2001

Updated audit database for breast imaging/histopathology correlation.

AIM: To develop, test and validate an audit database, evolved from a prior, peer-reviewed, audit tool for symptomatic multi-modality breast imaging services. MATERIALS AND METHODS: The database is to cover all aspects of non-invasive breast imaging and recognize subspeciality inputs. When more than one imaging investigation is used for diagnosis, an overall breast imaging audit grade is to be introduced. Data derived from clinical studies has been input into the new database. RESULTS: Results for mammography alone are virtually identical to those of the previous program. A slight increase in accuracy is suggested by using more investigations if the first investigation is not conclusive. More comprehensive reports can be issued. CONCLUSION: The audit program can be used in the same context as the old audit. If mammography is the sole investigation, there is no change from the previous standards of a minimum mammography (ultrasound)/histopathology agreement of 70%, an equivocal rate of less than 15%, a false-positive rate of less than 7.5% and a false-negative rate of less than 6.5%. Although there is no statistical difference when more than one imaging investigation is used, there is some marginal improvement. It is suggested that initial audit standards for multi-imaging should be 75% for minimum agreement, a 10% maximum for an equivocal rate, a 5% maximum for false negative and an unchanged false positive rate of 7.5% maximum. These standards will be refined with experience. Due to the nature of the database, complex queries can be made including those about histopathological data. If widely used, the database will be a useful tool to audit the accuracy of symptomatic breast imaging services and types and frequencies of symptomatic breast disease, as seen in routine settings.

Breast Neoplasms↗

PubMed1999

The Conquest Hospital picture archiving and communications system development, 1992 to 1999.

Conquest Hospital was a UK regional development site for a pre-Digital Imaging and Communications in Medicine (DICOM) picture archiving and communication system (PACS). The initial system was installed in mid 1992. Identification has been made of data transfer, ergonomic and single point of failure issues in the original PACS, which was called "iLAN." This has informed respecification of a DICOM/HTML PACS, the first stages of which have been hospital renetworking and installation of new DICOM 3.0 computed radiography/fluorography and computed tomography/magnetic resonance imaging segments. Final PACS elements are at contract stage. Plans are being completed for linkage of PACS to a clinical information system to create a comprehensive electronic patient record system.

Computer Communication Networks↗

PubMed1999

PACS: the second time around.

Conquest Hospital was a Picture Archiving and Communication Systems development site, designed to inform the specification of low cost systems and to provide information on benefits and drawbacks. The American College of Radiologists/National Electrical Manufacturers Association 2.0 protocol was used for image management. The Regional Health Authority sponsored the system, initially installed in mid 1992. It used a high-speed dedicated optical fibre distributed data interface network and for teleradiology an Integrated Services Digital Network solution. Image and other data were captured and archived satisfactorily. Image reporting folders were manually constructed and sent to reporting viewstations. Radiologists were able to directly request 'ad hoc' images from archive. The reporting function of the associated but unlinked radiology information system was satisfactory. Identification was made of data transfer, ergonomic, single point of failure and many other issues. These informed re-specification and the commercial approach for a Digital Images Communication in Medicine/Hyper Text Mark-up Language Picture Archiving and Communication System, the first stages of which have been whole hospital re-networking, Intranet introduction, installation of new Computed Radiography/Fluorography and Computed Tomography/Magnetic Resonance Imaging segments and a new Radiology Information System. The Picture Archiving and Communication System is now seen as part of a full Electronic Patient Record system. Networking and provision of high quality Personal Computer hardware for data review are seen as a corporate responsibility and a hospital overhead, no longer borne by individual projects. Our present work is synergistic with the procurement of a new Clinical Information System and the further development of the hospital Intranet.

Computer Communication Networks↗

PubMed1997

Clinical audit and standard setting for symptomatic breast imaging in South Thames region.

Audit is recognized as an important part of the UK National Health Service Breast Screening programme. This paper describes a simple method of auditing breast imaging in symptomatic women which was applied in the South Thames (East) Region of England. No appropriate standards were available before this audit started. Standards were set at the end of the first cycle by the Regional Radiology Audit Committee and these were used in the second cycle of this audit. A comparison between hospitals which organize both breast screening and symptomatic imaging and those with units providing symptomatic breast imaging only shows no significant difference in the accuracy diagnosis and the false negative and false positive rates between the two. However non-screening units, are significantly more likely to issue an equivocal radiology report (P = 0.000001). Measures to reduce the incidence of equivocal reporting, by prospectively issuing an audit grade with the report and double reporting of equivocal images are recommended.

Breast Neoplasms↗