Training novice users to assess stroke aetiology in remote settings using transcranial ultrasound: pilot study.

Introduction: Emergency care delivery to patients in remote and rural areas is limited by diagnostic restrictions and long transport times to major centres of care. People with suspected acute stroke living long distances from a hospital are unlikely to receive time-critical reperfusion therapy for these reasons. Basic brain imaging assessing blood flow in the major intracranial arteries could facilitate such care in remote settings.

The use of transcranial ultrasound and clinical assessment to diagnose ischaemic stroke due to large vessel occlusion in remote and rural areas.

Rapid endovascular thrombectomy, which can only be delivered in specialist centres, is the most effective treatment for acute ischaemic stroke due to large vessel occlusion (LVO). Pre-hospital selection of these patients is challenging, especially in remote and rural areas due to long transport times and limited access to specialist clinicians and diagnostic facilities. We investigated whether combined transcranial ultrasound and clinical assessment ("TUCA" model) could accurately triage these patients and improve access to thrombectomy.

Diagnostic value of transcranial ultrasonography for selecting subjects with large vessel occlusion: a systematic review.

Introduction: A number of pre-hospital clinical assessment tools have been developed to triage subjects with acute stroke due to large vessel occlusion (LVO) to a specialised endovascular centre, but their false negative rates remain high leading to inappropriate and costly emergency transfers. Transcranial ultrasonography may represent a valuable pre-hospital tool for selecting patients with LVO who could benefit from rapid transfer to a dedicated centre.

Methods: Diagnostic accuracy of transcranial ultrasonography in acute stroke was subjected to systematic review.

Diagnostic accuracy of clinical tools for assessment of acute stroke: a systematic review.

Introduction: Recanalisation therapy in acute ischaemic stroke is highly time-sensitive, and requires early identification of eligible patients to ensure better outcomes. Thus, a number of clinical assessment tools have been developed and this review examines their diagnostic capabilities.

Methods: Diagnostic performance of currently available clinical tools for identification of acute ischaemic and haemorrhagic strokes and stroke mimicking conditions was reviewed.

The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: a systematic review and subgroup meta-analysis.

Background: The aim of the present review is to assess the effectiveness of ultrasound (US) in the detection of upper and lower limb bone fractures in adults compared to a diagnostic gold standard available in secondary and tertiary care centres (e.g. radiography, CT scan or MRI).

Paramedic and physician perspectives on the potential use of remotely supported prehospital ultrasound.

Introduction: During remotely supported prehospital ultrasound (RSPU), an ultrasound operator performs a scan and sends images to a remote expert for interpretation. This novel technology has been undergoing investigation in the randomised controlled SatCare trial, which seeks to assess the capability of RSPU to improve patient outcomes and standard of prehospital care in the Highlands of Scotland. This study aimed to explore the views of emergency medicine physicians and paramedics prior to starting the trial.

Telesonography in emergency medicine: A systematic review.

Ultrasound is an efficacious, versatile and affordable imaging technique in emergencies, but has limited utility without expert interpretation. Telesonography, in which experts may remotely support the use of ultrasound through a telecommunications link, may broaden access to ultrasound and improve patient outcomes, particularly in remote settings. This review assesses the literature regarding telesonography in emergency medicine, focussing on evidence of feasibility, diagnostic accuracy and clinical utility.

Remotely supported prehospital ultrasound: A feasibility study of real-time image transmission and expert guidance to aid diagnosis in remote and rural communities.

Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video.

Combining transcranial ultrasound with intelligent communication methods to enhance the remote assessment and management of stroke patients: Framework for a technology demonstrator.

With over 150,000 strokes in the United Kingdom every year, and more than 1 million living survivors, stroke is the third most common cause of death and the leading cause of severe physical disability among adults. A major challenge in administering timely treatment is determining whether the stroke is due to vascular blockage (ischaemic) or haemorrhage. For patients with ischaemic stroke, thrombolysis (i.

Implementing transnational telemedicine solutions: a connected health project in rural and remote areas of six Northern Periphery countries Series on European collaborative projects.

This is the first article in a Series on collaborative projects between European countries, relevant for general practice/family medicine and primary healthcare. Telemedicine, in particular the use of the Internet, videoconferencing and handheld devices such as smartphones, holds the potential for further strides in the application of technology for the delivery of healthcare, particularly to communities in rural and remote areas within and without the European Union where this study is taking place. The Northern Periphery Programme has funded the 'Implementing Transnational Telemedicine Solutions' (ITTS) project from September 2011 to December 2013, led by the Centre for Rural Health in Inverness, Scotland.

Recommendations for research design and reporting in computer-assisted diagnosis to facilitate meta-analysis.

Computer-assisted diagnosis (CAD) describes a diverse, heterogeneous range of applications rather than a single entity. The aims and functions of CAD systems vary considerably and comparing studies and systems is challenging due to methodological and design differences. In addition, poor study quality and reporting can reduce the value of some publications.

A systematic review of computer-assisted diagnosis in diagnostic cancer imaging.

Objectives: This study reviews the evidence for the effectiveness of computer-assisted diagnosis (CAD) in cancer imaging. Diagnostic applications were studied to estimate the impact of CAD on radiologists' detection and diagnosis of cancer lesions.

Methods: Online databases were searched and 48 studies from 1992 to 2010 were included: 16 with radiologists using CAD to detect lesions (CADe) and 32 with radiologists using CAD to classify or diagnose lesions (CADx).

The effect of image colour distortion on evaluation of donor liver suitability for transplantation.

Some medical applications rely on the use of colour in the diagnostic process, even when poor colour reproduction can affect diagnosis. In this paper, we investigate the effect colour distortion can have on assessment of livers for possible transplantation. We compare the diagnostic effects for the likely colour shifts when illuminant and camera remain uncalibrated or when a monitor is incorrectly calibrated.