Bridging radiology and public health: the emerging field of radiologic public health informatics.

Radiology and public health have an emerging opportunity to collaborate, in which radiology's vast supply of imaging data can be integrated into public health information systems for epidemiologic assessments and responses to population health problems. Fueling the linkage of radiology and public health include (i) the transition from analog film to digital formats, enabling flexible use of radiologic data; (ii) radiology's role in imaging across nearly all medical and surgical subspecialties, which establishes a foundation for a consolidated and uniform database of images and reports for public health use; and (iii) the use of radiologic data to characterize disease patterns in a population occupying a geographic area at one time and to characterize disease progression over time via follow-up examinations. The backbone for this integration is through informatics projects such as Systematized Nomenclature of Medicine Clinical Terms and RadLex constructing terminology libraries and ontologies, as well as algorithms integrating data from the electronic health record and Digital Imaging and Communications in Medicine Structured Reporting.

Spinal cord stimulation for axial low back pain: a prospective, controlled trial comparing dual with single percutaneous electrodes.

Study Design: A prospective, controlled, clinical trial comparing single and dual percutaneous electrodes in the treatment of axial low back pain from failed back surgery syndrome.

Objectives: To clarify technical requirements and test the hypothesis that placing two linear arrays in parallel, thereby doubling the number of contacts, improves outcome.

Summary Of Background Data: Technical improvements have enhanced outcomes of spinal cord stimulation for chronic axial low back pain.

Evaluation of syndromic surveillance systems--design of an epidemic simulation model.

Introduction: The paucity of outbreak data from biologic terrorism and emerging infectious diseases limits the evaluation of syndromic surveillance systems. Evaluation using naturally occurring outbreaks of proxy disease (e.g.

Patient-interactive, microprocessor-controlled neurological stimulation system.

Objectives. Recent technical improvements in implanted stimulation devices, in particular the development of programmable, multicontact devices, have facilitated their clinical application in the management of pain. If the capabilities of these devices are to be used to full advantage, adjustment after implantation demands a major investment of time and effort.

Spinal cord stimulation with percutaneous and plate electrodes: side effects and quantitative comparisons.

Spinal cord stimulation is limited by the uncomfortable side effects experienced by the patient as the amplitude of stimulation is increased. These side effects include local segmental paresthesias or motor responses, which are objectively demonstrable as frequency-following muscle contractions, attributable to dorsal root stimulation. The authors present evidence for another mechanism of stimulation-evoked discomfort, namely recruitment of small fibers in ligamentum flavum, which occurs when electrodes are inserted percutaneously and their contacts are exposed circumferentially; this does not occur with plate electrodes with insulated dorsal surfaces.