Publications by authors named "Thomas Neumuth"

Article Synopsis
  • * Findings indicated that patients' median age at first ASCT has increased, while the use of tandem ASCT decreased, and there were improved survival rates across all age groups, especially older patients.
  • * Careful patient selection is crucial for tandem ASCT, as it is less beneficial for those with certain conditions (ISS III and renal impairment), older patients, and those who achieve complete response after initial ASCT.
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This study aimed to develop a graph neural network (GNN) for automated three-dimensional (3D) magnetic resonance imaging (MRI) visualization and Pfirrmann grading of intervertebral discs (IVDs), and benchmark it against manual classifications. Lumbar IVD MRI data from 300 patients were retrospectively analyzed. Two clinicians assessed the manual segmentation and grading for inter-rater reliability using Cohen's kappa.

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  • This study explores how a visualization system can transmit real-time patient data from ambulances to emergency trauma rooms (ETR) to enhance timely medical interventions before and after a patient arrives.
  • Researchers conducted in-depth interviews with 32 physicians from six hospitals in Germany and Switzerland to gather insights on a prototype system designed for this purpose.
  • The findings indicate that real-time data can improve workflow in ETRs, with physicians emphasizing the need for adaptable and mobile interfaces that display critical information relevant to patient care, suggesting future research should assess the system's practical application in clinical settings.
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In times where sudden-onset disasters (SODs) present challenges to global health systems, the integration of predictive, preventive, and personalized medicine (PPPM / 3PM) into emergency medical responses has manifested as a critical necessity. We introduce a modern electronic patient record system designed specifically for emergency medical teams (EMTs), which will serve as a novel approach in how digital healthcare management can be optimized in crisis situations. This research is based on the principle that advanced information technology (IT) systems are key to transforming humanitarian aid by offering predictive insights, preventive strategies, and personalized care in disaster scenarios.

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Article Synopsis
  • The purpose of the study is to enhance decision-making in the resuscitation room for severely injured patients using a clinical decision support system called TraumaFlow, which helps in coordinating activities and recommending treatments.
  • The system was built on medical guidelines and employed a workflow management approach through BPMN 2.0, along with a user-friendly web interface; an evaluation study with medical students and residents showed its effectiveness in training.
  • Results indicated that TraumaFlow improved adherence to guidelines, increased confidence in decision-making, reduced errors, and was helpful for both less experienced and highly experienced medical professionals during polytrauma training.
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Background: Obtaining large amounts of real patient data involves great efforts and expenses, and processing this data is fraught with data protection concerns. Consequently, data sharing might not always be possible, particularly when large, open science datasets are needed, as for AI development. For such purposes, the generation of realistic synthetic data may be the solution.

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The treatment landscape for multiple myeloma (MM) has experienced substantial progress over the last decade. Despite the efficacy of new substances, patient responses tend to still be highly unpredictable. With increasing cognitive burden that is introduced through a complex and evolving treatment landscape, data-driven assistance tools are becoming more and more popular.

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  • - The study investigated stroke survivors' preferences regarding patient-reported outcome measures (PROMs) to assess their quality of life and unmet needs, highlighting their perspectives on the assessment process.
  • - A paper-based questionnaire was distributed to stroke patients in Germany, revealing that most participants were open to PROMs, believing they could enhance care for themselves and others, with a preference for annual interviews and written surveys lasting 15-30 minutes.
  • - Findings suggest that personalized approaches to administering PROMs, including the preferred communication methods and timing, could better implement these assessments in clinical practice and improve stroke care outcomes.
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  • Increasing economic pressure is driving the need for better optimization of operational processes in surgical operating rooms (ORs), particularly in arthroscopic surgery, to ensure efficient use of limited resources and handle complex workflows.
  • A study was conducted that recorded and analyzed perioperative processes from 53 surgeries at a university hospital and 66 at an outpatient clinic, using a newly developed software toolset for detailed workflow analysis.
  • The analysis revealed significant differences in performance, with the outpatient clinic consistently performing faster in preoperative and postoperative phases compared to the university hospital.
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  • The management of polytraumatized patients is challenging and stress-inducing, but using a systematic approach like "TraumaFlow" can enhance outcomes and lower mortality rates.
  • A study tested the effectiveness of TraumaFlow by comparing medical students and residents' performances in simulated trauma scenarios, first without any support and then with the system implemented on a tablet.
  • Results showed a significant improvement in performance scores (from 6.6 to 11.6 out of 12) and a reduction in perceived mental stress when using TraumaFlow, indicating its potential benefits in trauma care.
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New possibilities in personalized medicine need to be complemented by clinical decision support systems as well as context-specific applications to be used in clinical routine. We aim to implement a shared technical backend for a large variety of applications in personalized head-and-neck cancer treatment. The infrastructure is conceptualized as a multi-purpose digital twin for cancer treatment.

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  • In trauma emergency rooms, it's crucial to prepare all resources before a patient arrives, highlighting the need for effective communication between pre-hospital services and the hospital using technology.
  • The study aimed to determine the specific pre-hospital information necessary to ensure that trauma teams are fully prepared for incoming patients.
  • Interviews with ETR physicians revealed common pre-hospital information needs but differences in how teams are alerted and notified, informing future improvements in communication systems.
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  • Recent studies demonstrate that hyperspectral imaging (HSI) paired with neural networks can effectively detect colorectal cancer, though post-processing techniques have been less examined compared to pre-processing methods.* -
  • The research tested two pre-processing techniques (Standardization and Normalization) and evaluated two 3D convolutional neural network (CNN) models (Inception-based and RS-based), along with two median filter post-processing algorithms on data from 56 patients.* -
  • Results show that Inception-based models outperformed RS-based models, especially with Normalization, and post-processing improved overall sensitivity and specificity by 6.6%, indicating that careful selection of pre- and post-processing methods enhances diagnostic performance.*
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Adapting intelligent context-aware systems (CAS) to future operating rooms (OR) aims to improve situational awareness and provide surgical decision support systems to medical teams. CAS analyzes data streams from available devices during surgery and communicates real-time knowledge to clinicians. Indeed, recent advances in computer vision and machine learning, particularly deep learning, paved the way for extensive research to develop CAS.

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Fusing data from different medical perspectives inside the operating room (OR) sets the stage for developing intelligent context-aware systems. These systems aim to promote better awareness inside the OR by keeping every medical team well informed about the work of other teams and thus mitigate conflicts resulting from different targets. In this research, a descriptive analysis of data collected from anaesthesiology and surgery was performed to investigate the relationships between the intra-abdominal pressure (IAP) and lung mechanics for patients during laparoscopic procedures.

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Problem: Similarity measures are widely used as an approved method for spectral discrimination or identification with their applications in different areas of scientific research. Even though a range of works have been presented, only a few showed slightly promising results for human tissue, and these were mostly focused on pathological and non-pathological tissue classification.

Methods: In this work, several spectral similarity measures on hyperspectral (HS) images of in vivo human tissue were evaluated for tissue discrimination purposes.

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The increase in diagnostic and therapeutic procedures in the treatment of oncological diseases, as well as the limited capacity of experts to provide information, necessitates the development of therapy decision support systems (TDSS). We have developed a treatment decision model that integrates available patient information as well as tumor characteristics. They are assessed according to their relevance in evaluating the optimal therapy option.

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Introduction: Intraoperative near-infrared fluorescence angiography with indocyanine green (ICG-FA) is a well-established modality in gastrointestinal surgery. Its main drawback is the application of a fluorescent agent with possible side effects for patients. The goal of this review paper is the presentation of alternative, non-invasive optical imaging methods and their comparison with ICG-FA.

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In case of sudden-onset disasters (SODs), the World Health Organization deploys specialized emergency medical teams (EMTs); yet, the coordination and operation of such teams pose significant challenges. One issue is the lack of digital information systems and standards. We developed a highly customizable and scalable electronic medical record (EMR) system, tailored to EMT requirements, called the "Emergency Medical Team Operating System" (EOS).

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By understanding stroke as a chronic disease, aftercare becomes increasingly important. For developing aftercare programs, the patients' perspective regarding, for example, stroke-related symptoms and interactions with the healthcare system is necessary. Records from a local stroke pilot program were used to extract relevant topics from the patients' perspective, as mentioned during a phone call two months after hospital discharge.

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Background: Surgical context-aware systems can adapt to the current situation in the operating room and thus provide computer-aided assistance functionalities and intraoperative decision-support. To interact with the surgical team perceptively and assist the surgical process, the system needs to monitor the intraoperative activities, understand the current situation in the operating room at any time, and anticipate the following possible situations.

Methods: A structured representation of surgical process knowledge is a prerequisite for any applications in the intelligent operating room.

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Previous navigation systems can determine the position of the "tracked" surgical instrument in CT images in the context of functional endoscopic sinus surgery (FESS), but do not provide any assistance directly in the video endoscopic image of the surgeon. Developing this direct assistance for intraoperative orientation and risk reduction was the goal of the BIOPASS project (ld ntologie und rozessgestütztes istenzsystem). The Project pursues the development of a novel navigation system for FESS without markers.

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The percutaneous biopsy is a critical intervention for diagnosis and staging in cancer therapy. Robotic systems can improve the efficiency and outcome of such procedures while alleviating stress for physicians and patients. However, the high complexity of operation and the limited possibilities for robotic integration in the operating room (OR) decrease user acceptance and the number of deployed robots.

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Laparoscopic procedures can be assisted by intraoperative modalities, such as quantitative perfusion imaging based on fluorescence or hyperspectral data. If these modalities are not available at video frame rate, fast image registration is needed for the visualization in augmented reality. Three feature-based algorithms and one pre-trained deep homography neural network (DH-NN) were tested for single and multi-homography estimation.

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Background: Patient-reported outcomes (PRO) assess disease burden and indicate unmet needs. Home-based electronic PRO measures (ePROMs) can support tumor aftercare (TAC). Creating an ePROM is the next step after implementing the software "OncoFunction" to assess PROs during TAC of head- and neck-cancer patients (HNC).

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