Covid-19 Technology Assessment Service

Purpose: As the COVID-19 emergency evolved, a wide range of 'new' technology based solutions were offered to meet clinical and occupational health needs in Europe. This technology extended beyond the standard medical devices usually deployed in clinical settings, and therefore required rapid assessment of suitability for use in hospitals. Here we describe a hospital-based COVID-19 technology assessment service (www.misa.ie/researchdevelopment/ bioengineering-lab/technology-assessment) that was developed and share our experience of its implementation. Material(s) and Method(s): A scientifically grounded assessment service was established to evaluate specific technological solutions. This service was led by a team of 2 Senior Medical Physicists and 1 Senior Clinical Engineer, with each assessment drawing on pan-hospital expertise and a specialist technology evaluation infrastructure. Each solution was evaluated using a standardized agile process: 1) user centric needs assessment;2) applicable literature and international standards review;3) balanced risk-benefit assessment;4) initial device functionality and usability assessment;5) in-depth device technical testing and safety assessment;6) rapid communications and detailed reporting;7) support for local clinical implementation/ installation with on-going evaluation. Evaluations were described in the form of short Bulletins with a webpage developed to share these findings internationally. Result(s): To date, a diverse range of technological systems and innovative solutions were evaluated, including thermal cameras for mass temperature screening, baby monitor devices for isolation room communications, augmented reality systems, a varied range of thermometers, and connected health technologies for remote working and clinical testing. Substantial variability in quality and standard of systems on offer was identified, with potential patient risks highlighted and mitigated. Critical success factors of the assessment service identified include: a central focus on the impact of solutions on both patients and staff, accessible local scientific and technical expertise supporting real-world testing and user feedback, an agile process which was responsive to high levels of uncertainty and a rapid communications process that was adaptive, responsive and connected both locally and nationally. Conclusion(s): Emergency situations, while challenging, are a huge stimulus for healthcare system-wide changes where barriers to technological innovation are significantly reduced, providing significant opportunities for adoption of new and innovative solutions. While there is a need for timely and practical technology assessments during an acute emergency, these should still be grounded in well-established scientific and safety principles that prioritize the health and safety of patients, staff and the public. A hospital-based COVID-19 technology assessment service has provided a practical and successful solution to this challenge.Copyright © 2023 Southern Society for Clinical Investigation.

Automated processing of thermal imaging to detect COVID-19 and microvascular dysfunction

Background: Coronavirus disease 2019 (COVID-19) is associated with microvascular dysfunction. Non-invasive thermal imaging can hypothetically detect changes in perfusion, inflammation and vascular injury. We sought to develop a new point-of-care, non-contact thermal imaging tool to detect COVID-19 by microvascular dysfunction, based on image processing algorithms and machine learning analysis. Materials and methods: We captured thermal images of the back of 101 individuals, with (n=62) and without (n=39) COVID-19, using a portable thermal camera that connects directly to smartphones. We developed new image processing algorithms that automatically extract multiple texture and shape features of the thermal images (Figure 1A). We then evaluated the ability of our thermal features to detect COVID-19 and systemic changes of heat distribution associated with microvascular disease. We also assessed correlations between thermal imaging to conventional biomarkers and chest X-ray (CXR). Results: Our novel image processing algorithms achieved up to 92% sensitivity in detecting COVID-19 with an area under the curve of 0.85 (95% CI: 0.78, 0.93;p<0.01). Systemic alterations in blood flow associated with vascular disease were observed across the entire back. Thermal imaging scores were inversely correlated with clinical variables associated with COVID-19 disease progression, including blood oxygen saturation, C-reactive protein, and D-dimer. The thermal imaging findings were not correlated with the results of CXR. Conclusions: We show, for the first time, that a hand-held thermal imaging device can be used to detect COVID-19. Non-invasive thermal imaging could be used to screen for COVID-19 in out-of-hospital settings, especially in low-income regions with limited imaging resources. Moreover, thermal imaging might detect micro-angiopathies and endothelial dysfunction in patients with COVID-19 and could possibly improve risk stratification of infected individuals (Figure 1B).

SARS-CoV-2 (Covid-19) workplace temperature screening: Seasonal concerns for thermal detection in northern regions.

Workplace temperature screening has become standard practice during the SARS-CoV-2 pandemic. The objective was to determine the consistency of four temperature devices during exposure to simulated and actual environmental conditions reflective of a workplace. An infrared (IR) digital thermometer (accuracy(A)±0.2), IR laser thermometer (A±1), and thermal imaging camera (A±0.3) were used to measure forehead and tympanic (digital only) temperatures. The first experiment was conducted in a controlled simulated environment (-20 to 20 °C) with three participants (32-YOF, 27-YOM, 20-YOF). The second experiment used actual outdoor conditions (-0.48 to 45.6 °C) with two participants (32-YOF, 27-YOM). The tympanic measurement was the least impacted by environmental temperature (mean(±SD)): simulated (36.8(±0.18) °C) and actual (36.9(±0.16) °C). The thermal imaging camera had the lowest RMSE values (0.81-0.97 °C), with outdoor temperatures ranging from 0 to 45 °C. Environmental temperature influenced forehead temperature readings and required a resting period in a thermoneutral environment (5-9 min (-20 to -10 °C) to immediate (15-20 °C)).