Comparison between different cost devices for digital capture of X-ray films: an image characteristics detection approach.

A common teleradiology practice is digitizing films. The costs of specialized digitizers are very high, that is why there is a trend to use conventional scanners and digital cameras. Statistical clinical studies are required to determine the accuracy of these devices, which are very difficult to carry out. The purpose of this study was to compare three capture devices in terms of their capacity to detect several image characteristics. Spatial resolution, contrast, gray levels, and geometric deformation were compared for a specialized digitizer ICR (US$ 15,000), a conventional scanner UMAX (US$ 1,800), and a digital camera LUMIX (US$ 450, but require an additional support system and a light box for about US$ 400). Test patterns printed in films were used. The results detected gray levels lower than real values for all three devices; acceptable contrast and low geometric deformation with three devices. All three devices are appropriate solutions, but a digital camera requires more operator training and more settings.

Agreement and reading time for differently-priced devices for the digital capture of X-ray films.

We assessed the reliability of three digital capture devices: a film digitizer (which cost US $15,000), a flat-bed scanner (US $1800) and a digital camera (US $450). Reliability was measured as the agreement between six observers when reading images acquired from a single device and also in terms of the pair-device agreement. The images were 136 chest X-ray cases. The variables measured were the interstitial opacities distribution, interstitial patterns, nodule size and percentage pneumothorax size. The agreement between the six readers when reading images acquired from a single device was similar for the three devices. The pair-device agreements were moderate for all variables. There were significant differences in reading-time between devices: the mean reading-time for the film digitizer was 93 s, it was 59 s for the flat-bed scanner and 70 s for the digital camera. Despite the differences in their cost, there were no substantial differences in the performance of the three devices.

Sistemas de información en el sector salud en Colombia / Information systems in health sector in Colombia / Sistemas de informação no setor saúde na Colômbia

Objetivo: caracterizar y evaluar los sistemas de información del sector salud en Colombia. Metodología: Se desarrolló un marco conceptual que incluyó contexto legal del país y conformaciónde sistemas de información en otros países. Posteriormente se caracterizó el sistema de información de salud colombiano, a partir de entrevistas con actores relevantes y literatura pertinente. Finalmente, se analizó la conformación del sistema, el flujo de información y las fortalezas y debilidades de éste, para la posterior formulación de recomendaciones. Resultados y conclusiones: el sistema de información en salud colombiano se encuentra fragmentado y presenta problemas de calidad, situación similar a la de otros países. Es esencial el desarrollo de una cultura de producción, difusión y utilización de la información. Se debe aprovechar el momento de cambio que sufre el sistema de salud para buscar la mejoría de la información. Los mecanismos de captura de la información requieren una simplificación y estandarización...

Objective: Characterizing and evaluating information systems on the health sector in Colombia. Methodology: A conceptual frame that included the legal context of the country and organization of information systems in other countries was developed. Later on, Colombian health informationsystem was characterized starting on interviews with important actors and papers. Finally, the organization of the system, information flows and its strengths and weaknesses were analyzed in order to propose some recommendations. Results and conclusions: information system ofthe Colombian health sector is divided and evidencing quality issues, as in other countries. The development of a production, diffusion and use of information culture is essential. We must take advantage of the change that is occurring in the health system for improving the information. Capture mechanisms for information require a simplification and standardization...

Objetivo: caracterizar e avaliar os sistemas de informação do sector da saúde na Colômbia. Metodologia: Quadro conceptual que incluiu contexto legal do país e conformação dos sistemasde informação em outros países foi desenvolvido. Seguidamente, o sistema colombiano de informacao da saúde foi caracterizado, a partir de entrevistas com os atores relevantes e consulta da literatura pertinente. No final, a conformação do sistema, fluxo de informações e pontos fortes e fracos do mesmo foram analisados para a posterior formulação de recomendações. Resultados e conclusões: O sistema colombiano de informação da saúde é fragmentado e apresenta problemasde qualidade, uma situação semelhante à de outros países. Resulta essencial o desenvolvimento de uma cultura de produção, difusão e uso da informação. Deve se explorar o ponto de viragemexperimentado atualmente pelo sistema de saúde para procurar a melhora na informação. Os mecanismos de captura das informações precisam de simplificação e padronização...

Comparison between differently priced devices for digital capture of X-ray films using computed tomography as a gold standard: a multireader-multicase receiver operating characteristic curve study.

OBJECTIVE: Film digitizers are a specialized technology that is available for scanning X-ray radiographs; however, their cost makes them unaffordable for developing countries. Thus, less expensive alternatives are used. The purpose of this study was to compare three devices for digital capture of X-ray films: a film digitizer (US $15,000), a flatbed scanner (US $1800), and a 10-megapixel digital camera (US $450), in terms of diagnostic accuracy, defined as the area under the receiver operating characteristic curves and computed tomography as the gold standard. MATERIALS AND METHODS: The sample included 136 chest X-ray cases with computed tomography confirmation of the presence or absence of pneumothorax, interstitial opacities, or nodules. The readers were six radiologists who made observations of eight variables for each digital capture of the X-ray films: three main variables to determine the accuracy in the detection of the above-mentioned pathologies, four secondary variables to categorize other pathological classifications, and one variable regarding digital image quality. RESULTS: The receiver operating characteristic curves for each device and pathology were very similar. For the main variables, there was no significant statistical difference in diagnostic accuracy between the devices. For the secondary variables, >84% of cases were correctly classified, even those that were classified with the lowest image quality. High accuracy was determined for the three main variables (0.75 to 0.96), indicating good performance for all tested devices, despite their very different prices. CONCLUSIONS: Choosing a device for a teleradiology service should involve additional factors, such as capture time, maintenance concerns, and training requirements.

Amplio espectro de la enfermedad vascular hepática en imágenes / Ample spectrum of vascular hepatic disease

La enfermedad vascular hepática (EVH)constituye un amplio espectro de entidades de baja prevalencia, pero con manifestaciones clínicas diversas que pueden llevar a la muerte. Una detección temprana y un tratamiento oportuno cambian el pronóstico. De ahí que las imágenes diagnósticas desempeñen un papel fundamental; sin embargo, hay que tener en cuenta el amplio diagnóstico diferencial. La tomografía computarizada de abdomen es una de las herramientas más útiles para el diagnóstico, sin olvidar otros métodos de imagen, como el ultrasonido Doppler y la resonancia magnética. La EVH puede clasificarse según la repercusión que se pueda derivar de ella, por lo que en términos prácticos puede dividirse en alteraciones venosas, portales, arteriales, sinusoidales y otras. El objetivo de esta revisión es describir la presentación más frecuente de la EVH y sus principales hallazgos y diagnósticos diferenciales, al tiempo que se reconoce su correlación con los mecanismos fisiopatológicos.

Hepatic vascular diseases (HVD) are a broad spectrum of entities of low prevalence but with different clinical manifestations that may even lead to death. Its early detection and timely treatment may change the prognosis. Diagnostic imaging plays a key role and imaging findings may be typical.However, in most cases, radiologists must take into account a wide range of differential diagnosis. Computed tomography (CT) of the abdomen is one of the most useful tools for the diagnosis of HVD taking also into account the value of other imaging methods such as Doppler Ultrasound andMagnetic Resonance Imaging (MRI).HVD can be classified according to the compromised vascular structure and can be divided into venous, portal, arterial, sinusoidal and others disorders. The objective of this review is to describe the most common presentation HVD . The major imaging findings and differential diagnosis recognizingits correlation with the pathophysiological mechanisms.

Prevalence of suicide risk factors and suicide-related outcomes in the National Mental Health Study, Colombia.

A community survey in 4,426 adults was undertaken as part of the World Mental Health Survey Initiative reporting the prevalence and risk factors for suicide-related outcomes in Colombia. Lifetime prevalence estimates of suicide ideation, plans, attempts, and risk factors for suicide-related outcomes were assessed. Retrospective reports of disorders age-of-onset were used to study associations between primary mental disorders and first onset of suicide-related outcomes. Risks of plans and attempts were highest with ideation early age-of-onset and within the first year. The highest risk for ideation and attempt among ideators occurred in the 18-29 age group. After first employment (defined as the first paid job accepted by the respondent) and presence of mental disorders constituted risk factors. Impulse-control disorders were strongest diagnostic predictors.

[Health care workers' perception of the Internet and mobile technologies in Colombia]. / Percepciones de los trabajadores del sector salud frente a Internet y las tecnologías móviles en Colombia.

In July 2007 in Medellín, Colombia, 1,200 health care professionals were asked to complete a questionnaire: of the 493 who participated, the mean age was 31.2 years; 58.8% were physicians; and 97.6% had Internet access, 60.5% on a daily basis and 27.7%, weekly. The preferred place to access the Internet was from home (58%) or from the work place (12.5%); 98% reported having a cell phone, and of those, 80% were interested in using health education tools via cell phone. These are the first data published regarding Internet and cellular phone penetration among health care workers in Colombia. Acceptance of the Internet and mobile systems as health information tools is gaining, and as such, creating a new opportunity for training and harnessing of these new technologies.

Percepciones de los trabajadores del sector salud frente a Internet y las tecnologías móviles en Colombia / Health care workers' perception of the Internet and mobile technologies in Colombia

In July 2007 in Medellín, Colombia, 1 200 health care professionals were asked to complete a questionnaire: of the 493 who participated, the mean age was 31.2 years; 58.8 percent were physicians; and 97.6 percent had Internet access, 60.5 percent on a daily basis and 27.7 percent, weekly. The preferred place to access the Internet was from home (58 percent) or from the work place (12.5 percent); 98 percent reported having a cell phone, and of those, 80 percent were interested in using health education tools via cell phone. These are the first data published regarding Internet and cellular phone penetration among health care workers in Colombia. Acceptance of the Internet and mobile systems as health information tools is gaining, and as such, creating a new opportunity for training and harnessing of these new technologies.