Data o zdravotní péči ve správě státem řízených organizací jsou pro společnost cenným nehmotným aktivem. Jejich využití by mělo být pro jejich správce a stát prioritou. Zcela paternalistický přístup správců a státu je nežádoucí, jakkoliv má za cíl ochranu práva na soukromí osob registrovaných v databázích. V souladu s evropskou politikou a celosvětovým trendem by však tato opatření neměla převážit společenský benefit, který z analýzy těchto údajů vyplývá, existují-li technické možnosti práva osob na soukromí dostatečně chránit. Česká společnost vede k tématu intenzivní diskusi, která se však podle autorů jen nedostatečně opírá o fakta a postrádá jasně artikulovaná stanoviska odborné veřejnosti. Cílem tohoto článku je tyto mezery zacelit. Techniky anonymizace údajů představují řešení, jak chránit práva jednotlivců na soukromí a zároveň zachovat vědeckou hodnotu údajů. Riziko ztotožnění jednotlivců v anonymizovaných souborech údajů je škálovatelné a lze ho minimalizovat v závislosti na typu a obsahu údajů a jejich použití konkrétním žadatelem. Nalezení optimální formy a rozsahu deidentifikovaných údajů vyžaduje kompetence a znalosti jak na straně žadatele, tak na straně správce. Je v zájmu žadatele, správce i chráněných osob v databázích, aby obě strany projevily ochotu a měly schopnost a odborné znalosti komunikovat v průběhu žádosti a jejího zpracování.
Healthcare data held by state-run organisations is a valuable intangible asset for society. Its use should be a priority for its administrators and the state. A completely paternalistic approach by administrators and the state is undesirable, however much it aims to protect the privacy rights of persons registered in databases. In line with European policies and the global trend, these measures should not outweigh the social benefit that arises from the analysis of these data if the technical possibilities exist to sufficiently protect the privacy rights of individuals. Czech society is having an intense discussion on the topic, but according to the authors, it is insufficiently based on facts and lacks clearly articulated opinions of the expert public. The aim of this article is to fill these gaps. Data anonymization techniques provide a solution to protect individuals' privacy rights while preserving the scientific value of the data. The risk of identifying individuals in anonymised data sets is scalable and can be minimised depending on the type and content of the data and its use by the specific applicant. Finding the optimal form and scope of deidentified data requires competence and knowledge on the part of both the applicant and the administrator. It is in the interest of the applicant, the administrator, as well as the protected persons in the databases that both parties show willingness and have the ability and expertise to communicate during the application and its processing.
The analysis and segmentation of articular cartilage magnetic resonance (MR) images belongs to one of the most commonly routine tasks in diagnostics of the musculoskeletal system of the knee area. Conventional regional segmentation methods, which are based either on the histogram partitioning (e.g., Otsu method) or clustering methods (e.g., K-means), have been frequently used for the task of regional segmentation. Such methods are well known as fast and well working in the environment, where cartilage image features are reliably recognizable. The well-known fact is that the performance of these methods is prone to the image noise and artefacts. In this context, regional segmentation strategies, driven by either genetic algorithms or selected evolutionary computing strategies, have the potential to overcome these traditional methods such as Otsu thresholding or K-means in the context of their performance. These optimization strategies consecutively generate a pyramid of a possible set of histogram thresholds, of which the quality is evaluated by using the fitness function based on Kapur's entropy maximization to find the most optimal combination of thresholds for articular cartilage segmentation. On the other hand, such optimization strategies are often computationally demanding, which is a limitation of using such methods for a stack of MR images. In this study, we publish a comprehensive analysis of the optimization methods based on fuzzy soft segmentation, driven by artificial bee colony (ABC), particle swarm optimization (PSO), Darwinian particle swarm optimization (DPSO), and a genetic algorithm for an optimal thresholding selection against the routine segmentations Otsu and K-means for analysis and the features extraction of articular cartilage from MR images. This study objectively analyzes the performance of the segmentation strategies upon variable noise with dynamic intensities to report a segmentation's robustness in various image conditions for a various number of segmentation classes (4, 7, and 10), cartilage features (area, perimeter, and skeleton) extraction preciseness against the routine segmentation strategies, and lastly the computing time, which represents an important factor of segmentation performance. We use the same settings on individual optimization strategies: 100 iterations and 50 population. This study suggests that the combination of fuzzy thresholding with an ABC algorithm gives the best performance in the comparison with other methods as from the view of the segmentation influence of additive dynamic noise influence, also for cartilage features extraction. On the other hand, using genetic algorithms for cartilage segmentation in some cases does not give a good performance. In most cases, the analyzed optimization strategies significantly overcome the routine segmentation methods except for the computing time, which is normally lower for the routine algorithms. We also publish statistical tests of significance, showing differences in the performance of individual optimization strategies against Otsu and K-means method. Lastly, as a part of this study, we publish a software environment, integrating all the methods from this study.
This work analyses the results of research regarding the predisposition of genetic hematological risks associated with secondary polyglobulia. The subjects of the study were selected based on shared laboratory markers and basic clinical symptoms. JAK2 (Janus Kinase 2) mutation negativity represented the common genetic marker of the subjects in the sample of interest. A negative JAK2 mutation hypothetically excluded the presence of an autonomous myeloproliferative disease at the time of detection. The parameters studied in this work focused mainly on thrombotic, immunological, metabolic, and cardiovascular risks. The final goal of the work was to discover the most significant key markers for the diagnosis of high-risk patients and to exclude the less important or only complementary markers, which often represent a superfluous economic burden for healthcare institutions. These research results are applicable as a clinical guideline for the effective diagnosis of selected parameters that demonstrated high sensitivity and specificity. According to the results obtained in the present research, groups with a high incidence of mutations were evaluated as being at higher risk for polycythemia vera disease. It was not possible to clearly determine which of the patients examined had a higher risk of developing the disease as different combinations of mutations could manifest different symptoms of the disease. In general, the entire study group was at risk for manifestations of polycythemia vera disease without a clear diagnosis. The group with less than 20% incidence appeared to be clinically insignificant for polycythemia vera testing and thus there is a potential for saving money in mutation testing. On the other hand, the JAK V617F (somatic mutation of JAK2) parameter from this group should be investigated as it is a clear exclusion or confirmation of polycythemia vera as the primary disease.
- Publikační typ
- časopisecké články MeSH
The subject of the work was the experimental verification of the negative influence of gravity sets in a pressure volumetric infusion pump with an impact on the accuracy of infusion solution dosing. The quality criterion for gravity sets was the accuracy of the flow versus the reference set by the volumetric infusion pump. The solution consisted of 14-hour measurements with two types of gravity sets, Intrafix® Primeline sets were used as universal sets and Standardline IS 103 gravity sets. The insulin pump flow rate was set at 300 ml/h and 50 ml/h, and the actual flow rate of the infusion solution was recorded every hour using a graduated cylinder. Used gravity sets were also processed by mechanical tests, unused sets were subjected to these tests and the obtained data were compared with each other. Experiments carried out showed that at the set flow rate of 300 ml/h, the flow error with the universal set was -3% and at a set flow rate of 50 ml/h the error was +2.3%. Flow accuracy using gravity sets was worse, a flow error of -7.2% was detected for a flow rate of 50 ml/h and a flow error of -7.7% was measured for 300 ml/h. The volumetric pump used declares a tolerated inaccuracy of ± 3% when used with standard infusion sets. Based on the data, it can be concluded that the replacement of set types has an influence on the dosage of infusion solutions.
- MeSH
- bezpečnost pacientů MeSH
- infuzní pumpy * škodlivé účinky MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
Wavelet transformation is one of the most frequent procedures for data denoising, smoothing, decomposition, features extraction, and further related tasks. In order to perform such tasks, we need to select appropriate wavelet settings, including particular wavelet, decomposition level and other parameters, which form the wavelet transformation outputs. Selection of such parameters is a challenging area due to absence of versatile recommendation tools for suitable wavelet settings. In this paper, we propose a versatile recommendation system for prediction of suitable wavelet selection for data smoothing. The proposed system is aimed to generate spatial response matrix for selected wavelets and the decomposition levels. Such response enables the mapping of selected evaluation parameters, determining the efficacy of wavelet settings. The proposed system also enables tracking the dynamical noise influence in the context of Wavelet efficacy by using volumetric response. We provide testing on computed tomography (CT) and magnetic resonance (MR) image data and EMG signals mostly of musculoskeletal system to objectivise system usability for clinical data processing. The experimental testing is done by using evaluation parameters such is MSE (Mean Squared Error), ED (Euclidean distance) and Corr (Correlation index). We also provide the statistical analysis of the results based on Mann-Whitney test, which points out on statistically significant differences for individual Wavelets for the data corrupted with Salt and Pepper and Gaussian noise.
In this paper, a new approach for the periodical testing and the functionality evaluation of a fetal heart rate monitor device based on ultrasound principle is proposed. The design and realization of the device are presented, together with the description of its features and functioning tests. In the designed device, a relay element, driven by an electric signal that allows switching at two specific frequencies, is used to simulate the fetus and the mother's heartbeat. The simulator was designed to be compliant with the standard requirements for accurate assessment and measurement of medical devices. The accuracy of the simulated signals was evaluated, and it resulted to be stable and reliable. The generated frequencies show an error of about 0.5% with respect to the nominal one while the accuracy of the test equipment was within ±3% of the test signal set frequency. This value complies with the technical standard for the accuracy of fetal heart rate monitor devices. Moreover, the performed tests and measurements show the correct functionality of the developed simulator. The proposed equipment and testing respect the technical requirements for medical devices. The features of the proposed device make it simple and quick in testing a fetal heart rate monitor, thus providing an efficient way to evaluate and test the correlation capabilities of commercial apparatuses.
- MeSH
- lidé MeSH
- monitorování fyziologických funkcí MeSH
- plod * MeSH
- srdeční frekvence plodu * MeSH
- srdeční frekvence MeSH
- těhotenství MeSH
- ultrasonografie MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Terapeutická adherence je nezbytnou podmínkou dlouhodobě úspěšné léčby řady závažných onemocnění, přesto zůstává u poloviny pacientů nízká. Mezi hlavní příčiny patří na jedné straně nedostatečné aktivní zapojení pacientů do léčby, ale na druhé straně také malá motivace poskytovatelů otázky adherence řešit. Předpokladem pro zlepšování adherence je možnost jejího adekvátního hodnocení, k čemuž bohužel nadále postrádáme univerzální a spolehlivé nástroje. Subjektivní metody staví na osobním odhadu adherence ze strany pacienta či poskytovatele péče, objektivní jsou založeny na průkazných informacích. V posledních letech dochází k častějšímu využití postupů založených na telemedicíně. Ty umožňují jednak sledovat terapeutickou adherenci pacientů, ale také intervenovat ve prospěch jejího zvyšování. Obsahem článku je krátké připomenutí principů posuzování a měření adherence a dále shrnutí nových technologic-kých nástrojů využívaných při její podpoře. Obojí je v době opakujících se plošných karanténních opatření a často pouze distančně poskytované péče aktuální více než dříve.
Therapeutic adherence is a necessary condition for the long-term successful treatment of many serious diseases, yet it remains low in half of the patients. The main reasons include insufficiently active patients' involvement in treatment on the one hand, but also the low motivation of providers to address adherence issues on the other hand. The possibility of its adequate evaluation is a precondition for improving adherence, unfortunately, we still lack universal and reliable tools. Subjective methods are based on personal assessment of adherence by the patient or caregiver, objective ones are based on conclusive information. In recent years, there has been a more frequent use of telemedicine-based practices. They enable to monitor patients' therapeutic adherence, but also to intervene in favour of its increase. The article contens a brief reminder of the principles of assessment and measurement of adherence and a summary of new technological tools used in its support. Both are relevant more than before at this time of recurrent global quarantine measures and related remote care.
BACKGROUND: In the sense of Act No. 123/2000 Coll., as amended (hereinafter referred to as "the Act"), a medical device is understood to be a wide range of resources, especially medical equipment. To implement innovative technologies in practice, it is becoming extremely important to be cost-conscious and effective. The aim of the article is to use an ultrasonographic device case study in a selected hospital to show the possibility of solving the use effectiveness of medical devices. METHODS: Within the first step, a summary of the use of ultrasonographic devices is developed in terms of performance number and time. Also, a summary of all costs for the last 5 years has been created. The analyzed ultrasonographic device set is evaluated in terms of activity indicators, profitability, and Du Pont decomposition. Revenues from the operation of individual instruments and payroll productivity are taken into account. All of this is evaluated in the context of the requirements of the department and the spectrum of ultrasonographic devices. RESULTS: The results show that the economic evaluation of device use efficiency, comparing the requirements of the department and spectrum of the devices, suggests a major revision in use of these devices and savings. CONCLUSION: The new design of the most profitable system differs significantly in the arrangement of individual ultrasonographic devices. The benefit of the study is not just a newly designed organization-specific arrangement, but it can be perceived as a modeling approach that can be used to analyze other sets of medical technology.
n this work, a commercial flexible thermoelectric generator (f-TEG) was used to harvest the body thermal energy during the execution of activities of daily living (ADL). The f-TEG was placed at the level of the ankle, and the performed activities were sitting at the desk and walking. In the first stage of measurements, tests were performed to choose the value of the resistor load that maximizes the power output. Then, while performing ADL, the values of generated power were in the range from 100 to 450 μW. Moreover, while users are walking, the pattern of the output signal of f-TEG is compatible to a sine function with frequency close to that one of human gait. This preliminary result may represent a new way to study the movement of human body to recognize ADL.
- MeSH
- diagnostické zobrazování metody přístrojové vybavení MeSH
- dítě MeSH
- fotografování klasifikace přístrojové vybavení MeSH
- lidé MeSH
- nervus opticus anatomie a histologie MeSH
- novorozenec nedonošený MeSH
- novorozenec MeSH
- retina anatomie a histologie patologie MeSH
- retinopatie nedonošených * diagnóza MeSH
- teoretické modely MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- práce podpořená grantem MeSH
