Papers by Dimitris-Dionissis Koutsouris
Technology and Health Care, Dec 1, 2002
Progress in Brain Research, 2021
Tinnitus is the perception of a phantom sound and the patient's reaction to it. Although much... more Tinnitus is the perception of a phantom sound and the patient's reaction to it. Although much progress has been made, tinnitus remains a scientific and clinical enigma of high prevalence and high economic burden, with an estimated prevalence of 10%-20% among the adult population. The EU is funding a new collaborative project entitled "Unification of Treatments and Interventions for Tinnitus Patients" (UNITI, grant no. 848261) under its Horizon 2020 framework. The main goal of the UNITI project is to set the ground for a predictive computational model based on existing and longitudinal data attempting to address the question of which treatment or combination of treatments is optimal for a specific patient group based on certain parameters. Clinical, epidemiological, genetic and audiological data, including signals reflecting ear-brain communication, as well as patients' medical history, will be analyzed making use of existing databases. Predictive factors for different patient groups will be extracted and their prognostic relevance validated through a Randomized Clinical Trial (RCT) in which different patient groups will undergo a combination of tinnitus therapies targeting both auditory and central nervous systems. From a scientific point of view, the UNITI project can be summarized into the following research goals: (1) Analysis of existing data: Results of existing clinical studies will be analyzed to identify subgroups of patients with specific treatment responses and to identify systematic differences between the patient groups at the participating clinical centers. (2) Genetic and blood biomarker analysis: High throughput Whole Exome Sequencing (WES) will be performed in well-characterized chronic tinnitus cases, together with Proximity Extension Assays (PEA) for the identification of blood biomarkers for tinnitus. (3) RCT: A total of 500 patients will be recruited at five clinical centers across Europe comparing single treatments against combinational treatments. The four main treatments are Cognitive Behavioral Therapy (CBT), hearing aids, sound stimulation, and structured counseling. The consortium will also make use of e/m-health applications for the treatment and assessment of tinnitus. (4) Decision Support System: An innovative Decision Support System will be implemented, integrating all available parameters (epidemiological, clinical, audiometry, genetics, socioeconomic and medical history) to suggest specific examinations and the optimal intervention strategy based on the collected data. (5) Financial estimation analysis: A cost-effectiveness analysis for the respective interventions will be calculated to investigate the economic effects of the interventions based on quality-adjusted life years. In this paper, we will present the UNITI project, the scientific questions that it aims to address, the research consortium, and the organizational structure.
Frontiers in Digital Health, 2020
As life expectancy increases, it is imperative that the elderly take advantage of the benefits of... more As life expectancy increases, it is imperative that the elderly take advantage of the benefits of technology to remain active and independent. Mobile health applications are widely used nowadays as they promote a healthy lifestyle and self-management of diseases, opening new horizons in the interactive health service delivery. However, adapting these applications to the needs and requirements of the elderly is still a challenge. This article presents a smartphone application that is part of a multifactorial intervention to support older people with balance disorders. The application aims to enable users to self-evaluate their activity and progress, to communicate with each other and, through strategically selected motivational features, to engage with the system with undiminished interest for a long period of time. Mock-up interfaces were evaluated in semi-structured focus groups and interviews that were performed across three European countries. Further evaluation in the form of four pilot studies with 160 participants will be performed and qualitative and quantitative measures will be used to process the feedback about the use of the application.
2009 9th International Conference on Information Technology and Applications in Biomedicine, 2009
Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology
... [2] James Rumbaugh, Ivar Jacobson, Grady Booch, The Unified Modeling Language ReferenceManu... more ... [2] James Rumbaugh, Ivar Jacobson, Grady Booch, The Unified Modeling Language ReferenceManual, Addison-Wesley ... and biomedical engineering, Chicago 2000, Chicago, USA, 23-28July 2000 [8] S Moehrs, G. Brelstaff, P. Anedda, G. Zanetti, M. Tuveri, Internet Patient ...
4th International IEEE EMBS Special Topic Conference on Information Technology Applications in Biomedicine, 2003.
A Virtual patient record (VPR) is an ideal Electronic healthcare record (EHR) that is decentraliz... more A Virtual patient record (VPR) is an ideal Electronic healthcare record (EHR) that is decentralized and contains heterogeneous and distributed medical and clinical data Extensible Markup Language (XML) is a Web standard that was introduced by the World Wide Web Consortium (W3C) and today has become the major driver towards heterogeneous system integration for any industry solution. This work is based on our efforts to create an XML Schema that operates as an interface between different heterogeneous patient record structures. The XML Schema structure is based on standards such as HL7, DICOM, VITAL, CEHR and prENV 1 3 6 M and was modeled with UML metadata techniques. We are describing our efforts and technological platform used to test this XML schema by implementing various healthcare scenarios and using state of the art java components and XML based technologies. The developed pilot is initially being tested for two homecare scenarios (anticoagulation treatment and ventilation and oxygen therapy mpport) in conjunction with a standard primary healthcare patient record software package.
Proceedings. 1998 IEEE International Conference on Information Technology Applications in Biomedicine, ITAB '98 (Cat. No.98EX188), 1998
Recent studies conclude that early and specialized prehospital management contributes to emergenc... more Recent studies conclude that early and specialized prehospital management contributes to emergency case survival. Ambulance personnel, who usually are the first to handle emergency situations, do not have the required theoretical knowledge and experience. Financial and practical reasons do not allow the participation of specialized physicians on ambulance vehicles. Within the framework of the health telematics programme We have developed a portable medical device that allows telediagnosis, long distance support and teleconsultation of mobile health care providers by specialized physicians. The device allows the transmission of vital biosignals and still images of the patient from the incident place to the hospital. The transmission is performed through the GSM mobile telephony network. The device can telematically "bring" a specialist doctor at the site of the medical emergency, allow him to evaluate patient data and issue directions to the emergency personnel on treatment procedures until the patient is brought to hospital. Due to the need of storing and archiving data being interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the "AMBULANCE" system. The performance of the system has been validated in four different countries using a controlled medical protocol.
Opportunities and Challenges
It is paradoxical that, although several major technological discoveries such as Magnetic Resonan... more It is paradoxical that, although several major technological discoveries such as Magnetic Resonance Imaging and Nuclear Medicine and Digital Radiology, which facilitate improvement in patient care, have been satisfactorily embraced by the medical community, this has not been the case with Healthcare Informatics. Thus, it can be argued that issues such as Data Management, Data Modeling, and Knowledge Management have a long way to go before reaching the maturity level that other technologies have achieved in the medical sector. This chapter proposes to explore trends and best practices regarding knowledge management from the viewpoint of performance management, based upon the use of Key Performance Indicators in healthcare systems. By assessing both balanced scorecards and quality assurance techniques in healthcare, it is possible to foresee an electronic healthcare record centered approach which drives information flow at all levels of the day-to-day process of delivering effective and managed care, and which finally moves towards information assessment and knowledge discovery.
Journal of Telemedicine and Telecare, 2001
We have developed a novel emergency telemedicine system which allows the transmission of physiolo... more We have developed a novel emergency telemedicine system which allows the transmission of physiological data (electrocardiogram, oximetry, blood pressure and temperature) and still images of the patient. The transmission is performed through wireless links using either GSM mobile phones or satellite. Because of the low bandwidth available through these links, data compression is required to allow realtime transmission of electrocardiographic (ECG) data. A new integrated design approach for an optimal zonal wavelet compression (OZWC) method was implemented for the ECG data. The performance of the mobile system with compressed ECG data segments was evaluated in terms of the percentage root-mean-square difference and visual inspection. The optimum wavelet algorithm achieved a maximum compression ratio of 18:1 with low distortion.
Computers in Cardiology, 2003, 2003
In this study, Decision Tree algorithms are used with promising results in a crucial and at the s... more In this study, Decision Tree algorithms are used with promising results in a crucial and at the same time complicated classification problem concerning differential diagnosis of heart sounds. Decision Tree structures are constructed, using data mining/distillation methods and then are used to classify heart sounds that were recorded from patients that have either Aortic Stenosis (AS) or Mitral Regurgitation (MR). Emphasis is given on the selection of the appropriate features that are adequately independent from the heart sound signal acquisition method. The differentiation capabilities and the classification performance of t he fully expanded Decision Tree classifiers and the pruned Decision tree classifiers are studied for this problem. For each constructed Decision Tree classifier the partial classification accuracies for the AS and MR auscultation findings are also estimated.
2005 IEEE Engineering in Medicine and Biology 27th Annual Conference, 2005
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2005
The evolution of telecommunications technologies in connection with the robustness and the fideli... more The evolution of telecommunications technologies in connection with the robustness and the fidelity these new systems provide, have opened up many new horizons as regards the provision of healthcare and the quality of service from the side of the experts to that of the patients. The purpose of this paper is to evaluate the third generation telecommunications systems that are only recently being deployed in Europe, as well as argue on why a transition from 2G and 2.5G to 3G telecommunications systems could prove to be crucial, especially in relation to emergency telemedicine. The experimental results of the use of these systems are analyzed, the implementation of a tele-consultation unit is presented and their exploitation capabilities are explored.
The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings, 2006
The objective of this study was to classify hysteroscopy images of the endometrium based on textu... more The objective of this study was to classify hysteroscopy images of the endometrium based on texture analysis for the early detection of gynaecological cancer. A total of 418 Regions of Interest (ROIs) were extracted (209 normal and 209 abnormal) from 40 subjects. Images were gamma corrected and were converted to gray scale. The following texture features were extracted: (i) Statistical Features, (ii) Spatial Gray Level Dependence Matrices (SGLDM), and (iii) Gray level difference statistics (GLDS). The PNN and SVM neural network classifiers were also investigated for classifying normal and abnormal ROIs. Results show that there is significant difference (using Wilcoxon Rank Sum Test at a=0.05) between the texture features of normal and abnormal ROIs for both the gamma corrected and uncorrected images. Abnormal ROIs had lower gray scale median and homogeneity values, and higher entropy and contrast values when compared to the normal ROIs. The highest percentage of correct classifications score was 77% and was achieved for the SVM models trained with the SF and GLDS features. Concluding, texture features provide useful information differentiating between normal and abnormal ROIs of the endometrium.
Lecture Notes in Computer Science, 2009
2006 International Conference of the IEEE Engineering in Medicine and Biology Society, 2006
Implementing telemedical solutions has become a trend amongst the various research teams at an in... more Implementing telemedical solutions has become a trend amongst the various research teams at an international level. Yet, contemporary information access and distribution technologies raise critical issues that urgently need to be addressed, especially those related to security. The paper suggests the use of watermarking in telemedical applications in order to enhance security of the transmitted sensitive medical data, familiarizes the users with a telemedical system and a watermarking module that have already been developed, and proposes an architecture that will enable the integration of the two systems, taking into account a variety of use cases and application scenarios.
Telemedicine and e-Health, 2010
Objectives: During the last few years, wireless networks have been increasingly used both inside ... more Objectives: During the last few years, wireless networks have been increasingly used both inside hospitals and in patients' homes to transmit medical information. In general, wireless networks suffer from decreased security. However, digital watermarking can be used to secure medical information. In this study, we focused on combining wireless transmission and digital watermarking technologies to better secure the transmission of medical images within and outside the hospital. Methods: We utilized an integrated system comprising the wireless network and the digital watermarking module to conduct a series of tests. Results: The test results were evaluated by medical consultants. They concluded that the images suffered no visible quality degradation and maintained their diagnostic integrity. Discussion: The proposed integrated system presented reasonable stability, and its performance was comparable to that of a fixed network. This system can enhance security during the transmission of medical images through a wireless channel.
IEEE Transactions on Information Technology in Biomedicine, 2006
Information technology advances have brought forth new challenges in healthcare information manag... more Information technology advances have brought forth new challenges in healthcare information management, due to the vast amount of medical data that needs to be efficiently stored, retrieved, and distributed, and the increased security threats that explicitly have to be addressed. The paper discusses the perspectives of digital watermarking in a range of medical data management and distribution issues, and proposes a complementary and/or alternative tool that simultaneously addresses medical data protection, archiving, and retrieval, as well as source and data authentication. The scheme imperceptibly embeds in medical images multiple watermarks conveying patient's personal and examination data, keywords for information retrieval, the physician's digital signature for authentication, and a reference message for data integrity control. Experimental results indicate the efficiency and transparency of the scheme, which conforms to the strict requirements that apply to regions of diagnostic significance.
IEEE Engineering in Medicine and Biology Magazine, 2000
Future Generation Computer Systems, 1999
The morphology of Greece has a significant effect on the structure and operational characteristic... more The morphology of Greece has a significant effect on the structure and operational characteristics of the Greek health care system. The remote location of many rural health care centers and the concentration of major hospitals in the few big cities have an effect on both the quality and availability of health care that is provided. We are developing a strategic plan that would allow hospitals and health care centers across Greece to exchange medical data in digital form and have access to telemedicine and teleconsulting facilities. Two pilot networks have been implemented. The first network is designed to allow for telemedicine and teleconsulting services in the island of Evia. The second pilot network is an Image Management and Communications Systems (IMAC) and was implemented in the Onassio Hospital in Athens. Results of the pilot demonstrators were evaluated and have been very promising for a scaled-up implementation of this pilot project.
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Papers by Dimitris-Dionissis Koutsouris