Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study.
Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study.
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缩小农村环境中获得多模态成像的最后一英里差距：农村地区纵向研究风险的成像核心设计。
DOI：
10.1161/circimaging.123.015496
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发表时间：
2024
期刊：
影响因子：
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作者：
Fazlalizadeh,Hooman;Khan,MuhammadShahzeb;Fox,ErvinR;Douglas,PamelaS;Adams,David;Blaha,MichaelJ;Daubert,MelissaA;Dunn,Gary;vandenHeuvel,Edwin;Kelsey,MichelleD;Martin,RandolphP;Thomas,JamesD;Thomas,Yngvil;Judd,SuzanneE;
在农村人口中实现最佳的心血管健康可能具有挑战性，原因包括获得医疗服务的机会减少，成像设备、专科医生和其他重要的医疗团队成员的可获得性有限。因此，需要创新的解决方案来优化卫生保健和解决农村地区的心血管健康差距。流动检查单位可以将成像技术带到服务不足或获得卫生保健服务机会有限的偏远社区。流动检查单元可配备各种评估工具和多种成像方式，如计算机断层扫描和超声心动图。心血管和肺病理的详细结构评估，以及计算机断层成像提供的心外病理检测，结合超声心动图获得的功能和血流动力学评估，为流行病学研究中历来代表性不足的人群提供了深入的心肺疾病表型。此外，通过将流动检查股带到当地社区，现在可以采取创新的方法，包括让当地专业人员参与进行这些成像评估，从而增加当地的专门知识和经验。然而，在基于流动检查单元的检查可以有效地整合到农村卫生保健环境中之前，存在几个挑战，包括标准化采集协议、保持一致的图像质量以及解决伦理和隐私考虑。在此，我们讨论了心脏多模式成像对改善农村地区心血管健康的潜在重要性，概述了这一领域的新兴经验，强调了当前面临的重要挑战，并根据我们在农村(农村地区纵向潜在风险)队列研究中的经验提出了解决方案。
Achieving optimal cardiovascular health in rural populations can be challenging for several reasons including decreased access to care with limited availability of imaging modalities, specialist physicians, and other important health care team members. Therefore, innovative solutions are needed to optimize health care and address cardiovascular health disparities in rural areas. Mobile examination units can bring imaging technology to underserved or remote communities with limited access to health care services. Mobile examination units can be equipped with a wide array of assessment tools and multiple imaging modalities such as computed tomography scanning and echocardiography. The detailed structural assessment of cardiovascular and lung pathology, as well as the detection of extracardiac pathology afforded by computed tomography imaging combined with the functional and hemodynamic assessments acquired by echocardiography, yield deep phenotyping of heart and lung disease for populations historically underrepresented in epidemiological studies. Moreover, by bringing the mobile examination unit to local communities, innovative approaches are now possible including engagement with local professionals to perform these imaging assessments, thereby augmenting local expertise and experience. However, several challenges exist before mobile examination unit–based examinations can be effectively integrated into the rural health care setting including standardizing acquisition protocols, maintaining consistent image quality, and addressing ethical and privacy considerations. Herein, we discuss the potential importance of cardiac multimodality imaging to improve cardiovascular health in rural regions, outline the emerging experience in this field, highlight important current challenges, and offer solutions based on our experience in the RURAL (Risk Underlying Rural Areas Longitudinal) cohort study.