Partnership for Primary Care Imaging

初级保健影像合作伙伴关系

• 批准号: 8293005
• 负责人: Stephen A Boppart
• 金额: $ 94.33万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8293005
• 关键词: 3-Dimensional; Acute; Address; Algorithms; Ambulatory Care Facilities; Antibiotic Resistance; Antibiotic Therapy; Antibiotics; Bacterial Antibiotic Resistance; Blood flow; Cervix Uteri; Characteristics; Chronic; Clinic; Clinical; Clinical Management; Data; Databases; Decision Making; Detection; Devices; Diabetes Mellitus; Diabetic Retinopathy; Diagnostic; Diagnostic Imaging; Disease; Disease Progression; Disease regression; Ear; Early Diagnosis; Eye; Family Practice; Goals; Hand; Image; Imaging technology; Infection; Information Systems; Institution; Light; Lighting; Link; Measurement; Medicine; Microbial Biofilms; Monitor; Obesity; Operative Surgical Procedures; Ophthalmology; Ophthalmoscopes; Ophthalmoscopy; Optical Coherence Tomography; Optics; Oral mucous membrane structure; Otitis Media; Otitis Media with Effusion; Otosclerosis; Otoscopes; Otoscopy; Outpatients; Overweight; Pathology; Patient Monitoring; Patients; Pediatrics; Prevalence; Primary Care Physician; Primary Health Care; Recurrence; Regimen; Reliance; Research Personnel; Resolution; Retinal; Site; Skin; Specialist; Structure; Structure of mucous membrane of nose; Surface; System; Technology; Thick; Three-Dimensional Image; Three-Dimensional Imaging; Time; Tissues; Treatment Protocols; Tube; Tympanometry; Tympanostomy; Ultrasonography; Visit; analog; base; computer aided detection; design; diabetic patient; digital; ear infection; early onset; effusion; evidence base; improved; instrument; medical specialist; medical specialties; middle ear; optical imaging; point of care; point-of-care diagnostics; primary care setting; skills; sound; success; tool; user-friendly

DESCRIPTION (provided by applicant): Primary Care Medicine, including Family Practice and Pediatrics, has traditionally relied on physical exam skills and simplistic instruments for critical diagnostic decision making, monitoring, and referral to medical specialists. The otoscope and ophthalmoscope are two historical and ubiquitous instruments that largely only illuminate and magnify tissue surfaces in the ear and eye, respectively. This Partnership will develop a new Primary Care Imaging system integrating optical coherence tomography (OCT) imaging with these instruments in a handheld scanner and portable system to advance the technological diagnostic and monitoring capabilities in primary care, and more effectively manage and refer patients based on quantitative data. A partnership composed of collaborating academic, clinical, and industrial institutions and investigators will develop and clinically evaluate this new point-of-care diagnostic technology. OCT is the optical analogue to ultrasound imaging, but generates 3-D images based on the backscatter of near-infrared light rather than sound. This Primary Care Imaging system with a MEMS-based handheld scanner and interchangeable tips enables high-resolution real-time 3-D imaging of the multiple tissue sites commonly examined during primary care outpatient exams including the eyes, ears, oral and nasal mucosa, skin, and cervix. For this project, system demonstration will focus on two increasingly prevalent diseases encountered in the primary care office, namely otitis media (middle ear infections) and diabetic retinopathy. Recent evidence has strongly associated chronic, recurrent episodes of otitis media with the presence of middle ear bacterial biofilms, and currently no non-invasive means exists to detect and quantify, let alone longitudinally monitor, these structures, which act as reservoirs to antibiotic-resistant bacterial for seeding recurrent infections. OCT enables quantitative assessment of middle ear biofilms and effusions, with the potential to significantly improve the antibiotic regimens and clinical management of this common disease. The rapidly rising prevalence of obesity has already been followed by increases in diabetes among increasingly younger patients, along with the associated complications of this disease, such as diabetic retinopathy. The successful use of OCT in ophthalmology can subsequently be advanced to the front-line of primary care to monitor patients for early evidence of diabetic retinopathy, and to quantify longitudinal changes during treatment. With an increasing reliance on effective primary care patient management for the expected increase in numbers of patients, new advanced diagnostic and quantitative technologies and instruments are needed in the outpatient primary care clinic for the early detection of disease, for quantitative monitoring of disease progression or regression, and for more efficient and evidence-based referrals to medical specialists. This Primary Care Imaging system addresses this critical need, and for the first time, brings advanced diagnostic imaging technology to the primary care office.

描述（由申请人提供）：传统上，包括家庭实践和儿科在内的初级保健医学，包括身体检查技能和简单的工具，用于关键的诊断决策，监测和转诊至医学专家。耳镜和眼镜镜是两种历史和无处不在的仪器，在很大程度上仅照亮和眼睛中的组织表面。该合作伙伴关系将开发一种新的初级保健成像系统，将光学相干断层扫描（OCT）与手持式扫描仪和便携式系统中的这些仪器相结合，以推动基于定量数据的技术诊断和监测能力，并更有效地管理和转介患者。 由合作，临床和工业机构和研究人员组成的合作伙伴关系将开发和临床评估这一新的护理诊断技术。 OCT是超声成像的光学类似物，但基于近红外光而不是声音的反向散射生成3-D图像。该基于MEMS的手持式扫描仪和可互换尖端的初级保健成像系统可实现在初级保健门诊期间通常检查的多个组织部位的高分辨率实时3D成像，包括眼睛，耳朵，口腔和鼻粘膜，皮肤，皮肤和子宫颈。对于该项目，系统演示将集中于初级保健办公室遇到的两种日益普遍的疾病，即中耳炎（中耳感染）和糖尿病性视网膜病。 最近的证据与中耳细菌生物膜的存在密切相关，中耳炎培养基的慢性复发性发作，目前尚无可检测和量化的非侵入性手段，更不用说纵向监测这些结构，这些结构可作为抗生素抗生素抗性细菌复发性感染的结构。 OCT可以对中耳生物膜和积液进行定量评估，并有可能显着改善这种常见疾病的抗生素方案和临床管理。肥胖症患病率的迅速上升之后，越来越年轻的患者的糖尿病增加，以及这种疾病的并发症，例如糖尿病性视网膜病变。随后可以成功地将OCT在眼科中使用，以监测患者早期糖尿病性视网膜病的证据，并在治疗过程中量化纵向变化。 随着对有效的初级保健患者管理越来越依赖患者人数的预期增加，在门诊初级保健诊所需要进行新的先进诊断和定量技术和仪器，以便早期发现疾病，以定量监测疾病的进展或退化，以及对医学专家的有效和基于证据的转诊。这种初级保健成像系统解决了这一关键需求，这是第一次将高级诊断成像技术带到初级保健办公室。