Distributed Intelligent Ultrasound Imaging System for Secure in-community Diagnostics (SecureUltrasound)

拟议的研究将开发低成本，安全，护理点超声成像产前护理在印度。在印度，能否找到熟练的技术人员或医生为偏远地区的孕妇进行超声波扫描是一项重大挑战。在印度，超声诊断的使用也一直存在争议，因为它被广泛滥用于性别选择性堕胎。印度政府早在1994年就通过《PC-PNDT（孕前和产前诊断技术）法》（PC-PNDT， pre -孕前和产前诊断技术）立法禁止披露胎儿性别，并不断加强监管以限制这种滥用，但这些努力收效甚微或根本没有效果。这个问题的性质和规模是印度独有的。具有引导图像捕获和远程诊断服务的安全超声扫描系统可以在印度农村地区发挥作用，这对于显着改善产前护理、健康评估和母婴福祉至关重要。印度的挑战也适用于经合组织发展援助委员会名单上的其他低收入和中等收入国家（LMICs），例如非洲国家。拟议的研究建立在最先进的手绘3D超声技术、护理路径建模和设计、基于云的超声图像分析框架、医疗保健提供的服务化和基于增强现实的产前扫描数字医疗助理的基础上。这项研究将建立在现有研究的基础上，并调查新技术的发展，以解决印度产前护理期间的“技能短缺”和“选择性堕胎”挑战。这项研究将使印度最好的大学和研究机构直接与克兰菲尔德大学合作，利用最新技术解决这一社会挑战。这项研究将在印度建立低技能超声扫描产前护理的能力和能力，在扫描过程中没有视觉反馈。研究将从在印度进行为期两周的利益相关者互动和深入的文献综述开始。根据印度的道德准则，这种互动将包括在结构松散的农村地区、农村保健中心、半城市市区、城市贫困地区和现代医院进行直接产前护理观察。将与英国的三家诊所和三家医院进行较短的互动。与最终用户接触以更好地理解他们的期望和需求将是这部分研究的主要焦点。这些需求将是超声扫描系统开发的基础，从概念设计开始。该系统将有两个主要组成部分：带有定制超声波换能器的超声波发送和接收系统以及基于AR的数据捕获助手。这些技术的工作原型将用于受控的临床验证。在两国的研究过程中，伦理准则和流程将按照克兰菲尔德大学、IISc、SJRI和NIAS的要求，以系统的方式实施。这项研究将涉及参与社区的文化和社会敏感性。这将对用户交互、数据采集、传输和存储产生直接影响。开发的新技术将首先在实验室条件下进行测试，然后在SJRI的受控临床环境中进行测试。新的超声硬件和软件性能将与商业市场上最优质的超声扫描仪进行比较。同时，将采用定量和定性相结合的方法研究安全超声扫描服务对不同社区母亲的影响。新技术对印度社会的影响将由NIAS详细研究。研究小组将与制造商及其供应链合作，进一步利用这项研究的结果。

The proposed research is going to develop low cost, secure, point of care ultrasound imaging for prenatal care for India. The availability of skilled technician or doctor that can conduct ultrasound scanning for pregnant mothers in remote areas is a major challenge in India. Usage of diagnostics ultrasound in India has also been controversial because of its extensive misuse for sex-selective abortions. Indian government introduced legislation back in 1994 to ban the disclosure of foetus gender through the PC-PNDT (Pre-Conception and Prenatal Diagnostic Techniques) Act and continuously tightened regulation to limit such misuse, these efforts have had limited or no effect on the ground. The nature and scale of the problem is unique to India. A secure ultrasound scanning system with guided image capture and a remote diagnostic service, that can work in rural areas in India, is essential to significantly improve the prenatal care, health assessment and wellbeing for the baby and the mother. The Indian challenge is also valid in other Low and Middle Income Countries (LMICs) on the OECD DAC list of ODA recipients, such as African states.The proposed research builds on state of the art freehand 3D ultrasound technology, care pathway modelling and design, cloud based framework for ultrasound image analysis, servitization of the healthcare provision and augmented reality based digital medical assistant for prenatal scanning. This research will build on the existing research and investigate new technology development to address the 'skills shortage' and 'selective abortion' challenges in India during prenatal care. The research will bring the best universities and research institutes in India to work directly with Cranfield University to solve this social challenge using latest technologies. This research will build capability and capacity in less-skilled ultrasound scanning for prenatal care with no visual feedback during scanning in India. The research will start with a two weeks long stakeholder interaction in India and intensive literature review. The interaction will involve direct prenatal care observation in unstructured rural areas, rural healthcare centres, semi-urban municipality areas, urban deprived areas and modern hospitals as per the ethical guidelines of India. A shorter interaction will take place with three surgeries and three hospitals in the UK. Engaging with the end user to better understand their expectations and requirements will be a major focus of this part of the research. The requirements will be the basis for the ultrasound scanning system development, starting with a concept design. The system will have two major components: the ultrasound transmit and receive system with customised ultrasound transducer and the AR based data capture assistant. Working prototypes of the technologies will be built for controlled clinical validations. During the research across the two countries, ethical guidelines and processes will be implemented in a systematic manner in compliance with the requirements from Cranfield University, IISc, SJRI and NIAS. The research will address the cultural and social sensitivities of the participating communities. This will have direct impact on the user interaction, data capture, transmission and storage. New technologies developed will be tested in laboratory conditions first and then in SJRI within a controlled clinical environment. The new ultrasound hardware and software performance will be compared to the best quality ultrasound scanners available in the commercial market. In parallel, the impact of the secure ultrasound scanning service for mothers across different communities will be studied using a combination of quantitative and qualitative methods. The impact of the novel technologies on the Indian society will be studied in detail by NIAS. the research team will engage with the manufacturers and their supply chain to further exploit the results of this research.