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Medical Speech Recognition Software makes clinical documentation process efficacious and cost-effective, says the latest KLAS report.

The report titled “Speech Recognition 2010: Vocalizing Benefits” includes feedback from 355 providers and covers both back-end and front-end speech-recognition technology.

As reported by the participants report, the primary advantages of adopting Medical Speech Recognition Software technology includes:

• staff reductions
• improved report turnaround times
• increased physician satisfaction

But there are still difficulties in the adoption process like technology training, difficulties with the varied accent of non-native English speakers, workflow interruption during the initial adoption process.

“The speech recognition market is ripe for healthy growth,” said Ben Brown, report author.  “Currently, less than one in four hospitals use the technology, however, in light of meaningful use and the benefits providers point out in this study, we expect it will assume a more prominent place in the role of clinical documentation.”

But physicians are enthusiastic about the technology and are willing to learn and adopt it to their practics.

Report says that Nuance is the market leader in front end speech recognition technology with PowerScribe and RadWhere while MedQuist’s SpeechQ is not far behind as their biggest competitor. Agfa’s TalkStation takes the fourth place with its slow and steady growth.

You can learn more and purchase the report at http://www.klasresearch.com/reports

Selenia Dimensions System

The U.S. Food and Drug Administration have given approval for the for the first three dimensional mammography system.

Selenia Dimensions System, the first X-ray mammography device that provides three-dimensional (3-D) images of the breast for breast cancer screening and diagnosis is expected to increase the accuracy of breast cancer diagnosis.

The Selenia Dimensions System, an upgrade to Hologic’s existing FDA-approved 2-D system, can provide 2-D and 3-D X-ray images of the breasts. The 3-D images may help physicians more accurately detect and diagnose breast cancer.

The Selenia Dimensions System is marketed by Hologic Inc.

See the FDA press release here

The iStethescope Pro application has added yet another healthcare application to the iPhone, which as the name suggests can monitor heart beat like the stethescope. It allows you to listen to the heart beat using sensors of the smartphone and see the heart wave form in a graphical manner similar to that of an electrocardiogram.

The application was developed by University College London researcher, Peter Bentley and more than three million doctors have downloaded the application on their smartphones after the free version was introduced last week.

“Everybody is very excited about the potential of the adoption of mobile phone technology into the medical workplace, and rightly so,” said Bentley

CT Colonography or Virtual Colonoscopy can detect colonic as well as extra-colonic abdomino-pelvic lesions, an added advantage over colonoscopy.  Virtual colonoscopy uses computerized tomography (CT) to produce hundreds of cross-sectional images of the abdominal organs which are analysed tp produce a veirtual image of the inside of the colon and rectum while colonoscopy is the endoscopic examination of the colon using a colonoscope allowing direct vizualisation of the colon and rectum.

The new findings were reported in the September issue of the American Journal of Roentgenology.

Even though CT colonography (CTC) cannot be compared to CT pelvis and abdomen, the extracolonic findings detected during the procedure can be significant and provides a clear advantage over conventional optical colonoscopy Dr. Ganesh R. Veerappan, MD, of Walter Reed Army Medical Center in Washington and colleagues conducted a retrospective study to analyse the significance of these lesions.

The researchers found that out of the 2277 patients who underwent CTC, about 45 percent cases had extracolonic findings and a quarter of these findings were significant. Further radiology procedures, surgery and follow-up revealed 7 high-risk lesions among the significant lesions and the radiology studies added approximately $50 extra per patient. The virtual colonoscopy examination found six intracolonic malignancies and three adenomas with high-grade dysplasia.

“CT colonography [CTC] not only identifies colorectal cancer [CRC] but also doubles the yield of identifying significant early extracolonic lesions, resulting in lives saved,” Ganesh Veerappan reported in the journal.

The team concluded that the odds of identifying high-risk lesions were raised by 78% with CTC and thus the examination should be considered as an alternative to conventional colonoscopy in colo-ractal cancer screening or as a one-time screening procedure for intracolonic and extra-colonic lesions.

Ultrasound is the standard investigation done in the diagnosis and follow-up of urinary calculi. But researchers at the department of urology, St. Michael’s Hospital, University of Toronto suggest that ultrasound may not be the most reliable investigation in the management of renal stones.

According to them, the two promimant disadvantages of ultrasound when compared to computed tomography in renal stones management are:

1. Overestimation of stone size: When compared with axial unenhanced CT, ultrasound shows the size to be bigger than the actual size which can lead to unnecessary surgical interventions in cases where only conservative management is warranted. Thus the authors advise against for planning treatment based solely on ultrasonography (US) findings. The study also found that the skin-stone distance, ie the distance between the ultrasound probe over the skin and the position of the calculi, is a significant factor determining the magnitute of the error. The error was not dependent on the body mass index and location of the calculi in the urinary tract.

2. Poor sensitivity and specificity for kidney and ureter stones: The team found that the sensitivity and specificity of US for the detection of ureteric calculi was 45% and 94%, respectively, and for the detection of renal calculi was 45% and 88%, respectively. Thus they consider US as not that worthy during an initial workup in the diagnosis of renal stones.

The authors found that CT is superior to ultrasound and US may be limited to:

• pregnant and pediatric patients where exposure to radiation is harmful.
• follow-up of translucent urinary calculi.
• in cases of hydronephrosis
• when there is need for repeated CT

Mammography is less effective in breast cancer detection in women in their forties, concluded a recent study published recently in The Journal of the National Cancer Institute.

It is already known that mammography screening outcomes in women less than 50yrs is poorer when compared to older women and the main suggested attributes are lesser mammogram sensitivity in younger women due to dense breast tissue and faster tumor growth in younger women.

Sylvia K. Plevritis and colleagues from the of the Department of Radiology at the Stanford University School of Medicine investigated to determine which factor contributes most to the poor mammography outcomes. They used a computer simulated model to estimate and compare the relative effect of biology and technology on mammograms of women in their forties with those in fifties and sixties.

The researchers found that from their simulation model (Breast Cancer Screening Simulator) that lowered mammographic tumor detectability accounted for 79% and faster tumor volume doubling time accounted for 21% of the poorer sensitivity in mammography screening among younger women, compared with older women.

“The age-specific differences in mammographic tumor detection contribute more than age-specific differences in tumor growth rates to the lowered performance of mammography screening in younger women,” according to the authors.

A new study published in the Acta Oncologica has found an association between dental x-rays and risk for incidence of thyroid cancers.

A dental x-ray is one of the basic investigations when you consult a dentist. It helps to vizualise the teeth as well as bone and soft tissue structures around it. It enables detection of tooth cavities, cysts, hidden wisdom tooth etc.  And dental x-rays are a common source of low-dose radiation as a course of dental treatment might require multiple dental radiography and the neighouring stuctures like the thyroid gland is also exposed to it. Concern rises as it is proven that the thryoid tissue is quite vulnerable to radiation induced carcinogenesis.

To assess the risk of thyroid cancer from dental x-rays, researchers from Brighton (England), Cambridge (England) and Kuwait conducted a case control study, the results of which are published in the journal Acta Oncologica. The researchers were led by Dr Anjum Memon, senior lecturer and consultant in public health medicine at Brighton and Sussex Medical School (England), a partnership between Brighton and Sussex universities, and NHS (National Health Service) Brighton and Hove (England).

The population-based case-control interview study was conducted in Kuwait and included 313 patients with thyroid cancer and a similar number of individually matched (year of birth ± three years, gender, nationality, district of residence) control subjects.

The results showed that exposure to dental x-rays was significantly associated with an increased risk of thyroid cancer (odds ratio = 2.1, 95% confidence interval: 1.4, 3.1) (p=0.001) with a dose-response pattern (p for trend <0.0001). The association did not vary appreciably by age, gender, nationality, level of education, or parity. Researchers opine that further studies using historical dental x-rays is required to support the hypothesis.

“The public health and clinical implications of these findings are particularly relevant in the light of increases in the incidence of thyroid cancer in many countries over the past 30 years,”said Dr. Anjum Menon, the lead investigator.

A new CT technology that utilizes cone-shaped X-ray beams and a digital flat panel detector to produce 3-D images are studied by Radiologists at Emory University.

Thousands of women are dying of breast cancer in US and the rest of the world every year.Mammograms and clinical breast exams are usually performed to investigate the intentsity or trace tumors. However, younger women below 50 years may not be detected accurately by mammograms.

Emory University is one of the only three sites in the United States studying the CT breast scanner manufactured by Koning Corporation.Three set studies are being conducted by Radiologists at Emory University with a new CT technology using cone-shaped X-ray beams and digital flat panel detectors to produce 3-D images. In the First Test The new breast CT scan is compared with diagnostic mammography as a tool for detecting cancer. The 2nd test included enhanced CT scans compared with contrast dye with MRI in the evaluation of newly diagnosed breast cancers. 3rd, they are examining the effectiveness of breast CT scans in tracking how tumors are responding to chemo treatment.

1,093 patients have been examined on both stereo and standard digital mammograms by the Emory doctors. All the patients were on high risk alert for developing breast cancer.

This capacitates the researchers to re-build a breast image from all angles. Further with computerised processing, focus on calcification is maintained. The CT may however, be used for routine screenings or in combination with other technologies for cancer diagnosis and treatment. 300 pictures in ten seconds from this new prototype cone beam CT scanner is expected each time. The X-ray beams and a digital detector rotate around the breast to take the desired images for checks. The 3D images from the scan can locate tumors upto five millimeters in size.

The new digital technology,called Stereo mammography may also decrease the number of women recalled due to false postives by 49% unlike the conventional digital mammography that only features a two-dimensional image.

“Standard mammography is widely considered to be one of the most difficult exams to read because lesions may be disguised by normal tissue,” says radiologist Carl D’Orsi, director of breast imaging.”

The Extended Learning center,California State University Commission (CSUSM) was awarded $50,000 in order to motivate the progress of a new certification Health Information Technology (HIT).

A study finds that surgeons specially trained to perform breast cancer surgeries can interpret a mammogram as good as a trained breast radiologist and they provide an excellent alternative to meet the shortage of radiologists.

The findings of the study, titled ‘Surgeon-Read Screening Mammography: An Analysis of 10 020 Examinations,’ was presented at the 11th Annual Meeting of the American Society of Breast Surgeons.

The objective of the study was to determine whether the reading performance of breast surgeons can be compared to that of mammography radiologists.

The prospective research involved 13 622 mammograms read at a dedicated, surgeon-run breast health centre between January 2003 and June 2009.

Mammograms were conducted according to conventional mammography guidelines by certified technicians on state of the art film-screen and from July 2006 on full-field digital equipment.

All the mammograms were double read by two experienced breast surgeons and the findings were catagorised according to BIRADS.

The study concluded that the findings of the breast surgeons were equivalent to that in organized national screening programs run by specialized breast radiologists in Europe and Australia. With fewer recalls, a lower biopsy rate with a higher malignancy rate of biopsy and a high cancer detection rate, they were better than highly skilled radiologists in the United States.

This study provide a first benchmark for surgeon-read screening mammography.

“These findings suggest that the ability to precisely analyze breast images is enhanced by both ongoing experience and specialized training,” comments Justus Apffelstaedt, MD, FCS (SA), Associate Professor of Surgery and Head: Breast Clinic, University of Stellenbosch, chief author of the study, who practices at the South African site. He added that, ‘Breast surgeons review large numbers of breast images as part of their ongoing treatment planning and delivery.  Now, this study shows that with appropriate training, they prove to be highly accurate primary mammography interpreters.’