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Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Research in Telemedicine / La Recherche Européenne en Télémédecine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Telemedicine uses telecommunication and information technologies and provides clinical health care for people who are at a distance. Telecardiology is a type of telemedicine that can send electrocardiogram (ECG) signals over a wireless network to remote healthcare professionals. The aim of this paper is to simulate the transmission of ECG signals over a communication system that uses digital video broadcasting –terrestrial (DVB-T) or digital video broadcasting –satellite version 2 (DVB-S2) technologies. Bit error rate (BER) performance of this system is analyzed over an additive Gaussian white noise (AWGN) channel and compared to theoretical results. Keeping in mind that wireless channel suffers from multipath propagation, multiple-input multiple-output (MIMO) antenna technology is additionally used along with DVB-T in a fading environment. It is shown that DVB-S2 technology offers performance improvements of up to 18 dB over DVB-T in an AWGN channel. It is also shown that using MIMO along with DVB-T mitigates the effects of multipath and improves the performance. This improvement is around 5 dB. Being a superior technology, however, does not necessarily mean DVB-S2 should be chosen over DVB-T in every circumstance. For example, in the case where less delay is important (i.e. in real-time transmission) DVB-T might still be the choice of transmission of ECG signals if performance degradation can be tolerated. [ABSTRACT FROM AUTHOR]

Résumé Contexte Le tableau clinique de certaines pathologies cardiovasculaires exige une prise en charge spécialisée. En Côte d’Ivoire cette prise en charge spécialisée n’était réalisable qu’au Sud du pays à l’institut de cardiologie d’Abidjan. Objectif Le but de ce travail était de démontrer l’efficacité d’un projet de télécardiologie dans la prise en charge des pathologies cardiovasculaires en Afrique noire. Matériels et méthodes Nous avons établi un réseau de télémédecine en dotant onze centres de santé de kit médico-net (KMN) leur permettant de réaliser des électrocardiogrammes (ECG) en cas de nécessité et de les transmettre via Internet pour analyse par un cardiologue du CHU de Bouaké (au centre de la Côte d’Ivoire) de septembre 2008 à février 2014. Résultats Dix centres ont effectué 689 télé-ECG qui ont été lus par le cardiologue du CHU de Bouaké. La ville de Korhogo (Nord de la Côte d’Ivoire) avec 328 télé-ECG (47,6 %) a réalisé le plus de télétransmissions d’ECG. L’hypertension artérielle avec 25 % a été le motif le plus fréquent de la demande de télé-ECG et l’anomalie ECG la plus retrouvée était l’hypertrophie ventriculaire gauche dans 36 % des cas. Quatre diagnostics de syndrome coronarien STEMI (0,7 %) ont été retrouvés et les troubles du rythme en général ont représenté 7,2 % des anomalies. Conclusion La téléexpertise pour l’interprétation des ECG en Côte d’Ivoire est une application de télémédecine simple, réalisable et efficace qui contribue au diagnostic et à la prise en charge de certaines pathologies cardiovasculaires. Summary Context The management of cardiovascular diseases demands accessibility to specialists. In the Ivory Coast, this specialized management of cardiovascular diseases is feasible only in the south of this country, at the Cardiology Institute in Abidjan. Objective The purpose of this study was to demonstrate the effectiveness of a telecardiology project in the management of cardiovascular diseases in black Africa. Materials and methods We established a telemedicine network by providing eleven health centers with “Medico-net” kits (MNK), allowing them to perform electrocardiograms (ECGs) when necessary and transmit them via the Internet for analysis by an expert cardiologist at the University Hospital of Bouaké (located at the center of the Ivory Coast) from September 2008 to February 2014. Results Of the eleven pre-selected centers, ten centers performed 689 tele-ECGs that were read by the cardiologist of the University Hospital of Bouaké. The city of Korhogo (in northern Ivory Coast), with 328 tele-ECGs (47.6%), was the most active site in the realization and the teletransmission of ECGs. The most frequent motive for requesting a tele-ECG was hypertension in 25% of cases; left ventricular hypertrophy was the most frequent anomaly found on ECG in 36% of cases. Four diagnoses of acute coronary syndrome STEMI (0.7%) were made and arrhythmia generally represented 7.2% of the anomalies found. Conclusion Using tele-expertise for the interpretation of ECGs in the Ivory Coast is a simple, practicable and effective application of telemedicine which contributes to the diagnosis and to the management of some cardiovascular diseases. [ABSTRACT FROM AUTHOR]

One of the main reasons that leads to a low adoption rate of telemedicine systems is poor usability. An aspect that influences usability during the reporting of findings is the input mode, e.g., if a free-text (FT) or a structured report (SR) interface is employed. The objective of our study is to compare the usability of FT and ST telemedicine systems, specifically in terms of user satisfaction, efficiency and general usability. We comparatively evaluate the usability of these two input modes in a telecardiology system for issuing electrocardiography reports in the context of a statewide telemedicine system in Brazil with more than 350.000 performed tele-electrocardiography examinations. We adopted a multiple method research strategy, applying three different kinds of usability evaluations: user satisfaction was evaluated through interviews with seven medical professionals using the System Usability Scale (SUS) questionnaire and specific questions related to adequacy and user experience. Efficiency was evaluated by estimating execution time using the Keystroke-Level Model (KLM). General usability was assessed based on the conformity of the systems to a set of e-health specific usability heuristics. The results of this comparison provide a first indication that a structured report (SR) input mode for such a system is more satisfactory and efficient with a larger conformity to usability heuristics than free-text (FT) input. User satisfaction using the SUS questionnaire has been scored in average with 58.8 and 77.5 points for the FT and SR system, respectively, which means that the SR system was rated 18.65 points higher than the FT system. In terms of efficiency, the completion of a findings report using the SR mode is estimated to take 8.5 s, 3.74 times faster than using the FT system (31.8 s). The SR system also demonstrated less violations to usability heuristics (8 points) in comparison to 14 points observed in the FT system. These results provide a first indication that the usage of structured reporting as an input mode in telecardiology systems may enhance usability. This also seems to confirm the advantages of the usage of structured reporting, as already described in the literature for other areas such as teleradiology. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is one of the most widespread health problems with unpredictable and life-threatening consequences. The electrocardiogram (ECG) is commonly recorded for computer-aided CVD diagnosis, human emotion recognition and person authentication systems. For effective detection and diagnosis of cardiac diseases, the ECG signals are continuously recorded, processed, stored, and transmitted via wire/wireless communication networks. But long-term continuous cardiac monitoring system generates huge volume of ECG data daily. Therefore, a reliable and efficient ECG signal compression method is highly demanded to meet the real-time constraints including limited channel capacity, memory and battery-power of remote cardiac monitoring, ECG record management and telecardiology systems. In such scenarios, the main objective of the ECG signal compression is to reduce the data rate for effective transmission and/or storage purposes without significantly distorting the clinical features of different kinds of PQRST morphologies contained in the recorded ECG signal. Numerous ECG compression methods have been proposed by exploiting the intra-beat correlation, inter-beat correlation and intra-channel correlation of the ECG signals. This paper presents a prospective review of wavelet-based ECG compression methods and their performances based upon findings obtained from various experiments conducted using both clean and noisy ECG signals. This paper briefly describes different kinds of compression techniques used in the one-dimensional wavelet-based ECG compression methods. Then, the performance of each of the wavelet-based compression methods is tested and validated using the standard MIT-BIH arrhythmia databases and performance metrics. The pros and cons of different wavelet-based compression methods are demonstrated based upon the experimental results. Finally, various practical issues involved in the validation procedures, reconstructed signal quality assessment, and performance comparisons are highlighted by considering the future research studies based on the recent powerful digital signal processing techniques and computing platform. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Research in Telemedicine / La Recherche Européenne en Télémédecine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Research in Telemedicine / La Recherche Européenne en Télémédecine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: This paper proposes a SCP-ECG security extension after having analyzed the features of this standard, its security requirements and the current measures implemented by other medical protocols. Our approach permits SCP-ECG files to be stored safely and proper access to be granted (or denied) to users for different purposes: interpretation of the test, consultation, clinical research or teaching. The access privileges are scaled by means of role-based profiles supported by cryptographic elements (ciphering, digital certificates and digital signatures). These elements are arranged as metadata into a new section which extends the protocol and protects the remaining sections. The application built to implement this approach has been extensively tested, showing its capacity to authenticate users and to protect the integrity of files and the privacy of sensitive data, with a low impact on file size and access time. In addition, this solution is compatible with any version of the SCP-ECG and can be easily integrated into e-health platforms. [Copyright &y& Elsevier]

Copyright of European Research in Telemedicine / La Recherche Européenne en Télémédecine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of IRBM is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Today''s coronary care unit patients include those with complicated and uncomplicated myocardial infarction, decompensated heart failure and frank cardiogenic shock, severe valvular heart disease, high-grade conduction disturbances, and incessant ventricular arrhythmias. Increasingly in modern medicine, these conditions are not seen in isolation but rather in connection with a series of additional medical comorbidities. Increased life expectancy results in an increase in the prevalence of chronic cardiovascular diseases and an increased demand for health care services. Telemedicine is the provision of health care services, through the use of information and communication technology, in situations where the health care professional and the patient, or 2 health care professionals, are not in the same location. It involves the secure transmission of medical data and information, through text, sound, images, or other forms needed for the prevention, diagnosis, treatment, and follow-up of a patient. Telecardiology is one of the oldest applications in telemedicine and has been largely applied during the last 10 to 20 years. This study evaluated the feasibility of remote surveillance of coronary care unit and cardiology ward patient monitoring data by a “telecardiologist” with access to electronic health care record data and digitally stored 12-lead electrocardiograms. The remote access to the hospital intranet proved to be technically feasible. Also, the server applications used over the remote connection proved to be reliable and showed robustness against network performance variations. Extending remote patient surveillance to other hospitals is possible, provided that similar electrocardiogram and electronic health care record applications are available and a remote access can be arranged to them. However, the usability from cardiologist''s perspective may be degraded if connecting with multiple applications and hospital networks is needed. The study indicated potential for speeding up the diagnostic and therapeutic processes in the hospital, although the study was limited in that the telecardiologist played a passive role and did not acutely impact patient care. In the future, the system could be expanded to surveillance of smaller hospitals. Telemedicine has the potential to aid in solving the conflict between aging of population, rise in the demand for critical care services, and shortage of professional personnel. This might, however, require a more active remote surveillance than the one tested in this study. Privacy- and security-related aspects are major components of building trust and confidence in telemedicine systems. In telecardiology, the real-time interactive telemedicine model with 24/7 service has potential superior performance compared with a store-and-forward telemedicine model. [Copyright &y& Elsevier]

Abstract: In this paper, two novel and simple, target distortion level (TDL) and target data rate (TDR), Wavelet threshold based ECG compression algorithms are proposed for real-time applications. The issues on the use of objective error measures, such as percentage root mean square difference (PRD) and root mean square error (RMSE) as a quality measures, in quality controlled/guranteed algorithm are investigated with different sets of experiments. For the proposed TDL and TDR algorithm, data rate variability and reconstructed signal quality is evaluated under different ECG signal test conditions. Experimental results show that the TDR algorithm achieves the required compression data rate to meet the demands of wire/wireless link while the TDL algorithm does not. The compression performance is assessed in terms of number of iterations required to achieve convergence and accuracy, reconstructed signal quality and coding delay. The reconstructed signal quality is evaluated by correct diagnosis (CD) test through visual inspection. Three sets of ECG data from three different databases, the MIT-BIH Arrhythmia (mita) ( Hz, 11b/sample), the Creighton University Ventricular Tachyarrhythmia (cuvt) ( Hz, 12b/sample) and the MIT-BIH Supraventricular Arrhythmia (mitsva) ( Hz, 10b/sample), are used for this work. For each set of ECG data, the compression ratio (CR) range is defined. The CD value of 100% is achieved for CR 12, CR 8 and CR 4 for data from mita, cuvt and mitsva databases, respectively. The experimental results demonstrate that the proposed TDR algorithm is suitable for real-time applications. [Copyright &y& Elsevier]

Copyright of European Research in Telemedicine / La Recherche Européenne en Télémédecine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)