Why rankings of biomedical image analysis competitions should be interpreted with care.

International challenges have become the standard for validation of biomedical image analysis methods. Given their scientific impact, it is surprising that a critical analysis of common practices related to the organization of challenges has not yet been performed. In this paper, we present a comprehensive analysis of biomedical image analysis challenges conducted up to now. We demonstrate the importance of challenges and show that the lack of quality control has critical consequences. First, reproducibility and interpretation of the results is often hampered as only a fraction of relevant information is typically provided. Second, the rank of an algorithm is generally not robust to a number of variables such as the test data used for validation, the ranking scheme applied and the observers that make the reference annotations. To overcome these problems, we recommend best practice guidelines and define open research questions to be addressed in the future.

Calidad en rehabilitación e indicadores de efectividad / Quality in rehabilitation and indicators of effectiveness

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El psicoanálisis en tiempos de la tecnocultura: algunas reflexiones sobre el destino del cuerpo en el espacio virtual / Psychoanalysis in times of technoculture: some reflections on the fate of the body in virtual space

La autora constata la creciente presencia en la vida contemporánea de la tecnocultura y el ciberespacio. Partiendo de la ya polémica contraposición freudiana entre la realidad fáctica y la realidad psíquica (con elementos virtuales por definición), se pregunta por la influencia psíquica de los mundos virtuales que ofrecen internet y el ciberespacio. Se adentra en la complejidad de algunos de ellos, como Second Life o diferentes programas de investigación en que el protagonista puede habitar diferentes cuerpos o avatares en el mundo virtual. Presenta la experiencia de un proceso analítico con un paciente que motu proprio hace uso primero de vídeos y chats que va llevando como material a su analista, para más adelante pasar a experiencias virtuales con contacto visual con otros, y finalmente a contactos en la realidad fáctica. Analiza la trascendencia para el paciente de estos intercambios progresivos para asumir y desarrollar aspectos de su imagen corporal e identidad sexual. La autora propone el mundo del ciberespacio como un espacio potencial para la experimentación y progresiva elaboración psíquica y que podría ser considerado en los procesos psicoanalíticos como material de utilidad para el crecimiento y la maduración psíquica (AU)

The author notes the increasing presence of techno-culture an cyberspace in contemporary life. Starting from the already controversial Freudian opposition between factual reality and psychic reality (with virtual elements by definition), she questions the psychic influence of the virtual worlds offered by the internet and cyberspace. She explores the complexity of some of these, such as Second Life and various other programs for experimentation in which the protagonist may inhabit different bodies or avatars in the virtual world. She presents the experience of an analytic process with a patient who, of his own accord, first makes use of videos and chat rooms, which he brings to his analyst as material, to later move on to virtual experiences with visual contact with others, and finally to contact in factual reality. She analyzes the significance for the patient of these progressive exchanges in coming to terms with and developing aspects of his body image and sexual identity. The author puts forward the world of cyberspace as a potential space for experimentation and progressive psychic elaboration and suggests that it might be considered in psychoanalytic processes as useful material for psychic growth and maturation (AU)

Comentario al trabajo de Alessandra Lemma "El psicoanálisis en tiempos de la tecnocultura: algunas reflexiones sobre el destino del cuerpo en el espacio virtual" / No disponible

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App-synopsis: self-assessment on trust or distrust of health-apps.

Mobile devices and the apps running on them have become an integral part of daily life and this also includes the areas of medicine and health. Target audiences include those interested in their health, patients, and professional users. Nevertheless, the sheer number of available apps makes it hard for users to decide whether an app they are interested in is trustable or not. Nevertheless, such a decision should be based on a careful analysis of the available information. If left to their own devices, especially casual users may tend to forget certain aspects when performing such an evaluation. In order to provide them with a guideline on how to perform their evaluations, we propose a checklist covering the most important aspects for deciding whether an app can be entrusted with information that - especially when it comes to personal, health related information - is usually of a highly sensitive nature.

High intensity, multimodality and incoherence: grand challenges in the analysis of data for health-enabling technologies.

When working with health-enabling technologies, researchers all over the world usually have to analyze highly intensive, multimodal and incoherent data. We explain that there is a lack of systematization within the set of methods of analysis suitable for these data. As a first step towards a methodology in this context, we present the Systematic Nomenclature for Contexts, Analysis Methods and Problems in Health-Enabling Technologies (SNOCAP-HET).

Setting the scene: taxonomy of personal health monitoring.

In order to provide a systematic basis for communication in trans-disciplinary research projects, there is a need for taxonomies and ontologies. Our developed taxonomy of personal health monitoring (PHM) is based on a systematic literature review and an iterative adaption process with trans-disciplinary partners. The construction method of the taxonomy is an ongoing process and need regularly updates.

[Evaluation of new and emerging health technologies. Proposal for classification]. / Evaluación de tecnologías sanitarias nuevas y emergentes. Propuesta de clasificación.

AIMS: Review and develop a proposal for the classification of health technologies (HT) evaluated by the Health Technology Assessment Agencies (HTAA). DESIGN: Peer review of AETS of the previous proposed classification of HT. Analysis of their input and suggestions for amendments. Construction of a new classification. Pilot study with physicians. SETTING: Andalusian Public Health System. Spanish HTAA. PARTICIPANTS: Experts from HTAA. Tutors of family medicine residents. METHOD: HT Update classification previously made by the research team. Peer review by Spanish HTAA. Qualitative and quantitative analysis of responses. Construction of a new and pilot study based on 12 evaluation reports of the HTAA. RESULTS: We obtained 11 thematic categories that are classified into 6 major head groups: 1, prevention technology; 2, diagnostic technology; 3, therapeutic technologies; 4, diagnostic and therapeutic technologies; 5, organizational technology, and 6, knowledge management and quality of care. In the pilot there was a good concordance in the classification of 8 of the 12 reports reviewed by physicians. CONCLUSIONS: Experts agree on 11 thematic categories of HT. A new classification of HT with double entry (Nature and purpose of HT) is proposed. APPLICABILITY: According to experts, the classification of the work of the HTAA may represent a useful tool to transfer and manage knowledge. Moreover, an adequate classification of the HTAA reports would help clinicians and other potential users to locate them and this can facilitate their dissemination.

Scanning the horizon of obsolete technologies: possible sources for their identification.

OBJECTIVES: The aim of this study was to identify and rank the sources for the detection of potentially obsolete technologies (POTs). METHODS: A specific questionnaire related to the search strategies and sources used for the identification of POTs and also for ineffective, inefficient or harmful health technologies was sent to the Health Technology Assessment International's Information Resources Group (HTAi-IRG) group. With the obtained information and taking into account the sources used for the identification of new and emerging technologies, a second questionnaire was elaborated and sent to EuroScan and International Network of Agencies for Health Technology Assessment (INAHTA) members, who had to select and score them. For the final ranking, the number of votes and the median score were taken into account. RESULTS: Seven HTAi-IRG members answered to the first questionnaire. Seventeen agencies answered to the second one (thirteen EuroScan members and four more members from INAHTA), but only seven had worked in the identification of POTs and one of them using only experts for it. The remaining six agencies answered the part related to devices, diagnostics, and procedures; five of them did it for settings and programmes and only three for drugs. The Canadian Agency for Drugs and Technologies in Health (5 votes; median = 2), Cochrane Collaboration (5 votes; median = 3), NICE (4 votes; median = 1), Food and Drug Administration (4 votes; median = 1.5), and EuroScan (4 votes, median = 2) were the most relevant sources for devices and diagnostics. CONCLUSIONS: There is little experience on POTs identification. The identified sources provide mostly indirect information and further research should take place to determine the best use of them.

Health technology assessment for radiologists: basic principles and evaluation framework.

Decision makers are faced with the task of allocating health resources to maximize patients' health under budget constraints. To offer structure to the complexity of the decision-making process, the field of health technology assessment (HTA) was developed. This paper offers an introduction to the fundamental aspects of HTA and acts as a guide to the conduct of HTA for radiologists. First, the authors define HTA and describe how it is linked to the field of diagnostics. Second, a basic 11-step framework for the conduct of an HTA is outlined. The framework begins with the identification of the problem and proceeds through to the dissemination and impact of an HTA. Third, the authors provide a real-world example of an HTA in the field of diagnostics. Last, they describe the challenges and barriers faced in HTA.

Health technology assessment and primary data collection for reducing uncertainty in decision making.

BACKGROUND: Health care expenditures continue to escalate, and pressures for increased spending will continue. Health care decision makers from publicly financed systems, private insurance companies, or even from individual health care institutions, will continue to be faced with making difficult purchasing, access, and reimbursement decisions. As a result, decision makers are increasingly turning to evidence-based platforms to help control costs and make the most efficient use of existing resources. Most tools used to assist with evidence-based decision making focus on clinical outcomes. HEALTH TECHNOLOGY ASSESSMENT: Health technology assessment (HTA) is increasing in popularity because it also considers other factors important for decision making, such as cost, social and ethical values, legal issues, and factors such as the feasibility of implementation. In some jurisdictions, HTAs have also been supplemented with primary data collection to help address uncertainty that may still exist after conducting a traditional HTA. ROLE OF PRIMARY DATA COLLECTION: The HTA process adopted in Ontario, Canada, is unique in that assessments are also made to determine what primary data research should be conducted and what should be collected in these studies. In this article, concerns with the traditional HTA process are discussed, followed by a description of the HTA process that has been established in Ontario, with a particular focus on the data collection program followed by the Programs for Assessment of Technology in Health Research Institute. An illustrative example is used to show how the Ontario HTA process works and the role value of information analyses plays in addressing decision uncertainty, determining research feasibility, and determining study data collection needs.

Health technology assessment: a review of international activity and examples of approaches with computed tomographic colonography.

The growth of health technology assessment (HTA) internationally is currently reflected in the growing membership of the International Network of Agencies for Health Technology Assessment. Many national and regional HTA institutions emerged in the 1980s and 1990s, and more recently, HTA has emerged in newly industrialized countries and in European Union member states in transition. Health technology assessment activities are becoming an increasingly important part of health care culture, with the appearance of HTA units in hospitals and hospital departments. This article provides a brief overview of who conducts HTA internationally and looks at how HTA is conducted and how this information is used. To highlight the different structures, processes, and methods available, a portion of this article is dedicated to describing different approaches that have been observed with respect to the assessment of computed tomographic colonography in North America for population-based colorectal cancer screening.

Development of a taxonomy for health information technology.

Taxonomies provide schemas to help classify entities and define the relationships between them. Early computing enabled the development of ontologies and Medical Subject Headings (MeSH), the first modern classification of medical terminology as applied to medical literature. Later developments, such as MEDLINE, expanded MeSH to include a number of medical informatics terms. However, a lack of specificity in MeSH and other existing informatics taxonomies for terminology used to describe the growing field of health information technology (health IT) created the need for the development of a specialized taxonomy. Experts associated with the Agency for Healthcare Research and Quality (AHRQs) National Resource Center for Health Information Technology (NRC) created and evaluated a taxonomy for health IT, to enable users of a public health IT Web site to efficiently identify resources within an online, searchable repository.

Pharmacoeconomics and immunotherapy.

Pharmacoeconomics is a relatively new discipline whose scope is to describe, measure and compare costs and outcomes of alternative healthcare programmes from a variety of perspectives. This article is aimed at describing the various types of pharmacoeconomics analyses, indicating what types of costs and outcomes could be measured within each type of study, summarising the value of modelling techniques in pharmacoeconomics studies and finally suggesting what kind of pharmacoeconomic research can usefully be conducted in order to appreciate the burden of respiratory allergic disease and to evaluate the economic impact of health technologies that can effectively be used to manage it. Pharmacoeconomics is a relatively recent discipline whose use has been spread by the necessity of decision makers in most industrialised countries, to gain understanding of the economic effect of medical technologies in parallel with their clinical performance: only a wider use of the techniques of pharmacoeconomics analysis, together with an increasing willingness of the scientific community to understand the mechanics and appreciate the added value of pharmacoeconomics analysis, can help the discipline to proceed and provide further improvement to the healthcare system and to the society.

Year 2006 update of the Israel National List of Health Services.

In Israel, updating of the National List of Health Services is performed on a yearly basis by means of a systematic and structured mechanism for almost a decade. The existence of such a mechanism is vital for keeping medicine up to date, since many innovative and breakthrough medical technologies continuously and frequently evolve. The 2006 update is unique in several aspects, relating both to the mechanism and to the decision-making process. In this article we describe notable issues that arose during the current process: modifications to the update mechanism, the four-phase increase in allocated resources to fund the addition of new medical technologies (including the addition of finances at the expense of the 2007 planned budget), and public funding for high-cost therapies. Finally, we discuss the impact of medical advances on healthcare costs and a suggested constant annual addition to the budget.