Applying data mining techniques to medical time series: an empirical case study in electroencephalography and stabilometry.

One of the major challenges in the medical domain today is how to exploit the huge amount of data that this field generates. To do this, approaches are required that are capable of discovering knowledge that is useful for decision making in the medical field. Time series are data types that are common in the medical domain and require specialized analysis techniques and tools, especially if the information of interest to specialists is concentrated within particular time series regions, known as events. This research followed the steps specified by the so-called knowledge discovery in databases (KDD) process to discover knowledge from medical time series derived from stabilometric (396 series) and electroencephalographic (200) patient electronic health records (EHR). The view offered in the paper is based on the experience gathered as part of the VIIP project. Knowledge discovery in medical time series has a number of difficulties and implications that are highlighted by illustrating the application of several techniques that cover the entire KDD process through two case studies. This paper illustrates the application of different knowledge discovery techniques for the purposes of classification within the above domains. The accuracy of this application for the two classes considered in each case is 99.86% and 98.11% for epilepsy diagnosis in the electroencephalography (EEG) domain and 99.4% and 99.1% for early-age sports talent classification in the stabilometry domain. The KDD techniques achieve better results than other traditional neural network-based classification techniques.

Nanoinformatics: developing new computing applications for nanomedicine.

Nanoinformatics has recently emerged to address the need of computing applications at the nano level. In this regard, the authors have participated in various initiatives to identify its concepts, foundations and challenges. While nanomaterials open up the possibility for developing new devices in many industrial and scientific areas, they also offer breakthrough perspectives for the prevention, diagnosis and treatment of diseases. In this paper, we analyze the different aspects of nanoinformatics and suggest five research topics to help catalyze new research and development in the area, particularly focused on nanomedicine. We also encompass the use of informatics to further the biological and clinical applications of basic research in nanoscience and nanotechnology, and the related concept of an extended "nanotype" to coalesce information related to nanoparticles. We suggest how nanoinformatics could accelerate developments in nanomedicine, similarly to what happened with the Human Genome and other -omics projects, on issues like exchanging modeling and simulation methods and tools, linking toxicity information to clinical and personal databases or developing new approaches for scientific ontologies, among many others.

Costs and added value of haemodialysis and peritoneal dialysis outsourcing agreements.

BACKGROUND: Despite the discrepancy in results from Spanish studies on the costs of dialysis, it is assumed that peritoneal dialysis (PD) is more efficient than haemodialysis (HD). OBJECTIVES: To analyse the costs and added value of HD and PD outsourcing agreements in Galicia, the medical transport for HD and the relationship between the cost of the agreement and the cost of consumables used in continuous ambulatory peritoneal dialysis (CAPD) with bicarbonate. METHODS: The cost of the outsourcing agreements and the staff was obtained from official publications. The cost of PD and medical transport were calculated using health service data for one month and extrapolating it to one year. The cost of CAPD consumables was provided by the suppliers. The added value was calculated from the investments generated for each agreement treating 40 patients. RESULTS: Expressed as patient/year, the mean costs for treatment were €21595 and €25664 in HD and PD, respectively. Medical transport varied between €3323 and €6338, while those of the CAPD agreement and consumables were €19268 and €12057, respectively. The added value was greater with the HD agreement, especially considering the jobs created. CONCLUSIONS: One cannot generalise that the cost of PD, which is significantly influenced by prescriptions, is lower than that of HD. It would be appropriate to review the additional cost to consumables in the CAPD agreement. The added value generated by dialysis agreements should be considered in future studies and in health planning. More controlled studies are needed to better understand this issue.

Costes y valor añadido de los conciertos de hemodiálisis y diálisis peritoneal / Costs and added value of haemodialysis and peritoneal dialysis outsourcing agreements

Antecedentes: A pesar de los resultados discrepantes en estudios españoles sobre costes de diálisis, se asume que la diálisis peritoneal (DP) es más eficiente que la hemodiálisis (HD). Objetivos: Analizar los costes del concierto de HD y DP en Galicia y su valor añadido, los del transporte sanitario para HD y la relación en diálisis peritoneal continua ambulatoria (DPCA) con bicarbonato entre el coste del concierto y el del fungible utilizado. Métodos: El coste de los conciertos y del personal se obtuvo de publicaciones oficiales. Los de DP y del transporte sanitario se calcularon con datos del servicio de salud de un mes, extrapolados a un año. El del fungible de DPCA fue facilitado por proveedores. El valor añadido se estimó con las inversiones generadas por cada concierto tratando 40 pacientes. Resultados: Expresados por paciente/año, los costes medios del tratamiento fueron 21.595 y 25.664 € en HD y DP, respectivamente; los del trasporte sanitario oscilaron entre 3.323 y 6.338 € y los del concierto y fungible de DPCA fueron 19.268 y 12.057 €, respectivamente. El valor añadido fue superior con el concierto de HD, destacando los puestos de trabajo generados. Conclusiones: No puede generalizarse la afirmación de que el coste de DP, muy influenciado por la prescripción, es inferior al de HD. Convendría revisar el coste adicional al fungible en el concierto de DPCA. El valor añadido generado por los conciertos de diálisis debería considerarse en futuros estudios y en la planificación sanitaria. Se necesitan más estudios controlados para conocer mejor esta cuestión (AU)

Background: Despite the discrepancy in results from Spanish studies on the costs of dialysis, it is assumed that peritoneal dialysis (PD) is more efficient than haemodialysis (HD). Objectives: To analyse the costs and added value of HD and PD outsourcing agreements in Galicia, the medical transport for HD and the relationship between the cost of the agreement and the cost of consumables used in continuous ambulatory peritoneal dialysis (CAPD) with bicarbonate. Methods: The cost of the outsourcing agreements and the staff was obtained from official publications. The cost of PD and medical transport were calculated using health service data for one month and extrapolating it to one year. The cost of CAPD consumables was provided by the suppliers. The added value was calculated from the investments generated for each agreement treating 40 patients. Results: Expressed as patient/year, the mean costs for treatment were €21 595 and €25 664 in HD and PD, respectively. Medical transport varied between €3323 and €6338, while those of the CAPD agreement and consumables were €19 268 and €12 057, respectively. The added value was greater with the HD agreement, especially considering the jobs created. Conclusions: One cannot generalise that the cost of PD, which is significantly influenced by prescriptions, is lower than that of HD. It would be appropriate to review the additional cost to consumables in the CAPD agreement. The added value generated by dialysis agreements should be considered in future studies and in health planning. More controlled studies are needed to better understand this issue (AU)

Hemotórax como forma de presentación de angiosarcoma cardíaco / Cardiac angiosarcoma presenting as hemothorax

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[Clinical usefulness and cost-effectiveness of transbronchial needle aspiration for the diagnosis of mediastinal adenopathy]. / Utilidad clínica y coste-efectividad de la punción-aspiración transbronquial en el diagnóstico de adenopatías mediastínicas.

Transbronchial needle aspiration (TBNA) of mediastinal or hilar enlarged lymph nodes is a useful and safe technique. Nevertheless, its use has not become widespread, and the necessity of a specific training to obtain good results has been reported. In order to evaluate the clinical usefulness and cost-effectiveness of TBNA in inexperienced brochoscopists in this technique, a prospective study was conducted of this technique used in all patients with a chest CT with paratracheobronchial lymph nodes larger than 10 mm who had a fiberbronchoscopy ordered. TBNA was performed in 66 lymph node staging in 59 patients. In 76% of cases adequate specimens were obtaned, and a cytohistologic diagnosis was established in 59%. In 44% of patients, TBNA avoided other more invasive diagnostic procedures. Had TBNA not been performed, cost was estimated to have been at least five times higher. We conclude that TBNA could be a useful cost-effective technique in inexperienced teams.

Utilidad clínica y coste-efectividad de la punción-aspiración transbronquial en el diagnóstico de adenopatías mediastínicas / Clinical usefulness and cost-effectiveness of the transbronchial needle aspiration for the diagnosis of mediastinal lymph node enlargement

La punción-aspiración transbronquial (PATB) de adenopatías mediastínicas o hiliares es una técnica útil y segura. Sin embargo, su uso no se ha generalizado, describiéndose la necesidad de un entrenamiento específico para la obtención de buenos resultados. Con el objetivo de evaluar la utilidad clínica y el coste-efectividad de la PATB en broncoscopistas sin experiencia previa en la misma hemos realizado de forma prospectiva esta técnica a todos los pacientes con una tomografía axial computarizada (TAC) torácica con adenopatías paratraqueobronquiales mayores de 10 mm y a los que se les había solicitado una fibrobroncoscopia. Se realizó la PATB en 66 estaciones ganglionares de 59 pacientes. En el 76 por ciento de los casos se obtuvieron muestras adecuadas, pudiéndose realizar un diagnóstico citohistológico en el 59 por ciento. La PATB evitó en el 44 por ciento de los pacientes la realización de otros procedimientos más cruentos para el diagnóstico. De no haberse realizado la PATB estimamos que el coste hubiera sido como mínimo 5 veces superior. Concluimos que la PATB podría ser una técnica con una buena rentabilidad y coste-efectividad en equipos sin experiencia previa en la misma (AU)

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