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Sven, Van Poucke, MD Introduction to the...
Chronic wounds:   Problem?
Chronic wounds:   Problem? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic wounds:   Problem? ,[object Object],[object Object],[object Object],[object Object],[object Object],BMJ Clinical Evidence
Chronic wounds:   The overall incidence of venous stasis syndrome and venous ulcer were 76.1 and 18.0 per  100,000 person-years, respectively. The incidence of both was higher in women than in men  (83.7 vs 67.4 per 100,000 person-years for venous stasis syndrome;  20.4 vs 14.6 per 100,000 for venous ulcer) and increased with age for both sexes.  Problem? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic wounds:   Costs Chronic wounds cost the UK over £1  billion each year Chronic wounds cost the nation (USA) $20 billion to $25 billion a year Harding, KG, Morris, HL and Patel, GK. "Healing chronic wounds." BMJ 324: 160-163, 2002
Chronic wounds: the facts Chronic or nonhealing ulcers:  -defective remodeling of the extracellular matrix,  -a failure to reepithelialize,  -and prolonged inflammation.  Monitoring  of acute and chronic wounds:  by  measuring  in an objective, precise, and reproducible way
Middle Ages?
Chronic wounds:  1. the  prevalence and cost  of managing chronic wounds continue to escalate,  2. despite the availability of  advanced wound care products ,  specialists and consultants , and the creation of risk assessment tools and wound healing centers.  3.   serious morbidity and financial costs   precipitated by these wounds,  4. a serious call is made to health care providers, payers, and policymakers   to revisit the way such wounds are managed today.
Chronic wounds: the problem   1.Treatment decisions are based on  visual perception .  2.Descriptive analysis of wounds is  poorly standardized and rarely reproducible . 3.The assessment and measurement of the temporal changes of wounds using digital images  can now be calibrated, reducing the difficulty of obtaining reproducible color content .  The color content of the images becomes  independently of any camera settings and illumination features. 4. Growing demand for randomized clinical trials, health technology assessments and increasing economical pressure on health budgets:  optimal data sharing with standardization and agreements on universals and instances . 5. Consistent, controlled and universally accepted vocabularies seems essential for documenting, describing and comparing wounds. 6.  Ontologies (controlled vocabularies)  promise to help address many of the difficulties currently experienced in managing large image databases.
< > Documentation Assessment
non-invasive wound assessment by image analysis:  Wound bed preparation   - a procedure aimed at assisting clinicians in wound bed assessment and the development of strategies to maximise healing potential  - is now recognised as an important aspect of care. The  Red-Yellow-Black-scheme   is commonly used for classifying chronic wounds. S implified direction for selecting appropriate   dressings for open wounds by focusing on the phase of healing   as evidenced by the predominant condition of the wound base The associated development of the  TIME framework  (Tissue management; Inflammation and infection control; Moisture balance; Epithelial (edge) advancement)  offers clinicians a practical tool for translating wound bed preparation into practice.  Falanga V. Wound bed preparation: science applied to practice. In: European Wound Management Association (EWMA). Position Document.  Wound Bed Preparation in Practice.  London: MEP Ltd, 2004; available from URL:  http://www.ewma.org/ .
 
non-invasive wound assessment by image analysis: wound bed preparation  M Flanagan  The Philosophy of Wound Bed Preparation in Clinical Practice  2003 Preparing the Wound Bed 2003: Focus on infection and inflammation Ostomy Wound management; 49(11):24-51 Sibbald RG, Orsted H, Schultz GS, Coutts P and Keast  D
non-invasive wound assessment bymage analysis: measurement  Wound measurement and assessment  is important for several reasons including: Tracking patient progress to ensure that healing of a specific wound is progressing with the selected treatment regime   Allowing institution managers to audit patient progress and institution effectiveness  Building a reliable and consistent database for outcomes based studies of wound care  Improving patient compliance  Consistently documenting patient care for reimbursement purposes and   for protection of the health care provider against litigation.
some  efficiency some  efficacy something is missing
The Club The Club House
1. a  free accessible database and archive system  for high-quality multidimensional digital images of wounds, with their supporting metadata. 2. anonimized images and their metadata available electronically for personal study, educational (clinical dicision support systems), commercial, medical and scientific research purposes.  3. tools and interfaces to assist in the submission, discovery, downloading and visualization of such images, and making comparisons between them.  4.  links between these images  and relevant items including semantics,  clinical information, ontologies , etc.  5. facilitate effective  data representation and information visualisation  through the construction of adaptive interfaces that meet the needs of individual users.  6. To provide tools for assisting in  annotation of wound images  and the development of ontologies related to these images.  7. To develop  theoretical (mathematical, colorimetric,...) models  related to the language and terminology used by the wound care community.
 
Woundontology Consortium Working Groups 1.  Wound Image Base Working Group  2. Wound Image Visual Diagnostic Expert Group  3. Wound Image Colour, Pattern, Texture and Shape Group 4. Wound Image Ontology Working Group
 
 
Woundontology Consortium Working Groups Wound Image Ontology Working Group: Involvement of domain (clinical) experts in the knowledge elicitation process as preparation of ontology development.
Woundontology Consortium Working Groups Wound Image Ontology Working Group: Involvement of domain (clinical) experts in the knowledge elicitation process as preparation of ontology development.
Woundontology Consortium  The Woundontology Consortium is a semi-open, international, virtual community of practice devoted to advancing the field of research in non-invasive wound assessment by image analysis, ontology and semantic interpretation and knowledge extraction .  Web:  www.woundontology.com Image Server: www.colibrate.com Email: info@woundontology.com Discussion:  http://groups.google.com/group/woundontology   Discussion  Email woundontology@googlegroups.com

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Woundontology Consortium

  • 1. Sven, Van Poucke, MD Introduction to the...
  • 2. Chronic wounds: Problem?
  • 3.
  • 4.
  • 5.
  • 6. Chronic wounds: Costs Chronic wounds cost the UK over £1 billion each year Chronic wounds cost the nation (USA) $20 billion to $25 billion a year Harding, KG, Morris, HL and Patel, GK. &quot;Healing chronic wounds.&quot; BMJ 324: 160-163, 2002
  • 7. Chronic wounds: the facts Chronic or nonhealing ulcers: -defective remodeling of the extracellular matrix, -a failure to reepithelialize, -and prolonged inflammation. Monitoring of acute and chronic wounds: by measuring in an objective, precise, and reproducible way
  • 9. Chronic wounds: 1. the prevalence and cost of managing chronic wounds continue to escalate, 2. despite the availability of advanced wound care products , specialists and consultants , and the creation of risk assessment tools and wound healing centers. 3. serious morbidity and financial costs precipitated by these wounds, 4. a serious call is made to health care providers, payers, and policymakers to revisit the way such wounds are managed today.
  • 10. Chronic wounds: the problem 1.Treatment decisions are based on visual perception . 2.Descriptive analysis of wounds is poorly standardized and rarely reproducible . 3.The assessment and measurement of the temporal changes of wounds using digital images can now be calibrated, reducing the difficulty of obtaining reproducible color content . The color content of the images becomes independently of any camera settings and illumination features. 4. Growing demand for randomized clinical trials, health technology assessments and increasing economical pressure on health budgets: optimal data sharing with standardization and agreements on universals and instances . 5. Consistent, controlled and universally accepted vocabularies seems essential for documenting, describing and comparing wounds. 6. Ontologies (controlled vocabularies) promise to help address many of the difficulties currently experienced in managing large image databases.
  • 11. < > Documentation Assessment
  • 12. non-invasive wound assessment by image analysis: Wound bed preparation - a procedure aimed at assisting clinicians in wound bed assessment and the development of strategies to maximise healing potential - is now recognised as an important aspect of care. The Red-Yellow-Black-scheme is commonly used for classifying chronic wounds. S implified direction for selecting appropriate dressings for open wounds by focusing on the phase of healing as evidenced by the predominant condition of the wound base The associated development of the TIME framework (Tissue management; Inflammation and infection control; Moisture balance; Epithelial (edge) advancement) offers clinicians a practical tool for translating wound bed preparation into practice. Falanga V. Wound bed preparation: science applied to practice. In: European Wound Management Association (EWMA). Position Document. Wound Bed Preparation in Practice. London: MEP Ltd, 2004; available from URL: http://www.ewma.org/ .
  • 13.  
  • 14. non-invasive wound assessment by image analysis: wound bed preparation M Flanagan The Philosophy of Wound Bed Preparation in Clinical Practice 2003 Preparing the Wound Bed 2003: Focus on infection and inflammation Ostomy Wound management; 49(11):24-51 Sibbald RG, Orsted H, Schultz GS, Coutts P and Keast D
  • 15. non-invasive wound assessment bymage analysis: measurement Wound measurement and assessment is important for several reasons including: Tracking patient progress to ensure that healing of a specific wound is progressing with the selected treatment regime  Allowing institution managers to audit patient progress and institution effectiveness Building a reliable and consistent database for outcomes based studies of wound care Improving patient compliance Consistently documenting patient care for reimbursement purposes and for protection of the health care provider against litigation.
  • 16. some efficiency some efficacy something is missing
  • 17. The Club The Club House
  • 18. 1. a free accessible database and archive system for high-quality multidimensional digital images of wounds, with their supporting metadata. 2. anonimized images and their metadata available electronically for personal study, educational (clinical dicision support systems), commercial, medical and scientific research purposes. 3. tools and interfaces to assist in the submission, discovery, downloading and visualization of such images, and making comparisons between them. 4. links between these images and relevant items including semantics, clinical information, ontologies , etc. 5. facilitate effective data representation and information visualisation through the construction of adaptive interfaces that meet the needs of individual users. 6. To provide tools for assisting in annotation of wound images and the development of ontologies related to these images. 7. To develop theoretical (mathematical, colorimetric,...) models related to the language and terminology used by the wound care community.
  • 19.  
  • 20. Woundontology Consortium Working Groups 1. Wound Image Base Working Group 2. Wound Image Visual Diagnostic Expert Group 3. Wound Image Colour, Pattern, Texture and Shape Group 4. Wound Image Ontology Working Group
  • 21.  
  • 22.  
  • 23. Woundontology Consortium Working Groups Wound Image Ontology Working Group: Involvement of domain (clinical) experts in the knowledge elicitation process as preparation of ontology development.
  • 24. Woundontology Consortium Working Groups Wound Image Ontology Working Group: Involvement of domain (clinical) experts in the knowledge elicitation process as preparation of ontology development.
  • 25. Woundontology Consortium The Woundontology Consortium is a semi-open, international, virtual community of practice devoted to advancing the field of research in non-invasive wound assessment by image analysis, ontology and semantic interpretation and knowledge extraction . Web: www.woundontology.com Image Server: www.colibrate.com Email: info@woundontology.com Discussion: http://groups.google.com/group/woundontology Discussion Email woundontology@googlegroups.com