Utility of routine data sources for feedback on the quality of cancer care: an assessment based on clinical practice guidelines

Background Not all cancer patients receive state-of-the-art care and providing regular feedback to clinicians might reduce this problem. The purpose of this study was to assess the utility of various data sources in providing feedback on the quality of cancer care. Methods Published clinical practice guidelines were used to obtain a list of processes-of-care of interest to clinicians. These were assigned to one of four data categories according to their availability and the marginal cost of using them for feedback. Results Only 8 (3%) of 243 processes-of-care could be measured using population-based registry or administrative inpatient data (lowest cost). A further 119 (49%) could be measured using a core clinical registry, which contains information on important prognostic factors (e.g., clinical stage, physiological reserve, hormone-receptor status). Another 88 (36%) required an expanded clinical registry or medical record review; mainly because they concerned long-term management of disease progression (recurrences and metastases) and 28 (11.5%) required patient interview or audio-taping of consultations because they involved information sharing between clinician and patient. Conclusion The advantages of population-based cancer registries and administrative inpatient data are wide coverage and low cost. The disadvantage is that they currently contain information on only a few processes-of-care. In most jurisdictions, clinical cancer registries, which can be used to report on many more processes-of-care, do not cover smaller hospitals. If we are to provide feedback about all patients, not just those in larger academic hospitals with the most developed data systems, then we need to develop sustainable population-based data systems that capture information on prognostic factors at the time of initial diagnosis and information on management of disease progression.

Improving visual noise insensitivity in small vocabulary audio visual speech recognition applications

Visual noise insensitivity is important to audio visual speech recognition (AVSR). Visual noise can take on a number of forms such as varying frame rate, occlusion, lighting or speaker variabilities. The use of a high dimensional secondary classifier on the word likelihood scores from both the audio and video modalities is investigated for the purposes of adaptive fusion. Preliminary results are presented demonstrating performance above the catastrophic fusion boundary for our confidence measure irrespective of the type of visual noise presented to it. Our experiments were restricted to small vocabulary applications.

Can audio-visual speech recognition outperform acoustically enhanced speech recognition in automotive environment?

The use of visual features in the form of lip movements to improve the performance of acoustic speech recognition has been shown to work well, particularly in noisy acoustic conditions. However, whether this technique can outperform speech recognition incorporating well-known acoustic enhancement techniques, such as spectral subtraction, or multi-channel beamforming is not known. This is an important question to be answered especially in an automotive environment, for the design of an efficient human-vehicle computer interface. We perform a variety of speech recognition experiments on a challenging automotive speech dataset and results show that synchronous HMM-based audio-visual fusion can outperform traditional single as well as multi-channel acoustic speech enhancement techniques. We also show that further improvement in recognition performance can be obtained by fusing speech-enhanced audio with the visual modality, demonstrating the complementary nature of the two robust speech recognition approaches.

Aerial SLAM with a single camera using visual expectation

Micro aerial vehicles (MAVs) are a rapidly growing area of research and development in robotics. For autonomous robot operations, localization has typically been calculated using GPS, external camera arrays, or onboard range or vision sensing. In cluttered indoor or outdoor environments, onboard sensing is the only viable option. In this paper we present an appearance-based approach to visual SLAM on a flying MAV using only low quality vision. Our approach consists of a visual place recognition algorithm that operates on 1000 pixel images, a lightweight visual odometry algorithm, and a visual expectation algorithm that improves the recall of place sequences and the precision with which they are recalled as the robot flies along a similar path. Using data gathered from outdoor datasets, we show that the system is able to perform visual recognition with low quality, intermittent visual sensory data. By combining the visual algorithms with the RatSLAM system, we also demonstrate how the algorithms enable successful SLAM.

The undirected feedback vertex set problem has a Poly(k) Kernel

Resolving a noted open problem, we show that the Undirected Feedback Vertex Set problem, parameterized by the size of the solution set of vertices, is in the parameterized complexity class Poly(k), that is, polynomial-time pre-processing is sufficient to reduce an initial problem instance (G, k) to a decision-equivalent simplified instance (G', k') where k' � k, and the number of vertices of G' is bounded by a polynomial function of k. Our main result shows an O(k11) kernelization bound.

Assessment of retinal structure and visual function in association with diabetic peripheral neuropathy

Diabetes is an increasingly prevalent disease worldwide. Providing early management of the complications can prevent morbidity and mortality in this population. Peripheral neuropathy, a significant complication of diabetes, is the major cause of foot ulceration and amputation in diabetes. Delay in attending to complication of the disease contributes to significant medical expenses for diabetic patients and the community. Early structural changes to the neural components of the retina have been demonstrated to occur prior to the clinically visible retinal vasculature complication of diabetic retinopathy. Additionally visual functionloss has been shown to exist before the ophthalmoscopic manifestations of vasculature damage. The purpose of this thesis was to evaluate the relationship between diabetic peripheral neuropathy and both retinal structure and visual function. The key question was whether diabetic peripheral neuropathy is the potential underlying factor responsible for retinal anatomical change and visual functional loss in people with diabetes. This study was conducted on a cohort with type 2 diabetes. Retinal nerve fibre layer thickness was assessed by means of Optical Coherence Tomography (OCT). Visual function was assessed using two different methods; Standard Automated Perimetry (SAP) and flicker perimetry were performed within the central 30 degrees of fixation. The level of diabetic peripheral neuropathy (DPN) was assessed using two techniques - Quantitative Sensory Testing and Neuropathy Disability Score (NDS). These techniques are known to be capable of detecting DPN at very early stages. NDS has also been shown as a gold standard for detecting 'risk of foot ulceration'. Findings reported in this thesis showed that RNFL thickness, particularly in the inferior quadrant, has a significant association with severity of DPN when the condition has been assessed using NDS. More specifically it was observed that inferior RNFL thickness has the ability to differentiate individuals who are at higher risk of foot ulceration from those who are at lower risk, indicating that RNFL thickness can predict late-staged DPN. Investigating the association between RNFL and QST did not show any meaningful interaction, which indicates that RNFL thickness for this cohort was not as predictive of neuropathy status as NDS. In both of these studies, control participants did not have different results from the type 2 cohort who did not DPN suggesting that RNFL thickness is not a marker for diagnosing DPN at early stages. The latter finding also indicated that diabetes per se, is unlikely to affect the RNFL thickness. Visual function as measured by SAP and flicker perimetry was found to be associated with severity of peripheral neuropathy as measured by NDS. These findings were also capable of differentiating individuals at higher risk of foot ulceration; however, visual function also proved not to be a maker for early diagnosis of DPN. It was found that neither SAP, nor flicker sensitivity have meaningful associations with DPN when neuropathy status was measured using QST. Importantly diabetic retinopathy did not explain any of the findings in these experiments. The work described here is valuable as no other research to date has investigated the association between diabetic peripheral neuropathy and either retinal structure or visual function.

Visual voice activity detection using frontal versus profile views

Visual activity detection of lip movements can be used to overcome the poor performance of voice activity detection based solely in the audio domain, particularly in noisy acoustic conditions. However, most of the research conducted in visual voice activity detection (VVAD) has neglected addressing variabilities in the visual domain such as viewpoint variation. In this paper we investigate the effectiveness of the visual information from the speaker’s frontal and profile views (i.e left and right side views) for the task of VVAD. As far as we are aware, our work constitutes the first real attempt to study this problem. We describe our visual front end approach and the Gaussian mixture model (GMM) based VVAD framework, and report the experimental results using the freely available CUAVE database. The experimental results show that VVAD is indeed possible from profile views and we give a quantitative comparison of VVAD based on frontal and profile views The results presented are useful in the development of multi-modal Human Machine Interaction (HMI) using a single camera, where the speaker’s face may not always be frontal.

Error analysis and attitude observability of a monocular GPS/visual odometry integrated navigation filter

In this paper, we present a method for the recovery of position and absolute attitude (including pitch, roll and yaw) using a novel fusion of monocular Visual Odometry and GPS measurements in a similar manner to a classic loosely-coupled GPS/INS error state navigation filter. The proposed filter does not require additional restrictions or assumptions such as platform-specific dynamics, map-matching, feature-tracking, visual loop-closing, gravity vector or additional sensors such as an IMU or magnetic compass. An observability analysis of the proposed filter is performed, showing that the scale factor, position and attitude errors are fully observable under acceleration that is non-parallel to velocity vector in the navigation frame. The observability properties of the proposed filter are demonstrated using numerical simulations. We conclude the article with an implementation of the proposed filter using real flight data collected from a Cessna 172 equipped with a downwards-looking camera and GPS, showing the feasibility of the algorithm in real-world conditions.

Ocular aberrations in the peripheral visual field

We modified a commercial Hartmann-Shack aberrometer and used it to measure ocular aberrations across the central 42º horizontal x 32º vertical visual fields of five young emmetropic subjects. Some Zernike aberration coefficients show coefficient field distributions that were similar to the field dependence predicted by Seidel theory (astigmatism, oblique astigmatism, horizontal coma, vertical coma), but defocus did not demonstrate such similarity.