Research & Education

In addition to providing affordable and accessible health care, the ITW model of sustainability is built on education.  Our “train the trainer model ” is essential to promoting local ownership and professional development in country.  We also collaborate with like-minded organizations to offer accelerated and on-line teaching modules that promote continuing education and lifelong learning skills.

Imaging the World also supports education domestically by providing opportunities for students and professors to engage in educational projects, fieldwork, research projects and scholarships.

Publications

ITW is conducting multiple projects at the University of Vermont to test additional protocols addressing long bone trauma, chest and abdominal trauma (eFast), pediatrics and breast cancer diagnosis.


Category: Obstetrics  Year: 2014

Title: Ancillary benefits of antenatal ultrasound: an association between the introduction of a low-cost ultrasound program and an increase in the numbers of women receiving recommended antenatal treatments.

Summary: This was a prospective study of 577 pregnant women presenting to a rural clinic in Uganda from July 27, 2010–June 30, 2011. An enriched subset of 57 women was selected for analysis. Each woman underwent a standard obstetric protocol performed by a professionally-trained clinic-based ultrasonographer, and a second using a previously described, surface anatomy-guided protocol performed by a front-line health worker. Four experts trained in diagnostic ultrasonography determined intrauterine pregnancy, fetal number, fetal presentation, placental position, amniotic fluid volume, and free pelvic fluid. Responses were dichotomized into normal or abnormal. Concordance in diagnostic outcomes was measured using sensitivity and specificity. Inter-rater agreement was also calculated.

Read the Abstract

Ross AB, DeStigter KK, Coutinho A, et al. Ancillary benefits of antenatal ultrasound: an association between the introduction of a low-cost ultrasound program and an increase in the numbers of women receiving recommended antenatal treatments. BMC Pregnancy and Childbirth. 2014;14:424. doi:10.1186/s12884-014-0424-9.

 


Category: Obstetrics – Concordance  Year: 2013

Title: Diagnostic performance of a simplified, low-cost ultrasound protocol in the recognition of common prenatal diagnoses.

Summary: This was a prospective study of 577 pregnant women presenting to a rural clinic in Uganda from July 27, 2010–June 30, 2011. An enriched subset of 57 women was selected for analysis. Each woman underwent a standard obstetric protocol performed by a professionally-trained clinic-based ultrasonographer, and a second using a previously described, surface anatomy-guided protocol performed by a front-line health worker. Four experts trained in diagnostic ultrasonography determined intrauterine pregnancy, fetal number, fetal presentation, placental position, amniotic fluid volume, and free pelvic fluid. Responses were dichotomized into normal or abnormal. Concordance in diagnostic outcomes was measured using sensitivity and specificity. Inter-rater agreement was also calculated.

Publication:
Journal of Ultrasound in Obstetrics and Gynecology

 


Category: Obstetrics  Year: 2013

Title: A comparative evaluation of a simplified, low-cost ultrasound protocol with standard obstetrical
ultrasonography in the recognition of common prenatal diagnoses

Summary: To compare the diagnostic performance of a simplified, low-cost volumetric ultrasound scanning protocol for image collection and remote interpretation with that of the current clinical standard of skilled obstetric ultrasonography in determination of common prenatal diagnoses.

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Morey, G., DeStigter, K., Kim, P., Rielly, M., Souza, S., Miele, F., Nelson, M., Silfen, E., Kawooya, M. and Garra, B. (2013), OC23.03: A comparative evaluation of a simplified, low-cost ultrasound protocol with standard obstetrical ultrasonography in the recognition of common prenatal diagnoses. Ultrasound Obstet Gynecol, 42: 47. doi:10.1002/uog.12713

 


Category: Obstetrics  Year: 2013

Title: A Low-Cost Ultrasound Program Leads to Increased Antenatal Clinic Visits and Attended Deliveries at a Health Care Clinic in Rural Uganda.

Summary: In June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics.

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Publication: PLoS ONE 8(10): e78450. doi:10.1371/journal.pone.0078450

Ross AB, DeStigter KK, Rielly M, Souza S, Morey GE, et al. (2013) A Low-Cost Ultrasound Program Leads to Increased Antenatal Clinic Visits and Attended Deliveries at a Health Care Clinic in Rural Uganda. PLOS ONE 8(10): e78450. doi: 10.1371/journal.pone.0078450

 


Category: Obstetrics  Year: 2013

Title: The prevalence of prenatal conditions detected by ultrasound in a rural clinic in Uganda.

Summary: In June 2010, Imaging the World began offering access to basic antenatal ultrasound at Nawanyago Health Centre (HC III) in Uganda. This program, consisting of simple scanning protocols and internet based remote reading and reporting, provides reliable identification of several common prenatal conditions such as confirming intrauterine pregnancy, fetal number, fetal position, placental position, amniotic fluid volume and pelvic mass. Clinical records were collected prospectively after introduction of the ultrasound program in June of 2010 through March of 2012.

Publication: 23rd World Congress on Ultrasound in Obstetrics and Gynecology, October 2013, Sydney, Australia.

Read the Abstract

DeStigter, K., Souza, S., Rielly, M., Nelson, M., Morey, G., Silfen, E., Kawooya, M., Matovu, A. and Garra, B. (2013), OC23.01: The prevalence of prenatal conditions detected by ultrasound in a rural clinic in Uganda. Ultrasound Obstet Gynecol, 42: 46. doi:10.1002/uog.12711

 


Category: Methodology  Year: 2011

Title: A Low-Cost Teleradiology for Rural Ultrasound.

Summary: Work to establish and validate an obstetric care model in Uganda, and the design and for a clinical study to measure this model’s efficacy in terms of improving outcomes at delivery.  The central objective of this care model is to reduce mortality in remote locations by providing expectant mothers and their primary care-givers with advance notice of complications so that women at-risk can be referred to appropriate care centers in time.  The components of this model are described, including portable ultrasound machine, scanning protocols for clinical data acquisition by local operators, custom clinical data compression and transmission capabilities, and internet-based infrastructure for remote reading and reporting

Publication: Proceedings of the IEEE Global Humanitarian Technology Conference (GHTC). Seattle, WA. 2011 Oct 30–Nov 1. IEEE Press. 290–5.

Read the Publication

K. K. DeStigter et al., “Low-Cost Teleradiology for Rural Ultrasound,” 2011 IEEE Global Humanitarian Technology Conference, Seattle, WA, 2011, pp. 290-295. doi: 10.1109/GHTC.2011.39

Category: Methodology  Year: 2008

Title: Scan protocols for use by non-medical personnel in developing countries: organ visibility and reproducibility evaluation

Summary: ITW completed testing of the hardware/software, volume ultrasound scan protocols and training methods in two pilot studies conducted in rural Vermont and in Belize. Initial results reported at the American Institute of Ultrasound in Medicine and the Radiological Society of North America meetings in 2008 showed that the ITW protocols produce high quality images that can be compressed and sent without loss of diagnostic quality. Both of these pilot projects proved the ITW model works well in a low-resource country.

Publication: J Ultrasound Med 2008; 27(3): S16-17.