An integrated teleconsultation system for the evaluation of the risk of stroke

Abstract

This paper describes the design and development of an integrated teleconsultation system for the estimation of the annual incidence of stroke related to carotid atherosclerotic plaque and the detection of high risk and low risk subgroups of patients which is a decisive factor for the selection of the therapy, i.e. medical or surgical. Thus, only patients at high risk will be considered for carotid endarterectomy, while patients at low risk will be spared from unnecessary and expensive surgery which also carries a risk. The system takes into consideration important non-invasive (para-clinical) parameters extracted from high resolution ultrasound images, and stroke related clinical risk factors. The knowledge base of the system concerning ultrasound images was from 274 collected from the department of vascular surgery, Faculty of Medicine, Imperial College, London, while the clinical risk factors database was built from a total of 1298 cases collected under the EU BIOMED II ACSRS (Nicolaides et.al 2003) project for the identification of individuals with asymptomatic carotid stenosis at risk of stroke. The proposed system facilitates (a) the identification and standardization of noninvasive tests or combinations of such tests, particularly ultrasonic plaque echodensity and texture analysis that are associated with increased risk of stroke, and (b) determine combinations of such tests as well as appropriate criteria that can achieve the identification of high and low risk subgroups of patients. © 2005 University of the Aegean and University of Plymouth.