Professional Documents
Culture Documents
ANNUAL REPORT
2017 / 2018
Board of Directors 8
Research Program 15
Health Informatics 16
Biomedical Informatics 30
Health Services 44
aehrc.com
6 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
The Biomedical Informatics group The AEHRC was part of the external review
continues to lead medical image analysis of CSIRO Health and Biosecurity conducted
for national trials in areas such as by an external panel in November 2017.
Alzheimer’s disease and cerebral palsy The external review resulted in a strong
and clinical applications such as prostate result for the AEHRC, with the review panel
cancer. assessing the AEHRC as being Benchmark
in the areas of Impact and Innovation
Nationally the AEHRC is delivering Capacity and Strong to Benchmark in
significant projects for the Australian Science. This was a great endorsement of
Government Department of Health. Our the quality of the science and the impact
health data analytics scientists have that the AEHRC is having on healthcare in
developed the risk algorithm for the Australia.
Healthcare Homes program – now being
trialled in 200 clinics around Australia. The AEHRC is now an established part
We were recently awarded funding by the of Australia’s digital health ecosystem
Australian Government Department of – contributing to the digital health and
Health for a Primary Care Data Quality clinical research ecosystem. Going into
Foundations project, to work with industry the new financial year the AEHRC is well
and peak clinical bodies on standards for placed to continue to implement its 2017-
primary care data. These projects are in 2022 strategy and continue the growth of
addition to the Department of Aged Care the past five years.
funded program for our Smarter Safer
Homes Technology. We have also partnered
in the NHMRC-funded Australian Dementia
Network (ADNet).
RIAC Chair: Dr Michael Steyn A number of AEHRC staff members attended RIAC meetings
The following persons were members of the Research and during 2017-2018 as guest presenters.
Investment Advisory Committee throughout 2017-2018: 8 February 2017
Chair At this meeting the RIAC discussed the research from the
• D
r Michael Steyn, Director Department of Anaesthesia Health Informatics group, discussing the opportunities for
& Perioperative Medicine, Royal Brisbane & Women’s further work with new initiatives within Queensland Health.
Hospital (2017) • Health data interoperability – Michael Lawley
• P
rof Keith McNeil, Chief Clinical Information Officer, • Health text processing – Anthony Nguyen
Queensland Health
• Health data analytics – Sankalp Khanna
Members
19 July 2017
• D
r Andrew Staib, Metro South Health and Hospital
Service (HHS) and e-Health Queensland At this meeting the RIAC discussed the 2017/18 AEHRC
Annual Business Plan, with considerable discussion on the
• M
s Cathy Ford, Chief Digital Officer, e-Health adoption of and impact from AEHRC research.
Queensland, Queensland Health
• M
r Michael Drahiem, Chief Information Officer, Metro • D
iscussion on the AEHRC 2017-2018 project Portfolio –
South Health and Hospital Service David Hansen
• M
r David Bunker, Executive Director, Queensland • Health services research – Mohan Karunanithi
Genomics Health Alliance • Health informatics research – Michael Lawley
• D
r David Hansen, CEO, the Australian e-Health Research • Biomedical informatics research – Jurgen Fripp
Centre
• D
r James Lind, Director, Emergency Medicine Training,
Gold Coast Hospital Emergency Department
aehrc.com
8 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
BOARD OF DIRECTORS
Richard Symonds
Minutes Secretary
Kelly Tighe
Finance Manager, CSIRO
aehrc.com
10 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
The first session this year provided an We then had talks from Robert Lee from Attendees had the opportunity to view
opportunity to highlight various digital the Australian Digital Health Agency about posters, discuss our projects and
health initiatives in Queensland. Dr Australia's MyHealthRecord program; technology with our scientists during
Claire Sullivan, Clinical Lead for the A/Professor Andrew Mallett from the the morning tea and lunch breaks,
Digital Health Program Queensland RBWH Nephrology Department about and observe multiple technology
Health, described how Queensland using genomics in the Kidney Clinic; demonstrations.
Health is using digital disruption to and Tim Blake on a new consumer-
transform the state's healthcare – and focussed digital health guide for mobile Feedback from the day was again
some of the great outcomes from apps. The AEHRC's Jim Steel rounded excellent and it was great to see so
the iEMR program. We then had the out the session by discussing a new many of our partners and stakeholders
opportunity hear from Dr Wendy Dutton, Health Informatics on FHIR course being together.
Director of Obstetrics at Redland introduced for third-year IT students at the
Hospital, about the M♥THer trial and University of Queensland in collaboration
how we're working in conjunction with with AEHRC and Qld Health.
Redland Hospital. The M♥THer trial
provides a mobile app to support women The afternoon session provided an
with gestational diabetes app, and opportunity for AEHRC to highlight
this app provides information to their some of our new research. David
clinicians via an Interactive Clinician Ireland spoke about chatbots for people
Portal. The final talk of the morning with autism and other neurological
came from the AEHRC's Dr Sankalp conditions; Natalie Twine presented on
Khanna who provided an update on how machine learning enhances genetic
the Logan Hospital trial of a big data variant discovery for Motor Neurone
analytics-based tool to identify patients Disease; James Doecke spoke on a new
at high risk of re-hospitalisation. blood test for early Alzheimer's disease
diagnosis; Jason Dowling presented
The pre-lunch session highlighted on a phase II prospective trial of MR-
national initiatives. Our key note speaker alone treatment planning for localised
this year was Professor Enrico Coiera, prostate cancer; and finally Alejandro
Chief Investigator NHMRC Centre of Metke and Andrew Patterson provided
Research Excellence in Digital Health use cases for clinical terminology and
(CREiDH) and Professor of Health data when introducing genomics into
Informatics at Macquarie University. clinical care.
Prof Coiera provided a great overview
of the work program of the CREiDH,
of which AEHRC is a core member.
12 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
MANAGEMENT AND
RESEARCH LEADERSHIP
Dr David Hansen
CEO, Australian e-Health Research Centre
David Hansen is CEO of the Australian e-Health Research Centre, the national digital
health program of the CSIRO Health and Biosecurity. David leads an e-Health research
portfolio developing information and communication technologies for the healthcare
system. These projects across health informatics, biomedical informatics and health
services research will underpin the e-health architecture in Australia.
Prior to joining CSIRO, David worked for LION bioscience Ltd in the UK, developing
genomic data and tool integration software that was used to publish the first human
genome and used at over 200 pharmaceutical and biotechnology companies and
research institutes worldwide.
Michael Lawley
Group Leader, Health Informatics
Dr Michael Lawley is Senior Principal Research Scientist and Group Leader with the
CSIRO Australian e-Health Research Centre, part of CSIRO’s Health and Biosecurity
business unit. Michael leads the Health Informatics Group with teams in health data
semantics, health statistics, and software engineering.
He has deep expertise in clinical terminology and specifically large scale ontologies
such as SNOMED CT. Work developed by Michael and his team have produced
technologies that have been licensed nationally and internationally by standards bodies,
government organisations and SMEs.
Jurgen Fripp
Group Leader, Biomedical Informatics (May-June)
Jurgen Fripp is the group leader for the Biomedical Informatics group at the AEHRC
and completed his honours thesis and PhD in the area of medical imaging at the
University of Queensland and with the CSIRO. His bachelor degree from the University
of Queensland was in Science (applied mathematics) and Electrical Engineering.
Jurgen’s team conducts research into image analysis algorithms for applications
in Positron Emission Tomography (PET), Magnetic Resonance Imaging (MRI), and
Computed Tomography (CT). Their workflows developed have been applied to support
various large clinical studies, including AIBL (http://aibl.csiro.au/).
Mohan Karunanithi
Group Leader, Health Services
Mohanraj Karunanithi leads the Health Services group at the AEHRC. Mohan has
a doctorate in Biomedical Engineering from the University of New South Wales.
He has over 10 years of experience in cardiac research and five years’ medical
industries experience. At AEHRC, Mohan manages and coordinates research in
ICT applications in healthcare management, chronic disease and aged care.
Prof Yogesan has developed medical technologies from bench to bed and one of his
inventions is used by NASA in the International Space Station. He was an Australian
of the Year finalist from Western Australia (2015) and also Western Australia Business
Leader of the Year finalist in 2014 for his contribution to medical sciences and
prevention of blindness. He is a Visiting Scholar to Harvard University and professor at
the School of Medicine at the University of Notre Dame. He was a Fulbright Scholar to
Stanford University School of Medicine and a NHMRC Research Fellow.
Olivier Salvado
Group Leader, Biomedical Informatics (July-April)
Dr Salvado is the group leader for the Biomedical Informatics group at the AEHRC. He
is adjunct Professor at the University of Canberra, adjunct Associate Professor at the
University of Queensland, and Honorary Research Fellow at the Florey Neuroscience
Institute. His research interests include developing bioinformatics methods for large
multi-scale clinical studies, neuroimaging technologies, and investigating novel multi-
modal clinical imaging biomarkers. Since 2009, he has been co-supervisor or assessor
of 10 PhD students (two current co-supervisions).
Dr Salvado has published over 70 original research papers cited more than 2700 times in
highly vregarded journals including Lancet Neurology, JAMIA, Journal of Neuroscience,
NeuroImage, PLoS One, Annals of Neurology, and Brain. Dr Salvado was the co-chair of
the ISBI conference that took place in Melbourne, Australia in 2017.
aehrc.com
14 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
• W
e took part in a joint media announcement with the Florey • D
enis Bauer appeared in the “This is my architecture
Institute of Neuroscience and Mental Health to promote our series” on AWS. Her team had numerous blogs published
research about the link between iron in the brain and the on various tech websites, along with a story in CIO online.
speed of Alzheimer’s disease progression. It received national • D
ana Bradford and David Ireland were interviewed by ABC
media coverage, with stories on the front page of The Herald Radio National about chatbots in the health sector.
Sun, on the ABC and Sky News, and mentions on TV news
• D
avid Hansen was interviewed by ABC Radio about the
and The Project, reaching more than two million people.
M♥THer app for gestational diabetes.
• T
he team’s work creating an eye test GPs could use to detect
• J ames Doecke was featured in articles by the ABC and
diabetic retinopathy, and a subsequent grant from Diabetes
The New Daily for his involvement in a project to develop
Research WA, received wide coverage. Yogi Kanagasingam
a blood test that can detect Alzheimer’s disease up to 20
was interviewed for stories in The West Australian, The Echo,
years before symptoms begin.
The Post, ZDNet, Gizmodo, Pulse+IT, IT Wire, Australian
Doctor, Insight News and more, reaching an audience of • T
he Australian Financial Review published an article
approximately one million. on Cardihab’s commercialisation, and it also received
coverage in tech media.
• D
avid Silvera’s work with robots to support children on the
autism spectrum was featured across national ABC TV and
radio news, reaching 1.5 million people.
Awards
Our teams were successful again this year winning and placing in a number of awards nationally, including the Queensland and
Victorian iAwards and the Western Australia Information Technology and Telecommunications Alliance Incite Awards (WAITTA).
• Queensland iAwards • T
he M♥THer Gestational Diabetes Mellitus platform won
−− erit recipient of the Research and Development
m the Health Round Table Innovation Award in the ‘Improving
Project of the Year award for the Mobile-Pulmonary Patient Centred Care’ stream. It was also a finalist in the
Rehabilitation Platform (m-PR). International Hospital Federation Awards.
−− inners of the QLD Premier’s iAward for Public
w • C
ONSULT Neurosurgical Planning project was a finalist in
Sector Innovation for the Mobile-Pulmonary the RBWH Research Excellence Awards.
Rehabilitation Platform (m-PR). • Y ing Xia won the best poster award of the World Federation
−− erit recipient of the Community Service Markets
m of Nuclear Medicine and Biology conference, for the
award for the PD-BUDDy: Support for Peritoneal Neuroscience competition.
Dialysis Patients. • S
ajib Saha received a Rising Star Award at the Science on
−− erit recipient of the Research & Development
m the Swan Conference 2018, for development of artificially
Project of the year for the PD-BUDDy: Support for intelligent methods for the diagnosis of retinal disease.
Peritoneal Dialysis Patients. • S
haun Frost was included in the list of Top Ten Posters
for the Science on the Swan Conference 2018 for his
• V
ictorian iAwards: CALD-Assist won the Health Round submission on ‘Retinal morphology for pre-clinical
Table Innovation Award. detection of Alzheimer’s Disease’
• W
AiTTA (WA Information Technology and
Telecommunications Alliance Incite Awards) 2017-2018:
the team was awarded the winner of “Most Innovative
Enabler in Health Care” on its project titled “AEye
Screening System for Patients with Diabetes” and the
National iAwards Finalist of “Research & Innovation
Project of the Year - Industry Award” on its project titled
“Cloud-based Retinal Vascular AnalySis Platform: VASP”.
RESEARCH PROGRAM
Over the past five years the The AEHRC strategy for the next five years aims to use the research capability of
our three research groups – health informatics, biomedical informatics and health
Australian e-Health Research
services research – to continue to tackle challenges of Australia’s healthcare system
Centre has developed into a and expand the impact of our research. The challenges set out in this strategy are to:
full health and biomedical • increase our science outcomes to be recognised in the top three e-Health
informatics research program. research centres in the world
This program spans health • increase our impact through increased adoption of our technologies
informatics, covering data • d
evelop new areas of impact in Indigenous health, precision medicine, big data
about patients, services and medical research, healthy ageing and a learning healthcare system
informatics, using patient • continue the growth of the AEHRC around Australia.
genomic and imaging data Our research program is informed through strong partnering with the health industry,
to personalise diagnosis and including clinicians, researchers, health service executives and the health IT vendor
community. With more than half our staff based at the Royal Brisbane and Women’s
treatment; and health services, campus in Brisbane, our scientists and engineers have strong relationships with
the use of technology in Queensland health administrators, clinicians and researchers. As CSIRO’s e-Health
delivering services to patients. research program, we can also access expertise from across CSIRO.
Our scientists and engineers Our scientists and engineers Our scientists and engineers
apply machine learning, natural use the simultaneous use our expertise in mobile
language processing, formal logic, application of statistics, technology, home monitoring,
and statistical and simulation computer programming, and telemedicine, wellbeing and
approaches to the collection, applied mathematics to develop behavioural change to improve
processing, analysis and sharing solutions that communicate health services to urban, rural
of health information for decision insights to clinicians and clinical and remote Australians.
support, systems modelling and researchers.
reporting.
aehrc.com
16 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
HEALTH INFORMATICS
Australia’s healthcare system faces many challenges. One is the increasing demand for clinical information to be shared
between individual health practitioners, healthcare provider organisations and state/territory health departments.
Our health informatics research develops and applies innovative tools and techniques for evidence-based solutions
and strategies to support improved health outcomes. Our goal is to improve the quality of, and unleash the value
in, health data, including electronic health records and administrative data sets, to improve patient outcomes and
health system performance and productivity.
We apply machine learning, natural language processing, formal logic, and statistical and simulation approaches to
problems involving decision support, systems modelling and reporting.
Our team also works in the genomics area, specifically around representing patient phenotype data using standards
and terminologies. Our involvement in several genomics alliances in Australia and internationally has helped us
position ourselves as leaders in this field.
PROJECTS
H E A LT H I N F O R M AT I C S
Snorocket.
aehrc.com
18 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
SNOMED CT in the
Queensland digital hospital
project
The Queensland digital hospital project
introduced SNOMED CT terminology
as part of the implementation of an
integrated Electronic Medical Record.
As part of this project we worked with
the Princess Alexandra Hospital's
(PAH) digital hospital program on
several collaborative projects. An early
outcome was to work with the PAH and
the Australian Digital Health Agency
to release an extension to SNOMED
CT-AU containing more than 100 new
procedure codes required to support
the pioneering use of SNOMED CT in
the deployment of the Cerner Surginet
product. Further work continues to
H E A LT H I N F O R M AT I C S
RACS MALT goes SNOMED Genomics & Clinical Broadening support for genomics
terminologies
CT-native Phenotypes
Many terminologies used in genomics
During 2017 we continued our During 2017/2018 the AEHRC has formed are distributed in OWL format. FHIR has
collaboration with the Royal a valuable working relationship with a no native support for OWL ontologies
Australasian College of Surgeons number of genomic health alliances. The and some of the characteristics of OWL
(RACS) after the successful transition Australian Genomics Health Alliance are challenging to represent in FHIR
in 2016 of their Morbidity Audit Logbook is a national research collaboration code systems. A generic transformation
Tool (MALT) from ad-hoc terminology to of researchers and clinicians working between OWL and FHIR code systems
using SNOMED CT-AU procedure codes together to provide effective and was designed and implemented. This
natively. This included the development sustainable delivery of genomic medicine allowed supporting terminologies such
and maintenance of aggregation maps in healthcare. The AEHRC is part of as the Human Phenotype Ontology,
to support ongoing reporting processes the Phenotype Capture project, whose the Phenotypic Quality Ontology, the
from the MALT data. During 2016/17 objectives are to enable different sources Foundational Model of Anatomy and
RACS migrated to an NCTS-based of phenotype data to be used for research Orphanet in Ontoserver.
deployment of Ontoserver using FHIR- and clinical applications, and to represent
based valueset and map artefacts, and different data in the same format, by Aligning terminologies
we are now working toward expanding transformation to computer-readable In an effort to commence the
their initial SNOMED CT valueset (from standardised ontologies such as SNOMED standardisation of genomic data collections,
14,000 concepts, to 30,000 procedure CT and the Human Phenotype Ontology. a great deal of work has been done looking
concepts). Work also continues in the at the alignment and the creation of a map
development of new procedure content Standardising research data between the Human Phenotype Ontology
for release in SNOMED CT AU. This One of the main issues in the Australian and SNOMED CT. To date we have found
enhances its usability and relevance in Genomics Health Alliance is that 18% exact match alignment and work in
the Australian surgical domain. To date, flagships (the organisations doing this space continues.
H E A LT H I N F O R M AT I C S
well over 300 new concepts have been clinical research) capture phenotypic
created and released in SNOMED CT AU. data in slightly different ways, despite Defining minimum clinical data sets
RACS is also considering broadening the using the same platform (REDCap). Development has commenced of flagship-
use of SNOMED CT, so MALT will allow This makes it very hard to reuse the specific FHIR value sets based on the
their users to also capture data relevant data or interoperate with other systems. data currently being collected. It is hoped
to diagnoses and outcomes. This problem was solved by designing that these value sets will form the basis
and implementing the FHIRCap for ongoing development of SNOMED
platform, a novel solution based on a CT genomics reference sets for use and
domain specific transformation rules release in the international edition. The
language that allows expressing how value sets have been deployed in an
the REDCap data should be represented Australian Genomics Health Alliance
in standardised format, in this case the Ontoserver instance and can be browsed
FHIR standard. using a value set viewer extension of
Shrimp, our terminology server browser.
aehrc.com
2 0 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
K
ey Project Highlights Project Aims for
Collaborators: for 2017/18: 2018/19:
• A
ustralian Digital Health • D
evelopment of Ontoserver V5 • E
xpand and improve
Agency/National eHealth for the NCTS with the latest terminology-enabled data
Transition Authority STU3 version of HL7's FHIR APIs analytics
• R
oyal Australasian College of and syndication support • D
evelop enhanced algorithms
Surgeons • C
ontribution to the refinement for automated analysis of
• P
rincess Alexandra Hospital, of the HL7 FHIR Terminology terminology quality metrics to
Metro South HHS Services API standard R4 improve data quality
• A
ustralian Genomics Health • O
rganised FHIR connectathons • D
evelop more sophisticated
Alliance. in the UK and negotiated an auto-mapping strategies in
evaluation license of Ontoserver Ontoserver to be utilised via
with NHS Digital Snapper
• Impact and expansion of the • D
evelop assistive technologies
snoMAP tool as it has been that will support the clinician
taken up at additional sites community to capture accurate,
throughout Queensland codeable data for documentation
• D
evelopment of FHIRCap for of patient records
the Australian Genomics Health • E
xtend our automated
Alliance and completion of the techniques for developing
full mapping of the Somatic aggregation-based maps for
Cancer Flagship data reporting and data analytics
• S
upport for OWL-based • B
uild on the successful rollout
ontologies in Ontoserver to of Ontoserver as the NCTS
support genomics projects. terminology server platform-
of-choice through international
adoption and licensing.
H E A LT H I N F O R M AT I C S
AEHRC is extracting information about to the ED that this checking process is
Our solutions have been developed cancers from the free-text contents performed. This process results in time
in partnership with healthcare of histopathology reports for cancer inefficiencies with delays in reporting,
practitioners from cancer registries, notifications, synoptic reporting and delays in checking reports, and delays
hospital radiology and emergency cancer staging. This is enabling QCCAT in recalling patients. A timelier and
medicine departments. Working with to build a real-time cancer registry that efficient process is therefore required
health industry stakeholders allows processes new histopathology reports to improve patient outcomes and staff
our health text analytics solutions to as they are available from public and resources.
leverage the wealth of clinical free-text private pathology laboratories across In partnership with the Royal Brisbane
reports and aid in decision support and the state of Queensland. This processed and Women’s Hospital and The
reporting. information provides the capacity to Prince Charles Hospital EDs, we have
support key activities such as cancer developed algorithms and models to
monitoring, health service planning and reliably identify abnormal or positive
research. results from radiology and pathology
This medical text analytic service reports respectively, and link these with
uses the AEHRC Medtex platform to patients’ disposition as recorded in the
automatically read and analyse the Emergency Department Information
pathology reports. System to provide decision support to
the, currently manual, checking process.
Future work will develop software to
demonstrate the clinical and patient
benefits arising from the information
technology-based solution.
aehrc.com
2 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Figure 2: Medical free-text analytics applications for three different clinical document classification tasks:
(i) identification of the ICD-10-AM diagnosis codes from progress notes;
(ii) identification of abnormalities from radiology reports; and
(iii) classification of cancer stages from pathology reports.
H E A LT H I N F O R M AT I C S
Figure 3: Screenshot of our task-oriented search engine for evidence-based medicine.
aehrc.com
2 4 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
P
hD student profile
Harry Scells
AEHRC PhD Top-Up
Patient risk stratification predictive model for Health Risk stratification for
H E A LT H I N F O R M AT I C S
Care Homes hospital avoidance in acute
care
In 2017/18, the team successfully The benefits of such a risk stratification
delivered the Predictive Risk tool include: In 2017/18, partnering with the
Model (PRM) pivotal to the federal Queensland Health’s Healthcare
• r educed level of dependency
government’s Health Care Homes Improvement Unit and Logan Hospital,
and improved health outcomes
initiative aimed at improving quality the team successfully delivered a
for patients due to early clinical
and safety of the primary health care real-time web-based risk stratification
intervention
system. Partnering with Precedence algorithm that can be used to identify
• c ost savings as a result of reduced chronic disease patients with a high
Health Care and Sonic Health Services
readmission rates risk of rehospitalisation while they are
for this project, we were responsible
for the development and validation • reduced acute length of stay still in hospital. Model development and
of the predictive model to be used in • reduced emergency presentations validation involved employing routinely
the program at a GP practice-level to collected administrative and clinical
• improved equality in health care
identify potentially eligible patients, by datasets that were available in real
access based on actual need
stratifying patients according to their time, and a web-based clinical decision
• m
ore effective and coordinated support tool was built to provide risk
risk of unplanned hospital admission in
health service planning based on groups and individual patient risk profiles
the next 12 months. Patients identified
health needs to care teams. A 12-month evaluation
by our algorithm were then contacted
by the general practice and invited to • facilitation of person based to assess the impact of the risk tool on
undertake an assessment to further health care planning through the chronic disease readmissions and care
assess their eligibility and Health Care provision of risk scores to treating planning processes is underway at Logan
Home tier level. practitioners. Hospital.
To date the tool has been installed in
over 170 GP practices and Aboriginal
Community Controlled Health Services
(ACCHS) around Australia participating
in the Health Care Homes program to
provide services to patients with chronic
and complex conditions.
aehrc.com
2 6 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Figure 1: Risk of readmission and representation to ED are provided via a dashboard for all patients staying
overnight in hospital.
H E A LT H I N F O R M AT I C S
Generating an evidence
base for informing policy
around after-hours care
There is a need to deliver healthcare
in a manner that maximises outcomes
for patients. In 2017/2018, the team
completed a large state-wide study
commissioned through the Queensland
Clinical Senate to investigate whether
outcomes are different for patients who
Figure 2: Patient-specific factors contributing to risk of readmission are provided for each inpatient via a seek care at public hospitals outside
dashboard. of normal business hours compared to
other times of the week.
Developing an evidence
base to better target efforts
to improve the scheduling
of surgery in public
hospitals
In 2017/18, the team commenced
an engagement with Queensland
Health's Healthcare Improvement
Unit to undertake additional statistical
modelling of surgical and inpatient data
for the major public hospitals across
Queensland. The modelling builds on
previous analysis by the team aimed at
maximising the utilisation of operating
theatres as one of the highest resource
costs of hospitals. The additional HealthLinks Chronic Care evaluation
analysis explores whether the day of the
week that elective surgery is undertaken HealthLinks Chronic Care (HLCC) The HLCC funding model is to provide
affects post-operative length of stay, is a 3.5 year pilot program by the capitation funding (termed "flexible
whether sessions comprising the same Victorian Department of Health and funding") to health services for patients
medical specialty are more highly Human Services (DHHS) and evaluated at risk of multiple unplanned (re)
utilised than sessions with a mix of by CSIRO. It is well established that admissions that the health service
specialties, and whether more frail integrated, co-ordinated care can result may be able to impact through better
H E A LT H I N F O R M AT I C S
patients lead to longer procedure times in better health outcomes for people discharge planning, better streaming to
and turnover times between operations. living with chronic disease. There is existing (clinical and social-economic
These insights into scheduling can be also evidence that current funding driven) programs or new service models
used by administrators in targeting mechanisms can limit health services for community management. A novel
efforts to address current challenges in from providing a cohesive and co- risk algorithm will identify the eligible
surgery scheduling practice. ordinated model of care that integrates cohort of patients who are at high risk
hospital, ambulatory and community- of unplanned readmission to hospital
based services. This project aims to and these patients will be enrolled in
remove some of those barriers, enabling the HealthLinks program. Ten health
health services to trial innovative services in metropolitan Melbourne are
models of integrated care. part of this evaluation.
aehrc.com
2 8 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Predicting unexpected
patient deterioration in a
digital hospital setting
In 2017/18, planning commenced for
a new project aimed at reducing the
incidence of unplanned adverse patient
outcomes within hospital using new
applied predictive tools developed
specifically for a digital hospital setting.
Such a system is the future of hospital
health care. The specific outcomes of Source: Clinical Informatics, Metro South Health
focus are to:
1. R
educe unplanned Intensive Care
Unit admissions from a general
ward
Collaborators:
• Federal Department of Health
2. R
educe Rapid Response Calls
arising from a non-deteriorating • Victorian Department of Health and Human Services (DHHS)
patient, and • Precedence Health Care/Sonic Health Services
H E A LT H I N F O R M AT I C S
3. R
educe the rate of serious injury/ • Queensland Ambulance Service
disability or death due to an adverse • Healthcare Improvement Unit, Queensland Health
outcome while in hospital. • Metro South Hospital and Health Service, Queensland Health
Additionally this research will seek to: • Metro North Hospital and Health Service, Queensland Health
• Sunshine Coast Hospital and Health Service, Queensland Health
1. C
ustomise vital signs thresholds
programmed into a digital hospitals’ • Telstra Health.
Electronic Medical Record that suit
individual patients using historic Project Highlights for 2017/18:
data.
• P
atient risk stratification model was developed, validated and
2. P
redict the likelihood of a patient
accepted by the Department of Health for to be used by GPs in the
deteriorating significantly before
National Health Care Homes trial
they become a candidate for critical
or intensive care using a range of • W
eb based risk stratification algorithm for predicting
data sources. rehospitalisation developed and trial started at Logan Hospital
• R
eport provided to Queensland Health on patient outcomes around
wo digital hospitals will be
T after-hours hospital care
participating in this study: the Princess
• F
irst interim HealthLinks evaluation report delivered to DHHS for this
Alexandra as the training site and the
3.5 year project.
Townsville Hospital as the test site. A
project proposal has been submitted
to the Clinical Excellence Division at Project Aims for 2018/19:
HITEC for potential funding and the
project has employed a post-doc to • H
ealthLinks Chronic Care evaluation: completion of annual report for
work on the project. year 1 and year 2
• E
valuation of the web-based risk stratification algorithm at Logan
Hospital
• S
tart of a new collaboration with Victorian Agency for Health
Information (VAHI) which has oversight of all Victorian hospital data
• S
tart of a new collaboration with WA Health with a project at Fiona
Stanley Hospital to gain better insight into theatre efficiency
• C
ontinued support, validation and extension of the Patient Admission
Prediction Tool within Queensland Health.
Our world class Health Data Engineering MoTER chronic disease Delivery of technology into
team is a dedicated team of software
engineers who work with our scientists
platform the health system
across the Australian e-Health Research Many of the projects from the Mobile Our team provides the bridge between
Centre in delivering solutions to our Health group involve testing the research outcomes and deployment
customers and partners. With specialists effectiveness of new care models of technology into the health system
skills in mobile app design and delivered through mobile technologies by productising, system integration,
development and web-based software like smartphones and wearables and deployment and support. As an
development, as well as specialist sometimes passive sensors. Our team example, PAPT has been made into
knowledge in health IT standards such manages a common framework known a product and is deployed into
as HL7, the team contributes to projects as the MoTER platform to deliver these Queensland Health and licensed to
across the AEHRC. projects, attempting to maximise reuse Telstra Health, greatly increasing
while not hindering innovation. The its impact. The Readmission RISK
Over the past 12 months the team has
platform consists of iOS and Android Stratification system is deployed at
continued to develop our MoTER mobile
native applications and a web portal for Logan and being used daily for decision
phone platform to support our mobile
clinicians to review the collected data. support.
health projects, worked with our clinical
terminology specialists to deliver on the
National Clinical Terminology Service, AEHRC on FHIR Clinical trial support
developed a new version of our MedText
medical narrative processing software Activities include: We provide support for clinical trial data
and developed FHIR-based resources for management systems like REDCap and
• p
articipating in Connectathons and OpenClinica as well as custom data
use across our projects. The team also
Hacking Health to build skills and collection solutions. REDCap has been
continues to support a number of clinical
awareness; using the Medications extended to support using an external
trials with various clinical trial software
Resource to represent medications FHIR-based terminology server for
packages.
H E A LT H I N F O R M AT I C S
from the Australian Medicines coded data fields.
Terminology and other sources;
using ValueSets for medication input
in mobile apps
• e
xperimenting with the use of FHIR
ConceptMaps for MedText
• investigating the use of FHIR to
represent and exchange clinical
trials data, both as a view of ODM/
CDISC data and natively
• d
ynamic generation of Angular-
based data entry user interfaces
from FHIR profiles
• a
n extended version of the HAPI
FHIR Server, Sapphire, that
delegates to Ontoserver for its
terminology subsystem to take
advantage of its advanced SNOMED
capabilities.
aehrc.com
3 0 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
BIOMEDICAL INFORMATICS
PROJECTS
B I O M E D I C A L I N F O R M AT I C S
babies born each year in Australia are diagnosed with cerebral palsy, and half of with real-time feedback on progress and
later diagnosed with CP. Understanding them have later learning and behavioural potentially imminent safety issues during
the relationship between brain structure difficulties. Diagnosis of cerebral palsy is surgery itself. CONSULT aims to make
and clinical function is crucially important currently made on average at 19 months brain surgery safer, more effective, and
for diagnosis and prognosis. corrected age, diagnosis of learning allow surgeons to treat patients who
and behavioural difficulties even later. would previously have been considered
Using brain MRI, we are developing During the first two years of life, there too high risk. This work is performed
methods to quantify the degree of brain is substantial scope to reduce later in conjunction with clinical partners,
injury and brain developmental status of difficulties, because at this age the brain including radiologists and neurosurgeons
children with CP relative to neurotypical has a large capacity for repair. Earlier at prominent Australian hospitals. The
children. Together with our collaborators diagnosis and prognosis are crucial to research is funded through grants
at The University of Queensland and the identifying infants at high risk so that from Advance Queensland (Research
Cerebral Palsy Alliance, our team is using tailored therapy can be provided at an Fellowship), the Royal Australian and
these methods to predict clinical function early age when it is most effective. New Zealand College of Radiologists, and
and to assess neuroplasticity in response
RBWH Foundation (Diamond Care Grant).
to intervention. One observational study We are developing approaches to model
of children aged 8-10 years is currently normal neurodevelopment of the infant
underway (Predict-CP), with the aim brain using MRI, and identify abnormal
to determine the relationship between development. These approaches include
brain development and clinical function, methods to improve image quality,
as well as two randomised controlled automatically delineate brain structures
trials of early intervention for infants of interest to observe their growth and
aged three months to two years at high changes in their microstructure, and
risk of CP (GAME and REACH). Together the extent to which different parts of
with collaborators at The University of the brain communicate. Together with
Queensland, funding has been secured for our collaborators at The University of
a new randomised controlled intervention Queensland and the Royal Brisbane and
trial for children with CP aged 6 to 18 Women’s Hospital, our internationally
years (HABIT-ILE). Additional funding recognised team is using these methods
has been secured with collaborators at to predict the potential for adverse
Melbourne University for an observational neurodevelopment earlier, and to more
study of the early natural history of CP. accurately identify those in need of therapy.
This research will enable major advances This research will enable major advances
in the management of children with CP in the management of preterm babies
by providing a means to identify those and has the potential to reduce the
therapies that will provide the greatest burden of cerebral palsy on the health Figure 2: CONSULT: Automated delineation of the optic
pathway, including Meyer’s Loop, which is commonly
benefit to the individual child. system, while increasing the integration severed during temporal lobectomy and usually
of these children into society. considered extremely difficult to identify with MRI.
aehrc.com
3 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Musculoskeletal image
analysis: ChondralHealth
Osteoarthritis (OA) is a joint disease
that characterised by the breakdown
of joint cartilage and underlying bone.
Traumatic injuries such as a tear of
the anterior cruciate ligament (ACL)
increase the risk of developing OA and
provide a targeted way to investigate
early pathophysiological changes in
Figure 1: Femoroacetabular Impingement in the Hip: An automated MR-based method was developed for
cartilage and intervene in the disease quantitative assessment of the hip joint that evaluates 3D bone morphology and provides 360° calculation of
process. alpha angles around its femoral head-neck (FHN) junction. Analysis of the upper anterior quadrant of the FHN
junction enable to distinguish bone lesions characterised by elevated alpha angles as shown in the figure (red
arrow): hip joints having (a) smaller and (b) larger anterosuperior and anterior alpha angles (left: polar plots
Our current research involves
of alpha angles around the FHN junction, right: 3D bone models of the proximal femur surfaces automatically
developing techniques using advanced segmented from the MR scan).
magnetic resonance imaging (MRI)
and image processing that can be used
to improve the clinical picture of the
MRI-based paediatric lung structure and function
pathophysiological processes preceding assessment
B I O M E D I C A L I N F O R M AT I C S
the development of OA. The algorithms This project is a collaboration between CT scans every two years during which
we have developed can be used for the Lady Cilento Children's Hospital, time untreated, asymptomatic infections
automated segmentation of joint Siemens Healthcare, the Herston can permanently damage their airways.
cartilages that are used for computation Imaging Research Facility and CSIRO. Clinicians are also unable to quickly
of morphological and biochemical The aim is to improve health outcomes and accurately evaluate response
imaging biomarkers of the cartilage for children with Cystic Fibrosis (CF) to treatment. Children with A-T are
damage. and Ataxia-Telangiectasia (A-T) by extremely radio-sensitive and cannot
To evaluate and explore novel developing methods to use MRI to have CT scans. Non-invasive monitoring
biomarkers we are running a clinical provide information on lung status. of disease progression and treatment
trial with patients after knee or hip response is vitally important in
Currently the most informative method managing disease onset and extending
injury (ACL rupture, labral tear) and for lung imaging in these children is
healthy controls. The novel MRI life for these patients.
computed tomography (CT) scanning.
protocols and processing techniques CT scans combine a large number of To address this clinical need we are
are also evaluated on clinical data from x-ray images and repeated CT scanning developing image acquisition methods
our academic and industrial partners increases a child’s cancer risk due to and software to extract quantitative
(Steadman Philippon Research Institute, the radiation dose delivered. This is a disease status metrics from MRI.
USA). Results of these studies have critical consideration, particularly as This work is supported by a CSIRO
been presented in clinical (e.g. European the lifespan of people with CF and A-T OCE postdoc position and external
Journal of Radiology) and technical increases from improved treatment. For funding from the Ataxia Telangiectasia
(e.g. Medical Physics) international this reason children currently only have Children's Project.
journals. The developed software,
ChondralHealth, has been shared
with our industrial partner (Siemens MRI-alone radiation therapy planning for prostate cancer
Healthcare, Germany) who are running
validation studies at multiple centres. In collaboration with the Calvary Mater improvements are also leading to
Newcastle Hospital, and with funding cost savings arising from the reduced
Results of this research will provide support from the Prostate Cancer need to manage side effects. After
tools for medical practitioners to Foundation Australia and the NSW two successful retrospective trials
improve the diagnosis and clinical Cancer Council, we have developed involving 80 men, this work has grown
management of OA worldwide. In the first atlas-based method to map into a Phase II multi-centre prospective
addition we are using the multi- realistic electron densities to MRI scans trial for MRI-alone localised prostate
tissue 3D imaging capabilities of for dose calculations. This method is cancer external beam radiation therapy
magnetic resonance (MR) for non- now being used in the clinic for the first (ANZCTR trial: ACTRN12616001653459).
invasive objective assessments of hip time to refine radiotherapy planning As at 30 June 2018, 15 men have
joint biomechanics, morphology and during treatment to reduce side effects completed treatment for localised
biochemistry in patients. of prostate cancer patients. These prostate cancer with this technology.
B I O M E D I C A L I N F O R M AT I C S
American Academy for Cerebral software in a multicentre study
• Q
ueensland Cerebral Palsy and
Palsy and Developmental • D
evelopment of automatic
Rehabilitation Research Centre
Medicine 71st Annual Meeting, quantitative MRI reports for
• Siemens Healthcare September 13-16, 2017, Montreal children with cerebral palsy and
• S
teadman Philippon Research • L
ee Reid: People’s Choice Award infants at risk of cerebral palsy
Institute and CSIRO Accelerator Award at • M
RI-based non-invasive and
• Lady Cilento Children’s Hospital Impact 7, Melbourne zero radiation paediatric lung
• R
oyal Brisbane and Women’s • International multi-centre structure and function evaluation
Hospital prospective clinical trial for MRI- (for cystic fibrosis and ataxia-
• Q
ueensland Cerebral Palsy and alone, external beam radiation telangiectasia)
Rehabilitation Research Centre therapy for localised prostate • D
evelopment and validation of
cancer methods for automatic clinical
• Stella Maris Institute, Pisa
• Initiation of a new project aimed trial quality assurance and
• Ingham Institute for Applied
at MRI-based non-invasive linked information extraction
Medical Research
lung structure assessment for from retrospective radiation
• C
alvary Mater Newcastle children with cystic fibrosis oncology data sources
Hospital
• D
evelopment of a method • D
evelop approaches to predict
• Sir Charles Gairdner Hospital to quantify structures from adverse outcomes from
• L
iverpool and Macarthur Cancer neonatal MRIs neurosurgery in adults using
Services • D
evelopment of a method for structural and/or diffusion MRI
• U
niversities of Queensland, improved regional measures of • S
tart development of motion
Newcastle, New South Wales, the cartilage from biochemical correction methods to improve
Western Australia, Melbourne, MRIs at 3T/7T the analysis of dynamic image
Sydney, South Australia and • D
evelopment of a method for data
Wollongong automated detection of small • V
alidation of methods for
• University of Barcelona, Spain lesions on MRI images contrast synthesis and
• Brisbrain and Spine. • D
evelopment of a method for segmentation based on deep
automated delineation of the learning
optic radiation using MRI • S
egmentation tools for
• J ournal papers in top rated retrospective mining of radiation
medical imaging and clinical oncology imaging data.
journals
• S
uccessful grant funding,
including NHMRC, RANZCR,
RBWH Foundation.
aehrc.com
3 4 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
P
hD Student
and hippocampus will be used as seed addressed. Methods for the use of a
regions for delineation of white-matter camera to track head motion, and the
tracts to explore longitudinal changes tracking of head motion directly from
in connectivity measures in associated raw PET data in three dimensions have
tracts. The last aim is to investigate been devised. A particular focus of the
the relationship between structural project is the previous under-researched
measures, diffusion measures, and area of PET motion correction in the
neurological outcomes at three and thoracic area, where novel methods
12 months of age in a large cohort of utilise the capabilities of the newly
neonates born very preterm. available PET/MR scanners.
NEUROIMAGING
B I O M E D I C A L I N F O R M AT I C S
window for pre-clinical treatment. neurobiological features associated
with high risk for dementia, and identify
AIBL and the Alzheimer's disease network (ADNet) the changes that lead to a patient’s
transition from high risk to cognitive
As expectations increase for data-driven number of centres, however there has impairment. The combined use of
knowledge and understanding, it will been considerable variability in the genetic risk scores and neurobiological
be necessary to consider data streams exact numbers reported as quantitative markers creates a potential prognostic
in combination with each other, not as outcome measures of tracer retention. marker for dementia development.
silos, to provide improved classification, The centiloid scale was developed by an Outcomes of the study will inform
categorisation of comorbidity burden, international working group to alleviate and establish a platform for future
diagnosis and prognosis at the some of these issues and provide a intervention programs that target
individual level. This will require framework to standardise measures preventing and treating dementia. So
harmonisation of imaging biomarkers to of Aβ burden from PET images. The far, 93 subjects have been recruited in
give the best overall picture. centiloid framework was applied to the PISA.
calibration of CapAIBL; we showed that
An example where we are currently reliable centiloid estimates could be
working on harmonisation is the obtained with our CSIRO pipeline. There
centiloid scale. Amyloid imaging with is still a need to validate the centiloid
positron emission tomography (PET), scale with longitudinal dataset.
has produced remarkably consistent
qualitative findings across a large
aehrc.com
3 6 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
NEUROIMAGING (continued)
B I O M E D I C A L I N F O R M AT I C S
Figure 1: Example quantitative reports for PET analysis (CapAIBL), MR morphometry (CurAIBL) and FLAIR white matter
hyperintensity segmentation (HIST)
B I O M E D I C A L I N F O R M AT I C S
• 1
7 published journal articles and
• Macquarie University other data to provide clinically
31 conference papers.
• University of Western Australia. meaningful staging criteria for
progressive diseases such as
Alzheimer’s disease.
P
hD Student
aehrc.com
3 8 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
TRANSFORMATIONAL BIOINFORMATICS
B I O M E D I C A L I N F O R M AT I C S
parallelising the individual search tasks
using a revolutionary new compute
approach called Functions-as-a-Service.
aehrc.com
4 0 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Figure 3. Marc Horlacher (Masters student), Amnon Bleich (Masters student) and Aidan O’Brien (PhD student).
S
tudent Profile
Aidan O’Brien, PhD student Amnon Bleich, Masters student in Marc Horlacher, Masters student in
co-supervised with ANU. the Bioinformatics Student Exchange the Bioinformatics Student Exchange
Program. Program.
Topic: Genome editing is a new
molecular discipline with transformative Topic: Genome-wide association studies Topic: Genome editing with CRISPR-
impact on human health, environmental (GWAS) have contributed towards finding Cas9 is opening up new avenues in
and agricultural applications. Of disease genes over recent decades. The almost all facets of research. While
particular promise is the ability to traditional GWAS approaches use odds- CRISPR-Cas9 normally induces random
insert synthetic DNA into the genome ratio and defined distributions, like chi- mutations, some control can be exerted
at precise locations as enabled square tests, to compute p-values for by leveraging specific repair pathways
through CRISPR-Cas9 and homology- associating SNPs with traits. While this within the cell. One such pathway is
directed-repair. Being able to do is appropriate and efficient for simple Microhomology Mediated End Joining
this with the precision and efficiency genotype-phenotype patterns, they are (MMEJ), which results in a controlled
requires extensive computational not capable of identifying interacting deletion of a very specific portion of the
optimisation processes. This project SNPs for multi-genic diseases (e.g. DNA. What drives a target to be repaired
builds sophisticated machine learning diabetes, ALS). Machine learning via this mechanism is still unknown,
models that enable researchers to methods, such as Random Forest, can making its use unreliable. This project
identify the optimal genomic location overcome these limitations. This project uses machine learning approaches
for an intervention. Working together investigates how to improve upon to identify features that predict MMEJ
with Australia’s premier research standard Random Forest algorithms to repair, helping researchers design
organisation and CRISPR facility, the be applicable to genomic data analysis. CRISPR-Cas9 applications that take
computational tools will be validated advantage of this pathway and providing
on novel datasets and enable new greater control over the results.
application areas.
BIOSTATISTICS
B I O M E D I C A L I N F O R M AT I C S
of neurodegenerative disorders and decisions made on disease diagnosis in
psychoses. By bringing together the clinic. In Parkinson's disease, the disease progression model developed in
industry, end users and health care team assesses genomic biomarkers collaboration with partners at the Florey
providers, researchers in the AIBL study that align with the presence of disease Institute for Mental Health, a figure
aim to develop and commercialise our physiology, and in cerebral palsy, the which is widely cited and used in the
research findings in order to deliver team provides statistical guidance on literature.
changes to treatment in medical and MRI data to assess cognitive function
health care practices. Recently, key from children with the disease.
researchers from AIBL were awarded This research has led to six journal
a $20 million grant to start the publications in high-ranking journals.
Australian Dementia Network. This
research project will kick off in 2019,
and will involve recruiting about 4000
participants over the next five years
from around Australia, hosting data
from imaging, biomarkers and lifestyle
similar to the AIBL study.
aehrc.com
4 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
BIOSTATISTICS (continued)
B I O M E D I C A L I N F O R M AT I C S
B I O M E D I C A L I N F O R M AT I C S
University
• Institute for Future
Environments, QUT
• risbane Inflammatory Bowel
B
Disease group
• International Inflammatory
Bowel Disease Genetics
Consortium
• MD Anderson Cancer Center
• epartments of Neurology,
D
Harvard Medical School
• aurice Wohl Institute for
M
Clinical Neuroscience, Kings
College London
• Institute of Health Informatics,
University College London
aehrc.com
4 4 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
HEALTH SERVICES
capabilities as a world leader in providing scientific evidence supporting mobile health. The team's objective is to make
prevention of and management of chronic disease services accessible to all people from their home or community. To
enable this, the team works closely with clinical partners already providing such services, to develop new innovative
care models and technology-based systems and test through clinical trials for evidence base.
The team, based in Perth, is centred on research that provides digital disease screening and diagnosis using
telemedicine to enable healthcare accessible to rural and remote Australia. The team's main focus is the development
of novel telemedicine technologies to deliver non-invasive ocular imaging techniques for chronic diseases such
as diabetes, neuro-degenerative diseases such as Alzheimer’s disease and stroke, and burns and wound care
management. The team were recognised for WA Information Technology and Telecommunications Alliance (WAiTTA)
Incite Awards 2018 – Winner of Most Innovative Enabler in Health Care, and Achiever of the Year.
PROJECTS
H E A LT H S E R V I C E S
and evaluated patient online portals are given in figure 2. This data allows
and mobile applications to improve the collaborating occupational therapist
coordinated care in a variety of chronic to provide a patient-centric intervention
conditions including heart disease, program to lower medication intake
diabetes, lung disease and kidney and pain levels and ultimately increase
disease. Furthermore, the team has wellbeing.
developed a solution for activity pacing
(in pain management) and is also
involved in a project for early detection of
cerebral palsy, using a wearable sensor
system for monitoring body movements
of neonates. Selected projects are
presented below.
Figure 1. Screenshots of the mobile application. The app alerts individuals to enter their pain score every waking hour. Individuals also enter their daily activities and
opioid medication in an electronic diary.
aehrc.com
4 6 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Figure 2. Examples of the visualisation of the Pain ROADMAP portal that show a user’s day of activities, levels of pain and times of medication intake. Activities are colour
coded to indicate the type of activity.
The results of this pilot study have The aim of this project is to enable major disease at an earlier age. The infant
been extremely encouraging. After the advances in the management of babies at wearable sensors under development
third monitoring period, participants risk of cerebral palsy, reduce the financial can be used to measure and quantify
reported less pain, stress and anxiety, burden of the condition on the health extremity motor characteristics, indicative
with increases in physical activity. system, and increase societal integration of normal or abnormal development.
Most importantly, there was a general and quality of life for children born with Under normal developmental trajectories,
reduction in the amount of pain this difficult-to-diagnose disease. infant movements will be fluent and
H E A LT H S E R V I C E S
H E A LT H S E R V I C E S
(n=50 patients), or usual care control
group (UC-COPD) (n=50 patients) for A B C
six months. The MH-COPD program
has been designed to integrate a
mobile health system within a clinical
COPD care service. In the program,
participants will use a mobile health
application at home to review educational
videos, monitor COPD symptoms, use
an electronic action plan, modify the
risk factors of cigarette smoking and
regular physical activity, and learn to use
inhalers optimally. All participants will be
assessed at baseline, three months, and
six months. The primary outcomes will
be COPD symptoms and quality of life;
the secondary outcomes will be patient
adherence, physical activity, smoking
cessation, use of COPD medicines,
frequency of COPD exacerbations
Figure 4. Selected screenshots showing the user interface of the mobile application.
and hospital readmissions, and user
A: Scheduled educational videos preloaded in the app
experience of the mobile app. B: User interface to record symptoms and risk factors
C: User interface showing an assessment of symptoms in the COPD action plan.
The study has integrated an innovative
mobile system with a clinical COPD
service and will evaluate this approach
through a randomised control trial.
The evaluation will provide a unique
opportunity to improve COPD care in
the community through mobile health
innovations.
aehrc.com
4 8 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Mobile Pulmonary
rehabilitation Platform
(m-PR)
Pulmonary rehabilitation (PR) is
an evidence-based and effective
treatment but only 5-10% of eligible
patients are currently attending PR
services. PR services are delivered
in highly specialised hospitals and
this service model is inefficient and
unsustainable. Lack of motivation,
transport issues and clinical patient’s
liability have been signalled as causes
for low uptake and adherence to the
current PR programs, leading to
poorer clinical outcomes and misuse
of resources. The mobile Pulmonary
Rehabilitation (m-PR) platform is a
novel smartphone and Internet-based
interactive solution to support patients
H E A LT H S E R V I C E S
H E A LT H S E R V I C E S
site photos, which automatically upload
to a password-protected clinician portal.
The aim of the PD-BUDDy platform is
to assist both patients and clinicians
during their PD procedure, reduce
possible PD-associated complications,
improve quality of life for patients and
reduce the financial burden on the
healthcare system by saving time.
PD-BUDDy leverages from CSIRO’s
existing clinically validated mobile
health digital platform for cardiac
rehabilitation, and through the close
relationship with stakeholders, features
have been incorporated to PD-BUDDy
that are unique to PD patients such as
ultra-filtration volume quantification,
clinician-driven communication and
ability to share photos of catheter exit
sites for potential infection. PD-BUDDy
has extended functionality to connect
Figure 1. A patient from Logan Hospital relating her PD-BUDDy experience.
to wireless physiological monitors and
fits perfectly for new remote health care
delivery models extended to community
and home care.
aehrc.com
5 0 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
M♥THer: gestational diabetes app helps health workers monitor pregnant women
Gestational diabetes mellitus (GDM) is
an increasing problem among pregnant
women worldwide with a prevalence of up
to 20% depending on diagnosis criteria
and population. The increasing number
of pregnant women being diagnosed with
GDM is leading to snowballing healthcare
costs. M♥THer is an interactive system
designed to support women throughout
diagnosis of GDM to childbirth. It also
improves multidisciplinary care co-
ordination by providing shared access to
the women’s clinical information.
alternative to the paper-based blood Figure 1. Redland Hospital Chronic Disease Team CNC Roisine Warwick
glucose level (BGL) recordings. All
respondents agreed that the app was Diversity To address the objective of this study,
user friendly, convenient and helpful in we have engaged with four different
managing their GDM, making them feel In 2014, we validated a mobile countries in Europe starting a pilot
confident in the management of their health home-care model for cardiac study in different CR centres of Sweden,
condition. Treating clinicians reported rehabilitation (CR), which used Belgium, Netherlands and Poland.
improved communication with the smartphones and the internet to deliver Following the results of this study,
women in their care and experienced rehabilitation in the patient’s home a randomised clinical trial with the
an increase in multidisciplinary co- setting to align with their lifestyle. This participant sites will be proposed. For
ordination amongst themselves. The platform was tested in a randomised this study we are utilising Cardihab as
platform enabled early intervention clinical trial, becoming the first clinically commercial partner for delivering of
for a number of women identified with validated mobile health delivery of the cardiac rehab platform, which has
elevated BGL readings in the first week CR, improving uptake, adherence, been translated into Swedish, Dutch and
of using the app, and due to elevated completion rates of participants and with Polish.
fasting BGLs, a number of women were similar health outcomes as that of the
timeously commenced on Metformin or traditional centre-based CR programme.
insulin treatment. Now, in 2018, we want to develop this
concept internationally and test how our
Data input received from the M♥THer technology can be validated irrespective
app include physiological measuring of the intrinsic characteristics of the
outputs and supports decisions on health structure and the culture and
patient management that can impact language of the users.
clinical outcomes and patient care.
M♥THer expands access and can
improve the quality of healthcare for
women in regional and rural areas. It
reduces burdens for these women, such
as travel to receive specialist care, and
improve monitoring, timeliness, and
communications within their care teams.
H E A LT H S E R V I C E S
feasibility study in Czech
disorder. Republic, extending diversity
• T
he M♥THer platform was study to Kuwait and China,
shortlisted as finalist in the entering the US market.
International Hospital Federation
Awards, with final judging based
on a pitch to be delivered on 10
October 2018 during the World
Hospital Congress in Brisbane.
• D
r David Ireland and Dr
Christian Redd were successful
in obtaining funding for early
stage projects through Acorn
Awards. These projects are
‘Bots, Bullies and Autism’, and
‘A Universal Smart Toy Sensor
System for Monitoring Child
Development’, respectively.
• T
he Mobile Health Systems
team has this year been very
engaged in community programs
such as the CSIRO’s Assets
Work Placement for Indigenous
students, work experience, and
Indigenous cadets.
aehrc.com
5 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
PhD Student
Nazli Ghafouryan
Project title: A mobile based multidisciplinary virtual clinic for patients with Acute Coronary Syndromes: A Randomised
Controlled Trial, MoTER-ACS project
The aim of this research is to develop a The post-discharge virtual clinic on a remote server. Following testing
mobile based multidisciplinary virtual will be offered to patients as an of the feasibility of the mobile-based
clinic based on the existing platform alternative program to a hospital- intervention in the pilot study (N=54),
(MoTER) and to investigate the impact based follow-up. The mobile phones a randomised control trial will be
of such a clinic on health outcomes and are used for providing education and conducted to evaluate its effectiveness.
clinical management of patients with personalised feedback, monitoring We hypothesise that the use of mobile-
Acute Coronary Syndrome (ACS). MoTER physiological data as well as recording based clinics offer effective post-
is a platform designed for home based patients’ self-observations on their discharge management tools for both
monitoring in cardiac rehabilitation health-related behaviour and virtual patients and healthcare professionals.
using smartphone application and consultation via audio or video. All the
the internet. We customised the data is synchronised daily to a portal Collaborators: Metro North Hospital
MoTER platform for delivering care in and Health Service.
patients with ACS as a comprehensive
virtual clinic. This study consists of a
pre-study survey and a pilot testing
H E A LT H S E R V I C E S
P
ublications:
• B
ashi N., Fatehi F., Fallah M.,
Walters D., Karunanithi M. Self-
management education via mobile
health (mHealth): A review of
strategies and structures. JMIR
Mhealth Uhealth. 2018 Jun 26. doi:
10.2196/10771. [In print]
• B
ashi, N., Karunanithi, M., Fatehi,
F., Hang Ding, H., Walters, D.
Remote Monitoring of Patients
with Heart Failure: An Overview of
Systematic Reviews. J Med Internet
Res; 2017;19(1): e18, doi:10.2196/
jmir.6571
The Internet of Things (IoT) refers to a network of internet connected devices that collect and transmit data through embedded
sensors. The Health Internet of Things team uses IoT to build solutions for health and aged care.
H E A LT H S E R V I C E S
with multidisciplinary collaboration
including universities, aged care service
providers and local clinicians. It uses
cutting edge pervasive communication
and wireless sensor and monitoring
technology, and features a novel,
personalised measure of functional
independence, indexed through the
“Objective Activity of Daily Living”. The Figure 1. SSH iPad application allows residents to view data derived from the sensors and medical devices.
potential benefits of these technologies
are multiplied where distance separates
families and adds substantial costs to
delivery of health and other services.
Figure 2. Objective-Activity of Daily Living (OADL) scores of the SSH app to represent everyday health and
wellbeing status.
aehrc.com
5 4 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Dementia and aged care services: Sustainable, cost effective, Smarter Safer Homes 100
smart assisted independent living – Smarter Safer Homes testbed
This project’s objective is to deploy 100
This project’s objective is to use the To achieve this, our Smarter Safer
Smarter Safer Homes platforms within
Smarter Safer Homes platform to Homes platform will be implemented in
Australia to provide an ongoing testbed
revolutionise aged care services delivered metro, regional and rural service settings
for AERHC research. Its aims are:
to people in their homes, in alignment in four sites that present different
with consumer directed care, through: geographical challenges and work force • T
o collect longitudinal sensor and
issues. This implementation will be activity data from real residential
• d
eveloping innovative service models facilitated by national, metro, regional, homes and construct a database
appropriate across a range of and rural service providers as partners to continuously develop, evaluate
service and geographical settings of the consortium. The evaluation will and extend the Smarter Safer
which is effective, client-driven and be conducted among 200 participants, Homes platform (installation of
focused. aged 65 years and over living at home inconspicuous sensors and devices
• e
nabling a platform that not only and supported by home care service to monitor the activities of daily
tailors to individuals, including those providers, through a pragmatic living of seniors).
with dementia, basic functional and randomised controlled trial which • T
o foster collaborations with service
health needs, but also supports translates evidence into real practice and providers on a well-developed
carers’ needs. policy. The outcomes of the trial include research platform with continuous
changes in quality of life, functional, inputs of large quantity of real data
psychological and cognitive health, carer to help shape an economic and
H E A LT H S E R V I C E S
C
ollaborators: Collaborators:
• S
ervice providers: Anglicare Australia, integratedliving Australia Ltd, • integratedliving Australia
All About Living. Ltd.
H E A LT H S E R V I C E S
the use of wearable technologies to
detect falls in everyday environments.
Although wearable sensor solutions
provide good accuracy and sensitivity
for fall detection, it may not always
be convenient or desirable for older
adults to wear a tag or sensor in home
environments. This project discusses
using non-wearable ultra-wideband
(UWB) radar sensors as a practical,
environmental fall detection solution in
home settings.
aehrc.com
5 6 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Immersive augmented
reality: remote clinical
consultation
Using emerging augmented reality
(AR) technologies on mobile devices,
this project developed an AR clinical
consultation system through an iPad
and a Kinect sensor. This low-cost
and highly portable AR consultation
system can be easily deployed in a
patient's home and clinician's office with
minimum footprints on their normal daily
activities. It not only provides a great
and immersive telehealth consultation
experience for patients, but also can
help clinicians to easily explain complex
medical conditions to patients through
Figure 6. AR Doctor system structure.
visualisation and simulation.
H E A LT H S E R V I C E S
The Digital Health Engagement team Activate TKR: mobile support for orthopaedic surgery
draws on expertise across human-
computer interaction, personalisation Summary
& recommendations, persuasive
technology and neuroscience to be Total knee replacement (TKR) surgeries video-based exercise demonstrations,
a leading team in the design and have increased in recent years. Exercise and tools for self-monitoring of daily
evaluation of technologies to facilitate the programs and other interventions activities including an activity tracker.
provision of equitable health care. The following TKR can facilitate the recovery The app transmits patient-gathered data
team designs technologies that can be process. With limited clinician contact to a purpose-built web portal where
used by clinicians to improve workflow time, patients with TKR have a substantial clinicians can view patient progress and
and enhance service delivery, and by burden of self-management and limited configure exercise programs remotely.
individuals to support them in playing an communication with their care team, Activate TKR is designed to provide
active role in their health management and so they often fail to implement an flexibility in care delivery, and increased
to meet short- or long-term health effective rehabilitation plan. engagement with rehabilitation services.
and lifestyle goals. The team has a
The Australian eHealth Research A randomised control trial began
strong collaborative approach, leading
Centre, together with Johnson & in November 2016 to evaluate the
and contributing to projects across the
Johnson Medical Devices Australia, technology platform. It is being
e-Health program and into several other
are looking at new ways to address the conducted at multiple sites in a number
CSIRO divisions. In 2017/18 the team
challenges of motivating and assisting of states in Australia, with about 150
engaged primarily with industry partners
patients to complete rehabilitation patients undergoing TKR surgery.
to deliver excellence in science.
programs while also reducing the Participants are randomised to either
H E A LT H S E R V I C E S
communication gaps that exist between a control group or the intervention
clinicians and patients. We have group, with both receiving usual care as
designed and developed Activate TKR, provided by their surgeon or hospital.
an orthopaedic support technology The intervention group receives the app
platform, comprised of a mobile app, a and wearable activity tracker in addition
wearable activity tracker, and a clinical to usual care. This trial is investigating
web portal. The technology platform the clinical and behavioural efficacy of
aims to assist patients in managing the app, and the impact of the technology
their surgery preparation and speed platform components in terms of service
up their recovery, and to bridge the satisfaction, acceptance, and economic
communication gaps between clinicians benefits of the provision of digital
and patients. The purpose-built app services. The trial is running for a period
includes behavioural coaching, practical of 13 months for each patient.
hints and tips for surgical preparation,
Figure 1. Activate TKR clinical portal. The web portal allows clinicians (e.g. surgeons, physiotherapists) to view
patient data and configure exercise programs for individual patients.
aehrc.com
5 8 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Figure 2. Activate TKR app: Home screen. Figure 3. Activate TKR app: Physio Coach Figure 4. Activate TKR app: Today screen. Shows
screen. Exercise programs are configured by data from the activity tracker (daily step, stairs, and
physiotherapists from a library of videos typically sleep) and self-reports (pain and knee ROM).
used for TKR rehabilitation.
• T
KR user needs paper published
O
utcomes Outputs to date
in JMIR: van Kasteren Y, Freyne
• Increase patient engagement • D
evelopment of the technology J, Hussain MS Total Knee
with rehabilitation services platform (patient app and clinical Replacement and the Effect of
(surgical preparation and portal) Technology on Cocreation for
recovery) Improved Outcomes and Delivery:
• R
andomised control trial launched
Qualitative Multi-Stakeholder
• B
ridge the communication gaps in November 2016; kicked-off with
Study J Med Internet Res
between clinicians and patients four trial sites in NSW and SA
2018;20(3):e95.
• P
rovide flexibility in TKR care • First media release in March 2017
delivery, particularly in rural, • S
howcased project together with
remote, or busy lifestyles, with O
utputs expected in 2018/19
Johnson & Johnson Medical
the potential to achieve the same Devices at the Bennelong • D
ata extraction and preliminary
clinical outcomes as normal Innovation Summit at Parliament data analysis (quantitative)
business-as-usual care. House in March 2017
• Qualitative research findings
• R
esearch protocol paper published
• Interim outcomes workshop with
Impact
in JMIR: Hussain MS, Li J, Brindal
Johnson & Johnson.
E, van Kasteren Y, Varnfield M,
• J ohnson & Johnson’s interest Reeson A, Berkovsky S, Freyne J
in application to other joint "Supporting the Delivery of Total
replacement studies Knee Replacements Care for Both
• H
ealth care industry’s Patients and Their Clinicians With
application to health and a Mobile App and Web-Based
wellness solutions. Tool: Randomized Controlled
Trial Protocol" JMIR Res Protoc
2017;6(3):e32
H E A LT H S E R V I C E S
The prevalence of prostate cancer, the • M
en spoke candidly about the CSIRO: 2018. EP18233
impact of symptoms on mental wellbeing psychological ramifications of
• B
radford, Dana. Improving
and the increase in suicide ideation their prostate cancer journey
care for men with prostate
indicate an urgent need for a greater • A
number of potential strategies cancer. CSIRO: 2017.
understanding of how psychological were identified to enhance the EP176237. https://doi.
services can support men on their provision of psychological services. org/10.4225/08/59b6dd593f5ea
prostate cancer journey. Movember
Foundation has established and funded • B
radford, Dana. Sunshine
Impact Coast TrueNTH Focus Groups:
the TrueNTH network, a prostate
cancer survivorship initiative which is Improving engagement and care
• U
nderstanding the trigger points
a collaborative effort among various experience of men living with
for men allows Movember to
global organisations, of which CSIRO is a prostate cancer. CSIRO: 2017.
provide enhanced services when
member. Through the TrueNTH program, EP175572.
they are most required.
Figure 5. CALD Assist app: upon selection of an individual phrase, translated text and appropriate image is devices in almost all classrooms across
displayed on the screen.
Australia. The implementation of these
technologies facilitates skill acquisition
across a range of learning styles and will
have far reaching benefits for students
• 2
015 Health Informatics Society
O
utcomes in their future careers. Students on the
Australia, Branko Cesnik Award
autism spectrum tend to show a keen
• A
new app was developed for Best Academic/Scientific
interest in, and respond positively to,
that includes nursing-specific paper
technology including chat-bots, tablet-
content • 2
015 Gold ‘Improving health based communication devices, and
• An evaluation trial was finalised equality and closing the gap’, robots. These technologies open the door
Victorian Public Healthcare towards new approaches to education
• It was confirmed that
Awards and learning. We are working with the
interactions between nursing
staff and CALD patients are • 2
017 The Health Roundtable wider autism community to understand
less successful than those with Innovations Award ‘Improving the roles that innovative technology can
English-speaking patients. the Continuum of Care’ play during successive stages of childhood
• 2
018 iAwards Victoria Merit development in the home, in the classroom,
Certificate (Public Sector & and during extracurricular activities,
I mpact
Government) with a focus on social participation. In
• Improve the clinicians’ ability to collaboration with the Autism Hub, we
• J . Freyne, D. Bradford, C.
adequately assess and respond conducted a think tank to explore the
Pocock, D. Silvera-Tawil,
to patient needs in a timely directions for the future of technology-
K. Harap, S. Brinkmann.
manner supported education to create better
Developing digital facilitation of
outcomes for students on the spectrum and
• Improve the frequency and assessments in the absence of
the wider autism community.
quality of communication an interpreter: a participatory
between staff and CALD patients. design and evaluation with allied
health groups. JMIR Formative O
utputs to date
O
utputs to date Research, 2 (1), 2018.
• D
. Silvera-Tawil, C. Pocock, • B
radford, Dana; Ireland, David;
• F
reyne, J., Pocock, C., Bradford, D. Bradford, K. Harap, S. Silvera, David; Farr-Wharton,
D., Harrap, K., Brinkman, Brinkmann. CALD Assist – Geremy; Xiao, Yi; Cooper, Anabelle.
S. Designing technology for Nursing: Improving Patient Teachnology: Tech reshaping the
assessments of CALD patients. Communication in the Absence face of education in the Autism
HIC Brisbane 4 August 2015 of Interpreters. Journal of community. A report of the Autism
Clinical Nursing, 2018. Technology Think Tank. CSIRO:
2018. EP183925.
H E A LT H S E R V I C E S
in social interaction,
world and its rewards, while interpersonal in students with Autism or
communication, participation
skills are sacrificed or not generalised to Intellectual Disability,” in IEEE
and self esteem
real world settings. Robots Man Systems Interactions
• B
enefits observed in students Conference, 2018.
We have developed interactive modules to when they interacted with
support therapy and education for children robots in the classroom are
with autism and intellectual disability. We transferring to interpersonal
are trialling four different social robots: interactions.
NAO, KASPAR (from the University of
Hertfordshire), PARO and ROBOTIS OP3,
including trials in partnership with the
University of New South Wales, Autism
Spectrum Australia (ASPECT) and Murray
Bridge High School in South Australia.
Social robots are novel, animated and
appear to be autonomous, setting
themselves apart from other technology,
and their physical, 3D presence provides
a compromise between the virtual world
and the real world. Robots can provide
complex behaviour patterns, while
appearing much less intimidating than
humans. They can also deliver predictable
behaviours and repetitive feedback, and
they don’t get angry, tired or stressed.
More than anything, robots provide a new
environment where it is fun to learn. To
support our trials, we have developed an
app and compatible platform that can be
used as a user interface to control the
social robots used during our trials.
Figure 6. The humanoid robot NAO and the robot seal PARO at the Murray Bridge High School Disability Unit.
aehrc.com
6 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
direct benefits for those who need this disengagement and result in social
technology the most: individuals on the isolation. Identifying bullying in children
spectrum, and their families and carers. with ASD is hampered by the fact that
children with ASD may have limited
‘Hear’ to help: striving for speech and struggle to communicate
greater participation and their experiences. In these cases, being
bullied can compound social interaction
wellbeing through tailored difficulties and impede communication
chat-bot technology development. Sadly, many children on
the autism spectrum who wish to make
In collaboration with Curtin University,
new friends have an even higher chance
Autism Academy for Software Quality
of being bullied. It can be strongly
Assurance (AASQA), the Queensland
argued there needs to be an ongoing
Department of Education and Training,
and early implementation of programs
and Autism Spectrum Australia, this
to build lifelong resilience against
project will work with people on the
Figure 7. An example of a conversation to identify if a bullying behaviour.
child perceives they are being bullied. autism spectrum, support service
In light of this, seed funding from
CSIRO’s Health and Biosecurity
business unit was provided to develop a
specific bullying module for the Harlie
chat-bot. Harlie’s bullying module is
under development and will be co-
designed by the autism community.
A number of key stakeholders have
expressed interest in being involved
in the evolution of this module for
children, young adults in tertiary
education and young employed adults
with autism. Early content includes an
example interaction of the beginning
of a conversation involving identifying
whether the user is being bullied.
Images are embedded into the
Figure 8. A sample dialogue between Harlie and a person with autism. Green rectangles designate dialog responses to help guide the meaning of
generated from Harlie, blue rectangles designate responses from the user, grey rectangles indicate pauses in
the timeline.
the conversation.
H E A LT H S E R V I C E S
We have been developing a AAC app and Bradford, D. Social Fringe Project Aims for
with an embedded chat-bot, herein Dwellers: Can chat-bots 2018/19:
referred to as Alex. Alex is designed for combat bullies to improve
participation for children • F
inalise clinical trial for
use by people on the autism spectrum.
with autism? Journal of Activate TKR program
Programming Alex does not need any
specialist skills and is designed for Community Informatics, • R
oll out evidence-based
speech therapists, parents and other Special Issue (In press). implementation of robots into
key stakeholders to contribute what • A
. Cooper and D. Ireland, Queensland schools
they deem relevant. The user is able ‘Designing a Chat-Bot for • D
evelop and deploy chat-
to practice spontaneous conversation Non-Verbal Children on the bot technology to facilitate
with Alex in a safe, non-judgemental Autism Spectrum’, Studies participation in tertiary
environment. The long-term aim in health technology and education and offer bullying
of this research is to examine the informatics. Volume 252 pp. strategies for children on the
validity of intervention based on 63-68, Health Informatics autism spectrum.
artificial intelligence that augments Conference (HIC), 2018
conventional therapy.
tudent or postdoc
S
highlight
Yi Xiao initially joined CSIRO as a
Vacation Student from the University
of New South Wales. During this time,
she developed an Android-based user
interface to facilitate the use of robots in
therapy and education. She has a strong
technical background in computer
science with a focus in robotics, artificial
intelligence and machine learning. She
is now doing her Bachelor of Honours
research project with the Digital
Health Engagement team around the
Figure 9. Example of conversation using AAC. The blue box holds the user input, and the green box shows application of social robotics for autism
Alex’s response. and intellectual disability.
aehrc.com
6 4 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Highlights:
1. F
irst to deploy artificial intelligence-based grading system for diabetic retinopathy and other eye diseases into a real-
world clinical setup (Midland GP Superclinic)
2. Developed a automated retinal imaging platform called VASP to measure ocular biomarkers
3. D
eveloped and validated a mobile app called MICE, Medical Image Communication and Exchange, at the Burns Unit at
Fiona Stanley Hospital. This is expected to be rolled out into hospitals in South Metro Health Service
4. T
ele-dentistry system has been developed using mobile phones for imaging and evaluated in WA. One PhD (Mohamed
Estai who received Dean’s Award for his PhD on tele-dentistry) has published over 10 papers around this study
5. A
ttracted major funding from NeuroVision Imaging to conduct further clinical trials around Alzheimer’s disease and
eye imaging.
PROJECTS
Artificial intelligence-based
grading and diagnosis of
diabetic retinopathy at GP
clinics
The Australian Tele-Health Research
and Development Group has obtained a
Diabetes Research WA grant to validate
our smart eye-screening system for
early detection of the sight-threatening
condition, diabetic retinopathy (DR). The
aim of the project is to build and validate
a novel artificial intelligence-based
A U S T R A L I A N T E L E - H E A LT H R E S E A R C H A N D D E V E L O P M E N T G R O U P
disease grading and clinical decision
support system for screening and
telemedicine-based diagnosis of DR.
The proposed system will be integrated
with fundus cameras, with real-time
image quality control software for colour
fundus images to produce sensitivity
and specificity over 90% for DR grading.
aehrc.com
6 6 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
• C
ompleted the system • Implement the system at Royal
development Perth Hospital and REACH
A U S T R A L I A N T E L E - H E A LT H R E S E A R C H A N D D E V E L O P M E N T G R O U P
Clinic.
• P
articipated in “Explore
Diabetes” Expo event
organised by Diabetes
Research WA and showcased
the technology to audiences
• L
icensed the system to
TeleMedC, and through the
company rolled out the system
in Singapore by collaborating
Figure 2: Smart phone application of the DR with National University
screening system. Hospital Singapore
• W
AiTTA Incite Awards 2018
- Winner of “Most Innovative
Enabler in Health Care”.
Medical Image
Communication and
Exchange (MICE) app for
burns applications
Using the Medical Imaging and
Communication Exchange App, junior
doctors, specialists and nurses can
now seek expert real-time diagnostic
advice about various conditions by
securely sending burns images through
a mobile device to a burns specialist.
By streamlining the medical image
capture and storage process, the app
introduces a secure way of sending
medical images to the specialist. Images
captured through the app are not saved
on the mobile device and can only be
viewed by the specialists and related Figure 3: MICE app screenshots.
doctors. Medical records and images are
managed through our award-winning
store-and-forward telehealth system
(Remote-I). This system can be accessed
via web or mobile and maintains secure
access rights for all users.
A U S T R A L I A N T E L E - H E A LT H R E S E A R C H A N D D E V E L O P M E N T G R O U P
• ~
120 images with ~ 200 image Project highlights • L
icense MICE to WA Health for
use at different hospitals
tags for 2017/18:
• A
gile: On-site agile development • F
urther develop MICE on other
within the hospital – app was • D
iabetic retinopathy grading mobile platforms and disease
co-developed with hospital staff system evaluation on training conditions
to cater for their direct clinical data set completed • E
valuate data from various
requirements • Image quality control system clinical trials using VASP
• B
arcode: Patient record evaluation completed (hypertension, stroke,
integration using barcode • M
ICE app developed for iOS Alzheimer’s disease).
scanning feature (iPhones)
• R
eporting: Reporting • M
ICE app trial completed by the
functionality for hospital systems specialists and junior doctors at
integration Fiona Stanley Hospital and the
• Image tagging: Images taken hospital executive committee
from the app are tagged to is supporting the project for
identify the pictured body part, statewide rollout.
to assist in searchable clinical
images
• E
ngagement: Engaged
with many other hospital
departments (such as plastics,
orthopedics, business intelligent
unit, security, IT)
aehrc.com
6 8 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
P
ostdoctoral fellow
Sajib Saha, PhD for the detection and classification Dr Saha acts as a reviewer for many
of DR pathologies. He has published journals, IEEE Transactions on
Dr Sajib Kumar Saha is a postdoctoral numerous research articles in top Broadcasting, Biomedical Signal
fellow at the CSIRO Australian e-Health ranked journals including ‘Investigative Processing and Control, Biomedical
Research Centre working towards Ophthalmology & Visual Science (IOVS)’ Physics and Engineering Express,
the development of machine learning journal (IF 3.43), ‘Journal of Medical Computer Methods in Biomechanics and
techniques for the automated detection Systems’ (IF: 2.46), 'Biomedical Signal Biomedical Engineering, Computers in
and progression analysis of sight Processing and Control' (IF: 2.7). Biology and Medicine, Journal of Digital
threatening eye disease, specifically Imaging, and the Journal of Cultural
diabetic retinopathy (DR) and age- Dr Saha has led the establishment Heritage. He is an editorial member of
related macular degeneration (AMD). Dr of a collaboration with the University the journal titled EC Ophthalmology.
Saha joined CSIRO in August 2015 and of California, Berkley and Stanford
during this time he has proposed and University in California to use their
developed several artificial intelligence- retinal image dataset and to develop
based methods for the automated novel techniques for the analysis of
analysis of retinal pathologies. His the disease. Dr Saha is also working
core developments include a novel with researchers from Sankara
retinal image registration method, an Nethralaya, India and Khulna University,
automated image quality assessment Bangladesh. Presently, Dr Saha is
method for DR screening, an automated working at UCLA for six months on
non-uniform/poor illumination applying deep learning methods for
correction method for fundus images, detecting early AMD pathologies from
a novel colour normalisation method OCT images.
to eliminate intersubjective colour
variability to facilitate automated
analysis, a deep learning method for
the "disease/no-disease" grading of
AMD, and a deep learning method
A U S T R A L I A N T E L E - H E A LT H R E S E A R C H A N D D E V E L O P M E N T G R O U P
and Melbourne. This work will be an COPD, to include 50 patients
expansion of the pilot study conducted in a follow-on multi-state trial.
previously at the Royal Perth Hospital We plan to submit a grant
in collaboration with Dr Yuben Moodley proposal for a multi-centre
(now posted at the Fiona Stanley study to NHMRC.
Hospital). We are exploring additional
funding to continue a large scale multi-
centre study.
aehrc.com
7 0 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
In this stream of work we are exploring Preliminary results have been presented Retinal imaging in resistant
ways to develop biomarkers to screen at the Alzheimer’s Association
and diagnose diseases early, so International Conference, the
hypertension
appropriate treatment and surgery can International Conference on Alzheimer’s This is a collaborative research
be provided in a timely manner. Our and Parkinson’s diseases, and the project between Royal Perth Hospital
focus has been studying the changes Association for Research in Vision Hypertension Clinic and the ATRDG.
related to vascular parameters from and Ophthalmology Annual Meeting. The major aim of the project is to
the retina and the anterior segment in A manuscript communicating these identify novel retinal imaging markers
relation to various disease development results is in preparation. that may closely correlate with best
such as stroke, hypertension, practice blood pressure measurements
Alzheimer’s disease, heart disease and Retinal imaging equipment, protocols
and other signs of hypertensive organ
mental disorders. All data collection and image analysis techniques have
damage in these high risk patients.
has been carried out in partnership with all been improved as a result of these
Such a retinal marker or set of markers
various Perth clinics. studies. The latest technology is being
A U S T R A L I A N T E L E - H E A LT H R E S E A R C H A N D D E V E L O P M E N T G R O U P
A U S T R A L I A N T E L E - H E A LT H R E S E A R C H A N D D E V E L O P M E N T G R O U P
may have utility both in assessing
retinal vascular changes and stroke, Diseases in 2017. A positive correlation
stroke/CVD risk and monitoring the
suggesting that retinal photography was found between carotid disease
vascular impact of dietary intervention
could have utility in assessing and both mean width of arterioles (r
to increase blood carotenoids.
underlying stroke risk factors and = 0.40, p = 0.00571) and venules (r =
Additionally, in malnourished
prognosis after stroke. 0.30, p = 0.0381). The results provide
populations, this technique offers
further evidence that retinal vascular
potential to track carotenoid status as
The retinal microvasculature is highly features are clinically informative about
part of interventions aimed to reduce
accessible with modern imaging underlying stroke risk factors, and
vitamin A deficiency. A publication is in
equipment facilitating precise demonstrate the utility of handheld
preparation.
measurement and monitoring of retinal photography in the stroke ward.
vascular features. However, use of this
equipment is a challenge in the stroke With the RPH Stroke ward closing, the Retinal imaging to
ward setting as patients are frequently ATRDG is now pursuing contacts at detect H.Pylori related
unable to maintain the required seated Sir Charles Gairdner Hospital and the inflammation
position and pupil dilatation is often not Perron Institute for Neurodegenerative
feasible as it could potentially obscure Diseases to develop a new stroke This is a collaborative research project
important neurological signs of stroke research program. between Hollywood Private Hospital
(HPH) Nobel prize winner Professor
Barry Marshall and ATRDG. Retinal and
anterior eye image collection has begun
at HPH investigating ocular signs of
inflammation co-morbid with H.Pylori
infection, which results in increased
incidence of glaucoma. This is a pilot
study, with five patients so far, and it will
continue until we reach 20 patients.
Figure 2: Retinal fluorescence image - identifying AD plaques in retina and how they increase over time.
aehrc.com
7 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Figure 4: VASP image processing modules detect vessel tree structures, classify artery/vein, and measure
vessel thickness at various regions.
A U S T R A L I A N T E L E - H E A LT H R E S E A R C H A N D D E V E L O P M E N T G R O U P
Figure 5: VASP system architecture is based on client-server web framework. The dynamic data representations and user
interactions are translated into data, saved at central database, and communicated to the Automatic Image Processing Unit.
Postdoc highlight
Project aims for
C
ollaborators:
2018/19: Shuang Yu, PhD
• N
eurovision Imaging, • C
omplete new AD trial with As a Postdoctoral Research Fellow
Sacramento, California new imaging technology and at CSIRO, Dr Shuang Yu joined the
protocols Australian e-Health Research Centre in
• H
ollywood Private Hospital
September 2015. Her research focussed
(Ramsay Health Care) • P
ublish AD, tropicamide and
on the automatic analysis of retinal
• Royal Perth Hospital SAHMRI study results
vascular structures with graph theory
• University of Western Australia • D
evelop RPH studies into and machine learning algorithms. This
additional clinical areas year her work led to a software patent
Project highlights • C
omplete HPH trial on and numerous improvements to the way
H.Pylori infection and retinal retinal image analysis is conducted. Dr
for 2017/18: inflammatory markers Yu’s work was presented at ARVO 2017
• C
linical trial nearing and EMBC 2017.
• A
s the stroke clinic at Royal
completion - external funding
Perth Hospital has been closed
from Janssen, next-generation
and moved to Sir Charles
retinal fluorescence imaging
Gairdner Hospital we will be
in AD
seeking to establish similar
• V
ASP software patented - study with a new cohort
Cloud Based Multi-modality
• R
edefine the stroke study to
Intelligent Retinal Vessel
explore people with secondary
Analysis Platform for stroke,
stroke.
hypertension and H.Pylori
studies
• T
ropicamide study completed -
manuscript under preparation.
aehrc.com
74 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
24. K. Harrington, Y. Lim, D. 30. B. Koopman, G. Zuccon, 35. R. Martins, V. Villemagnen, 40. A. Nakamura, N. Kaneko,
Ames, J. Hassenstab, S. P. Bruza, “What Makes an H. Sohrabi, P. Chatterjee, T. V. Villemagne, T. Kato,
Laws, R. Martins, S. Rainey- Effective Clinical Query and Shah, G. Verdile, P. Fraser, J. Doecke, V. Dore, Q. Li,
Smith, J. Robertson, C. Querier?”, Journal of the K. Taddei, V. Gupta, S. R. Martins, C. Rowe, T.
Rowe, O. Salvado, V. Dore, Association for Information Rainey-Smith, E. Hone, S. Tomita, K. Matsuzaki, K.
V. Villemagne, C. Masters, Science and Technology, vol. Pedrini, W. Lim, I. Martins, S. Ishii, K. Ishii, Y. Arahata, S.
P. Maruff, “Amyloid-β 68, pp. 2557–2571, Sep 2017. Frost, S. Gupta, S. O’Bryant, Iwamoto, K. Ito, K. Tanaka,
associated cognitive A. Rembach, D. Ames, K. C. Masters, K. Yanagisawa,
decline in the absence of 31. J. Lan, A. Galindo, J. Doecke, Ellis, S. Fuller, B. Brown, S. “High performance plasma
clinical disease progression C. Fowler, R. Martins, S. Gardener, B. Fernando, P. amyloid-β biomarkers
and systemic illness”, Rainey-Smith, O. Cominetti, Bharadwaj, S. Burnham, S. for Alzheimer’s disease”,
Alzheimer’s and Dementia, L. Dayon, “A systematic Laws, A. Barron, K. Goozee, Nature, vol. 554, pp. 249–254,
vol. 8, pp. 156-164, Aug 2017. evaluation of the use of E. Wahjoepramono, P. Asih, Jan 2018.
human plasma and serum J. Doecke, O. Salvado, A.
25. S. Holmes, I. Esterlis, C. for mass spectrometry- Bush, C. Rowe, S. Gandy, 41. A. Nakamura, N. Kaneko,
Mazure, Y. Lim, D. Ames, S. based shotgun proteomics”, C. Masters, “Alzheimer’s V. Villemagne, T. Kato, J.
Rainey-Smith, C. Fowler, K. Journal of Proteome Disease: A Journey Doecke, V. Dore, C. Fowler,
Ellis, R. Martins, V. Dore, O. Research, vol. 17, pp. 1426- from Amyloid Peptides Q. Li, R. Martins, C. Rowe,
Salvado, V. Villemagne, C. 1435, Feb 2018. and Oxidative Stress, to T. Tomita, K. Matsuzaki, S.
Rowe, S. Laws, C. Masters, Biomarker Technologies Iwamoto, K. Ito, K. Tanaka,
R. Pietrzak, P. Maruff, 32. S. Laws, S. Gaskin, A. C. Masters, K. Yanagisawa,
Woodfield, V. Srikanth, D. and Disease Prevention
“Trajectories of depressive Strategies-Gains from AIBL “High performance plasma
and anxiety symptoms Bruce, P. Fraser, T. Porter, P. Aβ-amyloid biomarkers
Newsholme, N. Wijesekara, and DIAN Cohort Studies”,
in older adults: a 6-year Journal of Alzheimer’s for Alzheimer’s disease”,
prospective cohort study”, Q. Li, S. Burnham, V. Dore, Nature, vol. 554, pp. 249–254,
P. Maruff, C. Masters, S. Disease, vol. 62, pp. 965–992,
Geriatric Psychiatry, vol. 33, Mar 2018. Feb 2018.
pp. 405–413, Feb 2018. Rainey-Smith, C. Rowe, O.
Salvado, V. Villemagne, R. 36. A. Menon, L. Gray, F. 42. A. Neubert, K. Wilson, C.
26. H. Huang, D. Bauer, P. Martins, G. Verdile, “Insulin Fatehi, D. Darssan, D. Engstrom, R. Surowiec,
Lelliott, M. Dixon, L. Tilley, resistance is associated Bird, D. Bennetts, A. A. Paproki, N. Johnson,
B. McMorran, S. Foote, G. with reductions in specific Russell, “A comparison of S. Crozier, J. Fripp, C. Ho,
Burgio, “Ankyrin-1 gene cognitive domains and characteristics of patients “Comparison of 3D bone
exhibits allelic heterogeneity increases in CSF tau in seen in a tertiary hospital models of the knee joint
in conferring protection cognitively normal adults”, diabetes telehealth service derived from CT and 3T MR
against malaria”, G3, vol. 7, Scientific Reports, vol. 7, pp. versus specialist face-to- imaging”, European Journal
pp. 3133-3144, Sep 2017. 9766, Aug 2017. face outpatients”, Journal of of Radiology, vol. 93, pp.
Telemedicine and Telecare, 178–184, Aug 2017.
27. M. Kholghi, L. Sitbon, G. 33. H. Leroux, A. Metke
Zuccon, A. Nguyen, “Active Jimenez, M. Lawley, vol. 23, pp. 842-849, Nov 43. A. Pagnozzi, N. Dowson, J.
learning reduces annotation “Towards achieving semantic 2017. Doecke, S. Fiori, A. Bradley,
time for clinical concept interoperability of clinical 37. S. Mohammad Mohaimin, R. Boyd, S. Rose, “Identifying
extraction”, International study data with FHIR”, S. Saha, A. Mahamud relevant biomarkers of brain
Journal of Medical Journal of Biomedical Khan, A. Mohammad Arif, injury from structural MRI:
Informatics, vol. 106, pp. 25- Semantics, vol. 8, pp. Article Y. Kanagasingam, “An Validation using automated
31, Oct 2017. 41, Sep 2017. Automated Method for the approaches in children with
Detection and Segmentation unilateral cerebral palsy”,
28. M. Kholghi, L. De Vine, 34. Y. Lim, S. Rainey-Smith, PLoS ONE, vol. 12, pp.
L. Sitbon, G. Zuccon, Y. Lim, S. Laws, V. Gupta, of Drusen in Color Fundus
Image for the Diagnosis e0181605, Aug 2017.
A. Nguyen, “Clinical T. Porter, P. Bourgeat, D.
Information Extraction Ames, C. Fowler, O. Salvado, of Age-related Macular 44. K. Pannek, J. Fripp, J.
Using Small Data: An Active V. Villemagne, C. Rowe, Degeneration”, IET Image George, S. Fiori, P. Colditz, R.
Learning Approach Based on C. Masters, X. Zhou, R. Processing, vol. 12, pp. 919- Boyd, S. Rose, “Fixel-Based
Sequence Representations Martins, P. Maruff, “BDNF 927, May 2018. Analysis reveals alterations
and Word Embeddings”, Val66Met in preclinical 38. G. Mokhtari, N. Bashi, Q. in brain microstructure
Journal of the Association Alzheimer’s disease is Zhang, G. Nourbakhsh, and macrostructure of
for Information Science associated with short-term “Non-wearable human preterm-born infants at term
and Technology, vol. 68, pp. changes in episodic memory identification sensors for equivalent age”, NeuroImage:
2543–2556, Nov 2017. and hippocampal volume smart home environment: a Clinical, vol. 18, pp. 51-59,
but not serum mBDNF”, review”, Sensor Review, vol. Jan 2018.
29. L
. Koivula, M. Kapanen, T. International Psychogeriatrics,
Seppala, J. Collan, J. Dowling, 38, pp. 391-404, Dec 2017. 45. A. Paproki, C. Engstrom,
vol. 29, pp. 1825-1834, Nov
P. Greer, C. Gustafsson, A. 2017. 39. G. Mokhtari, A. Anvari- M. Strudwick, K. Wilson, R.
Gunnlaugsson, L. Olsson, L. Moghaddam, Q. Zhang, Surowiec, C. Ho, S. Crozier,
Wee, J. Korhonen, “Intensity- M. Karunanithi, “Multi- J. Fripp, “Automated T2-
based dual model method residential localization and mapping of the menisci from
for generation of synthetic activity recognition in Smart magnetic resonance images
CT images from standard Home Using Bluetooth in patients with acute knee
T2-weighted MR images – Low Energy Technology”, injury”, Academic Radiology,
generalized technique for International Journal of vol. 24, pp. 1295-1304, Oct
four different MR scanners”, Medical Informatics, vol. 18, 2017.
Radiotherapy and Oncology, pp. 908, Mar 2018.
vol. 125, pp. 411-419, Dec
2017.
aehrc.com
76 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
4. J . Doecke, Q. Li, P. Bourgeat, 11. N. Hearn, V. Dore, J. Fripp, 18. H. Ngo, A. Metke Jimenez, A. 24. H. Scells, G. Zuccon, B.
C. Fowler, S. Collins, V. Dore, M. Grothe, S. Teipel, C. Nguyen, “Knowledge-based Koopman, A. Deacon, S.
C. Rowe, C. Masters, V. Masters, C. Rowe, O. Feature Engineering for Geva, “A Test Collection
Villemagne, O. Salvado, “CSF Salvado, E. Coulson, V. Detecting Medication and for Evaluating Retrieval
Total Tau as a biomarker Villemagne, “Global tau Adverse Drug Events from of Studies for Inclusion in
for neuronal injury in burden correlates with Electronic Health Records”, Systematic Reviews”, SIGIR,
Alzheimer’s Disease: basal forebrain atrophy in NLP Challenges for Detecting Tokyo, Japan, 7-11 August
Aligning rates of CSF change healthy aging subjects”, Medication and Adverse Drug 2017.
with rates of hippocampal World Federation of Nuclear Events from Electronic Health
and cortical gray matter Medicine and Biology, Records (MADE1.0), USA, May 25. H. Scells, G. Zuccon, B.
atrophy”, AAIC, London, July Melbourne, 20-24 April 2018. 4, 2018. Koopman, A. Deacon,
2017. L. Azzopardi, S. Geva,
12. S. Hussain, B. Nicholson, 19. T. Nguyen, Q. Zhang, D. Le, “Integrating the Framing of
5. J . Doecke, E. Whittle, V. J. Freyne, “Tune your sun M. Karunanithi, “Dirichlet Clinical Questions via PICO
Villemagne, C. Masters, right: Persuasive app Process Gaussian Mixture into the Retrieval of Medical
S. Varghese, B. Roberts, towards healthy & safe sun Model for Activity Discovery Literature for Systematic
“Graphical network analyses exposure behavior”, The 29th in Smart Homes with Reviews”, CIKM 2017,
informs PET Aβ-amyloid Australian Conference on Ambient Sensors”, EAI Singapore, November 6-10,
biomarker discovery via Human-Computer Interaction International Conference 2017.
quantification of individual (OzCHI), Brisbane, Australia, on Mobile and Ubiquitous
peptide connections”, AAIC, 28th Nov - 1st Dec, 2017. Systems: Computing, 26. Z. Shahabi Kargar, S.
London, July 2017. Networking and Services, Khanna, A. Sattar, J. Lind,
13. Jimmy, G. Zuccon, B. Melbourne, Australia, “Improved Prediction of
6. R
. Finnegan, J. Dowling, L. Koopman, “Choices 6-9/11/2017. Procedure Duration for
Holloway, J. Otton, E. Koh, in Knowledge-Base Elective Surgery”, HIC 2017,
C. Luo, P. Atluri, S. Tang, Retrieval for Consumer 20. A. Pagnozzi, N. Dowson, Brisbane, Australia, 6-9
G. Delaney, V. Batumalai, Health Search”, European J. Doecke, A. Bradley, S. August.
D. Thwaites, “Feasibility Conference on Information Fiori, R. Boyd, S. Rose,
of Automatic Cardiac Retrieval, Grenoble, France, “Optimization of MRI-based 27. K. Shen, V. Dore, S. Rose,
Segmentation in Planning 26-29 March 2018. scoring scales of brain J. Fripp, K. McMahon, G.
CT”, Engineering and Physical injury severity in children de Zubicaray, N. Martin,
Sciences in Medicine, Hobart, 14. B. Koopman, G. Zuccon, J. with unilateral cerebral P. Thompson, M. Wright,
29 October 2017. Russell, “A Task-oriented palsy”, American Academy O. Salvado, “Genetic
Search Engine for Evidence- for Cerebral Palsy and Correlation between cortical
7. S
. Frost, Y. Kanagasingam, based Medicine”, SIGIR, Developmental Medicine, gray matter thickness and
M. Koronyo-Hamaoui, Tokyo, August 7-11, 2017. Montreal, 13 - 16 September white matter connections”,
Y. Koronyo, D. Biggs, S. 2017. MICGen - MICCAI Workshop
Verdooner, K. Black, R. 15. B. Koopman, L. Cripwell, on Imaging Genetics, Munich,
Martins, t. AIBL Research G. Zuccon, “Generating 21. S. Pedrini, V. Gupta, E. Hone, Germany, 9 October 2015.
Group, “Retinal morphology Clinical Queries from Patient J. Doecke, S. O’Bryant, I.
in pre-clinical Alzheimer’s Narratives: A Comparison James, A. Bush, C. Rowe, 28. H. Sohrabi, S. Gardener,
Disease”, ARVO Annual between Machines and V. Villemagne, D. Ames, C. M. Weinborn, K. Shen, S.
Meeting - The Association Humans”, SIGIR, Tokyo, 7-11 Masters, R. Martins, t. AIBL Rainey-Smith, K. Taddei,
for Research in Vision and August 2017. Research Group, “IL-10 J. Doecke, O. Salvado, V.
Ophthalmology, Honolulu, and IL-12/23p40 are jointly Villemagne, G. Savage,
16. A. Largent, J. Nunes, D. Ames, C. Masters, C.
Hawaii, April 2018. S. Herve, A. Simon, N. associated as predictor of
β-amyloid load in a broader Rowe, R. Martins, t. AIBL
8. T
. Fuangrod, A. McNeilly, P. Perichon, A. Barateau, Research Group, “Cognitive
C. Hervé, L. Caroline, J. blood-based biomarker
Pichler, J. Dowling, P. Greer, panel”, AAIC, London, July super-aging vs. typical aging
“Verification of accuracy of Dowling, R. de Crevoisier, in community-dwelling
O. Acosta, “Pseudo-CT 2017.
substitute CT for MRI-only older adults: Longitudinal
prostate IMRT using transit Generation by Conditional 22. L. Reid, A. Pagnozzi, S. Rose, trajectories in global cortical
dosimetry”, Engineering and Inference Random Forest J. Fripp, “Self-Organising thickness over six years”,
Physical Sciences in Medicine, for MRI-based Radiotherapy Maps Enable Global AAIC, London, July 2017.
Hobart, 29 October 2017. Treatment Planning”, Searching For Patch Based
European Signal Processing Segmentations”, ISMRM, 29. Y. Thong, T. Nguyen, Q.
9. P
. Greer, P. Pichler, H. Conference (EUSIPCO) 2017, Paris, 2018. Zhang, M. Karunanithi,
Richardson, P. Hunter, Greece, August 28 2017. L. Yu, “Predicting Food
C. Wratten, J. Dowling, 23. D. Roach, M. Jameson, Nutrition Facts Using
“MRI-only prostate cancer 17. A. Neubert, C. Engstrom, J. Dowling, M. Ebert, A. Pocket-size Near-Infrared
treatment – the HIPSTER I. Croci, S. Chandra, B. Kennedy, P. Greer, L. Sensor”, 39th Annual
study”, Engineering and Schmitt, S. Crozier, J. Fripp, Holloway, “Development and International Conference of
Physical Sciences in Medicine, “Automated evaluation validation of a CT-MR pelvic the IEEE Engineering, Korea,
Hobart, 29 October 2017. of T2 relaxation time atlas for clinical trial quality 11/7/2017.
measurements in the knee assurance”, Engineering and
10. T. Hadwen, V. Smallbon, Q. cartilage at 3T”, ISMRM Physical Sciences in Medicine,
Zhang, M. D’Souza, “Energy Annual Meeting, Paris, Hobart, 29 October 2017.
Efficient LoRa GPS Tracker France, 16-21 June 2018.
for Dementia Patients”,
39th Annual International
Conference of the IEEE
Engineering in Medicine
and Biology Society, Korea,
11/7/2017.
aehrc.com
7 8 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
30. S. Tran, Q. Zhang, M. 37. J. Yin, S. Tran, Q. Zhang, 45. D. Bauer, A. O’Brien, O. Luo, 53. P. Bourgeat, V. Villemagne,
Karunanithi, “Hidden Markov “Human Identification via N. Twine, A. Bayat, L. Wilson, V. Dore, C. Masters, D.
Models for Multi-resident Unsupervised Feature L. Langit, P. Szul, “Genomics Ames, C. Rowe, O. Salvado,
Activity Recognition in Smart Learning from UWB Radar from a Bioinformatician and J. Fripp, “18F-AV1451 Tau
Homes”, IJCAI 2017 AI4IoT Data”, Pacific-Asia Knowledge a Developer”, YOW! Brisbane, Quantification without MRI”,
Workshop, Melbourne, Discovery and Data Mining, Brisbane, 4 - 5 December AAIC 2017, London, UK, 16-
August 2017. Melbourne, Australia, 3-6 2017. 20 July 2017.
June 2018.
31. S. Tran, Q. Zhang, V. 46. D. Bauer, A. O’Brien, O. Luo, 54. P. Bourgeat, V. Dore, D.
Smallbon, M. Karunanithi, 38. T. Young, D. Thwaites, J. N. Twine, A. Bayat, L. Wilson, Ames, C. Masters, J. Fripp,
“Multi-Resident Activity Dowling, G. Liney, R. Rai, P. Szul, “How novel compute O. Salvado, V. Villemagne,
Monitoring in Smart P. Greer, L. Holloway, “The technology transforms C. Rowe, “Implementing the
Homes: A Case Study”, Effect of MRI Sequence life science research”, Centiloid transformation
SmarterAAL Workshop at Variations on Substitute Cloudera Government Forum, for 18F-Florbetaben
IEEE International Conference CT Generation for MR-Only Canberra, 5 December 2017. and 18F-NAV4694 using
on Pervasive Computing and Planning”, Engineering and CapAIBL”, AAIC 2017,
Communicaitions, Athen, Physical Sciences in Medicine, 47. D. Bauer, A. O’Brien, O. Luo, London, UK, 14-20 July 2017.
Greece, 19-23 March 2018. Hobart, 29 October 2017. N. Twine, A. Bayat, L. Wilson,
L. Langit, P. Szul, “Genomics 55. P. Bourgeat, V. Dore, P.
32. V. Villemagne, V. Dore, N. 39. B. Yu, L. Zhou, L. Wang, J. from a Bioinformatician and Raniga, J. Fripp, C. Masters,
Okamura, D. Baxendale, Fripp, P. Bourgeat, “3D cGAN a Developer”, YOW! Sydney, C. Rowe, V. Villemagne,
R. Harada, R. Mulligan, S. Based Cross-Modality MR Sydney, 7-8 December 2017. O. Salvado, “MilxCloud: a
Furumoto, O. Salvado, K. Image Synthesis for Brain web-based platform for
Yanai, C. Masters, C. Rowe, Tumor Segmentation”, ISBI 48. D. Bauer, A. O’Brien, O. Luo, PET and MR quantification”,
“To tau or to MAO-B? Most 2018, Washington DC, USA, N. Twine, A. Bayat, L. Wilson, 12th Congress of the World
of the 18F-THK5351 signal is 4-7 April 2018. P. Szul, “How novel compute Federation of Nuclear
blocked by selegiline”. technology transforms life Medicine and Biology,
40. S. Yu, D. Xiao, Y. science research”, Linux Melbourne, Australia, 20-24
33. K. Williams, N. Twine, E. Kanagasingam, “Exudate Conference, Sydney, 22 April 2018.
McCann, A. O’Brien, D. Detection for Diabetic January 2018.
Bauer, I. Blair, “Discovery Retinopathy With 56. P. Bourgeat, V. Villemagne,
of previously unknown Convolutional Neural 49. D. Bauer, A. O’Brien, O. Luo, V. Dore, D. Ames, R. Martins,
relationships between ALS Networks”, Annual N. Twine, A. Bayat, L. Wilson, C. Masters, O. Salvado, C.
patients increases power International Conference P. Szul, “How novel compute Rowe, J. Fripp, “18F-AV1451
to identify causal disease of the IEEE Engineering in technology transforms life TAU Quantification Without
genes”, International Medicine and Biology Society science research”, Agile India MRI”, 12th Congress of the
Symposium on ALS/MND, (EMBC), Jeju Island, Korea, - Digital Transformation Day, World Federation of Nuclear
Boston, 8-10 December 11 July 2017. Bengaluru, India, 8 March Medicine and Biology,
2017. 2018. Melbourne, Australia, 20-24
41. G. Zuccon, B. Koopman, April 2018.
34. D. Xiao, S. Yu, J. Vignarajan, “SIGIR 2017 Tutorial on 50. D. Bauer, A. O’Brien, O. Luo,
M. Tay-Kearney, Y. Health Search (HS2017): A N. Twine, A. Bayat, L. Wilson, 57. P. Bourgeat, V. Dore, S.
Kanagasingam, “Retinal Full-day from Consumers “Going Server-less for Web- Williams, D. Ames, R.
hemorrhage detection by to Clinicians”, SIGIR, Tokyo, Services that need to Crunch Martins, C. Masters, O.
rule-based and machine Japan, 7-11 August. Large Volumes of Data”, Salvado, V. Villemagne, C.
learning approach”, IEEE Agile India - Continuous Rowe, “Implementing the
EMBC 2017, Jeju, Korea, 11 42. E. Bariola, N. Good, J. Li, Delivery and DevOps Day, Centiloid transformation
July 2017. M. Varnfield, R. Sparks, Bengaluru, India, 9 March of 18F-Florbetaben and
D. Rolls, A. Reeson, R. 2018. 18F-NAV4694 using
35. Y. Xie, S. Khanna, N. Good, Jayasena, “Reducing CapAIBL”, 12th Congress
J. Boyle, “Weekly hospital unplanned hospital re- 51. D. Bauer, A. O’Brien, O.
Luo, N. Twine, A. Bayat, L. of the World Federation of
workforce data: a data admissions: Evaluation of Nuclear Medicine and Biology,
visualisation exercise”, alternative models of care”, Wilson, P. Szul, “How AI and
‘Big Learning’ transforms Melbourne, Australia, 20-24
HIC (health information HIC Conference, Brisbane, April 2018.
conference), Brisbane, 6-9 9th August. life science research”, AI Dev
August 2017. Days, Bengaluru, India, 9 58. D. Bradford, “Healthy
43. D. Bauer, A. O’Brien, O. Luo, March 2018. Mates: Collaborations
36. Y. Xie, N. Good, S. Khanna, N. Twine, A. Bayat, L. Wilson, to enhance Indigenous
J. Boyle, “Exploratory L. Langit, P. Szul, “Cloud 52. G. Bischof, P. Bartenstein,
H. Berthel, B. van Berckel, health autonomy”, NHMRC,
Multivariate Analysis of Data Pipelines for Genomics Brisbane, November 2017.
Hospital Admissions Data in from a Bioinformatician and V. Dore, T. Van Eimeren,
Conjunction With Workforce a Developer”, YOW! Data, N. Forster, J. Hammes, 59. D. Bradford, M. Barber,
Data”, The 39th Annual Sydney, Sept 2017. A. Lammertsma, S. C. Robinson, D. Smith, G.
International Conference Minoshima, C. Rowe, O. Farr-Wharton, “Leveraging
of the IEEE Engineering in 44. D. Bauer, A. O’Brien, O. Luo, Sabri, J. Seibyl, K. Van Technologies to Improve
Medicine and Biology Society N. Twine, A. Bayat, L. Wilson, Laere, R. Vandenberghe, Workplace Wellbeing for
(EMBC’17), Jeju Island, L. Langit, P. Szul, “Genomics V. Villemagne, I. Yakushev, Aboriginal and Torres
Korea, 11-15 July 2017. from a Bioinformatician A. Drzezga, “Comparing Strait Islander Employee”,
and a Developer”, YOW! Amyloid PET Tracers and OzCHI, Brisbane, Australia,
Melbourne, Melbourne, 30 Interpretation Strategies: November 28th - December
Nov - 1 Dec 2017. Results from the CAPTAINs 1st.
Study”, SNMMI, Philadephia,
June 2018.
60. D. Bradford, D. Ireland, 67. G. Farr-Wharton, D. Ireland, 74. H. Leroux, P. Raniga, “FHIR 81. K. Pannek, J. Welsh, J.
J. Wiles, “Talk to me: D. Bradford, “Social Fringe as an integrative platform Fripp, J. George, P. Colditz,
The Chatbot as a speech Dwellers: Designing Chat Bots for reproducible biomedical R. Boyd, S. Rose, “Removal
pathology monitoring tool”, as Bridges for Children with imaging research”, INCF or correction of volumes
Health by Tech, University of ASD”, OzCHI 2017, Brisbane, Neuroinformatics 2017, Kuala affected by bulk motion:
Twente, 1 June 2018. Australia, November 28th to Lumpur, Malaysia, August impact on DTI and NODDI
December 1st. 20-21, 2017. metrics”, Joint Annual
61. D
. Bradford, S. Brinkmann, Meeting of ISMRM and
“Speaking my language: 68. A. Fazlollahi, S. Ayton, I. 75. H. Leroux, K. Fung, I. Priebe, ESMRMB, Paris, France, 16-
technology to facilitate hospital Diouf, P. Bourgeat, P. Raniga, M. Buckley, A. Ovenden, E. 21 June 2018.
assessment of culturally and V. Dore, A. Ng, J. Fripp, D. Berton, K. Surinya, J. Wei,
linguistically diverse patients”, Ames, C. Masters, C. Rowe, M. Thomas, J. Moore, R. 82. D. Rolls, J. Boyle, S.
Health by Tech, Netherlands, 1 V. Villemange, A. Bush, Singh, A. Ruszkiewicz, L. Khanna, N. Good, “Practical
June 2018. O. Salvado, “Quantitative Cosgrove, “Using Clinical considerations for using
susceptibility mapping of Research Data to Evaluate administrative data
62. S. Burnham, P. Bourgeat, V. the hippocampus predicts a Blood-Based Biomarker and risk stratification
Dore, S. Laws, O. Salvado, hippocampal atrophy in Panel for the Detection of to reduce unplanned
C. Masters, C. Rowe, V. Abeta+ elderly controls Colorectal Cancer”, Health rehospitalisations”, HIC 2017,
Villemagne, “Implementing and Alzheimer’s disease Data Analytics, Brisbane, Brisbane, August 6-9, 2017.
the ATN classification in patients”, Alzheimer’s Queensland, Australia,
AIBL”, 12th Congress of the Association International October 11-12, 2017. 83. C. Rowe, V. Dore, R.
World Federation of Nuclear Conference, London, Mulligan, P. Bourgeat, O.
Medicine and Biology, England, 16-20 July 2017. 76. J. Li, J. Freyne, D. Bradford, Salvado, C. Masters, V.
Melbourne, Australia, 20-24 “Streamlining Surgeries: Villemagne, “Tau Imaging
April 2018. 69. S. Gardener, S. Rainey- Digital Preference Card for in Alzheimer’s Disease with
Smith, K. Shen, P. Bourgeat, Surgical Item Management”, 18F-MK6240, a Second
63. S. Burnham, S. Laws, K. Taddei, D. Ames, C. HIC2017, Brisbane, 6-9 Generation Selective Tau
V. Dore, P. Bourgeat, O. Masters, C. Rowe, O. August 2017. Tracer”, 12th Congress of
Salvado, C. Masters, C. Salvado, R. Martins, the World Federation of
Rowe, V. Villemagne, “Mediterranean diet 77. E. McCann, J. Fifita, K. Nuclear Medicine and Biology,
“The impact of APOE e4 adherence is associated with Williams, S. Chan, K. Melbourne, Australia, 20-24
carriage and gender on attenuated cortical thinning Zhang, S. Freckleton, R. April 2018.
the age of onset of amyloid in an Australian study of Lyu, N. Twine, D. Bauer,
deposition”, 12th Congress ageing”, AAIC, London, UK, D. Rowe, G. Nicholson, I. 84. C. Rowe, S. Amadoru, V.
of the World Federation of 16-20 July 2017. Blair, “Discovery of new Dore, C. McLean, F. Hinton,
Nuclear Medicine and Biology, disease genes in motor C. Shepherd, G. Halliday,
Melbourne, Australia, 20-24 70. J. George, R. Ware, S. Fiori, neuron disease utilising C. Leyton, J. Hodges, V.
April 2018. J. Fripp, K. Pannek, S. next generation sequencing Villemagne, “Correlation
Rose, P. Colditz, R. Boyd, technologies and genetic of Amyloid PET in Centiloid
64. T. Cummins, A. Elias, M. “Early structural MRI linkage”, FightMND, units with neuropathological
Hopwood, J. Rosenfeld, V. and concurrent clinical Melbourne, March 2018. findings in Alzheimer’s
Dore, F. Lamb, R. Williams, assessment in very preterm disease”, SNMMI,
L. Margison, O. Salvado, C. infants: relationship with 78. R
. Mito, T. Dhollander, D. Philadelphia, June 2018.
Masters, V. Villemagne, C. 12 month motor outcome”, Raffelt, Y. Xia, O. Salvado,
Rowe, “Assessing Aβ & tau Australasian Academy A. Brodtmann, C. Rowe, V. 85. C
. Rowe, V. Dore, R. Mulligan,
pathology in Vietnam war of Cerebral Palsy and Villemagne, A. Connelly, F. Lamb, P. Bourgeat, T.
veterans with chronic Post- Developmental Medicine, “Investigating microstructural Cummins, O. Salvado, C.
Traumatic Stress Disorder”, Auckland, New Zealand, 21- heterogeneity of white matter Masters, V. Villemagne,
SNMMI, San Diego, June 24 March 2018. hyperintensities in Alzheimer’s “Tau Imaging in Alzheimer’s
2016. disease using single-shell Disease with 18F-MK6240, a
71. N. Hearn, V. Dore, J. Fripp, 3-tissue constrained spherical second generation selective
65. V. Dore, P. Bourgeat, R. M. Grothe, S. Teipel, C. deconvolution”, Joint Annual tau tracer”, SNM, Miami, 22-
De Flores, R. La Joie, Masters, C. Rowe, E. Meeting ISMRM-ESMRMB, 25 June 2018.
A. Fazlollahi, J. Fripp, Coulson, V. Villemagne, Paris, France, 16-21 June,
V. Villemagne, C. Rowe, “Global tau burden 2018. 86. S. Smith, H. Leroux, J.
G. Chetelat, O. Salvado, correlates with basal Carrano, D. Gorse, P. Croll,
“Selective age-association forebrain atrophy in healthy 79. A. O’Brien, D. Bauer, M. Santamaria, L. Schaper,
of hippocampus subfields in aging subjects”, AAIC, “DevOps 2.0: Evidence-based “A thematic analysis of
cognitively healthy elderly”, London, July 20117. evolution of serverless Health Data Sharing
AAIC, London, July 2017. architecture through Barriers and Information
72. K. Lai, L. Wilson, D. Reti, automatic evaluation of Blocking from the HISA
66. V. Dore, S. Bullich, C. D. Bauer, “Improving “infrastructure as code” Survey for the Productivity
Rowe, P. Bourgeat, S. predictability of CPRISPR- deployments”, YOW! Data, Commission”, Health
Konate, A. Stephens, Cpf1 activity”, AGTA 2017 Wesley Conference Centre, Informatics Conference,
J. Fripp, C. Masters, O. Annual Conference, Hobart, Sydney, 14-15 May 2018. Brisbane, QLD, August 6-9,
Salvado, V. Villemagne, 29/10/2017 - 01/11/2017. 2017.
S. De Santi, “Comparison 80. A. Pagnozzi, L. Reid, R.
of 18F-florbetaben 73. H. Leroux, M. Lawley, Boyd, S. Rose, “Measuring
quantification results using S. Gibson, “REDCap neuroplasticity in cerebral
MR-based and MR-Less under FHIR: Enhancing palsy: what cohort sizes are
CapAIBL: Validation against electronic data capture with needed for MR imaging?”,
histopathology”, AAIC, FHIR capability”, Health American Academy
London, July 2017. Informatics Conference, for Cerebral Palsy and
Brisbane, QLD, Australia, Developmental Medicine,
August 6-9 2017. Montreal, Canada, 13-16
September, 2017.
aehrc.com
8 0 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
aehrc.com
8 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
Detailed financial information from pages 84-91 have been deliberately omitted from this report.
The directors have determined that the unincorporated joint venture is not a reporting entity and that this special
purpose financial report should be prepared in accordance with the terms of the joint venture agreement and the
accounting policies outlined in Note 1 to the financial statements.
The directors declare that the accompanying Statement of Comprehensive Income, Statement of Financial
Position, Statement of Cash Flows, Statement of Changes in Joint Venture Funds and Notes to the Financial
Statements present fairly the unincorporated joint venture’s financial position as at 30 June 2018 and its
performance for the year ended on that date in accordance with the terms of the joint venture agreement and the
accounting policies described in Note 1 to the financial statements.
Director Director
Brisbane Brisbane
Date: Date:
Director Director
Brisbane Brisbane
Date: Date:
aehrc.com
9 2 A E H R C A N N U A L R E P O R T 2 0 17/ 2 0 18
aehrc.com
The Australian e-Health Research Centre
Level 5, UQ Health Sciences Building 901/16
Royal Brisbane and Women's Hospital
Herston QLD 4029 Australia
Acknowledgments
Editorial: Dr David Hansen, the Australian e-Health Research Centre
Marianne Chalk, the Australian e-Health Research Centre