CALOPUS - Computer Assisted LOw-cost Point-of-care UltraSound

Lead Research Organisation: University of Oxford
Department Name: Engineering Science

Abstract

The CALOPUS project is an inter-disciplinary UK-India collaboration that aims to automate the analysis of antenatal ultrasound images to facilitate referral to the appropriate level of pregnancy care in rural settings, an important unmet need in many LMICs. Unlike in the western world, many women in India do not have an antenatal ultrasound check-up scan in the first or second trimester. Without such a check-up, health problems of the fetus and mother can go unnoticed, leading, in the worst case, to a still-birth or preterm birth. India has the highest number of still births and preterm births in the world (Lancet 2O15, 2012). Thus the ultimate clinical aim motivating this work is to reduce the burden of adverse pregnancy events and improve the health of future generations.

The approach we are taking is to use a low-cost portable imaging technology, ultrasound imaging, as the basis for a novel point-of-care (POC) system that enables a healthcare worker, with limited or no knowledge of ultrasound, to refer a patient to a clinical unit or hospital. Ultrasound scanning normally requires skill to acquire images which is a barrier to use. Our idea is to combine capture of ultrasound videos with machine learning (deep learning) to automatically interpret the content of the ultrasound videos and make the recommendation to the non-expert user. This project explores how we can do this, and will look, as well, at how we can make the technological solution culturally acceptable, and usable in the intended clinical environment.

In addition to the primary scientific endeavour, an important secondary objective will be capacity-building in point-of-care imaging in the India partner team and counter-mentoring of UK investigators in health (particularly in factors related to healthcare technology needs and adoption), and research and cultural issues that are at play in LMICs. This cross-dialogue will strengthen the international team and build mutual respect and complementary expertise.

Planned Impact

Who might benefit from this research?

To ensure maximal impact we will engage with

- healthcare professionals in India who might be impacted by this research which includes radiologists, public health professionals, general physicians, gynecologists, frontline health workers (ANMs, ASHAs)

- pregnant women

- healthcare technology companies in India.

- healthcare professionals interested in healthcare policy, public health and introduction of new healthcare interventions.

How might they benefit from this research?

- the ultimate goal of the technology is to support frontline health workers in identification of high risk pregnancies.

- Pregnant women may benefit from quicker referral, access to antenatal care closer to home, and comfort (if not referred) that the pregnancy is not of concern. The system may also lead to earlier identification of problems before they become critical.

- Healthcare policy makers and professionals working in public health will be interested in understanding how this variant of POC technology might have impact if introduced into clinical practice.

Publications

10 25 50
 
Description Biometry Automation in OBstetrics And Beyond (BAOBAB)
Amount $531,215 (USD)
Funding ID OPP1197123 
Organisation Bill and Melinda Gates Foundation 
Sector Charity/Non Profit
Country United States
Start 11/2018 
End 10/2020
 
Description Oxford University Hospitals NHS Foundation Trust - Nuffield Department of Women's and Reproductive Health 
Organisation Oxford University Hospitals NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Engineering research expertise, intellectual input.
Collaborator Contribution Access to real-world data (data acquired in clinic), knowledge of clinical sonography.
Impact Multiple research grants, trained personnel (clinical and engineering), supported also by academic outputs in engineering and medicine. WRH is the academic department associated with the hospital's Women's Centre. This is an inter-disciplinary collaboration between engineering and medicine. The collaboration has also led to a spin-out (Noble and Papageorghiou are co-founders of Intelligent Ultrasound Ltd founded in 2012).
Start Year 2008
 
Description THSTI 
Organisation Translational Health Science And Technology Institute
PI Contribution THSTI are the India partner on the CALOPUS project.
Collaborator Contribution THSTI are the India partner on the CALOPUS project and bring both their own experience of conducting research in obstetric ultrasound in India to the project, and their collaborative links with hospitals in New Delhi.
Impact Successfully jointly applied for the CALOPUS project
Start Year 2018
 
Description Frontiers of Engineering for Development (Vietnam) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Royal Academy of Engineering organised Frontiers of Engineering for Development meeting held in Vietnam. Aimed at bringing together ECR and mid-career researchers with different backgrounds together to discuss challenges in healthcare technology innnovation for low and middle income setting countries. Keynote lectures, activities and an opportunity to pitch for seed grants to work on a problem suggested from new understanding developed at the meeting. I co-chaired the meeting.
Year(s) Of Engagement Activity 2018
URL https://www.raeng.org.uk/policy/partnerships/international-policy-and-development/gcrf-international...
 
Description Inspirational Engineer Talk - University of Cambridge 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Invited talk on my career and research given in at in invited lecture at the Department of Engineering, University of Cambridge.
Year(s) Of Engagement Activity 2019
 
Description Invited talk at CVPR 2019 workshop 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited talk given at CVPR 2019 workshop
Year(s) Of Engagement Activity 2019
 
Description Invited talk at IEEE ISBI 2019 Special Session entitled "Imaging for Developing Countries" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Intended purpose was to bring together researchers in medical image analysis interested or working in global health imaging/image analysis to encourage others to consider working in this space and discuss progress in the area.
Year(s) Of Engagement Activity 2019