Theodoros Arvanitis

• RT, DPhil
• Chair at University of Warwick

Introduction The General Data Protection Regulation (“GDPR”) legal basis for obtaining consent for the processing of personal data for research purposes, where those purposes cannot be fully specified in advance, is provided for in Articles 6, 7 and Recital 33. However, GDPR’s requirements for obtaining consent, as to the secondary use and sharing...

Background Ambulance services treat over 32,000 patients sustaining an out-of-hospital cardiac arrest annually, receiving over 90,000 calls. The definitive treatment for out-of-hospital cardiac arrest is defibrillation. Prompt treatment with an automated external defibrillator can improve survival significantly. However, their location in the commu...

BACKGROUND Current European standard-of-care for localised intracranial germinoma is multi-agent chemotherapy (carboPEI: carboplatin/etoposide/ifosfamide) followed by definitive radiotherapy, with excellent survival. MonoGerm is a de-escalation, non-inferiority trial aiming to reduce toxicity. Twelve-week carboplatin (PMID:8039122) AUC10 or vinblas...

Introduction: Multimorbidity is prevalent among older adults and is associated with cognitive impairment and dementia, increasing the need for innovative care solutions. The CAREPATH project, funded by the European Commission Horizon 2020 program, has developed an integrated care platform tailored to older adults with multimorbidity, particularly t...

Healthcare faces significant challenges in exchanging and utilizing health information across diverse providers, necessitating innovative solutions for improved interoperability. This study presents a comprehensive exploration of scalable technical and semantic solutions for patient care integration, emphasizing the implementation of these solution...

Digital health solutions hold promise for enhancing healthcare delivery and patient outcomes, primarily driven by advancements such as machine learning, artificial intelligence, and data science, which enable the development of integrated care systems. Techniques for generating synthetic data from real datasets are highly advanced and continually e...

Advances in general-purpose computers have enabled the generation of high-quality synthetic medical images that human eyes cannot differ between real and AI-generated images. To analyse the efficacy of the generated medical images, this study proposed a modified VGG16-based algorithm to recognise AI-generated medical images. Initially, 10,000 synth...

Brain tumours are the most commonly occurring solid tumours in children, albeit with lower incidence rates compared to adults. However, their inherent heterogeneity, ethical considerations regarding paediatric patients, and difficulty in long-term follow-up make it challenging to gather large homogenous datasets for analysis. This study focuses on...

Healthcare projects necessitate effective collaboration between clinical and technical partners, particularly during pivotal phases like lab testing and piloting. However, challenges in coordination often impede seamless collaboration, leading to inefficiencies and delays. This paper presents a comprehensive approach to developing a help desk servi...

Objective Establish a relationship between digital health intervention (DHI) and health system challenges (HSCs), as defined by the World Health Organization; within the context of hazard identification (HazID), leading to safety claims. To improve the justification of safety of DHIs and provide a standardised approach to hazard assessment through...

Introduction This paper outlines the design, implementation, and usability study results of the patient empowerment process for chronic disease management, using Patient Reported Outcome Measurements and Shared Decision-Making Processes. Background The ADLIFE project aims to develop innovative, digital health solutions to support personalized, int...

BACKGROUND Current European standard-of-care for localised intracranial germinoma is multi-agent chemotherapy (carboPEI: carboplatin/etoposide/ifosfamide) followed by definitive radiotherapy, with excellent survival. MonoGerm is a de-escalation, non-inferiority trial aiming to reduce toxicity. Twelve-week carboplatin (PMID:8039122) AUC10 or vinblas...

Purpose The European funded project ADLIFE focuses on the application of digitally enabled integrated care for people with advanced chronic diseases. The implementation of the ADLIFE intervention required a robust practical tool that would be common to all pilot sites while allowing flexibility for local variations as well as the ability to adapt t...

Introduction The CAREPATH Project aims to develop a patient-centered integrated care platform tailored to older adults with multimorbidity, including mild cognitive impairment (MCI) or mild dementia. Our goal is to empower multidisciplinary care teams to craft personalized holistic care plans while adhering to evidence-based guidelines. This necess...

Proton magnetic resonance spectroscopy ( ¹ H‐MRS) is increasingly used for clinical brain tumour diagnosis, but suffers from limited spectral quality. This retrospective and comparative study aims at improving paediatric brain tumour classification by performing noise suppression on clinical ¹ H‐MRS. Eighty‐three/forty‐two children with either an e...

H‐magnetic resonance spectroscopy (MRS) has the potential to improve the noninvasive diagnostic accuracy for paediatric brain tumours. However, studies analysing large, comprehensive, multicentre datasets are lacking, hindering translation to widespread clinical practice. Single‐voxel MRS (point‐resolved single‐voxel spectroscopy sequence, 1.5 T: e...

Background The malignant childhood brain tumour, medulloblastoma, is classified clinically into molecular groups which guide therapy. DNA-methylation profiling is the current classification ‘gold-standard’, typically delivered 3–4 weeks post-surgery. Pre-surgery non-invasive diagnostics thus offer significant potential to improve early diagnosis an...

Introduction: The ADLIFE project aims to improve the quality of life of older people with advanced chronic diseases by providing integrated intelligent personalised care via a digitally enabled holistic and integrated supportive care ICT Toolbox. The two interlinked user-facing tools are firstly, a Personalised Care Plan Management Platform (PCPMP)...

Introduction: Implementing complex health service innovations, such as digitally enabled integrated care within real world conditions, is challenging, both at a project and programme level. ADLIFE is a large-scale implementation project, funded through the European Commission Horizon Europe programme. It focuses on the implementation of integrated...

Objective Integrated care and digital health technology interventions are promising approaches to coordinate services for people living with chronic conditions, across different care settings and providers. The EU-funded ADLIFE project intends to provide digitally integrated personalized care to improve and maintain patients’ health with advanced c...

The rapid development and implementation of Internet of Medical Things has made interoperability a serious challenge. In this scoping review, we provide an overview of the interoperability challenge, as reported in the health literature, and highlight the proposed solutions. After searching between January 2018 and June 2023 in Compendex via Engine...

In this narrative review, we investigate the potential opportunities and benefits, as well as the challenges and concerns of integrating the Internet of Things in healthcare. The opportunities include enhanced patient monitoring and management, improved efficiency and resource utilization, personalized and precision medicine, empowering patients an...

Introduction: Multimorbid older adults with dementia require complex care provided to them. CAREPATH is an Horizon 2020 funded project (Grant agreement ID: 945169) aiming to generate a digital health solution, supported by an Information and Communication Technology infrastructure, for care based on the current best practice guidelines, for treatme...

Electrochemical sensing is ubiquitous in a number of fields ranging from biosensing, to environmental monitoring through to food safety and battery or corrosion characterisation. Whereas conventional potentiostats are ideal to...

Simple Summary Brain tumours are abnormal growth of cells in the human brain. Continuous effort is being made towards improving diagnosis and treatment options for such brain neoplasms. Manual classification and segmentation of imaging scans are tedious, time-consuming, and subjective. Over the last decade, the use of intelligent systems in the for...

Technical and semantic interoperability are broadly used components of interoperability technology in healthcare. Technical Interoperability provides interoperability interfaces to enable data exchange within different healthcare systems, despite any underlying heterogeneity. Semantic interoperability make different healthcare systems understand an...

Introduction This paper outlines the design, implementation, and usability study results of the patient empowerment process for chronic disease management, using Patient Reported Outcome Measurements and Shared Decision-Making Processes. Background The ADLIFE project aims to develop innovative, digital health solutions to support personalized, int...

The abnormal accumulation of cells in the human brain, if left untreated, may cause brain damage. Management and treatment of these tumours require an early and accurate diagnosis, while their prognostic characterisation can also be beneficial in the choice of care planning for the patient. CDSSs are being continuously developed and integrated into...

Objective Investigate the performance of qualitative review (QR) for assessing dynamic susceptibility contrast (DSC-) MRI data quality in paediatric normal brain and develop an automated alternative to QR. Methods 1027 signal–time courses were assessed by Reviewer 1 using QR. 243 were additionally assessed by Reviewer 2 and % disagreements and Coh...

Citation: García-Lorenzo, B.; Gorostiza, A.; González, N.; Larrañaga, I.; Mateo-Abad, M.; Ortega-Gil, A.; Bloemeke, J.; Groene, O.; Vergara, I.; Mar, J.; et al. Abstract: Due to population ageing and medical advances, people with advanced chronic diseases (ACD) live longer. Such patients are even more likely to face either temporary or permanent re...

Background Mobile health (mHealth) technology is being used predominantly in low- and middle-income countries. Developing countries with low level of investment in health infrastructure can augment existing capacity by adopting low-cost affordable technology. The aim of the review was to summarize the available evidence on mHealth interventions tha...

The role of the field of informatics in medical imaging is vital; novel or adapted informatics’ core methods can be employed to realise innovative information processing and engineering of medical images. As such, imaging informatics can assist in the interpretation of image-based, clinically recorded evidence. This, in turn, leads to the generatio...

Introduction: CAREPATH is an Horizon 2020 funded project aiming to generate a digital health solution, supported by an information and communication technology infrastructure, for care based on the current best practice guidelines, optimizing it for specific regions and health systems, for treatment and management of multimorbid patients with mild...

Background: The technology enabled distributed model in Kerala is based on an innovative partnership model between Karkinos Healthcare and private health centers. The model is designed to address the barriers to cancer screening by generating demand and by bringing together the private health centers and service providers at various levels to crea...

The process of developing a computer interpretable, integrated clinical guideline requires multiple considerations and decisions. As part of the CAREPATH project, a holistic approach to comorbidity has been adopted using an integrated clinical guideline for the management of multimorbid patients with mild cognitive impairment or mild dementia. The...

Management of multiple chronic conditions introduces demanding challenges for patients. This situation becomes more complex when multimorbidity is associated with dementia. In this paper, we present the design of a mobile Patient Empowerment Platform that enables older multimorbid patients with mild dementia or mild cognitive impairment (MCI) to ea...

In the health care sector, person-centred treatment approaches have shown the potential to improve treatment outcomes and quality of life of patients. In particular, this applies where patients are living with complex conditions like multimorbid older patients with Mild Cognitive Impairment (MCI) or mild dementia. Such treatment approaches quite of...

CAREPATH project is focusing on providing an integrated solution for sustainable care for multimorbid elderly patients with dementia or mild cognitive impairment. The project has a digitally enhanced integrated patient-centered care approach clinical decision and associated intelligent tools with the aim to increase patients' independence, quality...

Modern healthcare providers rely upon Electronic Healthcare Records (EHR) systems to record patient data inside their own organization. Some healthcare providers share this data to facilitate patient care with other providers. Medical devices and healthcare providers can use differing standards of recording healthcare information. The Structural an...

It is typical for many digital health research projects to develop IT architectures that will implement integrated care services that may also deliver interventions. As part of compliance with the requirements of the regulation, the components that are considered as a medical device will need to be classified to a medical device category. This is o...

The Tommy's National Centre for Miscarriage Research aims to support the diagnosis and treatment for couples suffering from recurrent miscarriage. Tommy's Net is an electronic data gathering tool, collecting miscarriage data and links with hospital Clinical Information System databases. The gathering of patient reported data is an important aspect,...

Background: CIGs languages consist of approach specific concepts. More widely used concepts, such as those in UMLS are not typically used. Objective: An evaluation of UMLS concept sufficiency for CIG definition. Method: A popular guideline is mapped to UMLS concepts with NLP. Results are reviewed to evaluate gaps, and appropriateness. Results...

INTRODUCTION: Perfusion is associated with grade and survival in children’s brain tumours. Dynamic susceptibility-contrast (DSC-) MRI measures perfusion non-invasively, estimating relative cerebral blood volume (rCBV). We previously showed significant differences between pre-treatment rCBV in low- and high-grade tumours in a multicentre study. Cont...

INTRODUCTION: Magnetic resonance imaging is a key investigation in the diagnosis of childhood solid tumours. Advanced techniques such as diffusion weighted imaging (DWI), magnetic resonance spectroscopy (MRS) and perfusion imaging probe the underlying cellular, chemical and vascular nature of the disease. Coupled with machine learning these scannin...

BACKGROUND: Intracranial germinoma is chemosensitive but radiotherapy (RT) is needed for cure. In localised disease, three-drug standard-of-care (SOC) inpatient chemotherapy is used to reduce RT fields/dose. Concomitant diabetes insipidus is common, making chemotherapy delivery challenging. Small studies have demonstrated benefits from single-agent...

IntroductionCOVID-19 pandemic has caused major disruptions to delivery of various cancer care services as efforts were put to control the outbreak of the pandemic. Although the pandemic has highlighted the inadequacies of the system but has also led to emergence of a new cancer care delivery model which relies heavily on digital mediums. Digital he...

Background Relative cerebral blood volume (rCBV) measured using dynamic susceptibility-contrast MRI can differentiate between low- and high-grade pediatric brain tumors. Multicenter studies are required for translation into clinical practice. Objective We compared leakage-corrected dynamic susceptibility-contrast MRI perfusion parameters acquired...

Digital health applications can improve quality and effectiveness of healthcare, by offering a number of new tools to users, which are often considered a medical device. Assuring their safe operation requires, amongst others, clinical validation, needing large datasets to test them in realistic clinical scenarios. Access to datasets is challenging,...

Background Image segmentation is an essential step in the analysis and subsequent characterisation of brain tumours through magnetic resonance imaging. In the literature, segmentation methods are empowered by open-access magnetic resonance imaging datasets, such as the brain tumour segmentation dataset. Moreover, with the increased use of artificia...

Introduction: The Topol Programme for Digital Fellowships in Healthcare is a flagship national programme for digital health aspirants in England. This programme is heavily over-subscribed with applicants, representing a cross section of healthcare professionals interested in a future digital health career. The aim this study was to identify motiva...

Background Urinary tract infection (UTI) is one of the most common bacterial infections responsible for increased annual incidence of antimicrobial resistance (AMR) cases. Clinical diagnosis of UTI AMR relies heavily on conventional urine culture and antibiotic susceptibility testing (AST) which has a turnaround time of ∼3 days. Often, irrespective...

Objectives To measure pregnancy outcome following attendance at a recurrent miscarriage service and identify factors that influence outcome. Design Prospective, observational electronic cohort study. Setting Participants attending a specialist recurrent miscarriage clinic, with a history of two or more pregnancy losses. 857 new patients attended...

MRS can provide high accuracy in the diagnosis of childhood brain tumours when combined with machine learning. A feature selection method such as principal component analysis is commonly used to reduce the dimensionality of metabolite profiles prior to classification. However, an alternative approach of identifying the optimal set of metabolites ha...

Background: Artificial Intelligence (AI) has seen an increased application within digital healthcare interventions (DHIs). DHIs use entails challenges about their safety assurance. Exacerbated by regulatory requirements, in the UK, this places the onus of safety assurance not only on the manufacturer, but also on the operator of a DHI. Clinical Sa...

Background COVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19. Methods Inpatien...

Aims Magnetic resonance imaging (MRI) is a valuable tool for non-invasive diagnosis of paediatric brain tumours. The rarity of the disease dictates multi-centre studies and imaging biomarkers that are robust to protocol variability. We investigated diffusion tensor MRI (DT-MRI), combined with machine learning, as an aid to diagnosis and evaluated t...

1 H-magnetic resonance spectroscopy (MRS) provides noninvasive metabolite profiles with the potential to aid the diagnosis of brain tumours. Prospective studies of diagnostic accuracy and comparisons with conventional MRI are lacking. The aim of the current study was to evaluate, prospectively, the diagnostic accuracy of a previously established cl...

Brain tumors represent the highest cause of mortality in the pediatric oncological population. Diagnosis is commonly performed with magnetic resonance imaging. Survival biomarkers are challenging to identify due to the relatively low numbers of individual tumor types. 69 children with biopsy-confirmed brain tumors were recruited into this study. Al...

Objective Remote or mobile consulting is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during coronavirus disease 2019 and beyond. We explored whether mobile consulting is a viable option for communities with minimal resources in low- and middle-income countries. Methods W...

Multimorbid patients are prescribed a number of medications in parallel, which may often interact with each other, resulting in adverse effects. However, clinical guidelines on prescription of medications predominantly focus on individual conditions do not consider the guidance in the context of other guidelines, resulting in conflicts. C3-Cloud is...

Objectives To measure pregnancy outcome following attendance at a recurrent miscarriage service and identify factors that influence outcome. Design Prospective, observational electronic cohort study. Setting Participants attending specialist recurrent miscarriage clinic, within a tertiary centre, with a history of two or more pregnancy losses. Th...

Aims/Objectives Extensive research considers associations between inpatient glycaemic control and outcomes during hospital admission; this cautions against overly tight glycaemic targets. Little research considers glycaemic control following hospital discharge. This is despite a clear understanding that people with diabetes are at increased risk of...

Background: Digital health applications can improve quality and effectiveness of healthcare, by offering a number of tools to patients, professionals, and the healthcare system. Introduction of new technologies is not without risk, and digital health applications are often considered a medical device. Assuring their safe operation requires, amongst...

Background Myocardial infarction (MI; location and extent of infarction) can be determined by late enhancement cardiac magnetic resonance (CMR) imaging, which requires the injection of a potentially harmful gadolinium-based contrast agent (GBCA). Alternatively, emerging research in the area of myocardial strain has shown potential to identify MI us...

To determine if apparent diffusion coefficients (ADC) can discriminate between posterior fossa brain tumours on a multicentre basis. A total of 124 paediatric patients with posterior fossa tumours (including 55 Medulloblastomas, 36 Pilocytic Astrocytomas and 26 Ependymomas) were scanned using diffusion weighted imaging across 12 different hospitals...

INTRODUCTION Magnetic Resonance Imaging (MRI) is routinely used in the assessment of children’s brain tumours. Reduced diffusion and increased perfusion on MRI are commonly associated with higher grade but there is a lack of quantitative data linking these parameters to survival. Machine learning is increasingly being used to develop diagnostic too...

Objective Remote or mobile consulting (mConsulting) is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during COVID-19 and beyond. We explored whether mConsulting is a viable option for communities with minimal resources in low- and middle-income countries (LMICs). Methods W...

Aim To identify known risk factors for mortality for adult patients, discharged from hospital with diabetes. Method The systematic review was based on the PRISMA protocol. Studies were identified through EMBASE & MEDLINE databases. The inclusion criteria were papers that were published over the last 6 years, in English language, and focused on ris...

Background: Patients with diabetes are at an increased risk of readmission and mortality when discharged from hospital. Existing research identifies statistically significant risk factors that are thought to underpin these outcomes. Increasingly, these risk factors are being used to create risk prediction models, and target risk modifying interven...

BACKGROUND Myocardial infarction (MI; location and extent of infarction) can be determined by late enhancement cardiac magnetic resonance (CMR) imaging, which requires the injection of a potentially harmful gadolinium-based contrast agent (GBCA). Alternatively, emerging research in the area of myocardial strain has shown potential to identify MI us...

BACKGROUND There is an increasing need to organise the care around the patient and not the disease, as well as taking into account the complex realities of multiple physical, psycho-social conditions and polypharmacy. Integrated patient-centred care delivery platforms have been developed for both patients and clinicians. These platforms could provi...

Background: There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a pr...

Objective To analyse mortality statistics in the United Kingdom during the initial phases of the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic and to understand the impact of the pandemic on national mortality. Methods Retrospective review of weekly national mortality statistics in the United Kingdom over the past 5 years, including...

Background: C3-Cloud is an integrated care ICT infrastructure offering seamless patient-centered approach to managing multimorbidity, deployed in three European pilot sites. Challenge: The digital delivery of best practice guidelines unified for multimorbidity, customized to local practice, offering the capability to improve patient personalizatio...

Digital health interventions (DHIs) enable improvements in health strategy and address health system challenges. The World Health Organization provides a formal classification for DHIs. However, safety claims, about such interventions, vary in quality and are often vague as to how they are communicated between technical, clinical experts and stakeh...

Background: Assurance of digital health interventions involves, amongst others, clinical validation, which requires large datasets to test the application in realistic clinical scenarios. Development of such datasets is time consuming and challenging in terms of maintaining patient anonymity and consent. Objective: The development of synthetic d...

Background: Increasing numbers of intelligent healthcare applications are developed by analysing big data, on which they are trained. It is necessary to assure that such applications will be safe for patients; this entails validation against datasets. But datasets cannot be shared easily, due to privacy, and consent issues, resulting in delaying i...

Background New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it ea...

Background Brain tumours represent the highest cause of mortality in the paediatric oncological population. Diagnosis is commonly performed with magnetic resonance imaging and spectroscopy. Survival biomarkers are challenging to identify due to the relatively low numbers of individual tumour types, especially for rare tumour types such as atypical...

Abstract Objective The poorest populations of the world lack access to quality healthcare. We defined the key components of consulting via mobile technology (mConsulting), explored whether mConsulting can fill gaps in access to quality healthcare for poor and spatially marginalised populations (specifically rural and slum populations) of low- and m...

Research into the ability to coordinate one’s movements with external cues has focussed on the use of simple rhythmic, auditory and visual stimuli, or interpersonal coordination with another person. Coordinating movements with a virtual avatar has not been explored, in the context of responses to temporal cues. To determine whether cueing of moveme...

Background: Patients with diabetes are at an increased risk of readmission and mortality when discharged from hospital. Existing research identifies statistically significant risk factors that are thought to underpin these outcomes. Increasingly, these risk factors are being used to create risk prediction models, and target risk modifying intervent...