Research on the benefits of 3D printing in a trauma hospital
3D printing is seeing increasingly widespread adoption in the medical field, with numerous examples of applications that help surgeons accurately plan cosmetic surgery. Now, the potential of 3D printing is being examined by hospitals treating patients who are fighting for their life.
The ETZ (Elisabeth-TweeSteden Ziekenhuis) is one of 11 trauma centres in the Netherlands. As the only centre in the country with trauma surgeons on location 24 hours a day, it serves as the main location for emergency patients in North Brabant. 3D printing has already been used to visualise bone fractures, but pioneering researchers believe it can also be used to help treat trauma patients.
Mike Bemelman, MD, trauma surgeon at the ETZ, had already seen the potential of 3D printing back in 2016. Together with Lars Brouwers, MD, PhD-candidate, and Koen Lansink, MD, trauma surgeon, they have started conducting research into the benefits and effectiveness of 3D printing, compared to traditional and other new technologies. Their idea is to 3D print scanned bone fractures in order to give both surgeons and patients a clear understanding of each situation, before operating.
Before 3D printing
In order to prepare for an operation, surgeons will analyse CT scans of the patient. Getting an exact idea of each situation is challenging, even for an experienced surgeon. CT scans are converted into a 3D reconstruction, enabling surgeons to examine it virtually on a computer screen. While this has improved the ease of understanding each situation, it has limitations: surgeons sometimes find it difficult to orient the model, and 3D reconstructions are viewed on a 2D screen, lacking a realistic sense of depth.
3D printing fractured bones
Lars started using the Ultimaker to print fractured bone structures, allowing surgeons to analyse a fracture not only by looking at it, but also touching and rotating it, which gives important added value to the operation planning process.
Using water-soluble PVA support material, complex, organic geometries can be accurately reproduced with small cavities and important details included.
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Adopting 3D printing to the process
One challenge of adopting 3D printing was finding a simple and efficient way to convert DICOM files—the proprietary file format of CT scans—into 3D printable STL files. Using Philips IntelliSpace Portal, Lars is able to directly export a 3D model of the scan, which he can prepare in Ultimaker Cura, and send to the Ultimaker 3.
Benefits for the patient
After the patient is in a stable condition, a CT scan is produced so that doctors can make a diagnosis. CT scan information is immediately available to Lars in the 3D print studio, where he can begin printing the fractured bone structure of the patient. The 3D print will be ready within a day and is used by surgeons to plan the operation and explain the process to the patient before it happens.
Our goal was to investigate if 3D printing can be of added value in classifying acetabular fractures. The most important conclusion of our research is that 3D printing is of added value.
Results of Lars’ research
When a patient has a fracture, doctors will analyse the x-rays or 2DCT scans and decide on an appropriate treatment. The better the understanding of the situation, the more accurately the right procedure can be determined. Surgeons will reach a solution using an agreement scoring system, known as the kappa score. On average, surgeons with little experience have a kappa score around 0.2, using traditional 2DCT images. Surgeons with more years of experience have a kappa score around 0.4.
Lars researched the agreement score when surgeons used other techniques such as 3DCT, 3D printing and VR visualization. Using a 3D printed model, both new and experienced surgeons scored a kappa of between 0.6 up to 0.7, which is the highest score of all methods.
The increased kappa score demonstrates the added value of 3D printing to the decision-making process. By conducting this research, Lars hopes to prove that 3D printing can be of added value to patient satisfaction, surgical satisfaction, operation time, and health-related quality of life for the patient.
Disclaimer: Ultimaker 3D printers are designed and built for Fused Filament Fabrication with Ultimaker engineering thermoplastics within a commercial/business environment. The mixture of precision and speed makes the Ultimaker 3D printers the perfect machine for concept models, functional prototypes and the production of small series. Although we achieved a very high standard in the reproduction of 3D models with the usage of Ultimaker Cura, the user remains responsible to qualify and validate the application of the printed object for its intended use, especially critical for applications in strictly regulated areas like medical devices and aeronautics.
Jvion launches AI-powered map to tackle mental health crisis
Clinical AI company Jvion has launched an interactive map of the US that highlights areas that are most vulnerable to poor mental health.
The Behavioral Health Vulnerability Map uses Jvion's AI CORE™ software to analyse public data on social determinants of health (SDOH) and determine the vulnerability of every US Census block group.
Vulnerability refers to the likelihood that residents will experience issues like self-harm, suicide attempts or overdoses. The map also identifies the most influential social determinants in each region, to show the social and environmental conditions that contribute to mental illness.
As an example, the map shows that Harrison County in Mississippi has a 50% higher suicide rate than the rest of the state. It also shows a high percentage of individuals in the armed forces at a time when active duty suicides are at a six-year high, along with a high prevalence of coronary artery disease, arthritis, and COPD, all chronic illnesses that are linked to a higher suicide risk.
The map also shows Harrison County has a high percentage of Vietnamese Americans, who studies suggest have high rates of depression and may be less likely to seek help from mental health professionals.
The map was built using the same data and analytics that Jvion used to create the COVID Community Vulnerability Map, which was launched towards the start of the pandemic.
With this new map, Jvion is aiming to tackle the growing mental health crisis in the US. “At a time when so many Americans are struggling with their mental health, we’re proud to offer a tool that can help direct treatment resources to the communities that need it most,” said Dr John Showalter, MD, Jvion’s chief product officer, who led the development of the map.
“For too long, the healthcare industry has struggled to address social determinants of health, particularly in the context of behavioural health. Our hope is that by surfacing the social and environmental vulnerabilities of America’s communities, we can better coordinate our response to the underlying conditions that impact the health and wellbeing of people everywhere.”