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Проблемы финансирования и обучения специалистов в области посмертной томографической визуализации в Великобритании
Фетисов В.А. Проблемы финансирования и обучения специалистов в области посмертной томографической визуализации в Великобритании. Consilium Medicum. 2016; 18 (13): 48–51. DOI: 10.26442/2075-1753_2016.13.48-51
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Fetisov V.A. Issues of financing and specialist training in postmortem cross-sectional imaging in Great Britain. Consilium Medicum. 2016; 18 (13): 48–51. DOI: 10.26442/2075-1753_2016.13.48-51
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Аннотация
В статье описаны возможные варианты выполнения аутопсий в Великобритании с использованием различных дополнительных методов исследования, включая посмертную томографическую визуализацию (postmortem cross-sectional imaging – PCSI). Показано, что официально утвержденной программы подготовки специалистов по PCSI не существует и такая совместная работа ведется в некоторых центрах Великобритании в инициативном порядке. Доказывается необходимость разработки собственных национальных стандартов и учебных программ в рамках каждой профессии с созданием соответствующих систем аудита (проверки, инспекции) и внешнего контроля качества PCSI. Отмечено, что выполнение и хранение томографических данных осуществляется главным образом в учреждениях Национальной службы здравоохранения Великобритании с оплатой работы специалистов по второй категории (аналог выполнения судебно-медицинской экспертизы). Во избежание стагнации и торможения развития данной работы крайне важно, чтобы в основе данного нового научного направления лежала сильная академическая исследовательская стратегия, подкрепленная устойчивым финансированием, осуществляемым на национальном уровне. Показана важность полноценного материального обеспечения PCSI и разработки собственных стандартов, доказывающих возможность использования PCSI в качестве альтернативы для классической аутопсии.
Ключевые слова: посмертная томографическая визуализация, аутопсия, национальные стандарты, учебные программы, финансирование научной деятельности.
Ключевые слова: посмертная томографическая визуализация, аутопсия, национальные стандарты, учебные программы, финансирование научной деятельности.
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In this article, we list possible options of autopsy performance using various additional research methods, including postmortem cross-sectional imaging (PCSI), in Great Britain. Statistics show that there is no such thing as the officially approved PCSI specialists training program, and that it is available only as the joint initiative of several medical centers of the UK. The necessity of developing national standards and training programs in every professional field, creating the corresponding audit systems (checking and inspection), and outer PCSI quality control is also stated. The National Health Service institutions of the United Kingdom, with remuneration of the II category specialists’ work (forensic medical expertise analogue), mainly do implementation and keeping of tomographic data. To avoid stagnation and development deceleration of the said work, it is of the uttermost importance to have a strong academic research strategy, strengthened by the stable funding on the national level in the basis of the new scientific direction. The importance of the full-fledged PCSI funding and standards development, proving the possibility of PCSI use as the classic autopsy alternative.
Key words: postmortem cross-sectional imaging, autopsy, national standards, educational programs, scientific activity financing.
Полный текст
Список литературы
1. NCEPOD 2006. The Coroner's Autopsy – Do We Deserve Better?
2. Jeffery AJ. The role of computed tomography in adult post-mortem examinations: an overview. Diagnostic Histopathology 2010; 16 (12): 546–51.
3. Levy AD, Harcke HT. New approaches to radiology in mass casualty situations. Brogdon's Forensic Radiology (2nd edition), 2011.
4. Rutty GN, Robinson CE, BouHaidar R et al. The role of mobile computed tomography in mass fatality incidents. J Forensic Sci 2007; 52: 1343–9.
5. Sidler M, Jackowski C, Dirnhofer R et al. Use of multislice computed tomography in disaster victim identification – advantages and limitations. Forensic Sci Int 2007; 169 (2–3): 118–28.
6. RCR/RCPath statement on standards for medico-legal post-mortem cross-sectional imaging in adults. The Royal College of Radiologists. The Royal College of Radiologists. London. 2012.
7. Rutty G. Can cross-sectional imaging as an adjunct and/or alternative to the invasive autopsy be implemented within the NHS? NHS Implementation Sub-group, Leicester, England; 2012 October.
8. Ebert LC, Ptacek W, Naether S et al. Virtobot- a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy. Int J Med Robot 2010; 6: 18–27.
9. Saunders SL, Morgan B, Raj V et al. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011; 125: 609–16.
10. Roberts ISD, Benamore RE, Peebles C et al. Diagnosis of coronary artery disease using a minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011; 66: 645–50.
11. Grabherr S, Doenz F, Steger B et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Leg Med 2011; 125: 791–802.
12. Bolliger SA, Filograna L, Spendlove D et al. Postmortem Imaging-Guided Biopsy as an Adjuvant to Minimally Invasive Autopsy With CT and Postmortem Angiography: A Feasibility Study. Am J Roentgenol 2010; 195: 1051–6.
13. Rutty GN, Robinson C, Morgan B et al. Fimag: the United Kingdom disaster victim/forensic identification imaging system. J Forensic Sci 2009; 54: 1438–42.
2. Jeffery AJ. The role of computed tomography in adult post-mortem examinations: an overview. Diagnostic Histopathology 2010; 16 (12): 546–51.
3. Levy AD, Harcke HT. New approaches to radiology in mass casualty situations. Brogdon's Forensic Radiology (2nd edition), 2011.
4. Rutty GN, Robinson CE, BouHaidar R et al. The role of mobile computed tomography in mass fatality incidents. J Forensic Sci 2007; 52: 1343–9.
5. Sidler M, Jackowski C, Dirnhofer R et al. Use of multislice computed tomography in disaster victim identification – advantages and limitations. Forensic Sci Int 2007; 169 (2–3): 118–28.
6. RCR/RCPath statement on standards for medico-legal post-mortem cross-sectional imaging in adults. The Royal College of Radiologists. The Royal College of Radiologists. London. 2012.
7. Rutty G. Can cross-sectional imaging as an adjunct and/or alternative to the invasive autopsy be implemented within the NHS? NHS Implementation Sub-group, Leicester, England; 2012 October.
8. Ebert LC, Ptacek W, Naether S et al. Virtobot- a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy. Int J Med Robot 2010; 6: 18–27.
9. Saunders SL, Morgan B, Raj V et al. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011; 125: 609–16.
10. Roberts ISD, Benamore RE, Peebles C et al. Diagnosis of coronary artery disease using a minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011; 66: 645–50.
11. Grabherr S, Doenz F, Steger B et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Leg Med 2011; 125: 791–802.
12. Bolliger SA, Filograna L, Spendlove D et al. Postmortem Imaging-Guided Biopsy as an Adjuvant to Minimally Invasive Autopsy With CT and Postmortem Angiography: A Feasibility Study. Am J Roentgenol 2010; 195: 1051–6.
13. Rutty GN, Robinson C, Morgan B et al. Fimag: the United Kingdom disaster victim/forensic identification imaging system. J Forensic Sci 2009; 54: 1438–42.
________________________________________________
1. NCEPOD 2006. The Coroner's Autopsy – Do We Deserve Better?
2. Jeffery AJ. The role of computed tomography in adult post-mortem examinations: an overview. Diagnostic Histopathology 2010; 16 (12): 546–51.
3. Levy AD, Harcke HT. New approaches to radiology in mass casualty situations. Brogdon's Forensic Radiology (2nd edition), 2011.
4. Rutty GN, Robinson CE, BouHaidar R et al. The role of mobile computed tomography in mass fatality incidents. J Forensic Sci 2007; 52: 1343–9.
5. Sidler M, Jackowski C, Dirnhofer R et al. Use of multislice computed tomography in disaster victim identification – advantages and limitations. Forensic Sci Int 2007; 169 (2–3): 118–28.
6. RCR/RCPath statement on standards for medico-legal post-mortem cross-sectional imaging in adults. The Royal College of Radiologists. The Royal College of Radiologists. London. 2012.
7. Rutty G. Can cross-sectional imaging as an adjunct and/or alternative to the invasive autopsy be implemented within the NHS? NHS Implementation Sub-group, Leicester, England; 2012 October.
8. Ebert LC, Ptacek W, Naether S et al. Virtobot- a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy. Int J Med Robot 2010; 6: 18–27.
9. Saunders SL, Morgan B, Raj V et al. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011; 125: 609–16.
10. Roberts ISD, Benamore RE, Peebles C et al. Diagnosis of coronary artery disease using a minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011; 66: 645–50.
11. Grabherr S, Doenz F, Steger B et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Leg Med 2011; 125: 791–802.
12. Bolliger SA, Filograna L, Spendlove D et al. Postmortem Imaging-Guided Biopsy as an Adjuvant to Minimally Invasive Autopsy With CT and Postmortem Angiography: A Feasibility Study. Am J Roentgenol 2010; 195: 1051–6.
13. Rutty GN, Robinson C, Morgan B et al. Fimag: the United Kingdom disaster victim/forensic identification imaging system. J Forensic Sci 2009; 54: 1438–42.
Авторы
В.А.Фетисов
ФГБУ Российский центр судебно-медицинской экспертизы Минздрава России. 125284, Россия, Москва, ул. Поликарпова, д. 12/13
f_vaddimm64@mail.ru
ФГБУ Российский центр судебно-медицинской экспертизы Минздрава России. 125284, Россия, Москва, ул. Поликарпова, д. 12/13
f_vaddimm64@mail.ru
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V.A.Fetisov
Federal Center of Forensic Medical Expertise of the Ministry of Health of the Russian Federation. 125284, Russian Federation, Moscow, ul. Polikarpova, d. 12/13
f_vaddimm64@mail.ru
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