An evaluation of telemedicine in surgery: telediagnosis compared with direct diagnosis

Details

Serval ID
serval:BIB_33311E76E74C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
An evaluation of telemedicine in surgery: telediagnosis compared with direct diagnosis
Journal
Archives of Surgery
Author(s)
Demartines  N., Otto  U., Mutter  D., Labler  L., von Weymarn  A., Vix  M., Harder  F.
ISSN
0004-0010 (Print)
Publication state
Published
Issued date
07/2000
Volume
135
Number
7
Pages
849-53
Notes
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jul
Abstract
HYPOTHESIS: Telemedicine for real-time transmission of clinical documents and interactive remote telediagnosis allows accurate clinical application in surgery. DESIGN: Prospective cohort study in which 2 hospitals, 120 miles apart, were connected via integrated services digital network (ISDN) teleconferencing units, and each evaluated clinical cases in real time. SETTING: A tertiary care university hospital and primary care county hospital. PARTICIPANTS: Between May 1, 1998, and June 30, 1998, 112 patients undergoing digestive or endocrine surgery were evaluated by teletransmission (study group) and direct vision (control group). Diagnosis had to be known by the viewer, and either conventional magnetic resonance imaging or computed tomographic scans were available. MAIN OUTCOME MEASURES: Picture quality, organ structure, and pathologic finding viewed on telemedicine documents were evaluated by radiologists and surgeons blind to diagnosis. Accuracy of remote 128-kilobit (kb)/s transmission-rate diagnoses and results were compared with those obtained directly. RESULTS: Picture quality was "good" or "excellent" in 92.9% of transmitted documents and 95.5% of live images (P>.4). The target organ was always recognized, structure and pathologic finding were analyzable in 98.2% of transmitted documents and 99.1% of live documents, and fine structures were assessable in 89.3% of transmitted pictures and 95.5% of live pictures (P>.05). Diagnosis was made in 84.8% of transmitted cases and 93.8% of live cases (P = .02). CONCLUSIONS: Low bandwidth (128 kb/s) telemedicine application in surgery is reliable in evaluating remote cases. Loss of image quality through teletransmission occurred in 2.7% of cases, and diagnosis was not possible in 15.2% of transmitted vs 6.2% of live cases, suggesting factors other than technical quality (choice of radiological studies, additional clinical information required, etc). This underscores the importance of real-time interactive discussion during surgical teleconferences.
Keywords
Cohort Studies Data Interpretation, Statistical *Diagnosis Humans Magnetic Resonance Imaging Prospective Studies Reproducibility of Results *Surgical Procedures, Operative/statistics & numerical data Switzerland *Telemedicine/instrumentation/organization & administration/standards/statistics & numerical data Tomography, X-Ray Computed
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 8:53
Last modification date
20/08/2019 13:19
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