A comparison between digital images viewed on a Picture Archiving and Communication System diagnostic workstation and on a PC-based remote viewing system by emergency physicians

Parasyn, A; Hanson, Ralph; Peat, J. K.; Silva, M De

doi:10.1007/bf03168724

Cited by 25 publications

(17 citation statements)

References 13 publications

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“…Furthermore, it is a viable option for almost all medical specialties, particularly those for which images comprise the main diagnostic tool (4)(5)(6)(7) . Thus, the fields of radiology, dermatology, pathology, ultrasound, and ophthalmology, among others (8)(9)(10)(11)(12) , are especially favorable for the establishment of data transmission protocols with diagnostic purposes (13,14) . Ophthalmology, for example, can greatly benefit from telemedicine (15,16) , as it is crucial to identify patients that present urgent cases in order to avoid morbidity and permanent disorders (17) .…”

Section: Introductionmentioning

confidence: 99%

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Ribeiro

Rodrigues

Guerreiro

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purposes: To validate a teleophthalmology mobile system aimed at improving and providing eye urgency screenings in remote and poor area settings in Brazil. The system enables one or more ophthalmologists to remotely examine a patient's condition and submit a decision describing the gravity of the case. If necessary, the patient can be forwarded to a hospital for further consultation. Methods: A cellphone (Nexus One model, with a 5 megapixel camera) was used to collect data and pictures from 100 randomly selected patients at the Ophthalmology Emergency Room located at the General Hospital of the Federal University of São Paulo (UNIFESP). Data was then sent remotely to an online recording system to be reviewed by an ophthalmologist who provided feedback regarding the state of ocular urgency. Results were then compared to the gold standard diagnosis provided at the hospital. Results: The diagnosis of urgency was given by two ophthalmologists: one in the hospital (gold standard) and one remotely. When we compared both diagnoses we obtained results of 81.94% specificity, 92.85% sensitivity, and 85% accuracy, with a negative predictive value of 96.72%. This work also included a processing time analysis, resulting in an average time of 8.6 min per patient for remote consultations. Conclusions: This study is the first that has used only a cellphone for diagnosing the urgency of ocular cases. Based on our results, the system can provide a reliable distinction between urgent and non-urgent situations and can offer a viable alternative for the servicing of underprivileged areas. In screening techniques, the most important outcome is to identify urgent cases with a high level of sensitivity and predictive negative value. Thus, our results demonstrate that this tool is robust and we suggest that a major study aimed to verify its efficiency in resource-poor areas should be initiated.

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Section: Introductionmentioning

confidence: 99%

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Ribeiro

Rodrigues

Guerreiro

et al. 2014

Arquivos Brasileiros De Oftalmologia

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“…55 For example, remote diagnosis has been shown to have the same accuracy as direct, live diagnosis for several specialties, with agreement reaching 95%. 48,56,57 This raises the question of whether live and remote diagnosis warrant the same professional fees. Thus, this new mode of providing care raises potentially formidable compensation and procedural issues that require further definitive analysis.…”

Section: Cost-benefit Analysismentioning

confidence: 99%

“…These proportions reflect the complexity of the cases and are consistent with other reports of approximately 30% uncertain telediagnoses. 47,48 This limitation invokes the issue of medical responsibility, 49 with clinical responsibility (including diagnosis) remaining with the surgeon in charge of the patient. To avoid medicolegal problems, it is therefore important to establish medical responsibility at the beginning of a telesurgery program, with all the participants involved.…”

Section: Quality Of Transmission For Clinical Applicationmentioning

confidence: 99%

Assessment of Telemedicine in Surgical Education and Patient Care

Demartines

Mutter²,

Vix³

et al. 2000

Annals of Surgery

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ObjectiveTo analyze the value of teleconferencing for patient care and surgical education by assessing the activity of an international academic network. Summary Background DataThe uses of telemedicine include teleeducation, training, and consulting, and surgical teams are now involved, sharing diagnostic information and opinions without the need for travel. However, the value of telematics in surgery remains to be assessed. MethodsDuring a 2-year period, weekly surgical teleconferences were held among six university hospitals in four European countries. To assess the accuracy of telediagnosis for surgical cases, 60 randomly selected cases were analyzed by a panel of surgeons. Participants' opinions were analyzed by questionnaire. ResultsSeventy teleconferences (50 lectures and 271 case presentations) were held. Ninety-five of the 114 participants (83.3%) completed the final questionnaire. Eighty-six percent rated the surgical activity as good or excellent, 75.7% rated the scientific level as good or excellent, 55.8% rated the daily clinical activity as good or excellent, and 28.4% rated the manual surgical technique as good or excellent. The target organ was identified in all the cases; the organ structure and pathology were considered well defined in 93.3%, and the fine structure was considered well defined in 58.3%. Diagnosis was accurate in 17 cases (28.3%), probable in 25 (41.7%), possible but uncertain in 16 (26.7%), and not possible in 2 cases (3.3%). Discussion among the remote sites increased the rate of valuable therapeutic advice from 55% of cases before the discussion to 95% after the discussion. Eighty-six percent of the surgeons expressed satisfaction with telematics for medical education and patient care. ConclusionsParticipant satisfaction was high, transmission of clinical documents was accurate, and the opportunity to discuss case documentation and management significantly improved diagnostic potential, resulting in an accuracy rate of up to 95%. Teleeducation and teleconsultation in surgery appear to be beneficial.In this information age, the new computer-based communication technologies called telematics offer enormous potential for applications in medical and surgical practice and education.1 The introduction of these tools in surgery has attracted much interest; however, the possibilities of combining increasing computing power 2 with surgeons' objectives and needs have not yet been properly analyzed. First, we must assess the results of telematic applications in medicine and surgery. 3,4 The field of telemedicine involves far more than just the transmission of patient files.5 It involves education, 6,7 training, 8 consulting, 9 and mentoring, 10 -12 and in the near future will include accreditation. 13 Currently, surgical teams are involved in teleconferencing, sharing medical advice and offering second opinions without the need to transfer the patient.14 -16 The time and costs of travel on the part of experts are limiting factors to joint consultations or meet- 282ings.17 Telemedicine s...

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“…4 In addition, clinical review of images will necessitate the use of Internet-based distribution technologies. This will require the use of thin clients and thin networks for distribution that maintain the use of standard Internet protocols.…”

Section: Primary Clinical Interpretationmentioning

confidence: 99%

The primary interpretation workstation: Information beyond image data

et al. 1998

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With the advent of picture archival and communication systems (PACS), the importance of design surrounding prima~y review workstations has become apparent. To help acceptance of filmless medical imaging, workstations must be developed that serve the needs of both radiologists and referring clinicians. This report will discuss integral requirements of workstation design, including information creation, medical management, medical knowledge, and enabling technologies. Copyright 9 1998 by W.B. Saunders Company p ICTURE ARCH]VING and communication systems (PACS) have made possible the viewing of radiographic images on computer workstations both where interpretation occurs and where clinical care is delivered. With the advent of this technology, much development has been focused towards improving both aspects of these deployments from an image-centric perspective. This report will serve to discuss the experiences of the Massachusetts General Hospital-Advanced Imaging Laboratory's (MGH-AIL) design and development of primary interpretation and clinical review workstations that include not only image data, but also the integration of a variety of other essential patient information and medical knowledge. PRIMARY RADIOLOGIC INTERPRETATIONThe ideal primary radiologic interpretation workstation serves to provide the radiologist with not only the sets of images for clinical interpretation, buta host of tools and other information necessary to make this process more efficient and accurate. While our currently deployed workstations are primarily DICOM-based image display stations running C+ + display applications in UNIX OS, future workstations will run Active X components on NT OS layers. Because of this trend, the features added to the existing workstations by the MGH-AIL ate occurred on Microsoft OS platforms using Active X modules. To interface to existing UNIX

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A comparison between digital images viewed on a Picture Archiving and Communication System diagnostic workstation and on a PC-based remote viewing system by emergency physicians

Cited by 25 publications

References 13 publications

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Assessment of Telemedicine in Surgical Education and Patient Care

The primary interpretation workstation: Information beyond image data

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