J Telemed Telecare - Near real-time echocardiography teleconsultation using low bandwidth and MPEG-4 compression: feasibility, image adequacy and clinical implications.

Tópicos

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Resumo

We assessed the feasibility, image adequacy and clinical utility of a tele-echocardiography service which combined video compression with low-bandwidth store-and-forward transmission. Echocardiograms were acquired by a hospital geriatrician, compressed and transmitted using both near real-time (urgent) and delayed (pre-programmed) protocols via an Internet connection to the notebook PC of a remote cardiologist. Clinical utility was evaluated as a change in therapeutic management. During a one-year period, 101 tele-echocardiography consultations were successfully performed (feasibility = 100%) on 95 patients (age 22-95 years), admitted with cardiovascular or neurological diagnoses (24% of the consultations were urgent). In total, 4617 files (1.4 GByte of data) were transmitted, 2669 of which were short video clips. On average, 46 files (13.8 MByte) were transmitted (mean duration 10 min) at each examination. Consultations (both urgent and pre-programmed) were clinically useful in 83% of examinations. Logistic regression analysis showed that both a low left ventricular systolic function and the examination indication were determinants of clinical utility. The transmitted images were considered adequate for diagnosis in 100% of the pre-programmed teleconsultations. Tele-echocardiography using MPEG-4 video compression is a feasible, adequate and clinically useful tool for telemedicine.

Resumo Limpo

assess feasibl imag adequaci clinic util teleechocardiographi servic combin video compress lowbandwidth storeandforward transmiss echocardiogram acquir hospit geriatrician compress transmit use near realtim urgent delay preprogram protocol via internet connect notebook pc remot cardiologist clinic util evalu chang therapeut manag oneyear period teleechocardiographi consult success perform feasibl patient age year admit cardiovascular neurolog diagnos consult urgent total file gbyte data transmit short video clip averag file mbyte transmit mean durat min examin consult urgent preprogram clinic use examin logist regress analysi show low left ventricular systol function examin indic determin clinic util transmit imag consid adequ diagnosi preprogram teleconsult teleechocardiographi use mpeg video compress feasibl adequ clinic use tool telemedicin

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