Telemed J E Health - Remote diagnosis of congenital heart disease in southern Arizona: comparison between tele-echocardiography and videotapes.

Tópicos

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Resumo

JECTIVE: We report our experience with tele-echocardiography and echocardiograms recorded digitally or on videotape (recorded-echos) at The University of Arizona from August 2006 to December 2010 and compare their quality and diagnostic accuracy.MATERIALS AND METHODS: Tele-echocardiograms (tele-echos) were transmitted from the Yuma Regional Medical Center to The University of Arizona via a T-1 and aT-3 line at a bandwidth of 768 kilobits per second. Recorded-echos were shipped for interpretation to The University of Arizona by overnight mail. Diagnostic accuracy was assessed by comparing tele- and recorded-echos with electrocardiograms performed by a pediatric cardiologist (PedsCard-echos).RESULTS: Three hundred forty-six tele-echos in 260 patients and 455 recorded-echos in 406 patients were performed (median age, 6 and 8 days, respectively). Indications included possible congenital heart disease (CHD), patent ductus arteriosus (PDA), and persistent pulmonary hypertension of the newborn. Diagnostic categories included complex CHD, non-critical disease, PDA, and other. PedsCard-echos were available for 27% of the tele-echo and 30% of the recorded-echo patients. Comparisons between tele- and PedsCard-echo yielded no discrepancies in 12 (23%), expected resolution of condition in 26 (49%), and minor in 14 (26%). One (2%) major discrepancy was detected. Comparisons between recorded- and PedsCard-echo showed no discrepancies in 28 (40%), expected resolution of condition in 14 (20%), and minor discrepancies in 28 (40%) patients. No significant difference with respect to discrepancies was detected between tele- and recorded-echos. There was significant (p<0.01) improvement in tele- and recorded-echo study quality by 2010.CONCLUSIONS: (1) Tele-echocardiography can be performed successfully with excellent accuracy. (2) The quality of tele- and recorded-echo studies improved toward the end of the analysis period. (3) Although initially tele-echo studies were more accurate than recorded-echo studies, there was no difference between these two types of studies by the fourth year of the study. (4) Both tele- and recorded-echos were indispensible in the remote diagnosis of CHD.

Resumo Limpo

jectiv report experi teleechocardiographi echocardiogram record digit videotap recordedecho univers arizona august decemb compar qualiti diagnost accuracymateri method teleechocardiogram teleecho transmit yuma region medic center univers arizona via t line bandwidth kilobit per second recordedecho ship interpret univers arizona overnight mail diagnost accuraci assess compar tele recordedecho electrocardiogram perform pediatr cardiologist pedscardechosresult three hundr fortysix teleecho patient recordedecho patient perform median age day respect indic includ possibl congenit heart diseas chd patent ductus arteriosus pda persist pulmonari hypertens newborn diagnost categori includ complex chd noncrit diseas pda pedscardecho avail teleecho recordedecho patient comparison tele pedscardecho yield discrep expect resolut condit minor one major discrep detect comparison record pedscardecho show discrep expect resolut condit minor discrep patient signific differ respect discrep detect tele recordedecho signific p improv tele recordedecho studi qualiti conclus teleechocardiographi can perform success excel accuraci qualiti tele recordedecho studi improv toward end analysi period although initi teleecho studi accur recordedecho studi differ two type studi fourth year studi tele recordedecho indispens remot diagnosi chd

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