Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 1999
Teleconsultation in otolaryngology: live versus store and forward consultations.
Клиническое исследованиеСравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sclafani A P, Heneghan C, Ginsburg J, Sabini P, Stern J, Dolitsky J N
Аннотация
OBJECTIVE: To evaluate the relative strengths and weaknesses of interactive and delayed teleconsultations in otolaryngology.
SETTING: Ambulatory clinic at an urban tertiary care facility.
SUBJECTS: Forty-five adult patients with known or suspected upper aerodigestive tract pathology.
INTERVENTION: Patients were interviewed by an otolaryngology chief resident (CR) using a standardized protocol; the results were presented to a board-certified otolaryngologist present locally (LBCO) and a remote physician viewing the encounter by video-conferencing elsewhere in the hospital (RBCO). The CR performed a complete otolaryngologic examination, including fiberoptic nasopharyngolaryngoscopy. The CR and LBCO viewed the examination on a video monitor; the RBCO viewed the same image on the video-conferencing monitor. Each physician independently recorded findings and rendered a diagnosis. A third board-certified otolaryngologist, who reviewed the stored data file (text and stored images) in a delayed fashion (DBCO), documented his findings and made a diagnosis.
RESULTS: The CR and LBCO agreed on diagnosis in 92% (36 of 39) of cases. The LBCO and RBCO arrived at the same diagnosis in 29 of 34 (85%) cases. The DBCO agreed with the LBCO for 18 of 28 (64%) diagnoses. Agreement on management recommendations between the LBCO/DBCO pair were also lower than for the LBCO/RBCO pair.
CONCLUSIONS: Both interactive and delayed techniques can be used to provide relatively accurate clinical consultations in otolaryngology. Telemedicine can be applied for subspecialty consultations, screening programs, remote emergency triage, second opinions, and resident education.
SETTING: Ambulatory clinic at an urban tertiary care facility.
SUBJECTS: Forty-five adult patients with known or suspected upper aerodigestive tract pathology.
INTERVENTION: Patients were interviewed by an otolaryngology chief resident (CR) using a standardized protocol; the results were presented to a board-certified otolaryngologist present locally (LBCO) and a remote physician viewing the encounter by video-conferencing elsewhere in the hospital (RBCO). The CR performed a complete otolaryngologic examination, including fiberoptic nasopharyngolaryngoscopy. The CR and LBCO viewed the examination on a video monitor; the RBCO viewed the same image on the video-conferencing monitor. Each physician independently recorded findings and rendered a diagnosis. A third board-certified otolaryngologist, who reviewed the stored data file (text and stored images) in a delayed fashion (DBCO), documented his findings and made a diagnosis.
RESULTS: The CR and LBCO agreed on diagnosis in 92% (36 of 39) of cases. The LBCO and RBCO arrived at the same diagnosis in 29 of 34 (85%) cases. The DBCO agreed with the LBCO for 18 of 28 (64%) diagnoses. Agreement on management recommendations between the LBCO/DBCO pair were also lower than for the LBCO/RBCO pair.
CONCLUSIONS: Both interactive and delayed techniques can be used to provide relatively accurate clinical consultations in otolaryngology. Telemedicine can be applied for subspecialty consultations, screening programs, remote emergency triage, second opinions, and resident education.