title: Validation of first-trimester telemedicine as an obstetric imaging technology: a feasibility study.
abstract: OBJECTIVE
  To establish whether first-trimester obstetric ultrasonography interpreted by a live video telemedicine link is comparable to an established videotape review network in a low-risk patient population.
  
  
  METHODS
  An integrated services digital network was established from three satellite offices to our central prenatal diagnostic center. All patients had a sonographic evaluation of the uterus, adnexa, and gestational sac recorded onto videotape by a trained sonographer. A live, interactive video telemedicine link was established, and a perinatologist directed the sonographer through the scan. Subsequently, a different perinatologist, blinded to the telemedicine interpretation, reviewed the original videotaped examination. The reports generated from both modalities then were compared by means of a score of 12 sonographic characteristics.
  
  
  RESULTS
  The first 100 patients were included. The mean gestational age (+/-standard deviation) was 8.9 +/- 2.3 weeks (range 5.7-14.4), and the mean duration for telemedicine scans was 7.8 +/- 2.9 minutes (range 3.8-20.1). Telemedicine and videotape review scores were the same in 95 cases, and the final diagnosis was identical in 98 cases. This study had 80% power to detect a 10% difference in diagnosis at a significance level of .05. The ability to detect abnormalities was equivalent using both systems.
  
  
  CONCLUSIONS
  The interpretation of first-trimester obstetric ultrasonography using live video telemedicine is equivalent to a system of videotape review. Obstetric telemedicine may prove to be a useful tool for providing sonographic imaging for low-risk obstetric patients.
authors.affiliation: Department of Obstetrics and Gynecology, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts, USA.
authors.forename: J
authors.initials: J
authors.lastname: Nores
authors.forename: F D
authors.initials: FD
authors.lastname: Malone
authors.forename: A
authors.initials: A
authors.lastname: Athanassiou
authors.forename: S D
authors.initials: SD
authors.lastname: Craigo
authors.forename: L L
authors.initials: LL
authors.lastname: Simpson
authors.forename: M E
authors.initials: ME
authors.lastname: D'Alton
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011261:Pregnancy Trimester, First; D017216:Telemedicine; D016216:Ultrasonography, Prenatal; D014743:Videotape Recording