Diagnostic accuracy with US: remote radiologists' versus on-site radiologists' interpretations.
OBJECTIVE
To compare the diagnostic accuracy of radiologists interpreting static ultrasonographic (US) images electronically transmitted to an academic medical center (remote radiologists) with that of radiologists performing "hands-on" US at a community-based outpatient site (on-site radiologists).


METHODS
During 8 months, 80 patients underwent pelvic US at a community-based outpatient site. Images were electronically transmitted to a remote medical center as they were acquired at the community site and were printed on a laser printer identical to the one used at the outpatient site. The reference standard for correct diagnosis was based on histopathologic findings (n = 13), additional imaging results (n = 34), or review by a second independent observer (n = 33). Both an on-site and a remote radiologist interpreted the images, and their interpretations were rated as agree, both correct; agree, both incorrect; or disagree. Cases of disagreement were rated as major or minor.


RESULTS
On-site and remote radiologists agreed in 69 of 80 patients (86%), and both radiologists were correct in all of these cases. There were 10 minor discrepancies and one major discrepancy. The diagnostic accuracies of the one-site and remote radiologists were 92% and 94%, respectively.


CONCLUSIONS
High levels of diagnostic accuracy can be achieved by radiologists interpreting static US images. Strict protocols and excellent communication between the radiologist and sonographer are necessary to avoid diagnostic errors.
Rosen
M P
MP
Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Levine
D
D
Carpenter
J M
JM
Frost
L
L
Hulka
C A
CA
Western
D L
DL
McArdle
C R
CR
D000046:Academic Medical Centers; D000554:Ambulatory Care Facilities; D003151:Community Health Centers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007834:Lasers; D008297:Male; D010388:Pelvis / Q000000981:diagnostic imaging; D011247:Pregnancy; D011327:Printing; D012015:Reference Standards; D019114:Remote Consultation; D019112:Teleradiology; D014463:Ultrasonography; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000000981:diagnostic imaging