Telemedicine network telecolposcopy compared with computer-based telecolposcopy.
OBJECTIVE
To compare computer-based telecolposcopy with telemedicine network telecolposcopy.


METHODS
An on-site expert and local clinician at two rural sites conducted colposcopic examinations on 264 women. Colposcopic images were captured and transmitted to two other experts at a remote location using a statewide telemedicine system and a computer and modem-based system. Sensitivity and specificity, agreement of examination adequacy and management, effects of delayed interpretations, and costs were compared for each system.


RESULTS
A greater rate of satisfactory colposcopy results was reported by the telemedicine network (66.1%) compared with computer-based (43.6%) telecolposcopy (p < .0001). Greater rates of cervical biopsy (p = .005) and endocervical curettage (p = .03) were required by delayed telecolposcopy compared with immediate telecolposcopic services. There were no significant differences in sensitivity of detecting cervical neoplasia among the types of the telecolposcopy. Computer-based telecolposcopy cost 28 dollars less per patient than telemedicine network telecolposcopy.


CONCLUSIONS
Computer-based telecolposcopy may be a reasonable, cost-effective adjunct to on-site colposcopy for evaluating women in medically underserved areas. Synchronous telecolposcopic examination minimizes histologic sampling and improves consultation.
Ferris
Daron G
DG
Gynecologic Cancer Prevention Center, Department of Family Medicine, the Medical College of Georgia, Augusta, GA 30912, USA. dferris@mail.mcg.edu
Bishai
David M
DM
Litaker
Mark S
MS
Dickman
Eileen D
ED
Miller
Jill A
JA
Macfee
Michael S
MS