title: Telemedicine network telecolposcopy compared with computer-based telecolposcopy.
abstract: 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.
authors.affiliation: Gynecologic Cancer Prevention Center, Department of Family Medicine, the Medical College of Georgia, Augusta, GA 30912, USA. dferris@mail.mcg.edu
authors.forename: Daron G
authors.initials: DG
authors.lastname: Ferris
authors.forename: David M
authors.initials: DM
authors.lastname: Bishai
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litaker
authors.forename: Eileen D
authors.initials: ED
authors.lastname: Dickman
authors.forename: Jill A
authors.initials: JA
authors.lastname: Miller
authors.forename: Michael S
authors.initials: MS
authors.lastname: Macfee