Qualitative assessment of telemedicine network and computer-based telecolposcopy.
OBJECTIVE
To qualitatively assess telemedicine network and computer-based telecolposcopy.


METHODS
A site expert and local colposcopist examined women presenting consecutively for colposcopic examination at 1 of 2 rural clinics. Images from the exam were transmitted to distant experts at a telemedicine center by an existing telemedicine network and computer-based telecolposcopy system. Colposcopists rated both systems with respect to complications, ease and confidence of procedure, and system resolution and visualization.


RESULTS
Rates of technically defective examinations were similar for network (25.1%) and computer-based (22.5%) telecolposcopy (p =.46). The ease of telecolposcopic examinations and colposcopists' confidence in and comfort with telecolposcopy were practically equal for both systems. Mean perceived quality of care was greater for network (3.92) compared with computer-based (3.82) telecolposcopy (Wilcoxon signed rank test, p =.03; Likert scale, 1 = minimal, 5 = maximum). Image resolution was rated better for computer-based (3.36) compared with network (3.07, p <.0001) telecolposcopy. However, visualization was better for the latter system in comparison (3.43 vs 3.07, p <.0001).


CONCLUSIONS
The quality of telecolposcopy was considered above average based on all parameters evaluated for each type of telecolposcopy. Although a few significant differences were detected, colposcopists perceived network and computer-based telecolposcopy to be very similar by subjective assessment.
Ferris
Daron G
DG
Gynecologic Cancer Prevention Center, Medical College of Georgia, Augusta, GA, USA. dferris@mail.mcg.edu
Litaker
Mark S
MS
Miller
Jill A
JA
Macfee
Michael S
MS
Crawley
Debra
D
Watson
Diane
D