title: Accuracy of paediatric echocardiographic transmission via telemedicine.
abstract: We evaluated the accuracy of realtime echocardiography studies conducted via telemedicine (at 384 kbit/s) and prerecorded video studies, by comparing the results with subsequent in-person echocardiography examination performed at follow-up. Between January 2002 and December 2004, there were 769 paediatric echo studies of patients aged one day to 19 years by telemedicine. There were three cases (0.4%) in which the study could not be successfully transmitted in realtime due to ISDN line or equipment failure. These were recorded, then transmitted and reviewed within 24 h. A normal heart was demonstrated in 272 studies (35%). A non-urgent congenital heart defect (CHD) was detected in 311 studies (41%). A critical cardiac abnormality was identified in 25 studies (3% of the total). Sixty-seven studies were repeated in person at the tertiary centre. All but one of the follow-up echocardiograms confirmed our initial telemedicine diagnosis (99% sensitivity). There were 655 videorecorded studies delivered to the tertiary centre between February 2002 and November 2003. Thirty-two patients had a repeated echocardiogram performed there. There were either discrepancies or lack of diagnostic clarity in 12 studies (38%) compared with on-site echo evaluations. This suggests that echocardiography evaluation using videorecordings may be less accurate than via realtime telemedicine.
authors.affiliation: Children's Hospital and Regional Medical Center, Seattle, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Lewin
authors.forename: Cathy
authors.initials: C
authors.lastname: Xu
authors.forename: Mary
authors.initials: M
authors.lastname: Jordan
authors.forename: Heidi
authors.initials: H
authors.lastname: Borchers
authors.forename: Catherine
authors.initials: C
authors.lastname: Ayton
authors.forename: Dennis
authors.initials: D
authors.lastname: Wilbert
authors.forename: Sanford
authors.initials: S
authors.lastname: Melzer
mesh_terms: D000293:Adolescent; D000328:Adult; D002309:Cardiology / Q000379:methods / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000592:standards*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards; D017216:Telemedicine / Q000379:methods / Q000592:standards*; D014861:Washington