Interpretation of Full-Length Pediatric Echocardiograms
Interpretation of Full-Length Pediatric Echocardiograms
Background: Transmission of echocardiograms via telemedicine links has allowed remote hospitals direct access to pediatric cardiology subspecialty care. This study assessed the accuracy of echocardiogram interpretation across an integrated services digital network (ISDN) telemedicine link.
Methods: Telemedicine systems were installed between Cape Fear Valley Medical Center neonatal intensive care unit and University of North Carolina Hospitals. One board-certified pediatric cardiologist interpreted 105 full-length echocardiograms that were videotaped and then transmitted over the system. Six months later, the same cardiologist reinterpreted the 105 original videotape studies from the off-site hospital and results were compared with the interpretations of the transmitted data.
Results: Interpretation of transmitted echocardiograms did not differ significantly from the original studies for diagnosis, evaluation of left ventricular function, valve function evaluation, and the presence of a ductus arteriosus. Minor differences in qualitative parameters were seen.
Conclusion: Transmission of full-length echocardiograms over the ISDN telemedicine link is comparable to videotape review. There was no loss of significant clinical information, and the minor discrepancies noted did not impact management decisions.
With the advent of telemedicine, smaller hospitals have easier access to large academic centers where subspecialty expertise can assist in the care of patients with complex medical problems. This technology has been used to provide medical diagnosis, consultations, and case management. In pediatric cardiology, echocardiography has emerged as the standard for diagnosis and management of complex congenital heart disease in children. Since many infants are born at hospitals without the availability of on-site pediatric cardiology consultation, transmission of echocardiograms using telemedicine links is emerging as an important tool in the care of these infants. By transmitting an echocardiogram, evaluation of the infant can be made rapidly by a pediatric cardiologist, facilitating appropriate care.
The type of data connection between two telemedicine sites directly influences the amount of information that can be transmitted per second (bandwidth). Because digitalization of echocardiographic images requires a large amount of computer memory, a connection that can rapidly transfer large amounts of data can relay the best images without significant loss of information. Several previous studies have described transmission of echocardiograms either in cine-loop or full-length format over various types of telemedicine links. In view of the complex anatomy, high heart rates, and amount of structural and functional information needed for diagnosis of congenital heart disease, we thought that review of full-length studies was essential to make an accurate interpretation. This study was designed to compare the accuracy of interpretations of full-length echocardiograms transmitted across a telemedicine link utilizing 3 bonded integrated services digital network (ISDN) lines at a rate of 384 kilobytes per second (kbps) with the original videotaped study.
Background: Transmission of echocardiograms via telemedicine links has allowed remote hospitals direct access to pediatric cardiology subspecialty care. This study assessed the accuracy of echocardiogram interpretation across an integrated services digital network (ISDN) telemedicine link.
Methods: Telemedicine systems were installed between Cape Fear Valley Medical Center neonatal intensive care unit and University of North Carolina Hospitals. One board-certified pediatric cardiologist interpreted 105 full-length echocardiograms that were videotaped and then transmitted over the system. Six months later, the same cardiologist reinterpreted the 105 original videotape studies from the off-site hospital and results were compared with the interpretations of the transmitted data.
Results: Interpretation of transmitted echocardiograms did not differ significantly from the original studies for diagnosis, evaluation of left ventricular function, valve function evaluation, and the presence of a ductus arteriosus. Minor differences in qualitative parameters were seen.
Conclusion: Transmission of full-length echocardiograms over the ISDN telemedicine link is comparable to videotape review. There was no loss of significant clinical information, and the minor discrepancies noted did not impact management decisions.
With the advent of telemedicine, smaller hospitals have easier access to large academic centers where subspecialty expertise can assist in the care of patients with complex medical problems. This technology has been used to provide medical diagnosis, consultations, and case management. In pediatric cardiology, echocardiography has emerged as the standard for diagnosis and management of complex congenital heart disease in children. Since many infants are born at hospitals without the availability of on-site pediatric cardiology consultation, transmission of echocardiograms using telemedicine links is emerging as an important tool in the care of these infants. By transmitting an echocardiogram, evaluation of the infant can be made rapidly by a pediatric cardiologist, facilitating appropriate care.
The type of data connection between two telemedicine sites directly influences the amount of information that can be transmitted per second (bandwidth). Because digitalization of echocardiographic images requires a large amount of computer memory, a connection that can rapidly transfer large amounts of data can relay the best images without significant loss of information. Several previous studies have described transmission of echocardiograms either in cine-loop or full-length format over various types of telemedicine links. In view of the complex anatomy, high heart rates, and amount of structural and functional information needed for diagnosis of congenital heart disease, we thought that review of full-length studies was essential to make an accurate interpretation. This study was designed to compare the accuracy of interpretations of full-length echocardiograms transmitted across a telemedicine link utilizing 3 bonded integrated services digital network (ISDN) lines at a rate of 384 kilobytes per second (kbps) with the original videotaped study.
