1
|
Gravina AG, Pellegrino R, Durante T, Palladino G, D'Onofrio R, Mammone S, Arboretto G, Auletta S, Imperio G, Ventura A, Romeo M, Federico A. Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future? World J Methodol 2023; 13:194-209. [PMID: 37771865 PMCID: PMC10523254 DOI: 10.5662/wjm.v13.i4.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 09/20/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic digestive disease that requires continuous monitoring by healthcare professionals to determine the appropriate therapy and monitor short-term and long-term complications. The progressive development of information technology has enabled healthcare personnel to deliver care services to patients remotely. Therefore, various applications of telemedicine in IBD management have evolved, including telemonitoring, teleconsulting, teleducation, telenursing, telenutrition, and telepathology. While evidence has been provided for some telemedicine applications, targeted studies are still required. This review summarises the major studies that have evaluated telemedicine and its application in the management of IBD.
Collapse
Affiliation(s)
| | - Raffaele Pellegrino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Tommaso Durante
- Mental Health Department, “S. Pio” Hospital, Benevento 82100, Italy
| | - Giovanna Palladino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Rossella D'Onofrio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Simone Mammone
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giusi Arboretto
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Salvatore Auletta
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giuseppe Imperio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Andrea Ventura
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Mario Romeo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| |
Collapse
|
2
|
Waye JD, Marin ML, Damoi JO, Lumala IF. Remote training in flexible gastrointestinal endoscopy. VideoGIE 2021; 6:439-442. [PMID: 34667911 PMCID: PMC8505227 DOI: 10.1016/j.vgie.2021.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jerome D Waye
- Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michael L Marin
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | |
Collapse
|
3
|
Yan T, Wong PK, Choi IC, Vong CM, Yu HH. Intelligent diagnosis of gastric intestinal metaplasia based on convolutional neural network and limited number of endoscopic images. Comput Biol Med 2020; 126:104026. [PMID: 33059237 DOI: 10.1016/j.compbiomed.2020.104026] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Gastric intestinal metaplasia (GIM) is a precancerous lesion of gastric cancer. Currently, diagnosis of GIM is based on the experience of a physician, which is liable to interobserver variability. Thus, an intelligent diagnostic (ID) system, based on narrow-band and magnifying narrow-band images, was constructed to provide objective assistance in the diagnosis of GIM. METHOD We retrospectively collected 1880 endoscopic images (1048 GIM and 832 non-GIM) via biopsy from 336 patients confirmed histologically as GIM or non-GIM, from the Kiang Wu Hospital, Macau. We developed an ID system with these images using a modified convolutional neural network algorithm. A separate test dataset containing 477 pathologically confirmed images (242 GIM and 235 non-GIM) from 80 patients was used to test the performance of the ID system. Experienced endoscopists also examined the same test dataset, for comparison with the ID system. One of the challenges faced in this study was that it was difficult to obtain a large number of training images. Thus, data augmentation and transfer learning were applied together. RESULTS The area under the receiver operating characteristic curve was 0.928 for the pre-patient analysis of the ID system, while the sensitivities, specificities, and accuracies of the ID system against those of the human experts were (91.9% vs. 86.5%, p-value = 1.000) (86.0% vs. 81.4%, p-value = 0.754), and (88.8% vs. 83.8%, p-value = 0.424), respectively. Even though the three indices of the ID system were slightly higher than those of the human experts, there were no significant differences. CONCLUSIONS In this pilot study, a novel ID system was developed to diagnose GIM. This system exhibits promising diagnostic performance. It is believed that the proposed system has the potential for clinical application in the future.
Collapse
Affiliation(s)
- Tao Yan
- School of Mechanical Engineering, Hubei University of Arts and Science, Xiangyang, 441053, China; Department of Electromechanical Engineering, University of Macau, Taipa, 999078, Macau, China
| | - Pak Kin Wong
- Department of Electromechanical Engineering, University of Macau, Taipa, 999078, Macau, China.
| | | | - Chi Man Vong
- Department of Computer and Information Science, University of Macau, Taipa, 999078, Macau, China
| | | |
Collapse
|
4
|
Bae JK, Vavilin A, You JS, Kim H, Ryu SY, Jang JH, Jung W. Smartphone-Based Endoscope System for Advanced Point-of-Care Diagnostics: Feasibility Study. JMIR Mhealth Uhealth 2017; 5:e99. [PMID: 28751302 PMCID: PMC5553006 DOI: 10.2196/mhealth.7232] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/16/2017] [Accepted: 06/02/2017] [Indexed: 11/24/2022] Open
Abstract
Background Endoscopic technique is often applied for the diagnosis of diseases affecting internal organs and image-guidance of surgical procedures. Although the endoscope has become an indispensable tool in the clinic, its utility has been limited to medical offices or operating rooms because of the large size of its ancillary devices. In addition, the basic design and imaging capability of the system have remained relatively unchanged for decades. Objective The objective of this study was to develop a smartphone-based endoscope system capable of advanced endoscopic functionalities in a compact size and at an affordable cost and to demonstrate its feasibility of point-of-care through human subject imaging. Methods We developed and designed to set up a smartphone-based endoscope system, incorporating a portable light source, relay-lens, custom adapter, and homebuilt Android app. We attached three different types of existing rigid or flexible endoscopic probes to our system and captured the endoscopic images using the homebuilt app. Both smartphone-based endoscope system and commercialized clinical endoscope system were utilized to compare the imaging quality and performance. Connecting the head-mounted display (HMD) wirelessly, the smartphone-based endoscope system could superimpose an endoscopic image to real-world view. Results A total of 15 volunteers who were accepted into our study were captured using our smartphone-based endoscope system, as well as the commercialized clinical endoscope system. It was found that the imaging performance of our device had acceptable quality compared with that of the conventional endoscope system in the clinical setting. In addition, images captured from the HMD used in the smartphone-based endoscope system improved eye-hand coordination between the manipulating site and the smartphone screen, which in turn reduced spatial disorientation. Conclusions The performance of our endoscope system was evaluated against a commercial system in routine otolaryngology examinations. We also demonstrated and evaluated the feasibility of conducting endoscopic procedures through a custom HMD.
Collapse
Affiliation(s)
- Jung Kweon Bae
- Ulsan National Institute of Science and Technology, Department of Biomedical Engineering, Ulsan, Republic Of Korea
| | - Andrey Vavilin
- Ulsan National Institute of Science and Technology, Department of Biomedical Engineering, Ulsan, Republic Of Korea
| | - Joon S You
- Ulsan National Institute of Science and Technology, Department of Biomedical Engineering, Ulsan, Republic Of Korea
| | - Hyeongeun Kim
- Ulsan National Institute of Science and Technology, Department of Biomedical Engineering, Ulsan, Republic Of Korea
| | - Seon Young Ryu
- Pohang University of Science and Technology, Creative IT Engineering, Pohang, Republic Of Korea
| | - Jeong Hun Jang
- Ajou University Hospital, Department of Otorhinolaryngology, Suwon, Republic Of Korea
| | - Woonggyu Jung
- Ulsan National Institute of Science and Technology, Department of Biomedical Engineering, Ulsan, Republic Of Korea
| |
Collapse
|
5
|
Malandraki GA, Kantarcigil C. Telehealth for Dysphagia Rehabilitation: The Present and the Future. ACTA ACUST UNITED AC 2017. [DOI: 10.1044/persp2.sig18.42] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Dysphagia affects about nine million adults and half a million children annually in the United States alone, and its prevalence is only projected to increase as the baby boomer generation grows older. For many individuals who live in rural or underserved areas, accessing a speech-language pathologist (SLP) with expertise in dysphagia can be challenging. Telehealth appears to be a viable solution to address the needs of individuals living in these areas, and for patients and clinicians with mobility/access limitations. This article provides an overview of the current research evidence in dysphagia telehealth and identifies research and clinical practice gaps as well as potential solutions. Our aim is to provide foundational knowledge for dysphagia clinicians who are interested in entering the telehealth arena.
Collapse
Affiliation(s)
- Georgia A. Malandraki
- Department of Speech, Language, and Hearing Sciences, Purdue University West Lafayette, IN
| | - Cagla Kantarcigil
- Department of Speech, Language, and Hearing Sciences, Purdue University West Lafayette, IN
| |
Collapse
|
6
|
Hougen HY, Lobo JM, Corey T, Jones R, Rheuban K, Schenkman NS, Krupski TL. Optimizing and validating the technical infrastructure of a novel tele-cystoscopy system. J Telemed Telecare 2015; 22:397-404. [PMID: 26489430 DOI: 10.1177/1357633x15610040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/31/2015] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Bladder cancer is the most costly malignancy to manage per capita due to the technical nature and intensity of follow-up. There are few urologists in rural areas, often necessitating that patients travel hours to receive follow-up care multiple times per year. We plan to train registered nurses and allied health professionals to perform cystoscopies which are monitored and interpreted in real-time by board-certified urologists. The key is to ensure optimal picture resolution to guarantee this technology is not inferior to traditional cystoscopy. Our objective was to develop the technical infrastructure needed for a tele-cystoscopy system through assessment of the transmitted video quality using expert reviewers and crowd-sourcing. METHODS All combinations of the tele-cystoscopy system were systematically tested using a single Thiel cadaver. The videos were reviewed by expert urologists and general reviewers using a crowd-sourcing website. The video quality responses were assessed to determine concordance between each set of reviewers, and to determine the optimal equipment that should be selected for the tele-cystoscopy system. RESULTS Of eight equipment combinations, only two were of high enough quality to be appropriate for medical use. We found there to be strong concordance of responses between the expert and crowd-sourced responses. The trade-offs between cost and tele-cystoscopy system component quality were compared with efficiency frontiers to elucidate the optimal system. DISCUSSION We created and tested the feasibility of a tele-cystoscopy system that was deemed suitable for medical diagnosis by a group of experts. We further validated tele-cystoscopy video quality using both experts and recently validated crowd-sourcing.
Collapse
Affiliation(s)
| | | | | | - Randy Jones
- School of Nursing, University of Virginia, USA
| | | | | | | |
Collapse
|
7
|
Zhang K, Liu WL, Locatis C, Ackerman M. Uncompressed high-definition videoconferencing tools for telemedicine and distance learning. Telemed J E Health 2013; 19:579-84. [PMID: 23808905 PMCID: PMC3719438 DOI: 10.1089/tmj.2012.0219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/21/2012] [Accepted: 11/23/2012] [Indexed: 11/12/2022] Open
Abstract
Uncompressed high-definition (HD) video image quality is superior to compressed HD video provided in most commercially available videoconferencing products. Uncompressed HD videoconferencing tools provide a more immersive experience because there is no reduction of image information and, in most cases, lower latency. Four open source uncompressed video applications are reviewed that have been tested at the National Library of Medicine: three transmitting uncompressed HD video and one transmitting loosely compressed standard-definition video. The technical requirements for implementing each are described, and test results in terms of image quality, latency, and application reliability are presented. Because the hardware and bandwidth requirements for uncompressed HD video are relatively high and most applications are still under development, they are generally not ready for mass deployment. Some are, however, ready for pilot testing and experimentation in clinical settings by either those who have or anticipate having bandwidth sufficient to support them or those interested in researching the effects higher-quality video may have on diagnostic and other clinical outcomes.
Collapse
Affiliation(s)
- Kai Zhang
- Office of High Performance Computing and Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA.
| | | | | | | |
Collapse
|
8
|
Locatis C, Ackerman M. Three principles for determining the relevancy of store-and-forward and live interactive telemedicine: reinterpreting two telemedicine research reviews and other research. Telemed J E Health 2013; 19:19-23. [PMID: 23186085 PMCID: PMC3546357 DOI: 10.1089/tmj.2012.0063] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 04/19/2012] [Accepted: 04/23/2012] [Indexed: 11/13/2022] Open
Abstract
The Agency for Healthcare Research and Quality sponsored two telemedicine research reviews. The latest review concluded that telemedicine is most relevant to specialties, such as psychiatry and neurology, where high levels of patient interaction are crucial to assessment. Telemedicine research studies cited in the reviews having positive findings in the specialties of ophthalmology, otolaryngology, obstetrics and gynecology, gastroenterology, and cardiology and more recent research in these areas are reviewed to identify criteria other than degree of interaction for determining the appropriateness of telemedicine interventions. These criteria include congruity or the extent that procedures used in telemedicine are similar to those of in-person examination, fidelity or the degree to which the information used for assessment in remote examinations is of similar quality to that used in-person, and reliability or the consistency with which information can be gathered and transmitted.
Collapse
Affiliation(s)
- Craig Locatis
- National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA.
| | | |
Collapse
|
9
|
Flexible bronchoscopy outside the hospital setting: to infinity and beyond! J Bronchology Interv Pulmonol 2012; 17:285-6. [PMID: 23168946 DOI: 10.1097/lbr.0b013e3181fb6bec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Cao MD, Minh CD, Shimizu S, Antoku Y, Torata N, Kudo K, Okamura K, Nakashima N, Tanaka M. Emerging technologies for telemedicine. Korean J Radiol 2012; 13 Suppl 1:S21-30. [PMID: 22563284 PMCID: PMC3341457 DOI: 10.3348/kjr.2012.13.s1.s21] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Accepted: 12/02/2011] [Indexed: 11/15/2022] Open
Abstract
This paper focuses on new technologies that are practically useful for telemedicine. Three representative systems are introduced: a Digital Video Transport System (DVTS), an H.323 compatible videoconferencing system, and Vidyo. Based on some of our experiences, we highlight the advantages and disadvantages of each technology, and point out technologies that are especially targeted at doctors and technicians, so that those interested in using similar technologies can make appropriate choices and achieve their own goals depending on their specific conditions.
Collapse
Affiliation(s)
- Minh Duc Cao
- Vietnam Research and Education Network, National Agency for Science and Technology Information, Hanoi 10000, Vietnam
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Shimizu S, Itaba S, Yada S, Takahata S, Nakashima N, Okamura K, Rerknimitr R, Akaraviputh T, Lu X, Tanaka M. Significance of telemedicine for video image transmission of endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography procedures. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2011; 18:366-74. [PMID: 21127912 DOI: 10.1007/s00534-010-0351-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND With the rapid and marked progress in gastrointestinal endoscopy, the education of doctors in many new diagnostic and therapeutic procedures is of increasing importance. Telecommunications (telemedicine) is very useful and cost-effective for doctors' continuing exposure to advanced skills, including those needed for hepato-pancreato-biliary diseases. Nevertheless, telemedicine in endoscopy has not yet gained much popularity. We have successfully established a new system which solves the problems of conventional ones, namely poor streaming images and the need for special expensive teleconferencing equipment. METHODS The digital video transport system, free software that transforms digital video signals directly into Internet Protocol without any analog conversion, was installed on a personal computer using a network with as much as 30 Mbps per channel, thereby providing more than 200 times greater information volume than the conventional system. Kyushu University Hospital in Japan was linked internationally to worldwide academic networks, using security software to protect patients' privacy. RESULTS Of the 188 telecommunications link-ups involving 108 institutions in 23 countries performed between February 2003 and August 2009, 55 events were endoscopy-related, 19 were live demonstrations, and 36 were gastrointestinal teleconferences with interactive discussions. The frame rate of the transmitted pictures was 30/s, thus preserving smooth high-quality streaming. CONCLUSIONS This paper documents the first time that an advanced tele-endoscopy system has been established over such a wide area using academic high-volume networks, funded by the various governments, and which is now available all over the world. The benefits of a network dedicated to research and education have barely been recognized in the medical community. We believe our cutting-edge system will be a milestone in endoscopy and will improve the quality of gastrointestinal education, especially with respect to endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS) procedures.
Collapse
Affiliation(s)
- Shuji Shimizu
- Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Ganeshalingam A, Pritchett S, Tam T, Cafazzo JA, Rossos PG. Effectiveness of asynchronous tele-endoscopy. Gastrointest Endosc 2010; 71:461-7, 467.e1-2. [PMID: 20189504 DOI: 10.1016/j.gie.2009.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Accepted: 10/14/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND Asynchronous tele-endoscopy can improve access and quality of patient care. This is the first published evaluation of the diagnostic accuracy of highly compressed digital video in GI endoscopy. OBJECTIVE To determine whether asynchronous tele-endoscopy using highly compressed video can accurately document and diagnose lesions in the upper GI tract. DESIGN Local endoscopists performed 50 elective upper GI endoscopies. A high-quality DV compressed video (25 megabits per second [Mbps], 720 x 480 pixels) and highly compressed MPEG-1 video (2.0 Mbps, 352 x 240 pixels) were simultaneously captured. Five endoscopists asynchronously reviewed 20 compressed digital videos (100 case reviews) for endoscopic diagnoses. In addition, demonstration technique and image quality were rated on a Likert scale. Concordance between local and asynchronous endoscopists for major and minor endoscopic findings was evaluated. An independent panel classified discrepancies as caused by image quality, endoscopic technique, or interobserver variability through comparison of the 2 forms of digital video. RESULTS Although asynchronous endoscopists rated the image quality of highly compressed video as diagnostic in 85% of cases, only 18% of studies yielded the same clinical diagnoses. There was high discordance for both major (kappa = 0.38, 95% CI, 0.19-0.57) and minor findings (kappa = -0.29, 95% CI, -0.43 to -0.15). Interobserver reporting was responsible for 90% of variability in contrast to only 4.9% for poor image quality. CONCLUSIONS The findings suggest that the diagnostic accuracy of low-bandwidth, low-resolution, highly compressed video is well tolerated and comparable to the current standard. Interobserver reporting variability accounted for most of the poor correlation. Improved synoptic documentation is required for effective communication among endoscopists.
Collapse
|
13
|
Hersh WR, Hickam DH, Severance SM, Dana TL, Pyle Krages K, Helfand M. Diagnosis, access and outcomes: Update of a systematic review of telemedicine services. J Telemed Telecare 2007; 12 Suppl 2:S3-31. [PMID: 16989671 DOI: 10.1258/135763306778393117] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Telemedicine services are being increasingly used. Although insurers and other payers are covering some services in the USA, the rationale for these coverage decisions is not always evidence-based. We reviewed the literature for telemedicine services that substitute for face-to-face medical diagnosis and treatment. We focused on three types of telemedicine services: store-and-forward, home-based and office/hospital-based services. Studies were included if they were relevant to at least one of the three study areas, addressed at least one key question and contained reported results. We excluded articles that did not study a service requiring face-to-face encounters (i.e. teleradiology was excluded). Our search initially identified 4083 citations. After review, 597 were judged to be potentially relevant at the title/abstract level. Following a full-text review, 106 studies were included. Store-and-forward services have been studied in many specialties, the most common being dermatology, wound care and ophthalmology. The evidence for their efficacy is mixed. Several limited studies showed the benefits of home-based telemedicine interventions in chronic diseases. Studies of office/hospital-based telemedicine suggest that telemedicine is most effective for verbal interactions, e.g. videoconferencing for diagnosis and treatment in specialties like neurology and psychiatry. There are still significant gaps in the evidence base between where telemedicine is used and where its use is supported by high-quality evidence. Further well-designed research is necessary to understand how best to deploy telemedicine services in health care.
Collapse
Affiliation(s)
- William R Hersh
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon 97239, USA.
| | | | | | | | | | | |
Collapse
|
14
|
de Lange T, Svensen AM, Larsen S, Aabakken L. The functionality and reliability of an Internet interface for assessments of endoscopic still images and video clips: distributed research in gastroenterology. Gastrointest Endosc 2006; 63:445-52. [PMID: 16500394 DOI: 10.1016/j.gie.2005.11.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Accepted: 11/08/2005] [Indexed: 02/08/2023]
Abstract
BACKGROUND Validation studies of medical images are required before the general use of new imaging techniques, and they necessitate a substantial number of observers. Multicenter studies are desirable but the logistic challenges are considerable. OBJECTIVE The aim of the present study was to develop and test the functionality and reliability of an Internet interface for distributed evaluation of endoscopic still images and video clips. DESIGN An Internet site for assessment of endoscopic still images and video clips was developed. To avoid limitations of the bandwidth, a solution was developed to launch and score high-quality video clips on digital video disks (DVDs) from the Internet interface. SETTING Fifty-five observers were enrolled in the randomized, prospective multicenter study of still images. The feasibility study of video clips included 7 observers. PATIENTS Four patients presenting with various degree of ulcerative colitis, ranging from normal to severe, were included. MAIN OUTCOME MEASUREMENTS We tested the reliability of the interface by dual-image assessment, as well as the feasibility of Internet assessment of endoscopic images. We physically distributed high-quality DVD video footage. RESULTS We recorded 2084 assessments of endoscopic still images and 35 assessments of video clips. The reliability of the Internet interface was confirmed by adequate repeatability and intraobserver agreement of the assessments. Video clips running from a DVD were also successfully shown on the Internet interface. Thus, high-quality video may be assessed independently of the Internet bandwidth. CONCLUSIONS The present Internet-based tool is functional, efficient, and reliable for high-volume assessment of endoscopic images and video clips.
Collapse
Affiliation(s)
- T de Lange
- Department of Gastroenterology, Faculty Division Ullevål University Hospital, University of Oslo, Norway
| | | | | | | |
Collapse
|
15
|
Shimizu S, Nakashima N, Okamura K, Hahm JS, Kim YW, Moon BI, Han HS, Tanaka M. International transmission of uncompressed endoscopic surgery images via superfast broadband Internet connections. Surg Endosc 2005; 20:167-70. [PMID: 16333545 DOI: 10.1007/s00464-005-0282-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2005] [Accepted: 07/29/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although telecommunication is increasing in popularity, poor-quality images sent through a narrowband network limit its use in the medical field. METHODS Kyushu University Hospital in Japan and four hospitals in Korea were linked via superfast broadband Internet connection. The digital video transfer system, which can transmit digital videos without loss of image quality, was used, and the bandwidth was 30 Mbps per line. RESULTS Of the 16 teleconferences conducted, 6 demonstrated real-time endoscopic surgery. In addition to the surgical images, preoperative diagnostic images, images of the operating room, and images of the staff in the conference room were transmitted to facilitate discussion. The network remained stable, and the sound delay was restricted to less than 0.3 s. In the other 10 teleconferences, recorded video images were used for discussion. CONCLUSIONS The authors have established a high-quality, practical teleconference system that is economical and easy to use in clinical practice. This system shows promise for remote education beyond geographic borders.
Collapse
Affiliation(s)
- S Shimizu
- Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, 3-1-1 Maidashi, Fukuoka, 812-8582, Japan.
| | | | | | | | | | | | | | | |
Collapse
|