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ABSTRACT BACKGROUND: Teleradiology consists of electronic transmission of radiological images from one location to another, including between countries, for interpretation and/or consultation. It is one of the most successful applications of telemedicine. Combining this methodology with ultrasound (called telesonography) can accelerate the process of making diagnoses. Despite this rationale, the quality of the evidence about the effectiveness and accuracy of teleradiology remains unknown. OBJECTIVE: To review the literature on the evidence that exists regarding use of telemedicine for ultrasound in situations of synchronous transmission. DESIGN AND SETTING: Narrative review conducted within the evidence-based health program at a federal university in São Paulo (SP), Brazil. METHODS: A search of the literature was carried out in April 2020, in the online databases MEDLINE, EMBASE, Cochrane Library, Tripdatabase, CINAHL and LILACS, for original publications in all languages. The reference lists of the studies included and the main reviews on the subject were also evaluated. RESULTS: We included ten studies that assessed procedures performed by different healthcare professionals, always with a doctor experienced in ultrasound as a distant mentor. Among these, only one study assessed disease diagnoses in relation to real patients. CONCLUSIONS: Despite the promising position of telesonography within telemedicine, no studies with reasonable methodological quality have yet been conducted to demonstrate its effectiveness.
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Telemedicine , Brazil , MEDLINE , UltrasonographyABSTRACT
Objective To explore the accuracy of ultrasonic diagnosis using the tele-ultrasound robot system . Methods During the period from May to June 2018 ,42 volunteers were consecutive selected to participate in this study ,and their digestive system and urinary system were examined using the robot method manufactured by GI Tech Co . ,Ltd ,Shenzhen and the traditional method . The results including the ultrasound diagnosis and the inspection time of two methods in each patient were compared . The ultrasonographic diagnosis of each volunteer was obtained by two methods and the time was recorded . The ultrasound images of the two methods were mixed together ,and the quality of the images was evaluated double-blindly by two senior doctors . Results There were actually 25 positive lesions in 42 volunteers . In the ultrasonic diagnosis of the two methods ,22 lesions were positive detected by robot method ,with 5 lesions misdiagnosed . In the traditional method , 24 lesions were positive detected , with 1 lesions misdiagnosed . Using the Wilcoxon signed rank test of paired sample comparison ,the score obtained by the robot method was 4 .79 ± 0 .57 ,and the score obtained by the traditional method was 4 .81 ± 0 .54 ( Z =0 .775 ,P= 0 .439) ,the difference was not statistically significant . There was no statistically significant difference in the images'qulity between the robot method and the traditional method using the chi-square test of the four-grid data( P >0 .05) . The check time for volunteers with negative result was ( 8 .64 ± 2 .95) min in robotic method and ( 2 .55 ± 0 .74 ) min in the traditional method ,the difference was statistically significant ( t =15 .161 , P =0 .000) . Conclusions The robot method has high value in common disease diagnosis and high quality in image acquisition ,and can be used in real-time diagnosis of the remote areas or community medical .
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OBJETIVO: Avaliar a viabilidade da transmissão de imagens de ultrassonografia do primeiro trimestre em tempo real. MATERIAL E MÉTODO: Estudo coorte, prospectivo, de imagens ultrassonográficas de fetos de gestantes maiores de 18 anos obtidas entre a 11ª e 13ª semanas e seis dias de gravidez. Os exames foram transmitidos em tempo real para três observadores independentes certificados pela Fetal Medicine Foundation, que realizaram a avaliação qualitativa. Cópias das imagens recebidas foram enviadas pelos avaliadores para subsidiar a análise quantitativa por meio do software ImajeJ. RESULTADOS: Todas as estruturas fetais puderam ser visualizadas e identificadas e a qualidade das imagens recebidas foi considerada regular pelos avaliadores. A análise quantitativa mostrou perda razoável no número de pixels em relação à imagem original. CONCLUSÃO: Atransmissão em tempo real de exames de ultrassom do primeiro trimestre utilizando hardwares esoftwares disponíveis no mercado e plataformas de videoconferência de baixo custo é viável.
OBJECTIVE: To evaluate the feasibility of transmitting ultrasoundimages of the first quarter real time. MATERIAL AND METHOD: Acohort study of ultrasound images of fetuses of pregnant womenover 18 obtained from the 11th and 13th weeks and six days ofpregnancy. Images of the examinations were transmitted in real time for three independent observers certified by the Fetal Medicine Foundation who conducted the qualitative assessment. Copiesof the images received were sent by the evaluators to support the quantitative analysis by ImajeJ software. RESULTS: All fetalstructures can be visualized and identified and the quality of imagesreceived was considered regularly by the evaluators. The analysis showed reasonable quantitative loss in the number of pixels in relation to the original image. CONCLUSION: It is feasible to transmit real-time ultrasound scanning of the first quarter using hardware and software easily available and a platform for low cost video conferencing.