Over an eight-year period, echocardiograms were transmitted by ISDN at 384 kbit/s for a total of 132 patients suspected of having congenital heart disease (CHD). Five transmitted scans were inadequate. Hands-on echocardiograms were performed subsequently on 116 of the remaining 127 cases (91%). Major CHD was diagnosed in 42 of the 116 infants (36%) and minor CHD in 49 (42%). The telemedicine diagnosis was accurate in 97% of the cases (kappa = 0.90). There were four diagnostic errors. Transfer to the regional unit was avoided in 95 patients (72%). The present study shows that high diagnostic accuracy is possible using a telemedicine link to transmit images obtained with the assistance of real-time guidance by a paediatric cardiologist. The results also demonstrate the importance of an expert interpreting the echocardiographic images, since the accuracy of diagnosis was considerably improved (the kappa coefficient increased from 0.14 to 0.90).

译文

:在8年的时间里,通过ISDN以384 kbit / s的速度发送了超声心动图,共计132名怀疑患有先天性心脏病(CHD)的患者。五次传输的扫描不充分。随后对其余127例病例中的116例(91%)进行了手动超声心动图检查。 116名婴儿中有42名(36%)被诊断出严重的CHD,而49名婴儿中(42%)被诊断出轻微的CHD。在97%的病例中,远程医疗诊断是准确的(kappa = 0.90)。有四个诊断错误。 95名患者(72%)避免转移到区域单位。本研究表明,使用远程医疗链接传输在儿科心脏病专家的实时指导下获得的图像可以实现较高的诊断准确性。该结果还证明了解释超声心动图图像的专家的重要性,因为诊断的准确性得到了极大的提高(卡帕系数从0.14增加到0.90)。

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