胃肠道内镜检查的远程临床评估（远程内镜检查）：初步经验。
Remote clinical assessment of gastrointestinal endoscopy (tele-endoscopy): an initial experience.
作者信息
Kim C Y, Etemad B, Glenn T F, Mackey H A, Viator G E, Wallace M B, Mokhashi M S, Cotton P B, Hawes R H
机构信息
Coastal Cancer Control Program, Ralph H Johnson VA Medical Center, Charleston, SC, USA.
出版信息
Proc AMIA Symp. 2000:423-7.
BACKGROUND
Gastrointestinal (GI) endoscopy is an effective tool to screen for cancers of the digestive tract. However, access to endoscopy is limited in many parts of South Carolina. This trial is a part of a prospective multi-part study for remote cancer screening in coastal South Carolina. This pilot study was to evaluate the quality of tele-endoscopy for cancer screening.
METHODS
10 patients scheduled for endoscopic procedures were observed simultaneously by the endoscopist and a remote observer connected over a 512 kbps ISDN line. Findings by both were compared for concordance on malignant or premalignant lesions.
RESULTS
The image quality was adequate to support remote diagnosis of GI cancer and abnormal lesions by an experienced observer. However, assessment of the esophagogastric junction for Barrett's esophagus was equivocal.
CONCLUSIONS
Overall, our tele-endoscopy setup shows great promise for remote supervision or observation of endoscopic procedures done by nurse endoscopists. Tele-endoscopy is both adequate and feasible for diagnosis of most gastrointestinal lesions. Subtle lesions still may be missed in our current setup. However, improvements are being made in our setup to address the problem with resolution prior to further evaluation.
背景
胃肠内镜检查是筛查消化道癌症的有效工具。然而，在南卡罗来纳州的许多地区，内镜检查的可及性有限。本试验是南卡罗来纳州沿海地区远程癌症筛查前瞻性多部分研究的一部分。这项初步研究旨在评估远程内镜检查用于癌症筛查的质量。
方法
10例计划进行内镜检查的患者由内镜医师和通过512 kbps综合业务数字网线路连接的远程观察者同时观察。比较两者对恶性或癌前病变的检查结果是否一致。
结果
图像质量足以支持经验丰富的观察者对胃肠癌和异常病变进行远程诊断。然而，对于巴雷特食管的食管胃交界部评估存在不确定性。
结论
总体而言，我们的远程内镜检查设置在远程监督或观察护士内镜医师进行的内镜检查方面显示出巨大潜力。远程内镜检查对于大多数胃肠道病变的诊断既充分又可行。在我们目前的设置中，仍可能遗漏细微病变。不过，我们正在对设置进行改进，以在进一步评估之前解决分辨率问题。
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