Mattioli L, Goertz K, Ardinger R, Belmont J, Cox R, Thomas C
Dept. of Pediatrics, KU Medical Center, Kansas City 66160-7337.
Kans Med. 1992 Dec;93(12):326, 347-50.
New long-distance audio/video and data communications links among health-care facilities promise to reduce rural patients' travel time and waiting time for subspecialty consultations. To offer a satisfactory alternative to face-to-face examination, the long-distance system must meet the subspecialty's minimum criteria. For pediatric cardiology in particular, the system has to permit satisfactory cardiac auscultation. A preliminary test of remote auscultation that uses an electronic stethoscope involved two pediatric cardiologists, one listening hands-on with an acoustic stethoscope, the other listening independently at long distance with the electronic instrument. Taking the acoustic findings as the reference standard, the electronic stethoscope did not miss the one case of heart disease, correctly recommended echocardiogram follow-up in the two cases requiring it, and agreed on 80% of the murmurs' qualitative specifics. The patients' parents also indicated that the system was highly acceptable. We are following up these results with a full-scale study of the effectiveness and parental acceptance of remote auscultation.
医疗保健机构之间新的远程音频/视频和数据通信链接有望减少农村患者前往专科会诊的出行时间和等待时间。为了提供一种令人满意的面对面检查替代方式，远程系统必须满足专科的最低标准。特别是对于儿科心脏病学，该系统必须允许进行令人满意的心脏听诊。一项使用电子听诊器的远程听诊初步测试涉及两名儿科心脏病专家，一名使用声学听诊器进行直接听诊，另一名使用电子仪器在远程独立听诊。以声学检查结果作为参考标准，电子听诊器没有漏诊一例心脏病，在两例需要的病例中正确建议进行超声心动图随访，并且在80%的杂音定性细节上达成一致。患者家长也表示该系统非常容易接受。我们正在对远程听诊的有效性和家长接受度进行全面研究，以跟进这些结果。
