Szot Agnieszka, Jacobson Francine L, Munn Samson, Jazayeri Darius, Nardell Edward, Harrison David, Drosten Ralph, Ohno-Machado Lucila, Smeaton Laura M, Fraser Hamish S F
Department of Radiology, Brigham and Women's Hospital, Boston MA, USA.
Int J Med Inform. 2004 Feb;73(1):65-73. doi: 10.1016/j.ijmedinf.2003.10.002.
Store-and-forward telemedicine, using e-mail to send clinical data and digital images, offers a low-cost alternative for physicians in developing countries to obtain second opinions from specialists. To explore the potential usefulness of this technique, 91 chest X-ray images were photographed using a digital camera and a view box. Four independent readers (three radiologists and one pulmonologist) read two types of digital (JPEG and JPEG2000) and original film images and indicated their confidence in the presence of eight features known to be radiological indicators of tuberculosis (TB). The results were compared to a "gold standard" established by two different radiologists, and assessed using receiver operating characteristic (ROC) curve analysis. There was no statistical difference in the overall performance between the readings from the original films and both types of digital images. The size of JPEG2000 images was approximately 120KB, making this technique feasible for slow internet connections. Our preliminary results show the potential usefulness of this technique particularly for tuberculosis and lung disease, but further studies are required to refine its potential.
存储转发远程医疗利用电子邮件发送临床数据和数字图像，为发展中国家的医生提供了一种低成本的方式来获取专家的二次诊断意见。为了探索这项技术的潜在用途，使用数码相机和观片灯拍摄了91张胸部X光图像。四位独立阅片者（三位放射科医生和一位肺科医生）阅读了两种数字格式（JPEG和JPEG2000）的图像以及原始胶片图像，并表明他们对已知的八个肺结核（TB）放射学指标特征存在的信心程度。将结果与两位不同放射科医生确立的“金标准”进行比较，并使用受试者工作特征（ROC）曲线分析进行评估。原始胶片图像的阅片结果与两种数字图像的阅片结果在总体表现上没有统计学差异。JPEG2000图像的大小约为120KB，这使得该技术在网络连接速度较慢的情况下也可行。我们的初步结果表明这项技术尤其对肺结核和肺部疾病具有潜在用途，但还需要进一步研究来完善其潜力。
