Lai Thy, Stafinski Tania, Beach Jeremy, Menon Devidas
Health Technology & Policy Unit, School of Public Health, University of Alberta, Edmonton, AB, Canada.
College of Physicians & Surgeons of Alberta, Edmonton, AB, Canada.
Ultrasound J. 2025 Jul 28;17(1):34. doi: 10.1186/s13089-025-00440-6.
Tele-ultrasound is known to offer potential benefits such as improved access and cost efficiency, but concerns still exist about image quality, operator skill, and data security. This study aimed to determine whether remotely supervised ultrasound is inferior to traditional in-centre ultrasound with an in-person imaging specialist regarding patient care quality, service quality, and access to care.
A systematic search for a critical appraisal of relevant peer-reviewed published literature, as well as a jurisdictional scan of relevant regulations and standards in other Canadian jurisdictions, was performed.
Of the original 6051 discrete records identified through the search, 18 studies were selected for inclusion in the review. They originated from 11 countries, and the patient populations spanned infants, children, adults, and pregnant women. The medical applications were echocardiography (including fetal), obstetrical ultrasound, breast ultrasound, thyroid ultrasound, and abdominal ultrasound. The distance between the tele-ultrasound site and the reference site ranged from 23 to 365 km, or a 30 to 45-min drive. In 3 studies, tele-ultrasound images were acquired in one country (India, Peru) and interpreted in another (US or UK). The majority of studies reported good diagnostic accuracy (the proportion of agreement between tele-ultrasound and in-centre ultrasound ranged from 43.4% to 100%, sensitivity ranged from 43% to 97%, and specificity ranged from 77.4% to 100% across studies and tele-ultrasound application). Details are displayed in Supplementary Table 2. There was limited evidence on patients' and providers' perspectives on tele-ultrasound, but in the studies identified, more than half of the patients surveyed felt that tele-ultrasound was acceptable. Additionally, all comments from providers were positive, including their perspectives on the value of tele-ultrasound. The image quality results were mixed. Some studies found that image quality ranged from at least sufficient quality for diagnosis to excellent. However, some other studies reported inadequate image quality in up to 36.8% of cases. It is possible that this range of responses may be due to the varying technical ability/capacity of local tele-ultrasound systems to acquire and transmit images to a remote reader. Cost savings associated with tele-ultrasound were also reported and attributed mainly to travel costs for patients.
There is no consistent evidence that tele-ultrasound is inferior to in-centre ultrasound, although further high-quality studies are needed.
远程超声检查已知具有潜在益处，如改善医疗可及性和成本效益，但在图像质量、操作人员技能和数据安全方面仍存在担忧。本研究旨在确定远程监督超声检查在患者护理质量、服务质量和医疗可及性方面是否逊于由现场成像专家进行的传统中心超声检查。
对相关同行评审发表文献进行系统的批判性评估搜索，并对加拿大其他司法管辖区的相关法规和标准进行司法管辖区扫描。
通过搜索识别出的6051条原始离散记录中，18项研究被选入综述。这些研究来自11个国家，患者群体涵盖婴儿、儿童、成人和孕妇。医疗应用包括超声心动图（包括胎儿）、产科超声、乳腺超声、甲状腺超声和腹部超声。远程超声检查地点与参考地点之间的距离为23至365公里，即驾车30至45分钟的路程。在3项研究中，远程超声图像在一个国家（印度、秘鲁）采集，在另一个国家（美国或英国）解读。大多数研究报告诊断准确性良好（远程超声检查与中心超声检查之间的一致性比例在43.4%至100%之间，敏感性在43%至97%之间，特异性在77.4%至100%之间，涵盖各项研究和远程超声检查应用）。详细信息见补充表2。关于患者和提供者对远程超声检查的看法的证据有限，但在已识别的研究中，超过一半接受调查的患者认为远程超声检查是可以接受的。此外，提供者的所有评论都是积极的，包括他们对远程超声检查价值的看法。图像质量结果不一。一些研究发现图像质量至少足以用于诊断，甚至非常出色。然而，其他一些研究报告称，高达36.8%的病例图像质量不足。这种不同的反应可能是由于当地远程超声系统获取和向远程阅片者传输图像的技术能力/容量不同。还报告了与远程超声检查相关的成本节约，主要归因于患者的交通费用。
没有一致的证据表明远程超声检查逊于中心超声检查，尽管需要进一步的高质量研究。
