Reid J G, McGowan J J, Ricci M A, McFarlane G
Vermont Initiative for Rural Health Informatics and Telemedicine, University of Vermont College of Medicine, Burlington, USA.
Proc AMIA Annu Fall Symp. 1997:403-7.
Research has shown that diagnostic quality images for most teleradiology applications requires a sophisticated telemedicine system and access to a large amount of bandwidth. While the ideal standards have been set by those involved in evaluating teleradiology, these standards are impractical for many small rural health centers which deliver routine trauma care. While there is no disagreement about the ultimate need for this level of teleradiology support, the purpose of this research was to determine whether Orthopedists would be able to read plain radiographs of orthopedic trauma injuries using a desktop teleradiology system in support of rural trauma care.
Two radiology residents and two orthopedic residents viewed forty radiographs, twenty through a desktop teleradiology system and twenty in person. Diagnostic findings and certainty of diagnosis were recorded.
There was no statistically significant difference between modalities in orthopedic residents' ability to correctly diagnose orthopedic trauma injuries. Further, for those instances when the diagnosis was imprecise, the residents were aware of their inability to make an accurate diagnosis.
Although the study was relatively limited and further research needs to be done, the use of desktop teleradiology in support of rural orthopedic trauma consultation is a promising alternative to the more expensive forms of telemedicine technology.
研究表明，对于大多数远程放射学应用而言，诊断质量的图像需要一个复杂的远程医疗系统以及大量带宽。虽然参与评估远程放射学的人员已经设定了理想标准，但这些标准对于许多提供常规创伤护理的小型农村医疗中心来说并不实用。虽然对于这种水平的远程放射学支持的最终需求并无异议，但本研究的目的是确定骨科医生是否能够使用桌面式远程放射学系统阅读骨科创伤损伤的普通X光片，以支持农村创伤护理。
两名放射科住院医师和两名骨科住院医师查看了40张X光片，其中20张通过桌面式远程放射学系统查看，20张亲自查看。记录诊断结果和诊断的确定性。
骨科住院医师正确诊断骨科创伤损伤的能力在不同查看方式之间没有统计学上的显著差异。此外，对于那些诊断不精确的情况，住院医师意识到自己无法做出准确诊断。
尽管该研究相对有限，还需要进一步开展研究，但使用桌面式远程放射学支持农村骨科创伤会诊是一种比更昂贵的远程医疗技术更有前景的替代方案。
