Diagnostic performance of a telemedicine system for ophthalmology: advantages in accuracy and speed compared to standard care.
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Date
2011-02-24
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Abstract
Telemedicine has potential to improve quality and delivery of medical care particularly in image oriented specialties where decisions are based on appearance of morphological features during examination In the ophthalmology domain nearly all published telemedicine studies have measured accuracy against a gold standard of ophthalmoscopic examination The purposes of this study are to examine difficulties in defining an absolute gold standard and to compare diagnostic speed in a representative disease retinopathy of prematurity We compare results from ophthalmoscopic and telemedicine examinations by the same physicians In 180 86 5 of 208 eyes the two examinations produced the same diagnosis In some discrepancies there was rationale suggesting that telemedicine may have provided a more accurate diagnosis than ophthalmoscopic examination The quantity and nature of these disagreements has important implications for evaluation of telemedicine systems in image based specialties and for the definition of gold standards in future studies