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Journal of Lower Genital Tract Disease:
Original Articles

Telemedicine Network Telecolposcopy Compared with Computer-Based Telecolposcopy

Ferris, Daron G. MD1,2,3; Bishai, David M. MD5; Litaker, Mark S. PhD1,4; Dickman, Eileen D. PhD, MBA1,2; Miller, Jill A. MD1,2; Macfee, Michael S. MD1,3

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Abstract

Objectives. To compare computer-based telecolposcopy with telemedicine network telecolposcopy.

Materials and Methods. An on-site expert and local clinician at two rural sites conducted colposcopic examinations on 264 women. Colposcopic images were captured and transmitted to two other experts at a remote location using a statewide telemedicine system and a computer and modem-based system. Sensitivity and specificity, agreement of examination adequacy and management, effects of delayed interpretations, and costs were compared for each system.

Results. A greater rate of satisfactory colposcopy results was reported by the telemedicine network (66.1%) compared with computer-based (43.6%) telecolposcopy (p < .0001). Greater rates of cervical biopsy (p = .005) and endocervical curettage (p = .03) were required by delayed telecolposcopy compared with immediate telecolposcopic services. There were no significant differences in sensitivity of detecting cervical neoplasia among the types of the telecolposcopy. Computer-based telecolposcopy cost $28 less per patient than telemedicine network telecolposcopy.

Conclusions. Computer-based telecolposcopy may be a reasonable, cost-effective adjunct to on-site colposcopy for evaluating women in medically underserved areas. Synchronous telecolposcopic examination minimizes histologic sampling and improves consultation.

©2004The American Society for Colposcopy and Cervical Pathology

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