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.
Computer-based telecolposcopy may be a reasonable cost effective procedure for assisting the evaluation of women in medically underserved areas.
1Gynecologic Cancer Prevention Center, Departments of 2Family Medicine and 3Obstetrics and Gynecology, and 4Office of Biostatistics and Bioinformatics, the Medical College of Georgia, Augusta, GA; and the 5Department of Population and Family Health Services, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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