CHICAGO - Teleradiology can improve diagnoses and lead to better clinical outcomes, according to researchers at Helsinki University Central Hospital in Finland.
To evaluate the effect of teleradiology consultation on diagnosis and treatment, 685 plain-film examinations were transmitted via ISDN connection in DICOM format from a primary healthcare center to a university hospital for a radiologist consultation.
Before the transmission, a general physician interpreted the images and recorded his suggestion for a clinical diagnosis, findings from the images, and planned treatment, according to Dr. Kiuru Martti, who presented the findings at this week’s RSNA meeting. The general physician also noted his plans for patient management in case the teleradiology consultation would not be available.
The information provided by the general physician was made available to the radiologist during his interpretation. A consensus decision was made by the two radiologists, and was considered to be the right diagnosis, according to the researchers. A few months later, the general physician and the radiologists went over the cases and together assessed the radiological consultation's effect on the diagnosis, treatment, prognosis, and health of the patient.
Of the 685 radiological examinations, pathological findings were diagnosed in 351 (51%) cases. These findings were undiagnosed by the general physician in 15% of these cases. False-positive interpretations were made considerably more often, and the specificity was 62%, according to the researchers.
While in 350 (51%) of the cases the teleradiology consultation helped with the diagnosis to some extent, only 9% of the cases produced a completely new diagnosis, according to the study team. In 4% of the cases, the consultation had some effect on the patient’s prognosis and health, and in 1% of the cases the researchers found it crucial.
Unnecessary treatment was avoided in 5% of the cases, and an unnecessary patient transportation was prevented in 4% of the cases, according to the researchers. In 5% of the cases, the consultation changed the quality of the treatment, and in 1% of the cases an entirely new treatment was ordered.
"In more than half the cases, the teleradiology consultation helped with the diagnosis; a completely new diagnosis was more rare," Kiuru said. "There was a noticed effect on the patient’s health and prognosis in 5% of the cases. (However), to achieve these positive effects, an adequate consultation level is required."
By Erik L. Ridley
AuntMinnie.com staff writer
December 1, 2000
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