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At least 307 records · Page 17Linked to original sources
PubMed2002

Attitudes of UK consultants to teledentistry as a means of providing orthodontic advice to dental practitioners and their patients.

OBJECTIVE: To determine UK orthodontic consultants' attitudes to the provision of orthodontic advice to general dental practitioners by electronic means. DESIGN: Questionnaire. SETTING: Conducted by email and surface mail as appropriate in August 2000. SUBJECTS: All those UK NHS orthodontic consultants contained in the membership lists of the Consultant Orthodontists Group of the British Orthodontic Society. OUTCOME: An 86 per cent response was obtained from the 231 consultants. RESULTS: More than half (58 per cent) of the consultants were interested in providing an electronic diagnostic service for the general dental practitioners in their locality and 70 per cent were in favour of further research into this possibility. Provided this was mediated through their GDP, only 26% would oppose consultant advice being given electronically from a centralized source. CONCLUSIONS: A majority of UK orthodontic consultants support the concept of using teledentistry to make their advice more accessible to dentists and patients.

Adult↗
PubMed2005

Acquisition and evaluation of radiography images by digital camera.

To determine applicability of low-cost digital imaging for different radiographic modalities used in consultations from remote areas of the Ecuadorian rainforest with limited resources, both medical and financial. Low-cost digital imaging, consisting of hand-held digital cameras, was used for image capture at a remote location. Diagnostic radiographic images were captured in Ecuador by digital camera and transmitted to a password-protected File Transfer Protocol (FTP) server at VCU Medical Center in Richmond, Virginia, using standard Internet connectivity with standard security. After capture and subsequent transfer of images via low-bandwidth Internet connections, attending radiologists in the United States compared diagnoses to those from Ecuador to evaluate quality of image transfer. Corroborative diagnoses were obtained with the digital camera images for greater than 90% of the plain film and computed tomography studies. Ultrasound (U/S) studies demonstrated only 56% corroboration. Images of radiographs captured utilizing commercially available digital cameras can provide quality sufficient for expert consultation for many plain film studies for remote, underserved areas without access to advanced modalities.

Adolescent↗
PubMed1999

Minimum requirements for remote realtime fetal tele-ultrasound consultation.

We studied the transmission bandwidth required for accurate diagnoses when performing realtime fetal tele-ultrasound consultations. The study was divided into three phases. In phase I, three experienced clinicians evaluated the quality of ultrasound images transmitted at various bandwidths (internally looped back within Brisbane) using eight commercially available codecs at random. The two codecs that performed best proceeded to phase 2, in which a realtime video-link of up to 2 Mbit/s was set up between Brisbane and Townsville (1,500 km apart). Testing with a standard video-tape was performed at seven different bandwidths selected at random, with four clinicians (who were blinded to the equipment and bandwidths used). The optimum line rates for transmission were determined, and testing was then performed using these line rates for fetuses with various anomalies (phase 3). The results showed significant differences in performance according to bandwidths used, but not according to observers. Bandwidths were grouped into three levels. At level I (256 kbit/s) the performance was significantly worse than at level II (384, 512 or 768 kbit/s), which was in turn worse than that at level III (1, 1.5 or 2 Mbit/s). However, within each level, performance at one bandwidth was not significantly different from that at the others. The most cost-effective transmission rates therefore appeared to be 384 kbit/s and 1 Mbit/s. Further testing with fetuses affected by various anomalies confirmed that the majority could be diagnosed using a 384 kbit/s link, with slight improvement in evaluation when the bandwidth was increased to 1 Mbit/s.

Analysis of Variance↗
PubMed1997

Proposal of a computerized algorithm for continuous wave CO2 laser on-line control during orthopaedic surgery. Phase II: simplified algorithm version (LCA-s) and helmet-mounted data access device solution.

This paper is the continuation of the Phase I report published in 1992 by Canestri. It contains recent findings on how to speed-up the process of sublimated volume forecasting for a TEM11* CO2 laserbeam in CW mode following an original model proposed by the author--called LCA--here presented in a simplified version (LCA-s) on PMMA (polymethylmethacrilate) samples. Other interesting parameters, such as the time required to create the minimal injury vb along with its physical interpretations, are reported and explained. TEM11*, TEM01* and TEM00 beams profiles are also compared and discussed for LCA-s. The results of both Phase I and Phase II of this investigation can be integrated in one single solution package for the end-user, combining fast decisions making and operational features. The final part of this paper describes the 'helmet-mounted' data recall visor methodology which allows the surgeon to access to a data base for information retrieval during the course of an operation without interrupting the surgical case itself. This particularly interesting application allows the surgeon to consult a centrally-located data base which contains important information regarding similar clinical cases, choice of laserbeam profiles and focal lengths, simulation of beam behaviours, performances and other data. The on-line and direct access to the data base supports him in all those borderline situations in the O.R. in which the laser device type and configuration/calibration play a device role in the success of the operation. Also, the helmet-mounted display frees surgeon's hands in order to allow him to continue the operation while consulting the data base on-line, thus speeding up decision processes regarding changes of laser set-up, general calibration optimization and remote clinical consultancy.

Algorithms↗
PubMed2000

System of telemedicine services designed for family doctors' practices.

The main goal of the most European telemedicine programs is to increase access to emergency and primary care; however, telemedicine presents both profound opportunities and challenges to general practice/family medicine. The aim of this project is to develop and demonstrate a regional primary care teleconsulting system in Poland linking an academic family medicine center and 10 family doctors' practices (both urban and rural) within a range of 100-200 km, serving a local population of 25,000 individuals. It is designed to support real-time consultations among health care providers via a computer network, provide secure access to multimedia patient records, and facilitate an innovative home monitoring and remote care from doctors to their patients. The entire process (planned for 3 years) includes: selecting the best technology (i.e., teletransmission system, communication protocols, etc.) and equipment; preparing the assumptions and conditions for formats and transmission rates; analysis of the existing techniques of compression and preparing own specific solution; finding an optimal infrastructure (i.e., equipment and communication configuration); implementing the system; evaluation of the medical, economic, organizational, and sociological aspects of the system (i.e., accessibility to primary health care, cost feasibility and cost-effectiveness of telemedicine services, quality of care assessment, etc.). The project offers the potential to improve: access to high-quality primary health care; the patient-physician bond and the attending physician's level of confidence; education of family doctors; use of expensive resources; and a convenient mode of delivering medical services to the patient.

Academic Medical Centers↗
PubMed2001

Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations.

Low-bandwidth, Internet-based videoconferencing was used to provide physical rehabilitation consultation services for eight community hospitals. Videoconferencing and file transmission used a PC and modem. A separate telephone line was used for voice. Over 21 months, 47 physical rehabilitation consultations were completed for communication disorders, foot care, gait problems, orthotics, prosthetics, arm weakness and wheelchair prescription. Consultations were approximately 40 min long. Clinician questionnaires were completed by 47 individuals. While more than 80% of the questionnaire responses supported the telemedicine approach, remote clinicians rated their satisfaction higher than did the specialists. Client questionnaires were completed by 24 individuals (a response rate of 51%). All clients were comfortable with and had confidence in the teleconsultations.

Attitude of Health Personnel↗
PubMed2000

Cleaning up. The development of the Alfred/Medseed Wound Imaging System.

This paper describes the rationale, development, functions and applications of a new digital wound imaging system developed at The Alfred Hospital in Melbourne. The system known as The Alfred/Medseed Wound Imaging System (AMWIS) comprises a software package that quantitatively analyses a digital wound photograph and tracks the healing of the wound as a function of the wound care treatment used. The system is designed to enable the wound images and assessment data to be securely transmitted via the internet for review or consultation to any site equipped with the wound imaging system. The AMWIS is capable of being operated at a single site such as a hospital, at remote locations or as a mobile system. We believe that this is the first system of this kind developed in Australia that incorporates sophisticated analytical functions yet retains the flexibility to be used in inpatient, ambulatory or remote settings.

Image Processing, Computer-Assisted↗
PubMed1996

Telecardiology: supporting the decision-making process in general practice.

To assess the initial phase of a telecardiology diagnostic service for general practitioners (GPs), we provided 93 GPs in 26 health centres with direct telephone access to a cardiologist, and equipped them with hand-held, automatic standard 12-lead electrocardiogram (ECG) transmitters for on-line cardiac consultations and ECG interpretation in their daily practice. Clinical details, reason for consultation and the ECG signal were transmitted from the GPs' practices or the patients' homes. A consultation followed and a full report, including ECG print-out, was then sent to the GP. During an 18-month study period, 2563 consultations were carried out. The system allowed the identification of 479 patients (19%) with urgent cardiac problems and the remaining 2084 (81%) in whom admission or outpatient investigation was unnecessary. Following the study, we distributed a questionnaire asking the GPs to rate the quality, define the use and consider the benefit of the service to their daily practice. We conclude that a telecardiology diagnosis and ECG interpretation service is simple, reliable and efficacious in routine primary care. It offers instant access to cardiac assessment and supports the decision-making process of GPs. A preliminary cost comparison with a conventional referral indicated that a teleconsultation was substantially cheaper. We expect that the future incorporation of teleechocardiography would expand the scope of telecardiology even further and allow comprehensive cardiology consultations.

Cardiology↗