Fetal diagnosis of congenital heart disease by telemedicine

Brian A McCrossan, Andrew J Sands, Theresa Kileen, Chris R Cardwell, Frank A Casey

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)

Abstract

OBJECTIVES: This study aimed to evaluate the feasibility, accuracy and user acceptability of performing remote fetal echocardiograms (FEs).

SETTING: A regional fetal cardiology unit and a district general hospital (DGH).

DESIGN: A prospective study over 20 months. An initial FE was performed by a radiographer in the DGH (D1) followed by a second FE transmitted to the regional centre, in real time, via a telemedicine link with live guidance by a fetal cardiologist (D2). A FE was performed later at the regional centre (D3, reference standard). Structured questionnaires were employed to evaluate the technical quality of each tele-link and the radiographers' confidence at performing FE.

RESULTS: 69 remote FEs were performed and showed 58 normal hearts and 11 with congenital heart disease (CHD). D2 was accurate in 97% of cases compared with D3 (κ score=0.89) indicating excellent agreement. All tele-links connected at first attempt with a mean study time = 13.9 min. Overall tele-link quality was rated highly (median=4/5). In 94% of tele-links, at least 11/12 components of the FE were confidently assessed. The mean composite radiographer's questionnaire score increased significantly during the study period (p<0.05).

CONCLUSIONS: To date this is the largest study of its kind. CHD can be confidently diagnosed and excluded by remote FE. Radiographers report increased confidence and proficiency following involvement in real-time telemedicine. This application of telemedicine could improve access to fetal cardiology and support radiographers screening for CHD.

Original languageEnglish
Pages (from-to)F394-7
JournalArchives of disease in childhood: Fetal and neonatal edition
Volume96
Issue number6
Early online date17 May 2011
DOIs
Publication statusPublished - 1 Nov 2011

Keywords

  • Adolescent
  • Adult
  • Attitude of Health Personnel
  • Cardiology Service, Hospital/organization & administration
  • Computer Systems
  • Feasibility Studies
  • Female
  • Fetal Diseases/diagnostic imaging
  • Heart Defects, Congenital/diagnostic imaging
  • Hospitals, District/organization & administration
  • Hospitals, General/organization & administration
  • Humans
  • Northern Ireland
  • Pregnancy
  • Prospective Studies
  • Teleradiology/methods
  • Ultrasonography, Prenatal/methods
  • Young Adult

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