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.
|Journal||Archives of disease in childhood: Fetal and neonatal edition|
|Early online date||17 May 2011|
|Publication status||Published - 1 Nov 2011|
- Attitude of Health Personnel
- Cardiology Service, Hospital/organization & administration
- Computer Systems
- Feasibility Studies
- Fetal Diseases/diagnostic imaging
- Heart Defects, Congenital/diagnostic imaging
- Hospitals, District/organization & administration
- Hospitals, General/organization & administration
- Northern Ireland
- Prospective Studies
- Ultrasonography, Prenatal/methods
- Young Adult