Is remotely supervised ultrasound (tele-ultrasound) inferior to the traditional service model of ultrasound with an in-person imaging specialist? A systematic review
Notice bibliographique
Résumé
BACKGROUND: Tele-ultrasound is known to offer potential benefits such as improved access and cost efficiency, but concerns still exist about image quality, operator skill, and data security. This study aimed to determine whether remotely supervised ultrasound is inferior to traditional in-centre ultrasound with an in-person imaging specialist regarding patient care quality, service quality, and access to care. METHODS: A systematic search for a critical appraisal of relevant peer-reviewed published literature, as well as a jurisdictional scan of relevant regulations and standards in other Canadian jurisdictions, was performed. RESULTS: Of the original 6051 discrete records identified through the search, 18 studies were selected for inclusion in the review. They originated from 11 countries, and the patient populations spanned infants, children, adults, and pregnant women. The medical applications were echocardiography (including fetal), obstetrical ultrasound, breast ultrasound, thyroid ultrasound, and abdominal ultrasound. The distance between the tele-ultrasound site and the reference site ranged from 23 to 365 km, or a 30 to 45-min drive. In 3 studies, tele-ultrasound images were acquired in one country (India, Peru) and interpreted in another (US or UK). The majority of studies reported good diagnostic accuracy (the proportion of agreement between tele-ultrasound and in-centre ultrasound ranged from 43.4% to 100%, sensitivity ranged from 43% to 97%, and specificity ranged from 77.4% to 100% across studies and tele-ultrasound application). Details are displayed in Supplementary Table 2. There was limited evidence on patients' and providers' perspectives on tele-ultrasound, but in the studies identified, more than half of the patients surveyed felt that tele-ultrasound was acceptable. Additionally, all comments from providers were positive, including their perspectives on the value of tele-ultrasound. The image quality results were mixed. Some studies found that image quality ranged from at least sufficient quality for diagnosis to excellent. However, some other studies reported inadequate image quality in up to 36.8% of cases. It is possible that this range of responses may be due to the varying technical ability/capacity of local tele-ultrasound systems to acquire and transmit images to a remote reader. Cost savings associated with tele-ultrasound were also reported and attributed mainly to travel costs for patients. CONCLUSION: There is no consistent evidence that tele-ultrasound is inferior to in-centre ultrasound, although further high-quality studies are needed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,099 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,009 | 0,008 |
| Bibliométrie | 0,007 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».