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R. V. Chan, G. M. Richter, G. Sun, T. C. Lee, J. T. Flynn, J. Starren, M. F. Chiang; Speed of Telemedicine versus Ophthalmoscopy for Retinopathy of Prematurity Diagnosis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3146.
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To compare the speed of ROP diagnosis using standard indirect ophthalmoscopy to that of telemedicine.
Prospective comparative study. 3 study examiners (2 pediatric retinal specialists, 1 pediatric ophthalmologist) conducted ROP diagnosis via standard indirect ophthalmoscopy and telemedicine. Each examiner performed: (1) standard ophthalmoscopy on 72-150 consecutive infants at his respective institution, and (2) telemedical diagnosis on de-identified retinal image sets of 125 infants. Time for ophthalmoscopic diagnosis was measured in two ways: (a) time spent by examiner at the infant bedside, and (b) mean total time commitment per infant. Time for telemedicine diagnosis was recorded by computer timestamps in the web-based system. For each examiner, non-parametric statistical analysis (Mann-Whitney) was used to compare the distribution of times for examination by ophthalmoscopy versus telemedicine.
Mean (±SD) times for ophthalmoscopic diagnosis by the three examiners ranged from 4.17 (±1.34) minutes to 6.63 (±2.28) minutes per infant. Mean (±SD) times for telemedicine diagnosis ranged from was 1.02 (±0.27) minutes to 1.75 (±0.80) minutes per infant. Telemedicine was significantly faster than ophthalmoscopy (p<0.0001). The total time commitment by ophthalmologists performing bedside ophthalmoscopy for ROP diagnosis, including travel and communication with families and hospital staff, was 10.08 (±2.53) minutes to 14.42 (±2.64) minutes per infant.
The ophthalmologist time requirement for telemedical ROP diagnosis is significantly less than for ophthalmoscopic diagnosis. Additional time requirements associated with bedside ROP diagnosis increased this disparity. Telemedicine has potential to alleviate the time commitment for ophthalmologists who manage ROP.
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