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OBJECTIVE: We have integrated endoscopic equipment with a network of video conference studios to develop a remote consultation service for diagnoses of patients with otorhinolaryngologic conditions. DESIGN: The study was performed as a diagnostic test in three phases. During the first phase, a general practitioner was instructed in otorhinolaryngologic examination techniques. In the second phase, remote endoscopic examinations were simulated and the diagnostic results were compared with results from a standard examination. In the third phase, the general practitioner made real telendoscopic examinations. SETTING: Signals from a video camera attached to the endoscope are transmitted from the primary care center to the otorhinolaryngologist who is 180 km away via a 2-million-bits-per-second circuit. The specialist observes the endoscopic examination on a monitor and influences the control and movement of the endoscope by communicating over a two-way sound-and-picture connection with the general practitioner. PATIENTS: A convenience sample of 24 patients was examined in the last two phases. RESULTS: Although the video image is compressed before transmission over the telecommunications network, our results show that the quality of the transmitted images was equivalent to the quality of the images from a standard endoscopic examination. CONCLUSIONS: Our study has shown that this method of consultation may be used in the clinic with the same degree of reproducibility as in a conventional consultation situation. This enables us to give patients in remote locations better service at a lower cost.
Pedersen et al. (Tue,) studied this question.