Teleultrasound for pre‐natal diagnosis: A validation study

Abstract

Introduction/Purpose: There are no large validation trials comparing teleultrasound to on-site ultrasound. We aim to compare the sensitivity and accuracy of teleultrasound and demonstrate that teleultrasound is not inferior to on-site ultrasound in the pre-natal diagnosis of fetal anomalies. Methods: All targeted ultrasounds performed between November 2010 and December 2012 were considered. We excluded studies performed at less than 17 weeks' gestation, on multiple gestations and for reasons other than an anatomical survey. Postnatal diagnoses were obtained from a state level mandatory birth defects surveillance programme. Descriptive statistics (sensitivity, specificity, positive and negative predictive values and accuracy) were calculated for both groups. A test of noninferiority was performed, with the non-inferiority difference set at 0.15. Results: The teleultrasound and on-site ultrasound groups consisted of 2368 and 3145 studies, respectively. The sensitivity of teleultrasound and on-site ultrasound was 57.46% and 76.57%, and the accuracy was 95.9% and 90.97%, respectively. The observed sensitivity difference was À0.1911. The accuracy, specificity, positive and negative predictive values of teleultrasound are similar to on-site ultrasound. Discussion: Teleultrasound is inferior to on-site ultrasound in the detection of fetal anomalies; however, it has improved accuracy, as well as higher negative and positive predictive values. A negative teleultrasound is more likely to identify a non-anomalous fetus, and a positive teleultrasound is more likely to correctly identify an anomalous fetus. Conclusion: Teleultrasound has an important role in pre-natal diagnosis for those patients unable or unwilling to travel for an onsite ultrasound.

Gynecologic Teleultrasound and COVID‐19

“…Teleultrasound was mainly used to transmit imaging of fetal anatomy but most importantly those regarding fetal anomalies were and are still the subject of most such publications. 11 , 12 , 13 …”

“…Teleultrasound was mainly used to transmit imaging of fetal anatomy but most importantly those regarding fetal anomalies were and are still the subject of most such publications. [11][12][13] It is striking that searching for teleultrasound in gynecology resulted in only one article. 14 A "deep dive" to find causes of lack of publication of teleultrasound use in gynecology may lead to the conclusion that US is an extremely operatordependent imaging modality, where creating an US picture is not identical with "examining" the gynecologic patient with US.…”

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“…показало, что телеультразвук может быть применен в пренатальной диагностике. Сравнение 3404 ультразвуковых исследований, проведенных в классическом варианте, и 2499 теле-АНАЛИТИЧЕСКИЙ ОБЗОР ультразвуковых исследований показало более высокую точность телеультразвука (95,9% против 90,97% у стандартного исследования) и специфичность (98,21% и 92,77%) [92].…”

Paramedic-Performed Prehospital Tele-Ultrasound: A Powerful Technology or an Impractical Endeavor? A Scoping Review

“…23,24 The concept of tele-ultrasound in the prehospital setting was initially devised in 2008 by Robosoft Inc. (Udupi, India) who developed a portable robot remotely controlled by physicians in France to conduct paramedic-assisted prehospital ultrasound examinations on remote patients in the Mediterranean Sea. 25 Since then, teleultrasound has been evaluated for the assessment or diagnosis of numerous clinical indications, including fetal structural abnormalities, [26][27][28] cardiac dysfunction, [29][30][31] acute trauma, 32,33 coronavirus disease 2019/COVID-19, 34 hepatic and biliary diseases, 35 thyroid nodules, 36 breast abnormalities, 37 dermatologic lesions, 38 and spinal alterations. 39 In addition, tele-ultrasound has primarily been studied in low-income rural communities 35,36 and resourceconstrained settings, 30,[39][40][41][42][43][44] but also in the intensive care unit (ICU) 45,46 and emergency department (ED).…”