The Feasibility and Effectiveness Study for Tele-ultrasonography
Condition: Teleradiology
Study type: Interventional

Summary: 
      Purpose

      - The investigators aim to evaluate the feasibility of remote interpretation for ultrasound
      images using a smartphone based realtime image transmission system.

      Methods

      A total of 100 echocardiography examinations; 50 showed the ejection fraction above 50% and
      remaining 50 cases showed the ejection fraction under 50%, and 100 abdominal ultrasound
      images; 50 had signs of acute appendicitis and the other 50 had no findings of appendicitis
      will be consecutively selected. The 12 raters review these original images using an LCD
      monitor of the ultrasound machine and also an iPhone which is connected to the ultrasound
      machine via remote image transmission system (CubeView, Alpinion medical system, Seoul,
      Korea), evaluating left ventricular systolic function (for echocardiography) by measuring the
      ejection fraction and grading the probability of presence of acute appendicitis on each
      examination by a five Likert scale.

      The sensitivity and specificity between two devices will be compared and the diagnostic
      performance between two devices will be also compared. The image quality between two devices
      will be measured using the double stimulation impairment scale (DSIS)
    

Detailed description: 
      The 12 raters are randomly divided into two groups

      The raters in group one review the echocardiographies examinations numbered from one to 50
      using LCD monitor of ultrasound machine and review the remaining 50 examinations numbered
      from 51 to 100 using iPhone with CubeView at their first visit The other group firstly review
      echocardiography numbered from one to 50 using iPhone with CubeView and 51 to 100 with the
      LCD monitor.

      They visit twice with an interval of four weeks and review the echocardiography examinations
      using revered devices at each session. They also review abdominal ultrasound images on the
      same plan as reviewing echocardiography.

      When they review the echocardiography, the raters measure the ejection fraction by visual
      estimation (1=obviously normal EF, 2 = probably normal EF, 3 = unsure, 4 = probably reduced
      EF, 5 = obviously reduced EF). In cate of d the abdominal ultrasound, they are instructed to
      rate the likelihood of the presence or absence of appendicitis in each case using a
      five-Likert scale (1 = obvious no appendicitis, 2 = unlikely appendicitis, 3 = unsure, 4 =
      likely appendicitis, 5 = obvious appendicitis).
    

Intervention name(s): Remote ultrasonography interpretation using the smartphone
Intervention type(s): Device
Intervention description(s): The reviewers interpreted the ultrasonography images on the smartphone transmitted from the ultrasound machine in real time
Other intervention name(s): Smartphone (A1530, iPhone 5S, USA)
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Diagnostic
Keywords: telemedicine; ultrasonography; echocardiography