The technical performance and clinical feasibility of telecolposcopy

BACKGROUND The purpose of our study was to demonstrate the technical perfor mance and clinical feasibility of a telecolposcopic system through assessme nt of image transmission veracity, ease of office system implementation, an d the patient's acceptance of the electronic image transmission. METHODS Vac used a telecolposcopic system incorporating a custom software p ackage that integrated patient history, current gynecologic status, epidemi ologic risk factors, and colposcopic images for local medical documentation and transmission, Satisfaction questionnaires were developed to measure ea se of implementation at the remote sites and the patients' acceptance of te lecolposcopy. RESULTS Seventy-nine women participated in our trial. From 3 to 20 images w ere captured for each woman, documenting cervical squamous intraepithelial lesions and vaginal and vulvar diseases. ALL images were received without d istortions in color size, or orientation. With complete visualization of th e squamocolumnar junction there was an 86% agreement between the remote and review sites (kappa=.533, P=.019), The interobsen er agreement for colposc opic impressions was 86% (kappa=.684, P <.001), and for colposcopic impress ions with histology within one level of disease severity, 86% (kappa=.78, P <.001), Colposcopists' and patients' satisfaction with telecolposcopy was excellent, More than 95% of the women stated that they would rather have th eir colposcopy locally with electronic transmission if an, experienced colp oscopist were more than 25 miles away, CONCLUSIONS The telecolposcopic system described in our study is technicall y feasible, can be implemented in an office system with limited technical s upport, and is preferred by women who have to travel many miles to receive referral health care.