Telemedicine techniques can be used to facilitate the conduct of multicentre trials

A multicentre randomized controlled trial was established in Pretoria, Bloe mfontein and Edendale in South Africa, and coordinated from London. The pur pose of the trial was to determine the efficacy of few-dose beta irradiatio n of glaucoma. Five communication modalities (telephone, fax, email, videoc onferencing and face-to-face meetings) were examined in terms of their bene fits in a multicentre trial. The eight stages of the multicentre trial exam ined were: set-up and training, recruitment, standardization, patient manag ement, data transmission, update and data dissemination, clinical follow-up and monitoring, and publication. On four-point Likert scales for rating th e usefulness of the communication modalities at each of the eight stages of the trial (from 0 = not useful to 3 = very useful; maximum score 24) the t elephone was given a total score of 10, fax 9, email 13, videoconferencing 15 and face-to-face meetings 9. Telemedicine techniques offer considerable benefits in the coordination of multicentre trials by improving data collec tion, maintaining the efficacy and monitoring of trials, while potentially offering reduced costs in terms of travel and time. The realtime scrutiny o f patient records helps to ensure data uniformity and completeness of data collection. Videoconferencing was most useful when considered as one of sev eral communication tools that can be used to improve the effectiveness of a service or process.