Telesonography In Emergency Medicine: A Systematic Review

G Marsh-Feiley, L Eadie, P Wilson

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Abstract

Ultrasound is an efficacious, versatile and affordable imaging technique in emergencies, but has limited utility without expert interpretation. Telesonography, in which experts may remotely support the use of ultrasound through a telecommunications link, may broaden access to ultrasound and improve patient outcomes, particularly in remote settings. This review assesses the literature regarding telesonography in emergency medicine, focussing on evidence of feasibility, diagnostic accuracy and clinical utility. A systematic search was performed for articles published from 1946 to February 2017 using the Cochrane, Medline, EMBASE, and CINAHL databases. Further searches utilising Scopus, Google Scholar, and citation lists were conducted. 4388 titles were identified and screened against inclusion criteria which resulted in the inclusion of 28 papers. These included feasibility, diagnostic accuracy and clinical pilot studies. Study design, methodology and quality were heterogeneous. There was good evidence of feasibility from multiple studies. Where sufficient bandwidth and high quality components were used, diagnostic accuracy was slightly reduced by image transmission. There was evidence of clinical utility in remote hospitals and low-resource settings, although reliability was infrequently reported. Further exploratory research is required to determine minimum requirements for image quality, bandwidth, frame rate and to assess diagnostic accuracy. Clinical trials in remote settings are justifiable. Telecommunication options will depend on local requirements; no one system conveys universal advantages. The methodological quality of research in this field must improve: studies should be designed to minimise bias, and must include details of their methods to allow replication. Analysis of cost effectiveness and sustainability should be provided.
Original languageEnglish
Article numbere0194840
Pages (from-to)1-22
Number of pages22
JournalPloS ONE
Volume13
Issue number5
DOIs
Publication statusPublished - 3 May 2018

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Telecommunications
Emergency Medicine
systematic review
Medicine
medicine
Ultrasonics
telecommunications
Feasibility Studies
Research
Cost-Benefit Analysis
Bandwidth
Image communication systems
Emergencies
Clinical Trials
Databases
Cost effectiveness
Image quality
Telecommunication links
Telecommunication
Sustainable development

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Telesonography In Emergency Medicine : A Systematic Review. / Marsh-Feiley, G; Eadie, L; Wilson, P.

In: PloS ONE, Vol. 13, No. 5, e0194840, 03.05.2018, p. 1-22.

Research output: Contribution to journalArticle

Marsh-Feiley, G ; Eadie, L ; Wilson, P. / Telesonography In Emergency Medicine : A Systematic Review. In: PloS ONE. 2018 ; Vol. 13, No. 5. pp. 1-22.
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