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 23 May 2018

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News

Is tele-endoscopy a way to provide diagnostic quality for remote populations?

Upper-GI tele-endoscopy has good diagnostic quality and is highly sensitive with regard to major findings, find investigators in the January issue of Gastrointestinal Endoscopy.

News image

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Endoscopy is important in digestive health, but access is limited in many regions.

By training non-physicians to perform diagnostic endoscopy and transmitting images to experienced endoscopists, digestive health for patients in remote areas may be improved.

In this study, investigators from the United States evaluated the diagnostic quality and accuracy of upper-GI tele-endoscopy.
The observer missed 1 major lesion and described 10 non-existing major lesions.
Gastrointestinal Endoscopy

They assessed 50 patients who were scheduled for EGD and who underwent upper-GI tele-endoscopy.

The procedures were observed simultaneously by the endoscopist and a gastroenterologist connected by 4 integrated services digital network telephone lines.

The investigators compared findings and concordance for the diagnosis of major and minor lesions.

They found that the tele-endoscopic image quality was sufficient for the remote observers to diagnose abnormal lesions.

Worsening image quality was caused by mild pixelation during rapid endoscope movement and rare loss of the telephone lines.

The endoscopist identified 47 different major and 44 minor findings in the 50 patients.

The team found that the observer missed 1 major lesion due to suspected inflammation and described 10 non-existing major lesions. They determined that differences may be due to interobserver variability.

Dr Stephan Wildi's team concluded, "Upper-GI tele-endoscopy by using telephone lines has good diagnostic quality and is highly sensitive with regard to major findings".

"The misinterpretation of certain findings (esophageal ring, gastric erosions) may be caused by interobserver variability".

"The data strongly suggest that endoscopist and observer see similar endoscopic views".

Gastrointest Endosc 2004; 59(1):
22 January 2004

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