Telecolposcopy in a Primary Care Women's Health Clinic

初级保健妇女健康诊所的远程阴道镜检查

• 批准号: 7071731
• 负责人: ANA MARIA LOPEZ
• 金额: $ 26.93万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7071731
• 关键词: adolescence (12-20); adult human (21+); biomedical equipment development; cancer prevention; cervix neoplasms; clinical research; cost effectiveness; diagnosis design /evaluation; endoscopy; female; female reproductive system disorder diagnosis; health care personnel; health care professional practice; health care quality; health care service availability; health disparity; health services research tag; human subject; neoplasm /cancer diagnosis; patient oriented research; primary care physician; rural area; rural health; telemedicine; women' s health

DESCRIPTION (provided by applicant): Telemedicine services are rapidly becoming an integral part of many hospitals and rural clinics around the world and are perceived as having great potential for accessing underserved populations. Although the mortality from invasive cervical cancer in the US has declined over 50% during the past 40 years, likely due to aggressive screening programs, the decrease has not been as dramatic among minority populations and rurally located populations. The Arizona- Sonora Binational Commission has identified cervical cancer prevention as a high priority for Hispanic women. Since the majority of patients with frank cervical carcinoma and cervical dysplasia, its precursor lesion, are asymptomatic, Pap smear screening provides the best approach to early detection. Patients with an abnormal Pap smear and no visible lesion on visual cervical inspection are referred to colposcopy. The colposcope is a magnifying instrument that can directly detect dysplastic lesions of the cervix. Once visualized, the lesion can be biopsied and a tissue diagnosis can be made. Telecolposcopy allows for the collection and transmission of digital cervical images via telecommunications technology. Telecolposcopy can be performed live, in "real-time," with direct communication between the colposcopist and the telecolposcopist, or the telecolposcopist can review the images at a later time via store-forward technology. The use of telecolposcopy provides a means for rural women to access this specialized care without being burdened by usual constraints includingtravel, time off from work due to travel and costs due to travel such as arrangements for child and elder care. Pilot data from a university tertiary care colposcopy clinic demonstrate that the efficacy of telecolposcopy is comparable to that of colposcopy. This study will build on the pilotdata by examining the feasibility of telecolposcopy outside of a tertiary care setting. The central hypothesis of this proposal is that telecolposcopy will be as clinically effective as in.person colposcopy in the assessment of the cervix after an abnormal Pap smear. The secondary hypotheses are (a) patients, their providers, and the telecolposcopists will be satisfied with telecolposcopy services and (b) telecolposcopy can be integrated into a primary care women's health clinical practice in a cost effective manner. The proposed study will result in the improved management of cervical lesions for women with decreased access to telecolposcopy services.

描述（由申请人提供）：远程医疗服务正在迅速成为世界各地许多医院和农村诊所的组成部分，并被认为具有进入服务不足人群的巨大潜力。尽管在过去的40年中，美国侵入性宫颈癌的死亡率已下降了50％以上，这可能是由于侵略性筛查计划所致，但在少数族裔和乡村人口中，这种下降并没有那么戏剧性。亚利桑那州 - 索诺拉双性恋委员会已将宫颈癌预防视为西班牙裔妇女的重中之重。由于大多数患有弗兰克宫颈癌和宫颈发育不良的患者无症状的先兆病变，因此PAP涂片筛查为早期检测提供了最佳方法。患有异常子宫颈抹片检查，视觉检查检查中没有可见病变的患者被称为阴道镜检查。阴道镜是一种放大仪器，可以直接检测子宫颈的发育不良病变。一旦可视化，就可以进行病变，并可以进行组织诊断。远程斜镜检查允许通过电信技术收集和传输数字宫颈图像。可以在“实时”的“实时”中实时进行远程斜镜检查，并通过阴道镜和远程验证师之间的直接通信，或者远程验证师可以通过商店前进的技术在以后的时间进行查看图像。远程斜镜检查的使用为农村妇女提供了一种访问这种专业护理的手段，而不会受到通常的限制，包括旅行，由于旅行而下班的时间以及由于旅行而导致的费用，例如儿童和老年人护理的安排。大学三级护理阴道镜诊所的试验数据表明，远程隔离的疗效与阴道镜检查相当。这项研究将通过研究三级护理设置以外的远程斜镜检查的可行性来建立。该提议的中心假设是，远程斜镜将在临床上与In.pop涂片异常后的子宫颈评估中的临床有效。次要假设是（a）患者，他们的提供者，远程斜镜医生将对远程侧镜服务感到满意，并且（b）可以以成本效益的方式将远程斜镜检查纳入初级保健妇女健康临床实践。拟议的研究将导致改善获得远程镜检查服务降低的妇女宫颈病变的治疗。