Diagnostic performance of a telemedicine system for ophthalmology: advantages in accuracy and speed compared to standard care

Michael Chiang, Lu Wang, David Kim, Karen Scott, Grace Richter, Steven Kane, John Flynn, Justin Starren

Research output: Contribution to journalArticle

9 Scopus citations


Telemedicine has potential to improve quality and delivery of medical care, particularly in image-oriented specialties where decisions are based on appearance of morphological features during examination. In the ophthalmology domain, nearly all published telemedicine studies have measured accuracy against a gold standard of ophthalmoscopic examination. The purposes of this study are to examine difficulties in defining an absolute gold standard and to compare diagnostic speed in a representative disease, retinopathy of prematurity. We compare results from ophthalmoscopic and telemedicine examinations by the same physicians. In 180 (86.5%) of 208 eyes, the two examinations produced the same diagnosis. In some discrepancies, there was rationale suggesting that telemedicine may have provided a more accurate diagnosis than ophthalmoscopic examination. The quantity and nature of these disagreements has important implications for evaluation of telemedicine systems in image-based specialties, and for the definition of gold standards in future studies.

Original languageEnglish (US)
Pages (from-to)111-115
Number of pages5
JournalAMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
Publication statusPublished - 2010
Externally publishedYes


ASJC Scopus subject areas

  • Medicine(all)

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