Title: The Effect on Physician Interpretation After Ultrasound Video Transmis-sion. Objective: There is a limited amount of qualified sonographers, which is problematic to rural, and prehospital settings that require clinical ultrasound. One solution is the use of telemedicine to transmit ultrasound videos to a distant expert. Our objective was to determine the effect of video image transfer using Skype on physician image interpretation. Methods: Three emergency medicine physicians of varied ultrasound proficiency were given 72 pairs of transmitted and non-transmitted ultrasound video clips in random order. Raters were instructed to determine whether ultrasound clips were positive or negative for pathology. Same interpretations between video pairs were categorized as homodiagnostic while different interpretations were categorized as heterodiagnostic. Raters were also asked to rate the image resolution, image detail, and total image quality using a 10-point Likert scale. For the diagnostic results, rater agreement, accuracy, sensitivity, and specificity were calculated. Results: The raters collectively demonstrated high agreement (92.1%), sensitivity (96.3%), specificity (92.8%), and accuracy (94.1%). Raters 1 (95.8%, κ = 0.912) and 3 (97.2%, κ = 0.942) had near perfect agreement, while rater 2 (83.3%, κ = 0.666) had substantial agreement. Only raters 1 and 3 detected a decrease in image resolution, image detail, and total image quality (p < 0.05). Rater agreement on transmitted videos was not significantly different statistically from non-transmitted videos and the presence of heterodiagnostic video pairs did not correlate with video transmission. Conclusions: This study demonstrates that transmission via Skype has minimal effect on a physician’s interpretation of an ultrasound video. The implications of these results are that ultrasound video transmission can be used to improve access to specialists without compromising accuracy which will ultimately increase patients’ quality of care.
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