Evaluation of a telemedicine system for supporting thyroid disease diagnosis

A telemedicine system connecting Japan and Belarus via a communication satellite and the international ISDN has been in use since February, 1999. Two relational databases, which are essentially the same, are set respectively at Nagasaki University School of Medicine and Gomel Regional Specialized Dispensary in Belarus for management of patients' data and for research including epidemiologic studies. The thyroid ultrasonographic images, microscopic images of cytological findings and other information on patients are sent from Gomel to Nagasaki once a week with diagnoses and comments by physicians at Gomel Regional Specialized Dispensary for cases whom they found difficult to diagnose. Thyroid specialists at Nagasaki University School of Medicine correct the diagnoses, if necessary, on the basis of information from Gomel and send their comments and instructions to Gomel for improving diagnosis skills of physicians at Gomel. The findings of 330 cases have been sent from Gomel to Nagasaki by September, 2000 since the commencement of the system in February, 1999. Of the 329 cases, thyroid diagnosis was made at Gomel for 261 cases in whom two or more diagnoses were made for 35 cases. As of the end of October, 2000, the Gomel diagnoses have been reviewed for 217 cases and the remaining 112 cases are under review at Gomel. The diagnoses made at Gomel and Nagasaki were in agreement for 110 (50.7%) of 217 cases. Thyroid cancer was diagnosed in 8 cases in whom 6 had been diagnosed at Gomel while the other 2 were diagnosed anew at Nagasaki. The usefulness of the system for improving thyroid diagnosis in Belarus was indicated.