Trial of tele-medicine to promote the fetal diagnosis of congenital - - PDF document

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Mar 18, 2023 298 likes •478 views

Motoyoshi Kawataki, Kanagawa Childrens Hospital Trial of tele-medicine to promote the fetal diagnosis of congenital heart disease (CHD) Motoyoshi Kawataki M.D. Depart. Of Neonatology, Kanagawa Childrens medical Center Yokohama, Japan

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 1

Trial of tele-medicine to promote the fetal diagnosis of congenital heart disease (CHD)

Motoyoshi Kawataki M.D.

Depart. Of Neonatology, Kanagawa Children’s medical Center

Yokohama, Japan

Before Era of Telemedicine

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 2

Hypoplastic left heart Syndrome (HLHS)

before Era of Telemedicine ductal shock pre-shock non-shock

Fetal Diagnosis of significant CHDs

10 20 30 40 50 60 70 93 94 95 96 97 98 99

Prenatal Diagnosis Postnatal Diagnosis

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 3

10 20 30 40 50 60 70 80 90 100 93 94 95 96 97 98 99

Detection rate of significant CHDs Our trial of tele-medicime to promote the fetal screening

2006～ Tele-diagnosis of CHD 2009～ Tele-seminar of advanced fetal cardiology (SINET) 2013～ Tele-conference of fetal heart disease (Internet)

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 4

Analysis and diagnosis by PC

Tele-diagnosis

Collection of the volume data clinic Our hospital Sent by CDROM

More than 200 cases after 2006

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 5

10 20 30 40 50

Kyuushuu Shikoku Chuugoku Kinnki Toukai Kantou Touhoku Hokkaidou

Diagnosis

ＣＨＤありＣＨＤなし

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 6

Transposition of Great Arteries (TGA)

Total Anomalous Pulmonary Venous Return (TAPVR)

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 7

level 2 diagnosis not only in complexed CHD but also

border line abnormalities

technical supports for obstetricians and sonographers
education and training of fetal heart screening

Tele‐diagnosis is useful for;

Problems of tele-diagnosis

1.Accuracy of diagnosis 2.Time consuming for fetal cardiologists 3.Responsibility 4.Cost

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 8

Tele-medicime to promote the fetal screening

2006～ Tele-diagnosis by CD-ROM 2009～ Tele-seminar of advanced fetal cardiology ( SINET) 2013～ Tele-conference of fetal heart disease (Internet)

Tele-seminar by SINET

Nation‐wide remote seminar trials of fetal echocardiography in Japan (Kazuto Noguchi /Ehime Univ./Japan)

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 9

Tele-medicine to promote the fetal screening

2006～ Tele-diagnosis (CD-ROM) 2009～ Tele-seminar of advanced fetal cardiology (SINET) 2013～ Tele-conference of fetal heart disease (Internet)

Yokohama Hukuoka

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 10 Shiga University Noda Clinic in Miyazaki

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 11 Miyagi Chirdren’s Hoapital

Outcome of telemedicine

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 12

20 40 60 80 100 120 140 160 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Tele-conference Tele-diagnosis Tele-seminar pts year

Significant CHDs diagnosed prenatally

10 20 30 40 50 60 70

Detection rate of significant CHDs

(%)

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 13

Detection rate of HLHS

1 2 3 4 5 6 7 8 9 10

1993 95 97 99 1 3 5 7 9 11

postnatal DX prenatal DX

2 4 6 8 10 12 14 16 18 20

93 95 97 99 1 3 5 7 9

Postnatal Dx prenatal Dx

Detection rate of TOF

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Motoyoshi Kawataki, Kanagawa Children’s Hospital The 7th Asia Telemedicine Symposium, 2013 14

2 4 6 8 10 12 14

93 95 97 99 1 3 5 7 9 11

neonatal DX prenatal DX

Detection rate of TGA

1 2 3 4 5 6 7 8 9