Evaluation of telemedicine in the management of dentogenous infections.
2013
Introduction/Aim. The first written evidence of telemedicine dates back to
the times of Sava Nemanjic (the end of 12th and the beginning of 13th
century). Nowadays, the use of telemedicine in Serbia gains momentum, and the
cause of this lies in the creation of a central telemedicine system XPA3
Online and the establishment of the Center for Telemedicine at the Faculty of
Medicine, University of Pristina/Kosovska Mitrovica, Kosovska Mitrovica,
Serbia. Dentogenous infections are among the most urgent conditions in
dentistry, which may have even a fatal outcome. The aim of this study was to
assess the possibility of using telemedicine methods in the pathology of
dentogenous infections. Methods. This experimental randomized study incl uded
414 patients with suspected dentogenous infection. The patients were enrolled
at 7 sites, with systematic photograph-taking, collection, and digitalization
of the available anamnestic and laboratory data, tests, and x-rays. Together
with clinical findings, the data were uploaded on the XPA3 Online central
telemedicine system; after that, 10 teleconsultants reviewed the material,
set the diagnosis, and gave their opinion about the treatment. The agreement
was determined using the Cohen’s kappa (k) coefficient, as well as diagnostic
sensitivity (SE), specificity (SP), and efficacy (EFF). Statistical
significance and comparisons were done using the z-test, and testing
nonparametric properties using the McNemar’s χ2-test for the significance
threshold of p = 0.05. Results. The results describing agreement of
telemedicine diagnosis of the areas primarily involved with infection
compared to clinical inspection, indicate an almost complete diagnostic
agreement (k = 0.971). Diagnostic agreement as to the type of infection was
also almost complete (k = 0.951), and a similar value was obtained also for
the treatment agreement (k > =0.892). Conclusion. The method of telemedicine
provides us with a tool to make a correct clinical diagnosis of dentogenous
infections equally well as in real time, as well as to get a deeper and wider
insight into their nature and to suggest adequate treatments.
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