Pressure Ulcers Clinical Trial
Official title:
Pressure Ulcer Assessment Via Telemedicine
A Web-based telemedicine system for monitoring the status of patients with pressure ulcers has been developed. It consists of three major data collection components: (1) digital photograph of ulcer; (2) quantitative measurements of wound status (i.e., ulcer area and volume, skin elasticity); and (3) other wound and patient data collected by a nurse. Data are collected via laptop computer and transmitted to a central database, where a computer program transforms the data into the necessary reporting format. The output is posted onto a World Wide Web page for access by the consulting physician. The system incorporates all data requirements for assessment recommended by AHCPR's Clinical Practice Guideline, Treatment of Pressure Ulcers.
Background:
A Web-based telemedicine system for monitoring the status of patients with pressure ulcers
has been developed. It consists of three major data collection components: (1) digital
photograph of ulcer; (2) quantitative measurements of wound status (i.e., ulcer area and
volume, skin elasticity); and (3) other wound and patient data collected by a nurse. Data
are collected via laptop computer and transmitted to a central database, where a computer
program transforms the data into the necessary reporting format. The output is posted onto a
World Wide Web page for access by the consulting physician. The system incorporates all data
requirements for assessment recommended by AHCPR's Clinical Practice Guideline, Treatment of
Pressure Ulcers.
Objectives:
The primary objective of this pilot study was to evaluate the clinical accuracy of a
telemedicine system for assessing the status of pressure ulcers, both chronic and those
which have been surgically repaired. The principal hypotheses were: (1) use of the
telemedicine system results in the same diagnoses as does in-person patient assessment; and
(2) patients are satisfied with the telemedicine system.
Methods:
Two VA medical centers and two specialties participated in the study: Ann Arbor (plastic
surgery) and Augusta (plastic surgery, physical medicine and rehabilitation). They
contributed inpatients and outpatients with a pressure ulcer of stage II, III, or IV over a
one-year enrollment period. All study patients were assessed both in-person (the "gold
standard") and with the telemedicine system. The in-person and telemedicine physicians
provided yes/no responses to four diagnostic questions concerning wound healing and
infection, based on AHCPR guidelines, and they were blinded to each other�s assessments.
Patient satisfaction data were collected using a specially designed, self-administered
questionnaire to measure perceptions regarding the burden of the telemedicine system,
confidence in the evaluation, and absence of direct contact with a physician.
Status:
Completed
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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