Analysis of Kiosk-Based Remote Exams for Aeromedical Certification: Proof of Concept and Preliminary Diagnostic Performance Studies

Details

• Creators:
  Cowl, Clayton T
• Corporate Creators:
  Mayo Clinic. Section of Transportation Medicine. Division of Public Health, Infectious Diseases, and Occupational Medicine
• Corporate Publisher:
  United States. Department of Transportation. Federal Aviation Administration
• Corporate Contributors:
  United States. Department of Transportation. Federal Aviation Administration. Civil Aerospace Medical Institute
• Subject/TRT Terms:
  • Aviation medicine
  • Certification
  • Air pilots
  • Medical examinations and tests
  • Telecommunications
  • Accessibility
• Publication/ Report Number:
  DOT/FAA/AM- 26/24
• DOI:
  https://doi.org/10.21949/z3h2-jr91
• Resource Type:
  Tech Report
• Geographical Coverage:
  United States
• Description:
  This study evaluated the preliminary feasibility, user acceptance, and diagnostic performance of kiosk-based telemedicine for selected components of aeromedical certification examinations. Two sequential studies were conducted. In Phase I, 15 pilots completed conventional in-person and simulated kiosk-based remote examinations to assess technical feasibility, user acceptance, and agreement of examination findings. In Phase II, four non-pilot patients with known potentially safety-sensitive physical findings and one control participant without such findings were examined remotely by five physicians, with results compared against in-person examinations. Phase I demonstrated the feasibility of remotely performing several examination components, although certain required tests were obtained separately and some examination elements could not be adequately assessed using the study configuration. Pilots generally reported favorable experiences, while physicians identified limitations in instrumentation, examination quality, and training. Remote and in-person findings were similar in the small Phase I sample. In Phase II, preliminary diagnostic performance estimates were 85% sensitivity, 100% specificity, 100% positive predictive value, and 62.5% negative predictive value for the study's predefined safety-sensitive findings. These estimates were based on a small, selected sample with repeated physician assessments and did not establish diagnostic equivalence. Overall, the studies demonstrated preliminary technical feasibility and user acceptance for selected examination components but did not establish an equivalent level of safety or readiness for operational implementation. Further technology development and larger, appropriately designed validation studies are needed.
• Format:
  PDF
• Funding:
  6973GH-23-T-00009
• Download URL:
  https://rosap.ntl.bts.gov/view/dot/94166/dot_94166_DS1.pdf
• File Type:
  [PDF - 1.20 MB]
• Collection(s):
  FAA Civil Aerospace Medical Institute
• Main Document Checksum:
  urn:sha-512:60ab01cf56454b4dda64cd482dbf3d2c8271e25edbca6fdc533b467b3cc2ec5ced971d98dfb99f77bed7b0ed148f079f32ea0bb4fcf8464a4e24ea0718c1839d