The article by Hiatt et al is an important contribution to the field of surgical education and the question of proctoring and credentialing. It is timely as well, as telemedicine is finally taking root and spreading to many disciplines, including surgery. While agreeing with the overall premise, there are exceptions to a few of the conclusions. For any task other than observation (or telemonitoring) there is no proof (and this study does not provide proof) that anything less than "lossless" compression is adequate for tasks such as teleproctoring or telementoring.
Compression schemata are also topics of very hot debate in radiological circles, where numerous studies have demonstrateloss-t only lossless compression is acceptable. It is encouraging that current laboratory schemata have achieved lossless ratios of 100:1. It must be commented that this study's methodology used a frame rate of 15 frames per second (fps) or less; it should be noted that