A new study, published in the latest issue of the Journal of Small Animal Practice (JSAP), suggests that diagnostic accuracy is not significantly impaired by viewing radiographs on a smartphone1.

It comes hot on the heels of the as-yet-unsubstantiated claim that remote dermatology diagnoses are as accurate as those conducted in person, and against a background of much debate in the profession about the risks and advantages of the various forms of telemedicine. 

For this new study "Reliability of smartphone-based radiographic interpretation for evaluating cardiogenic pulmonary oedema in dogs", researchers from Universidade Federal do ParanáBrazil, took thoracic radiographs from the medical records of 121 patients with cardiogenic pulmonary oedema or other differential diagnoses from three veterinary teaching hospitals.

All the images were then interpreted by two observers: a board-certified radiologist and an experienced cardiologist, both of whom were blinded to the patients’ diagnosis.

The images were reviewed both as JPEG images on a smartphone, and using a DICOM-viewing platform with an interval of four months between each viewing to reduce interpretation bias. The reviewers were asked to state only whether cardiogenic pulmonary oedema was present or absent. Diagnostic accuracy was assessed between interfaces and reviewers.

The authors say that the results of this study were consistent with previous research; a similar study found that small intestinal mechanical obstructions could be diagnosed from JPEG images of abdominal radiographs on a smartphone by radiologists.2

Lead author, Flavio Jojima said: "The diagnostic accuracy for cardiogenic pulmonary oedema in dogs was not significantly impaired when specialists used smartphones compared to a DICOM-viewing platform to interpret thoracic radiographs.

"This may provide supporting evidence for the use of smartphones for off-site expert interpretation of diagnostic radiographs, particularly in an out-of-hours clinical scenario, but not for routine interpretation of radiographs with a smartphone interface."

Nicholas Jeffery, editor of JSAP said: "These findings are reassuring. In off-site circumstances, particularly where immediate assessment and interpretation is needed, the use of smartphones could speed up the decision making process and enhance patient outcomes."

The full article can be found in the November issue of the Journal of Small Animal Practice which is free for BSAVA members. It can also be read online here https://www.onlinelibrary.wiley.com/doi/10.1111/jsap.13060

References

  1. Reliability of smartphone-based radiographic interpretation for evaluating cardiogenic pulmonary oedema in dogs F. S. Jojima, M. G. Sousa, T. R. Froes.
  2. Off-site smartphone vs. standard workstation in the radiographic diagnosis of small intestinal mechanical obstruction in dogs and cats. Veterinary Radiology and Ultrasound, 57 (5). P. G., Noel, A. J., Fischetti, G. Moore, A. B. Le Roux.

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