A new study published in The Spine Journal examines the reliability of smartphone-based teleradiology when examining thoracolumbar spine fractures.
For the study, an iPhone 6 smartpone was used to capture CT scans from a computer screen displaying PACS. Then the WhatsApp instant messaging system was used to send video clips of the scan to personal smart phones of five surgeons. The surgeons evaluated and diagnosed the patient as well as determined a course of treatment for each case.
The case evaluations were repeated four weeks later with the standard method of workstation-based PACS.
The researchers found:
1. There was intraobserver agreement to determine the fracture level was "near perfect."
2. For AO classification, proposed treatment, neural canal penetration and Denis classification, the intraobserver agreement was substantial. The "k" values were:
• AO classification: 0.75
• Proposed treatment: 0.73
• Neural canal penetration: 0.71
• Denis classification: 0.69
3. The intraobserver agreement for vertebral height loss "k" value was 0.55 and the kyphosis "k" value was 0.45 — both moderate.
4. The researchers determined the CT scan video clips could be captured by smartphones from a workstation-based PACS and then transmitted through WhatsApp. "Diagnosing, classifying and proposing treatment of fractures of the thoracic and lumbar spine can be made with equal reliability by evaluating video clips of CT scans transmitted to a smartphone or by the standard method of viewing the CT scan on a workstation-based PACS," they concluded.
5. The smartphone evaluation is readily accessible, simple and inexpensive; the researchers believe it can be reliably used between emergency physician and orthopedic or neurological residents with offsite, on-call specialists.
The technology can be particularly helpful for rural communities to communicate more effectively with surgeons at tertiary referral centers.