Abstract T P28: Diagnostic Accuracy of Mobile Devices for Remote Acute Stroke Neuroimaging Interpretation
BACKGROUND: Advances in technology allow physicians’ access to radiological images remotely, virtually anytime, anywhere to streamline stroke management.
OBJECTIVE: To compare the diagnostic accuracy of different mobile devices in interpretation of acute head CT for various ischemic stroke findings among various readers.
METHODS: 20 selected acute stroke head CT were independently interpreted by 11 readers (7 Neurologists, 3 Neuroradiologists and 1 Radiologist) on 2 mobile devices, iPad® 2 (1024x768 pixels) and iPhone® 4 (960x640 pixels), and on the Picture Archiving and Communication System (PACS) workstation (1280x1024 pixels). Both mobile devices used a FDA-cleared ResolutionMD software (ResMD® Calgary Scientific, Calgary, Canada). Primary outcome measures included: any acute ischemic sign (AIS), any non acute ischemic sign (NAIS), and any hyperdense middle cerebral artery (HMCA) sign. For each outcome intra-rater inter-device accuracy, using a rater specific gold standard, were evaluated and estimated % Sensitivity (Sen) and % Specificity (Spe) with 95% Agrest-Coull Confidence Intervals (CIs) were reported from frequency tables.
RESULTS: Across all 11 readers, for AIS: Sen = 76 (68, 82) and Spe = 75 (64, 83) on iPhone; Sen = 76 (69, 83), Spe = 71 (60, 80) on iPad. For for NAIS: Sen = 80 (72, 86) and Spe = 77 (67, 84) on iPhone and Sen = 75 (67, 82) and Spe = 80 (71, 87) on iPad. For HMCA Sen = 53 (39, 67) Spe = 97 (93, 99) on iPhone and Sen = 62 (48, 75) and Spe = 95 (91, 98) on iPad.
CONCLUSIONS: This is the first study directly comparing the diagnostic accuracy of two different mobile devices for acute head CT ischemic stroke findings. Both iPhone and iPad have fair sensitivity for detection of AIS and NAIS, while poorer sensitivity for HMCA when read by readers from different specialties. Specificity was good to excellent for all 3 head CT ischemic stroke findings. iPhone and iPad have similarly good diagnostic accuracy for acute ischemic stroke head CT scan findings supporting their use for remote neuroimaging interpretation. Their validation in routine clinical practice needs to be confirmed in larger studies.
Author Disclosures: C. Balucani: None. J. Weedon: None. S.R. Levine: Other Research Support; Modest; Calgary Scientic Inc. provided the mobile devices for the study.
- © 2015 by American Heart Association, Inc.