Home // eTELEMED 2019, The Eleventh International Conference on eHealth, Telemedicine, and Social Medicine // View article
Authors:
Antonio Salazar
Manuel Granja
Nicolás Useche
Sonia Bermúdez
Aníbal Morillo
Oscar Torres
Natalia Rueda
Brenda Ropero
Keywords: stroke; telestroke; teleradiology; smartphone; reliability; equivalence.
Abstract:
The aim of this study was to evaluate the equivalence of head computed tomography (CT) interpretations performed with either a diagnostic workstation or a smartphone in an emergency telestroke service. After institutional review board approval, a factorial design with 1504 interpretations was used (188 patients, 4 radiologists, and 2 reading systems). The variables evaluated included the following image findings: presence of hemorrhagic lesion, imaging contraindications for the administration of intravenous tissue plasminogen activator (tPA), ischemic lesion in the anterior cerebral artery (ACA), middle cerebral artery (MCA), and/or posterior circulation (PC) territory, hyperdense MCA, and a dichotomized score of the well-known Alberta Stroke Program Early CT Score (ASPECTS). The statistical equivalence between each variable was studied for all reading systems, and the reliability was analyzed using the Fleiss’ kappa coefficient. The statistical equivalence (P < 0.05) was achieved at a 5% difference for all variables. To claim equivalence, the differences between the two reading systems were obtained and ranged from 0.5% to 4% - the minimum for hemorrhagic lesions and maximum for hyperdense MCA. Intraobserver agreements were classified as moderate, good or very good, with kappa values ranging from 0.52 to 0.94. In addition, we obtained a maximum agreement on the hemorrhagic lesions and a minimum agreement on the presence of ischemic lesions in ACA; this outcome deserves a particular analysis. Finally, we conclude that after providing radiologists with real clinical scenarios, the diagnostic performance for detecting acute stroke is likely equivalent regardless of the use of a smartphone or a diagnostic workstation. Mobile solutions are feasible alternatives for the interpretation of head CT images in patients with acute stroke and can be used as a handy tool in the development of more efficient telestroke services.
Pages: 129 to 134
Copyright: Copyright (c) IARIA, 2019
Publication date: February 24, 2019
Published in: conference
ISSN: 2308-4359
ISBN: 978-1-61208-688-0
Location: Athens, Greece
Dates: from February 24, 2019 to February 28, 2019