Media messaging in diagnosis of acute CXR pathology: an interobserver study among residents

Abstract

The objectives of the study were to determine whether diagnostic accuracy and reliability by on-call teams is affected by communicating chest radiograph (CXR) images via instant messaging on smartphones in comparison to viewing on a workstation. 12 residents viewed 100 CXR images each with a 24% positive rate for significant or acute findings sent to their phones via a popular instant messaging application and reported their findings if any. After an interval of 42 days they viewed the original DICOM images on personal computers and again reported their findings. There were no statistically significant differences in accuracy, agreement, sensitivity, specificity, positive predictive value or negative predictive value between desktop workstation viewed images and images sent via the mobile application. Media messaging is a useful adjunct for quick second opinions on radiological images, without significant decay in diagnostic accuracy. If technical, ethical and legal issues are addressed, it could be incorporated into practice as a useful adjunct.

Using Smartphone to Evaluate Cranial Computed Tomography Videos: An Inter-Observer Study

“…There are contradictory results in studies evaluating the photographs of direct radiographies to be sent to the participants vie WhatsApp and similar applications. The decrease in the image quality according to the quality of both the program and the phone used by the participants is an issue to be discussed (3). While these evaluations have been found to be reliable in some studies, contrary results have been found in some other studies (3,6,7).…”

“…Evaluating CCT videos on a smartphone is a confusing ethical and technical problem for physicians. Medical assessments via WhatsApp have often been the subject of articles (2)(3)(4). The aim of this study was to evaluate the reliability of the CCT videos that are shared via WhatsApp application in the diagnosis.…”

Diagnostic accuracy and reliability of smartphone captured radiologic images communicated via WhatsApp®

“…. A non-radiology study by Handelman (2018) concluded that chest x-ray transmission via WhatsApp® results in a comparable ability to identify clinical findings as viewing the same image on a workstation 11 . A paediatric study published by Westberg et al in 2016 found no significant differences in the accuracy of diagnosing pneumothorax on a smartphone versus PACS 12 .…”

CheXpedition: Investigating Generalization Challenges for Translation of Chest X-Ray Algorithms to the Clinical Setting

“…While most deep learning models are trained on digital x-rays, scaled deployment demands a solution that can navigate an endless array of medical imaging / IT infrastructures. An appealing solution to scaled deployment is to leverage the ubiquity of smartphones: clinicians and radiologists in parts of the world take smartphone photos of medical imaging studies to share with other experts or clinicians using messaging services like WhatsApp [6]. While using photos of chest x-rays to input into chest-xray algorithms could enable any physician with a smartphone to get instant AI algorithm assistance, the performance of chest x-ray algorithms on photos of chest x-rays has not been thoroughly investigated.…”

“…developed and validated on digital x-rays, while the vast majority of the world relies on film for X-ray interpretation, a barrier that denies these populations from the advancements of automated interpretation [31]. In order to apply an interim digital solution, digital photographs of films for storage, interpretation, and consultation can be performed as a "workaround" [6]. Third, chest x-ray algorithms which are developed using the data from one institution have not shown sustained performance when externally validated in application data from a different unrelated institution, and instead, these models have been criticized as vulnerable to bias and non-medically relevant cues [40].…”