Internal and Emergency Medicine

, Volume 13, Issue 8, pp 1257–1263 | Cite as

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

  • Guy S. Handelman
  • Ailin C. Rogers
  • Zafir Babiker
  • Michael J. Lee
  • Morgan P. McMonagle


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.


Teleradiology Ethics, medical Mobile applications Liability, legal Near miss, healthcare, chest X-ray 



Chest X-ray


Digital imaging and communications in medicine


Picture archiving and communication system


Joint photographic experts group



The authors declare no sources of funding were used for this work.

Compliance with ethical standards

Conflict of interest

The Authors declare that they have no conflict of interest.

Ethical approval

For this type of study formal ethical approval is not required.

Statement of human and animal rights

The procedures followed were in accordance with the standards of the medical ethics committee and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was not required for this study.


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Copyright information

© SIMI 2018

Authors and Affiliations

  • Guy S. Handelman
    • 1
    return OK on get
  • Ailin C. Rogers
    • 2
  • Zafir Babiker
    • 3
  • Michael J. Lee
    • 4
  • Morgan P. McMonagle
    • 5
  1. 1.Department of RadiologyRoyal Victoria HospitalBelfastUK
  2. 2.Department of SurgeryBeaumont HospitalDublinIreland
  3. 3.Department of RadiologyUniversity Hospital WaterfordWaterfordIreland
  4. 4.Department of RadiologyBeaumont HospitalDublinIreland
  5. 5.Department of Vascular SurgeryUniversity Hospital WaterfordWaterfordIreland

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