Skip to main content

Advertisement

SpringerLink
Log in

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

  • EM - ORIGINAL
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

CXR:

Chest X-ray

DICOM:

Digital imaging and communications in medicine

PACS:

Picture archiving and communication system

JPEG:

Joint photographic experts group

References

  1. Patel RK, Sayers AE, Patrick NL, Hughes K, Armitage J, Hunter IA (2015) A UK perspective on smartphone use amongst doctors within the surgical profession. Ann Med Surg 4:107–112

    Article  Google Scholar 

  2. Mobasheri MH, King D, Johnston M, Gautama S, Purkayastha S, Darzi A (2015) The ownership and clinical use of smartphones by doctors and nurses in the UK: a multicentre survey study. BMJ Innov 1:174–181

    Article  Google Scholar 

  3. Statt N (2016) WhatsApp has grown to 1 billion users. http://www.theverge.com/2016/2/1/10889534/whats-app-1-billion-users-facebook-mark-zuckerberg. Accessed 27 Jul 2016

  4. Johnston MJ, King D, Arora S et al (2015) Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams. Am J Surg 209:45–51

    Article  Google Scholar 

  5. Migliore M (2015) The use of smartphones or tablets in surgery. What are the limits? Ann Ital Chir 86:185–186

    PubMed  Google Scholar 

  6. Astarcioglu MA, Sen T, Kilit C et al (2015) Time-to-reperfusion in STEMI undergoing interhospital transfer using smartphone and WhatsApp messenger. Am J Emerg Med 33:1382–1384

    Article  Google Scholar 

  7. Khanna V, Sambandam SN, Gul A, Mounasamy V (2015) “WhatsApp”ening in orthopedic care: a concise report from a 300-bedded tertiary care teaching center. Eur J Orthop Surg Traumatol 25:821–826

    Article  Google Scholar 

  8. Kaliyadan F, Ashique KT, Jagadeesan S, Krishna B (2016) What’s up dermatology? A pilot survey of the use of WhatsApp in dermatology practice and case discussion among members of WhatsApp dermatology groups. Indian J Dermatol Venereol Leprol 82:67

    Article  Google Scholar 

  9. Giordano V, Koch HA, Mendes CH, Bergamin A, de Souza FS, do Amaral NP (2015) WhatsApp messenger is useful and reproducible in the assessment of tibial plateau fractures: inter- and intra-observer agreement study. Int J Med Inform 84:141–148

    Article  Google Scholar 

  10. O’Sullivan DM, O’Sullivan E, O’Connor M, Lyons D, McManus J (2017) WhatsApp Doc? BMJ Innov 3:238–239 

    Article  Google Scholar 

  11. Stahl I, Dreyfuss D, Ofir D et al (2016) Reliability of smartphone-based teleradiology for evaluating thoracolumbar spine fractures. Spine J. https://doi.org/10.1016/j.spinee.2016.08.021

    Article  PubMed  Google Scholar 

  12. Al Zadjali N, Al-Senawi R, Al Reesi A, Al-Zakwani I, Nemeth J, Perry JJ (2009) Predictors of positive chest radiography in non-traumatic chest pain in the emergency Department. Oman Med J 24:22–26

    PubMed  PubMed Central  Google Scholar 

  13. Sharif BAR, O’Kane K, McWilliams S (2013) An audit of chest X-ray requests in acute medical settings at a London teaching hospital—are guidelines being met? European Congress of Radiology, Vienna

  14. Radiologists Fo (2011) Guidelines for the implementation of a national quality assurance programme in radiology—Version 2.0 Royal College of Surgeons in Ireland, Online

  15. Radiologists. TRCo (2012) Standards for the communication of critical, urgent and unexpected radiological findings, Second. The Royal College of Radiologists, London

    Google Scholar 

  16. Satia I, Bashagha S, Bibi A, Ahmed R, Mellor S, Zaman F (2013) Assessing the accuracy and certainty in interpreting chest X-rays in the medical division. Clin Med (Lond) 13:349–352

    Article  CAS  Google Scholar 

  17. Goost H, Witten J, Heck A et al (2012) Image and diagnosis quality of X-ray image transmission via cell phone camera: a project study evaluating quality and reliability. PLoS One 7:e43402

    Article  CAS  Google Scholar 

  18. Dey K (2014) Whatsapp—an innovative solution for the stroke care. J Neurol Neurosurg Psychiatry 85:e4

    Article  Google Scholar 

  19. Free C, Phillips G, Watson L et al (2013) The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med 10:e1001363

    Article  Google Scholar 

  20. Fiadino P, Schiavone M, Casas P (2014) Vivisecting whatsapp through large-scale measurements in mobile networks. ACM SIGCOMM Comput Commun Rev 44:133–134

    Article  Google Scholar 

  21. Liukkonen E, Jartti A, Haapea M et al (2016) Effect of display type and room illuminance in chest radiographs. Eur Radiol 26:3171–3179

    Article  Google Scholar 

  22. Office of Public Sector Information (1998) Data Protection Act 1998 (c.29) [online] HMSO, London

  23. Confidentiality: good practice in handling patient information (2009) General Medical Council, Manchester, Paragraph 8

    Article  Google Scholar 

  24. Organisation BM (2016) Recordings, publication and the media. https://www.bma.org.uk/advice/employment/ethics/confidentiality-and-health-records/confidentiality-and-health-records-tool-kit/5-recordings-publication-media. Accessed 27 Aug 2016

  25. Caldicott F (2013) Information: to share or not to share? The information governance review. Department of Health, London

    Google Scholar 

  26. Drake TM, Claireaux HA, Khatri C, Chapman SJ (2016) WhatsApp with patient data transmitted via instant messaging? Am J Surg 211:300–301

    Article  Google Scholar 

  27. Johnston M, King D, Darzi A (2016) Reply to the letter: WhatsApp with patient data transmitted via instant messaging? Am J Surg 211:301–302

    Article  Google Scholar 

  28. Miller R, Beaumont O, McGrath S (2016) Is it now safe to use WhatsApp for clinical messaging? Am J Surg 212:1032–1033

    Article  Google Scholar 

  29. Thomas K (2018) Wanted: a WhatsApp alternative for clinicians. BMJ 360

  30. Johnston M, Mobasheri M, King D, Darzi A (2015) The imperial clarify, design and evaluate (CDE) approach to mHealth app development. BMJ Innov 1:39–42

    Article  Google Scholar 

Download references

Funding

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

Author information

Authors and Affiliations

  1. Department of Radiology, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK

    Guy S. Handelman

  2. Department of Surgery, Beaumont Hospital, Dublin, Ireland

    Ailin C. Rogers

  3. Department of Radiology, University Hospital Waterford, Waterford, Ireland

    Zafir Babiker

  4. Department of Radiology, Beaumont Hospital, Dublin, Ireland

    Michael J. Lee

  5. Department of Vascular Surgery, University Hospital Waterford, Waterford, Ireland

    Morgan P. McMonagle

Authors
  1. Guy S. Handelman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ailin C. Rogers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zafir Babiker
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael J. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Morgan P. McMonagle
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Handelman, G.S., Rogers, A.C., Babiker, Z. et al. Media messaging in diagnosis of acute CXR pathology: an interobserver study among residents. Intern Emerg Med 13, 1257–1263 (2018). https://doi.org/10.1007/s11739-018-1859-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-018-1859-1

Keywords

Search

Navigation