Is smartphone-based teleradiology reliable for analyzing thoracolumbar spine fractures? 6 observations

In a study published by The Spine Journal, researchers compared the reliability of reading CT scans of thoracolumbar spine fractures via two formats:

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• Standard workstation-based picture archiving and communication system video clips sent via WhatsApp instant messaging, and viewed on an iPHone 6
• Viewed directly on a picture archiving and communication system

 

The study involved 30 adults with thoracolumbar spine fractures admitted to a Level 1 trauma center in 2014.

 

Five spine surgeons diagnosed, classified and determined treatment plans for patients based on video clips of the scans sent to their personal smartphones. The surgeons examined the cases four weeks later, via a workstation-based picture archiving and communication system. Researchers determined intraobserver agreement based on the value of Cohen’s kappa statistic.

 

Here are six observations:

 

1. Researchers found intraobserver agreement for determining the fracture level was nearly perfect.

 

2. The study revealed “intraobserver agreement for AO classification, proposed treatment, neural canal penetration and Denis classification” proved substantial.

 

3. In terms of loss of vertebral height and kyphosis, intraobserver agreement was moderate.

 

4. Researchers concluded spine surgeons can diagnose, classify and propose thoracolumbar fracture treatments via the smartphone method as reliably as if they viewed the scans via a workstation-based picture archiving and communication system.

 

5. Researchers noted the smartphone method could help with consultations between emergency physicians and off-site specialists.

 

6. The smartphone method could also aid “rural community emergency department physicians to communicate more efficiently and effectively with surgeons in tertiary referral centers,” according to study authors.

 

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