Mobile reads: Appendicitis diagnosis on smartphone similar to in-house reports

In a pinch, mobile consultation using a smartphone to interpret CT images can offer similar diagnostic performance to in-house reports when a preliminary diagnosis of appendicitis from on-call radiologists is inconclusive, according to a Korean study.

Nak Jong Seong, MD, of Seoul National University Bundang Hospital, and colleagues sought to simulate a mobile consultation, given that many hospitals rely partly on less-experienced radiologists for CT interpretations after hours.

“Teleradiology consultation systems utilizing mobile devices have the potential to eliminate the spatial gap between patients and expert radiologists,” wrote the authors. Their findings were published in the July issue of the American Journal of Roentgenology.

To simulate a mobile consultation, Seong and colleagues devised a study in which two off-site abdominal radiologists used a smartphone to interpret CT images from 68 patients for whom preliminary CT reports for suspected appendicitis made by in-house, on-call radiologists were inconclusive. The sample included 29 patients with confirmed appendicitis, and the smartphone readings were compared with the preliminary reports from the on-call radiologists as well as final reports by in-house abdominal radiologists.

Heat maps and kappa statistics showed the smartphone reads were closer to the final reports than they were to the preliminary reports, according to Seong and colleagues. Smartphone readings were more confident in diagnosing or ruling out appendicitis than the preliminary reports and had diagnostic confidence that did not differ significantly from the final reports.

“Even though the increased diagnostic confidence that we observed would undoubtedly facilitate the clinical decision on surgical disposition, our study design was unable to prove that the increased diagnostic confidence can result in better clinical outcome,” wrote Seong and colleagues.

The results suggest that mobile consultation can be used as an adjunct to preliminary reports from on-call radiologists, but that a final report from an in-house abdominal radiologist is still needed, according to the authors.