Abstract
Background
Smartphones are now a ubiquitous presence within the modern healthcare setting. Uses such as internet, database software and storage of medical textbooks, all contribute to the clinical value of the devices. Within orthopaedics, transmission of digital images via smartphones is now routinely used to obtain instant second opinions of trauma radiographs. However questions remain as to whether smartphone image quality is sufficient for primary diagnosis and secondary consultation
Aim
To assess the accuracy of diagnosis made when radiographs are viewed on a smartphone screen in comparison with a standard digital monitor. Also to assess the diagnostic confidence, diagnostic difficulty, subjective image quality and formulation of management plan.
Method
30 orthopaedic registrars viewed a total of 900 radiographs–450 radiographs were viewed on a 3.5inch, 640×960 PPI smartphone screen and 450 on a standard digital monitor. Likert scales were used to assess the diagnostic accuracy, confidence and difficulty along with image quality and management plan. Initially images were viewed on the smartphone screen and after one week the same images were viewed on the digital monitor. Results were then compared.
Results
There was no difference in diagnostic accuracy between smartphone and digital monitors although participants tended to be more confident in their diagnosis when made on the larger screen of the digital monitor. Diagnostic difficulty was higher in the smartphone group and image quality was lower. However there was a high correlation between management plans made after viewing images in both modalities
Discussion
This study demonstrates that although participants found the image quality poorer and found it marginally more difficult to make a diagnosis the same diagnosis was arrived at and the same management plan formulated using a smartphone compared to a standard digital monitor. Therefore smartphone based teleradiology appears to have a valid use in orthopaedic trauma
