1. Reliability of Smartphone for Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores in Acute Ischemic Stroke Patients: Diagnostic Test Accuracy Study.
- Author
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Sakai K, Komatsu T, Iguchi Y, Takao H, Ishibashi T, and Murayama Y
- Subjects
- Acute Disease, Aged, Alberta, Female, Humans, Male, Reproducibility of Results, Brain Ischemia diagnosis, Brain Ischemia diagnostic imaging, Diagnostic Tests, Routine methods, Smartphone standards, Stroke diagnosis, Stroke diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Background: High-quality neuroimages can be viewed using a medical app installed on a smartphone. Although interdevice agreement between smartphone and desktop PC monitor was found to be favorable for evaluating computed tomography images, there are no interdevice agreement data for diffusion-weighted imaging (DWI)., Objective: The aim of our study was to compare DWI interpretation using the Join smartphone app with that using a desktop PC monitor, in terms of interdevice and interrater agreement and elapsed interpretation time., Methods: The ischemic change in the DWI of consecutive patients with acute stroke in the middle cerebral artery territory was graded by 2 vascular neurologists using the Join smartphone app and a desktop PC monitor. The vascular neurologists were blinded to all patient information. Each image was categorized as either Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores (DWI-ASPECTS) ≥7 or DWI-ASPECTS <7 according to the Japanese Society for Neuroendovascular Therapy. We analyzed interdevice agreement and interrater agreement with respect to DWI-ASPECTS. Elapsed interpretation time was compared between DWI-ASPECTS evaluated by the Join smartphone app and a desktop PC monitor., Results: We analyzed the images of 111 patients (66% male; median age=69 years; median National Institutes of Health Stroke Scale score on admission=4). Interdevice agreement regarding DWI-ASPECTS between the smartphone and the desktop PC monitor was favorable (vascular neurologist 1: κ=0.777, P<.001, vascular neurologist 2: κ=0.787, P<.001). Interrater agreement was also satisfactory for the smartphone (κ=0.710, P<.001) and the desktop PC monitor (κ=0.663, P<.001). Median elapsed interpretation time was similar between the smartphone and the desktop PC monitor (vascular neurologist 1: 1.7 min vs 1.6 min; P=.64); vascular neurologist 2: 2.4 min vs 2.0 min; P=.14)., Conclusions: The use of a smartphone app enables vascular neurologists to estimate DWI-ASPECTS accurately and rapidly. The Join medical smartphone app shows great promise in the management of acute stroke., (©Kenichiro Sakai, Teppei Komatsu, Yasuyuki Iguchi, Hiroyuki Takao, Toshihiro Ishibashi, Yuichi Murayama. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.06.2020.)
- Published
- 2020
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