Smartphones for evaluation of computerized tomography scan of patients with suspected skull fractures and intracranial hemorrhage in emergency medicine

Abstract

Background/Aim: It is generally not probable to employ a radiologist or an experienced physician for interpreting radiological images at emergency services. The importance of telemedicine has grown, especially during the coronavirus 2019 pandemic. There are a few studies on cranial tomography image transfer and correct evaluation rate with smartphones in the literature. This study aims to evaluate the effectiveness of smartphones for diagnosing mortal pathologies such as skull fractures and intracranial hemorrhages compared to the original images on LED displays of radiology terminals. Methods: This methodological study was designed to validate smartphones' usefulness in assessing cranial computerized tomography scans in emergency cases. Four sets of CT scans, each containing 10 case samples in four diagnostic groups, subarachnoid hemorrhage, subdural hemorrhage, epidural hemorrhage, and bone fractures, and a set of 10 non-pathological CT scans were evaluated first on 6.1-inches smartphone display for 1 minute, and then on the 17-inches LED display again for 1 minute. The internal camera of the smartphone was used to capture the image before assessments. Results: A total of 12 neurosurgeons evaluated 50 CT scan images both on smartphones and LED displays. The overall accuracy between both methods ranged between 80%-100% for subarachnoid and epidural hemorrhage and bone fractures, and between 90%-100% for subarachnoid hemorrhage and non-pathological CT scans. The individual kappa coefficients of neurosurgeons ranged between 0.725 to 1.0 (P<0.001). Conclusion: The overall accuracy of smartphone CT readings with computer LED displays was satisfactory. Our results showed that smartphones are useful for rapid communication between neurosurgeons and emergency department doctors, contributing to timely and accurate patient management in emergency situations.