Efficacy of handhelds for radiologic consultation

To continue with the radiology theme from yesterday: Toomey RJ, Ryan JT, McEntee MF, et al. Diagnostic Efficacy of Handheld Devices for Emergency Radiologic Consultation. Am. J. Roentgenol. 2010;194(2):469-474.

Abstract: Diagnostic Efficacy of Handheld Devices for Emergency Radiologic Consultation
OBJECTIVE. Orthopedic injury and intracranial hemorrhage are commonly encountered in emergency radiology, and accurate and timely diagnosis is important. The purpose of this study was to determine whether the diagnostic accuracy of handheld computing devices is comparable to that of monitors that might be used in emergency teleconsultation.
SUBJECTS AND METHODS. Two handheld devices, a Dell Axim personal digital assistant (PDA) and an Apple iPod Touch device, were studied. The diagnostic efficacy of each device was tested against that of secondary-class monitors (primary class being clinical workstation display) for each of two image types—posteroanterior wrist radiographs and slices from CT of the brain—yielding four separate observer performance studies. Participants read a bank of 30 wrist or brain images searching for a specific abnormality (distal radial fracture, fresh intracranial bleed) and rated their confidence in their decisions. A total of 168 readings by examining radiologists of the American Board of Radiology were gathered, and the results were subjected to receiver operating characteristics analysis.
RESULTS. In the PDA brain CT study, the scores of PDA readings were significantly higher than those of monitor readings for all observers (p 0.01) and for radiologists who were not neuroradiology specialists (p 0.05). No statistically significant differences between handheld device and monitor findings were found for the PDA wrist images or in the iPod Touch device studies, although some comparisons approached significance.
CONCLUSION. Handheld devices show promise in the field of emergency teleconsultation for detection of basic orthopedic injuries and intracranial hemorrhage. Further investigation is warranted.

I’m not as sharp as many of you so I had to actually look up the word roentenology, which means “Radiology, the science of radiation and, specifically, the use of both ionizing (like X-ray) and nonionizing (like ultrasound) modalities for the diagnosis and treatment of disease.”

According to the article “the scores of PDA readings were significantly higher than those of monitor readings when all observers’ readings are taken into account” and “no statistically significant differences between handheld device and monitor findings were found for the PDA wrist images or in the iPod Touch devices studies, although some comparisons did approach significance.”

An interesting follow-up to this study would be to insert an iPad into the same scenario against the iPod touch. I would be very interested to see how radiologists would react to that. The iPad would offer similar functionality to the iPod touch with the advantage of a larger screen. I can only speculate that more screen real estate would be preferred over less screen real estate for radiologists if given a choice. Just a thought.