Smartphone stroke assessment shows promise

| October 11, 2012

A smartphone application that assists vascular neurologists (VNs) with the assessment of possible stroke patients shows excellent agreement with the interpretations of other radiologists and independent, blinded adjudicators, say researchers.

"Smartphone teleradiology assessments may offer a VN a single mobile health tool with which to expeditiously conduct full telestroke and teleradiology assessments necessary for a complete virtual stroke consultation in a remote environment," they write, in Stroke.

Bart Demaerschalk (Mayo Clinic, Phoenix, Arizona, USA) and colleagues undertook telemedicine consultations for 53 patients with ischemic stroke eligible for thrombolysis (34%), ischemic stroke ineligible for thrombolysis (43%), intracranial hemorrhage (6%), transient ischemic attack (4%), not cerebrovascular disease (9%), and undetermined conditions (4%) at a hospital 185 miles away from their institution.

Telemedicine consultations were performed using the ResolutionMD (ResMD) application that provides instant access to images and reports on mobile devices, and displays the standard noncontrast computed tomography (CT) images taken of each patient at emergency assessment.

"Essentially what this means is that telemedicine can fit in our pockets," said Demaerschalk in an associated press release. "For patients this means access to expertise in a timely fashion when they need it most, no matter what emergency room they may find themselves [in]," he added.

Overall, the CT scans were evaluated by one of five VNs at the researchers' institution using ResMD, one of 10 other stroke radiologists using a picture archiving and communication system (group 1), and by two adjudicators viewing scans on a compact disc (group 2).

Agreement between physicians using ResMD and those in groups 1 and 2 was total for presence of intracranial hemorrhage, with a kappa statistic of 1.00. Corresponding agreement with the ResMD for presence of radiologic contraindication to thrombolysis treatment, early ischemic chances, and hyperdense artery sign was also high, at 1.00 and 0.85, 0.62 and 0.58, and 0.40 and 0.44, report the authors.

"Smartphones are ubiquitous, they are everywhere," said Demaershalk, adding "if we can transmit health information securely and simultaneously use the video conferencing capabilities for clinical assessments, we can have telemedicine anywhere, which is essential in a state like Arizona where more than 40 percent of the population doesn't have access to immediate neurologic care" he concluded.

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