Background: Diagnostic accuracy of various mobile devices for remote acute ischemic stroke CT scan interpretation is not known.
Objective: Compare diagnostic accuracy of different mobile devices in acute CT interpretation for various ischemic stroke findings among various readers.
Subjects/methods: After IRB approval, 20 selected AIS CTs were independently interpreted by 11 readers (7 neurologists/3 neuroradiologists/1 radiologist) on 2 mobile devices: iPad®2 (1024 × 768 pixels) and iPhone®4 (960 × 640 pixels), and on a Picture Archiving and Communication System (PACS) workstation (1280 × 1024 pixels). Mobile devices used FDA-cleared ResolutionMD software (ResMD® Calgary Scientific, Calgary, Canada). Primary outcome measures: any acute ischemic sign (AIS), any non-acute ischemic sign (NAIS), and hyperdense middle cerebral artery (HMCA) sign. Intra-rater and inter-device accuracy, using a rater specific gold standard, was evaluated; estimated % sensitivity (Sen) and % specificity (Spe) with 95% Agrest–Coull confidence intervals (CIs) were calculated.
Results: Across all 11 readers, for AIS: Sen = 76 (68, 82) and Spe = 75 (64, 83) on iPhone; Sen = 76 (69, 83) and Spe = 71 (60, 80) on iPad. For NAIS: Sen = 80 (72,86) and Spe = 77 (67, 84) on iPhone; Sen = 75 (67, 82) and Spe = 80 (71, 87) on iPad. For HMCA: Sen = 53 (39, 67) and Spe = 97 (93, 99) on iPhone; Sen = 62 (48, 75) and Spe = 95 (91, 98) on iPad.
Conclusions: We believe this is the first study directly comparing the diagnostic accuracy of two different mobile devices for AIS on head CT. Both iPhone and iPad have fair sensitivity for detection of AIS and NAIS, but poorer sensitivity for HMCA when read by readers from different specialties. Specificity was good–excellent for all 3 CT findings. iPhone and iPad have similarly good diagnostic accuracy for AIS supporting their use for remote neuroimaging interpretation. Validation in clinical practice needs to be confirmed.
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© 2015 Published by Elsevier Inc.
