Abstract
Purpose
The aims of this study were to simulate mobile consultation for the coronary computed
tomography angiography (CCTA) at the emergency department (ED) and to measure the
diagnostic performance of the mobile reading.
Materials and methods
A total of 107 patients with acute chest pain who underwent CCTA and coronary angiography
(CAG) were included. The CCTA images were reviewed by a cardiac radiologist using
a smartphone. The degree of stenosis at each coronary segment was scored with 4-point
scale (score 1, <50%; score 2, 51%-70%; score 3, 71%-90%; score 4, >90%). The degree of stenosis at each coronary segments were also scored with preliminary
CCTA report by on-call residents, final CCTA reports by in-house attending cardiac
radiologists, and CAG. Interobserver agreement was measured using κ statistics. The areas under the receiver operating characteristic curves (AUCs) for
diagnosing segments with obstructive stenosis were compared between each reader and
CAG.
Results
The smartphone reader's reading was more similar to the CAG results and in-house radiologists'
reports than reading of on-call residents. The diagnostic performance of smartphone
reading for detection of obstructive stenosis was significantly greater than that
of on-call residents (AUC, 0.89 vs 0.75; P < .001) and did not significantly differ from that of the in-house radiologists (AUC,
0.89 vs 0.90; P = .05).
Conclusion
Smartphone reading by the cardiac radiologist was superior to the on-call residents'
reading. Further study with real-time mobile consultation needs to be investigated
to evaluate whether improvement in diagnostic competency can make a difference in
the outcome of patients.
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Article Info
Publication History
Published online: June 07, 2016
Accepted:
June 2,
2016
Received in revised form:
May 20,
2016
Received:
April 24,
2016
Footnotes
☆This work was supported by the Seoul National University Bundang Hospital Research Fund (grant number 14-2015-021 ). The funding source had no involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
