The Feasibility Study for Real-time Remote CT Reading for Suspected Acute Appendicitis Using iPhone

Not Applicable

Completed

• Conditions: Telemedicine
• Interventions: Device: Remote CT reading using the iPhone; Device: CT reading using LCD monitor

• Registration Number: NCT02108717
• Lead Sponsor: Hanyang University

Brief Summary

1. Purpose

- The investigators aim to evaluate the feasibility of iPhone based remote control system as a real-time remote CT reading tool for suspected appendicitis under 3G network and the suboptimal illumination.

2. Methods

* A total of 120 abdominal CT examinations; sixty had no findings of appendicitis, while the other sixty showed signs of acute appendicitis, were selected. The 16 raters reviewed these images using an LCD monitor of the PACS workstation and also an iPhone which was connected to the PACS workstation via remote control system, grading the probability of presence of acute appendicitis on each examination by a five Likert scale.

* The investigators will compare the diagnostic performance between two devices.

Detailed Description

The 16 raters were randomly divided into two groups

* The raters in group one reviewed the CT examinations numbered from one to 60 using LCD monitor and reviewed the remaining CT examinations numbered from 61 to 120 using iPhone with TeamViewer at their first visit

* The other group firstly reviewed the CT scans numbered from one to 60 using iPhone with TeamViewer and 61 to 120 with the LCD monitor.

* They visited twice with an interval of four weeks and reviewed the CT scans using revered devices at each session.

* The raters were instructed to rate the likelihood of the presence or absence of appendicitis in each case using a five-Likert scale (1 = obvious no appendicitis, 2 = unlikely appendicitis, 3 = unsure, 4 = likely appendicitis, 5 = obvious appendicitis).

Study Timeline

• Study Start: 2014-04
• Study First Submitted: 2014-04-07
• Study First Submitted QC: 2014-04-08
• Study First Posted: 2014-04-09
• Status Verified: 2014-05
• Primary Completion: 2014-05
• Study Completion: 2014-05
• Last Update Submitted: 2014-05-06
• Last Update Posted: 2014-05-08

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 16

Inclusion Criteria

• Board certified emergency physicians with a clinical experience of 5 years and over.

Exclusion Criteria

• Corrected eyesight < 20/30
• Color weakness or blindness

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Group II	CT reading using LCD monitor	The raters in this group II firstly reviewed the CT scans numbered from one to 60 using iPhone with TeamViewer and 61 to 120 with the LCD monitor. They visited twice with an interval of four weeks and reviewed the CT scans using revered devices at each session.
Group I	Remote CT reading using the iPhone	The raters in this group one firstly reviewed the CT scans numbered from one to 60 using LCD monitor and after mandatory rests of 20 minutes, reviewed the remaining CT examinations numbered from 61 to 120 using iPhone with TeamViewer at their first visit. They visited twice with an interval of four weeks and reviewed the CT scans using revered devices at each session.
Group I	CT reading using LCD monitor	The raters in this group one firstly reviewed the CT scans numbered from one to 60 using LCD monitor and after mandatory rests of 20 minutes, reviewed the remaining CT examinations numbered from 61 to 120 using iPhone with TeamViewer at their first visit. They visited twice with an interval of four weeks and reviewed the CT scans using revered devices at each session.
Group II	Remote CT reading using the iPhone	The raters in this group II firstly reviewed the CT scans numbered from one to 60 using iPhone with TeamViewer and 61 to 120 with the LCD monitor. They visited twice with an interval of four weeks and reviewed the CT scans using revered devices at each session.

Primary Outcome Measures

Name	Time	Method
Diagnostic performance between iPhone and LCD monitor	within one day	* Dorfman-Berbaum-Metz method with RSCORE and semi-parametric estimation of ROC indices by using the DMB-MRMC software (version 2.3, available at http://perception.radiology.uiowa.edu); * 95% confidence interval; * The reviewers and cases are taken as random factors
Diagnostic accuracy between the iPhone and the LCD monitor	within one day	◆ Sensitivity, specificity; * gold standard: The pathology report and the results of clinical follow up; * grade 1, 2 and 3 = negative appendicitis findings; * grade 4 and 5 = positive appendicitis findings; * McNemar's test to compare the sensitivity and specificity between the iPhad and the LCD monitor

Trial Locations

Locations (1)

Hanyang university guri hospital, Department of emergency medicine; 🇰🇷 Guri, GyeongGido, Korea, Republic of