Interobserver Variability of Radiographic Assessment Using a Mobile Messaging Application as a Teleconsultation Tool

Area of Science:

• Orthopedic surgery
• Medical imaging technology
• Digital health

Background:

• Assessing distal radius fractures requires reliable interpretation of radiographs.
• Current standard is Digital Imaging and Communications in Medicine (DICOM) viewers.
• Mobile messenger applications offer a potential alternative for remote viewing.

Purpose of the Study:

• To compare interobserver reliability, decision-making, and confidence in treating distal radius fractures.
• To evaluate radiographs viewed on mobile messenger apps versus standard DICOM viewers.

Main Methods:

• Surgeons reviewed distal radius fracture radiographs on either a smartphone messenger app or a laptop DICOM viewer.
• Twenty observers classified fractures (AO classification), recommended treatment (operative vs. conservative), and rated decision confidence.
• Observers were equally divided between the mobile messenger and DICOM viewer groups.

Main Results:

• No significant difference in interobserver reliability for fracture classification or surgical recommendation.
• Significantly higher recommendation for surgery in the messenger app group (89%) vs. DICOM viewer group (78%).
• Significantly higher confidence in treatment decisions in the mobile messenger group (8.9) vs. DICOM viewer group (7.9).

Conclusions:

• Mobile messenger applications may aid remote decision-making for distal radius fractures.
• Use of messenger apps for fracture assessment requires careful consideration due to potential biases.
• Further research is needed to validate these findings in clinical practice.