Reliability of Assessing Distal Radius Fractures on a Smartphone Versus PACS.

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Health Informatics

Background:

• Healthcare communication increasingly relies on technology, with telehealth expanding significantly during the pandemic.
• Remote viewing of medical imaging, such as distal radius fracture radiographs on smartphones, presents potential for efficient communication.
• The reliability of smartphone-based injury assessment compared to traditional methods remains largely unestablished.

Purpose of the Study:

• To evaluate the intraobserver and interobserver reliability of reviewing distal radius fracture radiographs using smartphones versus traditional Picture Archiving and Communication System (PACS).
• To compare the diagnostic accuracy and consistency of orthopedic surgeons assessing distal radius fractures on different imaging platforms.

Main Methods:

• Eight orthopedic specialists (attending surgeons, fellows, residents) reviewed 26 distal radius fracture radiographs.
• Evaluations were conducted on two platforms: smartphones and traditional PACS.
• Reviewers recorded treatment preference (operative vs. nonoperative), fracture classification, and specific treatment strategy, with reliability assessed using Fleiss' kappa coefficient.

Main Results:

• High intraobserver agreement was observed for operative decisions (97%), substantial agreement for classification (76%), and treatment (84%).
• Kappa scores indicated excellent agreement for operative decisions and substantial agreement for classification and treatment.
• Interobserver agreement was substantial across all categories for both smartphone and PACS evaluations.

Conclusions:

• Smartphone evaluation of distal radius fracture radiographs demonstrates reliability comparable to traditional PACS.
• This suggests that smartphones can be a viable tool for assessing distal radius fractures, potentially enhancing communication efficiency in orthopedic care.