The use of telemedicine in veterinary clinical practice continues to generate debate, with the profession considering both the potential risks and advantages associated with technological advances. One potential advantage of the use of telemedicine in vet-to-vet situations is the interpretation of diagnostic images such as radiographs, enabling faster diagnosis and potentially improving patient outcome.
Reliability of smartphone-based radiographic interpretation for evaluating cardiogenic pulmonary oedema in dogs, assessed diagnostic accuracy of cardiogenic pulmonary oedema in dogs when using JPEG images on a smartphone compared with a DICOM-viewing platform.1
“The diagnostic accuracy for cardiogenic pulmonary oedema in dogs was not significantly impaired when specialists used smartphones compared to a DICOM-viewing platform to interpret thoracic radiographs,” said lead author, Flavio Jojima. “This may provide supporting evidence for the use of smartphones for off-site expert interpretation of diagnostic radiographs, particularly in an out-of-hours clinical scenario, but not for routine interpretation of radiographs with a smartphone interface.”
The study, undertaken by Jojima, Sousa and Froes from Universidade Federal do Paraná, Brazil, took thoracic radiographs from the medical records of 121 patients with cardiogenic pulmonary oedema or other differential diagnoses from three veterinary teaching hospitals. All images were then interpreted by two observers: a board-certified radiologist and an experienced cardiologist, both of whom were blinded to the patients’ diagnosis. The images were reviewed both as JPEG images on a smartphone, and using a DICOM-viewing platform with an interval of four months between each viewing to reduce interpretation bias. The reviewers were asked to state only whether cardiogenic pulmonary oedema was present or absent. Diagnostic accuracy was assessed between interfaces and reviewers.
The results of this study are consistent with previous research; a similar study found that small intestinal mechanical obstructions could be diagnosed from JPEG images of abdominal radiographs on a smartphone by radiologists.2
Nicholas Jeffery, editor of JSAP concluded: “These findings are reassuring. In off-site circumstances, particularly where immediate assessment and interpretation is needed, the use of smartphones could speed up the decision making process and enhance patient outcomes.”
The full article can be found in the November issue of the Journal of Small Animal Practice which is free for BSAVA members. It can also be read online here
For more advice on interpreting thoracic patterns on radiographs, BSAVA advises vets to consult a reference book such as the BSAVA Manual of Canine and Feline Radiography and Radiology
Telemedicine is on the agenda for BSAVA Summit, a new 2-day event that will tackle some of the contentious clinical and non-clinical issues facing the veterinary professional today. Delegates will lead and shape discussions through a series of interactive workshops facilitated by experts, paired with a series of insightful keynote seminars delivered by key opinion leaders. For further information visit www.bsavaevents.com
1Reliability of smartphone-based radiographic interpretation for evaluating cardiogenic pulmonary oedema in dogs F. S. Jojima, M. G. Sousa, T. R. Froes.
2Off-site smartphone vs. standard workstation in the radiographic diagnosis of small intestinal mechanical obstruction in dogs and cats. Veterinary Radiology and Ultrasound, 57 (5). P. G., Noel, A. J., Fischetti, G. Moore, A. B. Le Roux.