Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 24, 2021
Open Peer Review Period: Feb 24, 2021 - Apr 21, 2021
Date Accepted: Jun 14, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Smartphone Application can Yield Accurate and Rapid Diagnosis of Acute Anterior Intracranial Arterial Occlusion
ABSTRACT
Background:
Telestroke have rapidly developed as a way to reach out to patients who are eligible for the administration of reperfusion therapy.
Objective:
The aim is to investigate if vascular neurologists can make a quick and precise diagnosis of an intracranial large vessel occlusion (LVO) using a smartphone as well as a hospital desktop personal computer (PC) monitor.
Methods:
MRIs of acute ischemic stroke consecutive 108 patients with a territory of middle cerebral artery within 24 hours of onset were retrospectively enrolled. A LVO was estimated at the internal carotid artery and the middle cerebral artery (M1, M2 and M3). After blinding all clinical information, two vascular neurologists evaluated the presence or absence of LVO on MRA and FLAIR by using a smartphone (Smartphone-LVO decision) and a hospital desktop PC monitor (PC-LVO decision), independently. In order to analyze inter-device variability comparisons (Smartphone-LVO decision and PC-LVO decision) κ statistics were conducted. Image interpretation times between a Smartphone-LVO decision and a PC-LVO decision were compared.
Results:
Regarding the presence or absence of arterial occlusion, Smartphone-LVO decision broadly agreed with PC-LVO decision (vascular neurologist 1, κ=0.94, p<0.001; vascular neurologist 2, κ=0.89, p<0.001). Interpretation time of the Smartphone-LVO decision was similar to that of the PC-LVO decision.
Conclusions:
The smartphone application can yield an accurate diagnosis of anterior intracranial arterial occlusion patients in and outside the hospital. It should play an important role in organizing the stroke team for hyper-acute ischemic stroke.
Citation
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