Clinical trial NCT02108717: The Feasibility Study for Real-time Remote CT Reading for Suspected Acute Appendicitis Using iPhone
Official title: The Feasibility Study for Remote CT Reading for Suspected Acute Appendicitis Using iPhone With Remote Control System in Realtime Under the Ambient Bright.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Telemedicine
Keywords: Telemedicine
appendicitis
remote consultation
Lead sponsor: Hanyang University
Sponsor class: OTHER
First posted: 2014-04-09
Enrollment: 16
Sex: MALE
Minimum age (years): 33
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: BASIC_SCIENCE

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).

Eligibility criteria: 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

Primary outcomes:
measure: Diagnostic performance between iPhone and LCD monitor
timeFrame: within one day
measure: Diagnostic accuracy between the iPhone and the LCD monitor
timeFrame: within one day
Secondary outcomes:
Other outcomes:
Locations:
city: Guri
country: Korea, Republic of
facility: Hanyang university guri hospital, Department of emergency medicine
state: GyeongGido
Study officials:
affiliation: Hanyang University
name: Bo Seung Kang, MD
role: STUDY_DIRECTOR
References:
citation: Choi HJ, Lee JH, Kang BS. Remote CT reading using an ultramobile PC and web-based remote viewing over a wireless network. J Telemed Telecare. 2012 Jan;18(1):26-31. doi: 10.1258/jtt.2011.110412. Epub 2011 Nov 8.
citation: Choudhri AF, Carr TM 3rd, Ho CP, Stone JR, Gay SB, Lambert DL. Handheld device review of abdominal CT for the evaluation of acute appendicitis. J Digit Imaging. 2012 Aug;25(4):492-6. doi: 10.1007/s10278-011-9431-9.
citation: Park JB, Choi HJ, Lee JH, Kang BS. An assessment of the iPad 2 as a CT teleradiology tool using brain CT with subtle intracranial hemorrhage under conventional illumination. J Digit Imaging. 2013 Aug;26(4):683-90. doi: 10.1007/s10278-013-9580-0.
citation: Kim C, Kang B, Choi HJ, Park JB. A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone. J Digit Imaging. 2015 Aug;28(4):399-406. doi: 10.1007/s10278-015-9775-7.