title: Diagnostic efficacy of handheld devices for emergency radiologic consultation.
abstract: OBJECTIVE
  Orthopedic injury and intracranial hemorrhage are commonly encountered in emergency radiology, and accurate and timely diagnosis is important. The purpose of this study was to determine whether the diagnostic accuracy of handheld computing devices is comparable to that of monitors that might be used in emergency teleconsultation.
  
  
  METHODS
  Two handheld devices, a Dell Axim personal digital assistant (PDA) and an Apple iPod Touch device, were studied. The diagnostic efficacy of each device was tested against that of secondary-class monitors (primary class being clinical workstation display) for each of two image types-posteroanterior wrist radiographs and slices from CT of the brain-yielding four separate observer performance studies. Participants read a bank of 30 wrist or brain images searching for a specific abnormality (distal radial fracture, fresh intracranial bleed) and rated their confidence in their decisions. A total of 168 readings by examining radiologists of the American Board of Radiology were gathered, and the results were subjected to receiver operating characteristics analysis.
  
  
  RESULTS
  In the PDA brain CT study, the scores of PDA readings were significantly higher than those of monitor readings for all observers (p < or = 0.01) and for radiologists who were not neuroradiology specialists (p < or = 0.05). No statistically significant differences between handheld device and monitor findings were found for the PDA wrist images or in the iPod Touch device studies, although some comparisons approached significance.
  
  
  CONCLUSIONS
  Handheld devices show promise in the field of emergency teleconsultation for detection of basic orthopedic injuries and intracranial hemorrhage. Further investigation is warranted.
authors.affiliation: University College Dublin School of Medicine and Medical Science, Health Science Centre, Belfield, Dublin, Ireland. racheltoomey@gmail.com
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Toomey
authors.forename: John T
authors.initials: JT
authors.lastname: Ryan
authors.forename: Mark F
authors.initials: MF
authors.lastname: McEntee
authors.forename: Michael G
authors.initials: MG
authors.lastname: Evanoff
authors.forename: Dev P
authors.initials: DP
authors.lastname: Chakraborty
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: McNulty
authors.forename: David J
authors.initials: DJ
authors.lastname: Manning
authors.forename: Edel M
authors.initials: EM
authors.lastname: Thomas
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Brennan
mesh_terms: D001930:Brain Injuries / Q000000981:diagnostic imaging*; D034201:Computers, Handheld; D003626:Data Display; D004630:Emergencies; D006801:Humans; D012372:ROC Curve; D011871:Radiology / Q000295:instrumentation*; D012984:Software; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface; D014954:Wrist Injuries / Q000000981:diagnostic imaging*