title: Personal smartphones for neonatal diagnostic imaging: A prospective crossover study.
abstract: OBJECTIVE
  Neonatal clinicians may be asked to review X-ray images when unable to directly access the original image. Transmitting an X-ray image to a smartphone is a technique increasingly being used by clinicians in a number of settings. Minimal data exist on its use in the neonatal setting. Our aim was to compare the ability of neonatal clinicians to correctly diagnose a pneumothorax from a chest radiograph (CXR) viewed on a smartphone, paralleled with the same image viewed on a computer screen.
  
  
  METHODS
  We investigated the accuracy, sensitivity, specificity, positive predictive value and negative predicative value of two methods of viewing CXR images to diagnose pneumothorax, compared with a gold standard radiologist report. Clinicians were presented with 40 CXR images on two occasions, at least 1 week apart. Images were viewed once on a smartphone and once on a computer screen. Both the viewing method and viewing order of the images were randomised. The clinical details of the infant at the time the CXR was taken were provided, and participants were asked if a pneumothorax was present.
  
  
  RESULTS
  Twenty-one clinicians viewed all CXR images using both viewing methods (840 paired observations). There was no difference in accuracy of detecting pneumothorax between viewing methods, 81% correctly identified a pneumothorax using the smartphone, versus 80% using the computer screen (P = 0.40 (95% CI), difference -4 to 1.5%).
  
  
  CONCLUSIONS
  Diagnosis of neonatal pneumothorax was as accurate using a smartphone as viewing CXR images displayed on a computer screen when clinicians were presented with X-rays with diagnosis of pneumothorax.
authors.affiliation: Medicine Programme, Linkopings University, Linkoping, Sweden.
authors.forename: Margreta
authors.initials: M
authors.lastname: Westberg
authors.affiliation: Medicine Programme, Linkopings University, Linkoping, Sweden.
authors.forename: Theresia
authors.initials: T
authors.lastname: Vasko
authors.affiliation: Department of Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Louise S
authors.initials: LS
authors.lastname: Owen
authors.affiliation: Paediatric Infant Perinatal Emergency Retrieval, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Risha
authors.initials: R
authors.lastname: Bhatia
authors.affiliation: Department of Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Marta Thio
authors.initials: MT
authors.lastname: Lluch
authors.affiliation: Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Donath
authors.affiliation: Department of Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
authors.affiliation: Department of Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dawson
mesh_terms: D018592:Cross-Over Studies; D003626:Data Display / Q000592:standards*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D000068997:Smartphone
keywords: diagnostic accuracy; infant; newborn; pneumothorax; smartphone; teleradiology