Kapıcıoğlu Mehmet, Erden Tunay, Ağır Muzaffer, Küçükdurmaz Fatih
Department of Orthopedics and Traumatology, Bezmialem Vakif University, 34093 Fatih, Istanbul, Turkey.
Eklem Hastalik Cerrahisi. 2019 Aug;30(2):149-54. doi: 10.5606/ehc.2019.66166.
This study aims to evaluate the reliability of the assessment of radiological X-ray images of traumatic injuries in the elbows of children using WhatsApp application, compared to true-size images on a Picture Archiving and Communication System (PACS) screen.
Between November 2017 and March 2018, X-ray images of a total of 90 pediatric patients (53 males, 37 females; mean age 6.2 years; range, 2 to 10 years) with an elbow injury were retrospectively evaluated. The images were captured and sent to three orthopedic surgeons via the WhatsApp instant messaging application on an iPhone 7S smartphone. Observers were asked to diagnose and classify for each case over their personal smartphones. The three observers independently assessed the images with a seven-day interval. Following one-week interval, revaluation was conducted using the PACS. Intra- and interobserver reliability were calculated by Cohen Kappa statistics.
There was a good agreement between the first and second evaluations by the physicians via WhatsApp (k=0.74). The intraobserver reliability was very good (k=0.8), moderate (k=0.55), and good (k=0.67). There was no significant difference in the intra- and interobserver reliability between the groups.
Using WhatsApp for consulting is a reliable method which can be used in the emergency setting for decision-making. Using WhatsApp can improve the efficacy of medical assessment and reduce waiting time in emergency admissions, although this method is not a substitution for evaluation of the images using computer-based PACS.
本研究旨在评估与图片存档和通信系统（PACS）屏幕上的真实尺寸图像相比，使用WhatsApp应用程序评估儿童肘部创伤性损伤的放射学X线图像的可靠性。
回顾性评估2017年11月至2018年3月期间共90例肘部受伤的儿科患者（53例男性，37例女性；平均年龄6.2岁；范围2至10岁）的X线图像。图像通过iPhone 7S智能手机上的WhatsApp即时通讯应用程序拍摄并发送给三名骨科医生。要求观察者在其个人智能手机上对每个病例进行诊断和分类。三名观察者每隔七天独立评估一次图像。间隔一周后，使用PACS进行重新评估。通过Cohen Kappa统计计算观察者内和观察者间的可靠性。
医生通过WhatsApp进行的第一次和第二次评估之间有良好的一致性（k = 0.74）。观察者内可靠性非常好（k = 0.8）、中等（k = 0.55）和良好（k = 0.67）。两组之间观察者内和观察者间的可靠性没有显著差异。
使用WhatsApp进行会诊是一种可靠的方法，可用于紧急情况下的决策。使用WhatsApp可以提高医疗评估的效率并减少急诊入院的等待时间，尽管这种方法不能替代使用基于计算机的PACS对图像进行评估。
