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Mobile device for thrombolysis decisions for telestroke
Salazar, Antonio J; Useche, Nicolás; Granja, Manuel F; Morillo, Aníbal J; Bermúdez, Sonia; Sossa, Didier; Ortiz, Claudia J; Torres, Oscar J & Ropero, Brenda
Abstract
Aim: This study compares the reliability of brain CT interpretations
performed using a diagnostic workstation and a mobile tablet
computer in a telestroke context.
Methods: A factorial design with 1,452 interpretations was used.
Reliability was evaluated using the Fleiss’ kappa coefficient on the
agreements of the interpretation results on the lesion classification,
presence of imaging contraindications to the intravenous recombinant
tissue-type plasminogen activator (t-PA) administration, and on the
Alberta Stroke Program Early CT Score (ASPECTS).
Results: The intra-observer agreements were as follows: good
agreement on the overall lesion classification (κ= 0.63, p <0.001),
very good agreement on hemorrhagic lesions (κ= 0.89, p <0.001), and
moderate agreements on both without acute lesion classification and
acute ischemic lesion classification (κ= 0.59 and κ= 0.58 respectively,
p <0.001). There was good intra-observer agreement on the
dichotomized-ASPECTS (κ= 0.65, p <0.001).
Conclusions: The results of our study allow us to conclude that the
reliability of the mobile solution for interpreting brain CT images of
patients with acute stroke was assured, which would allow efficient
and low-cost telestroke services.
Keywords
Infarction; Middle Cerebral Artery; teleradiology neurologists; stroke; cerebrovascular disorders intracranial hemorrhages tomography; X-Ray computed; aneurysm; computers; handheld; arteriovenous malformations
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