TY  - JOUR
AU  - Komatsu, Teppei
AU  - Sakai, Kenichiro
AU  - Iguchi, Yasuyuki
AU  - Takao, Hiroyuki
AU  - Ishibashi, Toshihiro
AU  - Murayama, Yuichi
PY  - 2021
DA  - 2021/8/27
TI  - Using a Smartphone Application for the Accurate and Rapid Diagnosis of Acute Anterior Intracranial Arterial Occlusion: Usability Study
JO  - J Med Internet Res
SP  - e28192
VL  - 23
IS  - 8
KW  - stroke
KW  - infarction
KW  - teleradiology
KW  - smartphone
KW  - telehealth
KW  - reperfusion
KW  - neurology
KW  - mHealth
KW  - application
KW  - mobile health
KW  - mobile applications
KW  - diagnosis
KW  - diagnostics
AB  - Background: Telestroke has developed rapidly as an assessment tool for patients eligible for reperfusion therapy. Objective: To investigate whether vascular neurologists can diagnose intracranial large vessel occlusion (LVO) as quickly and accurately using a smartphone application compared to a hospital-based desktop PC monitor. Methods: We retrospectively enrolled 108 consecutive patients with acute ischemic stroke in the middle cerebral artery territory who underwent magnetic resonance imaging (MRI) within 24 hours of their stroke onset. Two vascular neurologists, blinded to all clinical information, independently evaluated magnetic resonance angiography and fluid-attenuated inversion recovery images for the presence or absence of LVO in the internal carotid artery and middle cerebral artery (M1, M2, or M3) on both a smartphone application (Smartphone-LVO) and a hospital-based desktop PC monitor (PC-LVO). To evaluate the accuracy of an arterial occlusion diagnosis, interdevice variability between Smartphone-LVO and PC-LVO was analyzed using κ statistics, and image interpretation time was compared between Smartphone-LVO and PC-LVO. Results: There was broad agreement between Smartphone-LVO and PC-LVO evaluations regarding the presence or absence of arterial occlusion (Reader 1: κ=0.94; P<.001 vs Reader 2: κ=0.89; P<.001), and interpretation times were similar between Smartphone-LVO and PC-LVO. Conclusions: The results indicate the evaluation of neuroimages using a smartphone application can provide an accurate and timely diagnosis of anterior intracranial arterial occlusion that can be shared immediately with members of the stroke team to support the management of patients with hyperacute ischemic stroke. 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/8/e28192
UR  - https://doi.org/10.2196/28192
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34448716
DO  - 10.2196/28192
ID  - info:doi/10.2196/28192
ER  -