The Reliability of Mobile Multimedia Messaging (MMS) for Decision Making in Distal Radius Fractures: An Effective Alternative

Abstract

Background: Assessment of radiology is an integral part of fracture management in orthopaedic surgery. Mobile multimedia messaging (MMS) can be utilised in the referral process of patients with fractures. However, the reliability of using MMS in making management decisions in distal radius fractures has not been assessed. Methods: Radiographs of 20 consecutive cases of distal radius fractures managed with closed reduction and plaster, and 20 cases managed with open reduction and internal fixation (ORIF) were analysed retrospectively by two blinded orthopaedic surgeons on a computer and anApple iPhone 3GS. The interand intra-rater agreements were assessed. Results:Inter-rater agreement between the MMS group and the picture archiving and communication system (PACS) group were consistent among the surgeons (K -0.55, 0.80, p<0.001). However, the management decisions were different in seven cases (8.75%) in the study group. Conclusion: MMS x-ray pictures can be useful in formulating management plans for patients with distal radius fractures. With advancing technology smartphones will likely play a larger role in the communication process in delivering orthopaedic care.

Comparison of diagnostic accuracy of plain film radiographs between original film and smartphone capture: a pilot study

“…While there have been some studies focused on diagnostic imaging, many of these studies have come from specialties other than radiology [7][8][9][10]. For example, orthopedics [7,9] and ophthalmology [8] have demonstrated an interest in smartphone photography for clinical management. Padmasekara et al 2012 [7] exhibited strong inter-rater agreement amongst orthopedic surgeons when comparing smartphone iPhone 3GS images of distal radial head fractures interpreted on the iPhone itself via multimedia messaging (MMS) when compared to digitized PACS images.…”

“…Prior to increasingly widespread use of smartphone cameras, studies in the early 2000s concentrated on technical aspects of using digital cameras for sharing of diagnostic images in early telemedicine models [3][4][5][6]. While there have been some studies focused on diagnostic imaging, many of these studies have come from specialties other than radiology [7][8][9][10]. For example, orthopedics [7,9] and ophthalmology [8] have demonstrated an interest in smartphone photography for clinical management.…”

“…For example, orthopedics [7,9] and ophthalmology [8] have demonstrated an interest in smartphone photography for clinical management. Padmasekara et al 2012 [7] exhibited strong inter-rater agreement amongst orthopedic surgeons when comparing smartphone iPhone 3GS images of distal radial head fractures interpreted on the iPhone itself via multimedia messaging (MMS) when compared to digitized PACS images. Additionally, Bullard et al 2013 [9] from the emergency department demonstrated that mobile phone images of CT scans appeared to provide adequate imaging for triaging neurosurgical patients to a level 1 trauma center with strong inter-reader agreement that increased upon adding imaging to available clinical data.…”

The Eye Phone Study: reliability and accuracy of assessing Snellen visual acuity using smartphone technology

“…5 Communication between medical staff and hospitals has also been facilitated greatly with the use of 'push email' and notifications; in addition to certain hospitals integrating paging systems with smartphone notifications. 6 With the advent of custom designed applications, smartphone use has rapidly expanded and a number of specialties are producing innovative applications relevant to their own specialty, such as orthopedic decision support applications, 7 offsite radiology access, 8,9 anesthetic techniques, 10 or infectious disease physicians tracking epidemics, 11 to name a few. Smartphones have enabled volumes of medical literature and reference material to be accessible to students and clinicians in the palm of their hand.…”

An experience of the virtual desktop: a surgical perspective

“…(An example of this imaging can be seen in With the advent of Multimedia Messaging Services (MMS) on mobile phones, where images can be shared using mobile-to-mobile phone technology, the Citrix Receiver™ for iPad proves its superiority with a larger screen and higher resolution 5 . Nevertheless, a recent study by Padmasekara et al examining the reliability of MMS compared to the standard computer monitor for the decision making of distal radial fractures have revealed no significant difference between the two modalities 6 . Studies similar to this are a testament to the utility of mobile devices such as the iPad in tele-radiology.…”