Emerging technology: Remote analysis of traumatic musculoskeletal radiographs transmitted by electronic mail

Objectives: To determine whether remote analysis of radiographs via electronic mail (e-mail) had an impact on treatment decisionmaking. Design: Prospective. Setting: Level I trauma center. Patients/Participants: Twenty-five cases randomly selected from previous emergency room consultation. Intervention: Textual descriptions obtained from emergency medicine physicians were compared with computer-digitized images of radiographs sent via e-mail and with the actual radiographs. Four board-certified orthopaedic surgeons reviewed all three forms of data to determine fracture diagnosis and treatment plans. Main Outcome Assessment: Diagnosis and treatment plans were obtained via written questionnaire after review of each group of data (textual, digitized image, and actual radiograph). Results were then compared across groups to determine whether digitized images were better than textual descriptions and equivalent to actual radiographs. Results: Statistical analysis revealed a significant improvement in the frequency of correct diagnosis and treatment planning when digitized images were used (91 percent) compared with textual descriptions alone (48 percent) (p < 0.001), The difference in correct diagnosis and treatment plans between digitized images and actual radiographs was not statistically significant (p = 0.27). Conclusion: Digitized radiographs sent via e-mail can significantly improve accuracy of diagnosis and treatment compared with a simple verbal description.