Background and Objectives: Chest radiography is an important diagnostic tool in neonatology. Smartphones and messaging applications are commonly used to transfer information among medical staff, especially during on-call shifts when residents need the supportive consultation of an attending physician. However, they have not yet been approved for the interpretation of chest radiographs. In this study we wish to assess the extent of smartphone use for professional purposes among pediatricians and to determine if neonatal chest x-ray films (CXRs) sent for online consultation via a messaging application can be reliably interpreted.
Methods: Questionnaires on the use of smartphones for professional purposes were sent to all pediatric residents and neonatologists of three tertiary medical centers. Twenty-one neonatologists were asked to view 20 CXRs, twice on a computer screen using PACS and once on a smartphone using WhatsApp Messenger®, with a wash-out period between sessions. Differences in interpretations of the films were assessed between the methods.
Results: Sixty-eight pediatric residents and 20 neonatologists completed the questionnaire. All reported using smartphones and WhatsApp. The majority of residents (82%) and neonatologists (80%) used WhatsApp to send CXRs for purposes of consultation. The chest x-rays were interpreted equally well when viewed on a computer screen or via WhatsApp, except for the position of the umbilical lines. Neonatologists could determine line placement in only 80% of cases when using WhatsApp.
Conclusions: The WhatsApp application is a reliable means for preliminary online interpretation of neonatal CXRs, although particular caution is needed in assessing umbilical line position.
