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

Objectives: To determine whether remote analysis of radiographs via electro nic 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 em ergency room consultation. Intervention: Textual descriptions obtained from emergency medicine physici ans were compared with computer-digitized images of radiographs sent via e- mail and with the actual radiographs. Four board-certified orthopaedic surg eons reviewed all three forms of data to determine fracture diagnosis and t reatment plans. Main Outcome Assessment: Diagnosis and treatment plans were obtained via wr itten 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 an d equivalent to actual radiographs. Results: Statistical analysis revealed a significant improvement in the fre quency of correct diagnosis and treatment planning when digitized images we re used (91 percent) compared with textual descriptions alone (48 percent) (p < 0.001), The difference in correct diagnosis and treatment plans betwee n 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 descript ion.