Email and instant messaging applications as platforms for remote oral radiology consultation in maxillofacial fractures

Abstract Objectives The present study aimed to test the reliability and diagnostic efficacy of the evaluation of radiographs transmitted by email and through instant messaging in the diagnosis of maxillofacial fractures. Study Design Radiographs of 150 patients were screened as the gold standard diagnosis by a senior maxillofacial radiologist for the assessment of fractures using a workstation monitor. The radiographs were sent to the Gmail accounts of 2 observers, who independently evaluated the radiographs for fractures on their laptop computers. The same radiographs were sent to the smartphones of the observers via the WhatsApp® Messenger and evaluated on the smartphone screens. Intra- and interobserver reliability, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Results Reliability of the obsesrvers’ diagnoses for both modalities ranged from 0.96 to 1.00 compared to the gold standard. Intra- and interobserver reliability ranged from 0.85 to 0.98. Measures of diagnostic efficacy ranged from 93.5% to 100% for images sent by Gmail and from 95.2% to 99.9% for radiographs transmitted through the WhatsApp messenger. Conclusion The present study demonstrated that email and instant messaging applications can be reliable tools for the assessment of maxillofacial fractures by radiologists at remote sites.