Before these heart procedures, surgeons must know whether an artery
is healthy enough to snake a catheter through it to the heart to
remove any blockages and restore blood flow. Traditionally, they use
the so-called Allen test, which involves blocking circulation to the
hand until it turns white, then easing pressure on one of two main
arteries to see if the hand turns pink again, indicating a healthy
artery.
For the study, researchers compared doctors’ assessment of hand
color in the Allen test to an experimental circulation measurement
app that uses a smartphone camera to monitor changes in color in the
fingertips.
With the app, doctors correctly diagnosed artery health 92 percent
of the time, compared with 82 percent with the Allen test,
researchers report in the Canadian Medical Association Journal.
"Using a smartphone to monitor changes in color in the fingertips is
much more accurate in detecting subtle changes as opposed to the
doctors' general opinion of the color of the hand," said senior
study author Dr. Benjamin Hibbert, a researcher at the University of
Ottawa Heart Institute in Canada.
While the results suggest that smartphones may one day have
potential as medical tools, the app is experimental and not
available for widespread use by doctors or patients. Many smartphone
apps have not been rigorously tested in clinical trials necessary to
win regulatory approval under standards established for medical
devices.
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Still, the app in the study has the potential to enable doctors to
test blood flow at the bedside without buying new equipment and get
accurate results that can help surgeons choose which patients may be
good candidates for procedures to unblock arteries and restore blood
flow to the heart, Hibbert said by email.
One drawback of the study is that it used an older smartphone, the
iPhone 4, with software and a camera that’s been changed many times
in recent years as new versions of the device have been released.
The results might be different with other smartphones, researchers
note.
Rapidly evolving smartphone technology makes it hard to test the
effectiveness of mobile health tools, and the study was a rigorous
evaluation of the technology available at the time that it was
conducted, said Dr. Kumanan Wilson, author of an accompanying
editorial and a researcher at the University of Ottawa in Ontario,
Canada.
The advantage of the approach outlined in this study is it provides
an example of a readily available technology that can be
standardized in its application," Wilson said by email.
"Furthermore, the technology was properly evaluated which is often
not the case with mobile health technologies."
SOURCE: http://bit.ly/2H7Eep9 CMAJ, online April 3, 2018.
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