Abstract Number: OC 07.1
Meeting: ISTH 2021 Congress
Background: New tele-guidance technology on portable devices opens the possibility of patient self-imaging of hemophilic joints.
Aims: Elucidate the feasibility of patient self-imaging with/without tele-guidance.
Methods: Adult hemophilia patients (University of California) were invited to participate in a prospective joint self-imaging study. Patients received ultrasound teaching and manuals explaining how to self-image 11 views for hemarthrosis detection in ankles, elbows and knees (Joint tissueActivity and Damage Exam). Patients were asked to acquire 5 randomly selected views with the Butterfly/IQ probe (butterflynetwork.com) and an iPad without assistance 2, 6 weeks and 12 weeks later, followed by a tele-assisted session (Butterfly/IQ tele-guidance function). Image acquisition was timed, patients identified anatomic landmarks, and images were graded on a scale of 0-4 (0=not similar to 4=very similar; maximum score =20/5 views). Patients and facilitator completed questionnaires describing their experience. Hemophilia Joint Health Score (HJHS) indicated arthropathy status.
Results: Of 132 hemophilia patients, 10 [median age 52 years (range 29-73)] opted for inclusion.
At 2 and 6 weeks after training, ~80% images were acquired correctly [image grading: median ~12 (range 4-18.5] compared to 53% at 12 weeks [image grading: median=6 (range 0-18)]. Accuracy of landmark recognition was ~55%. With tele-guidance, all images were acquired correctly, with near-perfect image quality overall [Image grading: median 20 (range 18-20); p≤0.01 compared to 12 weeks). Median HJHS of scanned joints was 11.5 (range=2-20) at each time point, demonstrating a similar spectrum of arthropathic changes. Median time of image acquisition was similar with and without tele-guidance [median 01:04 (mm:ss) (range 00:17–04:56) vs. median 01:02 (range 00:16-06:01)], but differed slightly between arthropathic and non-arthropathic joints. Study participants and facilitator rated that it was easy to navigate mobile technology and acquire images with tele-guidance.
Conclusions: Mobile ultrasound with tele-guidance for joint self-imaging is feasible and warrants further exploration.
To cite this abstract in AMA style:Aguero P, Flores A, von Drygalski A. Implementation of Tele-guidance for Patient Self-imaging of Arthropathic Joints Using Mobile Ultrasound Devices –– Results from a Pilot Study [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/implementation-of-tele-guidance-for-patient-self-imaging-of-arthropathic-joints-using-mobile-ultrasound-devices-results-from-a-pilot-study/. Accessed September 22, 2023.
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