Smartphone app more accurate than traditional cardiac assessment

Robert Scammell 4 April 2018 (Last Updated April 4th, 2018 17:26)

Researchers have shown that a smartphone app can assess blood flow in a wrist artery for patients undergoing coronary angiography more accurately than a traditional physical examination.

Smartphone app more accurate than traditional cardiac assessment
The trial used the Instant Heart Rate app, which uses a phone’s camera function to measure changes in the blood flow. Credit: NEC Corporation of America with Creative Commons license.

Researchers have shown that a smartphone app can assess blood flow in a wrist artery for patients undergoing coronary angiography more accurately than a traditional physical examination.

The findings highlight the potential of smartphone apps to help physicians make decisions at the bedside.

University of Ottawa Heart Institute researcher Dr Benjamin Hibbert said: “Because of the widespread availability of smartphones, they are being used increasingly as point-of-care diagnostics in clinical settings with minimal or no cost.

“For example, built-in cameras with dedicated software or photodiode sensors using infrared light-emitting diodes have the potential to render smartphones into functional plethysmographs [instruments that measure changes in blood flow].”

The researchers compared the use of heart-rate monitoring app Instant Heart Rate with the modified Allen test, which measures blood flow in the radial and ulnar arteries of the wrist and is used to access the heart for coronary angiography.

They split 438 participants into two groups, assessing one group using the app and the other using the Allen test, which is considered a gold-standard physical examination.

The trial showed that the smartphone app had a diagnostic accuracy of 94% compared with 84% using the traditional method.

“The current report highlights that a smartphone application can outperform the current standard of care and provide incremental diagnostic yield in clinical practice,” said Dr Hibbert.

However, lead author Dr Pietro Di Santo cautioned that smartphone apps must be evaluated rigorously before being used clinically.

“When we designed the iRadialstudy we wanted to hold the technology to the highest scientific standards to make sure the data supporting its use was as robust as possible,” he said.

In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) ensures that healthcare apps comply with regulations and are ‘acceptably safe’.

MHRA’s director of medical devices John Wilkinson said in the UK government’s 2016 policy update that: “We live in an increasingly digital world, both healthcare professionals, patients and the public are using software and stand-alone apps to aid diagnosis and monitor health.”

In the guidelines the MHRA stresses that apps giving incorrect diagnoses or prescribe inappropriate treatments could have severe and potentially life-threatening consequences.

Currently, the Instant Heart Rate app is not certified for use in healthcare by any regulatory body, but Dr Hibbert believes the study ‘highlights the potential for smartphone-based diagnostics to aid in clinical decision-making at the patient’s bedside’.

Other experts have called for regulatory agencies to proactively look at the ways to maximise the benefits of mobile health solutions.

The randomised trial was published in the Canadian Medical Association Journal.