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DOI: 10.1055/s-0040-1713797
Aplicación móvil en el diagnóstico de dolor de hombro para médicos generales
Mobile Application in the Diagnosis of Shoulder Pain for General Physicians
Resumen
Objetivo Evaluar la concordancia diagnóstica durante la evaluación inicial de pacientes con dolor de hombro entre: (1) Traumatólogos especialistas en hombro realizando una evaluación convencional y (2) un médico general utilizando una nueva aplicación móvil.
Materiales y Método Se diseñó una aplicación móvil para asistir a médicos generales a realizar una evaluación del dolor de hombro entregando una hipótesis diagnóstica. Se diseñó un estudio de concordancia diagnóstica. Se evaluó un grupo de 60 pacientes, quienes consultaron por primera vez con un especialista en hombro. Primero, todos fueron evaluados por un médico general utilizando la aplicación. Se registró la hipótesis diagnóstica entregada por la aplicación. Luego, el especialista realizó una evaluación con anamnesis y examen físico, registrando su hipótesis diagnóstica. Se realizó una prueba Kappa para determinar la concordancia entre ambos evaluadores.
Resultados La concordancia global entre los especialistas y la aplicación móvil utilizada por el médico general fue sustancial (k = 0,74; p < 0,001). La concordancia fue casi perfecta para el Pinzamiento subacromial, dolor cervical, lesión acromioclavicular, inestabilidad de hombro, y el pinzamiento interno.
Conclusión La concordancia diagnóstica durante la evaluación inicial de pacientes con dolor de hombro entre traumatólogos especialistas y un médico general utilizando una aplicación móvil fue sustancial.
Nivel de Evidencia Tipo III.
Abstract
Objective To evaluate the diagnostic concordance during the initial evaluation of patients with shoulder pain between: (1) Shoulder orthopedic surgeons performing a conventional evaluation and (2) a general practitioner using a new mobile application.
Materials and Method A mobile application was designed to assist general practitioners to perform an evaluation of shoulder pain by providing a diagnostic hypothesis. A diagnostic concordance study was designed. A group of 60 patients were evaluated, who consulted for the first time with a shoulder specialist. First, they were all evaluated by a general practitioner using the application. The diagnostic hypothesis delivered by the application was recorded. Then, the specialist made an evaluation with anamnesis and physical examination, recording his diagnostic hypothesis. A Kappa test was performed to determine the agreement between both evaluators.
Results The overall agreement between the specialists and the mobile application used by the general practitioner was substantial (k = 0.74, p < 0.001). The agreement was almost perfect for subacromial impingement, cervical pain, acromioclavicular injuries, shoulder instability, and internal impingement.
Conclusion The diagnostic agreement during the initial evaluation of patients with shoulder pain between shoulder specialist and a general practitioner using a mobile application was substantial.
Level of Evidence Type III.
Publication History
Received: 18 July 2019
Accepted: 13 May 2020
Article published online:
20 July 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil
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