Summary points
What was already known:
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The presence of red blood cells in urine is termed hematuria. Gross hematuria is the visible presence of blood in the urine and represents between 4 and 20% of all urological consultations and hospitalizations [1]. Hematuria isn’t always easy to assess and patients often go to emergency care due to false hematuria diagnoses that requires no active treatment. This situation leads to over-treatment and further increases complications as well as health care expenses.
With the advancements in mobile phone technology and related applications, it is possible to send messages, photos, and videos [2]. By now, it is estimated that WhatsApp has over 10 million users and more than 3 billion messages are sent via WhatsApp around the world every day [3,4]. WhatsApp can provide rapid communication in challenging scenarios whenever the party in need of a second opinion is even miles away from the consulting party. This is actually called “Telemedicine” and is frequently used by various specialties to exchange opinions over medical images, recordings of CT or MRI images or any kind of medical data.
We suggest that the use of WhatsApp can be used to send photos of cases of hematuria to medical professionals in order to determine the severity of cases, and thereby discriminate whether active treatment is necessary or not. The main target population of this study is the health professionals, general practitioners who may need a urology consultation where a urologist is not present, and urologists in doubt that may need a second opinion about their patients. So, the objective of this study was to evaluate the reliability of WhatsApp in the evaluation of hematuria through inter-rater agreement and to see the reliability of telemedicine communication via WhatsApp upon making critical clinical decisions.
This study has been planned as a prospective evaluation of patients presenting with hematuria in an academic center. Between December 2014 and April 2016, a total of 212 patients were referred for our consultation for hematuria. As standard protocol of the university hospital in which the study was carried out, each patient was informed about the procedure upon admission and signed an informed consent agreement allowing data collection for research purposes. The study design is in accordance
The total number of patients evaluated for WhatsApp telemedicine communication outcome was 212. There were 26 (12.3%) female and 186 (86.7%) male patients. The median age of patients was 71 (29–78). The most common cause of hematuria was bladder cancer with 39 patients. The causes of hematuria are given in Table 2.
The 2 consultants had different opinions in 8 cases, so these patients were excluded from the analyses in order to have a patient cohort where diagnosis is based upon the common
Hematuria isn’t always easy to assess and still remains a clinical problem for the patient and for the urologist. Patients often go to emergency care due to false hematuria diagnoses requiring no active treatment. This situation adds excessive costs to public health and frequently creates overcrowding of emergency rooms and urology clinics.
The exchange of medical data from via electronic communication is referred to as “Telemedicine (TM)” and the idea behind this is to provide the transmission
It is possible to evaluate hematuria cases remotely and also reduce unnecessary costs of services for hematuria of mild clinical significance by using telemedicine. WhatsApp can provide a valuable aid to tertiary hospitals where the urologist is not always present as well as in rural areas. Also, the absence of compromise in photo quality, the easy use of WhatsApp are the major advantages that provide usefulness of the application in clinical practice.
This study demonstrates that patients
None of the authors have any financial interest to declare and no financial support was taken for the study.
Concept and design: Salvatore Butticè, Christopher Netsch, Rosa Pappalardo
Acquisition of data: Salvatore Butticè, Bahadir Sahin, Laurian Dragos, Rosa Pappalardo
Analysis and interpretation of data: Tarik Emre Sener, Salvatore Butticè, Bahadir Sahin,
Drafting the article Tarik Emre Sener, Salvatore Butticè, Bahadir Sahin, Laurian Dragos, Rosa Pappalardo
Revising the article for important intellectual content: Tarik Emre Sener, Salvatore Butticè, Carlo Magno Summary points What was already known:
We would like to thank the native speakers Selin Sakarcan, DPM Candidate, Temple University, School of Podiatric Medicine, Pennsylvania and Abdullah Sakarcan, MD, Pediatric Nephrologist in AACP (All About Children Pediatric Partners), Reading, Pennsylvania, USA for their contributions in language revision of the manuscript.
The authors contributed equally to the manuscript.