Ability of a handheld device to detect need for imaging or hospital admission based on difference in patient applied force

Introduction Abdominal pain is a common medical complaint, but it is challenging to evaluate during virtual appointments without the ability to do a physical examination. To address this concern, this study analysed a device that measures the self-applied force by the patient. This was used to predict the need for in-person care; specifically, the need for advanced imaging and/or admission to the hospital. The purpose of the device is to mimic abdominal palpation such that a provider can determine whether or not the patient can be safely treated virtually for their abdominal pain. Methods Complete data were collected on 76 patients presenting to a large county hospital emergency department with abdominal-related complaints. In this convenience sample, patients pressed the device on their own abdomens to mimic abdominal palpation. Separately, a blinded physician would evaluate the patient as usual. Results In this small derivation sample, the device was able to correctly categorise patients into low-, medium- and high-risk groups for receiving advanced imaging or hospital admission. 100% (53/53) of the patients that the device predicted as high risk required imaging and/or admission, which suggests the device is very effective at detecting high-acuity pathologies. 61.9% (13/21) of the patients in the medium-risk group underwent imaging and/or admission. None of the patients (0/2) deemed as low risk required imaging and/or admission. Conclusions Future studies will be needed to determine the generalisability and robustness of the results, but this early data suggests that the need for a physical examination in patients with abdominal pain will be a diminishing barrier to virtual care for this subset of patients as technology evolves.