Chapter 9 154 2.4 Assessment of Pictures Two independent investigators (nurse practitioners) evaluated all transmitted pictures according to the predefined criteria. To analyze the agreement between these 2 investigators, a simplified assessment scheme with dichotomous variables was used (refer to Figure 1). Assessment was done blindly to medical data after the inclusion period, on a high-resolution screen (1980 x 1080 pixels), paying attention to redness or hematoma. The investigators gave a conclusion on a set of pictures per case being clinically relevant or not. ‘‘Clinically relevant’’ was defined as possibly needing further clinical assessment or medical treatment. Both investigators were experienced in assessing wounds and puncture sites. Conservative therapy was defined as needing no additional clinical assessment or medical treatment. If the wound or puncture site was not visible or if the picture was not sharp or too dark according to the assessing nurse practitioner, the quality was deemed insufficient and should not be assessed further. If so, further data on all subitems were censored. 2.5 Statistical Analysis Continuous data are presented as means and corresponding standard deviations (SDs) or as median values and corresponding 25th and 75th percentiles. Categorical variables are represented as frequencies and percentages. For a comparison of normally distributed continuous variables between participants who used a smartphone versus those with a feature phone, Student t test was used; in case of skewed distribution, Mann-Whitney U test was used. For comparing frequencies, the χ2 test or Fisher exact test was used. Statistical analysis was performed using IBM SPPS 21 (IBM Corp, Armonk, New York). A P < .05 was considered statistically significant. 3. Results A total of 91 consecutive patients were screened for participation in the study. Fortyfive patients were excluded because of refusing participation (n = 12), the absence of an integrated camera in the mobile phone (n = 23), no mobile phone (n = 6), or no Internet connection (n = 2) or computer (n = 1). Forty-six of the 91 patients (51%) were included in the study. Baseline demographics of the study population are
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