Reliableness of Telegram between different evaluators in emergency general surgery practice

Sandipkumar Chaudhari, Jimitkumar Patel, Ajay Talvelkar, Nayan Pancholi, Latif Bagwan


Background: 'Telegram' is a popularly used social media application in routine clinical practice, often for communication between a resident doctor and a consultant. The purpose of this study is to establish the reliableness of the data transmitted through telegram to validate its use in general surgery practice.

Methods: Clinical findings and computerized tomographic (CT) images of 180 patients visiting the trauma center and emergency department were posted in a closed Telegram group involving three consultants (SSC, NBP, and LSB). The CT images were posted in the Telegram group as complete picture (CP) and picture of interest (POI) format and rated on a scale of 1-5. The consultants formulated a temporary diagnosis and initial management plan. The reliableness between different evaluators of these feedbacks was analyzed in our study.

Results: Mean CP rating ranged from 3.03±0.61 to 3.73±0.64 [Cronbach alfa (α)-0.494, p=0.006]. Mean POI rating ranged from 3.4±0.56 to 4.13±0.73 (α-0.824, p<0.0001). For diagnosis, the proportion of observed agreement (P0) was 83.3% for SSC and NP, 76.6% for SSC and LB, and 73.3% for NBP and LSB. For management, P0 was 86.6% for NBP and LSB, 86.6% for SSC and NBP, and 80% for SSC and LSB.

Conclusions: Telegram messenger serves to transmit good quality pictures of CT scan images. A reasonable diagnosis and management strategy can be formulated using this app with a fair reliableness between different evaluators.



Teleconsultation, Telegram, Feedback, Practice, Reliableness, Consultant

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Telegram introduces end-to-end encrypted video calls". The Next Web. 2020. Available at: Accessed on 29 March 2021.

"Telegram hits 500M monthly active users". Telegram. Available at: web/20210611161236/ Accessed on 11 June 2021.

"Durov Telegram". Telegram. 2021. Available at: Accessed on 09 February 2021.

Hashtarkhani S, Azimi A, Fatehi F. Televisit: an innovative mobile-based system for remote medical consultation using Telegram messaging app in Iran. International Conference on Successes and Failures in Telehealth (SFT-17). 2017.

Telemedicine Practice Guidelines Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine. Available at: Accessed on 08 September 2020.

Martin G, Khajuria A, Arora S, King D, Ashrafian H, Darzi A. The impact of mobile technology on teamwork and communication in hospitals: A systematic review. J Am Med Inform Assoc. 2019;26:339-55.

Luciani LG, Mattevi D, Cai T, Giusti G, Proietti S, Malossini G. Teleurology in the time of Covid-19 pandemic: Here to stay? Urology. 2020;140:4-6.

Devana SK, Chaudhary K, Sharma AP, Singh SK. Changing urological practice during COVID-19. Indian J Urol. 2020;36:153-8.

Cicchetti DV, Feinstein AR. High agreement but low kappa: II. Resolving the paradoxes. J Clin Epidemiol 1990;43:551-8.

Feinstein AR, Cicchetti DV. High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol. 1990;43:543-9.

Donker DK, Hasman A, van Geijn HP. Interpretation of low kappa values. Int J Biomed Comput. 1993;33:55-64.

Sener TE, Butticè S, Sahin B, Netsch C, Dragos L, Pappalardo R, et al. WhatsApp use in the evaluation of hematuria. Int J Med Inform. 2018;111:17-23.

Arada EI, Florencio L, Macalalag M, Mendiola F, Dy J, Ballesteros C, et al. Mp23-01 Using android smartphones to take cystoscopic and ureterosopic images for Exclusive online internet referrals. J Urol. 2015;193:e267.

Shapiro C, Varian HR. Information Rules. Harvard Business Press. 1999.

Bellote MC, Santamaria HT, Pelayo-Nieto M, Heman Prasad ES, Gadzhiev N, Gudaru K. Social media in the urology practice. Int Braz J Urol. 2019;45:877-81.

KamelBoulos MN, Giustini DM, Wheeler S. Instagram and WhatsApp in health and healthcare: An overview. Futur Internet 2016;8:1-14.