The Effect of Smartphone Video on Lead Time to Diagnosis of Infantile Spasms

Abstract

To assess whether access to smartphone video capture of infantile spasms at initial presentation is associated with improved time to diagnosis and treatment. We conducted a collaborative retrospective cohort study of 80 consecutive infants with confirmed infantile epileptic spasms syndrome initially presenting from 2015 to 2021 at 2 US pediatric centers. Statistical methods used included Mann-Whitney U test to assess the difference in lead times to electroencephalogram (EEG), diagnosis, and treatment between groups with and without video capture. A χ2 analysis was used to assess differences in demographics, clinical characteristics, and treatment outcomes between groups. Multivariate regression analysis was used to account for etiology types and infantile spasms capture on EEG. Patients with smartphone video infantile spasms capture initially presented a median of 9days earlier (P=.02), had their first EEG 16days earlier (P=.007), and were diagnosed and started treatment 17days earlier (P=.006 and P=.008, respectively) compared with the nonvideo group. The video group had a 25% greater response to initial standard treatment (P=.02) and a 21% greater freedom from infantile spasms at long-term follow-up (P=.03), although this long-term outcome lost statistical significance after adjustment for etiology type (P=.07) and EEG capture of infantile spasms (P=.059). Our findings suggest a benefit of smartphone video capture of infantile spasms in reduced time to diagnosis and initial standard treatment, which are associated with improved treatment response rates. Substantial differences in lead times and treatment response highlight the clinical importance of pediatricians recommending caregivers to obtain smartphone video of events concerning for infantile spasms.