The development and feasibility of a smartphone application to enhance the HINTS exam and effectively integrate AI Open Access

Abstract

This study examines the effectiveness of the HINTS+ (Head-Impulse, Nystagmus, Test of Skew, plus hearing) exam in detecting posterior circulation strokes, which often present atypically and delay treatment. This study evaluated a new iOS application to support HINTS exam use across clinical settings, aiming to improve stroke detection. Ten patients with vestibular symptoms were assessed using the application, with one correctly identified central and nine peripheral pathologies. The application showed 100% sensitivity and 66.7% specificity and allowed slowed video replay to allow examiners to assess nystagmus and head impulse saccades better than clinical non-video testing. Results suggest potential for wider HINTS application use, with future improvements through artificial intelligence.  

Table of Contents

Title page: 1

Disclosure: 2

Abstract: 2

Background: 2

Significance: 3

Purpose statement: 4

Population: 4-5

Epidemiology: 5

Organizational/ local knowledge of the program: 5-6

Project objectives: 6

Clinical questions: 6-7

Assumptions and limitations: 7-8

Theoretical framework: 8-9

Literature review and synthesis: 9-15

Practice implications: 15

Future research strategies: 15-16

Setting: Population/ sample: 16

Inclusion/exclusion criteria: 16

Methods: 17

Resources: 17

Key stakeholders and site support: 17-18

Protection of human rights: 18

Results: 18

Discussion and conclusion: 18-19

Implications and recommendations 19-20

Evaluation of process and experience 20

References: 21-22

Appendices: 23-25

About this Scholarly Project

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Nell Hodgson Woodruff School of Nursing
Specialty	Family/Emergency Nursing Practice
Degree	D.N.P.
Submission	Scholarly Project
Language	English
Research Field	Health Sciences, Nursing Computer Science
Keyword	Posterior CVA Emergency Medicine Smartphone application HINTS exam Diagnosis
Committee Chair / Thesis Advisor	Hope Bussenius , Emory University
Committee Members	DJ Demers, Emory University

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