Personal Computer versus Workstation Display: Observer Performance in Detection of Wrist Fractures on Digital Radiographs1

Middlemore Hospital, Окленд, Auckland, New Zealand
Radiology (Impact Factor: 6.87). 01/2006; 237(3):872-7. DOI: 10.1148/radiol.2373041439
Source: PubMed


To retrospectively compare the accuracy of observer performance with personal computer (PC) compared with that with dedicated picture archiving and communication system (PACS) workstation display in the detection of wrist fractures on computed radiographs.
This study was conducted according to the principles of the Declaration of Helsinki (2002 version) of the World Medical Association. The institutional clinical board approved the study; informed consent was not required. Seven observers independently assessed randomized anonymous digital radiographs of the wrist from 259 subjects; 146 had fractures, and 113 were healthy control subjects (151 male and 108 female subjects; average age, 33 years). Follow-up radiographs and/or computed tomographic scans were used as the reference standard for patients with fractures, and follow-up radiographs and/or clinical history data were used as the reference standard for controls. The PC was a standard hospital machine with a 17-inch (43-cm) color monitor with which Web browser display software was used. The PACS workstation had two portrait 21-inch (53-cm) monochrome monitors that displayed 2300 lines. The observers assigned scores to the radiographs on a scale of 1 (no fracture) to 5 (definite fracture). Receiver operating characteristic (ROC) curves, sensitivity, specificity, and accuracy were compared.
The areas under the ROC curves were almost identical for the PC and workstation (0.910 vs 0.918, respectively; difference, 0.008; 95% confidence interval: -0.029, 0.013). The average sensitivity with the PC was almost identical to that with the workstation (85% vs 84%, respectively), as was the average specificity (82% vs 81%, respectively). The average accuracy (83%) was the same for both.
The results of this study showed that there was no difference in accuracy of observer performance for detection of wrist fractures with a PC compared with that with a PACS workstation.

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    • "According to various other medical studies which looked at brain CT [25], radiography of wrist fractures [26, 27], computed radiographs of the hands in early rheumatoid arthritis [28], and chest radiographs in interstitial lung disease [29] with different displays, no significant difference was detected between the monitors, concurring with our study. "
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    • "The detectability was significantly poorer in the 800-speed CR image than in the 200-and 400-speed images; no significant difference was found between the latter two. Another recent ROC experiment compared observer performance in detection of wrist fractures with a common PC display and a dedicated diagnostic display (Doyle et al. 2005): surprisingly, no differences in "

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