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Measuring performance in chest radiography
E J Potchen1, T G Cooper, A E Sierra
1Department of Radiology, Michigan State University, 164 Radiology Bldg, East Lansing, MI 48824, USA. ejp@rad.msu.edu
Purpose:
To use a standardized set of chest radiographs to quantify interobserver differences and to provide a basis for comparing the diagnostic performance of physicians.
Materials And Methods:
A standardized set of 60 chest radiographs was presented to 162 study participants. Each participant reviewed the radiographs and recorded his or her diagnostic impression by using a fixed five-point scale. These response data were used to generate receiver operating characteristic curves and to establish performance benchmarks. The variations in performance were tested for statistical significance.
Results:
Significant interobserver variability was identified during these assessments. The composite group of board-certified radiologists demonstrated performance superior to that of the radiology residents and nonradiologist physicians.
Conclusion:
By using a receiver operating characteristic approach and a standardized set of chest radiographs, observer accuracy and variability are easily quantified. This approach provides a basis for comparing the diagnostic performance of physicians. When value is measured as a diminution in uncertainty, board-certified radiologists contribute substantial value to the diagnostic imaging system.
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