Direct measurement of the effect of film miniaturization on diagnostic accuracy

A method for directly measuring the reduction in diagnostic accuracy incurred by altering original radiographs was applied to evaluate a 35 mm film system. A total of 4,290 readings of 2,145 proved cases were collected. Analysis of the results indicate that the 35 mm system reduced diagnostic accuracy by about 2.3% +/- 2.4% at a 95% confidence level. The same method can be used to evaluate other photographic reduction systems, television displays, enhancement schemes, or even the importance of clinical data in roentgenographic interpretation.