Evaluation of a digital workstation for interpreting neonatal examinations. A receiver operating characteristic study

The purpose of this study is to compare the diagnostic accuracy of interpreting clinical neonatal radiographs using a commercially available digital workstation versus conventional radiographic images.

The case sample consists of 100 chest or abdominal radiographs from the neonatal intensive care unit in which diagnosis was confirmed. Four radiologists served as observers. During two initial reading sessions, half of the studies were viewed on digital radiography monitors and the other half by plain film. Observers indicated whether each patient had normal or abnormal findings and their degree of confidence in this judgment. Six weeks later, observers viewed cases on the alternate presentation system. Two statistical analyses were performed: the data from each observer were treated as a separate experiment in the first analysis; the data from all observers were combined using a new method in the second analysis.

No differences between areas under receiver operating characteristic (ROC) curves for viewing on the picture archiving and communication system (PACS) console and plain film were found for any observer (0.86 versus 0.86, 0.89 versus 0.86, 0.88 versus 0.85, 0.83 versus 0.82).

The study suggests that for pediatric plain film images, video images offer diagnostic information comparable with that of conventional radiographs for neonatal examinations.