Monochrome versus color softcopy displays for teleradiology: observer performance and visual search efficiency

This study evaluated the potential clinical utility for teleradiology of a high-performance (3-mega-pixel) color softcopy display compared with two monochrome softcopy displays: one of comparable luminance (250 cd/m2) and one of higher luminance (450 cd/m2). Six radiologists viewed 50 chest images, half with nodules and half without, once on each display. Eye position was recorded on a subset of the images to characterize visual search efficiency. There was no statistically significant difference in diagnostic performance as a function of monitor (F=1.176, p=0.3127), although the higher luminance display yielded slightly better performance. In terms of total viewing time, there were no statistically significant differences between the three monitors (F=1.478, p=0.2298). The dwell times associated with true- and false-positive decisions were shortest for the high luminance monochrome display, longer for the low luminance monochrome, and longest for the low luminance color display. Dwells for the false-negative decisions were longest for the high luminance monochrome display, shorter for the low luminance monochrome, and shortest for the low luminance color display. The true negative dwells were not significantly different. The study suggests that high-performance color displays can be used for teleradiologic interpretation of diagnostic images without negatively impacting diagnostic accuracy or visual search efficiency to a significant degree.