Double-contrast barium enema studies: effect of multiple reading on perception error

The images from 60 double-contrast barium enema (DCBE) examinations of patients who had also undergone colonoscopy were reviewed independently by three radiologists. The average radiologist detected 70.2% of the 46 radiologically visible lesions. The reports of the individual observers were combined to generate double and triple reading reports. The corresponding average double and triple reading combinations resulted in detection of 83.3% and 89.0%, respectively, of the visible lesions. These increases in sensitivity over those of the readings of the single observers were clinically and statistically significant. They were, however, accompanied by some decreases in specificity. The results confirm the concept that false-negative perception error is a major problem in the interpretation of DCBE examinations and indicate that multiple reading is an effective way to reduce this error.