TB or Not TB: interreader and intrareader variability in screening diagnosis on an iPad versus a traditional display

Mobile displays may have the ability to increase the flexibility of consulting radiologists if they can be shown not to negatively influence a reader's performance in clinical tasks. The authors report a comparison of a mobile display with a larger liquid crystal display for the task of making a binary decision for the diagnosis of tuberculosis on chest radiography. Deidentified DICOM images of 240 chest x-rays were transferred from a PACS to an iPad 2 running OsiriX HD software. The images were reviewed independently by 5 radiologists of varying experience and were graded as positive or negative for tuberculosis on both the liquid crystal display monitor and the iPad. The reading sessions were a minimum of 2 weeks apart to minimize recall bias. Agreement was measured in terms of κ statistics. Overall, multirater generalized κ was 0.9694. These results suggest that there is no detectable effect of monitor type (liquid crystal display or iPad 2) on the reader's decision for the task of tuberculosis diagnosis.