The effect of comparison films upon resident interpretation of pediatric chest radiographs

Radiology residents beginning training or at the end of the first, second, or third year of training served as observers in a study of the effect of previous or comparison radiographs upon the interpretation of current pediatric chest films. For physicians early in residency, a substantial improvement in detection accuracy occurred when a prior normal film was presented with each examination. Facilitation of a lesser magnitude was obtained for specific diagnosis (classification) of lesions. Thus, while normal comparison films may help reveal to the newer resident that an abnormality exists, it does less to reveal the nature of that abnormality. For physicians late in residency, the same difference in detection accuracy between groups was obtained, but the magnitude of the difference was quite small. However, substantially higher accuracy of specific diagnosis resulted when comparison films were available. While neither normal nor abnormal comparison films markedly changes the accuracy of detection by advanced residents, both improve diagnosis.