[Interpretation of chest radiographs in the intensive care unit: a hard- versus soft-copy comparative study].

Abstract

To compare the reliability of hard- versus soft-copy interpretation of intensive care unit chest radiographs, using a non-specialized standard resolution computer screen.104 chest radiographs were included in this study. Three physicians (one radiology resident, one intensive care unit resident and one experienced intensive care unit physician) gave their interpretations on computerized grids. Results were analyzed statistically using ROC curves and Kappa (kappa) index of concordance with experts.Results for reanimation equipment detection are almost independent from the modality (kappa(soft-copy)=0.891+/-0.037, kappa(hard-copy)=0.899+/-0.037). Regarding pathology detection, a global analysis only shows a difference at the limits of significance to the advantage of hard-copy films (kappa(soft)=0.514 +/-0.028, kappa(hard)=0.572+/-0.028). Overall results were significantly better for the radiologist compared to the intensive care unit physicians (kappa(radiologist)=0.751+/-0.048, kappa(intensive-care)=0.405+/-0.048).Concerning the task that is studied here, which requires only routine computer equipment, our results suggest that human factors can be more important than material factors.

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