title: Interpretation of emergency department radiographs by radiologists and emergency medicine physicians: teleradiology workstation versus radiograph readings.
abstract: OBJECTIVE
  To compare accuracy of interpretation by radiologists and emergency medicine physicians of conventional radiographs and digitized images on a workstation.
  
  
  METHODS
  One author selected 120 radiographs from the radiology department library, including 62 musculoskeletal, 20 abdominal, and 38 chest examinations. Analog radiographs were digitized. There were 60 positive and 60 control cases. Positive cases demonstrated clinically important disease and had a high degree of diagnostic difficulty. Thirty-one cases were judged to be critical to the patient's immediate care, requiring prompt accurate interpretation. Four groups of readers were used: staff radiologists and emergency medicine physicians and second-year radiology and emergency medicine residents.
  
  
  RESULTS
  All reader groups performed better when interpreting conventional radiographs than digitized images. Differences in favor of radiograph reading were statistically significant for overall accuracy related to all cases and to critical cases (P < .05, one-tailed test).
  
  
  CONCLUSIONS
  Results with the teleradiology system were found unacceptable for primary interpretation of the spectrum of radiographs seen in an emergency department.
authors.affiliation: Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21287.
authors.forename: W W
authors.initials: WW
authors.lastname: Scott
authors.forename: D A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: W K
authors.initials: WK
authors.lastname: Mysko
authors.forename: G E
authors.initials: GE
authors.lastname: Weller
authors.forename: G D
authors.initials: GD
authors.lastname: Kelen
authors.forename: R L
authors.initials: RL
authors.lastname: Reichle
authors.forename: J C
authors.initials: JC
authors.lastname: Weller
authors.forename: J N
authors.initials: JN
authors.lastname: Gitlin
mesh_terms: D015142:Baltimore; D004635:Emergency Medicine / Q000193:education; D004636:Emergency Service, Hospital; D006801:Humans; D007396:Internship and Residency; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D011871:Radiology / Q000193:education; D011873:Radiology Information Systems; D012680:Sensitivity and Specificity; D017216:Telemedicine