title: Computed radiography in neonatal and pediatric intensive care units: a comparison of 2.5 K x 2 K soft-copy images vs digital hard-copy film.
abstract: OBJECTIVE
  The goal of the study was to determine whether soft-copy images on high-resolution monitors (2.5 K x 2 K) are suitable for primary interpretation of images from pediatric and neonatal intensive care units. The hypotheses were that hard and soft images yield similar diagnostic information, and that both residents and faculty radiologists can use monitors effectively. Previous reports have produced conflicting results; the need for larger sample sizes has been emphasized.
  
  
  METHODS
  One thousand one hundred and four images produced by computed radiography using the Kodak Ectascan Imagelink system were prospectively analyzed by two pediatric radiologists, one reading hard copy and the other soft copy of the same images. Bias was controlled by equal distribution of modalities between observers and by daily alternation of modality. Hard- and soft-copy observations of presence or absence of nine specific tubes and nine specific diagnostic findings were compared. Interobserver differences between pediatric radiologists and radiology residents were studied on additional images. The kappa statistic was used to evaluate the level of agreement for all observations.
  
  
  RESULTS
  There was excellent agreement between hard and soft copy interpretation for each tube and diagnostic finding (kappa values 0.93-1.0) and excellent interobserver agreement between two pediatric radiologists (kappa values 0.84-1.0). The level of agreement between radiology residents and pediatric radiologist was excellent for the most objective findings. All results were statistically significant (p < 0.001).
  
  
  CONCLUSIONS
  High resolution soft-copy images are suitable for primary interpretation in patients in pediatric and neonatal intensive care units.
authors.affiliation: Department of Radiology, The New York Hospital - Cornell Medical Center, 525 East 68th Street, New York, NY 11021, USA.
authors.forename: P W
authors.initials: PW
authors.lastname: Brill
authors.forename: P
authors.initials: P
authors.lastname: Winchester
authors.forename: P
authors.initials: P
authors.lastname: Cahill
authors.forename: M
authors.initials: M
authors.lastname: Lesser
authors.forename: S M
authors.initials: SM
authors.lastname: Durfee
authors.forename: C S
authors.initials: CS
authors.lastname: Giess
authors.forename: P A
authors.initials: PA
authors.lastname: Auld
authors.forename: B
authors.initials: B
authors.lastname: Greenwald
mesh_terms: D002648:Child; D016288:Computer Terminals; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015278:Intensive Care Units, Pediatric; D015588:Observer Variation; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D011860:Radiography, Abdominal; D011873:Radiology Information Systems; D013896:Thoracic Diseases / Q000000981:diagnostic imaging; D014963:X-Ray Intensifying Screens