title: Influence of image processing on chest radiograph interpretation and decision changes.
abstract: OBJECTIVE
  The authors investigate the effect of image processing on diagnostic performance in the reading of computed chest radiographs.
  
  
  METHODS
  Six radiologists read 168 chest images with and without the use of image processing. Diagnostic performance was measured by means of receiver operating characteristic analysis, and changes made in diagnostic decisions with the use of image processing were evaluated.
  
  
  RESULTS
  There were no statistically significant differences between reader performance with image processing and reader performance without image processing (P < .05). Readers' decisions were just as likely to change from false-negative to true-positive as from true-positive to false-negative with the use of image processing. More decisions changed from true-negative to false-positive than from false-positive to true-negative with processing,
  
  
  CONCLUSIONS
  The effect of image processing does not greatly influence diagnostic performance in chest radiography.
authors.affiliation: Department of Radiology, University of Arizona, Tucson 85724, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Krupinski
authors.forename: M
authors.initials: M
authors.lastname: Evanoff
authors.forename: T
authors.initials: T
authors.lastname: Ovitt
authors.forename: J R
authors.initials: JR
authors.lastname: Standen
authors.forename: T X
authors.initials: TX
authors.lastname: Chu
authors.forename: J
authors.initials: J
authors.lastname: Johnson
mesh_terms: D001291:Attitude of Health Personnel; D001987:Bronchiectasis / Q000000981:diagnostic imaging; D003626:Data Display; D003657:Decision Making; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging; D015588:Observer Variation; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D011871:Radiology; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed