title: Diagnostic accuracy of chest X-rays acquired using a digital camera for low-cost teleradiology.
abstract: Store-and-forward telemedicine, using e-mail to send clinical data and digital images, offers a low-cost alternative for physicians in developing countries to obtain second opinions from specialists. To explore the potential usefulness of this technique, 91 chest X-ray images were photographed using a digital camera and a view box. Four independent readers (three radiologists and one pulmonologist) read two types of digital (JPEG and JPEG2000) and original film images and indicated their confidence in the presence of eight features known to be radiological indicators of tuberculosis (TB). The results were compared to a "gold standard" established by two different radiologists, and assessed using receiver operating characteristic (ROC) curve analysis. There was no statistical difference in the overall performance between the readings from the original films and both types of digital images. The size of JPEG2000 images was approximately 120KB, making this technique feasible for slow internet connections. Our preliminary results show the potential usefulness of this technique particularly for tuberculosis and lung disease, but further studies are required to refine its potential.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston MA, USA.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szot
authors.forename: Francine L
authors.initials: FL
authors.lastname: Jacobson
authors.forename: Samson
authors.initials: S
authors.lastname: Munn
authors.forename: Darius
authors.initials: D
authors.lastname: Jazayeri
authors.forename: Edward
authors.initials: E
authors.lastname: Nardell
authors.forename: David
authors.initials: D
authors.lastname: Harrison
authors.forename: Ralph
authors.initials: R
authors.lastname: Drosten
authors.forename: Lucila
authors.initials: L
authors.lastname: Ohno-Machado
authors.forename: Laura M
authors.initials: LM
authors.lastname: Smeaton
authors.forename: Hamish S F
authors.initials: HS
authors.lastname: Fraser
mesh_terms: D044962:Data Compression; D003906:Developing Countries; D034742:Electronic Mail; D006801:Humans; D010781:Photography / Q000295:instrumentation* / Q000379:methods; D011786:Quality Control; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods; D013902:Radiography, Thoracic; D011873:Radiology Information Systems / Q000592:standards*; D019114:Remote Consultation / Q000295:instrumentation*; D015203:Reproducibility of Results; D019112:Teleradiology / Q000295:instrumentation*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging*