title: Evaluation of off-the-shelf displays for use in the American Board of Radiology maintenance of certification examination.
abstract: OBJECTIVE
  To prospectively compare high-, mid-, and low-resolution off-the-shelf displays currently employed by commercial testing centers, in terms of visibility of lesion features needed to render a diagnostic decision when possible diagnoses are provided in a multiple-choice format during a maintenance of certification (MOC) examination.
  
  
  METHODS
  The Psychometrics Division of the American Board of Radiology (ABR) approved the studies (human subjects and HIPAA compliant). One study compared 1280 x 1024 displays with 1024 x 768 displays; the second, 1600 x 1200 with 1280 x 1024 displays. Images from nine subspecialties were used. In each study, observers viewed images twice-once on each display. Diagnoses were provided, and observers rated visibility of diagnostic features.
  
  
  RESULTS
  Of 7977 data pairs analyzed in study 1, the 1024 and 1280 displays received the same ratings for 5726 data pairs (72% of the time), with the 1024 display receiving a higher rating for 679 data pairs (9% of the time) and the 1280 receiving a higher rating for 1572 data pairs (19% of the time) (P < .0001). When rating differences existed, all subspecialties except nuclear medicine had significantly more high-visibility ratings with the 1280 display. Of 1090 data pairs analyzed in study 2, the 1280 and 1600 displays received the same ratings for 689 data pairs (63% of the time), with the 1280 receiving a higher rating for 162 data pairs (15% of the time) and the 1600 receiving a higher rating for 239 data pairs (22% of the time) (P = .0001). When rating differences existed, only cardiopulmonary and musculoskeletal images had significantly more high-visibility ratings with the 1600 display.
  
  
  CONCLUSIONS
  For the ABR MOC examinations, 1280 x 1024 displays should be used, compared to 1024 x 768 displays; 1600 x 1200 displays may be necessary for some images. Good-quality images must be used on the examinations, so digital rather than digitized film images should be used to ensure high-quality images.
authors.affiliation: Department of Radiology, University of Arizona, Bldg 211, Room 112, 1609 N Warren Ave, Tucson, AZ 85724, USA. krupinski@radiology.arizona.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Krupinski
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Becker
authors.forename: David
authors.initials: D
authors.lastname: Laszakovits
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Gerdeman
authors.forename: Michael G
authors.initials: MG
authors.lastname: Evanoff
mesh_terms: D002568:Certification; D016288:Computer Terminals; D003194:Computer-Assisted Instruction / Q000295:instrumentation* / Q000379:methods; D004521:Educational Measurement / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D013044:Specialty Boards; D014481:United States