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Proceedings Paper

Incorporation of a clinical history into the interpretation process in a PACS environment
Author(s): Lawrence A. Cooperstein; Barbara C. Good; Linda M. Miketic; Ellen K. Tabor; Samuel A. Yousem; Jill L. King; Rose C. Gennari; Marc A. Felice; Kathleen Sidorovich
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Paper Abstract

In a large-scale, multi-reader study to investigate questions surrounding the issue of the implementation of picture archiving and communications systems (PACS) into the modern radiology environment, we examined the effect that the incorporation of a clinical history into the reading process would have on levels of diagnostic accuracy. Because we wanted to test the inclusion of the clinical history in an environment as close to that of the clinical situation as possible, we defined "history" to be a concise, objective, and potentially computer-extractable version of what appears in the patient records, including a statement from the referring physician when this is available. In a series of studies, four radiologists interpreted 247 posteroanterior normal and abnormal chest images on conventional film both with and without accompanying patient histories; five radiologists read the same number of images presented on a high-resolution video workstation with and without clinical histories. There were no significant differences (p = .05) in diagnostic accuracy rates with or without clinical history for either the film or the workstation in cases of interstitial disease, nodules, or pneumothorax. Diagnostic accuracy for the radiologists as a group was not affected by the presence of the clinical history. We concluded that for the interpretation of these abnormalities, the incorporation of clinical history with images in the PACS environment should not be a major goal.

Paper Details

Date Published: 1 August 1990
PDF: 7 pages
Proc. SPIE 1234, Medical Imaging IV: PACS Systems Design and Evaluation, (1 August 1990); doi: 10.1117/12.18949
Show Author Affiliations
Lawrence A. Cooperstein, Univ. of Pittsburgh School of Medicine (United States)
Barbara C. Good, Univ. of Pittsburgh School of Medicine (United States)
Linda M. Miketic, Univ. of Pittsburgh School of Medicine (United States)
Ellen K. Tabor, Univ. of Pittsburgh School of Medicine (United States)
Samuel A. Yousem, Univ. of Pittsburgh School of Medicine (United States)
Jill L. King, Univ. of Pittsburgh School of Medicine (United States)
Rose C. Gennari, Univ. of Pittsburgh School of Medicine (United States)
Marc A. Felice, Univ. of Pittsburgh School of Medicine (United States)
Kathleen Sidorovich, Univ. of Pittsburgh School of Medicine (United States)


Published in SPIE Proceedings Vol. 1234:
Medical Imaging IV: PACS Systems Design and Evaluation
Samuel J. Dwyer; R. Gilbert Jost, Editor(s)

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