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Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance
To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI). Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000...
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| Published in: | Clinical radiology 2006-02, Vol.61 (2), p.163-173 |
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| Main Authors: | , , , |
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| container_title | Clinical radiology |
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| creator | Offiah, A.C. Moon, L. Hall, C.M. Todd-Pokropek, A. |
| description | To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI).
Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000R computed radiography system. Hard copies were printed with edge enhancement factors 0, 0.5 and 1.2. Images (edge enhancement 0.5) were also displayed on a 1K
2 monitor. Six observers independently evaluated all 200 images for the presence of abnormality. Observers also scored each image for visualization of soft tissues, visualization of trabecular markings and overall image quality. The paired Student's
t-test and location receiver operating curve (ROC) analysis were used to compare quality scores and diagnostic accuracy of each display method. Individual and pooled true-positive rates (sensitivity) were determined. For the purposes of ROC analysis, histology was taken as the gold standard.
There was no difference in duration of hard and soft-copy reading sessions (
p=0.76). After image manipulation soft-copy radiographs scored significantly better for image quality than hard copy (
p |
| doi_str_mv | 10.1016/j.crad.2005.09.004 |
| format | article |
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Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000R computed radiography system. Hard copies were printed with edge enhancement factors 0, 0.5 and 1.2. Images (edge enhancement 0.5) were also displayed on a 1K
2 monitor. Six observers independently evaluated all 200 images for the presence of abnormality. Observers also scored each image for visualization of soft tissues, visualization of trabecular markings and overall image quality. The paired Student's
t-test and location receiver operating curve (ROC) analysis were used to compare quality scores and diagnostic accuracy of each display method. Individual and pooled true-positive rates (sensitivity) were determined. For the purposes of ROC analysis, histology was taken as the gold standard.
There was no difference in duration of hard and soft-copy reading sessions (
p=0.76). After image manipulation soft-copy radiographs scored significantly better for image quality than hard copy (
p<0.0001). Pooled observer sensitivity (at a specificity of 90%) was below 50% for all display methods. Diagnostic accuracy varied significantly between observers. Diagnostic accuracy of individual observers was not affected by display method.
In suspected NAI, diagnostic accuracy of fracture detection is generally low. Diagnostic accuracy appears to be affected more by observer-related factors than by the method of digital image display.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2005.09.004</identifier><identifier>PMID: 16439222</identifier><identifier>CODEN: CLRAAG</identifier><language>eng</language><publisher>Amsterdam: Elsevier Ltd</publisher><subject>Biological and medical sciences ; Child Abuse - diagnosis ; Child, Preschool ; Data Display - standards ; Fractures, Bone - diagnostic imaging ; Humans ; Infant ; Injuries of the limb. Injuries of the spine ; Medical sciences ; Observer Variation ; Radiographic Image Enhancement - standards ; Sensitivity and Specificity ; Traumas. Diseases due to physical agents</subject><ispartof>Clinical radiology, 2006-02, Vol.61 (2), p.163-173</ispartof><rights>2005 The Royal College of Radiologists</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-37ddd7caa3472401b8de309c667a979b72b037917e79ecd5b0739c23cf62793c3</citedby><cites>FETCH-LOGICAL-c384t-37ddd7caa3472401b8de309c667a979b72b037917e79ecd5b0739c23cf62793c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17465234$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16439222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Offiah, A.C.</creatorcontrib><creatorcontrib>Moon, L.</creatorcontrib><creatorcontrib>Hall, C.M.</creatorcontrib><creatorcontrib>Todd-Pokropek, A.</creatorcontrib><title>Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI).
Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000R computed radiography system. Hard copies were printed with edge enhancement factors 0, 0.5 and 1.2. Images (edge enhancement 0.5) were also displayed on a 1K
2 monitor. Six observers independently evaluated all 200 images for the presence of abnormality. Observers also scored each image for visualization of soft tissues, visualization of trabecular markings and overall image quality. The paired Student's
t-test and location receiver operating curve (ROC) analysis were used to compare quality scores and diagnostic accuracy of each display method. Individual and pooled true-positive rates (sensitivity) were determined. For the purposes of ROC analysis, histology was taken as the gold standard.
There was no difference in duration of hard and soft-copy reading sessions (
p=0.76). After image manipulation soft-copy radiographs scored significantly better for image quality than hard copy (
p<0.0001). Pooled observer sensitivity (at a specificity of 90%) was below 50% for all display methods. Diagnostic accuracy varied significantly between observers. Diagnostic accuracy of individual observers was not affected by display method.
In suspected NAI, diagnostic accuracy of fracture detection is generally low. Diagnostic accuracy appears to be affected more by observer-related factors than by the method of digital image display.</description><subject>Biological and medical sciences</subject><subject>Child Abuse - diagnosis</subject><subject>Child, Preschool</subject><subject>Data Display - standards</subject><subject>Fractures, Bone - diagnostic imaging</subject><subject>Humans</subject><subject>Infant</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Medical sciences</subject><subject>Observer Variation</subject><subject>Radiographic Image Enhancement - standards</subject><subject>Sensitivity and Specificity</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNp9kUFv1DAQhS0EokvhD3BAvsAty8TOxjXiUhUKSJW4gMTNcsaTrVeJHeyk0v4Tfi6OdqXeerJH_t4b6z3G3tawraFuPx62mKzbCoDdFvQWoHnGNrVsd5UQ-s9ztgEAXWnRwgV7lfNhHRvRvGQXddtILYTYsH9fvN2HmGeP3CIuyeKRx5735TIvibijmXD2MXAfeF7yVCZyPMRQFd47CrMdytthScdPfL4nTn1fmNWE3L6M4d4GpLGA3AbHnd_7VeJ8ngZblgUeu0zpgRKfKPUxjSv_mr3o7ZDpzfm8ZL9vv_66-V7d_fz24-b6rkJ51cyVVM45hdbKRokG6u7KkQSNbausVrpTogOpdK1IaUK360BJjUJi3wqlJcpL9uHkO6X4d6E8m9FnpGGwgeKSjYLi29ZQQHECMcWcE_VmSn606WhqMGsf5mDWPszahwFtSh9F9O7svnQjuUfJuYACvD8DNqMdSuwBfX7kVNPuhFyNPp84Klk8eEomo6eSk_OppG1c9E_94z9e8qv7</recordid><startdate>20060201</startdate><enddate>20060201</enddate><creator>Offiah, A.C.</creator><creator>Moon, L.</creator><creator>Hall, C.M.</creator><creator>Todd-Pokropek, A.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20060201</creationdate><title>Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance</title><author>Offiah, A.C. ; Moon, L. ; Hall, C.M. ; Todd-Pokropek, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-37ddd7caa3472401b8de309c667a979b72b037917e79ecd5b0739c23cf62793c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Biological and medical sciences</topic><topic>Child Abuse - diagnosis</topic><topic>Child, Preschool</topic><topic>Data Display - standards</topic><topic>Fractures, Bone - diagnostic imaging</topic><topic>Humans</topic><topic>Infant</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Medical sciences</topic><topic>Observer Variation</topic><topic>Radiographic Image Enhancement - standards</topic><topic>Sensitivity and Specificity</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Offiah, A.C.</creatorcontrib><creatorcontrib>Moon, L.</creatorcontrib><creatorcontrib>Hall, C.M.</creatorcontrib><creatorcontrib>Todd-Pokropek, A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Offiah, A.C.</au><au>Moon, L.</au><au>Hall, C.M.</au><au>Todd-Pokropek, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2006-02-01</date><risdate>2006</risdate><volume>61</volume><issue>2</issue><spage>163</spage><epage>173</epage><pages>163-173</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><coden>CLRAAG</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI).
Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000R computed radiography system. Hard copies were printed with edge enhancement factors 0, 0.5 and 1.2. Images (edge enhancement 0.5) were also displayed on a 1K
2 monitor. Six observers independently evaluated all 200 images for the presence of abnormality. Observers also scored each image for visualization of soft tissues, visualization of trabecular markings and overall image quality. The paired Student's
t-test and location receiver operating curve (ROC) analysis were used to compare quality scores and diagnostic accuracy of each display method. Individual and pooled true-positive rates (sensitivity) were determined. For the purposes of ROC analysis, histology was taken as the gold standard.
There was no difference in duration of hard and soft-copy reading sessions (
p=0.76). After image manipulation soft-copy radiographs scored significantly better for image quality than hard copy (
p<0.0001). Pooled observer sensitivity (at a specificity of 90%) was below 50% for all display methods. Diagnostic accuracy varied significantly between observers. Diagnostic accuracy of individual observers was not affected by display method.
In suspected NAI, diagnostic accuracy of fracture detection is generally low. Diagnostic accuracy appears to be affected more by observer-related factors than by the method of digital image display.</abstract><cop>Amsterdam</cop><pub>Elsevier Ltd</pub><pmid>16439222</pmid><doi>10.1016/j.crad.2005.09.004</doi><tpages>11</tpages></addata></record> |
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| ispartof | Clinical radiology, 2006-02, Vol.61 (2), p.163-173 |
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| subjects | Biological and medical sciences Child Abuse - diagnosis Child, Preschool Data Display - standards Fractures, Bone - diagnostic imaging Humans Infant Injuries of the limb. Injuries of the spine Medical sciences Observer Variation Radiographic Image Enhancement - standards Sensitivity and Specificity Traumas. Diseases due to physical agents |
| title | Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance |
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