INTERPRETATION OF EMERGENCY DEPARTMENT RADIOGRAPHS BY RADIOLOGISTS AND EMERGENCY-MEDICINE PHYSICIANS - TELERADIOLOGY WORKSTATION VERSUS RADIOGRAPH READINGS

PURPOSE: To compare accuracy of interpretation by radiologists and eme rgency medicine physicians of conventional radiographs and digitized i mages on a workstation. MATERIALS AND METHODS: One author selected 120 radiographs from the radiology department library, including 62 muscu loskeletal, 20 abdominal, and 38 chest examinations. Analog radiograph s were digitized. There were 50 positive and 60 control cases. Positiv e cases demonstrated clinically important disease and had a high degre e of diagnostic difficulty. Thirty-one cases were judged to be critica l to the patient's immediate care, requiring prompt accurate interpret ation. Four groups of readers were used: staff radiologists and emerge ncy medicine physicians and second-year radiology and emergency medici ne residents. RESULTS: Al reader groups performed better when interpre ting conventional radiographs than digitized images. Differences in fa vor of radiograph reading were statistically significant for overall a ccuracy related to all cases and to critical cases (P < .05, one-taile d test). CONCLUSION: Results with the teleradiology system were found unacceptable for primary interpretation of the spectrum of radiographs seen in an emergency department.