COMPARATIVE-ASSESSMENT OF DIGITAL AND ANALOG RADIOGRAPHY - DIAGNOSTIC-ACCURACY, COST-ANALYSIS AND QUALITY OF CARE

Objective: the aim of this study was to compare digital and convention al radiography for diagnostic accuracy, direct costs, and quality of c are. Materials and methods: diagnostic accuracy was assessed by a crit ical review of the literature on sensitivity, specificity and ROC anal ysis of these imaging techniques and by a survey with a panel of radio logists. Direct costs and quality of care were evaluated with a before /after study of the implementation of digital radiography in a Departm ent of Radiology in 'Hospices Civils de Lyon' (France). We included 29 2 patients and measured duration of examinations and direct costs of e quipment, films, maintenance and depreciation. To evaluate any changes in working conditions and patient management, a questionnaire was fil led out by the staff of the department. Results: diagnostic accuracy w ith digital radiography was equivalent to that of conventional radiogr aphy but there were wide variations depending on the type of examinati on. In 1993, although digital radiography resulted in savings of FF 18 000 including tax (US$ 3600) on film consumption for 1 year of examin ations, there was a global additional cost of FF 253 000 (US$ 50 600) for maintenance and depreciation. Results showed a nonsignificant tend ency to reduced procedure times for all examinations. Working conditio ns improved, including greater availability for the patient, improved safety, and increased job interest. Conclusion: digital radiography ca n be introduced into a large hospital to improve patient and staff con ditions, at a higher cost than analog radiography, and depending on th e type of examinations performed by the radiology department. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.