SOFT-COPY VERSUS HARD-COPY CRANIAL SONOGRAPHY - INTRAOBSERVER AGREEMENT AND WORKSTATION EFFICIENCY

OBJECTIVE. The objective of the study was to determine the intraobserv er agreement, confidence level, and efficiency in interpretation of so ft-copy (workstation) versus hard-copy (laser-printed film) sonograms of the cranium. MATERIALS AND METHODS. Cranial sonograms of 100 premat ure infants were randomly reviewed twice on both soft-copy and hard-co py images by three observers and were graded for hemorrhage using a fi ve-level scale, The kappa statistic was calculated to measure intraobs erver agreement. Differences in agreement were tested for statistical significance with a test for marginal homogeneity. Observers rated the ir confidence in interpretation using a six-point ordinal scale. Total viewing time was recorded, and videotaped sessions were analyzed for image handling time (opening each case, closing each case, and selecti ng the next case) and interpretation time. RESULTS. For soft copy vers us hard copy, the mean kappa value was .73; for hard-copy 1 versus har d-copy 2, .71; and for soft-copy 1 versus soft-copy 2, .65, None of th ese differ ences was statistically significant (p >.05), The mean conf idence score was the same for soft copy (5.3) and hard copy (5.3), On average, the observers needed 24 min longer to review 100 studies on s oft copy than on hard copy, Opening and closing times for soft copy we re significantly faster than for hard copy (p =.0001); however, case s election for soft copy, which was not needed for hard copy, took 4.69- 9.09 sec per case. Extrapolated to 100 cases, case selection accounted for 8-15 min of viewing time. CONCLUSION. Radiologist agreement and c onfidence in the interpretation of cranial sonograms for hemorrhage wa s the same for soft copy and hard copy. However, viewing times were lo nger for soft copy, Elimination of inefficiency in case selection coul d improve image-handling time.