Effect of high sensitivity in a computerized scheme for detecting extremely subtle XXXX in chest radiographs: observer performance study.

@entity5474 @entity146
RATIONALES AND OBJECTIVES: This study investigated the effect of a high sensitivity in @entity146 ( @entity146 ) for detecting lung nodules in chest radiographs when extremely subtle cases were presented to radiologists. MATERIAL AND METHODS: The chest radiographs used in this study consisted of 36 normal images and 54 abnormals containing solitary lung nodules, of which 25 were extremely subtle and 29 were very subtle. Receiver operating characteristic analysis for detecting lung nodules was performed without and with @entity146 . The levels of @entity146 output were simulated with a hypothetical ideal performance of 100% sensitivity, but with three or four false positives per image. Six radiologists participated in an observer study in which cases were interpreted first without and then with the use of @entity146 . RESULTS: The average A(z) values for radiologists without and with @entity146 were 0.682 and 0.808, respectively. The performance of radiologists was improved significantly when high sensitivity was used (P = .0003). However, the radiologists were not able to recognize some extremely subtle nodules (5 of 54 nodules by all radiologists), even with the correct @entity146 output; these nodules were then considered as non-actionable. None of 306 computer-false positives was incorrectly regarded as a nodule by all radiologists, but 63 false positives were incorrectly identified by one or more radiologists. CONCLUSION: The accuracy of radiologists in the detection of some extremely subtle @entity5474 can be improved significantly when the sensitivity of a @entity146 scheme can be made to be at an extremely high level. However, all of the six radiologists failed to identify some nodules (about 10%), even with the correct output of the @entity146 .
