THe Effect of the Computer-Aided Diagnosis on the Diagnostic Performance

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As the baseline study to analyze the effects of the computer-aided diagnosis (CAD) on the diagnostic performance of radiologists in screening mammography, we have investigated the interobserver agreement in juding the findings of mammography. Then, to analyze the effects of CAD in screening thoracic helical CT,we have evaluated the radiologists' performance in detection of simulated lung nodules on helical CT.Further, we have evaluated the effects of CAD output as a "second opinion" on radiologists' performance in the detection diagnosis, by the image-reading study. Here, we have studied the effect of simulated CAD's with various sensitivities and specificities. Six radiologists with less experience read 100 signal pulse noise images and 100 noise only images that were produced by the computer and were randomly displayd on CRT.They reported their probability judgments regarding the presence of lines in the background noise. The radiologists' performance was evaluated with receiver operating characteristic (ROC) analysis, and A _z (the area under the binormal ROC curve) was used as an index of performance. The difference among A_z OF 26 kinds of image-reading experiments was analyzed by the analysis of variance of pseudovalues (ANOVA) computed by the jackknife method ; this ANOVA method was proposed by D.D.Dorfman et al.The conclusion is the following : 1) The diagnostic performance with the aid of CAD systems with the rather good accuracy is better than that without the aid of CAD systems. 2) The overall accuracy of CAD outputs is the most effective factor to affect radiologists' performance in the detection diagnosis. Here, in the cases in which the overall accuracy of CAD outputs are the same, radiologists' performance will be better in the higher sensitivity of CAD outputs than in the higher specificity.