First results of the diagnostic evaluation studies and the clinical efficacy evaluation in the Dutch PACS project

The objective of the studies was to evaluate the diagnostic performance of the image digitizing distribution and display equipment of the installed PACS (Philips) in the Utrecht University Hospital (see also procee-dings SPIE 914, 1988). The diagnostic accuracy was evaluated by means of observer performance studies, using ROC analysis. Three series of films were used: chest phantom radiographs, clinical mammographic films, and clinical head CT's. We compared: original films versus images digitized with a video scanner, and/or original films versus images digitized with a laser scanner. Both scanners have 1024x1024x8 bits output resolution. Four radiologists scored the presence on a 5-point scale. The results of the mammographic and head CT series will be presented in this paper. The results of the diagnostic accuracy studies of the chest radiographs and their specific methodology will be presented in a companion SPIE paper. Goal of the clinical efficacy study is to see if the use of a PACS multimodality viewing station at an internal ward has clinical advantages as compared to the conventional situation. Using PACS integrated with a HIS (including a RIS) more easier and faster information is accessible to the clinicians. In this paper we will describe: the procedures which are needed to evaluate the use of the workstation installed at the internal ward, the development of the user interface with four layers of the Image Management System, and the methodology of evaluation the clinical advantages