In February 2011 the University of Chicago Medical School distributed iPads to its trainee doctors for use when
reviewing clinical information and images on the ward or clinics. The use of tablet computing devices is becoming
widespread in medicine with Apple™ heralding them as "revolutionary" in medicine. The question arises, just because
it is technical achievable to use iPads for clinical evaluation of images, should we do so? The current work assesses the
diagnostic efficacy of iPads when compared with LCD secondary display monitors for identifying lung nodules on chest
x-rays.
Eight examining radiologists of the American Board of Radiology were involved in the assessment, reading chest images
on both the iPad and the an off-the-shelf LCD monitor. Thirty chest images were shown to each observer, of which 15
had one or more lung nodules. Radiologists were asked to locate the nodules and score how confident they were with
their decision on a scale of 1-5. An ROC and JAFROC analysis was performed and modalities were compared using
DBM MRMC.
The results demonstrate no significant differences in performance between the iPad and the LCD for the ROC AUC
(p<0.075) or JAFROC FOM (p<0.059) for random readers and random cases. Sample size estimation showed that this
result is significant at a power of 0.8 and an effect size of 0.05 for ROC and 0.07 for JAFROC.
This work demonstrates that for the task of identifying pulmonary nodules, the use of the iPad does not significantly
change performance compared to an off-the-shelf LCD.
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