Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services

Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera....

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Main Authors: Antonio J. Salazar, Javier A. Romero, Oscar A. Bernal, Angela P. Moreno, Sofía C. Velasco, Xavier A. Díaz
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:International Journal of Telemedicine and Applications
Online Access:http://dx.doi.org/10.1155/2016/3642960
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author Antonio J. Salazar
Javier A. Romero
Oscar A. Bernal
Angela P. Moreno
Sofía C. Velasco
Xavier A. Díaz
author_facet Antonio J. Salazar
Javier A. Romero
Oscar A. Bernal
Angela P. Moreno
Sofía C. Velasco
Xavier A. Díaz
author_sort Antonio J. Salazar
collection DOAJ
description Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations. The variables evaluated were the positive predictive value (PPV), accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curves (AUC). Result. The mean values for the observed variables were as follows: accuracy ranged from 0.77 to 0.82, the PPV ranged from 0.67 to 0.68, sensitivity ranged from 0.64 to 0.74, specificity ranged from 0.87 to 0.90, and the AUC ranged from 0.87 to 0.90. At a difference of 0.1 to claim equivalence, all alternatives were equivalent for all variables. Conclusion. Our findings suggest that telemammography screening programs may be provided to underserved populations at a low cost, using a film digitizer or a digital camera.
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spelling doaj-art-5498220def474f69aefdd53dddcb1ef92025-08-20T02:05:45ZengWileyInternational Journal of Telemedicine and Applications1687-64151687-64232016-01-01201610.1155/2016/36429603642960Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography ServicesAntonio J. Salazar0Javier A. Romero1Oscar A. Bernal2Angela P. Moreno3Sofía C. Velasco4Xavier A. Díaz5Electrophysiology and Telemedicine Laboratory, University of Los Andes, Carrera 1 Este No. 19A-40, Bogotá 11001, ColombiaDepartment of Diagnostic Imaging, Fundación Santa Fe de Bogotá University Hospital, Calle 119 No. 7-75, Bogotá 11001, ColombiaSchool of Medicine, University of Los Andes, Carrera 1 Este No. 19A-40, Bogotá 11001, ColombiaDepartment of Diagnostic Imaging, Fundación Santa Fe de Bogotá University Hospital, Calle 119 No. 7-75, Bogotá 11001, ColombiaDepartment of Diagnostic Imaging, Fundación Santa Fe de Bogotá University Hospital, Calle 119 No. 7-75, Bogotá 11001, ColombiaElectrophysiology and Telemedicine Laboratory, University of Los Andes, Carrera 1 Este No. 19A-40, Bogotá 11001, ColombiaObjective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations. The variables evaluated were the positive predictive value (PPV), accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curves (AUC). Result. The mean values for the observed variables were as follows: accuracy ranged from 0.77 to 0.82, the PPV ranged from 0.67 to 0.68, sensitivity ranged from 0.64 to 0.74, specificity ranged from 0.87 to 0.90, and the AUC ranged from 0.87 to 0.90. At a difference of 0.1 to claim equivalence, all alternatives were equivalent for all variables. Conclusion. Our findings suggest that telemammography screening programs may be provided to underserved populations at a low cost, using a film digitizer or a digital camera.http://dx.doi.org/10.1155/2016/3642960
spellingShingle Antonio J. Salazar
Javier A. Romero
Oscar A. Bernal
Angela P. Moreno
Sofía C. Velasco
Xavier A. Díaz
Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services
International Journal of Telemedicine and Applications
title Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services
title_full Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services
title_fullStr Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services
title_full_unstemmed Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services
title_short Noninferiority and Equivalence Evaluation of Clinical Performance among Computed Radiography, Film, and Digitized Film for Telemammography Services
title_sort noninferiority and equivalence evaluation of clinical performance among computed radiography film and digitized film for telemammography services
url http://dx.doi.org/10.1155/2016/3642960
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