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Agreement and reading time for differently-priced devices for the digital capture of X-ray films

We assessed the reliability of three digital capture devices: a film digitizer (which cost US $15,000), a flat-bed scanner (US $1800) and a digital camera (US $450). Reliability was measured as the agreement between six observers when reading images acquired from a single device and also in terms of the pair-device agreement. The images were 136 chest X-ray cases. The variables measured were the interstitial opacities distribution, interstitial patterns, nodule size and percentage pneumothorax size. The agreement between the six readers when reading images acquired from a single device was similar for the three devices. The pair-device agreements were moderate for all variables. There were significant differences in reading-time between devices: the mean reading-time for the film digitizer was 93 s, it was 59 s for the flat-bed scanner and 70 s for the digital camera. Despite the differences in their cost, there were no substantial differences in the performance of the three devices.