Effect of picture archiving and communication system on diagnosis accuracy in CT and radiography examinations in emergency departments

Int J Med Inform. 2023 Feb:170:104972. doi: 10.1016/j.ijmedinf.2022.104972. Epub 2022 Dec 21.

Abstract

Introduction: Picture archiving and communication system (PACS) affects the radiologists' and physicians' performance. We aimed to evaluate the effect of implementing PACS on the emergency department (ED) physicians' accuracy compared to a radiologist's diagnosis in Iran.

Methods: We retrospectively collected data for three six-month periods before and after the implementation of PACS on CT scan and radiography examinations. We compared ED physicians' diagnoses of CT scan and radiography images with a radiologist's interpretations for the same images. We compared 374 CT scans and 346 radiography examinations before implementing PACS (July 2015 to December 2015); 507 CT scans and 480 radiography examinations immediately after PACS (July 2016 to December 2016); and 870 CT scans and 1137 radiography examinations one year after PACS (July 2017 to December 2017).

Results: We found that diagnosis accuracy of ED physicians on CT scans increased from 75.9 % before implementing PACS to 84.4 % immediately after PACS and 94.9 % one year after PACS (p-value < 0.0001). Diagnosis accuracy for radiography images increased from 63.0 % before implementing PACS to 80.2 % immediately after PACS and 93.1 % one year after PACS (p-value < 0.0001).

Conclusion: Implementation of PACS technology increases ED physicians' diagnosis accuracy.

Keywords: Accuracy; CT scan; Diagnosis; Emergency department; PACS; Picture archiving and communication systems; Radiography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Emergency Service, Hospital
  • Humans
  • Radiography
  • Radiology Information Systems*
  • Retrospective Studies
  • Tomography, X-Ray Computed*