Relative gains in diagnostic accuracy between computer-aided diagnosis and independent double reading

Double readings of chest radiographs and mammograms made by two radiologists have been investigated as a way to improve diagnostic accuracy. Computer-aided diagnosis (CAD) also has been investigated as an alternative method to improve diagnostic accuracy. Our purpose was to compare the relative gains that can be obtained from independent double readings and from computer-aided diagnosis in the diagnosis of breast lesions in mammograms (determining a known lesion as malignant or benign). We conducted an observer study from which we obtained data of radiologists' unaided single-reading performance and their single-reading performance with a computer aid. We then derived their unaided double-reading performance according to six different methods. Our results show that computer-aided diagnosis can potentially improve radiologists' diagnostic accuracy more than independent double readings by two radiologists.