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March 22, 2026Tomography0 citationsOpen Access

The Hidden Variable in Radiological Accuracy: The Impact of Monitor Quality Under Real-Life Emergency Department Conditions

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BCBahadir CaglarSSSüha Seri̇n

Key Points

  • To assess the impact of different monitor types on radiological diagnostic accuracy in real-life emergency conditions.
  • Prepared three image sets of emergency radiological images including CT, MRI, and digital radiography images.
  • Five blinded emergency specialists evaluated images on standard, medical, and advanced monitors under emergency conditions.
  • Used statistical analysis, including Cochran’s Q test and multilevel modeling, to assess diagnostic accuracy and ease of diagnosis.
  • Overall diagnostic accuracy rates were 98.7% for standard monitors, and 100% for advanced and medical monitors.
  • Significant differences found between monitor types, with a p-value of 0.002.
  • Ease of diagnosis scores improved from 7.6 for standard monitors to 9.8 for medical monitors, indicating large effect size.

Abstract

Background/Objectives: Radiological assessment has become indispensable for modern clinical decision-making. Image quality plays a critical role in the reliability of radiological interpretation. Unlike most previous studies, this study investigated the effect of monitor type on diagnostic accuracy and ease of diagnosis under physical conditions outside the radiology unit. Methods: Three image sets were prepared for the study, consisting of emergency radiological images, each containing 50 computed tomography, magnetic resonance imaging, and digital radiography images. The image sets were examined by five emergency specialists, who were blinded to each other’s work, under emergency service conditions on a standard monitor (SM), medical monitor (MM), and advanced monitor (AM). The accuracy and ease of diagnosis were analyzed statistically according to the type of monitor used. Results: Overall diagnostic accuracy rates were 98.7% for SM, 100% for AM, and 100% for MM. Cochran’s Q test demonstrated a statistically significant difference between monitor types (p = 0.002), with significant pairwise differences for SM–AM and SM–MM comparisons. The absolute risk difference between SM and AM/MM was 1.3%, corresponding to a relative risk of 1.013 and a number needed to benefit (NNB) of 77. Ease of diagnosis scores increased progressively across monitor types (SM: 7.6 IQR 7–8, AM: 9.4 IQR 9–9.8, MM: 9.8 IQR 9.6–10; p < 0.001), with a large overall effect size (Kendall’s W = 0.81). Multilevel modeling confirmed that these associations persisted after adjustment for clustering effects. Conclusions: In situations where medical monitors cannot be used due to cost and operational constraints, opting for advanced monitors instead of standard monitors may modestly improve diagnostic accuracy while substantially enhancing perceived ease of diagnosis.

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Cite This Study

Caglar et al. (2026) studied this question.

synapsesocial.com/papers/69bf393dc7b3c90b18b43901https://doi.org/10.3390/tomography12030043
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