Does the accuracy of single reading with CAD (computer-aided detection) compare with that of double reading?: A review of the literature

AIM: To examine current evidence to determine whether the accuracy of single reading with computed-aided detection (CAD) compares with that of double reading. METHODS: We performed a literature review to identify studies where both protocols had been investigated and compared. We identified eight studies that compared single reading with CAD against double reading, of which six reported on comparisons of both sensitivity and specificity. RESULTS: Of the six studies identified, three showed no differences in either sensitivity or specificity. One showed single reading with CAD had a higher sensitivity at the same specificity, another that single reading with CAD had a higher specificity at the same sensitivity. However, one study, in a real-life setting, showed that single reading with CAD had a higher sensitivity but a lower specificity. CONCLUSION: As the majority of the studies were not in a real-life setting, used test sets, lacked sufficient training in the use of CAD and simulated double reading (using a protocol of recall if one suggests), current evidence is therefore limited as to the accuracy, in terms of sensitivity and specificity, of single reading with CAD in comparison with the most common practice in the UK of double reading using a protocol of consensus or arbitration. (c) 2006 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.