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The frequency of change in diagnosis and the correctness of such changes were recorded This information re ected the impact that use of CAD might have in actual clinical practice where altered diagnostic decisions would affect management options 2553 Effect of CAD-Assisted Reading on Clinicians Performance All the results quoted in subsequent sections refer to those calculated on per case or per patient basis 25531 Clinicians Improved Performance with CAD The Az values (area under the ROC curve) scored by individuals before and after CAD are presented in Figure 2513A and B Figure 2513A presents individual performance before and after using the CAD Only 1 of the 20 observers (observer 4) scored marginally lower Az after CAD The other 19 people all attained a variable increment after use of CAD Figure 25.

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12B depicts the three ROC curve pairs, each pair shows the group s (RS in green, RR in red, and EP in blue) performance to have improved (from a lighter to a darker color) with the aid of CAD Signi cantly improved performance is observed in the EP (emergency physician) average area under the ROC curve (Az), which increased from 08422 to 09294 (p = 00107) when the diagnosis was made without and with the support of CAD Az for RR (radiology resident) increased from 09371 to 09762 (p = 00088) Az for RS (radiology specialist) increased from 09742 to 09868 (p = 01755) but was statistically insigni cant The results are shown in Figure 2513B It was clear that the performance of the EP with support of CAD approached that of the RR without CAD.

Polyurethane and polymeric foams, 113 119 generally, 113 114 phenolic foams, 117 polyurethane foam, 114 117 uses of, 117, 119 Polyvinyl acetate, packaging applications, 157 Polyvinyl alcohol: biodegradable polymers, 368 biodegradable water-soluble polymer synthesis, 500 502 Polyvinyl alcohol, biodegradability, 160 Polyvinyl chloride, 96 101 agricultural applications, 185, 186, 203 204 characteristics of, 96 97 degradation mechanisms, 327 328 environmental and safety issues, 98 101 historical perspective, 78 incineration hazards, 55 56 manufacture of, 97 98 marine environment, 381 packaging applications, 144, 156 157 stabilization methods, 337 338 thermal destruction, 673 693 Population growth, challenge of, 8 10 Postconsumer plastics, de ned, 565 566 Powder coatings, shift to, 236 238 Preconsumer plastics, de ned, 565 566 Primary recycling, de ned, 565 Printing, textile processing wastes, 283 299. See also Coloration (textile processing wastes) Public health: global warming, 67 ozone depletion, 72 73 polyvinyl chloride, 98 101 Public policy. See Government Pullulan, biodegradable polymers, 365 366 Pullularia pullulans, biodegradable polymers, 365 Pyrolysis: catalytic, of nylons, textile ber recycling, 702 heat of, thermal destruction, 678 680 Pyrolysis, thermal destruction, 637

The performance of the RR with CAD was close to that of RS in this experimental condition, since the readers were limited to viewing images without the bene t of windowing or tiling images This result signi es that the CAD can improve reader performance as well as reduce variability among different clinician groups 25532 Sensitivity, Speci city, Positive, and Negative Predictive Values The sensitivity, speci city, positive, and negative predictive values were calculated for each reader both before and after use of CAD (Table 257) It was demonstrated that both sensitivity and speci city improved for each group The gain was the most remarkable for the EP whose average sensitivity/speci city improved from 733/814% to 805/905%, and less for the RR, which was from 862/881% to 938/929%, and least for the RS, which was from 922/93.

Figure 18.5 PACS acceptance testing (AT) design. (A) PACS network AT showing hot swap main network switch (red arrow); (B) an example of the components setup for the PACS acceptance testing (AT). Numerals described in text are the components needed to be included in the AT. Red: 100 Mbit/s; blue: 1 Gbit/s.

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