Treadmill-based workstation gets radiologists moving

CHARLOTTE, NC - Exercise brings a host of physical and mental benefits, but it's not easy for radiologists to be physically active while interpreting images. With the use of a treadmill-based workstation, however, they may be able to do just that, according to research presented Friday at the Society for Imaging Informatics in Medicine (SIIM) annual meeting.

Believing that radiologists could benefit physiologically from increased daily physical exercise, researchers from the University of Maryland in Baltimore installed a treadmill-based workstation called Walkstation. Walkstation consists of a three-monitor workstation and a treadmill that can be set to speeds up to 0.3 to 2.0 miles per hour, according to the study team.

Walkstation not only gets radiologists up and moving, but it might even improve their interpretation accuracy, said Dr. Amee Patel, a radiology resident at the university.

"According to our results, there was no statistically significant difference in the accuracy of detecting lung nodules depending on the radiologists' reading position," Patel said. "In fact, there appeared to be a slight increase in sensitivity while walking on the Walkstation at the expense of a slight decrease in specificity."

The workstation is also designed for minimal noise output to minimize radiologist distraction from noise and any negative impact on speech recognition.

To evaluate the Walkstation's effects on interpretation accuracy, the researchers selected 20 de-identified posteroanterior chest radiographs from the institution's imaging archives. The studies included 10 normal and 10 abnormal cases that showed a subtle lung nodule.

Eight readers, four attending physicians and four residents, reviewed the radiographs on a computer monitor in three randomized test positions (sitting, standing, and walking on the treadmill at 1 mph). The radiologists were allotted five seconds to each case in the reading session, which included five practice cases followed by the 20 chest radiographs in a randomized order.

The readers were asked to determine if a nodule was present; to identify its location in the upper, mid, or lower lung; and to identify the side of any pathology. Each reader had approximately 24 hours between each of his or her three sessions, she said.

Detection of lung nodules
Walking Standing Sitting
Mean sensitivity 80% 76% 71%
Mean specificity 56% 69% 77%

The differences in sensitivity, specificity, or accuracy were not statistically significant (p = 0.369). In addition, there was no evidence of a memory effect between the first, second, and third reading sessions (p = 0.37), according to Patel.

In a second phase of the study, 10 radiologists were asked to complete the following tasks while their heart rate and blood pressure were monitored: standing on the Walkstation, reading chest x-rays while standing on the Walkstation, dictating reports while standing on the Walkstation, and walking on the Walkstation at 1 mph.

Little difference in blood pressure and heart rate was seen between standing and sitting while interpreting images and walking, she said.

"However, there was a bump in both systolic blood pressure and heart rate when the radiologists were actually dictating studies, not necessarily when they were walking," she said.

Also, blood pressure and heart rate did not appear to increase during image interpretation itself and, interestingly, may have decreased slightly at its completion, Patel noted.

The researchers acknowledged several limitations of the study, including the relatively short period of time radiologists were on the treadmill prior to performing the image interpretation task, the high level of disease prevalence in the study cases, and a limited test group size. In addition, the study simulated the radiologist workday with selected cases, rather than the radiologists being monitored during their actual workday, Patel said.

By Erik L. Ridley
AuntMinnie.com staff writer
June 6, 2009

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