Reproducibility and speed of landmarking process in cephalometric analysis using two input devices:mouse-driven cursor versus pen

Aims. To define if the new portable appliances, like smartphone, iPad, small laptop and tablet can be used in cephalometric tracing without dropping out the validity of any measurement. Methods. We investigated and compared the reproducibility and the speed of landmarks identification process on lateral X-rays in two input devices: a mouse-driven cursor and a pen used as input means in mobile devices. One expert located 22 landmarks on 15 lateral X-rays in a repeated measure design two times, at time T1 and T2, after at least one month. The Intraclass Correlation coefficient was used to evaluate the reproducibility for each landmark tracing and the agreement between the value derived from both input devices. Also, the mean errors in measurements, the standard deviation and the Friedman Test significans (P < 0.05) between both input were statistically evaluated. Results. All landmarks had a high agreement and the Friedman Test indicated statistically significant differences (P<0.05) for the identification of Na, Po, Pt, PNS, Ba, Pg, Gn, UIE, UIA, APOcc and PPOcc landmarks. Conclusions. Even if the mouse input give higher agreement for landmark tracing the differences are really minimal and they can be ignored in private practice. We suggest the adequacy of pen input in clinical setting.