Insurance reimbursement of digital images

[PF. vd. Stelt]

There are a few reasons why the example of the manipulated radiograph is not
very convincing, and should easily be recognized as being tampered with. To
mention just a few clues:

1. the outline of the rubber dam clamp is completely different from what you
expect in a radiographic projection.
2. the shape of the clamp is probably not what is should be.
3. the center of the radiolucency shows "scratches', which are the result of
the drawing and pasting of darker pixels.
4. the contrast and density of the radiolucency is more than one would expect,
taking the general texture of the surrounding bone into account.

It took only a couple of minutes to manipulate the radiograph, but it also
took little time to find the suspicious features.

I assume, when digital will become more wide spread, the experience in
recognizing wrong images will also increase (as happened with conventional
analog images as well).

Paul van der Stelt
==============================================================
Paul F. van der Stelt, DDS, PhD
professor Oral and Maxillofacial Radiology
dept. of Oral and Maxillofacial Radiology, ACTA
Louwesweg 1
1066 EA Amsterdam
phone +31-20-5188262
fax +31-20-5188 480
email: p.vdstelt at acta.nl
==============================================================

- - - - - - - - - - - - - - Original Message - - - - - - - - - - - - - -
On Sat Feb 10 11:22:54 2001,
"Leif Kullman" <lkullman at KSU.EDU.SA> wrote:
>Hallo Curtis
>Unfortunately I cannot supply you with any information about how insurance
>companies reimburse DDX, but I can understand that the authorities are
>worried.
>According to my opinion, it will be very easy to cheat in the future.
>I attach two images from a dental colleague in Sweden. He used a very common
>software (I think it was PaintShop Pro) and changed the original radiograph
>(original.jpg)to a manipulated version (fejk.jpg)with an ongoing endo
>treatment.
>It took him only a couple of minutes!
>
>Best regards Leif
>
>
>Curtis SK Chen wrote:
>
>> Dear colleagues,
>>
>> The National Health Insurance System here is finally looking into
>> reimbursement of digital dental x-ray images. The decision makers are very
>> converned about the possibility of "modification" of digital images. Please
>> kindly provide me with info on how your insurance company reimburse DDX,
>and
>> how to prevent this possible fraud. Many thanks in advance!
>>
>> Sincerely,
>>
>> Curtis
>>
>> -------------------------------------------------
>> Curtis SK Chen DDS MSD PhD
>> Dentistry, NTU Hospital
>> No. 1, Chang-Te Street, Taipei, Taiwan
>> Tel: 886-2-23123456 ext 7696
>> Fax: 886-2-23831346
>> Email: cskchen at ccms.ntu.edu.tw
>> -------------------------------------------------
>
>--
>-----------------------------------------------------------------------------
>----------------------------------------------------
>
>Leif Kullman, DDS, PhD, Assoc. Professor
>Head, Division of Maxillofacial Radiology
>MDS Departm., College of Dentistry
>P.O. Box 60169, 115 45 Riyadh
>Kingdom of Saudi Arabia
>
>
>

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