Burling D, Moore A, Taylor S, La Porte S, Marshall M
St Mark's Hospital, Harrow, Middlesex, UK.
Clin Radiol. 2007 Jul;62(7):651-9. doi: 10.1016/j.crad.2007.02.004. Epub 2007 Apr 6.
Expert consensus recommends directed training and possibly in the future, formal accreditation before independent virtual colonoscopy (VC) reporting. We surveyed radiologists' experience of VC training, compared with barium enema, and assessed attitudes towards accreditation.
A questionnaire was sent to 78 consultant radiologists from 72 centres (65 National Health Service hospitals; seven independent primary screening centres) offering a VC service.
Fifty-four (69%) eligible radiologists responded. They had interpreted 18,152 examinations (range 3-1500) in total versus 232,350 (13 times more) barium enemas. Twenty-two (41%) deemed their VC training as inadequate [including five (45%) of screening centre radiologists], and only 14 (26%) had attended a training workshop due to lack of availability (54%) or financial/study leave constraints (24%). Eleven (20%) radiologists routinely double-reported VC examinations versus 37 (69%) barium enemas, yet 21 (39%) considered requirements for VC training were greater than barium enema. Thirty-eight (70%) favoured accreditation beyond internal audit for VC versus 15(28%) for barium enema. Of these 38, seven (18%) favoured "one-off," and 18 (47%) periodic testing, with 16 (42%) favouring external audit alone or in combination with testing. Overall, 42 (78%) considered specific accreditation for reporting screening examinations appropriate and 45 (83%) respondents preferred a national radiological organization to regulate such a scheme.
There is wide variability in reporting experience and recommendations for VC training have not been widely adopted, in part due to limited access to dedicated workshops. UK radiologists are generally in favour of VC accreditation, governed by a national radiology organization.
专家共识建议进行定向培训,未来可能还需要在独立进行虚拟结肠镜检查(VC)报告之前进行正式认证。我们调查了放射科医生的VC培训经验,并与钡灌肠检查进行比较,同时评估了他们对认证的态度。
向72个提供VC服务的中心(65家国民保健服务医院;7家独立的初级筛查中心)的78位放射科顾问医生发送了问卷。
54位(69%)符合条件的放射科医生做出了回应。他们总共解读了18152例检查(范围为3 - 1500例),而钡灌肠检查为232350例(多出13倍)。22位(41%)认为他们的VC培训不足[包括筛查中心放射科医生中的5位(45%)],并且由于缺乏培训机会(54%)或财务/学习休假限制(24%),只有14位(26%)参加过培训研讨会。11位(20%)放射科医生常规对VC检查进行双重报告,而钡灌肠检查为37位(69%),然而21位(39%)认为VC培训的要求高于钡灌肠检查。38位(70%)支持对VC进行内部审核以外的认证,而钡灌肠检查为15位(28%)。在这38位中,7位(18%)支持“一次性”认证,18位(47%)支持定期测试,16位(42%)支持仅进行外部审核或与测试相结合。总体而言,42位(78%)认为对筛查检查报告进行特定认证是合适的,45位(83%)受访者更倾向于由国家放射学组织来管理这样的计划。
报告经验存在很大差异,VC培训的建议尚未得到广泛采用,部分原因是难以获得专门的研讨会。英国放射科医生普遍支持由国家放射学组织管理的VC认证。