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[高年级医学生基于胸部X光片诊断肺结核的能力]

[Competence of senior medical students in diagnosing tuberculosis based on chest X-rays].

作者信息

Silva Vania Maria Carneiro da, Luiz Ronir Raggio, Barreto Míriam Menna, Rodrigues Rosana Souza, Marchiori Edson

机构信息

Department of Internal Medicine, Medical School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

J Bras Pneumol. 2010 Mar-Apr;36(2):190-6. doi: 10.1590/s1806-37132010000200006.

Abstract

OBJECTIVE

To evaluate the competence of senior medical students in diagnosing tuberculosis (TB) based on their reading of chest X-rays, as well as to identify the factors associated with high scores for the overall interpretation of chest X-rays.

METHODS

In October 2008, a convenience sample of senior medical students who had undergone formal training in radiology at the Federal University of Rio de Janeiro School of Medicine, in the city of Rio de Janeiro, Brazil, were invited to participate in the study. Six chest X-rays (three of TB patients and three of patients without TB) were selected. Participants were asked to choose one of the three probable radiological interpretations, and one of the four subsequent suitable clinical approaches. They also completed a questionnaire designed to collect data related to demographics, career of interest, time spent in emergency rooms and year of study. The sensitivity and specificity related to competence in the radiological diagnosis of TB, as well as a score for the overall interpretation of chest X-rays, were calculated.

RESULTS

The sensitivity of the probable radiological diagnosis of pulmonary TB, based on the three chest X-rays of patients with TB (minimal, moderate and extensive) was 86.5%, 90.4% and 94.2%, respectively, and the specificity was 90%, 82% and 42%. The only factor associated with a high score for the overall radiological interpretation was the year of study.

CONCLUSIONS

In this sample of medical students, who had received formal training in radiology early in their medical school course, the competence in interpreting the chest X-rays of TB patients was good. The year of study seems to influence overall chest X-ray reading skill.

摘要

目的

基于高年级医学生对胸部X光片的解读来评估其诊断结核病(TB)的能力,并确定与胸部X光片整体解读高分相关的因素。

方法

2008年10月,邀请了在巴西里约热内卢市里约热内卢联邦大学医学院接受过放射学正规培训的高年级医学生作为便利样本参与研究。选择了六张胸部X光片(三张来自结核病患者,三张来自非结核病患者)。参与者被要求从三种可能的放射学解读中选择一种,以及随后四种合适的临床方法中的一种。他们还完成了一份问卷,旨在收集与人口统计学、感兴趣的职业、在急诊室花费的时间和学习年份相关的数据。计算了与结核病放射学诊断能力相关的敏感性和特异性,以及胸部X光片整体解读的分数。

结果

基于结核病患者的三张胸部X光片(轻度、中度和广泛)对肺结核进行可能的放射学诊断的敏感性分别为86.5%、90.4%和94.2%,特异性分别为90%、82%和42%。与放射学整体解读高分相关的唯一因素是学习年份。

结论

在这个医学院课程早期接受过放射学正规培训的医学生样本中,对结核病患者胸部X光片的解读能力良好。学习年份似乎会影响胸部X光片的整体阅读技能。

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