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医患同训:能否提高住院医师甲状腺超声诊断水平及其观察者间变异性?

Man to man training: can it help improve the diagnostic performances and interobserver variabilities of thyroid ultrasonography in residents?

机构信息

Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea.

出版信息

Eur J Radiol. 2012 Mar;81(3):e352-6. doi: 10.1016/j.ejrad.2011.11.011. Epub 2011 Dec 1.

Abstract

OBJECTIVE

The purpose of this study was to determine whether the man to man training can improve the diagnostic performances and interobserver variabilities of residents on thyroid ultrasonography.

MATERIALS AND METHODS

A set of 80 quiz cases with ultrasonography images of thyroid nodules (40 benign and 40 malignant on histopathology) were shown to the residents. Residents 1, 2, and 3 had not received the man to man training while Residents 4, 5, 6, and 7 had. The seven residents were asked to fill out one of the ultrasonography features (internal composition, echogenicity, margin, calcification, and shape) and the final assessment (probably benign and suspicious). Thyroid nodules with one or more ultrasonography features including marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller than wide shape were assessed as suspicious nodules. The diagnostic performances of US by the seven residents and interobserver variabilities between the seven residents and a faculty radiologist were calculated.

RESULTS

The sensitivities, negative predictive values, and accuracies of Residents 4, 5, 6, and 7 were higher than those of Residents 1, 2, and 3. The final assessment between Residents 4, 5, 6, and 7 and the faculty radiologist showed almost perfect agreement but that between Residents 1, 2, and 3 and the faculty radiologist showed substantial agreement.

CONCLUSION

The man to man training is crucial for the residents to show better diagnostic performances and improvement of interobserver variabilities for evaluating thyroid nodules with ultrasonography.

摘要

目的

本研究旨在确定男性对男性培训是否可以提高居民在甲状腺超声检查方面的诊断表现和观察者间变异性。

材料与方法

向居民展示了一套 80 个甲状腺结节的测验病例(组织病理学上 40 个良性和 40 个恶性)的超声图像。居民 1、2 和 3 未接受男性对男性培训,而居民 4、5、6 和 7 接受了。这七名居民被要求填写超声特征(内部构成、回声、边缘、钙化和形状)之一和最终评估(可能良性和可疑)。具有一个或多个超声特征的甲状腺结节,包括明显的低回声、微叶状或不规则边缘、微钙化和高宽比,被评估为可疑结节。计算了这七名居民的超声诊断表现和这七名居民与一名放射科教授之间的观察者间变异性。

结果

居民 4、5、6 和 7 的敏感性、阴性预测值和准确率均高于居民 1、2 和 3。居民 4、5、6 和 7 之间以及居民 4、5、6 和 7 与放射科教授之间的最终评估显示出几乎完美的一致性,但居民 1、2 和 3 与放射科教授之间的评估显示出高度一致。

结论

男性对男性培训对于居民在超声评估甲状腺结节方面表现出更好的诊断表现和提高观察者间变异性至关重要。

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