Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, UK.
Clin Med (Lond). 2013 Aug;13(4):349-52. doi: 10.7861/clinmedicine.13-4-349.
The chest X-ray (CXR) is an important diagnostic tool in diagnosing and monitoring a spectrum of diseases. Despite our universal reliance on the CXR, our ability to confidently diagnose and accurately document our findings can be unreliable. We sought to assess the diagnostic accuracy and certainty of making a diagnosis based on 10 short clinical histories with one CXR each. We conclude from our study that specialist registrars (StRs) and consultants scored the highest marks with the highest average certainty levels. Junior trainees felt least certain about making their diagnosis and were less likely to be correct. We recommend that StRs and consultants review all the CXRs requested to ensure accuracy of diagnosis. There also needs to be discussion with the Joint Royal Colleges of Physicians Training Board (JRCPTB) about the need of including a separate CXR competency as part of a trainee's generic curriculum on the e-portfolio, something which is currently lacking.
胸部 X 光（CXR）是诊断和监测一系列疾病的重要诊断工具。尽管我们普遍依赖 CXR，但我们诊断和准确记录发现的能力可能不可靠。我们试图评估基于每个 CXR 的 10 个简短临床病史做出诊断的准确性和确定性。我们从研究中得出结论，专科住院医师（StR）和顾问的得分最高，平均确定性水平最高。初级受训者对做出诊断最不确定，并且不太可能正确。我们建议 StR 和顾问审查所有请求的 CXR，以确保诊断的准确性。还需要与联合皇家内科医师学院培训委员会（JRCPTB）讨论是否需要将单独的 CXR 能力作为学员电子档案中通用课程的一部分，目前这方面还存在欠缺。
