Bell Megan E, Patel Maitray D
Department of Radiology, Mayo Clinic, 5777 E. Mayo Blvd., Phoenix, AZ, 85054, USA.
Abdom Imaging. 2014 Oct;39(5):1114-8. doi: 10.1007/s00261-014-0139-4.
To evaluate if and to what extent the degree of subspecialization in abdominal imaging (AI) affects rates of discrepancies identified on review of body CT studies initially interpreted by board-certified radiologists not specialized in AI.
AI division radiologists at one academic medical center were classified as primary or secondary members of the division based on whether they perform more or less than 50% of their clinical duties in AI. Primary AI division radiologists were further subdivided based on whether or not they focus their clinical duties almost exclusively in AI. All AI radiologists performed subspecialty review of all after-hours body CT studies initially interpreted by any non-division radiologist. The discrepancies identified in the subspecialty review of consecutive after-hours body CT scans performed between 7/1/10 and 12/31/10 were analyzed and placed into one of three categories: (1) discrepancies that potentially affect patient care ("clinically relevant discrepancies", or CRD); (2) discrepancies that would not affect patient care ("incidental discrepancies", or ID); and (3) other types of comments. Rates of CRD and ID detection were compared between subgroups of Abdominal Imaging Division radiologists divided by the degree of subspecialization.
1303 studies met the inclusion criteria. Of 742 cases reviewed by primary members of the AI division, 33 (4.4%) had CRD and 78 (10.5%) had ID. Of 561 cases reviewed by secondary members of the AI division, 11 (2.0%) had CRD and 36 (6.5%) had ID. The differences between the groups for both types of discrepancies were statistically significant (p = 0.01). When primary members of the AI division were further subdivided based on extent of clinical focus on abdominal imaging, rates of CRD and ID detection were higher for the subgroup with more clinical focus on abdominal imaging.
The degree of AI subspecialization affects the rate of clinically relevant and ID identified in body CT interpretations initially rendered by board certified but non-abdominal imaging subspecialized radiologists.
评估腹部影像（AI）亚专业程度是否以及在何种程度上影响对由非AI专业的委员会认证放射科医生最初解读的身体CT研究进行复查时发现的差异率。
一家学术医疗中心的AI科室放射科医生根据其在AI领域履行的临床职责是否超过或少于50%，被分类为该科室的主要或次要成员。主要AI科室放射科医生进一步根据其临床职责是否几乎完全集中在AI领域进行细分。所有AI放射科医生对所有由非科室放射科医生最初解读的非工作时间身体CT研究进行亚专业复查。分析了在2010年7月1日至2010年12月31日期间连续进行的非工作时间身体CT扫描亚专业复查中发现的差异，并将其分为三类之一：（1）可能影响患者护理的差异（“临床相关差异”，或CRD）；（2）不会影响患者护理的差异（“偶然差异”，或ID）；（3）其他类型的注释。比较了按亚专业程度划分的腹部影像科放射科医生亚组之间的CRD和ID检测率。
1303项研究符合纳入标准。在AI科室主要成员复查的742例病例中，33例（4.4%）有CRD，78例（10.5%）有ID。在AI科室次要成员复查的561例病例中，11例（2.0%）有CRD，36例（6.5%）有ID。两组在两种差异类型上的差异具有统计学意义（p = 0.01）。当根据对腹部影像的临床关注程度对AI科室主要成员进一步细分时，对腹部影像临床关注更多的亚组的CRD和ID检测率更高。
AI亚专业程度影响由委员会认证但非腹部影像亚专业的放射科医生最初解读的身体CT解释中发现的临床相关差异和ID率。
