1 Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.
AJR Am J Roentgenol. 2014 Jul;203(1):3-9. doi: 10.2214/AJR.13.11787.
The purpose of this study was to simulate a mobile consultation in patients with inconclusive diagnosis of appendicitis made by on-call radiologists, as well as to measure the diagnostic confidence and performance of the mobile consultation.
Two off-site abdominal radiologists interpreted the CT images from 68 patients (including 29 patients with confirmed appendicitis) on a smart-phone for whom the preliminary CT reports by 25 in-house on-call radiologists were inconclusive. The smartphone readings were compared with the preliminary reports by on-call radiologists and with the original final reports by in-house abdominal radiologists. Heat maps, kappa statistics, Wilcoxon signed-rank tests, and ROC curves were used for data analysis.
The heat maps and kappa statistics showed that the smartphone readings were more similar to the final reports than to the preliminary reports. In diagnosing or ruling out appendicitis, the smartphone readings were more confident than the preliminary reports (p ≤ 0.01) and did not significantly differ in diagnostic confidence from the final reports (p ≥ 0.19). The AUCs of the smartphone readings (0.91 and 0.92) did not differ significantly from those of the preliminary (0.85) or final (0.97) reports (p ≥ 0.09).
With the given study sample, the diagnostic performance of the off-site smartphone readings did not differ significantly from that of the in-house preliminary reports. However, the smartphone readings provided higher diagnostic confidence than the preliminary reports.
本研究旨在模拟由轮值放射科医生对疑似阑尾炎患者进行移动咨询，并测量移动咨询的诊断信心和性能。
两名场外腹部放射科医生使用智能手机对 68 名患者（包括 29 名确诊阑尾炎的患者）的 CT 图像进行解读，这些患者的 25 名院内轮值放射科医生的初步 CT 报告结果不确定。智能手机阅读结果与轮值放射科医生的初步报告和内部腹部放射科医生的原始最终报告进行比较。使用热图、kappa 统计、Wilcoxon 符号秩检验和 ROC 曲线进行数据分析。
热图和 kappa 统计显示，智能手机阅读结果与最终报告更为相似，而与初步报告差异较大。在诊断或排除阑尾炎方面，智能手机阅读结果比初步报告更有信心（p≤0.01），与最终报告的诊断信心差异无统计学意义（p≥0.19）。智能手机阅读的 AUC 值（0.91 和 0.92）与初步（0.85）或最终（0.97）报告的 AUC 值无显著差异（p≥0.09）。
在给定的研究样本中，场外智能手机阅读的诊断性能与内部初步报告无显著差异。然而，智能手机阅读提供的诊断信心高于初步报告。
