Christiansen Janus Mølgaard, Gerke Oke, Karstoft Jens, Andersen Poul Erik
Thulevej 242, 6715 Esbjerg, Denmark.
Dan Med J. 2014 Jul;61(7):A4875.
Studies targeting medical students and junior doctors have shown that their radiological skills are insufficient. Despite the widespread use of chest X-ray; however, a study of Danish junior doctors' skills has not previously been performed.
A total of 22 participants per-used a standardised series of ten chest X-rays. The test used a multiple-choice form for each image, and the clinical data and the tentative diagnosis of each image were also made available to the participants. For each image, the participant chose a single primary diagnosis; and for each diagnosis, the participant's confidence in the diagnosis was assessed on a five-point Likert scale. The diagnoses were divided into four groups: normal findings, chronic diseases, acute diseases and hyperacute diseases or conditions.
A total of 22 doctors receiving basic clinical education (BCE) completed the study. Overall, participants correctly established 51% of the diagnoses. The participants' overall confidence in the primary diagnoses was 57.5% on the Likert scale, corresponding to 57.5% confidence in the proposed diagnoses. The sensitivity was calculated to 0.49 (95% confidence interval (CI): 0.41-0.57) and the specificity to 0.55 (95% CI: 0.41-0.68).
Based on the results from this study, we conclude that BCE doctors do not meet the minimum requirements for radiological diagnostic skills for the use of chest X-ray that were established for this study.
针对医学生和初级医生的研究表明,他们的放射学技能不足。尽管胸部X光被广泛使用;然而,此前尚未对丹麦初级医生的技能进行过研究。
共有22名参与者使用了一系列标准化的十张胸部X光片。测试针对每张图像采用多项选择题形式,并且还向参与者提供了每张图像的临床数据和初步诊断。对于每张图像,参与者选择一个单一的主要诊断;对于每个诊断,在五点李克特量表上评估参与者对诊断的信心。诊断分为四组:正常表现、慢性疾病、急性疾病以及超急性疾病或病症。
共有22名接受基础临床教育(BCE)的医生完成了该研究。总体而言,参与者正确诊断出51%的病例。参与者对主要诊断的总体信心在李克特量表上为57.5%,即对所提出诊断的信心为57.5%。计算得出敏感性为0.49(95%置信区间(CI):0.41 - 0.57),特异性为0.55(95%CI:0.41 - 0.68)。
基于本研究结果,我们得出结论,接受基础临床教育的医生未达到本研究设定的使用胸部X光进行放射学诊断技能的最低要求。