Stankiewicz K, Cohen M, Carone M, Sevinc G, Nagy P G, Lewin J S, Yousem D M, Babiarz L S
From The Russell H. Morgan Department of Radiology and Radiological Sciences (K.S., M. Cohen, G.S., P.G.N., J.S.L., D.M.Y., L.S.B.), Johns Hopkins Medical Institutions, Baltimore, Maryland.
Department of Biostatistics, University of Washington (M. Carone), Seattle, Washington.
AJNR Am J Neuroradiol. 2016 Nov;37(11):1977-1982. doi: 10.3174/ajnr.A4897. Epub 2016 Jul 28.
Trainees' interpretations of neuroradiologic studies are finalized by faculty neuroradiologists. We aimed to identify the factors that determine the degree to which the preliminary reports are modified.
The character length of the preliminary and final reports and the percentage character change between the 2 reports were determined for neuroradiology reports composed during November 2012 to October 2013. Examination time, critical finding flag, missed critical finding flag, trainee level, faculty experience, imaging technique, and native-versus-non-native speaker status of the reader were collected. Multivariable linear regression models were used to evaluate the association between mean percentage character change and the various factors.
Of 34,661 reports, 2322 (6.7%) were read by radiology residents year 1; 4429 (12.8%), by radiology residents year 2; 3663 (10.6%), by radiology residents year 3; 2249 (6.5%), by radiology residents year 4; and 21,998 (63.5%), by fellows. The overall mean percentage character change was 14.8% (range, 0%-701.8%; median, 6.6%). Mean percentage character change increased for a missed critical finding (+41.6%, < .0001), critical finding flag (+1.8%, < .001), MR imaging studies (+3.6%, < .001), and non-native trainees (+4.2%, = .018). Compared with radiology residents year 1, radiology residents year 2 (-5.4%, = .002), radiology residents year 3 (-5.9%, = .002), radiology residents year 4 (-8.2%, < .001), and fellows (-8.7%; < .001) had a decreased mean percentage character change. Senior faculty had a lower mean percentage character change (-6.88%, < .001). Examination time and non-native faculty did not affect mean percentage character change.
A missed critical finding, critical finding flag, MR imaging technique, trainee level, faculty experience level, and non-native-trainee status are associated with a higher degree of modification of a preliminary report. Understanding the factors that influence the extent of report revisions could improve the quality of report generation and trainee education.
学员对神经放射学研究的解读由神经放射科教员最终审定。我们旨在确定决定初步报告修改程度的因素。
对于2012年11月至2013年10月期间撰写的神经放射学报告，确定初步报告和最终报告的字符长度以及两份报告之间的字符变化百分比。收集检查时间、关键发现标记、遗漏关键发现标记、学员水平、教员经验、成像技术以及读者是否为非英语母语者等信息。使用多变量线性回归模型评估平均字符变化百分比与各种因素之间的关联。
在34661份报告中，一年级放射科住院医师阅读了2322份（6.7%）；二年级放射科住院医师阅读了4429份（12.8%）；三年级放射科住院医师阅读了3663份（10.6%）；四年级放射科住院医师阅读了2249份（6.5%）；研究员阅读了21998份（63.5%）。总体平均字符变化百分比为14.8%（范围为0% - 701.8%；中位数为6.6%）。遗漏关键发现（+41.6%，P <.0001）、关键发现标记（+1.8%，P <.001）、磁共振成像研究（+3.6%，P <.001）以及非英语母语学员（+4.2%，P =.018）会使平均字符变化百分比增加。与一年级放射科住院医师相比，二年级放射科住院医师（-5.4%，P =.002）、三年级放射科住院医师（-5.9%，P =.002）、四年级放射科住院医师（-8.2%，P <.001）和研究员（-8.7%；P <.001）的平均字符变化百分比降低。资深教员的平均字符变化百分比更低（-6.88%，P <.001）。检查时间和非英语母语教员不会影响平均字符变化百分比。
遗漏关键发现、关键发现标记、磁共振成像技术、学员水平、教员经验水平以及非英语母语学员身份与初步报告的更高修改程度相关。了解影响报告修订程度的因素可以提高报告生成质量和学员教育质量。
