Bunch Paul M, Altes Talissa A, McIlhenny Joan, Patrie James, Gaskin Cree M
Department of Radiology, Massachusetts General Hospital, 55 Francis Street, Boston, MA, 02114, USA.
Department of Radiology, University of Missouri, One Hospital Drive, Columbia, MO, 65212, USA.
Skeletal Radiol. 2017 Jun;46(6):785-793. doi: 10.1007/s00256-017-2616-7. Epub 2017 Mar 25.
To assess reader performance and subjective workflow experience when reporting bone age studies with a digital bone age reference as compared to the Greulich and Pyle atlas (G&P). We hypothesized that pediatric radiologists would achieve equivalent results with each method while digital workflow would improve speed, experience, and reporting quality.
IRB approval was obtained for this HIPAA-compliant study. Two pediatric radiologists performed research interpretations of bone age studies randomized to either the digital (Digital Bone Age Companion, Oxford University Press) or G&P method, generating reports to mimic clinical workflow. Bone age standard selection, interpretation-reporting time, and user preferences were recorded. Reports were reviewed for typographical or speech recognition errors. Comparisons of agreement were conducted by way of Fisher's exact tests. Interpretation-reporting times were analyzed on the natural logarithmic scale via a linear mixed model and transformed to the geometric mean. Subjective workflow experience was compared with an exact binomial test. Report errors were compared via a paired random permutation test.
There was no difference in bone age determination between atlases (p = 0.495). The interpretation-reporting time (p < 0.001) was significantly faster with the digital method. The faculty indicated preference for the digital atlas (p < 0.001). Signed reports had fewer errors with the digital atlas (p < 0.001).
Bone age study interpretations performed with the digital method were similar to those performed with the Greulich and Pyle atlas. The digital atlas saved time, improved workflow experience, and reduced reporting errors relative to the Greulich and Pyle atlas when integrated into electronic workflow.
评估与使用格雷厄姆和派尔图谱（G&P）相比，采用数字骨龄参考报告骨龄研究时的阅片者表现和主观工作流程体验。我们假设儿科放射科医生使用每种方法都能取得等效结果，而数字工作流程将提高速度、改善体验并提升报告质量。
本符合健康保险流通与责任法案（HIPAA）的研究获得了机构审查委员会（IRB）的批准。两名儿科放射科医生对随机分配采用数字方法（《数字骨龄伴侣》，牛津大学出版社）或G&P方法的骨龄研究进行研究解读，生成模拟临床工作流程的报告。记录骨龄标准选择、解读报告时间和用户偏好。对报告进行排版或语音识别错误审查。通过费舍尔精确检验进行一致性比较。通过线性混合模型在自然对数尺度上分析解读报告时间，并转换为几何平均数。通过精确二项式检验比较主观工作流程体验。通过配对随机排列检验比较报告错误。
两种图谱在骨龄测定方面无差异（p = 0.495）。数字方法的解读报告时间显著更快（p < 0.001）。教员表示更喜欢数字图谱（p < 0.001）。使用数字图谱的签署报告错误更少（p < 0.001）。
采用数字方法进行的骨龄研究解读与使用格雷厄姆和派尔图谱的解读相似。当整合到电子工作流程中时，相对于格雷厄姆和派尔图谱，数字图谱节省了时间，改善了工作流程体验，并减少了报告错误。
