Sunnybrook Health Sciences Centre, Department of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Crit Care Med. 2018 May;46(5):743-748. doi: 10.1097/CCM.0000000000003000.
Radiographic criteria for acute respiratory distress syndrome have been criticized for poor reliability. Our objective was to test an educational intervention to improve the radiographic identification of acute respiratory distress syndrome by participants in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study.
Randomized controlled trial.
Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study centers.
Study coordinators in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study.
Participants were randomized to either an online training module followed by a test module (intervention) or test module followed by training module (control).
The primary outcome was the number of radiographs correctly identified as meeting criteria for acute respiratory distress syndrome on an online test module (out of 11). Prespecified secondary analyses included a comparison of agreement between the groups and subgroup analyses by profession, age, years of experience, and stated familiarity with diagnostic criteria for acute respiratory distress syndrome. Four-hundred sixty-three study participants consented to participate. There was no effect of the intervention on correct answers by participants (proportion correct 58% [intervention] vs 56% [control]; p = 0.15), or in any subgroup analyses. Overall agreement between raters was 0.296 for the intervention and 0.272 for the control (p < 0.001).
Participant recognition of radiographic criteria for acute respiratory distress syndrome was low, with poor agreement. This was not impacted by an educational intervention designed to improve accuracy of identification of radiographic criteria for acute respiratory distress syndrome.
急性呼吸窘迫综合征的影像学标准一直以来都因其可靠性较差而饱受诟病。本研究旨在通过接受大型观察性研究以了解严重急性呼吸衰竭全球影响研究（Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study）的参与者，检验一项旨在提高急性呼吸窘迫综合征影像学识别能力的教育干预措施。
随机对照试验。
接受大型观察性研究以了解严重急性呼吸衰竭全球影响研究的研究中心。
大型观察性研究以了解严重急性呼吸衰竭全球影响研究的研究协调员。
参与者被随机分配至在线培训模块加测试模块（干预组）或测试模块加培训模块（对照组）。
主要结局指标为在线测试模块中正确识别符合急性呼吸窘迫综合征标准的影像学表现的胸片数量（共 11 张）。预设的次要分析包括比较两组之间的一致性，并进行按专业、年龄、从业年限和对急性呼吸窘迫综合征诊断标准熟悉程度进行的亚组分析。共有 463 名研究参与者同意参与研究。干预对参与者的正确答案数量无影响（正确答案比例为干预组 58%[vs 对照组 56%]；p = 0.15），也无任何亚组分析有影响。干预组和对照组的评估者之间的总体一致性分别为 0.296 和 0.272（p < 0.001）。
参与者对急性呼吸窘迫综合征影像学标准的识别率较低，且一致性较差。该教育干预措施并未提高对急性呼吸窘迫综合征影像学标准的识别准确性。
