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诊断放射学中双重读片的附加值:一项系统综述

Added value of double reading in diagnostic radiology,a systematic review.

作者信息

Geijer Håkan, Geijer Mats

机构信息

Department of Radiology, Faculty of Medicine and Health, Örebro University, 701 85, Örebro, Sweden.

Department of Radiology, Skåne University Hospital and Lund University, Lund, Sweden.

出版信息

Insights Imaging. 2018 Jun;9(3):287-301. doi: 10.1007/s13244-018-0599-0. Epub 2018 Mar 28.

Abstract

OBJECTIVES

Double reading in diagnostic radiology can find discrepancies in the original report, but a systematic program of double reading is resource consuming. There are conflicting opinions on the value of double reading. The purpose of the current study was to perform a systematic review on the value of double reading.

METHODS

A systematic review was performed to find studies calculating the rate of misses and overcalls with the aim of establishing the added value of double reading by human observers.

RESULTS

The literature search resulted in 1610 hits. After abstract and full-text reading, 46 articles were selected for analysis. The rate of discrepancy varied from 0.4 to 22% depending on study setting. Double reading by a sub-specialist, in general, led to high rates of changed reports.

CONCLUSIONS

The systematic review found rather low discrepancy rates. The benefit of double reading must be balanced by the considerable number of working hours a systematic double-reading scheme requires. A more profitable scheme might be to use systematic double reading for selected, high-risk examination types. A second conclusion is that there seems to be a value of sub-specialisation for increased report quality. A consequent implementation of this would have far-reaching organisational effects.

KEY POINTS

• In double reading, two or more radiologists read the same images. • A systematic literature review was performed. • The discrepancy rates varied from 0.4 to 22% in various studies. • Double reading by sub-specialists found high discrepancy rates.

摘要

目的

在诊断放射学中进行二次阅片能够发现原始报告中的差异,但系统的二次阅片程序会消耗资源。对于二次阅片的价值存在相互矛盾的观点。本研究的目的是对二次阅片的价值进行系统评价。

方法

进行系统评价以查找计算漏诊率和过度诊断率的研究,目的是确定人工观察者进行二次阅片的附加价值。

结果

文献检索得到1610条结果。经过摘要和全文阅读后,选择了46篇文章进行分析。差异率根据研究背景从0.4%到22%不等。一般来说,由专科医生进行二次阅片会导致报告更改率较高。

结论

系统评价发现差异率相当低。二次阅片的益处必须与系统的二次阅片方案所需的大量工作时间相权衡。一个更具效益的方案可能是对选定的高风险检查类型采用系统的二次阅片。第二个结论是,专科化对于提高报告质量似乎具有价值。随之而来的实施这一点将产生深远的组织影响。

关键点

• 在二次阅片中,两名或更多放射科医生阅读相同的影像。• 进行了系统的文献综述。• 各项研究中的差异率从0.4%到22%不等。• 专科医生进行二次阅片发现差异率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72e2/5990995/00c56868ee4c/13244_2018_599_Fig1_HTML.jpg

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