1 Center for Evidence-Based Imaging, Harvard Medical School, Brigham and Women's Hospital, Boston, MA.
2 Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
AJR Am J Roentgenol. 2019 Jan;212(1):135-141. doi: 10.2214/AJR.18.19958. Epub 2018 Nov 7.
The purpose of this study was to compare the yields of peer learning between a radiology electronic peer learning tool (PLT) and a score-based peer review (SBPR) system.
This retrospective study was performed from May 1, 2017, through October 31, 2017, at a 776-bed academic hospital performing more than 620,000 radiology examinations annually. Use of a PLT that generates alerts facilitating closed-loop feedback was initiated on March 1, 2017. Functions included providing peers with the following: clinical follow-up after review of prior reports, positive feedback, and consultation to solicit second opinions. In the same period, an SBPR system yielded the following scores: 1, agree with original interpretation; 2, minor discrepancy; 3, moderate discrepancy; and 4, major discrepancy. Potential learning opportunities were defined as cases receiving a clinical follow-up alert (PLT system) and reports scored 3 or 4 (SBPR system). Primary outcome was clinically significant feedback per total reports reviewed, measured as radiology report addendum rate (number with addenda divided by number of reports reviewed monthly for each system). The secondary outcome was potential learning opportunity rate (number of clinical follow-up alerts or reports scored 3 or 4 divided by the total number of radiology reports reviewed monthly). A paired t test was used for statistical analysis.
The overall PLT report addendum rate was 11.2% (23 addenda/206 reports) versus 0.27% (13 addenda/4861 reports) for SBPR (p = 0.03), a 41-fold difference (11.2/0.27). The potential learning opportunity rate for PLT was 50.0% (206 clinical follow-up alerts among 412 total alerts) versus 0.53% (26 scored 3 or 4 among 4861 reports reviewed) for SBPR (p = 0.00003), a 94-fold difference (50/0.53).
A PLT improves radiology peer learning with a significantly higher yield of clinically significant feedback and potential learning opportunities compared with a traditional SBPR system.
本研究旨在比较放射学电子同伴学习工具（PLT）和基于评分的同伴审查（SBPR）系统的同伴学习效果。
本回顾性研究于 2017 年 5 月 1 日至 2017 年 10 月 31 日在一家拥有 776 张床位的学术医院进行，该医院每年进行超过 62 万次放射学检查。2017 年 3 月 1 日开始使用生成便于闭环反馈的警报的 PLT。该工具的功能包括为同伴提供以下内容：审查先前报告后的临床随访、正面反馈和征求第二意见的咨询。同期，SBPR 系统生成以下评分：1、与原始解释一致；2、轻微差异；3、中度差异；4、主要差异。潜在的学习机会定义为收到临床随访警报（PLT 系统）和报告评分 3 或 4（SBPR 系统）的病例。主要结果是根据每月审查的报告总数计算的具有临床意义的反馈，以放射学报告附录率（有附录的数量除以每月审查的报告数量）来衡量。次要结果是潜在学习机会率（临床随访警报或评分 3 或 4 的报告数量除以每月审查的放射学报告总数）。采用配对 t 检验进行统计学分析。
PLT 报告附录率为 11.2%（23 个附录/206 份报告），而 SBPR 为 0.27%（13 个附录/4861 份报告）（p = 0.03），差异为 41 倍（11.2/0.27）。PLT 的潜在学习机会率为 50.0%（206 个临床随访警报中，412 个总警报中有 206 个），而 SBPR 为 0.53%（4861 份审查报告中，26 份评分 3 或 4）（p = 0.00003），差异为 94 倍（50/0.53）。
与传统的 SBPR 系统相比，PLT 可提高放射科同伴学习效果，具有更高的临床意义反馈和潜在学习机会的产生率。
