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乳腺 X 线摄影 BI-RADS 3(短期随访)评估率:与召回率的相关性及其作为性能基准的应用。

BI-RADS 3 (short-interval follow-up) assessment rate at diagnostic mammography: Correlation with recall rates and utilization as a performance benchmark.

机构信息

Advocate Illinois Masonic Medical Center, Chicago, Illinois.

Advocate Aurora Health, Oak Brook, Illinois.

出版信息

Breast J. 2020 Jul;26(7):1284-1288. doi: 10.1111/tbj.13838. Epub 2020 Apr 14.

Abstract

The purpose of this study was to identify a correlation between the screening BI-RADS 0 (recall) rates and diagnostic BI-RADS 3 (short-interval follow-up) rates of individual interpreting radiologists, with the goal of utilizing the BI-RADS 3 rate as an acceptable performance metric in the diagnostic population. A multicenter retrospective analysis of medical audit statistics was conducted on annual radiologist performance data collected over a 14-year period in a community hospital-based practice. Mixed regression models were used to estimate the association between screening BI-RADS 0 and diagnostic BI-RADS 3 examinations while adjusting for calendar year, annual radiologist screening volume, annual radiologist diagnostic volume, and diagnostic examination indication. A moderate statistically significant positive correlation was established between the screening BI-RADS 0 rates and Diagnostic BI-RADS 3 rates (Pearson correlation coefficient + 0.349, P ≤ .001). Furthermore, when utilizing a national benchmark range of 8%-12% as an acceptable BI-RADS 0 rate within a screening population, the correlative BI-RADS 3 assessment rate was demonstrated to be approximately 16%. We propose that this BI-RADS category 3 rate may represent an additional acceptable performance metric in the diagnostic population. Routine inclusion of an interpreting mammographer's diagnostic BI-RADS 3 rate in the annual medical audit may help reduce inappropriate and/or excess use of the BI-RADS 3 category, which may lead to significant potential reductions in follow-up examinations with their associated healthcare-related costs, resource expenditure, and induced patient anxiety.

摘要

本研究旨在确定个体解读放射科医师的筛查 BI-RADS 0(召回)率与诊断 BI-RADS 3(短期随访)率之间的相关性,目的是将 BI-RADS 3 率用作诊断人群中可接受的绩效指标。对社区医院实践中 14 年来每年收集的放射科医师绩效数据进行了多中心回顾性医学审核统计分析。使用混合回归模型,在调整了日历年度、放射科医师每年筛查量、放射科医师每年诊断量和诊断检查指征后,估计了筛查 BI-RADS 0 与诊断 BI-RADS 3 检查之间的关联。筛查 BI-RADS 0 率与诊断 BI-RADS 3 率之间建立了中度统计学显著正相关(Pearson 相关系数+0.349,P≤.001)。此外,当将全国 8%-12%的基准范围用作筛查人群中可接受的 BI-RADS 0 率时,显示出相关性 BI-RADS 3 评估率约为 16%。我们提出,该 BI-RADS 类别 3 率可能代表诊断人群中的另一个可接受的绩效指标。在年度医疗审核中常规纳入解释性乳房 X 线摄影术医师的诊断 BI-RADS 3 率,可能有助于减少 BI-RADS 3 类别的不适当和/或过度使用,从而可能导致后续检查及其相关的医疗保健相关成本、资源支出和诱导的患者焦虑显著减少。

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