From the Department of Radiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
Radiology. 2021 Mar;298(3):632-639. doi: 10.1148/radiol.2021203486. Epub 2021 Jan 26.
Background Workloads in radiology departments have constantly increased over the past decades. The resulting radiologist fatigue is considered a rising problem that affects diagnostic accuracy. Purpose To investigate whether data mining of quantitative parameters from the report proofreading process can reveal daytime and shift-dependent trends in report similarity as a surrogate marker for resident fatigue. Materials and Methods Data from 117 402 radiology reports written by residents between September 2017 and March 2020 were extracted from a report comparison tool and retrospectively analyzed. Through calculation of the Jaccard similarity coefficient between residents' preliminary and staff-reviewed final reports, the amount of edits performed by staff radiologists during proofreading was quantified on a scale of 0 to 1 (1: perfect similarity, no edits). Following aggregation per weekday and shift, data were statistically analyzed by using simple linear regression or one-way analysis of variance (significance level, < .05) to determine relationships between report similarity and time of day and/or weekday reports were dictated. Results Decreasing report similarity with increasing work hours was observed for day shifts ( = -0.93 [95% CI: -0.73, -0.98]; < .001) and weekend shifts ( = -0.72 [95% CI: -0.31, -0.91]; = .004). For day shifts, negative linear correlation was strongest on Fridays ( = -0.95 [95% CI: -0.80, -0.99]; < .001), with a 16% lower mean report similarity at the end of shifts (0.85 ± 0.24 at 8 am vs 0.69 ± 0.32 at 5 pm). Furthermore, mean similarity of reports dictated on Fridays (0.79 ± 0.35) was lower than that on all other weekdays (range, 0.84 ± 0.30 to 0.86 ± 0.27; < .001). For late shifts, report similarity showed a negative correlation with the course of workweeks, showing a continuous decrease from Monday to Friday ( = -0.98 [95% CI: -0.70, -0.99]; = .007). Temporary increases in report similarity were observed after lunch breaks (day and weekend shifts) and with the arrival of a rested resident during overlapping on-call shifts. Conclusion Decreases in report similarity over the course of workdays and workweeks suggest aggravating effects of fatigue on residents' report writing performances. Periodic breaks within shifts potentially foster recovery. © RSNA, 2021.
背景 放射科的工作量在过去几十年中不断增加。由此导致的放射科医生疲劳被认为是一个日益严重的问题，会影响诊断的准确性。目的 探讨从报告审核过程中的定量参数中进行数据挖掘，是否可以揭示报告相似性的日间和班次依赖性趋势，作为居民疲劳的替代标志物。材料与方法 从 2017 年 9 月至 2020 年 3 月期间，从报告比较工具中提取了 117 402 份由住院医师撰写的放射学报告的数据，并进行了回顾性分析。通过计算住院医师初步报告和工作人员审核的最终报告之间的杰卡德相似系数，量化工作人员放射科医生在审核过程中进行的编辑量，范围为 0 到 1（1：完全相似，无需编辑）。按工作日和班次进行汇总后，使用简单线性回归或单向方差分析（显著性水平， <.05）对数据进行统计学分析，以确定报告相似性与时间之间的关系和/或工作日。结果 观察到日班（ = -0.93[95%CI：-0.73，-0.98]； <.001）和周末班次（ = -0.72[95%CI：-0.31，-0.91]； =.004）的报告相似性随着工作时间的增加而降低。对于日班，周五的负线性相关性最强（ = -0.95[95%CI：-0.80，-0.99]； <.001），下班时报告的平均相似性降低了 16%（上午 8 点为 0.85 ± 0.24，下午 5 点为 0.69 ± 0.32）。此外，周五报告的平均相似性（0.79 ± 0.35）低于其他所有工作日（范围为 0.84 ± 0.30 至 0.86 ± 0.27； <.001）。对于晚班，报告相似性与工作周的进程呈负相关，从周一到周五连续下降（ = -0.98[95%CI：-0.70，-0.99]； =.007）。在午休后（日班和周末班）和值班医生休息后，报告相似性会出现暂时增加。结论 工作日和工作周内报告相似性的降低表明疲劳对住院医师报告撰写表现的影响逐渐加重。班次内的定期休息可能有助于恢复。 © RSNA，2021。
