Department of Medical Imaging, Ipswich General Hospital, Ipswich, Queensland, Australia.
School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
J Med Radiat Sci. 2021 Sep;68(3):237-244. doi: 10.1002/jmrs.466. Epub 2021 Mar 22.
Preliminary image evaluation (PIE) is a mechanism whereby radiographers provide a preliminary evaluation of whether pathology is present in their radiographs, typically acquired within the emergency department (ED). PIE provides referrers with a timely communication of pathology prior to the availability of a radiology report. The purpose of this study was to determine the most common radiographer PIE false-negative interpretations.
Each month over a two-year period, 100 PIEs of adult and paediatric patients were randomly reviewed in a metropolitan hospital ED. The radiographer's PIE was compared with the radiologist's report and categorised into basic quality indicators; true positive, true negative, false positive and false negative. The anatomical regions which most commonly indicated a false-negative interpretation were further analysed.
2402 cases were reviewed which resulted in an overall PIE accuracy of 88.7%. Wrists, hands, phalanges (upper), ankles, feet and phalanges (lower) reporting the highest false-negative or false-negative/true-positive interpretations (60/116). Of the 60 false-negative PIEs, 68 pathologies were identified. 41.1% (28/68) of the pathology not identified were in the phalanges. Within these regions, examinations with multiple injuries commonly reported false negatives (17/60).
This study demonstrated the most common false-negative radiographer PIEs were within the upper and lower distal extremities. Specifically, the phalanges and examinations demonstrating multiple injuries reported high levels of misinterpretation. The misinterpretation in multi-injury examinations could be attributed to 'Subsequent Search Miss (SSM)' error. These results provide valuable insights into areas of emphasis when providing image interpretation education.
初步图像评估（PIE）是放射技师对其在急诊科（ED）获得的放射影像中是否存在病理学进行初步评估的机制。PIE 为转诊医生提供了在获得放射学报告之前及时了解病理学的途径。本研究的目的是确定最常见的放射技师 PIE 假阴性解读。
在两年的时间里，每个月在一家大都市医院的 ED 中随机回顾 100 例成人和儿科患者的 PIE。将放射技师的 PIE 与放射科医生的报告进行比较，并分类为基本质量指标；真阳性、真阴性、假阳性和假阴性。进一步分析最常指示假阴性解释的解剖区域。
共回顾了 2402 例病例，总体 PIE 准确率为 88.7%。手腕、手、掌骨（上部）、踝关节、脚和跖骨（下部）的报告假阴性或假阴性/真阳性解读最多（60/116）。在这 60 例假阴性 PIE 中，发现了 68 种病理。未识别的病理有 41.1%（28/68）位于跖骨中。在这些区域中，伴有多处损伤的检查常报告假阴性（17/60）。
本研究表明，最常见的假阴性放射技师 PIE 位于上下肢末端。特别是指骨和显示多处损伤的检查报告了高水平的误读。多处损伤检查中的误读可归因于“后续搜索遗漏（SSM）”错误。这些结果为提供图像解读教育时的重点领域提供了有价值的见解。
