Institute for Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane, Brandenburg a. d. Havel, Germany.
Department of Radiology, Johanniter-Hospital Treuenbrietzen, Germany.
Rofo. 2021 Dec;193(12):1451-1460. doi: 10.1055/a-1541-8265. Epub 2021 Aug 4.
Evaluation of the diagnostic accuracy of a checklist-style structured reporting template in the setting of whole-body multislice computed tomography in major trauma patients depending on the level of experience of the reporting radiologist.
A total of 140 major trauma scans with the same protocol were included in this retrospective study. In a purely trial-intended reading, the trauma scans were analyzed by three radiologists with different levels of experience (resident, radiologist with 3 years of experience after board certification, and radiologist with 7 years of experience after board certification). The aim was to fill in the checklist 1 template within one minute to immediately diagnose management-altering findings. Checklist 2 was intended for the analysis of important trauma-related findings within 10 minutes. Reading times were documented. The final radiology report and the documented injuries in the patient's medical record were used as gold standard.
The evaluation of checklist 1 showed a range of false-negative reports between 5.0 % and 11.4 % with the resident showing the highest accuracy. Checklist 2 showed overall high diagnostic inaccuracy (19.3-35.0 %). The resident's diagnostic accuracy was statistically significantly higher compared to the radiologist with 3 years of experience after board certification (p = 0.0197) and with 7 years of experience after board certification (p = 0.0046). Shorter average reporting time resulted in higher diagnostic inaccuracy. Most of the missed diagnoses were fractures of the spine and ribs.
By using a structured reporting template in the setting of major trauma computed tomography, less experienced radiologists reach a higher diagnostic accuracy compared to experienced readers.
· In the setting of a pure trial reading, the diagnostic inaccuracy of template-based reporting of major trauma CT examinations is high.. · Fractures in general and especially of the vertebral bodies and ribs were the most commonly missed diagnoses.. · In a study setting, less experienced radiologists seem to reach a higher diagnostic accuracy when using a structured reporting approach..
· Dendl LM, Pausch AM, Hoffstetter P et al. Structured Reporting of Whole-Body Trauma CT Scans Using Checklists: Diagnostic Accuracy of Reporting Radiologists Depending on Their Level of Experience. Fortschr Röntgenstr 2021; 193: 1451 - 1460.
评估在全身多层计算机断层扫描（MSCT）中使用清单式结构化报告模板的诊断准确性，该模板基于报告放射科医师的经验水平。
本回顾性研究共纳入 140 例采用相同方案的严重创伤 MSCT 扫描。在纯粹的试验性阅读中，由三位经验水平不同的放射科医师（住院医师、经过 board 认证后 3 年经验的放射科医师和经过 board 认证后 7 年经验的放射科医师）分析创伤扫描。目的是在一分钟内填写清单 1 模板，以立即诊断出需要改变管理的发现。清单 2 用于在 10 分钟内分析重要的创伤相关发现。记录阅读时间。最终的放射学报告和患者病历中记录的损伤被用作金标准。
评估清单 1 显示，住院医师的准确性最高，假阴性报告率在 5.0%至 11.4%之间。清单 2 整体诊断准确性较低（19.3%至 35.0%）。与经过 board 认证后 3 年经验的放射科医师（p=0.0197）和经过 board 认证后 7 年经验的放射科医师（p=0.0046）相比，住院医师的诊断准确性有统计学意义上的显著提高。平均报告时间越短，诊断准确性越低。大多数漏诊的诊断是脊柱和肋骨骨折。
在严重创伤 CT 检查中使用结构化报告模板，经验较少的放射科医师的诊断准确性高于经验丰富的读者。
在纯试验阅读环境下，基于模板的严重创伤 CT 检查报告的诊断准确性较差。
一般来说，骨折，尤其是椎体和肋骨骨折，是最常见的漏诊诊断。
在研究环境中，使用结构化报告方法时，经验较少的放射科医师似乎可以达到更高的诊断准确性。
