Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.; Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Brookline, MA..
Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Brookline, MA.
Curr Probl Diagn Radiol. 2022 Jul-Aug;51(4):511-516. doi: 10.1067/j.cpradiol.2021.09.007. Epub 2021 Nov 3.
This study aimed to determine effect of modality, care setting, and radiology subspecialty on frequency of diagnostic image quality issues identified by radiologists during image interpretation.
This Institutional Review Board-exempt retrospective study was performed 10/1/18-6/30/20 at an academic radiology practice performing 700,000+ examinations annually. A closed-loop communication tool integrated in PACS workflow enabled radiologists to alert technologists to image quality issues. Radiologists categorized communications as requiring patient callback, or as technologist learning opportunities if image quality was adequate to generate a diagnostic report. Fisher's exact test assessed impact of imaging modality, radiology subspecialty, and care setting on radiologist-identified image quality issues.
976,915 imaging examinations were performed during the study period. Radiologists generated 1,935 technologist learning opportunities (0.20%) and 208 callbacks (0.02%). Learning opportunity rates were highest for MRI (0.60%) when compared to CT (0.26%) and radiography (0.08%) (p<0.0001). The same was true for patient callbacks (MRI 0.13%, CT 0.02%, radiography 0.0006%; p<0.0001). Outpatient examinations generated more learning opportunities (1479/637,092; 0.23%) vs. inpatient (305/200,206; 0.15%) and Emergency Department (151/139,617; 0.11%) (p<0.0001). Abdominal subspecialists were most likely to generate learning opportunities when compared to other subspecialists and cardiovascular imagers were most likely to call a patient back.
Image quality issues identified by radiologists during the interpretation process were rare and 10 times more commonly categorized as learning opportunities not interfering with a clinically adequate report than as requiring patient callback. Further work is necessary to determine if creating learning opportunities leads to fewer patients requiring repeat examinations.
本研究旨在确定成像方式、护理环境和放射学亚专业对放射科医生在图像解读过程中发现的诊断图像质量问题的频率的影响。
本研究为机构审查委员会豁免的回顾性研究，于 2018 年 10 月 1 日至 2019 年 6 月 30 日在一家每年进行 70 万次以上检查的学术放射科实践中进行。一个集成在 PACS 工作流程中的闭环通信工具使放射科医生能够提醒技术人员注意图像质量问题。放射科医生将通信分为需要患者回拨和技术人员学习机会两类，如果图像质量足以生成诊断报告，则属于技术人员学习机会。Fisher 精确检验评估了成像方式、放射学亚专业和护理环境对放射科医生识别的图像质量问题的影响。
在研究期间共进行了 976915 次影像学检查。放射科医生生成了 1935 次技术人员学习机会（0.20%）和 208 次回拨（0.02%）。与 CT（0.26%）和射线照相术（0.08%）相比，磁共振成像（MRI）的学习机会率最高（0.60%）（p<0.0001）。同样，患者回拨率也是如此（MRI 0.13%，CT 0.02%，射线照相术 0.0006%；p<0.0001）。与住院患者（305/200206，0.15%）和急诊部（151/139617，0.11%）相比，门诊检查产生了更多的学习机会（1479/637092，0.23%）（p<0.0001）。与其他亚专业相比，腹部亚专业放射科医生更有可能产生学习机会，而心血管成像放射科医生更有可能回叫患者。
放射科医生在解释过程中发现的图像质量问题很少，10 倍以上的问题被归类为不会干扰临床充分报告的学习机会，而不是需要患者回拨的问题。需要进一步研究以确定创建学习机会是否会导致更少的患者需要重复检查。
