Division of Orthopedic Surgery, Tel Aviv Medical Center, 6 Weitzman St., 6423906, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Trauma Emerg Surg. 2023 Dec;49(6):2589-2597. doi: 10.1007/s00068-023-02347-0. Epub 2023 Aug 13.
Imaging studies are a significant and integral part of the initial assessment of patients admitted to the emergency department. Developing imaging diagnostic abilities early in residency is of paramount importance. The purpose of this study was to evaluate and compare diagnosis accuracy of common musculoskeletal X-rays (XR) between residency disciplines and seniority.
A multicenter study which evaluated orthopedic surgery, emergency medicine (EM), and radiology residents, through a test set of common MSK XR. Residents were classified as "beginner" or "advanced" according to postgraduate year per residency. Residents were asked to answer whether the radiograph shows normal or pathological findings (success rate) and what is the diagnosis ("diagnosis accuracy"). Residents' answers were analyzed and assessed compared to experts' consensus.
A total of 100 residents (62% beginners) participated in this study. Fifty-four were orthopedic surgeons, 29 were EM residents and 17 were radiologists. The entire cohort's overall success rate was 88.5%. The overall mean success rates for orthopedic, EM, and radiology residents were 93.2%, 82.8%, and 83.3%, respectively, and were significantly different (p < 0.0001). Orthopedic residents had significantly higher diagnostic accuracy rates compared with both radiology and EM residents (p < 0.001). Advanced orthopedic and EM residents demonstrated higher diagnostic accuracy rates compared to beginner residents (p = 0.001 and p = 0.03, respectively).
Orthopedic residents presented higher diagnosis accuracy of MSK imaging compared to EM and radiology residents. Seniority had a positive effect on diagnosis accuracy. The development of an educational program on MSK XR is necessary to enhance the competency of physicians in their daily practice.
影像学研究是急诊科入院患者初始评估的重要组成部分。在住院医师阶段尽早发展影像学诊断能力至关重要。本研究旨在评估和比较不同住院医师专业和资历的常见肌肉骨骼 X 线（XR）的诊断准确性。
一项多中心研究，通过一组常见的 MSK XR 评估骨科、急诊医学（EM）和放射科住院医师。根据住院医师的研究生年限，将住院医师分为“初学者”或“高级”。要求住院医师回答 X 光片是否显示正常或病理发现（成功率）以及诊断结果（“诊断准确性”）。分析住院医师的答案并与专家共识进行比较。
共有 100 名住院医师（62%为初学者）参与了这项研究。其中 54 名是骨科医生，29 名是急诊医学住院医师，17 名是放射科医生。整个队列的总体成功率为 88.5%。骨科、急诊医学和放射科住院医师的总体平均成功率分别为 93.2%、82.8%和 83.3%，差异有统计学意义（p<0.0001）。与放射科和急诊医学住院医师相比，骨科住院医师的诊断准确性更高（p<0.001）。高级骨科和急诊医学住院医师的诊断准确性高于初级住院医师（p=0.001 和 p=0.03）。
与急诊医学和放射科住院医师相比，骨科住院医师对肌肉骨骼成像的诊断准确性更高。资历对诊断准确性有积极影响。需要制定肌肉骨骼 XR 教育计划，以提高医生在日常实践中的能力。
