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多学科团队会议病例中专科放射学审查的附加值是什么?

What is the added value of specialist radiology review of multidisciplinary team meeting cases in a tertiary care center?

机构信息

Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

出版信息

Eur Radiol. 2024 Oct;34(10):6460-6465. doi: 10.1007/s00330-024-10680-0. Epub 2024 Mar 15.

Abstract

PURPOSE

Multidisciplinary team meetings (MDTMs) are an important component of the workload of radiologists. This study investigated how often subspecialized radiologists change patient management in MDTMs at a tertiary care institution.

MATERIALS AND METHODS

Over 2 years, six subspecialty radiologists documented their contributions to MDTMs at a tertiary care center. Both in-house and external imaging examinations were discussed at the MDTMs. All imaging examinations (whether primary or second opinion) were interpreted and reported by subspecialty radiologist prior to the MDTMs. The management change ratio (MC) of the radiologist was defined as the number of cases in which the radiologist's input in the MDTM changed patient management beyond the information that was already provided by the in-house (primary or second opinion) radiology report, as a proportion of the total number of cases whose imaging examinations were prepared for demonstration in the MDTM.

RESULTS

Sixty-eight MDTMs were included. The time required for preparing and attending all MDTMs (excluding imaging examinations that had not been reported yet) was 11,000 min, with a median of 172 min (IQR 113-200 min) per MDTM, and a median of 9 min (IQR 8-13 min) per patient. The radiologists' input changed patient management in 113 out of 1138 cases, corresponding to an MC of 8.4%. The median MC per MDTM was 6% (IQR 0-17%).

CONCLUSION

Radiologists' time investment in MDTMs is considerable relative to the small proportion of cases in which they influence patient management in the MDTM. The use of radiologists for MDTMs should therefore be improved.

CLINICAL RELEVANCE STATEMENT

The use of radiologists for MDTMs (multidisciplinary team meetings) should be improved, because their time investment in MDTMs is considerable relative to the small proportion of cases in which they influence patient management in the MDTM.

KEY POINTS

• Multidisciplinary team meetings (MDTMs) are an important component of the workload of radiologists. • In a tertiary care center in which all imaging examinations have already been interpreted and reported by subspecialized radiologists before the MDTM takes place, the median time investment of a radiologist for preparing and demonstrating one MDTM patient is 9 min. • In this setting, the radiologist changes patient management in only a minority of cases in the MDTM.

摘要

目的

多学科团队会议(MDTMs)是放射科医生工作量的重要组成部分。本研究调查了在一家三级保健机构中,专门从事放射学亚专业的医生在 MDTM 中改变患者管理的频率。

材料与方法

在 2 年多的时间里,6 名亚专业放射科医生记录了他们在一家三级保健中心的 MDTM 中的贡献。MDTM 讨论了内部和外部的影像学检查。所有影像学检查(无论是初次检查还是二次检查)均由亚专业放射科医生在 MDTM 之前进行解读和报告。将放射科医生的管理变更率(MC)定义为放射科医生在 MDTM 中输入的病例数,这些病例的管理改变超出了内部(初次或二次)放射学报告提供的信息,占准备在 MDTM 中展示的所有影像学检查病例总数的比例。

结果

共纳入 68 次 MDTM。准备和参加所有 MDTM(不包括尚未报告的影像学检查)所需的时间为 11000 分钟,每次 MDTM 的中位数为 172 分钟(IQR 113-200 分钟),每位患者的中位数为 9 分钟(IQR 8-13 分钟)。放射科医生的输入改变了 113 例中的 1138 例患者的管理,对应的 MC 为 8.4%。每次 MDTM 的 MC 中位数为 6%(IQR 0-17%)。

结论

相对于放射科医生在 MDTM 中影响患者管理的少数病例比例而言,他们在 MDTM 中的时间投入相当可观。因此,应改进放射科医生在 MDTM 中的使用。

临床相关性声明

鉴于放射科医生在 MDTM 中投入的时间相对较少,而他们在 MDTM 中影响患者管理的病例比例也相对较小,因此应改进放射科医生在 MDTM 中的使用。

关键点

  1. 多学科团队会议(MDTMs)是放射科医生工作量的重要组成部分。

  2. 在三级保健中心,所有影像学检查均由专门从事放射学亚专业的医生在 MDTM 前进行解读和报告,放射科医生准备和演示一位 MDTM 患者的中位数时间投入为 9 分钟。

  3. 在这种情况下,放射科医生在 MDTM 中仅改变少数病例的患者管理。

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Eur J Radiol. 2023 Oct;167:111032. doi: 10.1016/j.ejrad.2023.111032. Epub 2023 Aug 10.
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Making Radiology Antifragile.让放射学具备抗脆弱性。
J Am Coll Radiol. 2023 Apr;20(4):470-472. doi: 10.1016/j.jacr.2023.02.004. Epub 2023 Feb 17.
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Understanding and Appreciating Burnout in Radiologists.理解并认识放射科医生的职业倦怠
Radiographics. 2022 Sep-Oct;42(5):E137-E139. doi: 10.1148/rg.220037. Epub 2022 Jul 15.

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