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比较放射科医生和放射技师对腰痛MRI转诊的评估:来自挪威两个影像中心的见解。

Comparing radiologists and radiographers' assessment of MRI referrals for low back pain: Insights from two imaging centres in Norway.

作者信息

Chilanga C C, Heggelund M, Kjelle E

机构信息

Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Pb 235, 3603 Kongsberg, Norway.

Institute for the Health Sciences, Norwegian University of Science and Technology (NTNU) Gjøvik, Norway.

出版信息

Radiography (Lond). 2025 Jan;31(1):290-296. doi: 10.1016/j.radi.2024.12.003. Epub 2024 Dec 16.

Abstract

INTRODUCTION

This study aimed to evaluate the differences in MRI referral assessments for low back pain (LBP) between radiologists and in-house trained radiographers.

METHODS

This is the second part of a retrospective study where MRI referrals for LBP conducted within two imaging centres in Norway were assessed for justification and referral quality. This study examines differences in how the recruited assessors (four radiologists and two radiographers) evaluated the referrals. The collected data was sorted in Microsoft Excel version 2021. Stata Statistical Software (Release 18) was used for data analysis. Mixed model analysis was used to compare the radiographers and radiologists' assessment of justification and referral quality. Gwet's agreement coefficient AC1/AC2 was used to determine the variation of agreements between the assessors in justification, and Gwet's AC2 between the assessor in referral quality. Kappa statistics was used to assess the interrater reliability between the two professions. A p-value of < 0.05 was considered statistically significant.

RESULTS

A total n = 300 patients' MRI referrals for LBP from the two imaging centres were collected and assessed. The two radiographers and one radiologist assessed 75 % of the referrals as justified, while the other radiologists had an overall justification rate ranging from 50 to 60 %. In general, radiographers more frequently assigned referrals as being of good and intermediate quality compared to radiologists. The study showed a statistically significant difference (p < .001) between radiographers and radiologists 'assessment of justification and quality of MRI referrals for LBP.

CONCLUSION

Radiographers assessed a higher proportion of referrals as justified and of good quality compared to radiologists, highlighting the need for targeted training to enhance radiographers' referral assessment skills.

IMPLICATIONS FOR PRACTICE

Radiographers are assigned tasks to justify imaging in radiology departments; however, targeted training is essential to ensure consistent and accurate referral assessments, ultimately enhancing patient care and optimising the use of resources.

摘要

引言

本研究旨在评估放射科医生与内部培训的放射技师在腰椎疼痛(LBP)的MRI转诊评估方面的差异。

方法

这是一项回顾性研究的第二部分,对挪威两个影像中心进行的LBP的MRI转诊进行了合理性和转诊质量评估。本研究考察了招募的评估者(四名放射科医生和两名放射技师)在评估转诊方面的差异。收集的数据在Microsoft Excel 2021版本中进行整理。使用Stata统计软件(版本18)进行数据分析。混合模型分析用于比较放射技师和放射科医生对合理性和转诊质量的评估。Gwet一致性系数AC1/AC2用于确定评估者在合理性方面的一致性差异,Gwet的AC2用于评估者在转诊质量方面的一致性差异。kappa统计用于评估两个专业之间的评分者间信度。p值<0.05被认为具有统计学意义。

结果

共收集并评估了来自两个影像中心的n = 300例患者的LBP的MRI转诊。两名放射技师和一名放射科医生将75%的转诊评估为合理,而其他放射科医生的总体合理率在50%至60%之间。总体而言,与放射科医生相比,放射技师更频繁地将转诊评定为质量良好和中等。该研究表明,放射技师和放射科医生在LBP的MRI转诊合理性和质量评估方面存在统计学显著差异(p <.001)。

结论

与放射科医生相比,放射技师评估为合理且质量良好的转诊比例更高,这突出了进行有针对性培训以提高放射技师转诊评估技能的必要性。

对实践的启示

放射技师被分配任务在放射科证明成像的合理性;然而,有针对性的培训对于确保一致且准确的转诊评估至关重要,最终可提高患者护理水平并优化资源利用。

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