Greenspan R H, Ravin C E, Polansky S M, McLoud T C
Invest Radiol. 1982 Nov-Dec;17(6):539-43. doi: 10.1097/00004424-198211000-00003.
In an effort to determine the sensitivity and specificity of the chest roentgenogram for the diagnosis of pulmonary embolism, roentgenograms of 152 patients who were all suspected of having pulmonary embolism were randomized and presented to nine interpreters. One hundred eight patients in the series were proven to have pulmonary embolism on the basis of a positive pulmonary angiogram. Forty-four patients were assumed not to have embolism on the basis of either a normal perfusion isotope scan or a pulmonary angiogram which did not show embolism. The interpreters were requested to indicate whether pulmonary embolism was present or absent, or whether they could not tell from the roentgenogram. Readers had no prior knowledge of the actual disease state. The average true-positive ratio (sensitivity) was 0.33, with a range of 0.52 to 0.88. The average true-negative ratio (specificity) was 0.59, with a range of 0.31 to 0.80. The false-positive and false-negative ratios were respectively, 0.21 (range 0.05 to 0.39) and 0.41 (range 0.15 to 0.70). A predictive index, reflecting the overall accuracy of diagnosis, was calculated for the entire group and was 0.40, with a range of 0.17 to 0.57. There appeared to be no correlation between training or experience and accuracy of performance in this study.
为了确定胸部X线片对诊断肺栓塞的敏感性和特异性，将152例均疑似患有肺栓塞患者的X线片随机分组后交给9名解读人员。该组中有108例患者经肺血管造影呈阳性证实患有肺栓塞。44例患者基于正常的灌注同位素扫描或未显示栓塞的肺血管造影被认定没有栓塞。解读人员被要求指出是否存在肺栓塞，或者他们能否根据X线片判断。解读人员事先并不了解实际的疾病状态。平均真阳性率（敏感性）为0.33，范围在0.52至0.88之间。平均真阴性率（特异性）为0.59，范围在0.31至0.80之间。假阳性率和假阴性率分别为0.21（范围在0.05至0.39之间）和0.41（范围在0.15至0.70之间）。为整个组计算了反映诊断总体准确性的预测指数，为0.40，范围在0.17至0.57之间。在本研究中，培训或经验与表现的准确性之间似乎没有相关性。
