Bergus G R, Franken E A, Koch T J, Smith W L, Evans E R, Berbaum K S
Department of Family Practice, University of Iowa, Iowa City 52242-1097, USA.
J Fam Pract. 1995 Oct;41(4):352-6.
Radiology is an integral part of the office practice of many family physicians. Nevertheless, data are sparse on the performance of family physicians in this endeavor. This study investigated the performance of family physicians at interpreting radiographs ordered in a free-standing family practice office.
A consecutive series of radiographic studies performed at a family practice office during a 3-year period was surveyed. All radiographic studies included in this analysis (N = 1674) were separately interpreted by the family physician ordering the study and an overreading radiologist. If the interpretations agreed, the studies were accepted as having been correctly interpreted. Cases in which the interpretations disagreed were reexamined.
Family physicians correctly interpreted 92.4% of the radiographic studies (95% confidence interval, 91.0 to 93.6). Their accuracy with extremity films (96.0%) was significantly higher than their accuracy with chest films (89.3%, P < .001). Family physicians were more likely to correctly interpret normal films (95.2%) than abnormal ones (85.9%, P < .001). Thirty-five percent of the cases in which there were differences between family physician and radiologist interpretations were correctly interpreted by family physicians.
Family physicians showed a high degree of accuracy in radiologic interpretation in an office setting. Chest films were inherently more difficult to interpret than extremity films. Because correct interpretation depends on body part examined and the prevalence of disease, the performance of family physicians will probably vary in different practice settings.
放射学是许多家庭医生门诊业务的一个重要组成部分。然而，关于家庭医生在这项工作中的表现的数据却很稀少。本研究调查了家庭医生在独立的家庭诊所解读所开X光片的表现。
对一家家庭诊所3年期间进行的一系列连续的放射学检查进行了调查。本分析纳入的所有放射学检查（N = 1674）均由开出检查单的家庭医生和一位阅片放射科医生分别解读。如果解读结果一致，则该检查被视为解读正确。解读结果不一致的病例进行了复查。
家庭医生正确解读了92.4%的放射学检查（95%置信区间，91.0%至93.6%）。他们对四肢X光片的解读准确率（96.0%）显著高于对胸部X光片的准确率（89.3%，P <.001）。家庭医生更有可能正确解读正常X光片（95.2%），而不是异常X光片（85.9%，P <.001）。在家庭医生和放射科医生解读结果存在差异的病例中，35%被家庭医生正确解读。
在门诊环境中，家庭医生在放射学解读方面表现出高度的准确性。胸部X光片本质上比四肢X光片更难解读。由于正确解读取决于所检查的身体部位和疾病的患病率，家庭医生的表现可能因不同的临床环境而有所不同。
