Babcook C J, Norman G R, Coblentz C L
Department of Radiology, McMaster University Medical Centre, Hamilton, Ontario, Canada.
Invest Radiol. 1993 Mar;28(3):214-7. doi: 10.1097/00004424-199303000-00005.
This study assesses the effect of a clinical history of "bronchiolitis" versus "well child" on the interpretation of pediatric chest radiographs.
Radiologists reviewed radiographs previously identified as "definite bronchiolitis," "equivocal bronchiolitis," "definite normal," and "equivocal normal." They were asked to identify features of bronchiolitis and give a confidence level for their diagnosis. A correct clinical history of "bronchiolitis" or a "well child" was provided for all definite and half the equivocal radiographs. The other half of the equivocal radiographs were matched with incorrect histories.
Given normal radiographs with a history of bronchiolitis, radiologists reported more features of bronchiolitis with increased confidence and also more features.
The results suggest that the effect of history is not simply to provide additional confirmatory information, thereby increasing the diagnosis rating, but rather to change the interpretation of features, to the extent that features apparently are seen even on normal radiographs.
本研究评估“细支气管炎”与“健康儿童”的临床病史对儿科胸部X光片解读的影响。
放射科医生回顾先前被认定为“明确的细支气管炎”“疑似细支气管炎”“明确正常”和“疑似正常”的X光片。他们被要求识别细支气管炎的特征并给出诊断的置信度。为所有明确的以及一半疑似的X光片提供“细支气管炎”或“健康儿童”的正确临床病史。另一半疑似X光片则匹配错误的病史。
对于有细支气管炎病史的正常X光片，放射科医生报告了更多细支气管炎特征，且置信度增加，特征数量也更多。
结果表明，病史的影响并非仅仅是提供额外的确证信息从而提高诊断评级，而是改变对特征的解读，以至于在正常X光片上也明显能看到这些特征。
