Siegle R L, Baram E M, Reuter S R, Clarke E A, Lancaster J L, McMahan C A
Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800, USA.
Acad Radiol. 1998 Mar;5(3):148-54. doi: 10.1016/s1076-6332(98)80277-8.
Prospective studies of radiologists' interpretations of selected radiographs reported 20-40 years ago indicated error rates of 30% and higher. The authors retrospectively evaluated the interpretations of groups of radiologists and determined a range of rates of disagreement in interpretation. Quality assessment or recredentialing may add to the importance of such studies in the future.
Over a 7-year period, a team of radiologists reviewed imaging interpretations in the radiology departments of six community hospitals. Each review, which lasted about 3 days, included evaluation of the interpretations of a 3%-4% sample of the images read by the radiologists at these hospitals. Reading errors were quantitated and evaluated qualitatively.
In a review of over 11,000 images read by 35 radiologists, the authors found a 4.4% mean rate of interpretation disagreement; only one radiologist had a mean rate above 8%. Qualitative analysis of the interpretation errors revealed a mean rate of 3.0% of errors that were considered to be below an acceptable standard of care. Radiologists whose errors included a relatively high proportion of false-positive findings tended to make relatively fewer total errors.
Rates of disagreement for a broad range of studies that radiologists interpret in a community hospital setting appear to be far lower than earlier studies on selective radiographs indicated.
对放射科医生对20 - 40年前所选X光片解读的前瞻性研究表明,错误率达30%及更高。作者回顾性评估了放射科医生团队的解读情况,并确定了解读意见分歧率的范围。质量评估或重新认证可能会增加此类研究在未来的重要性。
在7年时间里,一个放射科医生团队审查了6家社区医院放射科的影像解读。每次审查持续约3天,包括对这些医院放射科医生所读影像的3% - 4%样本的解读进行评估。对阅读错误进行了定量和定性评估。
在对35名放射科医生阅读的超过11000张影像的审查中,作者发现解读意见分歧的平均率为4.4%;只有一名放射科医生的平均率高于8%。对解读错误的定性分析显示,被认为低于可接受医疗标准的错误平均率为3.0%。错误中假阳性结果比例相对较高的放射科医生,其总错误往往相对较少。
在社区医院环境中,放射科医生对广泛研究的解读意见分歧率似乎远低于早期对选择性X光片的研究所示。