Association of volume of self-directed versus assigned interpretive work with diagnostic performance of radiologists: an observational study

Autor: Osamu Abe, Shiori Amemiya, Hidemasa Takao, Harushi Mori
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
health services administration & management
Workload
Sensitivity and Specificity
Correlation
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Japan
Radiologists
diagnostic radiology
Humans
Mass Screening
Medicine
030212 general & internal medicine
Practice Patterns
Physicians'
Association (psychology)
Diagnostics
Original Research
Aged
Retrospective Studies
Aged
80 and over
medicine.diagnostic_test
business.industry
Prostatic Neoplasms
Magnetic resonance imaging
General Medicine
Middle Aged
University hospital
medicine.disease
Magnetic Resonance Imaging
Physical therapy
Regression Analysis
Observational study
Clinical Competence
business
medical education & training
030217 neurology & neurosurgery
Human learning
Volume (compression)
Zdroj: BMJ Open
ISSN: 2044-6055
Popis: ObjectivesTo understand the sources of variability in diagnostic performance among experienced radiologists.DesignAll prostate MRI examinations performed between 2016 and 2018 were retrospectively reviewed.SettingUniversity hospital in Japan.ParticipantsData derived from 334 pathology-proven cases (male, mean age: 70 years; range: 35–90 years) that were interpreted by 10 experienced radiologists were subjected to the analysis.Primary and secondary outcome measuresDiagnostic performance measures of the radiologists were compared with candidate factors, including interpretive volume of prostate MRIs, volume of self-directed and assigned total annual interpretive work, and years of experience. The potential influence of fatigue was also evaluated by examining the effect of the report’s issue time.ResultsThere were 186 prostate cancer cases. Performance was based on accuracy, sensitivity and specificity (86%, 85% and 84%, respectively). While performance was not correlated with the volume of prostate MRIs, per se (ρ=–0.15, p=0.69; ρ=–0.01, p=0.99; ρ=–0.33, p=0.36) or the total MRIs assigned for each radiologist (p>0.6) or years of experience (p>0.4), all measures were strongly correlated with voluntary work represented by the interpretive volume of abdominal CTs (r=0.79, p2(2)=3.65, p=0.16).ConclusionsGreater autonomy, represented as enhanced self-directed interpretive work, was most significantly correlated with the performance of prostate MRI interpretation. The lack of a correlation between the performance and assigned volume confirms the complexity of human learning. Together, these findings support the hypothesis that successful promotion of internal drivers could have a pervasive positive impact on improving diagnostic performance.
Databáze: OpenAIRE
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