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首页> 外文期刊>Journal of the American College of Radiology: JACR >Discrepancies in Radiograph Interpretation Between Pediatric Radiologists and Pediatric Intensivists in the Pediatric or Neonatal Intensive Care Unit
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Discrepancies in Radiograph Interpretation Between Pediatric Radiologists and Pediatric Intensivists in the Pediatric or Neonatal Intensive Care Unit

机译：小儿或新生儿重症监护单元儿科放射科医生和儿科强度分子的X型射线照片解释差异

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BackgroundIn pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs), patient management decisions are sometimes based on preliminary interpretations of radiographs by pediatric intensivists (PIs) before a formal interpretation by a pediatric radiologist (PR). ObjectiveTo quantify and classify discrepancies in radiographic interpretation between PRs and PIs in the PICU and NICU. Materials and MethodsThis institutional review board–approved multi-institutional prospective study included three PRs and PIs at two PICUs and three NICUs. Interpretations of chest and abdominal radiographs by PIs and PRs were recorded on online forms and compared. Discrepancies in interpretations were classified as “miss,” “misinterpretation,” or “overcall.” The discrepancies were also categorized as “actionable” or “nonactionable” based on extrapolation of the ACR actionable reporting work group’s list of actionable findings. ResultsIn 960 radiographic interpretations, the total, nonactionable, and actionable discrepancy rates between PRs and PIs were 34.7%, 26.8%, and 7.9%, respectively. The most common actionable discrepancies were line or tube positions and identification and interpretation of parenchymal opacities in the lungs. Identification of air leaks in the PICU and differentiation of normal from abnormal bowel gas patterns in the NICU followed in frequency. Air leaks accounted for 1% of total discrepancies and 11% of actionable discrepancies. Most discrepancies were nonactionable and included retrocardiac atelectasis and mischaracterization of neonatal lung disease in the PICU and NICU, respectively. ConclusionAlthough the total discrepancy rate was high, most discrepancies were nonactionable. Actionable discrepancies were predominantly due to line and tube position, which should be an area of focused education.
机译：背景小子密集护理单位（PICUS）和新生儿重症监护单位（尼古斯），患者管理决策有时是基于儿科强度（PIS）在儿科放射科学专家（PR）的正式解释之前对射线照相的初步解释。 ObjectiveTo量化并分类PICU和Nicu在PRS和PIS之间的射线照相解释中的差异。材料和方法制度审查委员会批准的多制制前瞻性研究包括两个PICU和三个尼古斯的三个PRS和PIS。通过PIS和PRS对胸部和腹部射线照相的解释被记录在线表格上并进行比较。解释中的差异被归类为“小姐”，“误解，”或“过度交通”。基于ACR Actionable Reporting工作组的可操作调查结果名单的外推，差异也被分为“可操作”或“非分歧”。结果960射线照相解释，PRS和PIS之间的总，非可动性和可操作性差异率分别为34.7％，26.8％和7.9％。最常见的可操作差异是线或管道位置以及肺部实质不透明度的鉴定和解释。识别PICU中的空气泄漏和NICU中的异常排便的正常肠道气体图案的差异。空气泄漏占总差异的1％和可操作差异的11％。大多数差异都是不可取的，包括PICU和Nicu中新生儿肺病的肾外腺ATELECTAsis和Micr表现。结论虽然总差异率很高，但大多数差异都是不可取的。可行的差异主要是由于线路和管道位置，这应该是一个专注的教育领域。

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