referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging医师低估的程度异常心肌灌注成像的最终报告.pdfVIP

Trägårdh et al. EJNMMI Research 2012, 2:27 /content/2/1/27 ORIGINAL RESEARCH Open Access Referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging 1* 2 3 4 1 Elin Trägårdh , Peter Höglund , Mattias Ohlsson , Mattias Wieloch and Lars Edenbrandt Abstract Background: It is important that referring physicians and other treating clinicians properly understand the final reports from diagnostic tests. The aim of the study was to investigate whether referring physicians interpret a final report for a myocardial perfusion scintigraphy (MPS) test in the same way that the reading nuclear medicine physician intended. Methods: After viewing final reports containing only typical clinical verbiage and images, physicians in nuclear medicine and referring physicians (physicians in cardiology, internal medicine, and general practitioners) independently classified 60 MPS tests for the presence versus absence of ischemia/infarction according to objective grades of 1–5 (1 = No ischemia/infarction, 2 = Probably no ischemia/infarction 3 = Equivocal, 4 = Probable ischemia/ infarction, and 5 = Certain ischemia/infarction). When ischemia and/or infarction were thought to be present in the left ventricle, all physicians were also asked to mark the involved segments based on the 17-segment model. Results: There was good diagnostic agreement between physicians in nuclear medicine and referring physicians when assessing the general presence versus absence of both ischemia and infarction (median squared kappa coefficient of 0.92 for both). However, when using the 17-segment model, compared to the physicians in nuclear medicine, 12 of 23 referring physicians underestimated