PDF(Pubmed)
Abstract：
The purpose of the present study is to evaluate whether an online reference system (ORS, STATdx Elsevier, Amsterdam, Netherlands) impacts finding the histologically confirmed diagnosis of rare or atypical abdominal tumors and lesions in radiologic imaging. In total, 101 patients with rare tumor entities or lesions and atypical manifestations of common tumors were enrolled retrospectively. Blinded readings were performed by four radiologists with varying levels of experience, who reported on: (a) correct diagnosis (CD), (b) time needed to find the diagnosis, and (c) diagnostic confidence, initially without followed by the assistance of the ORS. The experienced reader (3 years of experience post-residency, CD 49.5%), as well as the advanced reader with 1 year of experience post-residency (CD 43.6%), and a resident with 5 years of experience (CD 46.5%) made the correct diagnosis more frequently compared to the less experienced reader (CD 25.7%). A significant improvement in making the correct diagnosis was only achieved by the advanced reader, the resident with 5 years of experience (CD with ORS 58.4%; p < 0.001). The advanced reader with 1 year of experience post-residency improved slightly (CD ORS 47.5%). The experienced reader (CD ORS 50.5%) and the less experienced reader (CD ORS 27.7%) did not improve significantly. The overall subjective confidence increased significantly when ORS was used (3.2 ± 0.9 vs. 3.8 ± 0.9; p < 0.001). While the ORS had a positive impact on making the correct diagnosis throughout all readers, it favored radiologists with more clinical experience rather than inexperienced residents. Moreover, the ORS increased the diagnostic confidence of all radiologists significantly. In conclusion, the ORS had no significant impact on the diagnosis of rare or atypical abdominal tumors and lesions except for one reader. The greatest benefit is the increase in diagnostic confidence.
摘要：
本研究的目的是评估在线参考系统(ORS，STATdxElsevier,阿姆斯特丹,荷兰）影响在影像学检查中发现经组织学证实的罕见或非典型腹部肿瘤和病变。总的来说,回顾性纳入101例罕见肿瘤实体或病变和常见肿瘤的不典型表现的患者。盲目的读数是由四名具有不同经验水平的放射科医生进行的，谁报告：（a）正确的诊断（CD），(b)发现诊断所需的时间，和(C)诊断信心，最初没有ORS的帮助。有经验的读者（居住后3年的经验，CD49.5%），以及具有1年居住经验的高级读者（CD43.6％），与经验不足的读者（CD25.7％）相比，具有5年经验的居民（CD46.5％）的正确诊断频率更高。只有先进的读者才能实现正确诊断的显着改进，具有5年经验的居民（CD，ORS为58.4％；p<0.001）。具有1年居住后经验的高级读者略有改善（CDORS47.5％）。有经验的读者（CDORS50.5％）和经验不足的读者（CDORS27.7％）没有显着改善。使用ORS时，总体主观置信度显着增加（3.2±0.9vs.3.8±0.9；p<0.001）。虽然ORS对所有读者做出正确的诊断产生了积极的影响，它更青睐具有更多临床经验的放射科医生，而不是没有经验的住院医生。此外，ORS显著提高了所有放射科医师的诊断信心.总之,除一名读者外,ORS对罕见或非典型腹部肿瘤和病变的诊断无显著影响.最大的好处是诊断信心的提高。
