Measuring Performance in Chest Radiography

Potchen, E. James; Cooper, Tim F.; Sierra, A.; Aben, Gerald R.; Potchen, Michael J.; Potter, Matthew G.; Siebert, James E.

doi:10.1148/radiology.217.2.r00nv14456

Cited by 83 publications

(51 citation statements)

References 16 publications

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“…The results of this study (similar to previous studies that investigated variability in the interpretation of chest radiographs and mammograms (23,24)) could have important implications for the clinical interpretation of CT scans in the context of lung nodule detection in which a single reader is responsible for what is clearly a difficult detection task. The question must be raised as to assisting the single reader with a second (or multiple) human reader, or assisting the single reader through the computer-aided diagnosis paradigm.…”

Section: Discussionsupporting

confidence: 83%

The Lung Image Database Consortium (LIDC): An Evaluation of Radiologist Variability in the Identification of Lung Nodules on CT Scans

et al. 2007

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Rationale and Objectives-The purpose of this study was to analyze the variability of experienced thoracic radiologists in the identification of lung nodules on CT scans and thereby to investigate variability in the establishment of the "truth" against which nodule-based studies are measured.Materials and Methods-Thirty CT scans were reviewed twice by four thoracic radiologists through a two-phase image annotation process. During the initial "blinded read" phase, radiologists independently marked lesions they identified as "nodule ≥ 3mm (diameter)," "nodule < 3mm," or "non-nodule ≥ 3mm." During the subsequent "unblinded read" phase, the blinded read results of all radiologists were revealed to each of the four radiologists, who then independently reviewed their marks along with the anonymous marks of their colleagues; a radiologist's own marks then could be deleted, added, or left unchanged. This approach was developed to identify, as completely as possible, all nodules in a scan without requiring forced consensus.Results-After the initial blinded read phase, a total of 71 lesions received "nodule ≥ 3mm" marks from at least one radiologist; however, all four radiologists assigned such marks to only 24 (33.8%) of these lesions. Following the unblinded reads, a total of 59 lesions were marked as "nodule ≥ 3 mm" by at least one radiologist. 27 (45.8%) of these lesions received such marks from all four radiologists, 3 (5.1%) were identified as such by three radiologists, 12 (20.3%) were identified by two radiologists, and 17 (28.8%) were identified by only a single radiologist.

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Section: Discussionsupporting

confidence: 83%

The Lung Image Database Consortium (LIDC): An Evaluation of Radiologist Variability in the Identification of Lung Nodules on CT Scans

et al. 2007

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“…At the threshold of uncertainty, radiologists can err on the side of making false-positive or false-negative decisions depending on their concern for the consequences of their decisions. 17 Which quality assessment approaches are used depends for the most part on the particular aspects of care being examined. Evaluation programs may be person centered or system centered, and their scope can be department wide, institution wide, or system wide.…”

Section: Assessment Of Accuracymentioning

confidence: 99%

Learning From Errors in Radiology: A Comprehensive Review

Pinto

Caranci

Romano

et al. 2012

Seminars in Ultrasound, CT and MRI

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An important goal of error analysis is to create processes aimed at reducing or preventing the occurrence of errors and minimizing the degree of harm. The discovery of any errors presents an opportunity to study the types that occur and to examine their sources and develop measures to prevent them from recurring. The development of an effective system for detecting and appropriately managing errors is essential to substantially attenuate their consequences. At this stage, the error analysis process identifies contributing factors to enable the implementation of concrete steps to prevent such errors from occurring in the future. Active and comprehensive management of errors and adverse events requires ongoing surveillance processes. Educational programs, morbidity and mortality meetings, and a comprehensive and respected root cause analysis process are also essential components of this comprehensive approach. To reduce the incidence of errors, health care providers must identify their causes, devise solutions, and measure the success of improvement efforts. Moreover, accurate measurements of the incidence of error, based on clear and consistent definitions, are essential prerequisites for effective action. Semin Ultrasound

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“…The error rates of non-radiology physicians are -not surprisingly -substantially higher than those of radiologists [5,6]. Potchen and colleagues [5] showed that when three groups of physicians (radiologists, radiology residents and non-radiology physicians) were asked to diagnose a standardized set of 60 chest X-rays, the certified radiologists outperformed the radiology residents and the residents performed better than the non-radiologists physicians.…”

Section: Introductionmentioning

confidence: 99%

“…Potchen and colleagues [5] showed that when three groups of physicians (radiologists, radiology residents and non-radiology physicians) were asked to diagnose a standardized set of 60 chest X-rays, the certified radiologists outperformed the radiology residents and the residents performed better than the non-radiologists physicians. Eng et al [6] found similar results when comparing emergency medicine physicians and emergency medicine residents to radiologists and radiology residents.…”

Section: Introductionmentioning

confidence: 99%

Radiology education: a radiology curriculum for all medical students?

2017

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Diagnostic errors in radiology are frequent and can cause severe patient harm. Despite large performance differences between radiologists and non-radiology physi cians, the latter often interpret medical images because electronic health records make images available throughout the hospital. Some people argue that non-radiologists should not diagnose medical images at all, and that medical school should focus on teaching ordering skills instead of image interpretation skills. We agree that teaching ordering skills is crucial as most physicians will need to order medical images in their professional life. However, we argue that the availability of medical images is so ubiquitous that it is important that non-radiologists are also trained in the basics of medical image interpretation and, additionally in recognizing when radiological consultancy should be sought. In acute situations, basic image interpretations skills can be lifesaving. We plead for a radiology curriculum for all medical students. This should include the interpretation of common abnormalities on chest and skeletal radiographs and a basic distinction of normal from abnormal images. Furthermore, substantial attention should be given to the correct ordering of radiological images. Finally, it is critical that students are trained in deciding when to consult a radiologist.

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Measuring Performance in Chest Radiography

Cited by 83 publications

References 16 publications

The Lung Image Database Consortium (LIDC): An Evaluation of Radiologist Variability in the Identification of Lung Nodules on CT Scans

The Lung Image Database Consortium (LIDC): An Evaluation of Radiologist Variability in the Identification of Lung Nodules on CT Scans

Learning From Errors in Radiology: A Comprehensive Review

Radiology education: a radiology curriculum for all medical students?

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