Recommendations for Additional Imaging in Radiology Reports: Multifactorial Analysis of 5.9 Million Examinations
Recommendations for Additional Imaging in Radiology Reports: Multifactorial Analysis of 5.9 Million Examinations
复制标题
DOI：
10.1148/radiol.2532090200
复制
发表时间：
2009-11-01
期刊：
影响因子：
19.7
通讯作者：
Thrall, James H.
中科院分区：
文献类型：
--
作者：
Sistrom, Christopher L.;Dreyer, Keith J.;Thrall, James H.
目的：为了量化率的建议，额外的成像（RAI）在大量的放射学报告的不同模式，并估计11个临床相关factors.Materials和方法的影响：这符合健康保险责任法案的研究是由机构审查委员会批准的快速协议下，分析匿名汇总放射学数据。研究了1995年至2008年期间由放射科医师解释的所有诊断性影像学检查（n = 5 948 342）。使用了一种专门设计用于从放射学报告文本中提取有关任何建议的信息的自然语言处理技术。分析数据集包括三个定量变量：解释放射科医生的经验，研究的年份，和病人的年龄。分类变量描述病人的位置（住院，门诊，急诊科），是否居民口述的情况下，病人的性别，方式，身体区域研究，订购服务，放射科医生的专业分工，以及检查结果是否是积极的。多变量logistic回归模型被用来确定这些因素中的每一个对RAI的可能性的影响，而持有所有其他equal.Results：建议增加在13年的研究，与未调整的利率上升约6%至12%。在考虑所有其他因素后，从1995年到2008年，任何一次检查导致RAI的几率增加了2.16倍（95%置信区间：2.12，2.21）。随着放射科医生经验的增加，RAI的几率每十年下降约15%。具有阳性结果的研究更有可能（比值比= 5.03; 95%置信区间：4.98，5.07）发生RAI。其余的因素也有显着的影响趋势RAI.Conclusion：RAI的可能性增加了15%，每十年的放射科医生的经验，大约翻了一番，超过13年的研究。(C)RSNA，2009年
Purpose: To quantify the rates of recommendation for additional imaging (RAI) in a large number of radiology reports of different modalities and to estimate the effects of 11 clinically relevant factors.Materials and Methods: This HIPAA compliant research was approved by the institutional review board under an expedited protocol for analyzing anonymous aggregated radiology data. All diagnostic imaging examinations (n = 5 948 342) interpreted by radiologists between 1995 and 2008 were studied. A natural language processing technique specifically designed to extract information about any recommendations from radiology report texts was used. The analytic data set included three quantitative variables: the interpreting radiologist's experience, the year of study, and patient age. Categoric variables described patient location (inpatient, outpatient, emergency department), whether a resident dictated the case, patient sex, modality, body area studied, ordering service, radiologist's specialty division, and whether the examination result was positive. A multivariable logistic regression model was used to determine the effect of each of these factors on likelihood of RAI while holding all others equal.Results: Recommendations increased during the 13 years of study, with the unadjusted rate rising from roughly 6% to 12%. After accounting for all other factors, the odds of any one examination resulting in an RAI increased by 2.16 times (95% confidence interval: 2.12, 2.21) from 1995 to 2008. As radiologist experience increased, the odds of an RAI decreased by about 15% per decade. Studies that had positive findings were more likely (odds ratio = 5.03; 95% confidence interval: 4.98, 5.07) to have an RAI. The remaining factors also had significant effects on the tendency for an RAI.Conclusion: The likelihood of RAI increased by 15% for each decade of radiologist experience and roughly doubled over 13 years of study. (C) RSNA, 2009