Research on the maximization of clinical effectiveness of the image diagnosis

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PURPOSE : To find the method of quantitative evaluation of radiological diagnosis by measuring influences to decision making by referring physicians, and to maximize the efficacy.MATERIALS AND METHODS : Work sheets of 260 questionaires and check lists composed of 10 items each to radiologists and referring physicians were prepared. The work sheets were delivered to 13 hospitals of the National University here in Japan. They were filled out by 10 cases of CT examination and 10 cases of MRI diagnosis at each hospital, and were returned to Osaka University. Every case was consistent through the each of exam order, image diagnosis and decision making. Every case was described by both a radiologist and the physician who ordered the examination and recieved the reports and images.RESULTS : 95% of 260 cases of interpretation of CT and MRI involved both process of the recognition and the thinking. Another 5% were based on genuine intuition. The thinking of physician's side was much more effected by the deeper thinking of radiologists. Pattern of reationship between radiologist's behavior and physician's decision making strongly depends on institutes and modalities.CONCLUSION : Analysis of these 260 cases tells that the level of accomplishment of technical efficacy and diagnostic accuracy on the side of radiology strongly influences the diagnostic thinking by the physician.