Research on the maximization of clinical effectiveness of the image diagnosis

目的：通过测量临床医生对放射诊断决策的影响，寻找定量评价放射诊断的方法，最大限度地发挥其效果。材料与方法：编制260份调查问卷和10项检查表，供放射科医生和转诊医生参考。这些工作单被送到了日本国立大学的13家医院。由各医院10例CT检查和10例MRI诊断填写，并送回大阪大学。通过检查顺序、影像诊断和决策，每个病例都是一致的。每个病例都由放射科医生和安排检查的内科医生描述，并收到报告和图像。结果：260例CT和MRI解释中，95%的病例既涉及识别过程，也涉及思维过程。另有5%是基于真实的直觉。医生一方的想法更多地受到放射科医生更深层次的思考的影响。放射科医师行为与医师决策的关系模式受机构和模式的影响较大。结论：对260例放射科医师的技术效能和诊断准确率的分析表明，放射科医师的技术效能和诊断准确率的高低对医师的诊断思维有很大影响。

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.