대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제82권6호
  • /
  • Pages.1545-1555
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  • 2021
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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원격판독 의료기관에서 시행한 원격판독의 동료평가: 세부전공분야와 촬영장비에 따른 판독 불일치 정도와 불일치 판독의 임상적 의의 비교

Peer Review of Teleradiology at a Teleradiology Clinic: Comparison of Unacceptable Diagnosis and Clinically Significant Discrepancy between Radiology Sections and Imaging Modalities

  • 서형석 (을지대학교 의정부병원 영상의학과) ;
  • 박재성 (순천향대학교 부천병원 영상의학과) ;
  • 오유환 (고려대학교 안암병원 영상의학과) ;
  • 성동욱 (경희대학교병원 영상의학과) ;
  • 이아름 (순천향대학교 부천병원 영상의학과)
  • Hyung Suk Seo (Department of Radiology, Eulji University Uijeongbu Hosptial) ;
  • Jai Soung Park (Department of Radiology, Soonchunhyang University Bucheon Hosptital) ;
  • Yu-Whan Oh (Department of Radiology, Korea University Anam Hospital) ;
  • Dongwook Sung (Department of Radiology, Kyung Hee University Hospital) ;
  • A Leum Lee (Department of Radiology, Soonchunhyang University Bucheon Hosptital)
  • 투고 : 2020.11.03
  • 심사 : 2021.02.03
  • 발행 : 2021.11.01
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초록

목적 동료평가를 시행하여 원격판독 불일치의 정도와 불일치 판독의 임상적 의의를 세부전공분야와 촬영장비별로 평가하고자 하였다. 대상과 방법 한 국내 원격판독 의료기관에서 2018년과 2019년에 시행한 동료평가를 대상으로 세부전공분야와 촬영장비별로 판독 불일치를 분석하였다. 동료평가 점수를 적격 진단과 부적격 진단으로 분류하였고, 판독 불일치는 임상적 의의에 따라 무의한 불일치와 유의한 불일치로 분류하였다. 카이제곱 검증으로 통계를 시행하였다. 결과 총 1312건의 동료평가 중 부적격 진단은 117건(8.9%)이고, 총 462건의 진단 불일치 중 유의한 불일치는 104건(21.6%)이었다. 세부전공분야에서 부적격 진단율은 근골격(21.4%)이 가장 높았고(각각 p < 0.05), 복부(7.3%)는 신경두경부(1.3%)에 비해 높았다(p < 0.05). 유의한 불일치는 흉부(32.7%)가 복부(17.1%)와 근골격(19.5%)에 비해 높았다(각각 p < 0.05). 촬영장비에서 부적격 진단은 MR (16.2%)이 일반촬영(7.8%)에 비해 높았고(p < 0.05), 유의한 불일치는 차이가 없었다. 결론 동료평가를 통해서 원격판독의 부적격 진단과 임상적 유의한 불일치의 정도, 세부전공분야와 촬영장비에 따른 차이를 알 수 있었다.

Purpose The purpose of this study was to evaluate the rates of unacceptable diagnosis and clinically significant diagnostic discrepancy in radiology sections and imaging modalities through a peer review of teleradiology. Materials and Methods Teleradiology peer reviews in a Korean teleradiology clinic in 2018 and 2019 were included. The peer review scores were classified as acceptable and unacceptable diagnoses and clinically insignificant and significant diagnostic discrepancy. The diagnostic discrepancy rates and clinical significance were compared among radiology sections and imaging modalities using the chi-square test. Results Of 1312 peer reviews, 117 (8.9%) cases had unacceptable diagnoses. Of 462 diagnostic discrepancies, the clinically significant discrepancy was observed in 104 (21.6%) cases. In radiology sections, the unacceptable diagnosis was highest in the musculoskeletal section (21.4%) (p < 0.05), followed by the abdominal section (7.3%) and neuro section (1.3%) (p < 0.05). The proportion of significant discrepancy was higher in the chest section (32.7%) than in the musculoskeletal (19.5%) and abdominal sections (17.1%) (p < 0.05). Regarding modalities, the number of unacceptable diagnoses was higher with MRI (16.2%) than plain radiology (7.8%) (p < 0.05). There was no significant difference in significant discrepancy. Conclusion Peer review provides the rates of unacceptable diagnosis and clinically significant discrepancy in teleradiology. These rates also differ with subspecialty and modality.

키워드

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