Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

DOI: 10.1148/radiol.2491080059
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dachman, A. H.
Right arrow Articles by Fletcher, J. G.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Dachman, A. H.
Right arrow Articles by Fletcher, J. G.
(Radiology 2008;249:167-177.)
© RSNA, 2008

Gastrointestinal Imaging

Formative Evaluation of Standardized Training for CT Colonographic Image Interpretation by Novice Readers1

Abraham H. Dachman, MD, Katherine B. Kelly, MD, Michael P. Zintsmaster 2, Rich Rana, MD 3, Shweta Khankari, MD, Joseph D. Novak, MD, Arif N. Ali, MD 4, Adnan Qalbani, MD 5, and Joel G. Fletcher, MD

1 From the Department of Radiology, University of Chicago, MC 2026, 5841 S Maryland Ave, Chicago, IL 60637 (A.H.D., K.B.K., M.P.Z., R.R., S.K., J.D.N., A.N.A., A.Q.); and Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minn (J.G.F.). Received January 9, 2008; revision requested February 26; revision received March 30; accepted April 17; final version accepted April 24. Address correspondence to A.H.D. (e-mail: ahdachma{at}uchicago.edu).

Purpose: To introduce an educational intervention—specifically, a specialized training course—and perform a formative evaluation of the effect of the intervention on novice reader interpretation of computed tomography (CT) colonographic data.

Materials and Methods: The study was institutional review board approved. Ten normal and 50 abnormal cases, those of 60 patients with 93 polyps—61 polyps 6–9 mm in diameter and 32 polyps 10 mm or larger—were selected from a previously published trial. Seven novice readers underwent initial training that consisted of a 1-day course, reading assignments, a self-study computer module (with 61 limited data sets), observation of an expert interpreting three cases, and full interpretation of 10 cases with unblinding after each case. After training, the observers independently interpreted 60 cases by means of primary two-dimensional reading with unblinding after each case. For each case, the reading time and the location and maximal diameter of the polyp(s) were recorded. A t test was used to evaluate the observers' improvements, and empirical receiver operating characteristic (ROC) curves were constructed.

Results: By-patient sensitivities and specificities were determined for each observer. The lowest by-patient sensitivity at the 6 mm or larger polyp threshold was 86%, with 90% specificity. Four observers had 100% by-patient sensitivity at the 10 mm or larger polyp threshold, with 82%–97% specificity. For polyps 10 mm or larger, mean sensitivity and specificity were 98% and 92%, respectively. For the last 20 cases, the average interpretation time per case was 25 minutes. The range of areas under the ROC curve across observers was low: 0.86–0.95.

Conclusion: In the described polyp-enriched cohort, novice CT colonographic data readers achieved high sensitivity and good specificity at formative evaluation of a comprehensive training program. Use of a similar comprehensive training method might reduce interreader variability in interpretation accuracy and be useful for reader certification.

© RSNA, 2008