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- W2277480651 abstract "1839 Objectives To assess MPS interpretations for overdiagnosing of positive findings compared to cardiac catheterization (CC), consensus review, and national data and to determine MPS overdiagnosis causes at our institution/give examples. Methods MPS studies over 3 mo were evaluated. Initial review of reports (original reader) with positive results (ex:reversible defects) was compared to CC (gold standard). Proportion referred for CC unnecessarily (i.e. negative CC) was computed with corresponding exact binomial 95% confidence intervals (CI). Significant difference noted when CI did not contain expected FP rate of 20-25% as reported in other studies (1,2). Second blinded consensus review by 2 NM Physicians (3rd reader as tie-breaker) was correlated to CC and agreement between initial & blinded consensus reviews was examined. Results 77 studies included. Initial review-57 MPS interpreted as positive (Figure 1). Of 35 subjects who had CC, 14 were negative. This proportion of 40% (14/35;95 CI,24-58%) is significantly higher than the 20% expected to be referred unnecessarily based on 1 study, but not significantly higher than 25% reported in another(1,2). Blinded review found 8 would have still been referred so that proportion of unnecessarily referred would have been 23% (8/35;95% CI,10-40%) which is in line with what would be expected. Kappa value of 0.68 showed fair to good agreement between initial & reviewed decisions for the 77 subjects (Figure 2). No reviewed decisions indicated a positive finding when initial decision was negative, thus indicating a bias toward referral for initial reviews. There were significantly more positive results for initial review decisions compared to blinded consensus (p=0.001). Conclusions There is room for improvement through continual MPS interpretation education/future QA reviews at our institution and probably others if not already in place. (Educational images will be provided with & without technical adjustments & with explanations." @default.
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- W2277480651 date "2012-05-01" @default.
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- W2277480651 title "QA review - Myocardial perfusion scan interpretations as a model of division-wide performance in practice evaluation" @default.
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