901-101 Evaluating the Effectiveness of a Nuclear Cardiology Training Program: Comparison of Trainees with Faculty

Abstract

To evaluate the effectiveness of structured nuclear cardiology training. the reproducibility and accuracy of image interpretation by nuclear cardiology faculty and senior cardiology fellows were compared. The reproducibility and accuracy of 3 faculty and 3 trainees with 6 months training following Nuclear Regulatory Commission/American College of Cardiology guidelines were assessed using 138 exercise Tc-99 m Sestamibi SPECT studies. Studies were randomly selected and included patients with < 5% likelihood of CAD as well as patients with angiographically demonstrated single and multivessel disease. Studies were interpreted twice by each reader without knowledge of clinical or exercise data. Each reader classified perfusion as normal (N) or abnormal (AB). AB perfusion was further classified as fixed (F) or ischemic (I). Reproducibility was compared with respect to first order (N vs AB) and second order (N vs F vs I) intra and inter observer agreement and assessed using percent agreement (%) and Cohen's kappa. Accuracy was assessed using sensitivity and normalcy rate and compared using percent agreement and Cohen's kappa. Trainees Faculty % kappa % kappa Reproducibility First order Intra: 89 0.78 92 0.82 inter: 80 0.59 86 0.71 * Second order intra: 81 0.66 87 0.74 * inter: 69 0.46 82 0.64 * Accuracy Sensitivity 82 87 Normalcy Rate 85 89 % agreement/kappa 83 063 87 0.73 * * p < 0.05 compared with trainees Trainees had high reproducibility and accuracy. comparing favorably with faculty in all categories. Faculty had significantly higher results in several categories. Structured training in nuclear cardiology following Nuclear Regulatory Commission/American College of Cardiology guidelines during clinical cardiology fellowship is very effective. resulting in high reproducibility and accuracy. Interpretive skills can be expected to further improve with experience.