Abstract
BackgroundIt is important that referring physicians and other treating clinicians properly understand the final reports from diagnostic tests. The aim of the study was to investigate whether referring physicians interpret a final report for a myocardial perfusion scintigraphy (MPS) test in the same way that the reading nuclear medicine physician intended.MethodsAfter viewing final reports containing only typical clinical verbiage and images, physicians in nuclear medicine and referring physicians (physicians in cardiology, internal medicine, and general practitioners) independently classified 60 MPS tests for the presence versus absence of ischemia/infarction according to objective grades of 1–5 (1 = No ischemia/infarction, 2 = Probably no ischemia/infarction 3 = Equivocal, 4 = Probable ischemia/infarction, and 5 = Certain ischemia/infarction). When ischemia and/or infarction were thought to be present in the left ventricle, all physicians were also asked to mark the involved segments based on the 17-segment model.ResultsThere was good diagnostic agreement between physicians in nuclear medicine and referring physicians when assessing the general presence versus absence of both ischemia and infarction (median squared kappa coefficient of 0.92 for both). However, when using the 17-segment model, compared to the physicians in nuclear medicine, 12 of 23 referring physicians underestimated the extent of ischemic area while 6 underestimated and 1 overestimated the extent of infarcted area.ConclusionsWhereas referring physicians gain a good understanding of the general presence versus absence of ischemia and infarction from MPS test reports, they often underestimate the extent of any ischemic or infarcted areas. This may have adverse clinical consequences and thus the language in final reports from MPS tests might be further improved and standardized.
Highlights
It is important that referring physicians and other treating clinicians properly understand the final reports from diagnostic tests
When a physician refers a patient to a myocardial perfusion scintigraphy (MPS), the physician wants to know whether ischemia and/or infarction are present, as well as the extent and severity of any perfusion defects
Initially, MPS tests performed at the Department of Nuclear Medicine, Skåne University Hospital, Malmö, Sweden during January-July 2011 were considered for inclusion in the study
Summary
It is important that referring physicians and other treating clinicians properly understand the final reports from diagnostic tests. The aim of the study was to investigate whether referring physicians interpret a final report for a myocardial perfusion scintigraphy (MPS) test in the same way that the reading nuclear medicine physician intended. Whenever diagnostic tests are performed, it is important that referring physicians fully understand the final report, written for example by other physicians who are most often radiologists or pathologists. Stress myocardial perfusion scintigraphy (MPS) is widely regarded as a clinically useful non-invasive imaging modality for diagnosing patients with suspected coronary artery disease [1,2,3]. In order to optimally manage the patient, the referring physician should fully understand the final report generated by the nuclear medicine specialist.
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