Influence of observer experience and training on proficiency in coronary CT angiography interpretation

Publication

Influence of observer experience and training on proficiency in coronary CT angiography interpretation

Journal Paper/Review - Apr 17, 2013

Herzog Christopher, Vogl Thomas J, Ackermann Hanns, Zwerner Peter L, Silverman Justin R, Bauer Ralf, Kim He-Ri, Scheuchenzuber Miriam, Liem Sven, Boehme Eike, Tekin Tuna, De Rosa Salvatore, Kerl J Matthias, Schoepf U Joseph

Citation

Herzog C, Vogl T, Ackermann H, Zwerner P, Silverman J, Bauer R, Kim H, Scheuchenzuber M, Liem S, Boehme E, Tekin T, De Rosa S, Kerl J, Schoepf U. Influence of observer experience and training on proficiency in coronary CT angiography interpretation. Eur J Radiol 2013; 82:1240-7.

Type

Journal Paper/Review (English)

Journal

Eur J Radiol 2013; 82

Publication Date

Apr 17, 2013

Issn Electronic

1872-7727

Pages

1240-7

Brief description/objective

PURPOSE
To assess the influence of experience and training on the proficiency in coronary CT angiography (CCTA) interpretation of practitioners with different levels of experience.

METHODS AND MATERIALS
Nine radiologist and cardiologist observers with varying prior CCTA experience ranging from novice to expert independently analyzed two case series of 50 catheter-correlated CCTA studies for coronary artery stenosis (0%, ≤49%, 50-74%, 75-99%, or 100%). Results of the first case series were unblinded and presented along with catheter angiography results to each reader before proceeding to the second series. Diagnostic accuracy on a per-segment basis was compared for all readers and both case series, respectively.

RESULTS
Correlation coefficients between CCTA and catheter angiography initially ranged between good (r=0.87) and poor (r=0.26), depending on reader experience, and significantly (p<0.05) improved in the second case series (range: r=0.42 to r=0.91). Diagnostic accuracy was significantly (p<0.05) higher for more experienced readers (range: 96.5-97.8%) as compared to less experienced observers (range: 90.7-93.6%). After completion of the second case series for less experienced readers sensitivity and PPV significantly (p<0.05) improved (range: 62.7-67.8%/51.4-84.1%), but still remained significantly (p<0.05) lower as compared to more experienced observers (range: 89.8-93.3%/80.6-93.3%).

CONCLUSION
The level of experience appears to be a strong determinant of proficiency in CCTA interpretation. Limited one-time training improves proficiency in novice readers, but not to clinically satisfactory levels.