How To Improve The Ability Of Reading Chest CT

Background:Chest CT has become the most important way among all kinds of imaging tests in the diagnosis of respiratory diseases. However, imaging diagnosis provided by the radiologists are more or less wrong due to their professional limitations, which requires the respiratory physicians to have good and independent abilities of reading chest CT. Moreover, as a clinical master degree candidate of the department of respiratory, she or he must master the skill of reading chest CT in a right way. Yet, existing methods of learning chest CT reading are unable to meet the need of rapidly and effectively improving reading skills.Objective:Build a training and testing system of chest CT reading for the clinical master degree candidates of the respiratory department to rapidly and effectively improve their chest CT reading skills.Methods:1. Collect clinical data of inpatients of the respiratory department in Qilu Hospital of Shandong University between June2012and March2013, including their imaging pictures and medical histories. 2. Build the above-mentioned system by the visual studio development program of Microsoft Corporation.3. Test weather this learning method is effective. Random allocation is taken among11clinical master degree candidates and5on-the-job training doctors. They are averagely divided into two groups, one is a system training team and the other is a imaging books training team. The former learn the reading skill though the built system while the latter learn by reading imaging books. And the test is in the form of examinations using the built system.Results:1. The numbers of collected imaging pictures and medical histories are respectively457and277.There are150cases (cases of the basic course are uncounted) in the built system after rigorous screening.2. The built system is made up of the following three parts:(1) The basic course:This part is in the form of Power point.12main CT transections of chest and27abnormal imaging signs are included.(2) The cases training course:This part is in the form of electronic test paper. There are50cases in total, including7cases of lung cancer,10cases of pneumonia,5cases of pulmonary tuberculosis,7cases of diffuse interstitial lung disease,7cases of pleural diseases,3cases of pulmonary vascular disease,5cases of trachea and bronchial diseases and6cases of rare Diseases. All the cases are edited into50one-choice questions and the possible diagnosis compose the options. The answers to the questions provide a analysis of diagnosis in the5following points, that is, onset of the disease, symptoms and signs, auxiliary examinations, chest CT appearances and the diagnosed results or effects of treatment.(3) The testing course:This part is in the form of electronic test paper.100cases are edited into100questions. One question composes of8true or false options about abnormal imaging signs on the given imaging pictures and1one-choice item about diagnosis. The100questions are equally divided into two parts according to their difficulty and involved diseases to form paper A and B.3. The comparative results of the examination between the two control learning methods and their own examination results before and after learning are as the follows:(1) Before the training, the mean examination result of the system training team is60.7±12.3and that of the imaging books training team is62.5±11.3. There is no obvious difference between the results and p value>0.05.(2) After the training, the mean examination result of the system training team is82.2±7.6and that of the imaging books training team is71.5±10.6. There is obvious difference between the results and p value<0.05.(3) There is obvious difference between the examination results before and after the training in each team and both p value<0.05.(4) The total exact time consumed by the training is respectively3.6±0.5hours and4.5±0.7hours in the system training team and the imaging books training team. There is obvious difference and the p value<0.05.Conclusions:1. Chest CT is the most important imaging test in the diagnosis of respiratory diseases.2. A clinical master degree candidate of the respiratory department must mater the skill of reading chest CT in a right way but existing methods of learning chest CT reading are unable to meet the need of rapidly and effectively improving reading skills.3. The built "training and testing system for chest CT reading" capablcs to meet the need of rapidly and effectively improving reading skills among clinical fellows of the respiratory department.4. A combined analysis of onset of the disease, symptoms and signs, auxiliary examinations, chest CT appearances and the diagnosed results or effects of treatment can effectively improve the accuracy of chest CT diagnosis. Thus, it is a method deserved to extend in reading chest CT.