随访数据信息化管理系统对超声医师诊断效能的影响

目的探讨随访数据信息化管理系统的构建，并研究该系统对超声医师诊断效能的影响。 方法回顾性分析2016年7月至2018年12月北京大学深圳医院的8951个病例，均经病理证实。采用分级诊断构建随访数据信息化管理系统。所有病例采用诊断等级（1~3级，每个等级细分为诊断符合与不符合）并进行诊断加权分评估。计算随访效率（随访每100个有效病例所需要的人员和时间）。超声医师诊断效能通过诊断等级、诊断符合率及诊断加权分评价。采用χ²检验比较随访数据信息化管理系统构建前后超声医师诊断等级、诊断符合率的差异，采用t检验比较诊断加权分的差异。 结果随访工作占用成本由随访系统构建前的5.2人时/100例降低至构建后的3.1人时/100例。随访数据信息化管理系统构建前、后诊断等级比较（1级/2级/3级∶21.0%/21.0%/58.0% vs 17.3%/23.9%/58.8%），差异有统计学意义（χ²=23.708，P＜0.001），构建后的诊断等级优于构建前，对病变良恶性作出判断病例（2级+3级）的构成比增加（82.7% vs 79.0%）。系统构建后1级、3级诊断符合率与系统构建前比较有所提高（83.8% vs 66.6%；87.8% vs 85.7%），差异均具有统计学意义（χ²=361.453、5.573，P＜0.001、=0.020）；2级诊断符合率比较，差异无统计学意义（P＞0.05）。超声医师诊断加权分均值从3.93分提高至4.51分，差异具有统计学意义（t=-14.816，P＜0.001）。 结论随访数据信息化管理系统的构建能提高随访效率，并定量评价超声医师的诊断效能，通过系统反馈和校正的方式可提高超声医师的诊断效能。

Influence of information management system of follow-up data on diagnostic efficiency of ultrasonic physicians

ObjectiveTo construct an information management system of follow-up data and investigate the influence of the system on the diagnostic efficiency of ultrasonic physicians. MethodsA total of 8951 cases at Peking University Shenzhen Hospital from July 2016 to December 2018 were analyzed retrospectively. All the cases were confirmed by pathology. An information management system of follow-up data was built by hierarchical diagnosis. Diagnostic grade (grades 1-3; each diagnostic grade was further divided into diagnostic conformity and non-conformity) and diagnostic weighted score were used in all cases. The efficiency of follow-up (the personnel and time required to follow every 100 valid cases) was calculated. The diagnostic efficiency of ultrasonic physicians was evaluated by diagnostic grade, diagnostic coincidence rate, and diagnostic weighted score. The differences of diagnostic grade and diagnostic coincidence rate of ultrasonic physicians before and after the use of the information management system of follow-up data were analyzed by the Chi-square test, and diagnostic weighted score was analyzed by t-test. ResultsThe cost of follow-up was reduced from 5.2 man-hours/100 cases to 3.1 man-hours/100 cases. The diagnostic grade after the use of the information management system of follow-up data was higher than that before the use (grade 1/grade 2/grade 3: 21.0%/21.0%/58.0% vs 17.3%/23.9%/58.8%; χ²=23.708, P＜0.001). The proportion of cases (grade 2+grade 3) that were judged as benign or malignant lesions increased (82.7% vs 79.0%). After the system was used, the diagnostic coincidence rate of grade 1 and grade 3 cases was significantly improved compared with that before the use of the system (83.8% vs 66.6%, χ²=361.453, P＜0.001; 87.8% vs 85.7%, χ²=5.573, P=0.020). There was no statistically significant difference in the diagnostic coincidence rate of grade 2 cases (P＞0.05). The mean weighted score of ultrasonic physicians' diagnosis increased from 3.93 points to 4.51 points, which was statistically different (t=-14.816, P＜0.001). ConclusionThe use of the information management system of follow-up data can improve the efficiency of follow-up, and evaluate the diagnostic efficiency of ultrasonic physicians quantitatively. And the diagnostic efficiency of ultrasonic physicians can be improved through the feedback and correction in the system.