关于肺栓塞的放射成像报告中的诊断不确定性的医生观点:一种定性研究
Lauren M Westafer1, Patrick Walsh2, Ron Helderman3
1Department of Department of Healthcare Delivery and Population Science, University of Massachusetts Chan Medical School-Baystate, Springfield, MA; Department of Emergency Medicine, University of Massachusetts Chan Medical School-Baystate, Springfield, MA.
当计算机断层扫描肺血管造影 (CTPA) 报告显示肺栓塞 (PE) 的不确定性时,医生往往缺乏明确的策略,这经常导致经验性抗凝和延迟测试.
科学领域:
- 放射学和成像学 放射学和成像学
- 肺部医学 肺部医学
- 临床决策 - 临床决策
背景情况:
- 计算机断层扫描肺血管造影 (CTPA) 对于诊断肺栓塞 (PE) 是至关重要的.
- 在CTPA报告中的诊断不确定性对临床管理提出了挑战.
研究的目的:
- 调查医生在CTPA报告显示PE的不确定性时如何解释和做出决定.
- 了解诊断不确定性对临床实践的影响.
主要方法:
- 半结构面试与美国的急诊医学和医院医学医生进行.
- 数据使用反射主题分析来分析.
主要成果:
- 医生报告说,CTPA报告中缺乏对诊断不确定性的有组织方法.
- 常见的主题包括默认使用实证抗凝药,推迟进一步测试,以及不愿重复成像.
- 虽然支持标准化沟通,但医生拒绝量化CTPA报告中的不确定性.
结论:
- 医生通常会在CTPAPE报告中遇到诊断不确定性,但缺乏结构化的方法.
- 经验性抗凝药和延期测试是常见的反应.
- 需要制定数据驱动的指导,以管理PE成像报告中的不确定性.
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