The effect of a Picture Archiving and Communications System (PACS) on diagnostic performance in the accident and emergency department

被引:0
作者
Weatherburn, G [1 ]
Bryan, S
Nicholas, A
Cocks, R
机构
[1] Brunel Univ, Hlth Econ Res Grp, Uxbridge UB8 3PH, Middx, England
[2] Univ Birmingham, Hlth Serv Management Ctr, Birmingham B15 2TT, W Midlands, England
[3] Hammersmith Hosp, Dept Accid & Emergency, London, England
[4] Prince Wales Hosp, Ctr Canc, A&E Med Acad Unit, Hong Kong, Hong Kong, Peoples R China
来源
JOURNAL OF ACCIDENT & EMERGENCY MEDICINE | 2000年 / 17卷 / 03期
关键词
PACS; misdiagnosis; radiography;
D O I
暂无
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective-A study has been conducted to identify the benefits to the accident and emergency (A&E) department of a hospital wide Picture Archiving and Communications System (PACS). Methods-The study was conducted in two parts: firstly while the hospital was using conventional radiographic films, and secondly when the PACS was in operation. For each part of the study; the diagnoses of radiographic images made by A&E clinicians were compared with those made by radiologists. This resulted in the estimation of the incidence of false negative findings by the A&E staff. The management of patients with such findings was studied to identify those for whom a change of treatment was required. Such data for the two periods, when film and when PACS was used, were compared. Results-It was found that the overall rate of misdiagnoses across all A&E patients who had radiography was low in both periods and there was a significant reduction when PACS was used (1.5% for film and 0.7% for PACS, 95% CI for difference between proportions: -0.014 to -0.0034), but the rate of serious misdiagnoses involving patient recall did not change significantly (95% CI for difference between proportions: -0.0059 to +0.0001). Conclusions-When PACS was used the diagnostic performance by A&E staff improved by reducing false negative interpretations but the rate of serious misdiagnosis did not change.
引用
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页码:180 / 184
页数:5
相关论文
共 26 条
[1]  
Altman DG, 1990, PRACTICAL STAT MED R
[2]   Large picture archiving and communication systems of the world .1. [J].
Bauman, RA ;
Gell, G ;
Dwyer, SJ .
JOURNAL OF DIGITAL IMAGING, 1996, 9 (03) :99-103
[3]   ACCIDENT AND EMERGENCY REPORTING IN UK TEACHING DEPARTMENTS [J].
BEGGS, I ;
DAVIDSON, JK .
CLINICAL RADIOLOGY, 1990, 41 (04) :264-267
[4]   A SURVEY OF ACCIDENT AND EMERGENCY REPORTING - RESULTS AND IMPLICATIONS [J].
BERMAN, L ;
DELACEY, G ;
CRAIG, O .
CLINICAL RADIOLOGY, 1985, 36 (05) :483-484
[5]  
Bryan S, 1999, J Health Serv Res Policy, V4, P204
[6]  
BRYAN S, 1998, EVALUATION HOSP WIDE
[7]  
CAREWMCCOLL M, 1983, BRIT J CLIN PRACT, V37, P375
[8]   OFF-HOURS INTERPRETATION OF RADIOLOGIC IMAGES OF PATIENTS ADMITTED TO THE EMERGENCY DEPARTMENT - EFFICACY OF TELERADIOLOGY [J].
DECORATO, DR ;
KAGETSU, NJ ;
ABLOW, RC .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1995, 165 (05) :1293-1296
[9]   AN ASSESSMENT OF THE CLINICAL EFFECTS OF REPORTING ACCIDENT AND EMERGENCY RADIOGRAPHS [J].
DELACEY, G ;
BARKER, A ;
HARPER, J ;
WIGNALL, B .
BRITISH JOURNAL OF RADIOLOGY, 1980, 53 (628) :304-309
[10]   VALUE OF RE-EXAMINING X-RAY FILMS OF OUTPATIENTS ATTENDING ACCIDENT SERVICES [J].
GALASKO, CSB ;
MONAHAN, PRW .
BRITISH MEDICAL JOURNAL, 1971, 1 (5750) :643-&