对省辖5家尘肺病诊断机构诊断质量的调查

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目的了解吉林省部分尘肺病诊断机构的诊断质量。方法抽取该省5家尘肺病诊断机构具有尘肺病诊断资质的医师进行阅片考核。随机选取5家机构接诊的粉尘作业人员高千伏胸部正位片88张,作为考核用片;邀请3名国内知名尘肺病诊断专家集体阅片,结果作为参照答案;从5家机构中每家抽取3名医师作为一个被考核组,分组集体阅片;将专家组阅片结果与5个被考核组的阅片结果进行比较,得出诊断符合率和不符合率;对五家机构的尘肺病诊断相关仪器设备情况进行问卷调查。结果专家组与被考核组间诊断符合56例、诊断不符合32例,符合率为63.64%(56/88);其中误诊11例,占12.50%;诊断偏高15例,占17.05%;诊断偏低6例,占6.81%;5个被考核组间诊断不符合率比较,差异有统计学意义(P<0.05);各项阅片技术指标总符合率66.92%。5家机构尘肺病诊断相关仪器设备存在不足。结论吉林省部分尘肺病诊断机构的诊断质量参差不齐且偏低,亟待提高。 Objective To understand the diagnostic quality of some pneumoconiosis diagnostic institutions in Jilin Province. Methods Five pneumoconiosis diagnostic institutions with pneumoconiosis diagnostic qualifications were selected for reading examination. Eight randomly selected high-voltage chest radiographs of 88 operators who were admitted to five institutions were selected as examination pieces. Three well-known experts in pneumoconiosis diagnosis were invited to participate in the screening. The results were used as a reference answer. From each of 5 institutions Three physicians were selected as a group to be assessed, groups collectively read the film; the group read the results of the examination group and the five were compared to read the results to draw the diagnostic compliance rate and the non-compliance rate; five institutions Pneumoconiosis diagnosis related equipment and equipment to conduct a questionnaire survey. Results 56 cases were diagnosed by experts group and 32 cases were not diagnosed. The coincidence rate was 63.64% (56/88). Among them, 11 cases were misdiagnosed, accounting for 12.50%; 15 cases were diagnosed as high, accounting for 17.05%; diagnosis 6 cases were low, accounting for 6.81%. The diagnostic incompatibility rates among the 5 groups were statistically significant (P <0.05). The total coincidence rate of all technical indexes of reading was 66.92%. Five institutions pneumoconiosis diagnostic equipment related to inadequate. Conclusion The diagnostic quality of some pneumoconiosis diagnostic institutions in Jilin Province is uneven and low, which needs to be improved urgently.
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