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Assessment of Factors That Affect the Quality of Performance and Interpretation of Sonography of Adnexal Masses

Departments of Radiology (D.L., T.S.M.) and Pathology (J.L.H.) and Division of Pulmonary, Critical Care, and Sleep Medicine (C.O.), Beth Israel Deaconess Medical Center, Boston, Massachusetts USA; Harvard Medical School, Boston, Massachusetts USA (E.A.); and Department of Radiology, Boston Medical Center, Boston, Massachusetts USA (J.B.).

Address correspondence to Deborah Levine, MD, Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215 USA., E-mail: dlevine{at}bidmc.harvard.edu

Objective. The purpose of this study was to assess factors that affect the quality of performance and interpretation of sonography of adnexal masses. Methods. Two gynecologic sonographers performed blinded reviews of up to 3 sonograms within 5 years before surgery in 325 consecutive women who underwent oophorectomy (610 sonograms). Three 5-point quality scores were assigned (with 5 being the best score) on the basis of the technical quality of the images, accurate description of findings, and summary impression in the report. The location of the examination (on-site, remote, or emergency department), type of fellowship, practice experience (<5, 5–10, or >10 years), and specialty (women’s imaging, abdominal imaging, or other) of the radiologists were recorded. Analysis of variance was used to assess the impact of these multiple factors on quality. Results. No significant differences were found among 31 radiologists on the basis of the type of training, years in practice, or number of examinations read. Average scores among radiologists for technical quality, findings, and impressions were 4.96, 4.88, and 4.83, respectively. Radiologists who specialized in women’s imaging performed best in the quality of their impressions (4.86 versus 4.79; P = .029). There were no significant differences in scores with respect to the examination location. Conclusions. Within this sample of radiologists, the technical quality of the examinations was not affected by the type of training or subspecialty practice. Reports of adnexal mass findings were accurately described by all radiologists, although specialization in women’s imaging improved the ability to provide an accurate impression.

Key Words: malignancy • ovarian mass • quality assurance • quality improvement

Abbreviations: MRI, magnetic resonance imaging