AI辅助结构化报告让医生看片更准更快,眼动更聚焦。
Effect of Reporting Mode and Clinical Experience on Radiologists' Gaze and Image Analysis Behavior in Chest Radiography
- 用AI填充结构化报告,引导医生聚焦影像区域。
- 诊断准确率从0.60提升至0.71,报告时间缩短至25秒。
- 适合临床训练和提升阅片效率的医生使用。
本前瞻性研究(2024年7月至12月)评估了三种报告模式对放射科医生影像分析行为的影响:自由文本(FT)、结构化报告(SR)及AI辅助结构化报告(AI-SR)。4名新手与4名非新手读者(放射科医生及医学生)各分析35张床边胸片,使用定制查看器与眼动追踪系统。结果包括诊断准确率(以专家共识为基准,采用Cohen's $κ$)、每张片报告时间、眼动指标及问卷用户体验。统计分析采用广义线性混合模型及Bonferroni校正($P \le .01$)。诊断准确率在FT($κ=0.58$)与SR($κ=0.60$)间无显著差异,但AI-SR显著更高($κ=0.71$, $P < .001$)。报告时间从FT的$88 \pm 38$秒降至SR的$37 \pm 18$秒,再到AI-SR的$25 \pm 9$秒($P < .001$)。扫视次数(图像区:FT $205 \pm 135$,SR $123 \pm 88$,AI-SR $97 \pm 58$)与报告区总注视时长(FT $11 \pm 5$ s,SR $5 \pm 3$ s,AI-SR $4 \pm 1$ s)均显著下降($P < .001$)。新手在SR下更关注图像,非新手则保持聚焦。AI-SR最受青睐。结论:结构化报告通过引导视觉注意力提升效率,而AI预填结构化报告进一步提升诊断准确率与用户满意度。
原文摘要 · Abstract (English)
Structured reporting (SR) and artificial intelligence (AI) may transform how radiologists interact with imaging studies. This prospective study (July to December 2024) evaluated the impact of three reporting modes: free-text (FT), structured reporting (SR), and AI-assisted structured reporting (AI-SR), on image analysis behavior, diagnostic accuracy, efficiency, and user experience. Four novice and four non-novice readers (radiologists and medical students) each analyzed 35 bedside chest radiographs per session using a customized viewer and an eye-tracking system. Outcomes included diagnostic accuracy (compared with expert consensus using Cohen's $κ$), reporting time per radiograph, eye-tracking metrics, and questionnaire-based user experience. Statistical analysis used generalized linear mixed models with Bonferroni post-hoc tests with a significance level of ($P \le .01$). Diagnostic accuracy was similar in FT ($κ= 0.58$) and SR ($κ= 0.60$) but higher in AI-SR ($κ= 0.71$, $P < .001$). Reporting times decreased from $88 \pm 38$ s (FT) to $37 \pm 18$ s (SR) and $25 \pm 9$ s (AI-SR) ($P < .001$). Saccade counts for the radiograph field ($205 \pm 135$ (FT), $123 \pm 88$ (SR), $97 \pm 58$ (AI-SR)) and total fixation duration for the report field ($11 \pm 5$ s (FT), $5 \pm 3$ s (SR), $4 \pm 1$ s (AI-SR)) were lower with SR and AI-SR ($P < .001$ each). Novice readers shifted gaze towards the radiograph in SR, while non-novice readers maintained their focus on the radiograph. AI-SR was the preferred mode. In conclusion, SR improves efficiency by guiding visual attention toward the image, and AI-prefilled SR further enhances diagnostic accuracy and user satisfaction.
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