Influence of the content of postgraduate education of radiologists on the number of diagnostic pitfalls

Background.Question about the quality and format of postgraduate education of doctors raises increasingly in recent years. Development of professional standards and transition to a system of continuing professional education have allowed professional communities to raise issues of the quality of modern education but there is no clear evidence of the dependence of the level of education and the quality of medical care in the accessible literature. Experts of Research and Practical Center of Medical Radiology carried out the identification of dependence of post-graduate education length for radiologists and the quality of their work that can serve as a rationale for amending the system of doctors training.Patients and methods.The data on education and actual work of 85 radiologists of out-patient and in-patient units of medical organizations of the Moscow Healthcare Department have been analyzed. According to the results of the audit of diagnostic studies, carried out in the “Unified Radiological Information Service” system by the specialists of the Research and Practical Center of Medical Radiology, the final assessment of the work of each radiologist was formed, which reflects the presence or absence of diagnostic discrepancies.Results.Parameters of diagnostic errors depending on the age of doctors, the general length of service and the length of service as radiologist, the duration of postgraduate education in the clinical specialty and the specialty “radiology” have been compared.As a result of the analysis, it was found that the increase in the proportion of diagnostic differences is directly related to the increase in the age of the doctor and does not depend on either the length of service or the time of work in the specialty. Differences between the groups of physicians with the largest (professional retraining after clinical residency) and the smallest (clinical education + radiology) percentage of clinically significant discrepancies are statistically significant (p = 0.05, at the normative value of the Student's test score of 2.16).Conclusion.The inverse relationship between the duration of training of the radiologist in the specialty and the proportion of diagnostic errors, which can serve as a significant justification for making proposals for the exclusion of professional retraining within 576 hours for admission to professional activities of radiologists.

Oncology phase II clinical trials in 2011: Summary description and comparison to phase II trials in other subspecialties.

e17568 Background: Phase II clinical trials in oncology have previously been reported to differ significantly in design compared to trials in other subspecialties. The purpose of this study is to provide a summary description of Phase II oncology clinical trials published in 2011, and to identify persistent major cross-specialty differences in clinical trial design. Methods: Records identified through a computerized literature search on PUBMED were reviewed manually using pre-defined criteria to identify abstracts of Phase II clinical trials published in 2011. The abstracts were classified according to variables including subspecialty, use of control group (active and/or placebo), randomization, blinding, and study conclusions. Trials with positive outcomes were defined as those in which the conclusion indicated that the intervention was safe and effective/worthy of further investigation. Statistical analysis was performed using the chi-squared test. Results: A total of 1,500 abstracts of Phase II clinical trials were identified, of which the majority (75%) describe trials on interventions for neoplastic diseases. Among oncology trials, the largest proportion of abstracts described trials evaluating intervention for hematologic neoplasms (16%), followed by upper and lower gastrointestinal (15%), lung (13%) and breast (11%) cancers. Compared to trials in other subspecialties, oncology trials are significantly less likely to include the use of randomization (17% vs 66%, p < 0.0001), blinding (3% vs 44%, p < 0.0001), and control (13% vs 70%, p < 0.0001). The majority of the abstracts reported positive outcomes (66% for oncology; 74% for the other subspecialties). Among oncology trials, trials utilizing a control group are less likely to report positive outcomes than those without a control group (53% vs 67%, p = 0.002). Conclusions: Major differences in design still exist between Phase II trials in oncology and other subspecialties. Only a minority of oncology trials report the use of randomization, blinding, or control groups. Whether the growing interest in randomized Phase II oncology trials will translate into a larger proportion of such trials in the future remains to be seen.