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A decision support system improves the interpretation of myocardial perfusion imaging

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the influence of a computer-based decision support system (DSS) on performance and inter-observer variability of interpretations regarding ischaemia and infarction in myocardial perfusion scintigraphy (MPS).

Methods

Seven physicians independently interpreted 97 MPS studies, first without and then with the advice of a DSS. Four physicians had long experience and three had limited experience in the interpretation of MPS. Each study was interpreted regarding myocardial ischaemia and infarction in five myocardial regions. The patients had undergone a gated MPS using a 2-day stress/gated rest 99mTc sestamibi protocol. The gold standard used was the interpretations made by one experienced nuclear medicine specialist on the basis of all available clinical and image information.

Results

The sensitivity for ischaemia of the seven readers increased from 81% without the DSS to 86% with the DSS (p = 0.01). The increase in sensitivity was higher for the three inexperienced physicians (9%) than for the four experienced physicians (2%). There was no significant change in specificity between the interpretations. The interpretations of ischaemia made with the advice of the DSS showed less inter-observer variability than those made without advice.

Conclusion

This study shows that a DSS can improve performance and reduces the inter-observer variability of interpretations in myocardial perfusion imaging. Both experienced and, especially, inexperienced physicians can improve their interpretation with the advice from such a system.

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Acknowledgements

This study was supported by a scholarship from Medicon Valley Association.

Conflicts of interests statement

Kristina Tägil and Lars Edenbrandt are shareholders in Exini Diagnostics AB, which owns the EXINI heart software used in the study.

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Authors and Affiliations

  1. Department of Clinical Sciences, Malmö, Lund University Research Program in Medical Informatics, Malmö University Hospital, 205 02, Malmö, Sweden

    K. Tägil & L. Edenbrandt

  2. Department of Nuclear Medicine, CHU—Nice, Nice, France

    M. Bondouy, J. P. Chaborel & P. R. Franken

  3. Department of Nuclear Medicine, CHU—Nancy, Nancy, France

    W. Djaballah, S. Grandpierre, P. Y. Marie & T. Poisson

  4. Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark

    B. Hesse

  5. Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden

    M. Lomsky & L. Edenbrandt

Authors
  1. K. Tägil
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  2. M. Bondouy
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  3. J. P. Chaborel
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  4. W. Djaballah
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  5. P. R. Franken
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  6. S. Grandpierre
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  7. B. Hesse
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  8. M. Lomsky
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  9. P. Y. Marie
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  10. T. Poisson
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  11. L. Edenbrandt
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Corresponding author

Correspondence to K. Tägil.

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Tägil, K., Bondouy, M., Chaborel, J.P. et al. A decision support system improves the interpretation of myocardial perfusion imaging. Eur J Nucl Med Mol Imaging 35, 1602–1607 (2008). https://doi.org/10.1007/s00259-008-0807-0

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  • DOI: https://doi.org/10.1007/s00259-008-0807-0

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