基于ROC理论定量评价超声科医师诊断乳腺甲状腺结节水平的构想

Concept of Based on the Theoretical of ROC to Quantitative Evaluation the Diagnostic Level of Ultrasound Physicians

目的探讨ROC理论定量评价超声科医师诊断水平的价值。方法选择笔者医院的乳腺肿块患者92例、甲状腺结节患者60例,让甲、乙超声医师分别进行检查。以穿刺或术后病理检查为金标准,对两位医师的诊断结果绘制ROC曲线,并进行比较和分析。结果对于乳腺肿块,乙医师的AUC为0.846,较甲医师的0.732高,两者差异有统计学意义(Z=1.696,P=0.045)。对于甲状腺结节,甲医师(AUC=0.798)和乙医师(AUC=0.767)之间差异无统计学意义(Z=0.297,P=0.383)。结论利用ROC分析方法进行超声科医师的诊断效能的比较,可真实的反映医师对于某一疾病的诊断鉴别能力。本方法为医院对医师鉴别诊断水平的评价提供了客观可靠的、指标和依据,并据此对医师的工作配置等,更能保证诊断的准确性。

Objective To investigate the value of quantitative evaluation the diagnostic level of ultrasound physicians by ROC theory. Methods A ultrasound examination was carried out respectively by A, B physicians on 92 patients with breast tumors and 60 patients with thyroid nodules of our hospital. Puncture or pathological examination was considered to be the gold standard. Diagnostic results made by two physicians were plotted to ROC curves,and area under curve（AUC） were compared and analyzed. Results For breast lumps,the AUC of B physician（O. 846） was higher than A physician（0. 732）, the difference was statistically significant （Z = 1. 696, P = 0. 045 ）. For thyroid nodules, there was no significant difference between A physician（0. 798） and B physician（0. 767） （Z = 0. 297, P = 0. 383 ）. Conclusion Using the ROC analysis mothod to compare the diagnostic efficacy of ultrasound physicians, can truly reflect physicians＇ ability of identify and diagnosis a disease. This method provides a objective indicators and basis for hospital to evaluation physicians＇ level of identify and diagnosis. And according this to configure the physicians＇ work,, would help to ensure the accuracy of diagnosis.