Man to man training: can it help improve the diagnostic performances and interobserver variabilities of thyroid ultrasonography in residents?

Abstract

OBJECTIVE: The purpose of this study was to determine whether the man to man training can improve the diagnostic performances and interobserver variabilities of residents on thyroid ultrasonography.

MATERIALS AND METHODS: A set of 80 quiz cases with ultrasonography images of thyroid nodules (40 benign and 40 malignant on histopathology) were shown to the residents. Residents 1, 2, and 3 had not received the man to man training while Residents 4, 5, 6, and 7 had. The seven residents were asked to fill out one of the ultrasonography features (internal composition, echogenicity, margin, calcification, and shape) and the final assessment (probably benign and suspicious). Thyroid nodules with one or more ultrasonography features including marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller than wide shape were assessed as suspicious nodules. The diagnostic performances of US by the seven residents and interobserver variabilities between the seven residents and a faculty radiologist were calculated.

RESULTS: The sensitivities, negative predictive values, and accuracies of Residents 4, 5, 6, and 7 were higher than those of Residents 1, 2, and 3. The final assessment between Residents 4, 5, 6, and 7 and the faculty radiologist showed almost perfect agreement but that between Residents 1, 2, and 3 and the faculty radiologist showed substantial agreement.

CONCLUSION: The man to man training is crucial for the residents to show better diagnostic performances and improvement of interobserver variabilities for evaluating thyroid nodules with ultrasonography.