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Journal of Primary Health Care & General Practice

Aabstract


Research Article

Inter-rater Agreement and Reliability among General Practitioners and Radiologists on Ultrasound Examinations after Specialized Training Program

Monica Solanes Cabus, Jesus Pujol Salud, Jesus Alonso Aliaga, Francesc Mayench Ariza, Josep Ramon Marsal Mora, Anna Sabate Navarro, Sergi Godia Lopez, Carme Florensa Piro, Mireia Abellana Sangra, Mireia Marin Munoz, Laia Llort Samso, Ramon Mur Garces, Jose Maria Palacin Peruga, Montse Ribes Ribes, Marta Ortega Bravo

Correspondence Address :

Monica Solanes Cabus
Onze de Setembre Primary Care Center
Institut Catala de la Salut (ICS)
25005 Lleida
Spain
Email: msolanes.lleida.ics@gencat.cat

Received on: February 12, 2019, Accepted on: February 27, 2019, Published on: March 04, 2019

Citation: Monica Solanes Cabus, Jesus Pujol Salud, Jesus Alonso Aliaga, et al. (2019) Inter-rater agreement and reliability among General Practitioners and Radiologists on Ultrasound examinations after specialized Training Program

Copyright: 2019 Monica Solanes Cabus et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
Introduction: Ultrasound examination is a medical diagnostic test broadly used, due to its properties of being a non-invasive method and its low operational costs. Commonly, Radiologists perform ultrasound examinations, as a part of their medical specialty. However, ultrasound examinations could be applied by other specialties, as a first screening test.
For that, a Training program for General Practitioners (GPs) leaded by Radiologists was designed, and the inter-rate agreement and reliability among GPs and Radiologists was analyzed in order to implement ultrasound examination performed by GPs at Primary Care Centers (PCC). Also, the level of patient' confidence on getting an ultrasound examination done by GPs, instead Radiologist, was measured by a satisfaction survey.
Methods: 60-hours course of theoretical and practical training was done, followed by 24-weeks practical sessions at the Radiology Service. Thirteen GPs were enrolled on the Training program. On practical sessions, both GPs and Radiologists assessed each patient and recorded the data on a newly built electronic form. Kappa index was calculated including the overall inter-rater agreement among GPs and Radiologists examinations.
After Training program completion, GPs used ultrasound examination in their Primary Care Centers and patient's satisfaction survey was done.
Results: The total number of patients assessed by both professionnels was 1,928: 1,377 patients had abdominal ultrasound scan, 345 patients had urological ultra Sound scan, and 206 patients had thyroid ultrasound scan. A high degree of agreement among raters was observed (κ ≥ 0.8) in most of the double-checked organs. The patients overall assessment rate was very satisfied: 4.8 out of 5.
Conclusions: This study provides insights into ultrasound examination used by GPs in PCC, after an appropriate training. That could be used as fundamental data in improving health care protocols in the near future.

Keywords: Ultrasound, General Practitioner, Radiologist, Primary Care, Training, Guidelines, Inter-Rater Agreement, Reliability