title: Initial Performance of Radiologists and Radiology Residents in Interpreting Low-Dose (2-mSv) Appendiceal CT.
abstract: OBJECTIVE
  The objective of our study was to prospectively evaluate the initial diagnostic performance and learning curve of a community of radiologists and residents in interpreting 2-mSv appendiceal CT.
  
  
  METHODS
  We included 46 attending radiologists and 153 radiology residents from 22 hospitals who completed an online training course of 30 2-mSv CT cases. Appendicitis was confirmed in 14 cases. Most of the readers had limited (≤ 10 cases, n = 32) or no (n = 118) prior experience with low-dose appendiceal CT. The order of cases was randomized for each reader. A multireader multicase ROC analysis was performed. Generalized estimating equations were used to model the learning curves in diagnostic performance.
  
  
  RESULTS
  Diagnostic performance gradually improved with years of training. The average AUC was 0.94 (95% CI, 0.90-0.98), 0.92 (0.88-0.96), 0.90 (0.85-0.96), and 0.86 (0.80-0.92) for the attending radiologists, senior residents, 2nd-year residents, and 1st-year residents, respectively. We did not observe any notable intrareader learning curves over the training course of the 30 cases except a decrease in reading time. Diagnostic accuracy and sensitivity were significantly affected by the reader training level and prior overall experience with appendiceal CT but not by the prior specific experience with low-dose appendiceal CT.
  
  
  CONCLUSIONS
  The learning curve is likely prolonged and forms gradually over years by overall radiology training and clinical experience in general rather than by experience with low-dose appendiceal CT specifically.
authors.affiliation: 1 Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Hyun Kyung
authors.initials: HK
authors.lastname: Yang
authors.affiliation: 1 Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Yousun
authors.initials: Y
authors.lastname: Ko
authors.affiliation: 2 Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 420-767, Korea.
authors.forename: Min Hee
authors.initials: MH
authors.lastname: Lee
authors.affiliation: 3 Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Hyunsik
authors.initials: H
authors.lastname: Woo
authors.affiliation: 4 Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Soyeon
authors.initials: S
authors.lastname: Ahn
authors.affiliation: 1 Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
authors.forename: Bohyoung
authors.initials: B
authors.lastname: Kim
authors.affiliation: 5 Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
authors.affiliation: 6 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Mi Sung
authors.initials: MS
authors.lastname: Kim
authors.affiliation: 7 Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Sung Bin
authors.initials: SB
authors.lastname: Park
authors.affiliation: 1 Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.|8 Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
authors.forename: Kyoung Ho
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D011829:Radiation Dosage; D011871:Radiology / Q000193:education*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: appendicitis; diagnostic performance; learning curve; low-dose CT