EFFECTIVENESS OF NUCLEAR CARDIOLOGY TRAINING GUIDELINES - A COMPARISON OF TRAINEES WITH EXPERIENCED READERS

Background. To evaluate the effectiveness of published nuclear cardiol ogy training guidelines, the diagnostic accuracy of image interpretati on by nuclear cardiology trainees was compared with that of experience d nuclear cardiologists.Methods and Results. The accuracy of three exp erienced nuclear cardiologists and three trainees with level II experi ence following Society of Nuclear Medicine/American College of Cardiol ogy/American Society of Nuclear Cardiology guidelines in the interpret ation of 114 exercise Tc-90m-labeled sestamibi single-photon emission computed tomographic imaging studies was evaluated. Studies were selec ted randomly and included patients with less than 5% likelihood of cor onary artery disease, as well as patients with angiographically demons trated single and multivessel disease. Studies were interpreted by eac h reader without knowledge of clinical or exercise data. Each reader c lassified perfusion as normal or abnormal. Accuracy was assessed accor ding to sensitivity, normalcy rate, and predictive accuracy. In additi on, the ability of experienced readers and trainees to identify abnorm al perfusion in patients with multivessel disease was compared. Traine es had high accuracy, comparable to experienced readers for sensitivit y, normalcy rate, and predictive accuracy, as well as the ability to i dentify abnormal perfusion in patients with multivessel disease. In al l categories, experienced interpreters demonstrated a trend toward gre ater accuracy with less observer variability than did trainees. Conclu sion. Structured training in nuclear cardiology following Society of N uclear Medicine/American College of Cardiology/American Society of Nuc lear Cardiology guidelines during clinical cardiology fellowship is ef fective, and trainees possess the skills to interpret myocardial perfu sion images accurately. Interpretive skills can be expected to improve further with experience.