Ultrasound Operators’ Confidence Influences Diagnosis of Ovarian Tumors - a Study in China

Aim: To assess the effect of ultrasound operators’ confidence in diagnosis of ovarian cancer, and the factorsinfluencing diagnostic accuracy.
Methods: Ultrasound images of selected ovarian cancers and controls wereevaluated by 8 sinologists who were instructed to diagnose and classify lesions into benign, borderline ormalignant, and we use structured questionnaire to investigate the level of confidence. We analyzed the accuracyof diagnosis, including sensitivity, specificity, positive and negative likelihood ratios and accuracy dependingon the different levels of confidence. In addition, factors influencing diagnostic accuracy was assessed bylogistic regression analysis.
Results: A total of 426 cases were examined. The confidence score was significantlyincreased with the level of accuracy (test for trend, p<0.05). Borderline tumors were most difficult to diagnose,and had lower accuracy, sensitivity and specificity compared with benign and primary invasive tumors. Workingexperience was positively closely associated with diagnosis accuracy. Logistic regression analysis revealed workingexperience and confidence score to be positively related to the diagnostic accuracy(OR, 95%CI, 1.68, 1.15-3.97for working experience; OR, 95%CI, 3.75, 1.67-6.98 for confidence score).
Conclusion: Our study showed thatlevel of confidence is positively associated with diagnostic performance, and the accuracy is greatly influencedby working experience and confidence score.