Alexander T. Ruutiainen MD, Presenter: Nothing to Disclose

Po-Hao Chen MD, MBA, Abstract Co-Author: Nothing to Disclose

Howard Lee Roth MD, Abstract Co-Author: Nothing to Disclose

Tessa S. Cook MD, PhD, Abstract Co-Author: Nothing to Disclose

Grading the severity of lumbar degeneration on an MRI is an important task which carries treatment implications. Although published criteria exist for assigning such grades, the consistency of their use varies among radiology trainees and some practicing radiologists. We hypothesized that such cutoffs could be effectively taught by providing rapid feedback to a learner. To this end, we developed a free web-based module, named Centaur, to teach the grading of spine degeneration using rapid feedback.

Seven musculoskeletal radiologists were asked to rate the size of disc bulges and the severity of spinal canal and neuroforaminal narrowing using a 7 point scale ranging from “normal” to “severe.” The correct response for each case was determined by statistical consensus; for weighting Fleiss’ kappa, responses were considered discordant if they differed from the consensus by more than one point. Next, a web-based module was created to present these cases to subjects: using the module, learners attempt to grade the established cases, and are provided with immediate feedback regarding their choices. The module automatically tracks performance to determine whether the accuracy of the responses improves with time.

Inter-observer concordance among practicing musculoskeletal radiologists was higher for assessing the size of disc bulges (Fleiss’ weighted kappa = 0.78), than central canal narrowing (kappa = 0.59) or neuroforaminal narrowing (kappa = 0.54). Detailed results from the analysis of all respondents who consent to the collection of their performance data using our web based module will be presented. Specifically, we aim to show that providing rapid feedback is an effective tool for teaching this concept.

We demonstrate the use of a web-based module that delivers rapid feedback to teach the grading of degenerative changes on an MRI of the lumbar spine. We believe that these results add to the body of radiologic pedagogy and highlight the general feasibility of using such web modules to teach some concepts in diagnostic radiology.

Learning to grade the severity of degeneration on a lumbar spine MRI is challenging but clinically important: we demonstrate the use of a web-based module that delivers rapid feedback to teach these criteria.

Ruutiainen, A, Chen, P, Roth, H, Cook, T, Rapid-feedback Using a Web-based Module to Teach the Grading of Degeneration on an MRI of the Lumbar Spine.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006019.html