Error Review: Can This Improve Reporting Performance?

Tudor, G; Finlay, David B.

doi:10.1053/crad.2001.0760

Cited by 20 publications

(8 citation statements)

References 19 publications

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“…Most worryingly, detection of large polyps by reader 2 fell from 60 to 14% after directed training. This phenomena of reduced performance after training has also been reported by Tudor and colleagues who found that radiologists frequently gave an incorrect chest X-ray diagnosis after error review, despite having previously correctly interpreted the same radiograph some months earlier [19]. Of the three readers, two achieved equivalence with the reference standard for detection of polyps 6 mm or larger following the second read whereas the third did not (reader 2).…”

Section: Discussionsupporting

confidence: 70%

CT colonography: effect of experience and training on reader performance

et al. 2004

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The purpose of this paper was to investigate the effect of radiologist experience and increasing exposure to CT colonography on reader performance. Three radiologists of differing general experience (consultant, research fellow, trainee) independently analysed 100 CT colonographic datasets. Readers had no prior experience of CT colonography and received feedback and training after the first 50 cases from an independent experienced radiologist. Diagnostic performance and reporting times were compared for the first and second 50 datasets and compared with the results of a radiologist experienced in CT colonography. Before training only the consultant reader achieved statistical equivalence with the reference standard for detection of larger polyps. After training, detection rates ranged between 25 and 58% for larger polyps. Only the trainee significantly improved after training ( P=0.007), with performance of other readers unchanged or even worse. Reporting times following training were reduced significantly for the consultant and fellow ( P<0.001 and P=0.03, respectively), but increased for the trainee ( P<0.001). In comparison to the consultant reader, the odds of detection of larger polyps was 0.36 (CI 0.16, 0.82) for the fellow and 0.36 (CI 0.14, 0.91) for the trainee. There is considerable variation in the ability to report CT colonography. Prior experience in gastrointestinal radiology is a distinct advantage. Competence cannot be assumed even after directed training via a database of 50 cases.

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Section: Discussionsupporting

confidence: 70%

CT colonography: effect of experience and training on reader performance

et al. 2004

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“…Our search yielded two studies on feedback to improve diagnostic performance 17 18. Both studies showed benefits of feedback on later diagnostic accuracy.…”

Section: Resultsmentioning

confidence: 99%

Cognitive interventions to reduce diagnostic error: a narrative review

Graber

Kissam

Payne³

et al. 2012

BMJ Qual Saf

374

287

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We identified a wide range of possible approaches to reduce cognitive errors in diagnosis. Not all the suggestions have been tested, and of those that have, the evaluations typically involved trainees in artificial settings, making it difficult to extrapolate the results to actual practice. Future progress in this area will require methodological refinements in outcome evaluation and rigorously evaluating interventions already suggested, many of which are well conceptualised and widely endorsed.

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“…It is more likely that the variability in skill acquisition reflects the individual differences in innate ability of trainees and differences in individual learning curves. Furthermore, there is some evidence that previous experience may bias subsequent learning and paradoxically impair knowledge acquisition [25]. Trainee variability is a key issue which underlies the importance of competency-based assessments for this type of skill acquisition.…”

Section: Discussionmentioning

confidence: 99%

How Should We Train Capsule Endoscopy? A Pilot Study of Performance Changes During a Structured Capsule Endoscopy Training Program

et al. 2008

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There are no validated training/accreditation guidelines for capsule endoscopy. We assessed the utility of a structured training program on two experienced gastroenterologists and one endoscopy nurse. Validated studies were standardized for difficulty in blocks of three. Trainees completed a standardized data sheet for each study reported (12 studies for the physicians, 22 studies for the nurse). After each block the trainer graded performance and highlighted learning points. Statistical analysis was performed. Physician trainees accurately identified landmarks throughout, while the nurse made errors even at the end of training. Improvement in lesion detection and diagnostic accuracy improved in the nurse, but in only one of the physician trainees, highlighting the variability in learning curves. Overall performance improved in all trainees but was most marked for the nurse trainee (correlation coefficient 0.41, P = 0.06). Improvements in lesion recognition and diagnosis can be demonstrated in senior trainees and nurses following a structured training program; however, there is considerable variability.

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Error Review: Can This Improve Reporting Performance?

Cited by 20 publications

References 19 publications

CT colonography: effect of experience and training on reader performance

CT colonography: effect of experience and training on reader performance

Cognitive interventions to reduce diagnostic error: a narrative review

How Should We Train Capsule Endoscopy? A Pilot Study of Performance Changes During a Structured Capsule Endoscopy Training Program

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