Preliminary Radiology Resident Interpretations Versus Final Attending Radiologist Interpretations and the Impact on Patient Care in a Community Hospital

Abstract

The results of this investigation highlight the minimal discrepancy rate that occurs with overnight resident coverage. Thus, there is no detrimental effect on the quality of patient care from relying on preliminary interpretations made by radiology residents.

Do Telephone Call Interruptions Have an Impact on Radiology Resident Diagnostic Accuracy?

“…There was only a 0.33% discrepancy rate in our data, although much of the literature indicates a 1%-3% error rate between radiology residents and attending radiologist final read (21)(22)(23)(24)(25)(26)(27)(28). Multivariate analysis was hindered by this paucity of data points and was therefore unable to determine if errors are more likely to occur at certain times during the shift.…”

“…The typical workflow using this model is for the resident to provide after-hour preliminary ''wet reads'' that are then reviewed and finalized by the staffing radiologist the next morning. There have been several prior studies investigating the discordance of resident preliminary interpretation with attending radiology final reads, most indicating a discrepancy rate of 1%-3% (21)(22)(23)(24)(25)(26)(27)(28). At our institution, any major discrepancy resulting in a change in diagnosis requiring direct communication to the ordering provider is logged for internal quality control and educational purposes.…”

“…There have been several prior studies investigating potential factors associated with resident discrepancies, including imaging volume, imaging modalities, and on-call resident training level (21)(22)(23)(24)(25)(26)(27)(28), but to our knowledge, there have been no studies directly measuring telephone calls as a root cause for diagnostic errors. Telephone call interruptions are one of the most frequent radiologist workflow interrupters (15), and thus, we focused on telephone calls as a potential root Film 13 7 7 0 1 0 28 Computed tomography 3 2 1 0 1 1 8 Ultrasound 0 0 0 3 0 0 3 Total 16 9 8 3 2 1 39 cause for radiology resident diagnostic errors.…”

Orion: A Web-Based Application Designed to Monitor Resident and Fellow Performance On-Call

“…There are several retrospective and prospective studies evaluating discrepancy rates between radiology residents, fellows, and attending radiologists, with most studies reporting a major discrepancy rate between 0.5% and 2% [2][3][4][5][6][7][8][9][10]. Most of these studies focus on a particular modality such as cross-section imaging of the abdomen and pelvis or neurological CT.…”

Can Metrics Obtained From Your IT Databases Help Start Your Practice Dashboard?

“…More recently, IT solutions have been developed and implemented at some practices. The ACR's RADPEER ® program [5,6] is an example of such a program and can be integrated into a picture archiving and communication system. While interpreting a current examination, a radiologist can review the report of a prior examination and agree or disagree with the prior interpretation.…”