RADPEER quality assurance program: a multifacility study of interpretive disagreement rates

Quality Control in Neuroradiology: Discrepancies in Image Interpretation among Academic Neuroradiologists

“…1,2 In the meantime, radiologists, similar to other physicians, struggle with assessing physician performance and reporting quality, to improve and deliver the best care possible. 3 L. Henry Garland pioneered the work on radiologic errors more than 60 years ago. [4][5][6] He uncovered a 30% rate of missed radiologic findings in a series of radiographs with abnormal findings among expert reviewers.…”

“…3,[12][13][14] Soffa et al 14 sampled approximately 7000 cases read by 26 radiologists and uncovered a 3% disagreement rate in general radiology, 3.6% in diagnostic mammography, 5.8% in screening mammography, and 4.1% in sonography, yielding the overall error rate of 3.5%. Robinson et al 13 compared reports for skeletal, chest, and abdominal radiographs completed by 3 radiologists and found a 3%-6% average error rate per observer.…”

“…In agreement with Garland's results, practices with arguably higher disease prevalence, like academic medical centers, tend to have higher error rates (Յ1.5% has been reported) than practices with a greater number of normal findings on studies, like community hospitals. 3 In this study, we set out to compare finalized dictations on record, with second-opinion reviews of neuroradiology cases read by subspecialty-trained neuroradiologists on staff at a university hospital. We did so in an effort to assess the detection or interpretation discrepancy rate for clinically significant radiographic findings between equally qualified subspecialty readers.…”

Staying Out of Trouble

“…The RADPEER program of the ACR is geared towards quality assurance/peer review that consumes as little time as possible but still satisfies the institutional peer review requirements of board recertification [21]. It relies on the rereading of prior examinations of the same patient by a different radiologist during the course of interpreting new exams, thus fitting into the routine of busy radiologists.…”

“…One of the findings of RADPEER has been the discovery of a small number of outlier radiologists with higher discrepancy rates than their peers [21]. This is a very sensitive subject.…”