Reporting of CT cervical spine after office hours by radiology trainees—analysis of discrepancy rates and RADPEER scores

Yan, Yet Yen; Khoo, Jenn Nee; Tan, Tien Jin; Francis, Joe; Chong, Le Roy; Chan, Elizabeth Hui-Ying

doi:10.1007/s10140-018-1597-8

Cited by 5 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sensitivity of junior and senior registrars was 63.2% and 83.3%, respectively, mirroring a trend found in several studies evaluating for correlation between registrar performance and experience 11,12,17,18 . These results highlight the importance of continued supervision and feedback for registrars throughout all years of training, not only during the early years of practice.…”

Section: Discussionsupporting

confidence: 81%

“…[5][6][7][8][9] A large Canadian study assessing on-call trainees found a major discrepancy rate of 1.0% from 192 CCTs, which was lower than the 2.5% background rate of major discrepancy for all CT regions. 11 A similar study by Yan et al 12 from a Level I trauma centre in Singapore, evaluating 254 after-hours CCTs reported by trainees, described an overall discrepancy rate of 4.7%. These minor differences in discrepancy rates between the current and prior studies may be the result of several factors, including local variations in registrar experience and patient populations.…”

Section: Discussionmentioning

confidence: 86%

“…A large Canadian study assessing on‐call trainees found a major discrepancy rate of 1.0% from 192 CCTs, which was lower than the 2.5% background rate of major discrepancy for all CT regions 11 . A similar study by Yan et al 12 . from a Level I trauma centre in Singapore, evaluating 254 after‐hours CCTs reported by trainees, described an overall discrepancy rate of 4.7%.…”

Section: Discussionmentioning

confidence: 89%

“…The effect of our low injury prevalence on the observed registrar report accuracy is uncertain. Yan et al 12 demonstrated impressive registrar sensitivity (91.2%) in the context of a relatively high injury prevalence (40.2%) at their major trauma institution, so it remains possible that increased exposure to positive cases could improve the registration detection of injury. Importantly, no CT initially reported as normal was found to have a definite fracture missed by the registrar.…”

Section: Discussionmentioning

confidence: 99%

“…Studies from the United Kingdom and Canada have demonstrated major discrepancy rates for CCT of 0.5% and 1.0% respectively. 10,11 Yan et al 12 found the rate of clinically significant discrepancies to be 2.0% and sensitivity of senior trainees to be 97.0%.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Accuracy of after‐hours trauma cervical spine CT reporting by radiology trainees: Experiences from two Australian teaching hospitals

et al. 2021

View full text Add to dashboard Cite

Introduction Like many teaching hospitals in Australia, after‐hours computed tomography (CT) reporting at our institution is undertaken by the on‐call radiology registrar. The accuracy of these reports is important as management is often initiated based on the interim findings, prior to review by the consultant radiologist. A common exception to this approach is cervical CT (CCT), as many hospital protocols recommend patients to remain in spinal precautions until the report is finalised by a consultant, although there are very few studies to support this practice. Methods The interim registrar reports for all CCTs performed after‐hours over a 12‐month period were retrospectively reviewed. The final consultant report was used as the gold standard to establish accuracy of the registrar report. The primary outcome was discrepancy between the provisional and final reports. Any discrepancy was classified as either an ‘overcall’ or ‘miss’. Discrepancies were graded by the RADPEER scoring system. Results A total of 1084 after‐hours CCT studies were reviewed. The number of cases positive for injury was 37 (3.4%). The total number of discrepancies was 14 (discrepancy rate 1.3%), including 4 overcalls (0.3%) and 10 misses (0.9%). The discrepancy rates for junior and senior registrars were 1.7% and 0.7% respectively. Only 5 misses (0.5%) were considered clinically significant. Conclusion Registrars reporting after‐hours CCT have low rates of discrepancy with very few clinically significant misses. However, the reduced registrar sensitivity for detection of cervical injury highlights the ongoing importance of consultant review in the process of cervical spine clearance pathways.

show abstract

Section: Discussionsupporting

confidence: 81%