The discrepancy rate between preliminary and official reports of emergency radiology studies: a performance indicator and quality improvement method

Issa, Ghada; Taslakian, Bedros; Itani, Malak; Hitti, Eveline; Batley, Nicholas; Saliba, Miriam; El-Merhi, Fadi

doi:10.1177/0284185114532922

Cited by 21 publications

(24 citation statements)

References 15 publications

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“…[18][19][20][21] Other studies have evaluated in house radiologists, registrars or residents during after hours for CT scan interpretations with discrepancy rates <5% and for MR scan interpretations with a major discrepancy rate of 4.2%. [22][23][24][25][26][27][28] Although there were slight differences in the methodology of these studies, major disagreement rate observed in our study is in accordance with those presented above. All included exams in the study were remotely interpreted by first and second readers, with potential increased risks of disagree ment than in house radiological interpretations.…”

Section: Discussionsupporting

confidence: 90%

Double Reading of Outsourced CT/MR Radiology Reports: Retrospective Analysis

et al. 2018

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Section: Discussionsupporting

confidence: 90%

Double Reading of Outsourced CT/MR Radiology Reports: Retrospective Analysis

et al. 2018

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“…There was no significant difference in the concordance rates when comparing residents by postgraduate year of training, suggesting that residents with as little as 1 year of radiology training before they started on-call responsibilities demonstrated diagnostic performance comparable to more experienced residents. At least one previous study has similarly shown no difference between resident postgraduate years [12], but the majority have demonstrated improvements in resident performance with increasing experience [13][14][15][16][17][18]. The high performance of junior residents in this study may be due, in part, to early focused training.…”

Section: Discussionmentioning

confidence: 45%

Performance of overnight on-call radiology residents in interpreting unenhanced abdominopelvic magnetic resonance imaging studies performed for pediatric right lower quadrant abdominal pain

et al. 2021

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Background Abdominopelvic magnetic resonance imaging (MRI) is increasingly being used to evaluate children with abdominal pain suspected of having acute appendicitis. At our institution, these examinations are preliminarily interpreted by radiology residents, especially when performed after hours. Objective To determine the accuracy of preliminary reports rendered by radiology residents in this setting. Materials and methods Three hundred seventy-seven pediatric abdominopelvic MRI examinations were included. The preliminary (resident) and final (attending) radiology reports were coded as diagnosing acute appendicitis or no acute appendicitis. The concordance between resident and attending radiologist interpretations was calculated. Additionally, both resident and attending reports were compared to available surgical pathology or clinical follow-up data. Results Overall concordance rate for the diagnosis of acute appendicitis was 97.1%. Concordance for verified cases of acute appendicitis was 93.4%. Concordance rates did not differ by residents’ postgraduate year levels. When compared against surgical pathology or clinical follow-up data, residents demonstrated 91.2% sensitivity and 97.6% specificity. There was no statistically significant difference in the sensitivity or specificity of resident or attending radiologist interpretations. Conclusion Radiology residents demonstrate high concordance with attending pediatric radiologists in their interpretations of pediatric abdominopelvic MRI for acute appendicitis. The diagnostic performances of residents and attendings were comparable.

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“…The commonest errors related to CT scanning are errors of interpretation of the images. [9][10][11] This can have serious consequences for patients. We had 65 erroneous reports out of a total of 1 566, which gives an error rate of 4%.…”

Section: Discussionmentioning

confidence: 99%

An analysis of adverse events and human error associated with the imaging of patients at a major trauma centre in South Africa

et al. 2019

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Background. There is growing realisation that human error contributes significantly to morbidity and mortality in modern healthcare. A number of taxonomies and classification systems have been developed in an attempt to categorise errors and quantify their impact. Objectives. To record and identify adverse events and errors as they impacted on acute trauma patients undergoing a computed tomography (CT) scan, and then quantify the effect this had on the individual patients. It is hoped that these data will provide evidence to develop error prevention programmes designed to reduce the incidence of human error. Methods. The trauma database was interrogated for the period December 2012 -April 2017. All patients aged >18 years who underwent a CT scan for blunt trauma were included. All recorded morbidity for these patients was reviewed. Results. During the period under review, a total of 1 566 patients required a CT scan at our institution following blunt trauma. Of these, 192 (12.3%, 134 male and 58 female) experienced an error related to the process of undergoing a CT scan. Of 755 patients who underwent a CT scan with intravenous contrast, detailed results were available for 312, and of these 46 (14.7%) had an acute deterioration in renal function. According to Chang's taxonomy, physical harm occurred as follows: grade I n=6, grade II n=62, grade III n=45, grade IV n=11, grade V n=27, grade VI n=21, grade VII n=15, grade VIII n=3 and grade IX n=2. Adverse events were performing an unnecessary scan (n=24), omitting an indicated scan (n=23), performing the scan incorrectly (n=8), scanning the wrong body part (n=7), equipment failure (n=18), omitting treatment following the scan (n=6), incorrect interpretation of the scan (n=65), deterioration during the scan (n=6) and others (n=35). The setting for the error was the ward (n=19), the radiology suite (n=126), the emergency department (n=45) and the operating theatre (n=2). The staff responsible for the adverse events were medical (n=155), nursing (n=4) and radiology staff (n=15). There were 67 errors of commission and 125 errors of omission. The primary cause was a planning problem in 78 cases and an execution problem in 114. Conclusions. Errors and adverse events related to obtaining a CT scan following blunt polytrauma are not uncommon and may impact significantly on the patient. Communication is essential to eliminate errors related to performing the wrong type of scan. The commonest errors relate to misinterpretation of the scan.

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The discrepancy rate between preliminary and official reports of emergency radiology studies: a performance indicator and quality improvement method

Cited by 21 publications

References 15 publications

Double Reading of Outsourced CT/MR Radiology Reports: Retrospective Analysis

Double Reading of Outsourced CT/MR Radiology Reports: Retrospective Analysis

Performance of overnight on-call radiology residents in interpreting unenhanced abdominopelvic magnetic resonance imaging studies performed for pediatric right lower quadrant abdominal pain

An analysis of adverse events and human error associated with the imaging of patients at a major trauma centre in South Africa

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