Radiology resident interpretations of on-call imaging studies: The incidence of major discrepancies

被引:94
作者
Cooper, Victoria F. [1 ]
Goodhartz, Lori A. [1 ]
Nemcek, Albert A., Jr. [1 ]
Ryu, Robert K. [1 ]
机构
[1] Northwestern Univ, Dept Radiol, Feinberg Sch Med, Chicago, IL 60611 USA
关键词
residents; resident education; quality assurance; error rate; on-call;
D O I
10.1016/j.acra.2008.02.011
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Rationale and Objectives. To determine the incidence of radiology resident preliminary interpretation errors for plain film, body Computed tomography, and neuroradiology (neuro)computed tomographic examinations read on call. Materials and Methods. We retrospectively reviewed the data in a prospectively acquired resident quality assurance (QA) database dating between January 2000 and March 2007. The database comprises all imaging studies initially interpreted by an on-call resident and later reviewed by a board-certified attending radiologist who determined the level of discrepancy between the two interpretations according to a graded scale from 0 (no discrepancy) to 3 (major discrepancy). We reviewed the data with respect to resident training level, imaging modality, and variance level. Statistical analysis was performed with chi(2) test, alpha = 0.05. We compared Our results with other published series studying resident and attending accuracy. Results. A total of 141,38 1 cases were entered into the database during the review period. Of all examinations, 95.7% had zero variance, 3.3% minor variance, and 1.0% major variance. There was a slight, statistically significant increase in overall accuracy with increased resident year from 95.4% of examinations read by first-year residents (R1s) to 96.1% by fourth-year resident (R4s) (P < .0001). Overall percentages of exams with major discrepancies were 1.0% for R1s, 1.1% for second-year residents, 1.0% for third-year residents, and 0.98% for R4s. Conclusions. The majority of preliminary resident interpretations are highly accurate. The incidence of major discrepancies is extremely low and similar, even with R1s, to that of attending radiologists published in other studies. A slight, statistically significant decrease in the error rate is detectable as residents gain experience throughout the 4 years of residency.
引用
收藏
页码:1198 / 1204
页数:7
相关论文
共 14 条
[1]   Residents managed trauma adequately using their own radiological interpretation as compared with "nighthawk" radiologists [J].
Ahmed, Naveed ;
Guo, Alan ;
Elhassan, Hisham ;
Qaiser, Rabia ;
Chung, Raphael .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2006, 61 (03) :555-556
[2]  
[Anonymous], ACGME PROGR REQ GRAD
[3]  
Borgstede James P, 2004, J Am Coll Radiol, V1, P59, DOI 10.1016/S1546-1440(03)00002-4
[4]   Preliminary interpretations of after-hours CT and sonography by radiology residents versus final interpretations by body imaging radiologists at a level I trauma center [J].
Carney, E ;
Kempf, J ;
DeCarvalho, V ;
Yudd, A ;
Nosher, J .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2003, 181 (02) :367-373
[5]   Interpretation of emergency department radiographs: A comparison of emergency medicine physicians with radiologists, residents with faculty, and film with digital display [J].
Eng, J ;
Mysko, WK ;
Weller, GER ;
Renard, R ;
Gitlin, JN ;
Bluemke, DA ;
Magid, D ;
Kelen, GD ;
Scott, WW .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2000, 175 (05) :1233-1238
[6]   Evaluation of emergency CT scans of the head: Is there a community standard? [J].
Erly, WK ;
Ashdown, BC ;
Lucio, RW ;
Carmody, RF ;
Seeger, JF ;
Alcala, JN .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2003, 180 (06) :1727-1730
[7]  
Erly WK, 2002, AM J NEURORADIOL, V23, P103
[8]   Quality assurance for abdominal CT: A rapid, computer-assisted technique [J].
Pomerantz, SM ;
Daly, B ;
Krebs, TL ;
NessAiver, M ;
Kepes, SY ;
Wong, JJ ;
Severson, M ;
Siegler, C .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1996, 167 (05) :1141-1145
[9]   RESIDENT INTERPRETATION OF EMERGENCY COMPUTED TOMOGRAPHIC SCANS [J].
ROSZLER, MH ;
MCCARROLL, KA ;
RASHID, T ;
DONOVAN, KR ;
KLING, GA .
INVESTIGATIVE RADIOLOGY, 1991, 26 (04) :374-376
[10]   Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital [J].
Ruchman, Richard B. ;
Jaeger, Joseph ;
Wiggins, Ernest F. ;
Seinfeld, Syndi ;
Thakral, Vikas ;
Bolla, Sudha ;
Wallach, Sara .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2007, 189 (03) :523-526