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Impact on patient care of discordance in radiology readings between external overnight radiology services and staff radiology readings at a level 1 trauma center

Published on Mar 1, 2013in American Journal of Surgery2.201
· DOI :10.1016/j.amjsurg.2012.10.017
Tutu Cheng1
Estimated H-index: 1
(Conemaugh Health System),
Russell Dumire4
Estimated H-index: 4
(Conemaugh Health System)
+ 1 AuthorsJames S. Gregory2
Estimated H-index: 2
(Conemaugh Health System)
Abstract
Abstract Background Overnight radiology services (ORSs) provide computed tomography (CT) scan readings that are automatically reviewed by staff radiologists (SRs) and the trauma service. Discordant readings and their clinical significance were investigated. Methods ORS-read CT scans over 3 years were reviewed. A discordant reading was clinically significant if it resulted in a substantive change in patient care. All clinically significant findings were reviewed by a blinded radiologist. Results Five hundred thirty-four CT scans were identified: 191 (35.8%) head, 187 (35%) cervical, 66 (12.4%) chest, and 90 (16.9%) abdomen/pelvis scans. One hundred twenty-three scans (23%) were abnormal with a DR of 16%: 5 head, 2 cervical, 7 chest, and 6 abdomen/pelvis scans. Seven (6%) scans had clinically significant findings missed: 3 head and 4 abdomen/pelvis scans. ORSs missed 7, and SRs missed 3 clinically significant findings. A blinded radiologist confirmed the clinically significant findings. Conclusions The discordant rate of readings for abnormal CT scans was 16% with 37% considered to be clinically significant. ORSs missed 100%, and 29% of the clinically significant findings were identified after SR/trauma service rounds. SR/trauma service review of ORS readings is supported.
  • References (9)
  • Citations (6)
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References9
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#1Owen D Terreblanche (University of the Witwatersrand)H-Index: 1
#2Savvas Andronikou (University of the Witwatersrand)H-Index: 21
Last. Pieter E Boshoff (University of the Witwatersrand)H-Index: 1
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BackgroundThere is a heavy reliance on registrars for after-hours CT reporting with a resultant unavoidable error rate.PurposeTo determine the after-hours CT reporting error rate by radiology registrars and influencing factors on this error rate.Material and MethodsA 2-month prospective study was undertaken at two tertiary, level 1 trauma centers in Johannesburg, South Africa. Provisional CT reports issued by the registrar on call were reviewed by a qualified radiologist the following morning an...
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#1Julie A. Ruma (UM: University of Michigan)H-Index: 5
#2Katherine A. Klein (UM: University of Michigan)H-Index: 14
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Purpose The aim of this study was to identify the rate of discrepancies between radiology residents and faculty radiologists at an academic hospital and to determine the distribution across subspecialties and modalities, specifically CT, MR, and ultrasound. Methods Consecutive CT, MR, and ultrasound preliminary interpretations rendered by on-call second-year through fourth-year radiology residents for 9 months on emergency department patients, inpatients, and urgent outpatients formed the study ...
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#1Victoria F. Cooper (NU: Northwestern University)H-Index: 1
#2Lori Ann Goodhartz (NU: Northwestern University)H-Index: 4
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